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1.
目的 观察胃镜下局部清创术治疗消化性溃疡 (Pu)的疗效和复发率。方法  10 0例十二指肠溃疡(Du)和 66例胃溃疡 (Gu)各分成治疗组和对照组 ,治疗组胃镜下清创术 (用毛刷刷掉Pu表面的坏死组织 ,再用活检钳咬除Pu周围的瘢痕组织 )后服枸橼酸铋钾、雷尼替丁、羟氨苄青霉素治疗 ,对照组只用药物治疗。结果 Du4周治愈率治疗组 98% ,对照组 82 %。Gu 6周治愈率治疗组 96% ,对照组 78%。Du 1、2年后复发率治疗组 9%和 15 % ,对照组 3 2 %和 47% ,Gu治疗组和对照组分别是 8%、12 %和 2 6%、3 8%。Pu的治愈率和复发率与对照组比较均有明显差异 (P <0 0 5 )。结论 清创疗法显著提高Pu治愈率和降低复发率  相似文献   

2.
胃次全切除术后早期肠内营养对胃肠动力的影响   总被引:8,自引:0,他引:8  
目的 观察胃次全切除术后早期给予肠内营养对胃肠动力的影响。方法 将1999年12月至2001年2月接受手术治疗的进展期胃癌患者共18例随机分成肠内营养组和对照组各9例,分别给予术后早期肠内营养和普通治疗。应用Synectics MicroDigitrapper动态测压仪及配套的Polygram软件记录、分析、比较两组术后胃肠动力波形的变化,记录术后并发症等情况。结果 胃切除术后早期所有患者的移行性复合运动(MMC)均消失,术后第一个MMC出现的时间为34min~4h不等,两组相比差异无显著性。术后早期MMC的表现与正常MMC有明显不同:缺乏MMCⅡ相,仅由Ⅰ相和Ⅲ相构成;72h内MMC的周期变异逐步趋于一致。观察期内偶见逆向传导的MMC。肠内营养组的MMCⅢ相持续时间(TIME)、曲线下面积(AREA)、传导速度(V)、动力指数(MI)四项指标均高于对照组,两组比较差异有显著性。两组的术后并发症比较差异无显著性。结论 胃次全切除术后早期实施肠内营养可加速MMC的传导,改善MMC的收缩活动,促进胃肠动力的恢复。  相似文献   

3.
口服负荷量普罗帕酮转复阵发性心房纤颤的临床疗效观察   总被引:2,自引:0,他引:2  
高峰  肖荣玲 《临床内科杂志》2004,21(10):663-664
目的 探讨口服负荷量普罗帕酮转复阵发性心房纤颤 (PAF)的临床疗效和安全性。方法 将 62例房颤持续时间 2~ 48小时的患者随机分为两组 ,治疗组 3 2例口服悦复隆 3 0 0mg~60 0mg ,对照组 3 0例静注西地兰 0 .4~ 0 .8mg。记录从用药到转复为窦性心律的时间。 结果 治疗组转复率 4小时内为 5 6.3 % ( 18/3 2 )、8小时内为 62 .5 % ( 2 0 /3 2 )、12小时内为 71.9% ( 2 3 /3 2 ) ;对照组转复率则分别为 16.7% ( 5 /3 0 )、40 .0 % ( 12 /3 0 )及 46.7% ( 14 /3 0 )。各时间段治疗组PAF转复率均明显高于对照组 (P <0 .0 5 )。 4小时内平均转复时间治疗组明显短于对照组 (P <0 .0 1)。治疗组中未转复成功的 9例患者房颤持续时间明显高于转复成功者 (P <0 .0 1)。结论 对于不伴有心功能不全、缓慢心律失常及急性心肌缺血的非瓣膜病PAF患者 ,口服负荷量普罗帕酮能有效和迅速地使PAF转复 ,缩短PAF持续时间  相似文献   

4.
我们对不同浓度丝裂霉素 C(MMC)在原发性青光眼首次小梁切除术中的有效性及安全性进行了观察 ,旨在探讨原发性青光眼首次小梁切除术中应用MMC的最佳浓度。现报告如下。1 资料与方法1 .1 临床资料 本组 81例 (87眼 )男 2 1例 ,女 6 0例 ,年龄最大 74岁 ,最小 2 3岁 ,平均 5 8.85 9.93岁。原发性开角型青光眼 3 1眼 ,原发性慢性闭角型青光眼 3 8眼 ,急性闭角型青光眼 1 8眼。术前眼压1 .3 6~ 8.86 k Pa(1 k Pa=7.5 mm Hg)将患者随机分为四组 ;对照组 (1组 ) 1 5例 (1 7眼 ) ,用一般手术方法 ;MMC浓度为 0 .1 mg/ ml(2组 ) 2 4例 (2…  相似文献   

5.
老年慢性阻塞性肺疾病血清白细胞介素-13的变化   总被引:2,自引:0,他引:2  
目的 探讨白细胞介素 13 (IL 13 )与慢性阻塞性肺疾病 (COPD )的关系。方法 用双抗夹心ABC ELISA法测定 3 5例老年COPD患者 (急性加重期 2 0例 ,稳定期 15例 )血清IL 13水平 ,并与 2 2名健康者 (对照组 )进行比较。结果 老年COPD急性加重期组 ,COPD稳定期组和对照组血清IL 13水平分别为 (4 7.2 6± 3 .47) pg/ml、(3 6.11± 5 .3 4)pg/ml和 (3 0 .99± 2 .19) pg/ml。COPD急性加重期组和COPD稳定期组血清IL 13水平均显著高于对照组 (P <0 .0 5 ) ,且COPD急性加重期组血清IL 13水平显著高于COPD稳定期组 (P <0 .0 5 )。结论 老年COPD患者血清中IL 13水平显著升高 ,IL 13与COPD的发生发展有关  相似文献   

6.
肝硬化失代偿期患者空腹胃十二指肠运动改变   总被引:1,自引:0,他引:1  
目的研究肝硬化失代偿期患者空腹胃肠动力有无异常。方法采用灌注式测压方法,检测15例健康志愿者和12例肝硬化失代偿期患者空腹胃窦和十二指肠动力。结果肝硬化失代偿期患者MMCⅠ期和Ⅲ期的持续时间与健康对照组比较均无显著差别(P〉0.05);肝硬化患者MMCⅡ期较健康对照组显著延长(P〈0.01);肝硬化患者MMC周期较对照组显著延长(P〈0.01)。与对照组比较,MMCⅡ期更常出现移行性簇状收缩(P〈0.05)。结论肝硬化患者MMCⅡ期持续时间延长导致MMC周期延长,导致MMCⅢ期发生频率减少,从而影响消化道清除食物残渣和细菌的能力。MMCⅡ期出现移行性簇状收缩亦可能削弱肝硬化患者消化道的清除能力。  相似文献   

7.
前列地尔对糖尿病肾病患者尿蛋白的影响   总被引:28,自引:0,他引:28  
目的 观察短期应用静脉推注前列地尔 (prostaglandin E1)对不同时期糖尿病肾病患者肾功能及尿蛋白的影响。 方法 糖尿病肾病患者 81例 ,年龄 4 0~ 81岁 ;男 4 5例 ,女 36例。分为治疗组 4 5例和对照组 36例。两组患者均根据尿蛋白和肾功能的不同再分别分为早期肾病组、临床期肾功能正常组和临床期肾功能不全组 3个亚组。治疗组静脉推注前列地尔 (商品名 :凯时 ) 10μg,每日一次 ,连续 14 d。对照组不给上述治疗。控制血压、血脂、血糖等其他治疗方法各组相同。 结果 和对照组比较 ,治疗组患者尿总蛋白和尿白蛋白明显降低 ,其中糖尿病肾病早期组尿总蛋白由治疗前的 (0 .34± 0 .0 6 ) g/2 4 h下降到(0 .2 1± 0 .0 7) g/2 4 h(P<0 .0 1) ,尿白蛋白由 (191± 76 ) mg/2 4 h下降到 (99± 5 3) mg/2 4 h(P<0 .0 1) ;在临床期肾功能正常组尿总蛋白由 (3.74± 1.99) g/2 4 h下降到 (2 .38± 1.4 7) g/2 4 h(P<0 .0 1) ,尿白蛋白由 (2 85 5± 1790 ) mg/2 4 h下降到 (16 34± 10 93) mg/2 4 h(P<0 .0 1) ;在临床期肾功能不全组尿总蛋白由治疗前的 (1.89± 0 .93) g/2 4 h下降到 (1.84± 1.0 8) g/2 4 h(P>0 .0 5 ) ,尿白蛋白由 (14 0 7± 835 ) mg/2 4 h下降到 (1116± 5 5 7) mg/2 4 h(P<0 .0 5 )。治疗  相似文献   

8.
目的 研究国产尼卡地平注射液在术后高血压中的应用。方法 采用随机、双盲和安慰剂对照的方法 ,将 40例各种普通外科手术后 2 4h内发生高血压患者随机分为治疗组 (2 0例 ,使用泰尼注射液 )和对照组 (2 0例 ,使用安慰剂 )。结果 治疗组的有效率为 95 % (19/2 0 ) ,对照组为 10 % (2 /2 0 ) (P <0 .0 0 1)。治疗组在剂量调整期的平均起效时间为 (11.9± 0 .4)min ,起效时的平均滴注速率为 (12 .8± 0 .4)mg/h。在维持期 ,平均维持滴注时间为 (6 .8±0 .6 )h ,平均维持速率为 (3.1± 0 .3)mg/h[(0 .34~ 11.88)mg/h]。不良反应较少。结论 尼卡地平注射液可安全有效地用于术后高血压患者  相似文献   

9.
目的 评估老年慢性心力衰竭经合理治疗对改善预后的影响。方法 对 83例慢性收缩期心力衰竭患者 ,进行随机分组研究 ,即合理治疗加生活指导组 (观察组 )和一般治疗组 (对照组 ) ,随访一年 ,分析统计因间接或直接原因引起心力衰竭的死亡率及因心力衰竭恶化再住院率和住院时间。结果 随访一年内直接死于心力衰竭者 ,观察组 6例 ( 6 / 4 2 ,14 3% ) ,对照组 15例 ( 15 / 4 1,36 6 % ) ,前者明显低于后者 (P <0 0 5 )。因心力衰竭再入院例数 ,观察组为 10例( 10 / 4 2 ,2 3 8% ) ,对照组 2 2例 ( 2 2 / 4 1,5 3 7% ) ,两组差异显著 (P <0 0 1)。再住院总人次 ,观察组为 14人次 ,对照组为 30人次 ,两组差异显著 (P <0 0 1)。再住院平均天数 ,观察组 13天 ,对照组 2 9天 ,两组差异显著 (P <0 0 1)。结论 老年慢性心力衰竭患者在合理治疗 ,去除心力衰竭恶化的因素 ,积极抗心力衰竭治疗 ,可明显改善患者预后。  相似文献   

10.
重组人白细胞介素-2辅助治疗复治肺结核近期疗效观察   总被引:13,自引:1,他引:13  
目的 研究和评价重组人白细胞介素 2 (IL 2 )辅助治疗肺结核病的疗效。方法 将 2 0 9例复治菌阳肺结核患者 ,采用计算机随机分组方法分为 :治疗组 10 6例 ,采用 3PaZ(TH)L2 VE(AK) +IL 2 / 4PaL2 V方案化疗 (Pa :力克肺疾 ,Z :吡嗪酰胺 ,TH :丙硫异烟胺 ,L :利福喷汀 ,V :左氧氟沙星 ,AK :阿米卡星 ,E :乙胺丁醇 ) ;对照组 10 3例 ,采用 3PaZ(TH)L2 VE(AK) / 4PaL2 V方案进行短程化疗。结果 完成疗程可评价疗效者 2 0 3例 ,其中治疗组 10 3例 ,对照组 10 0例。治疗第 1、2个月治疗组和对照组痰菌阴转率分别为 33 3%、7 2 %和 6 9 4 %、4 4 9% ,差异有非常显著性意义 (P <0 0 1)。治疗结束时治疗组和对照组显效率分别为 6 4 1%和 36 0 % ,差异有非常显著性意义 (P <0 0 0 1)。治疗组治疗 3和 7个月时CD4、CD4/CD8和NK细胞较对照组提高 ,差异有非常显著性意义 (P <0 0 1)。治疗 3个月时治疗组IL 2可溶性受体 (sIL 2R)较对照组降低 ,两组比较差异有显著性 (P <0 0 5 )。无严重不良反应发生。结论 重组人IL 2可辅助治疗肺结核 ,是一种安全、可靠的生物制剂。  相似文献   

11.
目的:评价奥美拉唑碳酸氢钠干混悬剂治疗消化性溃疡的有效性和安全性。方法:本研究为多中心、随机、双盲、双模拟、阳性药物平行对照的Ⅱ期注册临床试验,根据适应证不同,分为十二指肠溃疡和胃溃疡2项研究,采用分层区组随机化方法将患者按1∶1随机分为试验组和对照组。试验组治疗方案为奥美拉唑碳酸氢钠干混悬剂[奥美拉唑20 mg(十二...  相似文献   

12.
The Chinese Medical Doctor Association has initiated metabolic management center (MMC) program for 6 years since 2016 nationwide. It is worth investigating the level of control metabolic outcomes in patients with type2 diabetes (T2DM) after MMC model in Yan’an, northwest China. Patients with T2DM was admitted to MMC in Yan’an University Affiliated Hospital from November 2018 to July 2021. They were asked to revisit hospital every 3 months. Blood glucose, blood pressure and blood lipids at baseline were compared to its counterparts after 1 year MMC management. Glycosylated hemoglobin and low density lipoprotein cholesterol (LDL-C) level in T2DM patients after 1 year management were lower than their baseline level (glycosylated hemoglobin 7.74 ± 1.94% vs 8.63 ± 2.26%, P < .001; LDL-C 1.81 ± 0.73mmol/L vs 2.18 ± 1.49mmol/L, P < .001). Mean HOMA-β increased after management (65.89 ± 90.81% vs 128.38 ± 293.93%, P < .05). After 1 year of management, patients in high school or above group achieved higher control rate of body mass index than those in middle school or below group (71.82% vs 28.18%, P = .043). high density lipoprotein cholesterol control rate was higher in high income group (42.86% vs 34.97%, 16.28%, P = .012), while LDL-C control rate was higher in low-income group (97.67% vs 78.57%, 84.51%, P = .018). fasting plasma glucose control rate in new diagnosis group was higher than that of the middle and long course groups (71.43% vs 52.38%, 42.44%, P = .002). The comprehensive control rate increased from 9.83% at baseline to 26.15% after 1 year MMC management. The metabolic outcomes and their control rate in T2DM patients were improved after 1 year MMC management. It indicated that patients may achieve more benefits with MMC management.  相似文献   

13.
The interdigestive gastroduodenal motility was studied by means of a multilumen manometric probe in eight patients with active duodenal ulcer (group DU1) and in seven patients with hypersecretory gastroduodenitis (group GD). Both groups were selected on the basis of the presence of gastric acid hypersecretion. A group of five patients with non-active duodenal ulcer (group DU2) and a group of eight healthy subjects (group C) also were examined. Both of the latter groups were selected on the basis of the presence of normal gastric secretion. After a basal recording period of 200-300 min, in hypersecretory groups DU1 and GD, ranitidine was administered to decrease acid secretion; in normosecretory groups C and D2, impromidine was infused at two scalar doses to increase acid secretion. The basal recording showed in groups DU1 and GD a longer than normal time interval between consecutive activity fronts (AF) of the migrating motor complex (MMC cycle) and a shorter than normal percent of time occupied by AFs. In normal subjects and in DU2, the administration of the lowest dose of impromidine induced a motor pattern similar to that of the basal period of groups DU and GD, whereas the highest dose disrupted the MMC pattern that was replaced by an irregular motor activity. The results of this study indicate that duodenal ulcer with acid hypersecretion shows a marked inhibition of the MMC cycle that is not due to the ulcer itself, but to the increased acid secretion. In fact, the same motor pattern is observed in other hypersecretory states, both spontaneous and drug-induced, whereas DU with normal secretion showed a near normal motility. In active duodenal ulcer, the decreased incidence and duration of activity fronts may play a role in the pathogenesis of peptide ulcer, as it may impair the cyclic duodenal acid clearing, allowing a longer than normal contact of HCl with the duodenal mucosa.  相似文献   

14.
Fasting gastrointestinal motility and gallbladder motility during the interdigestive state and in the postprandial period was studied in eight patients who were operated for ulcer disease with an antrectomy and selective gastric vagotomy. Nocturnal motility recording revealed all three phases of the migrating motor complex (MMC) in all but one patient, where no phase III activity was recorded. In the rest of the patients 3–10 events with phase III activity were recorded. At scintigraphy ([75Se]HCAT) a cyclic gallbladder filling and emptying in relation to the MMC cycle was found. Episodes with emptying were confined to phase II and a total of 13 episodes with a median duration of 25 min (range 10–70 min) were observed. A median of 10.7% (6.1–17.7%) of the gallbladder contents was emptied. In a control group of eight healthy young men the values were 13.5 min (9–36 min) and 6.9% (3.7–31.1%), respectively. These differences were not significant. During the postprandial period, a lag period in gallbladder emptying of median 15 min (5–20 min) was observed when food ingestion took place during phase I of the MMC. Thereafter a gradual emptying occurred with a rate of 0.95%/min (0.71–1.15%/min). In a control group of healthy young males, the lag period was 13.5 min (9–22.5 min) and the emptying rate 0.61%/min (0.08–0.77%/min). When food ingestion occurred during phase II of the MMC, the lag period of gallbladder emptying in the patient group was median 0 min (0–5 min) and the emptying rate was 0.77%/min (0.33–0.86%/min). The values in the control group were 0 min (–9 to 13.5 min) and 0.76%/min (0.54–2.25%/min), respectively. These differences between the patients and controls were not significant. In conclusion, antrectomy and selective gastric vagotomy do not influence fasting gastrointestinal motility or gallbladder motility during the interdigestive state or in the postprandial period.  相似文献   

15.
BACKGROUND: The prevalence of duodenal ulcer (DU) has been considered high in patients with chronic pancreatitis; however, its pathogenesis is unclear. We hypothesized that Helicobacter pylori infection plays the major pathogenetic role. STUDY: One hundred seven cases (97 men, 10 women) of chronic alcoholic pancreatitis (CAP) were prospectively investigated from 1997 to 2001. One hundred thirty-seven DU patients and 59 nonulcer dyspepsia patients formed the two control groups. Pancreatic function was evaluated by determination of fecal fat excretion and fasting blood glucose concentration. Upper gastrointestinal endoscopy was performed in all patients, and gastric mucosal biopsies were taken for assessment of H. pylori infection with a modified Giemsa stain and rapid urease test. RESULTS: Fifteen (14%) of the 107 patients with CAP had active DU. There was a trend toward an association between the presence of diabetes mellitus and/or steatorrhea and the occurrence of DU in patients with CAP (p = 0.06). The rate of H. pylori infection was significantly higher in patients with CAP and DU than in those with only CAP (86.7% vs. 54.3%, p = 0.02) but the rate similar to that in patients with simple DU (75.2%). Trends toward higher prevalence of H. pylori infection in CAP with DU were noticed when they were compared with the nonulcer dyspepsia group (86.7% vs. 66.1%). There was no significant difference in prevalence of H. pylori between CAP patients without DU and dyspeptic patients (54.3% vs. 66.1%). CONCLUSIONS: These data demonstrate that the prevalence of DU in CAP is relatively high. H. pylori infection seems to play the major pathogenetic role in DU associated with CAP.  相似文献   

16.
目的 验证奥美拉唑镁肠溶片与奥美拉唑胶囊治疗消化性溃疡的生物等效性及评价其不良反应。方法 采用随机对照和开放试验的方法治疗经胃镜检查证实的消化性溃疡共 171例 ,其中奥美拉唑镁肠溶片组 (试验组 ) 68例 ,胃溃疡 2 1例 ,十二指肠溃疡 47例 ;奥美拉唑胶囊组 (对照组 ) 67例 ,其中胃溃疡 2 1例 ,十二指肠溃疡 46例 ;开放试验组 3 6例 ,其中十二指肠溃疡 2 9例 ,胃溃疡 7例。结果 试验组中胃溃疡的愈合率和总有效率分别为 80 9%和 10 0 %十二指肠溃疡的愈合率和总有效率分别为87 2 %和 97 8% ;对照组中胃溃疡的愈合率和总有效率为 85 7%和 95 2 % ,十二指肠溃疡的愈合率和总有效率为 84 7%和 97 8% ;开放试验组中胃溃疡的愈合率和总有效率均为 10 0 0 %十二指肠溃疡的愈合率和总有效率分别为 86 2 %和 10 0 % ;试验组中疼痛消失率及其他消化道症状的消失率在胃溃疡为 95 2 %和 89 0 %在十二指肠溃疡则为 97 8%和 98 3 % ;对照组中疼痛及其他消化道症状的消失率在胃溃疡为 95 2 %和 92 7% ,在十二指肠溃疡为 97 8%和 98 7%。两组在愈合率、总有效率、疼痛消失率和其他消化道症状消失率方面相比均无显著差别 (P >O 0 5 )。两组在治疗过程中均未见明显的不良反应。结论 奥美拉唑镁肠溶片与奥  相似文献   

17.
FD患者红霉素对胃十二指肠动力的影响   总被引:1,自引:0,他引:1  
目的研究红霉素对功能性消化不良(FD)患者消化间期胃窦和十二指肠的运动功能的影响.方法FD患者20例,采用导管灌注技术测定胃窦和十二指肠的压力,空腹连续测定35h,若未发现移行运动复合波(MMC)3期,于MMC1期匀速静滴红霉素200mg,滴速66mg/min,测定静滴红霉素期间胃窦和十二指肠的压力.结果空腹测定35h,8例FD未出现MMC3期,仅1期和2期交替出现,此后在静滴红霉素期间,胃窦和十二指肠均出现了宽大的收缩波,5例出现了MMC3期,且各项动力参数值较静滴红霉素前显著增加(P<005).结论部分FD于消化间期胃窦和十二指肠缺乏MMC3期,动力减低,静滴红霉素能诱发MMC3期,促进胃和十二指肠的运动功能  相似文献   

18.
老年急性心肌梗死住院期康复   总被引:1,自引:0,他引:1  
目的:探讨老年急性心肌梗死(AMI)患者住院期康复治疗的疗效、安全性。方法:比较20例接受四周程序康复治疗的老年AMI患者和19例对照患者的临床疗效、安全性。结果:20例老年AMI患者康复治疗未发生并发症;出院3个月后能生活自理的有18例(90%),左室射血分数(LVEF)>50%的患者13例(65%),未发生心绞痛和再梗。对照组发生心绞痛3例,再梗死1例,心衰2例,心源性猝死1例;出院3个月后能生活自理的仅12例(63%),LVEF>50%的患者仅6例(32%)。康复组的临床疗效及心功能(LVEF)均显著好于对照组(P<0.05)。结论:老年急性心肌梗死康复治疗是安全、有效、可行的。  相似文献   

19.
目的:探讨罗红霉素在冠心病治疗中的作用。方法:选择符合冠心病诊断标准的60例血肺炎衣原体抗体IgG阳性患者,采用随机方法均分为罗红霉索治疗组及对照组,1个月后治疗组复查血肺炎衣原体抗体IgG,随访1年。结果:罗红霉素治疗组,3例出现心血管事件,发生率10%,对照组10例出现心血管事件,发生率33.3%,罗红霉素治疗组心血管事件发生率明显低于对照组(P<0.05),两组治疗前,治疗组治疗前、后肺炎衣原体抗体IgG滴度比较差异无显著性。结论:罗红霉素能减少冠心病心血管事件发生率。  相似文献   

20.
用欣洛维(胸腺蛋白口服液)2周疗法治疗PU159例,并与雷尼替丁4周疗法对照,结果显示,欣洛维治疗GU愈合率77.2%,治疗DU愈合率65.3%,前者愈合率略高于雷尼替丁对照组(57.1%),后者则略低于雷尼替丁对照组(71.9%),但两组间比较均无显著性差异(p>0.05),提示用欣洛维治疗PU2周的疗效与用雷尼替丁治疗4周的疗效相近似。口服欣洛维过程中未出现明显副反应,根据部分病例追踪观察结果,口服欣洛维治疗PU年复发率31.8%,雷尼替丁组复发率69.0%,两组比较有非常显著差异(p<0.01)。欣洛维是从健康乳猪新鲜胸腺提取的一组蛋白类活性物质,其促溃疡愈合作用,可能与它有增强胃粘膜细胞膜k~ —Na~ —ATPase和胃粘膜细胞活力,增强胃粘膜前列腺素合成及降低血浆内皮素的作用等有关。  相似文献   

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