Summary of the invention
The technical problem to be solved is to provide a kind of heart-assist device for accessory heart acting.
To achieve these goals, embodiment of the present invention adopts the following technical scheme that
A kind of heart-assist device is provided, including:
First sacculus independent of each other, the second sacculus and the 3rd sacculus, form intermediate cavity between described first sacculus and described 3rd sacculus, described second sacculus is placed in described intermediate cavity;
First trachea independent of each other, the second trachea and the 3rd trachea, one end of described first trachea connects described first sacculus, and one end of described second trachea connects described second sacculus, and one end of described 3rd trachea connects described 3rd sacculus;
First driving means, described first driving means connects the other end of described first trachea, in order to described first inflated or bleed, makes described first sacculus expansion or shrinkage;
Second driving means, described second driving means connects the other end of described second trachea, in order to described second inflated or bleed, makes described second sacculus expansion or shrinkage;
3rd driving means, described 3rd driving means connects the other end of described 3rd trachea, in order to described 3rd inflated or bleed, makes described 3rd sacculus expansion or shrinkage;And
Control device, described control device is used for controlling described first driving means, described second driving means and described 3rd driving means, the circulation of described heart-assist device is made to realize the first state and the second state, described first state is described first sacculus and described second sacculus contraction, described 3rd sacculus expansion, fluid flows into described intermediate cavity, and described second state is that described first sacculus expansion, described 3rd sacculus expansion or shrinkage, described second sacculus gradually expand to promote the described fluid described intermediate cavity of outflow.
Wherein, described heart-assist device also includes:
First conduit, one end of described first conduit is positioned at described first sacculus side away from described second sacculus;
Second conduit, one end of described second conduit is between described first sacculus and described second sacculus or between described second sacculus and described 3rd sacculus;
3rd conduit, one end of described 3rd conduit is positioned at described 3rd sacculus side away from described second sacculus;
First pressure tester, described first pressure tester connects the other end of described first conduit, in order to detect the pressure of one end of described first conduit;
Second pressure tester, described second pressure tester connects the other end of described second conduit, in order to detect the pressure of one end of described second conduit;And
3rd pressure tester, described 3rd pressure tester connects the other end of described 3rd conduit, in order to detect the pressure of one end of described first conduit;
Described first pressure tester, described second pressure tester and described 3rd pressure tester are all connected with described control device.
Wherein, described heart-assist device also includes central canal, described first sacculus, described second sacculus and described 3rd sacculus are each arranged around described central canal, and described first trachea, described second trachea, described 3rd trachea, described first conduit, described second conduit and described 3rd conduit are arranged at the inside of described central canal.
Wherein, described first sacculus a length of first length in a first direction, described first direction is parallel to the axis of described central canal, described first sacculus outer diameter length in a second direction is the first external diameter, described second direction is perpendicular to described first direction, and described first external diameter is more than described first length;
Described second sacculus a length of second length in said first direction, and outer diameter length in this second direction is the second external diameter, described second external diameter is less than described second length;
Described 3rd sacculus a length of 3rd length in said first direction, and outer diameter length in this second direction is the 3rd external diameter, described 3rd external diameter is more than described 3rd length.
Wherein, described first length is more than or equal to 3mm and less than or equal to 10mm, and described first external diameter is more than or equal to 10mm and less than or equal to 25mm;
Described second length is more than or equal to 200mm and less than or equal to 350mm, and described second external diameter is more than or equal to 10mm and less than or equal to 25mm;
Described 3rd length is more than or equal to 3mm and less than or equal to 10mm, and described 3rd external diameter is more than or equal to 10mm and less than or equal to 25mm.
Wherein, the outer surface of described central canal arranges developing line, and described developing line extends along the axis direction of described central canal.
Wherein, described central canal offers multiple intercommunicating pore independent of each other, and one end of one end of described first trachea, one end of described second trachea, one end of described 3rd trachea, one end of described first conduit, one end of described second conduit and described 3rd conduit is fixed to the plurality of intercommunicating pore correspondingly.
Wherein, described central canal offers separate multiple through holes, and the other end of the other end of described first trachea, the other end of described second trachea, the other end of described 3rd trachea, the other end of described first conduit, the other end of described second conduit and described 3rd conduit is correspondingly through the plurality of through hole.
Wherein, described first driving means includes the first air pump and the first controller being connected, described first air pump connects the other end of described first trachea, and described first controller connects described control device, and described first controller is in order to control aeration quantity or the rate of air sucked in required of described first air pump offer;
Described second driving means includes the second air pump and the second controller being connected, described second air pump connects the other end of described second trachea, described second controller connects described control device, and described second controller is in order to control aeration quantity or the rate of air sucked in required of described second air pump offer;
Described 3rd driving means includes the 3rd air pump and the 3rd controller being connected, described 3rd air pump connects the other end of described 3rd trachea, described 3rd controller connects described control device, and described 3rd controller is in order to control aeration quantity or the rate of air sucked in required of described 3rd air pump offer.
Wherein, described control device includes processor, described processor receives, processes the first force value, the second force value of described second pressure tester formation and the 3rd force value of described 3rd pressure tester formation that described first pressure tester is formed, and forms control signal;
Described signal processing apparatus controls signal to described first controller, described second controller and described 3rd controller described in transmitting, in order to regulate the gas volume in described first sacculus, described second sacculus and described 3rd sacculus compared to prior art, the method have the advantages that
Heart-assist device of the present invention is by described first sacculus, described second sacculus and the interoperation of described 3rd sacculus, the circulation of described heart-assist device is made to realize the first state and the second state, and then auxiliary autologous patient heart completes following action: blood samples of patients flows to described intermediate cavity from its heart (usually left ventricle), the power of blood flowing is then provided by the expansion action of described second sacculus, makes the blood in described intermediate cavity continue towards other positions of patient body.In brief, autologous patient heart (usually left ventricle) provides the first power to make blood flow to described intermediate cavity from its heart, described heart-assist device provides the second power to make the blood in described intermediate cavity continue towards other positions of patient body, autologous patient heart does work the most successively with described heart-assist device, so that blood in the patient normally circulates.Therefore, heart-assist device described in the present embodiment can assist patient's heart to do work, it is to avoid produces and produces, due to the deficiency of autologous patient heart acting, the problem that other parts of patient body can not get sufficient blood supply.
Detailed description of the invention
Below in conjunction with the accompanying drawing in the embodiment of the present invention, the technical scheme in the embodiment of the present invention is clearly and completely described, it is clear that described embodiment is only a part of embodiment of the present invention rather than whole embodiments.Based on the embodiment in the present invention, the every other embodiment that those of ordinary skill in the art are obtained under not making creative work premise, broadly fall into the scope of protection of the invention.
See also Fig. 1 to Fig. 3, Fig. 5 and Fig. 7, the embodiment of the present invention provides a kind of heart-assist device, including: the first sacculus the 1, second sacculus 2 and the 3rd sacculus 3 independent of each other, first trachea the 41, second trachea 42 and the 3rd trachea 43 independent of each other, first driving means the 11, second driving means the 12, the 3rd driving means 13 and control device 6.Wherein, forming intermediate cavity 20 between described first sacculus 1 and described 3rd sacculus 3, described second sacculus is placed in described intermediate cavity 20.One end 411 of described first trachea 41 connects described first sacculus 1, and one end 421 of described second trachea 42 connects described second sacculus 2, and one end 431 of described 3rd trachea 43 connects described 3rd sacculus 3.Described first driving means 11 connects the other end 412 of described first trachea 41, in order to described first sacculus 1 is inflated or to be bled, makes described first sacculus 1 expansion or shrinkage;Described second driving means 12 connects the other end 422 of described second trachea 42, in order to described second sacculus 2 is inflated or to be bled, makes described second sacculus 2 expansion or shrinkage;Described 3rd driving means 13 connects the other end 432 of described 3rd trachea 43, in order to described 3rd sacculus 3 is inflated or to be bled, makes described 3rd sacculus 3 expansion or shrinkage.Described control device 6 is used for controlling described first driving means 11, described second driving means 12 and described 3rd driving means 13, the circulation of described heart-assist device is made to realize the first state and the second state, described first state is described first sacculus 1 and described second sacculus 2 shrinks, described 3rd sacculus 3 expands, fluid flows into described intermediate cavity 20, and described second state is that described first sacculus 1 expands, described 3rd sacculus 1 expansion or shrinkage, described second sacculus 2 gradually expand to promote described fluid to flow out described intermediate cavity 20.
nullSpecifically,When heart-assist device described in the present embodiment uses,Described first sacculus 1、Described second sacculus 2 and described 3rd sacculus 3 are installed to the aorta 100 of patient,Described first sacculus 1 is arranged near patient's heart、Described 3rd sacculus 3 is arranged away from patient's heart,Described second sacculus 2 is placed between described first sacculus 1 and described 3rd sacculus 3,And described first sacculus 1 and described 3rd sacculus 3 the most all can cut off the runner in aorta 100,And it is formed close to the nearly chambers of the heart 101 of heart、Away from the adapter cavity 102 between telecentricity chamber 103 and the described nearly chambers of the heart 101 and the described telecentricity chamber 103 of heart (now,Described adapter cavity 102 is described intermediate cavity 20),When described first sacculus 1 shrinks,The described nearly chambers of the heart 101 connects described adapter cavity 102,When described 3rd sacculus 3 shrinks,Described telecentricity chamber 103 connects described adapter cavity 102.Described first trachea 41, described second trachea 42 and described 3rd trachea 43 are external from extending to patient in the patient, it is external that described first driving means 11, described second driving means 12 and described 3rd driving means 13 are positioned over patient, correspondingly described first sacculus 1, described second sacculus 2 and described 3rd sacculus 3 is inflated or is bled.It is external that described control device 6 is also placed in patient, connect and control described first driving means 11, described second driving means 12 and described 3rd driving means 13, the circulation of described heart-assist device is made to realize the first state and the second state, described first state is described first sacculus 1 and described second sacculus 2 shrinks, described 3rd sacculus 3 expands, fluid flows into described adapter cavity 102 (namely described intermediate cavity 20), described second state is that described first sacculus 1 expands, described 3rd sacculus 3 expansion or shrinkage, described second sacculus 2 gradually expands to promote described fluid to flow out described adapter cavity 102 (namely described intermediate cavity 20).
For example: heart-assist device described in the present embodiment coordinates the cardiac cycle of autologous patient heart to be operated.When heart starts to shrink at, described heart-assist device is in described first state: described 3rd sacculus 3 remains inflated for cutting off described adapter cavity 102 and described telecentricity chamber 103, described first sacculus 1 is gradually reduced (preventing from causing the reverse flow of non-cardiac blood, such as head blood because of too fast reducing) with described second sacculus 2, and the blood making heart (usually left ventricle) flow out progresses into described adapter cavity 102 after flowing through the described nearly chambers of the heart 101.When, after heart pinned sheepshank bundle, described heart-assist device is in described second state: described first sacculus 1 expands to cut off the described nearly chambers of the heart 101 and described adapter cavity 102, described second sacculus 2 gradually expands so that the blood in described adapter cavity 102 flows out.Now, if described 3rd sacculus 3 remains inflated for, the blood in the most described adapter cavity 102 flows to connect the blood vessel of described adapter cavity 102;If described 3rd sacculus 3 shrinks, blood part in the most described adapter cavity 102 flows to connect the blood vessel of described adapter cavity 102, the blood vessel in the described telecentricity chamber 103 of part flow direction connection, therefore can be by the distribution condition regulating movement time and state the blood in described adapter cavity 102 controlling described 3rd sacculus 3.More than being the action of a working cycle of described heart-assist device, constantly circulation realizes described first state and described second state according to this.
In sum, heart-assist device described in the present embodiment passes through described first sacculus 1, described second sacculus 2 and the interoperation of described 3rd sacculus 3, the circulation of described heart-assist device is made to realize the first state and the second state, and then auxiliary autologous patient heart completes following action: blood samples of patients flows to described adapter cavity 102 (namely described intermediate cavity 20) from its heart (usually left ventricle), the power of blood flowing is then provided by the expansion action of described second sacculus 2, the blood in described adapter cavity 102 (namely described intermediate cavity 20) is made to continue towards other positions of patient body.In brief, autologous patient heart (usually left ventricle) provides the first power to make blood flow to described adapter cavity 102 (namely described intermediate cavity 20) from its heart, described heart-assist device provides the second power to make the blood in described adapter cavity 102 (namely described intermediate cavity 20) continue towards other positions of patient body, autologous patient heart does work the most successively with described heart-assist device, so that blood in the patient normally circulates.Therefore, heart-assist device described in the present embodiment can assist patient's heart to do work, it is to avoid produces and produces, due to the deficiency of autologous patient heart acting, the problem that other parts of patient body can not get sufficient blood supply.
Further, described heart-assist device can also include the third state, the described third state is between described second state and described first state, the described third state is: after described second sacculus 2 expands completely, described 3rd sacculus 3 expands completely, the most described first sacculus 1 still remains inflated for, and makes the described nearly chambers of the heart 101 keep higher and the long period high diastolic blood pressure state, to ensure myocardial blood flow.Described first state, described second state and the described third state are collectively forming a working cycle of described heart-assist device.
It should be appreciated that heart-assist device described in the present embodiment is mainly used in assisting the left ventricle of patient to do work, therefore heart-assist device described in the present embodiment is alternatively referred to as left ventricular assist device.
Simultaneously, it should be noted that heart-assist device described in the present embodiment, when assisting patient's heart acting, is possible not only to carry out part auxiliary, when the left ventricle of patient cannot be done work, it is also possible to assist completely.Specifically: if the heart of patient can carry out part acting, when heart starts to shrink at, the negative pressure (auxiliary power) that described systaltic malleation (major impetus) and described second sacculus 2 produce after shrinking makes intracardiac blood flow to described adapter cavity 102 simultaneously, and described heart-assist device carries out part auxiliary;If the heart of patient cannot be carried out acting, when heart starts to shrink at, the negative pressure (major impetus) that described second sacculus 2 produces after shrinking makes intracardiac blood flow to described adapter cavity 102, and described heart-assist device assists completely.When described heart-assist device assists completely, it should the volume making the inflatable of described second sacculus 2 or contraction is the biggest so that it is do work the biggest.
Certainly, heart-assist device described in the present embodiment can also complete to be similar to the action of aorta 100 aortic balloon device in prior art, to increase coronary blood confession, reduces heart oxygen consumption, reaches oxygen for the balance needed with oxygen.Such as: at paradoxical expansion, described first sacculus 1, described second sacculus 2 and described 3rd sacculus 3 all remain retracted state, and alteration of left ventricular afterload declines, and alleviates heart oxygen consumption;At diastole, described first sacculus 1 expands, and improves diastolic pressure at the described nearly chambers of the heart 101, increases coronary blood confession, thus increases heart oxygen and supply.Further, described heart-assist device can also be alternately carried out accessory heart acting and increase the action of coronary blood confession.
In the present embodiment, first driving means the 11, second driving means 12 and the inflation action of the 3rd driving means 13 and aeration quantity can proportionally be adjusted, namely the contraction or expansion action of described first sacculus 1, described second sacculus 2 and described 3rd sacculus 3 may each be completely or part.The described nearly chambers of the heart 101, connected relation between described adapter cavity 102 and described telecentricity chamber 103 includes but not limited to situation described in above-described embodiment, can be by regulating described first sacculus 1, described second sacculus 2 and described 3rd sacculus 3 are in installation site in the patient, and the described nearly chambers of the heart 101, connected relation between described adapter cavity 102 and described telecentricity chamber 103 (namely described first sacculus 1, described second sacculus 2 and the contraction or expansion action of described 3rd sacculus 3), make described heart-assist device can be applicable to the blood supply conditions of demand of each body part of different patients.Such as, can be by the position of described second sacculus 2 of regulation with described 3rd sacculus 3, the kidney making patient connects described adapter cavity 102 with abdominal viscera, the lower limb of patient connect described telecentricity chamber 103, by regulating Bulking Time point and the degrees of expansion of described 3rd sacculus 3, suitably to sacrifice lower limb blood supply, exchange kidney blood supply and the guarantee of abdominal viscera blood supply for.
Further, please also refer to Fig. 1 to Fig. 5 and Fig. 7, described heart-assist device also includes: the first conduit the 44, second conduit the 45, the 3rd conduit the 46, first pressure tester the 51, second pressure tester 52 and the 3rd pressure tester 53.Wherein, one end 441 of described first conduit 44 is positioned at described first sacculus 1 side away from described second sacculus 2, namely one end 441 of described first conduit 44 is positioned at the described nearly chambers of the heart 101, makes described first conduit 44 connect the described nearly chambers of the heart 101;One end 451 of described second conduit 45 is between described first sacculus 1 and described second sacculus 2 or between described second sacculus 2 and described 3rd sacculus 3, namely one end 451 of described second conduit 45 is positioned at described adapter cavity 102, described second conduit 45 is made to connect described adapter cavity 102;One end 461 of described 3rd conduit 46 is positioned at described 3rd sacculus 3 side away from described second sacculus 2, namely one end 461 of described 3rd conduit 46 is positioned at described telecentricity chamber 103, makes described 3rd conduit 46 connect described telecentricity chamber 103.Meanwhile, described first pressure tester 51 connects the other end 442 of described first conduit 44, in order to detect the pressure of one end 441 of described first conduit 44, namely is detected the pressure of the described nearly chambers of the heart 101 by described first conduit 44;Described second pressure tester 52 connects the other end 452 of described second conduit 45, in order to detect the pressure of one end 451 of described second conduit 45, namely is detected the pressure of described adapter cavity 102 by described second conduit 45;Described 3rd pressure tester 53 connects the other end 462 of described 3rd conduit 46, in order to detect the pressure of one end 441 of described first conduit 44, namely is detected the pressure in described telecentricity chamber 103 by described 3rd conduit 46.Described first pressure tester 51, described second pressure tester 52 and described second pressure tester 52 are all connected with described control device 6, give described control device 6 with the data signal that transmission is corresponding.
Heart-assist device described in the present embodiment can detect the described nearly chambers of the heart 101, described adapter cavity 102 and the blood pressure in described telecentricity chamber 103, thus provide data with the first driving means 11, described second driving means 12 and the action of described 3rd driving means 13 described in assist control, the interoperation (expansion or shrinkage) making described first sacculus 1, described second sacculus 2 and described 3rd sacculus 3 disclosure satisfy that the real needs of patient, obtains real-time tracking and feedback.
Further, see also Fig. 1 to Fig. 5, described heart-assist device also includes central canal 4, described first sacculus 1, described second sacculus 2 and described 3rd sacculus 3 are each arranged around described central canal 4, and described first trachea 41, described second trachea 42, described 3rd trachea 43, described first conduit 44, described second conduit 45 and described 3rd conduit 46 are arranged at the inside of described central canal 4.The expansion or shrinkage of described first sacculus 1, described second sacculus 2 and described 3rd sacculus 3 is active in one's movements the position relationship of said structure and steadily, the most described first pressure tester 51, described second pressure tester 52 and described 3rd pressure tester 53 can accurately be detected data.
Should be understood that, described first trachea 41, described second trachea 42, described 3rd trachea 43, described first conduit 44, described second conduit 45 and described 3rd conduit 46 can be formed (as shown in Figure 5) by the different chamber of described central canal 4, it is also possible to be to be inserted described central canal 4 by multiple pipes to be formed.In the present embodiment, the shape of described first trachea 41, described second trachea 42, described 3rd trachea 43, described first conduit 44, described second conduit 45 and described 3rd conduit 46 includes but not limited to circle, ellipse, square, fan-shaped etc..
Further, see also Fig. 1 and Fig. 2, a length of first length L1 on described first sacculus 1 X in a first direction, described first direction X is parallel to the axis 40 of described central canal 4, described first sacculus 1 outer diameter length in second direction Y is the first outer diameter D 1, described second direction Y is perpendicular to described first direction X, and described first outer diameter D 1 is more than described first length L1.Described second sacculus 2 a length of second length L2 on described first direction X, and the outer diameter length in described second direction Y is the second outer diameter D 2, described second outer diameter D 2 is less than described second length L2.Described 3rd sacculus 3 a length of 3rd length L3 on described first direction X, and the outer diameter length in described second direction Y is the 3rd outer diameter D 3, described 3rd outer diameter D 3 is more than described 3rd length L3.That is, described first sacculus 1 and described 3rd sacculus 3 are substantially in flat cryptomere, primarily serve the effect of a similar valve, to block or to connect the described nearly chambers of the heart 101 and described adapter cavity 102, described telecentricity chamber 103 and described adapter cavity 102;Described second sacculus 2 is the most cylindrical, and the volume of described expansion or contraction is relatively big, so that described adapter cavity 102 can accommodate more blood, makes the acting of described heart-assist device bigger, in hgher efficiency.
For example, described first length L1 of described first sacculus 1 is more than or equal to 3mm and less than or equal to 10mm, and described first outer diameter D 1 is more than or equal to 10mm and less than or equal to 25mm.Described second length L2 of described second sacculus 2 is more than or equal to 200mm and less than or equal to 350mm, and described second outer diameter D 2 is more than or equal to 10mm and less than or equal to 25mm.Described 3rd length L3 of described 3rd sacculus 3 is more than or equal to 3mm and less than or equal to 10mm, and described 3rd outer diameter D 3 is more than or equal to 10mm and less than or equal to 25mm.
Further, referring to Fig. 4, the outer surface of described central canal 4 arranges developing line 47, and described developing line 47 extends along the direction of the axis 40 of described central canal 4.For example, described central canal 4 includes the first face 401 being oppositely arranged and the second face 402 and connects described first face 401 and the tube wall 405 in described second face 402.The outer surface of described tube wall 405 arranges developing line 47, and described developing line 47 extends to described second face 402 from described first face 401.Described developing line 47 is X-ray developing line, makes the position of described first sacculus 1, described second sacculus 2 and described 3rd sacculus 3 can be determined by X-ray or perspective.Preferably, the segmentation that carries out different in width of described developing line 47 can show, thus further discriminate between the position of each several part being placed in described heart-assist device in the patient.
Further, see also Fig. 1, Fig. 2, Fig. 4 and Fig. 6, described central canal 4 offers multiple intercommunicating pore 403 and multiple through hole 404, and one end 461 of one end 411 of described first trachea 41, one end 421 of described second trachea 42, one end 431 of described 3rd trachea 43, one end 441 of described first conduit 44, one end 451 of described second conduit 45 and described 3rd conduit 46 is fixed to the plurality of intercommunicating pore 403 correspondingly.The other end 462 of the other end 412 of described first trachea 41, the other end 422 of described second trachea 42, the other end 432 of described 3rd trachea 43, the other end 442 of described first conduit 44, the other end 452 of described second conduit 45 and described 3rd conduit 46 is correspondingly through the plurality of through hole 404.The plurality of intercommunicating pore 403 is generally opened on described tube wall 405, and the plurality of through hole 404 is generally opened in described second face 402 or described tube wall 405.
Further, see also Fig. 1, Fig. 2 and Fig. 7, described first driving means 11 includes the first air pump 112 and the first controller 111 being connected, described first air pump 112 connects the other end 412 of described first trachea 41, described first controller 111 connects described control device 6, and described first controller 111 is in order to control aeration quantity or the rate of air sucked in required of described first air pump 112 offer.Described second driving means 12 includes the second air pump 122 and the second controller 121 being connected, described second air pump 122 connects the other end 422 of described second trachea 42, described second controller 121 connects described control device 6, and described second controller 121 is in order to control aeration quantity or the rate of air sucked in required of described second air pump 122 offer.Described 3rd driving means 13 includes the 3rd air pump 132 and the 3rd controller 131 being connected, described 3rd air pump 132 connects the other end 432 of described 3rd trachea 43, described 3rd controller 131 connects described control device 6, and described 3rd controller 131 is in order to control aeration quantity or the rate of air sucked in required of described 3rd air pump 132 offer.Described first controller 111, described second controller 121 and described 3rd controller 131 can be independent of each other, it is also possible to integrate.
Further, see also Fig. 1, Fig. 2 and Fig. 7, described control device 6 also includes processor, described processor receives, processes the first force value S1, the second force value S2 of described second pressure tester 52 formation and the 3rd force value S3 of described 3rd pressure tester 53 formation that described first pressure tester 51 is formed, and forms control signal S4.Described processor transmits described control signal S4 extremely described first controller 111, described second controller 121 and described 3rd controller 131, in order to regulate the gas volume in described first sacculus 1, described second sacculus 2 and described 3rd sacculus 3.
Heart-assist device described in the present embodiment can regulate the interoperation (expansion or shrinkage) of described first sacculus 1, described second sacculus 2 and described 3rd sacculus 3 in real time to meet the real needs of patient, makes patient obtain best therapeutic effect.
Being described in detail the embodiment of the present invention above, principle and the embodiment of the present invention are set forth by specific case used herein, and the explanation of above example is only intended to help to understand method and the core concept thereof of the present invention;Simultaneously for one of ordinary skill in the art, according to the thought of the present invention, the most all will change, in sum, this specification content should not be construed as limitation of the present invention.