At the beginning of the meeting, the moderator was Gu Zhijie.

Jiang Feng first reported the case, and Chen Tianming made additions.

Subsequently, each committee member expressed his views one by one, and all of them talked about their thoughts and ideas from their own departments. After all, the departments are becoming more and more detailed, and which departments are involved in the patient's disease may not be able to be accurately judged from the perspective of the attending department, and each department needs to be examined from its own perspective in order to diagnose and treat more comprehensively and accurately.

At first, Jiang Feng felt that some departments had no connection with his own medical records at all, and it was really unnecessary to speak, and it was a pure waste of time, but after listening to the opinions expressed by others from the perspective of medicine in their respective departments, he did feel new enlightenment, so he took notes very seriously, nodded from time to time, and asked some details and questions.

When it was the turn of the Department of Obstetrics and Gynecology to speak, it was their resident Tian Tian who participated in the expert consultation committee.

Although Tian Tian is also a resident doctor, the strength of the obstetrics and gynecology department of the three hospitals is relatively weak, and there are basically no highly educated people, only Tian Tian graduated from this graduate school, and the first condition for selecting committee members this time is academic qualifications, followed by work experience. In addition, their director strongly recommended her to join, so she was elected as a member of the expert consultation committee.

However, Tian Tian seemed very nervous, although she was fully prepared, she was still a little red and stammered when she spoke. It took a long time to make her point clear.

Her views are the same as Jiang Feng's, and she speaks more deeply and accurately.

She believes that the patient suffers from **endometriosis, the reason is that the patient is young, and every time he coughs up blood, it is like this several times in a row, so it is judged that her coughing up blood is closely related to menstruation, which should be caused by **endometriosis.

She also learned what metastatic infection caused by endometriosis is, which is the transfer of endometrial debris to other organs such as the lungs through blood circulation or lymphatic system, causing ectopic intimal invasion to the chest cavity, causing the patient to cough up blood. The most typical feature of this coughing up of blood is that it appears near menstruation. This was preceded by an X-ray of the patient's chest that found an abnormally dense focus, confirming this hypothesis. As for the treatment plan, she proposed to use hormones, and the effect should be noticeable.

Jiang Feng attaches great importance to Tian Tian's speech, and remembers it very seriously, which is extremely valuable for the director of a large department and the first knife of the three hospitals. If it weren't for a platform like the Expert Consultation Committee, he wouldn't have listened to the opinions of a small resident doctor in another department on his patients.

When Tian Tian expressed his opinions, he almost didn't dare to look up at the leaders and others, and after reading the speech he had already written in one breath, he breathed a sigh of relief.

glanced up, and just saw Jiang Feng looking at him, and suddenly panicked.

Jiang Feng smiled and said, "Doctor Tian, thank you, can you send me a copy of your speech from the intranet after the meeting?" ”

When Tian Tian heard this, he was excited and frightened. His opinion was able to get the praise and recognition of Director Jiang Feng, who was the first to cut it, of course, he was very excited and agreed repeatedly.

It was Zuo Li's turn to speak.

He said: "Yesterday I went to the ward to see the patient, and by feeling the pulse, I found that the patient's location was in the lungs, and now, I still insist on this judgment, that is, the patient's coughing up blood is caused by the cause of the diseased lung, not **endometriosis metastatic infection." ”

The stone was shattered, and everyone's eyes looked at him, including Chen Tianming.

Zuo Li continued: "**Endometriosis, Chinese medicine attributed to dysmenorrhea and symptoms, and the patient does have symptoms of irregular menstruation, qi stagnation and blood stasis, but her pulse is a string pulse, and the pathogenesis of endometriosis is caused by qi stagnation and blood stasis, cold condensation and phlegm obstruction, liver and kidney loss, and poor flow of qi and blood, so the pulse of patients with this disease is generally fine. However, the patient's pulse did not match, and neither the location nor the pulse supported the judgment that ** endometriosis metastatic infection caused by hemoptysis. ”

"Therefore, I have suggested that Director Jiang and Director Chen re-examine the patient's lungs again and conduct a more detailed examination to find out what the shadow of the lung is and how it came about. The Department of Thoracic Medicine is already doing this, but it hasn't worked out yet. I won't talk about the treatment plan until I get the results, and it may be better to decide after figuring out the location of the patient. ”

Gu Zhijie was a little surprised, but his eyes were full of approval. -- Discovering problems and avoiding misdiagnosis is what he hopes to achieve by insisting on setting up an expert consultation committee.

He nodded and looked at Jiang Feng: "What do you think of Doctor Zuo Li's opinion?" ”

Jiang Feng said calmly: "We attach great importance to Dr. Zuo's opinion, and we were a little busy yesterday, so we didn't arrange it. I have made arrangements just now, and I will re-examine the lung X-ray according to Dr. Zuo's request, and the results have not come out yet, but ......"

Speaking of this, he paused, a little hesitant, whether to say that he did not agree with Zuo Li's judgment, and at this moment, the door of the conference room was pushed open, and a nurse came in, holding an X-ray chest X-ray in her hand.

She saw Jiang Feng at a glance, waved the piece in her hand at him, and smiled apologetically at Gu Zhijie. Seeing Jiang Feng waving to her, she quickly came to Jiang Feng's table, put the chest X-ray on the table and said, "Doctor Jiang, I've already taken a film." I asked them to speed up and said that they were going to use the venue today, so they got it right away. ”

The nurse walked briskly out of the room.

Jiang Feng took out the film and held it above his head, looked at the light on the roof, nodded, glanced at Zuo Li, and said calmly to Gu Zhijie: "Dean Gu, I have been diagnosed, I just sent the patient to take another chest X-ray, and the results are consistent with the photos taken by the patient a few days ago,—— there is a circular dense shadow in the upper right lung, which is connected to the left hilum and is 5×4 cm. Combined with the judgment of gynecology, I still tend to identify it as hemoptysis caused by **endometriosis, and recommend transferring to gynecology for treatment. Of course, it is okay to stay with us for treatment, and I hope that the gynaecologist can help us. ”

Gu Zhijie nodded and looked at Zuo Li, there was no blame in his eyes, but a little encouragement. Seeing Gu Zhijie's gaze, Zuo Li originally wanted to say something, but he still didn't say it.

The eyes of others looking at Zuo Li are a little interesting, some are sympathetic, some are looking at jokes, as if to say, you also have a day of mistakes?

Gu Zhijie glanced at everyone and said, "Do you have anything to add?" ”

Tian Tian raised his hand and said, "Actually, Doctor Zuo's judgment is right." Doctor Zuo said that the patient's disease is located in the lungs, and now two chest X-rays have also confirmed that the lungs do have a similar round dense shadow, although this is a lung infection caused by the transfer of endometrial debris to the lungs through blood or lymph, but it can be regarded as a lung problem, Dr. Zuo just said that the disease is located in the lungs, so I think Dr. Zuo's judgment is no problem, and it also confirms our diagnosis of endometriosis metastatic infection causing hemoptysis. ”