There are even many 60-year-olds who insist on exercising and have better physical fitness than 30-year-old boys.
"This is an old problem of mine. I have been coughing for almost 30 years. At first it was just a cough with a lot of phlegm, and then I became short of breath. I am a rather impatient person. When I was teaching students, I saw that they were disobedient and would not listen. I study hard and get angry if I don’t finish my homework well. When I get angry, my cough becomes more serious, cough cough..."
After the man finished speaking, he started coughing violently again.
Unexpectedly, this man is also a teacher, no wonder he has a unique temperament.
It gives people a clean, tidy and serious feeling.
"Have you been to the hospital for a checkup?"
"I've seen it, and it says it can't be cured. I can only take some medicine to control it."
"Is there any illness?"
"It's because my lungs are not in good condition. I also heard people say that you have good technology and high medical ethics, so I wanted to come over and get some medicine to try. I used to go to designated hospitals to get medicine."
The man is a teacher, so he must have medical insurance.
Moreover, he is at least fifty-seven or eighteen years old, and his medical insurance payments have probably exceeded 25 years, so he can already enjoy lifelong medical insurance.
Now I go to Li Jingsheng’s small clinic to buy medicine. I haven’t yet qualified for designated medical insurance here!
Patients can only pay out of pocket.
"It's okay if I prescribe some medicine for you, but the medical treatment in our clinic is not reimbursed by medical insurance. Can you accept that?"
"If it's not a lot of money, it'll be fine. If it's too expensive, I'll just go to the hospital to get it. Ahem..."
Men can't talk too much.
He coughs violently when he talks too much.
"Do you usually smoke?"
"do not smoke."
"Do you have chest pain, coughing up blood, chills or other symptoms?"
"No, I just feel out of breath and have to inhale very hard."
The man's breathing had been rapid since he came in.
"Okay, let me listen to your heart and lung sounds first, and then take your blood pressure and temperature."
After measurement, the man's body temperature was normal and his respiratory rate was 19 times/minute.
The breath sounds in the lungs are rough, but there are no obvious wet and dry rales.
Heart sounds are also fairly normal.
My blood pressure is a little high, but it's not bad.
The man himself is thin, with an obvious barrel chest, and the gap between his ribs is wider than normal.
After Li Jingsheng measured the man, he was initially diagnosed with chronic bronchitis.
Old chronic bronchitis is very common clinically.
This is a stubborn disease that is difficult to cure and can easily relapse.
His small clinic was unable to perform blood gas analysis on the patient. After comprehensive diagnosis, he believed that the man's condition was not serious and he was capable of treating it.
The patient's main symptoms are shortness of breath and shortness of breath.
It should be chronic bronchitis, so treat it accordingly.
The man was coughing and spitting.
Very qualified, wrap it in a tissue.
Li Jingsheng saw that the phlegm was yellow and sticky.
Strangely, it was also mixed with serous frothy sputum.
It doesn’t seem to be an ordinary old slow-brained behavior!
Thinking of the patient's body temperature being normal, the lung sounds in both lungs were quite normal except for heavy breathing.
An increase in body temperature may occur during an acute episode of bronchitis.
"Let me listen to your lung sounds again!"
After feeling that it didn't look like bronchitis, Li Jingsheng decided to check it out more carefully.
This time, he listened especially carefully to the lung sounds.
"The lung sounds are very peculiar. They gradually become thicker. This is somewhat different from the lung sounds of bronchitis."
If it’s not bronchitis, what disease is it?
Li Jingsheng was worried about misdiagnosis, so he immediately became extremely cautious.
After all, his small clinic had just been troubled by patients.
His in-breath diagnosis is currently at the proficient level.
It is sufficient to diagnose most respiratory diseases.
However, when encountering some cases that are difficult to detect or obscure, and the clinic itself lacks various auxiliary examination methods, his proficiency in in-breath diagnosis is obviously insufficient.
There are still 402 health points left, which is more than enough to upgrade the in-call diagnosis.
This diagnostic technique is used almost every day, and is used very frequently.
Upgrade early and benefit early.
Based on this idea, Li Jingsheng began to spend money.
Directly upgraded the in-call diagnosis to Xiaocheng level.
Respiratory medicine minor 500/1000.
Diagnosis and treatment within the body has always been Li Jingsheng's specialty and the medical skill he is best at.
Many other medical skills have overtaken it with the help of the attribute panel, leaving it behind.
Even the diagnosis of gastrointestinal medicine has long been promoted to the level of minor success.
At this moment, it finally caught up again.
His health points have been almost wiped out again, with only 24 points left.
Feeling that the upgraded Hunei Diagnosis was extremely powerful, he felt that it was worth spending more health points.
Try to re-diagnose this patient using a small-scale in-breath diagnosis.
"Wow, it's so powerful! It can actually measure the nasal mucosa, the amount, concentration, and color of sputum, as well as the roughness and shortness of breath sounds, etc."
During the diagnosis, Li Jingsheng felt how good the in-breath diagnosis was at Xiaocheng level. Once a symptom appeared, multiple diseases consistent with the symptom would immediately pop up in his mind.
Even like a computer, it can filter automatically.
Rank those diseases that have a higher probability and are consistent in all aspects.
"When did you start feeling short of breath?"
"It started to get worse suddenly yesterday."
"Was it like this when you got sick before?"
"Yes, almost. It seems to be a little more serious this time."
After all, the patient is a teacher and is highly cooperative with Li Jingsheng’s consultation.
"The onset should be relatively acute, and the condition is still getting worse rapidly. The main symptoms are heavy breathing and shortness of breath. If it's not bronchitis, what kind of disease could it be?"
He racked his brains to diagnose the cause of the patient's illness.
A disease name that was highly consistent with these symptoms and course of the disease appeared in his mind.
COPD.
This is a name for a disease that causes extreme pain to many patients who suffer from it.
It is not a terminal disease in itself, but once it is acquired it is very difficult to reverse.
Just like cirrhosis and kidney failure, once started, it cannot be reversed.
There is no cure for this disease.
Only drugs and other treatments can be used to alleviate the condition. Such as oxygen.
If the condition is not treated in time after the onset of the disease, the condition will rapidly worsen, and the patient may even die directly in his dream.
Also, people with COPD cannot do strenuous exercise.
Cannot engage in heavy physical labor.
It will have a great impact on life.
The patient also said that after an examination at a large hospital, the doctor told him that there was something wrong with his lungs.
Li Jingsheng's eyes became bright and confident.
It must be this disease.
The symptoms and course of the disease are highly consistent in many aspects.
Now I finally understand why when the patient spits out yellow sticky sputum, it is also mixed with serous foamy sputum.
"Doctor, have you found out what the disease is?"
The patient seemed very patient.
At this moment, seeing that Li Jingsheng seemed to have a diagnosis, he asked.
"Your disease is highly similar to chronic pulmonary obstruction."
Li Jingsheng replied.
There was a clear hint of appreciation in the patient's expression.
"Now that I've been found out, please give me medicine!"
"OK."
Li Jingsheng calmly began to prescribe medicine to the patient.
Xiaocheng-level drug efficacy and drug metabolism are enough for him to prescribe easily.
Patients are receiving long-term medication in other hospitals, so when prescribing, they must consider avoiding some long-term medications.
Drug resistance can significantly reduce efficacy.
His mind quickly made a judgment: bronchodilators dilate and relax the airways, and glucocorticoids increase exercise tolerance and reduce the probability of acute exacerbations.
Expectorants promote the elimination of phlegm and reduce the chance of recurring exacerbations of the disease.
Antibiotics prevent infection.
Treat symptomatically from four aspects. After the patient takes the medicine, the curative effect should not be bad.
There are three types of bronchodilators commonly used in clinical practice, and beta2 receptor agonists should be the most commonly used type.
He decided to bypass this category and try a cholinergic receptor blocker, ultimately choosing tiotropium.
In fact, aminophylline can also be used, but considering the patient's poor physical condition and older age, his small clinic cannot bear the responsibility if something goes wrong.
…
Finally, Li Jingsheng prescribed prescriptions to the patients, some of which required oral administration or aerosol inhalation, and some required intravenous infusion.
This patient has just been treated here, and a new patient has arrived.
Li Jingsheng was happy to find that the small clinic had become busy again.
If it is reported to the media and successfully put on TV, it is not impossible that the small clinic will be overcrowded.
He was both nervous and looking forward to going on the TV station.
First of all, it is definitely a good thing to be on TV. But if it provokes the nerves of a certain big shot in this area, it's no joke.
I don’t even know how to close the door.
Boss Zhao had told him mysteriously that day that in this area in the south of the city, whether it was a small clinic or a grassroots medical institution, it was best not to try to expand it.
It's just that some things are beyond Li Jingsheng's control at all.
For example, if he goes to a TV station, will reporters listen to him?
Everyone works for their own interests and cannot possibly care about others.
After working until almost seven o'clock, Li Jingsheng finally took care of all the patients in his hands.
The patient with chronic obstructive pulmonary disease has achieved curative effect after taking the medicine.
When I left, I was quite satisfied.
He gave a thumbs up and praised Li Jingsheng for his ability and for treating him well.
Li Jingsheng also successfully earned 61 health points from this patient.
Successfully diagnosed with COPD, 50 health points should have been awarded.
Then when the patient leaves, he will give a positive review and an additional 10 points will be awarded.
The remaining 1 point is earned by diagnosis.
When the patient is cured in a few days, he can gain 1 more health point.
The income is quite good.
One such patient can outperform dozens of ordinary patients.
Li Jingsheng also experienced how good the intra-respiratory diagnosis, drug efficacy, and drug metabolism are at the Xiaocheng level.
None of the patients who came this afternoon were pushed away.
All done.
And he himself could predict that the curative effect of these patients would be very good.
I believe that at least most of them will become his repeat customers or introduce their relatives and friends to come for treatment.
It has been a while since Brother Qiu last took away his clinic materials, but there has been no movement.
It would be even more perfect if we could enter the centralized purchasing platform.
Because although his current level of prescription medicine is very good, it is difficult for a clever woman to make a meal without rice. There are many medicines that are simply not available in clinics and pharmacies. This is a big problem.
In addition, there is a huge benefit of joining the centralized purchasing platform. You can automatically obtain the extremely difficult medical insurance qualifications.
When the time comes, if you have both, the rise of the small clinic will be much smoother.
"Brother Li!"
A fat head poked out of the door, it was Boss Zhao.
I haven’t seen Boss Zhao coming over for several days.
After the Sunshine Clinic was disturbed by patients, customers did not dare to come in and all went to Kuai Kang Clinic.
Boss Zhao is probably having a pretty good life these days.
"I haven't seen you, Boss Zhao, for a few days. The business of your clinic must be very good these days!"
Li Jingsheng walked out consciously.
Regardless of whether they like it or not, everyone is working on this street to make ends meet, so they must maintain a harmonious appearance.
As long as Boss Zhao doesn't do anything dirty to Sunshine Clinic, he's pretty good.
With Boss Zhao on this street, it is estimated that it will be very difficult for new competitors to squeeze in.
Even the grand ostentation of Fredo's Drug Store suddenly became cold overnight.
That internet celebrity might even want to die.
If I had a choice, I would probably never come back to Chengnan Old Street, a land of tigers and wolves.
"Hey, compared to Brother Li, it's far behind!"
"Boss Zhao, please don't make fun of me. It's not like you don't know. I was harassed by a patient a few days ago and couldn't be more cold. Those patients and customers all went to your Kuai Kang Clinic. I know this. of."
Li Jingsheng looked miserable.
In front of competitors, you must suffer miserably.
Just make a fortune silently.
"Humph, two days earlier, that's really what I thought. I ran over and stood outside the door for almost two hours just now. I saw that you were busy so I didn't call you. I counted, you two I diagnosed and treated seven patients within an hour, and the success rate was 100%. By the way, your medical skills seem to have improved a lot recently? I heard that you now go to the second hospital from Monday to Friday for further training. You can do it. You can make money by training and opening a clinic. , both correct."
Boss Zhao said sourly.
Sure enough, there is nothing that can be hidden from Boss Zhao.
This old boy stares at others all day long.
He knows exactly which pharmacy is doing well and which clinic is doing well.
Then again, Li Jingsheng often stared at other competitors before.
"Who said that? I just run errands, do odd jobs, and study! It's not like you don't know, how can a big hospital treat our clinic doctors as human beings? We treat them as slaves, and they think it is a gift to us. "
Li Jingsheng will definitely not tell the truth.
Unless he's stupid, that's pretty much it.
"It's true that big hospitals are arrogant. But I believe that people can't afford to stay early if there is no benefit. If there is no big benefit, can you leave the clinic alone every day and go to the second hospital?"
Boss Zhao was dubious about his words.
It seems unclear why Li Jingsheng went to the Second Hospital.
This also means that Xiao Gao did not eat anything.
Just now, Li Jingsheng really suspected that Xiao Gao had leaked the information to Boss Zhao.
Now it seems that I am too worried.
But think about it, Xiao Gao’s salary at Sunshine Clinic last month was 11,752 yuan. A little less than Tang Ping, but already very impressive.
After all, he hasn't been in the job for long.
Selling health medicines, Tang Ping's daily sales were not low when he was not here.
Also, Tang Ping's basic salary is one thousand higher than him.
And this month, his salary is likely to exceed that of Tang Ping.
"In the past two hours, I saw that Xiao Gao sold a total of 12 health medicines and tonics. Why didn't I realize that Xiao Gao had such a good sales talent?"
Boss Zhao would be wasting his talent if he didn't become an agent.
Standing outside the Sunshine Clinic for two hours was just two hours of staring.
He knows exactly what kind of business Sunshine Clinic does.
"Aren't there sales talents everywhere? Boss Zhao has a wide network of contacts. If he wants to recruit talents for selling drugs, won't that be solved in a matter of minutes? Don't think about poaching Xiao Gao back again!"
Li Jingsheng greeted him.
"I want to dig but I can't. Xiao Gao is just a fool."
Boss Zhao realized that he had let something slip and immediately stopped.
"Have you really poached him? You are like Brother Li. You say that I am your savior, but secretly poach my sales leaders. This is not authentic!"
Li Jingsheng immediately blamed him after hearing this.
"Ahem...I'm just trying it out to help you test the loyalty of the employees. How can I really dig it out!"
Boss Zhao quickly took the message and took it over.
"Brother Li, I really underestimated you before. That man made a big fuss in your clinic that day, and I was worried about you, thinking that Sunshine Clinic was going to suffer. Unexpectedly, it was you who used an unparalleled trick. After a few days, a good show of apology was staged, which gave your clinic a lot of popularity and image. Did you know? Now, out of ten people in this area, at least eight people praise your Sunshine Clinic for its excellent medical ethics.
I went to eat noodles in the morning and someone praised Sunshine Clinic. When I went to a restaurant for lunch, someone still praised Sunshine Clinic. Even when I go to the supermarket to buy things, I still hear compliments on you.
Brother Li played this trick really well. "
The sourness was about to overflow from Boss Zhao's face.
The words said out loud are more sour than the green bayberry.
"Really? Why can't I hear it?"
Li Jingsheng would naturally not admit it.
Even if Boss Zhao's statement is a bit exaggerated, it shouldn't be too far from the truth.
The crisis at Sunshine Clinic has indeed turned into business opportunities and vitality.
After the Kuang family published their apology in the newspaper, the benefits to Sunshine Clinic became even greater.
Today's report, the effect is not that fast.
It is estimated that Sunshine Clinic will definitely win a small peak in the next few days.
"Brother Li has learned how to be cool now! Come on, I won't argue with you on this matter. It's your ability to be able to stir up the popularity of Sunshine Clinic in this way. I heard that you won the award for courageous service today. This is another thing. It’s a good sign! Why do I feel like I’m always making wedding dresses for you?”
Boss Zhao complained.
Li Jingsheng's eyes narrowed slightly, "Old Zhao has fallen short of his standard today," and this made it clear again.
The reward for being brave is to make a wedding dress for Li Jingsheng. What does this mean?
Isn't it equivalent to indirectly admitting that the incident at Fredo Drug Store was caused by Boss Zhao?
"Boss Zhao made me a wedding dress? That's a bit interesting!"
Li Jingsheng said with a profound smile.
"Ahem... I just said it casually. Brother, don't call me Boss Zhao anymore. Call me Lao Zhao or brother. We will definitely be die-hard allies on this street from now on. Wait for me I can’t work any more. I’ve retired and my son has taken over the family business. I’m afraid I’ll have to take more care of you in the future!”
Boss Zhao thinks really far.
But it also shows that he has truly accepted Li Jingsheng's rise and existence from his heart, and has made plans to share the world equally with Li Jingsheng.
Realizing that he had slipped up twice, Boss Zhao did not dare to talk any more.
Too much talk is too much to say. If Li Jingsheng knew about some bosses, wouldn't that be a way of giving others a handle?
Boss Zhao will not trust anyone.
"I almost forgot about business. I came here to send a message. Are you free tonight? How about having a meal at the Judong Building? Someone wants to meet you."
Boss Zhao quickly got down to business.
"Who is it? No one wants to see a little shrimp like me, right?"
Li Jingsheng asked curiously.
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(End of chapter)
