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1.
A retrospective matched case-control study wasdone on 259 cases of ectopic pregnancy in BeijingChaoyang Hospital during the period from January1973 to December 31, 1984. All the cases wereconfirmed by pathological findings of specimens. Theresult showed that the risk of ectopic pregnancyin women who currently used IUD as contraceptivemethod was 3.06-4.0 times that in those who didnot use IUD. The rate of ectopic pregnancy per1000 conceptions increased significantly. This trendis parrallel to the sharp rise of IUD insertions. Abrief investigation was done on two other contracep-tive methods to evaluate the association betweenoral contraceptives (OC) or sterilization and ectopicpregnancy, showing that the use of OC or steriliza-tion has no correlation with the increased risk ofectopic pregnancy.  相似文献   

2.
A prospective study was conducted during the period August 1, 1985 to July 31, 1986 from ten hospitals in Trinidad and Tobago to determine the incidence and aetiology of ectopic gestations. One hundred and fifty-four cases of ectopic gestations were diagnosed in 153 patients, during the period of study, with eight patients having a previous ectopic gestation. The incidence of ectopic gestation was 9.02 per 1,000 births. Ectopic pregnancies were more common in women of African descent (64.29%) as compared to East Indian women (27.27%) and were most often seen in the 21 to 35-year-old age group where they accounted for 72.07% of the total. There were 16.23% ectopic gestations in the 36 to 42-year-old age group. Fifty-six per cent of the ectopic gestations occurred in the right fallopian tube. Ninety-one per cent were ruptured and 80.13% had histological evidence of chronic salpingitis. The maternal mortality from ectopic gestations was 1.3%. One primary ovarian ectopic gestation (0.65%) and one twin ectopic pregnancy were seen during the period of study.  相似文献   

3.
This study was done to assess the age-specific incidence of admission for acute myocardial infarction in Antigua and Barbuda from 1990 to 2001. A retrospective review of Intensive Care Unit admissions for possible acute myocardial infarction was performed. Data obtained included age, gender, country of residence, electrocardiogram, creatine kinase results and intensive care unit outcome. There were, 250 admissions, 194 (78%) having data available for review. Acute myocardial infarction was found in 107/194 (55.2%) patients, age 59.9 +/- 13.7 years, 28% female, 70% from Antigua and Barbuda, 90/107 (85%) were between 35 and 75 years old. The incidence would be 7.5 per year or 9.7 per year if the confirmation rate documented was similar for all admissions. With a yearly population of 9555 men age 35 to 75 years in Antigua and Barbuda, with men accounting for 72% of acute myocardial infarctions, the incidence rate was 0.57 (confirmed) to 0.73 (all admissions) per year per 1000 men. For women, the yearly population was 10822 age 35 to 75 years, and the incidence rate was 0.19 to 0.24 per year per 1000 women. The mortality rate was 12/107 (11.2%), with women being older (67 vs 57 years, p = 0.001) and dying more often (17% vs 9%) compared with men. The mortality rate in the Intensive Care Unit was 0.07 per year for men, 0.04 per year for women per 1000 aged 35 to 75 years. In the United States of America (USA), the admission rate is 4.1 for men and 1.8 for women per year per 1000 aged 35 to 75 years; the mortality rate is 1.0 for men and 0.5 for women per year per 1000 aged 35 to 75 years. Rates of admission to the Intensive Care Unit for acute myocardial infarction in Antigua and Barbuda are 20%, and mortality rates are 10% of those reported in the USA.  相似文献   

4.
Antepartum cervical Chlamydia trachomatis infection is associated with an increased risk of peripartum maternal and neonatal morbidity. Chronic chlamydial salpingitis has been described in asymptomatic women. We studied the incidence of asymptomatic chlamydial colonization of the fallopian tubes during pregnancy, and the influence of such infection on the patients' clinical course, by culturing the fallopian tubes of 53 asymptomatic women who underwent tubal ligation in the immediate postpartum period. One patient had a positive chlamydial culture in one of her tubes, and two others had histologic evidence of acute and chronic salpingitis. These patients had no infectious morbidity during the antepartum, intrapartum, or postpartum periods. Our findings suggest that asymptomatic chlamydial colonization and inflammatory processes may exist in the fallopian tubes during the peripartum period.  相似文献   

5.
OBJECTIVE: To evaluate whether colonoscopy protects against subsequent colorectal cancer (CRC). DESIGN: Case and population survey. SETTING: Townsville region in northern Queensland, between mid 1985 and January 1998. SUBJECTS: All 8430 patients who underwent 11,148 colonoscopies performed by the author at the Mater Private Hospital (a community-based open-access colonoscopy service) between July 1985 and December 1996; those who were subsequently diagnosed with CRC, to January 1998; and all 476 residents diagnosed with colorectal cancer between 1994 and 1997. MAIN OUTCOME MEASURES: Age-standardised CRC incidence for 1994-1997 for patients who had had a previous colonoscopy and for the remaining community; Dukes' grade of CRCs. RESULTS: For people aged 50 years and over, the incidence of CRC was significantly lower among those who had had a previous colonoscopy than in the remaining community (1.14 versus 2.31 per 1000 patient-years; P = 0.0046). For people aged 35-49 years, the incidence was 0.35 versus 0.31 per 1000 patient-years (P = 0.86). Thirty-one CRCs developed in 29 people who had had previous colonoscopy; only five of these CRCs were graded Dukes C, with none graded Dukes D. In contrast, almost half the CRCs in the rest of the community were graded Dukes C or D (P < 0.001). All but one of those diagnosed with CRC on repeat colonoscopy had risk factors (personal or family history), and 23 of the CRCs were subclinical, with 20 being diagnosed during surveillance colonoscopy. CONCLUSIONS: Patients aged over 50 years who had previously undergone a colonoscopy and ensuing treatment were less likely to be diagnosed with CRC than otherwise expected. Surveillance colonoscopy led to diagnosis of CRCs with lower Dukes grades.  相似文献   

6.
B J Maciak  A M Spitz  L T Strauss  L Morris  C W Warren  J S Marks 《JAMA》1987,258(15):2069-2071
We examined pregnancy rates and birth rates among United States teenagers aged 15 to 19 years in 1974, 1980, and 1983. Pregnancy rate refers to live births plus induced abortions per 1000 women; birth rate refers to live births per 1000 women. We present these rates for all teens aged 15 to 19 years and for teens aged 15 to 19 years who were sexually experienced. Data sources included National Center for Health Statistics birth records, Centers for Disease Control abortion surveillance reports, and Bureau of the Census population estimates. Sexual experience estimates came from national surveys of adolescent sexual behavior. Between 1974 and 1980, the pregnancy rate among all teens increased; the pregnancy rate among sexually experienced teens declined. From 1980 to 1983, the pregnancy rate declined among all teens and among sexually experienced teens. Birth rates among US teenagers (all teens and sexually experienced teens) declined between 1974 and 1983. Whereas the decline in the birth rate from 1974 to 1980 was primarily due to increased use of abortion, the decline from 1980 to 1983 related to the decrease in teenage pregnancies.  相似文献   

7.
目的 研究孕前体质量指数(body mass index, BMI)对孕妇产科并发症发生率以及妊娠结局的影响。方法 以2014年06月至2015年12月同济大学附属第十人民医院收治的1000名正规产检并住院分娩孕妇作为研究对象,分析孕前和孕期体质量对产科并发症和妊娠结局的影响。结果 BMI越高,发生子痫前期、妊娠期糖尿病、早产、胎膜早破、巨大儿的风险越高,剖宫产率增加。BMI越低,妊娠期贫血发病率增高。ICP、妊娠期甲状腺功能减退及羊水过少发生率与BMI无明显相关性。结论 孕前BMI对孕妇产科并发症发生率以及妊娠结局具有较大影响。  相似文献   

8.
D M Glebatis  D T Janerich 《JAMA》1983,249(13):1730-1735
Data on ectopic pregnancies reported to the New York State Department of Health for upstate residents for the years 1971 through 1979 were analyzed by maternal age, race, and gravidity. Trends in the rate of ectopic pregnancies were also examined for this time period. The rate of ectopic pregnancies per 1,000 conceptions increased with increasing maternal age and was higher for nonwhite women compared with white women. There was a slight increase in the rate of ectopic pregnancies with increasing gravidity, but this was due in part to the interaction of age with gravidity. The rate of ectopic pregnancies per 1,000 conceptions increased by 217% from 1971 to 1979. This trend differed within subgroups of maternal age, race, and gravidity. The percentage of increase was greater for women 30 years of age or older compared with women 30 years of age or younger, greater for white women compared with nonwhite women, and greater for women with three or more previous pregnancies compared with women with fewer previous pregnancies.  相似文献   

9.
育龄期妇女生殖器官癌症发病流行特征   总被引:1,自引:0,他引:1  
目的为了解上海市杨浦区20~49岁育龄期妇女生殖器官癌症发病现状及流行特征。方法收集1988年至2005年杨浦区共18年的肿瘤报病资料,分析20~49岁女性生殖器官癌症发病情况。结果上海杨浦区20~49岁育龄期妇女乳腺癌、卵巢癌、子宫体癌、宫颈癌和外生殖器癌的平均发病率(1/10万)分别为40.76、7.00、4.34、3.16和0.13;标化发病率(1/10万)分别为50.18、8.60、5.35、3.89和0.16。育龄期妇女的各种生殖器官癌症在总病例中所占的比例相对较高,女性生殖器官癌症的发病率随着年龄的增长逐渐增加。结论继续加强上海市杨浦区女性生殖器官的保健,提高女性癌症防治方面的知识,减少女性生殖器官癌症的发生,仍是今后上海市杨浦区妇女保健工作和癌症防治工作的重要内容。  相似文献   

10.
86例异位妊娠的临床分析   总被引:2,自引:0,他引:2  
黄薇 《当代医学》2010,16(19):122-123
目的通过对就诊的宫外孕患者进行相关因素调查及比较分析,以了解宫外孕发病现状。方法对2007年5月~2009年5月在我院就诊、按异位妊娠诊断标准确诊的异位妊娠患者共86例进行回顾性分析。结果宫外孕患者中怀孕≥3次的患者比例明显高于怀孕仅1~2次的患者。在不同年龄组中,B组(20~29岁)比例显著高于其他任何组;其次为C组(30~39岁),显著高于A组(〈20岁)与D组(〉39岁);A组(〈20岁)与D组(〉39岁)在宫外孕患者中所占比例无明显差异。宫外孕患者中,已上环人数所占比例明显低于未上环人数。从未分娩的患者占有比例最高,显著高于其他两组;而剖宫产组所占比例显著高于顺产组。结论要加强对异位妊娠的认识,早发现、早治疗,避免死亡发生。  相似文献   

11.
Researchers studied 68 cases of tubal ectopic pregnancy that occurred at the university hospital in Benin city, Nigeria from February 1973- January 1976. Medical records existed for only 53 cases. The ratio of ectopic pregnancy to deliveries stood at 1:58 (incidence: 1.7%). Excluding maternity cases, these 68 cases represented 6.5% of all gynecological and adult female admissions. 1 of 40 abdominal surgeries performed at this hospital was due to a tubal ectopic pregnancy. Therefore it represents a significant condition in Nigeria. 90% of the women were 40 years old. 68% of the cases already had between 2-5 children. Average parity stood at 2.6. Only 9.4% of the women were nulliparous. Spontaneous abortions occurred in 26.48% of the women. Further, the investigators observed that the lower the parity the higher the incidence of spontaneous abortion. For example, the abortion rate for women with no children and those with 1 stood at 100% and 73.9% respectively while for women with 5 and 5 children it stood at 11.76% and 10.8% respectively. 58% of the cases had experienced a previous pelvic infection. Since there was an association between a high abortion rate and tubal ectopic pregnancy, the researchers also pointed out a possible common etiological factor causing both spontaneous abortions and tubal ectopic pregnancies. therefore a woman who may be likely to experience an early spontaneous abortion may be just as likely to have a tubal ectopic pregnancy and vice versa. Health practitioners should consider any pregnant woman who has had a tubal pregnancy to be at risk of a spontaneous abortion or early labor.  相似文献   

12.
IUDs have been used in Singapore since the mid 1960's but acceptance of this contraceptive method has fluctuated widely as a result of misconceptions regarding possible complications. The current generation of copper bearing devices have pregnancy rates below 1 per 100 women per year and this rate falls further with continued use. New developments which hold promise include a device releasing 20 mcg levonorgestrel per day and a copper device without a plastic frame which may reduce menstrual blood loss and dysmenorrhoea. In addition to the well established contra-indications to use, a past history of pelvic inflammatory disease or ectopic pregnancy, promiscuity, nulliparity and age less than 25 are now considered relative contraindications.  相似文献   

13.
Delayed childbearing in Sweden   总被引:1,自引:0,他引:1  
M R Forman  O Meirik  H W Berendes 《JAMA》1984,252(22):3135-3139
Using data from the Swedish Medical Birth Registry, we examined whether reproductive history influenced pregnancy outcomes among women aged 30 to 39 years who gave birth to a first or second child in 1976 through 1980. They were classified group 1, primigravida; group 2, gravida 2, para O; and group 3, gravida 2, para 1. Compared with women aged 20 through 24 years with the same parity and gravidity, the relative risk (RR) of late fetal deaths was significantly greater among those aged 35 through 39 years (RR: group 1 = 1.76, group 2 = 2.22, and group 3 = 2.39). The risk of giving birth to newborns who were low birth weight and preterm, or low birth weight at term, or 2,500 g or greater but preterm was greater among women aged 30 through 39 years in groups 1 and 2--significantly so for group 1 aged 30 through 39 years v group 1 aged 20 through 24 years. Risk increased with maternal age, from 30 through 34 to 35 through 39 years. The increased risk with age and parity-gravidity has ramifications for the increasing rate of delayed childbearing in the United States and elsewhere.  相似文献   

14.
Ziv E  Cauley J  Morin PA  Saiz R  Browner WS 《JAMA》2001,285(22):2859-2863
CONTEXT: Transgenic animal experiments suggest that increased expression of transforming growth factor beta1 (TGF-beta1) is protective against early tumor development, particularly in breast cancer. A T-->C (thymine to cytosine) transition in the 29th nucleotide in the coding sequence results in a leucine to proline substitution at the 10th amino acid and is associated with increased serum levels of TGF-beta1. OBJECTIVE: To determine whether an association exists between this TGF-beta1 polymorphism and breast cancer risk. DESIGN, SETTING, AND PARTICIPANTS: The Study of Osteoporotic Fractures, a prospective cohort study of white, community-dwelling women aged 65 years or older who were recruited at 4 US centers between 1986 and 1988. Three thousand seventy-five women who provided sufficient clinical information, buffy coat samples, and adequate consent for genotyping are included in this analysis. MAIN OUTCOME MEASURE: Breast cancer cases during a mean (SD) follow-up of 9.3 (1.9) years, verified by medical chart review and compared by genotype. RESULTS: Risk of breast cancer was similar in the 1124 women with the T/T genotype (56 cases; 5.4 per 1000 person-years) and the 1493 women with the T/C genotype (80 cases; 5.8 per 1000 person-years) but was significantly lower (P =.01) in the 458 women with the C/C genotype (10 cases; 2.3 per 1000 person-years). In analyses that adjusted for age, age at menarche, age at menopause, estrogen use, parity, body mass index, and bone mineral density, women with the C/C genotype had a significantly lower risk of developing breast cancer compared with women with the T/T or T/C genotype (hazard ratio [HR], 0.36; 95% confidence interval [CI], 0.17-0.75). There was no significant difference between the risk for women with the T/C genotype compared with women with the T/T genotype (adjusted HR, 1.04; 95% CI, 0.73-1.48). CONCLUSIONS: Our findings suggest that TGF-beta1 genotype is associated with risk of breast cancer in white women aged 65 years or older. Because the T allele is the common variant and confers an increased risk, it may be associated with a large proportion of breast cancer cases.  相似文献   

15.
CONTEXT: Based on observational and interventional data for middle-aged cohorts (aged 40-64 years), serum cholesterol level is known to be an established major risk factor for coronary heart disease (CHD). However, findings for younger people are limited, and the value of detecting and treating hypercholesterolemia in younger adults is debated. OBJECTIVE: To evaluate the long-term impact of unfavorable serum cholesterol levels on risk of death from CHD, cardiovascular disease (CVD), and all causes. DESIGN, SETTING, AND PARTICIPANTS: Three prospective studies, from which were selected 3 cohorts of younger men with baseline serum cholesterol level measurements and no history of diabetes mellitus or myocardial infarction. A total of 11,017 men aged 18 through 39 years screened in 1967-1973 for the Chicago Heart Association Detection Project in Industry (CHA); 1266 men aged 25 through 39 years examined in 1959-1963 in the Peoples Gas Company Study (PG); and 69,205 men aged 35 through 39 years screened in 1973-1975 for the Multiple Risk Factor Intervention Trial (MRFIT). MAIN OUTCOME MEASURES: Cause-specific mortality during 25 (CHA), 34 (PG), and 16 (MRFIT) years of follow-up; mortality risks; and estimated life expectancy in relation to baseline serum cholesterol levels. RESULTS: Death due to CHD accounted for 26%, 34%, and 28% of all deaths in the CHA, PG, and MRFIT cohorts, respectively; and CVD death for 34%, 42%, and 39% of deaths in the same cohorts, respectively. Men in all 3 cohorts with unfavorable serum cholesterol levels (200-239 mg/dL [5.17-6.18 mmol/L] and >/=240 mg/dL [>/=6.21 mmol/L]) had strong gradients of relative mortality risk. For men with serum cholesterol levels of 240 mg/dL or greater (>/=6.21 mmol/L) vs favorable levels (<200 mg/dL [<5.17 mmol/L]), CHD mortality risk was 2.15 to 3.63 times greater; CVD disease mortality risk was 2.10 to 2.87 times greater; and all-cause mortality was 1.31 to 1.49 times greater. Hypercholesterolemic men had age-adjusted absolute risk of CHD death of 59 per 1000 men in 25 years (CHA cohort), 90 per 1000 men in 34 years (PG cohort), and 15 per 1000 men in 16 years (MRFIT cohort). Absolute excess risk was 43.6 per 1000 men (CHA), 81.4 per 1000 men (PG), and 12.1 per 1000 men (MRFIT). Men with favorable baseline serum cholesterol levels had an estimated greater life expectancy of 3.8 to 8.7 years. CONCLUSIONS: These results demonstrate a continuous, graded relationship of serum cholesterol level to long-term risk of CHD, CVD, and all-cause mortality, substantial absolute risk and absolute excess risk of CHD and CVD death for younger men with elevated serum cholesterol levels, and longer estimated life expectancy for younger men with favorable serum cholesterol levels. JAMA. 2000;284:311-318  相似文献   

16.
Live-birth rates and multiple-birth risk using in vitro fertilization   总被引:15,自引:1,他引:14  
Schieve LA  Peterson HB  Meikle SF  Jeng G  Danel I  Burnett NM  Wilcox LS 《JAMA》1999,282(19):1832-1838
CONTEXT: To maximize birth rates, physicians who perform in vitro fertilization (IVF) often transfer multiple embryos, but this increases the multiple-birth risk. Live-birth and multiple-birth rates may vary by patient age and embryo quality. One marker for embryo quality is cryopreservation of extra embryos (if embryos are set aside for cryopreservation, higher quality embryos may have been available for transfer). OBJECTIVE: To examine associations between the number of embryos transferred during IVF and live-birth and multiple-birth rates stratified by maternal age and whether extra embryos were available (ie, extra embryos cryopreserved). DESIGN AND SETTING: Retrospective cohort of 300 US clinics reporting IVF transfer procedures to the Centers for Disease Control and Prevention in 1996. SUBJECTS: A total of 35554 IVF transfer procedures. MAIN OUTCOME MEASURES: Live-birth and multiple-birth rates (percentage of live births that were multiple). RESULTS: A total number of 9873 live births were reported (multiple births from 1 pregnancy were counted as 1 live birth). The number of embryos needed to achieve maximum live- birth rates varied by age and whether extra embryos were cryopreserved. Among women 20 to 29 years and 30 to 34 years of age, maximum live-birth rates (43 % and 36%, respectively) were achieved when 2 embryos were transferred and extra embryos were cryopreserved. Among women 35 years of age and older, live-birth rates were lower overall and regardless of whether embryos were cryopreserved, live-birth rates increased if more than 2 embryos were transferred. Multiple-birth rates varied by age and the number of embryos transferred, but not by whether embryos were cryopreserved. With 2 embryos transferred, multiple-birth rates were 22.7%, 19.7%, 11.6%, and 10.8% for women aged 20 to 29, 30 to 34, 35 to 39, and 40 to 44 years, respectively. Multiple-birth rates increased as high as 45.7% for women aged 20 to 29 years and 39.8% for women aged 30 to 34 years if 3 embryos were transferred. Among women aged 35 to 39 years, the multiple-birth rate was 29.4% if 3 embryos were transferred. Among women 40 to 44 years of age, the multiple-birth rate was less than 25% even if 5 embryos were transferred. CONCLUSIONS: Based on these data, the risk of multiple births from IVF varies by maternal age and number of embryos transferred. Embryo quality was not related to multiple birth risk but was associated with increased live-birth rates when fewer embryos were transferred.  相似文献   

17.
To estimate the incidence of fracture of the proximal end of the femur in people aged 50 years or older living in the Quebec area in 1971, 1976 and 1981 we determined the number of admissions for such fractures to the 15 acute care hospitals in the region. From 1971 to 1981 the number of fractures increased by 71%; the increases for those aged 75 to 84 years and 85 years or over were 98% and 118% respectively. The variation is only partly explained by changes in sex and age distribution of the population; the incidence rates also increased. Among men aged 75 to 84 years the incidence rate per 1000 person-years rose from 2.63 in 1971 to 5.22 in 1981, an increase of 98%; the corresponding figures for men aged 85 years or more were 9.76 and 16.91, an increase of 73%. Among women aged 75 to 84 years the rate rose from 7.28 to 8.81, an increase of 21%; the corresponding figures for women aged 85 years or more were 20.40 and 24.27, an increase of 21% and 19% respectively.  相似文献   

18.
Basic data were obtained from the records of 16,069 women who had smears taken for cervical cytological examination in Western Australia during an eight-week period in 1983. The peak smear rate was 340.7 per 1000 at 25-29 years of age and fell thereafter with age. The estimated peak frequency of smears that were designated as "screening" smears was 178.3 per 1000 at 30-34 years of age. Screening smears comprised 39% to 66% of the total number of smears, depending on age. After correction for the estimated prevalence of past hysterectomy, only in the age range 20-34 years did the rate of all smears approach the rate of screening smears that would be obtained under a recommended frequency of once every three years. The frequency of screening smears was 20% less in rural areas of Western Australia than in the capital city, Perth. In Perth it fell with decreasing socioeconomic status. General practitioners took 62.4% of all smears and 70.3% of screening smears. On average, female general practitioners took twice as many smears than did male general practitioners.  相似文献   

19.
目的分析体外受精(IVF)或卵母细胞胞质内单精子注射(ICSI)后进行新鲜或冻融胚胎移植(ET)妇女异位妊娠的发生情况及其影响因素。方法对接受胚胎移植治疗后获得临床妊娠的1564个周期的病因、年龄、移植时机、不育形式等高危因素进行回顾性调查。采用SPSS17.0软件进行统计学分析,计数资料采用t检验,计量资料采用x2检验,相关性统计采用Logistic回归分析。结果冻融周期ET后异位妊娠发生率明显低于新鲜周期ET。年龄≤30岁的患者ET后发生异位妊娠率高于年龄〉30岁者,继发不孕者较原发不孕者发生异位妊娠的比例更高。结论年龄、移植时机和不育形式是体外受精一胚胎移植后发生异位妊娠的重要相关因素。  相似文献   

20.
目的 分析2008年汶川大地震后地震重灾区高龄妇女再次妊娠结局,为高龄妇女的孕前保健提供参考。方法 回顾性调查接受地震重灾区再生育全程服务的542例妊娠经产妇的临床资料,根据妊娠终止年龄分为高龄组(≥35岁)和非高龄组(<35岁),比较两组妊娠结局,包括基本情况、妊娠率、妊娠合并症/并发症、妊娠结果及围产儿情况。结果 2008~2013年542例再生育妇女(高龄组366例,非高龄组176例)共妊娠622人次,生育(足月和早产)517人次,活产522人(双胎6例),有出生缺陷3例。高龄组的两年内累积妊娠率低于非高龄组,高龄组妊娠高血压疾病、妊娠期糖尿病、多胎、胎儿宫内窘迫、低出生体重儿、出生缺陷的发生率较高,非高龄组足月活产率较高、流产率较低,但差异无统计学意义。结论 接受地震灾区再生育全程服务的高龄经产妇再次妊娠结局与非高龄经产妇相当。  相似文献   

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