Since the outpatient clinic opened for chest patients, their group of 20 beds has housed a wide variety of chest patients.The case in Li Min's hand is a patient with a lung cyst secondary infection into a lung abscess.The patient was bedridden for three years and two months with cerebral hemorrhage, and usually lay flat in bed.This time, according to the family, he coughed up phlegm for more than two months, and was hospitalized for a week due to high fever - the specific number of fever days is unknown.After conservative medical treatment and control of high fever, surgical removal of the cyst is required.Li Min felt that the statement that coughing and coughing up phlegm for two months might not be reliable, because she asked about the medical history and found that the patient's wife and children were only in their early sixties, and even the patient's fever was inconsistent for a few days, and the patient's children were even more indistinct, and they didn't know how their families usually took care of them.Li Min inserted the X-ray film into the reader, pointed to the film and said, "This is the first film of the patient admitted to the hospital, and this is the second one taken yesterday when the body temperature dropped to 37.5 degrees."
In this film, you can see that there is an abscess with a smooth cyst wall and a flat fluid in the dorsal segment of the lower lobe of the right lung, and there is a dullness on the back percussion.The Department of Internal Medicine had aspirated pus from the abscess through a flexible bronchoscope 5 days ago for culture, and at the same time injected 10g of the broad-spectrum antibiotic meloxicillin, and 24 hours later injected another 10g.The high fever was finally brought under control for three consecutive days.Yesterday morning I did a blood test again, but the WBC was still around 20,000 with poisoning particles.This second film was taken for the removal of the abscess. ”Director Li took the medical record and looked through it in a hurry.Li Min added on the side: "The internal medicine department gave a combination of Qingda and kanamycin.Culture back is an anaerobic infection. ”This patient was taken by Director Shi to Li Min for respiratory internal examination, and then picked up yesterday afternoon."
Lao Shi, Xiao Li, what do you two mean?""
Because the cyst wall is intact, I am ready to have the abscess removed as soon as possible.This is also what Director Guan means when he asks for a consultation.I wanted to take advantage of the patient's high fever to be controlled and remove the abscess lesion.Otherwise, once the infection cannot be controlled, it will break through the cyst wall and enter the chest cavity, which can lead to the death of the patient. ”"What about the family's opinion?
What about my opinion?
”"I still seem to want to live well.Most of the family members felt guilty, saying that they did not take good care of her and turned over too little, but they were quite cooperative with the treatment. ”"Na Ming'er first did a brain tumor, then that esophageal cancer, and finally this one.Lao Chen, what do you think?
”"Okay."
Chen Wenqiang agreed, took the surgical sheet in Li Min's hand and began to fill it in."
Lao Li, Lao Shi, can Xiao Li do this lung abscess removal?"
Director Shi immediately replied, "I think so."
Tomorrow, I will go with you to show Xiao Li.Lao Li does the second station, how about it?
”Director Shi is a person who can grasp his position very well, and he understands that Chen Wenqiang wants to give Li Min a chance to do it.I also understand that I should be humble and take the initiative to Director Li - I should do to thank Chen Wenqiang; Passive - for the sake of Director Li, who is about to retire in less than two years, there is nothing that cannot be compromised.I still have more than ten years to work with Chen Wenqiang."
Good.If esophageal cancer goes well, it will be almost done in 1 o'clock.You can come back after lunch. ”"Okay, I'll call the operating room then."
Chen Wenqiang filled out the surgical order, and Li Min stood up and reached out to deliver the surgical order.Chen Wenqiang pinched the operation sheet and said, "I'll go, our group has temporarily added an operation, we have to talk to the head nurse of the operating room, and we also have to talk to Lao Zhou." ”*This is Li Min's first thoracotomy surgery.After returning the night after the operation, Li Min pulled Yan Hong and whispered."
Rainbow, I found thoracic surgery quite interesting.""
What's interesting just surgery?""
It's all interesting."
Li Min avoided Yan Hong's teasing.Yan Hong also accepted it when he saw it.Instead, he said, "Your admission ticket is with me, and I went to the medical office today to get it back."
The two of us are in the same examination room, and there are a few people in between.I took a look at the examination room, and the provincial institute was just us. ”"What about Xiaofeng and Liu Na?""
Xiaofeng doesn't share an exam room with us.This year, there are many people taking the exam, and there are several examination rooms.Liu Na said that she would not take the exam this year and would accompany Gong Hai to review. ”Li Min didn't quite understand, "Why?"
I reviewed it with Gong Hai, wouldn't it be over if I took the exam with Gong Hai?
”Yan Hong took out a roll of paper and gave it to Li Min: "I asked her the same too, she said that she can pass the exam next year anyway, and she can't make an exception this year."
I asked Officer Lu from the Medical Office to get last year's exam questions and show them to you. ”"Will Officer Lu give you this?""
His sister's sister-in-law just had a cesarean section.Su Ying and I did it. ”…… Li Min gave a thumbs up: "You luck!"
I found that Xie Xun and Dr.
Liu had a good relationship with him. ”"Su Ying said that they were middle school classmates.""
No wonder.Hey, this question is so simple?
That's right, I was promoted to the intermediate level last year. ”Li Min saw the back and turned it over and looked up.Yan Hong answered lightly, with some disdain in her tone: "Just like this, nearly half of them have failed." ”"Oh my God.We also started learning English in '78 or '79.Even if they start learning English late, they will have to take the English test from the beginning of the year, and it will definitely be more than five years until last year, right?
This, this is not much worse than the difficulty of our high school entrance examination English.Well, there are a few more technical words, and they are definitely not out of the scope of the third volume of medical English. ”"yes.So Liu Na said that she wanted to accompany Gong Hai to review, and I was embarrassed to persuade her to take the exam. ”"Gong Hai has only graduated for three years.The year they took the college entrance examination, the year of which their English was already a 100-point system. ”"He studied Japanese in middle school.I didn't change it until I was in college. ”Li Min nodded sympathetically, "That's about the same as Pan Zhi, there is no foundation in middle school."
But Gong Hai knew that he should enter the intermediate level, and he should be prepared for the foreign language exam. ”Yan Hong was noncommittal, and Li Min didn't say anything more on this topic.The two of them still read the third and fourth volumes of medical English for two nights in a row, and it is always good to be prepared.* Li Min and Yan Hong were lucky enough to be assigned to the examination room of the experimental primary school, while Leng Xiaofeng and Gong Hai were in another examination room outside the three stations.Several people left the dormitory together and broke up at the bus stop, Li Min and Yan Hong said to Xiaofeng and Gong Hai: "Come on!"
”"Come on."
The two of them followed the instructions in front of the elementary school to find the examination room, and found that there were already about twenty people inside, talking loudly to each other, and noisy as if they were boiling a pot.Li Min withdrew."
Rainbow, let's go in again later, it's too noisy.""
Okay."
The two of them stood at the door of the examination room and watched the endless stream of people coming in for the exam at the school gate."
You say, how many people are going to go to the intermediate level this year.""
There are only 20 examination rooms in this examination room, and there are 600 people to fill it.There are several test centers in one district. ”"There are definitely other majors.Our provincial institute is not small, and there are less than 100 people taking the exam this year.For those who want to enter the intermediate level in all the hospitals in the provincial capital, it is definitely enough to have an examination position in one district. ”"Your analysis makes a lot of sense."
The two of them stood at the door of the classroom and talked nonsense until the invigilator came over with the test paper to remind them."
Which exam room are you two from, it's time to go in for the exam."
The two of them hurriedly walked into the classroom, and only then did they find their place, and before they could sit down, the bell rang for the first time.The invigilator placed the paper on the podium and began to speak to the candidates below."
Before the second bell rings, you put items that don't meet the exam requirements on the podium.Violators will be treated as cheating.Dictionaries, admission tickets, and pens can be kept on everyone's desktop.Anything else should not be kept. ”Another teacher cooperated: "Please move faster, comrades, send your backpacks to the podium early, and let's hand out rolls of paper early."
There is 10 minutes between the first ringing and the second ringing. ”Li Min sat in the back, she slowly took the Oxford English-Chinese dictionary out of her school bag, two pens and a pencil with an eraser, and opened the first page of the dictionary to hold her admission ticket.She smiled at her picture and prepared to zip up her bag.The person in the back seat of her stood up and looked at her admission ticket and asked, "Are you the female doctor from the provincial hospital's surgery?"
”"Huh?
Be.You know me?
”The woman walked to Li Min's desk to block Li Min's way out, and continued to ask her: "I heard your classmates mention you, saying that you graduated from medical university last year and went to the provincial hospital for surgery?"
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”Li Min nodded."
You're going to take the exam this year!
Alas, I've taken the exam several times.It's been almost 20 years since I graduated.Where did you learn these ABCs when you were in school?
I am a midwife in the Sixth Municipal Hospital, you can see my admission ticket. ”Li Min looked up and down, and she handed the admission ticket in front of her."
You can finish answering in a moment, can you put it aside?
I haven't passed the exam for several years, and if I hadn't entered the intermediate retirement level and my salary was 5% higher, I wouldn't have tortured myself year after year. ”Li Min was stunned and didn't know what to say."1 thousand.How is it?
”"Comrades, hurry up, you, that lesbian, you two don't talk anymore, if you have anything to say, you will talk after the test.""
I'll help you carry your bag to the front."
The woman, who was about forty years old, straddled her own school bag, showed Li Min the contents of the envelope she was holding in her hand, and stood at Li Min's table and stretched out her hand."
Thank you."
Li Min handed her the bag and watched as she stuffed the envelope into her bag and zipped it up.
*In Li Min's opinion, the difficulty of the exam questions is naturally not much different from last year.But when the results come out, according to Gong Hai's words, it will still be more difficult than last year."
I was negligent last year, and I was a little bit closer.If Nana hadn't helped me revise early this year, I might have been a little bit worse this year. ”"You took the exam last year, do you want to make an exception?""
Where!
I know it myself.I went to the test in advance to see the difficulty of the questions.If you can't get over last year, won't you have this year?
Otherwise, it's all pressed this time, in case you can't get by, wouldn't you be able to declare the intermediate level this year.I look at the report card, you all have more than 90 points, it's amazing!
”"Nana didn't take the test, otherwise she would have scored more than ninety points."
Gong Hai silently snorted and said curtly: "I persuaded her to take the exam together." ”Liu Na said nonchalantly: "I asked, the provincial department does not approve of the cancellation of the training by our provincial hospital."
I'm not sure you'll be promoted next year, so it's just right for me to take the foreign language test next year.Otherwise, the test results are valid for two years, and I will have to take the test again the year after I am promoted to the chief doctor. ”Li Min looked at Yan Hong and then at Leng Xiaofeng, and everyone was poured cold water on Liu Na's words.Will it be an empty rejoicing?
※※※※※※※※※※※※※※※※※※※※ * Chronic disease patients who have been bedridden for a long time, people who are very sharpened caregivers.A little negligent, just ...... ** digression, it was said that there was no filial son before the bed of a long illness, but the age when the old man was sick happened to be the young and middle-aged stage when his children wanted to fight for their careers.In the vast majority of families where it is difficult to hire a professional caregiver, they still rely on their spouses and children to take care of each other.Therefore, when you can run and jump, you should be a little better to people () The distance is a little far