Impregnated Dye heard a rustling sound, and the microscope was turned on at the same time, and after a while, the invigilator asked again: "Candidates, there is nothing wrong with the light source and lens of the microscope, right?" Okay, so are you all ready? If you are ready, the reading will officially begin, and now I will talk about the rules of this exam. ”

Above the blackboard, the slide opened, and the invigilator pointed to the slide above the podium and said: "Everyone look up, now the slide has been opened, my slide will give you 20 cases of blood diseases, and what you get in your hands is a multiple bone marrow slice copied by the same patient, and according to the introduction on the big screen, the candidates tick out the corresponding answers after the exam questions, and we only have a short ten minutes for each film." ”

"Huh? Ten minutes? It's too hasty. The doctor below made an incredible noise.

When the invigilator heard this, he said with a smile: "Of course it is incredible to read a bone marrow film in ten minutes, and I believe that everyone here is an expert in reading the film in the laboratory department." Of course, as far as I know, in clinical practice, it is a skilled old expert in hematology, and the reading time of each bone marrow will be more than an hour, so it is not easy to classify a hundred bone marrow cells in this short ten minutes, but as an exam, it is to test your usual accumulation, I believe that your experience is rich, I believe that your speed is first-class, okay, the exam is about to start, are you ready? ”

The two palms of the two hands were wet and nervous, and the sweat on the forehead was also dripping, and the eyes were hot and painful.

I quickly wiped the sweat from my forehead and eyes with my sleeves, and kept taking deep breaths.

"Okay, the reading film has officially begun."

Saying that, the invigilator took out N white lockets from the wooden box and put them in front of each candidate, and quickly opened the locket, silently counting in his heart, exactly twenty bone marrow tablets, and each bone marrow piece has a corresponding number and name.

Dip the first bone marrow slice to the microscope, drip pine cedar oil, aim it with an oil glass, and listen to the invigilator's introduction:

During the reading process, if there is a sudden problem with the microscope, candidates can wait quietly at the table and explain the problem after the competition. These papers are multiple-choice and multiple-choice, and in order to save time, candidates can just tick the correct answer. ”

The exam papers were sent out one by one, Chu Xian took a cursory look, and his mood became relaxed in an instant, the multiple choice questions turned out to be his strength, and he encouraged himself: "Chu Mian, you have always been the best." ”

"Candidates, first write their work unit and name on the top left of the exam paper."

"Okay, are you ready? Reading begins. Please prepare the bone marrow slices and open the slides. ”

"Le Xiaoxuan, female, 22 years old, visited on March 17, 2012, clinical: dizziness, fatigue, palpitations, anemia symptoms......"

Dipping quickly looked at the cells in the oil mirror, and finally counted a hundred cells in the film, showing that hypoplasia, bone marrow granules and non-hematopoietic cell increases, which can rule out other diseases with pancytopenia (such as paroxysmal nocturnal blood proteinuria, myelodysplastic syndrome, malignant histiocytosis, etc.), and infiltrate aplastic anemia after the first multiple-choice question.

Hurriedly replaced with a second film, the second patient was introduced in the slideshow:

"XXX, male, 55 years old, clinical signs: low-grade fever, tinnitus-"

In this way, if the bone marrow slice with a high degree of differentiation is easier to identify, the result can be calculated after the infection is differentiated; If you come across a bone marrow piece with a low degree of differentiation, you have to search carefully for the infection, watch it back and forth, so as not to underreport and blind it, and then classify and count it to draw conclusions.

Sixteenth, seventeenth, eighteenth.

"Finally, there are two bone marrow tablets, and this is the nineteenth bone marrow tablet."

Chu Xianran breathed a sigh of relief in his heart, put the bone marrow piece on the microscope stage, clamped it with a tablet clamp, and the side of the slide was revealed, and he said: Luo Guangyao, male, 36 years old.

This is the voice of the big screen: "Luo Guangyao, male, 36 years old." Fever, malaise, fatigue, weight loss, recurrent infections, bleeding and anemia, hepatosplenomegaly, due to routine blood tests..."

Chu infiltration saw a large number of small lymphocytes through the microscope, only a few young lymphocytes or atypical lymphocytes, few platelets, obvious anemia, active nuclear cell proliferation, erythroid and megakaryocytes are reduced, Chu infiltration determined that this is a case of chronic lymphocytic leukemia.

Immersion under the nineteenth question, multiple-choice question, chronic lymphocytic leukemia is ticked behind.

"There's finally one last film." Dip the bone marrow piece on the microscope stage and clamp it with a tablet clamp.

Looking at the presentation on the slideshow:

"XXX, male, 18 years old, during the patient's health examination, it was found that the blood picture was abnormal, as the disease progressed, fatigue, low-grade fever, excessive sweating and night sweats, and the left upper quadrant felt distended due to splenomegaly......"

Immersion listened and looked at the bone marrow slices in the microscope, in which the bone marrow hyperplasia was obviously active, mainly granulocytes, eosinophils and basophils increased, and neutrophils, late larvale and rod nuclear granulocytes were the majority. ”

Impregnation hooked the last one to chronic myeloid leukemia.

The invigilator said softly, "Candidates, when the time comes, take your eyes off the microscope." ”

Dip dye turned off the power of the microscope, and looked at the exam paper again, and the answers were ticked at the back of each question in the exam paper.

Impregnated felt that he had overcome the task in the midst of tension.

Impregnated Dye set his eyes on the teacher in front of him, and felt that the teacher's clothes became colorful from head to toe, like every colored cell in a bone marrow piece.

Dipping and rubbing his eyes, he said in his heart: "I have been staring at the microscope for a long time, and everything I see has become colored cells. ”

"Candidates, please leave your seats."

Dip Dye stood up and walked outside the classroom, where he saw the invigilator receiving the exam papers of their group, and said to the candidates waiting outside, "Your group can come in, you can check and see if there is anything wrong with the microscope." ”

Ten candidates dressed in cell suits walked into the classroom on chatter, and another exam began.

Impregnated Dye stopped, looked up at the sky, the blue sky was full of colored cells, the white clouds were full of colored cells, and the green trees were also full of colored cells, Impregnation said with a smile: "What a beautiful world." ”

After a while, I felt that my eyesight was restored, the road under my feet was no longer a deep foot and a shallow foot, and the sky was no longer pityriasis.

When I turned around, I saw that there were still many old doctors rubbing their eyes, waiting for their injured eyesight to recover.