ࡱ>  CE89:;<=>?@AB .bjbj]q]q [?? 8 B<0:;0Q0Q0Q0O2O2O2;;;;;;;>A;-O2-2-2"O2S2;CQ0Q0; CCCW2Q0Q0;CO2;CC"d BJ#CQv^<<B<@BC@BC&O2O2O2 k:   Rotation: MSKRotation Duration: 4 wksMonth(s): 3Institution: Stanford, VACall Responsibility: NoneNight(s): covered by Junior callResponsible Faculty Member(s): Chris Beaulieu MD PhD Kate Stevens MD Sandip Biswal MD Garry Gold MD, MSEE Amelie Lutz, MD Location: Stanford bone board (one month) VA/SMOC: (2 months)Phone Numbers: Stanford Hospital: MSK Fellow Pager 14589, 14598, 14603 MSK Room SUH 3-6737 MSK Room Fax 4-3275 MRT/Claudia 8-6976 Hosp MR Rd. Rm 3-6955 Ultrasound SUH 3-3498 OPD 1-6790 Blake MRI 5-9413 North campus (SMOC): Reading room 1-7370 Reading Room 1 1-7343 Reading Room 2 1-7344 Fluoroscopy 1-7351 VA hospital: 650-493-5000 (+ extension) Front desk-64489 Reading room-63250 Technologists/Technical Staff: Aubrey Grey, lead fluoroscopy technologist Michelle Thomas, lead CT technologist SUH Teresa Nelson, lead MRI technologist SUH MRI technologists: Jill Bingelli Jorge Castaneda Martin Chavez Mark Coleman Samuel Dong Greg Dowdall Kim Duong Eric Gabriel Tony Galletta Robert Heriford Diane Jenuleson Darwin Jones William Keirn Sherrie Lee Navy Lu Connie Lund Michael Ody Jane Patrick Leah Pericolosi Steven Scherer Jason Smith Thanh Tang Kendall Thomas Carol Torbett Shannon Walters Michele Yerondopoulos Training Level: Years 1-3Goals & Objectives: A note about goals and objectives- The goals and objectives outlined in this document are based upon the six core competencies as defined by the ACGME. As residents gain experience and demonstrate growth in their ability to care for patients, they assume roles that permit them to exercise those skills with greater independence. This conceptgraded and progressive responsibilityis one of the core tenets of American graduate medical education. This document should provide you a framework for the stepwise progression of your knowledge and skills. MSK Rotation 1-Stanford hospital bone board-first year By the end of the first year rotation (including Santa Clara Valley), residents are expected to recognize fractures and dislocations in trauma and to have an approach to further workup (CT, MRI) of patients as needed. Residents are also expected to have basic understanding of arthritis, orthopedic hardware, and bone tumors, although these are not likely to be dealt with on call. Patient Care Goal: Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents are expected to: Knowledge Objectives: Gain skill in interpretation of digital (and occasional conventional) radiographs of MSK system. Understand radiographic positioning for common views of the spine and extremities. Describe the indications for MSK radiographs, as well as to recognize the limitations of radiographs, and to know when CT or MRI is necessary. Learn key principles in interpretation of trauma CT, including description of fractures affecting the pelvis, knee, ankle and foot, shoulder, elbow, and wrist and hand. Skill Objectives: Become facile with GE Centricity PACs, Centricity RIS, Nuance RadWhere voice-recognition dictation, and EPIC. Utilize available information technology to manage patient information. Provide concise, accurate reports. Learn to accurately interpret postoperative and trauma radiographs of the peripheral skeleton and spine. As part of pediatric radiology, gain a basic understanding of how to interpret pediatric bone radiographs, particularly fractures specific to children (e.g. greenstick fractures, torus fractures, Salter-Harris injuries). Behavior and Attitude Objectives: Work with the health care team in a professional manner to provide patient-centered care. Notify referring clinician for urgent, emergent, or unexpected findings, and document in dictation. Medical Knowledge Goal: Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care. Residents are expected to: Knowledge Objectives: Understand basic skeletal development and anatomic subdivisions of the skeleton into epiphysis, physis, metaphysis, and diaphysis. Discussed basic bone physiology. Describe the stages different types of fractures go through in the process of healing. Know all the bones of the skeletal system, as well as their anatomy. Identify the common imaging and clinical manifestations of arthritis, bone tumors, bone infections, and metabolic bone disease. Describe fracture and joint dislocation nomenclature and their radiographic appearances. Be familiar with more common orthopedic hardware and hardware complications. Before the beginning of call, the resident should be familiar with the manifestations and diagnosis of the disease entities listed in Appendix A: Skill Objectives: Establish a general approach to interpretation of plain films in trauma, the postoperative state, arthritis and infection. Identify normal and aberrant skeletal anatomy. Accurately diagnose more common osseous diseases. Learn a basic approach to solitary bone lesions. Accurately interpret spine and extremity radiographs. Behavior and Attitude Objectives: Recognize limitations of personal competency and ask for guidance when appropriate. Practice-Based Learning and Improvement Goal: Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and lifelong learning. Residents are expected to develop skills and habits to be able to: Knowledge Objectives: Assess radiographs for quality and suggest methods of improvement. Skill Objectives: Demonstrate independent self-study using various resources including texts, journals, teaching files, and other resources on the internet. Facilitate the learning of students and other health care professionals. Behavior and Attitude Objectives: Incorporate formative feedback into daily practice, positively responding to constructive criticism. Follow-up interesting or difficult cases without prompting and share this information with appropriate faculty and fellow residents. Systems Based Practice Goal: Residents must demonstrate an awareness of, and responsiveness to, the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to: Knowledge Objectives: Understand how their image interpretation affects patient care. Skill Objectives: Provide accurate and timely interpretations. Appropriately notify the referring clinician if there are urgent or unexpected findings and document such without being prompted. Practice using cost effective use of time and support personnel. Behavior and Attitude Objectives: Advocate for quality patient care in a professional manner, particularly concerning imaging utilization issues. Professionalism Goal: Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate: Knowledge Objectives: Understanding of the need for respect for patient privacy and autonomy. Understanding of their responsibility for the patient and the service, including arriving in the reading room promptly each day, promptly returning to the reading room after conferences, completing the work in a timely fashion, and not leaving at the end of the day until all work is complete. If the resident will be away from a service (for time off, meeting, board review, etc.), this must be arranged in advance with the appropriate faculty and/or fellow. Skill Objectives: Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation. Behavior and Attitude Objectives: Respect, compassion, integrity, and responsiveness to patient care needs that supersede self-interest. Interpersonal and Communication Skills Goal: Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. Residents are expected to: Knowledge Objectives: Know the importance of accurate, timely, and professional communication. Skill Objectives: Produce concise and accurate reports on most examinations. Communicate effectively with physicians, other health professionals. Obtain informed consent with the utmost professionalism. Behavior and Attitude Objectives: Work effectively as a member of the patient care team. MSK-2nd year / second rotation: VA/SMOC MSK By the end of this rotation, residents should have advanced their understanding of MSK radiographs. Although radiographs will be interpreted at SMOC, residents will begin to gain experience in MSK MRI and CT, as well as basic MSK procedures. Patient Care Goal: Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents are expected to: Knowledge Objectives: Continue to build on the knowledge objectives gained in rotation 1. Increase skill in interpretation of digital (and occasional conventional) radiographs of MSK system. Understand radiographic positioning for common and less common views of the spine and extremities. Describe the indications for MSK radiographs, as well as to recognize the limitations of radiographs, and to know when CT or MRI is necessary. Increase understanding of principles in interpretation of trauma CT, including description of fractures affecting the pelvis, knee, ankle and foot, shoulder, elbow, and wrist and hand. Select appropriate imaging modality for a particular patient and disease, including radiographic, CT, MR, and bone scan. Protocol MRIs and CTs for most musculoskeletal indications. Understand the use and interpretation of CT and MRI in the setting of musculoskeletal infection. Understand common indications for musculoskeletal ultrasound. Learn basic principles of arthrography, including aspiration or injection of the hip and total joint prostheses. Skill Objectives: Continue to build on the skills objectives gain in rotation 1. Perform arthrography for conventional arthrogram or MR arthrogram with supervision. Learn how to perform basic MSK US of tendons and muscles. Provide concise, accurate reports on all studies, including MSK MR and CT. Kate Stevens suggested MSK MRI templates can be found at http://www.xrayhead.com. Behavior and Attitude Objectives: Work with the health care team in a professional manner to provide patient-centered care. Notify referring clinician for urgent, emergent, or unexpected findings, and document in dictation. Medical Knowledge Goal: Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care. Residents are expected to: Knowledge Objectives: Continue to build on the knowledge objectives of rotation 1. Learn detailed anatomy of the knee and shoulder joints through MRI interpretation. Learn about common musculoskeletal neoplasms, including benign and malignant primary tumors and metastatic lesions. Understand applications of MR arthrography, including shoulder, hip, and knee. Understand the MR imaging appearance of tumor, infection, and arthritis. Learn the pathophysiology and manifestations of the least one half of the disease entities listed in appendix B. Skill Objectives: Continue to build on the skills objectives of rotation 1. Define findings in most musculoskeletal abnormalities, including soft tissue masses, as well as benign and malignant bone tumors. Learn basic interpretation of MRI of the knee and shoulder. Be able to accurately interpret radiographic studies for arthritis, including degenerative, inflammatory, and crystal-induced diseases. Behavior and Attitude Objectives: Recognize limitations of personal competency and ask for guidance when appropriate. Practice-Based Learning and Improvement Goal: Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and lifelong learning. Residents are expected to develop skills and habits to be able to: Knowledge Objectives: Assess radiographs, CT and MR for quality and suggest methods of improvement. Skill Objectives: Demonstrate independent self-study using various resources including texts, journals, teaching files, and other resources on the internet. Facilitate the learning of students and other health care professionals. Behavior and Attitude Objectives: Incorporate formative feedback into daily practice, positively responding to constructive criticism. Follow-up interesting or difficult cases without prompting and share this information with appropriate faculty and fellow residents. Systems Based Practice Goal: Residents must demonstrate an awareness of, and responsiveness to, the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to: Knowledge Objectives: Understand how their image interpretation affects patient care. Skill Objectives: Provide accurate and timely interpretations to decrease length of hospital and emergency department stay. Appropriately notify the referring clinician if there are urgent or unexpected findings and document such without being prompted. Practice using cost effective use of time and support personnel. Behavior and Attitude Objectives: Advocate for quality patient care in a professional manner, particularly concerning imaging utilization issues. Professionalism Goal: Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate: Knowledge Objectives: Understanding of the need for respect for patient privacy and autonomy. Understanding of their responsibility for the patient and the service, including arriving in the reading room promptly each day, promptly returning to the reading room after conferences, completing the work in a timely fashion, and not leaving at the end of the day until all work is complete. If the resident will be away from a service (for time off, meeting, board review, etc.), this must be arranged in advance with the appropriate faculty and/or fellow. Skill Objectives: Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation. Behavior and Attitude Objectives: Respect, compassion, integrity, and responsiveness to patient care needs that supersede self-interest. Interpersonal and Communication Skills Goal: Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. Residents are expected to: Knowledge Objectives: Know the importance of accurate, timely, and professional communication. Skill Objectives: Produce concise and accurate reports on most examinations. Communicate effectively with physicians, other health professionals. Behavior and Attitude Objectives: Work effectively as a member of the patient care team. MSK-3rd year VA/SMOC-third rotation By the end of this rotation, residents should have become expert in their understanding of MSK radiographs. Although radiographs will be interpreted at SMOC, residents will gain further experience in MSK MRI and CT, as well as more advanced MSK procedures. Patient Care Goal: Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents are expected to: Knowledge Objectives: Continue to build on the knowledge objectives of Rotations 1 and 2 Understand the indications for all musculoskeletal imaging, including more complex cases. Be facile with MSK imaging protocols, including spine and extremities. Learn to protocol and monitor MSK MRI studies. Understand common indications for musculoskeletal ultrasound. Learn basic principles of arthrography, including aspiration or injection of the hip and total joint prostheses, and injection of the glenohumeral joint. Learn principles of advanced MSK procedures, including tenography and US-guided procedures. Skill Objectives: Continue to build on the skills gained in rotations 1 and 2. Perform arthrography for conventional arthrogram or MR arthrogram with supervision. Learn how to perform basic MSK US of tendons and muscles. Provide concise, accurate reports on all studies. Behavior and Attitude Objectives: Work with the health care team in a professional manner to provide patient-centered care. Notify referring clinicians for urgent, emergent, or unexpected findings, and document in dictation. Medical Knowledge Goal: Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care. Residents are expected to: Knowledge Objectives: Continue to build on the skills gained in rotations 1 and 2. Describe imaging findings of more complex osseous pathology. Understand applications of MR arthrography, including shoulder, hip, and knee. Become familiar with basic principles of metabolic bone diseases, including osteoporosis, osteomalacia and hyperparathyroidism. Learn the pathophysiology and manifestations of the least one half of the disease entities listed in the appendix of this document. Understand the MR imaging appearance of tumor, infection, and arthritis. Recognize pertinent musculoskeletal anatomy, particularly knee, hip, and shoulder, and identify common abnormalities of these regions. Be able to interpret basic MRI of post-operative joints. Learn how to interpret MSK CT in the setting of orthopedic hardware. Learn how to perform multiplanar and 3D rendering of MSK studies. Have a comprehensive approach to differential diagnosis and workup of solitary bone lesions. Gain a basic understanding of various syndromes and developmental and dysplastic syndromes affecting the MSK system. Learn the pathophysiology and manifestations of all of the disease entities listed in the appendix of this document. Learn the pathophysiology and manifestations of the least one half of the disease entities listed in appendix B. Skill Objectives: Continue to build on the skills gained in rotations 1 and 2. Learn basic interpretation of MRI of the hip, ankle, elbow, and wrist. Be able to accurately interpret radiographic studies for arthritis, including degenerative, inflammatory, and crystal-induced diseases. Behavior and Attitude Objectives: Recognize limitations of personal competency and ask for guidance when appropriate. Practice-Based Learning and Improvement Goal: Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and lifelong learning. Residents are expected to develop skills and habits to be able to: Knowledge Objectives: Assess radiographs, CT and MR for quality and suggest methods of improvement. Skill Objectives: Demonstrate independent self-study using various resources including texts, journals, teaching files, and other resources on the internet. Facilitate the learning of students and other health care professionals. Behavior and Attitude Objectives: Incorporate formative feedback into daily practice. Follow-up interesting or difficult cases without prompting and share this information with appropriate faculty and fellow residents. Systems Based Practice Goal: Residents must demonstrate an awareness of, and responsiveness to, the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to: Knowledge Objectives: Understand how their image interpretation affects patient care. Skill Objectives: Provide accurate and timely interpretations. Appropriately notify the referring clinician if there are urgent or unexpected findings and document such without being prompted. Practice using cost effective use of time and support personnel. Behavior and Attitude Objectives: Advocate for quality patient care in a professional manner, particularly concerning imaging utilization issues. Professionalism Goal: Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate: Knowledge Objectives: Understanding of the need for respect for patient privacy and autonomy. Understanding of their responsibility for the patient and the service, including arriving in the reading room promptly each day, promptly returning to the reading room after conferences, completing the work in a timely fashion, and not leaving at the end of the day until all work is complete. If the resident will be away from a service (for time off, meeting, board review, etc.), this must be arranged in advance with the appropriate faculty and/or fellow. Skill Objectives: Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation. Behavior and Attitude Objectives: Respect, compassion, integrity, and responsiveness to patient care needs that supersede self-interest. Interpersonal and Communication Skills Goal: Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. Residents are expected to: Knowledge Objectives: Know the importance of accurate, timely, and professional communication. Skill Objectives: Produce concise and accurate reports on most examinations. Communicate effectively with physicians and other health professionals. Behavior and Attitude Objectives: Work effectively as a member of the patient care team. MSK written curriculum: posted online at  HYPERLINK "http://xray.stanford.edu" http://xray.stanford.edu Kate Stevens MSK MRI templates: http://www.xrayhead.com Duties and Workflow: General Guidelines 1. Plain Radiographs: Report to Bone reading room no later than 8:45 AM and begin reviewing plain films. If you cannot arrive by this time, you must page the bone attending. By 9:00 to 9:30 AM, you should be ready to read out with the bone attending. Note that attendings may not arrive until 9:00 AM, but should be available by pager by 8:30 AM. Wet Reads are radiographic exams where the referring physician has requested immediate review by a radiologist, and a call or fax back with results. These exams are brought to us throughout the day, and need to be reviewed by a faculty person before the report is called or faxed back. Particularly important are studies performed on Stanford Athletes ("team players"), which require timely reading and attending review. Residents should also prioritize films from the Vaden student healthcare center, to allow prompt referral for fractures. 2. ER/Trauma Coverage: The ER extremity MSK films are periodically read during the day, typically at least twice each morning and afternoon. Wet reads are entered into the PACs throughout the day until 5 PM when the junior resident takes over. Coverage is from 8:30 AM to 5 PM, except during noon conference. A trauma pager is available in the bone room to alert us that a major trauma is arriving. 3. MRI Interpretation: MRI readouts now occur at SMOC in Redwood City. During the 2nd and third-year rotations, the resident on service will be expected to drive to SMOC on Monday and Friday after morning conference (Tuesday, Wednesday and Thursday at the VA). Cross sectional imaging studies will be allocated to the MSK fellows and residents, who are expected to preview the case prior to readout with the attending. Teleconferencing is set up at SMOC to enable the resident to participate in the resident conference at noon. MSK ultrasound cases are also done at SMOC, and the resident will be given the opportunity to participate in these. 4. Procedures: Up to 5 arthrograms, tenograms and ultrasound-guided interventions are scheduled throughout the day at SMOC, usually commencing at 10am, with emergency cases added on as needed. Resident participation in these procedures is on a case-by-case basis, but it is expected that the resident will learn how to perform conventional hip and shoulder arthrograms. Note that we have an agreement that only attending physicians can perform procedures on Stanford and Professional Athletes, though residents and fellows may assist with these cases. 4. Teaching Cases: Interesting cases will be added to teaching folders on the PACS system, and the MSK fellows will also document interesting cases for presentation at bone rounds (every Thursday at 5:15 PM in the ballroom). 5. MSK Conference: Residents are encouraged to present cases during at least one conference during the month. This requires background reading on the disorders. Bone residents are expected to attend all morning conferences related to musculoskeletal imaging during their rotation, and are encouraged to attend bone rounds on Thursday afternoon at 5.15pm. 6. Pathology and other Clinical Consultations. Pathology residents will page you when tumor biopsy cases need radiographic/pathologic correlation. Coordinate time to meet with the pathologist and a bone radiology attending. Many of these cases are excellent additions to the teaching file or for AFIP. 7. Clinical conferences. Generally, these are attended by faculty and the fellow but residents are welcome to attend also. Orthopedics Grand Rounds with Radiology/Pathology sessions Wed AMs at 0730 hrs. Arthroscopy conference, 0700 hrs, one Monday per month at SMOC. Rheumatology case conference, third Tuesday of the month at 1200 hrs, run by Dr. Stevens. Preparing Films Readouts occur on the 2 PACS workstations in the bone room. Cases should be read directly from the SMOC work list. In addition, in the afternoon cases are read out from the MSK 1 work list. At a minimum all films taken before 2 pm on the SMOC work list must be read out on the same day, but obviously if it is a slow day, reading out more films is desirable. Occasionally there can be glitches in the system, and cases inadvertently do not make it to the work list that day, and are then added the subsequent day. The MSK fellow will independently read cases on the MSK 3 work list, time permitting, and if this is not possible the MSK fellow will alert the bone attending accordingly. What to do during readout Case reviewed with attending, resident takes notes and dictates later. There are a number of canned dictation examples printed out in the reading room, which can be helpful as a guideline. Conference Schedule/FormatTitleWednesdayTimeLocationMSK resident conferenceWednesday 7:30 AM weeklyLucasOrthopedics grand roundsWednesday7:30 AMMedical School (opposite canteen) Bone rounds Thursday 5:15 PM weekly BallroomRheumatology casesThird Tuesday of monthNoonBone roomSarcoma tumor board Friday 7 AM Cancer centerMethod of Assessment of Performance: Written evaluation of resident by responsible faculty member monthly Verbal feedback to resident by faculty ACR In-Training Service Exam annuallyRecommended reading during your 1st yr rotation includes: Helms, C: Fundamentals of Musculoskeletal Radiology This is an excellent introductory text for first year residents. Brower, A: Arthritis in Black and White Excellent review of features of the main types of arthritis. A book that is very useful to review again before boards. Harris, J: "Radiography of Acute Cervical Spine Trauma". Greenspan, A. Orthopedic Radiology. Websites and Electronic Resources: University of Virgina Skeletal Trauma Tutorial  HYPERLINK "http://www.med-ed.virginia.edu/courses/rad" http://www.med-ed.virginia.edu/courses/rad MSK MRI Atlas  HYPERLINK "http://www.freitasrad.net" http://www.freitasrad.net ACR Skeletal Radiology CD-ROM Good resource for cases http://www.wheelessonline.com/ Suggested supplementary reading : 1. Keats, T.: Atlas of Normal Roentgen Variants This is a book you need to know how to use, so that you can quickly find the information you are looking for. Particularly useful for ED reads and on-call. If in doubt about a developmental variant eg. accessory ossicles, nutrient channels, weird looking bones ! look it up in Keats! 2. Rogers, L.: Radiology of Skeletal Trauma Describes the common fracture and dislocation patterns in different body parts. Crucial for handling cases in the ER! 3. Keats, T.: Emergency Radiology This is an excellent and readable text for first year residents prior to taking ER call. 4. Kaplan, PA., Helms, C., Dussault, R., Anderson, MW. Musculoskeletal MRI Comprehensive textbook on MRI of the musculoskeletal system. Extremely useful to read this book when you are on the MSK MRI rotation. 5. Stoller, D., Tirman, P., Bredella, M. Diagnostic Imaging: Orthopaedics Excellent supplementary text for reading up around specific MRI pathology and considering differential diagnoses. Contains easy to understand illustrations and high quality MR images, with bullet points summarizing each condition. 6. Resnick, D: Diagnosis of Bone and Joint Disorders The musculoskeletal radiology (5 volume) bible! Useful as reference when you want to find out more about a certain topic, but not to be attempted to read from cover to cover unless you are a complete masochist! An "abbreviated (baby) Resnick" (1 volume) is also available for residents. Most of these books and a collection of other MSK radiology books are located in the locked cabinets in the bone reading rooms at Stanford and SMOC and can be used by the resident on the MSK and MSK MRI rotations. If you do borrow books for the evening please ensure that books are returned to the bone room. In the past books have been borrowed and not returned. This spoils it for residents subsequently on the rotation, as we cannot afford to keep replacing them.  Appendix A: knowledge objectives in rotation one in preparation for call. Pre-call1Acetabular Fracture2Achilles Tendon Tear & Tendinopathy3Acromioclavicular Dislocation4Acute Osteomyelitis: Child5Anterior Glenohumeral Dislocation6Avulsive Injury, Knee7Bisphosphonates, Complications8Calcaneus Fracture, Intraarticular9Carpal Dislocation10Charcot (Neuropathic)11Child Abuse: The Extremities12Chondrosarcoma13Finger Fracture and Dislocation14Distal Radius Fracture15Gout16Greater Tuberosity Fracture17Hydroxyapatite Deposition Disease18Hip Dislocation19Hip Implant20Insufficiency Fractures, Appendicular21Juvenile Distal Forearm Fractures22Malleolar Fracture23Medial Condylar Fracture, Elbow24Metacarpal Fracture and Dislocation25Metatarsal Fracture26Osteonecrosis, Hip27Osteosarcoma, Conventional28Osteosarcoma, Parosteal29Pathologic Fracture30Pelvic Fracture, Unstable31Pilon Fracture32Pyrophosphate Arthropathy33Radial Head/Neck Fracture34Salter-Harris Fracture, Ankle35Scaphoid Fracture36Septic Arthritis37Sickle Cell Anemia: MSK Complications38Slipped Capital Femoral Epiphysis39Stress Fracture, Adult40Tibial Plateau Fracture41Transcondylar Fracture, Elbow Appendix B: knowledge objectives for the remainder of the rotations. Musculoskeletal Acute and Chronic InjuryGeneral/systemic Injury42Complications of ParaplegiaSoft tissue, non-specific location, extraarticular43Hematoma44Myositis Ossificans/Heterotopic OssificationMuscle injury, non-specific location45Muscle InjuryNeural injuryPeriosteumJointFracture healingFractures with other contributing etiologies (other than acutely traumatic)Fractures, Pediatric46Physeal Injury (Salter-Harris)47Incomplete FracturesOther48Lead Poisoning49Chronic Repetitive TraumaInjury to joint & adjacent osseous structures, shoulder girdle & humerusSternoclavicular joint & clavicleAcromioclavicular joint50Os Acromiale51Traumatic Osteolysis, Distal ClavicleOsseous structures, glenohumeral joint & humerus52Posterior Glenohumeral Dislocation53Humeral Head/Neck Fracture54Little Leaguer's Shoulder55Osteochondral Injury, ShoulderMuscle injury, shoulder56Parsonage-Turner Syndrome57Pectoralis InjuryRotator Cuff tendons58Rotator Cuff Tendinopathy59Rotator Cuff Partial Thickness Tear60Calcific Rotator Cuff Tendinopathy61Subscapularis Tear62Rotator Cuff Full Thickness Tear63Rotator Interval TearBiceps Tendon/anchorLabrum/Capsule64Biceps Tendinopathy, Shoulder65Normal Labral Variants66Biceps Tendon Tear, Intraarticular67Biceps Tendon Dislocation68Posterior Labral Tear, Shoulder69Inferior Glenohumeral Ligament Injury70Bankart Lesion71Perthes Lesion72Multidirectional Instability, Shoulder73GLAD/GARD Lesion74SLAP TearNeural impingement75Rotator Cuff Denervation Syndromes76Suprascapular and Spinoglenoid Notch CystsInjury to joint & adjacent osseous structures, elbow & forearmTendons77Biceps Tendon Injury, Elbow78Common Extensor Tendon Injury, Elbow79Common Flexor/Pronator Tendon Injury, Elbow80Triceps Tendon Injury, ElbowLigaments81Radial Collateral Ligament Injury82Ulnar Collateral Ligament InjurySoft tissue abnormalities, other83Bicipioradial Bursitis84Olecranon BursitisOsseous Trauma85Capitellum Fracture86Elbow Dislocation87Lateral Condylar Fracture, Elbow88Monteggia Injury89Valgus Stress Mechanism/Little Leaguer's Elbow90Forearm FracturesNeural Impingement91Radial Nerve Injury92Median Nerve InjuryInjury to joint & adjacent osseous structures, wrist & handLigaments, +/- carpal instability93Intrinsic Ligament Tear, Wrist94Carpal InstabilityTendons95Extensor Tendon Injury, Wrist and Fingers96Extensor Carpi Ulnaris Tendinitis97Tenosynovitis, Wrist & HandSoft tissue abnormalities, otherDistal radius & ulna: osseous trauma98Trauma-related Osteolysis in ChildrenCarpus: osseous trauma99Carpal Fracture, Other than Scaphoid100Carpal Impaction SyndromesDistal Radioulnar JointTriangular Fibrocartilage Complex101Triangular Fibrocartilage Complex InjuryFingers102Collateral Ligament Injury, Fingers and Thumb103Flexor Tendon Injury, Wrist and Fingers104Carpometacarpal FracturesNeural impingement105Nerve Entrapment Syndromes, WristInjury to joint & adjacent osseous structures, spine106Scheuermann DiseaseInjury to joint & adjacent osseous structures, pelvisOsseous trauma107Pelvic Fracture, Stable108Pelvic Stress and Insufficiency Fracture109Osteitis Pubis, Nontraumatic Origin110Pelvic Avulsion Fracture/Apophysitis111Osteitis Pubis, Post-TraumaticTendonsLigamentsNeural impingementSoft tissue abnormalities, other112Adductor Insertion Avulsion Syndrome113Sports HerniaInjury to joint & adjacent osseous structures, hip & femurOsseous trauma114Stress Injury, Leg115Femoral Head Fracture116Femoral Neck Fracture117Subtrochanteric and Femoral Shaft Fracture118Trochanteric and Intertrochanteric FractureLabroligamentous Pathology119Femoral Acetabular Impingement120Hip Labral Trauma, Postoperative121Acetabular Labral TearMusculotendinous Injury122Proximal Hamstring Injury123Hip Flexor Injury124Hip Adductor Injury125Hip Internal and External Rotator InjuryLigamentsNeural impingementSoft tissue abnormalities, other126Bursitis, Hip and PelvisInjury to joint & adjacent osseous structures, knee & legOsseous trauma127Patellar Fracture128Subchondral Fracture, Knee129Osteochondral Injury, Knee130Transient Patellar Dislocation131Blount DiseaseMenisci132Discoid Meniscus133Parameniscal Cyst134Meniscal Ossicle135Meniscal Radial Tear136Other Displaced Meniscal Tears137Meniscal Pitfalls and Variants138Meniscal Vertical Longitudinal Tear139Meniscal Horizontal Tear140Meniscal Bucket-Handle Tear141Meniscocapsular SeparationAnterior Cruciate ligament142Anterior Cruciate Ligament Injury143Anterior Cruciate Ligament: Postoperative ImagingPosterior cruciate ligament144Posterior Cruciate Ligament Injury145Posterior Cruciate Ligament, PostoperativeMedial supporting structures146Medial Collateral Ligament, Knee147Posteromedial Corner Injury148Pes Anserine BursitisLateral supporting structures149Lateral Collateral Ligament Complex, Knee150Posterolateral Corner Injury151Iliotibial Band Friction SyndromeExtensor mechanism152Patellar Tendon Tears & Tendinosis153Osgood-Schlatter Disease154Quadriceps Injury155Patellar MalalignmentCartilage156Chondral Injury, Knee157Articular Cartilage: Postoperative ImagingNeural impingement158Peroneal Nerve InjuryMuscle injury, leg159Gastrocnemius Soleus StrainSoft tissue abnormalities, other160Intercondylar Notch Cyst161Prepatellar and Pretibial Bursitis162Popliteal Cyst163Popliteus Myotendinous InjuryInjury to joint & adjacent osseous structures, ankle & footTendons164Posterior Tibial Tendon Tear and Tendinopathy165Plantaris Tendon Injury166Extensor Tendon Tear and Tendinopathy, Ankle167Peroneal Tendon Tear and Tendinopathy168Tears of Intrinsic Foot Muscles and Plantar FasciaLigaments169Ankle Sprain170Syndesmosis Ligament Injury, Ankle171Lisfranc Ligament Injury172MTP Ligament Injury, Digit 1173Deltoid Ligament Injury174Anterior Impingement Syndrome, AnkleNeural impingementSoft tissue abnormalities175Plantar Fasciitis176Superficial FibromatosesOveruse syndromes177Accessory Ossicles, Ankle and Foot178Os Peroneum Syndrome179Os Trigonum Syndrome180Sesamoid DysfunctionOsseous trauma181Calcaneus Fracture, Nonarticular182Talus Neck and Head Fracture183Talus Dislocation184Stress and Insufficiency Fracture, Ankle and Foot185Chopart Dislocation186Talar Body and Process Fracture187Ankle Dislocation188Osteochondral Injury, Ankle189Navicular Fracture and Dislocation190Lisfranc Fracture-DislocationPost-operative Findings191Arthroplasty Loosening & Dislocation192Arthroplasty Component Wear/Particle Disease193Arthrodesis, Postoperative Appearance194Wrist Arthrodesis/Other Postoperative Appearances195Cement & Bone Fillers196Arthroplasty Implant/Periprosthetic Fx197Miscellaneous Hardware198Anchoring Devices199Revision Arthroplasty200Knee Implant201Shoulder ImplantInfection202Paget Disease203Chronic Recurrent Multifocal Osteomyelitis204Necrotizing Fasciitis205Brucellosis206Soft Tissue Infection207Spinal Infections208Acute Osteomyelitis, Adult209Acute Osteomyelitis, Child210Chronic Osteomyelitis211TuberculosisBone Marrow212Focal Marrow Infiltration and Replacement213Thalassemia214Extramedullary Hematopoiesis215Increased or Decreased Marrow Cellularity216Myelofibrosis217Mucopolysaccharidoses218Diffuse Marrow Infiltration and Replacement219Gaucher Disease220Bone Infarct221Transient Bone Marrow Edema222Osteonecrosis of Knee223Legg-Calv-Perthes224Osteonecrosis of Wrist225Osteonecrosis of ShoulderArthritisErosive patternRheumatoid arthritis226Rheumatoid Arthritis of Axial Skeleton227Rheumatoid Arthritis of Ankle and Foot228Rheumatoid Arthritis of Knee229Rheumatoid Arthritis of Shoulder and Elbow230Robust Rheumatoid Arthritis231Rheumatoid Arthritis of Wrist and Hand232Rheumatoid Arthritis of HipNon-rheumatoid arthritis, erosive233Juvenile Idiopathic Arthritis (JIA)Productive patternOsteoarthritis234Osteoarthritis of Axial Skeleton235Osteoarthritis of Shoulder and Elbow236Osteoarthritis of Hip237Osteoarthritis of Knee238Osteoarthritis of Wrist and HandNon-joint based239DISH240OPLLMixed erosive and productive241Ankylosing Spondylitis242Psoriatic Arthritis243Chronic Reactive Arthritis244Inflammatory Bowel Disease ArthritisConnective tissue disorders245Systemic Lupus Erythematosus246Progressive Systemic Sclerosis247Inflammatory MyopathyArthritis due to biochemical disorders and depositional disease248Amyloid DepositionMiscellaneous joint disorders249Pigmented Villonodular Synovitis (PVNS)250Synovial Osteochondromatosis251Hypertrophic OsteoarthropathyMetabolic bone disease252Hyperparathyroidism253Primary Osteoporosis254Disuse Osteoporosis255Osteomalacia and Rickets256Renal Osteodystrophy257Dialysis-Related Disease, SpondyloarthropathyDrug-induced & nutritional MSK conditions258Steroids, Complications259Scurvy260Radiation-Induced Non-neoplastic Marrow & Soft Tissue Abnormalities261AIDS Drug Therapy, Complications262Complications of ProstaglandinsVenomous-induced conditionsRadiation induced conditions263Radiation Osteonecrosis264Radiation-Induced Osteochondroma265Radiation-Induced Sarcoma266Radiation-Induced Complications of the SkeletonOsseous tumorsBone-forming tumorsBenign267Osteoma268Osteoid Osteoma269Enostosis (Bone Island)270OsteoblastomaMalignant271Osteosarcoma, Secondary272Osteosarcoma, Periosteal273Osteosarcoma, TelangiectaticCartilage-forming tumorsBenign274Enchondroma275Osteochondroma276Multiple Hereditary Exostoses277Chondroblastoma278Chondromyxoid Fibroma279Periosteal ChondromaMalignant280Chondrosarcoma, DedifferentiatedFibrous tumorsBenign281Desmoplastic FibromaMalignant282Fibrosarcoma283Malignant Fibrous Histiocytoma of BoneFatty tumors284Intraosseous LipomaGiant Cell tumor285Giant Cell TumorEpithelioid tumor286AdamantinomaVascular tumors287Angiosarcoma, OsseousNeural tumors288ChordomaMarrow tumorsMyeloma289Multiple Myeloma290POEMS291PlasmacytomaNon-myelomatous marrow tumors292Ewing Sarcoma293Leukemia: Osseous Manifestations294Lymphoma of BoneTumor-like lesions295Langerhans Cell Histiocytosis296Fibrous Dysplasia297Simple Bone Cyst298Aneurysmal Bone Cyst299Fibroxanthoma300Lower Extremity Variants, OtherMetastatic tumorsSoft Tissue tumorsOtherAdipocytic tumorsBenign301Lipoma, Soft Tissue302Hibernoma303Lipomatosis, Nerve304Parosteal Lipoma305Lipoma Arborescens, KneeIntermediate (Locally Aggressive)306Atypical Lipomatous TumorMalignant307Liposarcoma, Myxoid308Liposarcoma, PleomorphicFibroblastic/Myofibroblastic TumorsBenign309ElastofibromaIntermediate (Locally Aggressive)310Desmoid-Type FibromatosisIntermediate (Rarely Metastasizing)MalignantSo-called Fibrohistiocytic TumorsBenign311Giant Cell Tumor Tendon Sheath312XanthomaIntermediate (Rarely Metastasizing)Malignant313Pleomorphic MFH/Undifferentiated Pleomorphic Sarcoma314Dermatofibrosarcoma ProtuberansSmooth Muscle TumorsBenignMalignantPericytic (Perivascular) Tumors315Glomus TumorSkeletal Muscle TumorsBenignMalignantVascular & lymphatic tumorsBenign316Hemangioma, Soft Tissue317Klippel-Trenaunay-Weber SyndromeIntermediate (Locally Aggressive)Intermediate (Rarely Metastasizing)Malignant318Angiosarcoma of Soft TissueChondro-Osseous Tumors319Extraskeletal Osteosarcoma320Intraarticular ChondromaTumors of Uncertain DifferentiationBenign321Intramuscular MyxomaIntermediate (Rarely Metastasizing)Malignant322Synovial SarcomaPeripheral Nerve Sheath TumorsNon-neoplastic Lesions323Morton Neuroma324Traumatic NeuromaNeurofibroma325NeurofibromaSchwannoma326SchwannomaNerve Sheath MyxomaPerineuriomaGranular Cell TumorMalignant Peripheral Nerve Sheath Tumor (MPNST)327Malignant Peripheral Nerve Sheath TumorSkin and Subcutanious Lesions328Rheumatoid NoduleCongenital, Familial, & Developmental ConditionsGeneralized329Arthrogryposis330Fibrodysplasia Ossificans Progressiva331Neurofibromatosis332Osteogenesis ImperfectaUpper extremity disorders333Madelung Deformity334Glenoid Hypoplasia335Ulnar Variance336Carpal CoalitionLower extremity disorders337Developmental Dysplasia of the Hip338Proximal Femoral Focal DeficiencyFoot deformitiesContenital foot deformities339Club Foot (Talipes Equinovarus)340Congenital Vertical Talus (Rocker Bottom Foot)341Pes Planus (Flatfoot)AcquiredTarsal coalitions342Tarsal CoalitionOther (Nongeneralized Conditions)DisplasiasSkeletal dysplasiasDwarfism343Achondroplasia344Spondyloepiphyseal Dysplasia345Thanatophoric DwarfismNon-dwarfing dysplasias346Ollier Disease347Cleidocranial Dysplasia348Maffucci Syndrome349Nail Patella Disease (Fong)Sclersing dysplasias350Melorheostosis351Intramedullary Osteosclerosis352Pycnodysostosis353Osteopoikilosis354Progressive Diaphyseal Dysplasia355OsteopetrosisMusculolkeletal Complications of Systemic DiseasesDiabetes356Diabetes: MSK Complications357Dialysis-Related Disease, Metastatic CalcificationHIV-AIDS358HIV-AIDSHemophilia359Hemophilia: MSK ComplicationsSyphilisSarcoidosis360Sarcoidosis, BoneVascular DiseaseOtherPolioAnatomic VariantsLower Extremity361Dorsal Defect Patella362Gastrocnemius Muscle Variant363Talar Ridge364Accessory Muscles, Ankle and FootUpper Extremity365Buford 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$$7$8$H$Ifa$kd7$$If"rB & 264 ap2/@ABC6(( $$7$8$H$Ifa$kd8$$If"rB & 264 ap2 $7$8$H$IfCDGmn(kd9$$If"rB & 264 ap2 $7$8$H$If $$7$8$H$Ifa$nopqt $7$8$H$If $$7$8$H$Ifa$A3333 $$7$8$H$Ifa$kd;$$If"rB & 264 ap26(( $$7$8$H$Ifa$kd<<$$If"rB & 264 ap2 $7$8$H$IfӇԇ(kd\=$$If"rB & 264 ap2 $7$8$H$If $$7$8$H$Ifa$ԇՇևׇڇ $7$8$H$If $$7$8$H$Ifa$?@AA?9??@&gd 3kd|>$$If"rB & 264 ap2AjkmOkd?$$Ifl,&'&  &644 laXp $Ifgd 3tkkk_k $$Ifa$gd 3 $Ifgd 3kd!@$$Ifl,F&''A ' 3f3f&6    44 laXp3f3f8// $Ifgd 3kd@$$Ifl,r } &''''' 2&644 laXp2} $$Ifa$gd 3 $Ifgd 3mkd-B$$Ifl,0&'']# 3f&644 laXp3f8/// $Ifgd 3kdB$$Ifl,r } &''''' 2&644 laXp2-.#kd D$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3.0UVXZ\_m} $$Ifa$gd 3mkdU$$Ifl,r } &''''' 2&644 laXp2fi#kdmV$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ŋƋȋʋ̋ϋk_ $$Ifa$gd 3kdW$$Ifl,F &''' @&6    44 laXp $Ifgd 3 8/// $Ifgd 3kdsX$$Ifl,r } &''''' 2&644 laXp2#kdY$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3!; $$Ifa$gd 3 $Ifgd 3;<>@B8/// $Ifgd 3kdZ$$Ifl,r } &''''' 2&644 laXp2BEde#kd\$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3egik_ $$Ifa$gd 3kd/]$$Ifl,F &''' @&6    44 laXp $Ifgd 3 8/// $Ifgd 3kd^$$Ifl,r } &''''' 2&644 laXp2Œ#kd5_$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ŒČƌی܌ތk_ $$Ifa$gd 3kdd`$$Ifl,F &''' @&6    44 laXp $Ifgd 3 8/// $Ifgd 3kd;a$$Ifl,r } &''''' 2&644 laXp2 -.#kdjb$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3.0247Z $$Ifa$gd 3 $Ifgd 3Z[]_a8/// $Ifgd 3kdc$$Ifl,r } &''''' 2&644 laXp2adwx#kdd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3xz|~ $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kde$$Ifl,r } &''''' 2&644 laXp2Í#kd&g$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ÍōǍk_ $$Ifa$gd 3kdUh$$Ifl,F &''' @&6    44 laXp $Ifgd 3 8/// $Ifgd 3kd,i$$Ifl,r } &''''' 2&644 laXp234#kd[j$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3468:=` $$Ifa$gd 3 $Ifgd 3`aceg8/// $Ifgd 3kdk$$Ifl,r } &''''' 2&644 laXp2gj#kdl$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kdm$$Ifl,r } &''''' 2&644 laXp2ގߎ#kdo$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ގߎAB\]pqu,-1=>cdȐɐ,-WX\}~ϑБ 45OPڒے78<^h 3B*CJOJQJaJph"hdqh 35CJOJQJ\^Jhdqh 3CJ%hdqh 3B*CJOJQJaJphLߎ $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kdFp$$Ifl,r } &''''' 2&644 laXp2#kduq$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3A $$Ifa$gd 3 $Ifgd 3ABDFH8/// $Ifgd 3kdr$$Ifl,r } &''''' 2&644 laXp2HK\]#kds$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3]_acfp $$Ifa$gd 3 $Ifgd 3pqsu8/// $Ifgd 3kdu$$Ifl,r } &''''' 2&644 laXp2tkkk_k $$Ifa$gd 3 $Ifgd 3kd1v$$Ifl,F &''' @&6    44 laXp8/// $Ifgd 3kdw$$Ifl,r } &''''' 2&644 laXp2#kd7x$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3,-/19;=mkdfy$$Ifl,0&'']# 3f&644 laXp3f $Ifgd 3=>@BD8/// $Ifgd 3kdz$$Ifl,r } &''''' @@@2&644 laXp2DGcd#kdF{$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3dfhjm $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kdu|$$Ifl,r } &''''' 2&644 laXp2Ȑɐ#kd}$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ɐː͐ϐҐ $$Ifa$gd 3 $Ifgd 38//// $Ifgd 3kd~$$Ifl,r } &''''' 2&644 laXp2 ,VMMMAM $$Ifa$gd 3 $Ifgd 3kd$$Ifl,\ &'''t' @@(&644 laXp(,-/138/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp236WX#kd4$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3XZ\}~k_ $$Ifa$gd 3kdc$$Ifl,F &''' @&6    44 laXp $Ifgd 3 8/// $Ifgd 3kd:$$Ifl,r } &''''' 2&644 laXp2#kdi$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ϑБґԑّ֑k_ $$Ifa$gd 3kd$$Ifl,F &''' @&6    44 laXp $Ifgd 3 8/// $Ifgd 3kdo$$Ifl,r } &''''' 2&644 laXp2 #kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 4 $$Ifa$gd 3 $Ifgd 34579;8/// $Ifgd 3kd͉$$Ifl,r } &''''' 2&644 laXp2;>OP#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3PRTVY $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd+$$Ifl,r } &''''' 2&644 laXp2#kdZ$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3Òƒڒk_ $$Ifa$gd 3kd$$Ifl,F &''' @&6    44 laXp $Ifgd 3 ڒےݒߒ8/// $Ifgd 3kd`$$Ifl,r } &''''' 2&644 laXp2#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 378:<^mkd$$Ifl,0&'']# 3f&644 laXp3f $Ifgd 3^_acehtkkk_k $$Ifa$gd 3 $Ifgd 3kdo$$Ifl,F &''' @&6    44 laXp^_;<@abfהؔ,-1IJNpq!"FGK^_ÖĖ /0RS !%126IJNo"hdqh 35CJOJQJ\^J%hdqh 3B*CJOJQJaJphhdqh 3CJS8/// $Ifgd 3kdF$$Ifl,r } &''''' 2&644 laXp2#kdu$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd$$Ifl,r } &''''' @@@2&644 laXp2#kdӖ$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2;<#kd1$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3<>@abdfkkd`$$Ifl,F &''' @&6    44 laXp $Ifgd 3tkkk_k $$Ifa$gd 3 $Ifgd 3kd7$$Ifl,F &''' @&6    44 laXpה8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2הؔڔܔޔtkkk_k $$Ifa$gd 3 $Ifgd 3kd=$$Ifl,F &''' @&6    44 laXp 8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2 ,-#kdC$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3-/1IJLNpkkdr$$Ifl,F &''' @&6    44 laXp $Ifgd 3pqsuw{tkkk_k $$Ifa$gd 3 $Ifgd 3kdI$$Ifl,F &''' @&6    44 laXp8//// $Ifgd 3kd $$Ifl,r } &''''' 2&644 laXp2/kdO$$Ifl,r } &''''' @@@2&644 laXp2 $Ifgd 3#kd~$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3! $$Ifa$gd 3 $Ifgd 3!"$&(8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2(,FG#kdܦ$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3GIK^_aceik_ $$Ifa$gd 3kd $$Ifl,F &''' @&6    44 laXp $Ifgd 3 Ö8// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2ÖĖƖȖʖΖ} $$Ifa$gd 3 $Ifgd 3mkd$$Ifl,0&'']# 3f&644 laXp3f8// $Ifgd 3kdª$$Ifl,r } &''''' 2&644 laXp2 / $Ifgd 3mkd$$Ifl,0&'']# 3f&644 laXp3f/0246:Rtkkk_k $$Ifa$gd 3 $Ifgd 3kd$$Ifl,F &''' @&6    44 laXpRSUWY8/// $Ifgd 3kdy$$Ifl,r } &''''' 2&644 laXp2Y]#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kdׯ$$Ifl,r } &''''' 2&644 laXp2#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 38//// $Ifgd 3kd5$$Ifl,r } &''''' 2&644 laXp2 !#%//kdd$$Ifl,r } &''''' @@@2&644 laXp2 $Ifgd 3/1246IMkd$$Ifl,\ &'''t' @@(&644 laXp( $Ifgd 3IJLNotkkk $Ifgd 3kd$$Ifl,F &''' @&6    44 laXpoprtvztkkk_k $$Ifa$gd 3 $Ifgd 3kdm$$Ifl,F &''' @&6    44 laXpop ()IJjkיؙܙ!"MNoptΚϚ!"&237JKOpqћқ֛()NOxyܜݜBClm"hdqh 35CJOJQJ\^J%hdqh 3B*CJOJQJaJphhdqh 3CJS8/// $Ifgd 3kdD$$Ifl,r } &''''' 2&644 laXp2#kds$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 mkd$$Ifl,0&'']# 3f&644 laXp3f $Ifgd 3 (tkkk_k $$Ifa$gd 3 $Ifgd 3kdS$$Ifl,F &''' @&6    44 laXp()+-/8/// $Ifgd 3kd*$$Ifl,r } &''''' 2&644 laXp2/3IJ#kdY$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3JLNPTj $$Ifa$gd 3 $Ifgd 3jkmoq8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2qu#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3י $$Ifa$gd 3 $Ifgd 3יؙڙܙ8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2!tkkk_k $$Ifa$gd 3 $Ifgd 3kd$$Ifl,F &''' @&6    44 laXp!"$&(8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2(,MN#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3NPRTXo $$Ifa$gd 3 $Ifgd 3oprt8/// $Ifgd 3kdJ$$Ifl,r } &''''' 2&644 laXp2tkkk_k $$Ifa$gd 3 $Ifgd 3kdy$$Ifl,F &''' @&6    44 laXp8/// $Ifgd 3kdP$$Ifl,r } &''''' 2&644 laXp2ΚϚ#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ϚњӚ՚ٚ $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2!"#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3"$&02357JMkd $$Ifl,\ &'''t' @@(&644 laXp( $Ifgd 3JKMOptkkk $Ifgd 3kd$$Ifl,F &''' @&6    44 laXppqsuw{tkkk_k $$Ifa$gd 3 $Ifgd 3kd$$Ifl,F &''' @&6    44 laXpћ8// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2ћқԛ֛ $Ifgd 3mkd$$Ifl,0&'']# 3f&644 laXp3ftkkk_k $$Ifa$gd 3 $Ifgd 3kd$$Ifl,F &''' @&6    44 laXp 8/// $Ifgd 3kdt$$Ifl,r } &''''' 2&644 laXp2 ()#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3)+-/3N $$Ifa$gd 3 $Ifgd 3NOQSU8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2UYxy#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3y{} $$Ifa$gd 3 $Ifgd 38//// $Ifgd 3kd0$$Ifl,r } &''''' 2&644 laXp2/kd_$$Ifl,r } &''''' @@@2&644 laXp2 $Ifgd 3#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3œĜƜʜܜ $$Ifa$gd 3 $Ifgd 3ܜݜߜ8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2#BC#kdJ$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3CEGIMl $$Ifa$gd 3 $Ifgd 3lmoqs8/// $Ifgd 3kdy$$Ifl,r } &''''' 2&644 laXp2sw#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3m ,-YZ =>ijԟ՟ 12^_cvwȠɠ :;pqu¡23`az{"hdqh 35CJOJQJ\^Jhdqh 3CJ%hdqh 3B*CJOJQJaJphR $$Ifa$gd 3 $Ifgd 3ĝƝ8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2Ɲʝ#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 3 ,8/// $Ifgd 3kd5$$Ifl,r } &''''' 2&644 laXp2,-/137Ytkkk_k $$Ifa$gd 3 $Ifgd 3kdd$$Ifl,F &''' @&6    44 laXpYZ\^`8/// $Ifgd 3kd;$$Ifl,r } &''''' 2&644 laXp2`d#kdj$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3žk_ $$Ifa$gd 3kd$$Ifl,F &''' @&6    44 laXp $Ifgd 3 8/// $Ifgd 3kdp$$Ifl,r } &''''' 2&644 laXp2#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 =>@BDHik_ $$Ifa$gd 3kd$$Ifl,F &''' @&6    44 laXp $Ifgd 3 ijlnp8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2pt#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 3ԟ8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2ԟ՟ןٟ۟ߟ tkkk_k $$Ifa$gd 3 $Ifgd 3kd2$$Ifl,F &''' @&6    44 laXp 8/// $Ifgd 3kd $$Ifl,r } &''''' 2&644 laXp212#kd8$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 32468<^ $$Ifa$gd 3 $Ifgd 3^_acv8/// $Ifgd 3kdg$$Ifl,r } &''''' 2&644 laXp2vwy{}tkkk_k $$Ifa$gd 3 $Ifgd 3kd$$Ifl,F &''' @&6    44 laXp8/// $Ifgd 3kdm$$Ifl,r } &''''' 2&644 laXp2Ƞɠ#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ɠˠ͠ϠӠ $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3  $Ifgd 3 8/// $Ifgd 3kd)$$Ifl,r } &''''' @@@2&644 laXp2 $:;#kdX$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3;=?AEp $$Ifa$gd 3 $Ifgd 3pqsu8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2tkkk_k $$Ifa$gd 3 $Ifgd 3kd$$Ifl,F &''' @&6    44 laXp8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2¡ġơȡ̡tkkk_k $$Ifa$gd 3 $Ifgd 3kd$$Ifl,F &''' @&6    44 laXp8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp22tkkk_k $$Ifa$gd 3 $Ifgd 3kd$$Ifl,F &''' @&6    44 laXp235798/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp29=`a#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3acegkz $$Ifa$gd 3 $Ifgd 3z{}8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2#kd&$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3mkdU$$Ifl,0&'']# 3f&644 laXp3f $Ifgd 3,-OP MNqr #$@Adei{|ɥʥ IJqr˦̦23YZͧΧ56fghdqh 3CJ"hdqh 35CJOJQJ\^J%hdqh 3B*CJOJQJaJphR8/// $Ifgd 3kd$$Ifl,r } &''''' @@@2&644 laXp2,-#kd5$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3-/137O $$Ifa$gd 3 $Ifgd 3OPRTV8/// $Ifgd 3kdd$$Ifl,r } &''''' 2&644 laXp2VZ#kd $$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd $$Ifl,r } &''''' 2&644 laXp2ã#kd $$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 Mkd $$Ifl,\ &'''t' @@(&644 laXp( $Ifgd 3 #kd#$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 "$&*M $$Ifa$gd 3 $Ifgd 3MNPRT8/// $Ifgd 3kdR$$Ifl,r } &''''' 2&644 laXp2TXqr#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3rtvx| $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3äǤ $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2 #tkkk $Ifgd 3kd=$$Ifl,F &''' @&6    44 laXp#$&(*.@tkkk_k $$Ifa$gd 3 $Ifgd 3kd$$Ifl,F &''' @&6    44 laXp@ACEG8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2GKde#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3egi{|~k_ $$Ifa$gd 3kdI$$Ifl,F &''' @&6    44 laXp $Ifgd 3 8/// $Ifgd 3kd $$Ifl,r } &''''' 2&644 laXp2ɥʥ#kdO$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ʥ̥ΥХԥ $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd~$$Ifl,r } &''''' 2&644 laXp2 #kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3  "$(Ik_ $$Ifa$gd 3kd$$Ifl,F &''' @&6    44 laXp $Ifgd 3 IJLNP8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2PTqr#kd $$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3rtvx| $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd"$$Ifl,r } &''''' 2&644 laXp2˦̦#kd@#$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3̦ΦЦҦ֦ $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kdo$$$Ifl,r } &''''' 2&644 laXp2#kd%$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 2 $$Ifa$gd 3 $Ifgd 3235798/// $Ifgd 3kd&$$Ifl,r } &''''' 2&644 laXp29=YZ#kd'$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3Z\^`d $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd+)$$Ifl,r } &''''' 2&644 laXp2#kdZ*$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ɧ˧ͧΧЧҧԧاk_ $$Ifa$gd 3kd+$$Ifl,F} &'R '' &6    44 laXp $Ifgd 3 8/// $Ifgd 3kdf,$$Ifl,r } &''''' 2&644 laXp256#kd-$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 368:<@f $$Ifa$gd 3 $Ifgd 3fgikm8/// $Ifgd 3kd.$$Ifl,r } &''''' 2&644 laXp2mq#kd/$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3Ĩ $$Ifa$gd 3 $Ifgd 3ĨŨ56VWno $%EFbcϪЪ/0FGnoݫޫ/0GHnoϬЬ #89jkŭƭ"hdqh 35CJOJQJ\^Jhdqh 3CJ%hdqh 3B*CJOJQJaJphRĨŨǨɨ˨8/// $Ifgd 3kd"1$$Ifl,r } &''''' 2&644 laXp2˨Ϩ#kdQ2$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd3$$Ifl,r } &''''' 2&644 laXp2#56#kd4$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 368:<@V $$Ifa$gd 3 $Ifgd 3VWY[]8/// $Ifgd 3kd5$$Ifl,r } &''''' 2&644 laXp2]ano#kd 7$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3oqsuy $$Ifa$gd 3 $Ifgd 38//// $Ifgd 3kd<8$$Ifl,r } &''''' 2&644 laXp2/kdk9$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3#kd:$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd;$$Ifl,r } &''''' 2&644 laXp2 #kd<$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3$ $$Ifa$gd 3 $Ifgd 3$%')+8/// $Ifgd 3kd'>$$Ifl,r } &''''' 2&644 laXp2+/EF#kdV?$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3FHJLPb $$Ifa$gd 3 $Ifgd 3bcegi8/// $Ifgd 3kd@$$Ifl,r } &''''' 2&644 laXp2im#kdA$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kdB$$Ifl,r } &''''' 2&644 laXp2ϪЪ#kdD$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ЪҪԪ֪ڪ $$Ifa$gd 3 $Ifgd 38//// $Ifgd 3kdAE$$Ifl,r } &''''' 2&644 laXp2/VMMMAM $$Ifa$gd 3 $Ifgd 3kdpF$$Ifl,\ } &'l''' (&644 laXp(/02468/// $Ifgd 3kdyG$$Ifl,r } &''''' 2&644 laXp26:FG#kdH$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3GIKMQn $$Ifa$gd 3 $Ifgd 3noqsu8/// $Ifgd 3kdI$$Ifl,r } &''''' 2&644 laXp2uy#kdK$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 3ë8/// $Ifgd 3kd5L$$Ifl,r } &''''' 2&644 laXp2ëǫݫޫ#kddM$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ޫ $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kdN$$Ifl,r } &''''' 2&644 laXp2/0#kdO$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 30246:G $$Ifa$gd 3 $Ifgd 3GHJLN8/// $Ifgd 3kdP$$Ifl,r } &''''' 2&644 laXp2NRno#kd R$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3oqsuy $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kdOS$$Ifl,r } &''''' 2&644 laXp2#kd~T$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3Ϭ $$Ifa$gd 3 $Ifgd 3ϬЬҬԬ֬8/// $Ifgd 3kdU$$Ifl,r } &''''' 2&644 laXp2֬ڬ#kdV$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $Ifgd 3 8//// $Ifgd 3kd X$$Ifl,r } &''''' 2&644 laXp2!#8VMMM $Ifgd 3kd:Y$$Ifl,\} &'''' (3f3f3f&644 laXp(3f3f3f89;=?Cjtkkk_k $$Ifa$gd 3 $Ifgd 3kdCZ$$Ifl,F &''' @&6    44 laXpjkmoq8/// $Ifgd 3kd[$$Ifl,r } &''''' 2&644 laXp2qu#kdI\$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ŭ $$Ifa$gd 3 $Ifgd 3ŭƭȭʭ̭8/// $Ifgd 3kdx]$$Ifl,r } &''''' 2&644 laXp2̭Э#kd^$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3" $$Ifa$gd 3 $Ifgd 3"#UV|}ҮӮծ./^_ͯίү"#DEcdذٰ*+KLNͱα()QRmn˲̲HI"hdqh 35CJOJQJ\^Jhdqh 3CJ%hdqh 3B*CJOJQJaJphR"#%')8/// $Ifgd 3kd_$$Ifl,r } &''''' 2&644 laXp2)-UV#kda$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3VXZ\`| $$Ifa$gd 3 $Ifgd 3|}8/// $Ifgd 3kd4b$$Ifl,r } &''''' 2&644 laXp2Үtkkk_k $$Ifa$gd 3 $Ifgd 3kdcc$$Ifl,F &''' @&6    44 laXpҮӮծ8//// $Ifgd 3kd:d$$Ifl,r } &''''' 2&644 laXp2VMMMM $Ifgd 3kdie$$Ifl,\} &'''' (3f3f3f&644 laXp(3f3f3f .VMMMAM $$Ifa$gd 3 $Ifgd 3kdrf$$Ifl,\ &'''t' @@(&644 laXp(./1358/// $Ifgd 3kdug$$Ifl,r } &''''' 2&644 laXp259^_#kdh$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3_acei $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kdi$$Ifl,r } &''''' 2&644 laXp2#kdk$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ͯ $$Ifa$gd 3 $Ifgd 3ͯίЯү8/// $Ifgd 3kd1l$$Ifl,r } &''''' 2&644 laXp2tkkk_k $$Ifa$gd 3 $Ifgd 3kd`m$$Ifl,F &''' @&6    44 laXp8/// $Ifgd 3kd7n$$Ifl,r } &''''' 2&644 laXp2#kdfo$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3"#%')-D} $$Ifa$gd 3mkdp$$Ifl,0&'']# 3f&644 laXp3f $Ifgd 3DEGIK8/// $Ifgd 3kdFq$$Ifl,r } &''''' 2&644 laXp2KOcd#kdur$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3dfhjn $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kds$$Ifl,r } &''''' 2&644 laXp2#kdt$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ذٰ۰ݰ߰} $$Ifa$gd 3mkdv$$Ifl,0&'']# 3f&644 laXp3f $Ifgd 38/// $Ifgd 3kdv$$Ifl,r } &''''' 2&644 laXp2 *+#kdw$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3+-/15K $$Ifa$gd 3 $Ifgd 3KLN8// $Ifgd 3kdy$$Ifl,r } &''''' 2&644 laXp2} $$Ifa$gd 3 $Ifgd 3mkd@z$$Ifl,0&'']# 3f&644 laXp3fͱ8// $Ifgd 3kdz$$Ifl,r } &''''' 2&644 laXp2ͱαбұԱر} $$Ifa$gd 3 $Ifgd 3mkd |$$Ifl,0&'']# 3f&644 laXp3f8/// $Ifgd 3kd|$$Ifl,r } &''''' 2&644 laXp2 ()#kd~$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3)+-/3Q $$Ifa$gd 3 $Ifgd 3QRikm8/// $Ifgd 3kd/$$Ifl,r } &''''' 2&644 laXp2mnprtxtkkk_k $$Ifa$gd 3 $Ifgd 3kd^$$Ifl,F} &'R '' &6    44 laXp8/// $Ifgd 3kd;$$Ifl,r } &''''' 2&644 laXp2#kdj$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3˲ $$Ifa$gd 3 $Ifgd 3˲̲βвҲ8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2Ҳֲ#kdȄ$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2HI#kd&$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3Istvxz~ $$Ifa$gd 3OkdU$$Ifl,&'&  &644 laXp $Ifgd 3Istȳɳ#$NOmn޴ߴ>?TUWmnr}~εϵ?@ghjĶŶ )*IJNZ[h 3B*CJOJQJaJph%hdqh 3B*CJOJQJaJphhdqh 3CJ"hdqh 35CJOJQJ\^JL8/// $Ifgd 3kdڈ$$Ifl,r } &''''' 2&644 laXp2#kd $$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd8$$Ifl,r } &''''' 2&644 laXp2#$#kdg$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3$&(*.N $$Ifa$gd 3 $Ifgd 3NOkm8// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2mn $Ifgd 3mkdŎ$$Ifl,0&' ' &644 laXptkkk_k $$Ifa$gd 3 $Ifgd 3kdv$$Ifl,F} &'R '' &6    44 laXp8/// $Ifgd 3kdS$$Ifl,r } &''''' 2&644 laXp2޴ߴ#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ߴ $$Ifa$gd 3 $Ifgd 3 8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2 >?#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3?NPRTUWkmMkd$$Ifl,\ } &'l''' (&644 laXp( $Ifgd 3mnpry{}tkkkkk $Ifgd 3kd$$Ifl,F&''A ' 3f3f&6    44 laXp3f3f}~8/// $Ifgd 3kd$$Ifl,r } &''''' @@@2&644 laXp2#kd$$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kdS$$Ifl,r } &''''' 2&644 laXp2εϵ#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ϵѵӵյٵ $$Ifa$gd 3 $Ifgd 38//// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2VMMMAM $$Ifa$gd 3 $Ifgd 3kd$$Ifl,\ &'''t' @@(&644 laXp( "8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2"&?@#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3@BDFJg $$Ifa$gd 3 $Ifgd 3ghj8// $Ifgd 3kdA$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3mkdp$$Ifl,0&'']# 3f&644 laXp3f8/// $Ifgd 3kd!$$Ifl,r } &''''' @@@2&644 laXp2#kdP$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3Ķ $$Ifa$gd 3 $Ifgd 3ĶŶǶɶ˶8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2˶϶#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 3 8/// $Ifgd 3kdݦ$$Ifl,r } &''''' 2&644 laXp2)*#kd $$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3*,.04I $$Ifa$gd 3 $Ifgd 3IJLNXZ8//// $Ifgd 3kd;$$Ifl,r } &''''' 2&644 laXp2Z[]_aeVMMMAM $$Ifa$gd 3 $Ifgd 3kdj$$Ifl,\ &'''t' @@(&644 laXp(8//// $Ifgd 3kdm$$Ifl,r } &''''' 2&644 laXp2VMMMMM $Ifgd 3kd$$Ifl,\} &'''' (3f3f3f&644 laXp(3f3f3f̷ͷѷݷ޷'(*;<Z[]rs¸ָ׸ !#56:FGbcstǹȹ)*RSopĺź "#%124"hdqh 35CJOJQJ\^J%hdqh 3B*CJOJQJaJphhdqh 3CJS8/// $Ifgd 3kd$$Ifl,r } &''''' @@@2&644 laXp2̷ͷ#kdԮ$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ͷϷѷ۷ݷ޷Mkd$$Ifl,\ &'''t' @@(&644 laXp( $Ifgd 3#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3' $$Ifa$gd 3 $Ifgd 3'(*79;8//// $Ifgd 3kd5$$Ifl,r } &''''' 2&644 laXp2;<>@BFZVMMMAM $$Ifa$gd 3 $Ifgd 3kdd$$Ifl,\} &'''' (3f3f3f&644 laXp(3f3f3fZ[]npr8//// $Ifgd 3kdm$$Ifl,r } &''''' 2&644 laXp2rsuwy}VMMMAM $$Ifa$gd 3 $Ifgd 3kd$$Ifl,\} &'''' (3f3f3f&644 laXp(3f3f3f8//// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2VMMMAM $$Ifa$gd 3 $Ifgd 3kdԷ$$Ifl,\} &'''' (3f3f3f&644 laXp(3f3f3f¸ҸԸָ8//// $Ifgd 3kdݸ$$Ifl,r } &''''' 2&644 laXp2ָ׸ٸ۸ݸVMMMAM $$Ifa$gd 3 $Ifgd 3kd $$Ifl,\} &'''' (3f3f3f&644 laXp(3f3f3f 8//// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2  VMMMAM $$Ifa$gd 3 $Ifgd 3kdD$$Ifl,\} &'''' (3f3f3f&644 laXp(3f3f3f !#1358//// $Ifgd 3kdM$$Ifl,r } &''''' 2&644 laXp2568:BDFVMMMMM $Ifgd 3kd|$$Ifl,\} &'''' (3f3f3f&644 laXp(3f3f3fFGIKM8/// $Ifgd 3kd$$Ifl,r } &''''' @@@2&644 laXp2MQbc#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3cegims $$Ifa$gd 3 $Ifgd 3stvxz8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2z~#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ǹk_ $$Ifa$gd 3kdA$$Ifl,F &''' @&6    44 laXp $Ifgd 3 ǹȹʹ̹ι8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2ιҹ#kdG$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 3%')8//// $Ifgd 3kdv$$Ifl,r } &''''' 2&644 laXp2)*,.04RVMMMAM $$Ifa$gd 3 $Ifgd 3kd$$Ifl,\} &'''' (3f3f3f&644 laXp(3f3f3fRSUWY8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2Y]op#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3prtvz $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kd $$Ifl,r } &''''' 2&644 laXp2#kd;$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ĺ $$Ifa$gd 3 $Ifgd 3ĺźǺɺ˺8/// $Ifgd 3kdj$$Ifl,r } &''''' 2&644 laXp2˺Ϻ#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3  Mkd$$Ifl,\} &'''' (3f3f3f&644 laXp(3f3f3f $Ifgd 3 "#%+-/1Mkd$$Ifl,\ } &'l''' (&644 laXp( $Ifgd 3124FHJ8//// $Ifgd 3kd$$Ifl,r } &''''' 23f3f3f3f&644 laXp23f3f3f3f4JKOZ[yzȻɻ89=IJhiüļܼݼ()-QRVbce½սֽڽOPz{}ؾپ %hdqh 3B*CJOJQJaJphhdqh 3CJ"hdqh 35CJOJQJ\^JSJKMOVXZVMMMMM $Ifgd 3kd $$Ifl,\} &'''' (3f3f3f&644 laXp(3f3f3fZ[]_a8/// $Ifgd 3kd$$Ifl,r } &''''' @@@2&644 laXp2aeyz#kdA$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3z|~ $$Ifa$gd 3 $Ifgd 38/// $Ifgd 3kdp$$Ifl,r } &''''' 2&644 laXp2#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3Ȼ $$Ifa$gd 3 $Ifgd 3Ȼɻ˻ͻϻ8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2ϻӻ#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 38k_ $$Ifa$gd 3kd,$$Ifl,F &''' @&6    44 laXp $Ifgd 3 89;=GI8//// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2IJLNPThVMMMAM $$Ifa$gd 3 $Ifgd 3kd2$$Ifl,\ &'''t' @@(&644 laXp(hikmo8/// $Ifgd 3kd5$$Ifl,r } &''''' 2&644 laXp2os#kdd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ümkd$$Ifl,0&'']# 3f&644 laXp3f $Ifgd 3üļƼȼʼ8/// $Ifgd 3kdD$$Ifl,r } &''''' @@@2&644 laXp2ʼμܼݼ#kds$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3ݼ߼ (k_ $$Ifa$gd 3kd$$Ifl,F &''' @&6    44 laXp $Ifgd 3 ()+-Q8/// $Ifgd 3kdy$$Ifl,r } &''''' 2&644 laXp2QRTV`btkkkk $Ifgd 3kd$$Ifl,F &''' @&6    44 laXpbceVMM $Ifgd 3kd$$Ifl,\ &'''t' @@(&644 laXp( $Ifgd 3mkd$$Ifl,0&'']# 3f&644 laXp3f8/// $Ifgd 3kd3$$Ifl,r } &''''' @@@2&644 laXp2½#kdb$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3½ĽƽȽ̽ս $$Ifa$gd 3 $Ifgd 3սֽؽڽ8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2 tkkkk $Ifgd 3kd$$Ifl,F &''' @&6    44 laXpOVMMMAM $$Ifa$gd 3 $Ifgd 3kd$$Ifl,\ &'''t' @@(&644 laXp(OPRTV8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2VZz{#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3{}kkd$$Ifl,F&''A ' 3f3f&6    44 laXp3f3f $Ifgd 3 8//// $Ifgd 3kd$$Ifl,r } &''''' @@@2&644 laXp2ؾVMM $Ifgd 3kd$$Ifl,\ &'''t' @@(&644 laXp(ؾپ۾ݾ߾} $$Ifa$gd 3 $Ifgd 3mkd$$Ifl,0&'']# 3f&644 laXp3f 8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2 tkkkkk $Ifgd 3kd$$Ifl,F&''A ' 3f3f&6    44 laXp3f3f !-.0LMQ\]ҿӿ׿ 346MNst()DEGfgk &'+:;?STXhdqh 3CJ"hdqh 35CJOJQJ\^J%hdqh 3B*CJOJQJaJphR!+-8//// $Ifgd 3kd$$Ifl,r } &''''' @@@2&644 laXp2-.0LVMM $Ifgd 3kd$$Ifl,\ &'''t' @@(&644 laXp(LMOQXZ\ $Ifgd 3mkd$$Ifl,0&'']# 3f&644 laXp3f\]_ac8/// $Ifgd 3kd$$Ifl,r } &''''' @@@2&644 laXp2cg#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 3ҿ8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2ҿӿտ׿tkkk $Ifgd 3kd4$$Ifl,F &''' @&6    44 laXp tkkkk $Ifgd 3kd $$Ifl,F &''' @&6    44 laXp 3VMMMAM $$Ifa$gd 3 $Ifgd 3kd$$Ifl,\ &'''t' @@(&644 laXp(346M8// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2MNPRTXs} $$Ifa$gd 3 $Ifgd 3mkd$$Ifl,0&'']# 3f&644 laXp3fstvxz8/// $Ifgd 3kd$$Ifl,r } &''''' 2&644 laXp2z~#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3mkd#$$Ifl,0&'']# 3f&644 laXp3f $Ifgd 38/// $Ifgd 3kd$$Ifl,r } &''''' @@@2&644 laXp2#kd$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3&(kkd2$$Ifl,F &''' @&6    44 laXp $Ifgd 3()+-/3DVMMMAM $$Ifa$gd 3 $Ifgd 3kd $$Ifl,\ &'''t' @@(&644 laXp(DEGf8// $Ifgd 3kd $$Ifl,r } &''''' 2&644 laXp2fgik $Ifgd 3mkd; $$Ifl,0&'']# 3f&644 laXp3ftkkk_k $$Ifa$gd 3 $Ifgd 3kd $$Ifl,F &''' @&6    44 laXp8/// $Ifgd 3kd $$Ifl,r } &''''' 2&644 laXp2#kd $$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3Mkd!$$Ifl,\ &'''t' @@(&644 laXp( $Ifgd 3#kd$$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3MkdS$$Ifl,\ &'''t' @@(&644 laXp( $Ifgd 3 #kdV$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3&')+8:kkd$$Ifl,F &''' @&6    44 laXp $Ifgd 3:;=?SVMMM $Ifgd 3kd\$$Ifl,\ &'''t' @@(&644 laXp(STVXtkkk $Ifgd 3kd_$$Ifl,F &''' @&6    44 laXptkkk_k $$Ifa$gd 3 $Ifgd 3kd6$$Ifl,F &''' @&6 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laXp(3f3f3f $Ifgd 3 4tkkk_k $$Ifa$gd 3 $Ifgd 3kd($$Ifl,F &''' @&6    44 laXp4579;8/// $Ifgd 3kd)$$Ifl,r } &''''' 2&644 laXp2;?no#kd*$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3oqsuy $$Ifa$gd 3 $Ifgd 38//// $Ifgd 3kd ,$$Ifl,r } &''''' 2&644 laXp2/kdO-$$Ifl,r } &''''' @@@2&644 laXp2 $Ifgd 3tkkk_k $$Ifa$gd 3 $Ifgd 3kd~.$$Ifl,F &''' @&6    44 laXp8// $Ifgd 3kdU/$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3mkd0$$Ifl,0&'']# 3f&644 laXp3f "$&VMMMM $Ifgd 3kd51$$Ifl,\ } &'l''' (&644 laXp(&')+468VMMMMM $Ifgd 3kd>2$$Ifl,\} &'''' (3f3f3f&644 laXp(3f3f3f89;=?8/// $Ifgd 3kdG3$$Ifl,r } &''''' @@@2&644 laXp2?CRS#kdv4$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3SUWY]z $$Ifa$gd 3 $Ifgd 3z{}8/// $Ifgd 3kd5$$Ifl,r } &''''' 2&644 laXp2#kd6$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3k_ $$Ifa$gd 3kd8$$Ifl,F &''' @&6    44 laXp $Ifgd 3 8/// $Ifgd 3kd8$$Ifl,r } &''''' 2&644 laXp2#kd :$$Ifl,r } &''''' 2&644 laXp2 $Ifgd 3 $$Ifa$gd 3 $$Ifa$gd 3 $Ifgd 3:;?TUnoFGIXY!013CD`acxy{&'TUWkljh 3Uh 3"hdqh 35CJOJQJ\^Jhdqh 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