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About AOBO Incontinence Centre 
 

About AOBO Incontinence Centre
Wholly-owned by the NYSE-listed American Oriental Bioengineering Inc., AOBO International Cease Enuresis Treatment And Medication (hereinafter as “AOBO-ICETM”) is a treatment and research institute specialized in improving enuresis (bedwetting), nocturnal urination, micturition (frequent urination) and urinary incontinence. Based in Hong Kong, AOBO-ICETM has been rolling out its global businesses, including:

1) to jointly establish treatment or research institutes with other parties in which specialized in improving enuresis, nocturnal urination, frequent urination and urinary incontinence; 2) to cooperate with other parties on the research and development of medication focusing on enuresis, nocturnal urination, frequent urination and urinary incontinence; 3) to cooperate with other parties to promote herbal medicines on treating the enuresis, nocturnal urination, frequent urination and urinary incontinence. To date, AOBO-ICETM has successfully cooperated with various local medical institutions in Mainland China to establish a network of specialist out-patient medical centers in Mainland China in which targeting the enuresis, nocturnal urination, frequent urination and urinary incontinence problems. Patients are treated with the AOBO-ICETM’s medications and treatments. Over the years, numerous patients with enuresis, nocturnal urination, frequent urination and urinary incontinence have recovered after receiving the treatments.
Employing a team of experts and specialists on enuresis, nocturnal urination, frequent urination and urinary incontinence , AOBO-ICETM has maintained long-term closely academic cooperation with local and overseas institutions. AOBO-ICETM has successfully invented two patented signature products to treat urinary incontinence and enuresis : ‘UrinStopper™ Capsule’ and ‘UrinStopper™ Patch’.

Our mission: With the application of proven and effective herbal medicines combining all-round customized treatments, to help the patients of enuresis, nocturnal urination, frequent urination and urinary incontinence all over the world recovery and say ‘farewell’ to the untold pain and embarrassment.

To further enhance its services, AOBO-ICETM’s CMP Consultation Room together with its AOBO Hong Kin Member Club (康健會) have been launched in 2008 in which dedicate to provide comprehensive and customized services for the patients of enuresis, nocturnal urination, frequent urination and urinary incontinence.

 

About CMP Consultation Room
Employing a registered CMP, the AOBO-ICETM CMP Consultation Room provides the following services :

1 Medical consultation services by a registered CMP;
2 Medical consultation services on urinary incontinence, nocturnal urination, frequent urination and children bedwetting.
3 Chinese herbal powder drinks;
4 Acupuncture treatment and far-infrared acupoint treatment;
5
Video resources on urinary incontinence.
6 Other curative trainings

Service Charges :
1 Consultation fee : $ 80
2 Medication fee : $ 50 (one-day medicine)
3 Acupuncture treatment $ 140


 
1. About Urinary Incontinence
1. Types & causes
-What is urinary incontinence? Urinary incontinence means unintentionally loss of urine and if it happens constantly for more than three weeks. Urinary incontinence will both affects one’s social life and causing hygiene problems.
•Causes :
1.Weak muscles of detrusor and sphincter
2.Low bladder sensitivity
3.Side-effects as a result of medicines
a.Anti-hypertensives medication
b.Cough syrup
c.Diuretics
4.Symptoms such as serious micturition, urinary urgency and urinary pain caused by urinary system infection
5.Constipation
6.Obesity
7.Bedridden
8.Multigravid women
9.With diabetic, prostatic hyperplasia, nerve damages (such as stroke, senile dementia, Parkinson’s disease, spinal damage)
•Urinary incontinence can be classified into 5 common types depending on the causes:
a.Stress incontinence : Due to weakened pelvic muscles that impairing the urethral orifice control, in which case, any action that exerting pressure to the belly such as coughing, jumping, walking downstairs, lifting heavy object will trigger unintentional urinary leak. Commonly occurs in multigravid women, women after childbirth, postmenopausal women, women with obesity or unproductive cough.
•b.Urge incontinence: Caused by a sudden, involuntary bladder contraction. This type is more common in patient with urethra infection or bladder disorder(overactive bladder). The cause is unknown. A common type of urinary incontinence with Hong Kong patients.
•c.Mixed incontinence : A common type of urinary incontinence with a combination of both the stress and the urge incontinence symptoms.
•d.Overflow incontinence : Bladder dysfunction caused by weak bladder contraction or obstructive urethral orifice, in which case, urine overflows when the bladder becomes full without feeling urge to urinate. This type of urinary incontinence commonly occurs in diabetic, neuropathic bladder problem caused by stroke-to-paraplegia, injury, genetic weakness.
•e.Functional incontinence : With this type of incontinence, the patient's urinary system can function normally, however, physical problems like disabiliy or restricted mobility, cognitive problems and other diseases (such as neuropathic problem, arthritis, soreness, cardiorespiratory problem) prevent you from getting to the washroom in time.
Depending on the level of illness and symptoms, urinary incontinence can also be classified into 3 categories :
•Mild : Basically it does not irritate one’s daily life.  Urine leak happens only in exceptional cases such as doing strenuous exercise or actions or guffawing that exerting much pressure on the belly.
•Moderate: Urinary leak happens that causing hassle to daily living. Urine leak triggered by coughing or movement that stressing the belly. Patients may resort to absorbent pad, tampon or absorbent shorts to prevent leakage.
•Serious: Daily life and personal image are being seriously affected. Surgeries should be rendered to treat incontinence.
 
2. Harmful to the health
Urinary incontinence is an embarrassing and frustrating problem in which affecting the patient's self-confidence and personal image and limiting one's social life. Urinary incontinence will increase the risk of infections such as urinary tract infection and genital skin diseases, hence, it is harmful to the health. In a nutshell, urinary incontinence irritates. It will constitute burdens not only to one's physiological and psychological aspects but also to the society.

3. Urinary Problems Survey in Hong Kong
•According to a 2002 survey, at least 330,000 males in Hong Kong have urination problem, making up one tenth of the whole male population.
•There are even 41% females aged between 18 and 70 suffering from the incontinence problem. Patients are often unaware of the problem or don't want to face it squarely, thus the treatment time is delayed, some even misinterpret only as “functional deterioration” or “minor problem” and overlook it, further worsening the problem, resulting in sequelae such as serious urinary incontinence.
•Cases of urinary incontinence in women have significantly increased when compared with those 10 years before. Pelvic floor relaxation or involuntary bladder contraction, caused by birth giving, obesity, aging and long-term constipation, leads to more frequent urine leakage and incontinence. Moreover, many patients are young females suffering great living pressure.
 
•60% female interviewees have experienced various urinary incontinence problems, of which 32% interviewees indicated urinary incontinence made them nervous and worried and, about 16% interviewees said urinary incontinence affecting their quality of life. Patients should deal with the problem squarely with an open mind and to seek appropriate treatments or to take curative healthy supplements aside from medications to treat the problem, without delay. However, for those serious cases, patients may resort to surgery.

The age distribution of women with Urinary Incontinence

Age
26-30
31-35
36-40
41-45
46-50
51-55
56-60
61-65
Mild (%)
3
24
36
36
50
45
55
31
Medium (%)
0
0
2
6
3
8
8
4
 
4. Urinary Incontinence In Women
Women experience incontinence twice as often as men. According to WHO's survey, 25% of the young women age group and 40%-50% of the middle-aged-and-elders age group have experienced different levels of micturition, urinary urgency, urinary incontinence. According to a Hong Kong report, in the 1990s, females accounted for 15-30% of all the urinary incontinence cases, of which, middle-aged women constituted the largest portion.
Why urinary incontinence is more common in women?
a) The structure the urinary tract of female is a case in point.
As the urethra of a female is straight in form and with only 3-5cm in length, it is more susceptible to urethra infection than male.
b) Given that the pelvis of a female is boarder than that of a male, her pelvic floor muscles supportability is thus weaker
c) A female's pelvic ligament will become loose when in pregnancy and after labouring.
d) A drop in estrogenic hormone of women after menopause will cause contraction in lamina tissues of urethra and vagina.
e) Damages in bladder or urethra tissues as a result of the pelvic surgery with women.

 
What kinds of females are more susceptible to urinary incontinence?
1.multigravid women,
2.primiparous women,
3.postmenopausal women,
4.With diabetic or nerve damage (such as stroke, senile dementia, Parkinson's disease, or spinal damage),
5.being overweight,
6.bedridden or patients with physical disabilities.
On the other hand, about 13% of women often experience urinary incontinence during sexual intercourses which really affecting their psychological state and sexuality.
5. Urinary incontinence in elders
It is reported that about 40% of elders in the world aged 75 or above experienced urinary incontinence. Hence, urinary incontinence is commonly found in elders.
Why urinary incontinence is more common in elders?
•  As a result of medicines(side effects of those medicines that will increase the voiding volume)
•  Symptoms such as serious micturition, urinary urgency, and urinary pain caused by urinary system infection.
•  Decline in holding and voiding ability as a result of weak contraction muscles of detrusor and sphincter.
•  Low bladder sensitivity
•  Stool impaction or constipation in elderly. The stool accumulated in the bottom and squashing against the bladder making it harder to hold the urine.
•  Caused by diseases such as diabetes, prostatic hyperplasia, nerve damages (such as stroke, senile dementia, Parkinson's disease, or spinal damage)
(In a nutshell, the causes of urinary incontinence in elders are diversified and complicated. As such, it should be evaluated by a doctor or an  expert.)
 
Although it may be more common as a person ages, urinary incontinence is not a normal part of aging. With the application of suitable treatments, 60% of symptoms of most patients will be improved and 30% of total patients could be successfully cured!
According to TCM, urinary incontinence in elders has been classified as “kidney yang deficiency”(weakness of the fire element in Mingmen acupoint). According to The Yellow Emperor’s Classic of Internal Medicine (《內經》), a woman’s Ren Meridian declines at the age of 49 with the menses exhausted and the passage menses obstructed. Whereas, a man experiences deficiency of qi in liver and tendon demotivated at the age of 56, with the menses exhausted and the essense degenerated and deficiency in kidney concurrent with body function languished. At the time of The Yellow Emperor, 49 and 56 are almost the age limits of women and men respectively. This explains that the body mechanisms of men and women will noticeably decline as they enter to midlife(menopause in Western Medicine perspective)in which featuring deficiency in the kidney which generating and storing Yin and Yang.(Clinical symptoms of menopause in women include permanent stopping of the monthly periods, whereas, symptoms in men would be impotence, soreness and weakness of waist and knees, cold limbs, clear and prolonged urination, frequent nocturnal urination. )
Symptoms of deficiency of‘yang’ in kidney at the primary stage include increases in the urinary volume and the voiding frequency, nocturnal urinary frequency(2-3 times every night). Deficiency in kidney’s yang will subsequently turn into micturition, urinary problem, frequent nocturnal urination and urinary incontinence.
It should be noted that not all the cases of elders incontinence are the result of deficiency of ‘yang’in kidney. Other causes include ‘downward flow of inner damp-heat ’, ‘spleen deficiency and qi sinking’,‘kidney Yin deficiency and hyperactivity of fire element’.Nevertheless, kidney yang deficiency and symptoms of micturition, frequent nocturnal urination and urinary incontinence thereof are common in elders. Hence, to tonify and warming the kidney is a medication way widely adopted by the TCM to treat urinary incontinence in elders.


6. Urinary incontinence in men
Urinary incontinence is not too common in men.
Causes of the two main types of urinary incontinence in men include:
1、Short-term incontinence:
      A:Urinary tract infection
      B:Acute delirium
      C:result of drugs:Hypnotic, tranquilizer
      D:Psychological factor:depression
      E:Constipation
2、Persistent incontinence:
       A: Prostate diseases:In most cases, urinary incontinence in men is due to prostate diseases which limiting the bladder control ability of holding and voiding urine, causing urinary incontinence. Prostate diseases will affect the bladder function and involuntary contraction of detrusor, in which case, causing urinary urgency, micturition and urinary incontinence.
       B:Cerebral cortical diseases(such as stroke, dementia), spinal diseases
       C:urinary tract injury caused by sphincter or pelvic nerve surgery.
       D:Overflow incontinence:caused by diabetes, alcohol intoxication, etc.
       E:bladder diseases


2. About Micturition (Frequent Urination) and Nocturnal Urination
1. Definition of Micturition (Frequent Urination)
The average number of voids during waking hours for a normal adult should be 3-8 times. For those who void more than 8 times daily without the use of any diuretic beverage can be classified as micturition (frequent urination). In severe cases, the patient may void every hour.

2. Definition of nocturnal urination
During sleeping hours, the average number of voids should be 0-1 for a normal adult. For those who awake to void more than 2 times per night can be classified as nocturnal urination. In severe cases, the patient may be awakening to void 6-7 times per night, hence, disrupting sleep and leading to negative consequences including exhaustion in daytime.

3. Micturition (Frequent Urination) and Nocturnal Urination in Traditional Chinese Medicine (TCM) Theory
According to TCM, frequent urination and enuresis may be caused by either ‘damp-heat bladder’ or ‘insecurity of kidney qi’.‘ The former is due to urinary tract infection (painful urination in TCM) with symptoms such as urinary urge, urinary pain, distension of lower abdomen, turbid urine. Symptoms of the latter include micturition, frequent nocturnal urination (two times or more during night), premature ejaculation, seminal efflux. Worse still, insecurity of kidney qi will turn into ‘kidney yang deficiency’ which featuring impotence, clear and prolonged urination (clear, scentless and abundant urine, in some cases the urinary volume exceeds the in-taken water volume), soreness and weakness of waist and knees, cold limbs, involuntary seminal efflux during urination.
 
3. About bedwetting with Children
1. Overview and definition
Enuresis, or bed-wetting, is an involuntary loss of urine in children aged 5 or above during sleeping. Children and adolescents aged between 5 to 13 often have the problem which is a common problem in childhood. Generally speaking, mild bedwetting(not frequent)case is not a disease. Generally, the bedwetting symptoms will disappear with advancing age. However, enuretic symptoms may persist into adulthood in some cases.
Bedwetting often occurs during night-sleeping (sometimes in daytime sleeping)and regular in frequency such as several times a night or, once every couple of nights or, one to two times a month. In some cases, bedwetting will halt for a couple of weeks after happening successive nights. 
Bedwetting may be gradational or may be persisted for months and years with the episodes continue in adulthood. Typical symptoms: Deep sleeping and cannot be waken up by the one's body to go to the washroom and, in which case, wetting the bed. Types and causation could be diversified, yet the harmful effects thereof coincide
A large epidemiological study conducted years ago by the Division of Paediatric Surgery, Department of Surgery, The Chinese University of Hong Kong, involving 16,000 local children and adolescents (aged 5 – 19 years) has revealed that about 2% in total had bed-wetting. About 16.2% of the children by age 5 and 2.8% by age 10, and, 1.5% of adolescents by age 19 have bedwetting problems. Bedwetting are more commonly found in girls than boys, in comparison.

Age
Morbidity
5
16.2%
10
2.8%
19
1.5%
Average
2.5%

 
2.  Causes and level of illness
What is the cause of urinary incontinence in children?
1.Deep sleep associated with immature control and coordination of bladder and urethral function in the brain stem.  
2.Genetic reason (If either the father or mother had urinary incontinence problem, the chance of bedwetting with the child will be 44%. The chance of bedwetting will be 77% with the child whose parent had urinary incontinence problem. Symptoms of incontinence are very much alike in twins. The age of ceasing bedwetting is alike with the child and parents.
3.Psychological and emotional factors (incidents such as boarding, relocating of home, switching of school, abrupt family condition changes will make children feeling tense and nervous)
4.Bad urinary habits (still using nappies by school age, accustomed to urinate anytime and anywhere) will gradually reduce the holding capacity of the bladder.
5.Dropping in secretion of vasopressin, an antidiuretic hormone, by the brain. The amount of vasopressin secreted by a healthy person at night is normally 2.5 times higher than that of daytime. However, the figure is only 1.5 for those urinary incontinence patients and, in which case, reducing the uptake of water by the kidney during the night and causing a greater volume of urine produced.
6.Latent spina bifida with thoracolumbar burst which harming the nerves and affecting the control ability of holding and voiding urine during the night. Other diseases such as urinary tract infection, calculus, abnormal urinary tract, enterobiasis, diabetes,
How to assess the level of incontinence in children?
4 benchmarks, the age, frequency, time of occurrence and the patient's alertness level when enuresis, are used  in assessing the level of incontinence of children aged 5 or above.
Benchmarks of assessment on bedwetting
Assessment:1-4 points as mild level 5-7 points as moderate level 8-12 points as serious level
For example:A 12 years’old boy(2 points)has experienced over two times of urinary incontinence every night(3 points)in which often occurring upon asleep(2 points)and hence wetting the bed sheet(3 points). In that case he got a score of 10 marks in total. That can be classified as serious form of urinary incontinence which needed treatment without delay.
 
Scores
1 point
2 points
3 points
Age
5-8
9-12
13 or above
Frequency
Twice per week
Once per night
Two times or more per night
When it occur?
At early morning(after 4am)
sometimes upon asleep
upon asleep(before 1am)
Alertness level
Will wake up before or after incontinence. Low urinary volume (wet the under) Will wake up when wakened or shaken by someone, or sometime will wake up upon incontinence. Medium urinary volume(wet the pajamas and under) Be asleep when waken or shaken by someone, or remain asleep after incontinence High urinary volume (wet the bed sheet, pajamas and under)
 
3. Risk
Urinary incontinence is not a fatal disease, however, it will constitute harmful effects to the physical and mental growth of children in an indirect, latent, chronical, gradual and long-lasting way. In many cases, the negative effects on the psychological development and personal image of the patients will not emerge until entering to the adulthood.
A survey quoted that, on average, the Intelligence quotients (IQ) of the bedwetting children would be 17-23% lower than those children of same age without bedwetting problem.
 
4. Advices on dealing with enuresis in children
General advices on treating enuresis:
•Parents and children should understand about the problem and work together to make it better.
•Encourage your children to urinate before going to bed every night.
•Don't drink too much water after dinner. Don't drink any beverages such as soup, herbal tea, juice which can irritate the bladder
•Mark down the occurrence of bedwetting everyday. Reward your child for remaining dry. Parents should avoid blaming or punishing your child as blaming and punishing will compose burden to the child and just making the problem worse.
•Arrange the child's bedroom to keep a short distance away from the washroom. In case the child is afraid of dark, the parents should keep the washroom light on overnight, or leaving a potty beside the bed of the child.
For those elder children, encourage them to change and cleaning any wet bedding or pajamas themselves so as to train up their responsibilities. Remember that care and encouragement work.
 
 
4.Treatments
1.Medication overview:
Urinary incontinence is often treated with antidiuretic endocrine, anti-cholinergic, antidepressant prescribed by doctors. In some cases, minimally invasive surgery like the transobturator tension-free vaginal tape (TVT) procedure is used to correct urinary incontinence. Drugs given by doctors to treat urinary incontinence are more expensive and having more corresponding adverse side effects. Moreover, the drugs have to be taken on a long term basis.
According to TCM, urinary incontinence is classified as “sudden loss of urine control” which is in conjunction with the malfunctions of the spleen, lung and the kidney in human body. According to clinical studies, urinary incontinence in women and elders are mainly due to deficiency of qi in kidney or bladder dyfunction. Herbal medicines such as Ootheca Mantidis, Alpiniae Oxyphyllae, Cinnamomi, Folium Artemisiae Argyi are often used in treatment for tonifying and warming the kidney. Although the consultation process is longer with TCM approach than that of the Western approach, the TCM is more thorough in improving the urinary incontinence, and is free of any adverse side-effect. With a combination of TCM and acupuncture practice, it is recognized that the effectiveness of treatment will be further enhanced.
In some cases, urinary incontinence is due to pelvic and hip problem that irritating the Dai Meridian which administrating the primary and secondary meridians and channels. As such, treating the pelvic and hip region will restore the health.
 
2  TCM HerbXanthoceras (文冠果)
Accordint to the surveys and studies conducted in early 1960s by the Institute of Applied Ecology, Chinese Academy of Sciences at Joo Oda Aimag, Xanthoceras seed has been widely used by the local people there as an herbal medicine to treat the bedwetting episode in children. The effectiveness in treating bedwetting in children has been specified in the Chapter 1 of the Record of Nationalities Medicines (《民族藥志》).
Hello!My name is Wenguanguo ( Xanthoceras Sorbifolia ). Some people also called me Wenguangguo (文光果), Wenguanmu(文冠木) or Wendangezi(溫旦 革子). We, Wenguanguo, are widely grown in Shandong, Shanxi, Shaanxi, Gansu and Inner Mongolia of China. My seeds, leaves and flowers are edible and have been used as an herbal medicine to treat urinary incontinence.

According to the Dictionary of Chinese Herbal Medicines (《中藥大辭典》), ‘Wenguanguo is sweet, neutral, non-toxic.’ Wenguanguo effectively nurtures the urinary system. Many studies have been conducted in Mainland China on the usage and application of Wenguanguo which can:
A.suppress the acetylcholine reaction on bladder and improving the sensory receptor at the Sphincter wall so as to increase the bladder capacity reducing the urinary frequency while increasing the voiding volume, 
B.improve the signal pathway from bladder to cerebral of the patient so that the patients can be more aware of the signals sent from the bladder and wake up from deep sleep,
C.   nourish the nerve system,
D.   help the patient to resume from abnormal deep sleep to normal sleep,
E.   enhance the learning ability of mice, as proven in a vivo test.
Having been undergone about 1500 clinical trials and observations in hospitals such as Beijing Children's Hospital, Second Affiliated Hospital of China Medical
University, Harbin Medical University, Liaoning Province Chinese Medical College, it has been testified that Xanthoceras is curative in treating bedwetting and urinary incontinence safe and is free of any adverse side-effect.
3.  Acupuncture   
Apart from herbal medicine, acupuncture or acupoint-treatment can be applied to improve the urinary incontinence, nocturnal urination, urinary leak and bedwetting.
The Du meridian, Ren meridian, acupoints of Shenque (navel), Qihai, Guanyuan, Shenyu, Mingmen and Baihui are commonly used in acupuncture.
Shenque:Navel
Qihai:1.5’ below navel
Guanyuan:3’ below navel
Shenyu:Two acupoints respectively located at 1.5’ left of Mingmen and 1.5’ right of Mingmen
Baihui:vertex of the head
Mingmen:an acupoint on the spine horizontally opposite the navel

4
. Bladder training (adult)
In general, urine is stored in the bladder, which stretches like a balloon as it fills up. When it stretches to a certain point of capacity and pressure, the nerves in the bladder wall trigger the brain that it needs to be emptied. The sphincter will then open with the bladder retracts to let the urine coming out. In case the sphincter fails to open normally when the bladder is filled up, urine will spill out. Worse still, the urine may be cannot flow out that causing damages or loss of elasticity with the bladder muscles, the urine holding and voiding ability will lose.
Bladder exercise is a behavioral modification treatment technique that involves placing a patient on a toileting schedule. A patient will be asked to keep a diary of his/her urination output and frequency and episodes of incontinence over a certain period of time. Through exercise to strengthen his/her bladder muscles and to enhance the holding capacity thereof in order to reduce the urinary frequency and increasing the time span between urination as well as improving the urinary incontinence. Having been clinically testified to be curative, bladder training is a free and safe treatment on urinary incontinence in which is free of any adverse side effect.

5.
Pelvic floor muscle exercise (adult)
Locating at the base of the spine, pelvic is bounded by several supportive muscles. Pelvic floor muscle is responsible for controlling the opening and closing of urethra and anal canal.
Regular pelvic floor muscle exercises make the muscles that support the pelvic organs stronger and in turn helps enhancing the muscles’ urine holding and voiding control. Without any adverse side effect, the pelvic floor muscle exercise is a free and safe treatment to the urinary incontinence. It has been testified that a combining of bladder exercise and the medication can effectively help reducing urinary frequency, increasing the urinary volume each time and, progressively expand the time intervals between voiding.

6. Urine holding training (child)
Encourage the child to have a large drink in daytime to enlarge the bladder capacity. When the child feels the need to urinate, distracting his / her attention to engage in some other activities so as to hold the urine as long as possible to, say, 10-20 minutes. Gauge the urination volume of the child every week to see if he / she has a larger bladder capacity.
*For details of the bladder exercise, the pelvic floor training and urine holding training, please feel free to come in person to the AOBO International Cease Enuresis Treatment And Medication where the demonstration experts will demonstrate the training skills to you. According to studies, 50% of adult patients could successfully have the urinary frequencies reduced and the urinary volume increased in every urination with the application of the two aforesaid muscle trainings.
 
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Contact Us
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Address: Unit A-B, 26/F, CNT Tower, 338 Hennessy Road, Wanchai, Hong Kong.
Tel: (852) 3102 3616
Fax: (852) 3102 0213
Email: info@bioaobo.com.hk
   
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www.bioaobo.com.hk