#人间瑰宝王天草[超话]# #人类瑰宝王晓佳#

“虽然那天清晨落叶满地，
两条路都未经脚印污染。
呵，留下一条路等改日再见！
但我知道路径延绵无尽头，
恐怕我难以再回返。

And both that morning equally layIn leaves no step had trodden black.Oh, I kept the first for another day!Yet knowing how way leads on to way,I doubted if I should ever come back.”

公务员果然是生活在平衡世界的另一个物种。
一个公务员朋友给我发蛋糕店，月饼店，包店，炒冰各种安利。我就回了句都不买了，经济不好消费降级。朋友马上惊讶，经济不好是一种感觉吗，是工资影响了还是猫粮升价了。可惜是不是单选是both。她就说这么夸张？！
可这怎么会是夸张，现在除了防疫产业那个行业还可以的？要我说在这么下去马上就可以大萧条了。

Severe frostbite!!
This is the case of a 50-year old homeless man who sustained grade IV frostbite injuries to both feet after sleeping out in sub-zero temperatures. The patient first presented with ischaemic feet with well demarcated areas around the ankle (Image 2 - frostbite on day 2).

Then the feet were left to demarcate and became fully ischemic and mummified. Underneath the ankles a dry, well-demarcated gangrene of black color is visible (Image 1 - 3 weeks post-injury.).
These lesions are consistent with fourth-degree frostbite injuries, eventually resulting in bilateral below knee amputations.

Frostbite can be graded into stages I to IV depending on tissue depth involvement. Two main approaches can be adopted with deep frostbite, either (a) early necrectomy with subsequent local treatment of wounds and (b) long-term conservative treatment until formation of demarcation line of necrotic tissue with subsequent resection and formation of a stump to facilitate rehabilitation.

This case highlights the importance of careful consideration of early versus late amputation as well as the importance of close collaboration between the rehabilitation, surgical, psychosocial, and public health disciplines in this rare and challenging problem.
#医学生Medic[超话]##medicaltalks#