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From: MDBG CC-CEDICT Chinese-English Dictionary 漢英字典

 嘔心瀝血 [ㄡˇ ㄒㄧㄣ ㄌㄧˋ ㄒㄩㄝˋ; ou3 xin1 li4 xue4]
 lit. to spit out one's heart and spill blood (idiom)
 to work one's heart out
 blood, sweat and tears