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1.
目的探讨地氟醚对小儿脑电双频谱指数(BIS)的影响,评价BIS在小儿地氟醚麻醉深度监测中的应用价值。方法选择30例ASA分级Ⅰ~Ⅱ级。气管内全麻下择期手术患儿(年龄3~6岁)。异丙酚、维库溴铵麻醉诱导气管内插管后行控制呼吸,吸入地氟醚维持麻醉,调整吸入浓度,使地氟醚呼气末浓度依次维持在0.6MAC、1.0MAC和1.3MAC,每一浓度稳定20min。记录各时点的MAP,HR和BIS。结果地氟醚麻醉期,MAP和BIS与麻醉诱导前相比明显降低(P〈0.05)。当地氟醚呼气末浓度由0.6~1.3MAC递增时,患儿MAP和HR无明显变化(P〉0.0S),而BIS逐渐下降(P〈0.05)。MAP、HR与地氟醚呼气末浓度的相关系数分别为-0.355和0.857(P〉0.05),BIS与地氟醚呼气末浓度相关系数为-0.993(P〈0.05)。结论在学龄前小儿地氟醚全麻中,BIS与地氟醚呼气末浓度呈一定的剂量相关性,可用于监测学龄前小儿地氟醚麻醉深度。  相似文献   

2.
地氟醚对听觉诱发电位指数和数量化脑电图的影响   总被引:1,自引:1,他引:0  
目的:观察地氟醚对听觉诱发电位指数(AAI)、数量化脑电图(QEEG)各参数和血流动力学的影响,评价AAI判断地氟醚麻醉深度的可行性。方法:选择行下腹部手术ASAⅠ~Ⅱ级的病人30例,在异丙酚、维库溴铵诱导插管后分别吸入0.8,1.0,1.3 MAC的地氟醚,每个浓度维持20 min。记录血压,心率,AAI(A-line ARX index),BIS(bispectral index),SEF(95% spectral edge frequency)和MF(midian frequency)的值。结果:随呼吸末地氟醚浓度的增高,AAI,BIS,95%SEF和MF均显著降低,以上改变与呼吸末地氟醚浓度呈线性相关关系(r分别为0.830,0.930,0.803,0.885,P<0.01)。MAP和HR却无明显变化,HR在地氟醚浓度为1.3 MAC时比1.0 MAC时要显著增快。结论:地氟醚浓度在0.8~1.3 MAC的范围内,AAI,BIS,95%SEF和MF都可作为地氟醚麻醉深度的监测指标。而MAP和HR不能反映地氟醚的麻醉深度。  相似文献   

3.
听觉诱发电位指数监测老年人地氟醚麻醉深度   总被引:1,自引:0,他引:1  
目的:观察老年人地氟醚麻醉中听觉诱发电位指数(AEP指数)和血流动力学的变化,评估AEP指数监测老年人地氟醚麻醉深度的应用价值。方法:选择ASAⅠ-Ⅲ级,择期全麻气管插管下手术患者40例,按年龄分为2组:老年组(年龄≥65岁,n=20)和中青年组(年龄18~55岁,n=20)。异丙酚、维库溴铵诱导气管插管后行控制呼吸,吸入地氟醚维持麻醉,调整吸入浓度,使地氟醚呼气末浓度依次维持在0.6MAC,1.0MAC和1.3MAC,每一浓度均稳定20min。监测麻醉前(T1)、注射异丙酚后2min(T2)、气管插管时(T3)、气管插管后2min(T4)、地氟醚呼气末浓度为0.6MAC(T5),1.0MAC(T6)和1.3MAC(T7)时的平均动脉压、心率和AEp指数。结果:地氟醚麻醉期2组患者平均动脉压均比麻醉前明显下降(P〈0.05),老年组心率与麻醉前相比亦显著减慢(P〈0.05)。地氟醚呼气末浓度由0.6MAC~1.3MAC递增时,2组患者平均动脉压和心率无明显变化(P〉0.05)。地氟醚麻醉期2组患者AEP指数与麻醉前相比显著降低(P〈0.05),老年组地氟醚呼气末浓度在1.0MAC和1.3MAC时AEP指数较0.6MAC时显著降低(P〈0.05),但中青年组地氟醚呼气末浓度各浓度间AEP指数差异无统计学意义(P〉0.05);在地氟醚各呼气末浓度时,老年组AEP指数均低于同时间点中青年组(P〈0.05)。AEP指数与地氟醚呼气末浓度在老年组和中青年组的相关系数分别为-0.983和-0.980(P〈0.05)。结论:听觉诱发电位指数与地氟醚呼气末浓度呈一定的剂量相关性,可监测老年人地氟醚麻醉深度变化并在一定程度上反映相同地氟醚呼气末浓度下老年人与中青年人麻醉深度的差异。  相似文献   

4.
目的:研究无手术刺激条件下地氟醚对老年人脑电双频谱指数(BIS)的影响,评估BIS在地氟醚吸入麻醉深度监测中的应用价值。方法: 40例ASA Ⅰ~Ⅲ级,拟择期在气管内全麻下手术患者,按年龄分为2组:老年组(年龄≥65岁,n=20例),中青年组(年龄18~55岁,n=20例)。环甲膜穿刺行气管内表面麻醉后予异丙酚2mg/kg、维库溴铵0.1mg/kg静脉注射诱导,插管后吸入地氟醚维持麻醉,逐步调整吸入浓度,使地氟醚呼气末浓度依次维持在0.6MAC,1.0MAC,1.3MAC,每一浓度均稳定20min。观察指标包括MAP,HR和BIS。记录时点分别为麻醉前、注射异丙酚后2min、气管插管时、气管插管后2min、地氟醚呼气末浓度为0.6MAC, 1.0MAC, 1.3MAC时。结果:在地氟醚麻醉期,当地氟醚呼气末浓度由0.6~1.3MAC递增时,2组患者MAP,HR无显著变化(P>0.05),MAP,HR的变化与地氟醚无量效关系。在地氟醚麻醉期,2组患者BIS在整个麻醉过程中的变化不同(P<0.05)。随着地氟醚呼气末浓度增加,BIS逐渐下降,但每组患者各浓度间BIS的变化差异无统计学意义(P>0.05)。BIS与地氟醚呼气末浓度呈高度相关,BIS与地氟醚在老年组、中青年组的相关系数分别为-0.996,-0.946(P<0.05)。结论:脑电双频谱指数与地氟醚呼气末浓度呈高度剂量相关性,可以较好地监测老年人与中青年人的地氟醚麻醉深度。在相同地氟醚呼气末浓度下,以脑电双频谱指数为指标反映出的麻醉深度在老年人与中青年人无明显差异。  相似文献   

5.
目的:评价脑电边缘频率(SEF)、双频谱指数(BIS)在麻醉深度监测中的应用.方法:择期行开胸手术患者随机分为异氟醚吸入全麻(GA)组和硬膜外阻滞复合全麻(EA)组,每组10例.EA组先于胸段硬膜外给予局麻药8~10 ml.两组均吸入异氟醚/O2维持麻醉.先记录两组异氟醚呼气末浓度达到0.5、1.0、1.5最低肺泡有效浓度(MAC)时的SEF、BIS值,然后使两组麻醉维持在稳定水平,记录不同阶段的呼气末MAC、SEF、BIS值.EA组每间隔60 min硬膜外给局麻药4~5 ml.结果:两组SEF、BIS值与异氟醚呼气末MAC均呈负相关;GA组异氟醚呼气末MAC值高于EA组,SEF、BIS值则低于GA组,两组差异有统计学意义(P<0.05).结论:硬膜外麻醉中局麻药常规剂量对脑电无影响;SEF、BIS在麻醉深度监测中有一定作用.  相似文献   

6.
目的 观察单肺通气(OLV)和双肺通气(TLV)时七氟醚呼气末浓度对脑电双频指数及血流动力学的影响.方法全身麻醉下行开胸食管癌手术40例,随机分成A,B,C,D4个组.全麻诱导后,插入双腔支气管导管控制呼吸,调节七氟醚挥发罐刻度使4组患者七氟醚呼气末浓度(CET-Sev)分别为0.8,1.0,1.2,1.4MAC.麻醉前(T1)、TLV(开胸前CET-Sev稳定后)15min(T2)、OLV(开胸后CET-Sev稳定后)15min(T3)、30min(T4)、60min(T5)记录术中的BIS,HR,MAP.结果 单肺通气后4组的BIS,HR,MAP明显高于双肺通气(P<0.05).单肺通气时15min,30min,60min,BIS,HR,MAP差异无显著性(P>0.05).随CET-Sev 的增加TLV和OLV时BIS,HR,MAP逐渐下降(P<0.05).TLV15min与OLV15min的BIS与CET-Sev呈线性负相关(r=-0.987,-0.983,P均<0.05).结论 单肺通气与双肺通气在合适的麻醉深度(40< BIS <65)时CET-Sev范围不同:双肺通气时CET-Sev范围是0.8~1.0 MAC,单肺通气时CET-Sev范围是1.0~1.2MAC.与双肺通气相比,单肺通气吸入七氟醚时应适当提高七氟醚吸入浓度.  相似文献   

7.
目的:探讨脑电双频指数(BIS) 用于婴幼儿七氟醚麻醉深度监测的可行性。方法:随机选取择期全麻手术的患儿60例,按月龄分为3组:A 组(1~6个月,n=20)、B 组(7~12个月, n=20)和C组(13~36个月, n=20)。3组均给予8%七氟醚诱导,逐步调节七氟醚呼气末浓度(CETSev),分别维持在最低肺泡有效浓度1.0 MAC(Ⅰ组);0.75MAC(Ⅱ组)和0.5 MAC(Ⅲ组)至少15min, 随后记录BIS、HR、SBP、DBP、RR和呼气末二氧化碳(PETCO2)。结果:3组患儿的BIS差异有统计学意义,A组BIS在不同CETSev均低于B组、C组(P<0.01);B组BIS在不同CETSev低于C组(P<0.01);随七氟醚呼气末浓度从1.0 MAC降至0.5 MAC, A组Ⅲ组BIS高于Ⅰ组、Ⅱ组(P<0.05)。B组、C组的Ⅱ组、Ⅲ组BIS明显高于Ⅰ组(P<0.01);Ⅲ组BIS明显高于Ⅰ组、Ⅱ组(P<0.01)。患儿的BIS均与CETSev浓度负相关。A组回归方程为Y(BIS)=54.742-8.914X(CETSev) (r=-0.431,P<0.01);B组回归方程为Y(BIS)=77.528-12.684X(CETSev) (r=-0.689,P<0.01);C组回归方程为Y(BIS)=88.863-14.395X (CETSev)相关性(r=-0.714, P<0.01),A组相关性低于B组与C组。结论:七氟醚全麻时,3组患儿BIS与CETSev 呈一定剂量的负相关,7~12个月和13~36个月患儿BIS相关性较好, BIS可用于七氟醚麻醉深度的监测,6月龄以下婴儿使用BIS的有效性还有待进一步研究。  相似文献   

8.
马启明  谢致  马刚 《宁夏医学杂志》2010,32(10):884-886
目的研究0.5MAC、1.0MAC和1.5MAC七氟醚对颅内压(ICP)的影响,并与异氟醚相比较。方法选择60例择期行大脑半球胶质瘤切除术的患者按简单随机法分为异氟醚(I)组和七氟醚(S)组,每组30例,每组再随机分为0.5MAC组、1.0MAC组和1.5MAC组,每组10例。全麻诱导前行L3-4穿刺置管测脑脊液压(CSFP)代替ICP;右颈内静脉穿刺置管测中心静脉压(CVP);右桡动脉穿刺置管测平均动脉压(MAP)。全麻诱导方案相同,诱导后分别吸入异氟醚或七氟醚,并于麻醉诱导前、异氟醚或七氟醚达预定呼气末浓度即刻、15min、30min时观察并记录MAP、CVP和ICP。结果七氟醚对ICP的影响呈剂量相关性增加,无论七氟醚或异氟醚,1.5MAC组的ICP与麻醉前基础值比较具有统计学意义(P〈0.05);相同MAC值的七氟醚与异氟醚增加ICP的作用比较无统计学意义(P〉0.05)。结论七氟醚对ICP的影响与异氟醚相似,呈剂量依赖性增加ICP,超过1.5MAC的七氟醚增加ICP尤为明显。  相似文献   

9.
目的探讨术前硬膜外给予曲马多对维持妇科手术中BIS值为40~60的呼气末地氟醚浓度的影响。方法随机选取40个全麻下腹式子宫切除的女性病人,随机分为两组,盐水组(S组)和曲马多组(T组)。所有病人均在腰3、4节段硬外腔置管,在麻醉诱导前20min分别注入生理盐水10mL加或不加曲马多200mg。麻醉中采用地氟醚持续吸入麻醉维持,测量手术前及术中每隔10min的BIS值、呼气末地氟醚浓度、心率和无创血压作为指标。结果与盐水组相比,曲马多组的呼气末地氟醚浓度明显呈下降趋势,差别具有统计学意义,该组心率在各测量时也较盐水组慢(P〈0.05),术中的BIS值差异无显著性。结论术前硬膜外注入曲马多可以减少全麻手术中地氟醚的用量。  相似文献   

10.
目的 比较相同MAC浓度的地氟醚和异氟醚对脑电图的影响。方法 选择 2 0例 2 0~ 5 0岁 ,ASAⅠ~Ⅱ级择期手术的病人 ,均不用术前药。麻醉诱导以静脉异丙酚 2mg/kg ,琥珀胆碱 2mg/kg快速气管插管 ,单纯吸入地氟醚或异氟醚维持麻醉。控制呼吸 ,维持呼气末二氧化碳分压 (PetCO2 )在 4 .7~ 6.0kPa。以TOF监测肌松 ,维持T4 /T1<2 5 %。以双导联方式监测脑电变化 ,观察呼气末麻醉药浓度在 0 .5、0 .8、1.0、1.3和 1.5MAC时的脑电边缘频率 (SEF)和双谱指数 (BIS)的改变。结果 随MAC的增加SEF和BIS逐渐减小 ,呈负性线性相关关系 (r分别为 - 0 .95和 - 0 .99,P <0 .0 1) ,2组间SEF和BIS无显著性差异 (P >0 .0 5 )。结论 地氟醚对脑电图的影响与异氟醚相似 ;EEG对监测麻醉深度有一定指导意义  相似文献   

11.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

12.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

13.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

14.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

15.
Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P<0.01);the MAP decreased(P<0.01)and the HR increased drastically(P<0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.  相似文献   

16.
Objective:To investigate the gene expression of osteoprotegerin(OPG) and osteoclast differentiation factor(ODF) in the bone tissue of patients with hip fracture due to osteoporosis. Methods:OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers(over 50 years old) with hip fracture(Observer Group) and 30 cases of hip facture sufferers with no osteoporosis(Control group) were analyzed with the Semi-Quantitative RT-PCR method. Results:The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion:Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.  相似文献   

17.
Objective:To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas(SPTP). Methods:Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin(HE) staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results:Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin(9/9 cases), AAT(9/9 cases), NSE(9/9 cases), ACT(7/9 cases), CK20(2/9 cases), CgA(1/9 cases), S-100(3/gcases), PR(4/gcases), Syn(3/9 cases) and CD56(5/9cases), negative in CEA and ER. Conclusion:SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.  相似文献   

18.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

19.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

20.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

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