1.Analysis of risk factors, pathogenic bacteria characteristics, and drug resistance of postoperative surgical site infection in adults with limb fractures.
Yan-Jun WANG ; Zi-Hou ZHAO ; Shuai-Kun LU ; Guo-Liang WANG ; Shan-Jin MA ; Lin-Hu WANG ; Hao GAO ; Jun REN ; Zhong-Wei AN ; Cong-Xiao FU ; Yong ZHANG ; Wen LUO ; Yun-Fei ZHANG
Chinese Journal of Traumatology 2025;28(4):241-251
PURPOSE:
We carried out the study aiming to explore and analyze the risk factors, the distribution of pathogenic bacteria, and their antibiotic-resistance characteristics influencing the occurrence of surgical site infection (SSI), to provide valuable assistance for reducing the incidence of SSI after traumatic fracture surgery.
METHODS:
A retrospective case-control study enrolling 3978 participants from January 2015 to December 2019 receiving surgical treatment for traumatic fractures was conducted at Tangdu Hospital of Air Force Medical University. Baseline data, demographic characteristics, lifestyles, variables related to surgical treatment, and pathogen culture were harvested and analyzed. Univariate analyses and multivariate logistic regression analyses were used to reveal the independent risk factors of SSI. A bacterial distribution histogram and drug-sensitive heat map were drawn to describe the pathogenic characteristics.
RESULTS:
Included 3978 patients 138 of them developed SSI with an incidence rate of 3.47% postoperatively. By logistic regression analysis, we found that variables such as gender (males) (odds ratio (OR) = 2.012, 95% confidence interval (CI): 1.235 - 3.278, p = 0.005), diabetes mellitus (OR = 5.848, 95% CI: 3.513 - 9.736, p < 0.001), hypoproteinemia (OR = 3.400, 95% CI: 1.280 - 9.031, p = 0.014), underlying disease (OR = 5.398, 95% CI: 2.343 - 12.438, p < 0.001), hormonotherapy (OR = 11.718, 95% CI: 6.269 - 21.903, p < 0.001), open fracture (OR = 29.377, 95% CI: 9.944 - 86.784, p < 0.001), and intraoperative transfusion (OR = 2.664, 95% CI: 1.572 - 4.515, p < 0.001) were independent risk factors for SSI, while, aged over 59 years (OR = 0.132, 95% CI: 0.059 - 0.296, p < 0.001), prophylactic antibiotics use (OR = 0.082, 95% CI: 0.042 - 0.164, p < 0.001) and vacuum sealing drainage use (OR = 0.036, 95% CI: 0.010 - 0.129, p < 0.001) were protective factors. Pathogens results showed that 301 strains of 38 species of bacteria were harvested, among which 178 (59.1%) strains were Gram-positive bacteria, and 123 (40.9%) strains were Gram-negative bacteria. Staphylococcus aureus (108, 60.7%) and Enterobacter cloacae (38, 30.9%) accounted for the largest proportion. The susceptibility of Gram-positive bacteria to Vancomycin and Linezolid was almost 100%. The susceptibility of Gram-negative bacteria to Imipenem, Amikacin, and Meropenem exceeded 73%.
CONCLUSION
Orthopedic surgeons need to develop appropriate surgical plans based on the risk factors and protective factors associated with postoperative SSI to reduce its occurrence. Meanwhile, it is recommended to strengthen blood glucose control in the early stage of admission and for surgeons to be cautious and scientific when choosing antibiotic therapy in clinical practice.
Humans
;
Surgical Wound Infection/epidemiology*
;
Male
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Female
;
Risk Factors
;
Retrospective Studies
;
Middle Aged
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Adult
;
Case-Control Studies
;
Fractures, Bone/surgery*
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Aged
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Drug Resistance, Bacterial
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Logistic Models
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Anti-Bacterial Agents/therapeutic use*
;
Incidence
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Bacteria/drug effects*
2.Effects of human umbilical cord-derived mesenchymal stem cell therapy for cavernous nerve injury-induced erectile dysfunction in the rat model.
Wei WANG ; Ying LIU ; Zi-Hao ZHOU ; Kun PANG ; Jing-Kai WANG ; Peng-Fei HUAN ; Jing-Ru LU ; Tao ZHU ; Zuo-Bin ZHU ; Cong-Hui HAN
Asian Journal of Andrology 2025;27(4):508-515
Stem cell treatment may enhance erectile dysfunction (ED) in individuals with cavernous nerve injury (CNI). Nevertheless, no investigations have directly ascertained the implications of varying amounts of human umbilical cord-derived mesenchymal stem cells (HUC-MSCs) on ED. We compare the efficacy of three various doses of HUC-MSCs as a therapeutic strategy for ED. Sprague-Dawley rats (total = 175) were randomly allocated into five groups. A total of 35 rats underwent sham surgery and 140 rats endured bilateral CNI and were treated with vehicles or doses of HUC-MSCs (1 × 10 6 cells, 5 × 10 6 cells, and 1 × 10 7 cells in 0.1 ml, respectively). Penile tissues were harvested for histological analysis on 1 day, 3 days, 7 days, 14 days, 28 days, 60 days, and 90 days postsurgery. It was found that varying dosages of HUC-MSCs enhanced the erectile function of rats with bilateral CNI and ED. Moreover, there was no significant disparity in the effectiveness of various dosages of HUC-MSCs. However, the expression of endothelial markers (rat endothelial cell antigen-1 [RECA-1] and endothelial nitric oxide synthase [eNOS]), smooth muscle markers (alpha smooth muscle actin [α-SMA] and desmin), and neural markers (neurofilament [RECA-1] and neurogenic nitric oxide synthase [nNOS]) increased significantly with prolonged treatment time. Masson's staining demonstrated an increased in the smooth muscle cell (SMC)/collagen ratio. Significant changes were detected in the microstructures of various types of cells. In vivo imaging system (IVIS) analysis showed that at the 1 st day, the HUC-MSCs implanted moved to the site of damage. Additionally, the oxidative stress levels were dramatically reduced in the penises of rats administered with HUC-MSCs.
Male
;
Animals
;
Erectile Dysfunction/metabolism*
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Rats, Sprague-Dawley
;
Mesenchymal Stem Cell Transplantation/methods*
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Rats
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Penis/pathology*
;
Humans
;
Disease Models, Animal
;
Umbilical Cord/cytology*
;
Peripheral Nerve Injuries/complications*
;
Mesenchymal Stem Cells
;
Nitric Oxide Synthase Type III/metabolism*
;
Actins/metabolism*
;
Nitric Oxide Synthase Type I/metabolism*
3.Synthesis and antibacterial activities of phosphonate derivatives containing aminothiazoloxime fragment
Yang-mi CHEN ; Yan AN ; Xiang-tao DONG ; Zi-cong LU ; Jia-qiang YANG
Acta Pharmaceutica Sinica 2024;59(1):161-165
Based on the principle of molecular hybridization, fifteen compounds were designed and synthesized through the combination of aminothiazoloxime and phosphonate fragment. The results showed that these compounds had better inhibitory effects on the tested bacteria. In particular, the activities of compounds
4.Clinical management of refractory prolactinomas:stone to sharpen yan,blunt for profit
Rui-Feng WANG ; Xiao-Zhen YE ; Jian-Rui LI ; Jing LI ; Jia-Liang LI ; Zi-Xiang CONG ; Yan LU ; Nan WU ; Yi-Feng GE ; Chi-Yuan MA ; Jia-Qing SHAO
Medical Journal of Chinese People's Liberation Army 2024;49(11):1237-1243
Refractory prolactinoma is the most common pituitary neuroendocrine tumor.Dopamine receptor agonists(DA)are the primary choice for drug treatment.Most patients with prolactinomas respond well to DA.However,a minority of prolactinomas patients still show resistance to DA.Although drug-resistant and refractory prolactinomas are rare in clinical practice,their treatment is extremely challenging.Even a combination of drug therapy,multiple surgeries,and radiotherapy may not yield satisfactory outcomes.Therefore,standardizing the diagnosis and treatment process and pathway for refractory prolactionmas and exploring more effective multidisciplinary collaborative treatment strategies are urgent problems to be solved.In the clinical management of refractory prolactinomas,it is often necessary to consider the patient's condition comprehensively,replace other types of DA,or consider surgery,radiotherapy,and immunotherapy,which requires multidisciplinary diagnosis and treatment.This review synthesizes the latest literature at home and abroad to systematically discuss the latest advances in drug therapy,surgery,and radiotherapy treatments for refractory prolactionmas,aiming to provide new ideas for basic research,clinical diagnosis and treatment.
5.Design of medical UV lamp control system based on development board
Jian-Ning DU ; Dong-Sheng LU ; Cong JIN ; Zi-Han LIN ; Ran WANG ; Min ZHANG
Chinese Medical Equipment Journal 2023;44(12):114-117
Objective To design a medical ultraviolet lamp control system based on a development board to achieve remote control and usage time recording of medical UV lamps.Methods The system was composed of a WeMos D1 mini development board,a 1-way relay module,an OLED display,a RCWL-0516 microwave radar sensor and an ACS712 current monitoring module,which had its control program written by integrated development environment(Arduino IDE).Results Tests proved the system developed functioned well in timed disinfection,manual disinfection and system timing;the ACS712 current monitoring module could detect the lamp failure and current failure;the system could immediately turn off the ultraviolet lamp when persons entered the space to be disinfected;the medical staff could be prompted to replace the lamp when it's about to run out of expiration date.Conclusion The medical UV lamp control system developed gains advantages in easy operation and low cost,and realizes remote control and usage time recording of medical UV lamps.
6.Protective Effect of Total Ginsenoside Ginseng Root on Learning and Memory Impairment and Anxiety in Rats Induced by Hindlimb Suspension
Yu BAO ; Ying CHEN ; Gui-rong ZENG ; Zi-yu YANG ; Rui-le PAN ; Zhe SHI ; Qin HU ; Jing-wei LYU ; Cong LU ; Yang HE ; Ning JIANG ; Bo PENG ; Xin-min LIU ; Lian-kui WEN
Chinese Journal of Experimental Traditional Medical Formulae 2021;27(7):49-56
Objective:To investigate the effect of total ginsenoside ginseng root on the learning and memory impairment and anxiety of hindlimb suspension rats by detecting the performance of rats in the water maze, elevated plus maze, and the expression of hypothalamic-pituitary-adrenal (HPA) axis, inflammatory factors and tryptophan pathway related factors through the intervention of ginsenosides in hindlimb suspension rats. Method:The Wistar male rats were divided into normal group, hindlimb suspension model group, Huperzine A group (0.1 mg·kg-1), and total ginsenoside ginseng root low and high dose groups (100, 200 mg·kg-1), with 8 rats in each group. Except for the normal group, the rats in the other groups maintained a -30° hindlimb suspension state for 24 h. The normal group and the model group received intragastric administration of 10 mL·kg-1 pure water . After 28 days of continuous administration, the water maze and elevated plus maze behavioral tests were performed. After the tests, blood was taken from the abdominal aorta, and the rat brain cortex was peeled off on ice, quenched with liquid nitrogen, and stored at -80 ℃ for later use. LC-MS/MS was used to detect neurotransmitter levels of dopamine, acetylcholine, glutamate,
7.Prescription Law of New Coronavirus Pneumonia in Different Stages
Lu-hua XU ; Yan-rong LI ; Dan-ru ZHENG ; Zong-fang SHAO ; Si-qi WEN ; Feng-xia LIN ; Zi-cong ZENG ; Yin-zhi SONG
Chinese Journal of Experimental Traditional Medical Formulae 2020;26(13):8-16
Objective:To study the clinical medication regulation for the prevention and treatment of new coronavirus pneumonia with traditional Chinese medicine(TCM),especially prescriptions,on the basis of "treatment in accordance with seasonal conditions". Method:The guidelines and suggestions on novel coronavirus pneumonia formulated and published by national,provincial and municipal governments and experts before February 17,2020, were retrieved and summarized. Data was recorded in stages according to "prevention period,clinical observation period,pre-clinical period,middle clinical period,late clinical period and recovery period". The frequency analysis of TCM and its efficacy,prescription and proprietary Chinese medicine was carried out,and then the factor analysis and cluster analysis of TCM were carried out to obtain rational drug combinations. Result:Totally 172 suggestions on combined structure of drugs,50 suggestions on prescriptions and 31 suggestions on proprietary Chinese medicine were involved in the study,and provided by 24 official agencies and 24 medical experts, 147 kinds of herbs,44 prescriptions and 16 proprietary Chinese medicines were collected. No matter for the drug category or for the specific drug selection,the law of drug use in different stages was not the same. Huoxiang Zhengqi capsule,Shufeng Jiedu capsule,Lianhua Qingwen capsule and Jinhua Qinggan capsule can be used in the observation period. Xuanbai Chengqitang can be used in the middle of the disease. Angong Niuhuangwan,Suhexiangwan or Zixuedan, and Angong Niuhuangwan can be selected in the middle of the disease. And Qingfei Paidu decoction can be used in all stages of the disease. Conclusion:Doctors need to adjust their prescriptions along with the progress of the disease,because the law of medication in each stage of the new coronavirus pneumonia is different.
8.Clinical and muscle magnetic resonance image findings in patients with late-onset multiple acyl-CoA dehydrogenase deficiency.
Dao-Jun HONG ; Min ZHU ; Zi-Juan ZHU ; Lu CONG ; Shan-Shan ZHONG ; Ling LIU ; Jun ZHANG
Chinese Medical Journal 2019;132(3):275-284
BACKGROUND:
Late-onset multiple acyl-coA dehydrogenase deficiency (MADD) is an autosomal recessive inherited metabolic disorder. It is still unclear about the muscle magnetic resonance image (MRI) pattern of the distal lower limb pre- and post-treatment in patients with late-onset MADD. This study described the clinical and genetic findings in a cohort of patients with late-onset MADD, and aimed to characterize the MRI pattern of the lower limbs.
METHODS:
Clinical data were retrospectively collected from clinic centers of Peking University People's Hospital between February 2014 and February 2018. Muscle biopsy, blood acylcarnitines, and urine organic acids profiles, and genetic analysis were conducted to establish the diagnosis of MADD in 25 patients. Muscle MRI of the thigh and leg were performed in all patients before treatment. Eight patients received MRI re-examinations after treatment.
RESULTS:
All patients presented with muscle weakness or exercise intolerance associated with variants in the electron transfer flavoprotein dehydrogenase gene. Muscle MRI showed a sign of both edema-like change and fat infiltration selectively involving in the soleus (SO) but sparing of the gastrocnemius (GA) in the leg. Similar sign of selective involvement of the biceps femoris longus (BFL) but sparing of the semitendinosus (ST) was observed in the thigh. The sensitivity and specificity of the combination of either "SO+/GA-" sign or "BFL+/ST-" sign for the diagnosis of late-onset MADD were 80.0% and 83.5%, respectively. Logistic regression model supported the findings. The edema-like change in the SO and BFL muscles were quickly recovered at 1 month after treatment, and the clinical symptom was also relieved.
CONCLUSIONS
This study expands the clinical and genetic spectrums of late-onset MADD. Muscle MRI shows a distinct pattern in the lower limb of patients with late-onset MADD. The dynamic change of edema-like change in the affected muscles might be a potential biomarker of treatment response.
Adolescent
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Adult
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Biopsy
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methods
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Carnitine
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analogs & derivatives
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blood
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Electron-Transferring Flavoproteins
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genetics
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Female
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Hamstring Muscles
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diagnostic imaging
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metabolism
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pathology
;
Humans
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Iron-Sulfur Proteins
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genetics
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Magnetic Resonance Imaging
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methods
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Male
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Middle Aged
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Multiple Acyl Coenzyme A Dehydrogenase Deficiency
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diagnostic imaging
;
genetics
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pathology
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Muscle, Skeletal
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diagnostic imaging
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metabolism
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pathology
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Oxidoreductases Acting on CH-NH Group Donors
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genetics
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Retrospective Studies
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Young Adult
9. Effect of Zuoguiwan in Improving BMD and Trabecular Bone Microarchitecture in Ovariectomy-induced Osteoporosis Rats by Regulating RANKL/OPG Pathway Mediated by β2AR
Fei-xiang LIU ; Zi-xuan LIN ; Dao-ming XU ; Su-min YE ; Ming-yue ZHANG ; Qiao-ling FAN ; Feng TAN ; Xing LI ; Yi CHAI ; Cong-ying MAI ; Sheng-feng LU
Chinese Journal of Experimental Traditional Medical Formulae 2019;25(18):1-8
Objective: To investigate the mechanism of Zuoguiwan in treating ovariectomy-induced osteoporosis rats by receptor activator of nuclear factor kappa-B ligand (RANKL)/osteoprotegerin (OPG) signaling pathway mediated by β2-adrenergic receptor (β2AR). Method: Forty Sprague-Dawley female rats were randomly divided into Sham-operated group (Sham) and four ovariectomized (OVX) subgroups. Rats in Sham and OVX groups were treated with 17β-estradiol (50 μg·kg-1·d-1), and low and high-dose ZGW (2.3,4.6 g·kg-1 lyophilized powder) for 3 months, respectively. Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum markers of bone turnover. Micro-CT was used to evaluate and measure trabecular bone microarchitecture and bone mineral density (BMD) of the right distal femur. Western blot analysis and Real-time PCR were used to measure mRNA and protein expressions of β2AR, OPG and RANKL. Result: After 12 weeks of treatment with Zuoguiwan, the level of serum β-cross-linked c-telopeptide of type Ι collagen (β-CTX) (P<0.01) was lower, while the level of serum bone-specific alkaline phosphatase (BALP) was higher (P<0.01) than those in the OVX group. Moreover, it could prevent the OVX-induced bone loss, and alleviate the trabecular bone microarchitecture of distal femur. Furthermore, Zuoguiwan could up-regulate the mRNA and protein expressions of OPG in tibia of the Zuoguiwan groups(P<0.01), reduce the mRNA and protein expressions of β2AR in the hypothalamus (P<0.01), and down-regulated the mRNA and protein expressions of RANKL (P<0.05) in the tibia, compared with those in the OVX group. Conclusion: The mechanism of Zuoguiwan in alleviating BMD and trabecular bone microarchitecture in ovariectomy-induced osteoporosis rats might be related to the regulation of RANKL/OPG Pathway mediated by β2AR.
10.Electro-acupuncture regulates the cholinergic anti-inflammatory pathway in a rat model of chronic obstructive pulmonary disease.
Xin-Fang ZHANG ; Shui-Ying XIANG ; Wen-Ye GENG ; Wen-Juan CONG ; Jing LU ; Chuan-Wei JIANG ; Kun WANG ; Zi-Bing LIU
Journal of Integrative Medicine 2018;16(6):418-426
OBJECTIVEAcupuncture has a definite therapeutic effect on chronic obstructive pulmonary disease (COPD), and the cholinergic anti-inflammatory pathway (CAP) has been shown to be involved in regulation of inflammation. In this study, we investigated whether electro-acupuncture (EA) affects the CAP in COPD.
METHODSSprague-Dawley rats were induced into COPD through exposure to cigarette smoke combined with lipopolysaccharide. EA treatment was applied at Zusanli (ST36) and Feishu (BL13) points for 30 min/d for 7 d. Seventy-two rats were randomly divided into six study groups, including normal, normal + EA, normal + α-bungarotoxin (α-BGT) (the antagonist of the nicotinic acetylcholine receptor α7 subunit (α7nAChR)) + EA, COPD, COPD + EA, and COPD + α-BGT + EA. Lung function, pathology and vagus nerve discharge were tested. The levels of acetylcholine (ACh), acetylcholinesterase (AChE), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in bronchoalveolar lavage fluid (BALF) and lung tissue were measured by enzyme-linked immunosorbent assay. The mRNA and protein expression and immunoreactivity of α7nAChR and its postreceptor inflammation signal pathway, including janus kinase 2 (JAK2), signal transducers and activators of transcription 3 (STAT3), nuclear factor-κB (NF-κB), were observed by quantitative reverse transcription-polymerase chain reaction, Western blot and immunohistochemistry.
RESULTSCompared with normal rats, there were a significant decline in lung function and discharge of the vagus nerve (P < 0.01), a marked sign of lung inflammation and an increase of ACh, AChE, IL-6 and TNF-α level in BALF or lung tissue (P < 0.05, P < 0.01) and higher expression of α7nAChR, JAK2, STAT3 and NF-κB (P < 0.05, P < 0.01) in the COPD rats. In rats receiving EA, the lung function and vagal discharge were enhanced (P < 0.01), lung inflammation was improved and the levels of ACh, AChE, IL-6 and TNF-α were decreased (P < 0.01). Further, the expression of α7nAChR, JAK2, STAT3 and NF-κB was downregulated (P < 0.05, P < 0.01). However, the above effects of EA were blocked in rats injected with α-BGT (P < 0.01).
CONCLUSIONEA treatment can reduce the lung inflammatory response and improve lung function in COPD, which may be related to its involvement in the regulation of CAP.

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