He was a doctor. To treat people, the most important thing is to learn to induce the phenomenon of indulgence

A patient with stomach pain, do you know exactly which part of the pain he has? Then the cause is determined by the location;

For example, Xu Ze has found that this patient has obvious gallstones through color ultrasound, and when the gallbladder is also swollen, it can basically be determined that this patient's abdominal pain is mainly caused by this gallstone

But being a doctor is not such an easy profession. Seeing a doctor is not such a simple thing. Xu Zefang just wanted to cope with this assessment, but he forgot that it was a very important thing for a doctor. That is, in addition to the main symptoms. It also carries out the identification and analysis of other diseases, because abdominal pain like this, in addition to gallstones, gastritis and even pancreatitis can be caused.

At present, Xu Ze can already confirm that it is mainly gallstones. However, it is also necessary to rule out other possible diseases, although the likelihood of comorbidities is more likely than that of a physician. You can't ignore the possibilities because of them; Because many times, it is only a little problem that is not paid attention to, which leads to serious consequences.

Now Xu Ze suddenly remembered this problem, although there should not be any big problems, but for him, who has always been cautious and responsible for patients, this is a problem that cannot be ignored.

So he settled down again, activated the color ultrasound, and scanned the patient's stomach and pancreas.

Color ultrasound can effectively determine the overall changes in the pancreas and stomach, and through this test, the division can roughly determine whether there is any abnormality.

The results of the color ultrasound scan made him feel a little relieved, the patient's stomach did not find any major problems, and the pancreas was very smooth on the outside, and there seemed to be nothing abnormal.

Xu Ze was almost relieved at this time. However, remembering the new blood amylase function in the recent tertiary system function, I also successfully gave it to the patient.

This blood amylase test is a standard test to rule out pancreatitis, as long as this test is done, then it can be completely confirmed whether there is a problem, and it is much more accurate than a simple color ultrasound scan.

Following his order, he quickly popped out a thin needle on the index finger of the patient's right hand and pricked it lightly on the patient's wrist, and before the patient knew it, a little blood was drawn for testing.

"Oukou Gong" Xu Ze looked at the red value displayed on his glasses. I couldn't help frowning, the blood starch woke up obviously exceeded, and this patient really had a pancreatic brake

However, the main diagnosis is gallstones, and the second is pancreatitis; TCM diagnostics. There shouldn't be any problems with the diagnosis of cholelithiasis.

At that moment, he slowly stood up, nodded at the senior national players who were already a little impatient in front of him, and then said, "Old Dean Guo." I've finished my consultation."

Hearing Xu Ze's words, all the senior national players also nodded slowly, and Wang Lao Guoshou looked at Xu Ze's face with a serious, but still confident look, and he was relieved.

Originally, Wang Laoguoshou saw where Xu Ze hesitated and hesitated, and saw that Xu Ze was indeed weaker than several other rookies in traditional Chinese medicine, and he was worried about whether Xu Ze could pass the test smoothly; But now Xu Ze has spent a little more time. But it seems that the confidence is still very strong, so it is natural to relax a little.

Wang Lao Guoshou is now not able to pass the test, and he doesn't care too much about the impact on his reputation, what he cares about is that the young man in front of him is indeed very good, if he can't pass this assessment to get a practicing certificate, it will be a pity.

Old Dean Guo looked at the young man with a solemn face on the other side, then nodded lightly, and said, "Okay, since the examination has been completed." Xu Ze, could you please answer the basis of this patient's diagnosis and treatment plan?

"The main manifestations of the patient are epigastric pain and bitter mouth and oil aversion. Signs can be seen thin yellow tongue coating, pulse strings, Western medical examination can show mild tenderness in the right upper abdomen, Murphy's sign is positive, so the diagnosis of traditional Chinese medicine considers: cholelithiasis, liver stagnation and qi stagnation type, the treatment principle is to soothe the liver and regulate qi, prescription selection: Bupleurum soothing the liver, acupuncture and acupuncture: take the sun and moon, the period gate, the gallbladder acupoint, with the foot of Sanli, Zhongxiao,"

Speaking of this, Xu Ze's eyes couldn't help but squint slightly. looked at the expressions of the first few senior national players, and saw that Wang Lao Guoshou smiled and nodded gently, and he was relieved in his heart, as long as this is not wrong, then he is not worried,

The next aspects of Western medicine diagnosis and treatment. For Xu Ze, it was naturally simple, and Xu Ze, who was in a relaxed mood, continued with a light smile at this time: "Western medical diagnosis considerations: acute cholecystitis, gallstones; It is not ruled out that acute pancreatitis may be "recommended to undergo hepatobiliary ultrasound, blood routine, blood amylase and other examinations, and in terms of treatment, temporarily give anti-infective treatment with cephaladine and ofloxacin, and give cimetidine acid suppression, Wangkou antispasmodic analgesic,"

"If there is a relevant examination to confirm the presence of gallstones. According to the patient's physical condition, it is recommended to perform surgical treatment under the condition of effective anti-infection and gastric acid inhibition to protect the pancreas."

Hearing what Xu Ze said, Dean Guo frowned slightly, Dean Guo obeyed traditional Chinese medicine, although in recent years he has gradually accepted Western medicine, but he is still very resistant to the surgery that Western medicine is good at.

Because in his opinion, if it can be treated conservatively, using traditional Chinese medicine to assist in stone removal is naturally the last, after all, Western medicine does surgery, although it is simple. But after all, it is a matter of killing 3,000 enemies and losing 800 of yourself. It is not in line with the way of traditional Chinese medicine.

However, at this time, although he was not very satisfied with the treatment method proposed by Xu Ze, after all, this operation belonged to the category of Western medicine, and it was naturally inconvenient for him to deny it easily, so he immediately turned his head to look at the two professors of Capital Medical University on the side, waiting for their judgment.

Old Dean Guo looked at Professor Tang Wuwu and Professor Jiang Lingyun, but found that the two of them looked at Xu Ze at this time, and there was a trace of surprise in their eyes.

Old Dean Guo was stunned for a moment, and couldn't help but wonder at the two professors: "Two professors, please comment,"

Tang Wuwu and Jiang Lingyun glanced at each other, but then Jiang Lingyun nodded and smiled; "Guo Lao, the diagnosis and dialectics of this son are extremely close, and the diagnosis of acute cholecystitis and gallstones is extremely clear, and the treatment plan is clear,"

Hearing Professor Jiang's words, Dean Guo was stunned, and the young man in front of him was Xu Ze. Could it be that the attainments of Western medicine have really reached such a high level?

And Wang Laoguoshou next to him also smiled lightly at this time, Xu Ze finally did not disappoint him,

However, the few people next to him, especially Guo Yujian. looked at Xu Ze, but his eyes also showed admiration. They all studied Chinese medicine, but Western medicine can reach this level, which is naturally incomparable to them.

Especially Guo Yujian, at this time, he also restrained the pride on his face,

was in shock, but he heard Professor Jiang, and suddenly said, "It's just,"

"But what?" Dean Guo was stunned when he heard this, but he didn't think it was strange, although Xu Ze seemed to be very superb in Western medicine, he was still too young after all, and it was very likely that there would still be some places where he would be poor.

At the moment, I was also a little happy in my heart, if Xu Ze had no problems at all in this round of assessment, then he could be so good at participating in the assessment of rookies in Chinese medicine as a student of Western medicine, then the faces of everyone here would not look good.

Moreover, originally his grandson Guo Yujian was already the first place today, and he also had a bad face with him, but if Xu Ze could achieve such good results in this round, then he could keep pace with his grandson, who had been carefully cultivated by his family for more than ten years, and he was naturally not very comfortable.

At the moment, it seems that there are still omissions in Xu Ze's answer. At that moment, he breathed a sigh of relief and said with a smile: "Professor Jiang is in charge of judging today, and it is okay to speak freely, if Xu Ze's diagnosis is inappropriate, Professor Jiang should mention it,"

Jiang Lingyun nodded with a smile, and then asked with a curious smile at Xu Ze, "Doctor Xu, right?"

"Professor Jiang, I'm Xu Ze!" Xu Ze looked at Jiang Lingyun like this, but he was also stunned. I have doubts in my heart, is what I said wrong?

"Dr. Xu, the basis for your diagnosis of acute cholecystitis and gallstones just now is very clear. The diagnosis is also very good; But how can you be sure that he has the possibility of acute pancreatitis? Professor Jiang looked at Xu Ze and asked curiously with some surprise.

Hearing Professor Jiang's words, Xu Ze's heart also had a hint of discoloration, and he said secretly: "Don't these two professors know that the patient has the possibility of acute pancreatitis?" "Look at Professor Jiang like that. Xu Ze had some bottom in his heart, these two professors must have seen this patient in advance, but they did not conduct detailed examinations and examinations in all aspects. That's why I didn't determine this, the conclusion.

However, Xu Ze naturally didn't say that he did blood amylase on the patient to determine it, of course. He was prepared. I have already thought of a way to defend myself.

He immediately smiled and said, "Professor Jiang, the patient reported that before he had abdominal pain, he had eaten a lot of greasy fried rice and beer, and he had abdominal pain in the back; This kind of overeating, and abdominal pain after eating and drinking, although it is one of the factors that can cause cholecystitis attacks; But there is also the disease of acute pancreatitis that must be considered, because the first article of internal medicine on this condition mentions that such overeating and drinking can lead to this more serious disease."

"So, I think that although it can be concluded that there is a high possibility of cholecystitis gallstones by a positive Murphy sign at present, this situation is naturally not excluded, and the possibility is not so, I propose this comorbidity,"

Hearing Xu Ze's analysis, Professor Jiang and Professor Tang Wuwu looked at each other in surprise, but they didn't expect that Xu Ze could even remember such a stunned article in the book. And it can be taken out and analyzed so clearly,

Even the two of them were not in a hurry. The situation that he didn't pay attention to can be analyzed in a short period of time, this young man is really extraordinary,

Thinking of this, Jiang Lingyun nodded at Xu Ze with a sigh, then turned his head to look at Dean Guo on the side and sighed: "Old Guo, these young people of yours are amazing, it is really not easy to diagnose such a complex situation with such simple means, it is not easy, it is not easy,

Hearing Professor Jiang's words, Old Dean Guo's face was stunned, and he naturally didn't expect it. Professor Jiang this. It's just that it made Xu Ze fight for a few points, and even the two old experts in the Western medicine field are so praised,

At the moment, he could only stroke his beard and smile dryly: "Seeing that the younger generations are now talented, we are also very relieved to be old, and we are so gratified,"

After saying that, he had no choice but to comment with a smile: "Xu Ze performed well today. The evaluation is excellent, all the rookies have successfully passed, please Director Lin to announce the overall situation of this assessment,"

Lin Zhiben, deputy director of the National Medical Examination Center next to him, nodded with a smile, and was about to speak, when suddenly an old man next to him suddenly interjected with a smile: "Old Guo, Brother Wang said that Xu Ze's acupuncture technique is very good, today we don't know if we can take a look, I don't know what everyone thinks?" ”

Hearing the words of this old man, Xu Ze frowned secretly in his heart, it seems that he came to participate in the assessment of this rookie of traditional Chinese medicine who majored in Western medicine, but he also achieved such good results, and stole the limelight of these rookies.

And this kid is like this today. The results are also better than the vast majority of Chinese medicine rookies. If this kid doesn't have that ability, it can be regarded as pressing him a little, and he will not let these old guys be too disgraced.

Seeing that everyone agreed, Wang Laoguoshou also smiled helplessly, and it was not good to object to everyone taking Xu Ze's test again.

Old Dean Guo also looked at Xu Ze and smiled at this time, and said, "Xu Ze, Brother Wang is very appreciative of your acupuncture technique, and we are also very curious, why don't you show it to this patient today?" ”

Seeing that all the old men were smiling, but they couldn't be objected to, Xu Ze had to smile bitterly, but his certificate is still in your hands, can you not agree?

At the moment, I had to nod and say: "Since the senior teachers want to test the below, they will naturally obey it."

The old man heard that although Xu Ze was a little angry in his words, he didn't dare to object, everyone smiled at each other, and then said: "That's naturally good, then let's start."

Xu Ze took a light breath, knowing that if he didn't show his hand today, he was afraid that it would be difficult to explain. These are all senior national players, and it's not good not to give them some face, so they immediately took out the silver needle they had always carried with him, and they were ready to do it.