As the simplest and cheapest method of examination, chest radiographs play a role in massive screening.

In order to screen problems as much as possible, the reading room needs to see a three-dimensional structure on a flat two-dimensional film. Based on the medical history, they need to distinguish which are lesions, which are just overlaps of normal tissues, which exceed normal boundaries, and which are acceptable...

The real reading of chest x-rays is much more difficult and complicated than that of patients, families, and even young doctors who have just entered the clinic.

There are too many things hidden in a small square film. After systematic study, training and years of experience accumulation, a qualified film-reading doctor can see nearly 20 anatomical structures.

The spinous process of the vertebral body, bilateral clavicle, trachea, anterior rib, posterior rib, scapula, aortic node, tracheal bifurcation, left main bronchus, hilar, hilar vascular, descending aorta, right atrium, breast soft tissue, diaphragm, gastric vesicle, liver.

The lungs are stained with more than half of the volume of the chest cavity, and because the three states of gas, liquid and solid in normal tissues are gathered together, it is particularly sensitive to chest X-ray examinations, and has always been a major player in chest X-ray examinations.

The doctor who reads the film needs to rely on the changes in the density in the film and clarify the nature of the lesions, then divide the lung tissue into three upper, middle, lower lung fields, inner, middle and outer zones. Then use the lung lobes learned in the anatomy to further accurately locate. (1)

After removing the lungs, the rest of the parts are not foils, and each has its own uses.

The vertebrae, clavicle, ribs, scapula and other bones can see fractures, inflammation and placeholder lesions. The diaphragm and gastric blisters can see whether there is free gas in the abdomen, indicating perforation of the digestive tract. If the liver is lucky, you can also see liver lesions, including abscesses, cysts, hemangiomas, placeholder, etc.

These edge structures are generally inconspicuous places, and some are not related to the main complaints, and are not even a reason for chest X-ray examination.

But because of the doctor's keen eye for the film reading doctor, the problem was found.

There are too many tumor bone metastasis, liver metastasis, various types of tuberculosis, hidden fractures, and periculation of the abdominal digestive tract were actually discovered by chance during chest X-ray examination, which also established the first choice for chest X-ray screening. It is a bit rough, but it is indeed useful. Since it is useful and the price of filming is cheap, it has the value of screening.

But sometimes the method of taking the chest x-ray and then ct or mri will make the patient's family very confused.

The heart is a typical example.

The chest x-ray is a simple floor plan, the heart is a hollow chamber, and there are ribs, sternum and lungs around it. A chest x-ray on the front can only take a contour, and nothing can be seen.

Chest radiographs are not used to check the heart. Compared with intuitive imaging examinations or electrocardiograms, cardiac color ultrasound is more stable.

In Miyao and Takahashi's eyes, Ye Han's chest X-rays are actually fine. The lungs are clean, the bones are fine, and the stomach and liver are good. The heart problems Qi Jing mentioned are just a little larger in size, which is completely acceptable after comparing them with the normal value.

"I think it's okay, my heart is not big." Miyao looked at the movie again and said, "It's okay to beat me normally."

Takahashi is relatively more rigorous. He plugged in the video reader and looked at it carefully, then said: "I understand what Qi Sang means. In fact, this distance is difficult to grasp. Her heart size is just stuck in a normal range. In theory, there is no need to increase the heart shadow."

Luo Sanguan (omitted below): (They think it’s okay, but think that the heart shadow is quite normal)

"A normal p!!" Qi Jing walked to Gaoqiao, used his finger as a tool, and measured it back and forth at the bottom of the heart shadow: "The mind-to-heart ratio is almost 0.5, which is not normal!" (2)

(He said that the mental ratio is almost 0.5, so it is not normal to be beaten)

After hearing Luo Sanguan's translation, Takahashi took out the caliper from his pocket, and after measuring it several times, he still shook his head: "It is still necessary to be more rigorous when reading films, and the mentality ratio is not only 0.5 or 0.49."

When Miyao heard this result, he chuckled softly, sat back to his desk, and began to pack up and prepare to get off work: "Teacher Takahashi, 0.5 can only increase the heart slightly, right?"

Takahashi nodded: "Yes."

(They insisted that it was only 0.49...)

Without translation, Qi Jing could guess the result from their expression changes during conversation. For him, this should not be something to discuss. Ye Han must have a problem with his heart. But Suo was not Danyang Hospital after all, so there was no Hu Dongsheng and Gao Jian helped him.

Qi Jing continued to explain: "If it were a middle-aged and elderly person, it would be fine, but she was only in her 20s and only 1/3 of her life had passed. How could her heart be so close to the critical value?"

Luo Sanguan thought about it and simply summarized it: (She is still young and her heart should not be so old)

Takahashi put away the caliper and continued to stick to his point of view: "It is indeed normal to put the standards here."

"Okay, don't translate this sentence."

Qi Jing's anger became more and his tone gradually increased. The thing he used to be in the diagnosis department and Danyang Hospital's emergency department began to leak out: "How many years have you worked? Why are you still so rigid? Do you know what is combined with clinical practice? If you don't combine with clinical practice, what's the use of just watching a movie?"

The translation level of the three views is actually average.

But people have potential, and sometimes they need to force themselves.

Under Qi Jing's forced force, his translation ability has improved by leaps and bounds. Since the last time the "Madecao" was about to move, his three views have been transformed, and he is more and more focused on intentions than form.

In these words of Qi Jing, combined with the clinical description that is commonly used in China, Japan does not have this thing. Luo Sanguan frowned and thought for a long time. He helped Qi Jing remove some useless and sharp tone, and then slightly modified some content. Then he said: "He thinks you are not flexible enough, and you must judge based on Ye Han's medical history when reading the film."

"What's the problem with the medical history?" Takahashi looked at Miyao, "Ye Han has a heart disease?"

Miyano shook his head: "No, there is only muscle pain."

"That's nothing to do with the heart." Takahashi laughed and looked at Qi Jing, "What do you mean by drawing a conclusion based on the medical history?"

Luo Sanguan was a little confused, but unexpectedly Takahashi began to mock people: (He thought what you said was wrong, but combined with the medical history, it made people feel that it had nothing to do with the heart)

"Then ask them, what's going on with the premature beat that Ye Han found these days?" Qi Jing explained, "The electrocardiogram she checked and the electrocardiogram she took at the beginning showed that there was premature beat. I was by the bedside and saw it very clearly."

(He said Ye Han had premature fight)

"It is normal for young people to have premature beats." This time it was changed to Dr. Yamada. Seeing Director Miyano leaving, he had to be a shield. "Apart from premature beats, she has no other heart problems. Whether it is heart rate or blood pressure..."

(Only premature beat, it's normal)

Enlarged cardiothoracic ratio means enlargement of the heart, indicating the possibility of cardiomyopathy. If there is a problem with the myocardial muscle, the first symptoms should be edema of the lower limbs caused by right heart weakness.

However, Qi Jing checked Ye Han's legs and there was no edema at all. In fact, even if there was edema at the beginning, it would be reduced by lying on the hospital bed for three days. This cardiomyopathy, which had just appeared, has not had a serious edema, and it is entirely possible to recover after raising the lower limbs.

After thinking about it, Qi Jing only had one symptom of premature dysfunction, and it was not easy to refute them. Since the reason was not reasonable, he could only be tough: "Brother Luo, tell them to check for a color ultrasound first, and then do a 24-hour dynamic electrocardiogram." (3)

Luo Sanguan can understand it at one point: (Doctor Qi hopes to do a few more tests)

This is actually not a very strict requirement. Ye Han kept it in the ward, so it would be better to do a few more insurances for examinations. There were 500,000 paving roads before, and the demands are now very reasonable. Qi Jing could not think of any reason to reject him.

But Takahashi didn't seem to buy it: "I just need to take care of my job anyway. On the chest x-ray, I will still write about the normal heart. As for what tests to do in the future, it's your clinician's business, it has nothing to do with me."

Miyano gave Yamada a wink, who was smart enough and quickly explained: "Since breast radiographs are normal, we have no reason to start the examination. If the examination is randomly conducted, if the leader blames it, it will be a fine of a lot of money."

"Yes, we have our own difficulties, too."

But in a short while, Miyano had already taken out his briefcase: "I think it's better to be discharged from the hospital as soon as possible. There's no problem with this girl."

Yamada, who was standing by, looked at his watch, gave Miyano to him, and continued to exonerate his director: "Miyano has an important meeting that needs to be attended. Next, I will handle Miss Ye Han's discharge, which will be completed soon. I heard that they are going to Tokyo Tower, and the Tokyo Tower is very beautiful at this time..."

"What do they mean? Do you still want money?" Qi Jing felt something was wrong and asked Xiang Sanguan, "Is it useless to have 500,000 yuan?"

Luo Sanguan is very clear about the rules here. The "subtle and restrained" Japanese people do not like to put the amount of bribes on the table. So for the translation of this paragraph, his words are very obscure, but the meaning is very clear: "Doctor Qi only requires a few tests, and we should meet his requirements."

Regarding this sentence, the three people present showed three completely different expressions on their faces.

Takahashi hesitated, but after struggling for a while, he felt relieved. The yen continued to depreciate, and the living standards in Tokyo were too high. In his opinion, 30,000 yen was not enough. He had already completed the 30,000 yen task by giving his own professional advice. There was no need to cater to the other party in particular.

Miyano, who was standing by the office door, seemed to be careless.

For him, the money has been in his pocket and the person has been left behind. Since it is a problem with prosthesis, then I will be discharged from the hospital and I shouldn't stay here at all. Moreover, there are too many uncertain factors included by the other party, so I feel at ease when I leave early.

The only surprise is the doctor Yamada.

He was originally standing aside with Miyano Takahashi, and should have sent Ye Han away as soon as possible according to Miyano's intentions, based on insisting on Takahashi's suggestion.

But now Yamada suddenly showed a strong interest in Qi Jing's idea: "In fact, Director Miyano and Dr. Qi's requests are not too much. Dynamic electrocardiograms are a bit troublesome, but the results can be produced on the spot..."

I don't know if it was a hurry or something else, but when I came to my senses, his hand had already grabbed Miyao's cuff.

In Japan, a society with distinct upper and lower classes, this kind of behavior is disrespectful.

"What do you mean?"

"No, no, I'm not...I'm just..." Yamada was already incoherent. She looked at Takahashi, then looked at Qi Jing beside her, and quickly sorted out the last point of thinking and explained, "I just think Dr. Qi's idea is pretty good. If there is any problem with Miss Ye, we can't afford it."

Can't afford to take it?

Miyano didn't know what Yamada, who had been sharing his worries, suddenly felt like a storm, and why did he do this?

The two of them had a consensus on Qi Jing before, and this is a Kaizi. If you can spend so much money on your friend's hospitalization, just force him to get it easily.

So they deliberately embarrass, mislead and make things difficult for them.

First, it is to force Qi Jing to give you money, it is best to give you another 500,000. Second, even if Qi Jing resists giving, they can drive away the "bomb" named Ye. It's a killing of two birds with one stone, and it's not a loss at all.

Anyway, Takahashi is just a scheming person, so it will be fine if he bites his heart to death. As long as the heart is fine, they will have reason to be discharged from the hospital.

But now...

"Yamada, I still have a meeting to attend. (Let this brat increase the money!)" Miyao leaned forward and smiled and said, "The next explanation work will be left to you." (Or let him get out of here!)

Yamada fully understands what Miyano means, but he really dares not take on this job.

Suddenly he thought that his trouble was actually on Takahashi, and he turned his finger: "Teacher Takahashi, you are very busy, so you should go back to the department first, just have me here."

In fact, he was afraid that the 70,000 yen he had swallowed would be accidentally exposed by Qi Jing, so he became a messenger. If he wanted to break the situation, he would go two ways, let Miyao leave Ye Han, or let Takahashi leave here.

The previous road was blocked by Miyano, and it seemed that it could not be done, so he wanted to try the next one.

Unexpectedly, Takahashi, the latter one, had no intention of leaving, and sat on the original sofa seat without moving: "There is another doctor in the office doing things, I am actually quite idle." (I also want to knock on this Kaizi again)

These words are almost like explicit statements, just like writing them on your face with a pen.

Yamada was really anxious and wanted to say a few more words to put out the flames. Unexpectedly, Qi Jing understood at this time: "Everyone, don't you think the 500,000 I gave before was too little?"

The words have been made clear, and the three views are no longer as implicit as before: "Dr. Qi feels that the 500,000 I gave before is enough for these two tests."

"Five hundred thousand???"

Takahashi stood up, unable to help but touched the three 10,000 yuan Japanese banknotes that were still in his pocket, and his face turned red: "Yamada, you gave me 300,000 after you took 500,000 yuan? Where can you send beggars??"
Chapter completed!