Journal of Digestive Diseases

Publisher: Chinese Society of Gastroenterology, Blackwell Publishing

Description

  • Impact factor
    1.85
  • 5-year impact
    1.81
  • Cited half-life
    2.80
  • Immediacy index
    0.28
  • Eigenfactor
    0.00
  • Article influence
    0.49
  • Other titles
    Journal of digestive diseases (Online)
  • ISSN
    1751-2980
  • OCLC
    123124871
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Blackwell Publishing

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    • Articles in some journals can be made Open Access on payment of additional charge
    • 'Blackwell Publishing' is an imprint of 'Wiley-Blackwell'
  • Classification
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE To evaluate the eradication rates, side effects and the compliance of patients of a dual therapy with rabeprazol and amoxicillin in different doses as the first-line therapy in patients with Helicobacter pylori (H. pylori) infection.METHODS One hundred and twenty patients who were diagnosed with non-ulcer dyspepsia with H. pylori infection endoscopically were randomly assigned into two groups who were treated with amoxicillin 1 g thrice daily plus rabeprazole either 10 mg twice daily (the R10A group) or 20 mg twice daily (the R20A group) for 14 days. H. pylori eradication was evaluated by 13C-urea breath test (UBT) at 4–6 weeks after the completion of the treatment. The H. pylori eradication rate was analyzed by per-protocol (PP) and intention-to-treat (ITT) analyses together with 95% confidence interval (CI). And the patients’ compliance and side effects were recorded.RESULTSOverall, 117 patients (58 in the R10A group and 59 in the R20A group) completed the study, among whom 5 missed the UBT. H. pylori eradication was achieved in 89.8% of the R20A group by ITT analysis and 93.0% by PP analysis, which were significantly higher than those in the R10A group (75.9% and 80.0%, respectively, P < 0.05). Side effects including skin rash, abdominal discomfort, headache, insomnia and nausea were all mild and were treated symptomatically without the need to discontinue the treatment.CONCLUSION The modified dual therapy with a high dose of rabeprazole and amoxicillin is considered an effective and safe primary therapy for H. pylori eradication and could be recommended as the first line eradication regimen for certain patients.
    Journal of Digestive Diseases 09/2014;
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    ABSTRACT: IntroductionEarly tumor recurrence, either local tumor recurrence or intrahepatic distant recurrence (IDR), after successful radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) remains a significant problem.Aim of the studyto determine the potential risk factors for intrahepatic distant recurrence (IDR) within one year after successful RFAPatient and methodsOne hundred and five patients with 138 lesions who underwent RFA and were followed up for at least 1 year were included in this study. The data of patients has been retrospectively reviewed. Multiple host and tumoral potential risk factors were reviewed and analyzed.Resultscumulative IDR free survival rates in all studied patients were 81.9 %, 45.4% and 35.2% at 1, 2 and 3 year respectively after RFA. Univariate and multivariate analysis showed that both tumor size > 2.8 cm and primary multinodular tumor (P < 0.05) were significant risk factors for IDR within 1 year.Conclusionpatients with large tumors >2.8cm and/ or multinodular HCC should be closely monitored for early recurrence after RFA. Combined and/or systemic therapies should be tried for those patients to improve their disease free and overall survival.
    Journal of Digestive Diseases 09/2014;
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    ABSTRACT: Neuromuscular and vascular hamartoma (NMVH) of small bowel is a very rare entity causing intestinal strictures. Some reports also debated it as “burnt out” phase of Crohn's disease. Here we reported one case of young woman with recurrent lower abdominal pain. Single balloon enteroscopy (SBE) showed ileum mucosal edema and she later received mesalazine therapy. But there was no distinct improvement after 2 years therapy and the symptoms become more severe. The exploratory laparotomy was then undertaken and multiple narrowing was found in a segment of terminal ileum. Presuming Crohn's disease, the narrowed segment was resected. Pathologic study found lesions with features identical to those of neuromuscular and vascular hamartoma. The patient recovered uneventfully for 6 months after this procedure and abdominal pain recurred. Second SBE found multiple ulcers in distal ileum and pathologic diagnosis favored Crohn's disease. She then received oral prednisone therapy and responded well.
    Journal of Digestive Diseases 09/2014;
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    ABSTRACT: Background Ursodeoxycholic acid (UDCA) is widely used in clinic to treat chronic liver diseases and shown its cytoprotective effect on normal hepatocytes. This study investigated the pro-apoptotic effects of UDCA on hepatocellular carcinoma cells and the underlying molecular events in vitro.MethodsHCC cells were cultured and treated by UDCA at different doses and period of time for assaying the changed cell morphology, viability, apoptosis, and gene expression using MTT, Annexin V/PI staining, TUNEL, ELISA, immunocytochemistry, and quantitative RT-PCR, respectively.ResultsUDCA treatment reduced cell viability, but induced HCC cell apoptosis at dose-dependent and time-dependent manners. UDCA arrested HepG2 cells at phase S of the cell cycle. At the gene levels, UDCA down-regulated expressions of bcl-2 and Smac proteins, but up-regulated Bax and Livin proteins in HCC cells. At the highest concentration, UDCA inhibited expression of Livin mRNA, but increased expressions of Smac and caspase-3 mRNA and activity of caspase-3 in HCC cells.Conclusions The data from the current study demonstrated that induction of HCC cell apoptosis by UDCA was at dose-dependent and time-dependent manners and mediated by regulation of Bax to bcl-2 ratio, expression of Smac and Livin, and expression and activity caspase-3.
    Journal of Digestive Diseases 09/2014;
  • Journal of Digestive Diseases 09/2014;
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    ABSTRACT: Methotrexate is effective in not only the treatmentof psoriasis36,38and rheumatoid arthritis39, but also various other disorders. The use of methotrexate has been somewhat limited by concerns regarding it's adverse effects, including potential for hepatotoxicity. The purpose of this article is to provide an overview of methotrexate-associated hepatotoxicity, including risk factors, pathogenesis, and recommendations regarding monitoring by US, UK and European guidelines as well as provide a brief overview of mechanism of action and high-dose
    Journal of Digestive Diseases 08/2014;
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    ABSTRACT: Objective To study the etiology and clinical features of acute recurrent pancreatitis (ARP) and to determine optimal management and outcomes.Methods The ARP cases among acute pancreatitis between January 2008 and December 2012 were retrospectively collected. The etiology, clinical features, treatments and outcomes of the ARP patients were analyzed.ResultsTotally, 8.9% (168/1894) of cases were classified as ARP among all of the pancreatitis patients. The proportions of mild and severe diseases were 86% and 14%, respectively. The common etiological factors were biliary (31%), alcohol (26%), hyperlipidaemia (21%) and pancreaticobiliary malformation (16%). At onset, 46 cases were cryptogenic, and 36 cases were subsequently confirmed by endoscopic retrograde cholangiopancreatography (ERCP). Among the hyperlipidaemic ARP patients, 72% failed to routinely monitor and control serum lipids; there were 28 cases with fatty liver and 16 with diabetes. ERCP was performed on 88 cases, and 48 patients also required endoscopic sphincterotomy or calculus removal. There were 22 patients who underwent cholangiopancreatic duct stent placement. A pancreatic necrosectomy was performed on 8 severe cases. The overall outcomes indicate that 8.3% of the cases developed into chronic pancreatitis that 33.3% of the cases receiving etiological treatment were recurrence-free. There were no deaths in is this study.Conclusions The etiological factors of ARP are similar to those of first onset acute pancreatitis. The management of ARP should be fully considered through etiological investigation.
    Journal of Digestive Diseases 08/2014;
  • Journal of Digestive Diseases 08/2014;
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    ABSTRACT: Background There is a paucity of validated instruments assessing symptoms in ethnic Chinese patients with functional dyspepsia.MethodsA Mandarin version of the Leeds Dyspepsia Questionnaire (M-LDQ) was developed according to standardised methods. Validity, internal consistency, test-retest reliability and responsiveness of the instrument were evaluated in both primary and secondary care patients.ResultsA total of 184 subjects (mean age 54.0 ± 15.7 years, 59% female, 74% with > secondary level education) were recruited between August 2012 and March 2013, from both primary (n=100) and secondary care (n=84). Both internal consistency of all components of the M-LDQ (Cronbach's α 0.79) and test-retest reliability (Spearman's Correlation Coefficient 0.78) were good. The M-LDQ was valid in diagnosing dyspepsia in primary care (AUC 0.84) and able to discriminate between secondary and primary care patients (median cumulative LDQ score 13.0 vs 3.0, p<0.0001). Among eight subjects with organic dyspepsia, the median M-LDQ score reduced significantly from 21.0 (pre-treatment) to 9.5, four weeks post-treatment (p<0.0001)Conclusion The Mandarin LDQ is a valid and responsive instrument for assessing ethnic Chinese adults with dyspepsia.
    Journal of Digestive Diseases 08/2014;
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    ABSTRACT: Objective Most of previous studies exploring the overlap of functional gastrointestinal disorders (FGIDs) only focused on overlap between functional dyspepsia (FD) and irritable bowel syndrome (IBS). Furthermore, there are no report about the spectra and overlap for the entire FGIDs in China. In this study, we sought to explore the spectra, symptom profiles and overlap for entire FGIDs using the validated Chinese version of Rome III questionnaire.Methods The consecutive new FGIDs patients presenting to our gastroenterology out-patient clinic between 10th May and 10th September 2012 were recruited. The patients eligible for the inclusion criteria were asked to complete the questionnaire. FGIDs were coded according to the scoring algorithm for the Rome III integrative questionnaire.ResultsAmong 350 eligible patients, 302 (86.3%) patients returned the completed questionnaires. A total of six major domains including 17 disorders in Rome III classification system were diagnosed. The four most prevalent FGIDs were FD (54.6%), IBS (40.7%), unspecified functional bowel disorder (13.9%) and functional constipation (12.6%). The three most prevalent symptoms for FGIDs were abdominal pain (66.2%), loose stool (58.3%) and bloating/distension (56.3%). Of these 302 patients with FGIDs, 152 (50.3%) patients had overlapped 1 to 5 FGIDs. Only functional bloating had no overlap. There were 6 patients overlapping with another 5 FGIDs simultaneously. Sixty three patients had FD-IBS overlapping.Conclusions This study provided the detailed spectra and symptom profiles for entire FGIDs. The overlap among FGIDs was common in China.
    Journal of Digestive Diseases 08/2014;
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    ABSTRACT: 22IntroductionIschemic colitis (IC) has been increasingly diagnosed; however, studies from the community settings are lacking. The aim of our study was to provide our 6 years’ experience.Methods This retrospective study was conducted in two hospitals on patients with IC from 2007-2013.ResultsA total of 118 patients with IC were identified (mean age: 69.41±15.07yrs, white females >80 %). The most common presenting symptoms were abdominal pain (82.2%), followed by rectal bleeding (74.6%) and diarrhea (55.1%). The most common comorbidities were hypertension, hyperlipidemia, coronary artery disease, and diabetes mellitus. CT of the abdomen without contrast was performed in 26.3%, CT with contrast in 45.8%, and CT angiogram in 28.8%. Colonoscopy was performed in 75.4% with erythema, edema, and erosions/ulcerations being the most common findings. The left colon was involved in 84.8%, whereas the right colon in 14.3%. There was one case of pan-colitis (0.9%). Descending colon was the most common affected segment (65.2%), followed by splenic flexure (51.8%) and sigmoid (43.8%). Rectum was the least affected segment (2.7%).The mean length of hospital stay was 6.7±7.6 days. The need for blood transfusion, ICU stay, mechanical ventilation, and surgery were in 20.3%, 19.5%, 11.9%, and 11.9%, respectively. IC recurred in 8.5% of cases during the 6-year study period. Severe IC occurred in 12.7%. Death within 30 days occurred in 4.2%.Conclusion In this study, right colon and rectum were affected in 14.3% and 2.7%, respectively. The overall mortality rate was 4.2%. Cardiovascular disease and its risk factors were the most common associated comorbidities.
    Journal of Digestive Diseases 08/2014;
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    ABSTRACT: Objective To investigate the role of serum microRNA (miR)-29s as biomarkers for disease progression in patients with chronic hepatitis B virus infection.Methods By using realtime quantitative polymerase chain reaction assay, we measured serum miR-29a/b/c levels in different groups of patients with chronic hepatitis B virus infection. We analyzed correlation of serum miR-29 levels with liver biochemistry, fibrosis and necroinflammation stage.ResultsPatients were divided by fibrosis stage into S0/1 (minimal fibrosis), S2/3 (progressing fibrosis) and S4 (cirrhosis). Serum miR-29a/c levels in S0/1 and S2/3 were significantly higher than those in S4 patients (P < 0.001), the difference between S0/1 and S2/3 patients was not significant. miR-29b levels were higher in S0/1 patients than other groups (P < 0.001), but not significantly different between S2/3 and S4. In fibrosis stage S0/1 and S2/3, patients with minimal liver inflammation (G0/1) tended to express higher miR-29 levels than advanced inflammation (G2-4), the difference was insignificant. All miR-29 members demonstrated significant correlation with ALT levels (P <0.05 for miR-29a, P <0.001 for miR-29b, P <0.01 for miR-29c) in S0-3 patients. Expression of miR-29s was highest in immune tolerant patients (P < 0.001).Conclusions Serum miR-29 levels negatively correlate with fibrosis and necroinflammation in patients with chronic hepatitis B virus infection. miR-29s appear to be novel biomarkers for predicting disease progression in these patients.
    Journal of Digestive Diseases 08/2014;
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    ABSTRACT: Objectives The aim of this study was to investigate the influence of gut microbiota on autophagy activation in intestinal epithelial cells (IECs). In addition, the IEC autophagy response to different types of bacteria was also evaluated.MethodsIEC-18 cells were treated with lipopolysaccharide (LPS) derived from enteropathogenic Escherichia coli (EPEC) O127:B8 and culture medium supernatants of four types of Bifidobacteria. Transepithelial electrical resistance (TEER) examination were recorded using EVOM chopstick voltohmmeter. Autophagy was determined by transmission electron microscopy (TEM), the ratio of LC3-II to LC3-I and the persistence of both green fluorescent protein (GFP) and mCherry signals using a tandem mCherry-GFP-LC3 construct. Expression of Atg12-Atg5-Atg16 complex was measured by quantitative real-time polymerase chain reaction (qRT-PCR).ResultsEPEC-LPS significantly diminished TEER of IECs compared with the untreated controls by around 45–55%. This reduction was not observed after treated with Bifidobacteria at all the time points. Bifidobacteria could initiate the activation of autophagy activation in IECs, based on both LC3-II/-I ratio and TEM. The four types of Bifidobacteria did not have different influences on autophagy response. Compared to Bifidobacteria, IECs reacted to EPEC-LPS much more intensively by autophagy accumulation. More mCherry+-LC3 autophagic puncta could be observed after treated with Bifidobacteria and EPEC-LPS. The expressions of autophagy genes ATG5, ATG12 and ATG16 were significantly higher after treated with Bifidobacteria and EPEC-LPS.Conclusions Bifidobacteria initiate autophagy activation in IECs. Atg12-Atg5-Atg16 multimeric complex might participate in the activation of Bifidobacteria-induced cell autophagy.
    Journal of Digestive Diseases 08/2014;
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    ABSTRACT: Oxaliplatin, a component of chemotherapy for colorectal carcinoma liver metastases, can result in hepatic sinusoidal injury; rarely, the injury is fatal. The manifestations of injury are variable and, predictors of susceptibility and outcome are unknown.A semi-quantitative system forassessing histologic features in non-tumor liverwascompared with clinical short and long term outcomes.
    Journal of Digestive Diseases 07/2014;
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    ABSTRACT: AimTo study the natural history of NAFLD patients using paired liver biopsies and to determine factors associated with disease progression.Methods Seventy-five NAFLD patients with liver biopsy in an earlier study were contacted. Patients who agreed for repeat liver biopsy were included. Factors associated with worsened NAFLD activity score (NAS) and fibrosis were determined.ResultsData for 35 patients were analyzed (mean age 47.5±10.9 years old, male 40.0%). At baseline, 2.9%, 31.4% and 65.7% had simple steatosis, borderline NASH and definite NASH, respectively. Mean interval between biopsies was 6.4±0.8 years. NAS worsened in 13, remained unchanged in 9 and improved in 13. Fibrosis worsened in 18 and remained unchanged in 17. Two developed cirrhosis. On multivariate analysis, elevated serum AST (OR = 10.74, 95%CI = 1.00–115.86, p = 0.050) and GGT (OR = 16.10, 95%CI = 1.30–198.90, p = 0.030) at follow-up were associated with worsened NAS. Patients with borderline NASH at baseline were significantly more likely to have worsened NAS at follow-up compared to patients with definite NASH (OR = 12.67, 95%CI = 2.29 – 70.02, p = 0.004). However, both groups of patients had similar likelihood of having worsened fibrosis at follow-up. No plausible factors were found to be associated with worsened fibrosis.ConclusionsNAFLD patients with persistently elevated serum AST and GGT levels during follow-up should be suspected of having worsened NAS. NASH patients can undergo significant disease progression over a relatively short period of time and fibrosis is irreversible without specific interventions.non-alcoholic fatty liver disease; NAFLD; non-alcoholic steatohepatitis; NASH; natural history; histology; disease progression
    Journal of Digestive Diseases 07/2014;
  • Journal of Digestive Diseases 07/2014;
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    ABSTRACT: Objective To provide a retrospective assessment of the imaging features of multi-detector row computed tomography (MDCT) and clinical characteristics of gastric glomus tumors.Methods Ten consecutive patients with pathologically confirmed gastric glomus tumor were included in the study. The MDCT images and medical records were retrospectively reviewed. The CT features including the location, number, shape, growth pattern, lesion size, calcification, density, and enhancement pattern were analyzed through PACS or a workstation.ResultsThere were seven female and three male patients with a mean age of 46.6 years (rang 25-67 years). Most cases had nonspecific clinical symptoms. All lesions were located in gastric antrum with a mean diameter of 2.7 cm. Gastric glomus tumor showed strong enhancement in the arterial phase, progressive fill-in enhanced pattern, and prolonged enhancement during multiphasic scans.Conclusion Gastric glomus tumor is an extremely rare entity. The combination of tumor location, size, and characteristic enhancement pattern of the subepithelial lesion can suggest the diagnosis of gastric glomus tumor.
    Journal of Digestive Diseases 07/2014;
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    ABSTRACT: Objective This meta-analysis aimed to compare the diagnostic accuracy of diffusion-weighted magnetic resonance imaging (DW-MRI) and fluorodeoxyglucose-positron emission tomography (FDG-PET) with or without computed tomography (CT) in evaluating and predicting pathological response to NCRT in patients with rectal cancer.Methods Comprehensive literature search was conducted in the manuscript published from January 2000 to December 2013 on the MEDLINE, PUBMED and EMBASE databases as well as on the SpringerLink, ScienceDirect, Scopus and the Cochrane Database of Systematic Review. Only articles in English were enrolled. Statistical value of combined sensitivity, specificity, positive (PPV) and negative predictive value (NPV) were calculated.ResultsAltogether 33 studies including 1564 patients, the pooled sensitivity (81% [95% confidence interval {CI} 74–86%] vs 85% [95% CI 75–91%]) and NPV (80% [95% CI 68–89%] vs 91% [95% CI 80–95%]) for FDG-PET or FDG-PET/CT were significantly lower than those for DW-MRI (P < 0.05). No differences were observed in the pooled specificity and PPV between DW-MRI and FDG-PET or FDG-PET/CT. Further subgroup analysis showed that DW-MRI yielded higher sensitivity on adenocarcinoma only than those including mucinous-type adenocarcinoma (92% [95% CI 83–99%] vs 76% [95% CI 63–90%], P = 0.00).ConclusionsDW-MRI might be a promising tool in predicting and evaluating the pathological response to preoperative NCRT in patients with rectal cancer and is superior to FDG-PET or FDG-PET/CT. However, the relatively low specificity and PPV will limit its application in clinic, making it not be currently appropriate for monitoring patients with mucinous-type rectal adenocarcinoma.
    Journal of Digestive Diseases 07/2014;
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    ABSTRACT: Though telbivudine has been reported causing myopathy and elevating creatine kinase (CK), there is still few reports on telbivudine and hyperlactatemia in patients with chronic hepatitis B. Here we report the case of hyperlactaemia during telbivudine treatment. A 26-year-old Chinese origin man has been received telbivudine antiviral treatment for chronic hepatitis B since 3 July, 2011, and found the CK was 68 U/L before the anti-viral treatment. After 3 months of therapy, he generally felt nausea and vomited frequently. The CK checked in local clinic was up to 222 U/L (upper limit of normal 170 U/L). However, he did not visit his doctor or stopped telbivudine treatment until he felt sore in muscles all over the body. By then, the level of CK had increased to 4151 U/ L just one year after the use of telbivudine. Even after withdrawal of telbivudine, myalgia exacerbated and CK decreased deadly slowly. Constant myolysis was developed into hyperlactatemia, finally he recovered by successfully continuous venovenous hemodiafiltration. The case findings suggested that telbivudine might lead to high level of CK and hyperlactatemia could occur if telbivudine was not stopped immediately when CK increased evidently. Besides, it is emphasized that the serum CK and lactate acid should be monitored closely during the treatment of telbivudine.
    Journal of Digestive Diseases 07/2014;
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    ABSTRACT: Objective To compare the efficacy and patient compliance of existing treatments for Helicobacter pylori (H. pylori) eradication, including moxifloxacin-based triple therapy, sequential treatment and the standard treatment.Methods Patients with H. pylori infection were randomly assigned to three therapy groups. The triple therapy (MML) group was given moxifloxacin 400 mg/day, metronidazole 500 mg b.i.d. and lansoprazole 30 mg b.i.d. for ten days. The sequential treatment (AL-CML) group was administrated amoxicillin 1g b.i.d. and lansoprazole 30 mg b.i.d. for the first five days followed by clarithromycin 500 mg b.i.d., metronidazole 500 mg b.i.d.and lansoprazole 30 mg b.i.d. for the second five days. The standard treatment (CAL) group received amoxicillin 1g b.i.d., clarithromycin 500 mg b.i.d. and lansoprazole 30 mg b.i.d. for 14 days. The eradication rates were evaluated by per-protocol (PP) analysis and intention-to-treat (ITT) analysis.ResultsThe eradication rates were 87.1%, 85.9%, 85.2% by PP analysis and 87.1%, 84.9%, 84.2% by ITT analysis in MML group, AL-CML group and CAL group, respectively, and the patient compliance rates were 98.2%, 96.5% and 97.1%, respectively. There were no significant differences in treatment efficacy and compliance rates among moxifloxacin-based triple therapy, sequential therapy and the standard treatment (P >0.05).Conclusions The present study revealed that standard triple therapy, sequential therapy and moxifloxacin-based triple therapy are all effective treatment regimens in terms of H. pylori eradication rates and therapy compliances in Turkey.
    Journal of Digestive Diseases 07/2014;

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