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    Translational medicine
    2017, 37 (01):  1. 
    Abstract ( 455 )   PDF (3922KB) ( 749 )  
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    Original article (Basic research)
    Construction of a rat tibial neuroma transposition model and changes of neurotrophin expressions in the nervous system
    TIAN Jin-ge, YU Ting-ting, ZHANG Xin, DU Dong-ping
    2017, 37 (01):  4. 
    doi: 10.3969/j.issn.1674-8115.2017.01.001

    Abstract ( 777 )   PDF (7462KB) ( 737 )  
    Objective · To construct a rat tibial neuroma transposition (TNT) model, observe changes in expressions of neurotrophins (NTs) family [nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF)] in injured nerves, dorsal root ganglions (DRGs), and spinal cord, and investigate the effects of changes in NTs expression after peripheral nerve injury on the formation of neuroma and pain-related behavior. Methods · TNT model was built by transecting the tibial nerve and transposing it in upper lateral ankle subcutis through a transcutaneous channel. Neuroma pain and plantar mechanical paw withdrawal threshold (PWT) were measured with Von Frey filaments at different time points after TNT surgery. Rats were sacrificed and injured tibial nerves were harvested at the end of the experiment. The formation of neuroma at the broken end of tibial nerves was observed by fluorescent labeling of nerve fibers with Neurofilament-20. Animal models were built again. Rats were sacrificed and tibial nerves, DRGs, and spinal cords at injured side were collected on days 7, 21, 42 and 49. Changes in NGF and BDNF expressions in tibial nerves and DRGs were measured with ELISA kit. Changes in NGF and BDNF expressions in spinal cords were detected with Western blotting. Results · The rate and score of neuroma pain at day 7 after surgery significantly increased. The PWT level in lateral plantar skin started to decrease at day 3 after surgery. The neuroma pain and mechanical pain in lateral plantar skin lasted the whole experimental period, while the PWT level in middle plantar skin has no significant changes. The immunofluorescence staining revealed neuroma was formed at the broken end of injured nerves. ELISA results showed that in tibial nerves the NGF expression was increased, while the BDNF expression was increased at days 7 and 21 after surgery and then gradually decreased to normal level. The NGF expression in DRG was increased at days 7 and 21 and then gradually decreased to normal level, while the BDNF expression was increased at day 7 after surgery and gradually decreased to normal level. NGF and BDNF expressions in spinal cords were increased at different time points after surgery and lasted the whole experimental period. Conclusion · TNT can cause the formation of neuroma at the broken end of nerves and neuropathic pain in rats (neuroma pain and mechanical allodynia). NGF and BDNF may be associated with the occurrence and development of neuroma and neuropathic pain.
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    Immune effect of major antigen components of Mycobacterium on NKT cells in C57BL/6 mouse livers
    LIU Yi, WANG Dan-ni, LEI Hang, SHI Hui-ying, SUN Yan, SUN Zhan-qiang, ZHANG Shu-lin
    2017, 37 (01):  7. 
    doi: 10.3969/j.issn.1674-8115.2017.01.002

    Abstract ( 757 )   PDF (4852KB) ( 1211 )  
     Objective · To evaluate the immune effect of major antigen components of Mycobacterium on NKT cells in C57BL/6 mouse livers. Methods · Mycobacterium bovis BCG cells, bacterial whole cell lysate (WCL), total lipid antigens (TLIP), culture filtrate protein B (CFP-B), and lipoglycan were used respectively to immunize C57BL/6 mice via tail vein injection. The liver cells were isolated 3, 6, and 12 days after immunization. Changes in NKT cell contents were measured with flow cytometry. Mice without antigen immunization were used as controls. Results · Flow cytometry showed that percentages of NKT cells in the control group, the lipoglycan group, the CFP-B group, the TLIP group, the WCL group, and the BCG group were (0.040 0±0.020 62)%, (0.027 8±0.039 93)%, (0.035 6±0.047 46)%, (0.411 1±0.245 38)%, (0.118 9±0.054 19)%, and (0.078 9±0.045 95)%, respectively. Statistical analysis showed that the content of NKT cells was significantly higher in the TLIP and WCL groups than in the control group (P<0.01) and was higher in the TLIP group than in the WCL group. The differences between other antigen groups and the control group were not statistically significant (P>0.05). Conclusion · Of major antigen components of Mycobacterium, TLIP can significantly increase the number of NKT cells in C57BL/6 mouse livers. TLIP is worthy of further investigation for its potential anti-tuberculosis immune function.
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    Effects of preventive curcumin on lesion and expression of tryptophan hydroxylase in a rat model of ulcerative colitis
    YANG Mei, WANG Juan, RONG Wei-fang, ZHANG Guo-hua
    2017, 37 (01):  11. 
    doi: 10.3969/j.issn.1674-8115.2017.01.003

    Abstract ( 717 )   PDF (5833KB) ( 1045 )  
    Objective · To investigate the preventive effects of curcumin on inflammation and expression of tryptophan hydroxylase (TPH) in a rat model of ulcerative colitis(UC). Methods · UC was induced by 5% dextran sulfate sodium (DSS) in drinking water provided to SD rats for continuous 7 d .The oral administrations of curcumin (60 mg/kg, once a day for 10 d) were started at Day 1 since the establishment of UC model as preventive treatment. The anti-inflammatory effects of curcumin were assessed by disease activities index (DAI) score and colonic histological score(H-E staining). The effect of curcumin on expression of TPH was examined by Western blotting. Results · DSS-induced histological change in colon defined as UC increased in DAI score and increased in protein level of TPH in colon (P=0.000). Compared with the control group, preventive treatment with curcumin significantly inhibited histological score (P=0.034)and DAI score (P=0.045), while curcumin did not alter the DSS-induced upregulation of TPH. Conclusion · Preventive treatment with curcumin suppresses the inflammatory responses, while curcumin does not alter the DSS-induced upregulation of TPH. These findings indicate that anti-inflammatory effect of curcumin is independent of inhibition of 5-HT synthesis.
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    Effect of neuropeptide substance P on proliferation of murine osteoblasts through induction of RUNX2 expression
    YU Wei, ZHU Chao, MAO Wei-wei, ZHAO En-dian, MENG Sheng-wei, JIANG Sheng-dan
    2017, 37 (01):  15. 
    doi: 10.3969/j.issn.1674-8115.2017.01.004

    Abstract ( 722 )   PDF (8024KB) ( 854 )  
    Objective · To investigate the effects of neuropeptide substance P(SP) on RUNX2 expression as well as cell proliferation in osteoblasts. Methods · Primary cultured murine skull-derived osteoblasts were isolated from C57BL/6J mice;gene expression of RUNX2 in osteoblast was silenced by transfection with siRNA. Osteoblasts were treated with SP,with or without Spantide(specific blocking agents of SP),L703606(specific blocking agents of NK-1 receptor)and RUNX2 siRNA,then the effects of SP on RUNX2 expression and cell proliferation were investigated. Osteoblast proliferation was determined by cell proliferation-toxicity assay kit(CCK-8) assay. RUNX2 expressions at the mRNA and protein levels were analyzed by real-time PCR and Western blotting analysis,respectively. Results · CCK8 assay showed that SP at the concentration of 10-12~10-6 mol/L promoted osteoblasts proliferation, with 10-8 mol/L being the most effective concentration. The expressions of RUNX2 at the mRNA and protein levels were significantly increased after osteoblasts were treated with 10-8 mol/L SP for 48 h. Moreover,Spantide and L703606 inhibited SP-induced enhancement of RUNX2 expression;RUNX2 siRNA reduced the baseline of osteoblast proliferation and further attenuated the promoting effects of SP on osteoblast proliferation. Conclusion · SP induced RUNX2 expression through binding to NK-1 receptor,thus promoting the proliferation of osteoblasts.
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    Effects of soluble CD40 ligand on leukemia Kasumi-1 cells and its mechanism
    REN Ming-qiang, CHEN Qi, ZHANG Ying
    2017, 37 (01):  21. 
    doi: 10.3969/j.issn.1674-8115.2017.01.005

    Abstract ( 769 )   PDF (6059KB) ( 1030 )  
    Objective · To investigate the effects of soluble CD40 Ligand (sCD40L) on the proliferation, apoptosis of Kasumi-1 cells in vitro and its mechanism. Methods · Different densities of sCD40L were applied to Kasumi-1 cells and the MTT assay was used to observe the inhibiting effects of sCD40L on the cell proliferation at 24, 48 and 72 h to screen the optimum concentration of sCD40L and intervention time. After Kasumi-1 cells were treated with the optimum concentration of sCD40L and time, the flow cytometry (FCM) was adopted to test the apoptosis and cell cycle of Kasumi-1 cells, Western blotting was used to measure the expression of Cytc, Bax, Bid and Bcl-2, ELISA was used to test the expression of IL-17 in the culture supernatants. Results · The optimum sCD40L experimental concentration and intervention time was 4 μg/mL and 48 h. After Kasumi-1 cells were disposed by sCD40L, the cell proliferation was inhibited and the apoptosis was increased significantly. SCD40L could change Kasumi-1 cell cycle distribution which showed increasing the proportion of cells in G1 phase and reducing the proportion of cells S phase. The expression level of proapoptotic factor Bax, Bid, Cytc of Kasumi-1 cell and IL-17 in cell culture supernatant were decreased and anti-apoptotic factor Bcl-2 was increased. Conclusion · SCD40L can significantly suppress Kasumi-1 cells proliferation and induce Kasumi-1 cells apoptosis. The mechanism maybe involve mitochondrial pathways and up-regulation of IL-17 level.
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    Original article (Clinical research)
    Evaluation of intraocular lens powers in eyes with short axial lengths
    SHEN Yin-chen, WANG Yu-lan, ZHU Bi-jun, XU Xian, SUN Yong, ZHENG Gao-xin, Chen Feng-e, XU Xun
    2017, 37 (01):  26. 
    doi: 10.3969/j.issn.1674-8115.2017.01.006

    Abstract ( 1694 )   PDF (5992KB) ( 809 )  
    Objective · To evaluate the predictive accuracy of SRK-Ⅱ , SRK/T, Haigis, Hoffer Q, and Holladay formulas on postoperative refraction error values in cataract patients with short axial length eyes. Methods · Fifty-five short axial length eyes of 42 patients with cataract were recruited. All the patients underwent phacoemulsification surgery and posterior chamber intraocular lens implantation. Corneal curvature, anterior chamber depth and axial length were measured by IOL Master before the surgery. SRK-Ⅱ, SRK/T, Haigis, Hoffer Q, and Holladay formulas were adopted to calculate predictive refraction after
    operation. Three to six months after operation follow-up visits were carried out to measure the refractive power of all the eyes and calculate the differences
    between the actual refraction powers and the predicted. Results · Among the 55 eyes, there were 28, 26, 27, 20, and 24 eyes shifting to hyperopias and 27, 29, 28, 35, and 31 eyes to myopia according to SRK-Ⅱ, SRK/T, Haigis, Hoffer Q, and Holladay formula, respectively. The values of postoperative myopic shift
    were statistically different among the 5 formulas (F=6.276, P=0.000), but those of the postoperative hyperopic shift were not (F=1.351, P=0.225). Hoffer Q
    and Holladay formula showed good accuracy. Haigis formula leaded to more myopia (P=0.000). In addition, there were 11, 12, 11, 21, and 16 eyes with less
    than 0.25 D of absolute errors calculated by SRK-Ⅱ, SRK/T, Haigis, Hoffer Q, and Holladay formula, respectively. However, the distribution of the absolute
    errors of 5 formulas was not statistically significant (P=0.163). Conclusion · In short axial length eyes, Hoffer Q and Holladay formula showed a good
    accuracy. Haigis formula leads to more myopia.
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    Primary study of group cognitive-behavioral therapy for patients with late-life depression
    LIU Na, LI Xia, SHI Yan-chen, SHENG Mei-qing, Qiu Qi, FANG Yuan, LIN Xiang
    2017, 37 (01):  30. 
    doi: 10.3969/j.issn.1674-8115.2017.01.007

    Abstract ( 966 )   PDF (5506KB) ( 1237 )  
    Objective · To evaluate the efficacy of group cognitive-behavior therapy to late-life depression (LLD) and investigate the feature of LLD patients who adapt GCBT. Methods · 37 LLD patients were enrolled. The duration of GCBT was 12 weeks. The efficacy of GCBT was evaluated by Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA) and Geriatric Depression Scale (GDS) before and after treatment. Demographic and clinical characteristics of completed group and dropped out group were compared. Results · 20 patients were accomplished the GCBT in 12 weeks. The score of HAMD, HAMA and GDS were significant declined compared to the baseline. Completed group and dropped out group hadn’t any difference in the age, sex, work type and severity of disease. The education level of LLD patients in different groups was significantly different. Conclusion · GCBT can improve the depression and anxiety symptoms of LLD patient. Patients with higher education level are appropriate candidates for GCBT.
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    Value of acceleration and surface electromyogram signals in discriminating tremor between Parkinson’s disease and essential tremor
    HUANG Fei-fei, ZHANG Bin, WU Dan-hong, ZHANG Ding-guo, LIU Jun
    2017, 37 (01):  34. 
    doi: 10.3969/j.issn.1674-8115.2017.01.008

    Abstract ( 860 )   PDF (6936KB) ( 717 )  

    Objective · To investigate the clinical value of acceleration and surface electromyogram (sEMG) signals in discriminating tremor between Parkinson’s disease (PD) and essential tremor (ET). Methods · Twenty-four patients with Parkinson’s disease and 20 patients with ET were enrolled and tested with a new posture for tremor measurement (i.e, Posture 1), which the results were compared with those of anothertraditional posture (i.e, Posture 2). The comparing characteristics included amplitude, frequency and burst pattern of tremor. Results · As regarding amplitude of tremor, for Posture 1, the confidence intervel of mean value of tremor amplitude of PD and ET in the log scale was 0.75-2.40 and 0.81-3.11 with significant diffierence (F=51.1, P=0.000), respectively. While for Posture 2, there was 0.92-3.38 and 1.43-2.96 between PD and ET, respectively, without significant difference (F=0.14, P=0.709). For tremor frequency, there were significant difference between both postures (F1=97.2, P1=0.000; F2=15.2, P2=0.000). However, the coefficient
    for discrimination increased by 148.1% from 0.27 to 0.67 when Posture 2 comparing to Posture 1. As for burst pattern of sEMG signals, there was no significant difference between PD and ET in sychronous or asychronous muscle activation pattern in both postures. Conclusion · The new posture for
    tremor measurement could improve tremor discrimination between PD and ET.

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    Association of carotid wall shear rate with carotid reconstruction in kidney transplant recipients
    LI Zhao-jun, LI Fan, QIN Yan, ZHANG Qian, DU Lian-fang, LUO Xiang-hong
    2017, 37 (01):  39. 
    doi: 10.3969/j.issn.1674-8115.2017.01.009

    Abstract ( 691 )   PDF (5406KB) ( 830 )  
    Objective · To analyze the relationships between the carotid structure and the shear rate (SR) in the patients with end-stage renal disease (ESRD) and the kidney transplant recipients(KTR), and to explore the effects of SR on the carotid structure. Methods · Thirty-one KTR, 31 patients with ESRD supported by hemodialysis and 84 control subjects were offered an ultrasound of carotid artery. Both sides of carotid intima-media thickness (CIMT), common carotid arterial diameter (CCAD) and SR were measured and their relationships were analyzed. Results · ① Compared with KTR group and control group, ESRD group had significantly thicker CIMT and wider CCAD , but there was no significant difference between KTR group and control group. ② In the ESRD and KTR group, the SR was less than that in control group respectively. There was no significant difference in SR between ESRD and KTR group. ③ In all subjects, CIMT and CCAD were all negative relative with SR. Moreover, in subgroups analysis, CIMT and CCAD were negative linear relative with SR in three groups respectively. Conclusion · The carotid artery was reconstructed in ESRD group, but was improved after successful kidney transplantation. The SR played a vital role in this alteration.
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    Epidemiological distribution, virulent genes and clinical characteristics of hypermucoviscous Klebsiella pneumonia in a Hospital
    TIAN Li-jun, WANG Xiao-li, XIAO Shu-zhen, SUN Jing-yong, LIU Jia-lin, QU Hong-ping
    2017, 37 (01):  43. 
    doi: 10.3969/j.issn.1674-8115.2017.01.010

    Abstract ( 1125 )   PDF (8439KB) ( 835 )  
    Objective · To investigate the epidemiological distribution, antibiotic resistance and virulent genes of the hypermucoviscous Klebsiella pneumonia (hvKP) strains isolated from Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine and the clinical characteristics of these patients. Methods · Klebsiella pneumonia isolates were collected from hospitalized patients between September 2014 and March 2016. hvKP isolates were identified by string test. Capsular serotypes and virulent genes were detected using polymerase chain reaction (PCR). Clinical data of the hvKP-detected patients were retrospectively studied. Results · ① Of the 872 non-repetitive Klebsiella pneumonia strains, the prevalence of hvKP was 14.7% (128/872), and the highest prevalence of hvKP was 44.1% (15/34) from pus. Respiratory tract specimen was the most prevailing specimen of hvKP (70.3%, 90/128). ② Vast majority of the hvKP strains were susceptible to main antimicrobial agents, but two carbapenem-resistant hvKP strains were found. ③ Most of hvKP strains belonged to K1 (31.3%, 40/128) or K2 (32.0%, 41/128) capsular serotypes. 95.2% (20/21) of K57 serotype hvKP strains were isolated from respiratory tract. All hvKP strains were fimH, wabG and ureA positive. The incidences of p-RmpA and p-RmpA2 were 91.4% (117/128) and 82.8% (106/128) respectively, while the incidences of kfuBC and allS were 41.4% (53/128) and 27.3% (35/128) respectively, related to K1 serotype. The prevalence of capsular serotypes and virulent genes displayed no significant difference among different specimen types. ④ hvKP isolates occurred commonly in patients with diabetes mellitus (28.9%, 37/128) and cancer/immunosuppression (44.5%, 57/128). 60.9% (78/128) of the hvKP isolates could cause an infection, among which 47.4% (37/78) were community-acquired infection. The prevalence of capsular serotypes and virulent genes of hvKP also displayed no significant difference between infection group and non-infection group, as well as community-acquired infection group and hospital-acquired infection group. Conclusion · The prevalence of hvKP in Ruijin hospital was not high, and the dominant specimen of hvKP was respiratory tract specimen, some of which were colonization bacteria. K1/K2 capsular serotypes were the predominant serotypes, and almost all K57 capsular serotype hvKP strains were isolated from respiratory tract. The prevalence of capsular serotypes and virulent genes of hvKP was not significantly associated with specimen type, infection and source of infection. It is noteworthy that hvKP infection shows a convert from community-acquired to hospital-acquired.
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    Evaluation of testicular function in cryptorchid children
    XU Li-ya, LIU Qing-xu, XU Wu-hen, LI Pin
    2017, 37 (01):  49. 
    doi: 10.3969/j.issn.1674-8115.2017.01.011

    Abstract ( 880 )   PDF (7699KB) ( 797 )  
    Objective · To investigate the effects of different types of cryptorchidism on testicular Leydig-cells and Sertoli-cells function at different ages of prepubertal boys. Methods · One hundred and one prepubertal cryptorchid boys were classified into categories according to different ages, position of testes and unilateral-bilateral cryptorchidism and they were conducted luteinizing hormone releasing hormone(LHRH) stimulation test, human chorionic gonadotropin (hCG) stimulation test, serum-Anti-Müllerian-Hormone (AMH) and inhibin-B (InhB)detection. The control group consisted of prepubertal boys with normal external genitalia and no urinary system diseases. Results · In case group, testosterone levels were significantly higher in 0.5-1years patients than other subgroups after hCG stimulation. The AMH and InhB levels in the case group were obviously lower than the control group. Compared with low-position group, testosterone-values after hCG stimulation tests, AMH and InhB-values in high-position group were respectively significantly lower. Testosterone-values after hCG stimulation tests, AMH and InhB-values between unilateral group and bilateral group all had no significant difference. Conclusion · During the prepubertal period, the testicular Sertoli cells were firstly affected by cryptorchidism. The testicular Leydig cells were not seriously affected in the cryptorchid boys within 1year. The position of testes, not the unilateral or bilateral cryptorchidism, played a role in the normal testicular function.
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    Expression of CD147 in triple-negative breast cancer and its association with the prognosis
    WANG Cheng, SHAN Ming, NIU Rui-jie, YE Man-na, XU Ming, ZHUANG Zhi-gang
    2017, 37 (01):  55. 
    doi: 10.3969/j.issn.1674-8115.2017.01.012

    Abstract ( 793 )   PDF (6125KB) ( 879 )  

    Objective · To investigate the expression of CD147 and its clinical significance in triple-negative breast cancer (TNBC) tissues and analyze the association between CD147 expression and the prognosis. Methods · Clinicopathological and follow-up data of 110 patients with TNBC were collected. The immunohistochemical assay was performed for CD147 and the association of CD147 expression with clinicopathological characteristics and the prognosis was analyzed. Results · The positive expression rate of CD147 in TNBC tissues was 81.82% (90/110). CD147 expression was positively correlated to histological grade, high expression of Ki-67, and positive expression of p53 (P=0.000, 0.047, and 0.046, respectively) and was not significantly correlated to age, tumor size, and axillary lymph node metastasis (P>0.05). Survival analysis showed that CD147 expression intensity was associated with overall survival and disease-free survival (P=0.024 and 0.001, respectively). Multivariate regression analysis indicated that CD147 and Ki67 were risk factors for the prognosis of TNBC. The higher the positive expression rates were, the shorter the survival was. Conclusion · CD147 is highly expressed in TNBC tissues and is closely associated with the prognosis. It can be used as an independent factor for predicting the prognosis of TNBC. Clinical application of CD147 antibody may be an important target therapy for TNBC in the future.

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    Feasibility analysis of triglyceride as a surrogate marker for insulin resistance in Chinese women with polycystic ovary syndrome
    ZHOU Li, GAO Jing, CHEN Chen
    2017, 37 (01):  60. 
    doi: 10.3969/j.issn.1674-8115.2017.01.013

    Abstract ( 599 )   PDF (5352KB) ( 908 )  

     Objective · To analyze the feasibility of triacylglycerol (TAG) as a surrogate marker for insulin resistance in Chinese women with polycystic ovary syndrome (PCOS). Methods · Height, weight, TAG, total cholesterol (TC), high density lipoprotein (HDL), OGTT, insulin release test were measured in 171 women with PCOS according to Rotterdam consensus, who went to Department of Obstetrics and Gynecology of Ruijin Hospital from May, 2012 to June, 2015. Body mass index (BMI) and HOMA-IR were calculated. PCOS patients were divided into obese and non-obese group by BMI to analyze the feasibility of TAG as a surrogate marker for insulin resistance in two groups. Results · TAG, HDL, TC, plasma glucose and insulin levels in obese group were significantly higher than those in non-obese group (P<0.05). The proportion of patients with insulin resistance was also higher in obese group (P=0.000). The ROC curve analysis demonstrated that TAG could not predict insulin resistance in obese group. But in non-obese group the areas under the ROC curve was 0.791. The optimal cut-off point was 1.585 mmol/L with sensitivity of 0.484 and specificity of 0.979. Conclusion · TAG can be used as a surrogate marker for insulin resistance in non-obese Chinese women with PCOS.

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    Robotic-assisted versus laparoscopic radical prostatectomy: a meta-analysis
    CHU Jing-jing, YE Chao, JIN Wen, YIN Xi
    2017, 37 (01):  64. 
    doi: 10.3969/j.issn.1674-8115.2017.01.014

    Abstract ( 819 )   PDF (7259KB) ( 642 )  

    Objective · To assess the outcomes of robotic-assisted laparoscopic prostatectomy (RALP)and laparoscopic radical prostatectomy (LRP). Methods · Databases including PubMed, Web of Science, Cochrane Library, EMbase, EBSCO, CINAHL, CNKI , WangFang and VIP Database were searched to collect the controlled studies on RALP for localized prostate cancer. Meta-analysis was applied using the Review Manager V5.3 software in accordance with the Cochrane Collaboration. Results · A total of 15 studies were identified, including 1 621 cases of RALP and 1 894 cases of LRP. The results of meta-analysis showed that, compared to LRP, operative blood loss[WMD=-120.29, 95% CI (-182.20, -58.39), P=0.0001] and transfusion rate[OR=0.44, 95% CI (0.25, 0.79), P=0.006] were lower in RALP. Moreover, RALP was associated with significantly improved outcomes in the postoperative urinary continence rate of 3-month, 6-month, 12- month[OR=2.76, 95% CI (1.99, 3.82), P<0.000 01; OR=2.50, 95% CI (1.72, 3.63), P<0.000 01; OR=2.28, 95% CI (1.51, 3.46), P<0.000 1]. But there were no significant differences between the two techniques in operation time, rate of positive surgical margins and complication (P>0.05). Conclusion · RALP showed benefits in terms of operative blood loss, transfusion rate as well as functional outcomes. Further studies of larger populations with a longer follow-up are needed to make any statement.

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    Clinical observation of oral premedication with midazolam, ketamine, and dexmedetomidine in children with tetralogy of Fallot
    LI Min, WANG Yan-ting, ZHANG Ma-zhong, BAI Jie, LIU Pei-pei, SUN Ying
    2017, 37 (01):  71. 
    doi: 10.3969/j.issn.1674-8115.2017.01.015

    Abstract ( 808 )   PDF (5584KB) ( 936 )  
    Objective · To compare the efficacy and safety of oral premedication with midazolam (MID), ketamine (KET), and dexmedetomidine (DEX) in children with tetralogy of Fallot (TOF). Methods · Sixty children undergoing selective primary repair for TOF were randomly assigned to orally receiving MID (0.5 mg/kg, Group M), KET (5 mg/kg, Group K), and DEX (5 μg/kg, Group D) with twenty children in each group. The acceptance of administration, HR, SpO2, and sedation score before administration and at different time points after administration, scores of separation and intravenous cannulation 30 min after administration were observed and recorded. Results · The acceptance of administration was significantly higher in Group D than in other two groups (P<0.05). There was no significant difference in sedation onset time among three groups (P>0.05). The satisfaction rates of separation and intravenous cannulation were significantly higher in Group K than in Group D and Group M (P<0.05). There were no significant differences between HR and SpO2 at different time points after administration and baseline values before administration in three groups. Conclusion · Oral premedication with MID, KET, and DEX can provide good sedation for children with TOF. Children receiving oral KET have the highest satisfaction rates of separation and intravenous cannulation.
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    Level of miR-183 in peripheral blood of the patients with gastric cancer
    SUN Ying, MA Jin, HU Mei-jie, ZHENG Xiong, LI Jian, GU Wei
    2017, 37 (01):  75. 
    doi: 10.3969/j.issn.1674-8115.2017.01.016

    Abstract ( 798 )   PDF (6330KB) ( 798 )  

    Objective · To evaluate level of miR-183 in peripheral blood of the patients with gastric cancer for diagnosis and prognosis. Methods · Quantitative real-time PCR was used to detect the miR-183 levels in sera of 76 cases of gastric cancer patients and 26 cases of normal control at the same term. The correlations of miR-183 levels with clinicopathological features and clinical prognosis were analyzed. Results · The significantly higher levels of miR-183 were observed in the sera of gastric cancer patients (4.798±0.267 vs 0.904±0.067, P=0.000) as compared with those in the corresponding control group. Up-regulation of miR-183 was associated with invasion depth, positive lymph node or distant metastasis, and advanced clinical stage in gastric cancer patients (P<0.05), but not associated with age, sex, and degree of tumor differentiation (P>0.05). ROC curve analysis showed that the AUC value of miR-183 in the prediction of gastric cancer was 0.978 (95% CI 0.955-1.001) with sensitivity of 93.42% and specificity of 92.31%. In the prediction of metastasis (lymph node metastasis or distant metastasis), the AUC value was 0.643 (95% CI 0.507-0.780) with sensitivity of 67.31% and specificity of 58.33%. Conclusion · The high level of miR-183 in serum is associated with gastric cancer development, its clinicopathological features and patient’s clinical prognosis. It may be used as a potential diagnostic bio-marker and a prognostic predictor in the patients with gastric cancer.

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    Clinical study of double-balloon catheter in full-term pregnancy to promote cevical maturity
    REN Hong, FAN Jian-hong, ZHANG Lin, YANG Zu-jing
    2017, 37 (01):  80. 
    doi: 10.3969/j.issn.1674-8115.2017.01.017

    Abstract ( 841 )   PDF (7624KB) ( 648 )  
    Objective · To evaluate the efficacy and safety of double-balloon catheters in cervical ripening and labor induction among full-term pregnant women. Methods · This prospective randomized study was conducted between May 2014 and January 2015. A total of 152 full-term primiparas in need of labor induction were recruited. These women were pregnant with single fetuses with vertex presentation and intact membranes, whose Bishop scores were below 6. They were randomly assigned to catheter group (51 cases), control group A (51 cases) and control group B (50 cases), who received cervical ripening with double-balloon catheters, dinoprostone suppositories, and continuous intravenous infusion of oxytocin, respectively. The efficiency of cervical ripening and labor induction, labor modes, perinatal outcomes, delivery courses of 3 groups were recorded and compared. Results · Forty-eight cases (94.1%) in catheter group succeeded in cervical ripening, while 47 cases (92.2%) in control group A and 16 cases (32.7%) in control group B. Double-balloon catheters exhibited to be more effective than intravenous infusion of oxytocin in control group B (P=0.000), but there was no significant difference between catheter group and control group A. Thirty-seven women (72.6%) in catheter group, compared with 39 women (76.5%) in control group A and 19 women (38.0%) in control group B achieved vaginal delivery. Higher vaginal delivery rate were found in catheter group than in control group B (P=0.006). No significant difference was found between catheter group and control group A (P=0.747). Besides, there was no significant difference in total labor duration, as well as in the incidences of amniotic fluid contamination, postpartum hemorrhage and neonatal asphyxia among the three groups (P>0.05). Less adverse reactions were found in catheter group than those in control group A (P=0.003) instead of in control group B (P=0.873). Conclusion · Double-balloon catheters present similar effects with dinoprostone suppositories in preinduction cervical ripening and labor induction, obviously more effective than single use of oxytocin. Furthermore, double-balloon catheters cause less side effects than dinoprostone suppositories.
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    Significance of B-type natriuretic peptide in choice of antithrombotic therapy for acute cerebral infarction patients with atrial fibrillation
    LIU Bang-jian, QU Zhong-sen, ZHAO Yu-wu, SUN Xiao-jiang, YANG Jia-jun
    2017, 37 (01):  85. 
    doi: 10.3969/j.issn.1674-8115.2017.01.018

    Abstract ( 832 )   PDF (5604KB) ( 896 )  
    Objective · To evaluate the significance of B-type natriuretic peptide (BNP) in choice of antithrombotic therapy for acute cerebral infarction patients with atrial fibrillation. Methods · Clinical data of 714 acute cerebral infarction patients with atrial fibrillation were retrospectively analyzed. The patients were divided into two groups according to the cut-off value of BNP (912.5 pg/mL, the 95th quantile). Each group was subdivided into antiplatelet group and anticoagulant group. National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) scores of patients at admission and day 21 after treatment were compared, and the incidence rates of complication, such as intracranial hemorrhage, symptomatic intracranial hemorrhage, gastrointestinal bleeding, recurrent infarction, deep vein thrombosis, and the mortality were also compared. Results · In BNP>912.5 pg/mL group, the improved rates of NIHSS (P=0.015) and mRS (P=0.031) of anticoagulant group were higher than those of antiplatelet group. The mortality and the incidence of cerebral infarction recurrence in antiplatelet group were higher than those in anticoagulant group, with no statistical significance. The incidences of all kinds of bleeding, intracranial hemorrhage, symptomatic intracranial hemorrhage, gastrointestinal bleeding, and deep vein thrombosis had no significant difference between the two groups. For those with BNP≤912.5 pg/mL, the differences of improved rate of NIHSS and mRS between the two groups were not statistically significant. The mortality and the incidence of cerebral infarction recurrence in antiplatelet group were higher than those in anticoagulant group without statistical significance. The incidences of all kinds of bleeding, intracranial hemorrhage, symptomatic intracranial hemorrhage, gastrointestinal bleeding, and deep vein thrombosis were not significantly different between the two groups. Conclusion · Acute cerebral infarction patients with atrial fibrillation and BNP>912.5pg/mL may benefit more from anticoagulants than antiplatelet agents.
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    Application of ultrasound guided and nerve stimulator located thoracic paravertebral nerve block to #br# intercostal nerve transfer surgery
    CUI Wei, ZHANG Chi, GE Pei-qing, WANG Xue-hu, YE Zhao-jun, YU Shi-jian, ZHANG Yi-jue, TAO Wei-ping, YUAN Hong-bin
    2017, 37 (01):  89. 
    doi: 10.3969/j.issn.1674-8115.2017.01.019

    Abstract ( 899 )   PDF (6384KB) ( 926 )  
    Objective · To observe the effects of ultrasound guided and nerve stimulator located thoracic paravertebral nerve block (TPVB) for patients undergoing intercostal nerve transfer surgery on postoperative pain relief, complications, and hemodynamics. Methods · Sixty patients undergoing intercostal nerve transfer surgery were recruited and randomly assigned to receiving TPVB analgesia (Group T) and intravenous analgesia (Group V) with 30 patients in each group. Group T received thoracic paravertebral block guided by ultrasound and located by nerve stimulator. 20 mL of 0.375% ropivacaine with 5 mg of dexamethasone were injected into the thoracic paravertebral space of T4-T5. Changes in arterial pressure and heart rate were observed, and the range of intercostal nerve block and complications were recorded. Group V received intravenous analgesia after operation on demand. Visual analogue scale (VAS) scores 6 h and 12 h after surgery were recorded and compared between groups. Results · Five dermatome segments of intercostal nerve between T3 and T7 at surgical side were blocked. No complications and significant changes in arterial pressure and heart rate were observed. The VAS scores 6 h after surgery were significantly lower in Group T than in Group V (P=0.001). The differences in VAS scores 12 h after surgery between two groups were not statistically significant. Conclusion · Ultrasound guided and nerve stimulator located TPVB is easy and safe to perform and provides wide range of intercostal nerve block with less complications and perfect analgesia. It is especially applicable to pain relief after the intercostal nerve transfer surgery for patients with severe pain.
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    Original article (Public health)
    Analysis of the pay satisfaction structure and dimensions of medical staff in Shanghai public hospitals
    YANG Tao, TAO Rong, LI Guo-hong
    2017, 37 (01):  93. 
    doi: 10.3969/j.issn.1674-8115.2017.01.020

    Abstract ( 781 )   PDF (7130KB) ( 747 )  
    Objective · To analyze the pay satisfaction structure and dimensions of medical staff in public hospitals in Shanghai and to provide reference for the policy making. Methods · The research randomly selected 4 hospitals from 38 hospitals in Shanghai as a sample and selected on-the-job medical staff to conduct the questionnaire survey. The data was analysed by Epidata 3.0, SPSS 17.0 and AMOS 17.0. Results · The score of pay satisfaction of the medical staffs in Shanghai was relatively low. The score was 2.91±0.86. In the five dimensions, the welfare satisfaction score was 2.81±0.95 and was the lowest. The pay satisfaction of the medical staffs in public hospitals in Shanghai was made up of five dimensions: pay level satisfaction, pay improvement satisfaction, welfare satisfaction, pay structure satisfaction and pay management satisfaction. The five dimensions had significant positive effect on pay satisfaction of medical staffs and the pay structure satisfaction had the highest degree of influence. Conclusion · Hospitals should strengthen the cognition of the multi-dimension model of pay satisfaction of medical staffs. The current pay level of Shanghai public hospital medical staffs should be maintained. The construction of public hospital medical staff welfare in Shanghai should be strengthen. A scientific and reasonable compensation increase mechanism
    should be established. A scientific and reasonable compensation structure should be set up and more advanced scientific compensation management system should be explored.
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    Situation of self-perceived health among old floating population in Shanghai
    NIE Huan-huan, PAN Yin-jun, SUN Wei, BAO Yong
    2017, 37 (01):  98. 
    doi: 10.3969/j.issn.1674-8115.2017.01.021

    Abstract ( 749 )   PDF (4382KB) ( 1102 )  
    Objective · To learn the situation of self-perceived health among old floating population in Shanghai, provide basis for improving health of old floating population. Methods · To Use and analyse the related data from 2015 national family planning dynamic monitoring of the floating population health survey. Results · 752 old floating people had involved in the survey, and 53.7% of them self-perceived in good health; 43.1% of them were in basically health; 2.9% of them were in poor health, but had self care ability; 0.3% of them had no self care ability. 23.1% of them were diagnosed with high blood pressure or diabetes. Situation of self-perceived health among old floating population with different age, household type, marital status, number of friends were significantly different. Conclusion · Self-perceived health status among old floating population were relatively good, and there were significantly different among old floating population with different characters. It is necessary to pay more attention to them, help them integrate into local life, improve their health awareness as well as take advantage of basic health service.
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    Analysis of Helicobacter pylori infection in 1 960 ocean seamen in Shanghai
    GONG Jin-fa, DONG Yuan-yuan*, ZHANG Yi, WANG Yue, DONG Wei, LUO Meng-yun, MO Dan-dan, ZHANG Zhi-ruo
    2017, 37 (01):  102. 
    doi: 10.3969/j.issn.1674-8115.2017.01.022

    Abstract ( 853 )   PDF (5892KB) ( 1076 )  

    Objective · To investigate the Helicobacter pylori infection in the ocean seamen, and to provide suggestions to prevent and treat diseases associated with Helicobacter pylori infection. Methods · 3 022 people including 1 960 ocean seamen and 1 062 people working on the ground, underwent medical tests in Yuanyang Branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, from July 2014 to July 2015. They were examined by 13C-urea breath test. The infection rate of Helicobacter pylori was compared. Both ocean seamen and people working on the ground were divided into four groups according to the age. The relationship between age and infection rate was analyzed. Results · The infection rate of Helicobacter pylori is 39.74% in ocean seamen, and 24.01% in people working on the ground. The infection rate of Helicobacter pylori is significantly higher than that in people working on the ground (χ2=75.752, P <0.001). Morever, the infection rate was higher in the ocean seamen than that in people working on the ground in each age group (P < 0.05). With the increase in age, the infection rate of Helicobacter pylori was decreased in people working on the ground. But there was no significant difference between the age and the infection rate of Helicobacter pylori in the ocean seamen. Conclusion · Compared with people working on the ground, the ocean seamen is a susceptible population of Helicobacter pylori infection. More attention should be paid to prevent and treat Helicobacter pylori infection-associated diseases in this sort of population.

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    Investigation on school lunch and nutritional status in primary schools and middle schools of Shanghai
    HUANG Zhen-ru, GAO Run-ying, ZHANG Ya-li, BAWUERJIANG·Nadila, CAI Mei-qin
    2017, 37 (01):  106. 
    doi: 10.3969/j.issn.1674-8115.2017.01.023

    Abstract ( 968 )   PDF (4857KB) ( 872 )  

    Objective · To evaluate the students’ lunch intake and nutritional status in primary schools and middle schools of Shanghai, providing evidence for later revise of nutritious lunch guidance. Methods · The stratified cluster random sampling was applied, and 3 primary schools, 3 junior high schools and 1 senior high school, totally 5 322 students were included for 3-day food weight survey. Their height and weight were obtained from school health center. Results · Supply for meat and eggs was excessive while supply for sea food was insufficient. Food intake of students from primary schools and junior high schools was inadequate except for meat and eggs. High school students were better performed in the food intake. What all students shared in common was that the vegetable intake was very low. Intake for primary school students was unsatisfying even worse for the lower grades. Girls in middle schools had worse nutrition intake than boys. The proportion of fat in total energy was too high while the intake of Vitamin A, Vitamin B2, calcium and iron was in shortage. Meanwhile, the overall wasting percentage was 11.4%, and the overweight/obesity percentage was 21.4%, exhibiting a dual problem of nutritional status. Conclusion · There still remained some problems in lunch intake and nutritional status. Therefore, the insufficient supply of sea food and inadequate intake of vegetable should be paid more attention when revising the guidance of school lunch.

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    Review
    Application progress of graphene, graphene derivatives and graphene composites in tissue engineering
    CAO Yi-meng, WU Qing-kai
    2017, 37 (01):  110. 
    doi: 10.3969/j.issn.1674-8115.2017.01.024

    Abstract ( 1175 )   PDF (6734KB) ( 1394 )  
    Graphene is one of the crystalline forms of carbon, which is composed of a single monolayer of sp2 hybridized orbitals tightly packed to a two-dimensional honeycomb lattice. Because of its remarkable physiochemical properties, graphene based nanomaterials have become a hot research topic in the field of biological applications, which are available in drug delivery, gene delivery, biological detection, tumor treatment, antibacterial, tissue engineering, etc. This paper reviews the material properties, preparation methods and many derivatives of graphene, and introduces the research progress of graphene based materials in tissue engineering, including the application in wound healing, stem cell engineering, skeletal muscle engineering. The future development of graphene in the field of tissue engineering is prospected.
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    Research advances on the mechanisms of delayed cerebral ischemia after subarachnoid hemorrhage
    JIN Ke, Lü Tao, JIN Yi-chao, ZHANG Xiao-hua
    2017, 37 (01):  114. 
    doi: 10.3969/j.issn.1674-8115.2017.01.025

    Abstract ( 776 )   PDF (6775KB) ( 969 )  
    Cerebral vasospasm is traditionally regarded as an important cause of delayed cerebral ischaemia which occurs after subarachnoid haemorrhage (SAH), and often leads to cerebral infarction, damaged nervous system function, and poor prognosis. However, recent studies suggest that vasospasm is not the sole cause of delayed ischaemic complications. Findings that marked reduction in the incidence of vasospasm does not lead to a reduction in delayed cerebral ischaemia or better outcomes have promoted researches on other possible mechanisms that may cause ischaemic complications. Early brain injury, cortical spreading depolarizations, microthrombosis, microvascular spasm, failure of cerebral blood flow autoregulation, cell death, blood-brain barrier disruption, and initiation of an inflammatory cascade are all associated with the incidence of delayed cerebral ischaemia.
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    Health behavior intervention models and theories for osteoporosis patients
    XU Zi-jun, CUI Ying-chao, Lü Cheng, WU Ying-yan, CAI Yong, SHEN Tian
    2017, 37 (01):  118. 
    doi: 10.3969/j.issn.1674-8115.2017.01.026

    Abstract ( 1007 )   PDF (6983KB) ( 796 )  
    Osteoporosis is a systemic metabolic bone disease causing many serious complications such as pain and fracture. It is difficult to reverse once it happens. Medications have limitations and can't cure the disease. Regulating the behaviors of patients can prevent occurrence and deterioration of osteoporosis to a great extent. Many studies in china and abroad have been devoted to the treatment and tertiary prevention of osteoporosis. Currently the theoretical models for intervention of osteoporosis include the knowledge, attitudes, and practices (KAP) model, the health belief model (HBM), and motivational interviewing (MI), etc. Compared with previous health related behavior change models, the information-motivation-behavioral (IMB) skills model referred to the understanding of "motivation" from the theory of reasoned action and introduced the concept of "self efficacy" from the theory of social thinking. Building the IMB model can analyze the independent effects of each variable and its routes to affect the final action. So it can provide a breakthrough point for intervention of osteoporosis and better targeted interventions for different populations. The IMB model has great prospects in intervening the behaviors of osteoporosis patients.
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    Progress of research on long noncoding RNA in breast cancer
    YAN Ning-ning, HE Zhan-qiang*, XU Hai-yan, ZHANG Feng-chun
    2017, 37 (01):  122. 
    doi: 10.3969/j.issn.1674-8115.2017.01.027

    Abstract ( 819 )   PDF (10755KB) ( 861 )  

    With the expanding of human genome project and advent of post-genomic era, understanding of genome structure and function is more and more deepening. Increasing noncoding RNAs (ncRNAs) were discovered, among which longer than 200 nucleotides termed as long non-coding RNAs (LncRNAs) are involved in the pathophysiological processes including proliferation, differentiation, development, and apoptosis, becoming the new hot spots of cancer research. Breast cancer is the most common malignant tumor among women. In this article, the conception of LncRNAs and its role in occurrence, development and prognosis of breast cancer is reviewed.

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    Research progresses of the assisted reproductive techniques for hypogonadotropic hypogonadism patients
    JIANG Shu-tian, KUANG Yan-ping
    2017, 37 (01):  128. 
    doi: 10.3969/j.issn.1674-8115.2017.01.028

    Abstract ( 909 )   PDF (10429KB) ( 950 )  

    Hypogonadotropic hypogonadism (HH) is a rare disease characterized by low serum follicle-stimulating hormone and low serum luteinizing hormone. An absence of puberty initiation, a lack of secondary sexual characters, amenorrhea, and infertility are the most common clinical manifestations of this disease. A hormone replaced therapy is usually needed for female HH patients in order to establish a normal menstrual cycle and prompt the development of reproductive organs. Ovulation induction then commences when fertility intention of HH patients appears. Currently the routine regimes of ovulation induction include the use of exogenous gonadotropin and pulsatile gonadotropin-releasing hormone. In-vitro fertilization and embryo transfer (IVF-ET) becomes a common treatment for HH patients suffering from repeated failure of ovulation induction or other infertile factors. This paper reviews research progresses of the ovulation induction treatment and IVF-ET treatment for HH patients.

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    Case report
    One case report of POEMS syndrome with hypothyroidism, systemic edema, and pulmonary hypertension as the initial manifestation
    CHENG Wei, JIANG Ying, ZHANG Wei-jia, LI Xiao-hua, XU Yan-hong, BEI Peng-jian
    2017, 37 (01):  134. 
    doi: 10.3969/j.issn.1674-8115.2017.01.029

    Abstract ( 913 )   PDF (5047KB) ( 1407 )  

    This paper reported 1 case of POEMS syndrome with 16-year hypothyroidism. The patient came to our hospital due to edema for 1 year. After perfect inspection, we found the patient had pulmonary hypertension, multiple serous cavity effusion, spleen enlargement and high serum prolactin. But after the conventional anti heart failure treatment, there was no improvement in the patient with edema. Finally after the electrophoresis and bone marrow cytology, the patient was diagnosed as POEMS syndrome.

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