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1.
目的 探讨神经衰弱与患者个性、生活事件及EB病毒的关系。方法 用艾森克人格问卷 (EPQ)、生活事件量表 (LES)及症状自评量表 (SCL 90 )对 30例神经衰弱患者治疗前后和 30名正常人进行评估 ,用酶联免疫吸附方法检测血清EB病毒抗体 IgG和IgM。结果 病例组EPQ中N分、LES总分及负性分、EBV IgG和EBV IgM阳性率高于对照组 ,E分低于对照组 ;治疗后患者SCL 90总分下降 ,EPQ中N分下降 ,血清EBVIgG、IgM呈下降趋势。结论 神经衰弱患者具有神经质和内向的个性特征 ,病前经历较多生活事件 ,还可能与EB病毒感染有关。  相似文献   

2.
目的探讨多发性硬化(MS)患者血清和脑脊液(CSF)中EpsteinBarr(EB)病毒IgG抗体检测的意义。方法采用酶联免疫吸附法检测MS患者65例、其他神经科疾病(OND组)患者71例、非神经科疾病(NND组)患者42例的血清和CSF中EB病毒核抗原、壳抗原和早期抗原的IgG抗体,并进行分析比较。根据血清抗体检测结果的组合,分析各组中病毒初次感染、既往感染和病毒重新激活的情况。结果3组患者血清EB病毒核抗原、壳抗原IgG抗体阳性率均>90%,差异无显著性(均P>0.05)。MS组EB病毒早期抗原IgG抗体阳性率(46.2%)明显高于其他两组(18.3%,9.5%,均P<0.05)。MS组病毒感染重新激活的比率(46.2%)明显高于其他两组(18.3%,9.5%,均P<0.05)。3组CSF病毒抗体阳性率差异无显著性(均P>0.05)。结论MS患者活动性的EB病毒感染较多,EB病毒感染重新激活的比例很高。  相似文献   

3.
精神病患者猝死的相关因素分析   总被引:13,自引:2,他引:11  
目的 探讨精神病患者猝死的相关因素。方法 选取 1997年 1月至 2 0 0 1年 12月在北京回龙观医院住院治疗中发生猝死的 6 5例精神病患者作为猝死组 ,以 2 0 0 2年 2月 2 0日所有在院的 110 7例精神病患者作为对照组。收集两组病例的主要人口学资料 (年龄、性别、精神障碍种类和病程 )和主要临床资料 (如合并躯体疾病种类、心电图特征、QTc间期、抗精神病药种类及剂量、合并其他精神药物的种类及剂量 ,主要不良反应等 ) ;对猝死组收集死因的临床判断及任何可能与猝死有关的资料。结果  (1)猝死组与对照组患者在抗精神病药剂量及QTc间期 (总体 )的差异均无显著性 (均P >0 0 5 )。 (2 )两组中接受氯氮平治疗者的QTc间期 [(0 36± 2 5 4 )ms]均长于非氯氮平治疗者 [(0 35±3 2 3)ms],差异有非常显著性意义 (P =0 0 0 ) ;其中 ,猝死组和对照组用氯氮平治疗者的QTc间期分别为 [(0 39± 1 31)ms和 (0 36± 2 4 6 )ms],未用氯氮平治疗者的QTc间期分别为 [(0 33± 3 2 3)ms和(0 35± 3 2 1)ms]。 (3)猝死组慢性起病者 (96 9% )多于对照组 (87 7% ;P =0 0 3) ,合并躯体疾病的比例 (89 2 % )高于对照组 (39 1% ;P =0 0 0 ) ,心电图异常率 (5 8 5 % )也高于对照组 (2 5 8% ;P =0 0 0 )。经非参数检  相似文献   

4.
抽动障碍患儿免疫功能检测与其临床意义   总被引:3,自引:0,他引:3  
目的 观察抽动障碍患儿外周血 T淋巴细胞亚群、自然杀伤细胞和体液免疫 ( Ig A,Ig G,Ig M)功能。方法 应用直接免疫荧光染色法 ,采用流式细胞术分别测定 3 0例抽动障碍患儿和 2 0名健康对照组儿童外周血 T淋巴细胞亚群、自然杀伤细胞。并用免疫透射比浊法测定患儿的体液免疫 ( Ig A、Ig G、Ig M)功能。比较两组的检测结果。结果 抽动障碍患儿外周血 CD4+细胞百分比、CD4+ /CD8+细胞比值和自然杀伤 ( NK)阳性细胞百分比分别为 ( 2 6.89± 9.0 8) %、( 0 .88± 0 .3 5 ) %、( 9.61± 6.45 ) % ,较对照组 ( 3 8.3 1± 6.95 ) %、( 1 .5 8± 0 .2 9) %、( 1 4.83±4.1 6) %明显降低 ,CD8+ 细胞百分比 [( 3 2 .5 8± 9.0 4) % ]较对照组 [( 2 4.82± 5 .5 4) % ]明显升高 ,而体液免疫Ig A、Ig G、Ig M含量与对照组比较则差异无显著性。结论 抽动障碍患儿存在细胞免疫功能紊乱 ,表现为 T淋巴细胞亚群平衡失调和自然杀伤细胞阳性率低。提示细胞免疫功能紊乱可能与某些儿童易患抽动障碍有关。  相似文献   

5.
目的 通过Meta分析探讨多发性硬化(MS)患者体内抗EB病毒(EBV)抗体阳性率。方法 检索对MS病例与对照血清中抗EBV抗体进行检测的随机对照试验(RCT),并通过Meta分析探索各种抗EBV抗体与MS之间的关系。计算机检索中国期刊全文数据库(CNKI)、万方科技期刊全文数据库、PubMed、EMbase和维普中文科技期刊全文数据库(VIP),检索时限均从建库至2021年12月。两名研究者严格根据制定的纳入及排除标准独立进行文献筛选并提取基本资料,依据修改后的纽卡斯尔-渥太华量表(NOS)工具评价文献质量。采用Rev Man 5.3软件合并计算所有纳入文献中的每一种抗EBV抗体血清阳性率的OR,并进行敏感性分析和亚组分析。以Egger检验评价发表偏倚。结果 共纳入35项研究。MS患者EBV衣壳抗原抗体(EBV-VCA)IgG/IgM、EBV核心抗原抗体(EBNA)IgG血清阳性率明显高于对照者,效应量指标总体OR值及其95%CI分别为:EBV-VCA IgM(OR=3.44,95%CI:1.93~6.13)、EBV-VCA IgG(OR=4.79,95%CI:2.82~8.15)、...  相似文献   

6.
慢性应激对大鼠海马CA3区长时程增强的影响   总被引:2,自引:0,他引:2  
目的 探讨慢性应激对大鼠海马CA3区长时程增强 (LTP)的影响及机制。方法 将 34只Wistar大鼠随机分成应激组 (8只 )、应激 +盐水组 (8只 )、应激 +MK 80 1组 (8只 )及空白对照组 (1 0只 ) ,应激刺激为饮水冲突模型 ,分别于实验初和LTP检测前 1天评定大鼠情绪性行为 ,在应激 1 5天后检测大鼠强直性LTP ,测量强直后 1 ,5 ,1 0 ,30 ,60 ,90 ,1 2 0minLTP群体峰电位幅度及峰潜期。结果(1 )应激前各组情绪性行为评分的差异均无显著性 ;应激后 ,应激 +盐水组 [(4 33± 0 50 )分 ]、应激 +MK 80 1组 [(3 60± 0 55)分 ]及应激组 [(2 90± 0 74)分 ]的评分均高于对照组 [(2 0 2± 1 1 6)分 ] ,差异有显著性 (P =0 0 0 0 ) ;(2 )应激组测试刺激阈值较对照组高 (45V∶30V) ;(3)在强直后第 1 ,90min时的LTP群体峰电位变化率应激组 [分别为 (2 1 1± 58) %和 (2 4 3± 69) % ]、应激 +盐水组 [分别为 (1 69±92 ) %和 (1 82± 1 61 ) % ]低于对照组 [分别为 (30 2± 2 1 0 ) %和 (30 3± 1 4 1 ) % ]和应激 +MK 80 1组 [分别为(375± 99) %和 (489± 2 36) % ] ,差异有显著性 (P <0 0 5) ,应激 +MK 80 1组与对照组的差异无显著性 ;(4)各应激组于各时点LTP峰潜期均较对照组长 ,但差异未呈显著性。结论 慢性  相似文献   

7.
目的 分析结核性脑膜炎 (TM)的脑神经损害的特征 ,及其与脑脊液 (CSF)免疫球蛋白 (Ig)和白蛋白 (Alb)的关系。方法 将确诊的 4 8例TM患者分为两组 :无脑神经麻痹TM组 (A组 ,30例 )和有脑神经麻痹TM组 (B组 ,18例 ) ,用速率散射比浊法测定其CSFIg和Alb的含量。结果 B组中展神经受损最多 ,为 10例 (5 5 6 % ) ,其次为动眼神经受损 (6例 )。视神经、听神经损害分别为 4例、2例 ;B组CSF蛋白含量明显高于A组 (P <0 0 0 1) ,CSFIgG、IgM、Alb含量 :A组分别为 (135 7± 4 1 4 )mg/L、(12 4± 3 3)mg/L及 (5 6 6 5± 2 71 8)mg/L ,B组分别为 (197 2± 4 5 1)mg/L、(36 7± 5 8)mg/L及 (813 3± 2 84 5 )mg/L ,两组比较差异均有显著性 (均P <0 0 0 1)。结论 TM常有脑神经损害 ,且与血 脑屏障破坏、CSFIg和Alb升高有关  相似文献   

8.
家庭干预对精神分裂症患者临床疗效的对照研究   总被引:13,自引:2,他引:13  
目的观察家庭干预对精神分裂症患者治疗效果的影响。方法将160例精神分裂症患者随机分为药物治疗并家庭干预组(家庭组)80例和单纯药物治疗组(对照组)80例。家庭组接受药物、家庭心理干预治疗,对照组仅接受药物治疗。出院时和随访2年末,采用简明精神病量表(BPRS)、自制调查表评定精神症状、疗效、住院天数、治疗依从性和复发率。结果出院时:家庭组平均住院天数明显短于对照组,分别为(56±7)天和(78±18)天,显效率和有效率明显高于对照组(72.2%vs 43.5%;91.7%vs 75.4%);BPRS量表分明显低于对照组[(24.3±4.1)vs(29.6±5.2)];治疗依从性分别是完全依从为75.0%、部分依从为19.4%、不依从为5.6%,对照组分别为52.2%、34.8%和13.0%,差异有显著性(P<0.01)。随访2年末:家庭组显效率和有效率明显高于对照组(63.9%vs30.4%;77.8%vs44.9%);BPRS量表分明显低于对照组[(27.2±5.1)vs(34.7±7.8)];治疗依从性分别是完全依从为62.5%、部分依从为26.4%、不依从为11.1%,对照组分别为36.2%、26.1%和37.7%,差异有显著性(P<0.01);复发率明显低于对照组(13.9%vs 30.4%),差异有显著性(P<0.01);两组脱落率则无显著性差异(P>0.05)。结论家庭干预有利于精神分裂症患者精神症状的改善,能缩短住院时间、提高治疗依从性和减少复发率。  相似文献   

9.
首发精神分裂症患者的糖代谢研究   总被引:5,自引:3,他引:5  
目的 探讨首发精神分裂症患者的糖代谢情况。方法 对 86例首发精神分裂症患者及 45名健康人进行糖耐量试验(OGTT) ,并检测其空腹血浆胰岛素、C肽的浓度。结果 两组间空腹血糖、餐后 3h血糖、空腹胰岛素、C肽的差异无显著性 ,病例组餐后 1h血糖值 [( 7 89± 1 77)mmol/L]、2h的血糖值 [( 6 2 4± 1 14 )mmol/L]、OGTT血糖曲线下面积 (AUC) [( 18 2 4± 2 76)mmol/(L·h) ]比对照组 [分别为 ( 6 5 4± 1 84)mmol/L ,( 5 88± 2 78)mmol/L ,( 15 86± 1 93 )mmol/L/h ,P分别小于 0 .0 1、0 .0 5、0 0 1]要大 ;组间糖耐量减退 (IGT)的发生率无显著性差异 ( χ2 =0 5 84,P >0 0 5 ) ;偏执型患者组与青春型患者组间的空腹血糖、2h血糖值无显著性差异 (t=1 476,P均大于 0 0 5 ) ;发生IGT的病例组与未发生IGT病例组组间阳性和阴性症状量表 (PANSS)总分及 4个分量表分值的差异无显著性差异 (P均大于 0 0 5 )。结论 首发精神分裂症患者存在餐后高血糖现象。  相似文献   

10.
脑血管病患者血小板膜糖蛋白测定的临床意义   总被引:7,自引:2,他引:5  
目的 探讨脑血管病患者血小板膜糖蛋白测定的临床意义。方法 采用流式细胞仪测定 5 4例脑血管病患者及 2 0名正常对照者外周血血小板活化分子标记物颗粒蛋白 (GMP) CD6 2 p,CD6 3;整合数 α b链 (CD4 1b) ;血小板膜糖蛋白 Gp Ib(CD4 2 b)。结果 脑梗死患者 CD6 2 p、CD6 3的阳性率明显高于健康对照组及脑出血组 (P<0 .0 1)。而脑梗死组发病 3天以内的 CD6 2 p、CD6 3阳性率较发病 2 0天以上者显著增高 (P<0 .0 1)。但后者仍高于健康对照组 (P<0 .0 1) ,CD4 1b、CD4 2 b在各组间无显著差异。结论 脑梗死患者的血小板活化程度明显增高 ,尤其是 CD6 2 p、CD6 3。提示阻止或抑制血小板活化的途径将是防治脑梗死的方法之一  相似文献   

11.
OBJECTIVE: To assess the presence of Epstein-Barr virus (EBV) and human herpesvirus 6B (HHV-6B) DNA in saliva and plasma from multiple sclerosis (MS) patients enrolled in a randomized, double-blind, placebo-controlled valacyclovir treatment study. METHODS: DNA was prepared following ultracentrifugation of saliva and plasma. EBV and HHV-6B DNAs were determined by real-time polymerase chain reaction. RESULTS: EBV and HHV-6B DNAs were detected in 41% and 65% of saliva samples, respectively. In patients treated with valacyclovir, the percentage of saliva samples with EBV was significantly reduced (9%; P = 0.000017), whereas the frequency of HHV-6B positive samples was unchanged (57%; P = 0.38). Longitudinal studies demonstrated a time-dependent reduction in the frequency of saliva samples containing EBV following valacyclovir treatment. In contrast, plasma contained EBV and HHV-6B DNAs in 17% and 25% of the samples, respectively, and these numbers were not significantly reduced following valacylovir treatment (13% and 16%, respectively), nor were they different from those of healthy controls (6% and 39%, respectively). Patients with high disease activity had a significantly higher frequency of EBV (P = 0.018) and HHV-6B (P = 0.023) positive samples than did patients with low disease activity. The presence of EBV and HHV-6B was strongly correlated in plasma (P < 0.00000001), but not in saliva (P = 0.41). CONCLUSION: MS patients express EBV and HHV-6B in both saliva and plasma, but only the expression of EBV in saliva is significantly reduced following valacyclovir treatment. Although EBV and HHV-6B DNAs can be detected in plasma from healthy individuals, the co-expression of both these viruses in MS patients is highly significant and further associated with clinical activity. The observations of viral DNA in plasma are consistent with an underlying immunologic defect in MS.  相似文献   

12.
OBJECTIVES: To study in relapsing-remitting (RR) multiple sclerosis (MS) whether exacerbations and brain activity as measured by magnetic resonance imaging (MRI) are associated with plasma levels of anti-Epstein Barr (EBV) antibodies and EBV DNA. METHODS: This was a prospective study with 73 RR MS patients followed for an average of 1.7 years with frequent neurological examination and blood sampling. Antibodies to various EBV proteins were measured by ELISA and plasma EBV DNA was measured by PCR. RESULTS: All MS patients had IgG antibodies to EBV (viral capsid antigen (VCA) and/or EBV nuclear antigen (EBNA)), irrespective whether samples were taken at stable disease or exacerbation. A significantly elevated percentage of the patients (48%) had antibodies against EBV antigens (early antigen, EA) that indicate active viral replication, compared with the age matched healthy controls (25%). Antibodies against a control herpesvirus, cytomegalovirus, were similar between the two groups. The percentage of EA positive individuals and EA titres did not differ between stable disease or exacerbation. Anti-VCA IgM was positive in three cases, unrelated to disease activity. Using a highly sensitive PCR on 51 samples taken at exacerbation visits, only three patients were found to have one timepoint with viraemia, and this viraemia was unrelated to disease activity. Of special note was the fact that anti-EA seropositive patients remained seropositive during follow up, with stable titres over time. We hypothesised that these patients may constitute a subgroup with higher disease activity, due to the triggering effect of a chronic attempt of the virus to reactivate. The EA positive group did not differ from the EA negative with respect to clinical disease activity or other characteristics. However, in the EA positive group, analysis with gadolinium enhanced MRI indicated more MRI disease activity. CONCLUSIONS: There was no evidence for increased clinical disease activity in the subgroup of MS patients with serological signs of EBV reactivation. However, the observation that chronic EBV reactivation may be associated with increased inflammatory activity as assessed by gadolinium enhanced MRI lesions should be reproduced in a larger and independent dataset.  相似文献   

13.
To determine whether multiple sclerosis (MS) risk increases following primary infection with the Epstein‐Barr virus (EBV), we conducted a nested case‐control study including 305 individuals who developed MS and 610 matched controls selected among the >8 million active‐duty military personnel whose serum has been stored in the Department of Defense Serum Repository. Time of EBV infection was determined by measuring antibody titers in serial serum samples collected before MS onset among cases, and on matched dates among controls. Ten (3.3%) cases and 32 (5.2%) controls were initially EBV negative. All of the 10 EBV‐negative cases became EBV positive before MS onset; in contrast, only 35.7% (n = 10) of the 28 controls with follow‐up samples seroconverted (exact p value = 0.0008). We conclude that MS risk is extremely low among individuals not infected with EBV, but it increases sharply in the same individuals following EBV infection. ANN NEUROL 2010;67:824–830  相似文献   

14.
The authors examined symptoms of neurasthenia in the context of trauma through a survey conducted 10 months post-earthquake, among a sample of earthquake survivors in rural Taiwan. An algorithm closely resembling neurasthenia as defined in ICD-10 was designed a priori. Three diagnostic groups were identified, including those with "pure" neurasthenia (n=27) who did not exhibit any Axis I disorder, those with an Axis I disorder but without neurasthenia (n=46) and controls who were without neurasthenia or an Axis I disorder (n=152). Those with neurasthenia were demographically similar to non-psychiatrically disordered controls and did not differ with respect to impact of trauma. Greater severity of intrusive and avoidant/numbing posttraumatic stress disorder (PTSD) symptoms and less resilience characterized neurasthenia relative to controls. Morbidity was similar for neurasthenia and Axis I disorders, except for the presence of less resilience in the neurasthenia group. Thus, "pure" neurasthenia appears to be independent from other psychopathology in a significant number of earthquake survivors, and was not closely related to the impact of earthquake trauma. The meaningful number of subjects meeting criteria for our algorithm of neurasthenia suggests that further study of this syndrome employing exact ICD-10 diagnostic criteria is warranted.  相似文献   

15.
目的探讨进展性脑梗死患者脑侧支循环的形成情况及其对近期神经功能的影响。方法根据352例急性脑梗死患者头部CTA影像结果,分析进展性脑梗死患者侧支循环的形成情况,采用NIHSS评分及ADL评分法评价患者入院时及治疗14d时的神经功能缺损程度及日常生活活动能力,分析侧支循环的形成对近期神经功能的影响。结果 (1)352例急性脑梗死患者中,进展性脑梗死97例(27.6%),非进展性脑梗死255例(72.4%)。进展性脑梗死97例中,无侧支循环形成56例(57.7%),有侧支循环形成41例(42.3%);非进展性脑梗死255例中,无侧支循环形成者99例(38.8%),有侧支循环形成者156例(61.2%)。进展性脑梗死患者较非进展性脑梗死患者侧支循环形成几率低(χ2=10.195,P=0.002)。(2)在进展性脑梗死患者97例中,无侧支循环形成患者治疗14d时NIHSS评分及ADL缺陷程度均明显高于有侧支循环形成组(t=2.567,P=0.012;Z=-2.152,P=0.031);在非进展性脑梗死患者255例中,无侧支循环形成者治疗14d时NIHSS评分及ADL缺陷程度均明显高于有侧支循环形成者(t=2.371,P=0.019;Z=-2.437,P=0.015)。结论进展性脑梗死患者侧支循环形成状况差,无侧支循环形成的急性脑梗死患者近期神经功能恢复差。无侧支循环形成的急性脑梗死患者容易发生进展,且近期神经功能恢复差。  相似文献   

16.
We studied seroprevalence and concentrations of Epstein-Barr virus (EBV) antibodies in 147 pediatric patients with multiple sclerosis (MS) and paired controls. The children with MS showed a near-complete seropositivity for EBV antibody against virus capsid antigen (98.6% vs 72.1% in controls, p = 0.001) but did not display serologic evidence for a recent EBV infection. EBV antibody concentrations of pediatric patients with MS were significantly higher vs controls.  相似文献   

17.
目的研究重症肌无力(MG)患者外周血中干扰素α抗体(IFN-αAb)的含量,并探讨其与MG的关系。方法采用ELISA法测定60例MG患者、20例正常对照组(NC)及20例非MG其他神经系统疾病患者(OND)血清中IFN-αAb。结果 发现伴胸腺瘤的重症肌无力患者(MGT)血清中IFN-αAb阳性率为75%,明显高于不伴胸腺瘤的重症肌无力患者(NTMG,11.5%)及对照组(P〈0.05);晚发型MG者IFN-αAb阳性率为29.41%,明显高于早发型MG患者7.69%(P〈0.05)。结论 伴胸腺瘤的MG患者及晚发型MG患者外周血中IFN-αAb表达增高。  相似文献   

18.
目的 观察重症肌无力(myasthenia gravis,MG)患者Th17细胞和调节性T细胞的水平,并研究甲强龙冲击治疗对其影响.方法 应用四色流式细胞仪检测66例MG患者及35名健康对照者外周血Th17细胞和CD4+CD25highT细胞百分率;分析其中18例患者外周血Th17细胞与美国MG协会(MGFA)评分相关性;观察8例MG患者甲强龙冲击治疗2周后上述细胞的变化.结果 MG患者与健康对照者外周血Th17细胞百分率分别为2.61%±0.28%与0.94%±0.12%(Z=4.059,P=0.0001);甲强龙治疗前后8例MG患者Th17细胞百分率分别为4.72%±1.21%与1.81%±0.69%,差异有统计学意义(Z=1.995,P=0.0460);患者外周血Th17细胞水平与MGFA评分呈正相关(r=0.5359,P=0.0219).结论 MG患者外周血中Th17细胞升高,甲强龙冲击治疗可降低其水平,这可能是改善MG患者病情的有效机制.  相似文献   

19.
目的 使用多导睡眠图、多次睡眠潜伏期试验客观分析帕金森病(PD)患者睡眠障碍特征.方法 对26例临床确诊的PD患者(PD组)和31名无明显中枢神经系统疾病的对照者(对照组)行全夜可移动视频多导睡眠监测及次日多次睡眠潜伏期试验,分析比较2组患者睡眠结构及平均睡眠潜伏期、入睡期快速眼球运动(REM)睡眠(SOREMPs)、睡眠发作(Sas)情况.结果 PD组N2睡眠期百分比(32.8%±13.1%)、REM睡眠期百分比(8.6%±5.3%)、平均睡眠潜伏期[(9.6±4.4)min]较对照组[40.2%±9.1%、11.5%±5.1%、(15.7±3.1)min]明显降低(t=-2.515、-2.054、-6.164,P<0.05),PD组醒觉指数[(41.8±32.1)次/h]较对照组[(28.6±11.0)次/h]明显升高(t=2.151,P<0.05).PD患者中出现日间过度瞌睡(EDS)7例(7/26,26.9%),明显高于对照组(1/31,3.2%;×2=4.764,P<0.05).多元逐步线性回归分析显示校正睡眠效率、呼吸暂停低通气指数、醒觉指数,PD患者平均睡眠潜伏期的缩短与年龄(β=-0.328)、左旋多巴等效剂量(β=-0.008)的增加呈线性相关(t=-2.829、-2.352,均P<0.05).PD组有5例(5/26,19.2%)出现SOREMPs,3例(11.5%)出现Sas,而对照组均无出现SOREMPs和Sas.结论 PD患者睡眠结构改变和EDS较常见,虽然PD患者中Sas不多见,但临床医师需提高警惕.  相似文献   

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