The little couple was in love, laughing and laughing, Li Min attacked Mu Jie and played defensively for a while, Li Min was tired and sweaty and went to take a bath, and Mu Jie went to serve ginger soup.When Li Min came back wrapped in a nightgown, he found that Mu Jie was still holding the diagnostic book."
General Mu, have you memorized this book?""
Almost.You burn your feet. ”Mu Jie closed the book and pushed it to Li Mindao: "Are you going to take the test?"
”"Let's talk about the plate test, what is the plate test, and what does it mean?"
Mu Jie thought for a moment and said, "As the name suggests, it is to let the examinee walk around on a movable tablet, which is used to screen patients with myocardial ischemia and early coronary heart disease. ”As he spoke, Mu Jie went to the bathroom and brought the footbasin over, and poured all the ginger soup boiled in the thermos bucket into it."
Try it, see if the temperature is right?
Would you like to mix some hot water again?
”"No, it's hot.Mu Jie also thinks that this ginger soup is better than simple hot water.I don't feel that cold these days. ”"yes, the most obvious is your ass.It used to be like a block of ice. ”"What do you say?
Do you dare to dislike me?
”Li Min was immediately upset."
No, no, no.I will dislike you, if you don't dislike me, I will burn high incense.Minmin, I mean, why don't you wear cotton pants in winter?
The 39 days in the Northeast are no joke in the end. ”"It's not nice to be bulky."
Li Min shook his head and said that this matter was not discussed."
Who do you want to see?"
Mu Jie's face is "let those who want to see it." ”Li Min smiled and was not afraid of Mu Jie's face."
You can't move in cotton pants, the temperature in the operating room is 23 °, and you sweat when you change clothes back and forth, and you can easily catch a cold when you go to the corridor to blow the cold wind again.""
Really?""
Of course.You see, my senior sister, Director Liu, is not wearing cotton pants.Rainbow didn't wear it either. ”Mu Jie stiffened his face and said, "How could I notice that they are wearing cotton pants or not." ”Li Min smiled and was not afraid of him, but slowly explained: "No one in our hospital wears cotton pants and jackets."
Because the temperature of the working environment is high, it is easy to sweat when you are a little busy.You think the thin clothes and pants inside are soaked, and if you need to go to the internal medicine building from the surgical side, the wind between the two buildings is very strong, and you will catch a cold 100%. ”Mujay was silent."
Even if I went from the ward to the emergency department, I wore a cotton jacket and cotton pants, and I was sweating when I was in a hurry.In case of a cold, after so many surgeries in the ward, people are lying in bed and can't get up, and if they are infected, they may turn from a small cold to a pneumonia.That would kill you. ”"You have so many reasons."
Mu Jie wanted to see the truth from Li Min's face and eyes."
yes.When I got home, the temperature in the house was so hot that I couldn't wear wool pants. ”"That's true."
Li Min saw that there was a door, so he continued to increase the size: "It is easy to get sick when it is cold and hot, and it is even more troublesome to be blown by the wind after sweating."
My mother said that the female workers in those textile factories have a temperature of more than 25 degrees Celsius in order to facilitate delicate work such as spinning and connecting.Then they went to the nursery to feed, went to the boiler to get food, some people were greedy for convenience and did not change their clothes, or went home sweaty after work, and many people ended up with rheumatism.Rheumatism has become an occupational disease of women textile workers. ”"Then you're going to have to burn your feet every night when you get home.I will remind Xiaofang to supervise you. ”"Good.If she's done as well as you do, I'm sure I'll be hot every night. ”"I told her.Minmin," you say. ”"I always feel that Xiaofang is not as active and diligent as his sister Xiaoyan.Are you sure to use her?
”"I don't have a better candidate for the time being.Why don't I talk to her first?
Maybe when you're gone, she will have no dependence or dependence, maybe she will change.It's really not good, I'll wait for Yan Hong and her parents to come back and bring people back. ”"It's good that you have the bottom in your heart.I went back and made a list of what she should do every day, and I asked her to do it, what do you think?
”"Okay.Hey, let's not talk about that, let's continue with the plate test just now.Do you remember how?
”"Before the test, the patient is given an electrocardiogram in the supine and upright positions, and the blood pressure is measured; Design a good exercise plan; Prepare rescue drugs and paste 12 ECG monitoring leads to the patient; By adjusting the movement speed and load of the treadmill, the heart rate of the examinee reaches the expected value, and then according to the electrocardiogram comparison before, during and after exercise, the examinee is judged to have myocardial ischemia. ”"Best time to exercise?""
8-12 minutes.""
Maximum exercise heart rate hold time?""
1-2 minutes.""
What do I do when I stop exercising?""
Detect an ECG every 2 minutes.Observe for at least 6 minutes.Until ST-segment ischemia returns to normal waveform. ”"How many indications are there?"
Mu Jie hesitated for a moment, and replied while thinking: "The subject who cannot be determined after the recumbent ECG examination has a history of atypical chest pain. ”"Wrong.How many do you have?
It's not specific. ”"4 of a kind.""
What are the types of tests that are not suitable for this test?""
ECG with pre-excitation waveform, left bundle branch block, paced rhythm.""
How many contraindications?""
Ten of a kind."
Mu Jie is good at learning this time."
Add 10 points!"
Li Min praised."
Do you remember what the ten are?"
Mu Jie asked Li Min."
I'll try.The first is that acute myocardial infarction is not OK.Myocardial infarction with ventricular aneurysm is not acceptable.2.
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Unstable angina.Heart failure.Moderate to severe valvular disease, congenital heart disease.Acute or chronic serious illness.Severe high blood pressure.Acute pericarditis and myocarditis.Acute pulmonary embolism, aortic dissection.Severe aortic stenosis.There are also people who are severely disabled and unable to exercise. ”Mujay closed the diagnostics and asked, "Have you seen this recently?"
”"Well, the other day the ECG room collapsed.I almost didn't get saved.Although these ten are mostly nonsense, especially the tenth is so severely disabled that they can't exercise, and the clinical doctor is blind, so he prescribes a plate test for such a person. ”Li Min played with his fingers and continued to speak."
The editor who wrote this text is definitely copying.The goal of the plank exercise is to distinguish normal patients from occult patients with myocardial ischemia.The first one has already had myocardial ischemia to infarction, is this differential diagnosis still needed?
The second one already has angina pectoris, and there is already an unstable diagnosis, so it is easy to rescue him if he is sent to a plate to induce angina. ”"This is the reason for the rescue like the one a few days ago.Dean Chen almost ran out of breath.scolded the party a bloody dog. ”"I thought I could become a doctor by memorizing this book."
Murjay regretfully put the book aside.Li Min smiled."
Generally speaking, those who have a history of atypical angina but have a normal ECG are the best candidates for a treadmill test.If there is already a clear history of angina, even if the ECG is normal, it can be observed with harmless means such as ambulatory ECG monitoring, commonly known as "back box".Even if you do it a few more times, you don't need to risk doing this experiment. ”"How did that party deal with it?""
The bonus of the month will be deducted, suspended for three months to study, and then the exam will be lowered to one level after passing the exam.This is the usual sanction.Proper medical malpractice.There may be other punishments, but we will have to wait for the council to discuss and decide.Fortunately, in the end, people were fine.But the entire provincial academy will usher in a big exam.I don't know how many people are scolding him behind his back. ”"When will I take the exam?""
At the beginning of next month.This part of the content is tested by the whole school.The practice of working hard and hurting money.For example, the auxiliary department does not have the right to prescribe this examination, do they know that it makes sense?
The nurses in the operating room also had to take the test, and the older ones were so sad that they were about to cry.But this counts as a continuing education credit.2 points.If you didn't get 6 points last year, not only will you not get a bonus this year, but you can't be promoted to a professional title. ”"It's just a few pages, and it's enough time to memorize one page a day.""
Those who can't memorize it, if you give them ten days, they still can't memorize a page.Those people's minds are not on these things.The water is cold, I don't soak anymore. ”Mu Jie handed Li Min the foot-wiping towel and brought the footbath to his side as she wiped her feet."
You mix some hot water.""
Okay."
Mu Jie burned his feet, and Li Min began to read.She looked at it for a moment, then looked up at Muljey and asked, "What are you doing staring at me?"
Is the water cold?
”"It's fine.""
Shall I get you some hot water?"
Li Min stood up and went to the kitchen to get a kettle."
No, just burn it."
Muljay asked for a towel to wipe his feet."
Minmin, let me tell you something.""
Say, what are you doing so seriously?""
Then I have to go back to my hometown."
Muljay struggled to squeeze out the sentence."
How do you want to go back to your hometown?""
In the afternoon, my second brother called me.My dad wrote to him and said that he was going to die and that we should take our wife and children back. ”Mu Jie's expression was wooden, and his voice was flat without the slightest repetition."
Huh?
He's not retired yet. ”Li Min was surprised.After Mu Jie poured the water for washing his feet, he came back and said to Li Min, who was sitting cross-legged, "He will retire next year." ”"What's wrong?""
The last time I came home, he said he had hepatitis B around '86 and then had mild cirrhosis.Minmin, I read the corresponding part of your "Internal Medicine", from mild cirrhosis to severe cirrhosis of the liver, how many years does it generally take?
”"It's hard to say.Chronic diseases are all about personal care.If it is well maintained for ten or twenty years, there is generally no problem.However, in the case of severe cirrhosis, there are many things involved.You remember everything in the book.However, some diseases are irreversible once they occur, and human intervention can slow down the progression of the disease.But to what extent, I don't have a deep understanding of this.I'll ask the head of the gastroenterology department tomorrow.Do you have any more medical history?
”Mujay shook his head.Li Min was worried: "Just this sentence, how can you ask?"
That's still your dad's.Without a more detailed history and examination, it is not good to bring him medication back. ”"No need to ask.You don't need to bring any medicine. ”Muljay coldly refused.Li Min knew where his heart was wrong, and when he saw this, he took his hand and stroked the back of his hand.Waiting for the evil qi on Mu Jie's body to subside a little, he continued to ask, "How is his medical expenses reimbursed?"
”"He has been working for 51 years, and the school should give him 80% of 90.""
It depends on the specific unit.If they have money in the school, they will report it according to the regulations, and if they don't have money, they may delay it.It's hard to say.You can go back with some money. ”"Hmm.My second brother said that their unit had just bought a fund-raising house, and he and my eldest brother were going to give 1,000 yuan. ”Mu Jie looked at Li Min's face as he spoke.I didn't have much money in the first place, so I got married this time......
Alas!"
Then we'll give these too.Do you think it's okay?
Otherwise, it seems that the eldest brother and the second brother are not good. ”"Okay."
Mu Jie held Li Min's hand with his backhand, and there was a faint excitement in his heart.Li Min stopped, thought for a while, and then said, "You can give another 1,000 to the eldest brother and the second brother."
When I bought a fund-raising house last year, although I didn't use the help of my eldest brother and second brother in the end, we can't ignore this favor. ”"Then you don't have to.They know what my monthly allowance is.I won't take this money. ”"Mujay, that's not the way to say it.Let me tell you this, my brother's place, the eldest brother often asks him to come over for dinner.The eldest brother and sister-in-law are teachers in school, and they are jobs with no living money, so adding a young man to my brother to improve it costs more money every month.I'm not saying that I want to get food money for my brother and sister-in-law, but I don't want my eldest brother to be difficult.You see that they take care of the third child in the capital, and my parents are also relieved of the third child, right?
”"Good.Then my second brother doesn't have to give it there. ”"What is this saying?
If you don't give it to the eldest brother or the second brother, it's still given in the name of fund-raising housing, in case the sister-in-law chats with the second sister-in-law one day, we won't offend the second sister-in-law to death.There is no unevenness. ”Mu Jie exhaled deeply: "Minmin, why are you thinking so thoroughly.You should be the eldest daughter-in-law. ”"The nurses in Corey are short every day.Besides, these are family matters, so you have to be careful.My mom taught me a lot about home and everything. ”Mu Jie nodded, changed the topic and asked, "That Minmin, how did you get enough money last year?"
”"I borrowed it from Yan Hong.""
Pan Zhi's family is so rich?""
It's okay.They also worked hard to decorate, almost 16 hours a day.It's easy to say when you meet a reasonable person, but when you meet someone who is picky and likes to make a fuss, you can't say it, and it's hard to get the full amount in the end. ”"There's nothing to do well, it's smooth and effortless."
After going around in a big circle, Li Min asked Mu Jie: "When are you leaving?"
”() The distance is a bit far