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2023| July-September | Volume 9 | Issue 3
Online since
September 11, 2023
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REVIEW ARTICLES
Potential of essential oils as alternative permeation enhancers for transdermal delivery
Jayshree Mahanty, Sofi Haamid Rasheed, Sudhir Kumar, Harjeet Singh, Alok Sharma
July-September 2023, 9(3):258-269
DOI
:10.4103/2311-8571.351508
Transdermal drug delivery plays a significant part in the drug delivery system when compared to other routes of drug administration. The function of the stratum corneum (SC) is a barrier. Recently, numerous methods have been thrived to improve the perforation of drugs across the skin. The most effective method is to use enhancers since these agents enhance skin permeability. Natural penetration enhancers like essential oils demonstrate higher enhancement activity and are more widely accepted than synthetic penetration enhancers. High potential in the expansion and interaction with the SC intercellular lipids has led to an increasing interest in these oils as penetration enhancers. This article gives an overview of a few essential oils, including their mode of action and important parameters for permeation improvement. The present work can provide essential oils as alternative enhancers, and this could be useful in transdermal administration.
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Formulation of ayurvedic medicines and extracts of medicinal plants as an alternative therapeutic treatment option for nephrolithiasis
Shikha Sachdeva, Jaspreet Kaur, Sanjana Mehta, Renu Saharan, Parminder Nain
July-September 2023, 9(3):278-283
DOI
:10.4103/2311-8571.351512
The incidence of nephrolithiasis, commonly known as kidney stone, is increasing worldwide with significant health and economic burden. Approximately 2 million people every year in India are affected by kidney stones. It affects all ages, genders, and races, but between the ages of 20 and 49 years, it affects most frequently in men than women. Different types of stones include calcium stones, cysteine stones, struvite or magnesium ammonium phosphate stones, uric acid stones, and drug-induced stones. This review article provides information about general pathophysiology, epidemiology, clinical presentation, and pharmacological treatment, which includes ayurvedic and herbal medicines for nephrolithiasis. Further understanding of the pathophysiological link between nephrolithiasis and systemic disorders is necessary for the development of new therapeutic options.
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Research progress on
Rodgersia
and predictive analysis on its quality markers
Ling-Ling Chu, Bin Li, Jia Wu, Ling Jiang, Xu-Dong Zhou, Wen-Bing Sheng, Cai-Yun Peng, Salman Zafar, Ping-An Liu, Wei Wang
July-September 2023, 9(3):243-257
DOI
:10.4103/2311-8571.343650
Rodgersia
is a traditional Chinese medicine that contains a variety of chemical constituents, including flavonoids, terpenoids, phenylpropanoids, gallic acid derivatives, steroids, volatile oils, and tannins, with anti-inflammatory, antioxidant, antitumor, antibacterial, antivirus, hepatoprotective, and other properties. In this paper, the main chemical constituents and pharmacological effects of
Rodgersia
are summarized. On this basis, the quality markers of this genus were predicted based on chemical composition, traditional medicinal properties, traditional efficacy, and measurable components. This review provides the basis for in-depth research, utilization, and quality control of
Rodgersia.
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ORIGINAL ARTICLES
Mechanism of wuweijiangyasan in the treatment of spontaneous hypertension based on network pharmacology
Ai-Ping Chen, Zi-Juan Zhang, Jing-Zhong Li, Ling Zuo, Ya-Xing Cheng, Dong Deng, Xue-Li Li, Xiao-Yun Ma, Da Man, Ming-Huang Zheng, Jian Chen, Bo Wen, Juan Wang, Jian-Guo Zhou, Hui-Hui Zhao
July-September 2023, 9(3):355-368
DOI
:10.4103/2311-8571.351793
Background:
Hypertension affects over 1 billion people globally and is the top risk factor of cardiovascular morbidity and mortality. Wuweijiangyasan (WWJYS), as an empirical prescription, has stable depressurization effects. This study investigated the chemical composition and pharmacodynamic effects of WWJYS in regulating the blood pressure (BP), emotion, and blood lipid of spontaneous hypertensive rats, and further explored the depressurization mechanism of WWJYS.
Materials and Methods:
This study used network pharmacology to identify the origins and predict targets of WWJYS, and artificial intelligence-based molecular docking is used to further predict targets and mechanisms. The chemical constituents of WWJYS were analyzed and identified by ultra high-performance liquid chromatography–mass spectrometry (MS)/MS.
Results:
In the WWJYS group, the systolic BP level significantly was decreased, and the HR was stable. The irritability became stable after the 5-week treatment compared with the model group (
P
< 0.05). Rats' rotation tolerance time increased after 2-weeks stabilization. Compared with the model group, angiotensin-converting enzyme 2 protein and mRNA of the WWJYS group increased significantly (
P
< 0.05). Network pharmacology collected 64 compounds and identified 22 potential targets of WWJYS for antihypertensive activity. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis showed that WWJYS might regulate smooth muscle cells, affect inflammatory response and improve endothelial function through multiple pathways. The molecular docking study further supported that the target proteins have good combinations with the main active components of WWJYS.
Conclusions:
The data indicated that WWJYS had significant depressurization, analgesic, and sedative, as well as lipid-lowering effects, and the depressurization mechanism of WWJYS may function in multiple signal pathways, especially in improving blood vessel function and intervening inflammation.
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REVIEW ARTICLES
Efficacy and safety of huachansu capsules for the treatment of esophageal cancer: A systematic review and meta-analysis
Meng-Meng Wang, Xing-Hui Zhang, Jun-Yan Wang, Jing Xua, Ming-Zhu Chen, Shu-Yue Wang, Min Jia, Zhi-Wen Shen, Ling-Jian Zhang, Yang Gong, Jian Gong
July-September 2023, 9(3):270-277
DOI
:10.4103/2311-8571.355009
The objective of this study was to systematically evaluate the efficacy and safety of Huachansu capsules in the treatment of esophageal cancer. We searched all relevant Chinese and English documents in the Cochrane Library Clinical Controlled Trials, PubMed, EMBASE, CNKI, and VIP databases, from the time the databases were established to December 2020. The studies were selected according to the inclusion and exclusion criteria, and their quality was evaluated. We used RevMan 5.4 to conduct the meta-analysis of measurement indicators and intervention measures. Six randomized controlled trials comprising 526 patients with esophageal cancer were included in the study. Compared with radiotherapy and chemotherapy alone, oral Huachansu capsules combined with radiotherapy and chemotherapy improved the clinical efficacy (risk ratio [RR] = 1.35, 95% confidence interval [CI], 1.17–1.55,
P
< 0.0001), quality of life (weighted mean difference [MD] = 10.01, 95% CI [3.39–16.64],
P
= 0.003), and immune level (CD3
+
: MD = 4.99, 95% CI [3.70–6.29],
P
< 0.0001; CD4
+
: MD = 6.49, 95% CI [5.55–7.42],
P
< 0.0001; CD5
+
: MD = 0.20, 95% CI [0.11–0.28],
P
< 0.0001), and reduced toxic and side effects (reductions in white blood cell count: RR = 0.63, 95% CI [0.44–0.90],
P
= 0.01; Reductions in blood platelet: RR = 0.70, 95% CI [0.52–0.94],
P
= 0.02; Gastrointestinal reaction: RR = 0.73, 95% CI [0.59–0.89],
P
= 0.002). However, the number of included studies was small, and conclusions still need to be further verified using larger samples and high-quality randomized, double-blind controlled trials.
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Symptom assessment and management in patients with lung cancer undergoing conventional or traditional chinese medicine care
Bao-Jin Han, Ya-Jie Liu, Jia-Yue Jin, Hong-Kun Xu, Wen-Zheng Zhang, Si-Meng Ren, Xin Shelley Wang, Jie Liu
July-September 2023, 9(3):235-242
DOI
:10.4103/2311-8571.382112
Patients with lung cancer may experience various symptoms as the disease progresses, which may reduce the benefits of cancer treatment, reduce treatment compliance, delay cancer treatment, reduce the quality of life (QoL), and impact survival. This review discusses comprehensive symptom assessment and management, which are crucial for high-quality lung cancer treatment. Traditional Chinese medicine (TCM) is important in relieving cancer-related symptoms in patients with lung cancer. Including patient-reported outcomes (PROs) in clinical trials and practice can provide a better assessment of symptom burden and the effectiveness of symptom management. Patient-centered care with TCM in lung cancer patients may include six steps: Symptom screening, etiology investigation, comprehensive assessment, integrative management, reassessment, and regular symptom follow-up monitoring. PRO measures can be used to evaluate symptom intensity, the degree to which symptoms interfere with activities of daily living, and the QoL. Clearly defined and reliable PRO measures can enhance patient satisfaction and improve symptom control. Quantitative PRO measures developed from the TCM perspective should be considered one of the important outcome measurements in TCM care. A multidisciplinary collaborative symptom management model, including TCM and conventional therapy, will be the future goal for treating patients with lung cancer.
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ORIGINAL ARTICLES
Chinese herb formulae inhibit the proliferation of human colon cancer SW480 cells by inducing cell apoptosis
Su Fu, Shao-Lin Qin, Wolf-Dieter Rausch
July-September 2023, 9(3):348-354
DOI
:10.4103/2311-8571.369650
Objective:
This study aimed to reveal the antitumor effects of Chinese herbal formulae and the underlying mechanisms in treating colorectal cancer, with a focus on developing traditional Chinese medicine (TCM) as a supplement and alternative therapeutic method for cancers.
Materials and Methods:
Human colon cancer SW480 cells were treated with three Chinese herbal formulae, Bu Zhong Yi Qi Decoction, Fuzi Lizhong Decoction, and Pulsatilla Decoction at different concentrations (50–600 μg/mL) for 24, 36, and 48 h, respectively. Cell viability was determined using the resazurin reduction assay, and cell survival rate was evaluated using a colony formation assay. After treatment with different concentrations (50–600 μg/mL) of these three formulae for 48 h, the effects of the Chinese herbal formulae on cell apoptosis were investigated using Hoechst/propidium iodide (PI) staining. The positive PI-stained cells were investigated using an EnSpire multilabel plate reader and the positive Hoechst-stained cells were observed under a fluorescence microscope for morphological changes.
Results:
Bu Zhong Yi Qi Decoction, Fuzi Lizhong Decoction, and Pulsatilla Decoction inhibited SW480 cell proliferation in a dose-and time-dependent manner and induced cell apoptosis.
Conclusion:
Chinese herbal formulae with a special prescription form of TCM with antitumor effects bring a new perspective in line with the principles of TCM in cancer treatment.
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Dalbergia odorifera
Essential oil protects against myocardial ischemia through upregulating nrf2 and inhibiting caspase signaling pathways in isoproterenol-induced rats
Can-Hong Wang, Bao Gong, Hui Meng, Yu-Lan Wu, Xiang-Sheng Zhao, Jian-He Wei
July-September 2023, 9(3):338-347
DOI
:10.4103/2311-8571.372727
Objective:
Dalbergia odorifera
has long been used as a Chinese herbal medicine for the treatment of cardiovascular and cerebrovascular diseases. This study aimed to determine the potential myocardial protective effect and possible mechanism of action of
D. odorifera
essential oil (DOEO).
Materials and Methods:
The essential oil of
D. odorifera
was extracted by hydrodistillation. The cardioprotective effects of DOEO were examined by histopathological observation, myocardial enzyme detection, peroxidation, anti-oxidant level detection, and related protein expression. The compounds in the blood were identified by gas chromatography–mass spectrometry.
Results:
These results showed that DOEO had significant myocardial cell protection, with IC
50
values ranging from 17.64 to 24.78 μg/mL
in vitro
. Compared to the myocardial ischemia group, the DOEO pretreatment groups had lower levels of myocardial injury, creatinine kinase, lactate dehydrogenase, alanine transaminase, aspartate transaminase, hydrogen peroxide, and nitric oxide, and higher levels of glutathione and superoxide dismutase. In addition, DOEO pretreatment significantly increased Na
+
-K
+
-ATPase and Ca
2+
-ATPase levels. Moreover, immunohistochemical experiments showed that DOEO remarkably increased the protein levels of NF-E2-related nuclear factor 2 (Nrf2) and heme oxygenase-1 (HO-1) and reduced the expression of apoptotic caspases, including caspase 3 and caspase 9. The main components of the blood were transnerolidol and nerolidol oxide. Overall, the study showed that DOEO displayed myocardial protection by upregulating the NF-E2-related nuclear factor- antioxidant response element (Nrf2-ARE) and caspase pathways. DOEO has a therapeutic effect on MI by inhibiting the oxidant and apoptotic effects.
Conclusions:
D. odorifera
may be a potential candidate drug for treating myocardial ischemic injury.
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Lung cancer treatment in traditional chinese medicine: History, current status, and development
Chu-Chu Zhang, Su-Ying Liu, Jie Liu, Pei-Ying Yang, Hong-Sheng Lin, Ying Zhang
July-September 2023, 9(3):297-306
DOI
:10.4103/2311-8571.382025
Objective:
This article discusses the following aspects, including the history of traditional Chinese medicine (TCM) in the treatment of lung cancer, the breakthrough in the theory of TCM in treatment of lung cancer, clinical study of TCM in treating lung cancer, microscientific interpretation of TCM treatment for lung cancer and the prospect of TCM in treating lung cancer.
Materials and Methods:
In this paper, through a systematic search, combing traditional Chinese medicine prevention and treatment of lung cancer ancient books and modern literature.
Results:
A series of large sample and multi-centered clinical studies have proved that TCM comprehensive treatment significantly improves the clinical efficacy for lung cancer. “TCM treatment system for non-small cell lung cancer” based on staged and standardized integration of TCM and Western medicine has been well developed and popularized in practice. Furthermore, in virtue of the international cooperation platform established by the National Cancer Institute of the United States, the scientific connotation of TCM in the prevention and treatment of lung cancer is systematically and deeply studied, thereby promoting the research and development of new Chinese drugs for lung cancer.
Conclusions:
Nowadays, TCM has realized a landmark breakthrough in treating lung cancer, bringing benefits to all lung cancer patients.
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Jujuboside a improved energy metabolism in senescent H9c2 cells injured by ischemia, hypoxia, and reperfusion through the CD38/Silent mating type information regulation 2 homolog 3 signaling pathway
Yi-Ran Hu, Hui-Yan Qu, Jia-Ying Guo, Tao Yang, Hua Zhou
July-September 2023, 9(3):322-329
DOI
:10.4103/2311-8571.372731
Objective:
This study explored the myocardial protection role of Jujuboside A through an ischemia–hypoxia–reperfusion (IHR) model.
Materials and Methods:
H9c2 cells were induced by D-galactose (D-gal) and IHR to establish an aging and IHR model. There are four groups of experiments: Control, IHR, D-gal + IHR, and D-gal + IHR + Jujuboside A. Cells viability, Adenosine triphosphate (ATP), reactive oxygen species (ROS), nicotinamide adenine dinucleotide (NAD
+
), nicotinamide adenine dinucleotide hydride (NADH) content, and NAD
+
/NADH ratio were detected using biochemical methods. Inflammatory cytokines level was detected by enzyme-linked immunosorbent assay. The expression of CD38, Recombinant NLR Family, pyrin domain-containing protein 3 (NLRP3), and silent mating type information regulation 2 homolog 3 (SIRT3) protein was detected by Western blotting.
Results:
Compared to the IHR group, cell viability, ATP content, NAD + content, NAD
+
/NADH ratio, and SIRT3 protein expression decreased, ROS level and inflammatory cytokines increased, and CD38 and NLRP3 proteins raised in the D-gal + IHR group. Compared to the D-gal + IHR group, cell viability, ATP content, NAD + content, NAD
+
/NADH ratio, and expression of SIRT3 protein increased, ROS level and inflammatory cytokines level decreased, and expression of the CD38 and NLRP3 proteins decreased in the D-gal + IHR + Jujuboside A group.
Conclusions:
Jujuboside A inhibited the expression of CD38, improved energy metabolism disorder, and mitochondrial function, and decreased inflammation in D-gal-induced H9c2 cells.
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The psychosomatic thought of tibetan medicine and its treatment methods
Zi-Juan Zhang, Xin Li, Ya-Xing Cheng, Amatti Jorigori, Dongzhu Renqing, Li-Ping Pan, Meng Mao, Xiao-Qiao Ren, Hui-Hui Zhao
July-September 2023, 9(3):330-337
DOI
:10.4103/2311-8571.373598
Objectives:
Call on people to treat the causes of physical diseases is to take into account the causes of psychological factors as well as external causes.
Materials and Methods:
The analysis was conducted by combining the classical medical books of Tibetan medicine, as well as the traditional culture and living habits of Tibetan people, with modern research results.
Results:
Many of the theories mentioned in Tibetan medicine related to mind-body medicine have been confirmed by modern research. Mental and physical treatment related to psychosomatic diseases should be administered simultaneously. First, when a person is healthy, he should cultivate his mind to build a solid psychological defense against diseases. Developing both the mind and body contributes to creating a stable physical protection barrier against diseases. When a person is ill, he should realign his mind and help his body adjust and promote its early recovery with the help of medications.
Conclusions:
Treating related psychosomatic diseases should treat the mind and body simultaneously. And the mind and body should be cultivated before diseases to reinforce the psychological and physical defense against diseases.
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29
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Shenyi capsule prolongs postoperative survival of patients with nonsmall cell lung cancer: A multicenter, randomized, controlled trial
Dao-Rui Li, Wei Hou, Bao-Jin Hua, Pei-Tong Zhang, Lu Xiong, Hao Liu, Qi-Yuan Mao, Hong-Sheng Lin, Bing-Kui Piao
July-September 2023, 9(3):314-321
DOI
:10.4103/2311-8571.382023
Objective:
The objective of this study was to examine the effect of the postsurgical administration of Shenyi capsules on the outcome and overall survival of patients with nonsmall cell lung cancer (NSCLC).
Materials and Methods:
This was a multicenter, randomized, placebo-controlled, double-blind clinical trial. Patients with stages I–IIIA NSCLC were randomized to Shenyi or placebo groups (treatment duration: 6 months) and followed up for 10 years. One-year, 2-year, 5-year, and 10-year survival rates and survival times were calculated. Symptoms, quality of life, traditional Chinese medicine (TCM) syndrome, and recurrence were evaluated.
Results:
A total of 361 patients (treatment group,
n
= 185; placebo group,
n
= 176) were randomized and followed up for 10 years. The two groups had similar baseline demographic and clinical characteristics. Among all 361 patients, the treatment group had significantly longer median survival (31 months, respectively) than the placebo group (22.3 months,
P
< 0.01). In stage II or III patients, recurrence and metastasis rates in the treatment group were lower than those in the placebo group (
P
< 0.05). The treatment group also had significantly longer 1-year and 2-year survival rates based on the full analysis set and per-protocol set; however, there was no statistically significant difference in the 5-year and 10-year survival rates (
P
< 0.01 for all comparisons). Multivariate analysis of variance showed that the interaction between stage and age had a significant impact on overall survival (
P
< 0.05). Compared with the placebo group, the treatment group showed a significant decrease in TCM syndrome (
P
< 0.01) and a significant increase in the Karnofsky Performance Score (
P
< 0.01) and body weight (
P
< 0.05).
Conclusions:
Adjunctive therapy with Shenyi capsules significantly prolonged the 1-year and 2-year survival rates after surgery and improved the quality of life. Moreover, none of the patients experienced severe adverse effects. These results suggest that Shenyi capsules may have clinical applications in treating patients with NSCLC.
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19
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The mechanism of total ginseng extracts in the treatment of lung cancer progression based on network pharmacology and experimental validation
Hong-Kuan Hana, Cheng Qian, Meng-Yao Song, Teng Zhang, Chun-Mei Yang, Ren-Jun Gu, Xian Zhou, Zhong-Hong Wei, Yang Zhao, Yin Lu
July-September 2023, 9(3):284-296
DOI
:10.4103/2311-8571.385513
Objective:
The objective of this study was to investigate the mechanism by which total ginseng extract (TGE) inhibits the progression of lung cancer through network pharmacology and experimentation.
Materials and Methods:
A Lewis lung carcinomas (LLC) model was established by injecting cancer cells through the tail vein and through administering different doses of TGE. The infiltrated immune cells into the microenvironment of lung cancer metastasis through flow cytometry were evaluated, and the messenger RNA (mRNA) expression levels of various immune cell-related chemokines were determined using quantitative reverse transcription–polymerase chain reaction. Therapeutic targets and signaling pathways of TGE in nonsmall cell lung cancer were investigated using systematic pharmacology and virtual docking. Immunoblotting was performed to determine the impacts of TGE on migration-related proteins.
Results:
Flow cytometry showed that 1.82 g/kg TGE increased the infiltrated T cells and inhibited the recruitment of myeloid cells, which was caused by decreased mRNA expression of chemokines after TGE treatment. Gene ontology and Kyoto Encyclopedia of Genes and Genomes analyses showed that the delayed progression of lung cancer by TGE might be related to the promotion of lung cancer cell apoptosis-associated signaling pathways. The virtual docking results indicated that the active components of ginseng are directly bound to apoptosis-related proteins. Immunoblotting showed that TGE inhibited tumor metastasis by regulating the expression of migration-related proteins.
Conclusions:
The study reveals the potential mechanism of ginseng extract in the treatment of lung cancer progression and provides a reliable basis for its clinical application.
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Characteristics and correlation analysis of negative emotions, quality of life, and chinese medicine syndromes in patients with lung cancer after surgery: A cross-sectional study
Cong-Meng Zhang, Yi-Feng Gu, Sheng-Ping Shen, Yi-Chao Wang, Ao Qi, Ling-Zi Su, Jia-Lin Yao, Jia-Qi Li, Wen-Xiao Yang, Qin Wang, Li-Jing Jiao, Xiong Qin, Ya-Bin Gong, Ling Xu
July-September 2023, 9(3):307-313
DOI
:10.4103/2311-8571.385512
Objective:
The objective of the study was to observe and analyze the characteristics of negative emotions and quality of life (QoL) in patients with nonsmall cell lung cancer (NSCLC) from 1 to 3 months after surgery, and summarize their population characteristics after surgery.
Materials and Methods:
The consolidation rehabilitation period was defined as 1 to 3 months after surgery. The main observation indicators were the general Hospital Anxiety and Depression Scale, the European Organization for the Research and Treatment of Cancer Core QoL Questionnaire (EORTC QLQ-C30), and EORTC QLQ-Lung Cancer-13. The secondary observation indicators were peripheral blood cytokines and immune function indicators. Statistical methods such as one-way analysis of variance and logistic regression were used to analyze the characteristics of this part of the population.
Results:
Among patients who underwent lung surgery, the overall incidence of anxiety during consolidation recovery was 13.66%, and that of depression was 10.38%. The scores of fatigue, pain, dyspnea, insomnia, and loss of appetite were significantly higher than those of other symptoms (
P
= 0.000). The presence of anxiety was associated with the site of surgery (
P
< 0.05) and the presence of depression was associated with emotional functioning and dyspnea (
P
< 0.05).
Conclusions:
The occurrence of negative emotions in the postoperative NSCLC population is related to gender, and the degree of emotions is negatively correlated with QoL and positively correlated with the degree of symptoms. The main relevant syndromes are the pulmonary and meridian categories.
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