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Lub zog tshiab hauv kev sib ntaus sib tua mob qog noj ntshav: Kev Saib Xyuas Ua Ke rau Mob Qog Noj Ntshav

Lub zog tshiab hauv kev sib ntaus sib tua mob qog noj ntshav: Kev Saib Xyuas Ua Ke rau Mob Qog Noj Ntshav

Lo lus "mob qog noj ntshav" ua rau peb txhua tus ntshai heev. Tab sis nrog kev nce qib ntawm kev kho mob, tam sim no muaj kev kho mob zoo heev los tawm tsam tus kab mob no. Tej zaum koj yuav tau hnov ​​​​​​txog chemotherapy, uas yog kev siv tshuaj uas tua cov hlwb qog noj ntshav ncaj qha. Tsis tas li ntawd, kev kho mob tshiab uas tam sim no tau tham txog ntau yog immunotherapy. Qhov no cuam tshuam nrog kev txhawb nqa peb lub cev lub cev tiv thaiv kab mob thiab ua rau nws tawm tsam mob qog noj ntshav. Tab sis qee zaum nws tuaj yeem nyuaj rau ua tiav cov txiaj ntsig xav tau nrog ib qho kev kho mob xwb. Yog vim li cas lub tswv yim ntawm "Kev Saib Xyuas Ua Ke" uas peb tab tom tham txog hnub no los ua ntej.

Vim li cas ho muab cov kev kho mob no ua ke?

Hais yooj yim xwb, ib pab tub rog uas muaj ntau lub peev xwm sib txawv yuav yeej ntau dua li ib tug tub rog uas sib ntaus ib leeg xwb. Qhov no kuj muaj tseeb rau kev kho mob qog noj ntshav. Thaum siv ib lossis ntau yam kev kho mob ua ke, yuav muaj feem ntau dua los tswj tau tus kab mob qog noj ntshav, kho tau tag nrho, lossis ua kom tus neeg mob muaj sia nyob ntev dua.

Cov kev kho mob ua ke no tseem ceeb heev rau cov mob qog nqaij hlav hnyav lossis mob hnyav heev, xws li mob qog nqaij hlav ntsws thiab mob melanoma ntawm daim tawv nqaij.

Cov kev cia siab tseem ceeb ntawm kev muab cov kev kho mob no ua ke yog dab tsi?

  • Ua kom peb lub cev tiv thaiv kab mob muaj zog tiv thaiv kab mob qog noj ntshav: Qee cov kev kho mob pab kom lub cev tiv thaiv kab mob paub txog cov hlwb qog noj ntshav yooj yim dua.
  • Kev cuam tshuam lub peev xwm ntawm cov hlwb qog noj ntshav kom "nkaum" ntawm lub cev tiv thaiv kab mob: Cov hlwb qog noj ntshav yog cov hlwb ntse heev. Lawv siv ntau txoj kev los khiav ntawm peb lub cev tiv thaiv kab mob. Kev kho mob ua ke tuaj yeem cuam tshuam cov tswv yim no.
  • Txo cov lej ntawm cov hlwb qog noj ntshav lossis qhov loj ntawm lub qog: Thaum ib txoj kev kho mob ua rau lub qog me me, nws yuav yooj yim dua rau lwm txoj kev kho mob los rhuav tshem cov hlwb seem.

Cov kev kho mob sib xyaw ua ke uas siv ntau

Cov kws kho mob muab ntau yam kev kho mob sib txawv ua ke. Cia peb saib ob peb yam ntawm lawv.

1. Ib chav kawm tshwj xeeb ntawm kev kho mob tiv thaiv kab mob hu ua Checkpoint Inhibitors

Qhov no yog ib txoj kev kho mob uas nthuav heev. Xav txog peb lub cev tiv thaiv kab mob zoo li ib pab tub rog uas tiv thaiv lub teb chaws. Cov hlwb tub rog no (T-cells) tuaj yeem txheeb xyuas thiab tawm tsam cov hlwb yeeb ncuab. Tab sis qee zaum cov hlwb mob qog noj ntshav tua cov "checkpoints" hauv cov hlwb tub rog no thiab ua si ib qho kev dag ntxias, hais tias, "Kuv yog ib tug ntawm koj li, tsis txhob tawm tsam kuv."

Cov tshuaj hu ua 'Checkpoint Inhibitors' ua yog tig lub qhov hloov uas cov hlwb qog noj ntshav tau kaw rov qab. Tom qab ntawd peb lub cev tiv thaiv kab mob tuaj yeem paub cov hlwb qog noj ntshav thiab pib tawm tsam lawv.

Ntau tshaj 75% ntawm kev tshawb fawb txog kev kho mob tiv thaiv kab mob niaj hnub no muab cov tshuaj tiv thaiv kev kuaj xyuas no nrog lwm yam kev kho mob. Txoj hauv kev no pab txo ntau hom mob qog noj ntshav, muab cov txiaj ntsig mus sij hawm ntev nrog tsawg dua cov kev phiv.

Piv txwv li, kev sib xyaw ua ke ntawm ob hom tshuaj checkpoint inhibitor, ipilimumab thiab nivolumab, tau siv tau zoo rau ntau xyoo los kho cov mob melanoma uas tau kis mus rau lub hlwb.

Cov tshuaj no tam sim no tau pom zoo rau lub raum, txoj hnyuv loj, siab, ntsws, thiab ntau hom mob qog noj ntshav.

2. Kev Sib Koom Ua Ke ntawm Kev Kho Mob Tiv Thaiv Kab Mob thiab Kev Kho Mob Siv Tshuaj Kho Mob

Qhov no kuj yog ib txoj kev uas tau pom tias muaj txiaj ntsig zoo heev. Thaum chemotherapy rhuav tshem cov hlwb qog noj ntshav, kev kho mob immunotherapy pab lub cev tiv thaiv kab mob nrhiav thiab rhuav tshem cov hlwb seem.

Hom mob qog noj ntshav Qhov zoo ntawm kev kho mob ua ke
Mob Cancer Mis Muaj tej hom mob qog noj ntshav hauv lub mis uas nyuaj rau lub cev tiv thaiv kab mob paub, tab sis kev siv tshuaj kho mob tiv thaiv kab mob nrog kev siv tshuaj kho mob qog noj ntshav (piv txwv li, Taxol) tau pom tias muaj txiaj ntsig zoo heev.
Mob Cancer Pancreatic Kev sib xyaw ua ke ntawm cov tshuaj chemotherapy nrog cov tshuaj immunotherapy xws li nivolumab tau ua rau muaj txiaj ntsig zoo rau mob qog noj ntshav pancreatic uas tau kis thoob plaws lub cev.
Mob qog ntshav Cov kev kho mob xws li CAR T-cell therapy ua tau zoo heev rau cov mob qog ntshav xws li leukemia. Tsis tas li ntawd xwb, kev sib xyaw cov tshuaj checkpoint inhibitor nrog chemotherapy tau ua rau cov neeg mob uas tsis teb rau kev kho mob muaj kev vam meej yuav luag ob npaug.
Mob qog nqaij hlav ntawm lub tsev menyuamRau cov mob qog noj ntshav uas rov tshwm sim tom qab chemotherapy thiab radiation, qhov ntxiv ntawm immunotherapy tau ua rau cov neeg mob muaj sia nyob ntau dua.

3. Kev Sib Koom Ua Ke ntawm Kev Kho Mob Tiv Thaiv Kab Mob thiab Kev Kho Mob Rau Lub Hom Phiaj

`Kev Kho Mob Targeted` yog ib txoj kev kho mob txawv ntawm kev kho mob chemotherapy. Kev kho mob chemotherapy tuaj yeem cuam tshuam rau txhua lub hlwb uas faib sai sai (cov hlwb mob qog noj ntshav thiab cov hlwb noj qab nyob zoo). Txawm li cas los xij, `Kev Kho Mob Targeted` tsom thiab tawm tsam ib qho teeb meem tshwj xeeb ntawm cov noob caj noob ces lossis cov protein uas ua rau cov hlwb mob qog noj ntshav loj hlob.

Kev siv txoj kev kho mob no ua ke nrog kev tiv thaiv kab mob tam sim no kuj qhia tau tias muaj txiaj ntsig zoo. Piv txwv li, cov kev kho mob ua ke no tam sim no tau pom zoo rau mob qog noj ntshav hauv lub raum thiab mob qog noj ntshav hauv qhov chaw mos.

4. Kev phais mob nrog kev kho mob tiv thaiv kab mob

Qhov no kuj yog ib txoj hauv kev tseem ceeb heev.

  • Ua ntej phais: Kev kho mob tiv thaiv kab mob tuaj yeem ua rau qhov loj ntawm tus mob qog noj ntshav me dua, ua rau kev phais yooj yim dua thiab txo cov nqaij uas yuav tsum tau tshem tawm.
  • Tom qab phais: Kev kho mob tiv thaiv kab mob tuaj yeem pab lub cev tiv thaiv kab mob tua cov hlwb me me (micrometastases) uas tej zaum yuav tsis pom tom qab phais. Qhov no txo ​​qhov kev pheej hmoo ntawm tus mob qog noj ntshav rov qab los.

Txoj kev no tau pom tias muaj txiaj ntsig zoo heev rau mob qog noj ntshav hauv lub hlwb, ntsws, mis, hnyuv loj, thiab qhov ncauj.

5. Kev Kho Mob Tiv Thaiv Kab Mob nrog Kev Kho Mob Hluav Taws Xob

Kev kho mob siv hluav taws xob ua rau cov qog nqaij hlav me dua. Cov kws tshawb fawb kuj ntseeg tias cov cim uas cov qe ntshav qog nqaij hlav uas raug hluav taws xob tso tawm ua rau lub cev tiv thaiv kab mob yooj yim dua los paub txog qog nqaij hlav. Yog li ntawd, kev tshawb fawb tseem tab tom ua mus kom pom tias kev sib xyaw ua ke ntawm kev kho mob nrog kev kho mob siv hluav taws xob puas tuaj yeem ua rau kev kho mob zoo dua.

Qhov tseem ceeb tshaj plaws: Yog tias koj lossis ib tus neeg ze koj muaj mob qog noj ntshav, nws yog ib qho tseem ceeb uas yuav tsum tau tham nrog koj tus kws kho mob txog kev kho mob twg zoo tshaj plaws rau koj, seb puas xav tau kev kho mob ua ke, thiab qhov zoo thiab qhov tsis zoo yog dab tsi. Cov ntaub ntawv hauv Is Taws Nem tsuas yog rau kev qhia xwb thiab yuav tsum tsis txhob suav tias yog kev hloov pauv rau cov lus qhia kho mob.

Cov Lus Qhia Txog Kev Coj Mus Tsev

  • Kev kho mob ua ke feem ntau muab cov txiaj ntsig zoo dua li kev kho mob ib zaug rau mob qog noj ntshav.
  • Cov phiaj xwm kho mob yog tsim los ntawm kev sib xyaw ua ke cov txheej txheem xws li kev kho mob tiv thaiv kab mob, tshuaj kho mob qog noj ntshav, kev kho mob tsom mus rau ib qho, kev phais, thiab kev kho mob hluav taws xob hauv ntau txoj kev.
  • Cov kev kho mob ua ke no tuaj yeem ua tiav cov hom phiaj xws li rhuav tshem cov hlwb qog noj ntshav, ua kom lub cev tiv thaiv kab mob muaj zog, thiab tiv thaiv kom tsis txhob rov qab muaj mob qog noj ntshav dua.
  • Qhov no yog ib qho teb uas tab tom loj hlob sai, nrog rau kev sib xyaw ua ke ntawm kev kho mob tshiab thiab zoo dua qub uas tau tsim tawm tas li.
  • Tsuas yog koj tus kws kho mob qog nqaij hlav thiaj li txiav txim siab tau txoj kev kho mob zoo tshaj plaws rau koj, yog li ntawd, tham txog txhua qhov kev txiav txim siab nrog koj tus kws kho mob.

Mob qog noj ntshav, Kev Kho Mob Qog Noj Ntshav, Kev Kho Mob Ua Ke, Kev Kho Mob Tiv Thaiv Kab Mob, Kev Kho Mob Chemotherapy, Kev Kho Mob Targeted, Cov Tshuaj Checkpoint Inhibitors, Cov Cell Qog Noj Ntshav
⚠️ Important: The medical articles and information on Nirogi Lanka are for general awareness only, and are by no means a substitute for professional medical advice, diagnosis, or treatment. For any medical problem you have, consult a qualified physician immediately.

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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.

Ntxiv koj cov lus

Thov xam: 5 + 1 =
Lub zog tshiab hauv kev sib ntaus sib tua mob qog noj ntshav: Kev Saib Xyuas Ua Ke rau Mob Qog Noj Ntshav

Lub zog tshiab hauv kev sib ntaus sib tua mob qog noj ntshav: Kev Saib Xyuas Ua Ke rau Mob Qog Noj Ntshav

Lo lus "mob qog noj ntshav" ua rau peb txhua tus ntshai heev. Tab sis nrog kev nce qib ntawm kev kho mob, tam sim no muaj kev kho mob zoo heev los tawm tsam tus kab mob no. Tej zaum koj yuav tau hnov ​​​​​​txog chemotherapy, uas yog kev siv tshuaj uas tua cov hlwb qog noj ntshav ncaj qha. Tsis tas li ntawd, kev kho mob tshiab uas tam sim no tau tham txog ntau yog immunotherapy. Qhov no cuam tshuam nrog kev txhawb nqa peb lub cev lub cev tiv thaiv kab mob thiab ua rau nws tawm tsam mob qog noj ntshav. Tab sis qee zaum nws tuaj yeem nyuaj rau ua tiav cov txiaj ntsig xav tau nrog ib qho kev kho mob xwb. Yog vim li cas lub tswv yim ntawm "Kev Saib Xyuas Ua Ke" uas peb tab tom tham txog hnub no los ua ntej.

Vim li cas ho muab cov kev kho mob no ua ke?

Hais yooj yim xwb, ib pab tub rog uas muaj ntau lub peev xwm sib txawv yuav yeej ntau dua li ib tug tub rog uas sib ntaus ib leeg xwb. Qhov no kuj muaj tseeb rau kev kho mob qog noj ntshav. Thaum siv ib lossis ntau yam kev kho mob ua ke, yuav muaj feem ntau dua los tswj tau tus kab mob qog noj ntshav, kho tau tag nrho, lossis ua kom tus neeg mob muaj sia nyob ntev dua.

Cov kev kho mob ua ke no tseem ceeb heev rau cov mob qog nqaij hlav hnyav lossis mob hnyav heev, xws li mob qog nqaij hlav ntsws thiab mob melanoma ntawm daim tawv nqaij.

Cov kev cia siab tseem ceeb ntawm kev muab cov kev kho mob no ua ke yog dab tsi?

  • Ua kom peb lub cev tiv thaiv kab mob muaj zog tiv thaiv kab mob qog noj ntshav: Qee cov kev kho mob pab kom lub cev tiv thaiv kab mob paub txog cov hlwb qog noj ntshav yooj yim dua.
  • Kev cuam tshuam lub peev xwm ntawm cov hlwb qog noj ntshav kom "nkaum" ntawm lub cev tiv thaiv kab mob: Cov hlwb qog noj ntshav yog cov hlwb ntse heev. Lawv siv ntau txoj kev los khiav ntawm peb lub cev tiv thaiv kab mob. Kev kho mob ua ke tuaj yeem cuam tshuam cov tswv yim no.
  • Txo cov lej ntawm cov hlwb qog noj ntshav lossis qhov loj ntawm lub qog: Thaum ib txoj kev kho mob ua rau lub qog me me, nws yuav yooj yim dua rau lwm txoj kev kho mob los rhuav tshem cov hlwb seem.

Cov kev kho mob sib xyaw ua ke uas siv ntau

Cov kws kho mob muab ntau yam kev kho mob sib txawv ua ke. Cia peb saib ob peb yam ntawm lawv.

1. Ib chav kawm tshwj xeeb ntawm kev kho mob tiv thaiv kab mob hu ua Checkpoint Inhibitors

Qhov no yog ib txoj kev kho mob uas nthuav heev. Xav txog peb lub cev tiv thaiv kab mob zoo li ib pab tub rog uas tiv thaiv lub teb chaws. Cov hlwb tub rog no (T-cells) tuaj yeem txheeb xyuas thiab tawm tsam cov hlwb yeeb ncuab. Tab sis qee zaum cov hlwb mob qog noj ntshav tua cov "checkpoints" hauv cov hlwb tub rog no thiab ua si ib qho kev dag ntxias, hais tias, "Kuv yog ib tug ntawm koj li, tsis txhob tawm tsam kuv."

Cov tshuaj hu ua 'Checkpoint Inhibitors' ua yog tig lub qhov hloov uas cov hlwb qog noj ntshav tau kaw rov qab. Tom qab ntawd peb lub cev tiv thaiv kab mob tuaj yeem paub cov hlwb qog noj ntshav thiab pib tawm tsam lawv.

Ntau tshaj 75% ntawm kev tshawb fawb txog kev kho mob tiv thaiv kab mob niaj hnub no muab cov tshuaj tiv thaiv kev kuaj xyuas no nrog lwm yam kev kho mob. Txoj hauv kev no pab txo ntau hom mob qog noj ntshav, muab cov txiaj ntsig mus sij hawm ntev nrog tsawg dua cov kev phiv.

Piv txwv li, kev sib xyaw ua ke ntawm ob hom tshuaj checkpoint inhibitor, ipilimumab thiab nivolumab, tau siv tau zoo rau ntau xyoo los kho cov mob melanoma uas tau kis mus rau lub hlwb.

Cov tshuaj no tam sim no tau pom zoo rau lub raum, txoj hnyuv loj, siab, ntsws, thiab ntau hom mob qog noj ntshav.

2. Kev Sib Koom Ua Ke ntawm Kev Kho Mob Tiv Thaiv Kab Mob thiab Kev Kho Mob Siv Tshuaj Kho Mob

Qhov no kuj yog ib txoj kev uas tau pom tias muaj txiaj ntsig zoo heev. Thaum chemotherapy rhuav tshem cov hlwb qog noj ntshav, kev kho mob immunotherapy pab lub cev tiv thaiv kab mob nrhiav thiab rhuav tshem cov hlwb seem.

Hom mob qog noj ntshav Qhov zoo ntawm kev kho mob ua ke
Mob Cancer Mis Muaj tej hom mob qog noj ntshav hauv lub mis uas nyuaj rau lub cev tiv thaiv kab mob paub, tab sis kev siv tshuaj kho mob tiv thaiv kab mob nrog kev siv tshuaj kho mob qog noj ntshav (piv txwv li, Taxol) tau pom tias muaj txiaj ntsig zoo heev.
Mob Cancer Pancreatic Kev sib xyaw ua ke ntawm cov tshuaj chemotherapy nrog cov tshuaj immunotherapy xws li nivolumab tau ua rau muaj txiaj ntsig zoo rau mob qog noj ntshav pancreatic uas tau kis thoob plaws lub cev.
Mob qog ntshav Cov kev kho mob xws li CAR T-cell therapy ua tau zoo heev rau cov mob qog ntshav xws li leukemia. Tsis tas li ntawd xwb, kev sib xyaw cov tshuaj checkpoint inhibitor nrog chemotherapy tau ua rau cov neeg mob uas tsis teb rau kev kho mob muaj kev vam meej yuav luag ob npaug.
Mob qog nqaij hlav ntawm lub tsev menyuamRau cov mob qog noj ntshav uas rov tshwm sim tom qab chemotherapy thiab radiation, qhov ntxiv ntawm immunotherapy tau ua rau cov neeg mob muaj sia nyob ntau dua.

3. Kev Sib Koom Ua Ke ntawm Kev Kho Mob Tiv Thaiv Kab Mob thiab Kev Kho Mob Rau Lub Hom Phiaj

`Kev Kho Mob Targeted` yog ib txoj kev kho mob txawv ntawm kev kho mob chemotherapy. Kev kho mob chemotherapy tuaj yeem cuam tshuam rau txhua lub hlwb uas faib sai sai (cov hlwb mob qog noj ntshav thiab cov hlwb noj qab nyob zoo). Txawm li cas los xij, `Kev Kho Mob Targeted` tsom thiab tawm tsam ib qho teeb meem tshwj xeeb ntawm cov noob caj noob ces lossis cov protein uas ua rau cov hlwb mob qog noj ntshav loj hlob.

Kev siv txoj kev kho mob no ua ke nrog kev tiv thaiv kab mob tam sim no kuj qhia tau tias muaj txiaj ntsig zoo. Piv txwv li, cov kev kho mob ua ke no tam sim no tau pom zoo rau mob qog noj ntshav hauv lub raum thiab mob qog noj ntshav hauv qhov chaw mos.

4. Kev phais mob nrog kev kho mob tiv thaiv kab mob

Qhov no kuj yog ib txoj hauv kev tseem ceeb heev.

  • Ua ntej phais: Kev kho mob tiv thaiv kab mob tuaj yeem ua rau qhov loj ntawm tus mob qog noj ntshav me dua, ua rau kev phais yooj yim dua thiab txo cov nqaij uas yuav tsum tau tshem tawm.
  • Tom qab phais: Kev kho mob tiv thaiv kab mob tuaj yeem pab lub cev tiv thaiv kab mob tua cov hlwb me me (micrometastases) uas tej zaum yuav tsis pom tom qab phais. Qhov no txo ​​qhov kev pheej hmoo ntawm tus mob qog noj ntshav rov qab los.

Txoj kev no tau pom tias muaj txiaj ntsig zoo heev rau mob qog noj ntshav hauv lub hlwb, ntsws, mis, hnyuv loj, thiab qhov ncauj.

5. Kev Kho Mob Tiv Thaiv Kab Mob nrog Kev Kho Mob Hluav Taws Xob

Kev kho mob siv hluav taws xob ua rau cov qog nqaij hlav me dua. Cov kws tshawb fawb kuj ntseeg tias cov cim uas cov qe ntshav qog nqaij hlav uas raug hluav taws xob tso tawm ua rau lub cev tiv thaiv kab mob yooj yim dua los paub txog qog nqaij hlav. Yog li ntawd, kev tshawb fawb tseem tab tom ua mus kom pom tias kev sib xyaw ua ke ntawm kev kho mob nrog kev kho mob siv hluav taws xob puas tuaj yeem ua rau kev kho mob zoo dua.

Qhov tseem ceeb tshaj plaws: Yog tias koj lossis ib tus neeg ze koj muaj mob qog noj ntshav, nws yog ib qho tseem ceeb uas yuav tsum tau tham nrog koj tus kws kho mob txog kev kho mob twg zoo tshaj plaws rau koj, seb puas xav tau kev kho mob ua ke, thiab qhov zoo thiab qhov tsis zoo yog dab tsi. Cov ntaub ntawv hauv Is Taws Nem tsuas yog rau kev qhia xwb thiab yuav tsum tsis txhob suav tias yog kev hloov pauv rau cov lus qhia kho mob.

Cov Lus Qhia Txog Kev Coj Mus Tsev

  • Kev kho mob ua ke feem ntau muab cov txiaj ntsig zoo dua li kev kho mob ib zaug rau mob qog noj ntshav.
  • Cov phiaj xwm kho mob yog tsim los ntawm kev sib xyaw ua ke cov txheej txheem xws li kev kho mob tiv thaiv kab mob, tshuaj kho mob qog noj ntshav, kev kho mob tsom mus rau ib qho, kev phais, thiab kev kho mob hluav taws xob hauv ntau txoj kev.
  • Cov kev kho mob ua ke no tuaj yeem ua tiav cov hom phiaj xws li rhuav tshem cov hlwb qog noj ntshav, ua kom lub cev tiv thaiv kab mob muaj zog, thiab tiv thaiv kom tsis txhob rov qab muaj mob qog noj ntshav dua.
  • Qhov no yog ib qho teb uas tab tom loj hlob sai, nrog rau kev sib xyaw ua ke ntawm kev kho mob tshiab thiab zoo dua qub uas tau tsim tawm tas li.
  • Tsuas yog koj tus kws kho mob qog nqaij hlav thiaj li txiav txim siab tau txoj kev kho mob zoo tshaj plaws rau koj, yog li ntawd, tham txog txhua qhov kev txiav txim siab nrog koj tus kws kho mob.

Mob qog noj ntshav, Kev Kho Mob Qog Noj Ntshav, Kev Kho Mob Ua Ke, Kev Kho Mob Tiv Thaiv Kab Mob, Kev Kho Mob Chemotherapy, Kev Kho Mob Targeted, Cov Tshuaj Checkpoint Inhibitors, Cov Cell Qog Noj Ntshav
⚠️ Important: The medical articles and information on Nirogi Lanka are for general awareness only, and are by no means a substitute for professional medical advice, diagnosis, or treatment. For any medical problem you have, consult a qualified physician immediately.

💬 Comments (0)

Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.

Ntxiv koj cov lus

Thov xam: 5 + 1 =