JP2009279110A - Hemodialysis system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a hemodialysis system capable of continuing dialyzing treatment to a patient even though it becomes impossible to feed dialyzing fluid owing to the malfunction of a dialyzing fluid feeding device for many persons. <P>SOLUTION: The hemodialysis system includes A raw fluid feeding means 10, B raw fluid feeding means 20, an RO device 30, a dialyzing fluid feeding device 40 for many persons connected to the A raw fluid feeding means and the B raw material feeding means, and the RO device, diluting A raw fluid and B raw fluid with RO water to produce the dialyzing fluid and feed the dialyzing fluid, and at least one of a dialyzing device 50 for an individual, wherein the respective dialyzing device 50 for individuals are connected to the A raw fluid feeding means 10 and the B raw fluid feeding means 20 and connected to the dialyzing device 40 for many person and the RO device 30 via flow path switching means 60 and is structured such that the flow paths from the dialyzing device 40 for many persons and the RO device 30 can be alternatively switched by the flow path switching means 60. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a hemodialysis system including a dialysate supply device for a large number of people who supplies dialysate, and in particular, even if the dialysate supply device for a large number of people fails and cannot supply dialysate, The present invention relates to a hemodialysis system that can continue dialysis treatment.

As is well known, hemodialyzers that purify a patient's blood can be broadly classified into dialysis monitoring devices (console) and personal dialysis devices.
The former monitoring device (console) for dialysis is a device that produces a plurality of dialysates by mixing A stock solution, which is a dialysate stock solution, B stock solution, and RO water, which is a dilution water, at a predetermined ratio. This is a device that receives dialysis fluid from a dialysis fluid supply device, sends blood from a patient to a dialyzer with a blood pump, contacts the dialysis fluid through a semipermeable membrane, and purifies the blood. In addition, the monitoring device for dialysis is a device that mainly receives dialysis fluid from a dialysis fluid supply device for a large number of people and performs dialysis treatment as described above, but additionally uses blood filtration (ECUM) and a replacement fluid pump. By doing so, hemofiltration dialysis is possible, and furthermore, online HDF is possible by attaching an endotoxin cut filter.

  The latter personal dialysis device is a device having a dialysate preparation function in addition to the above-described dialysis monitoring device function. In other words, unlike the former dialysis monitoring device, the personal dialysis device mixes the A stock solution, the B stock solution, and the RO water in its own device to create a dialysis solution to be used by itself. Although the use method varies depending on each facility, the advantage of personal dialysis equipment is that dialysis suitable for patients and dialysis in hospital rooms, ICUs, operating rooms, etc. are possible. Often used for patients who cannot move to the room.

  That is, the functional difference between the dialysis monitoring device and the personal dialysis device is whether or not it has a dialysate preparation function. As described above, since the latter personal dialysis machine creates a dialysis fluid to be used by itself, the dialysis fluid can be prepared at a mixing ratio suitable for the patient, while the number of A stock solution supply means and B stock solution according to the number of devices Supply means must be prepared. On the other hand, in the case of the former dialysis monitoring device, the dialysis fluid supply device for a large number of people prepares the dialysis fluid for a plurality of units at the same time, so the management becomes easy, and the increase in the number of dialysis monitoring devices Easy to handle.

For this reason, in dialysis centers and medical institutions that require a large number of hemodialysis machines, a so-called central system comprising a multi-person dialysate supply device 40 and a plurality of dialysis monitoring devices 70 illustrated in FIG. 9 is constructed. There are many cases to do.
On the other hand, in the case of the latter personal dialysis machine, since it has a dialysate preparation function, it is not connected to a dialysate supply device for multi-person use in principle, and therefore it is also possible to incorporate it into a central system. Is not. That is, the personal dialysis apparatus is generally used in an independent form. As an exception, Non-Patent Document 1 discloses a personal dialysis apparatus that can also be used as a dialysis monitoring apparatus.

By the way, since a dialysate is used in hemodialysis treatment, an accident that stops the supply of dialysate during dialysis treatment must be avoided. In particular, in the case of a central system to which a plurality of dialysis monitoring devices are connected, the multi-person dialysate supply device creates a plurality of dialysate solutions at the same time. Accidents that make it impossible to supply dialysate must be avoided.
Moreover, from the viewpoint of providing safe dialysis treatment with no accident for the patient, even if the dialysis fluid supply device for a large number of people fails and cannot supply the dialysis fluid, the dialysis treatment is performed on the patient. Should have a backup function that can continue.

  However, until now, it was extremely rare for a dialysate supply device for multi-persons to break down during dialysis treatment, and even if the supply of dialysate was stopped, the patient could quickly respond to such a situation. Since a medical worker who can do so is waiting, no hemodialysis system capable of realizing a dual safety has been devised so far.

As described above, Non-Patent Document 1 discloses a personal dialysis device that can also be used as a dialysis monitoring device. This is because the frequency of use of personal dialysis devices is not necessarily high. Therefore, when there is no plan to use as a personal dialysis machine, it can also be used as a dialysis monitoring device, which can increase the operating rate of the personal dialysis machine. It is assumed that the solution to the problem is to stop the supply of dialysate due to the failure of the dialysate supply device for large numbers of people and to prevent the occurrence of medical accidents due to the supply stop of the dialysate is not.
Experience using personal HDF device NDF-21, 11th Osaka Prefectural Clinical Engineering Engineers Conference, http://www.soryu.jp/me/shouroku/shou21.htm

  The problem to be solved by the present invention is to provide a hemodialysis system capable of performing a safe dialysis treatment without accident on a patient. To provide a hemodialysis system capable of continuing dialysis treatment for a patient even if a dialysis fluid cannot be supplied due to a failure.

  The present inventor has obtained the following technical knowledge as a result of various experimental studies and theoretical studies to solve the above problems.

(A) As described above, the central system is generally composed of a dialysate supply device for a large number of people and a plurality of monitoring devices for dialysis, but the dialysis monitoring device does not have a dialysate preparation function functionally. Unless you have a back-up machine for dialysate supply equipment for multiple people, you can't achieve double safety.

(B) As described above, a personal dialyzer having a dialysate preparation function is not connected to a dialysate supply device for a large number of people in principle, and therefore a personal dialyzer may be incorporated into a central system. Not in principle. In addition, incorporating a personal dialyzer into a central system means that the dialyzer preparation function inherently provided by the personal dialyzer is stopped and used, so the personal dialyzer is temporarily incorporated into the central system. Even so, the purpose is only to increase the operating rate of the personal dialysis machine (see Non-Patent Document 1, for example).

  However, from a different point of view, the personal dialysis machine inherently has a dialysate preparation function, so that a personal dialysis machine 50 is connected in place of the dialysis monitoring device as illustrated in FIG. The personal dialysis device 50 is connected to the A stock solution supply means 10 and the B stock solution supply means 20, and is connected to the multi-person dialysate supply device 40 and the RO device 30 via the flow path switching means 60. When the switching means 60 is configured to selectively switch the flow path from the multi-person dialysate supply device 40 and the RO device 30, the multi-person dialysate supply device 40 fails and supplies dialysate. The patient can continue dialysis treatment even if he is unable to do so.

  More specifically, when the multi-person dialysate supply device 40 is normal, the dialysate is supplied from the multi-person dialysate supply device 40 as shown in FIG. When the apparatus 40 fails and cannot supply the dialysate, the flow path is switched from the multi-person dialysate supply apparatus 40 to the RO apparatus 30 as shown in FIG. The patient can continue dialysis treatment by mixing the A stock solution, B stock solution, and RO water to create a dialysis solution that he uses.

(C) Furthermore, as shown in FIGS. 1 to 3, if the structure is such that the flow path from the multi-person dialysate supply device 40 and the RO device 30 can be selectively switched by the flow path switching means 60, Among the personal dialyzers 50 that receive dialysate supply from the dialysate supply apparatus 40 for personal use, the flow path is switched as shown in FIG. Dialysis treatment using the dialysate prepared at a mixing ratio suitable for the patient is performed, and dialysis treatment using the dialysate supplied from the multi-person dialysate supply device 40 is performed in parallel with other patients. What you can do.

Based on the above knowledge, the present inventor has developed a hemodialysis system capable of continuing dialysis treatment for a patient even if the multi-person dialysis fluid supply device fails and cannot supply the dialysis fluid. I came up with it. The gist is as follows.
(1) Connected to A stock solution supply means for supplying A stock solution, B stock solution supply means for supplying B stock solution, RO device for supplying RO water, A stock solution supply means, B stock solution supply means, and RO device A hemodialysis system comprising a multi-person dialysate supply device for preparing a dialysate by diluting A stock solution and B stock solution with RO water and at least one personal dialyzer. Each personal dialyzer is connected to the A stock solution supply means and the B stock solution supply means, and is connected to the multi-person dialysate supply device and the RO device via the flow path switching means. A hemodialysis system characterized in that the flow path from the dialysate supply device for a large number of people and the RO device can be switched selectively.
(2) The hemodialysis system according to (1), wherein at least one dialysis monitoring device is connected to the multi-person dialysate supply device.

(A) A hemodialysis system according to the present invention is a hemodialysis system including a multi-person dialysate supply device and at least one personal dialyzer, unlike a central system that has been generally constructed conventionally, The personal dialysis apparatus is connected to the A stock solution supply means and the B stock solution supply means, and is connected to the multi-person dialysate supply apparatus and the RO device via the flow path switching means. This is a hemodialysis system having a structure that can selectively switch the flow path from the dialysate supply device and the RO device.
Therefore, each personal dialysis machine receives the dialysate from the multi-person dialysate supply apparatus when the multi-person dialysate supply apparatus is operating normally. When the dialysate cannot be supplied due to failure, the flow path switching means switches the flow path from the multi-person dialysate supply apparatus to the RO apparatus, and the A stock solution, B stock solution, And RO water can be mixed to create a dialysate for use by itself.
That is, according to the hemodialysis system of the present invention, dialysis treatment can be continued for a patient even if the multi-person dialysate supply device fails and cannot supply dialysate. As a result, it is possible to provide a patient with a safe dialysis treatment without accident.

(B) In addition, the hemodialysis system according to the present invention has a structure in which the flow path from the multi-person dialysate supply apparatus and the RO apparatus can be switched selectively by the flow path switching means in this way. Of the at least one personal dialyzer connected to the multi-person dialysate supply device, the multi-person dialysate is supplied to the personal dialyzer used by patients who require prescription dialysis by means of the flow switching means. By switching the flow path from the apparatus to the RO apparatus, dialysis using a dialysate prepared at a mixing ratio suitable for the patient can be performed.
That is, according to the hemodialysis system according to the present invention, the personal dialysis apparatus incorporated in the system is not physically separated from the system, in other words, the personal dialysis apparatus is not changed at all. Just by switching the flow path to flow into the dialysis treatment using dialysis fluid prepared at a mixing ratio suitable for the patient and dialysis treatment using dialysis fluid supplied from a multi-dialysis fluid supply device It can also be done.

Hereinafter, the best mode for carrying out the present invention will be described with reference to FIGS.
FIG. 1 is a block diagram showing an embodiment of a hemodialysis system according to the present invention. As shown in the figure, the hemodialysis system according to the present invention includes an A stock solution supply means 10, a B stock solution supply means 20, an RO device 30, a multi-person dialysate supply device 40, and at least one personal dialyzer 50. And a flow path switching means 60.

The A stock solution supply means 10 is connected to the multi-person dialysate supply device 40 and each individual dialyzer 50, and supplies the A stock solution to these devices.
As the A stock solution supply means 10, A stock solution supply means used in a central system generally constructed in the past can be used. For example, a tank or bottle capable of storing A stock solution containing sodium chloride, potassium chloride, calcium chloride, magnesium chloride, anhydrous sodium acetate, glucose and the like can be used. Alternatively, a powder type dialysis fluid drug substance dissolving apparatus that dissolves a powder agent in which the above components are powdered as an A stock solution can be used.
1 is connected to the individual dialysis apparatus 50 and the individual dialysis apparatus 50, which are independent from each other, but in the present invention, this form is used. It is not limited to. For example, the hemodialysis system may include one A stock solution supply means, and the A stock solution supply means may be connected to a multi-person dialysate supply device and each individual dialyzer.

The B stock solution supply means 20 is connected to the multi-person dialysate supply device 40 and each individual dialyzer 50 and supplies the B stock solution to these devices.
As the B stock solution supply means 20, a B stock solution supply means used in a central system that has been generally constructed conventionally can be used. For example, a tank or a bottle that can store a B stock solution containing sodium hydrogen carbonate or the like can be used. Alternatively, a powder type dialysis fluid drug substance dissolving apparatus that dissolves a powder agent containing the above components in powder form as a B stock solution can be used.
1 is connected to the individual dialysis apparatus 50 and the individual dialysis apparatus 50 which are independent from each other, but in the present invention, this form is used. It is not limited to. For example, the hemodialysis system may include one B stock solution supply unit, and the B stock solution supply unit may be connected to a multi-person dialysate supply device and each individual dialyzer.

The RO device 30 is connected to the dialysis fluid supply device 40 for multiple people and is connected to each personal dialysis device 50 via the flow path switching means 60 to supply RO water to these devices.
The RO device 30 is not particularly limited as long as it can purify RO water, and an RO device used in a central system that has been generally constructed conventionally can be used. For example, an apparatus for purifying RO water by removing impurities contained in tap water by a reverse osmosis method can be used. Here, the reverse osmosis method is a membrane separation method using a phenomenon in which a water component filters the RO membrane by applying a pressure higher than the osmotic pressure to the primary solution through the RO membrane. Thus, dissolved ions, organic substances, bacteria, pyrogens and the like, which are impurities contained in tap water, can be almost completely removed.

The dialysate supply device 40 for a large number of people is supplied from the A stock solution that is the dialysate stock solution supplied from the A stock solution supply means 10, the B stock solution that is the dialysate stock solution supplied from the B stock solution supply means 20, and the RO device 30. The RO water, which is the diluted water, is mixed at a predetermined ratio to produce a plurality of dialysate, and the dialysate is supplied to the hemodialyzer connected to the hemodialysis system according to the present invention.
The dialysis fluid supply device 40 for a large number of people is not particularly limited as long as it fulfills the above functions, and a dialysis fluid supply device for a large number of people used in a central system that has been generally constructed conventionally can be used. it can.

  The personal dialysis machine 50 includes an A stock solution that is a dialysate stock solution supplied from the A stock solution supply means 10, a B stock solution that is a dialysate stock solution supplied from the B stock solution supply means 20, and an RO supplied from the RO device 30. Water is mixed at a predetermined ratio to prepare a single dialysate, and blood from the patient is sent to the dialyzer 80 by the blood pump 53 and brought into contact with the dialysate through the semipermeable membrane to purify the blood. . That is, the personal dialysis device 50 is a device having a dialysate preparation function in addition to the function of a dialysis monitoring device.

  FIG. 5 is a configuration diagram showing an aspect of the personal dialysis apparatus 50. As shown in the figure, each individual dialysis machine 50 includes a dialysate supply line 51, a dialysate drainage line 52, and a blood pump 53, and the dialysate supply line 51 is connected to the A stock solution via the stock solution pump 54. The supply means 10 and the B stock solution supply means 20 are connected. Similarly, the dialysate supply line 51 is connected to the multi-person dialysate supply device 40 and the RO device 30 via the flow path switching means 60.

  For the preparation of dialysate by the personal dialyzer 50 and the supply of the prepared dialysate to the dialysate supply line 51, the solenoid valves 55 respectively connected to the A stock solution line 11 and the B stock solution line 21 are alternately used. By opening and closing, the A stock solution flowing through the A stock solution line 11 and the B stock solution flowing through the B stock solution line 21 are alternately injected into the dialysate supply line 51 via the stock solution pump 54.

  Therefore, in the hemodialysis system according to the present invention including the multi-person dialysate supply device 40, when the multi-person dialysate supply device 40 is normal, each individual dialyzer 50 is shown in FIG. As shown, the dialysate is supplied from the multi-person dialysate supply apparatus 40 to perform dialysis treatment. In this case, the dialysate supplied by the multi-person dialysate supply apparatus 40 is the dialysate supply line 51. Is selected, and the solenoid valves 55 respectively connected to the A stock solution line 11 and the B stock solution line 21 are closed.

  On the other hand, when the dialysate supply device for a large number of people breaks down and the dialysate cannot be supplied, as shown in FIG. 30 and the individual personal dialysis device 50 mixes the A stock solution, the B stock solution, and the RO water in its own device to create a dialysis solution to be used by itself. By selecting a flow path for RO water supplied by the RO device 30 to flow into the dialysate supply line 51 and alternately opening and closing the electromagnetic valves 55 respectively connected to the A stock solution line 11 and the B stock solution line 21, The A stock solution flowing through the A stock solution line 11 and the B stock solution flowing through the B stock solution line 21 are alternately injected into the dialysate supply line 51 via the stock solution pump 54.

  In the personal dialysis device 50 illustrated in FIG. 5, the venous chamber 82 is connected to the venous blood line 84, but as another aspect, the arterial chamber is further connected to the arterial blood line 83. The aspect may be sufficient.

  As described above, the hemodialysis system according to the present invention is a hemodialysis system including a multi-person dialysate supply device 40 and at least one personal dialyzer 50, unlike a central system that has been generally constructed. Each personal dialyzer 50 is connected to the A stock solution supply means 10 and the B stock solution supply means 20 and to the multi-person dialysate supply device 40 and the RO device 30 via the flow path switching means 60. The hemodialysis system has a structure in which the flow paths from the multi-person dialysate supply apparatus 40 and the RO apparatus 30 can be selectively switched by the flow path switching means 60.

  Therefore, each personal dialyzer 50 receives the dialysate supply from the multi-person dialysate supply apparatus 40 as shown in FIG. 2 when the multi-person dialysate supply apparatus 40 is operating normally. When the dialysate supply device 40 for a large number of people fails and the dialysate cannot be supplied, the RO device is switched from the dialysate supply device 40 for a large number of people by the flow path switching means 60 as shown in FIG. The flow path can be switched to 30 and the dialysate used by itself can be created by mixing the A stock solution, the B stock solution, and the RO water in its own device.

  That is, according to the hemodialysis system according to the present invention having the flow path switching function, even if the multi-person dialysate supply device 40 fails and cannot supply the dialysate, the patient is dialyzed. The treatment can be continued, thereby providing the patient with a safe dialysis treatment without accident.

  In addition, the hemodialysis system according to the present invention has a structure in which the flow path from the multi-person dialysate supply device 40 and the RO device 30 can be selectively switched by the flow path switching means 60 in this way. Of the at least one personal dialyzer 50 connected to the multi-person dialysate supply device 40, the personal dialyzer 50 used by a patient requiring prescription dialysis is flowed as shown in FIG. By switching the flow path from the multi-person dialysate supply device 40 to the RO device 30 by the path switching means 60, dialysis using a dialysate prepared at a mixing ratio suitable for the patient can be performed.

  That is, according to the hemodialysis system according to the present invention, the personal dialysis apparatus 50 incorporated in the system is not physically separated from the system, in other words, the personal dialysis system is not changed at all. By simply switching the flow path to flow into the device 50, dialysis treatment using a dialysis solution prepared at a mixing ratio suitable for the patient and dialysis treatment using a dialysis solution supplied from the dialysis solution supply device 40 for a large number of people. It can also be done in parallel.

  The flow path switching means 60 illustrated in FIGS. 1 to 5 is for personal dialysis when a flow path is formed between the dialysate supply line 51 of the personal dialyzer 50 and the multi-person dialysate supply apparatus 40. When the flow path between the dialysate supply line 51 of the apparatus 50 and the RO apparatus 30 is closed, and on the contrary, the flow path between the dialysate supply line 51 of the personal dialyzer 50 and the RO apparatus 30 is formed, This is a selector type three-way valve that forms an alternative flow path in which the flow path between the dialysate supply line 51 of the dialyzer 50 and the dialysate supply apparatus 40 for multiple people is closed. The flow path switching means that can be used in such a hemodialysis system is not limited to this form.

  For example, as shown in FIG. 6, a solenoid valve is arranged in each of the dialysate line 41 and the RO water line 31 to which individual personal dialyzers 50 are connected, and the dialysate supply line 51 of the personal dialyzer 50 When forming a flow path with the dialysate supply device 40 for a large number of people, the solenoid valve arranged in the dialysate line 41 is opened and the solenoid valve arranged in the RO water line 31 is closed. When the flow path between the liquid supply line 51 and the RO device 30 is formed, the electromagnetic valve disposed in the dialysate line 41 may be closed and the electromagnetic valve disposed in the RO water line 31 may be opened.

In addition, the hemodialysis system according to the present invention described above is a hemodialysis system having at least one personal dialysis apparatus 50 illustrated in FIGS. 1 to 6, but as shown in FIG. At least one dialysis monitoring device (console) 70 may be connected to the dialysis fluid supply device 40 for the number of people. In other words, the personal dialysis device 50 and the dialysis monitoring device 70 may be connected in parallel.
In the case of this form, when the multi-person dialysate supply device 40 fails and can no longer supply dialysate, dialysis treatment by the connected dialysis monitoring device 70 cannot be continued. Since the dialysis treatment by the personal dialysis apparatus 50 connected in parallel to the system can be continued, it is possible to avoid a system down in which all the hemodialysis apparatuses incorporated in the system cannot be used simultaneously, and its technical significance is great. .
In addition, when the dialysis fluid supply device 40 for a large number of people is normal, the mixing ratio suitable for the patient can be obtained by simply switching the flow path flowing into the personal dialysis device 50 without changing the system configuration at all. Since the dialysis treatment using the prepared dialysis fluid and the dialysis treatment using the dialysis monitoring device 70 using the dialysis fluid supplied from the multi-dialysis dialysis fluid supply device 40 can also be performed in parallel, this technical significance. Also great about.

FIG. 8 is a block diagram showing an embodiment of the dialysis monitoring device 70. As shown in the figure, the dialysis monitoring device 70 includes a dialysis fluid supply line 51, a dialysis fluid drainage line 52, and a blood pump 53, as in the personal dialysis device 50. A dialysis fluid supply device 40 is connected. Then, the dialysate is supplied from the multi-person dialysate supply device 40, blood from the patient is sent to the dialyzer 80 by the blood pump 53, and brought into contact with the dialysate through the semipermeable membrane to purify the blood.
In the dialysis monitoring apparatus 70 illustrated in FIG. 8, the venous chamber 82 is connected to the venous blood line 84, but as another aspect, the arterial chamber is further connected to the arterial blood line 83. The aspect may be sufficient.

It is a lineblock diagram showing one mode of a hemodialysis system concerning the present invention. It is a figure which shows the flow-path selection in case the dialysate supply apparatus for many people is normal. It is a figure which shows the flow-path selection when the dialysate supply apparatus for many people is abnormal. It is a figure which shows prescription dialysis in case the dialysate supply apparatus for many people is normal. It is a block diagram which shows the one aspect | mode of the personal dialysis apparatus. It is a block diagram which shows another aspect of the hemodialysis system which concerns on this invention. It is a block diagram which shows another aspect of the hemodialysis system which concerns on this invention. It is a block diagram which shows the one aspect | mode of the monitoring apparatus for dialysis. It is a block diagram which shows the one aspect | mode of the hemodialysis system which concerns on a prior art.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 A undiluted solution supply means 11 A undiluted solution line 20 B undiluted solution supply means 21 B undiluted solution line 30 RO apparatus 31 RO water line 40 Multi-person dialysate supply apparatus 41 Dialysate line 50 Personal dialyser 51 Dialysate supply line 52 Dialysate Drainage line 53 Blood pump 54 Stock solution pump 55 Solenoid valve 60 Channel switching means 70 Dialysis monitoring device (console)
80 Dializer 82 Venous chamber 83 Arterial blood line 84 Venous blood line 87 Clamp P1 First liquid feeding means P2 Second liquid feeding means P3 Third liquid feeding means

Claims (2)

A stock solution supply means for supplying A stock solution;
B stock solution supply means for supplying B stock solution;
RO device for supplying RO water;
A multi-person dialysis fluid supply device connected to the A stock solution supply means, the B stock solution supply means, and the RO device to dilute the A stock solution and the B stock solution with RO water to produce a dialysis fluid and to supply the dialysis fluid; ,
A hemodialysis system comprising at least one personal dialysis machine,
Each personal dialyzer is connected to the A stock solution supply means and the B stock solution supply means, and is connected to the multi-person dialysate supply device and the RO device via the flow path switching means. A hemodialysis system characterized in that the flow path from the dialysate supply device for the number of people and the RO device can be switched selectively.
The hemodialysis system according to claim 1, wherein at least one dialysis monitoring device is connected to the multi-person dialysate supply device.

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