253 research outputs found
Horndeski Genesis: strong coupling and absence thereof
We consider Genesis in the Horndeski theory as an alternative to or
completion of the inflationary scenario. One of the options free of
instabilities at all cosmological epochs is the one in which the early Genesis
is naively plagued with strong coupling. We address this issue to see whether
classical field theory description of the background evolution at this early
stage is consistent, nevertheless. We argue that, indeed, despite the fact that
the effective Plank mass tends to zero at early time asymptotics, the classical
analysis is legitimate in a certain range of Lagrangian parameters.Comment: 10 pages, 1 figur
Laparoscopic Roux-en-Y reconstruction in a patient with afferent loop syndrome and peptic ulcers of gastroenteroanastomosis - A first experience
This paper is devoted to the description of a currently rare clinical observation of the surgical treatment of a patient with postgastroresection syndrome (afferent loop syndrome and peptic ulcers of gastroenteroanastomosis) - resection of the stomach stump with laparoscopic Roux-en-Y reconstructio
Development of the Republic of Sakha (Yakutia)'s Shadow Economy Assessment Methodology
The purpose of the article is to study the shadow economy assessment methodology. This article presents a comprehensive study of the parameters of a shadow economy, considers its essence, and defines its terminology. This study outlines the historical approach to the development of the shadow economy, both in Russia and worldwide, and gives a brief analysis of the economy of the Republic of Sakha. The authors examined the specifics of the statistical methods applied in assessing various structural elements of a shadow economy and measured and assessed the shadow economy in this region. The research conducted enabled the authors to formulate the main measures required to reduce the shadow economy. The scientific novelty is justified by the research results, which included studying and summarizing a wide range of published and unpublished materials, the examination of the initial and transitional periods of the shadow economy development in Yakutia. The article reveals the main causes and conditions that lead to the formation of the shadow economy in various sectors of the Yakutia economy. The solutions and suggestions proposed in the article are aimed at reducing the shadow economy parameters. The scientific research results are of theoretical and applied importance for public administration and authorities to improve the effectiveness of the fight against the shadow economy manifestations
Interaction of Educational Organizations as a Factor in the Formation of Practical Experience of Students
Π ΡΡΠ°ΡΡΠ΅ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°ΡΡΡΡ Π²ΠΎΠΏΡΠΎΡΡ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠΏΡΡΠ° ΠΎΠ±ΡΡΠ°ΡΡΠΈΡ
ΡΡ ΡΠ΅ΡΠ΅Π· ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠ΅ΡΡΡΡΠΎΠ² Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΈΡ
ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΉ. ΠΡΠΈΠ²Π΅Π΄Π΅Π½ ΠΏΡΠΈΠΌΠ΅Ρ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΡ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΉ ΡΡΠ΅Π΄Π½Π΅Π³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ.The article deals with the formation of practical experience of students through the use of resources of several educational organizations. An example of interaction of organizations of secondary vocational education is given
ΠΠ»ΠΈΡΠ½ΠΈΠ΅ ΡΠΈΡΠΎΠ·ΠΈΠ»-D-Π°Π»Π°Π½ΠΈΠ»-Π³Π»ΠΈΡΠΈΠ»-ΡΠ΅Π½ΠΈΠ»Π°Π»Π°Π½ΠΈΠ»-Π»Π΅ΠΉΡΠΈΠ»-Π°ΡΠ³ΠΈΠ½ΠΈΠ½Π° Π΄ΠΈΠ°ΡΠ΅ΡΠ°ΡΠ° (ΠΠ°Π»Π°ΡΠ³ΠΈΠ½) Π½Π° ΠΎΠΊΠΈΡΠ»ΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΡΡΡΠ΅ΡΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡΠΆΠ΅Π»ΠΎΠΉ ΡΠΎΡΠ΅ΡΠ°Π½Π½ΠΎΠΉ ΡΡΠ°Π²ΠΌΠΎΠΉ: ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅
ΠΠΠ’Π£ΠΠΠ¬ΠΠΠ‘Π’Π¬: Π’ΡΠΆΠ΅Π»Π°Ρ ΡΠΎΡΠ΅ΡΠ°Π½Π½Π°Ρ ΡΡΠ°Π²ΠΌΠ° (Π’Π‘Π’) ΠΎΡΡΠ°Π΅ΡΡΡ Π²Π΅Π΄ΡΡΠ΅ΠΉ ΠΏΡΠΈΡΠΈΠ½ΠΎΠΉ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ ΠΈΒ ΠΈΠ½Π²Π°Π»ΠΈΠ΄ΠΈΠ·Π°ΡΠΈΠΈ ΡΡΡΠ΄ΠΎΡΠΏΠΎΡΠΎΠ±Π½ΠΎΠ³ΠΎ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ. ΠΡΠΈ Π²ΠΎΠ·Π΄Π΅ΠΉΡΡΠ²ΠΈΠΈ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π°ΡΡΠ΅Π³ΠΎ ΡΠ°ΠΊΡΠΎΡΠ° Π·Π°ΠΏΡΡΠΊΠ°Π΅ΡΡΡ ΡΠ΅Π»ΡΠΉ ΠΊΠ°ΡΠΊΠ°Π΄ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΎΡΠ΅ΡΡΠΎΠ², ΠΏΡΠΈΠ²ΠΎΠ΄ΡΡΠΈΡ
ΠΊΒ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΏΠΎΠ»ΠΈΠΎΡΠ³Π°Π½Π½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ. Π¦ΠΠΠ¬ ΠΠ‘Π‘ΠΠΠΠΠΠΠΠΠ―: ΠΠ·ΡΡΠΈΡΡ Π²Π»ΠΈΡΠ½ΠΈΠ΅ ΡΠΈΡΠΎΠ·ΠΈΠ»-D-Π°Π»Π°Π½ΠΈΠ»-Π³Π»ΠΈΡΠΈΠ»-ΡΠ΅Π½ΠΈΠ»Π°Π»Π°Π½ΠΈΠ»-Π»Π΅ΠΉΡΠΈΠ»-Π°ΡΠ³ΠΈΠ½ΠΈΠ½Π° Π΄ΠΈΠ°ΡΠ΅ΡΠ°ΡΠ° (ΠΠ°Π»Π°ΡΠ³ΠΈΠ½Π°) Π½Π° Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΡ ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² ΠΎΠΊΠΈΡΠ»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΡΡΡΠ΅ΡΡΠ° ΡΒ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΒ Π’Π‘Π’ ΠΈΒ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΠΎΡΠ³Π°Π½Π½ΠΎΠΉ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠΈ. ΠΠΠ’ΠΠ ΠΠΠΠ« Π ΠΠΠ’ΠΠΠ«: ΠΒ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠ΅Π½ΠΎ 104Β ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° ΡΒ Π’Π‘Π’. ΠΒ Π³ΡΡΠΏΠΏΠ΅ ΠΠ°Π»Π°ΡΠ³ΠΈΠ½Π° 38Β ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Π²Β Π³ΡΡΠΏΠΏΠ΅ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ 66Β ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠ°ΡΠΈΠ΅Π½ΡΡ ΠΈΠ· ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ ΠΏΠΎΠ»ΡΡΠ°Π»ΠΈ ΠΠ°Π»Π°ΡΠ³ΠΈΠ½ Π²Β Π²ΠΈΠ΄Π΅ ΠΏΠΎΡΡΠΎΡΠ½Π½ΠΎΠΉ ΠΈΠ½ΡΡΠ·ΠΈΠΈ ΡΠ΅ΡΠ΅Π· ΡΠΏΡΠΈΡΠ΅Π²ΠΎΠΉ Π΄ΠΎΠ·Π°ΡΠΎΡ Π²Β Π΄ΠΎΠ·Π΅ 10Β ΠΌΠΊΠ³/ΠΊΠ³/Ρ Π²Β ΠΏΠ΅ΡΠ²ΡΠ΅ 12Β Ρ ΠΎΡ ΠΌΠΎΠΌΠ΅Π½ΡΠ° ΠΏΠΎΡΡΡΠΏΠ»Π΅Π½ΠΈΡ Π²Β ΡΡΠ°ΡΠΈΠΎΠ½Π°Ρ ΠΈΒ 5Β ΠΌΠΊΠ³/ΠΊΠ³/Ρ Π΄ΠΎ 72Β Ρ ΠΎΡ ΠΌΠΎΠΌΠ΅Π½ΡΠ° ΠΏΠΎΡΡΡΠΏΠ»Π΅Π½ΠΈΡ. ΠΠ°ΡΠΈΠ΅Π½ΡΡ Π³ΡΡΠΏΠΏΡ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΠΏΠΎΠ»ΡΡΠ°Π»ΠΈ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅. ΠΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ ΠΎΠΊΠΈΡΠ»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΡΡΡΠ΅ΡΡΠ° ΠΎΡΠ΅Π½ΠΈΠ²Π°Π»ΠΈΡΡ Π½Π° ΠΌΠΎΠΌΠ΅Π½Ρ ΠΏΠΎΡΡΡΠΏΠ»Π΅Π½ΠΈΡ (0-Π΅Β ΡΡΡΠΊΠΈ), Π΄Π°Π»Π΅Π΅ 1, 3, 5, 7, 10 ΠΈΒ 14-Π΅Β ΡΡΡΠΊΠΈ ΠΎΡ Π½Π°ΡΠ°Π»Π° ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. Π ΠΠΠ£ΠΠ¬Π’ΠΠ’Π«: ΠΒ ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ ΠΎΡΠΌΠ΅ΡΠ°Π»ΠΎΡΡ Π·Π½Π°ΡΠΈΠΌΠΎΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² ΠΎΠΊΠΈΡΠ»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΡΡΡΠ΅ΡΡΠ°, ΡΠ°ΠΊΠΈΡ
ΠΊΠ°ΠΊ ΠΌΠ°Π»ΠΎΠ½ΠΎΠ²ΡΠΉ Π΄ΠΈΠ°Π»ΡΠ΄Π΅Π³ΠΈΠ΄, ΡΒ 1-Ρ
Β ΡΡΡΠΎΠΊ Π»Π΅ΡΠ΅Π½ΠΈΡ (ΡΒ Β 0,05), ΠΎΠ΄Π½Π°ΠΊΠΎ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΡΡΠ΅Π΄ΠΈ Π²ΡΠΆΠΈΠ²ΡΠΈΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π±ΡΠ»Π° ΠΌΠ΅Π½ΡΡΠ΅ Π²Β Π³ΡΡΠΏΠΏΠ΅ ΠΠ°Π»Π°ΡΠ³ΠΈΠ½Π° (ΡΒ <Β 0,05). Π Π°Π·Π²ΠΈΡΠΈΠ΅ ΠΎΡΠ³Π°Π½Π½ΠΎΠΉ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠΈ (ΠΎΡΡΡΡΠΉ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΡΠΉ Π΄ΠΈΡΡΡΠ΅ΡΡ-ΡΠΈΠ½Π΄ΡΠΎΠΌ, ΠΎΡΡΡΠΎΠ΅ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠ΅ ΠΏΠΎΡΠ΅ΠΊ) Π²ΡΡΡΠ΅ΡΠ°Π»ΠΈΡΡ ΠΌΠ΅Π½ΡΡΠ΅ Π²Β Π³ΡΡΠΏΠΏΠ΅ ΠΠ°Π»Π°ΡΠ³ΠΈΠ½Π° (ΡΒ <Β 0,05), Π½ΠΎ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΎΠ½Π½ΡΠ΅ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡ (ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΡ, ΠΌΠ΅Π½ΠΈΠ½Π³ΠΈΡ, Π½Π°Π³Π½ΠΎΠ΅Π½ΠΈΠ΅ ΡΠ°Π½) Π±ΡΠ»ΠΈ ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΠΌΡ. ΠΠ«ΠΠΠΠ«: ΠΠ°Π»Π°ΡΠ³ΠΈΠ½ ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊΒ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² ΠΎΠΊΠΈΡΠ»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΡΡΡΠ΅ΡΡΠ° ΠΈΒ Π½ΠΎΡΠΌΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΡΠ½Π΄ΠΎΡΠ΅Π»ΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΡΡΠ½ΠΊΡΠΈΠΈ, ΡΡΠΎ ΡΠΏΠΎΡΠΎΠ±ΡΡΠ²ΡΠ΅Ρ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΡΠ°ΡΡΠΎΡΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΎΡΠ³Π°Π½Π½ΠΎΠΉ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠΈ
Natural study of marginal array rock`s stress state
Safety working out water-soluble ore fields in many ways depends on the stability of chamber development system`s elements. To monitor the interchamber pillars` status a method of experimental and theoretical evaluation of the geomechanical processes taking place in the array was developed, the essence of which lies in the meaningful results interpretation of mechanical characteristics and the stress state experimental studies of load-carrying structures by mathematical modeling methods.
The article describes the method of estimating the marginal rock array`s stress state. The tension control was made using an acoustic memory effect. The measurements were performed in the wells with the help of a Goodman hydraulic jack. Its feature is the ability to create a load on the borehole array in the same plane, that allows to evaluate the stress magnitude in various directions. During the loading of the measuring borehole walls there is a discontinuous increase in the activity of acoustic emission. The pressure, which is logged in the hydraulic system, was taken at the level of the natural stresses acting in the marginal array.
As a result of complex laboratory and field studies methodological features of stress analysis were identified using memory effects in salt rocks of the Verkhnekamskoye potash salt deposit. The experimental data analysis showed that in the βfreshβ interchamber pillars a bearing pressure maximum is located near the contour of exposure and in 1.8-2.0 times higher than the load of of the overlying rocks` weight (gH). In the central part of the pillar the vertical stress level is 1.25-1.4 gH. With the increase in pillars` service life the marginal array`s stresses magnitude declines to the stress level of the overlying rocks weight. The horizontal stress increases with moving from the pillar contour and are approximately 60-70% of the vertical. These instrumental measurements results are a source data for assessing the long-term sustainability of interchamber pillars in sylvinite layers mining
INVESTIGATION OF SORPTION CHARACTERISTICS OF POLYMERIC MINERAL-FILLED COMPOSITES FOR MEDICINE
The polymer compositions on the base of acrylic derivatives and bentonite particles modified by silver ions with various share and dispersion are received and studied by radical polymerization in the water. Partially neutralized acrylic acid, acrylamide and methylene-bis-acrilamide and particles of bentonite with fraction 0 - 0,05 mass.% are chosen as initial substances. The influence of bentonite concentration on absorbing characteristics of polymer materials in the distilled water is shown. It is demonstrated that the increase of bentonite fraction up to 5 mass.% leads to the rise of degree of equilibrium swelling by 1,5 β 2 times in comparison with an unfilled polymer matrix. The acrylic nanocompositions with a mass fraction of bentonite equal to 0,01 mass.% possess the greatest kinetic characteristics. Kinetic dependences of new composite materials swelling in physiological solution from a filler dispersion part are investigated. It is shown that in high dispersion (with particle size less than 0,25 mm) a part of mineralβcontaining filler equal to 1 mass.% leads to significant increase in values of equilibrium swelling degree in comparison with an unfilled sample (by 1,5 times). The effect of polyelectrolyte suppression of polymer composition swelling in physiological solution is studied. It results in values reduction of equilibrium swelling degree in comparison with these values in the distilled water. Application prospects for the received compositions are shown at bandages creation for wounds treatment of various etiologies. Research results are recommended for usage in medical practice for optimization of wound process march
ΠΠ»ΠΈΡΠ½ΠΈΠ΅ ΠΏΠ΅ΡΠ΅Π»ΠΈΠ²Π°Π½ΠΈΡ ΡΠ²Π΅ΠΆΠ΅Π·Π°ΠΌΠΎΡΠΎΠΆΠ΅Π½Π½ΠΎΠΉ ΠΏΠ»Π°Π·ΠΌΡ Π½Π° ΡΠ»Π΅ΠΊΡΡΠΎΡ ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΡ ΠΏΠ»Π°Π·ΠΌΡ ΠΊΡΠΎΠ²ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡΠΆΠ΅Π»ΠΎΠΉ ΡΠΎΡΠ΅ΡΠ°Π½Π½ΠΎΠΉ ΡΡΠ°Π²ΠΌΠΎΠΉ
Purpose: to study the dynamics of blood plasma electrochemical parameters in patients with severe combined trauma before and after fresh frozen plasma (FFP) transfusions.Materials and methods. The open circuit potential (OCP) of platinum electrode and antioxidant activity of blood plasma were studied in 35 patients with severe combined trauma and 35 post-FFP samples with at least 6-month shelf life. The electrochemical parameters of patientsβ blood plasma were analyzed before transfusion, and 1 hr. and 24 hrs. after transfusion.Results. OCP measured in FFP was found to be more positive vs. OCP measured in recipients' blood plasma in 34 out of 35 cases (97%). It has been shown that in patients with severe combined trauma, OCP increased from 5.047 [-7.553; 12.976] mV to 12.827 [-1.372; 24.764] mV and antioxidant activity decreased 24 hours after FFP transfusion from 16.979 [11.302; 20.946] Β΅C to 13.551 [9.288; 18.405] Β΅C. After FFP transfusion, there were no signiο¬cant changes in clinical blood parameters.Conclusion. By measuring electrochemical parameters of blood plasma in patients with severe combined trauma before and after FFP transfusions, it was discovered that in spite of absence of changes in blood parameters by routine methods, there are changes in the condition of the antioxidant system of the body, which manifest in the bias of patientsβ blood plasma OCP towards higher positive values and decreased antioxidant activity. Redox imbalance in the body might cause the oxidative stress development.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΈΠ·ΡΡΠΈΡΡ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΠ»Π΅ΠΊΡΡΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΎΠ² ΠΏΠ»Π°Π·ΠΌΡ ΠΊΡΠΎΠ²ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡΠΆΠ΅Π»ΠΎΠΉ ΡΠΎΡΠ΅ΡΠ°Π½Π½ΠΎΠΉ ΡΡΠ°Π²ΠΌΠΎΠΉ Π΄ΠΎ ΠΈ ΠΏΠΎΡΠ»Π΅ ΡΡΠ°Π½ΡΡΡΠ·ΠΈΠΉ ΡΠ²Π΅ΠΆΠ΅Π·Π°ΠΌΠΎΡΠΎΠΆΠ΅Π½Π½ΠΎΠΉ ΠΏΠ»Π°Π·ΠΌΡ (Π‘ΠΠ).ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π»ΠΈ ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π» ΠΏΡΠΈ ΡΠ°Π·ΠΎΠΌΠΊΠ½ΡΡΠΎΠΉ ΡΠ΅ΠΏΠΈ (ΠΠ Π¦) ΠΏΠ»Π°ΡΠΈΠ½ΠΎΠ²ΠΎΠ³ΠΎ ΡΠ»Π΅ΠΊΡΡΠΎΠ΄Π° ΠΈ Π°Π½ΡΠΈΠΎΠΊΡΠΈΠ΄Π°Π½ΡΠ½ΡΡ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΏΠ»Π°Π·ΠΌΡ ΠΊΡΠΎΠ²ΠΈ 35-ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡΠΆΠ΅Π»ΠΎΠΉ ΡΠΎΡΠ΅ΡΠ°Π½Π½ΠΎΠΉ ΡΡΠ°Π²ΠΌΠΎΠΉ ΠΈ 35-ΠΈ ΠΎΠ±ΡΠ°Π·ΡΠΎΠ² Π‘ΠΠ ΡΡΠΎΠΊΠΎΠΌ Ρ
ΡΠ°Π½Π΅Π½ΠΈΡ Π½Π΅ ΠΌΠ΅Π½Π΅Π΅ 6 ΠΌΠ΅ΡΡΡΠ΅Π². ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠ»Π΅ΠΊΡΡΠΎΡ
ΠΈΠΌΠΈ- ΡΠ΅ΡΠΊΠΈΡ
ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΎΠ² ΠΏΠ»Π°Π·ΠΌΡ ΠΊΡΠΎΠ²ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ Π΄ΠΎ ΡΡΠ°Π½ΡΡΡΠ·ΠΈΠΈ, ΡΠ΅ΡΠ΅Π· 1 ΡΠ°Ρ ΠΈ 24 ΡΠ°ΡΠ° ΠΏΠΎΡΠ»Π΅ ΡΡΠ°Π½ΡΡΡΠ·ΠΈΠΈ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠ±Π½Π°ΡΡΠΆΠΈΠ»ΠΈ, ΡΡΠΎ Π²Π΅Π»ΠΈΡΠΈΠ½Ρ ΠΠ Π¦ Π² Π‘ΠΠ Π±ΡΠ»ΠΈ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½Π΅Π΅ ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Π²Π΅Π»ΠΈΡΠΈ- Π½Π°ΠΌΠΈ ΠΠ Π¦, ΠΈΠ·ΠΌΠ΅ΡΠ΅Π½Π½ΡΠΌΠΈ Π² ΠΏΠ»Π°Π·ΠΌΠ΅ ΠΊΡΠΎΠ²ΠΈ ΡΠ΅ΡΠΈΠΏΠΈΠ΅Π½ΡΠΎΠ² Π² 34 ΠΈΠ· 35 ΡΠ»ΡΡΠ°Π΅Π² (97%). ΠΠΎΠΊΠ°Π·Π°Π»ΠΈ, ΡΡΠΎ Ρ ΠΏΠ°ΡΠΈ- Π΅Π½ΡΠΎΠ² Ρ ΡΡΠΆΠ΅Π»ΠΎΠΉ ΡΠΎΡΠ΅ΡΠ°Π½Π½ΠΎΠΉ ΡΡΠ°Π²ΠΌΠΎΠΉ ΠΏΡΠΎΠΈΡΡ
ΠΎΠ΄ΠΈΡ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ ΠΠ Π¦ Ρ 5,047 [-7,553; 12,976] ΠΌΠ Π΄ΠΎ 12,827 [-1,372; 24,764] ΠΌΠ, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ Π°Π½ΡΠΈΠΎΠΊΡΠΈΠ΄Π°Π½ΡΠ½ΠΎΠΉ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠ΅ΡΠ΅Π· 24 ΡΠ°ΡΠ° ΠΏΠΎΡΠ»Π΅ ΡΡΠ°Π½Ρ- ΡΡΠ·ΠΈΠΈ Π‘ΠΠ Ρ 16,979 [11,302; 20,946] ΠΌΠΊΠΠ» Π΄ΠΎ 13,551 [9,288; 18,405] ΠΌΠΊΠΠ». ΠΡΡΠ²ΠΈΠ»ΠΈ ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ Π·Π½Π°ΡΠΈΠΌΡΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΠΊΡΠΎΠ²ΠΈ ΠΏΠΎΡΠ»Π΅ ΡΡΠ°Π½ΡΡΡΠ·ΠΈΠΈ Π‘ΠΠ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π‘ ΠΏΠΎΠΌΠΎΡΡΡ ΠΈΠ·ΠΌΠ΅ΡΠ΅Π½ΠΈΠΉ ΡΠ»Π΅ΠΊΡΡΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΎΠ² ΠΏΠ»Π°Π·ΠΌΡ ΠΊΡΠΎΠ²ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡΠΆΠ΅Π»ΠΎΠΉ ΡΠΎΡΠ΅ΡΠ°Π½Π½ΠΎΠΉ ΡΡΠ°Π²ΠΌΠΎΠΉ Π΄ΠΎ ΠΈ ΠΏΠΎΡΠ»Π΅ ΡΡΠ°Π½ΡΡΡΠ·ΠΈΠΈ Π‘ΠΠ, Π²ΡΡΠ²ΠΈΠ»ΠΈ, ΡΡΠΎ, Π½Π΅ΡΠΌΠΎΡΡΡ Π½Π° ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ ΠΈΠ·- ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ Π² ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠ°Ρ
ΠΊΡΠΎΠ²ΠΈ, ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅ΠΌΡΡ
ΡΡΡΠΈΠ½Π½ΡΠΌΠΈ ΠΌΠ΅ΡΠΎΠ΄Π°ΠΌΠΈ, ΠΏΡΠΎΠΈΡΡ
ΠΎΠ΄ΡΡ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ Π² ΡΠΎΡΡΠΎΡ- Π½ΠΈΠΈ Π°Π½ΡΠΈΠΎΠΊΡΠΈΠ΄Π°Π½ΡΠ½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ ΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠ°, Π²ΡΡΠ°ΠΆΠ°ΡΡΠΈΠ΅ΡΡ Π² ΡΠΌΠ΅ΡΠ΅Π½ΠΈΠΈ Π²Π΅Π»ΠΈΡΠΈΠ½Ρ ΠΠ Π¦ Π² ΠΏΠ»Π°Π·ΠΌΠ΅ ΠΊΡΠΎΠ²ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π² ΠΎΠ±Π»Π°ΡΡΡ Π±ΠΎΠ»Π΅Π΅ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΡΡ
Π·Π½Π°ΡΠ΅Π½ΠΈΠΉ ΠΈ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠΈ Π°Π½ΡΠΈΠΎΠΊΡΠΈΠ΄Π°Π½ΡΠ½ΠΎΠΉ Π°ΠΊΡΠΈΠ²Π½ΠΎ- ΡΡΠΈ. ΠΠ°ΡΡΡΠ΅Π½ΠΈΠ΅ ΠΎΠΊΠΈΡΠ»ΠΈΡΠ΅Π»ΡΠ½ΠΎ-Π²ΠΎΡΡΡΠ°Π½ΠΎΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ Π±Π°Π»Π°Π½ΡΠ° ΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠ° ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ ΠΏΡΠΈΡΠΈΠ½ΠΎΠΉ ΡΠ°Π·Π²ΠΈ- ΡΠΈΡ ΠΎΠΊΠΈΡΠ»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΡΡΡΠ΅ΡΡΠ°
ΠΠ¦ΠΠΠΠ ΠΠΠ§ΠΠ§ΠΠ«Π₯ Π€Π£ΠΠΠ¦ΠΠ Π ΠΠΠΠ ΠΠ’ΠΠΠΠΠ ΠΠΠ§ΠΠΠΠ ΠΠΠ§ΠΠ§ΠΠ-ΠΠΠΠ’ΠΠ§ΠΠΠΠ Π ΠΠΠ
Β The main goal in the treatment of kidney tumors is to preserve renal function. Investigations made in the past decades show that chronic kidney diseases (CKD) are much more common than formerly estimated and conventional methods for evaluating renal function frequently reduce the incidence of CKD having more serious consequences than recognized before. CKD leads to renal dysfunction subsequently resulting in renal failure that increases a risk for the development and progression of cardiovascular diseases. Formulas for calculation of glomerular filtration rate on the basis of serum creatinine are presently in common use to evaluate renal function. The MDRD and Cockcroft-Gault formulas are most frequently used. Investigations dealing with the radiological estimation of renal volumes and function are also promising. In patients with renal cell carcinoma (RCC), the differences in cancer-specific and overall survival become significant just 3 years after surgery. Decreased renal function after surgical renal tissue removal in the presence of CKD is one of the significant reasons for no positive changes in the overall survival of patients with RCC. According to the data of different studies, the concurrence of RCC and CKD, which cause diminished renal function, is encountered in a considerable number of patients. Thus, the present-day treatment of patients with RCC should be focused on the optimization of renal function, the prevention of CKD, and the minimization of its degree. Researches to improve renal function in RCC patients who have undergone surgery are regarded as the priorities of urologic oncology.Π‘ΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΠ΅ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΉ ΡΡΠ½ΠΊΡΠΈΠΈ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΉ Π·Π°Π΄Π°ΡΠ΅ΠΉ Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ ΠΏΠΎΡΠ΅ΠΊ. ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎΡΠ»Π΅Π΄Π½ΠΈΡ
Π΄Π΅ΡΡΡΠΈΠ»Π΅ΡΠΈΠΉ ΠΏΠΎΠΊΠ°Π·ΡΠ²Π°ΡΡ, ΡΡΠΎ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΏΠΎΡΠ΅ΠΊ (Π₯ΠΠ) ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Ρ Π½Π°ΠΌΠ½ΠΎΠ³ΠΎ Π±ΠΎΠ»ΡΡΠ΅, ΡΠ΅ΠΌ ΡΡΠΎ ΠΎΡΠ΅Π½ΠΈΠ²Π°Π»ΠΎΡΡ ΡΠ°Π½Π΅Π΅, Π° ΡΡΠ°Π΄ΠΈΡΠΈΠΎΠ½Π½ΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΡΠ½ΠΊΡΠΈΠΈ ΠΏΠΎΡΠ΅ΠΊ ΡΠ°ΡΡΠΎ Π·Π°Π½ΠΈΠΆΠ°ΡΡ ΡΠ°ΡΡΠΎΡΡ Π₯ΠΠ, ΠΈΠΌΠ΅ΡΡΠΈΡ
Π±ΠΎΠ»Π΅Π΅ ΡΠ΅ΡΡΠ΅Π·Π½ΡΠ΅ ΠΏΠΎΡΠ»Π΅Π΄ΡΡΠ²ΠΈΡ, ΡΠ΅ΠΌ ΡΡΠΎ ΠΏΡΠΈΠ·Π½Π°Π²Π°Π»ΠΎΡΡ Π² ΠΏΡΠΎΡΠ»ΠΎΠΌ. Π₯ΠΠ ΠΏΡΠΈΠ²ΠΎΠ΄ΡΡ ΠΊ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ ΠΏΠΎΡΠ΅ΡΠ½ΡΡ
ΡΡΠ½ΠΊΡΠΈΠΉ Ρ ΠΏΠΎΡΠ»Π΅Π΄ΡΡΡΠΈΠΌ ΠΈΡΡ
ΠΎΠ΄ΠΎΠΌ Π² ΠΏΠΎΡΠ΅ΡΠ½ΡΡ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΡ, ΠΊΠΎΡΠΎΡΠ°Ρ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π΅Ρ ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΈ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ. Π Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΠΏΡΠΈ ΠΎΡΠ΅Π½ΠΊΠ΅ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΉ ΡΡΠ½ΠΊΡΠΈΠΈ ΡΠΈΡΠΎΠΊΠΎ ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΡΡΡΡ ΡΠΎΡΠΌΡΠ»Ρ ΡΠ°ΡΡΠ΅ΡΠ° ΡΠΊΠΎΡΠΎΡΡΠΈ ΠΊΠ»ΡΠ±ΠΎΡΠΊΠΎΠ²ΠΎΠΉ ΡΠΈΠ»ΡΡΡΠ°ΡΠΈΠΈ Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ ΡΡΠ²ΠΎΡΠΎΡΠΎΡΠ½ΠΎΠ³ΠΎ ΠΊΡΠ΅Π°ΡΠΈΠ½ΠΈΠ½Π°. Π§Π°ΡΠ΅ Π²ΡΠ΅Π³ΠΎ ΠΏΡΠΈΠΌΠ΅Π½ΡΡΡ ΡΠΎΡΠΌΡΠ»Ρ MDRD ΠΈ ΠΠΎΠΊΡΠΎΡΡΠ°βΠΠΎΠ»ΡΠ°. ΠΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Π½Ρ ΡΠ°ΠΊΠΆΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎ Π»ΡΡΠ΅Π²ΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠ΅ ΠΎΠ±ΡΠ΅ΠΌΠ° ΠΈ ΡΡΠ½ΠΊΡΠΈΠΈ ΠΏΠΎΡΠ΅ΠΊ. Π£ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΏΠΎΡΠ΅ΡΠ½ΠΎ-ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ (ΠΠΠ ) ΡΠ°Π·Π»ΠΈΡΠΈΡ Π² ΠΎΠ½ΠΊΠΎΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈ ΠΎΠ±ΡΠ΅ΠΉ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ ΡΡΠ°Π½ΠΎΠ²ΡΡΡΡ Π·Π½Π°ΡΠΈΠΌΡΠΌΠΈ ΡΠΆΠ΅ ΡΠ΅ΡΠ΅Π· 3 Π³ΠΎΠ΄Π° ΠΏΠΎΡΠ»Π΅ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ. ΠΠ΄Π½Π° ΠΈΠ· ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΏΡΠΈΡΠΈΠ½ ΠΎΡΡΡΡΡΡΠ²ΠΈΡ ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½ΡΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ Π² ΠΎΠ±ΡΠ΅ΠΉ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ β ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΉ ΡΡΠ½ΠΊΡΠΈΠΈ ΠΏΠΎΡΠ»Π΅ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ΄Π°Π»Π΅Π½ΠΈΡ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ Π½Π° ΡΠΎΠ½Π΅ Π₯ΠΠ.ΠΠΎ Π΄Π°Π½Π½ΡΠΌ ΡΠ°Π·Π½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ, ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠ΅ ΠΠΠ ΠΈ Π₯ΠΠ, ΠΏΡΠΈΠ²ΠΎΠ΄ΡΡΠΈΡ
ΠΊ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΉ ΡΡΠ½ΠΊΡΠΈΠΈ, Π²ΡΡΡΠ΅ΡΠ°Π΅ΡΡΡ Ρ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΈΡΠ»Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². Π’Π°ΠΊΠΈΠΌ ΠΎΠ±ΡΠ°Π·ΠΎΠΌ, ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ Π΄ΠΎΠ»ΠΆΠ½ΠΎ Π±ΡΡΡ ΡΡΠΎΠΊΡΡΠΈΡΠΎΠ²Π°Π½ΠΎ Π½Π° ΠΎΠΏΡΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ ΡΡΠ½ΠΊΡΠΈΠΈ ΠΏΠΎΡΠ΅ΠΊ, ΠΏΡΠ΅Π΄ΠΎΡΠ²ΡΠ°ΡΠ΅Π½ΠΈΠΈ Π₯ΠΠ ΠΈ ΠΌΠΈΠ½ΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΡΡΠΆΠ΅ΡΡΠΈ Π₯ΠΠ. ΠΠ°ΡΡΠ½ΡΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Ρ ΡΠ΅Π»ΡΡ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΉ ΡΡΠ½ΠΊΡΠΈΠΈ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ , ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠΈΡ
ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅, ΠΎΡΠ½ΠΎΡΡΡΡΡ ΠΊ ΠΏΡΠΈΠΎΡΠΈΡΠ΅ΡΠ½ΡΠΌ Π·Π°Π΄Π°ΡΠ°ΠΌ ΠΎΠ½ΠΊΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΠΈ
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