Director Qi of the outpatient department brought over a middle-aged rural woman in her forties.

"It's a little cold and I can't breathe, I often wake up at night, I go to the county hospital and the city central hospital to see it, it is interstitial pneumonia, and it will be better to stay in the hospital for a few days, but what should I do when I am discharged. The rural woman was not good at speaking, and Director Qi was afraid of delaying Yang Xi's time, so he replaced the rural woman and stated her illness.

Yang Xi glanced at the woman's chest CT film, and it did show signs of interstitial pneumonia, but in the diagnosis tips given by the [intelligent diagnosis system], interstitial pneumonia ranked behind, and the diagnosis rate was only less than ten percentage points.

"Basically, the diagnosis of interstitial pneumonia can be ruled out!" Yang Xi turned to the rural woman, observed it, and asked, "Is there anything else bad?"

The woman looked a little awkward when she opened her mouth to answer Yang Xi's question, as if her mouth couldn't be fully opened. "It's always hard to eat and drink. ”

Yang Xi nodded and continued, "Stretch out your hand to show me, any one is fine." ”

The woman hesitated, but handed her right hand in accordance with folk custom.

"The skin is very hard and tight, Director Qi, you touch it. Putting the patient's hand over to the old Qi's hand, Yang Xi then asked, "Isn't it difficult for your fingers to bend?"

The woman nodded vigorously and replied, "Well, well, I thought it was ruined by working too much." ”

Yang Xi smiled at Director Qi and said, "Look at this sister-in-law's mouth and nose again, the same skin is tight, and her mouth can no longer be fully opened, do you say, can interstitial pneumonia cause this symptom?"

Director Qi shook his head silently.

Dean Lin was also at a loss, and interjected: "What kind of disease is this? Looking at the film, it is indeed interstitial pneumonia!"

Yang Xi smiled faintly and said: "This disease is called systemic sclerosis, this disease is mainly based on vasculitis and tissue fibrosis of the whole body, and the clinical manifestations are mainly signs of sclerosis of the skin and internal organs, and the sclerosis of this sister-in-law is mainly on the lungs and esophagus, so it will produce the illusion of interstitial pneumonia and the manifestation of swallowing disorder." ”

Systemic sclerosis?

Isn't it scleroderma?

This disease belongs to my old cousin's rheumatism and immunology major, but, but, why didn't I think about it?

After listening to Yang Xi's diagnosis and explanation, Lao Qi suddenly realized that many atypical clinical conditions are like this, like a layer of paper, which makes people unable to see through and touch, but once this layer of paper is uncovered, everything is so simple and clear.

"How to treat it?" Old Qi casually asked these words and immediately felt inappropriate, and hurriedly added: "I mean to say that there are any tricks?"

The treatment for scleroderma is simple, with three drugs either used in combination or in combination, one is glucocorticoids, two is immunosuppressants, and three is vasodilators. Although there are clinicians' levels in many aspects such as drug screening, matching, dose control, and adjustment, the prognostic outcomes are all similar—not very satisfactory.

Even some cutting-edge treatments, such as targeted monoclonal antibody drugs and mesenchymal stem cell therapy, have the embarrassing result that a small number of patients are effective and most patients are not effective.

Moreover, whether it is targeted therapy or stem cell therapy, there is a practical problem of high cost, which is obviously not suitable for the rural sister-in-law in front of her.

"High trick ......" Yang Xi groaned while the appearance of a lewd little old man appeared in his mind: "I can't think of cheap and effective tricks, but there is someone on your old relative's side who may be able to cure this disease." ”

"Old Zhangtou?" Although Lao Qi thought of it, his face also showed a look of distrust.

Most of the people who engage in Western medicine treat Chinese medicine with the same kind of urine, and they don't look down on Chinese medicine in their bones. Most Western doctors do not resist Chinese medicine on the surface in line with the principle of not causing trouble, but in their hearts they often shake their heads and sigh that Chinese medicine is just a pseudoscience that cheats people out of money.

For example, this old relative.

Another example, the old forest next to this old relative.

After all, as a specialist in rheumatism and immunity, he knows that this scleroderma is really difficult to treat, not only the Western doctors are quite helpless, but it is also difficult to have an effect in the hands of traditional Chinese medicine.

But why did you Lao Lin show disdain?

To put it mildly, can you understand what scleroderma is?

It was also thanks to Dean Lin's quick reaction, and when he saw that Yang Xi's expression was wrong, he immediately realized his own problem, quickly changed his look, and shifted his attention to Zhu Lin, who had been silently observing Yang Xi after returning from the bathroom.

"Ah, Mr. Zhu, I'm sorry, our small hospital has limited conditions, so you have been wronged. As he spoke, Dean Lin hurriedly bypassed Yang Xi, walked towards Zhu Lin, and made a gesture of sending the guests away.

Coincidentally, Zhu Lin's specialty in the hospital is also rheumatism and immunity, and she is no stranger to the disease of scleroderma, but when she saw the patient, she never thought in the direction of scleroderma.

Is it because I have been out of the clinic for too long?

There are factors in this regard, but it cannot be said to be the main factor, and the main reason is that the patient's clinical signs are not typical enough, which makes it easy for doctors to deviate when making diagnostic thinking.

However, Yang Xi is neither a specialist in rheumatology and immunology, nor does he have much clinical experience, so how do you think he made a diagnosis so easily?

For a while, Zhu Lin was no longer simply surprised at Yang Xi, but mixed with a little admiration in the surprise.

You can't just leave it at that.

It is necessary to establish a close relationship with such a god-like doctor, and Huajian's business will inevitably take off in the future.

"Dean Lin, I thought about it again just now, and I feel that it is not impossible to invest in your hospital......" Although the decision has been made in his heart, Zhu Lin still did not let go of his lofty tone.

Dean Lin smiled and sighed, and secretly glanced at Yang Xi, and observed that the kid didn't seem to have heard Zhu Lin's change at all, and he understood nine times out of ten in his heart.

"Let's talk about it! Radiotherapy is not a trivial matter, the configuration certificate alone is enough to take it down, and you have to go through the environmental impact assessment, apply for medical insurance, there are many troubles, I have to go to make it clear one by one, and then say, save us from negotiating, the certificate can't be done, isn't it a waste of effort!"

These words happened to be the reason why Zhu Lin used to suppress Dean Lin at the beginning, but he didn't expect to be countered by Dean Lin on himself. He didn't want to hit himself in the mouth, so Zhu Lin had to follow Dean Lin's words and responded: "That's okay, then I'll wait for your news at any time." ”