Chapter 296: : This is what Teacher Chen said!

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"I'm telling you, Chen Cang talked really well. I've heard others talk about thoracentesis before, but it's far worse than Chen Cang!"
"The key is to look handsome!"
"Really so exaggerated?"
"It's more exaggerated than this. We asked about a dozen or 20 people yesterday, but we didn't ask others, they would do anything! I think Chen Cang is a must when talking about thoracentesis!"
"I'm obedient, Chen Cang isn't there yet!"
"I am the establishment of the Second Provincial Hospital. I am now sent to graduate school. He looks handsome, the unit is good, and the people are good. Come on!"
...
Several young girls who talked to each other were very happy. Actually, I did n’t come here for training today. They just came over and listened to it again. This is the same as when they were in college. Which teacher speaks well, looks handsome, and powder. There are so many people coming to the class!
In fact, many of those who came to participate in the training program are already graduate students, but they did not get a training certificate after graduation.
Now, as a doctor, all require a training certificate. This is as important as the qualification of a practicing doctor. Without a training certificate, there is no way to advance to the intermediate title.
To put it bluntly, if you do not have a training certificate, you cannot be judged as the attending doctor.
So many people come to participate in the training.
But at this time, we can see that the ratio of male to female medical students is coming.
Among the ten were seven girls and three men.
So in medical schools, boys are still relatively easy to find.
...
After a group of people pushed the door into the chest penetration room, they suddenly saw a man standing inside.
This man ... you want to cover up the reality of balding, the new white clothes want to stop the raised belly, it looks very greasy ...
Suddenly, the person who was preparing to sign in, hesitated!
This person should ... not Chen Cang?
"This is Chen Cang? So ... abstract?"
Even a few people who came yesterday were dumbfounded: "No! Chen Cang, my classmate, I don't know yet, where is Chen Cang?"
Several people grumbled and signed reluctantly, looking at Shi Qi curiously.
Come here, can't go?
Shi Qi watched everyone coming soon, opened the ppt with a smile, and put a smile like Wu Yanzu: "Well, welcome to the Second Hospital of the Province. I am Shi Qi. Today I will tell you about the operation of thoracentesis. And considerations. "
"Maybe you don't know much about me, but you will be familiar with it after a long time. I used to be the director of the Department of Thoracic Surgery in our hospital, and I have been reforming it since then. I went to breast surgery. Should I be the right one? "
With that said, Shi Qi smiled humorously.
"Thoracentesis is used in clinical practice a lot, and it is very important for medical workers. Everyone is a future doctor, so it is necessary to master such a skill."
"I'm usually very busy, but after receiving the invitation from the Guipei Center, I still feel that this matter is more important, so I'm here and start now ..."
Shi Qi's materials were left by Li Shijian at that time. At that time, Li Shijian outside the chest often trained with Chen Cang, so the materials were prepared.
Shi Qi is now going to be a director at the Guipei Center, because the old director does not retire because of the Department of Breast Science, and he doesn't go at all, and ... clinically, he doesn't want to do it now.
I have been a director of thoracic surgery for three years and salted fish for three years. Where did I get such a hard life?
Being a director at the Guipei Center and managing a few hundred students is comfortable.
What Shi Qi said ... is quite satisfactory, just like the scoring standards, very standard and very official.
Everyone can hear it.
However, people who heard Chen Cang's explanation yesterday suddenly felt a bit unpleasant.
There is no gap without comparison. Sometimes, the level of clinical doctors can be seen from the explanations. Some people have something to say, and some people are dry.
However, thinking that they are the directors of the original chest, everyone still thinks that they should be quite level, maybe just not good at explaining.
So patience listened, and after speaking, Shi Qi looked at everyone: "Are there any questions?"
At this time, one person asked: "Mr. Shi, the British Chest Association's 2010 pleural disease guidelines stated that for malignant pleural fluid, the amount of fluid for therapeutic thoracentesis should depend on the patient's symptoms at the time. The liquid volume should not be> 1500ml, and what you just said is not to exceed 700ml for the first time, and not to exceed 1000ml in the future, and Xiehe Respirology believes that it should not exceed 600ml for the first time, and not exceed 1000ml in the future. The domestic volume appears more conservative in the first time. why?"
This question comes out!
Most of the people present were blinded!
This question is awesome!
It sounds like a master!
Because the internal medicine written in the 5678 version is not more than 700 for the first time and not more than 1,000 in the future, but it seems that no one really asks why this is!
Shi Qi hesitated. This question was well asked. He pointed to a girl in front of him and asked, "What do you think of this question?"
The girl hesitated: "I use ... the eighth edition of" Internal Medicine "to see ..."
As soon as this word came out, all around was dumbfounded, and then laughed.
Shi Qi also smiled and said, "Because of excessive fluid withdrawal too quickly, recurrent pulmonary edema will occur, so we are relatively more conservative than foreign countries."
The girl stunned: "Are you not afraid of 1500 for the first time abroad? Is the reason for the difference between our domestic and foreign countries because we are conservative?"
Shi Qi said for a moment: "Each guide is a theory based on evidence-based medical research with a lot of case experience. I think we should respect the guide."
At this time, a girl suddenly raised her hand and said, "Mr. Shi, in fact, this value is from a source, and it is not a dead value."
"Physiology tells us that the average total lung volume of an adult male is 5,000ml, with a vital capacity of 3500ml + a residual air volume of 1500ml. Based on this, we speculate that the volume of the thoracic cavity should also be about 5,000ml, then the unilateral thoracic cavity is about 2500ml.
For a patient with a large amount of pleural effusion, we have taken 1000ml on one side, 2/5, which is quite large. If we take 1500ml (on one side) at a time, it is 3/5 of the unilateral thoracic volume, which is basically It is an insurmountable divide. "
"Statistics from evidence-based medicine show that it is an indisputable fact that European and American humans are taller. Their corresponding chest volume is also larger than ours, so they can understand that their single pump volume is larger than ours."
"And the true meaning of the guideline is not to emphasize this value, but this is only a critical value. In fact, in clinical practice, this" 700ml, 1000ml "cannot be static, because each patient's age, body type, and condition are It ’s different. We ca n’t use these two numbers at all. It ’s more important to observe the patient's situation at any time. At the same time, it is also the same in foreign countries. The guideline is a relatively wide range. As a doctor, you should always observe the patient and adjust the dosage.

The girls didn't say much, but they quieted the audience.
These remarks were thorough and clear, and the meaning of the value of the pumping fluid was immediately explained to the audience, and suddenly there was a sense of awakening.
That's it!
Even Shi Qi had a sudden and cheerful feeling ~ EbookFREE.me ~ It was so good, it turned out to be this way.
Shi Qi couldn't help asking: "This classmate, what a good word! Understanding is in place."
The girl didn't actually want to say it, but one didn't hold back and said it. Naturally, I didn't expect such a big response. Everyone around me looked at her with a look of wrath, and suddenly blushed.
"Actually ... this is not what I said, this is what Teacher Chen said." The girl said embarrassed, and then pointed to the classmates around her, "You ask them, they know!"
Several students nodded: "Yes, Mr. Chen has said it."
Everyone was dumbfounded!
Who is Teacher Chen?
That teacher Chen?
Even Shi Qi was bewildered. Who is Teacher Chen? It sounds familiar.