Ke Kūlike o nā Huaʻokoʻa Psychological a me nā Kaumāna o nā Neurotransmitters ma Shanghai Nā poʻe'ōpiopio me kaʻole kaʻole o ka hōʻinoʻana i ka hōʻailona o ka nohona: kahi hoʻonaʻauao kūkā (2013)

PLoS hana. 2013 Mei 3; 8 (5): e63089. hana: 10.1371 / journal.pone.0063089.

Zhang HX, Jiang WQ, Lin ZG, Du YS, Makahu A.

kahi

Keena o Hoʻonaʻauao Kauka, ʻo Zhongshan Hospital, Fudan University, Shanghai, Kina.

Hōʻuluʻulu Manaʻo

kāʻei kua

Hoʻomaʻamaʻa ʻia ka make ma ka pūnaewele pili ʻokoʻa (IAD) a ʻike i ka pili ʻana i ka hoʻonaʻauao a me nā hana pilikino. I kēia lā, ʻike liʻiliʻi mākou i nā mea pili i nā mea ola pili. Ua kuhi ʻia kēia noiʻi e hōʻiliʻili i kahi hui o nā ʻōpio me IAD a ʻo kahi makahiki a me ka poʻe kāne e pili ana i ka hui like ʻana. Hana mākou i ka poʻe ʻōpio me IAD e loaʻa i nā kiʻekiʻe kiʻekiʻe o ka hopohopo i hōʻike ʻia iho a me nā hōʻailona kaumaha, ua loli nā pae o ka dopamine koko peripheral, norepinephrine a me serotonin. Eia kekahi, ua hypothesized mākou i nā hola i hala ma ka pūnaewele e hoʻoponopono ʻia me ka kaumaha o ke kaumaha a me ka hopohopo i waena o kēia poʻe'ōpio me IAD.

Ka ʻinaʻōlelo / kumu kumu ʻike

Ua mālama ʻia kahi mahele ʻāpana ʻokoʻa o nā ʻōpio 20 i hālāwai me ke ʻano ʻo Beard no IAD a me 15 e hana pinepine nei i nā ʻōpio (hoʻohālikelike hui). Ua hoʻopau nā poʻe āpau i nā pae ʻai kaukani iho la o kā lākou helu helu ana (SDS), ʻIkena ʻeha o ka ʻeha ʻana (SAS), a me ka Pihi no nā ʻĀina e pili ana i nā ʻĀina Hōʻehaʻike (SCARED). Ua ho'āʻoʻia ke koko dopamine, serotonin a me nā norepinephrine. Ua emi ka haʻahaʻa o nā norepinephrine ma ka hui IAD ma mua o ka mea maʻamau i ke komoʻana o ka poʻe komo, akāʻaʻoheʻokoʻa keʻano o ka dopamine a me ka serotonin. Ua hoʻonuiʻia nā helu SDS, SAS a me SCARED i nā'ōpio me IAD. Ua hōʻikeʻia kahi hōʻike hoʻoponopono loiloi i ka hōʻikeʻana o kahi kiʻekiʻe SAS kiʻekiʻe a me ka pae haʻahaʻa o nā norepineprine i ke kohoʻana i nā lālā o ka IAD. ʻAʻole he pilina koʻikoʻi ma waena o nā hola i hoʻohanaʻia ma ka pūnaewele a me nā helu SAS / SDS ma ka hui IAD.

Nā Huaʻōlelo / Nui

Hoʻonui kūwaho e hōʻike i ka hopohopo a me ka hoʻohaʻahaʻa i ke koko norepinephrine i ke kū hoʻokahi me IAD.

Hōʻike: ʻO Zhang HX, Jiang WQ, Lin ZG, Du YS, Vance A (2013) Hoʻohālikelike o nā ʻĀina Psychological a me Serum Levels o Neurotransmitters ma Shanghai ʻO nā ʻōpio me a me ka ʻole o ka Hoʻopilikia Pūnaewele Pūnaewele: Kahi hihia hihia. PLOʻO 8 (5): e63089. doi: 10.1371 / journal.pone.0063089

Luna ho'oponopono: Jerson Laks, ke Kulanui ʻAmelika Hui Pū ʻIa o Rio de Janeiro, ʻo Brazil

Loaʻaʻia: 'Okakese 31, 2012; Uaʻaeʻia: Malaki 27, 2013; Kuhiʻia: E 3, 2013

Kuleana kope: © 2013 Zhang et al. He ʻatikala ʻōlelo wehe ʻia kēia i hoʻokaʻawale ʻia ma lalo o nā huaʻōlelo o ka ʻAha Kuhi Hoʻohui Kīwī, e ʻae ana i ka hoʻohana ʻole ʻia, ka hoʻoili ʻana, a me ka hoʻouluulu ʻana i kekahi ʻano mea i hana ʻia, i hāʻawi ʻia i ka mea kumu a me nā kumu i ʻike ʻia.

Kākoʻo kālā: Ua kākoʻo ʻia kēia hana e nā loiloi mai ka papahana ʻo "11th ʻelima mau makahiki" e kākoʻo ana i nā papahana ʻepekema a me ka ʻenehana ma Kina, ʻĀpana (2007BAI17B03). ʻAʻohe kuleana o ka mea kākoʻo kālā i ka hoʻolālā ʻana, hōʻiliʻili o ka ʻikepili a me ka nānā ʻana, hoʻoholo e paʻi, a hoʻomākaukau i ka kākau ʻana. ʻO ka pūnaewele o ka Ministry of Science a me Technology of the People Republic of China e like me kēia: http://www.most.gov.cn/.

Nā mea hoʻolimalima: Ua haʻi aku nā mea kākau i kaʻaʻohe hoʻokūkū hoʻokūkū.

Introduction

Ua ala i ka maʻi addict pūnaewele (IAD) me ka piʻi nui o ka pūnaewele: ʻoiaʻiʻo, ua ʻike ʻia ka nui o ke kaʻina holoʻana i ka ulu ʻana a me nā ʻāina hoʻomohala. [1]-[3]. ^ E Ha yM. Hoʻokomo ʻia nā hana kīnā i ka hana hoʻonaʻauao, pili kaiapuni, ʻohana a me nā limahana hana [2], [4]. ^ E Ha yM. ʻO nā mea he nui i hoʻopili ʻia e like me ka wā ʻōpio o ka hoʻohana ʻana i ka pūnaewele, hoʻonui i ka hopohopo a hoʻonui i nā hōʻailona kaumaha a / a i ʻole nā ​​hōʻeha [5]-[7]: nā helu kiʻekiʻe i nā Beck Depression Inventory (BDI) [6] a i ʻole ke kikowaena no nā Kumuhana Hoʻoikaika aʻo Epidemiological (CES-D) [7] pili me IAD. Eia kekahi, ʻoi aku ka nui o nā maʻi ʻehaʻeha o nā puʻuwai kiʻekiʻe e pili ana i nā nīnau ikaika a me nā pilikia. [8]-[10].

I kēia manawa, ʻike mau nā mea koʻikoʻi pili i IAD [6]. kaka pili kino i ka hemahema o nā pae hana o ka dopamine (DA), serotonin (5 – HT), a me / a norepinephrine (NE), kahi i hui pū ʻia me ka hoʻomaka ʻana o ke ʻano a me ke kaumaha ʻole e like me ka paleʻole o ka serotonin a me norepinephrine neuronal hoʻihoʻi axon [11]-[15]. Eia kekahi, kahi lohi hānai serotonin hoʻokaʻawale i hoʻopili ʻia i nā maʻi hōʻeha nui a hoʻokomo ʻia paha i IAD [16]. ^ E Ha yM. Hana mākou i ka poʻe ʻōpio me IAD e loaʻa i nā kiʻekiʻe kiʻekiʻe o ka hopohopo i hōʻike ʻia iho a me nā hōʻailona kaumaha a me nā loli o ka dopamine koko peripheral, norepinephrine a me serotonin.

Tonioni et al. [17] ua loaʻa ka pilina ma waena o nā hola i hala ma ka pūnaewele a me ke kaumaha / hoʻowahāwahā, ua hypothesized mākou i nā hola i hala ma ka pūnaewele e hiki ke hoʻopili ʻia me nā helu o ka SAS / SDS ma waena o ka poʻe'ōpio me IAD.

Nā Pono a me nā Una

i komo

ʻO nā haumāna ʻōpiopio 20 me IAD, e like me ke ʻano o Beard [17], i hōʻeuʻeu ʻia mai ka keʻena outpatient o ka Mental Health Center o Shanghai ma ke kula ʻo Jiao Tong University of Medicine mai Iulai 2008 a i Ianuali 2010. Lilo nā haumāna ma kahi hola 33.8 (16.8) i kēlā me kēia pule e hoʻohana ana i ka pūnaewele ma ka pūnaewele. TUa manaʻo ʻia nā mea āpau me ka Pūnaewele (noʻonoʻo e pili ana i ka hana ma o ka pūnaewele ma mua a i ʻole ke kali ʻana i kā lākou hui pūnaewele aʻe); pono e hoʻohana i ka Pūnaewele no ka hoʻonui ʻana i nā manawa o ka manawa e hoʻomaʻamaʻa ai; ʻaʻole hiki ke kāohi, ʻoki aku, a i ʻole oki i kā lākou Pūnaewele pūnaewele; oki, ʻoluʻolu, hoʻohaʻahaʻa, a me / a i ʻole he huhū i ka wā i hōʻoki ʻia ai kā lākou hoʻohana pūnaewele me ka ʻole; a ke noho lōʻihi nei ma luna o ka pūnaewele ma mua o ka mea i manaʻo ʻia. In Eia nō naʻe, ua hōʻike lākou i kahi liʻiliʻi i kekahi o kēia mau hōʻailona ʻekolu: hōʻike i ka nalowale o ka pilina pili, nā hana, ka hoʻonaʻauao a me ka manawa kūpono ma muli o kā lākou hoʻohana pūnaewele ʻana; wahaheʻe i ʻohana ʻohana a i ʻole kekahi e hūnā i ka nui o kā lākou hoʻohana ʻana i ka Pūnaewele; a / a hoʻohana i ka Pūnaewele ma ke ala he mea e pakele ai mai nā pilikia a i ʻole ka hoʻomaha ʻana i kahi ʻano dysphoric. ^ E Ha yM. Ua kuhi ʻia ʻo ia me ka maikaʻi ʻole inā ua hana ʻo ia i ka hana haʻawina, ʻike ʻia i ka haʻalele ʻana o ke kula a me / a aʻo ʻia e nā mana o nā mana (nā kumu a me / a i ʻole nā ​​mākua) no kā lākou makee pūnaewele. Ua hoʻokaʻawale ʻia nā haumāna inā loaʻa iā lākou nā hōʻike no kekahi pilikia olakino comorbid, ma mua nā maʻi psychiatric mua a me / a i lawe nei i kekahi lāʻau lapaʻau psychoactive.

ʻO ka hana pinepine ʻana i nā mea hana ʻōpio'ōpiopio, ka ʻenemi no ka makahiki a me ka wahine, mai ka like o ke ʻano socio-demographic (ke kula waena ma Shanghai) ʻaʻohe hanana olakino a ʻimi ʻole paha, ka wai inu wai a / a i ʻole e hoʻohana ʻia i ka hoʻohana ʻana i nā mea mālama olakino. Ua loaʻa ka ʻae hoʻomaopopo mai nā poʻe a pau a me ko lākou kahu ʻokoʻa. Aia nā keikikāne 18 a me nā kaikamahine 2 (ʻoi aku ka makahiki o 16.8 ± 1.8 mau makahiki) i ka hui IAD a me nā keikikāne 13 a me nā kaikamahine 2 (ʻo ia hoʻi nā makahiki o 18.1 ± 2.7 mau makahiki) i ka pūʻulu ulu kūlike.

Ka'ōlelo Kaumaha

ʻO kēia aʻo ʻana he ʻāpana nui o ka noiʻi i pili i nā maʻi ʻōpiopio. Ua aponoia ka hope o ka Institute Review Board of Shanghai Mental Health Center. Hana ʻia ka hoʻopaʻa ʻana ma Shanghai wale nō, ʻaʻole ʻo waho o Kina. Ua hele nā ​​poʻe komo a me kā lākou kahu mālama kānāwai ma ka Mental Health Center o Shanghai ma ke kula ʻo Jiao Tong University of Medicine no kahi hālāwai ʻelua hola me nā wā hoʻomaha he pono. Loaʻa ʻia ka ʻae hoʻomaopopo a kākau ʻia i ka hoʻomaka ʻana o ke kau, ma hope o ka hoʻākāka a me nā mea mālama kānāwai.

Pākuhi

He nīnau ninaninau a Beard no ka Hoʻopili Pūnaewele [18]: 8 mea i loko o nā mea a pau, me kahi dichotomous (ʻAe / ʻAeʻa) Likert scale. Hōʻike ka IAD i ka manawa a pau o nā mea kūʻai mua o 5 a loaʻa me ka liʻiliʻi loa i kekahi o nā mea e paʻi ʻia nei 3.

Kahakaha iho nei [19]: 20 mau huahana me ke ʻano ʻehā Likert ʻehā. ʻOi aku ka helu kiʻekiʻe e hōʻike i nā hōʻailona kaumaha loa. Ua lawa ka hōʻoia a me ka hilinaʻi i ka Repubalika o Kina.

Hōʻike Hōʻeha i ka hōʻaiʻē pākaha (SAS) [20]: 20 mau huahana me ke ʻano ʻehā Likert ʻehā. Hōʻike ka helu kiʻekiʻe i nā hōʻailona hopohopo koʻikoʻi. Ua lawa ka hōʻoia a me ka hilinaʻi i ka Repubalika o Kina.

Kuhi no nā pilikia ʻoluʻolu e pili ana i ka pīhoihoi keiki (SCARED) [21], [22]: He waiwai 41 ma nā mea a me ke kūʻai aku no Likert ʻekolu mau kākoʻo e kākoʻo i ʻelima mau: 'somatic / panic', 'generalized anxiety', 'wehe' hopohopo ',' ʻeha hopohopo 'a me ke' kaumaha kula. ʻOi aku ka kiʻekiʻe o ka helu, ʻoi aku ka kiʻekiʻe o ke hāʻawi ʻana i nā mea hopohopo i hāʻawi ʻia i kahi keiki. Ua lawa ka hōʻoia a me ka hilinaʻi i ka Repubalika o Kina.

Manaʻo ʻO nā Biochemistry

No kēlā me kēia limahana, ua hoʻoneʻe ʻia ka 5 ml koko o ka mana me ka heparin anticoagulation vacuum tube, mālama ʻia i loko o kahi anuanu me ka māmā i pale ʻia. Hana ʻia nā pae o DA a me NE i ka serum me ka hoʻohana ʻana i ka ELISA (ka hoʻohui ʻia o ka huakaʻi immuno-sorbent) a me ka pae o 5-HT ma nā pelekela koko peripheral me HPLC (kiʻekiʻe ka wai chromatography wai hoʻokūkū kiʻekiʻe).

Ke Kaʻina hana

Ua komo nā haumāna a me kā lākou kahu mālama kānāwai ma ka Mental Health Center ma Shanghai Jiao Tong University of Medicine. Ua loaʻa i ka ʻae ʻia nā ʻōlelo i kākau ʻia. ʻO nā hoʻokolohua āpau i mālama ʻia e nā lāʻau lapaʻau i hoʻopaʻa ʻia a me ka ʻikepili i loaʻa mai iā lākou i komo i ka ʻikepili pūnaewele.

ʻIkeʻIke Heluhelu

Ua hoʻopaʻa ʻia nā ʻikepili me ka hoʻohana ʻana i ka Statistical Package for Social Science (SPSS), kahi o 16.0 e hoʻohālikelike ai i ka IAD a me ka maʻamau e hoʻomohala i nā hui. Nā ʻano hoʻohālikelike e hoʻohālikelike ʻia i ka hoʻohālikelike ʻia e Kolmogorov-Smirnov, a i ʻole e hoʻohuli ʻia i ka hoʻoilina maʻamau ke hoʻohālikelike ʻia me ka hoʻohālike kūʻokoʻa t hōʻike i nā hōʻike. Ua hoʻohālikelike ʻia nā data helu-parametric e hoʻohana ana i ka Mann-Whitney U hoʻāʻo. Ua helu ʻia nā kuʻuna correlation i nā wā o ka mana o nā hua i ʻokoʻa ma waena o ka IAD. Eia nō naʻe, ua hoʻokomo ʻia kēia mau lula i loko o ka loiloi regression ʻoi aku ka hoʻoholo ʻana i nā ʻano ka mana ʻē aʻe i wānana i ka lālā o IAD. ʻO ka hoʻoponopono ʻana ma waena o nā hola i hala ma ka pūnaewele a me nā helu o ka SAS / SDS i ka hui IAD ua hoʻoholo ʻia e Pearson r.

Results

ʻO ka pae o ka Monoamine Neurotransmitters ma Plasma

ʻO ka haʻahaʻa o ka NE i ka hui IAD i ka haʻahaʻa ma mua o ia i ka hui kaomi maʻamau ((345 ± 68) pg / ml a (406 ± 76) pg / ml, kēlā me kēia. t = 2.515, p = 0.017]. ʻAʻole kaʻokoʻa koʻikoʻi ma nā pae o DA a i ʻole 5-HT ma waena o nā hui ʻelua (1 Pūnaewele).

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1 Pūnaewele. ʻO ke pae o 5-HT, NE a me DA i IAD a me nā hui hoʻokele.

hana: 10.1371 / journal.pone.0063089.t001

Nā Palapala Hoʻoiho pilikino

ʻO nā helu SDS, SAS a me SCARED i ka hui IAD ua ʻoi nui loa lākou ma mua o ka poʻe ma ka pae e hoʻomohala maʻamau.2 Pūnaewele).

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2 Pūnaewele. ʻO ka hoʻohālikelike o nā hōʻike o ka hōʻike ponoʻī e hōʻike ana i nā hōʻailona hōʻeha ma waena o ka IAD a me nā hui o nā hui.

hana: 10.1371 / journal.pone.0063089.t002

ʻO ka hoʻoponopono ʻana i nā hōʻailona pilikino i hōʻike ʻia me nā haʻuki NE

ʻO nā hua i ka wā kūʻai o ka hua Pearson no ka IAD a me ka ulu ʻana i nā hui i waena o −0.26 a −0.29 no ka pae o NE a me nā helu o SDS, SAS a me SCARED (r = −0.263, −0.269 a me −0.294, kēlā me).

ʻO ka loiloi loiloi logistic

Ua hoʻokomo ʻia nā mea kūʻokoʻa kūʻokoʻa i ke loea loiloi NE a me nā helu SDS, SAS a me SCARED. Ua manaʻo ʻia nā ʻano makahiki a me ke ʻano like ʻole o ka loli ʻano kūʻokoʻa. Ua noho mau ʻelua mau hoʻololi i ka hoʻohālikelike regression: ka pae SAS (V1) a me ka pae NE (V2) (3 Pūnaewele). ʻO ka hapa pākēneka pololei ʻo 80.0% (ka hoʻohālikelike regression: logit (P) = −14.729+0.475×V1−0.031×V2).

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3 Pūnaewele. Nā hualoaʻa o ka loiloi logistic o ka pae NE a me ka paʻakikī o ka hōʻike ponoʻī ʻana i hōʻike ʻia me ka hopena o ka maʻi IAD a i ʻole (ʻo nā ʻōpiopio 20 me IAD a me nā mana o 15).

hana: 10.1371 / journal.pone.0063089.t003

Ka hoʻoponopono ʻana o nā hola i hala ma ka pūnaewele a me nā helu o ka SAS / SDS I waena o nā ʻōpio me IAD

Ma waena o nā ʻōpio ʻo 20 me IAD, ka koina o ka correlation o nā hola i hoʻopau ʻia ma ka pūnaewele i kēlā me kēia pule i ke kiʻi o SAS ʻaʻole kū i ka helu koʻikoʻi (r = 0.015, p = 0.955), ʻaʻole hoʻi kēlā me ka helu o SDS (r = 0.015, p = 0.954).

kūkākūkā

ʻO ka loaʻa ʻana o nā mea ʻōpio me IAD ua hoʻokiʻekiʻe i ka hopohopo a me ke kaumaha kaumaha e kūpono me nā hana ma mua: Bernardi et al. [23] ʻike i kahi 30% o ka poʻe'ōpio me IAD i loaʻa i kahi maʻi koʻikoʻi o ka hopohopo. Ua nānā nā noiʻi ʻē aʻe i ka hui nui o ka IAD me ka pilikia nui [7], [9], [24], [25] a me ka nui o ka manawa e loaʻa ai ka poʻe ʻōpio me kahi puʻuwai kaumaha e hoʻomohala ma IAD [26], [27]: ka mea nui, ʻo kā mākou hoʻokolohua manuahi ma mua i loaʻa i nā ʻōpiopio me IAD i hoʻomaikaʻi i ke kaumaha a me nā hōʻailona kaumaha ma hope o ka noʻonoʻo ʻana o ka noʻonoʻo kognitive [28].

ʻO ka mea e mahalo ai, ʻoiai ua hoʻololi ʻia ka hana a DA, NE a me 5-HT ka pili me ka hopohopo koʻikoʻi a me nā hōʻailona kaumaha, ʻike mākou aia wale nō ka pae o NE a he haʻahaʻa ʻoi aku ka hopohopo kiʻekiʻe i ka hui IAD i hoʻohālikelike ʻia i ka hui like ʻole.. Eia kekahi, haʻahaʻa iki ka haʻahaʻa o NE me ka hoʻonui nui ʻana i nā hopohopo a me nā kumu kaumaha.

No laila, ʻo ka hopohopo a me nā pilikia hopohopo i ka poʻe ʻōpio me IAD e pili i ka hana hoʻololi monoamine. akā naʻe, ʻaʻole i kuhi ʻia ʻo 5-HT a me DA, e manaʻo ana paha aia kekahi mea koʻikoʻi NEI pili i ka IAD i ka wā kamaliʻi. ʻO kahi mea nui koʻikoʻi o kēia mea paha ʻo ka dopamine i hoʻohui ʻia i ka hoʻihoʻi ʻana i ka hana hoʻohālikelike ʻole i pili me ka IAD, e like me nā ʻano hana ʻē aʻe [29]. Eia nō naʻe, hāʻawi ʻia ʻo NE he huahana metabolic o DA, ʻoi aku ka nānā ʻana o nā ʻōnaehana ʻōnaehana. Zhu et al. [30] i kēia manawa hou ua hōʻike aku paha ka loli o ke koko peripheral NE me ka pili pono o ka mālama ʻana i ka IAD a me nā hōʻailona kaumaha a me nā hopohopo. Eia hou, pono ʻia nā hoʻokolokolo e hiki mai ana.

ʻOiai ʻo nā haʻawina mua [17], [31] manaʻo e pili ana i ka pilina ma waena o nā hola i hala me ke kaumaha a me nā pae kaumaha / hopohopo, ʻaʻole ʻike mākou i pili i kēlā me kēia loiloi. I mea e wehewehe ai i ka ʻokoʻa, hiki i kekahi mau mea pono ke aʻo hou aku ma waho aʻe o nā ʻōnaʻi loiloi e pili ana i ka naʻau (SCL-90 ma nā haʻawina ʻelua a me SAS, SDS i kā mākou aʻo).

Nui nā palena i kēia noiʻi e hoʻopaʻa i ka wehewehe ʻana o nā hopena. ʻO ka mea mua, hiki i ka nui helu liʻiliʻi ke alakaʻi i ka nui 1 a me nā helu hewa 2. ʻO ka lua, ʻo ka palena ʻokoʻa a me ka wehe ʻana i ka wahine i ka hoʻohālike e hōʻike ana ʻaʻole e hiki ke huki ʻia nā ʻōlelo e pili ana i ka ulu ʻana. ʻO ke kolu, ʻo ka nele o nā ʻike longitudinal i ʻole e hiki ke hana i nā kūkā kumu. ʻAno, nā ʻōpiopio ʻoi aku ka lōʻihi o nā keiki kāne a me nā kaikamahine, ma waena o ke kamaliʻi, ʻōpio a me nā ʻōpio ʻōpio, ua hoʻomaopopo pono ʻia no ka IAD a me nā kīnā comorbid, i loaʻa mai i nā kikowaena lehulehu e pane i kēia mau palena. Eia kekahi, pono e nānā ʻia ka hōʻike e hiki mai ana i nā holomua o ka NE i loko o nā hoʻokolohua mālama i mālama ʻia.

Nā mea kōkua i kākau

Hoʻonohonoho ʻia a hoʻolālā i nā hoʻokolohua: WQJ YSD. Hana ʻia nā hoʻokolohua: WQJ YSD ZGL. Hoʻopili ʻia nā ʻikepili: HXZ AV YSD. Hāʻawi ʻia nā reagents / mau mea hana / pono hana: WQJ HXZ YSD. Kākau i ka pepa: HXZ AV.

E hoʻomaopopo '

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