ŠĻą”±į>ž’ Ʊž’’’«¬­®’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ģ„Į5@ ųæ0 bjbjĻ2Ļ2 %ā­X­X£„I3’’’’’’ˆ¢¢¢¢*ĪvĪvĪv8wœ¢w“*YÕŽb|^Ą|Ö|Ö|Ö|+~+~+~ŲŌŚŌŚŌŚŌŚŌŚŌŚŌ$7×R‰ŁxžŌ׀ ~"+~׀׀žŌ¢¢Ö|Ö|3Õė”ė”ė”×€Œ¢RÖ|Ö|ŲŌė”×€ŲŌė”ė”ż”Ž€ŗXō"Œ¾Ö|V| €#ŹDĪĪvc’dŲ»(|Ą\)Õ0YÕ¼ŒŚĒ’ĘŚPŒ¾**¢¢¢¢Œ¾Ś æÜ+~ Ė~rė”=\™>+~+~+~žŌžŌ**¤qĪv”^**ĪvFAMILY MEDICINE-er-ob for the Uninsured Clinical Guidelines from Medicos para la Familia  HYPERLINK "http://www.medicosmundial.com" www.medicosmundial.com see  HYPERLINK "http://www.psot.com" www.psot.com Improve health care by minimizing fragmentation of health care and maximizing treatment at the point of service seven days a week. Use generic medications when they are equivalent. Minimize antibiotics for self limited infections. Teach awareness of risks generated by high cost, fragmented, hospital ED visits. Gather data describing the benefits of expanded Family Medicine and tell this to the public. Prepared by Wm. MacMillan Rodney MD Original 11.2.99 (Updated 11-7-4 wmr) Background Medicos encourages generic medication whenever the results are as good as more expensive drugs. Medicos has had a “no drug samples with rare exceptions” policy since 1999. Medicos seeks to maintain quality while reducing the unnecessary prescription of antibiotics and expensively unhelpful nongenerics. Note the Warner Lambert settlement over allegations of deceptive off-label marketing of Neurontin(gabapentin) Vioxx, Zyprexa, Zegerid and Avandia are additional examples. [Ref Am Med News 9/3/07 p.13] These high priced medications represent a financial beating for uninsured patients, and an unnecessary expense for taxpayers. ][Pfizer 2009 paid $ 2.3 billion in fines over misleading sales techniques,and pled guilty to one felony count on Bextra and other drugs]2 McMahon LF, Chopra V. Health Care Cost and Value. JAMA 2012; 307: 671-2. Every year, Medicos reviews charts and billing records to determine the most common diagnoses where antibiotics are prescribed. These studies determine if there has been penetration of drug detailing into the Medicos environment. Medicaid[Tenncare] audits have documented that Medicos physicians prescribe generic medications twice as frequently as other physicians in the state. The following “position paper” which was created as part of the vision statement during the formation of Medicos para la Familia in 1999. Since then US healthcare spending has grown to over $2.7 trillion per year[over $ 8,000 per person per year]. Medicos thanks all who have made Medicos one of the most successful generic prescribing programs and the largest and oldest privately funded  bilingual health care program in the state of Tennessee. TOP TEN CONDITIONS RECEIVING ANTIBIOTICS AT MEDICOS 1999-2009 VAGINITIS/ STD/ PID URI/BRONCHITIS with cough OTITIS MEDIA no cough SINUSITIS no cough STREPTHROAT no cough UTI/ PYELONEPHRITITIS CELLULITIS/ IMPETIGO/ABCESS antibiotics are rarely indicated for abcesses CONJUNCTIVITIS H PYLORI ERADICATION Anxiety-Transactional Issues[STD phobia, mental illness, and others] PRIORITY NUMBER ONE: Vaccinate where appropriate to prevent illness. But, be aware that some vaccines have controversial risk-benefit ratios[Gardasil, Rotavirus, meningitis vaccines, and others]. Note that public health policy has political influences. The Cochrane Database has questioned the evidence for flu vaccination. [Am Fam Phys 2006;74: 1825]. Government has legislated vaccine policy.  HYPERLINK "http://bmj.bmjjournals.com/cgi/content/short/333/7574/912?ehom" http://bmj.bmjjournals.com/cgi/content/short/333/7574/912?ehom= In 2011, wmr entered a blog on the Medicos experience. see www.psot.com PRIORITY NUMBER TWO:Physicians should prescribe effective antibiotics where indicated. Over-prescription of highly promoted, expensive new drugs (when these drugs have no additional benefit) should be resisted. [[References: Sachs HP. Consider the cost when prescribing antibiotics. Am Fam Physician Sept 1, 2002; 66:734 and Polly SM. The Antibiotic Paradox: How the Misuse of Antibiotics Destroys Their Curative Powers.(book review) JAMA 2002;288:2898-99]] A single course of newer macrolides[Biaxin or Zithromax] can significantly increase the proportion of antibiotic resistant oral streptococci. The effect can last as long as six months. Lancet 2007; 369: 482-490. Garbutt JM, Bannister C, Spitznagel E,Picirillo JF. Amoxicillin for Acute Rhinosinusitis: A Randomized Controlled Trial. JAMA 2012; 307: 685-692. There was no benefit from a 10 day course of amoxicillin 500 mg tid. Many patients with cultural and language barriers do not fill prescriptions and/or have a difficult time receiving appropriate instructions in their own language. For this reason, where indicated, antibiotics by injection may be more appropriate than pills. Medicos has improved access to care by providing small amounts of generic medication at the time of the visit. Point of service Care implies treatment with medication when indicated. If possible, place the medication into the patient at the time of diagnosis. PRIORITY NUMBER THREE: AVOIDANCE OF UNNECESSARY ANTIBIOTICS AMONG CHILDREN. Medicos has successfully conducted a prototype study using Periactin, Robitussin DM, and others for the viral syndromes seen in children 0-3 years of age. The FDA advisory on phenergan has been previously discussed. The office does not stock phenergan syrup, and you will probably receive a call from the pharmacy if you prescribe it in this age group. PRIORITY NUMBER FOUR: Wherever supported by evidence based medicine, shorten the traditional 10-14 day courses of antibiotics. Example. Li JZ, et al Am J Med 2007; 120: 783-790. Antibiotics given for 3-5 days are equally effective as 10-14 days for treatment of patients with community acquired pneumonia. PRIORITY NUMBER FIVE: Develop and test an educational curriculum challenging the overuse of tests and nongeneric medications. PLEASE REVIEW THE LIST OF MEDICATIONS AVAILABLE IN THE OFFICE AND MAKE SUGGESTIONS OR APPROVE. II. Guidelines for Antibiotics in the Office To improve patient compliance with unfilled prescriptions, the practice has made a commitment to provide common antibiotics such as Bactrim, Amoxicillin, Doxycycline, Keflex, Nitrofurantoin[Macrobid],and others. Penicillin and ampicillin were redundant to amoxicillin. Placing starter meds in the hands of the patient at the point of service, removes financial and other psychosocial barriers which prevent up to 40% of patients from filling prescriptions written in the office. A five-seven day supply of pills will be given with the expectation that the patient return for a recheck in two days if not better. Prescriptions are written as a backup. New problems and/or additional labs will be charged if they occur. The patients will receive a medication charge covering the cost. Since this can be $10-20, Tenncare patients usually receive prescriptions, but it is not wrong to engage in charity care by giving them starter meds. Legally physicians cannot ask any Tenncare[Medicaid] patient to pay anything other than a copay for the visit. Uninsured patients almost always save money with the Medicos system. Treatment is more effective when medications are distributed at the point of service. Complications, lab tests, and additional services will be charged extra. Intramuscular generic antibiotics such as Ampicillin, Gentamicin, Cefazolin(Ancef), Penicillin CR, and ceftriaxone (Rocephin) are also available. Medicos studied the use of other good and generically available drugs such as Lincocin, Claforan, IV Vancomycin, IV Metronidazole, IV doxycycline, and others. If physicians wish these drugs Medicos can order them. Topical medications such as lotrimin cream, steroid cream, Vosol ear drops[3% acetic acid], gentamicin eye drops, and sulamyd[sulfa] eye drops are available. Medicos avoids eyedrops and antifungals containing steroids, but they can be prescribed in those situations where the physician feels that they are indicated. III. Vignettes An aymptomatic 21-year old Latino female with noncontributory PMH, unremarkable review of systems, and normal vital signs, seeks prescription for an STD exposure. Should you order cultures and other lab or would you treat empirically? GUIDELINE: Treating empirically seems to have worked best in this community. Ordering GC/Chlamydia probes appeared to be free at the Meharry FPC, but 2-3 months later the uninsured patients received a bill for over $100. Prenatal panels were over $350. Medicos’ total visit with the prenatal lab is $200. Ultrasound is extra. A 28-year old Latino male complains of sore throat, pain on swallowing, and fever over the past 2 days. The Past medical history[ PMH] is noncontributory, and the oral temperature is 101.5. There are tender neck nodes. Will a rapid strep screen be helpful? GUIDELINE: Probably not. Reference: The Cochrane Library, Issue 3, 2004.(Evidence –based practice 2004; 7No 10: 6-7, citing Del Mar C, Antibiotics for sore throat-Cochrane Review) The authors conclude that traditional indications for antibiotic therapy of common strep throat have remarkably diminished and that it may now be appropriate to guide the antibiotic decision solely on the basis of faster symptom relief. Kopes-Kerr CP, Action Advisor 2005; 7[4]: 10 states: “The real importance of these data is that it supports using the least costly diagnostic assessment strategy since the risks [of rheumatic fever and glomerulonephritis have now been discredited]” Kopes-Kerr argues for the use of a simple “Strep score”. One point each for fever=/> 101.5, exudates, tender nodes, and absence of cough. “There is no justification or need for adding the cost of either a rapid Strep test or a culture, and, God forbid, a combination of both”. QUESTION: Does the group wish to maintain the cost of stocking rapid strep screen supplies? 2007 Review—finds that the answer is—Yes. In 2006, Medicos Memphis physicians ordered over 400 Strep screens. A 23-year old non-English speaking Latino male gives a two-year history of recurrent otitis externa which he suffers from today. He has received various antibiotic drops on 4 separate occasions in the last year. The PMH is otherwise non-contributory. What would be your choice of treatment? 1.GUIDELINE: Vosol[This is generic white vinegar drops] and systemic antibiotic are probably the next step. Starting with an IM antibiotic injection would not be wrong. 2.Vosol has increased its cost to over $20, and a replacement generic white vinegar drops are available in Memphis. Nashville please stock. 3. Otitis externa frequently is sufficiently painful to require codone analgesics. An 18 mo toddler with 2 d history of decreased feeding, irritability, and “fever” is noted to have an oral office temperature of 99.8 F and red appearance to one TM. 1. Reference: Spiro DM. A randomized trial to assess the effects of tympanometry on the diagnosis and treatment of acute otitis media. Pediatrics 2004; 114: 177-182. 2. Kopes-Kerr CP comments in his Action Advisor April 2005 p 4. “ These data lend no support to the expensive practice of routine tympanometry in the diagnosis of otitis media. The large majority of physicians who don’t use it…..I find the main value of tympanometry is to confirm the physical exam during the learning phase in the early years of practice. It is merely edifying, not practical. At Medicos, the tympanometry machine has been removed. 3. Air insufflation for tympanic mobility is not required. 4. Rocephin 250 mg IM with followup if not better in 2 days has worked well at Medicos since 1999. Five to ten day courses of po antibiotics are not wrong, but they are less convenient. 2007 Review—These prescribing behaviors have virtually disappeared from the Medicos offices. An 18 mo toddler with a 2d history of decreased feeding, irritability, and a “fever” is noted to have an oral office temperature of 102.4 F and normal TM’s. In both cases the pharynx is pink without exudate, lungs are clear, there is no adenopathy, the neck is supple, the child makes eye contact, and the mucous membranes are moist. 1. Education regarding “fever phobia” with specific mention of febrile seizures and newer studies indicating a lack of brain damage. MANY OF MEDICOS’ STAFF HAVE FEVER PHOBIA—EDUCATE, EDUCATE, EDUCATE!!!!!! See the Patient Education File in Practice Partner. There is a specific handout on fever phobia. 2. Buy time using mild “tonics”--Periactin, robitussin[aka by the generic Siltussin DM], Chlortrimeton liquid solutions qid x 2 days. Return if not better in one or two days. 3. Understand the “Yale Child Observation Score” as a way of identify serious versus trivial childhood illness. Playful alert children making eye contact are not seriously ill. “What to do for colds in kids”--I suggest nasal saline sprays/irrigation (depending on age/willingness of kid), tylenol for fever/aches/grumpiness, hot salt gargles for sore throat (plus popsicles!), and lots of kids/parents like the (?Vicks) chest "patches" with "menthalatum".  Honey in hot tea too.  I spend lots of time explaining the futility of antibiotics/cold meds.  The school nurses still kill me by telling folks to take the kid to the doc for "medicine".... Debbie Sutcliffe, MD; AAFP list serv 17 Oct 2008 PENILE RASHES  HYPERLINK "http://www.psot.com" www.psot.com Index--drug guidelines, penile creams[8-8-08] 1. Patient #50455 with "balanitis" received steroid cream and antifungal cream...  I believe that our policy is that creams are NEVER to be used on a penis.... Dr. Rodney, please tell me if this is true. Dr. Bangura saw him today and discontinued all of the creams. Conchita 2. WMR REPLY--This is a guideline which differs from a "policy". Especially among uncircumcised men, which includes many among the Latino community, rashes and abrasions on the glans and foreskin are prolonged by creams and ointments. This is one of a variety of medication prolonged and medication induced illnesses we see in a society recommending Neosporin ointment and Bacitracin cream for every cut and scratch. I literally have to pry the tube out of the hand of some women applying creams every hour on the hour after their child's circumcision. The cream leads to complications and impedes healing.   Worse yet are the over the counter sales of steroid creams which are inappropriately applied to otherwise self limited illness. Great for business, but bad for the patients.   Even among circumcised males, most of these "rashes" are the result of sexual abrasions and they are almost always self limited if allowed to dry out and close over. Rarely are they actually infected. When they do become infected, as in cellulitis, they require oral antibiotics. Testing for other sexually transmitted diseases should be considered, and/or empiric treatment given without cultures. This means Rocephin IM and doxycycline for 7 days. Bactroban is not appropriate. IV. Specific Examples Upper Respiratory Infections 1. Otitis. Recent studies have demonstrated that, when the cause of the otitis is truly bacterial, a one-time shot of Ceftraxone (Rocephin) is effective in the majority of cases. If a bacterial infection is in doubt, alternating Tylenol and Motrin may be given with a follow-up visit in one or two days. Febrile infants under three months require a more aggressive approach. Rectal temperatures are REQUIRED among sick infants up to 3 months of age. Centigrade temperatures of 36-38[Fahrenheit 96.8-100.4] degrees are not classified as fever. Neonates with concerns are best scheduled for return visits in 1-2 days. CLINICAL ALERT-- MEDICOS TEMPS MAY RUN LOW DUE TO EQUIPMENT AND/OR STAFF. DO NOT TRUST “A NORMAL TEMPERATURE” WHEN THE CHILD APPEARS ILL. 2. Pharyngitis. The decision to treat first or test first for Group A strep is controversial. This controversy has been raging for over 30 years . This guideline does not recommend Group B strep testing because most physicians successfully treat based on symptoms of fever, sore throat, etc. When accompanied by exudative tonsils, and the other three things mentioned above, testing does not change management. Rapid antigen tests may be of high specificity and helpful if the results are positive, but they lack sensitivity. This means when the rapid strep test is negative, throat culture is necessary to exclude strep infections. Culture strategies are extremely difficult for the patients, and the waiting time is impractical. Where treatment is chosen, single-dose Penicillin (CR) 1.2 million units [or 600,000 units IM if the child is 60 lbs. or less] is preferred over 10-day courses of Penicillin and/or Cefadroxil. The injection is also preferred over the five-day course of Azithromycin. Since medicaid does not pay the cost of IM penicillin, Medicos recommends ceftriaxone[Rocephin] 250 mg IM as an equally effective and cheaper alternative. MEDICOS para la Familia does not stock of azithromycin, clindamycin, and terbenafine even though generics are available, pharmaceutical lobbyists have made importation of these generics so costly that they are difficult to buy unless you are WalMart. 3. Sinusitis. The duration of symptoms (minimum 7-10 days) has been promoted as minimal diagnostic criteria. There should be other signs/symptoms such as nasal discharge, fever, toothache, facial tenderness, facial swelling, and/or facial erythema. The “double sickening” curve suggests that the diagnosis is sinusitis. One study suggests that Bactrim 3-5 days is as effective as 10 days of treatment. Garbutt JM, Bannister C, Spitznagel E,Picirillo JF. Amoxicillin for Acute Rhinosinusitis: A Randomized Controlled Trial. JAMA 2012; 307: 685-692. There was no benefit from a 10 day course of amoxicillin 500 mg tid. Usually physicians negotiate the least harmful to the ecology treatment. Medicos has found that patients perceive Nasonex AQ, Clartitin 10 mg daily, and the Siinus shot[DepoMedrol 40 mg with Decadron 4 mg IM to be helpful in their perceptions of "sinusitis. Bronchitis. Over seven studies have demonstrated that increased cough and sputum in patients without underlying lung disease derives no benefit from antibiotics. Despite this, over 60% of patients receive antibiotics. A bronchodilator may be better for relief. There are no absolutes in this situation. This guideline generally supports the use of generic short course antibiotics for afebrile cough with productive sputum after 5 days. AVOID STEROIDS. The temporary medical record has been designed to maximize inquiry regarding disruption of sleep cycle by any symptom. In particular, cough which is disruptive of the sleep cycle should be treated aggressively with a codeine based antitussive. Tuberculosis. Medicos sees a higher frequency of advanced cases. Liberal use of CXR and skin testing is encouraged. A control skin test (i.e., mumps or Candida) among healthy workers is not required. Physicians MUST document psychosocial issues such as language barrier, culture barrier, financial barrier, transportation barrier in the record or they could be held liable for the 30-40% of patients who never follow through with the public health department. Because of active TB cases who refuse to go to the Health department or who will not be seen for days if not weeks, are tragic. Medicos does everything it can to see that these patients start rifampin, ethambutol, and INH as soon as possible. It is the Dr. Rodney’s opinion that it would be better to start the patients on triple drugs immediately rather than have them coughing and untreated. But, the Memphis Health Department states that giving TB drugs to a patient under any circumstances is against the law and sought to prosecute Medicos physicians in 2007. Medicos will personally drive noncompliant patients to the public health department, but will not prescribe TB drugs until such time as there is protection from the state Health Department. When a referral to the MED/METRO or to the Public Health Dept is made, there must be written notification made to the Dept of Public Health. 6. Low-risk and moderate-risk pneumonias can be treated as outpatients. Low-risk is defined by the following: (No history of congestive heart failure, CVA, renal failure. or liver disease (Normal mental status (Pulse less than 125 bpm (Respiratory rate is 30/min or less (Systolic blood pressure greater than 90 (Temperature 35(-40(C (95(-104(F) When the patient does not fall into this lowest risk category, hospitalization may be considered. Among low-risk patients, studies indicate that Erythromycin, Azithromycin, Clarithromycin, Doxycycline, Pediazole, and Fluoroquinolones, have activity against most pneumococci. We recommend starting with those meds that can be obtained at the generic cost[Erythromycin and Doxycycline tabs would be examples.] 2007 Review—over 20% of children under the age of 3 with severe cough, fever, and abnormal lung sound had radiographic evidence of bilateral pneumonia. Caution is urged for all children under the age of three. A hemogram should be ordered in these children, and WBC greater than 15,000 requires review by a senior physician. Peer Reviewed Publications on the Topic: Acknowledgement to C Copes-Kerr and his Family Practice Newsletter April 15, 2005. Success of outpatient therapy has been confirmed in the literature. Carratal J, Fernandez-Sabe N, Ortega L, et al. Outpatient care compared with hospitalization for community-acquired pneumonia. A randomized trial in low-risk patients. Ann Intern Med 2005; 142: 165-72. Sputum cultures and Gram’s stains are of little value. Garcia-Vasquez E. Assessment of the usefulness of sputum culture for diagnosis of community-acquired pneumonia using PORT predictive scoring system. Arch Intern Med 2004: 164: 1807- Chest radiographs can be normal and blood cultures are rarely helpful. Basi Sk, et al. Patients admitted to hospital with suspected pneumonia andnormal chest radiographs: Epidemiology, microbiology, and outcomes. Am J Med 2004: 117: 305- Efficacy of short-course antibiotic regimens for community-acquired pneumonia: A meta analysis. Li JZ, Wisnton LG, Moore DH, Bent S. Am J Med 2007; 120:783-790 7. Lower tract urinary infections. A single dose or a 3-day course of Bactrim or the Fluoroquinolones are effective. Macrodantin, Keflex, and others are effective. This guideline recommends short course of generic drugs with close followup. 8. Pyelonephritis. Normal risk, moderate, and even some severe pyelonephritis (i.e., non-pregnant women without renal disease) can be managed with outpatient care. Dehydrated patients should be given IV antibotics and fluid in the Medicos observation areas. Medicos experience with empirical treatment and next day followup has been excellent. Blood cultures have had no value, and are reserved for those cases that require hospitalization. In 12 years there have been no changes to management as a result of urine culture. Ampicillin, Ancef, Amoxicillin have been successful. Fluoroquinolones cannot be used in pregnancy. Bactrim has now[2010] been approved in pregnancy past the first trimester. Gentamicin 3-7mg/kg/day can be given IM or IV. Two Drug therapy; e.g. antibiotic #1 with a shot of gentamicin[antibiotic #2] minimizes resistance. Dental. Stefanopoulos PK, et al. the clinical significance of anaerobic bacteria in acute orofacial odontogenic infections. Oral Surg Oral Med Oral Path Oral Radiol Endo 2004; 93: 398- Acknowledgement to Copes-Kerr and his Family Practice Newsletter April 15, 2005. Amoxicillin/clavulanate was active against all pathogens. Clindamycin covers nearly all pathogens for penicillin allergic patients. Combined with penicillin, metronidazole covers organisms responsible for odontogenic abcesses. Erythromycin is no longer the first line for penicillin allergic patients, but is still acceptable for mild infections. In these cases narcotic analgesics are appropriate. B. Sexually Transmitted Diseases 1. Gonorrhea. Erythromycin as a 2 gram(but not 1 gram) dose cures most uncomplicated gonorrhea. However, because of cost, compliance, and multifactoral disease we recommend Rocephin 250mg IM and Doxycycline 100mg bid x 7 days with a followup visit in 1 week to make sure that symptoms have improved. Cultures are obtained only in those cases that do not resolve. Note: Among the Latino males there have been a few young men who present with nonspecific symptoms requesting prophylactic protection against venereal disease because of unprotected sex. Usually these young men have girlfriends or wives back in Mexico. Although testing has been used, empirical therapy, education, and reassurance have been the best approach. 2. Pelvic Inflammatory Disease. Rocephin 250mg IM followed by Doxycycline 100mg bid x 14 days. Followup should not be open ended or prn. The patient should be seen within 1-7 days to confirm compliance with the medication and continuing resolution of symptoms. Metronidazole 500 mg po bid x 14d should be considered when symptoms are lingering. C. Meningitis. When suspected, it is a medical emergency. Referral to the hospital is appropriate. In 12 years and over 400, 000 visits, Medicos has seen one-two cases. A separate section is indicated for acute otitis media. Medicos recommends following the literature that withholds antibiotic therapy for all illnesses resembling uncomplicated otitis media until the symptoms persist for at least 48-72 hours. In the first 2-3 days, alternating doses of Motrin and Tylenol can be given q2h. Most cases seen at Medicos, are mildly ill children with viral syndromes. We have had success and avoided the temptation to overprescribe antibiotics through the use of Periactin [cyproheptadine]liquid 2.5-5 cc po q6h prn. When vomiting is one of the symptoms, Phenergan or Benadryl syrup has seemed to be helpful. [FDA phenergan advisory noted] Parents are instructed to bring the child back to the office in 1-2 days if they are not improved. When otitis media is felt to require antibiotics, one injection is an acceptable strategy. We do not use 10 days as a standard length of treatment anymore. If the physician chooses po medication, a five-day course is sufficient. Note that the new recommended high dose of Amoxicillin is 80-90mg/kg/day. Single dose Ceftriaxone (Rocephin) IM is now approved for the treatment of bacterial otitis media. Children younger than two years and infants younger than three months merit special consideration. medicos has a low threshold for ordering a hemogram and chest radiograph. VI. Single Dose Regimens A. Uncomplicated Gonorrhea – Azithromycin 2gms po. B. Uncomplicated Chlamydia - Azithromycin 2gms po. Trichamoniasis – Metronidazole 2gms po. Now approved for 1st trimester. VII. RECOMMENDATIONS JUNE 2002( HYPERLINK "http://www.cdc.gov/std" www.cdc.gov/std) Chlamydia routine Doxycycline 100 mg bid x 7d Erythromycin 400 mg tid x 7d Gonorrhea—Ceftriaxone 125 mg IM is effective. We do not stock 125 mg and use 250 mg IM instead. Nongonococcal urethritis(NGU) Doxycycline 100 mg bid x 7d Azithromycin 1 Gram po. Cost can be a barrier among the uninsured Outpatient PID Ceftriaxone 250 mg IM plus doxycycline 100 mg bid with or without metronidazole 500 mg bid x 14 d is still recommended among other regimens. Recurrent Herpes [Clin Infect Dis 2002;34: 544-548] Acyclovir 800 mg po tid x 2d is as effective as 5 days. Valcyclovir 500mg x 3d is as effective as 5d IX. FLU VACCINE AND OTHER SACRED COWS `A. Reference: Yee, D. of the Associated press citing: Bridges,C. epidemioloist with Centers for Disease Control; Commercial Appeal, August 13, 2004; p A10 Vaccine effectiveness in healthy adults—52 % Among patients with previous medical conditions—38% B. Cochrane database group challenges flu vaccine data. BMJ 2006 as reported in the American Family Physician December 1, 2006; p 1825 XI. Perennial-Allergic Rhinitis Intranasal steroids with budesonide once daily achieved control of symptoms among 74% of patients compared to 50% who received Allegra 10 mg daily. [J Allergy Clin Immunology 2002;109:526-532 Commonly Useful Medications for Uninsured Patients; A Quality Improvement Study Providing Treatment at the Point of Service. Medicos para la Familia Original May 2000 (wmr 8-19-07) MedicineComments# PillsTotal ChargesALLERGY RELATED ILLNESSESBenadryl 25 mg tabs and injection30- titrate qhs$20Claritin 10 mg tabs30 daily$20Doxepine 25 mg tabs30 qhs$20Hydroxyzine[Atarax] 10 mg tabs30-titrate$20Prednisone 20 mg tabs14-2daily$20Steroid Cream-get triamcinolone medium strength 0.1% --30 Gram tube1 tube$20ANTIBIOTICS Amoxicillin caps 500mg30-tid20 Ciprofloxacin 250-500 mg tabs500mg bid20 Doxycycline tabs 100mg20-bid20 Metronidazole tabs 500mg14-bid20 Nitrofurnatoin Macrodantin 500 mg14-bid20 SulfaTrim[BACTRIM] tabs14-bid20 Clindamycin We can obtain others from pharmacyASTHMA/URI Robitussin DM 60 cc Siltussin120 cc$10 Periactin 2mg/5cc 60 cc$10 Albuterol nebulizer treatmentsBACK PAIN-musculoskeletal pain Ibuprofen tabs 400mg30-tid10 Flexeril 5-10 mg tabs cyclobenzaprine20-qhs,q6-8h prn20 Methocarbamol tabs 500mg[Robaxin]21-tid20DEPRESSION Amitryptiline 50 mgTitrate effect30-qhs20 Bupropion 150 mg or 100 mgconsideringNot available yet Desipramine tabs 50mg— 30 qhs20 Doxepine 50 mg tabs have 25 mg30 qhs20 Fluoxetine 20 mg30 daily$20 Trazadone 50 mg— DISCONTINUE qhs titrate 30 20DIABETES Glyburide consider for GDM Glucotrol [glipzide]XL 5mg3020 Glucophage tabs 500mg[Metformin]3030 Insulin injectable for emergenciesDYSPEPSIA/N/V Compazine 10mg tabs10$20 Phenergan injectableSee encounter form Pyridoxine 50 mg tab30-bid$10 Omeprazole 20mg30$30 Ranitidine tabs 150mg60$20EAR DROPS Cortisporin Otic$ 20 [3% acetic acic--white vinegar]10cc$ 10 EYE DROPS Sulamyd 10% OR Gentamicin$ 20 Tobramycin CromolynFEVER Acetaminophen tabs 325mg/Tylenol PM3010FLU/VIRAL Acyclovir 400 mg caps DISCONTINUED30-tid$20  Cyproheptadine Susp 2mg/5ml2 oz.10 Ibuprofen tabs 400mg3010HTN Atenolol tabs 50mg/Propranolol 20mg3020  Captopril 25mg3020 Clonidiine 0.1 mgUrgent Meds Metoprolol 50 mg3020 HCTZ tabs 25mg30 daily$ 20 Lisinopril tabs 10 mg30 daily$20 Nifedipine caps 10mg in ER boxUrgent MedsNot stocked Hydralazine 10 mgUrgent Meds Spironolactone 25 mg30$ 20PRENATAL Compazine 10 mg tabs1010 Misoprostol 200 ug tabs ER boxUrgent Meds Mulivitamins-prenatal3010 Pyridoxine 50 mg tabs3010 Ranitidine 150mg tabs3010PSYCHIATRIC Amitryptiline 50 mgTitrate 3020 Bupropion being considered Cogentin 2mg tabs[see red box-use rare]Urgent Meds Desipramine 50 mg tabs[not avail 3/06] Doxepine 25-50 mg tabs3020 Fluoxetine 20 mg3020 Haldol 5 mg tabs and injectableUrgent Meds Lorazepam 1 mg tabs---- in ER boxUrgent Meds Trazadone 50 mgDiscontiueTitrate30 qhs20RASH Benadryl Syrup$10 Steroid cream hydrocortisone or triamcinolone30 Grams$10 Hyroxyzine HCI 10mg (Atarax)# 30$10 Lotrimin cream15G $10COMING SOON ???????? Ketaconazole; previously tried but deleted claforan, lincocin, trazadone, These basic drugs will be available at Medicos as a service for those who would have difficulty interacting at an English-speaking pharmacy. *These prices reflect our costs for the medicines, shipping, handling, storage fee, and packaging.  Meds Order Form May 25, 2000 (wmr 9.5.01; 3-13-07) PO MedicinesInjectablesMiscellaneous (Elixirs, Supp, Sprays, Etc.)Vaccines Acetaminophen tabs 325mgAmpicillin 500mgAnestheticsDTaPAcyclovir 400mg tabsBenadryl 50mg/ml – 10mlCarbocaine 1%Hep B – Adult-not availableBicillin C-R 600Lidocaine 1% 30mlHep B – ChildAmoxicillin caps 500mgBicillin C-R 1.2mLidocaine 2%HibMetoprolol tabs 50mgBicillin C-R 2.4mLidocaine 2% ViscousInfluenza--referCaptopril tabs 25mgB-12 (Cyanocobalamin) 1mg/mlMarcaine 0.5% w ith epinephrine for surgeryPneumovax Cephalexin caps 500mgCefazolin IM 1 GramBupivicaineTdCompazine 10 mg tabsClaforan IM 500mg-1 GramCyproheptadine Susp 2mg/5mlCelestone Soluspan 5mlSpraysTetanus Toxoid [deleted]Desipramine tabs 50mgDepo Medrol 40mg/mlCetacaine Topical SprayTuberculin Skin TestDoxepine 25mg tabsDepo Provera 150mg/mlHurricane Spray(Pina Colada)PrevnarDoxycycline tabs 100mgDemerol 50 mg/mlVaricella-referFlexeril 5 mg tabsFluoxetine 20 mgEpinephrine 1mg/ml 30mlHep A referGlucophage tabs 500mgGentamicin 40mg/ml (80/2 ml); ?Order higher concentration?SuppositoriesPediarix= HIB, DtaP, not availHCTZ tabs 25mgInsulin Humulin R 100 unitsAcetaminophen supp 120mgGlyburide tabs 2.5 mgIbuprophen tabs 400mgNaloxone 4mg/mlAcetaminophen supp 325mgLisinopril 10 mg tabsAcetaminophen supp 650mgOxytocin 1ml, 10 usp unitsPhenergan supp 25mgMethocarbamol tabs 500mgPromethazine IM 25mg/ml [phenergan]Metronidazole tabs 500mg MiscellaneousRocephin 250mgLotrimin cream 15 gr; or Monistat or Tinactin Prednisone 20mg tabsRocephin 500mgPrenatal Vitamins tabsRocephin 1gBronkosol syrupRanitidine tabs 150mgRobitussin DMSterile Water 10mlSulamyd eye gttsSulfaTrim tabs DSToradol 30mg/mlCortisporin HC oticVistaril 50mg/ml – 10mlGeneric Vosol[vinegar] for otitis eterna     Antimicrobial Therapy for Common Infections  PAGE 13 Do starter samples with an Rx improve outcomes? YZmƒ…†‡ž£¤„øÄĘĒČŌÕī  \ l  £ ­ ± šąŌšŌĮąøą¬šąŌšŌ™ąøąš‰š‰šyoaSh5f'B*CJOJQJph’h!B*CJOJQJph’hG|-CJOJQJhG|-9B* CJOJQJph3fh>M9B* CJ(OJQJph3f%jłhG|-9B* CJ(Uph3fhV9B* CJ(ph3fhG|-0J9CJ(%jhG|-9B* CJ(Uph3fhG|-9B* CJ(ph3fjhG|-9B* CJ(Uph3fhG|-9B* CJ(OJQJph3f(¤Ö×Z Œ ¾  l  · ø ¹ Ä Å ų żõėėėįįįįįŽŽŌĻĒĻŗŖŗŗ$„Š„Š^„Š`„Ša$gdĻ[Ä $„Š„Š^„Š`„Ša$$ & F a$$a$ &dPĘ’@& $ & F@&a$ $„Š@&^„Ša$ $„h@&^„ha$£ŒģŒžžž± ¶ · ¹ Å Õ p q y z Ā Ć @ B Ė Ģ h‡ü—˜UŒœŚSrńēŻÓÉÓæÓæÓæÓµ« «ÓÉÓÉÓÉÓæÓæ–Ó‚k‚k]hG|-B*CJOJQJph’,h^@Śh^@Ś0J5B*CJOJQJ^Jph&hĻ[Ä0J5B*CJOJQJ^Jphh65CJOJQJhĻ[ÄCJH*OJQJhĻ[ÄCJOJQJhxp/CJOJQJhm;CJOJQJh“^tCJOJQJhG|-CJOJQJhG|-CJOJQJhG|-CJOJQJhG|-B*CJOJQJph’!TU“”ØĀŲė`o…ŹĖĢė45 ćäļźźźāāāāāāāāāāźźÕÕÕÕĢĢĢ$„Š^„Ša$ $„Š„0ż^„Š`„0ża$$ & Fa$$a$$„Š„Š^„Š`„Ša$gd65r’ĮĀ×Ųźė’"+_`np„…®¼ÉŹĖ.YZ[§Ø©ēčéė4UńćÓćÓćÓćÓćÓćÓćÓćÓćÓćÅćÓ·­£™£‹p‹d‹­£­hG|-0JCJOJQJ!jŹhG|-CJOJQJUhG|-CJOJQJjhG|-CJOJQJUh65CJOJQJh!CJOJQJhG|-CJOJQJhG|-B*CJOJQJph’h“^tB*CJOJQJph’hG|-B*CJOJQJaJph’hG|-B*CJOJQJph’hxp/B*CJOJQJph’&Ug ć»uĮĀĆŪgq­®u‹Œ¢¹»¼äåōõ')ŖĄĮ()Š·1EaghÅĘĪōēŻēŠēĆēĆŻē¶ē¶ēŻ¬ž“ž“ž“ž“ž“ž¬‰ō~ēŻēĆēĆēqēĆēĆhĒ$²5CJOJQJ\h ļ5CJOJQJh!CJOJQJhm;5CJOJQJhm;hm;5CJOJQJhm;CJOJQJh“^t5CJOJQJ\h655CJOJQJ\hĻ[Ä5CJOJQJ\hG|-CJOJQJhG|-5CJOJQJ\hG|-5CJOJQJ,仼ĀĆtuŖ«‰Š·ø™ š e"f"½#¾#(%)%g&h&w&x&ó꯯ŻŻŻŻŻęęęę꯯ŻęęęŻŲŲŲ$a$$„Š^„Ša$ $„Š„0ż^„Š`„0ża$ $„Š^„Ša$gdĻ[ÄĪō    , O ” ¢ « E"d"“"Ó"##Ō$ä$¹%Š%Õ%Ö%h&w&O/Q/ł/ū/…0Ų0€1‚1ƒ1'2)2*2š3ē3č3$4%4&4'4(4e4†4;5<5Š6Œ6óęŁóŁóŁóČøóęóęó«óžóžóžó“ó†ó†ó«ó†«ó†«óžó«ó«†«ó«óČó†h/]±5CJOJQJ\hG|-CJOJQJ\hā.ˆ5CJOJQJ\h“^t5CJOJQJ\h!hG|-5CJOJQJ\!hG|-5B*CJOJQJ\ph’hĒ$²5CJOJQJ\h655CJOJQJ\hG|-5CJOJQJ\2x&Ŗ(­)c*Q+K,`-*.O/ł/…0Ų0€1'2ź3%4<5Š6¹7h899óóāÓÓÓÓĒ···Ē····Ē····$„ ¤(¤(^„ a$gd/]± $ & F¤(¤(a$$ & F¤(¤(a$gd/]±$„8„Š¤(¤(^„8`„Ša$ $ & F ¤(¤(a$Œ66¹7»7¼7Ś7ļ7 8808h8j8k8×8999:9\:„:!;";$;óęŁóĢęæ²ĢęŁóę²ę„“~i~WE"h`.t5B*CJOJQJaJph"h˜5B*CJOJQJaJph(h`.th|©5B*CJOJQJaJph(h`.th˜5B*CJOJQJaJph"h`.th˜5CJOJQJ\aJh`.t5CJOJQJ\h2Ø5CJOJQJ\h!5CJOJQJ\h|©5CJOJQJ\h/]±5CJOJQJ\hG|-5CJOJQJ\h˜5CJOJQJ\9";#;$;%;4;e;“;¦<ē<??µ?·?—A˜A®AšäääÕĢĢ沄 „ „‹$a$$„¤(¤(^„a$gd/]±gd$= „ „Š^„ `„Šgd$= „Š„Š^„Š`„Šgd$= „8„h^„8`„hgd/]±„8^„8gd/]±$ & F¤(¤(a$gd/]± $¤(¤(a$gd`.t$ & F¤(¤(a$gd`.t$;%;4;5;V;W;c;d;•;–;a<Š<œ<<¦<>>>%>ä>?vA•A—A˜A­A®AŁA7DEDHDīÜŹ½Ź²Ź½„½˜½˜½„˜„˜„˜„Ž„wjwj\jhĒ$²hG|-CJOJQJ\hG|-5CJOJQJ\hG|-CJOJQJh/]±5CJOJQJ\hū B*aJphhā.ˆh2ØB*aJphhā.ˆh$=B*aJphhā.ˆh/]±0JaJhā.ˆh/]±B*aJph"jhā.ˆh/]±B*UaJph"hā.ˆh/]±5CJOJQJ\aJ"h`.th`.t5CJOJQJ\aJ®AĖA7DĀDVEaFbF£G¤GJIKIFJGJŁKŚK¹LŗLĘMĒM’O“O‡P÷īīīåååīåååąÓÓĒĒĒÓæą¶$„^„a$$ & F a$ $„Š^„Ša$gdĻ[Ä $„p„0ż^„p`„0ża$$a$$„p^„pa$$„ ^„ a$$ & F a$HD]DaDiDĘDŃDaFbFÆHłHIISIqIIŸI«IµIDJJJTJŁKĘMĒMŲMO‘OˆP”P“RÓRŌRS1SESŻSŽSßSäSTTóęóęÜęĖę¾±ę±ę±¤ę¤ęÜę—ęÜęóęÜęŠóŠęŠęŠó|q|hĒ$²CJOJQJ\hĒ$²hĒ$²CJOJQJ\h!5CJOJQJ\hĻ[Ä5CJOJQJ\hM(ż5CJOJQJ\hłsÆ5CJOJQJ\hū 5CJOJQJ\!hG|-5B*CJOJQJ\ph’hG|-CJOJQJhG|-5CJOJQJ\hĒ$²5CJOJQJ\'‡PˆPTRHUÕUÖUDVEV”VŖVĆVēVW2W3W•W–WĢXZZZņźŻŻŲņĻĘ¹¹¹¹¹ĻĘņʬ¬Ų $„p„Š^„p`„Ša$ $„ „Š^„ `„Ša$$„p^„pa$$„ ^„ a$$a$ $„„h^„`„ha$$ & Fa$ $„p„0ż^„p`„0ża$T+TCTFTmToTT½TČTGUÕUŁUžUEVFV”V•VŖV«VĆVÄVēVčVWWW W#W$W)W*W.W/WZZZz]^ńęńęŲńęńęŹ½³½£½£½£½£½£½£½“½“½“½“½‚³tfh ļh ļ5CJOJQJh ļhG|-5CJOJQJ!hG|-5B*CJOJQJ\ph’ j°šhG|-5CJOJQJ\ jØšhG|-5CJOJQJ\hG|-CJOJQJhG|-5CJOJQJ\hĒ$²hG|-CJOJQJ\hĒ$²hĒ$²CJOJQJ\hĒ$²CJOJQJ\hĒ$²h!CJOJQJ\%ZŸ[Œ\z]^^ __aaabbblc§cńcPdČdüdżdeŒf÷gööööńäńä×ĪńĘ¾¾¾¾¾ńµää$„Š^„Ša$$ & F a$$ & F a$$„p^„pa$ $„ „0ż^„ `„0ża$ $„p„0ż^„p`„0ża$$a$$„Š`„Ša$^^^<^__²_`«`Ģ`a/a|?|M|ōźęŪźęźŃźęźęźęŪęźęźŃĆźęźęźęŪźęźęźµĆęźęźµźęźęŪō„ōęŪęźµźęźęźęźęŪźęŪhG|-B*CJOJQJ\ph’hG|-B* CJOJQJph€hG|-B*CJOJQJph’h¾U+CJOJQJhG|-5CJOJQJhG|-hG|-CJOJQJhG|-CJOJQJ\AÕxÖxįxāxćxäxbTGGG $¤¤$Ifa$ Ęx@¤¤$Ifkd]$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTäxåxyy yybTGGG $¤¤$Ifa$ Ęx@¤¤$Ifkd'$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTyy%y&y,y0ybTGGG $¤¤$Ifa$ Ęx@¤¤$Ifkdń$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT0y1yQyRySyTybTGGG $¤¤$Ifa$ Ęx¤¤$Ifkd»$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTTyUytybX ¤¤$Ifkd…$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTtyuy‹yŒy“y–y›€€€ $¤¤$Ifa$ Ęg€¤¤$IfdkdO$$IfT–lÖÖųżn#v%Ö0’’’’’’ö6ööÖ’Ö’Ö’Ö’4Ö laödžŠT–y—y“yÄyÅyÖyŁybTC666 $¤¤$Ifa$ ĘxĄ¤¤$Ifgd¾U+ ĘxĄ¤¤$Ifkd×$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTŁyŚyŪyÜyŻyŽybTGGG $¤¤$Ifa$ ĘxĄ¤¤$Ifkd”$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTŽyßyzz z zbTGGG $¤¤$Ifa$ ĘxĄ¤¤$Ifkdk$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT zzzzzzbXKKK $¤¤$Ifa$ ¤¤$Ifkd5$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTzz8zGzNzQzbTJ== $¤¤$Ifa$ ¤¤$If ĘxĄ¤¤$Ifkd’$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTQzRzuzvz‚z”zbTGGG $¤¤$Ifa$ ĘxĄ¤¤$IfkdÉ$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT”z•z®zÆz¶z¹zbTGGG $¤¤$Ifa$ ĘxĄ¤¤$Ifkd“$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT¹zŗzązįzčzėzbTGGG $¤¤$Ifa$ ĘxĄ¤¤$Ifkd]$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTėzģzžz’z{ {bTGGG $¤¤$Ifa$ ĘxĄ¤¤$Ifkd'$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT { {‡{bX ¤¤$Ifkdń$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT‡{ˆ{‘{’{›‘-dkdC$$IfT–lÖÖųżn#v%Ö0’’’’’’ö6ööÖ’Ö’Ö’Ö’4Ö laödžŠT ¤¤$Ifdkd»$$IfT–lÖÖųżn#v%Ö0’’’’’’ö6ööÖ’Ö’Ö’Ö’4Ö laödžŠT’{“{µ{¶{·{ø{Ś{Ū{Ž{ńäääGńääkdĖ$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT $¤¤$Ifa$ ĘxĄ¤¤$IfŽ{į{ā{||| |ņUGņņņ ĘxĄ¤¤$Ifkd•$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT $¤¤$Ifa$ | |6|7|8|9|bTGGG $¤¤$Ifa$ ĘxĄ¤¤$Ifkd_ $$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT9|:|;|<|=|>|bXKKK $¤¤$Ifa$ ¤¤$Ifkd)!$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT>|?|M|N|O|P|bXKKK $¤¤$Ifa$ ¤¤$Ifkdó!$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTM|P|Q|n|o|”|¢|Ė|Ģ|ė|ģ| } }}}}}3}4}m}n}}}€}}‹}Ž}}±}²}Ļ}Š}ģ}ķ}ó}ö}÷}#~$~.~1~2~N~[~h~i~j~k~n~o~–~—~“~µ~¶~¹~ŗ~¾~Į~Ā~ī~ļ~ś~ū~-9;<[\öņöņöņöņöņöņēöņēöņöņēöņēöņöņöņŻŁēöņöņēöņöĻöņöĮöņöņöņēöņēöņöņŻŁöņö³öņöņhG|-B*CJOJQJph’hG|-B* CJOJQJph€h²CƒCJOJQJh¾U+h¾U+CJOJQJhG|-5CJOJQJhG|-hG|-CJOJQJFP|Q|f|g|j|n|bTGGG $¤¤$Ifa$ Ę–¤¤$Ifkd½"$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTn|o|Œ||Ž|”|bTGGG $¤¤$Ifa$ Ę–¤¤$Ifkd‡#$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT”|¢|æ|Ą|Ē|Ė|bTGGG $¤¤$Ifa$ Ę–¤¤$IfkdQ$$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTĖ|Ģ|ć|ä|ē|ė|bTJ== $¤¤$Ifa$ ¤¤$If Ę–¤¤$Ifkd%$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTė|ģ|}}} }bTGGG $¤¤$Ifa$ Ę–¤¤$Ifkdå%$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT } }}}}}bXKKK $¤¤$Ifa$ ¤¤$IfkdÆ&$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT}},}-}.}3}bXKKK $¤¤$Ifa$ ¤¤$Ifkdy'$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT3}4}b}c}h}m}bXKKK $¤¤$Ifa$ ¤¤$IfkdC($$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTm}n}}}~}}€}bXKKK $¤¤$Ifa$ ¤¤$Ifkd )$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT€}}‹}Œ}}Ž}bXKKK $¤¤$Ifa$ ¤¤$Ifkd×)$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTŽ}}Ŗ}«}¬}±}bXKKK $¤¤$Ifa$ ¤¤$Ifkd”*$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT±}²}Ģ}Ķ}Ī}Ļ}bXKKK $¤¤$Ifa$ ¤¤$Ifkdk+$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTĻ}Š}é}ź}ė}ģ}bXKKK $¤¤$Ifa$ ¤¤$Ifkd5,$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTģ}ķ}ó}ō}õ}ö}bXKKK $¤¤$Ifa$ ¤¤$Ifkd’,$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTö}÷}~~ ~#~bTGGG $¤¤$Ifa$ ĘŠ¤¤$IfkdÉ-$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT#~$~.~/~0~1~bXKKK $¤¤$Ifa$ ¤¤$Ifkd“.$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT1~2~\~]~d~h~bTGGG $¤¤$Ifa$ ĘVĄ¤¤$Ifkd]/$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTh~i~k~l~m~n~bQDDD $¤¤$Ifa$ ĘVĄ¤¤$Ifgd²Cƒkd'0$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTn~o~Œ~~“~–~bTGGG $¤¤$Ifa$ Ę<@¤¤$Ifkdń0$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT–~—~­~®~±~“~bTGGG $¤¤$Ifa$ ĘxĄ¤¤$Ifkd»1$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT“~µ~¶~·~ø~¹~bXKKK $¤¤$Ifa$ ¤¤$Ifkd…2$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT¹~ŗ~¾~æ~Ą~Į~bXKKK $¤¤$Ifa$ ¤¤$IfkdO3$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTĮ~Ā~ē~č~ė~ī~bTGGG $¤¤$Ifa$ Ęg€¤¤$Ifkd4$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTī~ļ~÷~ų~ł~ś~bTGGG $¤¤$Ifa$ Ęg€¤¤$Ifkdć4$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTś~ū~  bTGGG $¤¤$Ifa$ ĘgĄ¤¤$Ifkd­5$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT-9:;bTGGG $¤¤$Ifa$ ĘxĄ¤¤$Ifkdw6$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT;<TUX[bTGGG $¤¤$Ifa$ ĘxĄ¤¤$IfkdA7$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT[\lmv{bTGGG $¤¤$Ifa$ ĘxĄ¤¤$Ifkd 8$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT\{|Ø©ŖÉÕāćźūü€ € €€'€0€1€:€=€>€b€c€ƒ€Š€–€˜€™€¾€æ€ä€å€   <KLVqtu„±³“¼ćęöņöņöäÖöņĢæ²Ģöņ§œöņ§öņöņöäÖöņöņöņöņ§öņ§öņœöņœŒöņœÖöņ§œöhG|-B* CJOJQJ\ph€hG|-CJOJQJ\hG|-5CJOJQJh²CƒhG|-CJOJQJh²Cƒh²CƒCJOJQJh²CƒCJOJQJhG|-B*CJOJQJph’hG|-B* CJOJQJph€hG|-hG|-CJOJQJ7{|š›¤ØbTGGG $¤¤$Ifa$ Ęx¤¤$IfkdÕ8$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTØ©ÉÕÖābTGGG $¤¤$Ifa$ Ęx¤¤$IfkdŸ9$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTāćü€ € €bXXKK $¤¤$Ifa$ ¤¤$Ifkdi:$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT € €'€(€+€0€bXXKK $¤¤$Ifa$ ¤¤$Ifkd3;$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT0€1€:€;€<€=€bXKKK $¤¤$Ifa$ ¤¤$Ifkdż;$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT=€>€[€\€_€b€bTGGG $¤¤$Ifa$ ĘV@¤¤$IfkdĒ<$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTb€c€Š€–€—€˜€bTGGG $¤¤$Ifa$ ĘV@¤¤$Ifkd‘=$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT˜€™€·€ø€»€¾€bTGGG $¤¤$Ifa$ ĘV@¤¤$Ifkd[>$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT¾€æ€Ż€Ž€į€ä€bTGGG $¤¤$Ifa$ ĘV@¤¤$Ifkd%?$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTä€å€ bTGGG $¤¤$Ifa$ ĘV@¤¤$Ifkdļ?$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT     bXKKK $¤¤$Ifa$ ¤¤$Ifkd¹@$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTbXKKK $¤¤$Ifa$ ¤¤$IfkdƒA$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT<EHKbXKKK $¤¤$Ifa$ ¤¤$IfkdMB$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTKLqrstbXKKK $¤¤$Ifa$ ¤¤$IfkdC$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTtu„±²³bXKKK $¤¤$Ifa$ ¤¤$IfkdįC$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT³“ćäåębXKKK $¤¤$Ifa$ ¤¤$Ifkd«D$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTęē‚‚ ‚ ‚bXKKK $¤¤$Ifa$ ¤¤$IfkduE$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTęēļ‚ ‚‚'‚.‚/‚7‚W‚c‚e‚f‚g‚j‚k‚q‚‹‚•‚”‚£‚¤‚½‚Č‚Ś‚Ū‚ą‚ć‚ä‚ś‚ū‚>ƒ?ƒgƒhƒ}ƒ~ƒ–ƒ—ƒ˜ƒ­ƒ®ƒśƒūƒüƒżƒī„š„üńęÜüęÜüńęĪÜüńÜüńę¾ĪÜüę®ÜüńÜüÜüÜüÜüܦüšüšü‹üšüšühG|-5CJOJQJ\aJhG|-CJOJQJaJhG|-OJQJhG|-B*CJOJQJ\ph’hG|-B* CJOJQJ\ph€hG|-B*CJOJQJph’hG|-CJOJQJhG|-CJOJQJ\hG|-5CJOJQJhG|-0 ‚‚'‚(‚+‚.‚bXKKK $¤¤$Ifa$ ¤¤$Ifkd?F$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT.‚/‚W‚c‚d‚e‚bXKKK $¤¤$Ifa$ ¤¤$Ifkd G$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTe‚f‚g‚h‚i‚j‚bXKKK $¤¤$Ifa$ ¤¤$IfkdÓG$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTj‚k‚•‚”‚¢‚£‚bXKKK $¤¤$Ifa$ ¤¤$IfkdH$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT£‚¤‚Č‚Š‚ׂŚ‚bXKKK $¤¤$Ifa$ ¤¤$IfkdgI$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTŚ‚Ū‚ą‚į‚ā‚ć‚bXKKK $¤¤$Ifa$ ¤¤$Ifkd1J$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTć‚ä‚ō‚õ‚ö‚ś‚bTGGG $¤¤$Ifa$ Ęg@¤¤$IfkdūJ$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTś‚ū‚0ƒ1ƒ:ƒ>ƒbTGGG $¤¤$Ifa$ Ęg€¤¤$IfkdÅK$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT>ƒ?ƒ]ƒ^ƒcƒgƒbTGGG $¤¤$Ifa$ Ęg€¤¤$IfkdL$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠTgƒhƒ~ƒƒƒƒ•ƒb\\\\$IfkdYM$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT•ƒ–ƒ—ƒb\$Ifkd#N$$IfT–lÖÖ\ųż©£én#±śF… Ö0’’’’’’ö6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laödžŠT—ƒ˜ƒ­ƒ®ƒÆƒśƒ›•1••dkduO$$IfT–lÖÖųżn#v%Ö0’’’’’’ö6ööÖ’Ö’Ö’Ö’4Ö laödžŠT$IfdkdķN$$IfT–lÖÖųżn#v%Ö0’’’’’’ö6ööÖ’Ö’Ö’Ö’4Ö laödžŠTśƒūƒüƒżƒļ„›•1•dkd…P$$IfT–lÖÖųżn#v%Ö0’’’’’’ö6ööÖ’Ö’Ö’Ö’4Ö laödžŠT$IfdkdżO$$IfT–lÖÖųżn#v%Ö0’’’’’’ö6ööÖ’Ö’Ö’Ö’4Ö laödžŠTļ„š„ń„ņ„ó„ō„õ„ö„÷„ų„ł„ś„ū„ü„ż„ž„’„…›––––––––––––––––$a$dkd Q$$IfT–lÖÖųżn#v%Ö0’’’’’’ö6ööÖ’Ö’Ö’Ö’4Ö laödžŠTš„ń„……4…5…6…]…{………†…°…¼…Į…Ā…Ū…Ü…††† †R†S††Ž†Ó†Ś†Ū†Ü†D‡E‡o‡{‡~‡‡­‡®‡Æ‡°‡Ä‡ģŁģĶɹŖ›Ŗ’ˆ|ˆÉˆÉˆrˆÉˆÉˆÉˆrˆÉˆÉˆgˆÉˆ|ˆÉˆhG|-5OJQJ\h²CƒCJOJQJhG|-CJOJQJaJhG|-CJOJQJhG|-5CJ\hG|-59B* CJ\ph€hG|-59B* CJ\ph€hG|-B*CJOJQJ^Jph’hG|-hG|-9B* CJph€%h¾U+59B* CJ,OJQJaJ,ph€%hG|-59B* CJ,OJQJaJ,ph€'……4…5…6…C…O…]…{…„………ł÷õóźźźźźź $$Ifa$$@&a$ ……†…Ÿ…°…¼…1++%$If$IfĶkd•Q$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’ŁŁŁ’ŁŁŁ’ŁŁŁ’ŁŁŁÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’ŁŁŁ’ŁŁŁ’ŁŁŁ’ŁŁŁŠT¼…Į…Ā…Ų…Ł…Ś…Ū…ł6łłłłĀkdÉR$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ’’’’’ŁŁŁÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ’’’’’’’’’’’’’’’’’’’’’ŁŁŁŠT$IfŪ…Ü…Ż…õ…††b\\\\$IfkdŁS$$IfT–lÖÖ\”’ę 4B!Č(R N  †Ö0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöŠT† †!†2†D†R†b\\\\$IfkdžT$$IfT–lÖÖ\”’ę 4B!Č(R N  †Ö0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöŠTR†S†j†|†‰††b\\\\$IfkdcU$$IfT–lÖÖ\”’ę 4B!Č(R N  †Ö0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöŠT†Ž†£†µ†Ź†Ū†b\\\\$Ifkd(V$$IfT–lÖÖ\”’ę 4B!Č(R N  †Ö0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöŠTŪ†Ü†š† ‡9‡D‡b\\\\$IfkdķV$$IfT–lÖÖ\”’ę 4B!Č(R N  †Ö0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöŠTD‡E‡[‡o‡{‡~‡b\\V\$If$Ifkd²W$$IfT–lÖÖ\”’ę 4B!Č(R N  †Ö0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöŠT~‡‡”‡­‡®‡Æ‡b\\V\$If$Ifkd…X$$IfT–lÖÖ\”’ę 4B!Č(R N  †Ö0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöŠTƇ°‡Ģ‡ć‡ź‡ł‡<6606$If$IfĀkdXY$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ’’’’’ŁŁŁÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ’’’’’’’’’’’’’’’’’’’’’ŁŁŁŠTćĖ‡ć‡ź‡ś‡ˆˆˆˆˆ[ˆ\ˆŖˆ«ˆÓˆŌˆÜˆćˆäˆåˆłˆśˆūˆüˆ%‰&‰1‰2‰3‰f‰„‰’‰°‰±‰²‰÷‰ų‰ŠŠRŠSŠ„Š…Š¶Š·ŠöŠ÷Š‹ ‹!‹"‹b‹c‹g‹h‹Ž‹‹Ä‹Å‹Ž‹ß‹ŒŒJŒōźŽźŠĀŠź¾ź¾ź¾ź¶ź¬ź¾ź¶ź¾ź¶¬ź¾źŠŽ¬ź¾ź¾ź¾ź¾ź¾ź¾ź¾ź”ź¾ź¾ź¾ź¾ź¾ź¾ź¾źhG|-5OJQJaJh²CƒCJOJQJhG|-OJQJhG|-h²CƒB*CJOJQJph’hG|-B*CJOJQJph’hG|-CJOJQJaJhG|-CJOJQJhG|-CJOJQJaJ?ł‡ˆˆˆ.ˆFˆ[ˆł6łłłłĀkdhZ$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ’’’’’ŁŁŁÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ’’’’’’’’’’’’’’’’’’’’’ŁŁŁŠT$If[ˆ\ˆoˆ…ˆ¢ˆŖˆb\\\\$Ifkdx[$$IfT–lÖÖ\”’ę 4B!Č(R N  †Ö0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöŠTŖˆ«ˆĀˆÓˆŌˆäˆb\\V\$If$IfkdK\$$IfT–lÖÖ\”’ę 4B!Č(R N  †Ö0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöŠTäˆåˆųˆłˆśˆ1++%$If$IfĶkd]$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠTśˆūˆüˆ ‰%‰ł+łłĶkdR^$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’ąąą’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’ąąą’ąąąŠT$If%‰&‰2‰3‰I‰łó%óĶkd†_$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’ąąą’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’ąąą’ąąąŠT$If$IfI‰„‰’‰±‰²‰łół%Ķkdŗ`$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’ąąą’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’ąąą’ąąąŠT$If$If²‰Į‰Ż‰ö‰÷‰łłłł$If÷‰ų‰ŠŠŠ1+++$IfĶkdīa$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠTŠŠŠ(Š8Šł+łłĶkdc$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$If8ŠQŠRŠSŠiŠłł+łĶkd:d$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$IfiŠjŠƒŠ„Š…Šłłł+Ķkd`e$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$If…Š†Š”ŠµŠ¶Šłłłł$If¶Š·ŠŠŠōŠõŠ1+++$IfĶkd†f$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠTõŠöŠ÷Š‹‹ł+łłĶkdŗg$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$If‹‹ ‹!‹"‹łłł+Ķkdąh$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’ąąą’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’ąąą’ąąąŠT$If"‹#‹2‹`‹a‹b‹łłłłł$Ifb‹c‹d‹e‹f‹1+++$IfĶkdj$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’’’ŁŁŁÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ŁŁŁŠTf‹g‹h‹}‹Œ‹ł+łłĶkd:k$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$IfŒ‹‹Ž‹‹§‹łł+łĶkd`l$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$If§‹³‹Ć‹Ä‹Å‹łłł+Ķkd†m$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$IfŋŪ‹Ü‹Ż‹Ž‹łłłł$IfŽ‹ß‹ķ‹ŒŒ1+++$IfĶkd¬n$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠTŒŒŒ%Œ5Œł+łłĶkdŅo$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$If5ŒIŒJŒKŒLŒłł+łĶkdųp$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$IfJŒKŒLŒŽŒŒ“Œ”Œ˜Œ™ŒšŒ£Œ¤Œ¦Œ§Œ©ŒŖŒ¬Œ­ŒÆŒÜŒŻŒćŒäŒęŒēŒčŒéŒėŒģŒ üīäüäüäüŚĖĆæĆæĆæĆæ·©Ÿ©©ŸŠüæyyüĖ hG|-CJhG|-5CJOJQJ hG|-0Jhiq0JOJQJmHnHuhG|-0JOJQJjhG|-0JOJQJUhG|-OJQJh¤Cšjh¤CšUhG|-5CJOJQJ\aJhG|-CJOJQJhG|-CJOJQJhG|-B*CJOJQJph’hG|-"LŒdŒŒŽŒŒłłł+Ķkdr$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’ąąą’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’ąąą’ąąąŠT$IfŒŒ‘Œ’Œ“Œłłłł$If“Œ”Œ•Œ–Œ—Œ1+++$IfĶkdRs$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’’’’’ąąą’ąąąÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’’’’’’’’’’’’’’’’’’’’’ąąą’ąąąŠT—Œ˜Œ™ŒšŒł+&$a$Ķkd†t$$IfT–lÖÖ\”’ę 4B!Č(R N  † ÖÖ(’ŁŁŁ’’’ŁŁŁ’ŁŁŁÖ0’’’’’’ö4)6ööÖ’’’’Ö’’’’Ö’’’’Ö’’’’4Ö laöpÖ(’ŁŁŁ’’’’’’’’’’’ŁŁŁ’ŁŁŁŠT$IfšŒ›ŒœŒŒžŒŸŒ Œ”Œ¢Œ£Œ„Œ¦ŒØŒ©Œ«Œ¬Œ®ŒÆŒčŒéŒźŒėŒģŒ śśśśśśśśõóóóóóóóóńńńóóóóóóõ$a$$a$# 0&P°Š/ °ą=!°š"°š#`$@%°łDŠÉźyłŗĪŒ‚ŖK© www.medicosmundial.comąÉźyłŗĪŒ‚ŖK© Vhttp://www.medicosmundial.com/yXō;HÆ,‚]ą'c„«ŃDŠÉźyłŗĪŒ‚ŖK©  www.psot.comąÉźyłŗĪŒ‚ŖK© Bhttp://www.psot.com/yXō;HÆ,‚]ą'c„«‰DŠÉźyłŗĪŒ‚ŖK© ?http://bmj.bmjjournals.com/cgi/content/short/333/7574/912?ehomąÉźyłŗĪŒ‚ŖK© –http://bmj.bmjjournals.com/cgi/content/short/333/7574/912?ehomyXō;HÆ,‚]ą'c„«ĆDŠÉźyłŗĪŒ‚ŖK© www.cdc.gov/stdąÉźyłŗĪŒ‚ŖK© .http://www.cdc.gov/std)$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –l ÖÖ(’ŁŁŁ’ŁŁŁ’ŁŁŁ’ŁŁŁÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžpÖ(’ŁŁŁ’ŁŁŁ’ŁŁŁ’ŁŁŁŠT†$$If–dž!vh5Öv%#vv%:V –lÖ0’’’’’’ö6ö5Öv%4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠT†$$If–dž!vh5Öv%#vv%:V –lÖ0’’’’’’ö6ö5Öv%4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠT†$$If–dž!vh5Öv%#vv%:V –lÖ0’’’’’’ö6ö5Öv%4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠT†$$If–dž!vh5Öv%#vv%:V –lÖ0’’’’’’ö6ö5Öv%4ÖaödžŠT†$$If–dž!vh5Öv%#vv%:V –lÖ0’’’’’’ö6ö5Öv%4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠTČ$$If–dž!vh5Ö±5Öś5ÖF5Ö… #v±#vś#vF#v… :V –lÖ0’’’’’’ö6ö5Ö±5Öś5ÖF5Ö… 4ÖaödžŠT†$$If–dž!vh5Öv%#vv%:V –lÖ0’’’’’’ö6ö5Öv%4ÖaödžŠT†$$If–dž!vh5Öv%#vv%:V –lÖ0’’’’’’ö6ö5Öv%4ÖaödžŠT†$$If–dž!vh5Öv%#vv%:V –lÖ0’’’’’’ö6ö5Öv%4ÖaödžŠT†$$If–dž!vh5Öv%#vv%:V –lÖ0’’’’’’ö6ö5Öv%4ÖaödžŠT†$$If–dž!vh5Öv%#vv%:V –lÖ0’’’’’’ö6ö5Öv%4ÖaödžŠT2$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’ŁŁŁ’ŁŁŁ’ŁŁŁ’ŁŁŁÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†/Ö ’4ÖpÖ(’ŁŁŁ’ŁŁŁ’ŁŁŁ’ŁŁŁŠT$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ’’’’’ŁŁŁÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖpÖ’’’’’’’’’’’’’’’’’’’’’ŁŁŁŠTĆ$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –lÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖŠTĆ$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –lÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖŠTĆ$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –lÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖŠTĆ$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –lÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖŠTĆ$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –lÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖŠTŃ$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –lÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†/Ö ’4ÖŠTŃ$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –lÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†/Ö ’4ÖŠT$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ’’’’’ŁŁŁÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖpÖ’’’’’’’’’’’’’’’’’’’’’ŁŁŁŠT$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ’’’’’ŁŁŁÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖpÖ’’’’’’’’’’’’’’’’’’’’’ŁŁŁŠTŃ$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –lÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†/Ö ’4ÖŠTŃ$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –lÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†/Ö ’4ÖŠT2$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†/Ö ’4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT2$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’ąąą’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†/Ö ’4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’ąąą’ąąąŠT2$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’ąąą’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†/Ö ’4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’ąąą’ąąąŠT2$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’ąąą’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†/Ö ’4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’ąąą’ąąąŠT$$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT2$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†/Ö ’4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT2$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’ąąą’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†/Ö ’4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’ąąą’ąąąŠT$$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’’’ŁŁŁÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ŁŁŁŠT$$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT$$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’’’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ąąąŠT2$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’ąąą’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†/Ö ’4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’ąąą’ąąąŠT2$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’’’’’ąąą’ąąąÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†/Ö ’4ÖpÖ(’’’’’’’’’’’’’’’’’’’’’ąąą’ąąąŠT2$$If–!vh5ÖR 5ÖN 5Ö 5Ö†#vR #vN #v #v†:V –l ÖÖ(’ŁŁŁ’’’ŁŁŁ’ŁŁŁÖ0’’’’’’ö4)6ö5ÖR 5ÖN 5Ö 5Ö†/Ö ’4ÖpÖ(’ŁŁŁ’’’’’’’’’’’ŁŁŁ’ŁŁŁŠTœ<@ń’< NormalCJ_HmH sH tH N@N  Heading 1$$@&a$5B*CJ\ph’>@>  Heading 2$@& 5CJ\DA@ņ’”D Default Paragraph FontVi@ó’³V 0 Table Normal :V ö4Ö4Ö laö (kō’Į( 0No List FB@ņF  Body Text$a$5CJ OJQJ\>>@> Title$a$5CJ OJQJ\4@4 Header  ĘąĄ!4 "4 Footer  ĘąĄ!.)@¢1.  Page NumberF%@BF Envelope Return OJQJ^J<J@R< Subtitle$a$ 5CJ\6U@¢a6  Hyperlink >*B*ph’RYrR  Document Map-D MĘ ’€ OJQJ^J*W@¢* ^@Ś`Strong5\H™’H 1RŃ0 Balloon TextCJOJQJ^JaJ6ž¢”6 1RŃ0 CharCJOJQJ^JaJ12 …’’’’’’’’’’’’’’’’125’’ …ā’’’’(¤Ö×ZŒ¾l·ø¹ÄÅųżT U “ ” Ø Ā Ų ė  ` o … Ź Ė Ģ ė 4 5 ć仼ĀĆtuŖ«‰Š·ø™šef½¾()ghwxŖ ­!c"Q#K$`%*&O'ł'…(Ų(€)'*ź+%,<-Š.¹/h011"3#3$3%343e3“3¦4ē477µ7·7—9˜9®9Ė97<Ā<V=a>b>£?¤?JAKAFBGBŁCŚC¹DŗDĘEĒE’G“G‡HˆHTJHMÕMÖMDNEN”NŖNĆNēNO2O3O•O–OĢPRRRŸSŒTzUVV WWYYaZbZl[§[ń[P\Č\ü\ż\]Œ^÷_ų_RaSabbFcGcee™fšfIgKgdgeg™gĶghhohph‚hžh¼hi:iVi˜i§i4jhj jĶjój’kækók{l|ll_mßmųmnn"n+n3nAnBn\n]nn€nn”n•n©nŖn³n·nønĢnĶnŌnŲnŁnųnłnoo oo o*o.o/osoto{oo€oŒoo„o¦o­o°o±o×oŲoāoåoęožo’op p p$p%p,p/p0pZp[pbpepfpp€p‡pŠp‹pŸp p”p¢p£p¤p„p¦p§pØpŅpÓpŌpÕpÖpįpāpćpäpåpqq qqq%q&q,q0q1qQqRqSqTqUqtquq‹qŒq“q–q—q“qÄqÅqÖqŁqŚqŪqÜqŻqŽqßqrr r rrrrrrr8rGrNrQrRrurvr‚r”r•r®rÆr¶r¹rŗrąrįrčrėrģržr’rs s s‡sˆs‘s’s“sµs¶s·søsŚsŪsŽsįsāsttt t t6t7t8t9t:t;tt?tMtNtOtPtQtftgtjtntotŒttŽt”t¢tætĄtĒtĖtĢtćtätētėtģtuuu u uuuuuu,u-u.u3u4ubucuhumunu}u~uu€uu‹uŒuuŽuuŖu«u¬u±u²uĢuĶuĪuĻuŠuéuźuėuģuķuóuōuõuöu÷uvv v#v$v.v/v0v1v2v\v]vdvhvivkvlvmvnvovŒvv“v–v—v­v®v±v“vµv¶v·vøv¹vŗv¾vævĄvĮvĀvēvčvėvīvļv÷vųvłvśvūv w wwww-w9w:w;wx[x\x_xbxcxŠx–x—x˜x™x·xøx»x¾xæxŻxŽxįxäxåxyyy y y y y yyyyyyyy{?{]{^{c{g{h{~{{ƒ{•{–{—{˜{­{®{Æ{ś{ū{ü{ż{ļ|š|ń|ņ|ó|ō|õ|ö|÷|ų|ł|ś|ū|ü|ż|ž|’|}}4}5}6}C}O}]}{}„}…}†}Ÿ}°}¼}Į}Ā}Ų}Ł}Ś}Ū}Ü}Ż}õ}~~ ~!~2~D~R~S~j~|~‰~~Ž~£~µ~Ź~Ū~Ü~š~ 9DE[o{~”­®Æ°Ģćźł€€€.€F€[€\€o€…€¢€Ŗ€«€Ā€Ó€Ō€ä€å€ų€ł€ś€ū€ü€ %&23I„’±²ĮŻö÷ų‚‚‚‚‚(‚8‚Q‚R‚S‚i‚j‚ƒ‚„‚…‚†‚”‚µ‚¶‚·‚Š‚ō‚õ‚ö‚÷‚ƒƒƒ ƒ!ƒ"ƒ#ƒ2ƒ`ƒaƒbƒcƒdƒeƒfƒgƒhƒ}ƒŒƒƒŽƒƒ§ƒ³ƒĆƒÄƒÅƒŪƒÜƒŻƒŽƒßƒķƒ„„„„%„5„I„J„K„L„d„„Ž„„„‘„’„“„”„•„–„—„˜„™„š„›„œ„„ž„Ÿ„ „”„¢„£„„„¦„Ø„©„«„¬„®„Æ„č„é„ź„ė„ģ„………!…0€€0€€0€€0€€ 0€€ 0€€€ 0€€€ 0€€€ 0€€€0€€€0€€€˜0€€˜0€˜ 0€˜0€€˜0€˜0€˜0€˜0€˜0€˜0€˜0€˜0€˜ 0€˜ 0€p˜ 0€p˜ 0€p˜ 0€p˜ 0€p˜ 0€p˜ 0€˜ 0€ˆ˜ 0 €p˜0€˜0€˜0€p˜0€p˜0€p˜0€p˜0€˜0€p˜0€p˜0€p˜0€p˜0€p˜0€p˜0€˜0€p˜0€ˆ˜0€ˆ˜0€ˆ˜0€˜0€p˜0€p˜0€p˜0€p˜0€p˜0€p˜0€ˆ˜0€˜0€p˜0€p˜0€˜0€˜0€p˜0€p˜ 0€p˜ 0€ˆ˜0€ˆ˜ 0€ˆ˜ 0€ˆ˜ 0€ˆ˜ 0€ ˜ 0€p˜0€p˜0€p˜0€p˜ 0€ˆ˜0€˜0€p˜0€p˜0€˜ 0€˜0€p˜0€˜0€p˜0€p˜ 0€p˜0€0˜0€p˜0€p˜ 0€p˜0€p˜0€p˜0€ˆ˜0€˜0€p˜0€p˜0€ˆ˜0€ˆ˜0€p˜0€˜0€p˜ 0€ˆ˜0€p˜0€ˆ˜0€˜0€p˜0€8˜0€p˜0€p˜0€p˜0€p˜0€p˜0€˜0€p˜0€p˜0€˜0€˜0€p˜0€p˜ 0€p˜0€˜0€ˆ˜0€ˆ˜ 0€ˆ˜0€p˜0€H˜0€p˜0€p˜0€p˜0€p˜0€˜0€˜0€p˜0€p˜0€p˜0€p˜0€p˜0€p˜0€˜0€p˜0€ˆ˜0€ˆ˜0€ˆ˜0€ˆ˜0€ˆ˜0€ˆ˜0€˜0€ €˜0€P˜0€p˜0€p˜0€p˜0€p˜ 0€p˜ 0bZˆ˜ 0bZ˜ 0bZp˜ 0bZp˜ 0bZˆ˜0€ˆ˜0€ˆ˜0€ˆ˜0€ˆ˜0€ˆ˜0€ˆ˜0€˜0€ˆ˜0€p˜ 0€˜0€ˆ˜0€`˜0€p˜0€p˜0€p˜0€p˜0€p˜0€˜0€˜0€˜0€ˆ˜ 0€ˆ˜0€p0€€˜0€hˆ˜ 0€hˆ˜ 0phh˜ 0phhˆ˜ 0€hˆ˜ 0€hˆ˜ 0ih €˜ 0ih €˜ 0€h €˜0€hp˜ 0€h ˜ 04jh €˜ 04jh˜0€€ €˜0€€0€€ 0€€ €0€€0€€ €˜0€€˜0€€(0€€ €0€€p˜0€€p˜0€€p©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€`©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ™0€€d ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ™0€€d ©0€€` ™0€€d ©0€€`©0€€` ™0€€d ©0€€` ™0€€d ©0€€` ™0€€d ˜0€€ų€˜0€€p˜0€€p˜0€€˜0€€˜0€€p˜0€€p˜0€€˜0€€p˜0€€p˜0€€˜0€€p˜0€€p˜0€€p˜0€€p˜0€€p0€€p0€€p˜0€€p˜0€€©0€€` ©0€€` ©0€€`©0€€` ©0€€`©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€`©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€`©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€`©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ©0€€` ©0€€` ©0€€` ©0€€` ™0€€d ˜0€€ų€˜0€€p˜0€€p˜0€€ˆ˜0€€p˜0€€ˆ˜0€€ˆ˜0€€ˆ˜0€€ €˜0€€ˆMy00•M9000FMy00•M900FMy00•M900FMy00•M900F˜@0€€ų€˜@0€€˜@0€€pMy00•M900 F˜0€€M90•M90•M90• HHHHHK± rUĪŒ6$;HDT^dovØxM|\ꁚ„ćJŒ GJLMOQSUWY[^p‡¤¶ÅŃėäx&9®A‡PZ÷gpósAv\v”v·vŲvw.wwŒw°wåw x/xexŠx¢x§xÕxäxy0yTyty–yŁyŽy zzQz”z¹zėz {‡{’{Ž{ |9|>|P|n|”|Ė|ė| }}3}m}€}Ž}±}Ļ}ģ}ö}#~1~h~n~–~“~¹~Į~ī~ś~;[{Øā €0€=€b€˜€¾€ä€ Kt³ę ‚.‚e‚j‚£‚Ś‚ć‚ś‚>ƒgƒ•ƒ—ƒśƒļ„………¼…Ū…†R††Ū†D‡~‡Æ‡ł‡[ˆŖˆäˆśˆ%‰I‰²‰÷‰Š8ŠiŠ…Š¶ŠõŠ‹"‹b‹f‹Œ‹§‹Å‹Ž‹Œ5ŒLŒŒ“Œ—ŒšŒ HKNPRTVXZ\]_`abcdefghijklmnoqrstuvwxyz{|}~€‚ƒ„…†ˆ‰Š‹ŒŽ‘’“”•–—˜™š›œžŸ ”¢£„¦§Ø©Ŗ«¬­®Æ°±²³“µ·ø¹ŗ»¼½¾æĄĮĀĆÄĘĒČÉŹĖĢĶĪĻŠŅÓŌÕÖ×ŲŁŚŪÜŻŽßąįāćäåęēčéźģķīļšIY†¤ĒŌZ Ø ē 43V3c36h\hlh …X’€X’€X’„X’ŒX’€9@CK!t’•€š8š@ń’’’€€€÷šźššˆš( š ššP¢ š  š€"ń?šš ššB šS šæĖ’ ?šßm …¹ł'˜t’’ ²,ā[²,ą[²ģÜ[²ģā[²¬Ż[²,ę[²Ģ”ˆ² •ˆ²Œ–ˆ ²T ²Ō[)Ą-@>]M]cifov1{h¦!…  a)Ē-@D]S]iimo‘v9{n¬!… C *€urn:schemas-microsoft-com:office:smarttags€metricconverter€  €1 gram€102.4 F€2 gram€2 oz€30 Gram€30 Grams€60 lbs€99.8 F €ProductID           IMQXYž £ČÕ²µéōR[\fhmovx„‹‚“ŗ  W _ Z b   õ ų Q _ _b'128<Eäėż.<¶¹KTĮŹ =DS^`fhvwœ¦ēļˆĄÅ  &13;Ÿ§©±¶ĄÅŅ×āFNej† §×ßäļ{†Q#V#$-$K$P$†&&\'a'ˆ(Ž((–(Å(Ė(Å)Ń)ś)***/*©*µ*Ź*Š*%+1+Ā+Ī+ń+ż+(,0,@,H,£,„,. .).3.Ś/ć/å/ļ/0 0001040Š1‘1#2.233«3“3c4j44„4W5\56%6¤8®8Q9Y9a9l9y9‚9Ņ9Ų9Ę<Ń<ü=>Y@c@”@­@µ@½@ł@AA ASAWA[AbAuAAƒAŽA”AŸA=BDB6C>CÜCćCõC’CD D*D8D“D·D0E7EmBmčmģmšm÷m nnŒnnønĄnŠnÓnŁnänånėnAoNoēoņo pp8pFpGpRpgppp“pžpśpqqq2q;qžq¦q“qĆqŅqÕqąqķqłqr$r1rZrcr–r”r²rµrĮrÉrärērķr÷rss?sBs™s¢sæsČsŹsŅsćsķsłstt%tRt[twt€tt‹tÓtŻtu&u'u+uMuQuu—uŸu©uĮuĖuąučupv~vvƒvĆvĖvüvww%wCwMw„wŽwŖw“wźwõwx xFxOxkxvx{x}x”x­x(y5yVy_y}y…y¼yĒyļy÷yz z7z=zLzVzsz|z¬zµz»zĒzÓzÖz"{/{@{J{U{[{Æ{»{Ś{ā{ä{ģ{ī{÷{}"}C}N}Ÿ}©}¼}Ą}õ}’}~~!~)~2~;~D~G~j~r~|~…~‰~Œ~Ž~˜~£~«~µ~¾~Ü~å~ö~  9BEO[dozˆ”œ°¾æĆĢÕÖŽņų€€€€€%€.€7€\€d€o€s€t€{€•€™€¢€©€«€¶€Ō€Ż€å€ķ€ü€&)3=IS’š”„ÉŠų‚‚‚(‚0‚S‚]‚†‚Ž‚—‚š‚”‚Ŗ‚·‚Ä‚Š‚Ü‚é‚ņ‚÷‚ƒ#ƒ+ƒDƒFƒ}ƒ…ƒ§ƒÆƒ³ƒ¼ƒ„„ „„„„%„,„5„@„D„H„L„T„l„q„„…„†„Œ„£„£„„„„„¦„¦„Ø„©„«„¬„®„Æ„Ü„ē„ė„ģ„…!…¢„£„£„„„„„¦„¦„Ø„©„«„¬„®„Æ„Ü„ē„!…Y£¤Õ®±ĪÕqqB†‡ü”œœö ® ¼ ā»gq­®„(×(‚)ƒ))***č+$,%,&,',(,|,‚,†,†,ŲCĘE6hmhņ|’|¢„£„£„„„„„¦„¦„Ø„©„«„¬„®„Æ„ė„ģ„………!…£„£„„„„„¦„¦„Ø„©„«„¬„®„Æ„ė„ģ„!…’’5010“TųĪpŗa’’’’’’’’’I߀Rī£’’’’’’’’’aGŸ M˜©NŸ2Ø|©µiŖłsÆ/]±x±Ē$²Ļ[Ä1RŃ^@ŚŁįĄ`ę ļX6ļ¤Cšvmń ióOöŖö0a÷ ųM(żnn"n+n3nAnBn\n]nn€nn”n•n©nŖn³n·nønĢnĶnŌnŲnŁnųnłnoo oo o*o.o/osoto{oo€oŒoo„o¦o­o°o±o×oŲoāoåoęožo’op p p$p%p,p/p0pZp[pbpepfpp€p‡pŠp‹pŸp p”p¢p£p¤p„p¦p§pØpŅpÓpŌpÕpÖpįpāpćpäpåpqq qqq%q&q,q0q1qQqRqSqTqUqtquq‹qŒq“q–q—qÄqÅqÖqŁqŚqŪqÜqŻqŽqßqrr r rrrrrrr8rGrNrQrRrurvr‚r”r•r®rÆr¶r¹rŗrąrįrčrėrģržr’rs s s‡sˆs‘s’s“sµs¶s·søsŚsŪsŽsįsāsttt t t6t7t8t9t:t;tt?tMtNtOtPtQtftgtjtntotŒttŽt”t¢tætĄtĒtĖtĢtćtätētėtģtuuu u uuuuuu,u-u.u3u4ubucuhumunu}u~uu€uu‹uŒuuŽuuŖu«u¬u±u²uĢuĶuĪuĻuŠuéuźuėuģuķuóuōuõuöu÷uvv v#v$v.v/v0v1v2v\v]vdvhvivkvlvmvnvovŒvv“v–v—v­v®v±v“vµv¶v·vøv¹vŗv¾vævĄvĮvĀvēvčvėvīvļv÷vųvłvśvūv w wwww-w9w:w;wx[x\x_xbxcxŠx–x—x˜x™x·xøx»x¾xæxŻxŽxįxäxåxyyy y y y y yyyyyyyy{?{]{^{c{g{h{~{{ƒ{•{–{—{˜{­{®{ś{ū{ü{ż{ļ|š|5}6}C}O}{}…}†}Ÿ}°}¼}Į}Ā}Ų}Ł}Ś}Ū}Ü}Ż}õ}~~ ~!~2~D~R~S~j~|~‰~~Ž~£~µ~Ź~Ū~Ü~š~ 9DE[o{~”­®Æ°Ģ柀€€.€F€[€\€o€…€¢€Ŗ€«€Ā€Ó€Ō€ä€å€ų€ł€ś€ū€ü€ %&23I„’±²ĮŻö÷ų‚‚‚‚‚(‚8‚Q‚R‚S‚i‚j‚ƒ‚„‚…‚†‚”‚µ‚¶‚·‚Š‚ō‚õ‚ö‚÷‚ƒƒ ƒ!ƒ"ƒ#ƒ2ƒ`ƒbƒcƒdƒeƒfƒgƒhƒ}ƒŒƒƒŽƒƒ§ƒ³ƒĆƒÄƒÅƒŪƒÜƒŻƒŽƒßƒķƒ„„„„%„5„I„J„K„L„d„„Ž„„„‘„’„“„”„•„–„—„˜„™„¢„!…+*žžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžž–+*žžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžžž–’@€c» …p@’’Unknown’’’’’’’’’’’’G’:ąAxĄ ’Times New Roman5€Symbol3& ’:ąCxĄ ’ArialM, Footlight MT LightQBaskerville Old FaceQ& ‡ŸFranklin Gothic Book5& ’>į[`Ą)’Tahoma"1ˆšŠh@ā@ā*÷FĖŲpCšĖŲpCšŃ$š„Ą““€4d`„`„2ƒQšßß’’HX š’$Pä’’’’’’’’’’’’’’’’’’’’’>M’’Medicos para la Familia Karen Carter5010P            ž’ą…ŸņłOh«‘+'³Ł0˜˜ ĄĢäšü , H T ` lx€ˆäMedicos para la Familiaedi Karen Carterla areare Normal.dotr5010l.d210Microsoft Word 10.0@FĆ#@ś;Ģ@p>¬DĪ@p>¬DĪĖŲpž’ÕĶ՜.“—+,ł®DÕĶ՜.“—+,ł®H hp€ˆ˜  Ø°ø Ą ääMedicosšC`„A Medicos para la Familia Title˜ 8@ _PID_HLINKSäAP.- http://www.cdc.gov/stdYZ http://www.psot.com/op?http://bmj.bmjjournals.com/cgi/content/short/333/7574/912?ehomYZhttp://www.psot.com/;,http://www.medicosmundial.com/  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~€‚ƒ„…†‡ˆ‰Š‹ŒŽ‘’“”•–—˜™š›œžŸ ”¢£¤„¦§Ø©Ŗ«¬­®Æ°±²³“µ¶·ø¹ŗ»¼½¾æĄĮĀĆÄÅĘĒČÉŹĖĢĶĪĻŠŃŅÓŌÕÖ×ŲŁŚŪÜŻŽßąįāćäåęēčéźėģķīļšńž’’’óōõö÷ųłśūüżž’      !"#$%&'()*+,ž’’’./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~€‚ƒ„…†‡ˆ‰Š‹ŒŽ‘’“”•–—˜™šž’’’œžŸ ”¢ž’’’¤„¦§Ø©Ŗž’’’ż’’’ż’’’ż’’’ż’’’°ž’’’ž’’’ž’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’Root Entry’’’’’’’’ ĄFĄMŹDĪ²€Data ’’’’’’’’’’’’ņŗu1Table’’’’-QŚWordDocument’’’’%āSummaryInformation(’’’’’’’’’’’’›DocumentSummaryInformation8’’’’’’’’£CompObj’’’’’’’’’’’’j’’’’’’’’’’’’ž’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ž’ ’’’’ ĄFMicrosoft Word Document MSWordDocWord.Document.8ō9²q