!,,.J.-3(R$-$+<-$:A-=$-=J/-.

%-<A/-,%-{R<-\J%-2,

35S-}R/-aR2-(J/-2R.-=$?-$?R-<A$-aR2-\A%-,
!/-29%-o=,
 !,,.J.-3(R$-$+<-$:A-=$-=J/-.%-<A/-,%-{R<-\J%-2,

.2%-(-3A-g$-(<-eJ?-:):-5S/-28A/, ,
35/-~/-3A-2g/-*A-><-2-3R-28A/, ,
o-/R<-3A-g$-l-3$R:C-9A=-2-28A/, ,
3.R<-/-2.J-,%-!/-IA-l-2-;A/, ,
?-2&.-.%-0R, $+<-$:A-$R-.R/,
?-2&.-$*A?-0, $+<-$:A-}R/-:PR-.%-(-L.-<%-3A-<%-/.-$8A,
?-2&.-$?3-0, $+<-$:A-$.2-.3A$?-.%-1/-;R/,
?-2&.-28A-2, YA/-2-0.-3?-/.-O$-:)A2-0:A-H.-(R?,
?-2&.-s-2, O$-T-.%-O$-$A-%R-2R, .L%-5.-?R$?-2!/-0,
?-2&.-S$-0, $+<-$:A-=R$-$/R/-2!/-0,
?-2&.-2./-0, $+<-$:A-*J-*R/-.%-;R/-+/-2>.-0,
?-2&.-2o.-0, .0J-35S/-/.-$8A-:$<-$+<-eJ?-GA-1/-:V?-2>.-0,
?-2&.-.%-0R, $+<-$:A-$R-.R/, .%-0R, $+<-$:A-$R-.R/,
$+<-$ $+<-8J?-0-1$-0:A-.R/-.%-#-/A-$4$?-2?-29R?-0:A-k-#:A-.R/-;A/-
=, 3.R<-/-$+<-$-8J?-0-/A-=?-GA-O$-l:A-$+<-.3A$?-GA-!J%-.-$4$?-2-
2hJ$?-/?-/.-O$-KA<-.L%-2<-LJ.-0:A-.J.-GA-3A%-%R-,
$*A?-0, $+<-LJ.-$4$?-2:A-i3-P%?-.%-<3-:.J$?-(-L.,
,A<-2+%-(-L.-GA-i3-P%?-=-o.-.%R?-2!/-.-542!/-;R.-0-.%-, 0R-+-=:A-0<-3-?R<-28$-L?-
0:A-#J-.$J:A-0<-3:A-/%-.-562!/-;R., ,%-$:A-.0J-<A?-$?=-2>.-/%-.-i3-P%?-802!/-;R., $;-
,R$-.$R%?-o/-=?-832!/-;R.-0-?R$?-.J.-GA-(-L.-=-i3-P%?-3A-:S-2-3%-.-2!/-3R., :.A<-
{2?-?-22?-0:A-$+<-LJ.-GA-$4$?-2-=-.LJ-2-i3-0-S$-;R.-.J, .J-
.$-?R-?R-/A,$4$?-2-LA:-&-$:A-1R-:S-2, $4$?-2-v$-*=, $4$?-2-
!-<J-#-:S, $4$?-2-(-PA-:S-2, $4$?-2-tJ-9R<, $4$?-:S-V%-2-
!-<J-#, LA:-&-$:A-1R-:S,
&/-(S=-$4$?)2&?-?R,,

$4$?-2-V%-2-&/, $4$?-2-(-PA-:S-2, $4$?-2-v$-*=, $4$?-2-9R<-.LA2?, o/-,R.-GA-(-L., .$-?J=-(/-m?,

>A%-2-.%-=$-<?, 2~=-$./-.%-2~=-,$ $8$-OA:3-$+<-!J$?, b%-0:A-l:A-hR-!J$?, V%-#J2?, 5.-:6B/-O$-$R.,

=R-2&-$*A?, LA-2, \%-, !$ ;R?, :V$ 4=, g, =$ 3J=, L, HA, 1$

]-$9:, z$ %J/, 1<, 1<, *A, .3<, .3<, ?%?, ?%?, ?%?, ^ z$

YR$-$9:, .3<, z$ %J/, %J/, z$ ?%?, ?%?, ^ 1<, 1<, z$ .3<,

$>J.-$9:, %J/, 1<, ?%?, ?%?, 1<, z$ z$ 1<, .3<, .3<, 1<, %J/,
$?3-0, <%-.%-3A-<%-/.-$8A-2g$-0,
o.-=?, $+<-.-<%-2:A-/.-$8A-:P3?-:O$?-<A3?,,0%?-0-k-.%-SJ$-/.-?<-;-.%-,,3J-.2=-(-
?J<-36K-/.-=-?R$?-0:A, ,5-2-O$-3OA?-=?-I<-$+<-2:A-/., , &J?-.%-, 3A-<%-$.R/-&/-9%?-9.-
43-3-.%-,,24?-eJ?-*-j2-$&R%-(J/-3J-SR.-*3?,,3.R<-/-2.-_%-=?-I<-/.-=-%%-,,:R/-G%-O$-3-KJ.-
.%-<A3?-3-(A/, ,!R%-5.-.$-3-$?R.-.%-$*/-5.-.%-,,9%?-9.-5-2-;A/-;%-$+<-3A-<%-,,2.-_%-/.-
G%-O$-3OA?-2#R%?-/-$+<,,.R$-.%-l-3..-]-$/?-?<-3A-$+<,, 8J?-$?%?-0-v<-<R,,
28A-2, </-.%-3A-</-.?-5S.-=-2g$-0,
o.-=?, L%-#R$-O$-22?-.R/-=-9A/-0-.%-, ,O$-3-(R.-.%-o?-:O$?-(A/-=R%-3J.,,.?-=-3A-2#.-
2lR/-0?-,R$-3<-$+<,,2<-.-$+<-.?-$9J<-.?-P%->3-(.,,l-o.-tA-4A.-o?-0:A-.?-/-$+<,,O$-KJ.-
<A-3R-3J.-/-.?-=-1J2?,,.J-v<-3A/-/-,%-$A?-KJ-=-$+<,,O$-3OA?-%/-O$-l-.3A$?-LJ<-2-.%-,,9?-GA?-
5-<R-2*J.-=-,-3<-$+<,,$+<-2-}?-/-_%-2*J.-5-2-LJ<,,:KA?-/-%/-O$-l-:P3?-<R-3A-,R/,,5-!R2?-(J-
/-l-.R/-i$-+-:S=,, 8J?-$?%?-0-v<-<R,,
s-2, $+<-2:A-;=,
;/-=$-2o.-0-=?, .J-;%-2&-S$-3-=R/-.%-,,2./-&-:.?-/-O$-3A-.L%-,, 8J?-0-v<-<R,,
S$-0, $+<-2:A-}R/-:PR, ( <A%-2-.%-, *J-2:A-}R/-:PR)
 2./-0, $+<-2:A-$/?-?3-$+<-.3A$?-,A<-2>.-0,
,A<-/-$+<-l:A-.3A$?-3%-3R.-eJ-9<-3#<-2?, 35S$-$?%-$-lJ-,R%-l-$?3,,i-2:A-KA-/%-uR/->A%-28A,,
v$-l-v$-<=-$?J<-3.%-S$ ,tJ-3A$-?R-l-lJ-(%-2o., ,.J-v<-*J<-$&A$-3$R-{J<-<R,,.0%-l-|%-l-S$-3$R-
.%-,,$R.-!-<-,%-\R-~A%-:.R3?, ,\R-3(A/-3(A/-3OA?-:.R3?-l-.%-,,2.-3OA?-(-?J<-$>:-<J%?-.%-,,S$-
:.?-*R<-$R%-YA/-=$-$A,o2-l-$*A?-$*A?-U/-2-S$,?3-&-l-28A-=$-0<-<R,,b%-0<-l-(J/-|2-l-.%-,,g-
3,<-LA/-$8$-LA/-GR$-.%-, ,$.R%-l-=R%-l-;R2-$R%-.%-, ,o-l-$*A?-$*A?-2&R-2o.-.R,,&2?-=-1R-2:A-G-
$*A?-.%-,,1R-35/-:P3-l-$*A?-.J-28A,,.J-v<-21A=-2?-2./-&-2./,,8J?-$?%?-0-v<-<R,,
2o.-0, $+<-2:A-=$-=J/-.%R?,
$&A$ 2~=-,2?, $*A?, $.2-,2?,
?-2&.-$?3-0, $+<-$:A-$.2-.3A$?-.%-1/-;R/,
.%-0R, 3$R-{J-=-$+<-l-*J<-$&A$ (o/-.-3,R%-3%-2:A-l-.3A$?-#$-&A$)
135S$-3-tA-2-.%-.T=-2-$9J<-2, 3A$-x$?-9$-&A%-/-2, <A3?-
IA?-3$R-2R-:#R<-2, 2.-3OA?-3$R-/.-.%-(%-:,%-SR.-5K-3$R-/-
2, 3A$-IJ/-.-3A-,J$-0, 3A$-1$?-?-/-9$-$+R%-2-2&?-=, 35S$-$?%-,
2 $-2<-O$-3OA?-5-2:A-/.-8$?-0:3-$-O$-?R$?-GA?-
nJ/-0?-$-2$-:$$?->A%-.2$?-:LA/-d2?-.!:-2-.%-$-
>-.R/-0, $-/?-i$-O$-(-?J<-:6$-0, 3A$-=-{3-5$-o?- $-l,
0-?R$?-=-1/, 3.R<-/-$-2$-:$$?-0, 3A$-/.-$>J<-5$-
$A?-3A$-3A/-.3<-0R<-I<-2, 5-2-o?-0-2&?-=,

3 .T=-2-$9J<-2-.%-, 3A$-/.-{3-5$-.%-.3<-
.%=-3.%-,
5$ $>J<-5$-o?-0, 52?-/.-GA?-3A$-$A-mA-3-LA-
2, 3A$-IJ/-.-3A-,J$-0-?R$?-=,

4~A%-5.-GA?-{R3-..-(J-2-.%-, %$-3A-2.J-2, #-#-2, O$-

3OA?-nJ/-IA?-tJ-0%?-0:3-$?-0, tJ-.A$-/?-5-.!:-2,
tJ-l,
.%-$-3A-2.J-2, 3A.-0-/-2, .J-28A/-PJ-5.-GA-/.-.%-,tJ-$?-
0, PJ-:$$?-GA-/.-?R$?-.%-2.-3OA?-.2%-$A?-*$-0-=,
5 3A$-=-.3<-5$-o?->A%-3A$-l-.3<-2-.%-, 3A$-/.-O$-
o?-GA-/., =A%-+R$-;%-;%-.R/-0, 3A$-<2-<A2-LJ.-0, 3A$- 3A$-l,
$A-mA-3-LA-2-2&?-=,
6 O$-.%-3OA?-0-=?-I<-2:A-?R-/.-.%-, ?R-YA/-O$-3OA?-
.%-2#R%?-0, ?R-fA=-=-O$-o?-+J-0%?-;R.-0-2&?-=, ?R-l,-

7 3$R-.%-.R/-$R.-,A:A-wJ-3A$-!J-!R.-/.-!/-=-l-:.A-$+<-/-1/-=,
[.-YA/-IA-/., o?-5.-.%-:O$?-5., \R-2<-5.-0-:P3?-0, =?-
4A.-0, L%-#R$-+-O$-22?-0, .R/-=-k-9A/-0, 0%?-0-.%-:V?-GA-
/., .2%-2R-:,A2?-0, 3$R-($-5-2-*J?-0, O$-$A-!R2?-GA?-=?-
4A.-&A%-2o=-:2R$-LJ.-0, :V?-GA-/.-:1J=-2:A-o-:$R$-0-?R$?-=-
1/-0?-.R/-$R.-,A:A-wJ-3A$-;%-9J<-2?-.R/-$R.-!/-=-1/-(J-2<-2>.-
G%-$?%-.3A$?-2!/-0-43-=?-=$-=J/-.%R?-+J-3,R%-o-3-L%-%R-, lJ-(%-,
 $*A?-0, =$-0:A-$+<-l-?R-28A,
1 <R-!R.-$9J<-2-.%-, =?-tA-2, \R-5.-GA-/., .2$?-,%-2, |%-l,
O$-+-=-2, $&R%-,2?-?-=-2, {.-:$$?-0, =$-0-4A.-0,
g$-+-$-O$-:6$-0-2&?-=,
2 \R-=-2, $-O$-o?-0, .2$?-3A-2.J-2, ~A%-.%-YR$-l-3(A/-
SA-V%-o2-2&?-4$?-/?-/-2, *A/-$%-.%-35/-$%-=?-tA-8A%- $R.-!

>J?-0-:,A2?-0, !R.-/-8A%-\R-2<-O$-o?-+J-V%-o2-$9J<-2-.%-,
=.-0-:$R$-.!:-2, $-O$-:6$-0, ;/-=$-4A.-0, .R/-$R.-
,/-3R%-$A-/.-=,
3 3(A/-0<-($-0R:C-5-0/-:SA=-2:3-O$-5.-o?-0, :P3?-
:O$?-<A3?-5., 3(A/-5.-.%-3(A/-O$-o?-0, 3(A/-O$-1R-
2<-z%-2, 3(A/-5.-,<-.-22?-0,o-5.-GA?-:O-2, .$-($- <-,%-,

3(A/-0<-22?-0?-3(A/-0-o?-0, 3A$-/.-.3<-5$ 3$R-.%-

:P3-0-lA2-=R$?-$9J<-2-?R$?-=,
<-,%-,

1 2~=-eJ?-GA-<-,%-, 2 .$-?J=-LJ.-0,

3 $4$?-0, .L%-28A/-0:A-%/-O$ 2~=-,$-\R.-0,

$?3-0, b%-0:A-$+<-l-2&R-2o.,
1 1R-=R%-?R$?-L%-#R$-(.-.-35S/-1R$-!J-35S/-O$-/%-.-z%-2-.%-,
1R-2:A-\%-,2?, 1R-=R%-$/?-?-5-&R?-LJ.-0, o-=R%-.-$*/-#-o?-
0, .$-/., o-=R%-/.-GA?-O$-:O-2, SA-(-:$$?-0, 3R-/.-3%=- =R%-l,
0/-:SA=-2, ^-35/-:I%?-0:3-:L3?-0, o-82?-$9J<-2,
:.R3?-0%?-0, <?-5B$?-$9J<-8A%-0%?-0:3-&R?-0-?R$?-(.-GA-
|R-$*A?-8J?-3.R<-/-(.-/.-$+<-.$R?-!/-=,
2 o-3<-O$-o?-0, 3$R-2R:C-,A$-*R/-~A%-=-22?-/?-$9J<-9$-$+R%-
2-.%-, ~A%-$9J<-/., ~A%-/.-52?-(J/-.%-2&R?-h$?-0-?R$?-=, o-l,

3 SJ$-/.-.%-, P3-2-(-?J<-IA-/., b%-3$R-:P3?-0-?R$?-GA?-

b%-0:A-3,A=-.%-2R=-$R%-=-.3<-0%?-($?->A%-5-><-o$-0:3-
$9J<-9$-$+R%-2, 0?-3R-b%-5B$?-/-2-.%-4A.-0-2&?-=, ;R2-$R%-,
s-2, o.-=?-&?-0:A-$2-l-<J-s-=?-$+<-3%-2:A-l-.3A$?-:$:-2>.-0,
1 3OA?-/.-GA?-3$R-/-2-.%-, !R/-.JA.-GA-.?-?-3$R-/-2, 3A-
.%-*A-3?-SR?-5K-35S$-3-tA-8A%-$9J<-2, (%-/.-GA?-3$R-2R-$9J<- .T=-l,

8A%-3A$-3A-,J$-0, $8/-;%-/R-LJ.-.%-(3-c/, $-;A-/.-?R$?-=,

2 y-2-*J?-2:A-/.-= y-l,

3 SJ$-P3-.%-b%-:23-GA-/.-?R$?-=, SJ$-l,

4 (.-.-5-2-8$?-0, P3-2:A-/.-.%-(-?J<-(.-.-z%-2,
5-2<-2#R%?-0:A-(-?J<-/$-0R, SJ$-.%-:23-/$-?R$?-=, P3-l,
?-2&.-28A-2, YA/-2-0.-3?-/.-O$-:)A2-0:A-H.-(R?,

Leech

?-2&.-s-2, O$-T-.%-O$-$A-%R-2R, .L%-5.-?R$?-2!/-0,

O$-$A-:#R<-2*R.-$?=-2:A-<J:-3A$
\R-2:A-#R.-l, :1<-l:A-#R%-0R,

~A%-#%-$;R/-0, ~A%->$-$;R/-0,
1%-P2-;A-%,
\R
-&:A-%,
~A%->$-$;?-0, ~A%-#%-$;?-0, l-&2?-U-3R,

\R-2:A-:1<-l, L%-#R$-!R.-(.-GA-#R.-l,

\R-2:A-:#R<-o/, :#R<-o/-(J-2,
?-2&.-S$-0, $+<-$:A-=R$-$/R/-2!/-0,

?-2&.-2./-0, $+<-$:A-*J-*R/-.%-;R/-+/-2>.-0,
 ?-2&.-2o.-0, .0J-35S/-IA-/.-$8A-:$<-$+<-$?-2&R?-eJ?-GA-1/-:V?-2>.-0,
.%-0R, SJ$-/.-GA-.0J-35S/-/.-.J2,
#R-2R?-2008=R:C-^-2-2:A-5K?-27*A/-/?-35S-}R/-8A%-(J/-2R.-(/-#%-$A-(/-=3?-5/-#$-+-8$-
#R.-LJ.-28A/-0:A-SJ$-/.-GA-.0J-35S/-/.-0-8A$-$A-,R$-3:A-/.-$8A-%R?-:6B/, 2<-.-$+<-$-?R$?-GA?-
$?R-2&R?-L?-5=, ,-3:A-$+<-eJ?-GA-1/-:V?-?R$?-=-8A2-+-2#<-.JR.-L?-0-/A,
UA 644.2umol/L( 135-415umol/l) 5/3/2008 PRO:neg
RBC 7.50 (3.5-6.0) UA 455.4umol/L(135-415umol/l)
Hgb 23.63 (11.00-18.00) 8/3/2008 PRO:neg
F:20ml 13/3/2008 PRO:neg
Hct 75.06 (35.00-55.00) S:18ml RBC 5.75 (3.5-6.0)
ASO 395.00Iu/ml( 0-116Iu/ml) T:20ml Hgb 17.8(11.0-18.0)
CRP 3.49mg/dl (0-0.8mg/dl) Hct 56.52(35.0-55.0)
IGM 380.00mg/dl (46-304mg/dl) UA 378umol/l(135-415 umol/l)
PRO 0.75g/l(2+) 14/3/2008 HUIJIA

#R3-5B$ o-O$-3OA?-=?-I<-2:A-SJ$-/.-GA-/.-0<-SJ$-l-$+<-/-1/-,R$->A/-+-(J,
$*A?-0, 3A$-/.-.3<-5$-$A-.0J-35S/-/.-.J2,
2008=R:C-^-8-0:A-5K?-18*A/-/?-zR-#-?-(:A-/.-0-8A$ O$->J.-130/90mmHg-;A/-=, 3A$-3A/-.%-3A$-
tA2?->A/-+-.3<-2, o=-3R:C-!J%-.-=A%-,R$-.%->-36K<-o?-;R.-0, 3A$-$;R/-0:A-3,R%-/?-)J-8/-.-?R%-
;R.-0, tJ-3.R$-*-?J<-.-I<-;R.-=-%R-2R-&%-{3-0R<-I<-;R.-3R., <R-5S<-o/-w/-;A/-0, SA-(-.3<-?J<-y-
2-cR.-=-?%?-*J/-0, l-o.-U-=-PA3?->A%-:1<-P%?-.2$?-=-=/-S$-:PR-2, :1<-5=-~R3?-0, O$-
$A-m?-:I<-=-2g$-.J.-GA-:V?-2-o/-w/-;A/-0-?R$?-GA?-3A$-$;R/-.3<-5$?-.%->-36K<-&/-.-%R?-
:6B/-L?-0-;A/-=,
$<-$3-2&-$?3-?R$?-#R%-(/-IA-!J%-, :V?-2-?3-,%-?R$?-$+<-$:A-}R/-:PR-=J$?-0<-L?-+J-5K?-
20*A/-.%=-3.%-/?-%/-O$-@R-ZJ%-8043-.L%-2?-.J:A-.$R%-3R-/?-/-9$-.%-, 5-:O$ ZJ2-.%-9-:U$-
=%?-2-?R$?-GA-g$?-8A-!J-3A$-(-*%-.-?R%-2-.%-, 3,R%->$?-)J-=J$?-+-?R%-2-2&?-GA-3%R/-5=-L%-, .J-
/?-a<-KA-*A/-/?-:V?-2-?3-,%-3-3,.-.-2!J/-=, 5K?-23-*A/-$9:-{<-5K?-(-.%-2!/-a<-.T=-l-
$+<-+J-%/-O$-@:R-ZJ%-10043-.L%-2?-1/-/?-z$-0<-,R/-+J-3.R<-/-3A$-3A/-.%-3A$-tA2?-2&?-o/-w/-
v<-I<-;R.-0-.%-, *A/-$?3-IA-eJ?-?->-36K<-8A-!J-$;?-$;R/-3,R%->$?-o/-w/-.-I<-!2?-^-8-0:A-
5K?-26-*A/-$4S-2&R?-(/-0?-(/-#%-/?-KA<-2.-0-;A/-/R,,
#R3-5B$ o-O$-3OA?-=?-I<-2:A-3A$-/.-!/-=-3A$-l-.%-$?J<-3.%-.%=-3.%-$?3-$+<-/-1/-(J,
$?3-0, O$-:1J=-/.-GA-.0J-35S/-/.-.J2, $&A$ /.-g$?-.%-/.-$8A-%R?-:6B/,
2007=R:C-^-8-0:A-5K?-9-*A/-~J-3R-mR%-$A-/.-0-8A$ %R-$.R%-.3<-($-+-I<-;R.-0-.%-,
=?-;R%?-tA-8A%-+A.-=$-0, ~A%-.%-<R-!R.-/-2, 3,A=-28A-5-8A%-{2?-?-d=-,R/-0, 1R-3(A/-
$/?-?-3A-2.J-8A%-$9J<-2, ?R<-3R:C-lJ-i3?-4A.-&A%-$.R%-.%-3(-+R, ;/-=$-$A-?J/-3R:C-3.R$-
i3?-.3<-($-+-I<-;R.-0, S$->=-IA-eJ?-.%-SR?-5K-3$R-2R-:#R<-8A%-H.-0<-,A-$4$-.%-
v$-o?-GA-$/?-?-$9J<-9$-$+R%-2, $3-2&.-9?-GA?-z$-+-$/R.-0, .2$?-:5B%-2, ,%-
(.-=-.%%?-0$-=%?-2, $*A.-.-;<-5K-}<-2-3%-2, 3A$-3A-$?=-8A%-<2-<A2-LJ.-0, 3A$-
3A/-.3<-0R<-I<-;R.-0, tJ-!J%-2.-!/-*-?J<-3,$-0R?-$;R$-;R.-0, l-o.-:2<-:SA=-
3IR$?-=-~R3?-0, (-3.R$-&%-?J<-=-?%?-0, y-2-?%?-*J/-0, O$->J.-GA-2g$-:V?-
170/130mmHg;A/-0, $8/-;%-$?R-L-*A.-GA-2eR.-=$?-v<-/-/.-0-<%-*A.-=-.?-o/-
IA-:5S-2:A-OR.->-.%-3<-?R$?-$3-2&.-GA-9?-9-o<-.$:-8A%-(%-<$-=-.%-2?-=R-$&A$-$A-
}R/-.-?-$/?-(/-#%-$A?-O$->J.-3,R-2:A-/.-.-%R?-:6B/-L?-+J-(/-.-*-<-*J<-s-?R$?-2!J/-
MR%-3R., $?R-2&R?-GA-1/-/?-(J/-0R-3-,R/-KA<-*A/-.J<-uR%?-(/-lA?-#%-.-:LR<-=, c/-
=$?-GA?-O$-_%-$A-/.-.%-, O$->J.-3,R-2:A-/.-.-%R?-:6B/-L?,
$*A?, $?R-2&R?-.%-1/-:V?,
$*J/-0R-*-<-*J<-s-?R$?-#R%-(/-IA-!J%-:V?-2-?3-,%-*A/-$?3-43-=-2!J/-.-
2&$-eJ?-^-8-0:A-5K?-12-*A/-<-,%-$;?-.J-$+<-/?-%/-O$-@R-ZJ%-250-43-.L%-2-;A/-=,
*A/-.J:A-.$%-3R-/?-$?R-L-*A.-GA-=?-;R%?-=-2.J-$%-$A?-#J%?->A%-, $R%-$?=-IA-3$R-2R-
$9J<-8A%-3$R-;-:#R<-2-2&?-GA-g$?-(->?-8A-;R.-0?, ;%-2*<-:V?-2-?3-,%-*A/-
2./-43-2!J/-eJ?-^-8 0:A-5K?- 20 *A/-o2-l-S$-:.?-$;R/-0<-$+<-+J-%/-O$-@R-ZJ%-
6043-.L%-=, *A/-.J-/?-29%-$R%-$?=-IA-g$?-=?-2o-(:A-9043-8A-;R.-0<-3-9.,
*A/-.J<-O$->J.-G%-150/110mmHg-=-aJ2?-;R.-0?, 5K?-21*A/-;%-2*<-.T=-l-$+<-
+J-%/-O$-@R-ZJ%-50-43-.L%-=, *A/-.J<-O$->J.-140/90mmHg=-aJ2?-;R.-0?-c/-=$?-
GA?-$?R-L-*A.-=-9?-{R3-$3-2&.-.%-(%-<$-?R$?-*<-IA-<A$?-3A-<%-2:A-$.3?-0-;%-
;%-$/%-!J-KA<-=R$-+-2&$-$R,
#R3-5B$ O$-:1J=-IA-/.-=-<-,%-.%-.T=-l-?R$?-$%-o?-GA-l-$+<-/-1/-0->A/-+-(J,
28A-2, y-2:A-/.-GA-.0J-35S/-/.-.J2, $&A$ /.-g$?-.%-/.-$8A-%R?-:6B/,

2007=R:C-^-9-0:A-5K?-3-*A/-/$?-(-?-$/?-GA-/.-0-8A$-uR%?-(/-lA?-
#%-$A-|R-2!J/-2o.-.J.-2&R?-5/-#$-+-:LR<-=, (/-#%-.-:LR<-.?-/.-g$?-
$4S-2R-/A, 3A.-0-/-8A%-, {J-2+<-.%-5-2eR.-.!:-2, .2$?-:LA/-d2-3A-2.J-2,
9?-{R3-3A.-.!:-2, 3-3$=-:R$-+-!<-$-(J-2-43-IA-0%?-hR$-.R/-;R.-0, m?-
:I<-IA-.J.-:V?-P>0.05;A/-0-.%-, TPOAb.%-TGAb$*A?-GA-.J.-:V?-
$.$?-$>A?-?-I<-;R.-0-?R$?-GA?-?-$/?-(/-#%-$A?-y-2:A-/.-.-%R?-:6B/-L?-
+J-1J-/A-?A-=A/-?R$?-$*/-5.-$&R$-0:A-KA-=$?-(/-m?-GA?-$?R-2&R?-L?-3R.-1/-
2*J.-3-L%-!2?, *A/-.J<-.J.-2&R?-5/-#$-+-:LR<-2-;A/-=, c/-=$?-GA?-y-
2:A-/.-=-%R?-:6B/-L?,
$*A?, $?R-2&R?-.%-1/-:V?,
$*J/-0R-:V?-2-?3-,%-?R$?-GA-#R%-(/-2!J/-eJ?-5K?-6*A/-y-l-$;?-2-$+<-=,
$+<-.?-,R$-3<-2~=-,$-$A?-{J-o2-/?-3./-.-2{R<-=-3./-/?-3..-0-zR.-0R<-2#3-/?-
$J-$*A?-/.-0-<%-*A.-GA?-=$-+-28$-+J-$+<-KR$?-GA-l-:2<-;R%-2:A-2<-.-:,J/-.-2&$-eJ?-
y-l-$;?-0-.J-$+<-/?-%/-O$-@R-ZJ%-5-43-.L%-=, *A/-.J:A-.$%-3R-/?-$?R-L-*A.-GA-3A.-0-
/-2-.%-, 5-2eR.-.!:-2-?R$?-GA-g$?-&%-8A-2?, KA-*A/-/?-*A/-2./-43-=-:V?-2-?3-,%-
2!J/-eJ?-5K?-13*A/-$?R-L-*A.-GA-/.-g$?-1=-(J<-8A-!J-0%?-wR$-G%-(%-%<-I<-;R.-!2?-y-
l-$;R/-0-.J-$+<-/?-%/-O$-@R-ZJ%-843-.L%-=, $+<-eJ?-}-3R-/?-P-1A$-;R.-0:A-2=-,$-
8A$-$+<-.3A$?-GA-2-$<-2&$-+J-y-l-<%-2#3-/?-O$-$&R.-,2?-L?-3R.-3-5.-0?-o-8-*J-
=?-P2-0:A-i-=%-v-2:A-.LA2?-=J2-3R-2-$<-5.-.%-</-0-8A$-$A?-2#3-/?-O$-2&.-0-;A/-=,
^-10-0:A-5K?-16*A/-/.-0:A-3-3$=-:R$-$A-y-2:A-0%?-wR$-3J.-0<-I<-+J-/.-$8A-?%?-S$-+-
?R%-;R.-0?-KA<-(/-#%-.-c/-=$?-=-2!:-SA/-8-<-:R%-2-;A/-/R,,
#R3-5B$ y-2-*J?-2:A-/.-=-y-l-$+<-/-1/-0->A/-+-(J,
 s-2, l-:23-/.-GA-.0J-35S/-/.-.J2, $&A$ /.-g$?-.%-/.-$8A-%R?-:6B/,
2007-=R:C-^-8-0:A-5K?-17*A/-z-?-PR%-HJ<-(-><-mR%-3*J?-,%-?-(:A-/.-0-8A$ 2R.-uR%?-(/-
lA?-#%-$A-|R-2!J/-2o.-.J.-2&R?-5/-#$-+-:LR<-=, (/-#%-.-:LR<-.?-/.-g$?-$4S-2R-b%-
0-$;?-$;R/-IA-#R.-l-3HR$-o?-?-I<-;R.-=, .LA2?-.%-3.R$-?-:2-/$-<A%-v<-;R.-0, $;?-
0:A-LA/-~A%-$A-$/?-?-l-3..-;R.-0, $?R-L-*A.-GA-b%-0:A-;-~A%-$A-$/?-?-o/-.-$9J<-9$-=%?-
0-.%-, 8R$?-0-=?-.$%-3R-$9J<-9$-(J-2, :PR-.!:-8A%-,%-(.-0, ;/-<A%-=%?-eJ?-b%-
3$R:CA-<?-U/-$9J<-2, l-3..-!J%-$A-0$?-0<-9-:U$-=%?-8A%->/-0-.R/-;R.-0, l-$/?-?-5-
2o$-0-.%-$/R/-9$-;R.-0, l-o.-LA%-8/-~R3?-0, tJ-3.R$-*-?J<-($?-0, (-3.R$-*-?J<-
!-;-Y2-0-?R$?-GA-g$?-L%-2?-2R.-uR%?-3A-.3%?-(/-#%-.-/.-$8A-2g$-2&R?-LJ.-.-?R%-3R.,
$?R-2&R?-(/-0?-$>$-2&R?-L-.$R?-5=-,.-GA-{R<-3%-0R-\J%-2?-2&R?-3-:.R.-0<-(/-#%-:.A<-
:LR<-=, c/-=$?-GA?-/.-$8A-l-:23-33-#R.-l-3HR$-o?-GA-/.-.-%R?-:6B/-36.,
$*A?, $?R-2&R?-.%-1/-:V?,
$*J/-0R-:V?-2-?3-,%-?R$?-GA-#R%-(/-*A/-$?3-43-=-2!J/-.-2&$-eJ?-^-
8-0:A-5K?-20-*A/-=R%-l-$;?-$+<-+J-%/-O$-@R-ZJ%-300-43-.L%-=, .J-/?-;%-
2*<-*A/-2./-43-=-:V?-2-?3-,%-2!J/-.-2&$-eJ?-^-8-0:A-5K?-27 *A/-/.-
0:A-b%-0:A-5-9$-.%-9-:U$-=%?-2-?R$?-=-3%R/-$?=-IA-1/-2*J.-(J/-0R-L%-
;R.-!2?-=R%-l-$;R/-.J-$+<-/?-%/-O$-@R-ZJ%-160-43-.L%-2-;A/-=, ^-9-2:A-
5K?-26-*A/-,J%?-$?3-0<-(/-#%-.-,R/-.?-l-o.-o/-w/-v<-I<-;R.-=, 5-
9$-=%?-2-?R$?-$R%-$?=-IA-g$?-;R%?-?-8A-!J-1=-(J<-?%?-S$-+-?R%-0?-c/-
=$?-GA?-S$->=-IA-=?-.%-5-*<-GA-9?-?R$?-=-$92-.$R?-0:A-{R<-IA-$.3?-
0-.%-2&?-KA<-=R$-+-2&$-$R,
#R3-5B$ l-:23-33-#R.-l-:HR$-o?-GA-/.-=-=R%-l-$+<-/-1/-0->A/-+-(J,
HJ.-5S?-*/-0<-2!:-SA/-(J-8-2-;A/,

2N->A?-2.J-=J$?-1/-?3-5S$?-0<->R$ ,