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1.
Objective To explore the effect of plaster external fixation raising ill limbs in treating hand trauma and postoperative early swelling.Methods 2008 cases of hand trauma and postoperative early swelling without artery injurty patients were treated,such as plaster external fixation raising ill limbs.Paid attention to observe the effect for one week.Results Assess the standard according to the clinic, in 280 sufferers of this research,the significantly effect ,and effectiveness were 151 cases and 126 cases; the totaleffective rate was 98.9%.There were 3 cases appear the osteofasical compartment syndrome between the anadesma and the bone, because of the open decompression in time, it did not appear the serious complications.Conclusions This method in treating hand trauma and postoperative early swelling has obvious results; nursing intervention is simple, easy, effective, no severe complication.  相似文献   

2.
踝关节骨折手术治疗的临床研究   总被引:1,自引:0,他引:1  
目的 探讨踝关节骨折手术治疗的临床疗效.方法 回顾性分析2007年3月至2009年10月97例踝关节骨折患者的临床资料,所有患者术前均行CT和三维重建检查判断踝关节损伤情况,并据此选择手术治疗方案,术后在医生指导下进行功能锻炼,并采用改良Baird-Jackson评分系统对疗效进行评价.结果 术后随访6~18个月,平均13个月.疗效为优者64例(66.0%),良22例(22.7%),可6例(6.2%),差5例(5.2%),优良率为88.7%.术后2例患者出现伤口周围皮肤坏死,无患者发生骨不连、骨折畸形愈合等,术后6个月8例患者行走时仍有小腿酸胀和踝部不适感,合并下胫腓联合分离的患者中1例发生轻度骨性关节炎.结论 术前合理的处理以及正确的选择手术时机,术中完美的复位和稳定的内固定,术后指导患者进行积极的功能锻炼,可使踝关节骨折患者获得良好的临床疗效.
Abstract:
Objective To explore the results of internal fixation performed for ankle joint fracture.Methods From march 2007 to october 2009, Of 97 cases with ankle joint fractures were treated with open reduction and internal fracture, All cases were examined preoperation by CT scan and 3-D CT. Select the best surgical approach based on the 3-D CT views. Postoperative function exercise was performed under the guidance of doctors.All patients were evaluated with modified Baird and Jackson scoring system for postoperative function. Results A follow-up for 6 ~ 18 months showed that 64 cases(66% ) with an excellent result, good in 22 cases(22.7% ), fair in 6 cases(6.2% ) and poor in 5 cases(5.2% ). Excellent and good results were 88.7%. 2 cases with around skin necrosis after surgery, no patients with nonunion, malunion. Eight cases of patients still had legs sour and ankle soreness. I case merge syndesmosis occurred with mild osteoarthritis after 6 months of operation. Conclusions Preoperative treatment reasonable and select the correct surgical time, intraoperative perfect reduction and stable internal fixation, postoperative with positive exercise in patients with ankle fractures can obtain good clinical efficacy.  相似文献   

3.
跟骨骨折内固定手术并发症58例分析   总被引:2,自引:0,他引:2  
目的 探讨跟骨关节内骨折内固定手术并发症的发生原因、预防和对策.方法 收集2004年9月至2009年7月在石河子市人民医院采用切开复位+"Y"形钢板内固定伴必要时自体植骨治疗的Ⅱ~Ⅳ型跟骨骨折58例(共64足)患者的临床资料进行回顾性分析.结果 采用Maryland足部评分标准评价手术效果:优良55足,优良率为85.9%,9足发生术后复位不佳、畸形愈合、切口延迟愈合、感染等并发症.发生明确的早期并发症6足,发生率15.5%.结论 跟骨骨折内固定手术并发症与其解剖特点和骨折机制有关,采取相应措施可有效减少并发症的发生.
Abstract:
Objective To discuss complications of the fixed surgery of internal fixation of intra- articular calcaneal fracture. Methods Totally 64 sides of calcaneal fracture in 58 patients were treated with open reduction and Y-shaped plate fixation through lateral approach. All the cases were followed up, and the associated complications were analyzed retrospectively. Results The clinical results were evaluated according to Maryland Foot Score.Excellent and good results were acchieved in 55 cases. The precentage of complication was 85.9%. The complications were foud in 9 cases, including postoprerative wound dehiscence,malunion,infection etc. Conclusions The complications of internal fixations treating fractures arc related to anatomic features of calcaneus.  相似文献   

4.
陈广灿  曾永明  李威 《中国基层医药》2009,17(10):1601-1602
Objective To compare the clinical effects of palliative drainage to pancreatic and periampullary carcinoma which could not be excised with the operation.Methotis A retrospective study was accomplished on the palliative drainage treatment of 68 patients with pancreatic and petiampullary carcinoma hospitalized from 1996 to 2003.Results The disease course was two days to eight months.A definite preoperative diagnosis was made for 64 cases.Among them.single test diagnosed 24 cases and multiple tests diagnosed 40 cases.56 patients suffered from jaundice before operation.34 patients were treated by Roux-Y choledochojejunostomy.Choledochoduodenostomy was performed in 16 patients,cholecystduodenostomy for biliary by pass Was performed in 8 patients and stented internal drainage of the biliary duct in the liver and duodenostomy was performed in 10 patients.After reducing jaundice,12 patients was performed surgical resection.The second operation was performed in 4 patients because of postoperative jaundice and in 3 patients because of pylofic obstruction.The pefioperative compllcations include 4 cases of jaundice pyloric,3 cases of obstruction,2 cases of postoperative bleeding and 5 cases of infection of incisional wound.The aver-age stay in hospital waa 13.3 days(8~22 days).Conclusion Multiple tests were helpful to make a definite preoper-ative diagnosis.The selection of palliative drainage method based on the condition of patients had good curative effect in clinic.Surgocal exploration and reducing jaundice could set win conditions for second operation.  相似文献   

5.
Objective To compare the clinical effects of palliative drainage to pancreatic and periampullary carcinoma which could not be excised with the operation.Methotis A retrospective study was accomplished on the palliative drainage treatment of 68 patients with pancreatic and petiampullary carcinoma hospitalized from 1996 to 2003.Results The disease course was two days to eight months.A definite preoperative diagnosis was made for 64 cases.Among them.single test diagnosed 24 cases and multiple tests diagnosed 40 cases.56 patients suffered from jaundice before operation.34 patients were treated by Roux-Y choledochojejunostomy.Choledochoduodenostomy was performed in 16 patients,cholecystduodenostomy for biliary by pass Was performed in 8 patients and stented internal drainage of the biliary duct in the liver and duodenostomy was performed in 10 patients.After reducing jaundice,12 patients was performed surgical resection.The second operation was performed in 4 patients because of postoperative jaundice and in 3 patients because of pylofic obstruction.The pefioperative compllcations include 4 cases of jaundice pyloric,3 cases of obstruction,2 cases of postoperative bleeding and 5 cases of infection of incisional wound.The aver-age stay in hospital waa 13.3 days(8~22 days).Conclusion Multiple tests were helpful to make a definite preoper-ative diagnosis.The selection of palliative drainage method based on the condition of patients had good curative effect in clinic.Surgocal exploration and reducing jaundice could set win conditions for second operation.  相似文献   

6.
宫颈环形电切术治疗宫颈糜烂疗效观察   总被引:3,自引:2,他引:1  
赵改芹 《中国基层医药》2010,18(21):1637-1638
Objective To observe the clinical curative effect of cervical loop electrosurgical excision procedure in treatment of patients with cervical erosion by LEEP.Methods 268 patients whose cervical erosions were above Ⅱ°were treated by LEEP,and the length of operation time,bleeding volume in the operation, amount of vaginal discharge after the operation,the length of bleeding time and cervical repair were observed.Results Follow-up was 12 weeks.262 cases (97.76% ) were cured, 6 cases (2.24% ) were effective.The bleeding amount was less than 10ml.The average surgery time was(2.62 ±0.58) minutes.18 cases(6.71% ) had the colporrhagia.No infectious case was found.Conclusion The curative effect of LEEP for cervical erosion was significant,and operation was simple and safe.LEEP was a well treatment method of cervical erosion.  相似文献   

7.
郑铁  郭可泉  王坚刚  孟旭 《中国医药》2010,5(1):598-599
Objective To assess the therapeutic methods and results of surgical closure of atrial septal defect (ASD) after the failure of occlusion therapy via non-cardiopulmonary bypass (CPB)-minimally invasive intercostal incision (MⅢ). Methods From January 2008 to December 2008, twelve patients from 268 patients underwent occlusion therapy via non-CPB- MⅢ, were performed surgical closure of ASD after the failure of occusion. The causes accounting for the transition consist of introoperative or postoperative dislodgment of occusion device in 6 cases and 1 case respectively, infeasibility in 3 cases, Ⅲ °atrio-ventricular block (AVB) in 1 case and residual shunt in 1 case. All patients underwent the removal of occlusion device and surgical closure of ASD. Results The mean stretched diameter of the ASD (28.6 ± 6.2 mm) was significantly larger ( P < 0.01 ) than that measured by transesophageal echocardiography (TEE) (24.3 ±4.1 mm). The pathological type of ASD was confirmed with the inferior vena cava type in 4 cases of introoperative dislodgment of occusion device, the central tyepe in 2 cases and 1 case of introoperative or postoperative dislodgment repectively, the sieve pore type in 1 cases infeasible to occlusion, and with thin marginal tissue in 1 case with residual shunt. Sinus rhythm was postoperatively observed in all patients. No perioperative mortality and postoperative residual shunt was found. Conclusion Surgical treatment should be performed in time after the failure of occlusion to achieve a good outcome.  相似文献   

8.
郑铁  郭可泉  王坚刚  孟旭 《中国医药》2009,5(12):598-599
Objective To assess the therapeutic methods and results of surgical closure of atrial septal defect (ASD) after the failure of occlusion therapy via non-cardiopulmonary bypass (CPB)-minimally invasive intercostal incision (MⅢ). Methods From January 2008 to December 2008, twelve patients from 268 patients underwent occlusion therapy via non-CPB- MⅢ, were performed surgical closure of ASD after the failure of occusion. The causes accounting for the transition consist of introoperative or postoperative dislodgment of occusion device in 6 cases and 1 case respectively, infeasibility in 3 cases, Ⅲ °atrio-ventricular block (AVB) in 1 case and residual shunt in 1 case. All patients underwent the removal of occlusion device and surgical closure of ASD. Results The mean stretched diameter of the ASD (28.6 ± 6.2 mm) was significantly larger ( P < 0.01 ) than that measured by transesophageal echocardiography (TEE) (24.3 ±4.1 mm). The pathological type of ASD was confirmed with the inferior vena cava type in 4 cases of introoperative dislodgment of occusion device, the central tyepe in 2 cases and 1 case of introoperative or postoperative dislodgment repectively, the sieve pore type in 1 cases infeasible to occlusion, and with thin marginal tissue in 1 case with residual shunt. Sinus rhythm was postoperatively observed in all patients. No perioperative mortality and postoperative residual shunt was found. Conclusion Surgical treatment should be performed in time after the failure of occlusion to achieve a good outcome.  相似文献   

9.
目的 研究非小细胞肺癌肋骨骨髓微转移及肺癌组织nm23表达的意义,及其之间的相互关系.方法 79例非小细胞肺癌组织标本,免疫组织化学法检测其nm23蛋白表达活性及肋骨骨髓微转移细胞.结果 79例非小细胞肺癌患者中,nm23阳性表达47例,阳性率为59.5%;nm23阴性表达32例,阴性表达率为40.5%.骨髓微转移检测阳性37例,阳性率为46.8%;阴性42例,阴性率为53.2%.nm23阳性的47例中骨髓微转移阳性患者17例,无骨髓微转移者30例(P<0.05).结论 非小细胞肺癌患者骨髓微转移与肿瘤nm23的表达密切相关,nm23蛋白表达和骨髓微转移联合检测对肺癌的治疗和预后有着指导性的意义.
Abstract:
Objective To evaluate the clinical significance and the relationship of the expression of nm23 and micrometastases in bone marrow with non-small-cell lung cancer (NSCLC). Methods Immunohistochemical staining was used to detect the nm23 expression in the tumor tissue and micrometastases in the rib bone marrow.Results For all the 79 patients, expression of nm23 was positive in 47 ( 59.5 % ) while negative in 32 (40.5%)cases and micrometastasis were detected in 37 (46.8%) while negative in 42 ( 53.2% ) cases. Expression of nm23 positive in 17 ( 36.2% ) cases was detected micrometastases in the rib bone marrow and 30( 71.4% ) cases was not detected( P<0.05). Conclusions The micrometastases in bone marrow are closely related to nm23 in patients with NSCLC. Therefore, Combined detection of expression of nm23 and micrometastases in bone marrow plays a key role in prediction and prognosis of NSCLC.  相似文献   

10.
目的 分析胸外科择期全身麻醉(全麻)手术患者气管插管术后口腔细菌移位对肺部感染的影响,寻求降低肺部感染的具体措施.方法 将我院胸外科2010年1-12月择期全麻手术317例患者完全随机分成研究组(136例)和对照组(181例).对照组患者术前口腔不采取任何处理措施;研究组术前全部使用1%~1.5%双氧水深漱口2遍,时间20~30 s.观察2组患者术后1周内肺部感染的情况.结果 181例对照组患者中,术后1周发生肺部感染28例,感染发生率为15.5%;研究组136例患者术后1周发生肺部感染仅9例,感染发生率为6.6%.研究组患者肺部感染发生率明显低于对照组(P<0.05).痰培养显示,肺部感染菌株与口腔细菌菌株有很大相似之处.结论 1%~1.5%双氧水口腔深漱口可明显减少口腔细菌含量,较其他漱口液更为舒适,容易被患者接受,可明显降低口腔细菌移位致气管发生的肺部感染.
Abstract:
Objective To investigate the impact of oral bacterial translocation by endotracheal intubation on pulmonary infection in patients undergoing selective thoracic anesthesia surgery and efficient measures to reduce pulmonary infection. Methods Three hundred and seventeen patients undergoing selective thoracic anesthesia surgery in 2010 were randomly divided into two groups: control group (181 cases with no preoperative oral cleaning treatment) and study group(136 cases with preoperative oral cleaning). The cleaning process was a two-round mouthwash with 1% -1.5% hydrogen peroxid, with 20-30 seconds each round. Data of pulmonary infection of patients were collected within the first post-operation week. Results Pulmonary infection occurred in 28 cases of 181 control patients during 1 week after operation, the infection rate was 15.5%. While pulmonary infection occurred in 9 cases of 136 patients in study group, the infection rate was 6.6%. The pulmonary infection rate was significantly lower in experimental group than in control group (P< 0.05). Conclusion The mouthwash using oral disinfectant can significantly reduce the oral bacteria population and the incidence rate of lung infection by prohibiting their translocation to lung.  相似文献   

11.
病灶清除植骨术并前路内固定治疗胸腰椎结核   总被引:1,自引:1,他引:0  
刘刚  袁忠治  李继云 《河北医药》2005,27(11):807-808
目的探讨脊柱胸腰结核前路病灶清除、椎体间植骨融合同期前路内固定的治疗效果.方法对46例胸腰椎结核患者行前路病灶清除、椎体间植骨融合同期前路内固定治疗.结果46例脊柱结核患者均获治愈,平均随访11个月,植骨全部骨性融合,融合时间平均3.7月,后突矫正角度20度.治疗优良率达95.5%.结论胸腰椎结核前路病灶清除椎体间植骨融合同期前路内固定是安全和有效的,并在重建脊柱稳定性中具有重要的意义.  相似文献   

12.
目的探讨不同方法病灶清除植骨内固定术治疗脊柱结核的临床效果。方法据病灶部位的不同对64例脊柱结核患者采用不同的入路及内固定方法进行手术治疗。随访18个月,观察对比手术前后患者病灶、植骨融合、内固定、后凸畸形及骨髓损害情况。结果前路病灶清除一期植骨钢板内固定35例,前路病灶清除一期植骨后路经弓根钉棒内固定21例,前路病灶清除一期植骨前路钢板后路钉棒联合内固定8例。治疗后X线检查显示病灶情况、植骨融合情况、内固定情况、后凸畸形情况、合并脊髓损害者术后神经功能改善情况均取得较满意效果,3种入路及内固定方法间的治疗效果比较差异无统计学意义(P〉0.05)。结论病灶清除植骨内固定术能明显缓解脊柱结核的症状,有效清除病灶,改善神经功能,并且术后植骨融合良好,内固定稳定,治疗效果明显,但应注意据患者的病灶部位等选择合适的入路和内固定方式。  相似文献   

13.
目的分析对脊柱结核(胸腰段)患者进行手术治疗的理想化方案。方法对本院2007年10月~2011年10月收治的100例脊柱结核(胸腰段)患者中65例信息进行回顾性分析。其中65例患者采取病灶清除并植骨融合的内固定术进行治疗。在A组中30例患者于一期前路行病灶清除并植骨融合后再予以钉棒矫形的内固定术;在B组中35例患者于一期后路行钉棒矫形后再予以内固定术,之后行前路病灶的清除并植骨融合术。两组又分成累及单个椎体组(即A1组与B1组)和累及多个椎体组(即A2组与B2组)。再对A1组与B1组,以及A2组与B2组其手术时间与术中的出血量及其矫形率进行对比。结果其中,A1组的手术时间与术中的出血量显著低于B1组(P〈0.05);而B2组的矫形率与稳定性均优于A2组(P〈0.05)。结论脊柱结核(胸腰段)累及单个椎体时,于一期前路行病灶清除并植骨融合,之后行钉棒矫形的内固定术治疗,为理想化方案;而累及多个椎体,特别脊柱后凸的角度偏大时,于一期后路行钉棒矫形后再予以内固定术,之后行前路病灶的清除并植骨融合术则为理想化方案。  相似文献   

14.
目的探讨Ⅰ期病灶清除植骨融合加内固定术治疗胸腰段结核的疗效分析。方法回顾性分析评价:采用I期病灶清除植骨内固定术治疗胸腰段结核158例,男97例,女61例,经2周中西医结合正规抗结核治疗后Ⅰ期行病灶清除植骨融合加内固定术,术后继续中西医结合抗结核1~1.5年,计算患者术前、术后1周及末次随访时Cobb角,采用配对t检验进行统计学分析。分析术前与术后脊髓神经功能Frankel分级情况。结果术后随访1~2.5年,平均18个月,158例患者无局部复发及窦道形成,术前与术后Cobb角差异有统计学意义。Frankel分级除2例A级无变化外,其余均有1~2级恢复。结论针对性抗结核治疗是脊柱结核治疗的关键,病灶清除植骨融合内固定治疗胸腰段脊柱结核安全有效。  相似文献   

15.
目的对髂骨钉联合椎弓根钉内固定同期病灶清除,自体髂骨植骨融合治疗腰骶椎结核的手术方法和疗效进行探讨。方法采用后路髂骨钉联合腰椎椎弓根钉内固定,腰骶椎结核病灶清除自体髂骨椎间植骨手术治疗腰骶椎结核患者12例。结果术口一期愈合,术后4星期可佩带护腰支具下床活动,8个月以上随诊X线片显示植骨均骨性融合。结论采用后路髂骨钉联合椎弓根钉内固定,加同期病灶清除自体髂骨植骨融合治疗腰骶椎结核是安全有效的方法。  相似文献   

16.
目的:探讨胸腰椎结核一期前后方融合、后路内固定治疗的临床疗效。方法:28例胸腰椎结核患者采用一期前路或侧前方入路病灶清除、植骨,后路椎弓根螺钉固定。结果:平均手术时间为190min,出血量为800~1500ml,植骨融合时间为3~16个月。术后均无神经症状加重,术后切口一期愈合,术后12~18个月停用抗结核药物无复发。结论:采用一期前后方融合后路内固定治疗胸腰椎结核,能有效地清除病灶,重建脊柱稳定性,促进植骨融合并能为截瘫恢复创造良好条件。  相似文献   

17.
目的:探讨胸腰段脊椎(T10~L3)前路手术入路局部解剖结构指导前路椎体次全切除减压植骨内固定的临床效果。方法通过对10具(男性6具、女性4具)成人尸体标本进行胸腰段脊椎(T12~L3)进行解剖学研究,并于2010年1月~2013年10月对30例脊髓压迫主要来自于椎管前方的胸腰段椎体暴散性骨折病人行胸腰段前路减压植骨内固定术。其中,男21例,女9例;年龄20~65岁,平均38.5岁。均采用右侧卧位、左侧入路,切除左第十一肋骨,行T12、或L1、L2椎体次全切除植骨内固定术,其中T125例,L112例、L213例,所有病例均行相隔一个椎体、短节段固定。观察手术时间中出血并发症发生以及术后随访对比分析,观察植骨融合情况。结果平均手术时间(1.8±1.3)h,平均术中出血量(400~2100)800mL,术中胸腹损伤5例,术后胸腔引流3例,无大血管损伤及内脏脏器损伤,无脊髓神经损伤加重病例。随访6~46个月,平均20个月。所有病例均获满意复位,随访期间无复位丢失,内固定位置佳,无松动断裂,均于5个月获得骨性融合,融合率为100%。结论对于胸腰段(T12~L2)椎体暴裂性骨折,脊髓压迫主要来自于椎管前方,熟悉脊椎前入路局部解剖,掌握前路技术要点,采用前入路行椎体次全切除植骨内固定术,能够有效缩短手术时间。减少出血量及并发症发生,脊髓减压确实,术中植骨融合率高,手术效果好。  相似文献   

18.
王健  臧传义  唐杰 《中国医药》2014,(1):103-105
目的探讨后路椎弓根内固定联合前路病灶清除植骨融合治疗腰椎结核的临床效果。方法2005年6月至2013年6月北京老年医院接受腰椎结核治疗的患者128例,根据随机数字表法将患者分为对照组(常规前路或后路手术)和观察组(后路椎弓根内固定联合前路病灶清除植骨融合手术),每组64例。比较2组的手术时间、出血量、住院时间和术后1、3个月的红细胞沉降率。结果观察组手术时间、出血量、住院时间和术后1、3个月的红细胞沉降率分别为(201±16)min、(874±89)ml、(15.6±3.1)d、(26.5±3.1)mm/1h、(10.1±2.2)mm/1h;对照组分别为(130±13)min、(604±45)ml、(24.2±2.1)d、(27.8±2.1)mm/1h、(12.3±1.9)mm/1h。对照组手术时间,出血量少于观察组(均P〈0.05)。观察组术后12个月Cobb角优于对照组(10.2°±1.9°比12.8°±1.7°),骨融合率优于对照组[98.4%(63/64)比87.5%(56/64)],复发率低于对照组[1.6%(1/64)比12.5%(8/64)],差异均有统计学意义(P〈0.05)。结论后路椎弓根内固定联合前路病灶清除植骨融合手术具有术后恢复快、矫正角度丢失少、植骨融合快、复发率低。  相似文献   

19.
目的探讨一期前路病灶清除钛网支撑植骨融合加内固定治疗胸腰椎结核的临床疗效。方法回顾性分析2006年2月至2009年3月在新乡医学院第一附属医院接受治疗的胸腰椎结核患者45例,男23例,女22例,年龄21~69岁,平均45.5岁。所有患者均采用一期前路病灶清除、钛网支撑植骨融合加前路内固定术,其间观察围手术期并发症,测定融合节段后突角度、椎间平均高度、钛网沉降率及植骨融合情况。结果全部病例随访20~48个月,平均26个月,除1例出现肋间神经痛,其余44例均无术后并发症。随访期间未发现结核病灶残留或复发,术后融合节段后凸角为(8.0±2.1),°终末随访时矫正角度丢失(3.9±1.3)°,椎间高度丢失(2.3±0.2)mm,所有患者终末随访均达到骨性愈合。结论一期前路病灶清除钛网支撑植骨融合加内固定治疗胸腰椎结核的临床疗效显著,具有重建可靠,减压彻底和复发率低等优点。  相似文献   

20.
目的通过侧后方入路病灶清除、椎弓根钉棒系统内固定、植骨融合术治疗严重下腰椎结核,评估其治疗效果。方法回顾性分析2008年4月~2011年8月下腰椎结核行以上手术患者9例,术后随访6~12月观察其植骨融合率,症状缓解情况。主要评价标准包括:VAS评分、美国脊髓损伤神经学分类国际标准(2006)Asia损伤分级、血沉(ESR)。结果术后所有患者均显示骨性融合,术前疼痛活动受限症状术后均完全缓解,VAS评分均下降到0~2分,有神经损害表现者均恢复正常,Frankel分级恢复到D或E级,ESR均降至正常水平。结论通过对VAS评分、Frankel分级、血沉变化值进行统计分析,下腰椎结核采用Ⅰ期侧后方入路病灶清除植骨融合内固定手术,可改善症状,稳定脊柱,该术式效果良好。  相似文献   

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