CN101536902B - Injection system - Google Patents

Injection system Download PDF

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Publication number
CN101536902B
CN101536902B CN2008100349498A CN200810034949A CN101536902B CN 101536902 B CN101536902 B CN 101536902B CN 2008100349498 A CN2008100349498 A CN 2008100349498A CN 200810034949 A CN200810034949 A CN 200810034949A CN 101536902 B CN101536902 B CN 101536902B
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Prior art keywords
injection
injecting systems
entry needle
sheath pipe
fixture
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CN2008100349498A
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CN101536902A (en
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可大年
杨志健
虞奇峰
刘翔
梅奇峰
罗七一
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Minimally Invasive Investment Holdings Ltd
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Microport Medical Shanghai Co Ltd
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Abstract

The invention discloses an injection system. The injection system comprises an injection device and an electric signal detection device. The injection system is characterized in that the electric signal detection device comprises at least one electrode; and the electrode is arranged at the injection end of the injection device. The injection system can accurately position a target injection region so as to accurately inject medicine to a target region of the inner wall of a body cavity. The injection device can be better realized by mounting a bending compensation mechanism for the length of an injection needle, an injection needle locking mechanism, a quantitative automatic injection mechanism and the like.

Description

A kind of injecting systems
Technical field
The present invention relates to the intervention therapeutic apparatus field, be specifically related to a kind of injecting systems of injectable drug in vivo.
Background technology
In the interventional therapy field, adopting suitable injecting systems or device is the key point of treatment to the target area with the accurate locating injection of medicine.As to adopt biochemical preparations such as hepatocyte growth factor or stem cell to treat infarcted myocardium zone behind the myocardial infarction be a focus in the current biomedical research, is the key of this technology with the accurate locating injection of said medicine to the zone of scheming infarction how.
At present, the mode that medicines such as stem cell or somatomedin is transported to the myocardial infarction zone has three kinds: a kind of is stem cell to be transported in the crown artery and vein blood vessel in myocardial infarction zone by conduit, the utilization rate of this kind method stem cell is lower, according to the literature, only there is 5% stem cell to work in the myocardial infarction zone; Second kind is by open chest surgery stem cell to be expelled to impaired cardiac muscle through visceral pericardium, but wound is bigger, is unfavorable for the patient's body recovery; The third is with the method that gets involved cardiology, to the sheath pipe femoral artery puncture of entry needle be housed, be transported to the left ventricle of heart, stem cell is expelled to impaired cardiac muscle through endocardium, but the sixty-four dollar question that exists is the locating therapy inaccuracy of target area, and prior art is still not ideal enough on the sport technique segment that conducts drugs to the target area exactly.
Summary of the invention
The object of the present invention is to provide a kind of injecting systems, it can be expelled to the body region of interest within exactly with medicine, makes the target area obtain accurate locating therapy.
For achieving the above object, technical scheme provided by the invention is as follows:
A kind of injecting systems comprises injection device and electrical signal detection device, and wherein said electrical signal detection device comprises at least one electrode, and described electrode is installed in the dispensing end of injection device.
Preferably, described electrode is a potential-measuring electrode, can adopt the metal potential electrode.At the dispensing end of injection device cylindric head end electrode is installed; A plurality of metal ring electrodes can also be installed as required, constitute one group of signal acquisition point, be used to gather the electricity physiological signal of cardiac muscle in the heart or other cavity wall, as current potential etc. with the head end electrode.
Preferably, described injection device also is equipped with automatic injection mechanism, and described automatic injection mechanism is provided with the controller of control injection volume and injection speed.Injection volume and injection speed can be set on controller in advance, and drive push rod by motor and push certain distance, thus the injection certain amount of medicine.
Wherein, described injection device has handle and injection sheath pipe, is provided with entry needle and entry needle conduit in the injection sheath pipe.The head end of entry needle conduit is provided with entry needle, and the entry needle conduit passes from the inside of handle, the dispensing end installing electrodes of injection sheath pipe.The dispensing end of described injection sheath pipe is compounded with elastomeric material, and it is crooked that appropriateness can take place under external force.
Preferably, the Spin Control part of control injection sheath pipe dispensing end degree of crook is installed on the described handle, the Spin Control part is connected with the dispensing end of injection device by the traction seal wire.Described Spin Control part has rotary sleeve and fixture, fixture is fixedlyed connected with handle, the seal wire fixture is installed on the rotary sleeve, fixture is provided with cannelure, rotary sleeve is provided with the plug-in unit that inserts in the cannelure, this plug-in unit can rotate in cannelure during the rotary sleeve rotation, so but owing to plug-in unit rotary sleeve in cannelure can not axially move along injection sheath pipe range axle.Similar scheme, described Spin Control part has rotary sleeve and fixture, fixture is fixedlyed connected with handle, the seal wire fixture is installed on the rotary sleeve, rotary sleeve is provided with cannelure, the plug-in unit that inserts in the cannelure is set on the fixture, and the rotation rotary sleeve can make the rotary sleeve rotation but can not axially move along injection sheath pipe range axle.
Preferably, the compensating part that the extension elongation that makes entry needle is consistent is installed between described Spin Control part and the injection sheath pipe, compensating part with inject the sheath pipe and fixedly connected, have the helicitic texture that matches with the Spin Control part on the compensating part.Described helicitic texture is that helicla flute is set on compensating part, installs on the Spin Control part and inserts the spiral fluted plug-in unit, and compensating part is provided with the plug-in unit that is used to limit the compensating part rotation that inserts the Spin Control part.Described insertion spiral fluted plug-in unit is installed on the rotary sleeve of Spin Control part; The plug-in unit of described restriction compensating part rotation inserts in the fixture, can axially move in fixture, but can not rotate with respect to fixture.
Preferably, the entry needle length control piece be used to control the entry needle extension elongation is installed on the described handle, described entry needle length control piece has the graduated scale of adjusting the length that entry needle thrusts.
Preferably, be provided with multi-cavity catheter in the described injection sheath pipe, electrode cable and traction seal wire can pass from the different cavity of multi-cavity catheter, and the entry needle conduit passes from the multi-cavity catheter center cavity.In addition, between multi-cavity catheter and entry needle conduit, form the contrast solution tube chamber.
Preferably, the pushing block that links to each other with described entry needle conduit is set on the described handle, on pushing block, is provided for the locking mechanism of locked entry needle extension elongation.
Preferably, the back of described entry needle length control piece is provided with limited block, the length that the control pushing block is pushed ahead.
The beneficial effect of injecting systems of the present invention is as follows:
Install and measure electrode by dispensing end at injection device, electrode can be measured the signal of telecommunication of contact point accurately, in order to the zone of accurate judgement medicine injection is myocardial infarction zone or the transition region between cardiac muscle anyway, adopt the multi-electrode probe can measure the multiple-point signal of telecommunication, thereby help selected injection zone in big regional extent.
In an optimized technical scheme of the present invention, by on handle, being provided with the Spin Control part that connects the traction seal wire, this Spin Control part accurately changes the degree of crook of injection device dispensing end by rotation tension traction seal wire, can make injection sheath pipe dispensing end vertical with cavity wall, be convenient to thrusting and injection depth control of entry needle, simultaneously selected target injection point more easily also.Rotoflector controlling organization of the present invention axial push-pull fashion more of the prior art more can help the selected accurately injection point of equipment, more helps injection.
In the technical scheme of present invention further optimization, the compensating part that the entry needle extension elongation is consistent that matches with the Spin Control part has been installed on handle, and Spin Control part on the handle and compensating part match and can drive the nose balance motion that injection sheath pipe is made trace.Because when dispensing end produces when crooked because injection sheath pipe and injection needle diameter different, radical length shrinks also different, causing the thorn of entry needle to go out length changes with the variation of bending curvature, this compensating motion can make entry needle go out pin length and remain unchanged when any degree of crook, thereby guarantees accurate injection depth.
In addition, the present invention can be equipped with automatic injection mechanism, can accurately control per injection amount and injection speed, also makes injection operation become rapidly simple; Have, the present invention can also be provided with the entry needle length control piece of regulating the entry needle extension elongation again, keeps stable injection depth during with the injection after guaranteeing injection needle and thrusting in that locking mechanism is set on the pushing block.
Description of drawings
Fig. 1 is an injecting systems structural representation of the present invention.
Fig. 2 is Spin Control part model of action and structure chart thereof among the present invention.
Fig. 3 is compensating part model of action and structure chart thereof among the present invention.
Caption:
1, entry needle, 2, the head end electrode, 3, the metal ring electrode, 4, injection sheath pipe, 5, compensating part, 6, the Spin Control part, 7, handle, 8, pushing block, 9, entry needle length control piece, 10, graduated scale, 11, limited block, 12, the injection interface, 13, the contrast-medium injection mouth, 14, the connecting line socket, 15, connect the buttock line socket, 16, the multicore transmission line, 17, the polygraph joint, 18, injection hose, 19, syringe cylinder, 20, push rod, 21, motor, 22, control line, 23, controller, 24, base, 25, the traction seal wire, 26, crooked steel disc, 27, the entry needle conduit, 501, the compensating part alignment pin, 502, helicla flute, 601, the far-end pin, 602, the near-end pin, 603, the seal wire steady pin, 604, fixture, 605, cannelure, 606, the seal wire winding groove, 607, connector, 608, rotary sleeve.
The specific embodiment
Injecting systems of the present invention can be expelled to the body region of interest within exactly with medicine, further specifies the present invention below by way of embodiments and drawings, but does not therefore limit the present invention in the described scope of embodiments.
This paper for convenience, " far-end " described in the injecting systems of the present invention is meant the end near injection needle, i.e. dispensing end; Described " near-end " is meant the end away from injection needle.
Below in conjunction with accompanying drawing embodiments of the invention 1 are described.As shown in Figure 1, injecting systems of the present invention can be on the far-end of existing injecting systems or device the installation and measuring electrode, head end electrode 2 at the injection device far-end can be installed, can adopt columned metal potential electrode, can also a plurality of metal ring electrodes 3 be installed in far-end one side as required, constituted one group of signal acquisition point with head end electrode 2, be used to gather the electricity physiological signal of cardiac muscle or other cavity wall, as current potential etc.
When injecting systems used, the signal of telecommunication that detecting electrode produces reached the connecting line socket 14 of handle 7 afterbodys through lead, connects buttock line socket 15 and is used for the signal of telecommunication is sent into buttock line and then sent into signal processing system.Connecting the important accessory of buttock line as injecting systems of the present invention, is the electrical transmission line that connects the electric signal measurement system, and by connecting buttock line socket 15, multicore transmission line 16 and polygraph joint 17 constitute.When being used for the medicine locating injection in myocardial infarction zone, because there were significant differences behind the UP voltage of normal person's LV and the myocardial infarction [Gepstein L, Gollin A, LessickJ, et al.Circulation, 1998; 98 (19): 2055-206], therefore can accurately judge the myocardial infarction zone, utilize injecting systems of the present invention medicine can be expelled to exactly body cavity inwall target area according to myocardium current potential.Can also save metal ring electrode 3 in the said structure, only keep head end electrode 2.
Below in conjunction with accompanying drawing embodiments of the invention 2 are described.In order to realize the purpose of accurate locating injection of the present invention better, injecting systems of the present invention can also be installed Spin Control part 6 on first kind of embodiment basis, the far-end bending of injection sheath pipe 4 is convenient to thrusting with injection depth of entry needle and is controlled when making injection.
As shown in Figure 2, Spin Control part 6 is installed on handle 7, Spin Control part 6 comprises fixture 604 and the rotary sleeve 608 that is sleeved on the fixture 604, wherein fixture 604 is fixed on the handle 7 by connector 607, the seal wire winding groove of passing through for traction seal wire 25 606 is set on the fixture 604, cannelure 605 also is set on the fixture 604, the near-end pin 602 that is fixed on the rotary sleeve 608 is inserted in the cannelure 605, and near-end pin 602 makes rotary sleeve 608 can only do rotation and can not axially move along injection sheath pipe range axle.Be installed with seal wire steady pin 603 on rotary sleeve 608, traction seal wire 25 process seal wire winding groove 606 are connected on the seal wire steady pin 603.
The far-end of injection sheath pipe 4 is to be made by softer elastomeric material, and it is crooked that appropriateness can take place under external force, does not need crooked position to select for use the harder material of quality to make.Head end electrode 2 is fixed in the far-end of injecting sheath pipe 4, connects traction seal wire 25 and crooked steel disc 26 on the head end electrode 2, and injection sheath pipe 4 is enclosed within outside traction seal wire 25 and the crooked steel disc 26.
When the injecting systems of the present invention that the Spin Control part is installed used, the far-end of rotary sleeve 608 injection sheath pipe 4 when the direction rotation of tension traction seal wire 25 can bend, and the elastic force of crooked steel disc 26 makes injection sheath pipe far-end recover to become straight when loosening traction seal wire 25.The far-end of injection sheath pipe 4 can be under the Spin Control of Spin Control part 6, effect by traction seal wire 25, bend to the radian of certain curvature radius, make injection sheath pipe 4 far-ends vertical with cavity wall, be convenient to thrusting and injection depth control of entry needle 1, simultaneously degree of crook that also can be by changing injection sheath pipe 4 far-ends selected target injection point more easily.
Below in conjunction with description of drawings embodiments of the invention 3.In front in second kind of embodiment, when the far-end of injection sheath pipe 4 produces when crooked because injection sheath pipe 4 and entry needle conduit 27 diameters different, it is also different to cause the thorn of entry needle to go out length, and goes out length with the variation injection acupuncture of bending curvature and also change.For addressing the above problem, the bending compensation device that present embodiment has further been installed injection length is a compensating part 5, compensating part 5 and Spin Control part 6 match, and the rotary sleeve 608 of Spin Control part can drive the nose balance motion that injection sheath pipe 4 is done trace when rotating.
As shown in Figure 3, compensating part 5 is sleeved between the rotary sleeve 608 of injection sheath pipe 4 and Spin Control part 6, and the far-end of compensating part 5 is fixed on the injection sheath pipe 4, can adopt bonding mode to fix; The near-end of compensating part 5 is provided with compensating part alignment pin 501, and compensating part alignment pin 501 is inserted in the axial groove of fixture 604, and compensating part alignment pin 501 can axially move in the axial groove of fixture 604 and can not rotate.Helicla flute 502 is set on compensating part 5, far-end pin 601 is installed on the Spin Control part 6, far-end pin 601 is inserted in the helicla flute 502.
When the injecting systems of the present invention of compensating part 5 and Spin Control part 6 has been installed in use, the far-end of injection sheath pipe 4 bends during rotary sleeve 608 rotations, far-end pin 601 just drives the nose balance motion that compensating part 5 is made trace simultaneously, because the far-end of compensating part 5 is fixed on the injection sheath pipe 4, the axially-movable of compensating part 5 drives injection sheath pipe 4 and axially moves, thereby injection sheath pipe 4 and entry needle conduit 27 are done relative motion, so compensating part has played the compensate for bend effect of injection length.Compensation dosage when the pitch of screw thread can change revolution unit's angle on the change compensating part, i.e. length amount of movement.
Can select to use other parts in the injecting systems of the present invention.Be provided with multi-cavity catheter in injection sheath pipe 4, entry needle conduit 27 passes through from the multi-cavity catheter center, forms the contrast solution tube chamber between multi-cavity catheter and entry needle conduit, and the multi-cavity catheter near-end is connected with the base joint, is used for linking to each other with the needle tubing of injection of contrast medium.Multi-cavity catheter provides a plurality of tube chambers, and above-mentioned traction seal wire 25 can pass from multi-cavity catheter, and the connection lead of head end electrode 2 and metal ring electrode 3 also can pass from multi-cavity catheter.
Head end electrode 2 middle parts are provided with an endoporus, allow entry needle 1 to pass through, and have certain interval to allow contrast agent or other drug to pass through between entry needle 1 and endoporus.The near-end of entry needle conduit 27 is provided with injection interface 12, and this injection interface can connect automatic injection mechanism.The near-end of entry needle conduit 27 links to each other with pushing block 8 on the handle 7, and is preceding when pushing away pushing block 8, the entry needle 1 of far-end promptly from the beginning the centre bore of termination electrode 2 sting out.On pushing block 8, locking mechanism can also be installed, just by locked, can unclamp after the injection and rebound after promptly injection needle 1 is released.
The thorn of the entry needle length control piece 9 scalable entry needles on the handle goes out length, cooperates the graduated scale 10 at knob place, can preestablish the corresponding length of stinging out.The length that limited block 11 control pushing blocks 8 are pushed ahead is set in the back of entry needle length control piece 9, unclamps pushing block 8 after the injection, entry needle can rebound automatically.
Injecting systems of the present invention also can be provided with and inject the automatic injection mechanism that interface 12 links to each other.Frame of broken lines part as Fig. 1.This automatic injection mechanism mainly comprises syringe cylinder 19, push rod 20, motor 21, control line 22, controller 23, base 24.During use every startup once, motor 21 just drives push rod 20 and pushes certain distances, thus the injection certain amount of medicine.Injection volume and injection speed can be set on controller 23 in advance.Start push rod 20 and can carry out the crawl startup by hand, also can thrust back startup automatically.
Be that example illustrates concrete using method of the present invention now with four electrode injecting systems:
1, by the routine operation femoral artery puncture of interventional procedure injecting systems is injected the sheath pipe and send into heart left ventricle through aorta;
2, inject contrast agent from contrast-medium injection mouth 13, the demonstration heart can not jumped or is beated and is weaker than normal position;
3, the rotary sleeve 608 on the Spin Control part 6 on the turning handle makes the injection sheath pipe 4 far-end bendings of injecting systems;
4, push or rotate the wall of the heart that injecting systems makes 4 electrodes contact the necrotic area simultaneously and measure 4 myocardium potential value, and change position repeated acquisition potential value, confirm the myocardial necrosis district;
5, reorientate injecting systems, make the basic vertical wall of the heart of injection sheath pipe far-end, head end electrode 2 contact walls of the heart;
6, adjust entry needle length control piece 9, adjust according to graduated scale 10 and thrust length (this operation also can be done) before 1;
7, the electrode potential of measuring contact point is once more confirmed this current potential target injection point;
8, pushing pushing block 8 makes injection needle 1 thrust cardiac muscle;
9, push the injection that injection carries out biochemical preparation immediately, for example stem cell is expelled in several tissue regions of the impaired heart;
10, the multi-point injection of anticipation is finished in the operation of repetition 5-9;
11, the rotary sleeve 608 of adjustment Spin Control part 6 makes injection sheath pipe 4 curved distal tunes recover linear state;
12, injecting systems is taken out external according to conventional interventional procedure.
Preferred operation embodiment is:
1. with the heart left ventricle's structure after the ultrasoundcardiogram diagnostic apparatus observation people cardiac muscle infarction, judge the zone of myocardial infarction;
2. the connecting line socket 14 with injecting systems links to each other with polygraph, the conduit emptying, to insert injection sheath pipe from the femoral artery puncture mouth after the heparinization, from inserting femoral artery to the process of left ventricle, polygraph monitoring people's changes in heart rate, prevent from operation process, to occur unusually, and carry out the iconography monitoring;
3. after injection sheath pipe enters left ventricle, judge the myocardial infarction zone with the ultrasoundcardiogram diagnostic apparatus, and whether the head end electrode 2 of observation syringe is in infarcted region, and by polygraph record myocardium voltage herein, obviously low as voltage than normal structure, then determine it is infarcted region herein;
4. adjust entry needle length control piece 9, adjust according to graduated scale 10 and thrust length, injection depth is between 2-8mm; The rotary sleeve 608 of the Spin Control part 6 on the turning handle makes the 4 far-end bendings of injection sheath pipe, selects injection point;
5. push pushing block 8 and make entry needle 1 thrust cardiac muscle, medicine is injected, after the injection entry needle is return; Preferred scheme is during injectable drug, and injecting systems is combined with adjustable calibrated shot device, and injection volume and injection speed can be set on controller in advance, drive push rod by motor and push certain distance, thus the injection certain amount of medicine;
6. repeat 4,5 operations, reselect injection point, select a plurality of some injections as required;
7. the rotary sleeve 608 of adjusting Spin Control part 6 makes injection sheath pipe 4 curved distal tunes recover linear state;
8. syringe is taken out external according to conventional interventional procedure.
By above operating procedure, injecting systems of the present invention can be expelled to medicine body cavity inwall target area accurately, makes the target area obtain accurate locating therapy.

Claims (15)

1. an injecting systems comprises injection device and electrical signal detection device, it is characterized in that, described electrical signal detection device comprises at least one electrode, and described electrode is installed in the dispensing end of injection device; Described injection device has handle and injection sheath pipe, be provided with entry needle and entry needle conduit in the injection sheath pipe, the Spin Control part of control injection sheath pipe dispensing end degree of crook is installed on the described handle, and the Spin Control part is connected by the dispensing end of traction seal wire with injection sheath pipe; The compensating part that the extension elongation that makes entry needle is consistent is installed between described Spin Control part and the injection sheath pipe, compensating part with inject the sheath pipe and fixedly connected, have the helicitic texture that matches with the Spin Control part on the compensating part.
2. according to the described injecting systems of claim 1, it is characterized in that described electrode is a potential-measuring electrode.
3. according to the described injecting systems of claim 2, it is characterized in that described electrode is the metal ring electrode.
4. according to the described injecting systems of claim 1, it is characterized in that described injection device also is equipped with automatic injection mechanism.
5. according to the described injecting systems of claim 4, it is characterized in that described automatic injection mechanism is provided with the controller of control injection volume and injection speed.
6. according to the described injecting systems of claim 1, it is characterized in that the dispensing end of described injection sheath pipe is compounded with elastomeric material.
7. according to the described injecting systems of claim 1, it is characterized in that described Spin Control part has rotary sleeve and fixture, fixture is fixedlyed connected with handle, the seal wire fixture is installed on the rotary sleeve, and fixture is provided with cannelure, and rotary sleeve is provided with the plug-in unit that inserts in the cannelure.
8. according to the described injecting systems of claim 1, it is characterized in that described Spin Control part has rotary sleeve and fixture, fixture is fixedlyed connected with handle, the seal wire fixture is installed on the rotary sleeve, and rotary sleeve is provided with cannelure, and the plug-in unit that inserts in the cannelure is set on the fixture.
9. according to claim 7 or 8 described injecting systems, it is characterized in that, described helicitic texture is that helicla flute is set on compensating part, installs on the Spin Control part and inserts the spiral fluted plug-in unit, and compensating part is provided with the plug-in unit that is used to limit the compensating part rotation that inserts the Spin Control part.
10. according to the described injecting systems of claim 9, it is characterized in that described insertion spiral fluted plug-in unit is installed on the rotary sleeve of Spin Control part, the plug-in unit of described restriction compensating part rotation inserts in the fixture.
11. according to the described injecting systems of claim 1, it is characterized in that, the entry needle length control piece that is used to control the entry needle extension elongation be installed on the described handle.
12., it is characterized in that according to the described injecting systems of claim 1, be provided with multi-cavity catheter in the described injection sheath pipe, electrode cable and traction seal wire pass from the different cavity of multi-cavity catheter, and the entry needle conduit passes from the multi-cavity catheter center cavity.
13., it is characterized in that forming between described multi-cavity catheter and entry needle conduit the contrast solution tube chamber according to the described injecting systems of claim 12.
14. according to the described injecting systems of claim 1, it is characterized in that, the pushing block that links to each other with described entry needle conduit be set on the described handle.
15. according to the described injecting systems of claim 14, it is characterized in that, be provided for the locking mechanism of locked entry needle extension elongation on the described pushing block.
CN2008100349498A 2008-03-18 2008-03-18 Injection system Active CN101536902B (en)

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Publication number Priority date Publication date Assignee Title
CN102198305B (en) * 2010-03-23 2013-06-05 上海微创医疗器械(集团)有限公司 Device and system for locally delivering therapeutic agents
CN104083214B (en) * 2014-06-13 2017-01-25 先健科技(深圳)有限公司 Bend-adjustable medical catheter and assembling method thereof
CN107551401B (en) * 2017-08-25 2021-03-09 创领心律管理医疗器械(上海)有限公司 Active electrode rotating device
KR20220131998A (en) * 2020-03-27 2022-09-29 니혼라이프라인 가부시키가이샤 Chemical injection needle and chemical liquid injection needle system
CN112494239B (en) * 2020-11-19 2022-01-11 联赢医疗科技有限公司 Clinical emergency treatment robot for acute patient
CN113440690A (en) * 2021-08-03 2021-09-28 复旦大学 Intelligent quantitative drug administration electric needle injection device based on electromyographic signal feedback
CN113893002B (en) * 2021-10-08 2023-05-23 河北医科大学第二医院 Stone-taking basket and operation method thereof

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CN1684729A (en) * 2002-08-02 2005-10-19 利布尔-弗拉希姆公司 Injector
EP0962191B1 (en) * 1998-06-04 2007-05-09 Biosense Webster, Inc. Catheter for injecting therapeutic and diagnostic agents

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