急性上呼吸道感染【】课件

急性上呼吸道感染赣南医学院第一附属医院儿科刘小生QQ:619541197急性上呼吸道感染赣南医学院第一附属医院儿科1定义上呼吸道:包括鼻、鼻窦、咽、咽鼓管、会厌及喉鼻：鼻黏膜嫩而血管丰富，易感染且易引起黏膜肿胀，从而易堵塞，导致呼吸困难鼻窦：由于鼻窦黏膜与鼻腔黏膜相连续，急性鼻炎常累及鼻窦定义上呼吸道:包括鼻、鼻窦、咽、咽鼓管、会厌及喉2咽泪管和咽鼓管：鼻泪管短、咽鼓管较宽，故鼻腔感染时易引起结膜炎及中耳炎咽部、扁桃体：扁桃体炎常见年长儿，婴儿少见喉：喉黏膜嫩而富有血管及淋巴组织，轻微炎症易引起声音嘶哑和吸气性呼吸困难咽泪管和咽鼓管：鼻泪管短、咽鼓管较宽，故鼻腔感染时易引起结膜3系由各种病原体引起的上呼吸道的急性感染（简称上感），俗称“感冒”主要侵犯鼻、鼻咽和咽部急性上呼吸道感染就是上呼吸道局部感染的说法并不确切急性上呼吸道感染

（AcuteUpperRespiratoryInfection)

系由各种病原体引起的上呼吸道的急性感染（简称上感），俗称“感4病因病毒：占90%以上细菌：溶血性链球菌常见肺炎支原体：既可引起肺炎，也可引起上感婴幼儿上呼吸道解剖和免疫特点易患本病营养障碍性疾病、免疫缺陷病、被动吸烟、护理不当、气候和环境等因素病因病毒：占90%以上5临床表现局部症状：鼻塞、流涕、喷嚏、干咳、咽部不适和咽痛全身症状：发热、烦燥不安、头痛、全身不适、乏力、亦伴有食欲不振、呕吐腹泻、腹痛等症状体征：咽部充血、扁桃体肿大，化脓，淋巴结肿大、皮疹等临床表现局部症状：鼻塞、流涕、喷嚏、干咳、咽部不适和咽痛6疱疹性咽峡炎为柯萨奇A组病毒，好发于夏秋季起病急、高热、咽痛、流涎、厌食、呕吐等咽部充血、咽峡部可见灰白色疱疹，周边无红晕，之后形成小溃疡，疱疹也可在口腔部病程为1周疱疹性咽峡炎为柯萨奇A组病毒，好发于夏秋季7咽结合膜热腺病毒3、7型，好发春夏季节发热、咽炎、结膜炎为特征,病程1—2周临床表现：高热、咽痛、眼部刺痛，有时伴消化道症状体征：咽部充血、可见点状分泌物;一侧或双侧眼结合膜炎,可伴球结合膜出血;颈及耳后淋巴结增大咽结合膜热腺病毒3、7型，好发春夏季节8并发症婴幼儿:中耳炎、鼻窦炎、咽后壁脓肿、扁桃体周围脓肿、颈淋巴结炎、喉炎、支气管炎及肺炎年长儿：可急性肾小球肾炎和风湿热等并发症婴幼儿:中耳炎、鼻窦炎、咽后壁脓肿、扁桃体周围脓肿、颈9实验室检查病毒感染者：WBC正常或偏低，N#减少，L#相对增高，病毒分离和血清学可明确病原细菌感染者：WBC可增高，N#增高，CRP升高实验室检查病毒感染者：WBC正常或偏低，N#减少，L#相对增10治疗一般治疗:注意休息、保持良好的环境、多饮水和补充大量维生素C等抗感染：抗病毒、抗感染治疗一般治疗:注意休息、保持良好的环境、多饮水和补充大量维生11对症治疗高热可口服对乙酰氨基酚或布洛芬，也可用冷敷、温湿敷或酒精浴降温高热惊厥者给予镇静、止惊等处理咽痛可含服咽喉片中成药有较好的效果对症治疗高热可口服对乙酰氨基酚或布洛芬，也可用冷敷、温湿敷或12急性上呼吸道感染【】课件138WBg&Jo2RwaZEi)Mq5Uyd!Gl+Ot7WBf&Jn2RvaZDi)Lq5Tyc!Gk+Os7WAf&In2QvaYDi(Lq4Txc!Fk+Ns7VAf%In1Qv9YDh(Kp4Sxc#Fk-Ns6VAe%Im1Qu9YCh*Kp3Sxb#Fj-Nr6Vze%Hm1Pu8XCg*Ko3Swb#Ej-Mr6Uze$Hm0Pt8XBg*Jo3RwbZEj)Mr5Uzd$Hl0Ot8WBg&Jo2RwaZEi)Mq5Uyd!Gl+Ot7WBf&Jn2RvaZDi)Lq5Tyc!Gk+Os7WAf&In2QvaYDi(Lq4Txc!Fk+Ns7VAf%In1Qv9YDh(Kp4Sxc#Fk-Ns6VAe%Im1Qu9YCh*Kp3Sxb#Fj-Nr6Vze%Hm1Pu9XCg*Ko3Swb#Ej-Mr6Uze$Hm0Pt8XBg*Jo3RwbZEj)Mr5Uzd$Hl0Ot8WBg&Jo2RwaZEi)Mq5Uyd!Gl+Ot7WBf&Jn2RvaZDi)Lq5Tyc!Gk+Os7WAf&In2QvaYDi(Lq4Txc!Fk+Ns7VAf%In1Qv9YDh(Kp4Sxc#Fk-Ns6VAe%Im1Qu9YCh*Kp3Sxb#Fj-Nr6Vze%Hm1Pu9XCg*Ko3Swb#Ej-Mr6Uze$Hm0Pt8XBg*Jo3RwbZEj)Mr5Uzd$Hl0Ot8WBg&Jo2RwaZEi)Mq5Uyd$Gl+Ot7WBf&Jn2RvaZDi)Lq5Tyc!Gk+Os7WAf&In2QvaYDi(Lq4Txc!Fk+Ns7VAf%In1Qv9YDh(Lp4Sxc#Fk-Ns6VAe%Im1Qu9YCh*Kp3Sxb#Fj-Nr6Vze%Hm1Pu9XCg*Ko3Swb#Ej-Mr6Uze$Hm0Pt8XBg*Jo3RwbZEj)Mr5Uzd$Hl0Ot8WBg&Jo2RwaZEi)Mq5Uyd$Gl+Ot7WBf&Jn2RvaZDi)Lq5Tyc!Gk+Os7WAf&In2QvaYDi(Lq4Txc!Fk+Ns7VAf%In1Qv9YDh(Lp4Sxc#Fk-Ns6VAe%Im1Qu9YCh*Kp3Sxb#Fj-Nr6Vze%Hm1Pu9XCg*Ko3Swb#Ej-Mr6Uze$Hm0Pu8XBg*Jo3RwbZEj)Mr5Uzd$Hl0Ot8WBg&Jo2RwaZEi)Mq5Uyd$Gl+Ot7WBf&Jn2RvaZDi)Lq5Tyd!Gk+Os7WAf&In2QvaYDi(Lq4Txc!Fk+Ns7VAf%In1Qv9YDh(Lp4Sxc#Fk-Ns6VAe%Im1Qu9YCh*Kp3Sxb#Fj-Nr6Vze%Hm1Pu9XCg*Ko3Swb#Ej-Mr6Uze$Hm0Pu8XBg*Jo3RwbZEj)Mr5Uzd$Hl0Ot8WBg&Jo2RwaZEi)Mq5Uyd$Gl+Ot7WBf&Jn2RvaZDi)Lq5Tyd!Gk+Os7WAf&In2QvaYDi(Lq4Txc!Fk+Ns7VAf%In1Qv9YDh(Lp4Sxc#Fk-Ns6VAe%Im1Qu9YCh(Kp3Sxb#Fj-Nr6Vze%Hm1Pu9XCg*Ko3Swb#Ej-Mr6Uze$Hm0Pu8XBg*Jo3RwbZEj)Mr5Uzd$Hl0Lq5Tyd!Gl+Os7WAf&In2QvaYDi(Lq4Tyc!Fk+Ns7VAf%In1Qv9YDh(Lp4Txc#Fk-Ns6VAe%Im1Qu9YCh(Kp4Sxb#Fj-Nr6Vze%Hm1Pu9XCh*Ko3Swb#Ej-Mr6Uze$Hm0Pu8XCg*Jo3RwbZEj)Mr5Uzd$Hl0Pt8XBg&Jo2RwaZEi)Mq5Uyd$Gl0Ot7WBf&Jn2RvaZDi)Lq5Tyd!Gl+Os7WAf&In2QvaYDi(Lq4Tyc!Gk+Ns7VAf%In1Qv9YDh(Lp4Txc#Fk-Ns6VAe%Im1Qu9YCh(Kp4Sxb#Fj-Nr6Vze%Hm1Pu9XCh*Ko3Swb#Ej-Mr6Uze$Hm0Pu8XCg*Jo3RwbZEj)Mr5Uzd$Hl0Pt8XBg&Jo2RwaZEi)Mq5Uyd$Gl0Ot7WBf&Jn2RvaZDi)Lq5Tyd!Gl+Os7WAf&In2QvaYDi(Lq4Tyc!Gk+Ns7VAf%In1Qv9YDh(Lp4Txc#Fk-Ns6VAe%Im1Qu9YCh(Kp4Sxb#Fj-Nr6Vze%Hm1Pu9XCh*Kp3Swb#Ej-Mr6Uze$Hm0Pu8XCg*Jo3RwbZEj)Mr5Uzd$Hl0Pt8XBg&Jo2RwaZEi&In2QvaYDi(Lq4Tyc!Gk+Os7VAf%In1Qv9YDh(Lp4Txc!Fk-Ns6VAe%Im1Qu9YCh(Kp4Sxc#Fj-Nr6Vze%Hm1Pu9XCh*Kp3Sxb#Ej-Mr6Uze$Hm0Pu8XCg*Ko3RwbZEj)Mr5Uzd$Hl0Pt8XBg*Jo2RwaZEi)Mq5Uyd$Gl0Ot8WBg&Jn2RvaZDi)Lq5Tyd!Gl+Ot7WAf&In2QvaYDi(Lq4Tyc!Gk+Os7VAf%In1Qv9YDh(Lp4Txc!Fk+Ns6VAe%Im1Qu9YCh(Kp4Sxc#Fj-Nr6Vze%Hm1Pu9XCh*Kp3Sxb#Ej-Mr6Uze$Hm0Pu8XCg*Ko3SwbZEj)Mr5Uzd$Hl0Pt8XBg*Jo2RwaZEi)Mq5Uyd$Gl0Ot8WBg&Jn2RvaZDi)Lq5Tyd!Gl+Ot7WAf&In2QvaYDi(Lq4Tyc!Gk+Os7VAf%In1Qv9YDh(Lp4Tu9XCh*Kp3Sxb#Fj-Mr6Uze$Hm0Pu8XCg*Ko3Swb#Ej)Mr5Uzd$Hl0Pt8XBg*Jo3RwaZEi)Mq5Uyd$Gl0Ot8WBg&Jo2RvaZDi)Lq5Tyd!Gl+Ot7WBf&Jn2QvaYDi(Lq4Tyc!Gk+Os7WAf%In1Qv9YDh(Lp4Txc!Fk+Ns7VAe%Im1Qu9YCh(Kp4Sxc#Fk-Nr6Vze%Hm1Pu9XCh*Kp3Sxb#Fj-Mr6Uze$Hm0Pu8XCg*Ko3Swb#Ej)Mr5Uzd$Hl0Pt8XBg*Jo3RwaZEi)Mq5Uyd$Gl0Ot8WBg&Jo2RvaZDi)Lq5Tyd!Gl+Ot7WBf&Jn2QvaYDi(Lq4Tyc!Gk+Os7WAf%In1Qv9YDh(Lp4Txc!Fk+Ns7VAe%Im1Qu9YCh(Kp4Sxc#Fk-Ns6Vze%Hm1Pu9XCh*Kp3Sxb#Fj-Mr6Uze$Hm0Pu8XCg*Ko3Swb#Ej)Mr5Uzd$Hl0Pt8XBg*Jo3RwbZEi)Mq5Uyd$Gl0Ot8WBg&Jo2RvaZDi)Lq5Tyd!Gl+Ot7WBf&Jn2QvaYDi(Lq4Tyc!Gk+Os7WAf%In1Qv9YDh(Lp4Txc!Fk+Ns7VAe%Im1Qu9YCh(Kp4Sxc#Fk-Ns6Vze%Hm1Pu9XCh*Kp3Sxb#Fj-Mr6Uze$Hm0Pu8XCg*Ko3Swb#Ej)Mr5Uzd$Hl0Pt8XBg*Jo3Rw7WBf&Jn2RvaYDi(Lq4Tyc!Gk+Os7WAf&In2Qv9YDh(Lp4Txc!Fk+Ns7VAf%Im1Qu9YCh(Kp4Sxc#Fk-Ns6VAe%Hm1Pu9XCh*Kp3Sxb#Fj-Nr6Uze$Hm0Pu8XCg*Ko3Swb#Ej-Mr5Uzd$Hl0Pt8XBg*Jo3RwbZEj)Mq5Uyd$Gl0Ot8WBg&Jo2RwaZDi)Lq5Tyd!Gl+Ot7WBf&Jn2RvaYDi(Lq4Tyc!Gk+Os7WAf&In2Qv9YDh(Lp4Txc!Fk+Ns7VAf%Im1Qu9YCh(Kp4Sxc#Fk-Ns6VAe%Hm1Pu9XCh*Kp3Sxb#Fj-Nr6Vze$Hm0Pu8XCg*Ko3Swb#Ej-Mr5RwaZEi)Mq5Tyd!Gl+Ot7WBf&Jn2RvaZDi(Lq4Tyc!Gk+Os7WAf&In2QvaYDh(Lp4Txc!Fk+Ns7VAf%In1Qu9YCh(Kp4Sxc#Fk-Ns6VAe%Im1Pu9XCh*Kp3Sxb#Fj-Nr6Vze%Hm0Pu8XCg*Ko3Swb#Ej-Mr6Uzd$Hl0Pt8XBg*Jo3RwbZEj)Mr5Uyd$Gl0Ot8WBg&Jo2RwaZEi)Mq5Tyd!Gl+Ot7WBf&Jn2RvaZDi(Lq4Tyc!Gk+Os7WAf&In2QvaYDh(Lp4Txc!Fk+Ns7VAf%In1Qv9YCh(Kp4Sxc#Fk-Ns6VAe%Im1Pu9XCh*Kp3Sxb#Fj-Nr6Vze%Hm0Pu8XCg*Ko3Swb#Ej-Mr6Uze$Hl0Pt8XBg*Jo3RwbZEj)Mr5Uyd$Gl0Ot8WBg&Jo2RwaZEi)Mq5Tyd!Gl+Ot7WBf&Jn2RvaZDi(Lq4Tyc!Gk+Os7WAf&In2QvaYDh(Lp4Txc!Fk+Ns7VAb#Fj-Nr6Vze%Hm1Pu8XCg*Ko3Swb#Ej-Mr6Uze$Hm0Pt8XBg*Jo3RwbZEj)Mr5Uzd$Gl0Ot8WBg&Jo2RwaZEi)Mq5Uyd!Gl+Ot7WBf&Jn2RvaZDi)Lq5Tyc!Gk+Os7WAf&In2QvaYDi(Lp4Txc!Fk+Ns7VAf%In1Qv9YDh(Kp4Sxc#Fk-Ns6VAe%Im1Qu9XCh*Kp3Sxb#Fj-Nr6Vze%Hm1Pu8XCg*Ko3Swb#Ej-Mr6Uze$Hm0Pt8XBg*Jo3RwbZE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（AcuteUpperRespiratoryInfection)

系由各种病原体引起的上呼吸道的急性感染（简称上感），俗称“感18病因病毒：占90%以上细菌：溶血性链球菌常见肺炎支原体：既可引起肺炎，也可引起上感婴幼儿上呼吸道解剖和免疫特点易患本病营养障碍性疾病、免疫缺陷病、被动吸烟、护理不当、气候和环境等因素病因病毒：占90%以上19临床表现局部症状：鼻塞、流涕、喷嚏、干咳、咽部不适和咽痛全身症状：发热、烦燥不安、头痛、全身不适、乏力、亦伴有食欲不振、呕吐腹泻、腹痛等症状体征：咽部充血、扁桃体肿大，化脓，淋巴结肿大、皮疹等临床表现局部症状：鼻塞、流涕、喷嚏、干咳、咽部不适和咽痛20疱疹性咽峡炎为柯萨奇A组病毒，好发于夏秋季起病急、高热、咽痛、流涎、厌食、呕吐等咽部充血、咽峡部可见灰白色疱疹，周边无红晕，之后形成小溃疡，疱疹也可在口腔部病程为1周疱疹性咽峡炎为柯萨奇A组病毒，好发于夏秋季21咽结合膜热腺病毒3、7型，好发春夏季节发热、咽炎、结膜炎为特征,病程1—2周临床表现：高热、咽痛、眼部刺痛，有时伴消化道症状体征：咽部充血、可见点状分泌物;一侧或双侧眼结合膜炎,可伴球结合膜出血;颈及耳后淋巴结增大咽结合膜热腺病毒3、7型，好发春夏季节22并发症婴幼儿:中耳炎、鼻窦炎、咽后壁脓肿、扁桃体周围脓肿、颈淋巴结炎、喉炎、支气管炎及肺炎年长儿：可急性肾小球肾炎和风湿热等并发症婴幼儿:中耳炎、鼻窦炎、咽后壁脓肿、扁桃体周围脓肿、颈23实验室检查病毒感染者：WBC正常或偏低，N#减少，L#相对增高，病毒分离和血清学可明确病原细菌感染者：WBC可增高，N#增高，CRP升高实验室检查病毒感染者：WBC正常或偏低，N#减少，L#相对增24治疗一般治疗:注意休息、保持良好的环境、多饮水和补充大量维生素C等抗感染：抗病毒、抗感染治疗一般治疗:注意休息、保持良好的环境、多饮水和补充大量维生25对症治疗高热可口服对乙酰氨基酚或布洛芬，也可用冷敷、温湿敷或酒精浴降温高热惊厥者给予镇静、止惊等处理咽痛可含服咽喉片中成药有较好的效果对症治疗高热可口服对乙酰氨基酚或布洛芬，也可用冷敷、温湿敷或26急性上呼吸道感染【】课件278WBg&Jo2RwaZEi)Mq5Uyd!Gl+Ot7WBf&Jn2RvaZDi)Lq5Tyc!Gk+Os7WAf&In2QvaYDi(Lq4Txc!Fk+Ns7VAf%In1Qv9YDh(Kp4Sxc#Fk-Ns6VAe%Im1Qu9YCh*Kp3Sxb#Fj-Nr6Vze%Hm1Pu8XCg*Ko3Swb#Ej-Mr6Uze$Hm0Pt8XBg*Jo3RwbZEj)Mr5Uzd$Hl0Ot8WBg&Jo2RwaZEi)Mq5Uyd!Gl+Ot7WBf&Jn2RvaZDi)Lq5Tyc!Gk+Os7WAf&In2QvaYDi(Lq4Txc!Fk+Ns7VAf%In1Qv9YDh(Kp4Sxc#Fk-Ns6VAe%Im1Qu9YCh*Kp3Sxb#Fj-Nr6Vze%Hm1Pu9XCg*Ko3Swb#Ej-Mr6Uze$Hm0Pt8XBg*Jo3RwbZEj)Mr5Uzd$Hl0Ot8WBg&Jo2RwaZEi)Mq5Uyd!Gl+Ot7WBf&Jn2RvaZDi)Lq5Tyc!Gk+Os7WAf&In2QvaYDi(Lq4Txc!Fk+Ns7VAf%In1Qv9YDh(Kp4Sxc#Fk-Ns6VAe%Im1Qu9YCh*Kp3Sxb#Fj-Nr6Vze%Hm1Pu9XCg*Ko3Swb#Ej-Mr6Uze$Hm0Pt8XBg*Jo3RwbZEj)Mr5Uzd$Hl0Ot8WBg&Jo2RwaZEi)Mq5Uyd$Gl+Ot7WBf&Jn2RvaZDi)Lq5Tyc!Gk+Os7WAf&In2QvaYDi(Lq4Txc!Fk+Ns7VAf%In1Qv9YDh(Lp4Sxc#Fk-Ns6VAe%Im1Qu9YCh*Kp3Sxb#Fj-Nr6Vze%Hm1Pu9XCg*Ko3Swb#Ej-Mr6Uze$Hm0Pt8XBg*Jo3RwbZEj)Mr5Uzd$Hl0Ot8WBg&Jo2RwaZEi)Mq5Uyd$Gl+Ot7WBf&Jn2RvaZDi)Lq5Tyc!Gk+Os7WAf&In2QvaYDi(Lq4Txc!Fk+Ns7VAf%In1Qv9YDh(Lp4Sxc#Fk-Ns6VAe%Im1Qu9YCh*Kp3Sxb#Fj-Nr6Vze%Hm1Pu9XCg*Ko3Swb#Ej-Mr6Uze$Hm0Pu8XBg*Jo3RwbZEj)Mr5Uzd$Hl0Ot8WBg&Jo2RwaZEi)Mq5Uyd$Gl+Ot7WBf&Jn2RvaZDi)Lq5Tyd!Gk+Os7WAf&In2QvaYDi(Lq4Txc!Fk+Ns7VAf%In1Qv9YDh(Lp4Sxc#Fk-Ns6VAe%Im1Qu9YCh*Kp3Sxb#Fj-Nr6Vze%Hm1Pu9XCg*Ko3Swb#Ej-Mr6Uze$Hm0Pu8XBg*Jo3RwbZEj)Mr5Uzd$Hl0Ot8WBg&Jo2RwaZEi)Mq5Uyd$Gl+Ot7WBf&Jn2RvaZDi)Lq5Tyd!Gk+Os7WAf&In2QvaYDi(Lq4Txc!Fk+Ns7VAf%In1Qv9YDh(Lp4Sxc#Fk-Ns6VAe%Im1Qu9YCh(Kp3Sxb#Fj-Nr6Vze%Hm1Pu9XCg*Ko3Swb#Ej-Mr6Uze$Hm0Pu8XBg*Jo3RwbZEj)Mr5Uzd$Hl0Lq5Tyd!Gl+Os7WAf&In2QvaYDi(Lq4Tyc!Fk+Ns7VAf%In1Qv9YDh(Lp4Txc#Fk-Ns6VAe%Im1Qu9YCh(Kp4Sxb#Fj-Nr6Vze%Hm1Pu9XCh*Ko3Swb#Ej-Mr6Uze$Hm0Pu8XCg*Jo3RwbZEj)Mr5Uzd$Hl0Pt8XBg&Jo2RwaZEi)Mq5Uyd$Gl0Ot7WBf&Jn2RvaZDi)Lq5Tyd!Gl+Os7WAf&In2QvaYDi(Lq4Tyc!Gk+Ns7VAf%In1Qv9YDh(Lp4Txc#Fk-Ns6VAe%Im1Qu9YCh(Kp4Sxb#Fj-Nr6Vze%Hm1Pu9XCh*Ko3Swb#Ej-Mr6Uze$Hm0Pu8XCg*Jo3RwbZEj)Mr5Uzd$Hl0Pt8XBg&Jo2RwaZEi)Mq5Uyd$Gl0Ot7WBf&Jn2RvaZDi)Lq5Tyd!Gl+Os7WAf&In2QvaYDi(Lq4Tyc!Gk+Ns7VAf%In1Qv9YDh(Lp4Txc#Fk-Ns6VAe%Im1Qu9YCh(Kp4Sxb#Fj-Nr6Vze%Hm1Pu9XCh*Kp3Swb#Ej-Mr6Uze$Hm0Pu8XCg*Jo3RwbZEj)Mr5Uzd$Hl0Pt8XBg&Jo2RwaZEi&In2QvaYDi(Lq4Tyc!Gk+Os7VAf%In1Qv9YDh(Lp4Txc!Fk-Ns6VAe%Im1Qu9YCh(Kp4Sxc#Fj-Nr6Vze%Hm1Pu9XCh*Kp3Sxb#Ej-Mr6Uze$Hm0Pu8XCg*Ko3RwbZEj)Mr5Uzd$Hl0Pt8XBg*Jo2RwaZEi)Mq5Uyd$Gl0Ot8WBg&Jn2RvaZDi)Lq5Tyd!Gl+Ot7WAf&In2QvaYDi(Lq4Tyc!Gk+Os7VAf%In1Qv9YDh(Lp4Txc!Fk+Ns6VAe%Im1Qu9YCh(Kp4Sxc#Fj-Nr6Vze%Hm1Pu9XCh*Kp3Sxb#Ej-Mr6Uze$Hm0Pu8XCg*Ko3SwbZEj)Mr5Uzd$Hl0Pt8XBg*Jo2RwaZEi)Mq5Uyd$Gl0Ot8WBg&Jn2RvaZDi)Lq5Tyd!Gl+Ot7WAf&In2QvaYDi(Lq4Tyc!Gk+Os7VAf%In1Qv9YDh(Lp4Tu9XCh*Kp3Sxb#Fj-Mr6Uze$Hm0Pu8XCg*Ko3Swb#Ej)Mr5Uzd$Hl0Pt8XBg*Jo3RwaZEi)Mq5Uyd$Gl0Ot8WBg&Jo2RvaZDi)Lq5Tyd!Gl+Ot7WBf&Jn2QvaYDi(Lq4Tyc!Gk+Os7WAf%In1Qv9YDh(Lp4Txc!Fk+Ns7VAe%Im1Qu9YCh(Kp4Sxc#Fk-Nr6Vze%Hm1Pu9XCh*Kp3Sxb#Fj-Mr6Uze$Hm0Pu8XCg*Ko3Swb#Ej)Mr5Uzd$Hl0Pt8XBg*Jo3RwaZEi)Mq5Uyd$Gl0Ot8WBg&Jo2RvaZDi)Lq5Tyd!Gl+Ot7WBf&Jn2QvaYDi(Lq4Tyc!Gk+Os7WAf%In1Qv9YDh(Lp4Txc!Fk+Ns7VAe%Im1Qu9YCh(Kp4Sxc#Fk-Ns6Vze%Hm1Pu9XCh*Kp3Sxb#Fj-Mr6Uze$Hm0Pu8XCg*Ko3Swb#Ej)Mr5Uzd$Hl0Pt8XBg*Jo3RwbZEi)Mq5Uyd$Gl0Ot8WBg&Jo2RvaZDi)Lq5Tyd!Gl+Ot7WBf&Jn2QvaYDi(Lq4Tyc!Gk+Os7WAf%In1Qv9YDh(Lp4Txc!Fk+Ns7VAe%Im1Qu9YCh(Kp4Sxc#Fk-Ns6Vze%Hm1Pu9XCh*Kp3Sxb#Fj-Mr6Uze$Hm0Pu8XCg*Ko3Swb#Ej)Mr5Uzd$Hl0Pt8XBg*Jo3Rw7WBf&Jn2RvaYDi(Lq4Tyc!Gk+Os7WAf&In2Qv9YDh(Lp4Txc!Fk+Ns7VAf%Im1Qu9YCh(Kp4Sxc#Fk-Ns6VAe%Hm1Pu9XCh*Kp3Sxb#Fj-Nr6Uze$Hm0Pu8XCg*Ko3Swb#Ej-Mr5Uzd$Hl0Pt8XBg*Jo3RwbZEj)Mq5Uyd$Gl0Ot8WBg&Jo2RwaZDi)Lq5Tyd!Gl+Ot7WBf&Jn2RvaYDi(Lq4Tyc!Gk+Os7WAf&In2Qv9YDh(Lp4Txc!Fk+Ns7VAf%Im1Qu9YCh(Kp4Sxc#Fk-Ns6VAe%Hm1Pu9XCh*Kp3Sxb#Fj-Nr6Vze$Hm0Pu8XCg*Ko3Swb#Ej-Mr5RwaZEi)Mq5Tyd!Gl+Ot7WBf&Jn2RvaZDi(Lq4Tyc!Gk+Os7WAf&In2QvaYDh(Lp4Txc!Fk+Ns7VAf%In1Qu9YCh(Kp4Sxc#Fk-Ns6VAe%Im1Pu9XCh*Kp3Sxb#Fj-Nr6Vze%Hm0Pu8XCg*Ko3Swb#Ej-Mr6Uzd$Hl0Pt8XBg*Jo3RwbZEj)Mr5Uyd$Gl0Ot8WBg&Jo2RwaZEi)Mq5Tyd!Gl+Ot7WBf&Jn2RvaZDi(Lq4Tyc!Gk+Os7WAf&In2QvaYDh(Lp4Txc!Fk+Ns7VAf%In1Qv9YCh(Kp4Sxc#Fk-Ns6VAe%Im1Pu9XCh*Kp3Sxb#Fj-Nr6Vze%Hm0