CN112972499A - Operation method for radically treating malignant tumor of breast surgery by pseudomonas aeruginosa and application thereof - Google Patents
Operation method for radically treating malignant tumor of breast surgery by pseudomonas aeruginosa and application thereof Download PDFInfo
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- 241000589517 Pseudomonas aeruginosa Species 0.000 title claims abstract description 49
- 238000001356 surgical procedure Methods 0.000 title claims abstract description 30
- 238000000034 method Methods 0.000 title claims abstract description 23
- 206010006187 Breast cancer Diseases 0.000 title description 3
- 208000026310 Breast neoplasm Diseases 0.000 title description 2
- 238000002347 injection Methods 0.000 claims abstract description 35
- 239000007924 injection Substances 0.000 claims abstract description 35
- 210000001165 lymph node Anatomy 0.000 claims abstract description 20
- 201000011510 cancer Diseases 0.000 claims abstract description 14
- 108010053779 Pseudomonas aeruginosa mannosesensitive haemagglutinin Proteins 0.000 claims abstract description 12
- 210000002751 lymph Anatomy 0.000 claims abstract description 5
- 206010027476 Metastases Diseases 0.000 claims abstract description 4
- 208000024770 Thyroid neoplasm Diseases 0.000 claims abstract description 4
- 235000015263 low fat diet Nutrition 0.000 claims abstract description 4
- 230000009401 metastasis Effects 0.000 claims abstract description 4
- 235000021590 normal diet Nutrition 0.000 claims abstract description 4
- 201000002510 thyroid cancer Diseases 0.000 claims abstract description 4
- 210000002416 recurrent laryngeal nerve Anatomy 0.000 claims description 18
- 230000002980 postoperative effect Effects 0.000 claims description 16
- 206010037660 Pyrexia Diseases 0.000 claims description 12
- 210000000481 breast Anatomy 0.000 claims description 12
- 238000004140 cleaning Methods 0.000 claims description 7
- 239000007788 liquid Substances 0.000 claims description 7
- 210000002990 parathyroid gland Anatomy 0.000 claims description 7
- 206010013952 Dysphonia Diseases 0.000 claims description 6
- 208000010473 Hoarseness Diseases 0.000 claims description 6
- 206010028980 Neoplasm Diseases 0.000 claims description 6
- 230000001394 metastastic effect Effects 0.000 claims description 6
- 206010061289 metastatic neoplasm Diseases 0.000 claims description 6
- 230000006378 damage Effects 0.000 claims description 4
- 230000000849 parathyroid Effects 0.000 claims description 4
- 210000001685 thyroid gland Anatomy 0.000 claims description 4
- 208000000038 Hypoparathyroidism Diseases 0.000 claims description 3
- 206010061218 Inflammation Diseases 0.000 claims description 3
- 230000023597 hemostasis Effects 0.000 claims description 3
- 208000021760 high fever Diseases 0.000 claims description 3
- 208000015181 infectious disease Diseases 0.000 claims description 3
- 230000004054 inflammatory process Effects 0.000 claims description 3
- 210000001268 chyle Anatomy 0.000 claims description 2
- 238000012544 monitoring process Methods 0.000 claims description 2
- 238000011084 recovery Methods 0.000 claims description 2
- 239000012530 fluid Substances 0.000 abstract 1
- 208000027418 Wounds and injury Diseases 0.000 description 14
- 210000001365 lymphatic vessel Anatomy 0.000 description 5
- 108010004103 Chylomicrons Proteins 0.000 description 4
- 210000000683 abdominal cavity Anatomy 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 230000001926 lymphatic effect Effects 0.000 description 2
- 239000000243 solution Substances 0.000 description 2
- 210000002978 thoracic duct Anatomy 0.000 description 2
- KEQXNNJHMWSZHK-UHFFFAOYSA-L 1,3,2,4$l^{2}-dioxathiaplumbetane 2,2-dioxide Chemical compound [Pb+2].[O-]S([O-])(=O)=O KEQXNNJHMWSZHK-UHFFFAOYSA-L 0.000 description 1
- 206010050979 Lymphorrhoea Diseases 0.000 description 1
- 238000001266 bandaging Methods 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 210000003109 clavicle Anatomy 0.000 description 1
- 235000005911 diet Nutrition 0.000 description 1
- 230000037213 diet Effects 0.000 description 1
- 230000029087 digestion Effects 0.000 description 1
- 239000003792 electrolyte Substances 0.000 description 1
- 238000011156 evaluation Methods 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 210000004698 lymphocyte Anatomy 0.000 description 1
- 230000002265 prevention Effects 0.000 description 1
- 108090000623 proteins and genes Proteins 0.000 description 1
- 102000004169 proteins and genes Human genes 0.000 description 1
- 210000001321 subclavian vein Anatomy 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
- A61K35/66—Microorganisms or materials therefrom
- A61K35/74—Bacteria
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/08—Solutions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
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Abstract
The invention discloses an operation method for radically treating malignant tumors of pseudomonas aeruginosa in breast-nail surgery and application thereof, wherein 85 cases of thyroid cancer patients with lateral cervical lymph metastasis are obtained and classified to form a treatment group and a control group, wherein 44 cases of the treatment group and 41 cases of the control group are obtained, PA-MSHA is used in the conventional operation treatment in the treatment group, the control group adopts the conventional operation treatment, the PA-MSHA is used in the step 3, 2ml of pseudomonas aeruginosa injection is firstly injected into an operation wound cavity through a drainage tube in a retrograde manner by using the PA-MSHA using method, negative pressure is introduced again after the drainage tube is clamped and closed for 5 minutes, meanwhile, low-fat diet is carried out, the drainage fluid is lower than 20ml every time continuously for two days under the normal diet condition, the drainage tube can be pulled out, the conventional use of the wound surface after the side area of the pseudomonas aeruginosa injection is cleaned can effectively reduce the drainage volume, the hospitali, and reduces the risk of chylotesis after lymph node clearing in the central area, which is important for treatment groups with unconventional placement of drainage tubes.
Description
Technical Field
The invention relates to a surgical malignant tumor treatment for breast-nail surgery, in particular to an operation method for radically treating the malignant tumor of the breast-nail surgery by pseudomonas aeruginosa and application thereof, belonging to the technical field of surgical malignant tumor treatment for breast-nail surgery.
Background
Lymphatic leakage is one of the common complications after thyroid operation, the incidence rate is 1-3.5%, and the reason for the lymphatic leakage is as follows:
1. the thoracic duct is arranged in an abdominal cavity chylomicron pool, is the largest lymphatic vessel of the whole body, has the function of digesting fat, and the lymph in the abdominal cavity chylomicron pool is milk white during digestion, so the celomic liquid is called chylomicron, is stored in the chylomicron pool, contains rich fat, protein, sugar, electrolyte, lymphocyte and the like, has a pH value of 7.4-7.8, and is caused by injury to the thoracic duct of the neck section or the right lymphatic vessel in the operation, and 75% -92% of the left neck cleaning operation can occur;
2. the capillary vessels of all levels to lymphatic vessels of all levels to common lymphatic vessels of all levels to the subclavian veins of the left and the right clavicles are placed in centripetal flow;
the prevention and treatment of the right lymph leakage adopts drainage, local pressure bandaging and matching with general drainage, diet control, secondary operation treatment and lymphatic vessel ligation and suture treatment, but the effect is not obvious in the treatment, so that the pseudomonas aeruginosa is designed in the Jiaru
The surgical operation method for radical cure of malignant tumor and its application can be used for optimizing the above-mentioned problems.
Disclosure of Invention
The invention mainly aims to provide an operation method for radically treating malignant tumors of the pseudomonas aeruginosa in the breast surgery A and application thereof, the pseudomonas aeruginosa injection can effectively treat the chylotesis appearing after the lateral area is cleaned, the drainage amount can be effectively reduced by the conventional use of the wound surface after the lateral area of the pseudomonas aeruginosa injection is cleaned, the postoperative hospitalization day is shortened, the complications are not increased, the pseudomonas aeruginosa injection is safe to recurrent laryngeal nerves and parathyroid gland, the risk of the chylotesis after the lymph node in the central area is cleaned is reduced, and the method is important for a treatment group which is not provided with a drainage tube in a conventional way.
The purpose of the invention can be achieved by adopting the following technical scheme:
the method for radically treating the malignant tumor of the pseudomonas aeruginosa in the breast surgery comprises the following steps:
step 1: acquiring 85 cases of thyroid cancer patients with lateral cervical lymph metastasis;
step 2: classifying to form a treatment group and a control group, wherein the treatment group comprises 44 cases, and the control group comprises 41 cases;
and step 3: wherein the treatment group is treated by conventional surgery and PA-MSHA is used in the surgery, and the control group is treated by conventional surgery;
and 4, step 4: wherein, in the step 3, the PA-MSHA application method is used to inject 2ml of pseudomonas aeruginosa injection into the wound cavity of the operation through the drainage tube in a retrograde manner;
and 5: 5 minutes later after clamping the drainage tube, the negative pressure is connected again, and low-fat diet is carried out at the same time;
step 6: under the condition of normal diet, the drainage liquid is less than 20ml every time for two consecutive days, and the drainage tube can be pulled out;
and 7: and observing indexes such as drainage volume, complications, postoperative hospitalization days and the like after the operation.
The pseudomonas aeruginosa injection can effectively treat the chylotia after the lateral area is cleaned, the drainage amount can be effectively reduced by the conventional use of the wound surface after the lateral area of the pseudomonas aeruginosa injection is cleaned, the postoperative hospitalization day is shortened, the complication is not increased, the pseudomonas aeruginosa injection is safe to recurrent laryngeal nerves and parathyroid gland, the chylotia risk after the lymph node in the central area is cleaned is reduced, and the pseudomonas aeruginosa injection is important for a treatment group which is not provided with a drainage tube in a conventional way.
Preferably, the sex, age, body mass index, location, size of primary tumor, left and right lateral zone clean, number of metastatic lymph nodes, number of lymph nodes cleaned, 24-hour maximum drainage, total drainage, days of hospital stay after operation, infection and fever of the treatment group and the control group are collected during the course of treatment.
Preferably, wherein the treatment group in gender collection is male: female is 13: 31, control group male: female is 8: 33;
the age of the treated group is 24.4-49.2 years, and the age of the control group is 24-56.8 years;
body mass index treatment at 19-27, control at 19.5-24.7;
treatment groups were measured at 17:27, control group 16: 25;
the size of the primary tumor is 1.2-3.4 in the treatment group, and 1.2-2.8 in the control group;
the left versus right zone treatment groups were 17:27, the control group was 16: 25.
preferably, the number of the metastatic lymph nodes is 5.9-13.7 in the treatment group, and 3-17 in the control group;
the number of the lymph nodes is 28-58 for the treatment group, and 25.6-55 for the control group;
the maximum drainage volume treatment group in 24 hours is 60-203, and the control group is 76-301;
the total drainage volume treatment group is 127-;
the number of days of hospitalization after operation is 3.7-7.3, and the number of control groups is 5.3-7.9;
the number of the fever treatment groups was 23, and the number of the control groups was 4.
Preferably, in the operation in the step 4, 2-3ml of pseudomonas aeruginosa injection is uniformly sprayed on the wound surface after sufficient hemostasis is achieved, a drainage tube is arranged after 5 minutes, and the incision is sutured.
Preferably, the safety evaluation of PA-MSHA in thyroid surgery is carried out, wherein the safety of the pseudomonas aeruginosa injection on recurrent laryngeal nerves and parathyroid gland is examined, and whether the wound surface can reduce drainage volume and shorten hospitalization days like the wound surface for lateral area cleaning after the pseudomonas aeruginosa injection is used for central area lymph node cleaning is examined.
Preferably, wherein the indicators observed in step 7 include post-operative hoarseness, permanent parathyroid damage, drainage volume, fever, and other complications.
Preferably, the recurrent laryngeal nerve detector is used in two groups of patients to verify that the recurrent laryngeal nerve potentials at two sides are normal and no hoarseness appears after the operation, the recurrent laryngeal nerve is exposed to the safety, local inflammation and fever of the pseudomonas aeruginosa injection liquid and does not influence the recurrent laryngeal nerve function, after the operation, the two groups of patients have no permanent hypoparathyroidism, the pseudomonas aeruginosa injection liquid is used for reducing the risk of postoperative central area chylous leakage when being used for the central area wound surface, and the pseudomonas aeruginosa injection liquid is used for the central area wound surface and does not appear in patients with high fever, and the tolerance is good.
The invention has the beneficial technical effects that:
the invention provides an operation method for radically treating malignant tumors of a first breast surgery by using pseudomonas aeruginosa injection and application thereof, the pseudomonas aeruginosa injection can effectively treat chylotesis appearing after a lateral area is cleaned, the drainage amount can be effectively reduced by using a wound surface after the lateral area of the pseudomonas aeruginosa injection is cleaned conventionally, the postoperative hospitalization days are shortened, complications are not increased, the pseudomonas aeruginosa injection is safe to recurrent laryngeal nerves and parathyroid gland, the risk of chylotesis after a lymph node in a central area is cleaned is reduced, and the method is more important for a treatment group which is not provided with a drainage tube conventionally.
Detailed Description
In order to make the technical solutions of the present invention more clear and definite for those skilled in the art, the present invention is further described in detail with reference to the following examples, but the embodiments of the present invention are not limited thereto.
The method for radically treating the malignant tumor of the pseudomonas aeruginosa in the breast surgery A provided by the embodiment comprises the following steps:
step 1: acquiring 85 cases of thyroid cancer patients with lateral cervical lymph metastasis;
step 2: classifying to form a treatment group and a control group, wherein the treatment group comprises 44 cases, and the control group comprises 41 cases;
and step 3: wherein the treatment group is treated by conventional surgery and PA-MSHA is used in the surgery, and the control group is treated by conventional surgery;
and 4, step 4: wherein, in the step 3, the PA-MSHA application method is used to inject 2ml of pseudomonas aeruginosa injection into the wound cavity of the operation through the drainage tube in a retrograde manner;
and 5: 5 minutes later after clamping the drainage tube, the negative pressure is connected again, and low-fat diet is carried out at the same time;
step 6: under the condition of normal diet, the drainage liquid is less than 20ml every time for two consecutive days, and the drainage tube can be pulled out;
and 7: and observing indexes such as drainage volume, complications, postoperative hospitalization days and the like after the operation.
In this example, the sex, age, body mass index, location, size of primary tumor, left and right lateral zone cleansers, number of metastatic lymph nodes, number of cleared lymph nodes, 24-hour maximum drainage, total drainage, days of hospital stay after operation, infection and fever of the treatment group and the control group were collected during the course of treatment.
In this example, where treatment groups of men in gender collection were: female is 13: 31, control group male: female is 8: 33;
the age of the treated group is 24.4-49.2 years, and the age of the control group is 24-56.8 years;
body mass index treatment at 19-27, control at 19.5-24.7;
treatment groups were measured at 17:27, control group 16: 25;
the size of the primary tumor is 1.2-3.4 in the treatment group, and 1.2-2.8 in the control group;
the left versus right zone treatment groups were 17:27, the control group was 16: 25.
in this example, the number of metastatic lymph nodes treated group is 5.9-13.7, the control group is 3-17;
the number of the lymph nodes is 28-58 for the treatment group, and 25.6-55 for the control group;
the maximum drainage volume treatment group in 24 hours is 60-203, and the control group is 76-301;
the total drainage volume treatment group is 127-;
the number of days of hospitalization after operation is 3.7-7.3, and the number of control groups is 5.3-7.9;
the number of the fever treatment groups was 23, and the number of the control groups was 4.
In the embodiment, in the operation of the step 4, 2-3ml of pseudomonas aeruginosa injection is uniformly sprayed on the wound surface after sufficient hemostasis, a drainage tube is arranged after 5 minutes, and the incision is sutured.
In this example, the safety of PA-MSHA in thyroid surgery was evaluated by examining the safety of the p.aeruginosa injection to recurrent laryngeal nerve and parathyroid gland and whether the wound could be reduced and hospitalized days shortened as if it were used for lateral area lymph node cleaning after p.aeruginosa injection was used for central area lymph node cleaning.
In this example, the observation indicators in step 7 include postoperative hoarseness, permanent parathyroid damage, drainage volume, fever, and other complications.
In the embodiment, the recurrent laryngeal nerve detector is used for verifying that the potentials of the recurrent laryngeal nerves of two groups of patients are normal in the operation, no hoarseness occurs after the operation, the recurrent laryngeal nerves are exposed to the safety of the pseudomonas aeruginosa injection, the local inflammation and the fever do not influence the function of the recurrent laryngeal nerves, the two groups of patients do not have permanent hypoparathyroidism after the operation of continuous monitoring, the function and the recovery of the postoperative parathyroid gland are not influenced by using the pseudomonas aeruginosa injection, the risk of postoperative central region chyle leakage is reduced when the pseudomonas aeruginosa injection is used for the central region wound surface, and the high fever patients do not appear and have good tolerance.
The above description is only for the purpose of illustrating the present invention and is not intended to limit the scope of the present invention, and any person skilled in the art can substitute or change the technical solution of the present invention and its conception within the scope of the present invention.
Claims (8)
1. The method for radically treating the malignant tumor of the pseudomonas aeruginosa in the breast surgery A is characterized by comprising the following steps: the method comprises the following steps:
step 1: acquiring 85 cases of thyroid cancer patients with lateral cervical lymph metastasis;
step 2: classifying to form a treatment group and a control group, wherein the treatment group comprises 44 cases, and the control group comprises 41 cases;
and step 3: wherein the treatment group is treated by conventional surgery and PA-MSHA is used in the surgery, and the control group is treated by conventional surgery;
and 4, step 4: wherein, in the step 3, the PA-MSHA application method is used to inject 2ml of pseudomonas aeruginosa injection into the wound cavity of the operation through the drainage tube in a retrograde manner;
and 5: 5 minutes later after clamping the drainage tube, the negative pressure is connected again, and low-fat diet is carried out at the same time;
step 6: under the condition of normal diet, the drainage liquid is less than 20ml every time for two consecutive days, and the drainage tube can be pulled out;
and 7: and observing indexes such as drainage volume, complications, postoperative hospitalization days and the like after the operation.
2. The method for radical treatment of pseudomonas aeruginosa for surgical malignant tumor in breast A surgery according to claim 1, wherein: the sex, age, body mass index, location, size of primary tumor, left and right lateral zone clean, number of metastatic lymph nodes, number of lymph nodes cleaned, 24-hour maximum drainage, total drainage, days of post-operative hospitalization, infection and fever were collected during treatment.
3. The method for radical treatment of pseudomonas aeruginosa in breast surgery A, according to claim 2, wherein: treatment groups of males in gender collection: female is 13: 31, control group male: female is 8: 33;
the age of the treated group is 24.4-49.2 years, and the age of the control group is 24-56.8 years;
body mass index treatment at 19-27, control at 19.5-24.7;
treatment groups were measured at 17:27, control group 16: 25;
the size of the primary tumor is 1.2-3.4 in the treatment group, and 1.2-2.8 in the control group;
the left versus right zone treatment groups were 17:27, the control group was 16: 25.
4. the method for radical treatment of pseudomonas aeruginosa for surgical malignant tumor in breast A surgery according to claim 3, wherein: the number of the metastatic lymph nodes is 5.9-13.7 in the treatment group, and 3-17 in the control group;
the number of the lymph nodes is 28-58 for the treatment group, and 25.6-55 for the control group;
the maximum drainage volume treatment group in 24 hours is 60-203, and the control group is 76-301;
the total drainage volume treatment group is 127-;
the number of days of hospitalization after operation is 3.7-7.3, and the number of control groups is 5.3-7.9;
the number of the fever treatment groups was 23, and the number of the control groups was 4.
5. The method for radical treatment of pseudomonas aeruginosa for surgical malignant tumor in breast A surgery according to claim 4, wherein: wherein in the operation in the step 4, 2-3ml of pseudomonas aeruginosa injection is uniformly sprayed on the wound surface after sufficient hemostasis, a drainage tube is arranged after 5 minutes, and the incision is sutured.
6. The method for radical treatment of pseudomonas aeruginosa in breast surgery A, according to claim 5, wherein: and (3) evaluating the safety of PA-MSHA in thyroid surgery, wherein the safety of the pseudomonas aeruginosa injection on recurrent laryngeal nerves and parathyroid gland is examined, and whether the wound surface can reduce the drainage volume and shorten the hospitalization day like the wound surface for lateral area cleaning after the pseudomonas aeruginosa injection is used for central area lymph node cleaning.
7. The operation method for radically treating the malignant tumor of the pseudomonas aeruginosa in the breast surgery A and the application thereof according to claim 6 are characterized in that: wherein the observation indicators in step 7 include post-operative hoarseness, permanent parathyroid damage, drainage volume, fever, and other complications.
8. The use of pseudomonas aeruginosa according to claim 7 for radical treatment of malignant tumors in breast surgery a, wherein: the usage of the recurrent laryngeal nerve detector in the operation of two groups of patients proves that the recurrent laryngeal nerve potentials at two sides are normal, no hoarseness appears after the operation, the recurrent laryngeal nerve is exposed to the safety, local inflammation and fever of the pseudomonas aeruginosa injection, the recurrent laryngeal nerve function is not influenced, the postoperative continuous monitoring is carried out, the two groups of patients have no permanent hypoparathyroidism, the usage of the pseudomonas aeruginosa injection has no influence on the function and recovery of the postoperative parathyroid, the incidence risk of the postoperative central area chyle leakage is reduced when the pseudomonas aeruginosa injection is used for the central area wound surface, and the pseudomonas aeruginosa injection is used for the central area wound surface without the occurrence of high fever patients, and the tolerance is good.
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| 王北等: "铜绿假单胞菌注射液治疗Whipple术后淋巴漏的临床分析", 《中国现代药物应用》 * |
| 郭智慧等: "常规处理方案联合铜绿假单胞菌制剂治疗乳腺癌疗效的Meta分析", 《中国普通外科杂志》 * |
| 魏涛等: "铜绿假单胞菌注射液治疗甲状腺癌颈部淋巴结清扫术后淋巴漏的临床分析", 《中国普外基础与临床杂志》 * |
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