After sleeping well for a few days in a row, Li Min was surprised to find that his dark circles had lightened a lot when he looked in the mirror.At the breakfast table, she proudly announced the latest beauty news, attracting Liang Gong, Mu Jie, and Xiaofang to look at her carefully.She also plucked her eyes, and turned her head back and forth to show the three people at the dinner table.Liang Gong first said: "Well, it's a lot shallower."
My daughter has become pretty, too. ”Mu Jie said: "Now Min Min is more beautiful." ”When Li Min saw her, Xiao Fang also joked: "Aunt Min has become more beautiful." ”Li Min was a little embarrassed by the three of them.But she immediately covered her mouth in horror and said, "Mom, they all say that people who conceive girls will become beautiful, don't they?"
”"Generally, yes.Is it because you don't like girls?
”Liang Gong was surprised.But there is a hint of accusing Mu Jie of wanting a boy.Li Min hurriedly said, "It's gone." ”Then she covered it up: "Anyway, Mu Yu's name can be boys and girls." ”Mu Jie also immediately expressed his attitude: "A smart and capable beautiful girl like Min Min will not be exchanged for two Tao boys." ”"What about the three?"
Li Min asked Mu Jie.Mu Jie smiled dotingly and said, "I won't change 100."
Mu Yu belongs to our family, and Tao Boy belongs to someone else's family. ”Liang Gongwan smiled, sure enough, it was a young couple, this child had a shadow, and even the name was chosen."
Mu Yu is a good name.But it's better for girls to use jade characters. ”"It's not the jade of the jewelry, it's the one with two taels added to the narrow hook of the word, which means that it is very literary."
Li Min gestured with his left hand."
It's the 'Yu' of Xun Yu in the Three Kingdoms.This word also means luxuriant and educated. ”Liang Gong followed his daughter's gesture and wrote this word in the palm of his hand, and then praised: "Well, yes, the shape of the word is beautiful, the interpretation is also beautiful, and it is not easy to duplicate the name."
You two have come up with a good name for your child. ”Li Min triumphantly glanced at Mu Jie.Mu Jie laughed and said, "I didn't participate, it was the girls in their dormitory who married."
It turned out that I wanted to call it a shower gel. ”"You guys."
Liang Gong understands that in the hearts of girls, everything must be shared with each other if they have a good time."
That shower gel is a joke.That's how Pan An's name was chosen?
”"yes.Fortunately, he is good-looking, and the longer he gets, the better he looks, otherwise he would have to change his name. ”Li Min talked about Pan An's various things while eating, "I look one thing in the morning, and I look another one when I get off work in the evening." ”"The children in the moon department are all like this, and when the moon is full, it is like two people who have just been born.I remember that Yan Hong is coming back today, right?
”"Hmm.The incision looks very good, and there is no need for infusion, so it is still more comfortable to go home than in the hospital.That Xiaofang, you can follow your sister in a moment and see if you can help out with something. ”"Good.I washed the dishes, washed the dishes and went over. ”Li Min nodded, turned to Liang Gong and said, "Mom, don't forget to buy a table today." ”"Good.When it was time to buy groceries, I bought them by the way. ”Liang Gong promised his daughter.Minmin is missing a desk in this house.It just so happens that with such a large dining table, there are few people at home who usually eat, and it is really good to use it as a desk.Then buying one of those folding tables is quite suitable.* There was no surgery scheduled on the 11th floor today, and Chen Wenqiang, Li Min and others did not look as nervous as usual after their ward rounds.But there is still one at Director Shi on the twelfth floor today.After the shift was handed over, Director Shi said: "Lao Chen, I had surgery this morning, Xiao Pan, Xiao Zheng, and Xiao He I brought to the stage, and all the interns followed you to check the ward, and Corey also had to take care of you and Xiao Li." ”"Okay."
Chen Wenqiang responded, and Li Min also nodded.Director Shi announced the adjournment of the meeting, Chen Wenqiang stood up and turned around, and immediately saw Xiao Huang yawning.He frowned and asked, "What did you do last night?"
Stuck like this early in the morning. ”Xiao Huang covered his mouth and withdrew half of his yawn.He stood up and replied, "I'll go to the ICU to see the kidney tumor surgery done yesterday." ”Chen Wenqiang's expression eased a little when he heard this, and then asked him, "How is the patient?"
”"General condition, clear consciousness, stable vital signs, blood pressure 160/88, heart rate 85.I CHANGED THE MEDICINE FOR HIM IN THE MORNING, AND THE OOZING WAS TOO MUCH, THE DRAINAGE VOLUME WAS ABOUT 25ML, AND THERE WAS NO ACTIVE BLEEDING. ”"Well, then you can check it out when you have time."
Chen Wenqiang nodded slightly and walked out.Xiao Huang saw that Chen Wenqiang didn't say anything more and walked over, and said "thank you" to Li Min, who was following behind Chen Wenqiang.Xiao Huang's actions all fell into the eyes of Dr.
Yang, and when Dr.
Yang saw that Xiao Huang was willing to go to the ICU to see the patient, his anger towards him couldn't help but ease a little.Director Shi said to Pan Zhi: "You and Xiao Zheng take the patient, and I will go to the operating room first." ”"Yes."
There were three discharges on the eleventh floor today, and Lu Qing chased them into the corridor with the medical records thrown out by Li Min, and asked, "Doctor Li, who are you giving the medicine to these patients when they are discharged?"
”"Give the nurse in charge a shift, and I'll rest in the afternoon."
The three patients had already left the hospital yesterday, and their families came to settle the bill and take out the medicine from the hospital today.Their beds have been given to new patients admitted on Thursday.The bed that will be poured out by the patient who will be discharged next Monday will be given to the person scheduled for surgery next Friday.Today is the day of the big rounds on the eleventh floor.In Chen Wenqiang's words, that is, I checked carefully on Saturday, and I can rest for a day on Sunday.But resting on Sunday with peace of mind this plan is useless for Li Min, she is on the day shift on Sunday.She specially asked for this day so that she could accompany Dean Chen's daughter to review her homework during the day on Sunday.And you don't have to sleep in Cory.After she told Director Liang the reason for being on duty, Director Liang agreed.Director Liang came forward to propose that Xie Xun and Li Min be transferred to a duty team.The reason is that such a combination can allow everyone to have a good and reassuring day off on Sunday Xie Xun has no objection to being on the day shift on Sunday, which also saves Su Ying's second-line shift from his night shift, Su Ying was asked to go to the obstetrics and gynecology department for consultation and surgery at night, so that no one at home took care of the children.The day shift on Sunday is second only to the night shift on Saturday.It belongs to the value that no one loves.Director Wang of the Department of Orthopedics had no opinion on this, and he also thoughtfully arranged Dr.
Sun, an attending physician in the Department of Orthopedics, who was full of curly hair and a classmate of Dr.
Liu, to their group.With such a combination, you can all deal with any kind of patient on Sunday.As for the night shift on Saturday, Chen Wenqiang came forward to ask for it.Leading cadres, they have to endure hardships first and enjoy them last, and the duty time that others don't like is nothing more than one less rest for the night shift, and it is not easy to arrange compensatory rest time in normal times.He didn't care about this compensatory leave.But he was very satisfied that Li Minken wanted to take her daughter Chen Hongyan to review her homework on Sunday's day shift.But then the big rounds on the 11th floor were scheduled for Saturday.
*Rounds are very detailed every Saturday.Because there are postoperative patients with medulloblastoma in the ward, Chen Wenqiang's focus on this ward round is this disease.His question now is, "Where is medulloblastoma from?"
Where is it easy to get a good place?
What is the nature of the tumor?
”Some of the eight interns still know about it."
Medulloblastoma originates from embryonic residual tissue.It is more likely to occur in the supracerebellar vermi, ""Malignant?
”"Highest."
This question knows the answer.But one student gave the most complete standard answer: "It is one of the most malignant neuroepithelial tumors in the central nervous system." ”"Classification?"
Li Min waited for a while, and when he saw that no one spoke, he had to answer: "It belongs to one of the primitive neuroectodermal tumors." ”"Pathological typing?
Prognosis?
”"Divided into Wnt, SHH, Group3, Group4.The first Wnt has the best prognosis, and the latter two have the worst prognosis. ”"What kind of intracranial tumor needs to be differentiated?"
This time, there was a jagged rush to answer: "Fourth ventricular ependymoma." ”"Brain CT?"
This time, Chen Wenqiang began to assign students to answer: "You answer." ”"CT shows slightly high-density or isodense solid masses with clear borders, and most of them are relatively homogeneous masses.The surrounding cerebellar tissue has varying degrees of low-density rings. ”On Tuesday afternoon, Li Min told them about it."
Performance on magnetic resonance?"
Chen Wenqiang asked a different student."
T1 showed an equal signal or a long signal shadow, T2 showed a hyperintense shadow, and the homogeneity of the lesion was significantly enhanced after enhancement.""
Gone?""
Hmm."
The intern was a little panicked, is this because his answer is not comprehensive enough?"
Who added?"
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Chen Wenqiang's eyes swept over the other interns, especially those who stood back and did not answer positively just now.The dodging intern and the eyes that did not dare to make contact with Chen Wenqiang made Chen Wenqiang's face begin to turn cloudy.Li Min just wanted to speak, but Dr.
Ma, who was studying for further study, replied: "Sometimes the tumor grows too fast, and there will be necrosis in the tumor.Cystic changes are seen retrospectively on the film. ”Dr.
Deng, who is studying, also added: "When the magnetic resonance is enhanced, it is more obvious than that of ependymoma. ”Chen Wenqiang was more satisfied, and then he said: "You can go back and memorize the book by yourself."
What about the clinical risk?
You come to answer, what are the high-risk ones?
”"Under three years of age; Only most of the tumor can be removed; The tumor invades the brainstem and has metastases. ”"Where will it all be shifted?
You answer. ”Chen Wenqiang has another student."
It can be transferred to the arachnoid.""
What else?"
Chen Wenqiang saw that the student was stuck, and turned to look at the other."
Lateral ventricles.""
Don't squeeze toothpaste.What else?
”Chen Wenqiang became stern, and the intern was a little scared.But someone whispered: "Third ventricle, subarachnoid space." ”"Extracentral nervous system metastases."
Li Min hurriedly added, if you wait any longer, you won't be able to finish the investigation at eleven o'clock.Then I asked about ventricular puncture and external drainage."
What does the punctured ventricle refer to?""
Two lateral ventricles.""
Puncture site, needle insertion point, depth?"
This is asking Li Min."
According to the division of the lateral ventricles, four puncture sites are generally selected.The puncture point of anterior angle puncture is 2.5 cm in front of the coronal suture and 2.5 cm next to the midline, and the puncture direction is parallel to the sagittal plane and the depth is not more than 5 cm......
Lateral puncture again......
Finally, transorbital puncture ......"
Li Min replied in detail, which are all the contents to be used in clinical treatment.Then there is the question of indications and contraindications.There are many indications, and the basic answers put together by eight students are complete, and the content is no less than the puncture point.However, the only contraindication is subdural empyema or brain abscess.Because ventricular puncture can spread the infection into the brain and there is a risk of an abscess rupturing into the ventricles, Chen Wenqiang did not harshly or make things difficult for these interns.While they were answering questions, they secretly looked through the handouts that Li Min had given them a lecture before.I sighed in my heart, this batch of students is still a little worse than the previous batch.Even Miao Yuesheng, who wanted to do neurosurgery, thought very well in his heart, but obviously couldn't work hard.During today's rounds, Chen Wenqiang focused most of his attention on medulloblastoma, from histological origin to imaging manifestations, and then treatment.The position and path of ventricular puncture and drainage and craniotomy, especially when the cranium is closed, should be tightly sutured and the dura mater should not be placed.The most important thing is to pay attention to the "nucleus" of the tumor as completely as possible during the operation, because medulloblastoma is fragile, and if the outer capsule is broken during the operation, it will cause artificial implant metastasis.As for the postoperative treatment, it is radiotherapy plus chemotherapy, Chen Wenqiang told everyone about it."
Although medulloblastoma is mildly to moderate sensitivity to radiation, postoperative radiotherapy is also an essential treatment.The scope of radiotherapy is the whole brain plus the tumor, and the whole spinal cord.Chemotherapy is given within four weeks after surgery.In short, the malignancy of this tumor makes us have to use all treatments. ”Today's rounds, because of Chen Wenqiang's questions and explanations on medulloblastoma, took up a lot of time, and when it was over, it was close to eleven o'clock.By the time the last patient was checked, everyone had the feeling of escape.But the morning work is not over, and all patients must be changed in the morning.Fortunately, the director's ward rounds can be kept until the afternoon.It's not just the students who are tired.When Li Min returned home, he said, "I hate ward rounds the most."
It's better to go for surgery. ”"Why?"
Mujay asked."
For me, it's not that it's tiring, it's annoying.Nine and a half out of ten questions I know what's going on, wasting my time. ”Liang Gong nodded at his daughter and said, "Don't your tail when you know."
All your life, I hope that all the people you meet every day are you. ”"Learn from the past."
Mu Jie comforted Li Min like this.※※※※※※※※※※※※※※※※※※※※ all your life, I hope that all you encounter every day is your tongue twister, don't you?
But this is definitely what most doctors want, and what all patients hope for, () the distance is a bit far