medical treatment

At nearly ten o'clock in the evening, Yu Zhiming carried a bamboo basket and Gu Qingning returned to Zijinyuan's rental apartment with a pot-bellied casserole in his arms.

Yu Xiangwan, who was at home, hurriedly got up to greet her, and took the casserole from Gu Qingning's arms.

"It's heavy, what's in it?"

"Return gift?"

Gu Qingning giggled and said, "Sister, this is Buddha jumping over the wall."

"All the ingredients inside have been processed. Tomorrow, it will be simmered for ten hours on a low fire, and it will be ready to eat."

Yu Zhiming showed the things in the bamboo basket to the fourth sister, and introduced: "This is tripe mushroom, morel mushroom, chicken fir mushroom, Hericium erinaceus, all of which are relatively valuable fungi."

"Tomorrow night, let Zhang Bai cook it and eat it."

Yu Xiangwan hummed, and asked loudly while carefully placing the big belly casserole and the fungi in the bamboo basket.

"Qing Ning, are your parents satisfied with Lao Wu?"

Gu Qingning replied with a smile: "Sister, my parents are very satisfied. They also said that in addition to the normal dowry, they need to add a big house of more than 200 square meters."

Yu Xiangwan smiled happily and said, "As long as you are satisfied."

"After the Spring Festival, when my parents and eldest sister come to Binhai, we can sit down and discuss your marriage."

Yu Zhiming reminded: "Sister, you are ahead of me, your marriage with Zhang Bai is a higher priority."

Yu Xiangwan smiled and said, "Zhang Bo and I are not in a hurry, we have to pass Zhang Bai's mother's anniversary anyway."

"Fifth, you are shouldering the important task of carrying on the family line of Yu's family. My parents have been anxious for several years."

This made Yu Zhiming depressed.

At first, I was urging to find a girlfriend.

Now that I have found my girlfriend, I will definitely be urging the marriage.

The next step is to give birth to a child.

One was born, and then the second was born...

Yu Zhiming suddenly had a headache, and involuntarily aimed at Qing Ning's belly.

"Qing Ning, didn't you say you want to have three children? It's a one-off solution, how about having three children..."

At nearly [-]:[-] the next morning, Yu Zhiming rushed to the central building of the hospital with some backache and leg pain.

He found that Zhou Mo had arrived one step earlier.

"Zhou Mo, I came earlier because I had to go to the ward area first, so you don't have to come so early."

Zhou Mo rolled his eyelids and said, "How dare the little assistant come to work later than the boss? Is this because you want to be fired because your left foot advanced into the office?"

"Doctor Yu, only if you don't roll yourself first, can my little assistant dare to relax."

Yu Zhiming also rolled his eyelids, and took the A4 paper that this guy handed over.

Above are the detailed addresses of the families of those leaders and colleagues on Yu Zhiming's annual gift list.

Zhou Mo also carefully marked the people who live in the same community, or those who live relatively close.

Not only that, Zhou Mo also marked the addresses of these people on the city map printed on the back of the paper.

"Good job, hard work."

Yu Zhiming praised him, took out a somewhat thick red envelope from the briefcase, and handed it to Zhou Mo.

"Today is the day for salary and year-end bonus. As your boss, I should be more or less concerned."

Zhou Mo took the red envelope, opened it, and found that it was [-] in cash, and immediately smiled.

"Boss Yu, thank you for your generosity."

"I promise, I will do my assistant job wholeheartedly, so that you will be less tired."

After a short pause, Zhou Mo introduced again: "Doctor Yu, today only the salary is paid. According to the hospital's practice, the year-end bonus will not be paid until around NO.15."

Yu Zhiming let out an oh, and took out a thinner red envelope from the briefcase.

"This belongs to Qiao Lei, you can give it to him for me."

Zhou Mo took the red envelope and nodded.

After Yu Zhiming changed into his white coat and got ready for work, he suddenly remembered that there was one more thing he forgot to ask.

"Hey, Zhou Mo, yesterday your green plum..."

Seeing Zhou Mo's eyes widen, Yu Zhiming immediately changed his words: "Yesterday, the teacher and his ex-wife held a gathering of relatives and friends for Qi Zhen's return to China. Is there any news?"

"For example, showing love on the spot or something?"

Zhou Mo let out a long breath and said, "You really confessed your love to me, and even knelt down on one leg to give me the ring..."

Yu Zhiming glanced deliberately, but didn't see the ring on her finger.

"Refused?"

Zhou Mo nodded, and said distressedly: "The situation at that time was a bit chaotic. For some reason, my mind just twitched, and I said that I don't like men."

"What do you mean?" Yu Zhiming didn't react for a while.

"It means that I publicly declare in front of dozens of people that I don't like men, but women."

Zhou Mo lamented again: "Doctor Yu, it's all your fault."

"After you proposed the bad idea of ​​finding a boyfriend with an abnormal orientation to marry, I have been thinking about the feasibility for the past few days."

"I didn't expect that when I was nervous and my brain twitched, I made myself into an abnormal orientation."

"I'm sick!"

Yu Zhiming was serious, and said with a serious face: "Zhou Mo, have you ever thought that maybe this is not a twitch of your brain, but a true expression of your heart?"

The knuckles of Zhou Mo's right hand snapped, and he asked with cold eyes: "Doctor Yu, I didn't hear what you said just now, can you say it again?"

Yu Zhiming took a step back and said, "I just said that if you pinch your joints like this, it may cause joint damage."

He retreated towards the door while talking, and then said "I'm going to the ward for rounds", then turned and ran away...

Although there is no need for outpatient consultations today, Yu Zhiming is still busy. It was not until nearly [-]:[-] in the morning that he had free time to check his salary.

Today is the [-]th of January, and yesterday was Sunday, so the payment of wages is postponed until today.

He first took out his mobile phone and read two text messages from the bank.

The latest one said that the transfer income was more than 21 yuan, which was his income in Ning'an Hospital last month.

The second bank text message stated that the transfer income was more than 2707 million, which was the income of Huashan Hospital last month.

This number is within Yu Zhiming's estimate.

Last month, 210 million for the women's club in Beijing, 100 million for movie star Zhao Zhiwen, 45 for Qing Ning's cousin and uncle, and 30 for the two physical examinations organized by the Health Bureau.

In addition to these, plus Yu Zhiming's daily work income at Huashan Hospital, project allowances, talent allowances, etc., the total income should be 40 million.

After deducting personal tax, hospital financial expenses, insurance, provident fund and other expenses, the actual income was 270 million, which set a new record for Yu Zhiming's income.

Yu Zhiming took out his tablet computer and wanted to check the details of last month's income, when he heard footsteps and the sound of a wheelchair approaching.

Looking up, I saw Dr. Xiong Jing, and a man in a wheelchair pushed by a middle-aged woman who was sucking oxygen, appeared at the door of the big office.

"Doctor Yu..."

Dr. Xiong walked two steps quickly, and said with a look of shame, "I was the one who disturbed you yesterday. I was in a hurry and forgot that it was your rare rest time."

Yu Zhiming replied politely: "Doctor Xiong, you don't need to apologize, you are a doctor's parent, I can understand."

"Let's check the patient's body first..."

The 47-year-old patient had a successful heart transplant three years ago because of severe heart failure.

Dr. Xiong said that within a week, the patient's heart function declined significantly.

Today, it is less than half of the original.

This is, heart failure occurred again.

A few minutes later, in the examination room, Yu Zhiming started to examine the patient with swollen lower limbs who was not able to walk, and found that his right ventricle had a little hypertrophy.

At the same time, Yu Zhiming also felt the weakness of the heart, especially the right ventricle.

He clearly felt that the blood pumping pressure of the right ventricle was much higher than that of the left ventricle.

Is this heart failure caused by pulmonary hypertension?

With this question in mind, Yu Zhiming made a detailed exploration of the lungs along the patient's pulmonary artery.

Unsurprisingly, he found that compared with other parts, the blood circulation in the patient's lungs was a bit slow, and the blood vessels were slightly swollen.

There were indeed signs of pulmonary hypertension.

Yu Zhiming did a quick check on other body parts of the patient, and found symptoms such as liver and kidney damage, splenomegaly, and gastrointestinal bleeding.

Next, Yu Zhiming communicated his findings with Dr. Xiong Jing and the patients.

"Heart failure from pulmonary hypertension?"

The patient didn't understand very much, and said out of breath: "Since the heart transplant, I have stopped working and focused on recuperating and recovering my body."

"In May, Dr. Xiong, I had a heart and physical examination, and you said that my body is very good, just like a young boy."

"Do you remember?"

Xiong Jing nodded and said, "Of course I remember."

"So, I'm surprised that you came to me this time with such a bad heart."

"It's only been half a year."

The patient said bitterly: "In the past six months, I didn't do anything else, just look at the scenery in Dali, take a walk, and take care of my body as before."

Dali? !
pulmonary hypertension!
Yu Zhiming asked, "Is it the Dali plateau area?"

Hearing this, Xiong Jing hurriedly took out his mobile phone to check, and then he was speechless.

The altitude of Dali is mostly at 3000 meters.

For ordinary people, this height will not feel any discomfort, but for heart disease patients, it is a height that may cause altitude sickness.

If it is a short-term trip, there is no major problem, but the patient has been in Dali for half a year.

Although the patient feels no discomfort, long-term chronic hypoxia keeps the pulmonary arterioles in a state of contraction for a long time, which can cause hypertrophy of the smooth muscle in the media of the pulmonary vessels, hardening of the arteries, and stable pulmonary hypertension.

Pulmonary hypertension increases resistance to right ventricular ejection.

In addition, hypoxia-induced erythrocytosis increases blood viscosity and increases pulmonary circulatory resistance.

This leads to the patient's right ventricle having to do more work to satisfy the pulmonary circulation, which causes some changes in the structure of the right ventricle, and symptoms of hypertrophy appear.

But this is not a long-term solution. The compensatory ability of the heart is limited. After a certain limit is exceeded, the structure and function of the myocardium will lose its compensatory ability, which will lead to heart failure.

What's more, the patient's heart was originally transplanted, so it was very delicate and needed to be taken care of carefully.

After listening to Dr. Xiong's detailed explanation, the patient was dumbfounded.

"I deliberately chose a tourist destination with good scenery and suitable climate to take care of my body, but it ended up hurting myself?"

"Doctor Xiong, in my situation, is there any help?"

Xiong Jing glanced at Yu Zhiming first, then looked at the patient, and said in a deep thought: "Heart transplantation, heart failure, and liver and kidney damage, how to use medicine is a troublesome matter."

"All I can say is, do your best..."

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