刘继帅

[{"body":{"content":"您好，一天的体重变化没有意义的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652964981124},{"body":{"content":"要一周以上变化才有意义","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652964990367},{"body":{"content":"哦哦，好的，我知道了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965020351},{"body":{"content":"体脂较高怎么办","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965052880},{"body":{"content":"采用调整饮食结构，增加运动量的方式。调整饮食不是控制饮食，而是调整为高蛋白（鸡胸，**，鱼，虾，豆制品等）低碳水（粗粮为主）低脂肪（少食肥肉，烧菜时少放油等）这种饮食模式。另外运动是为了增加基础代谢率的，这样减肥才能持续，不容易反弹。运动方式比较多，跑步，跳绳，仰卧起坐，爬楼梯，游泳等都是可以的，可以根据自己平时的生活习惯选择。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965234553}]

女21岁

2022.05.20

[{"body":{"content":"尊敬的plus用户您好，我是骨科医生，很高兴能为您提供医疗咨询服务。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050114551},{"body":{"content":"您好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050128922},{"body":{"content":"这是才拍的mr\n","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050141414},{"body":{"content":"您目前有什么不适的症状，颈肩酸胀？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050145379},{"body":{"content":"想提前知道严重么","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050148509},{"body":{"content":"是的会有恶心","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050157154},{"body":{"content":"头晕有时","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050166306},{"body":{"content":"感觉脖子硬","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050172520},{"body":{"content":"收到，从您上传的资料看存在颈曲变直，椎体的增生退变。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050244947},{"body":{"content":"不算严重的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050253502},{"body":{"content":"您出现不适的症状多长时间了？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050259791},{"body":{"content":"一年了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050268514},{"body":{"content":"那会不会后期很严重","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050280018},{"body":{"content":"这样下去\n","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050288395},{"body":{"content":"后期日常生活不注意，是有可能加重的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050323556},{"body":{"content":"最坏是什么结果呀","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050354498},{"body":{"content":"该怎么主意呢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050363690},{"body":{"content":"最坏是什么结果-----------颈椎间盘退变，突出出现手指麻木，走路不稳的情况，这种结果过程是比较长的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050429598},{"body":{"content":"该怎么主意呢----------注意工作、学习姿势正确，避免长时间低头或抬头，尽量每工作一小时左右起身放松脖颈几分钟。晚上睡觉时避免枕头过高或过低，可以枕专门的颈椎枕。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050456370},{"body":{"content":"目前有什么治疗手段","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050464408},{"body":{"content":"还能恢复么","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050469303},{"body":{"content":"还是说只能保持现状是最好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050483203},{"body":{"content":"治疗针对性的治疗，请问您有无某些药物过敏史，无肝肾功能异常，无消化道溃疡的病史，并不处于妊娠、哺乳、备孕等特殊阶段。（如无，可直接回复：没有）","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050512842},{"body":{"content":"还能恢复么--------无法恢复正常的情况了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050521678},{"body":{"content":"没有的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050522153},{"body":{"content":"减缓呢\n","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050533481},{"body":{"content":"或者增生退变没有了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050555033},{"body":{"content":"建议您注意休息，参考使用***** 1日2次 1次1袋 +外用*******1天1次，1次1贴，","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050563671},{"body":{"content":"那做做推拿什么有用么","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050583192},{"body":{"content":"减缓呢-------药物改善症状，好转后，注意颈部的保养，避免持续发展","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050588865},{"body":{"content":"这种还可以**么","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050591439},{"body":{"content":"或者增生退变没有了-------这个是不会的，随着年龄增长都会出现增生退变","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050610903},{"body":{"content":"躺着玩手机会影响么","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050619553},{"body":{"content":"那做做推拿什么有用么---------推拿属于理疗，有条件可以操作","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050623011},{"body":{"content":"需要颈托么，目前的状况","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050668293},{"body":{"content":"躺着玩手机会影响么--------使用专门的颈椎枕","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050672730},{"body":{"content":"注意颈肩的距离","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050703714},{"body":{"content":"需要颈托么----------日常工作时可以使用充气颈托起到保护和固定颈椎，避免长时间的低头","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050767075},{"body":{"content":"目前有带的必要么","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050787875},{"body":{"content":"或者我理解的颈托是阻止长时间 并不是治疗工具","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050806379},{"body":{"content":"目前有颈肩不适，工作时可以使用的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050820808},{"body":{"content":"还想问一下您说不算严重，那这个属于中度?","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050846620},{"body":{"content":"到最后面不会要开刀吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050862377},{"body":{"content":"纠正颈部的姿势，起到治疗作用；轻中度","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050879946},{"body":{"content":"然后我转动脖子他会响也是这个引起的?","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050916353},{"body":{"content":"到最后面不会要开刀吧----------持续性的加重椎间盘突出 压迫脊髓是需要的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050920718},{"body":{"content":"是的 颈部弹响有关系","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050958253},{"body":{"content":"您还有没有什么推荐的活动动作，可以减缓之类，或者纠正","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050966319},{"body":{"content":"我才28岁这样","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051065296},{"body":{"content":"会不会太早了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051069916},{"body":{"content":"目前社会的发展，颈腰椎疾病年轻化了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051167093},{"body":{"content":"好难","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051176161},{"body":{"content":"谢谢您了，那个枕头是您推的么?","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051194598},{"body":{"content":"是的，为您推荐的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051266508},{"body":{"content":"好的，谢谢您了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051278013},{"body":{"content":"不客气的，随时关注身体状况，疾病都存在演变过程，如果症状没有缓解或者出现加重的情况，建议您立即到线下医院骨科就诊，以免延误病情。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051346612},{"body":{"content":"麻烦您了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051347116},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051354404},{"body":{"content":"请问您是否还有其他医药问题需要咨询？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051384376},{"body":{"content":"没有了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051389764},{"body":{"content":"好的， 没有其他问题的话我这边就先结束问诊了，希望我的建议能够帮助到您，感谢您的信任，请在对话结束后给予五星好评，您的好评是对我工作最好的肯定和鼓励。祝您早日康复","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051400226},{"body":{"content":"后续您如果还有问题需要咨询可以在京东健康APP或京东APP中搜索“***”进行咨询。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051411918},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051418711}]

女28岁

2022.05.20

[{"body":{"content":"请问出现这个情况多久了？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878926609},{"body":{"content":"出现这个情况跟一些遗传因素有关系，如果经常熬夜吃辛辣刺激性也会导致现在这个情况可以通过涂抹*****，口服******，也可以使用透明质酸修复生物膜，或者使用******等进行治疗。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878953126},{"body":{"content":"这是什么病啊\n出现好久了\n\n","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879095560},{"body":{"content":"一直没管\n","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879111127},{"body":{"content":"医生，请您帮我开具处方或用药建议。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879129557},{"body":{"content":"这个。鱼鳞病。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879445984},{"body":{"content":"附近药店都有购买，现在平台缺货。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879452591},{"body":{"content":"应该用什么药啊\n","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879480796},{"body":{"content":"有什么注意事项没啊\n","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879596817},{"body":{"content":"这个病能根治吗\n","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879714129},{"body":{"content":"这个只能缓解，不能根治，口服******，涂抹*****。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879772459},{"body":{"content":"要注意忌口，不要熬夜，不要吃**，海鲜鱼虾蟹，然后要注意经常锻炼身体，提高机体免疫力。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879780059},{"body":{"content":"他能不能恢复到看不出来的样子啊\n\n","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879939503},{"body":{"content":"大概看不出。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880518711}]

男22岁

2022.05.20

[{"body":{"content":"您好,感谢您的信任!!!","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965657287},{"body":{"content":"请问您有什么需要咨询的医学问题？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965660973}]

女41岁

2022.05.20

[{"body":{"content":"您好，仝（tong）医生为您提供医疗咨询服务。不是AI智能机器人。我正在详细阅读您的病情描述。点击我的头像，可以看到有关信息。回复您慢了，请不要着急，还有其他人也在咨询。多谢理解*******。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049918043},{"body":{"content":"消毒**蘸温****，或者双氧水清洗局部。方法是将消毒**朝这个方向轻轻转动。或者用3%******，在药师指导下清洗局部。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049941703},{"body":{"content":"局部清洗后可用氧化锌软膏，或者*****轻轻涂抹，也可以口服******，或者******，抗过敏，缓解症状。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049950195},{"body":{"content":"尽可能不要频繁掏耳朵，洗头洗澡时不要让耳朵进水。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049981180},{"body":{"content":"不抽烟，不喝酒，对恢复健康有帮助。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049985696},{"body":{"content":"饮食清淡，少吃辛辣油腻食物和肉类，少吃油炸食品，少吃奶制品和甜食，少吃咸菜，少吃海鲜类食品。不吃零食，不吃泡面。尽可能不要熬夜，多喝温水，多吃蔬菜，对恢复健康有帮助。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049989183},{"body":{"content":"现在有炎症","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050015406},{"body":{"content":"右耳耳鸣已经几年了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050046843},{"body":{"content":"医生，请您帮我开具处方或用药建议。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050102605},{"body":{"content":"上医院不方便，这个月去过两次，都是清洗耳道换药","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050154441},{"body":{"content":"**的能用吗？感觉这个******没什么作用","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050205123},{"body":{"content":"耳朵里面晚上回有点痒，白天就没什么感觉","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050241170},{"body":{"content":"嗯，好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050272606},{"body":{"content":"谢谢医生","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050281101},{"body":{"content":"根据您目前症状，结合我的临床经验，特此推荐上述产品信息。都属于非处方药，无需医生开处方，您直接下单订购，即可寄到自己手中。请按照说明书使用1周左右，对恢复健康有帮助。请自由选择。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050309288},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050319826},{"body":{"content":"上述综合措施，对恢复健康有帮助。您是否已经理解了？还有其他健康问题需要帮助咨询吗？结束本次问诊后，请留下墨宝，简单给予评价。祝健康。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050361877},{"body":{"content":"不建议随意使用***，譬如****，**等。需要根据医院血液检查结果，判断是否需要***。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050366313},{"body":{"content":"嗯","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050391898},{"body":{"content":"自己用双氧水洗方便吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050421915},{"body":{"content":"双氧水耳浴办法~在医生或者药师指导下，将患侧耳朵朝上，把双氧水滴满耳道静置10分钟左右，这时可能会有气泡，属于正常现象，等**与耳道内脓性分泌物充分混合反应后坐起来，再将患侧耳朵朝下，让**从外耳道流出来即可。当然，可以用**轻轻将外耳道残留**擦净。每天两次，连续清洗3天即可。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050464730},{"body":{"content":"右耳真菌感染也可以用双氧水洗吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050498415},{"body":{"content":"外耳道霉菌、真菌感染时，可以用双氧水清洗外耳道后，再用********，或者******耳浴，或者******进行外耳道冲洗，抑制真菌，缓解症状。在药师指导下，按照说明书使用，滴耳或者涂擦外耳道。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050838529},{"body":{"content":"明白了，谢谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051006204},{"body":{"content":"希望我的建议能够帮助到您，感谢您的信任！本次问诊结束后，请留下您的墨宝，简单给予留言评价。假如还有其他问题，可再次发起问诊，祝健康。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051044309}]

男32岁

2022.05.20

[{"body":{"content":"您好，这里是京东互联网医生，请问您有什么需要解决的医学问题？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965804059},{"body":{"content":"请问你们医院有没有3mg的**卖","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965825924},{"body":{"content":"请问您是咸阳中心医院的吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965858717},{"body":{"content":"这里是洛阳市精神卫生中心","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965910084},{"body":{"content":"哦，不好意思","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965922705},{"body":{"content":"谢谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965926555},{"body":{"content":"不客气","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965939740}]

男29岁

2022.05.20

[{"body":{"content":"你好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965415873},{"body":{"content":"肚子疼和吃饭有关吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965426383},{"body":{"content":"你好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965431096},{"body":{"content":"大便怎样","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965436602},{"body":{"content":"大便感觉还行","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965447741},{"body":{"content":"就是一直隐疼","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965467676},{"body":{"content":"肚子哪个部位呢","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965479753},{"body":{"content":"小肚子","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965488060},{"body":{"content":"左中右","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965499327},{"body":{"content":"？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965510139},{"body":{"content":"都有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965512514},{"body":{"content":"像你这样36岁，下腹部疼痛，还是考虑肠道问题","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965544147},{"body":{"content":"什么问题？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965555910},{"body":{"content":"建议做个肠镜看看","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965559203},{"body":{"content":"哦","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965566050},{"body":{"content":"有可能是肠道功能紊乱","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965573688},{"body":{"content":"就做个肠镜吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965580056},{"body":{"content":"熬夜，喝酒，不良饮食习惯都可以导致","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965592678},{"body":{"content":"是的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965596786},{"body":{"content":"哦","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965599258},{"body":{"content":"需不需要做个腹部彩超","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965614366},{"body":{"content":"做肠镜检查，排查一下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965616763},{"body":{"content":"?","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965626438},{"body":{"content":"下腹部主要是肠管","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965627455},{"body":{"content":"只有右下腹有阑尾可以做彩超","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965643507},{"body":{"content":"隐痛，间断出现，考虑肠道问题","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965679257},{"body":{"content":"********，****，可以吃上看看","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965714511}]

男36岁

2022.05.20

[{"body":{"content":"您好,感谢您的信任!!!","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965154087},{"body":{"content":"请问您有什么需要咨询的医学问题？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965167720},{"body":{"content":"您好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965171628},{"body":{"content":"您好,感谢您的信任!!!","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965195569},{"body":{"content":"请问这个像尖锐湿疣吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965197572},{"body":{"content":"请稍等","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965280779},{"body":{"content":"您重新拍一下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965294009},{"body":{"content":"发原图给我","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965297220},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965304371},{"body":{"content":"看见了吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965563522},{"body":{"content":"您好,感谢您的信任!!!","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965569204},{"body":{"content":"不太清楚","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965579737},{"body":{"content":"拍照时点一下手机屏幕","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965650756},{"body":{"content":"这样呢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965679262},{"body":{"content":"图片不要⭕","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965704833},{"body":{"content":"看到哪个小泡泡是吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965812356},{"body":{"content":"嗯嗯","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965824847},{"body":{"content":"图片看不考虑尖锐湿疣","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965843259},{"body":{"content":"那这个像什么啊","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965860074},{"body":{"content":"您好,感谢您的信任!!!","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965871945},{"body":{"content":"您好,感谢您的信任!!!","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965872252},{"body":{"content":"龟头炎吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965873070},{"body":{"content":"考虑疱疹","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965879239},{"body":{"content":"什么是疱疹","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965899205},{"body":{"content":"图片其他地方看有问题吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965918810},{"body":{"content":"就是病毒疱疹","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965952230},{"body":{"content":"其他正常","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965959734},{"body":{"content":"这个碍事吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965969942},{"body":{"content":"需要治疗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965985457},{"body":{"content":"要开药吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965991326},{"body":{"content":"怎么治","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965992730},{"body":{"content":"抹药","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966004778},{"body":{"content":"确定是疱疹吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966005403},{"body":{"content":"是的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966010696},{"body":{"content":"尖锐湿疣是怎么样子的啊","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966114587},{"body":{"content":"您再看看这个","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966149268},{"body":{"content":"就是疱疹","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966212855},{"body":{"content":"其他正常","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966220868},{"body":{"content":"好吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966228032},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966240590},{"body":{"content":"这个好治吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966262787},{"body":{"content":"好治疗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966307295},{"body":{"content":"尖锐湿疣初期是什么样子啊","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966328726},{"body":{"content":"因人而异的，具体不太好形容，","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966403013},{"body":{"content":"好吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966457161}]

男25岁

2022.05.20

[{"body":{"content":"你好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050394644},{"body":{"content":"胃间质瘤，晚期","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050422226},{"body":{"content":"你发一下报告吧，你这样子拿着拍片子，我一点都看不见。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050434568},{"body":{"content":"发现半年了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050434790},{"body":{"content":"要什么样的报告","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050448111},{"body":{"content":" CT报告。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050502699},{"body":{"content":"发一下病理报告。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050518452},{"body":{"content":"没做病理，","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050546380},{"body":{"content":"大夫没让做","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050562605},{"body":{"content":"没做病理怎么知道是胃间质瘤？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050568380},{"body":{"content":"沈阳肿瘤大夫根据加强ct给的结果","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050589143},{"body":{"content":"建议你第1个是取病理明确病理诊断，只有病理诊断才能够确诊恶性肿瘤，第二如果是胃肠间质瘤，如果有CD117阳性的话，可以进行靶向治疗，效果还是挺好的。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050618619},{"body":{"content":"光影像没有办法确诊。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050626187},{"body":{"content":"之前寇有为大夫给开的****，吃了之后效果不好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050676700},{"body":{"content":"除了这个药还有别的药好用吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050689817},{"body":{"content":"因为你没明确，也不知道你到底适合不适合吃这个药。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050705748},{"body":{"content":"就是做个胃镜取一块东西就能确诊的事儿，怎么那么麻烦呢？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050719225},{"body":{"content":"你首先不明确诊断让大夫怎么跟你说怎么治疗。现在要求治疗恶性肿瘤，必须有病的诊断。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050739267},{"body":{"content":"如果确诊是恶性肿瘤，胃间质瘤，那怎么治疗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050817617},{"body":{"content":"得看CD117和CD34的表达水平。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050844452},{"body":{"content":"好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050848684},{"body":{"content":"大夫没让做病理的原因是，现在肚子里全是肿瘤，怕破裂，","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050968254},{"body":{"content":"这么这边的底线是病理","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051000334},{"body":{"content":"没有病理不能按恶性肿瘤治疗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051018839},{"body":{"content":"明白了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051045812},{"body":{"content":"因为不知道到底是间质瘤还是胃癌，怕方向错了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051051392},{"body":{"content":"希望您可以理解，都是家里人带老人去治疗的，我这边也是想多一个方向","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051105127},{"body":{"content":"嗯嗯","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051117743}]

男73岁

2022.05.20

[{"body":{"content":"您好，感谢信任，接到您的问题，我先根据您提供的情况仔细分析一下，然后给您答复。我这条内容您不用回复，请稍等几分钟，我会详细解答。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879268155},{"body":{"content":"他现在在做靶免治疗，这边医生说肿瘤控制的还可以，就是肝硬化有点严重。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879324502},{"body":{"content":"你好，看结果，肝功能异常，与肝硬化，肝癌，以及肝癌靶免治疗都有关系，目前具体用的那几个药物？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879402729},{"body":{"content":"\n他现在吃 *******，*****，当***，*******","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879443546},{"body":{"content":"嗯，靶免治疗用的什么？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879536304},{"body":{"content":"而且靶免治疗多久了？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879664881},{"body":{"content":"用的*****联合*****","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879722424},{"body":{"content":"嗯，目前看肝功能指标，黄疸转氨酶都比较高，靶免治疗需要注意风险","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879795185},{"body":{"content":"21天一次用了5次","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879798590},{"body":{"content":"嗯嗯，因为靶免治疗也有肝损害风险","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879817120},{"body":{"content":"那您能给一个治疗建议，治疗方案吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879889341},{"body":{"content":"一般我们的患者靶免治疗期间如果肝功能指标持续升高，就要先暂停一次，加强***物治疗，等肝功能改善，尤其是胆红素水平最好降低到40以下再恢复","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879957265},{"body":{"content":"谢谢医生 那现在有没有用药建议。他吃的药需不需要换。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880150636},{"body":{"content":"如果乙肝病毒DNA阴性，*****就不用换，***物也可以先维持目前几个，观察一周左右复查肝功能看变化，再决定下一步方案","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880220951},{"body":{"content":"那等一周后肝功能结果出来了我再联系你吧医生。他之前吃**，后来换的这个","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880358250},{"body":{"content":"可以，方案是否有效，关键看复查结果","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880385869},{"body":{"content":"那就先维持治疗，靶免停一停吧。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880445830},{"body":{"content":"对的，治疗安全第一，其次是效果","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880477356},{"body":{"content":"他现在还会偶尔发烧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880587846},{"body":{"content":"如果没有明确细菌感染，发烧考虑肿瘤有关，可以对症治疗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880636479},{"body":{"content":"这边医生考虑是腹水引起的腹膜炎","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880672486},{"body":{"content":"那就要用***","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880684305},{"body":{"content":"嗯 输着***，到时候看看效果吧。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880706907},{"body":{"content":"嗯嗯一般至少3-5天","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880725506},{"body":{"content":"好 等结果出来我再联系您吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652881425055},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652881434381}]

男54岁

2022.05.20