Yang Ping and Song Zimo could only drink apple cider vinegar, and the brothers drank the vinegar into wine.

"!"

"Dry"

Grunt another cup.

Those who don't know the truth must think that this is the heroic dry cloud on the wine table.

Xu Zhiliang poured three glasses, but the momentum of drinking was admirable.

Zhang Lin is always "No, the last cup!" But it always doesn't pour, as if it's the last cup.

Xiao Wu's face is not red, and his heart is not beating, as if he has just started.

Liang Fatzi looked at the performance, not very stable, and performed well today.

The new anesthesiologist, Dr. Wei, seemed a little out of place, sitting next to him, resigned, and very reserved.

Dr. Wei is a scalper-type character who only works and does not like to talk.

They drank up two dozen beers.

Zhang Lin rested on his back in the chair, and as soon as the phone rang, his wife checked the post and immediately sobered up.

"Drink one or two cups, meaning, with Professor Yang, don't worry, I haven't finished two cups, there is still half of it left, it's good." Teacher Zhang was extremely gentle, and his waist was almost close to the ground, but he couldn't help but take a wine gap.

The fat man here greeted the waiter, and shouted without knowing the times: One more dozen.

Zhang Lin hurriedly covered his mobile phone.

The fat man squinted his eyes: "Look at your bear-like, I'm afraid that my wife will be like this, and I will train my wife to be obedient in the future." ”

The fat man touched the cup: "It's full." ”

But I found that the cup was long gone, the cup, the cup.

There are fewer opportunities to drink so freely, and everyone usually eats until they are ordered.

But today is different, the clinical trial of the external cristal fixator was successful, which is a big deal for Corey.

In addition to the newcomer Dr. Wei, others participated a lot, Song Zimo and Xu Zhiliang were the backbones of the main pillars, Zhang Lin was responsible for the data collection of patients after admission, and Xiao Wu was responsible for communicating with patients and follow-up after discharge.

Everyone has a share of the credit for this success, so everyone is very happy.

There is another reason, the fat man fell out of love, and he was depressed and sad for a day, and his brothers accompanied him to go crazy and vent the negative emotions in his heart.

After eating, everyone dispersed.

Xiao Wu and Zhang Lin accompanied the fat man to go around the hospital, and several people didn't go home, went to sleep in the department, and played a few games casually.

Yang Ping and Xiao Su were taking a walk around the hospital, and the two families were urging marriage very much, and the two wanted to discuss marriage.

Parents are always like this, urging you to find a partner, then asking you to get married, and then encouraging you to have children.

Yang Ping and Xiao Su are not in a hurry, Xiao Su knows that Yang Ping is now busy with new topics, and the matter of marriage can be postponed.

But people in the rivers and lakes can't help themselves.

——

In the morning, the weather was nice.

Yang Ping crossed the overpass and rushed to the hospital to work, and today Saturday, the forum will be broadcast live at nine o'clock.

"Iron Triangle" drank a little too much last night, and was still washing in the duty room, all of them were panda eyes, and they must have played games late last night.

Song Zimo and Xu Zhiliang arrived early, and they were preparing for the nine-o'clock lecture.

The venue is set up in the demonstration classroom, where the camera is pointed at the podium, and the lecture can be broadcast live.

One after another, people arrived at the doctor's office, and these graduate students, trainees, and interns all came to attend the lectures.

Usually, it is a trilogy of ward rounds and surgeries.

But today is Saturday, and there is no big shift, just the doctors and nurses on duty who take over the shift privately.

No surgery was arranged, and the ward rounds were also made by each bedside doctor to check on his patients individually.

Yang Ping asked the doctor on duty if there was any special for the newly admitted patients, and the doctor on duty said that a patient was admitted to the obstetrics and gynecology clinic in the afternoon.

Li Jun, male, 26 years old, had a distended abdomen for three months.

On examination, a palpable lower abdominal mass may be solid, well-defined, mildly tender, moderate ascites, sensory disturbances in the perineal area and perianal skin, and absent anal reflexes.

Ancillary tests include color ultrasonography and magnetic resonance imaging (MRI).

"The patient was admitted from the obstetrics and gynecology department?" Yang Ping felt strange.

There are often people who are hung in the wrong department, but few men are hung in the obstetrics and gynecology department, even if the man has a distended abdomen, he generally thinks of the tumor first, and will not think of pregnancy.

It's not that Yang Ping is curious, but that the doctor wants to make the diagnosis and treatment process clear.

This is called medical history, and only by understanding the medical history can the diagnosis be truly made, especially for incurable diseases.

"I don't know." The doctor in charge of the bed is a little difficult, and he is also wondering how men look at obstetrics and gynecology.

"Look at the film!"

Yang Ping only mentioned it in passing, and did not delve into this reason.

Magnetic resonance imaging and color ultrasound are done in the outpatient clinic, and pictures are generally typed on the screen first for everyone to analyze, which is not only familiar with the information of newly admitted patients, but also can cultivate the doctor's ability to think independently.

After a brief analysis, the results of the imaging examination are typed.

In fact, an experienced clinician is better at interpreting X-rays, CT and MRI images than radiologists because he can often combine imaging with surgical observations.

Junior doctors, on the other hand, rely heavily on the diagnosis of radiologists.

However, color ultrasound is an exception, most surgeons do not have the ability to interpret color ultrasound, they can only rely on the report, and the pictures on the color ultrasound report are only symbolic, unlike X-rays, which can be interpreted directly.

"A lump in the abdomen? Is it a lump? Teeth and ridges are clearly visible, as well as other bones. ”

"Is there a mistake in the medical records? Female, right? ”

"Fetus?"

Everyone's first reaction was, apart from the fetus, how could there be a spine?

Someone questioned him for mistaking his gender and annoying the doctor on duty, who defended his reputation: "I did a detailed physical examination and the genitals were male. ”

If you suspect that I have written the wrong medical record, shut up and don't fan the fire.

At this time, there were more and more people, everyone gathered around the electronic reading screen, Song Zimo, Xu Zhiliang, Zhang Lin, Xiao Wu and the fat man also finished washing and had breakfast.

Drinking was still not good, and after a night, after washing up, Yang Ping could still smell their wine.

Fortunately, it was Saturday, and everyone was resting, so it didn't matter much.

"Enlarge the point, is that the spine vertebrae?"

"It's a bit like a vertebrae."

"Is there a CT?"

"No, I asked the director of the obstetrics and gynecology department who was admitted to the hospital, and she said that she was really afraid of misdiagnosis, so she didn't dare to do CT." The doctor on duty is more serious and deserves praise.

In this way, the obstetrician and gynecologist at that time was afraid that this was the fetus, so he did not dare to do CT and chose MRI.

There is no ionizing radiation in nuclear magnetic resonance, and ionizing radiation in CT is relatively large.

Everyone discussed it for a long time, and the doctor on duty was like selling a pass, just not releasing the diagnosis.

The main crest vertebrae stumped everyone, and all the tumors in the mind, how could there be long crest vertebrae.

Even teratomas are mostly teeth, hair, nerves, bones, fat, and so on.

Such an obvious ridge vertebrae, I have never seen or heard of it.

Everyone was anxious, afraid that Professor Yang would ask questions, and hated the doctor on duty in their hearts.

The doctor on duty slowly released the patient's diagnosis: pelvic teratoma with sacral nerve damage.

Yang Ping's eyes narrowed slightly, looking at the image on the screen.

It is more common for teratomas to have teeth, hair, and irregular bone masses, and it is indeed rare for them to have a ridge.

It's better to see the patient first, the clinician, to be in touch with the patient, it's a must.

It was only seven o'clock, and Yang Ping decided to go and see this patient.

The patient is white and clean, with delicate facial features and excellent appearance, and has a feminine beauty that is now a small student.

Accompanying the bed was a sunny boy, tall, wearing a stylish T-shirt and some strange tattoos on his arms.

After Yang Ping asked about his medical history, there was no obvious discrepancy with the record in the medical record.

The patient has always felt a feeling of distension in the lower abdomen, but he cares about it, and the lower abdomen began to swell slightly three months ago.

Until the belly was getting bigger and bigger, they did a color ultrasound in the local hospital, and the two felt that the level of the local hospital was not good, so they came to Nandu Sanbo Hospital across the province to seek medical treatment.

"Who are you?"

Yang Ping asked the sunshine boy.

The patient, Li Jun, looked sideways at the sunny boy, as if he had no opinion.

"I'm his cousin, is it serious?"

The sunny boy was a little nervous.

"I'll talk to you in more detail later."

Yang Ping felt that he should have a good talk with them, because this tumor compressed the sacral nerve, and it also grew into the sacral foramen and entered the sacral canal, and it was difficult to completely remove it.

Moreover, the physical examination showed that the anal area had been sensory disordered, and the bowel and bowel movements were a little uncontrollable.

"Did the outpatient doctor explain the treatment to you at that time?"

The patient Li Jun didn't speak, and the sunny boy helped to answer: "I didn't explain anything, I just said that I would consider teratoma and go to your department for surgery, and said, this teratoma is a bit strange, how can there be a well-developed ridge, I have never seen this kind of teratoma." ”

"It's a bit complicated, close the door, I'm going to check it for you." Yang Ping took the gloves handed by Song Zimo.

Although the door was closed, there was a large circle of regular trainees and interns around, all of whom were hungry and thirsty for study.

Even boys are a little embarrassed.

"It's okay, we're a teaching hospital, it's a normal thing."

Indeed, while enjoying the advanced medical technology of the teaching hospital, it is also important to remember that it is a teaching hospital, and it is necessary to be mentally prepared to accept onlookers, and these interns will never be able to grow without cases for interns to observe.

"It's okay, it's okay!"

The Sunshine Boy strokes the patient's forehead and comforts him.

The patient was lying down first and then lying on his stomach, his pants were completely removed, and the diaper tied inside was untied.

There is no wrong gender in the medical record, which can be confirmed this time, and everyone will not have any doubts.

Yang Ping examined the skin sensation one dermatome by one and found that the doctor on duty had an accurate physical examination, the perineal and perianal skin sensory disorders, and the anal reflex could not be elicited.

"Do you usually have problems with bowel and bowel movements?"

"I often don't know it, and the stool and urine come out."

So he tied his diapers.

That is, the sacral nerve root has been severely compressed.

These interns can see more clearly, and some are a little crowded and some are eager to come and check the anal radiation.

"You can check the muscle strength of the sarcomere, the feeling of the dermatome, especially the anal reflex, and you can experience it."

There is no way, when encountering classic cases, it is necessary to let the intern doctor do it and experience it himself.

Everyone is eager to try, and they have already held a pointed percussion hammer in their hands, and will use this spike to stimulate the patient's anal mucosa and observe whether the anus has contraction.

Sometimes, in order to pursue preparation, the index finger is stretched out, the lubricant paraffin oil is applied, and the index finger is placed in the patient's anus to feel if there is any contraction.

"Everyone line up, don't crowd! Come one by one! ”

Zhang Lin maintained the order, and then demonstrated by himself how to check the anal reflex.

Although the sunshine boy was very unhappy, he just hid it in his heart and did not raise any objections.

"I'll talk to you about the condition alone!"

It is true that the condition is a bit complicated, even if the tumor is removed, the nerves may not be restored after the operation, the skin of the perineum and perianal area is numb, like a piece of dead skin, and there will be incontinence, and stool and urine will flow out unconsciously.

The sunny boy's face looked gloomy and he agreed.