Medical care is no small matter, the medical industry is extremely risky, medical behavior, as the medical titan Zhang Xiaoqian mentor said “like walking on thin ice, like facing the abyss”, this warning has also become my life’s motto. Over the past few decades, I and my colleagues in the unit treated hundreds of thousands of patients, rescued hundreds of cases of serious illnesses, without a medical incident, my practice and experience is: not asleep on duty, ward look at leisure time, new and old seriously see, often think about difficult diseases, serious illnesses, full treatment, learning medical skills high. The night shift, whether in small clinics or in large hospitals, is the primary task and responsibility of doctors, especially young doctors. Naturally, on duty, we have to admit patients, observe changes in their conditions, take history, check the body, write medical records, issue medical orders and checklists, and be busy, sometimes even through the night. I usually check all the rooms once after taking over the shift, so that I can have a good idea of what to expect, prioritize and plan well, so that I will not be in a hurry. For those who are seriously ill or hospitalized on the same day, check at least one or two times in the middle of the day to find problems and deal with them in time. For blood pressure, blood sugar, high body temperature, fast or slow heart rate, they should be dealt with appropriately to prevent problems before they happen. Before going to bed, I visited the ward once more, and even when I was lying in bed, I was thinking about whether the treatment of serious illness was reasonable or not. How will the disease develop and change? What is the prognosis? How to confirm the diagnosis of difficult patients? The company’s main business is to provide a wide range of products and services to the public. I rushed there. Dai, an old cadre of the ministry, was admitted to the hospital 3 days ago for 2 hours of coma and paralysis, and imaging showed brainstem hemorrhage, and his condition was stabilized after treatment. I found that his breathing had slowed down and his pupils were unequal in size, so he was treated for brain herniation, and he was brought back to health a few hours later. Not long ago, I met him in the hallway and nodded in greeting, although he could not speak. As a clinician, as the name implies, you have to go to the bedside frequently. Only by asking history and examining the patient personally can you get real and accurate first-hand information, and even more so by observing changes in the condition. Once typical symptoms and signs are observed, such as butterfly erythema, mitral valve face, pestle finger, croup, seizure, sigh-like breathing, hearing seagulls and galloping horse rhythm, it is very helpful to make a clear diagnosis and judge the prognosis. Over the decades, I have made it a habit to see patients during the night and day shifts when I have free time. In the early morning of June one year, I went to the monitoring room and saw an elderly woman with eyes rolled up and upper limbs twitching, heart rate of 32 beats on the ECG monitor, and her bedside family still asleep. I rushed over immediately and saw that the infusion bottle was empty, so I immediately administered oxygen and other treatments. This case was caused by the treatment of hypertensive encephalopathy with intercerebral syndrome and pressurized dehydration, and a nurse forgot to observe the treatment on time. As a department director and old party member, since I chose this profession, I should take the ward as my home and care about the patients. Since decades of medical practice, almost every day is concerned about the department, wards, every meeting, travel must be arranged for the work of the department, every day there are senior doctors sitting. Whenever there is a holiday, the medical staff is small, and those who come to the clinic are often very sick and complicated, so a little negligence is more likely to happen, so I always insist on more shifts. Even when I am resting at home, I always read books and look up information, and if I see that I need to observe certain signs and perform certain tests, I will go to the ward to observe and deal with them immediately. New and old patients should be taken seriously, that is, new and old patients should be treated seriously. Doctors are generally able to carefully question the first patient and carefully check the body, while the old patients tend to think habitually and simply engage in, sometimes easy to make mistakes. Because the patient’s symptoms, signs, biochemical indicators often change, only in accordance with the real-time situation to adjust the medication, reasonable treatment to obtain satisfactory results. Over the years I have insisted that new and old patients be treated equally seriously. On a certain day in May 2009, a 54-year-old patient complained of right upper chest pain and breath-holding, and was treated as coronary heart disease in a large hospital for one month. I examined and analyzed that the patient had risk factors for coronary heart disease, but right-sided chest pain was rare in coronary heart disease, the nature of chest pain was not supported, and the treatment according to coronary heart disease was ineffective. middle-aged persistent chest pain should be alert to tumor, so I checked CT and found right upper mediastinal tumor. late one night in winter 1989, I learned that a patient who was about to be discharged from the hospital with cerebral infarction suddenly vomited and passed out, and I immediately rushed to the ward. Dr. Xu asked, “Is the onset of cerebral infarction reoccurring in a quiet state at night?” I found that the blood pressure was high and the pupils were dilated, so I treated the patient according to brain hemorrhage and brain hernia and notified the family to come to the hospital. I always think about every difficult and critically ill patient, constantly reading books, consulting information, or discussing with colleagues, or asking for consultations and sending tests, until the diagnosis is clear and the treatment is effective. A female, 25 years old, was admitted to the surgical ward with abdominal pain, stopped defecation and exhaustion for 5 days. She had a history of intestinal obstruction for three times and was treated surgically once. This time, she improved with symptomatic treatment, but then she developed frequent episodes of limb convulsions and was transferred to the neurological ward. He developed hypertension, paroxysmal tachycardia, hyponatremia, tetraplegia, hoarseness, dysphagia, EEG showed extensive slow waves, and increased cerebrospinal fluid protein. I think that convulsions are commonly associated with grand mal seizures, but can be excluded from the seizure form and what is seen on the EEG. Vegetative seizures are clinically common with tachycardia, hypertension, chills, fever, a few with impaired consciousness and twitching of the extremities, but abdominal pain and paralysis are difficult to explain. Upper and lower motor neuron disease can cause paralysis, but other manifestations do not support it. On review, hematoporphyria is a rare unexplained metabolic disease. Acute intermittent hepatic hematoporphyria is most commonly seen in women aged 20-40 years, with clinical manifestations of three major syndromes: cutaneous, abdominal, and neurological. Hyponatremia may be present with damage to the inferior optic thalamus, hoarseness and dysphagia with damage to the cranial nerves, and hypertension with dysfunction of the vegetative nervous system, with red urine heating as its characteristic manifestation. I then took the urine and put it on the hot water heater, and it turned lemon color in less than 10 minutes to provide strong supporting evidence, and the diagnosis was later confirmed by the examination at Concord Hospital. The case was discussed in the internal medicine system and published in the Journal of Aerospace Medicine. In the afternoon of a day in September 1968, shortly after I arrived in Luoyang to work, a child was injected with penicillin due to lung infection, and although the skin test was negative, we routinely kept the child under observation for half an hour to prevent accidents. About 20 minutes later, the child suddenly became pale, had difficulty breathing, and did not respond to calls. In the evening of one summer 1987, I saw a tricycle in front of the former surgical building, and my doctor’s alertness made me realize that there might be a serious patient in the emergency room, so I rushed there. Dr. Wang Shurong was working on a civilian with an electrocardiogram indicating acute heart attack, and ventricular fibrillation appeared in a short while, so we performed cardiopulmonary resuscitation on the diagnostic bed and routinely applied lidocaine, epinephrine and other drugs, and the resuscitation was successful after 3 hours, all feeling relieved despite being sweaty and exhausted. at noon one day in 2005, I heard about a patient about to be discharged from the hospital with DDV poisoning who suddenly went into respiratory arrest, and Dr. Qiu Zhiyong immediately Dr. Qiu Zhiyong immediately gave mouth-to-mouth breathing and asked the anesthesia department to perform tracheal intubation. I rushed to the ward to organize resuscitation, use ventilator and symptomatic treatment, and also urgently asked Chaoyang Hospital to consult and diagnose intermediate syndrome, they met 2 cases, only one case was successfully resuscitated. I went home at 12 o’clock that day and arrived at the ward again at 4 o’clock in the morning. After 9 days and 9 nights of joint efforts of the whole department, the patient was finally cured and discharged from the hospital, avoiding a medical incident. Learning medical skills high Medical treatment in a sense is guided by philosophical ideas, based on the respective characteristics of the disease, the use of drugs and equipment to relieve the pain. For medical workers, dealing with patients’ lives, learning the business becomes more important. Low level of practice, insufficient knowledge, improper diagnosis and treatment, not only affect the effectiveness of treatment, and even endanger the lives of patients. In addition, science is developing, knowledge is being updated, it is necessary to continuously improve the technical level. I know that the consciousness and persistence of learning comes from the spirit of enterprise and career, from high standards and strict requirements, so that we can be proactive, persistent, never complacent, and strive for excellence. The first is to learn this specialty, followed by the knowledge of disciplines and marginal disciplines related to this specialty, and then the new technology and new advances in diagnosis and treatment. For the working staff, self-learning is the main focus, learning from books, learning from the surrounding comrades, attending lectures, academic conferences, case discussions, and further training. Even when I retired and returned to work, I often attended academic meetings, read books, and sometimes went to the Concordia Library or the Asian Games Village Bookstore to read excerpts. I have been able to improve my diagnosis and treatment level. In the early years, I participated in the new medical thinking case discussion for many times to win awards, even in the city’s case discussion, I also spoke many times and received praise. He has diagnosed or treated difficult cases such as green tumor, pulmonary nodular disease, Marfan’s syndrome, and hereditary spherocytosis. In the spring of 2003, when SARS was rampant and the ward was routinely disinfected with ultraviolet light every day, a woman was treated with an infusion and the nurse forgot to cover both eyes, and on the second day she was discharged with conjunctival congestion and discomfort in her left eye. In the conversation, I learned that the patient had a history of dry mouth, dry eyes, and dry nose for one year, and suspected dry irritability syndrome, and asked him to go to the Union Hospital to confirm the diagnosis, and reached an agreement that if it was the disease, he should not come to make trouble.