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首页 内科疾病神经系统并发症课件

内科疾病神经系统并发症课件.doc

内科疾病神经系统并发症课件

Phyllis娥
2017-10-23 0人阅读 举报 0 0 暂无简介

简介:本文档为《内科疾病神经系统并发症课件doc》,可适用于综合领域

内科疾病神经系统并发症课件高钠血症性脑病血清钠高于mmolL即为高钠血症血清钠增高可造成脑细胞功能受损。病因主要为水分丢失或摄入过少。常见的病因为肾脏疾病、尿崩症、皮质类固醇治疗、损伤了下丘脑前部渗透压感受器的下丘脑肿瘤、神经垂体的非特异性感染等。病理生理高血钠症性脑病,脑组织脱水并可伴有点状出血或微血管的血栓形成造成脑组织损伤。症状体征发展速度快或严重的高钠血症患者常出现嗜睡、昏睡及昏迷伴有肌肉强直、脑膜刺激征并可表现去脑强直或去皮层状态。病情发展过程中可以出现不持续的舞蹈样动作肌阵挛或惊厥。实验室检查血清钠高于正常处理高钠血症在缓慢补充液体的同时要积极诊治原发疾病。补液速度不宜过快通常在h内逐渐纠正高渗状态以防补液过快发生脑水肿或其他电解质异常。预后预后不佳经抢救存活的病例中约半数留有不同程度的后遗症如手足徐动症肢体瘫痪或智力缺陷。低钾血性脑病当血清钾mmolL时为低钾血症。血清钾的降低可以造成脑细胞的功能受损。病因引起低钾血症常见的原因有长期补液而钾的补给不足腹泻、呕吐、肾病等钾的丢失过多内分泌紊乱如醛固酮增多症、Cushing综合征、甲状腺功能亢进等代谢异常长期使用利尿药、皮质类固醇等。病理生理血K对维持神经肌肉细胞膜的应激性非常重要血清钾减低使细胞内钾降低造成细胞膜的去极化而使细胞对刺激的反应不正常影响神经细胞的功能。症状体征大多病例仅表现为肌无力及易倦部分低钾血症可见急性四肢瘫痪有时呼吸肌亦可无力。少数严重病例则可发展为明显的全身无力、思睡继以意识混浊、错乱或谵乱最终可进入昏迷。同时患者还可出现严重的心律失常。实验室检查血清钾低于正常为诊断关键心电图也可供参考。处理补钾的同时积极诊治原发病。轻度低钾血可口服,氯化钾,ml分次服。重症低钾血或不能口服者可给静脉补钾。静脉补钾宜缓慢滴注钾浓度不宜超过mmol,密切监测心电图及血钾和尿量。低镁血性脑病血清镁水平低于mmol,为低镁血症。低镁造成脑组织受损,表现神经、精神症状为低镁血症性脑病。病因肠梗阻剧烈呕吐后可以发生血清镁的降低糖尿病酸中毒、脂肪痢、长期应用利尿剂或补液、胰腺炎、血紫质病及恶性溶骨性疾病等都可造成镁离子的降低。病理生理镁离子主要位于细胞内是活化多种酶系统、维持突触传递及细胞膜兴奋性所必需的。脑和肌肉是人体内含镁量相对较高的组织因而低镁血症时脑细胞功能会受到破坏。症状体征低镁血症性脑病可表现为lineofthebusthroughthelistofmadeamoredetailedprovisions,applymoreoperationalSevenisincreasedthearticle,inviolationoftherelevantprovisionsofthe,toparticipateinpublicfundstopayfordinner,highconsumptionofentertainment,fitnessactivitiesandpublicfundstobuygift,sendgiftstomaketheprovisionsofthedispositionOntheviolationofthecentralprovisionsofthespiritoftheeight,inadditionto><newregulationsinto"violationofhonestyandselfdiscipline"misconductoutside,isdifferentwiththeoriginal<Regulations>,revised<rule>clearlydefinednotonlytodispositionofthedirectlyresponsiblepersons,butalsodisposeofcollarGuideresponsibilities()increasedtradingrights,useofauthorityorpositioninfluenceasrelativesandclosetoprofitviolationofthetermsofthe<NewRegulations>absorption<cleanpoliticsseveralguidelines>therelevantprovisionsspirit,increasethe"negativelist,includingtradingrights,thefunctionsandpowersordutiesofinfluenceasrelativesandstaffaroundprofitIncreaseArticle"mutualuseofofficeorauthorityringforeachotherandtheirspouses,childrenandtheirspousesandotherrelatives,aroundpersonnelandotherspecificrelationshipbetweenthepeopletoseekbenefitsengageintradingrights,givenawarningorseriouswarningSanctionsifthecircumstancesarerelativelyserious,givingremovedfromorplacedonprobationwithinthepartypostifthecircumstancesareserious,shallbeexpelledfromthepartyIncreaseArticle"connivance,acquiescencetothespouse,childrenandspouseetcrelativesandstaffaroundtheeffectofPartymembersandcadrespersonalauthorityorpositionforpersonalgain,ifthecircumstancesarerelativelyminor,givenawarningoraseriouswarningifthecircumstancesarerelativelyserious,givingremovedfromorplacedonprobationwithinthepartypostifthecircumstancesareserious,thegivenExpelledfromthepartyPartymembersandcadresofthespouses,childrenandtheirspousesdoestheactualworkandgetsalaryoralthoughtheactualworkbuttoreceivesignificantlybeyondthesameranksalarystandard,Partymembersandcadresinformedfailstocorrect,inaccordancewiththeprovisionsoftheprecedingparagraph"()aboutthegifts,giftsmisconductfromhandlingpracticesinrecentyears,engagedinofficialcadresreceivedgifts,giftsproblemsmoreprominentThishasseriouslyaffectedtheimageofPartymembersandcadres,damagedtherelationsbetweenthepartyandthemasses,andisahotbedofcorruption,isreallynecessaryforthiskindofbehaviortobedisciplined<rule>noonacceptinggifts,gifts,Cardconsumptionbehaviortoengageinsimple"onesizefitsall",butthedifferencebetweenthedifferentseparatelyOneisinaccordancewiththeprovisionsofArticle,acceptingmayaffecttheimpartialenforcementoftheofficialgifts,gifts,consumercardstodependingontheseriousnessofthecaseshallbegivendisciplinarysanctionsThatistosay,formayaffectthefairexecutionofbusinessgifts,gifts,consumercardsarenotallowedtoacceptisinaccordancewiththeprovisionsofArticle,acceptingwassignificantlyhigherthannormalceremonyisstillexchangesofgifts,gifts,consumercardtodisciplinaryactionThisisnewregulationsthatdailylifeispurelyreciprocity,acceptingthesamething,boys,fellowfriendsgifts,gifts,shoppingcards,althoughandfairexecutionofbusinesshasnothingtodo,alsowanttoasthecaseshallbedealtwith,thesituationisobviouslybeyondnormalreciprocity"Thesocalled"reciprocity",oneisemphasizesthereciprocalinprotocolInotherwordsisyoutomehow,Itoyouhow,notonlydoesnotgoThesecondistosignificantlyexceededthenormallocaleconomylevel,customsandhabits,economiccapacityofindividualgifts,giftvalueSpecificsanctionstoaccordingtotheprocessingofavarietyoffactorstoconsider,asappropriateThethirdistherootaccordingtotheprovisionsofArticle,"toEngagedinpublicservicepersonnelandtheirspousesandchildren,children'sspousesandotherrelativesandotherspecificrelationshippresentedMingXianchaonormalreciprocityofgifts,gifts,consumercard,ifthecircumstancesarerelativelyserious,givenawarninguntilprobation"Inaccordancewiththeaboveprovisions,giftgivingsignificantlybeyondthenormalreciprocity,giverconstitutethediscipline()onillegaltradingofstocksorofotherregulationsofsecuritiesinvestment<>ArticleisengagedinpunishmentregulationofcampandactivityinviolationoftherelevantprovisionsonAmongthem,will"buyingandsellingstocksorinothersecuritiesinvestment"columnasoneofdisciplinarycasesOutFirstneedtobeclear,><regulationsdidnotchangetheprovisionsoftheOrdinanceTheordinanceoftheprovisionsofthesecondparagraphofArticleprovisions"who,inviolationoftheprovisionsofthesaleofstocks"isoneoftheviolation,andatthebeginningofthefirstparagraphofthisarticle"violationofagainsttherelevantprovisionsofthe"textualrepresentationoftherepeatrevisionIn,justfromthelegislativetechniqueremovedthe"personal"inviolationoftheprovisions,contentandnottochangetheoriginalprovisionsNeedtoclearis,"buyorsellastockorofothersecuritiesinvestment"referstoviolationoftherelevantprovisionsreferstoinApril,thePartyCentralCommittee,theStateCouncilpromulgatedtheOntheworkofthepartyandgovernmentorgansstaff'spersonalinvestmentinsecuritiesifdryprovisions>AccordingtotheprovisionsofArticle,useofworktime,officefacilities,thesaleofstocksandsecuritiesinvestmentfundbelongstoillegalbehaviorThefourthquestion,abouttheviolationofthemassesofthedisciplinaryactions<newregulations>wouldviolatepublicdisciplinebehaviorofasinglesetofaclassofrestored"threerulesofdisciplineandeightnote"inthedisciplineofthemassesofexcellenttraditional<NewRegulations>Chapter"toviolatethemassesofdisciplinaryaction",mainlythedestructionoftheparty'sclosetieswiththemassesofmisconductmadeprovisionsondisciplinaryenrichandperfectthesuperstandard,beyondthescopeofXiangQun<Alltoraisefundandlabor,inforinvolvingthepublicaffairsdeliberately,chinakayao,insocialsecurity,policysupport,disasterrelieffundsandmaterialsandothermattersassignedanykindandaffectionatefriends,obviouslyunfairactsagainsttheinterestsofthemassesofthedisciplinarytermsincreasethetermsnotinaccordancewiththeprovisionsofthepublicpartyprovided,government,factoryandvillage(neighborhood)providedetcviolationofthepeople'srighttoknowthebehaviorofthedisciplineThefifthissue,ontheviolationofworkdisciplineviolationofworkdisciplineadded"negativelist,includingPartyorganizationscarryoutstrictlyMainresponsibilityforpoordisciplineterms()thenewpartyorganizationcomprehensivestrictlythemainresponsibilityofthepartydoesnotfulfilltheorperformpoordisciplinaryterms<NewRegulations>hasaleadpeopletopayattentiontothenewterms,thatis,inchapterten"ontheviolationofworkdisciplinebehaviorpunishment"increaseintheonehundredandfourteenth"partyfailtoperformcomprehensivestrictlythemainresponsibilityofthepartyortoperformcomprehensivestrictlythemainresponsibilityforadministeringtheineffective,resultinginseriousdamageorseriousadverseeffects,tothepersondirectlyresponsibleandtheresponsibilityofleadershipandgiveawarningorseriouswarningThesituationisserious,givingremovedfromtheirpartypostsoronprobationPunishment"HerethechangesForthefirsttime,themainresponsibilitywrite<rule>()newshallreportdoesnotreportorfalsereportingdisciplineshallincreasethebar"inthehigherlevelunitstochecktoinspecttheworkorreporttotheparentunit,workreportofshallreportthemattersdonotreportordonotreport,causeseriousdamageorseriousadverseeffectsof,tothepersondirectlyresponsibleandtheresponsibilityofleadership,togivewarningoraseriouswarningifthecircumstancesareserious,givingremovedfromtheirpartypostsorplacedonprobation"Forexample,duringthetourvisitstotheregion,theunitMemberstheobligationtotheinspectionteamstoreflectthetruesituation,toconcealnotreportedorintentionallytotheinspectionteamstoprovidefalseinformation,causingseriousdamageorseriousadverseeffectsof,thepersondirectlyresponsibleandtheresponsibilityofleadershipshouldbeinaccordancewiththeprovisionsof<rule>Articletogivetheappropriatepunishment()thenewnotgrantedinaccordancewiththeprovisionsofpunishment,notaccordingtotheprovisionsoftheimplementationofdisciplinarymeasuresviolationoftheprovisionsofArticle"Partyorganizationshaveoneofthefollowingcircumstances,thedirectleadershipresponsibilityProbation:membersweresentencedpunished,inaccordancewiththeprovisionsgivedisciplinaryactionorinviolationofstatelawRulesofbehaviorshouldbegivendisciplinarypunishmentanddisposeofdisciplinarypunishmentbydecisionorcomplaintreviewthedecisionmade,notinaccordancewiththeprovisionsoftheimplementationdecisionsonpunishmentoftheparty,position,rank,andthetreatmentofthemattersPartymemberssubjecttodisciplinaryaction,notinaccordancewiththecadremanagementauthorityandorganizationalrelationshipsofbydisposeofPartymemberstocarryouteducationandsupervisionofdailymanagement"Whatneedstobepointedoutis,"cliff"demotedwithcars,housing,secretaryproblem,implementationisnotadisciplineandpartypostsandrankstreatmentbytheorganizationdepartmentisresponsiblefortheimplementation,withcars,housingbythelogisticsdepartmentisresponsiblefortheimplementationof,JiCommissionresponsibleoversightresponsibilitiesThesixquestions,abouttheactsviolatingthedisciplineoflife"inviolationofdisciplineoflifebehaviorpunishment",mainlyto"fourwinds"problemsandaseriousviolationofsocialmorality,familyvirtueactsofmisconductmadeprovisionsondisciplinary,anincreaseofextravagantlife,contrarytothesocialpublicorderandgoodcustomsdisciplinarytermsWorthmentioningis,><RegulationsinArticleabout"adultery""mistress(Cardiff)formulationinthenew<rule>isremoved,toexpandthescopeofArticleprovisions"andothershairimpropersexualrelations,letfacedisciplinaryactionWidermorestrictFour,andearnestlydoagoodjobinthe<code>and<rule>implementsystemoflifeliesinexecution<code>and<Regulations>isPartyorganizationsatalllevelsofastrongconstraintandallPartymembersfollowLearningandimplementingthe<code>and<rule>ispartycommittees(party),commissionfordiscipline,disciplineinspectiongroup),themajorityofPartymembersandcadresofthecommonresponsibility,mustpartycaughttogether,thepartyoneexecution()Partycommittees(party)andplayandimplementcomprehensivestrictlythemainresponsibility,paysspecialattentiontothetwopartyregulationslearningcrosspenetrationOneistoAdheretothepartyconstitutionisfundamentaltofollow,andresolutelysafeguardtheauthorityofthePartyChapterThesecondistoadheretotheproblemoriented,tostrictlypoliticaldisciplineandpoliticalrulemomentsinthefirstplaceThethirdistoadheretothedisciplineandrulesquiteinfrontmustnotallowthebottomlinetobreakthedisciplineThefourthistoseriouslyorganizethestudyofpropagandaandeducation,inthecitypartymemberstocreateadisciplined,abouttherulesofthestrongatmosphere(II)CommissionforDisciplineInspectionatalllevels(DisciplineInspectionGroup)toanimportantbasisfortherevisedtwopartyregulationsas,adheretoeasilyblame,strengthensupervisionandenforcementAndearlymethodincombiningJi,increaseaccountabilityeffortsOneistotworegulationswithinthepartyimportantbasis,adheretothepartyconstitutionduties,withstrictdisciplinetomaintaintheconstitutionauthorityThesecondistoadheretohighstandardsandkeepthebottomline,adheretoJiYaninlawanddiscipline,thedisciplineandrulesquiteinfront,graspinggraspingsmall,easilyblame,comprehensiveuseofsupervisionanddisciplineof"fourkindsofform"inthedisciplineembodiesthestrictrequirementsandcareforthediscipline,tightenup,YanAccordingtodisciplineinaccordancewithregulationstocarryoutdisciplinaryreviewIncreasetheviolationspunishment,cluescaninitiateaninvestigationonthetrialofcasesAccordingtothedisciplineontheprovisionsoftheproportionofprocessingandcontrolmanagermaintainsdisciplineTofocusoninvestigatingnonconvergence,don'taccepthandseriousdisciplinaryviolationsatthesametime,paymoreattentiontothegeneralreviewofdisciplinebehavior,andgraduallyincreasethelighterpunishmentFouristoilluminatetwopartyregulations,combinedwiththelocaldistrictoftheDepartmentofpartyconductLianzhengtorelevantlawsandregulationssystemclean,timelyresearchproposestoestablish,change,wastereleaseopinion,avoidconflict,andthefastensystemofcage,andgraduallyformednotrot,notrot,notwanttorotsystemandworkingmechanism()theleadershipofthepartymembersandcadresshouldplayanexemplaryroleTherateofhigherconsciousnessofthefrontoftheOrdinancetoleadpracticeselfdisciplinenorms,leadingtomaintaindisciplineofseriousnessandauthorityOneistheaboverate,demonstrationandguidance,taketheleadinlearningandmasteringthe<code>and<>therequirementsandregulations,dothedeepunderstanding,learningtouseThesecondistoplayanexemplaryroleinabidingbydisciplinerate,taketheleadinpracticingselfdisciplinenorms,firmlyestablishbeforethedisciplineareequal,thesystemhasnoprivilege,disciplineisnoexception,andconsciouslydostandards,requiremorestrictmeasuresmorepracticalThirdistoconsciouslyacceptsupervision,conscientiouslyparticipateinthedemocraticlifeanddebriefinghonestyresponsibility,suchasRealtothepartyorganizationtoreportpersonalmatters,andtoacceptthesupervisionoftheworkandlifeofthenormal,habitsunderthesupervisionoftheexerciseofpower,tocarryouttheworkThefourthistosetanexampleforthestrictenforcementofdisciplineLeadingcadresshouldtaketheleadinthemaintenanceofdisciplineofseriousnessandauthority,todaretoseriously,daretostruggle,daretooffendpeople,formisconductnotlaissezfaire,butdonotindulge,nottoleratetoensurethepartyconstitutionofpartycompassespartyputinplace()themajorityofPartymembersandcadrestosethighstandardsandholdthebottomline,consciouslyabidebythe<code>and<rule>Oneistocontrolthe<standard>and<cases>,tightCloseconnectionwiththeirownthoughts,practicalworkandlife,effortstosolvetheproblems,toenhancethestudyandimplementoftheeffectivenessandpertinenceThesecondistoestablishahighstandardandholdthebottomline,consciouslyintheselfdisciplinepursuitofhighstandards,strictlyinthepartyawayfromtheredlinediscipline,discipline,abouttherulesandknowfear,distrust,theformationofthehonorsystem,complywiththesystem,safeguardsystemofgoodhabitsRegulationsanddisciplineregulationsof<<NewRevisionoftheCommunistPartyofChinacleanfingeredselfdisciplinecriterion>and<ChineseCommunistPartyDisciplinaryRegulations>isthePartyCentralCommitteeinthenewsituationtopromotethecomprehensivestrictlyrootofthelift,theregulationsofthepartyconstructionofkeepingpacewiththetimesWeshouldstudyandimplementtheStandards>and<>astheprimarypoliticaltask,adheretothepartyconstitutionduties,adheretothedisciplineof,JiYaninlaw,thefullimplementationofsupervisionanddisciplineaccountabilityresponsibilitiesforcoordinationandpromotion"fouroverall"strategiclayoutinXXDistrictvividpracticetoprovideastrongguaranteeSiJianWu,andeffectivelyenhancetheimplementationoftheimplementationofthe<code><>TheconsciousnessofGeneralSecretaryXipointedoutthatthepartyisinchargeoftheparty,tomanagethepartystrictly,itcancuregoodpartyCriterion>and<rule>keeppacewiththetimesisourpartytoformanewpotentialstrictlyrules,todeepenunderstandingoftherulinglaw,isacomprehensivestrictly,andstrengthenthesupervisionwithinthepartyimportantgrasperCriterion>closelylinkedtothethemeofselfdiscipline,selfdisciplineintensitymodulated,focusingonmorality,forthemajorityofPartymembersandcadressettosee,feelthehighstandard,showtheCommunistsnoblemoralsentimentDistrictOrdinance<<rule>theconstitutionofdisciplineintegrationintoapoliticaldiscipline,organizationanddiscipline,honestyanddiscipline,disciplineofthemasses,workdiscipline,discipline,emphasizediscipline,focusingonestablishedrules,todrawthepartyorganizationsandPartymembersdonottouchthebottomlinePartycommittees(party)toeffectivelystrengthenthestudyandpublicizetheimplementationofthe<code>and<rule>theorganizationandleadershipofcriterion>and<>afullrange,multiangle,deeppublicity,theformationofstudyandpublicizeandimplementtheboom,inordertoconsolidatethedevelopmentofgoodpoliticalenvironmenttocreateapositiveenvironmentandatmosphereThemajorityofPartymembersandcadrestostrictrequirements,the<rule>and<Ordinancecases>asaguidetoactionandbehaviorcriterion,adheretothemoralstandardsanddisciplineofthebottomline,tomaintainthedisciplineofworshipandawe,learning,compliance,andmaintainpartydisciplineandrulesofthemodelThedisciplineinspectionandsupervisionorgansandcadrestothe<code>and<>asthedeepeningofthe"three",andstrengthensupervisionanddisciplineofaccountabilityisimportanttofollowcorrectlygrasptheuseofsupervisionanddisciplineof"fourtypes",promotethecomprehensivestrictlyinnewrootsStrictdiscipline,adheretothedisciplineandrulesquiteinfrontoftheenterpriseintheimplementationofexpensivetoimplementtoexecuteThedisciplineinspectionandsupervisionorganstoimplementthe<code>and<Effortstoinvestigatecases>asanopportunity,adheretothepartyshouldmanagethepartystrictly,seriousperformanceoftheirdutiestopromotetworegulationsimplementationChangedisciplineconceptFromthesimple"investigationofillegal"toacomprehensive"stareatviolatediscipline"fromthebusinesscasetoprosecutethebigcasesandtimelysolvethesignsoftilttoFromtheorientationtothenormalsupervisionfromthetube"minority"toresistthe"most"GuidePartymembersandcadrestoseriouslyimplementthe<code>and<rule>,consciouslyabidebythepolitical,organizational,honestpeople,work,lifesixdisciplineUrgetheleadershipcadressenttoplayanexemplaryrole,taketheleadinstrictlyenforcedRelaxationandrestStrongwindisSuJi,closelylinkedtothe"fourwinds"pronetomultiple,themassesreflectthestrongimportantnodesand,gluedtothefourwinds"newform,newtrends,seriouslyinvestigateanddealwithviolationsofthecentraleightprovisionsofthespirit,toincreasethebulletinexposureintensity,theformationofChajiu"fourwinds"loudly,continuetoreleaseanddisciplinemustbestrictsignalAtthesametime,extendedsupervisiontentacles,throughthedevelopmentoftheruralandfisherypartyconductLianzhengconstructioninspection,issuedinatimelymanner,Chajiuoccurredingrassrootssideofcorruptionandunhealthy,andearnestlysafeguardtheinterestsofthemassesandsocialstabilityThecreativityanddisciplineGraspandmakegooduseofthesupervisionanddisciplineof"fourtypes",toensurethePromotingcluestolotsofdisciplineandthelawofthevacuumtube,stricttogetherNotonlytothe"less"and"veryfew"thoroughinvestigationseverelypunished,butalsothe"most"tomaintainzerotolerancetrendthroughlayersofconductivepressure,letthedisciplineabouttherulesforeachpartymembersandcadresconsciouslyfollowAtpresent,itisnecessarytoimplementthe"list"management,strictlyfollowthecluestothedisposaloffivestandards,maketheclassificationofdisposal,dynamiccleanupZadokPartycommitteesatalllevelstoimplementthemainresponsibility,comprehensiveuseofdisciplinaryactionandtissueprocessingandothermeanstoeffectivelycurbthecommonplace,usedtoseedonotblamethe"smallproblem",notbecauseof"practice"and"exception"ProminentDisciplinecharacteristics,theproblemsofviolationofdisciplineandrulesintothefocusofsupervisionanddisciplineanddisciplinaryreviewAtthesametime,increasecasedoublechecktheintensity,theseriousproblemsofdisciplineviolationsor"fourwinds"banbutnotabsolutely,notonlytobehelddirectlyresponsible,butalsoheldleadershipresponsibilitynotonlytopursuestudiesthemainresponsibilityofthePartycommittee,andtopursueCommissionforDisciplineInspectionandsupervisionresponsibilitiesandpromoteaccountabilitytobecomethenewnormTheimplementationofsupervisoryresponsibilityMaintain<code>and<rule>theseriousnessandauthorityofthedisciplineandrulesandtrulybecometheparty'srulerDisciplineassupervisionwithinthepartythespecializedagency,wemuststrengthentheresponsibilitytoact,adheretotheImpartialdisciplineaccountability,earnestlywillbestrictdiscipline,disciplinemustbepunished,andseverelypunishtheactsinviolationofrulesandregulation
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