Cov cim qog nqaij hlav yog cov khoom tshwj xeeb uas tshwm sim hauv cov ntshav thiab qee zaum hauv cov zis ntawm cov neeg mob qog noj ntshav vim yog cov haujlwm tseem ceeb ntawm cov qog nqaij hlav cancer. Tag nrho cov ntawm lawv muaj ntau haiv neeg nyob rau hauv lawv cov qauv, tab sis feem ntau lawv yog cov proteins thiab lawv cov derivatives. Nws yog ib qho tseem ceeb kom paub tias cov cim qog tuaj yeem pom hauv cov ntshav hauv qee cov kab mob thiab cov xwm txheej uas tsis cuam tshuam nrog oncology. Qhov no tau piav qhia meej hauv peb tsab xov xwm.
Kev kuaj ntshav rau cov qog qog qhia dab tsi?
Ib qib zuj zus ntawm cov ntsuas yuav qhia tau tias muaj cov txheej txheem pathological ntev. Cov txiaj ntsig no pab saib xyuas thiab kuaj mob qog noj ntshav. Yog tias ib tug neeg paub tias cov cim qog yuav dhau los rau kev tiv thaiv, yog tias pom tau qhov zoo, qhov muaj cov qog tuaj yeem kuaj tau thaum ntxov. Tom qab ntawd kev kho tus kab mob yuav ua tau zoo dua.
Cov cim qog nqaij hlav yog cov molecules uas niaj hnub ncig hauv cov ntshav. Feem ntau, lawv lub xub ntiag qhia tias muaj mob qog noj ntshav.mob. Tab sis lawv cov ntsiab lus siab tsis yog ib txwm qhia tias ib tus neeg tau tsim mob qog noj ntshav. Cov kab mob qog tuaj yeem tham txog cov txheej txheem inflammatory hauv lub cev uas tshwm sim hauv daim siab, raum, txiav thiab lwm yam kabmob. Tsis tas li ntawd, cov qauv protein no muaj nyob rau hauv qee qhov kev xav ntawm tus neeg mob. Txawm li cas los xij, yog tias qhov kev sim rau cov qog nqaij hlav yog qhov zoo, qhov no yog ib qho laj thawj rau kev kuaj ntxiv.
Npaj rau kev tshuaj ntsuam
Nws yuav tsum tau qhia meej tias cov txheej txheem no yuav tsum tau ua tiag tiag. Yog tias tus neeg mob tsis ua raws li cov cai, ces qhov tshwm sim tuaj yeem ua yuam kev, thiab kev tshuaj xyuas yuav tsum rov qab ua dua. Yog li, cov kws kho mob qhia kom ua raws li cov lus pom zoo hauv qab no kom cov txiaj ntsig ntawm oncomarkers raug:
- Ib lub lis piam ua ntej hnub xav tau ntawm kev sim, nws raug nquahu kom tshem cov chips, crackers, yuav cov kua txiv hmab txiv ntoo, qab zib qab zib, nrog rau cov ntses haus luam yeeb thiab cov hnyuv ntxwm los ntawm kev noj haus. Tag nrho cov khoom saum toj no muaj cov dyes, stabilizers thiab cov khoom siv dag zog. Yog tias lawv nyob hauv cov ntshav hauv qhov ntau, lawv tuaj yeem ua rau qhov tshwm sim tsis raug.
- Ua ntej lub sijhawm dhau los ntawm kev tshuaj ntsuam, nws yog qhov yuav tsum tau coj koj lub xeev kev puas siab puas ntsws rov zoo li qub. Yog tias tus neeg mob muaj kev ntxhov siab, qee cov tshuaj hormones raug tso tawm. Lawv kuj cuam tshuam cov tsos ntawm cov qauv protein hauv cov ntshav. Yog li ntawd, ua ntej pib kuaj ntshav, koj yuav tsum tau so kom zoo thiab tsis txhob ntshai.
- Yuav kom tau txais cov txiaj ntsig raug ntawm cov qog qog, nws yuav tsum tau zam kev haus luam yeeb thiab cawv ib ntus.
- raupeb hnub ua ntej hnub teem tseg, koj yuav tsum tsis txhob noj tshuaj, tshuaj ntsuab tshuaj yej, infusions thiab decoctions.
- Yuav tsum xeem dhau 8-00 txog 12-00. Cov txheej txheem yuav tsum tau nqa tawm ntawm lub plab khoob. Koj tsuas haus tau ib khob dej xwb tsis muaj roj thiab ntxiv.
Tus poj niam yuav tsum noj cov qog qog dab tsi?
Rau kev tiv thaiv thiab tshawb xyuas cov kab mob, tsuas yog siv cov ntsuas tshwj xeeb uas tuaj yeem ua kom paub txog oncology. Koj yuav tsum paub tias tag nrho cov qog nqaij hlav yog qhov tsis tshua muaj siab rau txhua yam txheej txheem inflammatory. Yog li ntawd, yog tias tsawg kawg yog ib qho kev mob tshwm sim nyob rau hauv lub cev, cov kev ntsuam xyuas tuaj yeem pom tias muaj cov qog nqaij hlav cancer. Txhawm rau kom qhov tshwm sim yog qhov tseeb, nws yog thawj zaug yuav tsum tau mus kuaj mob hauv tsev kho mob thiab tsis suav nrog cov kab mob ntev.
Cov cim qog loj:
- "CA-15-3 thiab MCA" - tsim los kuaj cov qog nqaij hlav hauv lub mis. Tsis tas li, siv cov ntsuas no, qhov tsis muaj lossis muaj cov metastases tau txiav txim siab.
- Deciphering tus oncomarker "CA-125" qhia tias muaj lossis tsis muaj qog nqaij hlav zes qe menyuam. Tsis tas li ntawd, cov qauv ntawm cov protein no nyob rau hauv ntau ntau tshwm sim thaum cev xeeb tub. Yog li ntawd, yog tias "CA-125" yog qhov zoo, tom qab ntawd kev tshuaj xyuas ntxiv tau ua tiav.
- "CA-72-4" - hom no yog siv rau hauv cov xwm txheej uas muaj kev xav tias mob qog noj ntshav ntawm zes qe menyuam, thaum koj yuav tsum tau ua kom paub tseeb tias kev kho mob tau ua tiav lawm, thiab tseem kom paub meej tias qhov ua kom qis dua. kev puas tsuaj ntawm malignantcells.
- "hCG" hauv cov poj niam pab kuaj mob qog noj ntshav hauv tsev menyuam. Ua tsaug rau qhov kev sim, cov kab mob pathological tuaj yeem kuaj pom thaum ntxov. Tsis tas li ntawd, kev tshuaj xyuas zoo sib xws yog siv los kuaj xyuas tus kab mob ntawm cov ntaub so ntswg ntawm lub tsev menyuam tom qab kev phais.
Yuav ua li cas thiaj li yuav tsum tau coj los tiv thaiv tus txiv neej?
Txhua qhov kev sim hauv qab no (muab tias lawv tau dhau los lawm) pab txhawm rau kuaj pom muaj cov kab mob qog nqaij hlav ua ntej lawv raug kuaj pom los ntawm cov txheej txheem kuaj mob.
Cov cim qog loj:
- "AFP" - ua rau nws muaj peev xwm txiav txim siab qhov muaj kev hloov pauv hauv cov txiv neej testicles.
- "PSA" yog txiv neej qog cov cim siv los kuaj mob qog noj ntshav prostate. Nws kuj yog siv los kuaj mob mob nyob rau hauv cheeb tsam no ntawm lub cev, uas yuav pab tau raws sij hawm kev kho mob.
Thaum cov ntsuas no nce ntau, qhov no yog thawj lub cim ntawm oncology.
mob qog noj ntshav
Raws li twb tau hais lawm, tus kab mob qog nqaij hlav yog cov protein zais los ntawm cov qog nqaij hlav cancer thiab qee cov hlwb noj qab haus huv. Nws muaj nyob rau hauv ob qho tib si tso zis thiab ntshav. Thaum mob qog nqaij hlav qog nqaij hlav, ntshav tau noj rau cov cim qog hauv qab no:
- "Calcitonin" - tuaj yeem pom hauv tus neeg mob cov ntshav lossis zis. Siv rau hauv kev kuaj mob qog noj ntshav modular. Nws cov concentration nyob ntawm qhov tsim thiab lub sijhawm ntawm cov txheej txheem pathological.
- Y "Thyroglobulin" yogib qho protein uas khaws cov thyroid follicles. Nws yog tus cim tseem ceeb hauv kev kuaj mob ntawm cov qog nqaij hlav malignant.
- "CEA" (mob qog noj ntshav-embryonic antigen) - nrog cov thyroid kab mob, tus kab mob oncomarker nce. Nws tsuas yog txiav txim siab hauv cov ntshav ntshav xwb.
Kev kuaj mob qog nqaij hlav hauv plab
Tag nrho cov qog qog paub hnub no tuaj yeem muab faib ua ob pawg:
- Specific. Lawv qhia tias tus txheej txheem oncological yeej muaj nyob rau hauv lub cev, pab txiav txim nws hom.
- Tsis yog tshwj xeeb - qhia txog qhov muaj peev xwm ntawm cov txheej txheem oncological, tab sis kuj tseem qhia tau tias lub cev muaj qhov mob ntawm lub cev thaum tsis muaj oncology.
Tshwj xeeb tuaj yeem faib ua:
- "REA" yog tus cim qog siv los kuaj xyuas cov teeb meem hauv txoj hnyuv thiab qhov quav. Yog tias nws muaj nyob rau hauv kev tshuaj ntsuam, nws muaj peev xwm xav tias muaj kev hloov pauv ntxiv ntawm cov qog, tau txais cov ntaub ntawv tsim nyog hais txog qhov tsis sib xws ntawm malignant neoplasm thiab teeb tsa lub sijhawm loj hlob.
- "CA 242" qhia txog cov kab mob ntawm txoj hnyuv loj, pancreas thiab lub qhov quav thaum ntxov. Raws li cov txiaj ntsig ntawm qhov kev ntsuam xyuas no, nws tuaj yeem kwv yees qhov tsim ntawm cov qog hauv 3-5 lub hlis.
- "CA 72-4" yog lub qog qog, lub npe uas paub txog ntau tus kws pab kuaj mob. Nws surrenders ua ke nrog "REA". Yog tias muaj cov tshuaj tiv thaiv kab mob, qhov no qhia txog kev puas tsuaj rau cov hlwb ntawm lub ntsws thiab cov hnyuv loj thaum lub sijhawmtsim cov qog nqaij hlav me me.
- "M2-RK" tus cim no qhia txog cov txheej txheem metabolic hauv cov qog nqaij hlav cancer. Nws lub ntsiab feature yog qhov tsis muaj qhov tshwj xeeb hauv kev kuaj mob ntawm lub cev, uas yog vim li cas nws thiaj li hu ua "kos npe ntawm kev xaiv". Qhov kev sim no yog siv los ua qhov taw qhia tshwj xeeb hauv metabolic, txij li cov qog nqaij hlav qog nqaij hlav hauv plab qhia txog tus kab mob nyob rau theem pib.
Tsis yog tshwj xeeb suav nrog:
- "AFP" (alpha-fetoprotein) - qhia pom muaj cov neoplasm hauv sigmoid thiab qhov quav.
- "CA 19-9" - (carbohydrate antigen) nthuav tawm cov kab mob uas nyob hauv lub txiav, txoj hlab pas, gallbladder thiab ducts ntawm txoj hnyuv loj.
- Deciphering tus oncomarker "CA 125" nyob rau hauv cov ntaub ntawv no qhia tau hais tias muaj ib tug oncological txheej txheem nyob rau hauv lub sigmoid nyuv. Nws yuav tsum raug sau tseg tias tus cim no feem ntau siv rau poj niam mob. Nws feem ntau pom muaj nyob rau hauv o nyob rau hauv lub peritoneum, nyob rau hauv lub xub ntiag ntawm zes qe menyuam hlwv, thaum cev xeeb tub.
- "CYFRA 21-1" - nce ntxiv ntawm cov protein no qhia txog teeb meem hauv qhov quav.
- "SCC" - qhov taw qhia qhia qhov swb ntawm kev mob qog noj ntshav ntawm lub qhov quav.
- "LASA-P" - qhov muaj ntau tus lej ntawm cov cim no qhia txog kev mob qog noj ntshav hauv cov hnyuv.
Cov kab mob qog rau kev tiv thaiv
Txhua tus paub tias kev tiv thaiv kabmob kheesxaws tseem ceeb dua li kho qhov pib ntawm tus kabmob. Kev ntsuam xyuas cov qog nqaij hlav pab kuaj mob qog noj ntshav ua ntej pom tus yam ntxwvcov tsos mob. Feem ntau, cov ntsuas pib nce rau lub hlis ua ntej qhov pib ntawm metastases. Cov txiv neej tshaj li plaub caug xyoo yuav tsum saib xyuas lawv txoj kev noj qab haus huv thiab pub ntshav rau PSA, vim qhov kev tshuaj ntsuam no pab txheeb xyuas cov qog nqaij hlav prostate. Kev nce siab me ntsis "CA-125" qhov tseem ceeb yuav yog ib qho kev qhia ntawm cov qog nqaij hlav, thiab cov txiaj ntsig tau ntau dua li cov qauv los ntawm 4-6 zaug qhia tias muaj cov kab mob malignant.
Cov kab mob qog dab tsi los tiv thaiv? Nov yog cov npe ntawm lawv:
- Nyob rau hauv rooj plaub uas muaj teeb meem plab hnyuv, kuaj ntshav rau "CA 15-3". Cov neeg muaj hnub nyoog tshaj 50 xyoo muaj kev pheej hmoo rau hom kab mob pathological no.
- "Thyroglobulin" yog cov qog nqaij hlav ntawm cov thyroid caj pas kom kuaj pom cov kab mob hauv nws. Ib qho loj ntawm cov protein no tuaj yeem qhia txog kev loj hlob ntawm metastases, nrog rau qhov tseeb tias muaj cov thyroid antibodies hauv cov ntshav. Qib ntawm "calcitonin" qhia qhov loj thiab ceev ntawm txoj kev loj hlob ntawm pathology.
- txhawm rau txheeb xyuas cov teeb meem hauv daim siab thiab kab mob plab, lub oncomarker "AFP" yog siv, uas nyob rau hauv ib nrab ntawm cov neeg mob nce 3 lub hlis ua ntej pib cov tsos mob ntawm pathology. Txhawm rau kom paub meej qhov kev kuaj mob ntxiv, nws yuav tsum tau kuaj xyuas cov protein "CA 15-3", "CA 19-9", "CA 242", "CA 72-4".
- NSE raug coj mus kuaj lub ntsws rau cov qog nqaij hlav. Qhov ntsuas no tuaj yeem muaj nyob hauv cov paj hlwb thiab hauv lub hlwb. Yog tias tus nqi siab tau kho, tus neeg ntawd muaj mob qog noj ntshav.
- Cov qog nqaij hlav dab tsi dhau raukev tiv thaiv ntawm mob qog noj ntshav pancreatic, ntau tus yuav tsum paub, vim qhov no yog ib yam kab mob ntau heev. Cov kws kho mob feem ntau sau tshuaj ntsuam xyuas rau "CA 19-9" thiab "CA 242". Yog tias koj txiav txim siab tsuas yog qhov ntsuas kawg nkaus xwb, tom qab ntawd koj tuaj yeem ua yuam kev hauv kev kuaj mob, vim "CA 242" tuaj yeem nce ntxiv vim cysts, pancreatitis lossis lwm yam tsim. Yog li, kev tshuaj xyuas rau "SA 19–9" yog ntxiv rau kev kuaj mob.
- Rau txoj kev tshawb fawb ntawm lub raum, muaj kev sim metabolic "M2-RK". Qhov ntsuas no yuav pab txiav txim siab seb qhov mob hnyav npaum li cas. Nws txawv ntawm lwm tus nyob rau hauv uas nws muaj cov nyhuv tsub zuj zuj. Kev nce hauv qhov ntsuas no tuaj yeem qhia txog oncology ntawm lub plab thiab lub mis.
- Thaum kuaj lub zais zis, nws raug nquahu kom dhau "UBC". Nws tuaj yeem qhia pom muaj oncology nyob rau theem pib hauv 70% ntawm cov neeg mob. Txhawm rau kom paub meej qhov tseeb ntawm kev kuaj mob, koj yuav tsum tau dhau qhov "NMP22".
- Nyob rau hauv cov qog nqaij hlav qog nqaij hlav, cov qog nqaij hlav cancer ua rau muaj kev nce hauv 2-microglobulin. Tus nqi ntawm cov antigen no zoo li nce ntxiv nrog cov kab mob pathological tshwm sim hauv txhua lub cev. Yog li, qhov taw qhia tuaj yeem txiav txim siab theem ntawm oncology.
- Kom paub meej tias muaj kab mob hauv lub hlwb, koj yuav tsum dhau 4 tus neeg saib xyuas hauv ib qho nyuaj. "AFP" - qhia tias muaj cov neoplasm. "PSA" - tej zaum yuav qhia txog kev hloov pauv hauv cov hlwb hlwb. "CA 15-3" - siv los kuaj mob hlwb metastases. Cyfra 21–2 qhia tau hais tias me me cell carcinoma ntawm lub hauv paus paj hlwb.
- Tumor markers "TA-90" thiab "S-90" yog siv nyob rau hauv oncology ntawm daim tawv nqaij. Yog nyob rau hauv kev tsom xamcov ntshav lawv dhau qhov kev cai, qhov no yog pov thawj ntawm kev muaj metastases. Qhov kev tshuaj ntsuam no tuaj yeem muab cov ntaub ntawv nthuav dav tsuas yog ua ke nrog lwm cov cim.
- Thaum kuaj cov pob txha rau mob qog noj ntshav, TRAP 5b tus cim muab cov duab ua tiav. Qhov no yog ib qho enzyme uas tuaj yeem tshwm sim hauv lub cev hauv ntau qhov sib txawv. Nws muaj nyob rau hauv ob qho tib si poj niam thiab txiv neej. Yuav tsum muaj tus kws kuaj mob tshwj xeeb los ntsuas qhov ntsuas.
- txhawm rau kuaj mob caj pas, yuav tsum muaj ob lub cim - "SCC" thiab "CYFRA 21-1". Thawj yog ib qho antigen zoo tib yam, thiab qhov thib ob yog cov protein tshwj xeeb, uas tshwm sim nws tus kheej hauv cov ntsuas ntau dua li qub. Yog tias muaj qhov tshwm sim ntawm qog nqaij hlav qog noj ntshav, ces "SCC" yog ntau dua 60%. Tab sis cov ntaub ntawv no tuaj yeem tshwm sim nrog lwm yam mob.
- Txhawm rau txiav txim siab txog oncology ntawm cov qog adrenal, koj yuav tsum tau saib seb muaj ntau cov qog nqaij hlav hauv cov ntshav thiab zis. Feem ntau, cov kws kho mob tau sau cov ntshav rau "DEA-s". Kev xeem ntxiv tuaj yeem raug xa mus rau qhov kev xeem tseem ceeb.
- Thaum kuaj pom poj niam oncology, koj yuav tsum paub tias 125 oncomarker qhia dab tsi. Nws tau tshaj tawm saum toj no tias nws qhia tias muaj cov kab mob malignant hauv cov poj niam zes qe menyuam. Cov protein no kuj muaj nyob rau hauv cov poj niam noj qab haus huv, tab sis tsawg heev.
- Yog tias muaj kev xav tias mob qog noj ntshav mis, tus kws kho mob tau sau ntawv rau kev xa cov oncomarkers "MCA" thiab "CA 15-3". Thawj qhov taw qhia yog ib qho antigen uas tso cai rau koj los kuaj xyuas cov kab mob benign thiab malignant nyob rau hauv lub hauv siab.
- Oncomarker "S 100" tuaj yeem taug qab txhua qhov kev cuam tshuam ntawm cellular thiab extracellular. Nws kuj tseem pab txhawm rau txhawm rau txhawm rau kuaj mob qog noj ntshav ntawm daim tawv nqaij. Cov txiaj ntsig siab ntawm qhov kev sim no muab cov ntaub ntawv qhia tias lub cev muaj melanoma lossis lwm yam txheej txheem pathological.
Kev txiav txim qog nqaij hlav
Tus neeg mob nws tus kheej tsis tas yuav delve rau hauv kev txhais cov nqi ntsuas. Txawm li cas los xij, yog tias koj yuav tsum tau mus ntsib kws kho mob hnub tom qab, thiab nws yog qhov nthuav kom tau txais cov ntaub ntawv tam sim ntawd, koj tuaj yeem siv lub rooj ntawm cov cim qog. Nws yog qhia hauv qab no.
| Marker | Upper limit of normal | Diagnosis | saib xyuas | |
| CA-125 | Tus qauv ntawm tus kab mob SA hauv cov poj niam thiab txiv neej yuav tsum tsis pub tshaj 35 IU / ml | siv rau kev tshawb nrhiav qog nqaij hlav zes qe menyuam | SCC, NOT4 | + |
| SA-15-3 | tus nqi yuav tsum tsis pub tshaj 30 U / ml | shows mis cancer | REA | + |
| SA-19-9 | txog 10 U / ml yog suav tias yog ib txwm | AFP thiab mob qog noj ntshav plab |
REA (m) AFP(e) |
Tsuas yog ua ke nrog CEA |
| CA-242 | yuav tsum tsis pub tshaj 30 IU/ml | nyeem tib yam li CA-19-9 | - | exclusively paired with SA-19-9 |
| CA-72-4 | - | tshwm sim hauv qog nqaij hlav zes qe menyuam, mob qog noj ntshav mis thiab plab hnyuv carcinomas | CA-125, SCC, CEA (m) | + |
| AFP | qhov ntsuas muaj nqis txog 10IU / ml (yog tias cev xeeb tub tshwm sim tam sim no, ces cov ntaub ntawv tuaj yeem pom txog 250IU / ml) | qhia txog teratoma, qog nqaij hlav qog nqaij hlav thiab lub siab metastases | hcg | + |
| NE4 | from 70 pmol / l - 140 pmol / l tom qab menopause | qhia txog kev mob qog nqaij hlav zes qe menyuam thaum ntxov | - | + |
| SCC | 2.5 ng/l | qhia squamous cell carcinoma ntawm txhua qhov chaw | + | CA-125, CA-72-4NE4, |
| PSA | txog 40 xyoo - 2.5 ng / ml, cov neeg muaj hnub nyoog tshaj 50 xyoo - 4 ng / ml | siv los kuaj mob qog noj ntshav prostate | PSA Free | + |
| REA | mus txog 4 ng / ml (cov pab pawg no tsis suav nrog cov poj niam cev xeeb tub) | qhia uterine, zes qe menyuam, ntsws thiab qog nqaij hlav mis | HE4, CA-15-3, SCC, CA-125 | + |
Tsuas yog tus kws pab kuaj mob thiab tus kws kho mob oncologist, uas saib xyuas tus neeg mob thiab kev kho mob, tab tom txiav txim siab tag nrho cov txiaj ntsig ntawm cov qog qog.
Tus nqi pabcuam
Yog tus neeg mob raug kuaj mob oncology ntawm lub tsev kho mob hauv nroog, lawv tuaj yeem them los ntawm lub xeev (yog tias tus neeg mob muaj txoj cai). Qhov ntawd yog, nws yuav pub dawb rau tus neeg mob.
Hauv cov chaw kho mob ntiag tug, cov kev sim no raug nqi ntawm 500 rubles rau ib qho.
Kuv tuaj yeem pub cov qog nqaij hlav nyob qhov twg?
Yuav kom dhau qhov kev sim no, nws yog qhov zoo dua los xaiv cov chaw kho mob tshwj xeeb. Yog vim li casNws yog qhov tsim nyog los txiav txim siab txog cov tsev kho mob uas muaj cov cuab yeej tsim nyog thiab cov kws tshaj lij uas tsim nyog uas tuaj yeem txiav txim siab qhov txiaj ntsig ntawm qhov kev xeem.
Nyob rau hauv rooj plaub no, tus neeg mob yuav kuaj tau qhov tseeb thawj zaug, thiab nws yuav tsis tas siv nws tus kheej lub sijhawm rau kev kawm ntxiv. Koj tuaj yeem xeem tau hauv cov tsev kho mob hauv nroog tsis tu ncua. Tab sis kev xyaum qhia tau hais tias tom qab cov kev ntsuam xyuas no, cov neeg mob tig mus rau cov tsev kho mob tshwj xeeb kom rov ua dua.
Lub sijhawm tsim nyog rau kev tshuaj ntsuam
Nws yog tsis yooj yim sua kom meej meej tsim lub sijhawm tos rau qhov tshwm sim, vim nws ncaj qha nyob ntawm theem ntawm lub tsev kho mob thiab nws cov haujlwm. Yog tias cov cuab yeej siv tau zoo, ces cov txiaj ntsig tuaj yeem tau txais hauv ib hnub. Hauv cov tsev kho mob hauv nroog, tib txoj kev tau qeeb rau ob peb hnub, thiab qee zaum txawm lub lis piam.
