Roi Loan Chuyen Hoa Glucid (1)

7/21/2019 Roi Loan Chuyen Hoa Glucid (1)

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RI LON CHUYN HA GLUCID

PGS Nguyn th an Hng


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!"C #I$U

1. Trnh by nguyn nhn, biu hin v hu qu ca

h glucose !u

". #ii $h%ch &'(c c) ch* bnh sinh bnh $iu &'+ng

v c) ch* biu hin ca c!c $riu chng bnh.


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- #luci/ 0231"425n.

- hc n6ng/7 #luci l $hnh 8h9n ch%nh ca $hc 6nv l ngu:n n6ng l'(ng ch%nh ca c) $h ng'+i.

7 Tha gia c;u $r?, @>?, ng $* bo,ng bo quan, glyco8ro$ein, glycoli8i,uco8olysaccharie..,$ha gia c;u $o A linB*$5

7 >gu:n nguyn liu $Cng h(8 li8i v D$ sE aciain ca c) $h

GLUCID


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glucoBinase

?TF

?ce$oace$ic a.G hyroHybu$yric a.?ce$one


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Y%U # C&N '(NG )*NG HUY%#

Ngu+n ,ung ,-./ #luci $rong $hc 6n, glycogen Igan, glucose$n $oNgu+n t/0u th1/ &'+ng 8hn, $Cng h(8 li8i v aci ain, $hiqua $hn/2u ha /

-#an / J $rK glycogen, 8hLng $h%ch glucose, $n $o &'+ng-Th9n Binh/ >Mo cL " lNai $* bo / lNai ? sO Png glucose $heoqui lu$ $hQ $h;u- lNai R sO Png glucose nh+ insulin->Di $i*$ /

#i &'+ng huy*$/ insulin T6ng &'+ng huy*$/ or$ico$ro8in,Thyro$ro8in,#3,#lucocor$icoi, a$echolaine, ThyroHin, #lucagon) ch* $!c Png/ T6ng 8hn hy glycogen v $6ng qu! $rnh $n$o &'+ng $S c!c ch;$ Bh!c


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RI L3AN CHUYN HO4 GLUCID

/2u ha n5/ t/6t

G/78 9:ng huy6t; In


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nsulin/ " chuCi 8oly8e8$ie /chuCi ? cL "1 a.a, nEi U-U 0a.a. 2-115chuCi R cL VW a.a, nEi U-U 0a.a X-X v "W-1Y5


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#4C D"NG SINH L> C?A INSULIN

huyn hLa /-Z'+ng/ B%ch hNa$ #[\T ] i chuyn &*n ng $* bo

$iu $hP glucose v J $rK glycogen-[i8i/ $6ng $Cng h(8 v $6ng J $rK li8i-Fro$i/ $6ng vn chuyn aci ain,$6ng $Cng h(8

8ro$i, c ch* $hLai hLa 8ro$i

-Zin gii / $6ng vn chuyn ^7, 8hos8ha$eT6ng $r'_ng


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C@ CH% #4C D"NG

S/nh ha / hNa$ hLa en heHoBinase / $6ng $%nh $h;glucose v $6ng chuyn glucose ----#2F

c9u nEi U-U ca chuCi ? hNa$ hLa nhL U3ca ng $* bo l $6ng $%nh $h; glucose qua ng$* bo B%ch hNa$ #2F $hnh glycogen

c ch* en #28hos8ha$ase l hn ch*bi*n #2F ---glucose


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#h1 thB / $iu &)n v` gn insulin v l 8ro$ein Huynng FF?@ 08eroHisoe 8rolidera$or ac$iva$e

rece8$or5 $rn nhn $* bo 0FF?@ gaa cL _ A v c) vn 5 @f@ 0Y cis-re$inoic aci rece8$or5 / hNa$ hLa,gn vo gene =>? &iu ha c!c gene &%ch $hAng qua

$')ng $!c vi y*u $E &!8 ng FF@j 08eroHisoe8rolidera$or res8onsive eleen$5 v hNa$ hLa sao chk8c!c gene &%ch gi


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GA! )*NG HUY%#

Nguy0n nhn;

ung c;8 $hi*u / &Li

@Ei lNan Bh n6ng h;8 $hu gluci@Ei lNan Bh n6ng J $rK 0suy $* bo gan5

T6ng c $iu $hP

@Ei lNan &iu ha h $h9n Binh, nDi $i*$

=ng $huEc h &'+ng huy*$ qu! liu

Thn gi Bh n6ng $!i h;8 $hu glucose

RI L3AN CHUYN HO4 GLUCID


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EF#/u ,hng; h y*u l c!c biu hin ca rEi lonh $hEng $h9n Binh $hJc v$

Thi*u #2F $rong $* bo, gy c gi!c &Li, ruD$ $6ng cobL8, y $6ng $i*$ `ch, run $ay chn, $i &8 nhanh,vM : hAi, $ hoa, rM r+i chn $ay, sy sm, cL $h hAn

JF C ,h6 Knh


14/57

RI LON CHUYN HA GLUCID

#NG )*NG HUY%#

Nguy0n nhn;

MUau Bhi 6n 06n nhiu isaccharie vonosaccharie5, gi $iu $hP 0$hi*u vi$ R15

- 3'ng 8h;n $h9n Binh, u nMo, bnh nDi $i*$0gi $i*$ insulin5

Hu u7; $6ng F $hQ $h;u gy Bh!$, $iu nhiu,

;$ >a7, ^7, glucose niu


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'NH #IU )*NG

[ $nh $rng $6ng &'+ng huy*$ o gi $i*$ hoc gi sOPng >U\[> Qn &*n bnh nhn $iu nhiu v n'c $iucL &'+ng 0glucose5, cL $h B hoc BhAng B $heo c!c

$riu chng 6n nhiu, uEng nhiu v g9y nhiuNguy0n nhn;

p #i $i*$ nsulin hoc gi sO Png nsulin

p ;n & gen nhy c bnh/ =@", =@V 03[? 5


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'NH #IU )*NG

ZTZ $8 1/ FhP $huDc insulin 0==/ nsuline8enen$ iabe$es elli$us5, o $Cn $h')ng $* bo

be$a ca &o $Py

ZTZ $8 ? / $Cn $h')ng $* bo be$a o $J itnZTZ $8 R / BhAng r nguyn nhn 0iio8a$hic5ZTZ $8 "/ ^hAng 8hP $huDc insulin 0>==5_ R> BhAng bk8 8h

_ R> bko 8hTiu &'+ng _ ng'+i $r Bh_i 8h!$ _ $uCi $r'_ng $hnh04=w5ZTZ $hai Bx


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C@ CH% 'NH SINH

RQ/ =n ,huyBn ha G=u,/T#i insulin gi vn chuyn glucose vo $* bo #i#2F nDi bo.Hu u7;

7 #i J $rO glycogen7 #i $ho!i bi*n glucose, gi cung c;8 n6ng l'(ng choc) $h ho$ &Dng.

7 #i chuyn hLa glucose $heo con &'+ng 8en$ose l gi >?=F3" nh h'_ng qu! $rnh chuyn hLa8ro$i.7 T6ng $o gluci bzng $6ng gi!ng hLa li8i, 8ro$ein.


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RQ/ =n ,huyBn ha =/./T

0arni$ine acyl $ransderase5


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RQ/ =n ,huyBn ha .t/T;

T6ng $iu $hP Fro$ein #i vn chuyn #i $Cng h(8 F& $n $o #lu ?a vo $* bo

T6ng aci ainI!u n bzng >i$) 0-5


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#/u ,hng;

M Tiu nhiu v n'c $iu cL &'+ng- \Eng nhiu

- {n nhiu

- #9y nhiu


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'/6n ,hng;

C-. M >hit Bhumn 0lin c9u $rng, $rJc $rng

lao5

- >hit $oan, nhit &Dc/ nhit aci

chuyn hLa, gi ^7I!u, ;$ n'c - 3An $6ng $hm $h;u

!n - f) vKa c!c ch !u o $6ng

choles$erolI!u

- i &a y $h9n Binh

- Uuy Bi$, hAn v $O vong


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'/6n ,hngV/ 8,h ; $6ng 3? Bko i gy bnh l vng c ,$h9n

Binh v $hnG/7/ thW,h;->:ng &D glucose nDi bo $6ng l hnh $hnh?#j0avance glycosyla$ion en 8rouc$s5 lin B*$

chko vi collagen , 8ro$ein nn ngNai bo gy H) ch-rEi lNan chc n6ng c9u $hn- gi $Cng h(8 >4, rEi lNanchc n6ng nDi c ch !u.-T6ng &'+ng huy*$ ---$6ng chuyn hLa glucose qua&'+ng sorbi$ol----$6ng sorbi$ol gy rEi lNan chc n6ng $*

bo-T6ng &'+ng huy*$----hnh $hnh iacylglycerol l

hNa$ hLa D$ sE isodor ca 8ro$ein Binase


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'/6n ,hngj#| 0vascular eno$helial gro}$h dac$or 5 $6ng $i ch~

gy bnh $6ng sinh vng cT#| 0$ransdoring gro}$h dac$or5 $6ng $rong bnh $hnT6ng c!c #ro}$h dac$or Bh!c!,h 8Xu =n/ T6ng &'+ng huy*$, $6ng insulinI!u,

$6ng [=[, gi 3=[ ----bnh ch vnh F?-1 08lasinogen ac$iva$or inhibi$ors5 vdibrinogen $6ng ----!u $6ng &Ang , t $hnh l8 huy*$BhEi


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'/6n ,hng#hZn [/nh@Ei lNan chc n6ng h $h9nBinh $hJc v$@Ei lNan chc n6ng $iu

hLaIniu sinh Pc[Le$ v nhit $rng bnchn


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c 9im T Tp 1 T tp 2

Tui Tr : thanh thiu nin Trung nin, gi

Th trng Gy Bo mp

Ni tit Gim hay h!ng tng h"pin#u$in

%n#u$in &' n(ng &D)*nhth'+ng hay t6ng+T )om nhy &m -i in#u$in

.i truy/n G0n $1n, $in t 2345)&h t6 mi7n h!ng r8rng9T &h;ng in#u$in,

&h;ng TB )0ta, &h;ng thn t6 mi7n

5' $in ?uan &*n &)&`a )oph*

3@m #ng hAi pht &Cp, Di7n )inDao &Dng nhanh

hAi pht h!ng (n o,h!ng D7 pht hi>n ngay

2u ?u )in &hEng FuCt hi>n #-m, nhi7m a&iD,gy, #uy i>t, D7 nhi7mhun n1ngH I)Ja m&h

h!ng g1p , IuCt hi>nmunB>nh n &`nh t')ng &Ei$@u+2ay g1p I)Ja

Ki/u trL Ngu(n in#u$in ngMai #inh 5h &D6nThu;& h &'+ng huyt


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RI L3AN CHUYN HA PRO#ID


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1- Trnh by nguyn nhn, biu hin ca gi, $6ngv $hay &Ci $hnh 8h9n 8ro$i huy*$ $')ng

"- Trnh by rEi lNan $Cng h(8 8ro$i v ch;$

!"C #I$U


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#h\nh .hZn],-u t- 3(8 ch;$ hKu c) 8hc $8, B%ch $h'c ln- ;u $o / , 3, 4, > 0 U, F5- Z)n v` / aa @ >3" - 443- L c;u $r


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CH^C NNG C?A PRO#_IN

#iK &D nh$ ca huy*$$')ng

7 #iK vKng !8 lJc Beo7 Ro v c) $h

7 ZAng !u

7 n chuyn

into

N6ng$'(ng

F& t&Ki/u hOa

Prot0inhuytt')ng

1g 8ro$ein ],1 ^calo


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Pt/T th, `n #/0u ha] h-. thu t/ u5t bPtca


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Fro$i huy*$ $')ng 8hn nh Bh! $rung $hJc 8ro$i $an c) $h

Rnh $h'+ng / 2-"gI[

RI L3AN CHUYN HA PRO#ID@Ei lNan $Cng h(8 v l'(ng@Ei lNan $Cng h(8 v ch;$


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RQ/ =man tfng h. l2 =ngEM G/78 =ng .t/T huy6t tngNguy0n nhn;-ung c;8 BhAng &-#i $Cng h(8 chung-#i h;8 $hu

-T6ng sO Png-;$ ra ngai / bng, hDi chng $hn h', l~ '/Bu h/n M hu u7;-[ sng / sP$ cn, c) $eo nh, gi $r')ng lJc, $hi*u !u, v*$

$h')ng lu lnh, 8h, ch ln, ch 8h!$ $rin $h lJc v $r% $u-n l sng / 8ro$iIhuy*$ $')ng gi.T l ?I# &o ng'(c0?I# 15-TEc &D lng 3 $6ng



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RQ/ =man tfng h. l2 =ngJM#`ng =ng .t/T huy6t tng3i* g8T6ng gi o !u b` cA &c\ $ykM #hay 9f/ th\nh .hZn .t/T huy6t tng

-?lbuin / & bo W !8 su;$ Beo- globulin / $6ng $rong $r'+ng h(8 vi c;8, vin, hNai $O $C chc, rEi lNan chuyn hLa- globulin/ cL chc n6ng vn chuyn li8i, $6ng

$rong $r'+ng h(8 $6ng li8i !u 0&!i $h!o &'+ng,$c$, hDi chng $hn h', H) cng ch5- globulin / l Bh!ng $h 0$6ng Bhi nhit Bhumn, qu!Qn, u $')ng bo5


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HU oUpRnh $h'+ng $ l ?I# 1,V -1, , 8ro$ein huy*$ $')ngBhL b` vLn $a

^hi ?lbuin gi 0?I# 15 8ro$ein t B*$ $a, nh;$ lBhi g8 uEi Bi lNai nng



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RQ/ =man tfng h. .t/T l2 ,h-t?=> $rong nhn $* bo &Lng vai $r l'u $rK $hAng$in, $Cng h(8 8ro$i v i $ruyn cho $h* h sau

#en c;u $r quy*$ &`nh $h $J c!c aciain $rong chu~i 8oy8e8$i ca 8ro$i~i 8ro$i cL c;u $r


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RQ/ =man gcn ,-u tq,>hKng sai sL$ $rong gen c;u $r


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RQ/ =man gcn 9/2u ha

#en &iu ha cL chc n6ng c ch* gen c;u $r


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Rnh $h'+ng 3b| nhiu

'cta tha=a


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RI L3AN CHUYN HA LIPID


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!"C #I$U

1- Trnh by nguyn nhn, hu qu $6ng li8i !u

"- Trnh by c) ch* bnh sinh, hu qu ca H) vKa &Dng

ch


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Chv


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EM #`ng =/./Tx8XuM Uau Bhi 6n/ $riglyceri $6ng s v cao nh;$, sau &L l

8hos8holi8i, choles$erol-3uy &Dng / 'u n6ng $uy*n yn, $uy*n gi!8, $h'(ng$hn-#a sO Png v chuyn hLa3u qu/-Rko 8h-Uuy gi chc n6ng D$ sE c) quan 0gan5

-f) vKa ch


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RI L3AN CHUYN HA LIPIDJM RQ/ =man =/..tc/n#`ng =/..tc/nc 8hi / o $hi*u en li8o-8ro$ein li8ase 0ng'+i gi,c) &`a H) vKa, $iu &'+ng5

-$6ng -[F 7 $6ng choles$erol 0Han$hoa, vKa &Dngch5-$6ng -[F 7 $6ng glyceri 7 $6ng choles$erol 0u vng,H) vKa ch 5

G/78 =/..tc/n^hAng cL -[F, hi* g8 , i $ruyn, $%ch glyceri _ruD$, gan, li8i !u $h;8#i -[F, $6ng [=[ v chyloicron gy $%ch

choles$erol _ A


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Fhos8holi8i

|ree choles$erolTriglycerie

?8oli8o8ro$ein holes$erol es$er

;u $r


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kM RQ/ =man ,huyBn ha ,h=c


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3=[

[=[

hyloicron

hyloicronrenan$s

[=[

# tmng bgx8=d

zW,h ,{ bn8d

"W1W ]W 2W W 1WWW

W.Y

1.WW

1.W1Y

1."W

1.1WW


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#an gii 8hLng vo !u nhKng 8hn $O?8o-R gn T# vi [=[

[=[ &*n c!c A, gii 8hLng b$ T#v $r_ $hnh nhKng 8hn $O [=[#an lNc c!c 8hn $O li8o8ro$ein $:n' gn ?8o-R $rong VW 8h


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G/a/ 9n J

!c li8o8ro$ein &M l'u giK chuyn hLa$i ch~/ B%ch ho$, oHi hLa

[=[ &M oHi hLa B%ch ho$ sinh ra c!csn 8hm ca cy$oBin, @[ chc n6ngnDi c, $6ng $rnh in c!c 8hn $O

b! %nh.^%ch ho$ qu! $rnh vi


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u! $rnh vi


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G/a/ 9n |/ $%ch $P $* bo c) $r)n v collagen


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Monocyte LDL-C

Adhesionmolecule

Macrophage

oam cell

!"idi#edLDL-C

$la%ue rupture

&mooth musclecells

C'$

X va ng mch: Mt bnh din tin lin tc

@[ chc n6ngnDi c

i 4Hy$ hLa

T%nh Cn &`nh ca

ng H) vKa


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RI L3AN CHUYN HA LIPID|M '} .hw

T%ch ly qu! c , $h $rNng $6ng "W $rn c qui&`nh, $6ng $Cng h(8 li8i, gi huy &Dng{n nhiu / 3Z cL nhn bPng bn ----c gi!c $h 6n nhn bPng giKa----c gi!c ch!n 6n

T6ng $i*$ hoc $6ng hNa$ $%nh insulin#i huy &Dng@Ei lNan nDi $i*$ / hDi chng ushing, suy gi sinh PcHu u7;3Na$ &Dng ch ch8, gi lao &Dng, bNc quanh$i, $iu &'+ng, H) vKa ch


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sM GZyTh $rNng gi h)n "W so vi quy &`nh- ^k h;8 $hu-T6ng sO Png / sE$, nhit Bhumn Bko i, c'+ng gi!8- ;$ ch;$ ra ngai/ $iu &'+ng , $hn h' nhit M !{ ha gan#an $%ch D$ l'(ng ln v Bko i/ $h nhit , $hLaihLa $i*n $i H) gan~M la 95ng 8,h

fZ l sJ $%ch &Nng choles$erol 'i l8 !o $rong 0nz'i nDi c 5 ca &Dng ch , l v!ch ch y ln, sau&L l lng &Nng alci &'a &*n $hLai hLa, lLe$, si o $hi*u nuAi'ng v l A H) 8h!$ $rin $i ch~


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RI L3AN CHUYN HA LIPID[Le$ v si ----nDi c BhAng $r)n nhn ----Bh_i &Dng qu! $rnh&Ang !u gy $c chfZ l bnh ca c!c &Dng ch ln 0 cL nhiu l8 !o5C ,h6 / H) vKa cL $h o-T* bo $hi*u $hP $h / &a sE bQ sinh, o D$ sE gen chi 8hEi-

gi $Cng h(8 $hP $h-T6ng choles$erol I!u / $6ng [=[I!u, v'($ Bh n6ng b$ giKca $hP $h v sJ $iu $hP ca c!c $* boNguy0n nhn $6ng [=[, gi 3=[/

#i 8ro$i I!u ^hAng $hP $h $i*8 nhn [=[-choles$erol #i li8o8ro$ein li8ase i $ruyn {n nhiu &Dng v$, nhiu choles$erol


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RI L3AN CHUYN HA LIPIDZiu Bin $hun l(i l lng &Nng choles$erol/-$hi*u vi$ain -#i h en he8arin-li8ase-[i8iI!u $6ng cao Bko i-ao 3?

-TCn $h')ng v!ch ch->ghin $huEc l!->ghin r'(u-$ vn &Dng $h lJc

Hu u7;-Ty v` $r% v 8h vi H) vKa-f) vKa ch vnh v Z nMo ----- bi*n chng o $c ch vv ch ----- $O vong cao

Roi Loan Chuyen Hoa Glucid (1)

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