4. M0t s 6 cdi t i l n ciia D v n vj chdm sdc s&c khde tgi nhd.
B0c didm eda giao thdng Hd Nfli c6 luu luyng dflng, dudng phd ch$t hgp vd c6 nhilu tuydn phd 1 ehidu. Dde bi0t tinh trgng t i e dudng thudng xdy ra vdo d c gid eao didm, han n&a phgm vl hogt dflng cda dich vy khd rflng. Do dfl dd ddm bdo thyc hl0n d v l chit luyng vd sd luyng djch vg, t i l t kl0m xdng diu vd thdi gian, chdng tfll dd thyc hi0n 2 gill phdp:
Dd nghi0n cdu hinh thdnh 4 cung dudng thuin lyi cho 4 xe, mdi xe sd di chuydn theo mflt hudng, tuydn dudng lidn mgeh khdp kin, khodng cdch di chuyin gida cde nhd khdch hdng g i n nhau.Thye hifln di thdng t i m d l trdnh t i c dudng trong gid eao didm, tidt kiflm duyc thdi gian vd qudng dudng xe di v l Ide nghi tnj-a.
Khi sd luyng ca chdm sflc ldn han 60 ca/ ngdy don vj phai huy dflng 5 xe (5 dfli chdm sflc) thl mdi vua dam bio tidn dfl cflng vi0e vd edng vda d i m bdo chit luyng chdm sdc trong luu v y c bdn kinh quy d\nh.
KtJ LUAN
1- Sau 5 ndm hogt dflng djeh vy ehdm sflc sde khde sinh sdn tgi nhd dd mang Igi nhilu tifln Ich cho ngudi b0nh. Cdc djch vg chd y l u duyc thyc hi0n Id dich vg khdm vd ehdm sde cho mg - bd sau sinh vd dich vg t i m so sinh (78%). B0nh nhdn vd gia dinh hdi Idng vt duyc t u v l n v l chdm sdc sdc khde t h l chit, s&e khde tinh t h i n cho d n phg sau sinh; duye hudng d i n vd cdch ehdm sflc vd theo dfli trd trong thdng d i u tidn sau sinh vd nhdn vidn y t l phdt hi0n
sdm vd didu trj kjp thdi duye nhidu bidn ch&ng sau dd cua mg vd cidc b0nh thudng gdp cua bd.
2- Sd luyng ca chdm sflc trung blnh/ngdy tdng Idn ddng kd : ndm 2008 Id 35 ca/ngdy ddn ndm 2012 Id 58 ca/ ngdy. Bidu ndy ddng nghTa vdi vi0c gidm tdi b0nh nhdn didu tq nfll trd cho bflnh vifln tmng blnh Id 58 b0nh nhdn/ ngdy.Vdl tmng blnh 60 ca chdm s6c trong mflt ngdy Id thich hyp cho 4 dfli ehdm sflc dk ddm bdo cho tidn dfl vd chit luyng chdm sdc bflnh nhdn duyc tdt.
TAI LI$U THAM KHAO
1. Alere.com, "Obstetrical homeeare services'.
United state, 2010.
<http://www.alere.eom/us/en/health-solutions/
health-management/ women-and-ehildrens-health/
ob-homeeare.htnil>
2. Allinahealth.org, "OB Homeeare", Chicago, 2013.
< http:// www. alllnahealth.org/ahs/pregcare.nsf/
page/homecare>
3. Katherin LWisner, Corothy K.Y.Sit. (2012).
"Mental health and behavioral disorders in pregnancy" Obstetrics - Normal and pmblem pmgnaneies" siy\h edition, pp1062-1063
4. Medicinenet.com,"Postpartum Problems", New York, 2005, <www. medicinenet.eom/script/
main/art.asp?articlekey=51744&page=1>
5. Trinltyhhs.com, " Trusted obstetrical care in the comfort of home" Flodia, 2012, <
http://www.trinityhhs,com/#i >
NGHIEN Cl)U SlTTHAY DO'I CAC CHI S6 LIPID MAU or PHU NUT TIEN MAN KINH VA MAN KINH
NGUYEN KHOA DI$U V A N , B^nh vidn Bgch Mai NGd DLTC K^, B^nh vidn hdu nghj da khoa Ngh^ An
T6M TAT
Ca sd: Suy glAm cAc hormon cOa budng trdng.
C^c biit IA estmgen - honnon ed ddc tinh bAo vd tim mgch. lAm thay ddi thAnh phin lipid mAu theo hwdng tAng cAc thAnh phin lipid gAy vda xa ddng mgch [4].
Muc tfll/: Nghidn cdu sw thay ddi cAc chi sd lipid mAu vA tim hiiu mdi lidn quan gida rdi logn lipid mdu vdn ndng dd estmgen huyit twang. Phircmg phAp:
nghidn cdu md ti cAt ngang cd phdn tlch 141 binh nhAn. Do cdc chf sd nhdn trie. lAm xdt nghidm lipid mdu. xAt nghidm ndng dd estmgen huyit twang.
Ddnh gid rdiiogn lipid mAu theo NCEP -ATP III [6].
Kit qui: Ndng dd lipid mAu tmng binh d phu nd tiin mdn kinh linlux?t id TC 4.95 ±1.17mmol/l; TG 1.73 ± 1.18 mmol/l; HDL - C 1.47 ± 0,51 mmol/l; LDL • C 2.81 ±0,94 mmoi/l. 0 phu nd mdn kinh lin Iwq/t IA TC 5.82 ± 0,94 mmol/i; TG3,16± 3.99 mmol/l; HDL • C J,53 ± 0,41 mmol/l: LDL -C3,16± 0,80 mmo/l. Gid tq
edc chi sd lipid mAu TC, TG, LDL ~ C d phu nd mdn kinh cao hon cd )f nghJa thdng kd so vdi nhdm tiin mSn kinh (p < 0,05). Cd mdi twang quan nghich cd •y nghia thdng kd gida estradiol huyit twang vdi TC vA TG (ndng dd estradiol cAng giAm thi ndng dd TC, TG cAng eao).
Td khda: lipid mdu, estrogen huyit twang SUMMARY
Background: Reduced ovarian hormones, particularly estrogen - the hormone has cardiopmteetive pmperties, changing the lipid composition in the dimction of increasing lipid components cause athemsclemsis [4]. Objective: To study changes in blood lipid indicators and explom the mlationship between dyslipidemia and plasma estmgen levels. Methods: cross-sectional descriptive study analyzed 141 patients. Measurement of anthmpometry, blood lipid tests, tests of plasma
Y HOr THirr HAwu ra<« _ erf diiM i 61
estmgen concentmtions. Assessment of dysiipklemla according to the NCEP-ATP III [6]. Results: The avemge blood lipid concentrations in postmenopausal vmmen, mspectiveiy TC 4.95 ± 1.17 mmol/l; TG 1.73
± 1.18 mmol/l; HDL-C 1.47 ± 0. 51 mmol/l; LDL-C 2.61 ± 0.94 mmol / I. In postmenopausal women, mspectiveiy TC 5.82 ± 0.94 mmol/i; TG 3.16 ± 3.99 mmol/l; HDL-C 1.53 ± 0.41 mmol/l; LDL-C 3, 16 ± 0.80 mmo/l. Blood lipid index values TC, TG, LDL-C in postmenopausal women wem significantly higher than the pmmenopausal gn^up (p <0.05). Them Is a statistically significant inverse cormlation behAreen plasma estmdiol with TC and TG (declining estmdiol levels, the levels of TC. TG higher).
Keywords: blood lipid, plasma estmgen DAT V A N D £
-Tiln mdn kinh vd mdn kinh Id mflt glal dogn thay ddl sinh ly blnh thudng md ngudi phg n& phdi trdi qua. Nguydn nhdn do budng tr&ng gidm sdn x u l t hai hormon sinh dye nd Id estrogen vd progesterone [6].
-Suy gidm cdc hormon cda budng tr&ng, ddc bi0t Id estrogen - hormon cfl dde tinh bdo vfl tim mgeh, Idm thay ddi thdnh p h l n lipid mdu theo hudng tdng cdc thdnh p h l n lipid gdy v&a xo dflng maeh [6]. Phdt hifln, phflng vd d i l u tq Sdm rdi logn lipid mdu trd thdnh mdu chdt trong phflng edc b0nh tim mgch ngay d thdi tidn mdn kinh vd mdn kinh..
-Mye tidu nghidn cdu: Nghi0n c&u s y thay ddi cdc chi sd lipid mdu vd tim hidu mdi lidn quan gi&a rdi logn lipid mdu vdi ndng dfl estrogen huydt tuono.
DOI TU'P'NG, PHUONG PHAP NGHIEN CU'U -Nghidn cuu duyc tidn hdnh trdn 141 phy n& tidn mdn kinh vd mdn kinh ddn khdm tgi Khoa Khdm b0nh theo ydu c l u , Khoa Nfli t i l t - Ddi thdo dudng - B0nh Vien Bgch Mai
-Thdi gian t d thdng 4 - 8/2011.
Tidu c h u i n lya chpn ddi t u y n g nghidn c d u - Phu nu tudi t u 40 - 70 tudi. khdm sue khde dinh ky.
- Chgn phu n& tidn mdn kinh vd mdn kinh dd tidu chuin theo (Jnh nghTa eda WHO [11].
Tidu c h u i n logi trip
- Phy nd dang m I e edc b0nh d p tinh, ho$c mgn tinh.
- Cdc b0nh nfll tidt vd mflt sd bflnh gdy rdi logn chuydn hda lipid: bflnh Basedow, suy gidp, hfli eh&ng eushing, suy tuydn ydn, to ddu chi, hfli ch&ng th0n hu. ddi thdo dudng.
- Phy n& dd dwq/c phdt hi0n c6 khdi u budng tn>ng, u xa t d eung, budng tr&ng da nang, dd duyc phlu thudt d t t u cung, budng trung, dang su dyng thude trdnh thai hode mdi ngung thudc < 1 thdng, dang d i l u trj rdi iogn lipid mdu,
Phuang phdp nghidn e&u
- Thidt kd theo phuang phdp mfl ta e l t ngang ed phdn tich.
- Cdc b0nh nhdn du tidu chuin sd duyc do huydt dp, vflng eo, BMI, Idm xdt nghiflm lipid mdu, glucose mdu ddi.
Ddnh g i l k ^ t q u d
- Phdn logi vdng eo theo tidu c h u i n cda WHO 2000 dp dyng cho ngudi tnj'dng thdnh Chdu A - Thdi Blnh Duang [12]: Phdn logi vdng eo d n d > 80 cm.
- Rdi logn lipid mdu theo tiSu c h u i n NCEP-ATP 111 [6] nhu sau: Tdng triglycerid > 1.7 mmol/l; tdng cholesterol > 5.2 mmol/l; tdng LDL - cholesterol > 3,4 mmol/l; g l l m HDL - cholesterol < 1,0 mmol/l.
- Sd liflu d u y c trinh bdy d u d i dgng tmng blnh ± dd I0eh chuin.
- p < 0,05 dwcfc xem Id s y khde bi0t cd y nghTa thdng kd.
- S6 Ii0u 6w(yc x u ly b i n g p h l n m i m SPSS 16.0.
K£T QUA
1. D$c didm ddi t u y n g nghidn cOru C6 51,8% phy n& mdn kinh vd 48,2% phg nd tiln mdn kinh, s y khdc bi0t khflng cfl y nghTa thdng kd.
Tudi mdn kinh trung blnh 48,9 ± 3,4 tudi, sdm nhit 41 tudi. mufln nhit 56 tudi. Da sd phg n d b i t d i u mdn kinh d tudi 47 - 50.
2. G i l tr| trung blnh estradiol, FSH huy^t t u v n g cDa nhdm tidn mdn kinh v l mdn kinh
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1
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Bilu dd 1: Tnjng binh estradiol, FSH, huylt tuang theo nhdm tudi
Trung binh ndng dfl estradiol huylt tuang giam d i n theo tudi vd nguyc lgi ndng dfl FSH tdng din theo tudi Sy thay ddi vd ndng dfl estradiol vd FSH huydt tuang d phy n& TMK vd MK cd y nghTa thdng k 0 ( p < 0,001).
3. Cdc chl sd lipid mdu
Bdng 1. Gid tri trung blnh lipid mdu theo nhdm TMK vd MK
Chi s6 lipid (mmol/l) 1 X ± SD)
TG TC HLD-C LDL-C
Nh6m TMK (n = 68) 1,73 ±1,18 4,95 ±1.17 1,47 ±0.51 2,81 ±0,94
Nh6m MK (n= 73) 3,16 ±3,99 5,82 ± 0,94 1,53 ± 0,41 3,16 ±0,80
P p = 0,005 p = 0,000 D ' 0,47 P = 0,0(9 Gid tri cdc chi s6 lipid mdu ir phg nO' MK dSu \ifn hon nhbm Tli/IK, ddc bi$t sif khSc bi#t c6 } nghTa thing kS a6i vfti TC (p < 0,000), TG (p = 0,006), LDL- C ( p = 0,019).
Y HOC THVC HANH (8«5) - S6 4/2013
Bdng 2. Gid tii trung blnh lipid mdu theo ndm hit Chi sA lipid
(mmol/l) 1 XlSD TG TC HDL-C LDL-C
Nam het kinh TMK
(n = 68) 1,73±1,18 4,95 ±1,17 1,46 ±0,6 2,8 ±0,93
1-5 nam (n = 16) 3,05 ±1,85 6,95 ±1,12 1,67 ±0,54 3,27 ± 0,82
a 5 nam (n = 57) 3,22 ±4,71 5,76 ±0,84 1,46 ±0,29 3,09 ± 0,79
P 0,02 0,000 012 0,046 Gid trj trung blnh cdc chl sd lipid mdu thay ddi theo thdi gian hdt kInh.Sau mdn kinh 1 - 5 ndm tnjng blnh cde cht sd lipid mdu dd tdng, d i e bI0t c6 y nghTa
»idng kd ddi vdi TG. TC, LDL-C (p < 0,05). Ridng HDL-C ed thay ddi nhung khflng efl y nghTa thdng kd (p > 0.05).
4. Lidn quan gifra rdi iogn cdc c h i s d lipid mdu vdi ndng d0 estrogen huydt t u a n g
Su dgng phuang trinh tuydn tinh tim h i l u mdi tuong quan gi&a estradiol huyet tuang vdi ede ehi sd lipid mdu, thflng qua hfl sd tuong quan r thu duyc kdt qui sau:
^ d u dd 3, M i l tuong quan gi&a cdc chT sd lipid mdu vdi estradiol huylt tuang Dya vdo bidu dd 3 chOng tdi t h i y cfl mdi tuong quan nghjch cd y nghTa thdng kd gi&a TC, TG mdu vd estradiol huylt tuang (p < 0.05).
BAN LUAN
Tudi mdn kinh tnjng blnh Id 48,9 ± 3.4 tudi. da sd phy n& bit d i u mdn kinh d 47 - 50 tudi. Kdt qud ndy tuong ty nhu cdc tdc g i l trong nude[1],[3].Hormon estrogen gidm d i n theo tudi vd sau mdn kinh 1-2
ndm thl ndng dfl estrogen gidm hdn so vdi thdi ky tidn mdn kinh. Nhu vfly tudi edng eao thi ndng dfl honmon estradiol edng thdp.
Nhidu nghidn c&u dpe I5].[7],[8] dd chi ra ring m&e dfl tdng TG, TC b i t d i u t d giai dogn d i u thdi ky tidn mdn kinh vd s y gia tdng TG, TC nhanh Idn ngay khi man kinh. TG, TC tdng cao d phy n d giai dogn tudi tmng nidn (40 -69 tuoi) didu ndy duyc chdng minh Id phg nO d giai dogn ndy nguy co m i c cde bflnh tim mgch tuang t y nhu ddn Ong.
Nghidn cdu cCia chung tfli eho thdy efl mdi tuong quan nghjeh efl y nghTa thdng kd gi&a estradiol huydt tuong vdi TC vd TG (p < 0,05). Ridng thdnh phdn HDL - C khflng cO s y khdc biflt, d i l u ndy cd Id do nghidn edu chOng tfli c d m i u edn bd. Mdt khde, nhOm c6 rdi loan ede ehi sd lipid thl ndng dfl estradiol huydt tuong ddu t h i p hon c6 y nghTa so vdi nhflm eO ehi sd lipid blnh thudng. Tde gid Lejla Me5ali6 vd CS eOng eho ring ed mdi tuang quan nghjch giua estradiol huydt tuang vdi TC, TG vd ndng dfl HDL - C c6 lidn quan d i n ehu ki kinh nguy0t [9]. Nhu vdy. d thdi ky tidn mdn kinh md dde bi0t Id thdi ky mdn kinh sy gidm sut estradiol huydt tuong c6 lidn quan ddn thay ddi edc ehi sd lipid mdu b i t lyi vd tdng ty 10 rdi logn lipid mdu, D$e bl0t cholesterol tdng cao dd trd thdnh mflt d i u hiflu sinh hpe bdo dflng nguy eo tdng vpt ty 10 b0nh tim mach d phu n& mdn kinh.
K^T LUAN
Nhu vdy, d phg n u dd b i t d i u rdi loan chuydn hfla lipid ngay t d giai doan tidn mdn kinh vd tdng d i n theo ndm het kinh. Su rdi loan ndy efl lidn quan ddn suy giam hormone estrogen huylt tuang. Qua dfl edn t i m sodt sdm ede rdi loan lipid mdu dd didu tri k!p thdi nhlm trdnh nguy eo b0nh tim mgch eho ddi tuyng ndy.
TAI LIEU THAM KHAO
1. D§ Minh Hien (2009), Nghi§n cdu cdc roi loan ca ndng thdi ky tien man kinh va tac dpng cua bdi thudc Ky cue dia hoang hodn gia vi Luan van tien sy y hpc, Dai Hoc Y Ha Nfli.
2. Nguyen Trung Kien (2007). Nghien cdu m^t sd chi so smh hpc va moi twang quan gida cdc chi s6 nay a phu nw mSn kinh Can Tha. Lugn vdn tien sy y hgc, Dgi Hpc Y Ha Nfli
3. Le Quang Toan (2005) Nghien cdu mpt so chl s6 lipid mAu va biin doi estradiol d phu nw dd tuoi quanh mdn kinh (49±3 tuoi). Ludn van thge sy y hgc, Dgi Hge Y HdNfli
4. Barbara Millen Posner, DrPH, RD, L Adrienne Cupples, PhD,Donald R, Miller va CS (1993).
Diet.menopause, and semm choiesterni levels in women.
The Framingham Study. Febmary 1993 American Heart Joumal, Volume 125 Number 2, Pall 1
5. Carol A.Derby, Sybil L. Crawford, Richard C Pastemak, MaryFran Sowers, Barbara Stemfeld, and Karen A, Matthews (2009), Lipid changes During the menopause Transition in Relation to age and weight.
The Study of V\/omen's Health Across the Nation. Am J Epidemiol 2009:169; 1352-1361 .Vol, 169, No. 11
6. Expert Panel of the National Cholesterol
Y HOC THirr HAWH raAi\ . ciS Anati 63
Education Program. Executive Summary of the Third Report of the NaGonal Choiesterni Education Pmgram (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Choiesterni in Adults (Adults Treatment Panel ill). JAMA 2001; 285: 2486-2497.(48)
7. Imke Janssen, PhD; Lynda H Powell, PhD; Sybil Crawford, PhD; Bill Lasley, PhD; Kim Sutton-Tyrrell, DrPH. Menopause and the Metabolic Syndmme:The Study of Women's Health Acmss the Nation. Arch Intern Med. 2008;168(14):1568-1575
8. Kim Sutton-Tyrrell, Rachel P. Wildman, Karen A.
Matthews vd CS. Sex Hormone-Binding Globulin and the Free Andmgen Index Am Related to Cardiovascular Risk Factors in Multiethnic Pmmenopausal and Perimenopausal Women Enmlled in the Study of Women Acmss the Nation (SWAN). Circulation 2005:111,1242-1249.
9. Lejla MeSalifl, Emir Tupkovic, Sulejman Kendie, Devleta Ballfl. Correlation between honnonal and lipid status in women in menopause. BOSNIAN JOURNAL OF BASIC MEDICAL SCIENCES 2008; 8 (2); 189-192
10. Lewis H. Kuller. Hormone Replacement Therapy and Risk of Cardiovascular Disease: implications of the Results of the Women's Health Initiative. Arterioscler Thromb Vase Biol 2003, 23:11-16: originally published online November 7,2002
11. WHO Scientific Group. Reseamh on the menopause in the 1990's. A mport of the WHO Scientific Gmu. World Health Organization 1996; 866:1-79
12. WHO, International Association for the Study of Obesity, International Obesity TaskForee. Asia-Pacafic perspective: Redefining obesity and its treatment".
Health Communications 2000.
NGHIEN Cl)!l MOT SO DAC DIEM DICH T I DONG DAU MAT CO' Of TRE EM
T6M TAT
G/6f tfi/0u.' nghidn cdu tiin cdu 120 binh nhi nhdp vidn tgi Vidn Bdng Qudc Gia. XAc dinh tin xuit, ca chi vd tdc nhdn gdy bdng. Tin suit bdng d tri cao nhit do nhidt wdt chiim 83,33%, ki din Id bdng do nhipt khd chiim 16,67%. Mite tidu nghidn cdu:
Ddnh giA mot sd ddc diim dich ti bdng diu mdt cd d tre em. Phwong phAp nghidn cdu: Nghidn cdu tiin cdu md tA cBt ngang Kit qud: Trd d nhdm tudi td 1 - 5 bi bdng nhiiu nhit, chiim ty Id 71,66%.Trd nam nhiiu han tri nd. Bdng nhidt wdt chiim t'y' Id cao 83,33%>, bdng Ida chiim ty id 16,67%. Thdi gian trd bi bdngtdll gid- 13gidvA 17 gid-22 gid IA cao nhit.
Ket ludn: Nghidn cwu dich ti bdng trd em ddng vai trd rit quan trpng trong vin di phdng ngda vA c6 hwdng chin doAn - didu tri sdm trAnh di lai nhwng thwang tAt khdng dAng cd cho tri.
Td khda: bdng, trd em SUMMARY
STUDY CHARACTERISTICS OF HEAD AND NECK BURNS IN CHILDREN
Introduction: prospective study, of 120 pediatric patients admitted to National institute of bums was undertaken to identify the incidence, mechanism, and agents of pediatric bum. The highest incidence of pediatric bum was hot water (83,33%,), followed by fireburn (16,67) Objectives: Evaluate some chamcteristics of epidermioiogy in head and neck bum. Study design: prospective, cmss secsion study Results: Children in age of 1 - 5 year was burnt at highest rate with 71,66%. Male > female.
Conclusion: Study of epidermiological bum is very inporiant to prevention and treatment in eariy stage in order to avoid the morbidity which may not be happened for children.
Keywords: pediatric bum. Children
D A N G X U A N QUANG Bdnh vi^n cap cdu Tnrng Vwong Tp. HCM DAT V A N D t
T u khi con ngudi bidt tao ra Ida vd su dgng Ida (khoang 500,000 ndm trudc cflng nguydn) thi bdng lufln Id tai nan song hdnh eung vdi s u tdn tai vd phdt tridn eiJa Iflai ngudi, Mac du nhdn loai lufln cd gIng tim hidu, nghien euu ve bong, dua ra cde bi0n phdp cuu ehua nhdm han chd thuong tdn do bdng gdy ra, song sd ty 16 tai nan bong vd ty le t u vong do bong gay ra v l n cOn cao.
Dl Chung bdng d i u mat cd Idm eho trd thidu ty tin, ICing tung, ngai ngung che ddu nhdng khuydt tdt khi tidp xCic cflng ddng trong sinh hogt, hpc tdP- Di ch&ng bdng va t d vong do bong Id mdt mdt ldn vdi gia dinh, cflng ddng vd xd hfli,
Xuat phdt t u nhung thue td trdn, ehCing tdi tidn hdnh de tdi "Nghien cuu mflt sd ddc didm dich 16 bong ddu mdt ed d tre em" vdi nhung muc tidu sau'
Muc tidu tong quAt: Phan tlch mflt sd ddc dilm djeh td bdng ddu mdt ed 6 tre em.
Afue tidu chuydn bidt:
Phdn tieh vd tudi, gidi tinh tre bi bdng.
Phdn tlch vd dja didm, thdi didm, hodn canh, nguyen nhdn xay ra tai ngn bdng.
Phdn tieh vd thdi gian nhdp vifln sau bdng, cong tdc so cdp euu,
TdNG QUAN
Tinh hinh nghidn e&u djch t l bdng d trd em tren thd g i d i vd Vidt Nam
Nhidu d y dn vd phdng chdng bdng d tre em SA cho thiy: tai ngn bong d tre em efl thd giam thip vd efl thd phOng trdnh duyc. Tgi My, theo Vi0n Trao Doi Thdng Tin Bong Qudc Gia (National Infomiation Exchange - NBIE), sau khi thue hign 3 d u dn Quoc gia ve phdng ehdng bdng thl ty le bdng d tre em giam 50 - 65%.
Theo Lara B, bong Id mflt trong nhdng nguyfln
Y HOC THUC HANH (865) - S 6 4/2013
