求英文病历摘要，谢谢~ 求个英文摘要，不要机译的，谢谢~
\u82f1\u6587\u75c5\u5386~~\u6025AN EXAMPLE OF MEDICAL CASE RECORD IN ENGLISH Patient Li Hua,mate,69 years old, a retired teacher, was admitted on June 6,1989,because of palpitation for one year and becoming worse in recent 5 months. The patient was quite well until one year before May,1988, He felt slight palpitation and dyspnia during hard work, fast walk , or climbing stairs, There was swelling of legs in the evening but he felt better after having a rest. In recent 5months, palpitation and dyspnia became so serious that he could neither walk nor lie down.He had to sit up during the whole night, Sometimes he coughed with small amounts of sputum, but without blood. He had no chill, fever, chest pain or sore joints. The urinating was normal. There was nothing else abnormal in the case history review except a cured lobor pneumonia in 1949. He had no history of drug allergy. Personal history\uff1aThe patient was born in Xi\u2019an in 1923. He had been to the south of China but did not contact contaminated water. He smoked a bout 10 cigarettes daily. He got married in 1945. His wife was healthy .They had a daughter who was also healthy. His father died of stomach cancer.His mather was well. Physical Examination\uff1aT.36.8C, P. 96/min, R. 28/min, BP.23.5/13.3kPa. The patient, an old fatty man who developed well and moderately nourished, was lying in bed with a semifallous position. He looked pale and suffered from general edima. He was mentally normal and cooperative in the examination.There was no eruption, no jaundice, no purpura on the skin, and the lymphnodes were not palpable. The head, eyes, nose, ears, mouth were normal while the lips were cyanotic. The neck was soft, there was no venous engorgement. Thyroid glands were not palpable, there were no thrill or brunt. The trachea was in midline. The chest and respiratory movements were symmetrical. There was no abnormal dullness but some moist rales were heard in the base areas of the both lungs. The points of maximal impulse (PMI) were not visible but palpable in the 6thcostal interspace, 14cm form the middle line, there was no thrill. The cardiac dullness, 14cm from the middle line, there was no thrill. The cardiac dullness were as follows; Right \uff08cm\uff09 Interspaces Left (cm) 1.5 \u2161 2.0 2.0 \u2162 4.0 3.0 \u2163 8.0 \u2164 10.0 \u2165 14.0 The distance from midsternal line to midclavicular line was 10cm. The heart rate was 96/min, regular. There was a grade \u2161soft blowinglike systolic murmurat the apex,P2>A2, but no pericardium friction sound was heard. Abdominal wall was soft without tenderness. The liver was palpable 2cm below the costal margin with slight tenderness. The spleen was not palpable and there was no shifting dull ness. The rest was normal. Impression\uff1a disease with degree\u2162 heart failure Signature \u00d7\u00d7\u00d7
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Challenges confronted with western countries have been unprecedented severe since the 1980's, as a result of both the social context that competitions of globalization and informationization are increasingly intense, and the government issues in crisises of financial, management and confidence.
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Emerging as the times require is the government reform in most western developing contries, named New Public Management.
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This text mainly explains the characteristics of New Public Management and the divergences between the new system and traditional bureaucracy ones, to provide general knowledges of New Public Management.
PATIENT'S NAME: Mary Swan
CHART NUMBER: 660518
DATE OF BIRTH:10-5-1993
SEX: Female
DATE OF ADMISSION: 10-12-2000
DATE OF DISCHARGE: 10-15-2000
Final Discharge Summary
Chief Complaint:
Coughing, wheezing with difficult respirations.
Present Illness:
This is the first John Hopkins Hospital admission for this seven-year-old female with a history of asthma since the age of 3 who had never been hospitalized for asthma before and had been perfectly well until three days prior to admission when the patient development shortness of breath and was unresponsive to Tedral or cough medicine.
The wheezing progressed and the child was taken to John Hopkins Hospital Emergency Room where the child was given epinephrine and oxygen. She was sent home. The patient was brought back to the ER three hours later was admitted.
Past History:
The child was a product of an 8.5-month gestation. The mother had toxemia of pregnancy. Immunizations: All. Feeding: Good. Allergies: Chocolate, dog hair, tomatoes.
Family History:
The mother is 37, alive and well. The father is 45, alive and well. Two sibs, one brother and one sister, alive and well. The family was not positive for asthma, diabetes, etc.
Review of Systems:
Negative except for occasional conjunctivitis and asthma.
Physical Examination on Admission:
The physical examination revealed a well-developed and well-nourished female, age 7, with a pulse of 96, respiratory rate of 42 and temperature of 101.0℉. She was in a mist tent at the time of examination.
Funduscopic examination revealed normal fundi with flat discs. Nose and throat were somewhat injected, particularly the posterior pharynx. The carotids were palpable and equal. Ears were clear. Thyroid not palpable. The examination of the chest revealed bilateral inspiratory and expiratory wheezes. Breath sounds were decreased in the left anterior lung field. The heart was normal. Abdomen was soft and symmetrical, no palpable liver, kidney, or spleen. The bowel sounds were normal. Pelvic: Normal female child. Rectal deferred. Extremities negative.
Impression:
Bronchial asthma, and pharyngitis.
Laboratory Data:
The white count on admission was 13,600 with hgb of 13.0. Differential revealed 64 segs and 35 lymphs with 3 Eos. Adequate platelets. Sputum culture and sensitivity revealed Alpha hemolytic streptococcus sensitive to Penicillin. Chest x-ray on admission showed hyperaeration and prominent bronchovascular markings. The child was started on procaine Penicillin 600,000 unites IM q.d in accordance with the culture and sensitivity of the sputum.
Hospital Course:
The child was given Penicillin IM as stated above. Ten drops of Isuprel were added to the respirator every 2 hours. The patient improved steadily. She took her diet well. She was discharged on 10-15-2000 in good condition.
Operation procedure: none
Condition on discharge: Improved
Diagnosis: Asthma. Pharyngitis. Possible right upper lobs pneumonia.
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