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1.
目的:获得正常健康人群肺部听诊结果分布情况。方法用专用肺部听诊设备对1896名健康成人行肺部听诊并录音,由呼吸专业医师根据录音判断肺部听诊情况。肺部听诊采集录取肺部喉部、左上、右上、左中、右中、左下、右下、左后、右后9个部位肺音。统计分析各部位啰音分布百分比。结果符合入选条件者1450人,9个听诊部位全部正常者1014人(69.9%),至少有1个部位听诊有啰音者436人(30.06%),至少有2个部位有啰音者190人(13.10%),至少有3个部位有啰音者81人(占5.58%);出现干啰音比例由高至低依次为:左上(13.4%)、左中和左后(1.4%)、喉部和右上和左下(1.2%)、右下(1.0%)、右后(0.9%);湿啰音比例由高至低依次为:右下(6.6%)、左后(5.9%)、右中(5.8%)、左下(5.1%)、右后(2.8%)、喉部(2.1%)、右上(1.9%)、左上(0.8%);左中、右下和左后同时具有干啰音和湿啰音各2例(0.1%)。各听诊部位间听诊啰音分布及听诊部位间啰音分布情况差异无统计学意义(P >0.05)。结论健康成人肺部啰音并非少见,其临床意义有待进一步研究。  相似文献   

2.
目的了解甘肃省老年人对抗生素相关知识及自我用药行为现状。方法对多阶段随机抽取的60岁及以上城乡老年居民进行抗生素知识及自我用药行为的入户问卷调查。结果农村老年居民对抗生素各项知识的正确回答率为11.13%~65.25%,城市老年居民为22.46%~79.19%;正确率最低的前两位、农村老年居民为"抗生素就是消炎药"(11.13%)、"治疗感冒必须要用抗生素"(20.74%),城市老年居民为"抗生素就是消炎药"(22.46%)、"静脉用药比口服用药疗效好"(29.49%)。分别有58.10%(农村)和71.11%(城市)老年居民常备抗生素、有48.35%(农村)和37.13%(城市)老年居民生病时自购抗生素;有26.10%(农村)和24.25%(城市)老年居民主动要求医生开抗生素、有17.72%(农村)和19.01%(城市)老年居民主动要求静滴方式给药;严格按医嘱用药农村老年居民有48.49%(剂量)、50.82%(频次),城市老年居民有57.93%(剂量)、52.40%(频次)。结论甘肃老年居民对抗生素的认知水平低,不良用药行为严重,农村居民在认知与行为方面均比城市居民差;相关的健康教育十分迫切,尤其对农村地区。  相似文献   

3.
本文报道了408例脑囊虫病患者脑CT检查、脑脊液中循环抗原和抗体(IHA)检测结果的比较.脑CT反映脑部有较多新鲜囊尾蚴或脑室系统有囊尾蚴寄生者.脑脊液中循环抗原阳性率达98.80%和96.67%,明显高于只有少量新鲜病灶(70.67%)、有多个陈旧病灶(75.56%)、CT未发现异常(57.58%)或少量新鲜、陈旧病灶混合的患者(69.49%).脑脊液中抗体阳性率以有较多陈旧病灶者最高,达91.11%,依次是有少量新鲜病灶(64.00%)、CT未发现异常(57.58%)或少量新鲜、陈旧病灶混合的患者(74.58%).  相似文献   

4.
目的纤维素性纵隔炎(FM)是一种少见疾病, 本研究通过探讨FM患者的临床和影像学特点, 提高临床和影像科医师对该病的认识。方法本研究为横断面研究。采用非随机抽样法选取甘肃省人民医院2015年12月至2022年1月通过胸部CT平扫、胸部增强CT扫描、CT肺血管造影检查、部分接受介入治疗(肺血管支架置入或球囊扩张)、支气管镜检查、手术治疗的FM患者的住院资料。对FM患者的临床表现、纵隔内组织器官受累情况进行总结。结果总共纳入110例患者, 男48例, 年龄(68.8±7.5)岁, 年龄范围为53~87岁;女62例, 年龄(67.3±8.1)岁, 年龄范围为51~83岁。58例(52.7%)有肺结核病史;6例(5.5%)怀疑肺结核;2例(1.8%)有自身免疫性疾病;44例(40.0%)未知病因。106例(96.4%)患者有气短;70例(63.6%)有咳嗽;17例(15.5%)有咯血;3例(2.7%)有胸痛;1例(1.0%)有吞咽困难。64例(58.2%)合并慢性阻塞性肺疾病;20例(18.2%)合并支气管哮喘;106例(96.4%)合并肺动脉高压;64例(58.2%)合并慢性肺源性心脏病;5...  相似文献   

5.
目的探讨丁型肝炎病毒(HDV)在重型乙型肝炎发展中的作用。方法以同期单纯HBV(+)重型肝炎死亡者244例为对照组,76例HDV(+)重型乙型肝炎死亡者进行临床表现、体征、并发症及主要生物化学指标比较。结果HDV(+)死亡组腹水(51.3%)、腹胀(88.2%)、消化道出血(48.7%)与对照组(分别为36.8%,77.1%,33.8%)差异有显著意义(χ2值分别为5.96、4.41和5.97,P<0.05);肝肾综合征(46.1%)、细菌感染(53.9%)及两种或两种以上并发症发生率(76.3%)与对照组(28.5%、35.7%和53.8%)差异有显著意义(χ2值分别为7.93、8.08和12.27,P<0.01);生物化学指标总胆红素[(485.45±107.60)μmol/L]、谷丙转氨酶[(38.76±20.15)U/L]、凝血酶原活动度(19.08%±8.09%)与对照组[(407.75±98.54)μmol/L、(56.86±26.75)μmol/L、(23.85±14.07)μmol/L]比较差异有显著意义(u值分别为5.61、7.33和3.67,P<0.01)。结论HDV对重型乙型肝炎的发展有促进作用。  相似文献   

6.
目的 探讨类风湿关节炎(RA)患者亚甲基四氢叶酸还原酶(MTHFR)基因677CDT[rs1801133)、1298A/C(rs1801131)单核苷酸多态性(SNP)及其与甲氨蝶呤(MTX)治疗的疗效和不良反应相关性.方法 收集RA患者184例.分为单用MTX组、MTX联用其他改善病情抗风湿药(DMARD)组、非MTX的DMARD组,于治疗前及治疗后24周检查临床及实验室指标,评价疗效及不良反应.采用实时荧光定量聚合酶链反应(FQ-PCR)方法检测RA患者及100名健康对照组的MTHFR基因677C/T及1298A/C多态性,比较两组间基因型分布及等位基因频率.结果 677CC/CT/TT基因型分布在RA组(19%、67%、14%)与健康对照组(27%、56%、17%)基因型分布频率差异无统计学意义(P>0.05);1298AA/AC/CC基因型分布在RA组(66%、31%、3%)健康对照组(70%、30%、0%)基因型分布频率差异无统计学意义(P>0.05).677CC/CT/TT基因型分布在RA有心血管并发症组(6%、75%、19%)与正常对照组(27%、56%、17%)差异有统计学意义(P<0.05).在单用MTX治疗者巾,1298AA/AC/CC在MTX治疗有效组(54%、44%、2%)和无效组(90%、10%、O%)中差异有统计学意义(P<0.05),677CC/CT/TT在MTX有不良反应组(13%、71%、16%)和无不良反应组(48%、48%、4%)中差异有统计学意义(P<0.05).在MTX联用其他DMARD组,677CC/CT/TT在有不良反应组(9%、78%、13%)和无不良反应组(35%、50%、15%)中差异有统计学意义(P<0.05).结论 MTHFR基因677C/T及1298A/C多态性与RA发病无关;677 C/T多态性与RA心血管并发症的出现有关、与MTX治疗后的不良反应相关,1298 A/C多态性与MTX的疗效相关.  相似文献   

7.
为调查贵州省都匀地区孕产妇弓形虫感染情况,收集2015-2018年就诊于贵州省都匀地区黔南州人民医院进行孕期、产前检查的妇女及曾出现过流产、死胎、畸形等病理妊娠的孕产妇血清,进行弓形虫特异性抗体IgM及IgG的ELISA检测。应用SPSS 17.0软件进行统计学分析,弓形虫抗体阳性率采用χ^2检验进行比较。共征集6931例孕产妇,包括6825例正常孕产妇和106例病理妊娠孕产妇。年龄为18~45岁,以汉族、布依族、苗族等为主。孕产妇弓形虫总抗体阳性率为6.1%(424/6931),其中正常孕产妇弓形虫抗体阳性率为5.9%(403/6825),病理妊娠孕产妇弓形虫抗体阳性率为19.8%(21/106),差异有统计学意义(P<0.01)。汉族、布依族、苗族、水族、土家族、侗族的孕产妇弓形虫抗体阳性率分别为7.5%(215/2886)、5.4%(132/2453)、5.5%(71/1300)、2.3%(3/131)、2.0%(2/100)、1.6%(1/61),差异有统计学意义(P<0.05)。职业为干部、教师、农村劳作、其他的孕产妇弓形虫抗体阳性率分别为1.3%(22/1714)、1.8%(22/1216)、13.2%(320/2418)、3.8%(60/1583),差异有统计学意义(P<0.01)。有、无动物接触史的孕产妇弓形虫抗体阳性率分别为26.2%(361/1379)和1.1%(63/5552),差异有统计学意义(P<0.01)。提示贵州省都匀地区孕产妇弓形虫抗体阳性者以有病理妊娠反应、汉族、主要从事农村劳作、有动物接触史等为主。  相似文献   

8.
目的分析肝硬化败血症患者的病原特点及预后,为有效救治提供依据。方法回顾分析我院肝硬化住院患者中有败血症临床征象并血培养阳性的病例资料,进一步分析其感染病原特点及预后。结果 2011—2013年进行血培养的肝硬化患者12 307例,血培养阳性1405例(11.42%)。病原菌包括革兰阴性杆菌(729株,51.89%)、革兰阳性球菌(604株,42.99%)、真菌(51株,3.63%)及其他(21株,1.49%)。败血症组中腹腔穿刺(25.69%)、肝癌有创治疗(18.65%)、静脉留置管(16.65%)、留置导尿管(16.16%)及糖尿病(5.12%)的比例明显高于对照组(P<0.05);革兰阴性杆菌感染组病死率(19.34%)明显高于革兰阳性球菌组(6.46%)(P<0.05);鲍曼不动杆菌感染病死率(56.52%)和铜绿假单胞菌感染病死率(58.62%)明显高于大肠埃希菌(30.23%)(P<0.05)。结论肝硬化败血症以革兰阴性杆菌感染为主,不同种类感染病原的预后不同,穿刺、肝癌有创治疗、插管及糖尿病患者更容易发生败血症。  相似文献   

9.
目的探讨老年人社区获得性肺炎(CAP)的临床特点。方法分析172例老年CAP(老年组)的临床表现、实验室检查、胸部影像学检查资料,并与同期收治的69例非老年CAP(对照组)作比较。结果老年组合并1种以上基础疾病的占93.60%,对照组为33.33%(P<0.01);老年组有胸闷、气促、胸痛症状的分别占75.58%、62.21%、21.51%,对照组分别为26.09%、21.74%、43.48%(P<0.01);老年组有精神状态改变、消化道症状的占29.07%、62.79%,对照组分别为7.25%(P<0.01)和39.13%(P<0.05);老年组有低蛋白血症的占43.02%,对照组为17.39%(P<0.01)。结论老年CAP容易合并有基础疾病,临床表现不典型,须加重视。当出现胸闷、气促、消化道症状或精神状态的改变并伴有不同程度的咳嗽时,应警惕肺炎。  相似文献   

10.
目的:调查分析广州疗养院疗养员高血压的降压治疗现状、控制率,探讨血压控制不良原因。方法:对778例原发性高血压患者降压药物应用方案进行登记,并观察血压控制情况。结果:高血压服药率96.66%,控制率76.48%,有针对性治疗后血压有显著改善(P<0.05~<0.01)。血压控制不良原因按百分率排列,依次为服用短效降压药(7.5%)、顽固性高血压(7.2%)、依从性差(6.3%)、白大衣高血压(1.7%)、不良行为方式(1.6%)。结论:针对病因的治疗对血压达标有重要意义。  相似文献   

11.
The organic stenosis of the coronary artery and vasospasm induced by ergonovine maleate (EM) were examined by cine angiography in 106 cases with unstable angina. They were divided into 5 groups: new angina at rest (27 cases), new angina of effort (15 cases), changing pattern from effort to rest (41 cases), crescendo-type angina at rest (20 cases) and changing pattern from rest to effort (3 cases). The following results were obtained: The incidence of a 75% or more organic stenosis was significantly lower in new angina at rest (52%) and crescendo-type angina at rest (55%) than in changing pattern from rest to effort (95%) (p less than 0.005). The incidence of a 90% or more organic stenosis was significantly lower in new angina of effort than in changing pattern from effort to rest (46% vs 88%, p less than 0.01). On the other hand, the incidence of a 50% or more spastic narrowing provoked by EM was 94% in new angina at rest, 90% in crescendo-type angina at rest, 56% in new angina of effort and 64% in changing pattern from effort to rest. In all 3 cases of changing pattern from rest to effort, total obstructions due to coronary spasm were found. However, there were no significant differences among these groups.  相似文献   

12.
Although a few familial forms of congenital hypothyroidism (CH) due to thyroid dysgenesis (TD) have been reported, this disorder is usually considered to be sporadic. Recently, we reported that 2% of CH patients with TD have a positive familial history. The aim of this study was to describe the clinical characteristics of these familial cases and to compare them with sporadic cases. We used the French national population-based registry of the first 19-yr screening program, which included 14,416,428 screened neonates with a 100% recovery rate. Familial history of CH with TD was investigated by means of a questionnaire sent to the pediatricians (n = 592) who provided ongoing clinical care for the 4049 CH patients detected during this period, including 2863 CH cases due to TD. Information was obtained from 73% of these pediatricians who were following up 2472 CH patients with TD (86%). In all, 67 patients with a positive family history of CH with TD were referred, belonging to 32 multiplex families (i.e. including at least 2 affected members). Families were identified with ectopic gland (n = 12), athyreosis (n = 7), or both (n = 13). Comparison of familial with isolated cases showed a similar etiological diagnosis distribution of CH (40% vs. 33% for athyreosis and 60% vs. 67% for ectopic thyroid gland, respectively), whereas a significantly lower predominance of females was found in familial than in isolated cases (1.4 vs. 2.7; P < 0.03). Extrathyroidal congenital malformations were found with a similarly higher incidence in familial and isolated CH populations compared with the general population (respectively, 9% and 8.2% vs. 2.5%). In conclusion, although familial cases represent a minority of cases of congenital hypothyroidism caused by thyroid dysgenesis, they were observed in a significantly higher proportion (>15-fold) than would be expected from chance alone. This familial clustering, including athyreosis and ectopic thyroid gland, strongly suggests that genetic factors could be involved in thyroid dysgenesis with a common underlying mechanism for both etiological groups. Moreover, the high proportion of extrathyroidal congenital malformations in a population affected by CH due to TD suggests that the potential genetic factors involved in thyroid gland organogenesis are also involved in the development of other organs.  相似文献   

13.
肺癌与血栓栓塞性疾病关系的临床分析   总被引:2,自引:0,他引:2  
目的提高临床医生对肺癌合并血栓栓塞性疾病的认识。方法对近5年经病理或细胞学证实的肺癌合并血栓栓塞性疾病患者的临床资料进行分析。结果本组患者中16例为腺癌。9例(52.94%)血栓栓塞发生在肺癌确诊之前,8例(47.06%)发生在肺癌确诊之后,其中13例(76.67%)肺癌确诊时间分布于栓塞前后120天。单纯并发下肢深静脉血栓形成(DVT)7例,单纯肺血栓栓塞(PTE)4例,DVT合并PTE 6例。10例合并PTE患者中8例(80%)有较典型的临床症状,9例(90%)表现为双肺多发栓塞,大多有低氧血症、血D二-聚体明显升高。心电图仅1例有典型SⅠQⅢTⅢ表现。8例在栓塞前有化疗史。结论病人出现不能解释的血栓栓塞性疾病应考虑有肿瘤的可能,腺癌患者易并发血栓栓塞性疾病。化疗是肺癌合并血栓栓塞性疾病的高危因素之一。及时诊断和治疗可以降低患者的死亡率。临床医生应提高对肺癌合并血栓栓塞性疾病的认识。  相似文献   

14.
目的探讨IFN联合利巴韦林(RBV)治疗CHC致甲状腺功能异常的临床特点。方法回顾性分析78例CHC患者应用干扰素联合RBV治疗过程中出现甲状腺功能异常的临床资料。78例患者随机分为重组人干扰素α2b(IFN-α2b)组58例,聚乙二醇化干扰素α-2a(Peg-IFN-α2a)组20例。结果 78例患者中,发生甲状腺功能异常(TD)者17例(21.79%),其中甲状腺功能亢进症5例,甲状腺功能减退症12例。78例患者的性别、基线HCV RNA载量、丙型肝炎病程、病毒应答时间、总疗程与TD发生无显著相关性,年龄、既往TD病史有显著相关性。78例患者中,有15例为一过性TD,仅2例终止干扰素治疗。两组患者导致TD的发生率分别为10%(2/20)和25.80%(15/58)。两组患者的年龄(χ2=4.974,P=0.026,OR=1.073)、既往TD病史(χ2=5.123,P=0.024,OR=16.569)与甲状腺疾病发生呈现正相关。出现TD时间主要集中在干扰素治疗后31~60天。结论 TD是干扰素治疗CHC中较常见的不良反应,特别是既往有TD病史者,多数TD为短暂性异常,应在密切监视下完成抗病毒疗程。  相似文献   

15.
We studied 1,179 North American travelers who visited Mexico from 2005 to 2007. Travelers' diarrhea (TD) was reported by 521 (44%) participants. Among subjects with TD, 218 cases were examined for cryptosporidiosis by polymerase chain reaction (PCR) and enzyme-linked immunoassays (ELISA). There were 14 (6%) cases of cryptosporidiosis and 141 cases (64%) of bacterial diarrhea. Compared with bacterial diarrhea, a longer stay in Mexico was a risk factor for cryptosporidiosis. Additionally, Cryptosporidium cases passed greater number of watery stools (P < 0.05), suffered more episodes of diarrhea (P < or = 0.05), and were more likely to experience tenesmus (P < or = 0.05) compared with bacterial causes of TD. ELISA detected seven (3%) cases of Cryptosporidium, whereas PCR identified an additional seven cases (6%). Speciation by 18SrRNA sequencing showed that 13 cases were caused by C. parvum and only 1 case was caused by C. hominis. ELISA showed a sensitivity of 50% and specificity of 100% compared with PCR.  相似文献   

16.
Fifty-two patients (29 female and 23 male) with lupuslike anticoagulants were reviewed retrospectively to determine whether their inhibitors were time dependent (TD). In 21 cases (40%), a TD pattern emerged: when patient plasma was added to normal plasma and an activated partial thromboplastin time (APTT) test was performed on the mixture, the patient/control ratio after incubation for one hour at 37 degrees C (60-minute ratio) exceeded significantly the respective preincubation ratio (zero-minute ratio). In four cases (8%), anticoagulant activity would have gone undetected if mixing studies had been restricted to the preincubation phase. The TD anticoagulants appeared to be more potent than their time-independent (TI) counterparts (mean APTT, 74.1 vs 58.5 s, respectively). An APTT greater than 63 s was 85% predictive of TD behavior. Greater overlap between the two groups was seen when zero-minute ratios were compared; an equivalent cutoff of 1.36 for the zero-minute ratio was only 65% predictive of TD behavior. The separation between the two groups was most striking when 60-minute ratios were compared. Nineteen TD patients (90%) had 60-minute ratios that exceeded the mean TI ratio of 1.33, while 30 TI patients (97%) had 60-minute ratios that were lower than the mean TD ratio of 1.89. Collectively, these findings indicate that many potent lupuslike anticoagulants require incubation to express maximal anticoagulant activity. Indeed, in some cases, anticoagulant activity might not be detected if mixing studies are restricted to the preincubation phase. The APTT can be helpful in predicting which anticoagulants will show TD behavior.  相似文献   

17.
Background: Thyroid dysfunction (TD) is associated to chronic hepatitis C (HCV) and interferon (IFN) therapy. The prevalence of TD at baseline and during IFN therapy among stages of hepatic fibrosis is unknown.Goals: To examine the frequency of TD at baseline and during Peg-IFN therapy among patients with severe and mild fibrosis.Study: 100 patients were treated with Peg-IFN and divided in 2 groups (50 each), according to liver histology; Metavir 0-2 (mild fibrosis) and Metavir 3-4 (severe fibrosis). Baseline TD was defined as history of TD, or abnormal thyroid stimulating hormone (TSH) or antiperoxidase thyroid auto-antibodies (TPO-Ab). Frequency of TD during therapy was defined as TD that required treatment.Results: 20% in the severe fibrosis group and 10% in the mild fibrosis group, had TD at baseline. Most of the cases, 31.4% were female as compared to 6.25% males. During therapy, 24% of patients in the severe fibrosis group, compared to 12% in the mild fibrosis, had TD. Most patients had biochemical hypothyroidism, and 66% were female, compared to 33.33 % male. TPO-Ab predicted TD during therapy in 50% of cases while those negative only had 16.6% TD during IFN therapy.Conclusions: Patients with severe fibrosis have more TD events at baseline and during treatment with Peg IFN alfa-2a. Patients with more hepatic fibrosis require careful attention to diagnose and manage TD. More research in the immune mechanisms of hepatic fibrosis progression and autoimmune complications is needed.  相似文献   

18.
目的 对比观察异丙肾上腺素与阿托品试验在经食管心房调搏中诱发室上性心动过速的异同。方法 87例阵发性室上性心动过速病人,54例用异丙肾上腺素(Iso组,2μg/min静脉滴注),33例用阿托品(Atr组,0.04mg/kg静脉注射)后重复经食管心房调搏检查。结果 异丙肾上腺素与阿托品诱发成功率分别为83.3%、66.7%,前者略高于后者,但两者无显著差异(P>0.05);异丙肾上腺素诱发房室结折返性心动过速多于房室折返性心动过速,而阿托品诱发房室折返性心动过速多于房室结折返性心动过速,两者有显著差异(P<0.05)。结论 异丙肾上腺素、阿托品均可取得大致相同的阵发性室上性心动过速的诱发成功率,仅在诱发室上性心动过速的类型上有一定差异。  相似文献   

19.
血栓栓塞性疾病与肺癌   总被引:47,自引:0,他引:47  
目的 提高对肺癌合并血栓栓塞性疾病的认识。方法 从80 ̄90年代由病理学细胞学确诊的1050例肺癌中,选择20例合并血栓栓塞性疾病的肺癌进行回顾性临床分析。结果 肺癌并发下肢深静脉止血栓形成(DVT)12例(1.14%);并发肺血栓栓塞(PTE08例(4例同时有DVT)(0.76%),并发伴动脉栓塞的无菌性血栓性心内膜炎(NBTE)4例(0.38%),其中6例DVT和(或)PTE发生于肺癌确诊前2  相似文献   

20.
Background:  Treatment of chronic hepatitis C with interferon is known to be associated with thyroid dysfunction (TD) in 5–14% of patients. We studied the incidence, types, outcome and risk factors predictive of thyroid dysfunction.
Methods:  A retrospective analysis was performed on all patients treated with interferon alpha (IFN) or pegylated interferon alpha (PEG-IFN) ± ribavirin (RBV), who developed abnormal thyroid function tests (TFTs). These cases were compared with treatment-matched controls to identify factors predictive of thyroid dysfunction. Statistical methods consisted of: χ2 test, Fischer's exact test, Welch's t -test, and multivariate analysis.
Results:  From a total of 511 patients, 45 cases with TD were identified (8.8%). Pegylated interferon alpha was associated with higher rates of TD than IFN (14.1% vs 6.0%, P  = 0.0029). Female sex (OR 5.6, 95% CI 1.1–7) and Asian ethnicity (OR 2.7, 95% CI 1.4–22) were independent predictors of developing TD. Cytology was obtained in 13 patients: benign follicular pattern (8); thyroiditis (3); and normal (2). Thyroid peroxidase (TPO) antibodies ( P  = 0.004) and earlier onset of dysfunction ( P  = 0.03) were associated with need for treatment. Sixteen patients had persistent TD by the end of the follow-up period, predicted by female sex, non-Asian ethnicity, prior history of TD and TPO antibodies.
Conclusions:  Pegylated interferon alpha, female sex and Asian ethnicity are independent risk factors for TD. Thyroid peroxidase antibodies and earlier TD within the course of IFN are associated with the requirement for treatment. Thyroid function tests should be monitored during and after IFN-based therapy. The most common cytological finding is a benign follicular pattern.  相似文献   

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