ứng dụng của các loại dao mổ trong phẫu thuật

1
TRƯỜNG ĐẠI HỌC BÁCH KHOA HÀ NỘI
VIỆN ĐIỆN TỬ VIỄN THÔNG

 !

"#$ #%&%'#(')
"*"+','" /-00-
123)14-/5.05 60
 !
2
78&9:1&2;<#=>');3?'<#@A;#AB;C#D');#E;#3FA;G8')#HA#F;IJI:8%3<#@A
;#AB;'K3I#A')IL')'#=<#@A;#AB;'23M83'K3G3N')$
O')A4N';PI)3Q<I#8CF;RAS:1'#TF;&9U=VI;W;'#X;:1
6$ H&&JA;#B;;W;
-$ 3S&;#3EAIJI;9';#=>')&D
-$ A4;GYIA')IX<&JA;#ZI##V<
0$ 3S&;#3EA'#3[&;G(')
\$ 3S&;#3EAI+')&D
]^_')^78&9IK;#ES'##=`');a30')A4N';PIUHAIH&&JAb;9';#=>')&Dc
IA')IX<&JA$
JI:8%3^78&9#8%;U2')C#JI'#7Ab^@'UF'#3?Ad');GN'&DC#JI'#7A$ #@A
;#AB;T3N'I#e'
:8%
3
^78
&9IKC#S'+')IH&&JA;#B;;W;c#%'I#F;9';#=>')&D
fA')RA7'#$9';#=>')&D'#3gAIK;#E:1&;+');Y'#;G%')T3N&IX<;Z'#cCh8
^13;3F';GY'#:1'#TF;&9$
"YTB4T3?I:i7I#e':8%3^78&9;W;c<#(#V<:1&2;;G8')'#j')4FA;W)K<<#H'
T18Mi;#1'#ID')Ik7IA2I<#@A;#AB;$

$lm 


6$ 78&9^(')'+'):=V')U3?'
;n
o
78&9U3?'U>'IiI
o
78&9U3?':=p')IiI
o
78&97MqG
-$ 78&9^(')'+'):=V')I>
#eI
o
78&9M3NA,&
G8')UKb^78&9U3?'U>'IiIc:=p')IiI:1-:8%3^78&9<#9r3F''#X;;G8')
IJIr?'#T3?'T1)H'U,4IKMifAX;#3?'Ik7^78&9M3NA,&$
3
$stuv
u
6$ 73:e73^w')
U3?
'

o
w')
U3?'6I#3gAx3GqI;
AGGq';
oy
w')

U3?'I#%4
;#q8
&2;I#3gA'#X;
Uz'#$
o
w')U3?' f874I#3gAx:;qG'7;3')AGGq';o yw') U3?' I#%4 ;#q8 -
I#3gAb
4
T1:3N';_I
US8

I#3gA$
"Z
^_
3?''#1b3?'
^(');G8')
^78&9U>'IiIb:=p')IiI$
W:H'^w')U3?'US8I#3gA;G8')6)3,4;#Y;=>')U=>')Ta3H'MWT1U=VIU8r{')
U>'TzqG;|x|y
-$ %3 M78r?'#'#,'C#D')rzU3?' )3B;C#3<#@A;#AB;T3N'^(') ^78 &9
U3?'
}
o
3?''#1IK;H'MWC#8S')~.qG;|bC#3I#Q');7I#%&T18M•rzU3?')3B;^8rzCZI#;#ZI#
;#H'C3'#I>$
o
"18;#B<'3N'6/ bG$€3::37&8T3qC#J&<#JG7G{');%3;H'MW•6 b Tw')
;G8')6)3,4x6 C|ybC#D')),4G7CZI#;#ZI#;#H'C3'#I>;GN'I>;#EMW')$
o
JI&J4UW;U3?'#3?''74UgATB'#1'#7';81'`;H'MW C|#8‚II78#>'

x'N'IL')U=VI)e3:1&J4IP;UW;I78;H'y$
0$ )A4N':ƒIk7^w')
U3?
'

w')U3?'M•U3;#q8I8'U=„')IKZ;;G`C#J')
'#X;$
o
…I>;#E')=„3bU3gA'14;†:?Ta3:=V')'=aII#d7;G8')&Dx&JAb;#H'C3'#bI>b&pb
f=>')y$=V')'=aII1')'#3gAb;G`C#J')I1')Z;$
o
‡#3&DrzMX4C#Db;G`C#J'))37;+')b^w')U3?'U3;Y&I8'U=„')C#JIUEU3$
8'U=„')'14C#D')r78)3„IWUz'#cC#KIK;#EU8J';G=aIU=VI$
\$ i:7';ˆ7'#3?;M7')
r
N
'

i:7';ˆ7'#3?;),4G7r`3^w')U3?'U3c'#3?;$
o
‡#3^w')U3?'RA7&D^@'b&DrzMX4C#D^w')U3?'U3;#q8I8'U=„')IKZ;;G`C#J')
'#X;bM•:7';ˆ7M7')-rN'Ik7U3?'IiI),4G7:7';ˆ7'#3?;:1&;9';#=>')&D-
rN'$
o
‡#3'#3?;U=VI;GA4g'RA7&DIL')),4G7#3?';=V'):7';ˆ7'#3?;M7')rN'$
i:7';ˆ7'#3?;M7')rN''#3gAM•),4;9';#=>')&DC#D')&8')&AW'bS'##=`')
UF'RAJ
;GY'#

:1'#

TF;&9cU‚Ir3?;:1:1&;9';#=>')IJI&DbI>RA7'RA7';Ge')
fA')RA7'#$"YTB4IJI'#1MS'fAX;U‰IW)P');Y&;w3cMJ')I#FUE
;%8G7:8%3^78&9IKC#S'+')#%'I#FMi:7';ˆ7'#3?;M7')rN''14$
5
2;T13:8%3^78&9:=p')IiI;3N';3F'#3?''74IKC#S'+')<#J;#3?';G`C#J')
T1;iU2')')P;^w')UE')+'')n7Mi:7';ˆ7'#3?;M7')rN'$
K:8%3^78&9:=p')IiICŠ;#AB;I78&a3IK#?MW'#3?;U2^=>')x 8M3;3Tq
q&<qG7;AGq8q‹Œ3I3q';o yIKC#S'+')^A4;GY'#3?;U2&D`C#8S')6 ℃b
)3S&;#3EA:7';ˆ7'#3?;$
$•6svŽ
l…

o
#3gA;JI^_')
o
7I#dI'+')
o
‡#D')IK^w')U3?'RA7')=„3r?'#'#,'
o
3?ARASC3'#;F
o
[M]^_')
o
';81'I#8r?'#'#,'
o
';81'I#8<#@A;#AB;T3N'
o
P;'#=6I8'^78
o
H&&JAUJ');3'IB4

o
3S&;#3EA;9';#=>')&D
o
3S&;#3EA&DI#J4;#1'#;#7'
o
‡#D')C#K3
2;:8%3^78&9:ƒ;=`')<#S3IK;JI^_')IP;IH&&JAI(')&2;:QI$
"$ •
•
6$ JI&J4UW;U3?'U>'IiIUHA;3N'U=VI)e3:1#?;#W')&J4UW;;3F<
UX;
o
w')U3?'U3;nUHAU3?'IiIbfA4N'RA7I>;#Er?'#'#,'bUF'U3?'IiI;#A#‘3T1
;G`TgUX;RA7^,4;3F<UX;b#81';X;&%I#U3?'$
o
JI&J4<#J;U3?';3F<UX;IK;#E),4G7'#j');9';#=>');%3I#*CF;3F<'#7A’
;#=„')`'#j')T(')'#=;74#8‚II#,'$)A4N''#,':1^8^w')U3?':AD';Y&
C3F&I8'U=„')UE;G`TgUX;b'N'rX;IdTB;C3&:8%3'18;3F<fQI')@A'#3N'Ta3
r?'#'#,'b'#=:1IJ3)3JC3&:8%3UE;Gq8^zI#;GA4g'#8‚IUEUi')&8'3;8G;#q8
^“3r?''#'#,'br1'&9”IK;#Efq&'#=:16U3?'IiI#X<^@'^w')U3?'T1:1&
;G?I##=a');G`TgIk7^w')U3?'$w')U3?''14M•;B<;GA')T1:1&rˆ')r?'#
'#,';%3I#*
'>3

&1
^w')U3?';3F<fQITa3TB;C3&:8%3UEIW)P');#8J;G7C#ˆ3I>
;#E$8UKbfS4G7#3?';=V')<#@A;#AB;T3N'U7')^(')^78&9
6
U3?'`T(')r_')&1r?'#'#,'rzI#J4rˆ')U3?'`;74#8‚II#,'$
"Y')A4I>'14b')14'74#HA#F;IJI'#1MS'fAX;C#D')Iw'&AW'MS'fAX;:8%3

&J4'14'j7b'#=')&2;MW&J4ILT@'Iw'U=VIM]^_')`IJIr?'#T3?';A4F'
#A4?'b;•'#`"3?;7&$
-$ J4UW;U3?'IJI#
:4
o
E)3S3RA4F;IJI')A4I>TW'IKIk7#?;#W')&J4;3F<UX;'#=;GN'b&J4UW;U3?'
IJI#:4U=VI<#J;;G3E'c)3a3;#3?AT18'+&6/–O$
o
"a3#?;#W')IJI#:4b&J4<#J;;G`;#1'#')A‘''+'):=V')Ik7I#Z'#'K$w')U3?'
;G`Tg&J4<#J;RA7')=„3r?'#'#,'UF'U3?'IiI;#A#‘3;GN'')=„3r?'#'#,'
#81';X;&%I#U3?'bT1C#D')IH'<#S3;3F<UX;'j7$
0$ JI')A4I>C#3M]^_')^78&9U>'
I
iI
#@A;#AB;'23M83^(')^78&9U>'IiIIK;#E:1&;+');#N&IJI')A4I>$7$3F<
fQI
;GiI

;3F<
o
—S4G7C#3UHA^78U3?'U7')#8%;U2')`)H'MJ;Ta36^_')I_^@'U3?'#746TB;
r{')C3&:8%3C#JIb^_')I_;#d#73'14rz'#3[&U3?'$w')U3?'M•;Y&I8'
U=„')IKZ;;G`C#J')'#X;UEUF'U3?'IiI;G`Tg;GN'r?'#'#,'UE#81';X;
&%I#U3?'$3gA'14IK;#E^@'UF';9';#=>')')#3N&;Ge');GN'r?'#'#,'&1
C#D'):=„');G=aIU=VI$
7
o
#@A;#AB;T3N'IWƒ;%8;3F<fQI;GiI;3F<I#%&UHA^78U3?'U7')#8%;U2')T18
^_')I_C#JIUEIH&&%I#&JA'#ˆ#74I#*U7')I#S4&JA$
o

D3C#3<#@A;#AB;T3N'TDƒI#%&UHA^78U3?'U7')#8%;U2')T18^_')I_C#JI
`')813<#@A;G=„');GN'&1'#Y'#b;#=„'))‚<;G8')<#@A;#AB;'23M83bIL')
#74)‚<;G8')<#@A;#AB;'23M83&2;TF;&9$
r$ 3F<fQIU3?'^A')
o
—S4G7C#3-TB;^@'U3?'U=VI;JI#G3N')r`36:a<IJI#U3?'$6^w')U3?';%8
G7
6;G=„');˜'#U3?')3j7-TB;^@'U3?'$‡F;RAS:1b6^w')U3?';G8')6TB;^@'
U3?'IK;#E;%8G76^w')U3?';G8')TB;^@'U3?';#d-$
o
#@A;#AB;T3N'IK;#E;%8G7;3F<fQIU3?'^A')C#3M]^_');G8I7GC3&:8%3r78
fA')RA7'#6^78&9U>'IiIU7')#8%;U2')-TB;^@'U3?':1;G8I7GC3&:8%3
cUHA^78U3?'bIJI#'#7Ar`3TB;IJI#U3?':1:a<IJI#U3?'Ik7^78&9x^_')I_
&KIUW;'23M83y$
I$a<IJI#U3?';GN'^_')I_'23M83rz;GKI
o
#*rz;GKI:a<IJI#U3?'I1')'#ˆb^w')U3?';B<;GA')I1')I78b),4G7;9'
;#=>')I1')')#3N&;Ge')$
^$ #J4'9;G8')<#w')&9
o
16;G8')'#j')')A4I>')#3N&;Ge')'#X;;G8')<#@A;#AB;
o
78&9U>'IiI#8%;U2')IK;#Ef™;;37:]7U3?'^[rP;:]7;G8')&D3;G=„')
<#w')&9IK'#3gA')A4N':3?A^[I#J4bC#Z8f4$
q$#J4rˆ');%3I#*C#3M]^_')#?;#W')&J4<#J;;3F<UX;$
‹$ 3?'IiI;#A#‘3;3F<fQIC#D');W;Ta3I>;#Er?'#'#,'FAU3?'IiI;#A#‘3
C#D');3F<fQIC#D');W;Ta3^7r?'#'#,'bI#J4rˆ')IK;#EfS4G7;%3I#*U3?'IiI
;#A#‘3$JI&J4#3?''74UgAIK#?;#W');#q8^“3UErS8US&Mi;3F<fQIIk7U3?'
IiI;#A#‘3Ta3r?'#'#,'$
"$ lš


•
78&9:=p')IiIM]^_')^w')U3?'f874I#3gA$w')U3?'I#•U3)3j7-U3?'IiI
x:1-UHAIk7^78&96UHA:1U3?'IiI^=>')cUHAC37:1U3?'IiI,&yT1RA7&D
U=VIC™<r`3-UHA^78&9$‡#D')IH'M]^_');X&U?&;GN'')=„3?'#'#,'
'j7$DU=VIC™<#81';X;&%I#U3?'$
8
78&9:=p')IiI#%'I#FIJI')A4I>Ik7^78&9U>'IiI'#=;3F<fQI;GiI;3F<
T1;3F<fQIU3?'^A')bIJI;9';#=>');%3I#*cIJI;9';#=>')^8:*3Ik7U3?'IiI
;#A#‘3$
‡#3&DrzMX4C#Db;G`C#J'))37;+')b^w')U3?';Y&I8'U=„')IKZ;C#J');G`'#X;
:1RA7-rN'Ik7^78&9^8UKM•),4;9';#=>')'#3?;:7';ˆ7-rN'#1&C™<Ik7
^78$
6$ 78&9:=p')IiI
;GA4g'
;
#W'
)
o
J4C#D')IKI>I#F<#S'#‘3UEfJIUz'#U3?';G`#8‚II>I#FC3E&M8J;'#3?;U2
'N'IK;#E),4G7;9';#=>')'#3?;:7';ˆ7G7-rN'GX;'#3gA$E#%'I#FU3gA'14b
<#@A;#AB;T3N'C#3M]^_')^78&9<#S3RA7'MJ;;#B;CŠr{')&P;UEC3E&M8J;
&dIU2I#J4:7'Ik7&D$
o
iIh<&DIk7-UHA^78&9Ch&'N'#3?ARASIH&&JAC#D')I78$#=#Y'#S'#
&3'##e7b-;#1'#Ik7&%I#&JAC#D')h<MJ;U=VIT18'#7A$
o
#=VIU3E&Ik7^78&9:=p')IiI:1I#•IK#3?Ad')UW;IH&&JA&1C#D')IKC#S
'+')IP;&D$
8


TB4
^78&9:=p')IiI;#=„')I#•U=VI^(')UEIH&&JA$w'C#3
M]^_')UE<#@A;ZI#;#YM7AC#3U‰IH&&JA7';81'b<#@A;#AB;T3N'<#S3^(')
Ch8UEIP;&D$
-$ 78&9:=p')IiI#3?'
U%3
78&9:=p')IiI#3?'U%3IS3;#3?'cC#PI<#_I#HA#F;'#j')#%'I#FIk7^78
:=p')IiI
;GA4g'

;#W')

iIh<I>#eIIk7^78&9:1&;+')#3?ARAS#1'&%I#&JAbIK;#E#1'&%I#&JA
UF'–&&
9
J4<#J;U8U=VIU3?';G`Ik7&DcC3E&M8J;U=VIT3?II#A4E')378'+'):=V')
U3?'›)3S&;#3EA;9';#=>'):7';ˆ7M7')rN'$
J4<#J;IKC#S'+');%8ID')')#?fA')3gA;3F;#3?ARASUW;r{')M]^_')
ID')')#?U3?';]$
KI>I#FIP;I>#eI’6I8'^78MPIUEIP;&DU3Cœ&;G8')^_')I_UW;:=p')IiI$
#@A;#AB;T3N'IK;#EIP;cIH&&JATa3I(')6^_')I_$
0$ 78&9:=p')IiI#3?'U%3;#F#?&a3
'#
X;
8%3^78'14IK6MWMJ')I#FcIS3;3F'&a3bIKC3E&M8J;'#3?;U2•6
8
b:1&
;+')#3?ARASIH&&JAc)3S&;#3EA;9';#=>')'#3?;M7')-rN'x•6&&y
XA #Y'# U3?' IiI ;#D') 

& 3'#'#3gAU3?'IiI,&fA')RA7'#6U3?'IiI^=>')
)3Q<;B<;GA')T1I#d7Mi^3I#A4E'Ik7^w')U3?'RA7&DI#•`;G8')#1&Ik7
^_')I_bC#D'):7'G7-rN'b:1&)3S&;#3EA;9';#=>')'#3?;G7-rN'x•6&&ybI#8
<#h<IP;T1IH&&JATa3U2I#Z'#fJII78bU‚Ir3?;IH';#3F;`)H'IJIIXA;GQIT1
I>RA7'RA7';Ge')$
? MW '#3?; U2 ^=>') x 8M3;3 Tqq&<qG7;AGq 
8q‹Œ3I3q';yV<I#X; 8:4&qGrN'
;G8')#1&C™<Ik7^_')I_^78U3gAI#•'#^w')'+'):=V');G8')MAW;I#A;GY'#
#8%;U2')UE^A4;GY'#3?;&DC#8S')6
8
b;GJ'#I#8#1&C™<C#ˆ3U%;'#3?;U2
I78RAJ&dIT1)3S&;#3EA#3?';=V')^Z'#b#K7;#7'#8‚I;%8C#K3$
78 #Y'# I#j ;%8 :iI h< & DU‘') 
'#X;78;G8')^_')I_U=VI;#3F;CFTa3IXA
;GQI#Y'##eI^%')I#jI#PIC#ˆqbIA')IX<:iIh<&DU‘')'#X;;GN';81'r2^3?'
;ZI##1&C™<Ik7^78b:1&)37;+')C#S'+')IH&&JA$H&&%I#&JA:a'ž–&&b
Ta3J<:iI#1'&%I#)X<–:H'J<:iI;,&;#A$
10
"$Ÿ

G8'):8%3^78&9^(')'+'):=V')M3NA,&'14bIS-T3?IIP;cIH&&JAUgA^i7
;GN'Mi;GA4g'I>#eIIk7MK'),&;n6')A‘''+'):=V')RA76I#X;;GA'))37'UF'
UHA:=p3^78#8%;U2')$
K0^S3MK')I>#eI
o
K')IK;H'MW^=a3&dI;73')#qIk7I8'')=„3• Tw')5)3,4xqG;|y
o
K')`&dI;73')#qIk7I8'')=„3bIK;H'MW ’ b Tw')5)3,4
o
K')M3NA,&IK;H'MW;GN'&dI;73')#qIk7I8'')=„3¡ $ Tw')5)3,4

o
78&9M3NA,&#8%;U2')`;H'MWOO$O Tw')5)3,4
6$ )A4N':ƒ#8%;U2')c3?Ad');GN'&DIk778&9M3NA
,
&

o
+'):=V')U3?';n&J4<#J;M•U=VII#A4E';#1'#MK')I>#eI;%3;74IH&Ik7^,4
^78^8`U,4IKIJIU˜7Md<3q|8oq:qI;G3II#A4E''+'):=V')U3?';#1'#I#A4E'
U2')I>#eI^eI;#q8I#3gA^13Ik7^78cU%;;H'MWOO$O :H'5)3,4$
JIU˜7Md

3q|8o
q:q
I;G3I
o
‡#3^78M3NA,&C™<&D#8%;U2')b'KM•;%8G7Mi&7MJ;'23r18;G8')&Db
:1&
<#JTp&W3:3N'CF;#4^G8›r3F';Z'#<G8;q3'T1;#1'#:B<C#W3UD')^Z'#$P;
cIH&&JAI('):QIbIK;#EIH&&%I#&JAUF'O&&$
o
#3?;U=VI;%8G7:1;#d<#J;^8Mi&7MJ;&DrN';G8'):1CF;RASIk7Mi
I#A4E'U2')&DTa3;H'MWI78b'N''#3?;U2 ;#X<•6
8
$
o
3?Ad')rKI;JI#MiI#A4E'U2')Ik7:=p3^78;%8G76T(')IKJ<MAX;;#X<b:1&
I#8^zI#'23r18rWI#>3`'#3?;U2;#X<$irWI#>3'=aI<#‘')G7b:1&;JI#IJI
:a<&DrN'^=a3:=p3^78b;+')I=„')C#S'+')rKI;JI#C#3^78#8%;U2')$
-$ lAU3E&Ik778M3NA,&


o
81';81'C#D')IK^w')U3?'RA7')=„3r?'#'#,'
o
_')I_^78U7I#dI'+')')813I#dI'+')IP;cIH&&JAb^_')I_^78Iw'IK;#E
^(')UErKI;JI#bC™<)3jbIP;')=VI`'#j')&DTD&%I#xr7ICoMI8G3')yb
U_I:*UE;%8:*;#D')bM]^_')#3?Ad')rKI;JI$
11
o
3S&;#3EA;9';#=>')'#3?;:7';ˆ7M7')-rN'x•6&&y›I#8<#h<IP;T1
IH&&JATa3U2I#Z'#fJII78bU‚Ir3?;IH';#3F;`)H'IJIIXA;GQIT1I>RA7'
RA7';Ge')$
o
¢;C#K3bZ;^Z'#
o
P;cIH&&JAI('):QIbIH&U=VI&%I#&JA;a3O&&UW3Ia3IJI:8%3^78^%')
Ch8bT1&%I#&JA-&&Ta3IJI^78^%'):=p3I8')#8‚IUHA&KI$
"$u£¤Ÿu

£
1MiCF;#V<)3j7^78&9:=p')IiI#3?'U%3c^78&9M3NA,&;G8')&2;&J4
<#J;$
"$Ÿ¥¦§¤§

6$ ';81'
-$ i:7';ˆ7'#3?;;W3;#3EA
0$ ‡#S'+')IH&&JA#3?ARAS
\$ WIU2c#3?ARAS
O$ 7I#dI'+')
~$ #3<#ZI#X<'#B<U=VI$

#@A;#AB;'23M83')14I1')U=VId')^_')'#3gAT1;G3E'C#73`'#3gA:8%3<#@A
;#AB;C#JI'#7Ab
;n

U>'
)3S'UF'<#dI;%<$"3?II#e':i7<#=>');3?'IH&&JA#jA
#3?A:1TDI(')RA7';Ge')b)3Q<I#8<#@A;#AB;T3N'IP;bUW;IH&&JA7';81'bIA2I
<#@A;#AB;;#1'#ID')Ta3'#j');#78;JI')14I1')U>')3S'bZ;&X;&JAb<#@A
;G=„')M%I#bG“G1')bIJI&DfA')RA7'#Z;rz;9';#=>')b)3S&;#3EAM7')I#X'&D$
JI'#1I#F;%8^_')I_C#D')')n')MJ');%8G7IJI;#3F;rz&a3'#{&UJ<d')
&8')&ˆ3Ik7IJI<#@A;#AB;T3N'bMi;3F'r2Ik7CŠ;#AB;bMi7';81'Ik7')=„3
r?'#$)=„3:1&ID');JIRAS':ƒT1')=„3^(')IH'Cz<;#„3'P&rP;T1M]^_')
#3?ARAS'#X;IJI<#=>');3?'&a3UEJ<^_')b<#J;;G3E'<#=>')<#J<U3gA;Gzf,&
'#B<;W3;#3EAx<#@A;#AB;'23M83y;%8G7Mi7';81'I#8IS;#H4;#AWI:@'r?'#
'#,'$
—$ŸŽ !
e3TB;I#X;;‘';%3fA')RA7'#;7UgAIXA;%8r`3IJI')A4N';]$*3')A4N'
;])‘&&2;'#,';ZI#U3?'^=>')T1IJIU3?';];ZI#U3?',&RA74fA')RA7'#'K
;#q8IJIRAŠU%8'#X;Uz'#$Y'#;#=„')U3?';ZI#Ik7#%;'#,'T1;9')U3?';ZI#Ik7
IJIU3?';]RA74RA7'#'Kr{')'#7ATg;GzMWT1;GJ3^XA;dI'K;GA')#w7TgU3?'$
‡#3')A4N';];#A'#B';#N&U3?';]'KM•;ZI#U3?',&)e3:138',&bIw'C#3')A4N'
;]&X;ra;U3?';]'KM•;#1'#38'^=>')$¦AJ;GY'#r3F';#1'#38')e3:1Mi38'#K7$
z'#')#˜7^w')U3?'w')U3?':1^w')I#A4E'U2')IK#=a')Ik7IJIU3?';]
;G8')&D3;G=„')^@'U3?'$
K-^%')^w')U3?'I#Z'#:1^w')U3?'f874I#3gAT1^w')U3?'&2;I#3gA$
w')U3?'f874I#3gAxyIw')e3:1^w')U3?'#Y'#M3'b:1^w')U3?';]IK
#=a'):A,'<#3N';#74U93b;#q8#1&MWM3'$
H'MW^w')U3?':1MW:H';#74U93#=a')Ik7^w')U3?';G8')&2;)3,4b;Z'#
r{')qG;|b6qG;|:1&2;I#AC¨&*3)3,4$
2;MW;H'MW;3NAr3EA

12
oO.|’~.|;H'MWU3?''#1
o6 |’OC|;3F')'K3rY'#;#=„')
o6 C|;#H'C3'#I>C#D')UJ<d')CZI#;#ZI#
o C|’0b0|;H'MW&J4<#@A;#AB;U3?'
oOO.C|’6b~|;H'MWMK')G7^38
o©©|’6.©|;H'MWMK')G7^38ª
oO\|’©©.|;H'MW3T3
w')U3?'&2;I#3gAxy:1^w')U3?'IK#=a')I#•^3I#A4E';#q8&2;#=a')b
^w')U3?'Ik7<3'#8‚I7IRA4:1^w')U3?'&2;I#3gA$
G`C#J'):1MiIS';G`T3?I^3I#A4E'^w')U3?';]Ik7TB;^@'U3?'b')=„3;7
'K33&<q^7'Iq:1'K3;G`C#J')^w')U3?'f874I#3gAIw'GqM3M;7'Iq:1;G`C#J')
^w')6I#3gA$G8')<#@A;#AB;U3?'b;G`C#J'):1r?'#'#,'$G`C#J')U8r{')
8#&$
3?AU3?';#FxU3?'J<y:1:iIU«4U3?';]^3I#A4E';G8')I#A;GY'#bU8r{')
"8:;b6T8::1:iIU«467&<^w')U3?'RA768#&M;G`C#J')$
=„')U2^w')U3?'
W:=V')U3?';]I#A4E'U2')RA7&2;U>'Tz^3?';ZI#;G8')&2;)3,4)e3:1
I=„')U2^w')U3?';Z'#r{')&<qxy$E^[#3EAI#Q');7:X4#Y'#;=V')&JA
;G8')&%I#&JAUE&3'##e7^w')U3?';G8')UKiII8rK<Ik7;3&;=>')d')Ta3
#3?AU3?';#Fb^w')&JAbIA'):=V');3&;=>')d')Ta3^w')U3?';])e3:1^w')U3?'
U=VIU8r{')7&<qb`'#j')I#*#™<x;=>')d')Ta3U3?';G`;+')y;3&;3F<;_Ir>&
Ta3:iI'#='#7A:1&J<:iI;GN'&%I#&JA;+'):1&;+')#A4F;J<b;=>');i;G8')
U3?'bC#3^w')U3?'9'Uz'#U3)‚<<#S3;G`C#J')xTZ^_'#=&D')=„3y;#Y:iI^w')
U3?'T1U3?';#F;+'):N'bMdIUgC#J');+')IL'):1&;+')'#3?;U2b^w')U3?'^,'
^_')`"3?;'7&IK;H'MW:1O.|$‡#3I#%4RA7')=„3'KIK;#E),4')n');3&b;A4
'#3N'C#3;H'MW^w')U3?';+'):N';#Y;JIU2'):N'&DIL');#74U93b;%3;H'MW
6 $ |^w')U3?'')n')CZI#;#ZI#;#H'C3'#I>bU3gA'14U=VI)3S3;#ZI#:1^8
;H'MW;#74U93#=a')Ik7^w')U3?'RAJ'#7'#'N';#H'C3'#I>C#D')Cz<UJ<d')$
#@A;#AB;U3?';(4'>3IK'#j');N')e3C#JI'#7A`#,A,A)e3:1'#3?;

<#@A;#AB;Iw'`Š)e3:1&J4UW;U3?'
1. zI#M]<#@A;#AB;U3?'
JI#'74O '+&I8'')=„3U‰r3F;^(')'#3?;Ik7:]7UEIH&&JAb&2;
;G8')'#j')d')^_')UHA;3N':1:1&'K')r1'k3r{'):]7M7AUKJ<T18TF;
;#=>')UEIH&&JA$=>');i'+&6©–O')=„3;7^(')^w')U3?'I#%4RA7^,4^@'
:1&'K')UˆI#Q'):N'G‘3J<T18&D$
#@A;#AB;U3?';#B;MiU=VI)3a3;#3?AUHA;3N'r`37GTq4AM#3')&2;'#1
<#@A;#AB;;#H'C3'#'93;3F')`ŠT1€3::37&8T3q&2;'#1TB;:ƒ`7GT7G^;n
'+&6/-\$nUKbTa3'#j')=AU3E&Ik7&Y'#b'K')14I1')U=VII#X<'#B'G2')
G‰3$#8UF''74IKC#8S')©.¬IJIIJII7<#@A;#AB;IKM]^_')<#@A;#AB;U3?'b
U3gA'14U‰:1&)3S&;#„3)37'<#@A;#AB;T1;#„3)37'#‘3<#_IIk7r?'#'#,'$J4
<#@A;#AB;U3?'UHA;3N'Ik78T3q:1&2;&J4UJ'#:]7#‘RA7')b)‘&-&S'#C3&
:8%3IJI#'#7Ar`3&2;C#8S')#`C#D')C#Zb'K#8%;U2'))3W')rAG3;G8')fq&D;Db
C#3U3?'J<UkI78;#YM•fS4G7#3?';=V')<#K')#‘RA7')$
2;I#A;GY'#U3?'<#S3r78)‘&r74FA;W&J4;%8^78U2')^w')U3?'bU3?'
IiI#8%;U2')T1U3?'IiI<#,';J'bI(')Ta3r?'#'#,';%8&2;Tw')C#h<CZ'$
2;^%')<#@A;#AB;^(')U3?'C#JI:1I7A;qG4U3?'$)=„3;7M]^_')^w')
U3?'6I#3gAU3RA7U3?';G`:1&I#Q')'K')Uˆ:N'UEUW;&Db
13
2. )A4N':ƒ#8%;U2')
#@A;#AB;U3?':1RAJ;GY'#M]^_')^w')U3?'f874I#3gA;H'MWI78x b
|’0b0 b |yUEIP;&DT1UD')&D$^w')U3?''14I#%4RA7;81'r2<#H'I>
;#E'{&)3j7UHAU3?'IiI#8%;U2')T1U3?'IiI<#,';J'b^=a3;JIU2')Ik7U3?'
;G=„')b8';G8')&D)H'Ta3U3?'IiI^3I#A4E'#Q'):3N';_IT7I#%&Ta3'#j')
')A4N';]T1<#,';]C#JIT1;GA4g'U2')'+')Ik7I#Q')I#8'#7A$3gA'14),4
;+')TB'U2')')@A'#3N'Ik7IJI<#,';];G8')&DT1Mi;B<#V<'14:1&;+')
'+'):=V')rN';G8');%8G7'#3?;$#3?;:1&'=aI)37'r18MD3b:1&;+')J<:iI'23
r18),4Tp&1');Fr18
G8')<#@A;#AB;U3?'')=„3;7<#S3M]^_')^w')U3?';H'MWI78UE)3S&
;#3EACZI#;#ZI#C#D')&8')&AW'UF'I>;#EbC#3`;H'MWI78^8;H'MW;#74U93

^w')U3?'RAJ'#7'#:1&;Fr18C#D')Cz<<#S'd')$Y'#;#=„');#H'C3'#I>M•
')n')UJ<d')Ta3^w')U3?';%3;H'MW6 $ |;G`:N'$J4UW;U3?'#8%;U2')`
;H'MW;n ‡|’0b0|b;H'MW'14I78#>')3a3#%';%3UK;#H'C3'#I>rzCZI#
;#ZI#C#J'#3gAx•6 $ |yb'N'T3?IM]^_')&J4<#@A;#AB;U3?'C#J7';81'$
2;^%')<#@A;#AB;^(')U3?'C#JI:1I7A;qG4U3?'b;G8')UK^w')U3?'U3
RA7&2;U3?';G`x^=a3^%')&2;U3?'IiIy:1&;+')'#3?;U2U3?';G`UF'&2;&dI
U2&8')&AW'M7AUK')=„3;7J<U3?';G`UKT18&DUEIP;#8‚IUW;$#=TB4
C#D')IK^w')U3?'I#%4RA7')=„3r?'#'#,'T1'#=TB4C#D')IH'U3?'IiI<#,'
;J'$
3. JI^%')<#@A;#AB;U3?'
#=>');3?'<#@A;#AB;U3?'#3?'U%3;%8G7MK')U3?';nIK;H'MWGX;I78b
)3j7 C|’0b0|bMK')^(');G8')<#@A;#AB;U3?'IK;Z'#I#X;Tg;H'MW)3W')
'#=;H'MWMK')G7^38^(');G8')<#J;;#7'#T1;GA4g';#7'#bTYTB4MK')<#@A;#AB;
U3?'Iw')e3:1MK');H'MW7^38$
J4<#@A;#AB;U3?'IK;#E;%8G7'#3gA^%')MK')C#JI'#7AbC#3;#74U93
^%')MK');#Y;JI^_')T18&DIL');#74U93;=>')d')$w')U3?'UEIP;:1^w')
U3?'IK^%')MK'):3N';_Ib'K;%8'#3?;GX;'#7'#T1),4rWI#>3&Dx#3?;:1&'=aI
)37'r18MD3b:1&;+')J<:iI'23r18),4Tp&1');Fr18$3gA'14)e3:1Mir74#>3
;Fr18ybIw'^w')U3?'UEUD')&DIK^%')MK'))3J'U8%'b'KM3'#'#3?;Z;#>'T1
I#B&#>''N';#74TYrWI#>3&DI#Q')I#•:1&C#DUD'):%3b)3j7-C3EA'14Iw'IK
IJIC3EA<#7;G2'IK;JI^_'))3j7IP;T1UW;$)813G7Iw'IKC3EAUW;<#A'UEIH&
&JA:7';ˆ7;GN'^3?'G2')$"a3;X;ISIJI&J4UW;U3?'#3?'U%3IJI;JI^_');#=„')
U=VI;%8r`3MK');G2'bT3?IU3gAI#•'#;JI^_')UW;T1IP;#81';81'U2I:B<'#7A
#74'K3C#JI#>';#YI=„')U2UW;IH&&JA;G8')RAJ;GY'#IP;;#YC#D')rzS'#
#=`')r`3T3?IU3gAI#•'#I=„')U2IP;$
J4UW;I>rS'Ik78T3qTa3^w')U3?'IP;T1UW;G3N')r3?;U‰U=VI^(')
G2')G‰3`Š;G8')C#8S');#„3)37'6/0.o6/~.bTa3&2;MWIS3;3F''#ˆb'+&6/–.
&J4UW;U‰IK'#j');3F'r2:a'b&%I#U3?'I#8<#h<;%8G7'#j')^%')MK')<#dI
#V<b;nUK'KI#8<#h<<#@A;#AB;T3N'IK;#E;#iI#3?'U=VI'#j')<#@A;#AB;;3'#
T3T17';81'#>'$

6b‡3EAIP;
w')U3?'IK^%')MK'):3N';_Ib^w')U3?'IKT8:;#X<U=VI<#J;G7:3N';_IIK
;JI^_');%8'#3?;'#7'#$EU%;U=VI#3?ARASIP;'N'UEUHAU3?'IiI'#™;GN'&D
UZI#$
-b‡3EAUW;
14
w')U3?'IK^%')MK'))3J'U8%'b'K;%8'#3?;Z;T1I#B&'N'I#•IK;JI^_')
UW;$
0b‡3EA<#7;G2'
‡3EA<#7;G2';GN'&J4<#J;U3?':1^%')MK')IP;'#=')U3?';#FI78#>'
&W;IP;;#D');#=„')bIK;JI^_')UW;rN'I%'#;JI^_')IP;$xAICqGb6//©y$$IK&2;
MW^%')MK')<#7;G2'IK;#E;#74U93;†MWIP;T1UW;$
\b‡3EAUW;<#A'
%;U=VIC#3&J4<#J;U3?'`I#FU2UW;bC3EAUW;;%8^%')MK'))3J'U8%'
4. JI#Y'#;#dI<#@A;#AB;U3?'
‡Š;#AB;<#@A;#AB;U3?'I#37;#1'#-'#K&I#Z'#U>'T1-IiI
%I#U3?'<#@A;#AB;;#Y;=>');i;G8')ISd')^_')U>'IiIT1#73IiI$
w')U3?';nIA2')378U2');#q8U3?'IiI#8%;U2')RA7&D')=„3G‘3;G`TgU3?'
IiI<#,';J'$G8')C3EA#73IiIISU3?'IiI#8%;U2')T1<#,';J'I(')'{&;GN'
;74IH&'N';#E;ZI#&D)3j7-U3?'IiIGX;'#ˆx7:3M6//~y$3gA'14I#8<#h<J<
^_')^w')U3?'UF'&DI#Z'#fJI#>'$G8')C3EAU>'IiIb;#E;ZI#&D)3j7-U3?'
IiIC#J:a'$
a. ?;#W')<#@A;#AB;U>'IiI
#@A;#AB;U3?'U>'IiI:1^%')<#@A;#AB;U3?'<#9r3F''#X;$G8')C3EA
U>'IiIb&J4<#J;U3?';%8^w')U3?'I#%4;nIiI#8%;U2')RA7I>;#Er?'#'#,'Tg
IiI<#,';J'T1;G`Tg&J4<#J;U3?';%8Tw')C#h<CZ'$
G8')C3EAIP;U>'IiIb^%')MK')U3E'#Y'#IK^%')#Y'#M3'q0’0b0|b
'+'):=V');B<;GA');%3UHAUW;Ta3U3?';#FGX;I78x;GN'-O T8:yIK&2;^w')
U3?'M•:7';ˆ7
;#q8#Y'#'K';nU3?'IiI#8%;U2')fAW')U3?'IiI<#,';J'$

)=„3;7;#X4IKMi^w^w')U3?'UJ')CE;nI#A;GY'#'14UF'&DCFIB'bU3gA
'14IK')#˜7IK^w')U3?'U3RA7IJI;9I#dI&DC#JI'{&)3j7I#Q')'#=&%I#
&JAb;#H'C3'#bI8f=>')bTT$
#iI;F')=„3;7;#X4IK&2;MW:=V')UJ')CEU3?'T1'#3?;`C#8S')IJI#6o
-I&fA')RA7'#;n&2;U3E&'#ˆ;3F<fQITa3U3?'IiI#8%;U2')$"Y:ƒ^8'14T3?I
^(')UW;U>'IiIrz#%'I#F$#Q')C#D')#8%;U2')U=VI;G8')&D3;G=„')=a;
#8‚I&JAbT1;#B&I#ZC#D')U=VII#%&T18f=>')bG+')#74C3&:8%3$
b. ?;#W')<#@A;#AB;#73IiIxr3<8:7Gy
?;#W')^(')MK')6|UEIP;b#j')')#3N'IdA<#@A;#AB;U‰C#-')
Uz'#G{');H'MW;W3=AI#8IP;&D:16|bTY'FA;H'MW;#X<#>'M•;%8G7'#j')
CZI#;#ZI#C#D')&8')&AW'Iw'`;H'MWI78#>'M•;%8'#3?;T1:7';ˆ7^w')U3?'
&2;IJI#UJ')CE$
+'):=V');%3UHAU3?'IiI#81';81'G3N')r3?;$w')U3?'C#D')I#%4RA7
')=„3&1I#•I#%4RA7T(')&D'#ˆ'{&)3j7-U3?'IiIbC#D')IH'&3F')<7^UX;b
'N':8%3rˆMi:7';ˆ7Ik7^w')U3?'T1'#3?;UF'IJI&DCFIB'$3?';#F&J4#73IiI
;#=„')I#•C#8S')6\.T8:M8Ta3#?;#W')U>'IiI:1C#8S')-O T8:$U3?';#F;#X<
T1;G`C#J')IiI;#X<:1&)3S&;#3EA'#j');JI^_')<#_^8'#3?;T1^wU3?'),4G7$
8')IL')^8U3?';#F;#X<'N'r3<8:7GC#D')#3?ARAS;G8');G=„')#V<I#S4&JA
'#3gAx3;I#q::b6/–©y$
JI#?;#W')r3<8:7G#3?'U%3xTZ^_#?;#W')3^q';y^(')#73^%')MK')C#JI
'#7AU=VII#=>');GY'#T1T3;Z'##K7UE;%8#3?ARAS;W3=A$‡#D'))3W')'#=&J4
UW;U>'IiIb#?;#W')r3<8:7GIK;#E^(');W;I#8IS&D3;G=„')=a;#74C#D$
15
?;#W')IK;#E^(')IP;#8‚IUW;;G8');X;ISIJI&D7';81'bCEIS;GiI;3F<
;GN'f=>')bG+')&1C#D')MV#8%3;]&D$
#j')=AU3E&C#3^(')r3<8:7GM8Ta3U>'IiI
®K;#E#8%;U2')U=VI;GN''#j')r?'#'#,'U‚;&J4;%8'#z<#74&J4<#J
GA')$
®P;T1UW;;G8')&D3;G=„')=a;#74C#DUgAU=VI
®‡#D')IH'<7^UX;bC#D')IK^w')U3?'RA7')=„3r?'#'#,'

®‡3E&M8J;'+'):=V')I#Z'#fJI
®‡#D')IKMiI8&D#74#K7;#7'
®8%;U2')IP;T1UW;;3NA;#_Z;U3?''+')#>'¯:=>')U3?''FA^(')&J4UW;
U>'IiI$
3S&;#3EA#3?';=V')'#3?;T1^w')U3?':7';ˆ7
)A4N':ƒ<#@A;#AB;I8r:7;38'
dIf%;H'MWG7^38:1)Y}
dIf%U3?';n;H'MWG7^38:1Mi;GA4g''+'):=V')r{')MK')G7^38xIKG‚')
;H'MW;n0C3:8#qG;|xC|y;80 )3)7#qG;|x|y$
)A‘'<#J;MK');H'MWG7^38
dIf%U3?';n;H'MWG7^38U=VI;%8r`3IS')A‘';i'#3N'T1'#,';%8
)A‘';i'#3N''#=&‚;;G„3b;GJ3UX;b;H')U3?':4bI#Q')<#J;G7;G=„')ª
&dIU2;#X<$
)A‘''#,';%8I#k4FA^(');G8'):‰'#TiIT3[';#D')bG7^38b;3T3bU3?';#8%3
^3U2')b&J4'#P';3'bU3?';#8%3C#D')^,4bT?;3'#b:wT3r7bG7^7Gb;#3F;rz'#3?;ID')
')#3?<b”
JI^_')Ik7MK');H'MWG7^38:N'&DM3'##eI
K0;JI^_')I#Z'#
JI^_')‹7G7^3IC#D');#=„'))‚<`'#j')&J4UW;#3?'U%3IK;H'MW;GN'
0 C|
JI^_')U3?':4),4G7^8Mi<#,'IiIIk738';G8')&DC#3^w')U3?'f874
I#3gAU‚;T18&D&1)‘&I#k4FA:1'=aIT1I#X;U3?')3S3b^8^w')U3?';H'MWI78
'N''#j')#%;38';G8')&DM•GA')#8‚I^3I#A4E''#™:1&;+')U2')'+')bU=7
UF';+')'#3?;U2&D
JI^_')'#3?;IK&2;T134FA;WS'##=`')UF'C3EA^@';GA4g''#3?;RA7
&D$=aI:1&D3;G=„');W3#S8UE^A4;GYI,'r{')'#3?;;G8')&D^8'KIK'#3?;U2
MD3#{')Uz'#$FA;WRA7';Ge')C#JI:1&%I#&JAIk7&DbTY;AH'#81')3Q<)3S3
'#3?;$JI^_')'#3?;:N'&DM3'##eI;(4;#A2IT18'#3?;U2IAW3I(')U%;U=VI;%3
&DT1C#8S');#„3)37'^A4;GY'#3?;U2I78;%3UK$‡#3'#3?;U2;+')I#B&b&DM•C#D
T1IKMiUD')<G8;q3'IXA;#1'#b;GJ3:%3C#3'#3?;U2;+')'#7'#UF'6

8
:1&MD3
'=aI'23r18),4;+')J<:iI:1&Tp&1');Fr18$‡#3'#3?;U2;+')RAJ'#7'#'=aI
C#D')Cz<rWI#>3IL')'#=&DI#=7Cz<)3S3'#3?;U3'N''=aIMD3:N''#7'#I#K')$
2;MW4FA;WC#JI:1'=aI:1&S'##=`')UF';G`C#J')Ik7&Db;G`C#J')
&DC#DI78#>'&D=a;$
8%;U2')IP;<#@A;#AB;U%;U=VIC#3'#3?;U2;G8')&D;+')I78'#7'#
I#K')UF'6 °;G8')Tw')&3IG8)3,4$