(Thanks to friends for their encouragement, thanks to friends for their encouragement, and thanks to their friends for encouraging them to stay awake)

I had a lot of fun eating at Zhou's house last night, and Liu Banxia played at a super level, so he naturally ate very satisfied. But for Wang Xiaoyan, this is not a good thing.

After saying that he was going to come back, he would continue to eat barbecue, but he ate it, and she and Jelly Bean became the main force. Let her give Liu Banxia and Qiao Qiao a break, but these two people are very thick-skinned and don't care at all.

"Chao, did you admit critically ill patients yesterday?" asked Liu Banxia after changing his clothes.

"Yesterday was quite peaceful, there was a car accident and two heart attacks. The car accidents were all minor injuries, and the heart attack was also rescued. Wang Chao said.

"But this year's flu is very domineering, and now we have a lot of people here every day to infuse, and I don't know when it will come back a little. ”

"This year's temperature is a bit abnormal, cold and hot. And it doesn't snow much, which is a bit sad. Liu Banxia said.

"I still have to tell the big guy to pay attention to personal protection, it is really uncomfortable to wear a mask for a long time, so I have to wear it. Especially for these nurses who often dismiss patients, disinfection must be done well to avoid cross-infection. ”

"Don't worry, the big guys are paying attention to this. How many surgeries did you have today?" Wang Chao asked.

"Three, two colostomy and one inguinal hernia repair. Liu Banxia said.

"I took them to the stage when nothing happened, and I just looked over the preoperative examination results, and they were all fine. I'm trying to get it done quickly and then I'll be able to come back and help. ”

"Go, go, if I have time, I'll show you a colostomy, okay?" asked Wang Chao.

"Okay, you're in control of your own time. Kids, get to work. Liu Banxia shouted.

If it had been changed in the past, Xu Yi promised that these interns would definitely be in a mess, but now that they have followed Liu Banxia on stage more times, they are not as excited as before.

But it's just that I'm not so excited, and I still cherish the opportunity for Liu Banxia to take them to the stage.

Because I have been interning with Liu Banxia for so long, even if there are other supervising doctors in name, the six of them are almost all in charge of Liu Banxia.

According to the understanding of the internship during this time, as long as it can be recognized by Liu Banxia, there will be many opportunities to intervene in the process of surgical operation.

This is very precious, and normally it is like today's ostomy surgery. But Liu Banxia is different, he will give them the opportunity to exercise, this is a rare experience.

Liu Banxia's hands are very fast, and the average operation time for him to go on stage in the second hospital is also the shortest. But even so, only one colostomy and one inguinal hernia repair were done in one morning.

The colostomy in the afternoon was a bit complicated, and it was also because the patient had rectal cancer, so it involved the problem of anal preservation. What can be done is to help the patient save the anus as much as possible.

"Mr. Liu, I received a patient in the morning, who was very emotionally unstable, and lethargic, and had swollen lymph nodes. Wang Huan walked over with a plate.

The interns who had dinner with Liu Banxia immediately pricked up their ears, and they liked others to ask Liu Banxia for consultation. It's just like solving puzzles, it's very fun.

"Brother Wang, in fact, you should wait for me to finish eating, just got off the stage. Liu Banxia said with a wry smile.

"I just got stuck at this time, you eat yours, I said mine. Wang Huan said.

"At first, I thought there might be some signs of depression, but the blood test results showed an increase in the sedimentation rate, which is almost inflammation. And the patient also has a fever. ”

"We suspected that there might be a brain tumor, and we did an MRI, but the test result was negative. We also suspected that there were parasites, and the blood and cerebrospinal fluid tests were also negative. ”

Listening to Wang Huan's description, Liu Banxia also became interested, "Can you rule out narcolepsy?"

Wang Huan nodded, "It can be ruled out, and the blood test results of narcolepsy are not like this, and we don't know what the main cause of fever and inflammation is." ”

"How long do you have to sleep every day?" asked Liu Banxia casually.

"Not necessarily, according to her husband, it will be at least fourteen hours, and Mo will be more in a day, maybe seventeen or eighteen hours. Wang Huan said.

"It's not like some people sleep in sections, and sleep in whole sections. When I wake up, I feel very bad, and sometimes I lose my temper when I talk too much. ”

"We are now considering whether it is a concomitant cancer syndrome, but the spinal fluid test is not in order. Now that I've been admitted to the hospital, will you take a look after dinner?"

Liu Banxia nodded, "Okay, but don't expect me." You're sure you're going to get a diagnosis too, and it's an interesting case. ”

"By the way, did you do any tests for pellagra? Didn't you meet one of these patients the other day? Although that patient didn't sleep as well as this one. ”

"Also checked, their standard of living is very good, and there is no stress in life. The child was also admitted to a relatively good university this year, and the couple's income was also very good. Wang Huan said.

Liu Banxia nodded, although he was still eating, he was also thinking about this case in his mind. It's really tricky, and I didn't find out the cause of so many instrument tests.

At this time, Wang Huan's mobile phone rang again, and his expression became serious after connecting it, "Okay, I'll go up." ”

"What's wrong?" asked Liu Banxia.

"You can eat this meal later, just now the patient had a brief seizure, and after recovering, he had hallucinations. Wang Huan said.

"Cheng, go up and watch first. Miao Rui, let Zhou Qiang help us keep the meal. After finishing speaking, Liu Banxia followed Wang Huan to the emergency center.

I haven't eaten a few bites of rice, and it's a shame to throw it all away. Wait until you come back and eat it, which is the norm in the hospital anyway.

"Mr. Wang, I have injected 5 mg of haloperidol into the patient, and it has stabilized. Zhou Shangkai said.

Wang Huan nodded and handed the medical record book on the bedside to Liu Banxia.

Liu Banxia took a closer look, the patient was forty-one years old, and the corresponding examination results were all negative.

"Doctor, can I do any other tests?" asked the patient's husband.

"Are there any other symptoms at home?" Because it's not convenient for us to ask patients about it, even if it's a trivial symptom, you should think about it. Liu Banxia said.

"For example, emotionally and physically, at the beginning of the patient's illness, is the patient's emotional instability before or after drowsiness?"

"At first, I was in a bit of a bad spirit, and occasionally I had a little headache. Later, I slept a lot, slept at night and during the day, and when I woke up, I was listless and had a bad temper. The patient's husband said.

"At first, we thought that we had fallen into evil, so we asked Mr. to show it, and it didn't work for two days. I came to the hospital, and now I sleep more and more. ”

"Are you usually so stable when you sleep, whether it's day or night?" asked Liu Banxia.

"Hmm...... At the beginning, I loved to turn over when I slept at night. Later, I couldn't do anything about it, so I moved to another house. The patient's husband said.

"I really didn't take it seriously at first, I thought it was a cold, and I just love to sleep after taking cold medicine. I've told Dr. Wang about all of this, and I really can't remember any more. ”

"The way she is now, I am too tired to do it. I have to be careful when I get home from work, and I'm afraid of waking her up, and if I wake up, I have to fight. ”

"Do you have pets at home?" asked Liu Banxia after a moment's thought.

"I raised it, I just raised it this year, and I have a pet cat. The patient's husband said.

"She liked it very much from the beginning, and she couldn't do it every day. Now like this, she doesn't even care about the cat, and the cat doesn't dare to come to him to beg for cheapness. ”

"Mr. Liu, do you think this may be because of an infectious disease brought by pets?" Wang Huan asked with a frown.

Liu Banxia shook his head, "It's still a little hard to be sure, at present, we can only consider it from many aspects." Could it be tularemia? High fever and swollen lymph nodes are anastomosis. ”

"At first, the patient thought it was a cold, and he should have been sore all over the body that had been overlooked. However, it is somewhat inconsistent with the symptoms of drowsiness in patients, and it can only be a guess for us at present. ”

"Okay, I'll arrange for a laboratory test. Well...... , both of them have to do a check, to verify each other. Wang Huan nodded.

"Is it really an infectious disease?" asked the patient's husband, with some concern.

"This is just a speculation on our part at the moment, and the indication of your wife is not very clear right now. So we can only do the elimination method and check it out for you later, just a simple blood test and skin test. Wang Huan explained.

The patient's husband glanced at his wife lying on the bed and nodded.

"Brother Wang, can I try streptomycin first? It's too long to wait for the test results. Liu Banxia said.

Wang Huan nodded, "Later, I will do a streptomycin test for the patient, and if there is no response, inject 500mg intramuscularly to see the effect." ”

Although there are still non-conforming symptoms, tularemia is somewhat reliable at present. In addition, streptomycin has a good bactericidal effect on microorganisms, and it can also be used as a trial at present.

Even if this is the case first, whether it is effective or not depends on the results of the examination and the effect of the drug after use.

After tossing around the top, Liu Banxia and the others returned to the restaurant to continue eating.

"Doctor Liu, what are you thinking?" asked Qingkova curiously.

"It's still the case just now, and I always feel that something is wrong. In particular, there is no reasonable explanation for this symptom of drowsiness. Liu Banxia said.

The interns didn't know what to say, and that's exactly what it was. They know tularemia, but they never have symptoms of drowsiness.

However, the rest of the symptoms are really consistent, and it may also be due to complications caused by tularemia, which is also uncertain.