1.Association between cardiometabolic diseases and quality of life and the mediation effect of perceived stress.
Ya Ling ZHAO ; Hao HUANG ; Jiao MA ; Qian ZHANG ; Ya Qiong WANG ; Chen Jie SUN ; Ziyi YANG ; Lei Lei PEI ; Fang Yao CHEN ; Yuan GAO ; Zu Yi YUAN ; Yi Hui XIAO
Chinese Journal of Cardiology 2023;51(7):709-715
		                        		
		                        			
		                        			Objective: To explore the association between cardiometabolic diseases (CMD) and quality of life, the association between CMD and perceived stress, and the mediation effect of perceived stress on the association between CMD and quality of life, and to provide evidence for the prevention and treatment of CMD and the improvement of quality of life in these patients. Methods: This is a cross-sectional study. Data were collected by the employees' physical examination of a company in Xi'an in 2021. Multiple linear regression models were used to analyze the association between the status of CMD (divided into three categories: no CMD, presence of one kind of CMD, and with≥2 kinds of CMD (≥2 kinds of CMD were defined as cardiometabolic multimorbidity (CMM)), quality of life, and perceived stress. Mediation analysis with a multi-categorical independent variable was conducted to determine the mediation effect of perceived stress on the association between CMD and quality of life. Results: Among all 4 272 participants, 1 457 (34.1%) participants had one kind of CMD and 677 (15.8%) participants had CMM. The average scores for quality of life and perceived stress were (57.5±15.7) and (16.9±7.9), respectively. Compared with participants without CMD, after adjusting for demographic and lifestyle factors, no statistically significant associations were observed between one kind of CMD and perceived stress or quality of life (both P>0.05). Perceived stress did not mediate the association between one kind of CMD and quality of life. However, participants with CMM had lower quality of life and higher perceived stress than participants without CMD. The relative total effect coefficient c (95%CI) and the relative direct effect coefficient c' (95%CI) between CMM and quality of life were -3.71 (-5.04--2.37) and -2.52 (-3.81--1.24) (both P<0.05), respectively. The relative indirect effect coefficient a2b (95%CI) of perceived stress on the association between CMM and quality of life was -1.18 (-1.62--0.77) (P<0.05). The mediation effect size was 31.8%. Conclusions: CMM is negatively associated with quality of life and positively associated with perceived stress. Perceived stress partially mediates the association between CMM and quality of life. Our results suggest that, in addition to preventing and treating CMM actively, efforts should be taken to relieve the perceived stress of people with CMM to improve their quality of life.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Quality of Life
		                        			;
		                        		
		                        			Cross-Sectional Studies
		                        			;
		                        		
		                        			Cardiovascular Diseases/complications*
		                        			;
		                        		
		                        			Stress, Psychological
		                        			
		                        		
		                        	
2.Efficacy and safety of various doses of hybutimibe monotherapy or in combination with atorvastatin for primary hypercholesterolemia: a multicenter, randomized, double-blind, double-dummy, parallel-controlled phase Ⅲ clinical trial.
Si Yu CAI ; Xiang GU ; Pei Jing LIU ; Rong Shan LI ; Jian Jun JIANG ; Shui Ping ZHAO ; Wei YAO ; Yi Nong JIANG ; Yue Hui YIN ; Bo YU ; Zu Yi YUAN ; Jian An WANG
Chinese Journal of Cardiology 2023;51(2):180-187
		                        		
		                        			
		                        			Objective: To evaluate the efficacy and safety of hybutimibe monotherapy or in combination with atorvastatin in the treatment of primary hypercholesterolemia. Methods: This was a multicenter, randomized, double-blind, double-dummy, parallel-controlled phase Ⅲ clinical trial of patients with untreated primary hypercholesterolemia from 41 centers in China between August 2015 and April 2019. Patients were randomly assigned, at a ratio of 1∶1∶1∶1∶1∶1, to the atorvastatin 10 mg group (group A), hybutimibe 20 mg group (group B), hybutimibe 20 mg plus atorvastatin 10 mg group (group C), hybutimibe 10 mg group (group D), hybutimibe 10 mg plus atorvastatin 10 mg group (group E), and placebo group (group F). After a dietary run-in period for at least 4 weeks, all patients were administered orally once a day according to their groups. The treatment period was 12 weeks after the first dose of the study drug, and efficacy and safety were evaluated at weeks 2, 4, 8, and 12. After the treatment period, patients voluntarily entered the long-term safety evaluation period and continued the assigned treatment (those in group F were randomly assigned to group B or D), with 40 weeks' observation. The primary endpoint was the percent change in low density lipoprotein cholesterol (LDL-C) from baseline at week 12. Secondary endpoints included the percent changes in high density lipoprotein cholesterol (HDL-C), triglyceride (TG), apolipoprotein B (Apo B) at week 12 and changes of the four above-mentioned lipid indicators at weeks 18, 24, 38, and 52. Safety was evaluated during the whole treatment period. Results: Totally, 727 patients were included in the treatment period with a mean age of (55.0±9.3) years old, including 253 males. No statistical differences were observed among the groups in demographics, comorbidities, and baseline blood lipid levels. At week 12, the percent changes in LDL-C were significantly different among groups A to F (all P<0.01). Compared to atorvastatin alone, hybutimibe combined with atorvastatin could further improve LDL-C, TG, and Apo B (all P<0.05). Furthermore, there was no significant difference in percent changes in LDL-C at week 12 between group C and group E (P=0.991 7). During the long-term evaluation period, there were intergroup statistical differences in changes of LDL-C, TG and Apo B at 18, 24, 38, and 52 weeks from baseline among the statins group (group A), hybutimibe group (groups B, D, and F), and combination group (groups C and E) (all P<0.01), with the best effect observed in the combination group. The incidence of adverse events was 64.2% in the statins group, 61.7% in the hybutimibe group, and 71.0% in the combination group during the long-term evaluation period. No treatment-related serious adverse events or adverse events leading to death occurred during the 52-week study period. Conclusions: Hybutimibe combined with atorvastatin showed confirmatory efficacy in patients with untreated primary hypercholesterolemia, which could further enhance the efficacy on the basis of atorvastatin monotherapy, with a good overall safety profile.
		                        		
		                        		
		                        		
		                        			Male
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Atorvastatin/therapeutic use*
		                        			;
		                        		
		                        			Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use*
		                        			;
		                        		
		                        			Hypercholesterolemia/drug therapy*
		                        			;
		                        		
		                        			Cholesterol, LDL/therapeutic use*
		                        			;
		                        		
		                        			Anticholesteremic Agents/therapeutic use*
		                        			;
		                        		
		                        			Treatment Outcome
		                        			;
		                        		
		                        			Triglycerides
		                        			;
		                        		
		                        			Apolipoproteins B/therapeutic use*
		                        			;
		                        		
		                        			Double-Blind Method
		                        			;
		                        		
		                        			Pyrroles/therapeutic use*
		                        			
		                        		
		                        	
3.Application and modern research progress of sea buckthorn leaves.
Yue LI ; Qing LIU ; Yue WANG ; Yuan-Hu ZU ; Zhi-Hong WANG ; Chun-Nian HE ; Pei-Gen XIAO
China Journal of Chinese Materia Medica 2021;46(6):1326-1332
		                        		
		                        			
		                        			Sea buckthorn(Hippophae rhamnoides) is widely distributed, with abundant resources, a long history of application, and rich nutrition and high medicinal value. Therefore, it has attracted extensive attention from researchers at home and abroad. The focus of attention is mainly on sea buckthorn fruit, but with weak research and development of sea buckthorn leaves. In order to develop and utilize abundant resources of sea buckthorn leaves, this paper systematically reviewed domestic and foreign literatures and summarized the current application, harvesting and processing, chemical constituents and pharmacological activities of sea buckthorn leaves. Sea buckthorn leaves have a wide development and utilization value in food raw materials(like a substituting-for-tea plant), pharmaceutical raw materials and animal feed. Modern studies have shown that the leaves of sea buckthorn are rich in polysaccharides, flavonoids, polyphenols, triterpenes and steroids, as well as vitamins(especially vitamin C), proteins, amino acids and mineral elements. It has various pharmacological effects, such as anti-obesity, hypoglycemia, anti-oxidation, antibacterial, anti-inflammatory and anti-cardiovascular diseases. Domestic and foreign studies have showed that sea buckthorn leaves have important development and utilization prospects, and are worth further study and development.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Flavonoids
		                        			;
		                        		
		                        			Fruit
		                        			;
		                        		
		                        			Hippophae
		                        			;
		                        		
		                        			Plant Leaves
		                        			;
		                        		
		                        			Polyphenols
		                        			
		                        		
		                        	
4.Design of moxibustion device for experimental rabbits.
Pei-Dong HUANG ; Xin-Yue WANG ; Zheng ZUO ; Wei YI ; Hai-Jing LIU ; Zu-Hong WANG ; Yun-Wu JIANG
Chinese Acupuncture & Moxibustion 2019;39(9):1024-1026
		                        		
		                        			
		                        			An experimental device is designed to solve the problem of fixing rabbits and providing moxibustion treatment at the same time. The device includes a rabbit fixing box and a moxibustion shelf. The rabbit fixing box and the moxibustion shelf are detachable, and could be used for moxibustion at the chest-back and abdomen of rabbits. A moxibustion device is placed on the moxibustion shelf. The moxibustion device can be moved forward, backward, leftward, rightward, upward and downward on the moxibustion shelf. It meets the requirements of moxibustion at multiple meridians or acupoints on the chest-back and abdomen at the same time. The moxibustion device is equipped with moxa cone or stick, which not only ensures the full burning of moxa, but also prevents the falling of moxa from hurting rabbits. In conclusion, the device has novel and unique structure, is safe and reliable, and easy to operate. It is an innovation in the experimental device of moxibustion, which could promote the animal experiment of moxibustion.
		                        		
		                        		
		                        		
		                        			Acupuncture Points
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Meridians
		                        			;
		                        		
		                        			Moxibustion
		                        			;
		                        		
		                        			instrumentation
		                        			;
		                        		
		                        			Rabbits
		                        			
		                        		
		                        	
5.Secondary metabolites of petri-dish cultured Antrodia camphorata and their hepatoprotective activities against alcohol-induced liver injury in mice.
Yu WU ; Wen-Jing TIAN ; Shuo GAO ; Zu-Jian LIAO ; Guang-Hui WANG ; Jir-Mehng LO ; Pei-Hsin LIN ; De-Quan ZENG ; Da-Ren QIU ; Xiang-Zhong LIU ; Mi ZHOU ; Ting LIN ; Hai-Feng CHEN
Chinese Journal of Natural Medicines (English Ed.) 2019;17(1):33-42
		                        		
		                        			
		                        			Antrodia camphorata, a well-known and highly valued edible medicinal mushroom with intriguing activities like liver protection, has been traditionally used for the treatment of alcoholic liver disease. A. camphorata shows highly medicinal and commercial values with the demand far exceeds the available supply. Thus, the petri-dish cultured A. camphorata (PDCA) is expected to develope as a substitute. In this paper, nineteen triterpenes were isolated from PDCA, and thirteen of them were the unique anthroic acids in A. camphorata, including the main content antcin K, which suggested that PDCA produced a large array of the same anthroic acids as the wild one. Furthermore, no obvious acute toxicity was found suggesting the edible safety of PDCA. In mice alcohol-induced liver injury model, triglyceride (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and malondialdehyde (MDA) had been reduced by the PDCA powder as well as the main content antcin K, which indicated that the PDCA could protect alcoholic liver injury in mice model and antcin K could be the effective component responsible for the hepatoprotective activities of PDCA against alcoholic liver diseases.
		                        		
		                        		
		                        		
		                        			Alanine Transaminase
		                        			;
		                        		
		                        			blood
		                        			;
		                        		
		                        			Aldehyde Dehydrogenase
		                        			;
		                        		
		                        			blood
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Antrodia
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Aspartate Aminotransferases
		                        			;
		                        		
		                        			blood
		                        			;
		                        		
		                        			Biological Products
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			pharmacology
		                        			;
		                        		
		                        			therapeutic use
		                        			;
		                        		
		                        			Chemical and Drug Induced Liver Injury
		                        			;
		                        		
		                        			etiology
		                        			;
		                        		
		                        			prevention & control
		                        			;
		                        		
		                        			Cholestenes
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			pharmacology
		                        			;
		                        		
		                        			therapeutic use
		                        			;
		                        		
		                        			Cholesterol, VLDL
		                        			;
		                        		
		                        			blood
		                        			;
		                        		
		                        			Disease Models, Animal
		                        			;
		                        		
		                        			Ethanol
		                        			;
		                        		
		                        			toxicity
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Fruiting Bodies, Fungal
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Liver
		                        			;
		                        		
		                        			drug effects
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			pathology
		                        			;
		                        		
		                        			Liver Diseases, Alcoholic
		                        			;
		                        		
		                        			prevention & control
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Malondialdehyde
		                        			;
		                        		
		                        			blood
		                        			;
		                        		
		                        			Mice
		                        			;
		                        		
		                        			Molecular Structure
		                        			;
		                        		
		                        			Triglycerides
		                        			;
		                        		
		                        			blood
		                        			;
		                        		
		                        			Triterpenes
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			pharmacology
		                        			;
		                        		
		                        			therapeutic use
		                        			
		                        		
		                        	
6.Research advance in chemical compounds,pharmacological action and clinical application of Dengzhan Shengmai Capsules.
Xue-Mei MU ; Nan MI ; Xian-Peng ZU ; Ji YE ; Pei-Ming YANG ; Wei-Dong ZHANG
China Journal of Chinese Materia Medica 2019;44(18):3917-3923
		                        		
		                        			
		                        			Dengzhan Shengmai Capsules( DZSMC),a well-known traditional Chinese medicine( TCM) formula,is comprised of the main drug of Erigeron breviscapus,and supplemented with Panax ginseng,Ophiopogon japonicus and Schisandra chinensis,with functions of supplementing Qi and nourishing Yin,promoting blood circulation and strengthening brain. DZSMC is the only Chinese patent drug with A-level evidence-based medicine in secondary prevention for stroke and ranks first among TCMs for neurological treatment. Modern studies indicate that the chemical constituents of DZSMC mainly include flavonoids,phenolic acids,lignans,saponins and so on. Pharmacological experimental studies have shown that DZSMC has such pharmacological effects as anti-oxidation,anti-inflammatory and anti-myocardial ischemia. DZSMC is mainly used in the convalescent care of ischemic cardiovascular and cerebrovascular diseases,and is often used in combination with various conventional therapeutic drugs to exert clinical efficacy through brain protection,neuroprotection,etc.,and improve clinical symptoms in patients. In this review,according to domestic and international related literature combined with research results obtained by our project,the research advances in the chemical constituents,pharmacological effects and clinical application of DZSMC have been systematically reviewed and summarized,providing reference and support for further study and secondary development of the formula.
		                        		
		                        		
		                        		
		                        			Drugs, Chinese Herbal/pharmacology*
		                        			;
		                        		
		                        			Erigeron/chemistry*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Medicine, Chinese Traditional
		                        			;
		                        		
		                        			Ophiopogon
		                        			;
		                        		
		                        			Panax
		                        			;
		                        		
		                        			Phytochemicals/pharmacology*
		                        			;
		                        		
		                        			Phytotherapy
		                        			;
		                        		
		                        			Schisandra
		                        			
		                        		
		                        	
7.Therapeutic effect of a new posterior chamber intraocular lens implantation for high myopia with low astigmatism
Hua FAN ; Peng JI ; Pei-Pei ZU ; Hong-Sheng BI ; Xing-Rong WANG ; Dong-Mei LIU
International Eye Science 2018;18(7):1346-1348
		                        		
		                        			
		                        			·AIM: To observe the efficacy and safety of a new posterior chamber intraocular lens ( ICMO V4c ) implantation in patients with high myopia and low astigmatism and to provide reference for the clinical diagnosis and treatment of these patients. ·METHODS: The study was to analyze the clinical data of patients with high myopia who underwent ICMO V4c implantation with low degree of astigmatism in our hospital from January 2015 to December 2016. The patients were followed up for 1, 3 and 6mo after operation. The items we analyzed including preoperative and postoperative uncorrected visual acuity ( UCVA) and best corrected visual acuity ( BCVA), diopter, spherical and cylinder equivalent, and manifest refraction spherical equivalent ( MRSE ), intraocular pressure ( IOP ), endothelial cell counting, anterior chamber depth (ACD), arch height and postoperative complications. ·RESULTS: Postoperative UCVA and BCVA improved compared with preoperative, and the difference between preoperative and postoperative was statistically significant (P<0. 05). All spherical and cylinder equivalent, and MRSE were reduced after surgery ( t = 38. 510, 20. 100, 34. 300; P<0. 01). The mean intraocular pressure increased at 1 and 3mo after operation ( t= 3. 998, 2. 837, all P<0. 05), but it returned to normal at 6mo ( t=0. 383, P>0. 05). The corneal endothelium counts in the patients at 3mo and 6mo after surgery were lower than those before surgery (t= 2. 119, 2. 411; all P<0. 05). The depth of anterior chamber was reduced to a certain extent within 6mo after operation, and recovered after surgery at 6mo after surgery, but it was still lower than the preoperative level (t=5. 850, 5. 260, 2. 556; all P<0. 05). The overall level of ocular arch after operation was stable and no significant fluctuations were observed. The incidence of postoperative complications in the surgical eye was low and significantly improved after active treatment. ·CONCLUSION: The new posterior chamber intraocular lens implantation in the treatment of high myopia with low astigmatism reaches satisfaction with less complications, is a good supplement to corneal refractive surgery.
		                        		
		                        		
		                        		
		                        	
8.Observations on the Therapeutic Effect of Kinetic Rectification Acupuncture on Acute Facial Neuritis
Zu-Hong WANG ; Chun-Yan GUO ; Pei-Dong HUANG ; You-Ling LONG ; Rong YI ; Xiao-Rong DUAN ; Li LI
Shanghai Journal of Acupuncture and Moxibustion 2018;37(2):205-208
		                        		
		                        			
		                        			Objective To investigate the clinical efficacy of kinetic rectification acupuncture in treating acute facial neuritis. Method Sixty patients with acute facial neuritis were randomized to observation and control groups. The observation group received kinetic rectification acupuncture and the control group, conventional acupuncture alone. Acupuncture was given five times a week, five times as one course. The therapeutic effects were evaluated after three courses of treatment. Result The total efficacy rate was 93.3% in the observation group and 73.3% in the control group; there was a statistically significant difference between the two groups (P<0.05). The latencies and amplitudes of the frontal muscle, orbicularis oculi muscle and quadrate muscle of upper lip improved in the two groups after treatment and had statistically significant pre-/post-treatment differences (P < 0.01). There were statistically significant differences in the pre-/post-treatment difference values of the latencies and amplitudes of the frontal muscle and orbicularis oculi muscle (P<0.01) and no statistically significant difference in the pre-/post-treatment difference values of the latency and amplitude of the quadrate muscle of upper lip (P>0.05) between the two groups. Conclusion Kinetic rectification acupuncture has a marked therapeutic effect on acute facial neuritis. This study provides a particular therapeutic method for clinical practice.
		                        		
		                        		
		                        		
		                        	
9.Optimization of preparation procedures for nano-sponges of flavonoids fromGlycyrrhizae Radix et Rhizoma by Box-Behnken response surface methodology based on CRITIC weighted evaluation.
Qiang SUN ; Xiao-Fang LI ; Kai-Pei LUO ; Tian-Tian ZHAO ; Zu-Bing MA ; Yu ZHENG ; Long XIE
China Journal of Chinese Materia Medica 2018;43(24):4855-4861
		                        		
		                        			
		                        			In this paper, nano-sponges of flavonoids from Glycyrrhizae Radix et Rhizoma (LF-NSP) were prepared by agitation-freeze drying method. Box-benhnken design and response surface method based on the single factor experiment was used to optimize the preparation process, with the stirring temperature as well as stirring time and speed as the independent variables, while with drug loading, particle size and the generalized "normalized value" as the response values. In addition, the nano-sponges were characterized by scanning electron microscope (SEM), infraredspectroscopy (FT-IR) and differential scanning calorimetry (DSC), and its release in vitro was also investigated. The results showed that the optimum preparation conditions for glycyrrhizin nano-sponges were as follows:The proportion of main drug and auxiliary drug was 1:2; the proportion of crosslinking agent DPC and β-CD was 4:1; stirring temperature 45 °C for 4.8 h at 245 r·min⁻¹. The comprehensive score of LF-NSP prepared under these conditions was 94.78. FT-IR and DSC results indicated the formation of Glycyrrhiza flavonoids nano-sponges, and SEM showed that they were spherical particles in shape. In release experiment in vitro, the cumulative release of glycyrrhizin flavonoids nano-sponges for 240 min was 81.8%, while that of crude drug was only 31.5%. Nano-sponges can significantly improve the dissolution of flavonoids from Glycyrrhizae Radix et Rhizoma.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Drugs, Chinese Herbal
		                        			;
		                        		
		                        			Flavonoids
		                        			;
		                        		
		                        			Glycyrrhiza
		                        			;
		                        		
		                        			Rhizome
		                        			;
		                        		
		                        			Spectroscopy, Fourier Transform Infrared
		                        			
		                        		
		                        	
10.Clinical Research of Shuangxin Decoction on Coronary Heart Disease Accompanied with Psychological Disorder
Wei-Bing NI ; Zu-Pei YAO ; Fang-Qing GE ; Xiao-Dan ZHENG ; Juan CAI ; Jin-Xiang PENG ; Hai-Yan SU
Journal of Nanjing University of Traditional Chinese Medicine 2017;33(1):26-29
		                        		
		                        			
		                        			OBJECTIVE To explore the clinical effects of Shuangxin Decoction in treating coronary heart disease accompa-nied with psychological disorder.METHODS 80 cases with coronary heart disease manifested as chest pain,chest distress plus psychological disorders like depression and anxiety were randomly divided into treatment group and control group.Patients in both groups were treated with routine western medicine plus psychological counseling.Based on which,patients in the treat-ment group were further given Chinese medicine Shuangxin Decoction,while those in the control group were added deanxit, with the course lasting for 6 weeks.Chest pain(distress) integral score scale,traditional Chinese medicine(TCM) syndrome score scale and comprehensive hospital anxiety and depression scale were evaluated to explore the therapeutic effects of chest pain,psychological disorder and clinical TCM syndromes before and after treatment of both groups,together with the changes of electrocardiogram test results and cardiac markers.RESULT Chest pain(distress) integral scores of treatment group were lower than those of control group(P <0.05),with the total curative rate being 82.50%,notably higher than 52.5% of the control group(P <0.01).The anxiety and depression scores of both groups were evidently reduced after treatment(P <0.01). The comparison of the two groups was P >0.05.TCM syndrome scores of both groups were notably declined(P <0.01).The total curative rate was 75%,which was superior to 20% of the control group(P <0.01).Both electrocardiogram test results and cardiac markers in both groups experienced an evident improvement than before(P <0.05).The comparison of the two groups showed P >0.05.No abnormality was detected in blood,urine,stool or liver and kidney function test in patients of both groups.CONCLUSION Shuangxin Decoction can efficiently improve chest pain,chest distress symptoms as well as TCM clinical syndromes due to coronary heart disease accompanied with psychological disorder.Also,it is helpful for improving de-pression and anxiety,which has been considered as a safe and effective formula for treating these two disorders,worthy of clin-ical application and promotion.
		                        		
		                        		
		                        		
		                        	
            
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