Tuam Tshoj Nephrology Summit Lub Rooj Sib Tham, Sib Tham Txog Kev Txhim Kho Tshiab Hauv Kev Tshawb Fawb Thiab Kev Kho Mob Raum Kab Mob

Thaum Lub Kaum Ob Hlis 2, 2022, "Tshaj Tawm Ntxiv thiab Ua Ntej Nrog Lub Sijhawm" - Alpha Sigma National Nephrology Summit Rooj Sib Tham tau tuav ib txhij hauv Shanghai thiab Nanjing. Ntau tus kws tshaj lij uas paub zoo hauv kev ua haujlwm ntawm nephrology hauv Suav teb tau raug caw tuaj koom rau hauv lub rooj sab laj no. Thaum lub rooj sib tham, cov kws tshaj lij txawv teb chaws tau raug caw tshwj xeeb los qhia txog huab cua los qhia txog qhov kev tshawb fawb tshiab tshaj plaws ntawm American Society of Nephrology (ASN) Lub Limtiam Raum. Cov kws tshaj lij uas koom nrog tau tsom mus rau kev mob ntshav qab zib nephropathy, kab mob hauv lub raum kawg (ESRD), thiab lwm yam kev kho mob thiab cov ncauj lus tswj hwm tus neeg mob. Qhia thiab sib tham, thiab sib koom ua ke nthuav tawm lub koob tsheej kev kawm zoo!

Nyem Yuav Cistanche rau mob raum

Xib fwb Mei Changlin los ntawm Shanghai Changzheng Tsev Kho Mob ntawm Naval Medical University tau ua tus thawj coj ntawm lub rooj sab laj no. Nws tau hais hauv nws cov lus qhib: "Nrog rau kev siv zog ntawm ntau tiam neeg ntawm cov kws tshaj lij nephrology, Tuam Tshoj txoj kev kho mob nephrology tau ua tiav zoo, thiab maj mam nce Nws tsim cov txheej txheem ntawm kev kuaj mob tshwj xeeb thiab kev kho mob, tsis tu ncua kev tsim lub peev xwm ntawm nephrologists ntawm txhua theem, coj kev tshawb fawb. , thiab tau tsim lub hauv paus rau kev txhim kho kom zoo ntxiv ntawm nephrology. Lub Rooj Sib Tham Hauv Tebchaws Nephrology Summit tau muab kev sib txuas lus zoo rau cov neeg ua haujlwm kho mob. Ntawm lub platform no, txhua tus tuaj yeem hais lus dawb, nquag tshawb nrhiav, thiab kawm los ntawm thiab txhim kho ib leeg rau kev kho mob zoo dua. cov neeg mob."

Ntawm lub rooj sib tham lub rooj sib tham no, cov kws tshaj lij uas koom nrog kuj tau sib tham txog kev siv tshuaj kho mob tus nqi ntawm levocarnitine, uas yog cov tshuaj tsim nyog rau kev kho mob ntshav qab zib, thiab sulodexide, kev xaiv tshuaj tiv thaiv kab mob tshiab los txo cov proteinuria hauv ntshav qab zib nephropathy thiab nephrotic syndrome. Nyob rau lub sijhawm no, "Kev Kho Mob Ntiaj Teb" tshwj xeeb tau caw cov thawj coj ntawm lub rooj sib tham - xibfwb Mei Changlin los ntawm Shanghai Changzheng Tsev Kho Mob ntawm Naval Military Medical University, xibfwb Jiang Gengru los ntawm Xinhua Tsev Kho Mob Koom Tes nrog Shanghai Jiaotong University School of Medicine, thiab xibfwb Wang Niansong los ntawm Sixth People's Hospital Affiliated to Shanghai Jiaotong University Hais txog kev sib pauv kev kawm thiab kev sib koom ntawm lub rooj sab laj, thiab kev siv tshuaj kho mob ntawm levocarnitine thiab sulodexide hauv kev kho mob raum mob.

Tus naj npawb ntawm cov neeg mob uas muaj kab mob raum ntev hauv Suav teb tau nce ntxiv, thiab nws tseem ceeb heev los txhim kho cov tswv yim tswj hwm

CKD (mob raum mob) tam sim no tau dhau los ua ib qho ntawm cov kab mob ntev nrog cov neeg mob coob tshaj plaws hauv Suav teb. Hauv xyoo 2012, kev tshawb nrhiav ntu ntu ntawm kev nthuav dav ntawm CKD hauv Suav teb coj los ntawm cov kws tshaj lij xws li xibfwb Wang Haiyan los ntawm Peking University Thawj Tsev Kho Mob tau pom tias cov neeg mob CKD ntawm Suav cov neeg laus cov kab mob yog kwv yees li 10.8 feem pua ​​[1], sib xws rau qhov loj. cov neeg mob muaj txog 130 lab. Txawm hais tias feem ntau cov neeg mob nyob rau theem pib-nruab nrab, ntau tus neeg mob tseem nce mus rau theem ntawm ESRD (kawg lub raum tsis ua haujlwm) txhua xyoo, uas yog, cov neeg mob tshiab uas muaj uremia yuav tsum tau lim ntshav lossis hloov lub raum.

Xib Fwb Mei Changlin tau qhia tias vim tias muaj pes tsawg lub raum hloov pauv hauv Suav teb tseem tsawg, kev lim ntshav tau dhau los ua qhov kev xaiv tseem ceeb rau cov neeg mob. Tam sim no, kwv yees li 900,000 ESRD cov neeg mob hauv Suav teb tau txais kev lim ntshav[2], thiab tus naj npawb ntawm cov neeg mob lim ntshav tseem nce zuj zus. Nws yuav ua ob npaug hauv 5-10 xyoo tom ntej, uas yuav ua rau lub nra hnyav rau cov neeg mob thiab kev kho mob thiab kev noj qab haus huv, thiab ntau tus neeg mob yuav nce mus rau theem ESRD, uas txhais tau hais tias tseem muaj ntau yam kev xav tau uas tsis tau txais. rau CKD kev kho mob hauv Suav teb.

Hauv qhov no, xibfwb Mei Changlin tau taw qhia tias, "Ua ntej tshaj plaws, Tuam Tshoj tseem tsis tau ua qhov kev tshuaj xyuas ntxov thiab kev tswj hwm ntawm CKD lub hom phiaj, thiab kev txhawb nqa txoj cai tsuas yog tsom rau kev kho ESRD es tsis yog 'tiv thaiv tus kabmob; thib ob, peb. tseem tsis muaj cov ntaub ntawv loj, kev saib xyuas thiab txawm tias Lub tshuab lossis tus qauv rau kev kwv yees qhov kev nce qib ntawm CKD, cov ntaub ntawv uas twb muaj lawm ntawm txhua lub tsev tau tawg thiab tsis tau koom ua ke thoob tebchaws; tam sim no, muaj tsawg tsawg cov tshuaj kho CKD hauv Suav teb thiab txawv teb chaws piv nrog ntshav qab zib thiab cov kab mob plawv, thiab cov tshuaj uas twb muaj lawm feem ntau Nws tsis txaus los tswj kev nce qib ntawm tus kab mob, thiab peb tseem tos ntsoov rau cov tshuaj kho tshiab tshiab; Tuam Tshoj kuj yuav tsum tau ua tiav ntau lub teb chaws ntau lub chaw soj ntsuam kev tshawb fawb raws li qhov Lub ntiaj teb cov neeg mob CKD coob tshaj plaws los teb ntau cov lus nug tseem ceeb hauv kev kho mob.Ua rau lub rooj tsav xwm luv luv no; ntxiv rau, qhov pib ntawm CKD tau muab zais thiab tsis muaj cov tsos mob pom tseeb thaum ntxov. ge kuj cuam tshuam rau tus neeg mob paub txog tus kab mob thiab tus nqi mus ntsib kws kho mob. "

Xib fwb Wang Niansong tshwj xeeb txheeb xyuas cov xwm txheej thiab cov teeb meem tam sim no ntawm kev lim ntshav hauv Suav teb, "Muaj ze li 750,000 cov neeg mob hemodialysis thiab txog 150,000 peritoneal dialysis cov neeg mob hauv Suav teb [2], thiab { {5}}xyoo thiab 10-xyoo muaj sia nyob tus nqi ntawm cov neeg mob Suav tseem sib piv rau cov neeg txawv tebchaws." Cov kab mob plawv thiab cerebrovascular yog qhov ua rau tuag ntawm cov neeg mob lim ntshav, suav txog li 64 feem pua ​​[3]. Vim tias qhov tsis sib npaug ntawm kev kho mob hauv Suav teb, txawm hais tias kev kho mob ntshav qab zib tau muab rau ntau thaj chaw, tsis muaj cov kws tshaj lij nephrology cov neeg ua haujlwm kho mob, ua rau kev lim ntshav qib ntawm cov neeg mob kev tswj hwm tsis sib xws, thiab cov qib ntawm cov txheej txheem raug txwv, uas cuam tshuam rau txoj kev kho raws tus nqi. "

"Yuav ua kom cov neeg mob lim ntshav ua lub neej zoo dua qub thiab rov qab mus rau lawv tsev neeg thiab zej zog, peb tseem muaj ntau txoj haujlwm ua. Piv txwv li, qhov hloov kho "Blood Purification Standard Operating Procedures (2021 Edition)" 2021 yuav ua tau zoo dua. rau Standardized tswj cov neeg mob dialysis", xibfwb Wang Niansong hais tias, "Lub "Kev tswj Standards rau Peridialysis Chronic raum kab mob nyob rau hauv Tuam Tshoj" qhia hais tias kev tswj cov neeg mob dialysis muab faib mus rau hauv lub pre-dialysis lub sij hawm, thawj lub sij hawm dialysis thiab predialysis lub sij hawm. , thiab cov ntsiab lus kev tswj hwm kuj txawv, xws li Rau cov neeg mob nyob rau theem pib ntawm kev lim ntshav, kev tswj kom zoo yuav tsum tau siv los ncua tus neeg mob lub lim piam ntau npaum li qhov ua tau thiab ua tiav qhov kev hloov pauv, txhawm rau txhim kho cov txiaj ntsig ntawm kev lim ntshav thawj zaug thiab yav tom ntej. "

Kev xaiv ntawm kev kho mob lim ntshav kuj yog ib qho teeb meem tsis sib haum xeeb hauv kev kho mob. Kev xaiv ntawm kev lim ntshav tsis zoo ib yam hauv ntau qhov chaw. Raws li xibfwb Wang Niansong, Shanghai tam sim no tsuas yog siv hemodialysis ntxiv rau hemodiafiltration ntxiv rau cov ntshav perfusion, uas yog, "ua ke" ntshav kho. Hom kev lim ntshav tuaj yeem txo qhov kev pheej hmoo ntawm cov hlab plawv thiab cerebrovascular tuag ntawm cov neeg mob. Xyoo no, qhov kev pom zoo tsim los ntawm Shanghai cov kws tshaj lij kuj tau luam tawm nyob rau hauv cov ntawv xov xwm txawv teb chaws thawj zaug [4], tab sis tseem muaj cov teeb meem ntawm qhov tshwm sim ntawm cov teeb meem loj thiab kev tswj tsis tu ncua hauv lwm thaj tsam, yog li nws yog qhov tsim nyog los txhim kho kev tswj hwm, tshwj xeeb tshaj yog. nyob rau hauv thawj 1 xyoo lub sij hawm ntawm cov neeg mob nkag mus rau kev lim ntshav, kom txo tau txoj kev pheej hmoo ntawm cov teeb meem thiab tuag ntawm cov neeg mob.

Kev txhawb zog rau kev tswj cov neeg mob lim ntshav, L-carnitine coj ntau yam txiaj ntsig kho mob

Txawm hais tias hom kev kho mob ntshav qab zib ESRD cov neeg mob tau txais dab tsi, lawv feem ntau ua rau carnitine deficiency. L-carnitine, tseem hu ua L-carnitine, yog ib yam khoom tseem ceeb los txhawb lipid metabolism hauv tib neeg lub cev. Nws yog ib qho dej-soluble tshuaj uas muaj qhov hnyav molecular thiab yooj yim tshem tawm los ntawm hemodialysis. Yog li, cov neeg mob hemodialysis feem ntau yuav raug kev txom nyem los ntawm carnitine deficiency, uas cuam tshuam rau cov txheej txheem fatty acid oxidation. , uas nyob rau hauv lem ua rau txawv txav lub zog metabolism hauv hlwb, tshwj xeeb tshaj yog nyob rau hauv cardiomyocytes, ua rau lub plawv tsis ua hauj lwm, hypotension, nyuaj rau taug kev, thiab lwm yam kev mob tshwm sim.

Thaum ntxov li 1990s thaum nws mus rau Tebchaws Meskas los ua tus kws tshawb fawb, xibfwb Mei Changlin paub txog kev tshawb fawb txog L-carnitine thiab cov teeb meem ntawm cov neeg mob lim ntshav. Tom qab rov qab mus rau Tuam Tshoj, nws kuj pom tias cov tsos mob zoo ib yam li cov neeg mob Asmeskas. Tsis ntev nws tau coj pab neeg los pib tshawb nrhiav qhov tob thiab ua tus thawj coj hauv kev tawm tswv yim ntawm "carnitine deficiency hauv cov neeg mob lim ntshav" hauv Suav teb, uas thawj zaug tau lees paub tias muaj cov levocarnitine deficiency hauv cov neeg mob lim ntshav, thiab nws yog ib qho tseem ceeb rau cov neeg mob. Kev tshwm sim thiab kev tsis zoo ntawm qee qhov kev lim ntshav thaum ntxiv levocarnitine hauv lub sijhawm tuaj yeem txo cov tsos mob xws li mob plawv, ntshav ntshav, thiab ntshav siab, thiab tom qab ntawd ua tiav kev txhim kho levocarnitine qhov ncauj kua thiab txhaj tshuaj.

Xib fwb Mei Changlin tau taw qhia tias, "Qhov pib ntawm levocarnitine feem ntau cuam tshuam nrog nws txoj kev txhim kho lub zog metabolism hauv cov leeg pob txha, cov leeg nqaij, thiab cov leeg nqaij leeg. Carnitine, dawb carnitine, thiab acylcarnitine ntau ntau, yog li txhim kho lub cev kev ua si, cov leeg nqaij, thiab noj zaub mov zoo, pab cov neeg mob kom zoo dua rau kev kho mob hemodialysis, thiab exogenous supplementation ntawm L-carnitine yuav tsis ua rau kom cov metabolic load ntawm lub siab tam sim no, kev lim ntshav. Center ntawm Changzheng Tsev Kho Mob siv 1 gram ntawm levocarnitine intravenously tom qab txhua lub lim piam.

Hais txog kev siv cov levocarnitine, xibfwb Wang Niansong kuj tau hais txog nws txoj kev xav, "Levocarnitine yog ib qho tshuaj siv uas cov kws kho mob nephrologists muab qhov tseem ceeb rau txhua theem ntawm cov txheej txheem CKD thiab txhim kho cov neeg mob ntshav qab zib, kev noj zaub mov zoo, thiab cov leeg nqaij. , thiab lub plawv ua haujlwm, peb tseem tab tom tshawb nrhiav yuav ua li cas thiaj li siv tau zoo ntawm levocarnitine, xws li kev tswj hwm kev noj tshuaj levocarnitine raws li kev ntsuas ntsuas txhua hli ntawm cov neeg mob, txhawm rau txhim kho kev kho mob raws li cov neeg mob, ua raws li kev cia siab. tias yuav muaj kev cia siab ntau ntxiv, ntau lub chaw soj ntsuam kev tshawb fawb tshwj xeeb los tshawb nrhiav cov txiaj ntsig kho mob ntawm levocarnitine, los muab cov pov thawj txaus-raws li kev kho mob pov thawj. "

Thaum Lub Kaum Hli 2022, Alpha Sigma (Shanghai) Pharmaceutical Consulting Co., Ltd. tau thim rov qab txoj cai kev lag luam ntawm thawj cov tshuaj levocarnitine txhaj thiab cov ntaub ntawv noj qhov ncauj uas tsim los ntawm niam txiv lub tuam txhab ALFFASIGMA Spa hauv Suav teb av loj, uas txhais tau hais tias Alpha Sigma Tuam Tshoj ua lag luam muaj. rov pib dua, kom nthuav dav nws cov raj xa dej hauv thaj tsam ntawm nephrology sai li sai tau. Raws li qhov no, Ms. Xu Ying, tus thawj tswj hwm ntawm Alpha Sigma Tuam Tshoj, kuj tau hais tias: "Tam sim no muaj 750,000 cov neeg mob hemodialysis hauv Suav teb [2], thiab tus lej tau nce xyoo los ntawm xyoo. Kev taw qhia ntawm cov kws tshaj lij hauv kev ua haujlwm thiab kev kho mob, cov neeg mob lim ntshav feem ntau muaj cov tsos mob ntawm L-carnitine deficiency, thiab L-carnitine yog cov khoom tseem ceeb ntawm tib neeg fatty acid metabolism. , thiab malnutrition los ntawm exogenous supplementation L-carnitine, Anti-atherosclerosis, tiv thaiv dialysis hypotension, thiab lwm yam. Nyob rau tib lub sij hawm, levocarnitine muaj zoo curative nyhuv thiab kev nyab xeeb nyob rau hauv kev kho mob ntawm cov neeg mob dialysis thiab yog pom zoo los ntawm domestic thiab txawv teb chaws cov lus qhia thiab kev pom zoo, xws li "Kev Tiv Thaiv thiab Kev Kho Mob ntawm Hypotension hauv Hemodialysis" Cov Kws Tshaj Lij Pom Zoo" [5], "Cov Lus Qhia rau Kev Ntsuas thiab Kev Kho Mob Carnitine Deficiency hauv Nyiv 2018" [6], thiab lwm yam.

Lub hom phiaj ntawm vascular endothelial tsis ua haujlwm, sulodexide cuam tshuam hauv "hauv paus" ntawm ntshav qab zib nephropathy.

Nrog rau kev nce ntxiv ntawm cov ntshav qab zib hauv Suav teb thiab cov neeg mob ntau dua 100 lab [7], ntshav qab zib nephropathy kuj tau dhau los ua qhov tseem ceeb ntawm CKD thiab txawm tias ESRD, uas muaj feem cuam tshuam rau cov neeg mob. Raws li xibfwb Wang Niansong, tus kws tshaj lij ntawm 11th Tuam Tshoj Diabetic Nephropathy Summit Forum, tam sim no, kwv yees li ib feem peb ntawm cov neeg mob CKD hauv Suav teb yog tshwm sim los ntawm ntshav qab zib nephropathy [8], thiab mob ntshav qab zib nephropathy yuav sai dua tus kab mob glomerular thiab dhau los tus naj npawb ib qho ua rau ESRD hauv Suav teb, yog li ntawd, muaj qhov xav tau ceev kom ncua kev kis tus kab mob ntawm cov neeg mob ntshav qab zib nephropathy los ntawm kev tswj kom zoo. Lub hom phiaj ntawm kev sib pauv ntawm lub rooj sib tham ua siab tshaj.

Xib fwb Jiang Gengru kuj tau hais tias, "Txoj kev tswj cov ntshav qab zib nephropathy yuav tsum tau txais tus qauv ntawm tus neeg mob vim tias cov neeg mob feem ntau raug kev txom nyem los ntawm ntau yam teeb meem xws li mob ntshav qab zib retinopathy, peripheral neuropathy, thiab mob ntshav qab zib ko taw, uas yuav tsum tau siv endocrinology, nephrology, thiab ophthalmology. Peb cov kws kho mob nephrologist feem ntau tsom mus rau mob ntshav qab zib nephropathy, tsis zoo li lwm cov kab mob hauv lub raum, ntshav qab zib nephropathy tuaj yeem nce mus rau ESRD hauv tsuas yog 3-5 xyoo, yog li yuav tsum muaj kev cuam tshuam, xws li tswj ntshav qab zib thiab ntshav siab, ntshav lipids. thiab lwm yam kev ntsuas, thiab kev tiv thaiv vascular endothelial muaj nuj nqi kuj tseem ceeb heev rau kev tswj cov ntshav qab zib nephropathy. "

Mob ntshav qab zib nephropathy yog ib qho ntawm cov teeb meem microvascular ntawm ntshav qab zib, thiab cov yam ntxwv xws li hyperglycemia, ntshav siab, thiab hyperlipidemia ua rau cov hlab ntsha endothelial, ua rau vascular endothelial tsis ua haujlwm, uas yog tus yuam sij rau ntau yam microvascular teeb meem ntawm ntshav qab zib. Xib Fwb Jiang Gengru tau qhia tias glycocalyx txheej npog lub vascular endothelium yog ib qho kev tiv thaiv ntuj tsim ntawm vascular endothelium thiab plasma, thiab kho ntxov ntawm glycocalyx puas yog qhov tseem ceeb rau kev tiv thaiv vascular endothelium. Ntawm cov tshuaj rau ntshav qab zib nephropathy uas tau tshwm sim nyob rau xyoo tas los no, cov tshuaj antithrombotic sulodexide tuaj yeem tiv thaiv vascular endothelium los ntawm kev kho cov glycocalyx barrier muaj nuj nqi, yog li hloov pauv cov txiaj ntsig ntawm cov neeg mob ntshav qab zib nephropathy.

Sulodexide yog ib txwm ua kom huv si glycosaminoglycan, uas feem ntau kho cov glycocalyx los ntawm kev txhawb nqa lub reconstruction ntawm glycocalyx thiab tswj nws degradation [9], yog li tiv thaiv vascular endothelial muaj nuj nqi ntawm cov neeg mob ntshav qab zib. Cov txheej txheem ntawm kev ua no Nws kuj tau lees paub los ntawm ntau cov kev tshawb fawb los ntawm Suav cov kws tshawb fawb hais tias nws tuaj yeem cuam tshuam zoo hauv cov txheej txheem kab mob ntshav qab zib nephropathy. Xib fwb Jiang Gengru kuj tau hais tshwj xeeb hais tias, "Sulodil yuav tsum tau siv thaum ntxov li sai tau nyob rau theem pib ntawm mob ntshav qab zib nephropathy thaum tus neeg mob lub vascular endothelial kev ua haujlwm tsis tau raug puas tsuaj ntau. Tsis tas li ntawd, cov tshuaj tiv thaiv kab mob, tiv thaiv thrombotic thiab tiv thaiv kev laus. Cov teebmeem ntawm sulodexide kuj tseem pab kom ncua qhov tshwm sim thiab kev nce qib ntawm ntshav qab zib nephropathy. "

Dinas, kev tshawb fawb soj ntsuam tau ua nyob txawv teb chaws, tau qhia tias kev tswj hwm qhov ncauj ntawm sulodexide tuaj yeem txo qis ntawm cov zis protein tawm hauv cov zis, thiab cov nyhuv yog nyob ntawm koob tshuaj (AER txo qis ntawm kev tswj hwm txhua hnub ntawm 50mg, 100mg, thiab 200mg ntawm sulodexide yog qis dua li ntawm pawg placebo, feem. 30 feem pua ​​, 49 feem pua ​​, thiab 74 feem pua ​​)[10], Tuam Tshoj kuj tau ua ntau qhov kev tshawb fawb txog kev kho mob thiab kev kho mob hauv ntau xyoo tsis ntev los no, cov txiaj ntsig tau zoo ib yam nrog kev tshawb fawb txawv teb chaws, uas. yog, sulodexide muaj cov nyhuv curative zoo thiab kev nyab xeeb hauv kev kho mob ntshav qab zib nephropathy, tuaj yeem cuam tshuam cov kab mob, txhim kho lub raum ua haujlwm, thiab tiv thaiv thromboembolism. Tsis tas li ntawd, cov nyhuv tiv thaiv endothelial ntawm sulodexide kuj tseem pab txhim kho microvascular teeb meem xws li mob ntshav qab zib ko taw thiab ntshav qab zib retinopathy, nqa cov txiaj ntsig kho mob.

Hais txog daim ntawv thov tus nqi ntawm sulodexide hauv nephrology, Ms. Xu Ying, tus thawj coj ntawm Alpha Sigma Tuam Tshoj, tau hais tias, "Raws li kev qhia ntawm cov kws tshaj lij hauv cov haujlwm thiab kev kho mob, cov hlab ntsha endothelial glycocalyx cuam tshuam nrog raum raug mob, mob thiab mob ntev. Cov kab mob hauv lub raum, ntshav qab zib, kab mob plawv, Kab mob xws li kab mob venous ntev, kab mob sclerosis, mob ntsws raug mob, ARDS thiab sepsis muaj feem cuam tshuam zoo. Sulodexide, raws li cov khoom siv purified glycosaminoglycan, tuaj yeem pab txhawb cov endothelial glycocalyx thiab muaj kev tiv thaiv vascular endothelial. Rau cov neeg mob uas muaj ntshav qab zib nephropathy, nws tuaj yeem txo lawv cov zis protein ntau tawm, thiab tiv thaiv thiab kho lwm yam mob ntshav qab zib xws li ntshav qab zib retinopathy. txij li xyoo 1997 hauv Suav teb Txij li thaum nws pib, nws tau lees paub thiab ntseeg tau d los ntawm cov kws kho mob thiab cov neeg mob. "

Yog xav paub ntxiv:ali.ma@wecistanche.com