Kev qhia rau kev siv thiab cov lus qhia rau kev siv tshuaj Formetin
Qhov ncauj tshuaj hypoglycemic los ntawm cov pab pawg biguanide.
Npaj: FORMETIN®
Cov tshuaj nquag ntawm cov tshuaj: metformin
ATX Encoding: A10BA02
KFG: Qhov ncauj tshuaj hypoglycemic
Cov naj npawb rau npe: LSR-003304/07
Hnub sau npe: 10.22.07
Tswv reg reg. doc .: FARMSTANDART-LEXREDSTVA OJSC
Daim ntawv tso tawm Formin, ntim tshuaj thiab muaj pes tsawg leeg.
Cov ntsiav tshuaj yog dawb, puag ncig, tiaj-cylindrical nrog bevel thiab nqis siab tshaj.
1 tab
metformin hydrochloride
500 mg
-«-
850 mg
Cov muaj feem xyuam: nruab nrab molecular phaus povidone (polyvinylpyrrolidone), croscarmellose sodium, magnesium stearate.
10 Pcs - blister packs (3) - pob ntawv ntawm cardboard.
10 Pcs - blister packagings (6) - pob ntawv ntawm cardboard.
10 Pcs - blister pob khoom (10) - pob ntawv ntawm cardboard.
Cov ntsiav tshuaj yog xim dawb, oval, biconvex, nrog kev nqis siab ntawm ob sab.
1 tab
metformin hydrochloride
1 g
Cov muaj feem xyuam: nruab nrab molecular phaus povidone (polyvinylpyrrolidone), croscarmellose sodium, magnesium stearate.
10 Pcs - blister packs (3) - pob ntawv ntawm cardboard.
10 Pcs - blister packagings (6) - pob ntawv ntawm cardboard.
10 Pcs - blister pob khoom (10) - pob ntawv ntawm cardboard.
Cov lus piav qhia ntawm cov tshuaj yog ua raws cov lus qhia raug pom zoo rau kev siv.
Pharmacological kev txiav txim ntawm formin
Qhov ncauj tshuaj hypoglycemic los ntawm cov pab pawg biguanide. Nws inhibits gluconeogenesis nyob rau hauv daim siab, txo qhov nqus ntawm cov piam thaj los ntawm txoj hnyuv, txhim kho kev siv ntawm cov kua nplaum ntev, thiab tseem ua rau kev nkag siab ntawm cov ntaub so ntswg mus rau insulin. Nws tsis cuam tshuam qhov zais cia ntawm insulin los ntawm pancreatic hlwb, tsis ua rau kev rov qab qog ntshav.
Lowers triglycerides, LDL.
Stabilizes lossis txo qhov hnyav lub cev.
Nws muaj cov nyhuv fibrinolytic vim yog kev tsuj tawm ntawm cov nqaij plasminogen activator inhibitor.
Pharmacokinetics ntawm cov tshuaj.
Tom qab lub qhov ncauj tswj hwm, metformin yog nqus los ntawm cov hnyuv. Bioavailability tom qab noj cov qauv tshuaj yog 50-60%. Cmax tom qab kev tswj hwm ntawm qhov ncauj tau tiav tom qab 2.5 teev.
Nws xyaum tsis khi rau cov plasma protein. Nws accumulates nyob rau hauv salivary qog, nqaij, mob siab, thiab ob lub raum.
Nws tawm hauv cov zis tsis hloov pauv. T1 / 2 yog 1.5-4.5 teev.
Dosage thiab txoj hauv kev ntawm kev tswj hwm tshuaj.
Teeb ntawm tus kheej, noj mus rau hauv tus account theem ntawm cov piam thaj hauv cov ntshav.
Qhov hno ua ntej txhua hnub feem ntau yog 500 mg 1-2 zaug / hnub lossis 850 mg 1 zaug / hnub. Tom qab, maj mam (1 zaug hauv ib lub lis piam), lub koob tshuaj tau nce mus rau 2-3 g / hnub. Qhov siab tshaj plaws niaj hnub noj yog 3 g.
Qhov koob tshuaj txhua hnub ntau dua 850 mg yog pom zoo nyob rau hauv ob lub tshuaj (thaum sawv ntxov thiab yav tsaus ntuj).
Hauv cov neeg mob laus, cov koob tshuaj txhua hnub yuav tsum tsis pub ntau tshaj 1 g.
Vim tias muaj kev pheej hmoo ntxiv ntawm cov kab mob lactic acidosis, thaum muab tshuaj metformin rau cov neeg mob uas ua rau lub cev tsis txaus siab, qhov koob tshuaj yuav tsum raug txo kom tsawg.
Cov tshuaj yuav tsum noj thaum lub sijhawm lossis tom qab noj mov tag nrho, nrog haus dej ntau.
Cov tshuaj yog npaj rau kev siv sijhawm ntev.
Sab nyhuv ntawm formin:
Los ntawm lub plab zom mov: xeev siab, ntuav, nws yog xim hlau hauv lub qhov ncauj, tsis muaj qab los noj mov, raws plab, plhaw, mob plab.
Ntawm ib feem ntawm cov metabolism: tsis tshua muaj - lactic acidosis (yuav tsum tsis ua haujlwm ntawm kev kho mob), nrog siv sijhawm ntev - B12 hypovitaminosis (malabsorption).
Los ntawm cov kab mob hemopoietic: qee kis - megaloblastic anemia.
Los ntawm cov kab ke endocrine: hypoglycemia (thaum siv tsis tas).
Kev ua xua rau: xoo pob khaus.
Contraindications rau cov tshuaj:
- uas ketoacidosis, mob ntshav qab zib precoma, coma,
- Mob raum tsis zoo,
- Lub siab ua haujlwm tsis zoo,
- qaug cawv qaug cawv,
- cov xwm txheej uas tuaj yeem pab txhawb rau qhov mob lactic acidosis, suav nrog mob plawv thiab ua pa tsis ua haujlwm, mob theem myocardial infarction, mob cerebrovascular mob hnyav, lub cev qhuav dej, mob cawv mus ntev,
- lactic acidosis thiab keeb kwm ntawm nws,
- Kev phais mob hnyav thiab raug mob (hauv cov teeb meem no, kev kho mob insulin yog qhia),
- siv tsis pub dhau 2 hnub ua ntej thiab 2 hnub tom qab ua kev tshawb fawb radioisotope lossis xoo hluav taws xob nrog kev qhia ntawm iodine-muaj qhov nruab nrab ntawm kev sib piv,
- kev ua raws li kev noj zaub mov kom tsis txhob muaj calories ntau tsawg (tsawg dua 1000 cal / hnub),
- lactation (pub niam mis),
- Hypersensitivity rau lub Cheebtsam ntawm cov tshuaj.
Nws tsis pom zoo kom siv cov tshuaj rau cov neeg mob hnub nyoog laus dua 60 xyoo uas ua haujlwm lub cev hnyav, vim tias qhov pheej hmoo ntawm mob lactic acidosis.
Cov lus qhia tshwj xeeb rau kev siv formin.
Thaum lub sijhawm siv cov tshuaj, cov ntsuas raum kev ua haujlwm yuav tsum raug saib xyuas. Tsawg kawg 2 zaug hauv ib xyoos, nrog rau qhov pom ntawm myalgia, lub lactate cov ntsiab lus hauv cov ntshav yuav tsum txiav txim siab.
Nws yog ib qho ua tau los siv Formetin txuam nrog sulfonylurea derivatives los yog insulin, thiab tshwj xeeb tshaj yog saib xyuas cov ntshav qabzib ntau ntau yog tsim nyog.
Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab
Thaum siv los ua kev kho mob monotherapy, cov tshuaj tsis cuam tshuam rau lub peev xwm tsav tsheb thiab ua haujlwm nrog cov txheej txheem.
Nrog rau kev sib xyaw ntawm Formetin nrog lwm cov tshuaj hypoglycemic (sulfonylurea derivatives, insulin), kev mob ntshav qab zib tsis txaus siab tuaj yeem txhim kho qhov uas muaj peev xwm tsav tsheb thiab lwm yam kev muaj feem phom sij uas xav tau kev nce siab thiab ceev ntawm psychomotor cov teeb meem kev mob ntau.
Kev siv tshuaj ntau dhau:
Cov tsos mob: tuag taus lactic acidosis yuav tsim. Qhov ua rau kev txhim kho ntawm cov kab mob lactic acid tuaj yeem tseem yog kev ruaj khov ntawm cov tshuaj vim tias lub zog ua haujlwm tsis zoo. Cov tsos mob thaum ntxov ntawm lactic acidosis yog qhov ua kom tsis muaj zog, xeev siab, ntuav, raws plab, txo qis lub cev kub, mob plab, mob leeg nqaij, txo ntshav siab, reflex bradycardia, yav tom ntej nws yuav nce ua pa, kiv taub hau, tsis meej pem thiab tsis nco qab.
Kev kho mob: yog tias muaj cov cim ntawm cov kab mob lactic acidosis, kev kho mob nrog metformin yuav tsum nres tam sim ntawd, tus neeg mob yuav tsum tau mus pw hauv tsev kho mob sai thiab, tau txiav txim siab qhov concentration ntawm lactate, paub meej tias txoj kev kuaj mob. Hemodialysis siv tau zoo tshaj plaws rau kev tshem tawm lactate thiab metformin tawm hauv lub cev. Yog tias tsim nyog, nqa tawm cov kev kho mob.
Kev sib cuam tshuam ntawm formin nrog lwm cov tshuaj.
Nrog rau kev siv tib lub sijhawm nrog sulfonylurea derivatives, acarbose, insulin, NSAIDs, MAO inhibitors, oxytetracycline, ACE inhibitors, clofibrate derivatives, cyclophosphamide thiab beta-blockers, nws yog qhov muaj peev xwm nce hypoglycemic effect ntawm metformin.
Nrog rau kev siv tib lub sijhawm nrog GCS, qhov ncauj tawm tsam, epinephrine (adrenaline), sympathomimetics, glucagon, cov thyroid hormones, thiazide thiab "voj" diuretics, phenothiazine derivatives thiab nicotinic acid, txo qis hauv cov nyhuv hypoglycemic ntawm metformin yog ua tau.
Cimetidine qeeb qeeb ntawm kev txiav tawm cov tshuaj metformin, vim tias qhov kev pheej hmoo ntawm lactic acidosis nce ntxiv.
Metformin tej zaum yuav ua rau cov tshuaj anticoagulants tsis muaj zog (coumarin derivatives).
Nrog rau kev tswj hwm ua ke nrog ethanol, txoj kev txhim kho ntawm cov kab mob lactic acidosis yog ua tau.
Nrog rau kev siv nifedipine tib lub sij hawm nce nqus ntawm metformin thiab Cmax, maj mam txo qis kev nthuav dav.
Cov tshuaj Cationic (amlodipine, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, vancomycin) zais cia rau hauv cov menyuam ua lag luam sib tw rau tubular thauj tshuab thiab, nrog kev kho lub sijhawm ntev, tuaj yeem nce cov tshuaj Cmax los ntawm 60%.
Cov ntaub ntawv dav dav, muaj pes tsawg leeg thiab daim ntawv tso tawm
Formin (saib duab) yog ib qho tshuaj yeeb hypoglycemic. Cov tshuaj yog ib feem ntawm pab pawg biguanide, yog li nws siv nyob rau hauv kev kho mob ntshav qab zib hom 2.
Raws li nyob rau hauv tag nrho cov kev npaj ntawm cov pab pawg biguanide, "Formmetin" muaj cov haujlwm ua haujlwm - Metformin hydrochloride. Nws cov nyiaj yuav yog 0.5, 0.85 lossis 1 g.
- croscarmellose sodium,
- magnesium stearate siv hauv kev lag luam kws tshuaj,
- nruab nrab molecular phaus povidone (polyvinylpyrrolidone).
Cov tshuaj muaj nyob hauv cov ntsiav tshuaj, daim ntawv uas nyob ntawm ntau npaum:
- 0.5 g puag ncig,
- oval biconvex (0.85 thiab 1 g).
Cov ntsiav tshuaj tau muag hauv cov thawv ntawv thawv, txhua tus tuaj yeem yog 30, 60 lossis 100 daim.
Cov chaw muag tshuaj thiab tshuaj pharmacokinetics
Cov tshuaj "Formin" cuam tshuam rau lub cev raws li hauv qab no:
- Kev ua haujlwm qeeb hauv cov txheej txheem ntawm gluconeogenesis nyob rau hauv daim siab,
- txo cov piam thaj hauv cov hnyuv nqus los ntawm txoj hnyuv,
- txhim kho kev siv nruab nrab ntawm cov piam thaj hauv cov ntshav,
- ua rau kev nce hauv cov nqaij hauv rhiab rau insulin,
- tsis ua rau kev txhim kho hypoglycemia,
- lowers triglycerides thiab LDL
- normalizes los yog txo qhov hnyav
- pab ua kom ntshav txhaws.
Qhov kev txiav txim ntawm pharmacological yog cov yam ntxwv ntawm kev nqus, kev faib tawm thiab kev tawm ntawm cov khoom tseem ceeb.
- Xuas. Qhov nquag ua haujlwm ntawm cov tshuaj yog nqus tau los ntawm phab ntsa ntawm lub plab zom mov tom qab noj tshuaj. Lub bioavailability ntawm ib tus qauv muab tshuaj yog los ntawm 50% mus rau 60%. Qhov siab tshaj plaws ntawm cov tshuaj tau teeb tsa 2.5 teev tom qab kev tswj hwm.
- Kev xa Khoom. Cov Cheebtsam ntawm cov tshuaj xyaum tsis tsim kev sib txuas nrog cov plasma protein.
- Chaw Sau Ntawv. Kev nqhis ntawm cov feem ntawm cov tshuaj yog nqa tawm tsis hloov pauv. Cheebtsam tawm hauv zis. Lub sijhawm xav tau rau ib nrab-lub neej ntawm cov tshuaj yog los ntawm 1.5 mus rau 4,5 teev.
Nyob rau hauv rooj plaub thaum thaum lub Cheebtsam ntawm cov tshuaj txuam hauv lub cev, koj yuav tsum paub nws yuav tshwm sim los ntawm dab tsi. Feem ntau, cov laj thawj nyob rau qhov tsis zoo lub raum.
Kev taw qhia thiab contraindications
Kev kho tshuaj yog tsim nyog nyob rau hauv cov xwm txheej hauv qab no:
- nrog kev rog dhau los lossis rog rog, thaum kev noj haus yog qhov tsis muaj txiaj ntsig,
- nrog hom mob ntshav qab zib zaum ob.
"Tshuaj" yuav tsum tsis txhob siv rau qhov poob phaus, txawm tias qhov tseeb tias tshuaj tiag tiag ua rau nws poob. Kev noj tshuaj yog qhov muaj txiaj ntsig ua ke nrog kev kho tshuaj insulin hauv cov neeg mob rog rog hnyav, uas nrog los ntawm kev cuam tshuam nrog cov tshuaj tiv thaiv qis.
Tus neeg mob thaum noj tshuaj yog contraindicated:
- ketoacidosis
- coma lossis precoma vim muaj ntshav qab zib,
- kev hloov pauv hauv ob lub raum thiab siab,
- cov xwm txheej ua rau muaj kev txhim kho cov kab mob lactic acidosis, nrog rau lub plawv tsis ua haujlwm, hloov pauv ntawm cov ntshav tawm ntawm lub hlwb, cov theem myocardial infarction, mob vwm ntev ntev, lub cev qhuav dej,
- qaug cawv lom,
- mob hnyav kis,
- kev pab cuam phais mob
- kev raug mob
- xoo hluav taws xob, cuam tshuam nrog kev qhia ntawm tus neeg sawv cev tshwj xeeb (2 hnub ua ntej thiab tom qab),
- ua raws li kev noj haus uas tso cai rau lub xub ntiag nyob rau hauv kev noj haus txhua hnub ntawm tsis pub ntau tshaj 1000 calories,
- pub niam mis, nrog rau qhov pib ntawm cev xeeb tub,
- ua kom lub cev tsis haum rau cov tshuaj ntawm cov tshuaj.
Cov lus qhia rau kev siv
Tsuas xaiv yuav tsum tau ua los ntawm tus kws kho mob nkaus xwb uas yuav tau suav txhua tus yam ntxwv ntawm tus neeg mob thiab mob ntshav qab zib. Cov lus qhia tau qhia tias pom zoo ntau npaum li cas thaum siv thawj zaug. Nws tuaj yeem yog los ntawm 500 txog 1000 mg rau ib hnub.
Kev hloov pauv ntawm tus qauv koob tshuaj yuav tsum tau ua tsis pub dhau 15 hnub tom qab thawj ntsiav tshuaj. Tsis tas li ntawd, nws yuav tsum tau xaiv yam kev tswj hwm glycemic. Qhov koob tshuaj txhua hnub tsis tuaj yeem siab dua 3000 mg. Feem ntau, kev kho kom zoo yuav tsum noj 1500-2000 mg / hnub. Cov neeg mob ntawm lub hnub nyoog qib siab yuav tsum tsis pub tshaj 1 g ntawm cov nquag ua hauj lwm.
Cov ntsiav tshuaj yuav tsum quag cawv tom qab noj mov. Cov koob tshuaj uas kws kho mob tau hais tseg yuav tsum muab faib kom sib npaug, thiab noj cov tshuaj ob zaug ib hnub. Qhov no yuav tiv thaiv qhov tshwm sim ntawm kev phiv cuam tshuam txog kev zom zaub mov.
Video los ntawm Dr. Malysheva txog Metformin thiab cov tshuaj raws nws:
Cov neeg mob tshwj xeeb
Cov tshuaj tau pom zoo rau kev siv tsis yog rau txhua tus neeg mob.
Cov pab pawg hauv qab no ntawm cov neeg mob muaj nyob hauv pawg tshwj xeeb:
- Cov poj niam cev xeeb tub thiab lactating. Kev ntsuam xyuas tau pom tias cov tshuaj hauv cov tshuaj tuaj yeem muaj qhov tsis zoo rau menyuam yaus hauv plab thiab tom qab yug menyuam.
- Cov neeg mob muaj kab mob siab. Lawv tau raug contraindicated hauv kev siv tshuaj.
- Cov neeg mob uas lub raum tsis ua hauj lwm zoo. Nrog rau txoj kev hloov pauv loj, kev siv tus neeg sawv cev los ntawm kws kho mob yog txwv. Hauv lwm qhov xwm txheej, kev kho nrog cov tshuaj no ua tau, tab sis nyob rau hauv kev saib xyuas tsis tu ncua ntawm kev ua haujlwm hauv nruab nrog cev.
- Cov neeg laus cov neeg mob. Muaj kev pheej hmoo ntawm cov kab mob lactic acidosis hauv cov neeg laus dua 60 leej uas niaj hnub ua cov haujlwm hnyav lub cev.
Cov lus qhia tshwj xeeb
Kev kho nrog cov tshuaj muaj qee cov yam ntxwv:
- Cov neeg mob yuav tsum tau saib xyuas kev ua haujlwm ntawm lub raum. Qhov ntau zaus ntawm kev ntsuas li no yog 2 zaug hauv ib xyoos. Qhov no yog vim qhov tseeb tias cov Cheebtsam ntawm "Formin" tuaj yeem nthuav mus rau sab hauv lub cev thaum muaj kev ntxhov siab hauv kev ua haujlwm ntawm lub cev.
- Yog tias myalgia tshwm sim, nws raug nquahu kom kuaj lub plasma lactate theem.
- Kev siv ntawm "Formmetin" ua ke nrog sulfonylurea derivatives yuav tsum muaj kev tswj glycemia.
- Txoj kev pheej hmoo ntawm kev mob ntshav qab zib nce ntxiv thaum cov ntsiav tshuaj no siv nrog lwm cov tshuaj uas tuaj yeem txo cov ntshav qab zib kom tsawg. Tus mob no yog txaus ntshai tshaj thaum tsav tsheb lossis koom nrog ib yam haujlwm muaj feem cuam sai.
- Txhawm rau tiv thaiv cov kab mob lactic acidosis hauv cov neeg mob uas mob metabolic tsis txaus, kev kho yuav tsum tau pib nrog kev noj tshuaj ntau dua.
Phiv thiab haus tshaj
Kev tshuaj xyuas cov neeg mob ntshav qab zib qhia tau hais tias kev kho mob nrog tus "Formmetin" tus neeg sawv cev yuav nrog kev tshwm sim los ntawm qee qhov tshwm sim tsis zoo:
- Hais txog kev zom mov - xeev siab, saj ntawm cov hlau hauv qhov ncauj, ntuav, tsis qab los, mob hauv plab, mob plab.
- Cov kab mob lactic acid tshwm. Tus mob no yuav tsum tsis ua kev kho vim qhov kev pheej hmoo ntawm kev tuag.
- Kev kho mob Hypovitaminosis.
- Megaoblastic anemia tshwm sim.
- Kev mob ntshav siab ntshav qis.
- Cov tawv nqaij sawv pob tshwm.
Nrog kev noj tshuaj ntau dhau, lactic acidosis tshwm sim. Nyob rau hauv cov xwm txheej zoo li no, nws yog qhov ceev kom tsis txhob muaj kev kho mob, thiab tus neeg mob yuav tsum tau mus pw hauv tsev kho mob. Hauv tsev kho mob chaw, qhov siab ntawm lactate yog txiav txim siab txhawm rau kom paub meej lossis tsis rov ua qhov mob. Kev siv cov tshuaj hemodialysis muaj txiaj ntsig zoo rau feem ntau rau kev nthuav dav ntawm lactate thiab metformin.
Kev sib cuam tshuam txog Yeeb Tshuaj thiab Analogs
Kev tiv thaiv hypoglycemic yog kho kom zoo los ntawm cov neeg ua haujlwm hauv qab no:
- kev txhaj tshuaj tshuaj insulin
- ACE inhibitors, MAO,
- Acarbose
- Oxytetracycline,
- beta blockers
- sulfonylurea derivatives.
Kev poob qis los ntawm cov tshuaj hauv qab no:
- GKS,
- tshuaj thaiv
- adrenaline
- glucagon,
- Cov tshuaj hormonal siv hauv pathologies ntawm cov thyroid caj pas,
- sympathomimetics
- derivatives ntawm phenothiazine, as Well as nicotinic acid.
Qhov ntxim nyiam ntawm lactic acidosis nce los ntawm kev noj cov tshuaj "Cimetidine", ethanol.
Txoj kev lag luam kws tshuaj muaj ntau yam tshuaj muaj suab thaj.Qee qhov ntawm lawv tuaj yeem siv los hloov chaw rau kev npaj "Formetin" vim tias muaj cov metformin hydrochloride hauv lawv cov qauv.
Tus neeg mob lub tswv yim
Los ntawm kev tshuaj xyuas cov neeg mob ntshav qab zib txog cov tshuaj Formmetin, peb tuaj yeem xaus tias cov tshuaj no tsis haum rau txhua tus, yog li, ua ntej siv nws, kws kho mob sab laj yog qhov yuav tsum tau ua.
Kuv muaj 66 xyoo thaum cov qib siab pom. Tus kws kho mob tam sim ntawd pom zoo kom noj Formmetin. Cov txiaj ntsig tau txaus siab. Tshaj li ntawm 2 xyoos ntawm kev kho, qab zib yog khaws cia hauv 7.5 mmol / L. Nws yog tshwj xeeb tshaj yog kev zoo siab uas peb tswj kom tshem tawm ntawm qhov ntxiv 11 kg, thiab kuj lub qhov ncauj qhuav ploj.
Rau ntau lub hlis Kuv yuav tsum tau xaiv ib cov tshuaj rau normalize cov piam thaj. Mob ntshav qab zib tau nrhiav tau 5 lub hlis dhau los, tab sis tsuas yog ua tsaug rau cov formin ntsiav tshuaj nws tau txais los ze zog li qub ib txwm muaj nuj nqis. Kuv lees yuav lawv nrog Siofor. Tsis zoo li lwm yam tshuaj nrog cov tshuaj no, Kuv tsis muaj teeb meem nrog kev zom zaub mov. Rau txhua tus neeg uas tseem tsis tau khaws cov tshuaj, Kuv xav sim nws.
Kuv nyeem lwm yam kev txheeb xyuas thiab xav tsis thoob txog lwm tus kev vam meej. Kuv tus kheej tau siv cov tshuaj no ntawm kev xav ntawm kws kho mob. Ua ntej nws haus Metformin Teva, tsis muaj teeb meem dab tsi. Thiab nrog kev hloov mus rau Formetin hauv 3 hnub, Kuv tau ntsib txhua cov kev mob tshwm sim uas twb muaj lawm. Kuv yog kiv taub hau, Kuv yog xeev siab, Kuv hnov qhov tsis muaj zog txaus, thiab kuv ntsiag to txog qhov uas seem. Cov tshuaj no yuav tsum tsis txhob noj tom qab 60 xyoo, tab sis tsis muaj leej twg ceeb toom kuv. Kos ntsiab lus xaus.
Tus nqi ntawm 60 ntsiav tshuaj ntawm formin nyob ntawm qhov ntau npaum. Nws yog txog 200 rubles.