53 results about "Anal sphincters" patented technology

There is disclosed a method for treating anal incontinence in women. The method comprises accessing the rectum or colon or anus though an incision in the vagina and implanting a powered restriction device on the rectum, colon or anal sphincter. There are also disclosed methods for energizing and controlling the restriction device.

The invention relates to a feedback type artificial anal sphincter system based on percutaneous energy supply. The feedback type artificial anal sphincter system based on percutaneous energy supply comprises a part implanted in vivo and a part implanted in vitro. The system implanted in vivo is composed of a sensing execution module, a part of a percutaneous energy supply module in vivo, and apart of a wireless communication module in vivo. The system implanted in vitro is composed of a part of the percutaneous energy supply module in vitro, a part of the wireless communication module in vitro, a microprogrammed control unit (MCU), a portable control module, and an external alarm module. According to the feedback type artificial anal sphincter system based on percutaneous energy supply, the problems of a traditional artificial anal sphincter that a patient cannot perceive waste volume degree and control is inconvenient, and infection can be led to a wire are solved.

The invention relates to an electromagnetic-controlled artificial anal sphincter apparatus based on a rectum sensing function. The electromagnetic-controlled artificial anal sphincter apparatus comprises a hinge-shaped mechanism which is composed of a first pressing plate and a second pressing plate, a DC (Direct Current) pushing-pulling electromagnet, an arc closing mechanism, a small-size sliding block and two pressure sensors; at a left side, the first pressing plate and the second pressing plate are hinged through a hinge to form a transmission pair; the electromagnet is fixed on the second pressing plate; a pushing rod in the electromagnet penetrates through a small hole of the second pressing plate and is connected with the first pressing plate through the sliding block; the arc closing mechanism is fixed at tail ends of the two pressing plates; meanwhile, two flexible baffle plates are fixed at a left side and a right side of the arc closing mechanism. The electromagnetic-controlled artificial anal sphincter apparatus is arranged in the body of a patient, and a function as an anal sphincter can be played; the pressure sensor is used for sensing pressure in rectum and analyzing amount of human excrement, and then judging whether the electromagnet is electrified or not, so that opening or closing of an artificial anal sphincter can be directly controlled. The apparatus has the advantages of simple design, convenience in manufacturing and simpleness in operation.

A uniformly-transmitting pressure sensor used for an artificial anal sphincter system and in the technical field of medical instruments comprises a closed cavity formed by a hemispheric wrapping layer and a fixing plate, a sensor bare chip arranged inside the closed cavity, and a liquid or gaseous medium used for uniformly transmitting pressure. The sensor bare chip is fixedly arranged on the inner side of the fixing plate, a signal leading-out welding pad is arranged on the outer side of the fixing plate correspondingly, and a micro circuit board is arranged on the fixing plate and comprises a bridge-type compensation circuit which is connected with the sensor bare chip. The uniformly-transmitting pressure sensor is mainly applied to elastic scaling-type artificial anal sphincter prostheses, finger-lock-type artificial anal sphincter prostheses and the like and is suitable for implanted systems which need to contact with intestinal walls to collect pressure, uniform transmitting of pressure value is realized, measuring effect of the pressure sensor is improved, and effective measuring of biotic pressure signals in-vivo intestinal tracts in complex intestinal tract environment is realized.

The present invention relates to a magnetocontrolled type artifical anal sphincter system, belonging to the field of biomedical engineering technology, in which first magnetic body and second magnetic body are connected into a whole body by means of first connecting bar, a first nut is mounted between first magnetic body and second magnetic body and can be moved between said first magnetic body and second magnetic body to drive first magnetic body and second magnetic body so as to control opening and closing of first medical conduit and second medical conduit, its third magnetic body and fourth magnetic body are connected into a whole body by means of second connecting bar, a second nut is mounted between third magnetic body and fourth magnetic body and can be moved between the third magnetic body and fourth magnetic body to drive third magnetic body and fourth magnetic body so as to control opening and closing of third medical conduit and fourth medical conduit.

The present invention relates to a spring-controlled miniature pump artificial anal sphincter, belonging to the field of medical equipment technology. It is characterized by that one end of first spring is fixed on a nut, its another end is fixed on first pressure plate, the first spring can be used for compressing the first pressure plate, so that said first pressure plate can be used for making fourth medical conduit branch tube and second medical conduit branch tube be compressed on the miniature motor end face so as to close the fourth medical conduit branch tube and second medical conduit branch tube; one end of second spring is fixed on the nut, its another end is fixed on the second pressure plate, the second spring can be used for compressing second pressure plate, said second pressure plate can be used for making first medical conduit branch tube and third medical conduit branch tube be compressed on the external shell so as to close the first medical conduit branch tube and third medical conduit branch tube. Said invention utilizes the control of translational direction of nut and utilizes the compression or tension of first spring and second spring to implement two-way excretion between first container and second container.

Disclosed is an in-situ implantation bionic anal sphincter system based on defecation intention function reconstruction. The in-situ implantation bionic anal sphincter system comprises an artificial anal sphincter module, a sensing detection and conversion module, a pelvic nerve stimulation module, an in-vitro control module and an in-vitro energy supply module, wherein the artificial anal sphincter module transmits a pressure signal acquired in vivo to the sensing detection and conversion module to generate an electrical stimulation intensity signal and generates a stimulation electrical signal with corresponding intensity through the pelvic nerve stimulation module to stimulate pelvic nerves; the in-vitro energy supply module is connected with the artificial anal sphincter module and supplies energy to the artificial anal sphincter module; and the in-vitro control module is connected with the artificial anal sphincter module so that a wearer can control defecation by himself / herself.The system has a man-machine interface and a control function, the amount of excrement in rectum or anal canal is detected through the sensing detection and conversion module, and an electric signalwith corresponding intensity is constructed based on detection information to stimulate pelvic nerves so as to activate the whole defecation reflex nerve pathway of the wearer, so that defecation intention perception function reconstruction is truly formed.

The invention relates to a mechanical artificial anal sphincter device capable of realizing constant-force clamping, which comprises an upper fixed top plate, a lower fixed bottom plate, a pair of transmission guide rods, a clamping mechanism, a constant-force mechanism and a transmission mechanism, a pair of transmission guide rods is vertically arranged between the upper fixing top plate and the lower fixing bottom plate at intervals, the clamping mechanism comprises an upper gripper and a lower gripper which are arranged up and down respectively, a channel which is used for containing intestinal canals and is adjustable in size is formed between the upper gripper and the lower gripper, and the constant force mechanism comprises an upper push plate, a lower push plate and paired shape memory alloy plates. The upper push plate and the lower push plate are movably arranged on the transmission guide rod up and down in the length direction of the transmission guide rod, the upper gripper is fixed to the bottom of the lower push plate, and the transmission mechanism is in transmission connection with the upper push plate. Compared with the prior art, constant-force clamping of the intestinal canal tissue by the clamping mechanism is achieved, and the problem of avascular necrosis of the intestinal canal tissue caused by mechanical mismatching of sphincter and the intestinal canal tissue is solved.

The invention relates to a three-ring bionic artificial anal sphincter protective sleeve for preventing tissues from proliferating inwards. The three-ring bionic artificial anal sphincter protective sleeve comprises an outer shell matched with a three-ring bionic artificial anus, two silica gel films and an elastic rope, wherein one sides of the two silica gel films are connected through the elastic rope, and the other sides of the two silica gel films are respectively attached to the inner sides of an upper ring and a lower ring of the three-ring bionic artificial anus through pressing sheets. The three-ring bionic anal sphincter protective sleeve is simple in overall structure, small in size, light in weight and good in sealing performance, the contact surface between an external intestinal tract and the inner part of the three-ring bionic anal sphincter prosthesis can be effectively reduced, and the problems that external tissue is proliferated and wrapped inwards, and intestinal obstruction is caused when the intestinal tract falls into the prosthesis through two ends of a port are solved; and a relatively independent closed space is formed in the prosthesis, the phenomenon that a middle ring swing arm cannot reach a specified clamping position due to tissue proliferation and intestinal obstruction is relieved, and the service life of the prosthesis is prolonged.

The invention discloses a high-simulation electronic monitoring anal fistula examination and seton therapy training model. The model is is provided with a high-simulation human body lower half body model and a microcomputer monitoring alarm, the hip of the model is provided with an anal fistula examination and seton operation training module, the deep part of the simulated anus of the anal fistula examination and seton operation training module is provided with a simulated rectum, the wall of the rectum is provided with a tooth-shaped line, an anal sphincter is arranged around the rectum, different modules are respectively provided with a straight anal fistula inner opening, a bent anal fistula inner opening, a straight anal fistula outer opening and a bent anal fistula outer opening, an anal fistula fistula is arranged between the anal fistula inner opening and the anal fistula outer opening, conductive metal wires are distributed on the surrounding tissue of the anal fistula fistula to be connected with a signal line, and a silver probe is connected with detection lines which are separately connected to a microcomputer sound-light monitoring circuit board of the microcomputer monitoring alarm, a loudspeaker and an alarm red light. The model is used for performing anal fistula examination and thread hanging therapy training and examination on medical students, revised students and hospitalized doctors in the anorectal department of a hospital, repeated practice can be performed, and when errors are probed by using a probe, the microcomputer monitoring alarm can automatically give a sound-light alarm, so that the training effect is obviously improved.

The invention provides a rectum assistant anal dilatation device which comprises a base and an anal dilatation assembly, wherein the anal dilatation assembly is arranged on the base. The rectum assistant anal dilatation device provided by the invention is provided with a conical lead part and an inner layer expanding part, the hollow elastic cone of the conical lead part can be firstly gradually put into an anus and an anal tube, then the anus and the anal tube of a patient can be gradually and controllably expanded, and primary anus dilatation of the anus and the anal tube can be achieved; the inner layer expanding part is capable of gradually expanding the hollow elastic cone in the conical lead part, then ani sphincter can be gradually adaptive to an amplitude which can be expanded by the inner layer expanding part, and anus dilatation of the anus and the anal tube can be achieved; the conical lead part and the inner layer expanding part cooperate with each other, a phenomenon of anal fissure can be effectively avoided, the patient can be relieved from pain, an anastomat can be assisted to be put into the anus and the anal tube through the inner layer expanding part, difficulties in putting the anastomat into the anus, which are caused by obstruction of the ani sphincter, can be avoided, and the working efficiency of medical operators can be greatly improved.

The invention relates to superior mucous membrane assisting equipment capable of rotating by 360 degrees, and the superior mucous membrane assisting equipment comprises an anal sphincter and a wallet guide device, wherein the an annular groove is formed in the anal sphincter; the wallet guide device comprises a guide part and a handle part; a rotation clamping strip is arranged on the wallet guide device and is embedded in the annular groove; a gap of 1-3cm is reserved between the annular groove and the rotation clamping strip in the annular groove; the section of the annular groove is in a trapezoid; the diameter of the rotation clamping strip is more than the opening of the annular groove. The superior mucous membrane assisting equipment has the advantages that the superior mucous membrane assisting equipment comprises the anal sphincter and the wallet guide device, the wallet guide device can rotate by 360 degrees, the operation is convenient, the operator can independently rotate the wallet guide device by a certain angle according to the needs, the operation efficiency is high, and the rotation plane is at the same height, so that the condition that the related complications are caused by too high or too low suture is avoided.

The invention discloses an anus dilator base component, comprising an anus dilator base, wherein the an anus dilator base comprises a body and a wide edge dilating outwards; the wide edge is connected with the near end of the body; and the body comprises a group of anus dilating pieces which are arranged in a surrounding manner. The anus dilator base component also comprises a driving device, wherein the driving device comprises a drive rod and a tapered cap connected with the far end of the drive rod; and the bottom end of the tapered cap is provided with a furling slot. The component can gradually and controllably dilate the anus and the anal tube of the patient and can ensure the anal sphincter to adapt to the amplitude of spreading the anus by the body of the novel anus dilator, thus avoiding anal fissure and alleviating the pains of the patient. The component can be widely applied to surgery.

The invention relates to an in-vitro control system of an artificial anal sphincter device based on an Android / iOS platform. The in-vitro control system comprises an artificial anal sphincter device arranged in vivo, a radio frequency communication module arranged in vitro and a control system arranged in mobile equipment, wherein the artificial anal sphincter device which is used for collecting intestinal tract pressure information and acts according to an instruction, and the control system which is used for remote control and pressure signal analysis of the artificial anal sphincter devicerealize bidirectional wireless communication through the radio frequency communication module; the artificial anal sphincter device collects the intestinal tract pressure information and outputs the intestinal tract pressure information to the control system through the radio frequency communication module, and the control system analyzes the intestinal tract pressure information in real time according to the optimal defecation intention threshold value and the intestinal tract pressure change threshold value determined through personalized calibration through an intelligent defecation intention recognition algorithm, so that alarm prompt is performed for defecation, or an instruction is sent to the artificial anal sphincter device through the radio frequency communication module by manualcontrol so as to execute defecation action. The accuracy of defecation intention recognition is improved, and the safety of the artificial sphincter in the body is enhanced.

The invention discloses an anus dilator base component, comprising an anus dilator base, wherein the an anus dilator base comprises a body and a wide edge dilating outwards; the wide edge is connected with the near end of the body; and the body comprises a group of anus dilating pieces which are arranged in a surrounding manner. The anus dilator base component also comprises a driving device, wherein the driving device comprises a drive rod and a tapered cap connected with the far end of the drive rod; and the bottom end of the tapered cap is provided with a furling slot. The component can gradually and controllably dilate the anus and the anal tube of the patient and can ensure the anal sphincter to adapt to the amplitude of spreading the anus by the body of the novel anus dilator, thus avoiding anal fissure and alleviating the pains of the patient. The component can be widely applied to surgery.

The invention belongs to the technical field of medical instruments, and particularly discloses an anal sphincter quantitative pressure measuring apparatus. The apparatus comprises a push rod, an airbag arranged at the insertion end of the push rod in a sleeve manner, a force sensor collecting apparatus fastened to one end, away from the air bag, of the push rod and used for sensing the size of thrust, and a push handle fastened to one side, away from the air bag, of the force sensor collecting apparatus, wherein the push rod is provided with a first pipeline and a second pipeline along the length direction, a hose of an endoscope is arranged in the first pipeline in a penetrating manner, an air pipe of the air bag is arranged in the second pipeline in a penetrating manner, and the endoscope, the air pipe and the force sensor collecting apparatus are all connected with external detection equipment. By means of the structural design, during operation, one end, provided with the air bag, of the push rod can be inserted into the anus of a patient through the push handle, the strength change of the anal sphincter of the patient is obtained through the contraction of the air bag, meanwhile, pathological changes in the anus of the patient can be detected through the hose of the endoscope, and thereby the great convenience is provided for the examination of the patient.

Surgical procedures, kits and implants for alleviating human urinary and fecal incontinence are disclosed. Electrical stimulation is provided at one or more locations or positions in relation to or within an anal sphincter muscle comprising an internal anal sphincter surrounding the anus, an external anal sphincter surrounding the internal anal sphincter, a levator ani coupled to the external anal sphincter and perineal floor muscles around the anal orifice to treat or control fecal incontinence. Stimulation electrodes are mounted to one of a mesh patch, a fecal sling or the cuff of an artificial anal sphincter. Tissue anchors may be provided to engage tissue to stabilize mesh patch(es) or the fecal sling. Rectal pressure is detected and employed in controlling delivery of electrical stimulation.

The invention discloses a toilet with flushing and drying functions. The toilet comprises a toilet body, a toilet seat ring and a toilet cover, wherein a flushing device and a drying device are arranged on the toilet body. After a toilet user finishes defecation, an electric water heater is started to produce hot water, and the hot water is jetted from a first through hole through a second water outlet pipe to flush the anus part of the toilet user; then a dryer is started, and produced hot air is blown from a second through hole through a pipeline to dry the hips of the toilet user. By washing with water after defecation, pollution produced by use of dirty paper is reduced, and meanwhile, paper is saved. In addition, a hemorrhoid patient can massage the anal sphincter by flushing. The flushing device and the drying device are arranged on the toilet body, and the toilet body is a ceramic product with high strength, and thus can be prevented from being damaged when being used by the toilet user. Moreover, the toilet body is relatively large in size. The mounting positions of the flushing device and the drying device are not limited, and the toilet has a large water flow, a good flushing effect and strong hot air, and is fast in drying.

The invention relates to a construction method of an infectious anal fistula animal model and application of the animal model in a method for screening anal fistula injury treatment drugs or simulating clinical administration and curative effect evaluation. The preparation method comprises the steps that a PVC wrapped aluminum wire penetrates through the anal sphincter from the position about 1 cm away from the left side or the right side of the anus, so that the PVC wrapped aluminum wire is in a virtual hanging state around the anal sphincter; meanwhile, fresh 2-5% dextran sodium sulfate salt drinking water is replaced for an animal to be modeled; after about one week, purulent secretions exist on a wound and a large amount of fecal secretions overflow when the periphery of a fistula is slightly pressed; and meanwhile, through magnetic resonance imaging (MRI) examination and pathological analysis results, it is shown that high-signal-shadow line-shaped fistula formation and pathological examination conform to pathological changes of anal fistula. The method is high in modeling success rate, good in stability, easy to operate, economical and applicable, more importantly, can simulate the clinical anal fistula pathogenesis, is very suitable for clinical research on anal fistula diseases, and solves the problem that there is no reasonable anal fistula animal model at present.

The invention discloses an ultrasonic imaging method and an ultrasonic imaging system for anal sphincter, and the method comprises the steps: transmitting ultrasonic waves to the anal sphincter of a detected object, and obtaining the ultrasonic body data of the anal sphincter; the position of the anal canal structure, the position of the external anal sphincter or the position of the internal anal sphincter are recognized based on the ultrasonic body data, and multiple reference lines used for conducting cross truncation layer imaging on the anal sphincter are determined based on the position of the anal canal structure, the position of the external anal sphincter or the position of the internal anal sphincter; and performing cross truncation layer imaging according to the plurality of reference lines, and generating and displaying a plurality of cross truncation layer images of the anal sphincter corresponding to the plurality of reference lines. According to the method, the reference line used for carrying out transverse truncation layer imaging on the anal sphincter is automatically determined according to the anal canal structure and the position of the internal anal sphincter or the position of the external anal sphincter, the transverse truncation layer image is automatically generated according to the reference line, manual operation of a user is greatly reduced, and the efficiency and accuracy of carrying out transverse truncation layer imaging on the anal sphincter are improved.

The invention relates to an electromagnetic-controlled artificial anal sphincter apparatus based on a rectum sensing function. The electromagnetic-controlled artificial anal sphincter apparatus comprises a hinge-shaped mechanism which is composed of a first pressing plate and a second pressing plate, a DC (Direct Current) pushing-pulling electromagnet, an arc closing mechanism, a small-size sliding block and two pressure sensors; at a left side, the first pressing plate and the second pressing plate are hinged through a hinge to form a transmission pair; the electromagnet is fixed on the second pressing plate; a pushing rod in the electromagnet penetrates through a small hole of the second pressing plate and is connected with the first pressing plate through the sliding block; the arc closing mechanism is fixed at tail ends of the two pressing plates; meanwhile, two flexible baffle plates are fixed at a left side and a right side of the arc closing mechanism. The electromagnetic-controlled artificial anal sphincter apparatus is arranged in the body of a patient, and a function as an anal sphincter can be played; the pressure sensor is used for sensing pressure in rectum and analyzing amount of human excrement, and then judging whether the electromagnet is electrified or not, so that opening or closing of an artificial anal sphincter can be directly controlled. The apparatus has the advantages of simple design, convenience in manufacturing and simpleness in operation.

The invention is suitable for the field of medical apparatus and instruments, and provides a neurogenic intestinal vibration therapeutic apparatus. The neurogenic intestinal vibration therapeutic apparatus comprises a shell; one end of the shell is provided with a connecting line; the neurogenic intestinal vibration therapeutic apparatus also comprises vibration plates installed on two sides of the shell and used for vibrating intestinal tracts, and a vibration transmission mechanism; and the vibration transmission mechanism comprises a circulating vibration assembly used for conducting circulating vibration on the vibration plates, a rotation transmission assembly used for conducting vibration transmission on the circulating vibration assembly and a supporting frame used for supporting and installing the circulating vibration assembly and the rotation transmission assembly. According to the neurogenic intestinal vibration therapeutic apparatus provided by the invention, the vibration plates and the vibration transmission mechanism are arranged, so that direct vibration stimulation can be performed on the anal sphincter and the rectal smooth muscle, stretching stimulation can be performed on the anus and the rectum besides a vibration effect, a vibration fragmentation effect can be performed on excrement of constipation, and through mechanical vibration wave stimulation, the influence is generated on neural and humoral reflex regulation.

The invention provides a bionic anal sphincter regulation and control device based on electric pulse regulation and control, and relates to the technical field of medical devices. The bionic anal sphincter regulation and control device comprises a sphincter regulation and control body and an excretion part, wherein the section of the sphincter regulation and control body is in a hollow circular ring shape, the periphery of the sphincter regulation and control body is wrapped with a compatible film layer, the excretion part is arranged in a hollow cavity of the sphincter regulation and controlbody, a contraction and expansion cavity is formed in the sphincter regulation and control body, an annular contraction and expansion part is arranged in the contraction and expansion cavity, and a wire penetrates through the interior of the contraction and expansion part and is electrically connected with an electric pulse generator through two electric interfaces. According to the regulation andcontrol device, pulse signal current is led into the wire along an electrode interface to stimulate contraction and expansion of the contraction and expansion part, so that excretion of feces is effectively controlled, and leakage of the feces is prevented; and the regulation and control device has few parts, the electric pulse generator and other elements are integrated in the sphincter regulation and control body to form an integrated structure, the installation space is saved, and regulation and control are convenient.

The invention relates to a spring-controlled micropump for artificial anal sphincter in the technical field of medical devices, wherein: one end of a first spring is fixed on a nut, and the other end is fixed on a first pressing plate, and the first spring compresses the first pressing plate so that The first pressing plate compresses the fourth medical catheter branch pipe and the second medical catheter branch pipe on the end face of the micro-motor, and separates the fourth medical catheter branch pipe and the second medical catheter branch pipe. One end of the second spring is fixed on the nut, and the other end is fixed on the second pressure plate. The second spring compresses the second pressure plate, so that the second pressure plate compresses the first medical catheter branch pipe and the third medical catheter branch pipe in the outer shell, and the first medical catheter branch pipe is cut off. Catheter branch and third medical catheter branch. Control the translational direction of the nut, compress or stretch the first spring and the second spring, realize bidirectional liquid discharge between the first container and the second container, and realize the function of maintaining pressure at any position.

The invention discloses a novel constant-force clamping artificial anal sphincter device, and relates to the technical field of medical apparatus and instruments. The novel constant-force clamping artificial anal sphincter device comprises a revolute pair, a connecting rod mechanism, a device shell and an outer clamping plate, wherein the connecting rod mechanism is arranged in the device shell, the revolute pair drives the connecting rod mechanism, and the tail end of the connecting rod mechanism is connected with the outer clamping plate. The system complexity of a distal center movement mechanism is greatly reduced, expansion can be carried out on the basis, the rotational degree of freedom of the whole mechanism around the distal center is generated, and the requirement for the degree of freedom needed by minimally invasive surgery is met.

The invention discloses a novel artificial anal sphincter with double uniform radial clamping, which relates to the technical field of medical apparatus and instruments, and comprises a knob type control shaft, a transmission mechanism and blades, wherein the knob type control shaft drives the blades to rotate through the transmission mechanism. According to the invention, the intestinal tract is uniformly clamped in the radial direction through circular contraction, meanwhile, excreta leakage is avoided through double clamping, and the problems that due to the fact that loads applied to the intestinal tract by an existing artificial anal sphincter are not uniform, the intestinal tract is subjected to avascular necrosis, and excreta leaks in the clamping process are solved.

The invention discloses a pedestal pan with washing and drying functions. The pedestal pan comprises a pedestal pan body, a pedestal pan circle and a pedestal pan cover, wherein the pedestal pan bodyis provided with a washing device and a drying device. After a user who goes to the toilet finishes relieving the bowels, hot water is ejected from a first through hole via a second water dischargingpipe to wash the anus position of the user who goes to the toilet; then, a dryer is started through a switch, and generated hot air is blown out of a second through hole through a pipeline to dry thehip of the user who goes to the toilet. Water washing is carried out after the user goes to the toilet, pollution caused when unclean paper is used can be reduced, and meanwhile, paper is saved. In addition, a haemorrhoid patient can massage the sphincter of the anus through washing. The washing device and the drying device are arranged on the pedestal pan body, the pedestal pan body is a ceramicproduct, has high intensity and can not be broken due to the use of the user who goes to the toilet, in addition, the size of the pedestal pan is large, so that the installation positions of the washing device and the drying device are not limited, and therefore, the pedestal pan has the advantages of large water yield, good washing effect, strong hot wind and quickness in drying.