Water sac sheath for small ultrasonic probe and preparation method thereof

Abstract

The present invention provides a water bag sheath tube for an ultrasonic small probe and a preparation method thereof. The water bag sheath tube comprises: a three-way connection seat and an insertion sheath tube, the insertion sheath tube comprising a water bag and an outer sleeve for inserting the ultrasonic small probe, one end of the outer sleeve being connected to the three-way connection seat, and the other end of the outer sleeve being closed; the outer sleeve being provided with a reducing section corresponding to the probe position of the ultrasonic small probe, the tube wall of the reducing section being provided with a plurality of through holes; the water bag being sealedly connected to the outer sleeve and wrapped around the outside of the reducing section; when liquid is injected into the tube of the outer sleeve through the three-way connection seat, the liquid then enters the water bag through the through holes, expanding the water bag. By adopting the technical solution of the present invention, after the liquid is injected and the water bag expands, it is supported by the outer sleeve, ensuring that the probe of the ultrasonic small probe is in the center position of the water bag, so that the imaging effect is stable, extending the service life of the small probe and avoiding the risk of cross infection.

Description

Technical Field

[0001] The present invention belongs to the technical field of medical device interventional consumables, and in particular relates to a water-bag sheath tube for a small ultrasonic probe and a preparation method thereof. Background Art

[0002] In modern interventional medical diagnosis and treatment, ultrasound imaging with a small probe is usually performed with auxiliary equipment into the human body cavity for examination. The small ultrasound probe rotates 360 degrees at high speed in the probe cavity to obtain cross-sectional images of tissues in the human cavity, thereby detecting early cancer and tiny tumors in the tissues and achieving early screening of tumors. This is currently a commonly used method for diagnosing lesions in tissues in the human cavity.

[0003] Endoscopic ultrasound probes can divide the digestive tract wall into five layers (corresponding to its anatomical structure), making it easy to discern the layers of tumor growth within the wall. Discontinuities or abnormal changes in any of these five layers can determine the depth of tumor invasion. For submucosal tumors of the esophagus, stomach, duodenum, and colorectum, endoscopic ultrasound is the gold standard for diagnosing submucosal tumors of the digestive tract. It can preliminarily determine the nature of the tumor based on its layer of origin, size, and echogenicity, and can differentiate whether a protrusion in the digestive tract is caused by compression from a submucosal tumor or an extramural lesion.

[0004] Currently, when using a small intracavitary ultrasound probe, if there is no body fluid in the lesion area, it is necessary to inject physiological saline or bubble-free water as an ultrasound conduction medium before ultrasound imaging can be performed to achieve accurate diagnosis and treatment. In addition, the small ultrasound probe needs to be cleaned and disinfected after each use, which seriously affects the service life of the small ultrasound probe and also poses a risk of cross-infection. There is a design in the prior art that adds a water bag to the front end of the ultrasound endoscope, but this design generally uses the water bag to block the lesion area, and then water needs to be injected into the cavity to complete the ultrasound detection. Therefore, it is very meaningful to produce a water bag sheath for the small ultrasound probe that can complete ultrasound detection without injecting water into the cavity, and provide more accurate ultrasound detection data. Summary of the Invention

[0005] In view of this, the present invention discloses a water-bag sheath tube for a small ultrasonic probe and a preparation method thereof, in order to solve the above technical problems.

[0006] To this end, the technical solution adopted in the present invention is:

[0007] A water bag sheath for an ultrasonic probe comprises a three-way connector and an insertion sheath. The insertion sheath includes a water bag and an outer sleeve for inserting the ultrasonic probe. One end of the outer sleeve is connected to the three-way connector, and the other end of the outer sleeve is sealed. The outer sleeve is provided with a reducing section corresponding to the probe position of the ultrasonic probe, and the wall of the reducing section is provided with a plurality of through holes. The water bag is sealedly connected to the outer sleeve and wrapped around the outside of the reducing section. When liquid is injected into the outer sleeve through the three-way connector, the liquid enters the water bag through the through holes, expanding the water bag. The water bag is self-expanding, that is, made of an elastic material.

[0008] Using this technical solution, the small ultrasonic probe is inserted into the outer sleeve, and liquid is injected into the outer sleeve through the three-way connector. The liquid enters the water bag through the through-hole of the reducing section. The more water there is, the larger the water bag becomes. The size of the water bag can be freely controlled according to actual needs. At the same time, due to the support of the outer sleeve, the probe of the small ultrasonic probe is guaranteed to be in the center of the water bag, and the probe positioning operation is simple and easy. Using the liquid in the water bag as an ultrasonic transmission medium, the small ultrasonic probe can perform ultrasonic imaging. Liquid is injected into the water bag through the outer sleeve, and there is no need to inject saline or bubble-free water into the cavity of the patient's lesion as an ultrasonic transmission medium. The diagnosis and treatment steps are simplified, the diagnosis and treatment time is shortened, and the patient's discomfort is reduced. Moreover, because the probe of the small ultrasonic probe is located in the middle of the water bag, it can ensure that the small ultrasonic probe has water in any direction and the detection depth is consistent, which is beneficial to ultrasonic imaging and imaging stability.

[0009] At the same time, only the disposable outer sleeve and water bag need to come into contact with human tissue, eliminating the need for cleaning and disinfection steps for the ultrasound probe, extending the service life of the ultrasound probe, avoiding the risk of cross-infection among patients, and solving the need for cleaning and disinfection of the ultrasound probe after use, while avoiding the risk of cross-infection and extending the service life of the ultrasound probe.

[0010] As a further improvement of the present invention, one end of the water bag is fixedly connected to the outer sleeve. Further, both ends of the water bag are fixedly connected to the outer sleeve.

[0011] Furthermore, the water bag may be open at one end or at both ends.

[0012] If one end of the water bag is open, the water bag is sheathed over the outer sleeve, with the open end fixedly connected to the outer sleeve, and the reducing section is wrapped within the water bag. The other end of the water bag can be fixed or loose, with the other end of the water bag being the end opposite the open end. If the other end of the water bag is loose, a liquid with a relatively high viscosity is selected. Preferably, the other end of the water bag is fixed, and the other end of the water bag can be fixedly connected to the other end of the outer sleeve using medical adhesive or a clip. Alternatively, the other end of the outer sleeve can be provided with a matching cap. First, the water bag is sheathed over the end of the outer sleeve, and then the cap is placed on the other end of the outer sleeve. In this way, the water bag is stuck to the other end of the outer sleeve. After the cap is fixed, it can be further fixed to the outer sleeve using medical adhesive or heat shrink tubing.

[0013] In the case where both ends of the water bag are open, the water bag is equivalent to an elastic sleeve, which is sleeved on the outside of the variable diameter section. The two ends of the water bag are fixedly connected to the outer sleeve respectively, and can be fixedly connected to the outer sleeve through medical adhesives, clips or heat shrink sleeves.

[0014] As a further improvement of the present invention, the three-way connecting seat includes: a connecting seat body, an outer sleeve locking part, a probe locking part and a liquid injection part. The connecting seat body includes three interfaces, and the three interfaces are respectively connected to the outer sleeve locking part, the probe locking part and the liquid injection part. The outer sleeve locking part is connected to one end of the outer sleeve, the probe locking part is used to lock the small ultrasonic probe, and the liquid injection part is used to connect to an external liquid injector.

[0015] Furthermore, the outer sleeve locking portion, probe locking portion, and liquid injection portion are all equipped with sealing rings, ensuring tightness while facilitating the use of a small ultrasonic probe. Furthermore, the liquid injection portion can be connected to a syringe with a three-way valve, allowing adjustment to various modes, such as exhaust and water suction. A pressure gauge can also be connected to provide additional pressure detection and obtain water pressure data within the water bladder, preventing excessive pressure within the water bladder from damaging it, making it more flexible and convenient to use.

[0016] As a further improvement of the present invention, one end of the outer sleeve is rotationally connected to the outer sleeve locking portion through a Luer connector, which is simple to operate and easy to disassemble.

[0017] As a further improvement of the present invention, there are two or more through holes. Preferably, the two or more through holes are evenly distributed on the pipe wall of the diameter-changing section. Further preferably, there are four through holes.

[0018] As a further improvement of the present invention, the expansion ratio of the water bag is 3-10 times. After the water bag is expanded, the probe of the small ultrasonic probe is located in the middle of the water bag. The probe will not be closer to one side of the water bag than the other side. The depth of water around the probe is basically the same, and the detection accuracy is greatly improved.

[0019] As a further improvement of the present invention, the length of the outer sleeve is 500-3000 mm, and the length of the water bag before expansion is 5-100 mm. More preferably, the length of the outer sleeve is 1800-2000 mm, and the length of the water bag before expansion is 10-30 mm.

[0020] As a further improvement of the present invention, the water bag is made of a medical polymer material, and more preferably, the water bag is made of medical rubber or polyurethane. With this technical solution, the water bag is made of medical materials, and medical rubber or polyurethane has good expansion properties, is close to the human body, and has little impact on the human body.

[0021] As a further improvement to the present invention, the outer sleeve is made of a medical polymer material. Further preferably, the outer sleeve is made of one of polytetrafluoroethylene, nylon, polyurethane, and polyolefin. This technical solution provides excellent flexibility and support, a simple process, low production costs, and excellent stability.

[0022] As a further improvement of the present invention, the three-way connector is made of a medical polymer material, preferably polycarbonate, MBS or PMMA.

[0023] As a further improvement to the present invention, the reducing section is located at the other end of the outer sleeve, and its diameter is 0.1-0.5 mm smaller than the main diameter of the outer sleeve. This solution makes the reducing section slightly smaller than the main diameter of the outer sleeve, facilitating installation of the water bladder. Furthermore, the outer diameter of the outer sleeve after installation is close to that of the outer sleeve, ensuring smooth insertion and easier operation.

[0024] The present invention also discloses a method for preparing a water-bag sheath tube for an ultrasonic small probe as described in any one of the above items, comprising the following steps:

[0025] Prepare a three-way connector and an outer sleeve, connect one end of the outer sleeve to one of the interfaces of the three-way connector, and reduce the diameter of the other end of the outer sleeve to form a reduced diameter section;

[0026] A plurality of through holes for water injection are formed on the diameter-changing section;

[0027] Prepare a water bag;

[0028] The water bag is fixed on the diameter-reducing section of the outer sleeve.

[0029] As a further improvement of the present invention, the water bag is fixed to the outer sleeve by medical adhesive or heat shrink tubing, and one end of the outer sleeve is connected to one of the interfaces of the three-way connector through a Luer male and female connector.

[0030] The present invention also discloses an ultrasonic small probe provided with a water bag sheath, comprising: an ultrasonic small probe, a probe driver, and the ultrasonic small probe with a water bag sheath as described above, wherein the ultrasonic small probe is connected to the probe driver, the probe driver drives the ultrasonic small probe to perform motion detection, and the ultrasonic small probe is arranged in the outer sleeve of the ultrasonic small probe with a water bag sheath.

[0031] This technical solution eliminates the need to inject water into the affected area during ultrasound diagnosis and treatment, as well as the need to clean and disinfect the small ultrasound probe after use. This reduces diagnosis and treatment time, alleviates patient pain, avoids the risk of cross-infection, and extends the probe's service life. Furthermore, the novel water bladder installation position and water inlet method simplify operation while ensuring that the small ultrasound probe's imaging window is centered in the water bladder, ensuring consistent detection depth, facilitating ultrasound imaging of lesions, and effectively ensuring image stability and clarity.

[0032] Compared with the prior art, the present invention has the following beneficial effects:

[0033] First, the present invention's technical solution secures the water bladder to the reducing section of the outer cannula. After liquid is injected and the water bladder expands, it is supported by the outer cannula, ensuring the small ultrasound probe is centered within the water bladder. This facilitates ultrasound imaging of lesions and ensures stable imaging results. A three-way connector connects the water bladder to the outer cannula, making assembly and disassembly easy and convenient for replacing the water bladder sheath, reducing operation time.

[0034] Second, by adopting the technical solution of the present invention, the water bag sheath and the small ultrasonic probe are combined, so that the small ultrasonic probe no longer comes into direct contact with human tissue, eliminating the disinfection and sterilization steps of the small ultrasonic probe, extending the service life of the small ultrasonic probe, and avoiding the risk of cross infection of patients. BRIEF DESCRIPTION OF THE DRAWINGS

[0035] Figure 1 This is a structural schematic diagram of a water bag sheath tube for a small ultrasonic probe according to embodiment 1 of the present invention.

[0036] Figure 2 Schematic diagram of the structure of the three-way connector of embodiment 1 of the present invention.

[0037] Figure 3 It is a schematic diagram of the local structure of the water bag after expansion of Example 1 of the present invention.

[0038] Figure 4Schematic diagram of the structure of the outer sleeve of Example 1 of the present invention.

[0039] Figure 5 This is a schematic diagram of the local structure of the water bag after expansion according to Example 3 of the present invention.

[0040] Reference numerals include:

[0041] 1- three-way connector, 2- insertion sheath, 3- small ultrasound probe, 4- Luer connector;

[0042] 11-connecting seat body, 12-outer tube locking part, 13-probe locking part, 14-liquid injection part;

[0043] 21-water bag, 22-outer sleeve, 23-reducing section, 24-through hole, 25-covering cap. DETAILED DESCRIPTION

[0044] The preferred embodiments of the present invention are described in further detail below.

[0045] Example 1

[0046] like Figures 1 to 4 As shown, a water-bag sheath for an ultrasonic probe comprises a three-way connector 1 and an insertion sheath 2. The insertion sheath 2 includes a water bag 21 and an outer sleeve 22 for inserting an ultrasonic probe 3. One end of the outer sleeve 22 is connected to the three-way connector 1, and the other end of the outer sleeve 22 is sealed. The outer sleeve 22 has a reducing section 23 corresponding to the probe position of the ultrasonic probe, and the wall of the reducing section 23 is provided with a plurality of through holes 24. The water bag 21 is sealedly connected to the outer sleeve 22 and wrapped around the outside of the reducing section 23, so that the through holes 24 are located inside the water bag 21. When liquid is injected into the outer sleeve 22 through the three-way connector 1, the liquid enters the water bag 21 through the through holes 24, expanding the water bag 21. The water bag 21 is cylindrical, self-expanding, and is fixedly mounted on the outside of the reducing section 23 of the outer sleeve 22.

[0047] There are more than two through holes 24, and the more than two through holes 24 are evenly distributed on the pipe wall of the diameter-changing section 23. In this embodiment, there are four through holes 24.

[0048] The three-way connecting seat 1 includes: a connecting seat body 11, an outer sleeve locking part 12, a probe locking part 13 and a liquid injection part 14. The connecting seat body 11 is provided with three interfaces, which are respectively connected to the outer sleeve locking part 12, the probe locking part 13 and the liquid injection part 14. The outer sleeve locking part 12 is rotatably connected to one end of the outer sleeve 22 through the Luer joint 4. The probe locking part 13 is used to be connected and fixed to the outer sheath of the ultrasonic small probe 3, so that the ultrasonic small probe 3 is fixed in the outer sleeve 22. The liquid injection part 14 is used to be connected to an external liquid injector.

[0049] Furthermore, the outer tube locking portion 12, probe locking portion 13, and liquid injection portion 14 are each equipped with a sealing ring, ensuring a tight seal while facilitating the use of the small ultrasonic probe 3. Furthermore, the liquid injection portion 14 can be connected to a syringe with a three-way valve, allowing for adjustment to various modes, such as air extraction and water suction. Pressure detection can also be added to obtain water pressure data within the water bladder 21, preventing damage to the bladder 21 caused by excessive pressure, making it more flexible and convenient to use.

[0050] More preferably, the length of the outer sleeve 22 is 500-3000 mm, and the length of the water bag 21 before expansion is 5-100 mm. More preferably, the length of the outer sleeve 22 is 1800-2000 mm, and the length of the water bag 21 before expansion is 10-30 mm.

[0051] Further preferably, the expansion ratio of the water bag 21 is 3-10 times, and after the water bag 21 is expanded, the probe of the small ultrasonic probe 3 is located in the middle of the water bag 21 .

[0052] More preferably, the reducing section 23 is located at the other end of the outer sleeve 22. In this embodiment, the reducing section 23 is a trapezoidal recessed portion provided on the outer sleeve 22. It may also be an arcuate recessed portion or a recessed portion of another shape. The diameter of the reducing section 23 is 0.1-0.5 mm smaller than the main diameter of the outer sleeve 22, which facilitates installation of the water bladder 21 and smooth insertion during use.

[0053] The water bladder 21 and outer tube 22 are made of medical polymer materials. More preferably, the water bladder 21 is made of medical rubber or polyurethane. Polyurethane is preferred, as it provides a better fixation when fixedly connected to the outer tube 22. The outer tube 22 is made of one of polytetrafluoroethylene, nylon, polyurethane, and polyolefin. The three-way connector 1 is made of a medical polymer material, preferably polycarbonate, MBS, or PMMA.

[0054] Furthermore, in this embodiment, one end of the water bladder 21 is open, and the water bladder 21 is sheathed outside the diameter-reducing section 23. One end of the water bladder 21 is fixedly connected to the outer sleeve 22, which can be fixed by medical adhesive, heat shrink tubing, or a clamp. The other end of the water bladder 21, i.e., the end located at the other end of the outer sleeve 22, is wrapped around the end of the outer sleeve 22 and fixedly connected to the outer sleeve 22, which can be fixed by medical adhesive or a clamp.

[0055] The method for preparing the water-bag sheath tube of the small ultrasonic probe as described above comprises the following steps:

[0056] Prepare a three-way connection seat and an outer sleeve, connect one end of the outer sleeve to one of the interfaces of the three-way connection seat, and reduce the diameter of the other end of the outer sleeve to form a reduced diameter section. The outer sleeve can be formed with the reduced diameter section during design and production.

[0057] Forming a plurality of through holes for water injection on the diameter-changing section by mechanical punching or laser punching;

[0058] Prepare a water bag;

[0059] The water bag is placed on the variable diameter section of the outer tube and fixedly connected by medical glue or other means. Alternatively, the outer tube and the water bag are integrally formed of different materials, eliminating the need for a bonding step and improving the tightness of the connection between the two.

[0060] One end of the outer sleeve is connected to one of the interfaces of the three-way connector through a Luer male and female connector.

[0061] Example 2

[0062] Based on Example 1, both ends of the water bag 21 are open, the water bag 21 is sleeved outside the diameter-reducing section 23, and both ends are fixedly connected to the outer sleeve 22, which can be bonded with medical glue, fixed with a heat shrink tubing, or clamped with a clamping piece.

[0063] Example 3

[0064] On the basis of Example 1, Figure 5 As shown, one end of the water bag 21 is open, and the water bag 21 is sleeved on the outside of the reducing section 23. A cap 25 is provided at the end of the outer sleeve 22. The water bag 21 is wrapped around the other end of the outer sleeve 22, and then the cap 25 is covered on the other end of the outer sleeve 22. At this time, the water bag 21 is fixed on the outer sleeve 22.

[0065] The open end of the water bag 21 is fixedly connected to the outer sleeve 22, which can be bonded with medical glue, fixed with a heat shrink tubing, or clamped with a clamping piece.

[0066] Example 4

[0067] A small ultrasonic probe provided with a water bag sheath comprises: a small ultrasonic probe, a probe driver, and a water bag sheath for the small ultrasonic probe as described in Example 1, Example 2, or Example 3, wherein the small ultrasonic probe is connected to the probe driver, and the probe driver drives the small ultrasonic probe to perform motion detection. The small ultrasonic probe is arranged in the outer sleeve of the water bag sheath of the small ultrasonic probe, and the outer sheath of the small ultrasonic probe is fixedly connected to the probe locking part 13 of the three-way connector.

[0068] When used, combine Figure 1 and Figure 3 As shown, the ultrasonic probe 3 is placed within the mounting inner tube, the various interfaces of the three-way connector 1 are connected, and liquid is injected into the outer sleeve 22 through the three-way connector 1. The liquid enters the water bag 21 through the through hole 24 of the reducing section 23. As the water bag 21 increases in size, the more water is added, the larger the water bag 21 becomes. The size of the water bag 21 can be controlled according to actual needs. Due to the support of the outer sleeve 22, the probe of the ultrasonic probe 3 can be positioned in the center of the water bag 21. Using the liquid in the water bag 21 as an ultrasonic conductive medium, the ultrasonic probe 3 can perform ultrasonic imaging. Because the ultrasonic probe 3 is located in the middle of the water bag 21, it can ensure that the ultrasonic probe 3 has water in any direction and the detection depth is consistent, which is beneficial to ultrasonic imaging and imaging stability.

[0069] The water bag sheath tube for the ultrasonic probe of the present invention can be a disposable water bag sheath tube, which can prevent the ultrasonic probe from contacting human tissue, eliminate the disinfection and sterilization steps of the ultrasonic probe, extend the service life of the probe, and avoid the risk of cross infection of patients.

[0070] The above is a further detailed description of the present invention in conjunction with specific preferred embodiments, and the specific implementation of the present invention should not be considered to be limited to these descriptions. For those skilled in the art of the present invention, without departing from the concept of the present invention, several simple deductions or substitutions can be made, which should be considered to fall within the scope of protection of the present invention.

Claims

1. A water bag sheath for a small ultrasonic probe, characterized in that: It comprises: a three-way connecting seat and an insertion sheath, the insertion sheath comprises a water bag and an outer sleeve for inserting a small ultrasonic probe, one end of the outer sleeve is connected to the three-way connecting seat, and the other end of the outer sleeve is closed; the outer sleeve is provided with a reducing section corresponding to the probe position of the small ultrasonic probe, and the tube wall of the reducing section is provided with a plurality of through holes; the water bag is sealingly connected to the outer sleeve and wrapped around the outside of the reducing section; when liquid is injected into the tube of the outer sleeve through the three-way connecting seat, the liquid enters the water bag through the through holes to expand the water bag; the two ends of the water bag are respectively fixedly connected to the outer sleeve; the expansion ratio of the water bag is 3-10 times, and after the water bag is expanded, the probe of the small ultrasonic probe is located in the middle of the water bag.

2. The ultrasonic probe with a water bag sheath according to claim 1, characterized in that: The three-way connecting seat includes: a connecting seat body, an outer sleeve locking part, a probe locking part and a liquid injection part. The connecting seat body includes three interfaces, and the three interfaces are respectively connected to the outer sleeve locking part, the probe locking part and the liquid injection part. The outer sleeve locking part is connected to one end of the outer sleeve, the probe locking part is used to lock the small ultrasonic probe, and the liquid injection part is used to connect to an external liquid injector.

3. The water-bag sheath for an ultrasonic probe according to claim 1, characterized in that: There are more than two through holes, and the through holes are evenly distributed on the pipe wall of the diameter-changing section.

4. The water-bag sheath for an ultrasonic probe according to claim 1, characterized in that: The length of the outer sleeve is 500-3000 mm, and before expansion, the length of the water bag is 5-100 mm; the length of the outer sleeve is 1800-2000 mm, and before expansion, the length of the water bag is 10-30 mm.

5. The water bag sheath for an ultrasonic probe according to any one of claims 1 to 4, characterized in that: The material of the water bag is one of medical rubber or polyurethane, the material of the outer sleeve is one of polytetrafluoroethylene, nylon, polyurethane, and polyolefin; the material of the three-way connecting seat is one of polycarbonate, MBS or PMMA.

6. The water-bag sheath for the small ultrasonic probe according to claim 5, characterized in that: The diameter-reducing section is located at the other end of the outer sleeve, and the diameter of the diameter-reducing section is 0.1-0.5 mm smaller than the main body diameter of the outer sleeve.

7. The method for preparing a water-bag sheath tube for an ultrasound probe according to any one of claims 1 to 6, wherein: The following steps are involved: Prepare a three-way connector and an outer sleeve, connect one end of the outer sleeve to one of the interfaces of the three-way connector, and reduce the diameter of the other end of the outer sleeve to form a reduced diameter section; A plurality of through holes for water injection are formed on the diameter-changing section; Prepare a water bag; The water bag is fixed on the diameter-reducing section of the outer sleeve; both ends of the water bag are fixedly connected to the outer sleeve respectively; after the water bag is expanded, the probe of the small ultrasonic probe is located in the middle of the water bag.

8. The method for preparing a water-bag sheath tube for an ultrasonic small probe according to claim 7, characterized in that: The water bag is fixed to the outer tube by medical adhesive or heat shrink tubing, and one end of the outer tube is connected to one of the interfaces of the three-way connector through a Luer male and female connector.

9. A small ultrasonic probe with a water bag sheath, characterized in that: include: An ultrasonic small probe, a probe driver, and a water bag sheath for an ultrasonic small probe as described in any one of claims 1-6, wherein the ultrasonic small probe is connected to the probe driver, the probe driver drives the ultrasonic small probe to perform motion detection, and the ultrasonic small probe is arranged in the outer sleeve of the water bag sheath for the ultrasonic small probe.

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