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Lu Z, Huang M, Lin H, Wang G, Li H. Network pharmacology and molecular docking approach to elucidate the mechanisms of Liuwei Dihuang pill in diabetic osteoporosis. J Orthop Surg Res 2022; 17:314. [PMID: 35701780 PMCID: PMC9195436 DOI: 10.1186/s13018-022-03194-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/21/2022] [Indexed: 12/12/2022] Open
Abstract
Background Diabetic osteoporosis (DOP) is one of the chronic complications of diabetes mellitus, but without a standardized treatment plan till now. Liuwei Dihuang pill (LDP) has gradually exerted a remarkable effect on DOP in recent years; its specific mechanism is not clear yet. Methods We adopted network pharmacology approaches, including multi-database search, pharmacokinetic screening, network construction analysis, gene ontology enrichment analysis, Kyoto Encyclopedia of Genes and Genomes pathway analysis and molecular docking to elaborate the active components, signaling pathways and potential mechanisms of LDP in the treatment of DOP. Results Twenty-seven active ingredients and 55 related disease targets have been found through integrated network pharmacology. Functional enrichment analysis shows that five key active ingredients, including beta-sitosterol, stigmasterol, diosgenin, tetrahydroalstonine, and kadsurenone, may give full scope to insulin secretion estrogen-level raising and angiogenesis in biological process through the pivotal targets. In addition, the underlying effect of PI3K/AKT/FOXO and VEGF pathways is also suggested in the treatment. Conclusion Based on systematic network pharmacology methods, we predicted the basic pharmacological effects and potential mechanisms of LDP in the treatment of DOP, revealing that LDP may treat DOP through multiple targets and multiple signaling pathways, which provide evidence for the further study of pharmacological mechanism and broader clinical thinking. Supplementary Information The online version contains supplementary material available at 10.1186/s13018-022-03194-2.
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Affiliation(s)
- Zhaoqi Lu
- The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Minling Huang
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Haixiong Lin
- Ningxia Hui Autonomous Region Hospital and Research Institute of Traditional Chinese Medicine, Yinchuan, Ningxia, China.,Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Gaoxiang Wang
- Shenzhen Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Huilin Li
- Department of Endocrinology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong, China.
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2
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Babos MB, Heinan M, Redmond L, Moiz F, Souza-Peres JV, Samuels V, Masimukku T, Hamilton D, Khalid M, Herscu P. Herb-Drug Interactions: Worlds Intersect with the Patient at the Center. MEDICINES (BASEL, SWITZERLAND) 2021; 8:44. [PMID: 34436223 PMCID: PMC8401017 DOI: 10.3390/medicines8080044] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/26/2021] [Accepted: 07/29/2021] [Indexed: 02/07/2023]
Abstract
This review examines three bodies of literature related to herb-drug interactions: case reports, clinical studies, evaluations found in six drug interaction checking resources. The aim of the study is to examine the congruity of resources and to assess the degree to which case reports signal for further study. A qualitative review of case reports seeks to determine needs and perspectives of case report authors. Methods: Systematic search of Medline identified clinical studies and case reports of interacting herb-drug combinations. Interacting herb-drug pairs were searched in six drug interaction resources. Case reports were analyzed qualitatively for completeness and to identify underlying themes. Results: Ninety-nine case-report documents detailed 107 cases. Sixty-five clinical studies evaluated 93 mechanisms of interaction relevant to herbs reported in case studies, involving 30 different herbal products; 52.7% of these investigations offered evidence supporting reported reactions. Cohen's kappa found no agreement between any interaction checker and case report corpus. Case reports often lacked full information. Need for further information, attitudes about herbs and herb use, and strategies to reduce risk from interaction were three primary themes in the case report corpus. Conclusions: Reliable herb-drug information is needed, including open and respectful discussion with patients.
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Affiliation(s)
- Mary Beth Babos
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN 37752, USA; (F.M.); (J.V.S.-P.); (V.S.); (T.M.); (M.K.)
| | - Michelle Heinan
- School of Medical Sciences, Lincoln Memoria University, Harrogate, TN 37752, USA;
| | - Linda Redmond
- Medical Center Long Term Care, University of Pittsburgh, Pittsburgh, PA 15260, USA;
| | - Fareeha Moiz
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN 37752, USA; (F.M.); (J.V.S.-P.); (V.S.); (T.M.); (M.K.)
| | - Joao Victor Souza-Peres
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN 37752, USA; (F.M.); (J.V.S.-P.); (V.S.); (T.M.); (M.K.)
| | - Valerie Samuels
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN 37752, USA; (F.M.); (J.V.S.-P.); (V.S.); (T.M.); (M.K.)
| | - Tarun Masimukku
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN 37752, USA; (F.M.); (J.V.S.-P.); (V.S.); (T.M.); (M.K.)
| | | | - Myra Khalid
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN 37752, USA; (F.M.); (J.V.S.-P.); (V.S.); (T.M.); (M.K.)
| | - Paul Herscu
- Research Division, Herscu Laboratory, Amherst, MA 01002, USA;
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Sabarathinam S, Vijayakumar TM. Assessment of Herb-drug Interactions Based on the Pharmacokinetic Changes of Probe Drug, Midazolam. Drug Metab Lett 2021; 14:5-8. [PMID: 33183217 DOI: 10.2174/1872312814666201112122110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND In healthy volunteers, the probe drug method is widely practised to assess the pharmacokinetic mediated herb-drug interactions (HDI). We analyzed the clinical evidence of CYP3 A4 probe drug, Midazolam. METHODS Literatures, where Midazolam was used as a probe drug for prediction of herb-drug interaction, were surveyed through an online database such as google scholar, Scopus, Cochrane, PubMed and clinicaltrials.gov. RESULTS Midazolam was considered a sensitive probe for CYP3A4 substrates due to its bioavailability. We observed that not all the herbs are causing drug interaction. However, significant changes of the Midazolam pharmacokinetics were found after high-dose and long-term intake of some herbs and food supplements, suggesting the induction and/or inhibition of CYP activities. CONCLUSION Probe drug technique is one of the easiest ways for predicting CYP enzyme-mediated herb-drug interactions. Midazolam shows a good response in clinical studies because of short halflife and low harmfulness compared with other probe drugs.
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Affiliation(s)
- Sarvesh Sabarathinam
- Department of Pharmacy Practice, SRM College of Pharmacy, SRM IST, Kattankulathur, Kancheepuram, Tamil Nadu, India
| | - Thangavel M Vijayakumar
- Department of Pharmacy Practice, SRM College of Pharmacy, SRM IST, Kattankulathur, Kancheepuram, Tamil Nadu, India
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Characteristics of the traditional Liu-Wei-Di-Huang prescription reassessed in modern pharmacology. Chin J Nat Med 2019; 17:103-121. [DOI: 10.1016/s1875-5364(19)30013-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Indexed: 12/25/2022]
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5
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Zhang L, Xu H, Zhan L. Pharmacokinetic Assessments of Liquiritin, Protocatechuic Aldehyde and Rosmarinic Acid in Rat Plasma by UPLC-MS-MS After Administration of ZibuPiyin Recipe. J Chromatogr Sci 2018; 56:139-146. [PMID: 29186346 DOI: 10.1093/chromsci/bmx093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 10/15/2017] [Indexed: 12/17/2023]
Abstract
The three analytes of the Traditional Chinese Medicine ZibuPiyin Recipe (ZBPYR), namely, liquiritin, protocatechuic aldehyde and rosmarinic acid, may synergistically play an important role in regulating memory and learning. However, the pharmacokinetic behaviors of these compounds after their co-administration remain unclear. To this end, a selective and sensitive ultra-performance liquid chromatography-tandem mass spectrometry method was developed and validated in rat plasma for the study of these three major bioactive ingredients in ZBPYR. The analytes in the plasma samples were separated on a Shiseido Capcell core C18 column using bendrofluazide as an internal standard, with a gradient mobile phase system of acetonitrile-water containing 0.1% formic acid. Electrospray ionization in the negative-ion mode and multiple reaction monitoring were used to identify and quantify the three analytes. All of the calibration curves showed good linearity (r > 0.992) over the concentration range, with a lower limit of quantification of 5 ng/mL. The precision of the analytical method was evaluated by intra- and inter-day assays, and the percentage of relative standard deviation (SD) was within 15%. Satisfactory extraction efficiency (between 83.4 and 99.4%) and matrix effects (76.4-107.4) were obtained by liquid-liquid extraction. The pharmacokinetic results showed that the three bioactive ingredients were rapidly absorbed and had a short terminal half-life in rats after oral administration of ZibuPiyin recipe. This UPLC-MS-MS study method used in this study may be useful for assessing the pharmacokinetic characteristics of various compounds, which would be helpful in determining their clinical potential.
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Affiliation(s)
- Lin Zhang
- College (Institute) of Integrative Medicine, Dalian Medical University, 9 Western Section, Lvshun South Road, Lvshunkou District, Dalian 116044, China
| | - Huiying Xu
- School of Basic Medical Sciences, Nanjing University of Chinese Medicine, 138 Xianlin Road, Nanjing 210023, China
| | - Libin Zhan
- School of Basic Medical Sciences, Nanjing University of Chinese Medicine, 138 Xianlin Road, Nanjing 210023, China
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Wang L, Hai Y, Huang N, Gao X, Liu W, He X. Human cytochrome P450 enzyme inhibition profile of three flavonoids isolated from Psoralea corylifolia: in silico predictions and experimental validation. NEW J CHEM 2018. [DOI: 10.1039/c7nj00884h] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Cytochrome P450 enzyme (CYP)-associated metabolic studies in vitro have been considered cost-effective for predicting potential clinical drug/herb–drug interactions (DDI/HDI).
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Affiliation(s)
- Lili Wang
- Tianjin University of Traditional Chinese Medicine
- Tianjin
- P. R. China
- Tianjin State Key Laboratory of Modern Chinese Medicine
- Tianjin
| | - Yue Hai
- Tianjin University of Traditional Chinese Medicine
- Tianjin
- P. R. China
| | - Nannan Huang
- Tianjin University of Traditional Chinese Medicine
- Tianjin
- P. R. China
| | - Xue Gao
- Tianjin University of Traditional Chinese Medicine
- Tianjin
- P. R. China
| | - Wenli Liu
- Tianjin University of Traditional Chinese Medicine
- Tianjin
- P. R. China
| | - Xin He
- Tianjin University of Traditional Chinese Medicine
- Tianjin
- P. R. China
- Tianjin State Key Laboratory of Modern Chinese Medicine
- Tianjin
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Therapeutic Risk and Benefits of Concomitantly Using Herbal Medicines and Conventional Medicines: From the Perspectives of Evidence Based on Randomized Controlled Trials and Clinical Risk Management. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:9296404. [PMID: 28491115 PMCID: PMC5405391 DOI: 10.1155/2017/9296404] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 03/22/2017] [Accepted: 04/02/2017] [Indexed: 12/30/2022]
Abstract
Despite increased awareness of the potential of herb-drug interactions (HDIs), the lack of rigorous clinical evidence regarding the significance provides a challenge for clinicians and consumers to make rational decisions about the safe combination of herbal and conventional medicines. This review addressed HDIs based on evidence from randomized controlled trials (RCTs). Literature was identified by performing a PubMed search till January 2017. Risk description and clinical risk management were described. Among 74 finally included RCTs, 17 RCTs (22.97%) simply addressed pharmacodynamic HDIs. Fifty-seven RCTs (77.03%) investigated pharmacokinetic HDIs and twenty-eight of them showed potential or actual clinical relevance. The extent of an HDI may be associated with the factors such as pharmacogenomics, dose of active ingredients in herbs, time course of interaction, characteristics of the object drugs (e.g., administration routes and pharmacokinetic profiles), modification of herbal prescription compositions, and coexistence of inducers and inhibitors. Clinical professionals should enhance risk management on HDIs such as increasing awareness of potential changes in therapeutic risk and benefits, inquiring patients about all currently used conventional medicines and herbal medicines and supplements, automatically detecting highly substantial significant HDI by computerized reminder system, selecting the alternatives, adjusting dose, reviewing the appropriateness of physician orders, educating patients to monitor for drug-interaction symptoms, and paying attention to follow-up visit and consultation.
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Zhou W, Cheng X, Zhang Y. Effect of Liuwei Dihuang decoction, a traditional Chinese medicinal prescription, on the neuroendocrine immunomodulation network. Pharmacol Ther 2016; 162:170-8. [DOI: 10.1016/j.pharmthera.2016.02.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Zheng L, Gong Z, Lu Y, Xie Y, Huang Y, Liu Y, Lan Y, Wang A, Wang Y. A UPLC-MS/MS method for simultaneous determination of danshensu, protocatechuic aldehyde, rosmarinic acid, and ligustrazine in rat plasma, and its application to pharmacokinetic studies of Shenxiong glucose injection in rats. J Chromatogr B Analyt Technol Biomed Life Sci 2015; 997:210-7. [PMID: 26118621 DOI: 10.1016/j.jchromb.2015.06.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 05/17/2015] [Accepted: 06/10/2015] [Indexed: 02/04/2023]
Abstract
A rapid and sensitive ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed for the simultaneous determination of the four major active ingredients, danshensu, protocatechuic aldehyde, rosmarinic acid, and ligustrazine, in the traditional Chinese medicine Shenxiong glucose injection in rat plasma. Acidified and alkalized plasma samples were extracted using ethyl acetate, and separated on a Waters C18 column (2.1mm×50mm, 1.7μm) by using a gradient mobile phase system of acetonitrile-water containing 0.1% formic acid and luteoloside as an internal standard. Electrospray ionization in the positive-ion mode and multiple reaction monitoring were used to identify and quantitate the active components. All calibration curves showed good linearity (r>0.994) over the concentration range, with a lower limit of quantification (LLOQ) between 0.02 and 0.21μg/mL. The precision of the in vivo study was evaluated by intra- and inter-day assays, and the percentage of relative standard deviation was within 15%. Moreover, satisfactory extraction efficiency was obtained (between 83.94 and 117.81%) by liquid-liquid extraction. The validated method was successfully applied in a pharmacokinetic study in rats after intravenous administration of Shenxiong glucose injection. The results showed that the four bioactive ingredients in Shenxiong glucose injection have linear pharmacokinetic properties in rats after intravenous injection within the administered dose range and partially different ones compared to single ingredient.
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Affiliation(s)
- Lin Zheng
- Provincial Key Laboratory of Pharmaceutics in Guizhou Province, School of Pharmacy, Guiyang Medical University, No.9, Beijing Road, Yunyan District, Guiyang 550004, People's Republic of China
| | - Zipeng Gong
- Provincial Key Laboratory of Pharmaceutics in Guizhou Province, School of Pharmacy, Guiyang Medical University, No.9, Beijing Road, Yunyan District, Guiyang 550004, People's Republic of China
| | - Yuan Lu
- Provincial Key Laboratory of Pharmaceutics in Guizhou Province, School of Pharmacy, Guiyang Medical University, No.9, Beijing Road, Yunyan District, Guiyang 550004, People's Republic of China
| | - Yumin Xie
- Provincial Key Laboratory of Pharmaceutics in Guizhou Province, School of Pharmacy, Guiyang Medical University, No.9, Beijing Road, Yunyan District, Guiyang 550004, People's Republic of China
| | - Yong Huang
- Provincial Key Laboratory of Pharmaceutics in Guizhou Province, School of Pharmacy, Guiyang Medical University, No.9, Beijing Road, Yunyan District, Guiyang 550004, People's Republic of China.
| | - Yue Liu
- Provincial Key Laboratory of Pharmaceutics in Guizhou Province, School of Pharmacy, Guiyang Medical University, No.9, Beijing Road, Yunyan District, Guiyang 550004, People's Republic of China
| | - Yanyu Lan
- Provincial Key Laboratory of Pharmaceutics in Guizhou Province, School of Pharmacy, Guiyang Medical University, No.9, Beijing Road, Yunyan District, Guiyang 550004, People's Republic of China
| | - Aimin Wang
- Provincial Key Laboratory of Pharmaceutics in Guizhou Province, School of Pharmacy, Guiyang Medical University, No.9, Beijing Road, Yunyan District, Guiyang 550004, People's Republic of China
| | - Yonglin Wang
- Provincial Key Laboratory of Pharmaceutics in Guizhou Province, School of Pharmacy, Guiyang Medical University, No.9, Beijing Road, Yunyan District, Guiyang 550004, People's Republic of China.
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Effects of the Chinese Herbal Formulation (Liu Wei Di Huang Wan) on the Pharmacokinetics of Isoflavones in Postmenopausal Women. BIOMED RESEARCH INTERNATIONAL 2015; 2015:902702. [PMID: 26146635 PMCID: PMC4471402 DOI: 10.1155/2015/902702] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 04/30/2015] [Indexed: 11/18/2022]
Abstract
A combination of soy isoflavones and Liu Wei Di Huang Wan (LWDHW) is potentially effective for postmenopausal women with intolerable vasomotor episodes who are not suitable candidates for hormonal therapy. The objective of this open-label, three-phase, crossover study was to determine the influence of both single and multiple oral doses of LWDHW on isoflavone pharmacokinetics in healthy postmenopausal women. Eleven subjects were assigned to receive the following regimens in a fixed sequence with washout periods of at least one week: Phase A, a single oral dose of soy milk; Phase B, a single oral dose of soy milk coadministered with LWDHW; and Phase C, multiple oral doses of LWDHW for 14 days followed by a single oral dose of soy milk. Blood samples were collected and mixed with β-glucuronidase/sulfatase to hydrolyze isoflavone conjugates to their respective aglycones (i.e., daidzein and genistein) and were determined using high performance liquid chromatography. The pharmacokinetic parameters analyzed were maximal plasma concentration (Cmax), time to reach peak concentration (Tmax), area under the plasma concentration-time curve (AUC), and half-life (t1/2). The results found no statistically significant differences in pharmacokinetic parameters of daidzein and genistein among the three regimens.
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Pharmacogenomics and herb-drug interactions: merge of future and tradition. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:321091. [PMID: 25821484 PMCID: PMC4363646 DOI: 10.1155/2015/321091] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 01/20/2015] [Accepted: 01/21/2015] [Indexed: 12/16/2022]
Abstract
The worldwide using of herb products and the increasing potential herb-drug interaction issue has raised enthusiasm on discovering the underlying mechanisms. Previous review indicated that the interactions may be mediated by metabolism enzymes and transporters in pharmacokinetic pathways. On the other hand, an increasing number of studies found that genetic variations showed some influence on herb-drug interaction effects whereas these genetic factors did not draw much attention in history. We highlight that pharmacogenomics may involve the pharmacokinetic or pharmacodynamic pathways to affect herb-drug interaction. We are here to make an updated review focused on some common herb-drug interactions in association with genetic variations, with the aim to help safe use of herbal medicines in different individuals in the clinic.
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