"There are more people going in, but not many people coming out, why is the blood sodium still so low? I think the teachers in various departments at that time also had a headache and struggled with this. ”

Ji Xiang saw the expressions of Professor Mo and Director Sun, and knew that the system NPC must have guessed correctly, so he was in a good mood and continued to repeat the explanation of the system NPC in his own words.

"When I think of a formula in physiology and biochemistry - concentration = solute ÷ solution"

"That's when I found out what the problem was.

Clinical use of sodium supplementation increased the total amount, but as a result, the blood sodium concentration still decreased - there is only one reason, there is more water in the blood vessels, which dilutes the sodium. So I estimate that the indicators of 24-hour urine electrolytes have also changed, and here it is. ”

Listening to Ji Xiang's explanation, Director Sun's harazi flowed out unconsciously, as if he had a sudden cerebral infarction.

He could understand every word Ji Xiang said, but when they were put together, he didn't know what it meant.

"Because the hormones that regulate the fluid balance of the patient are out of order, it leads to a series of symptoms.

In summary, this is a disease called SIADH, also known as antidiuretic hormone secretion disorder syndrome.

In particular, antidiuretic hormone dyssecretion syndrome may occur in patients with severe infections.

Therefore, I decided to take a slightly riskier medication in my treatment plan, using furosemide to remove excess water from the body while fixing albumin, and other diluted indicators also recovered. ”

"Teacher, my answer ideas have been reported."

After Ji Xiang finished speaking, he stood calmly in front of everyone, bowing slightly, as if he was defending his thesis.

The conference room was quiet, and there was not the slightest sound.

Is Ji Xiang right?

Nobody knows.

Although both Dean Zhao and Professor Mo, and even Director Sun are from clinical backgrounds, they have a thorough understanding of clinical practice.

But Ji Xiang's reasoning is too profound, even if he speaks in easy-to-understand words, everyone can't understand it.

It's not that I don't understand it completely, I understand every word, and I understand the syndrome of dysregulation of antidiuretic hormone secretion a little bit, but ......

It is estimated that only an endocrinologist or a renal expert can talk to this reserve trainee.

Where did this demon come from?!

You can guess the complex 24-hour electrolyte report just by guessing!

This kind of examination is what many doctors in grassroots hospitals have never heard of.

Dean Zhao was slightly depressed in his heart, how good it would be if his son could stand in front of him and say these words.

Although all kinds of envy and jealousy are mixed together, it is a little complicated and difficult to say, but Dean Zhao did not lose his temper.

He slowly stood up, walked over to Ji Xiang's side and patted his broad shoulder.

"Young man, welcome to the Second Affiliated Hospital."

"Thank you."

"Work hard in the future!"

After speaking, Dean Zhao left the conference room.

Director Sun suppressed the surprise in his heart and ran out after Dean Zhao.

It's just that he was in too much of a hurry and accidentally bumped into the table and was taken alongside.

Fortunately, Director Sun reacted quickly, put his hands on the ground, and did not grab the ground with his head. But at this moment, he ran out of the conference room like a dog.

Professor Mo didn't laugh at Director Sun, no matter how unpredictable his performance was, he didn't attract Professor Mo's attention, his eyes were extremely complicated and looked at Ji Xiang.

"Professor Mo, I still have a skills test." Ji Xiang said with a little regret.

Ji Xiang also can't wait to follow Professor Mo to have surgery immediately, no matter how good the exam is, the system will not give any rewards.

Surgery is different, doing one has the accumulation of one operation.

Whether it is the technique, experience or the rewards given by the system, it is real for Jixiang.

"Who is the examiner for the skills test?" Professor Mo asked.

"Professor Deng of the Department of Orthopedics."

"I'll call him." Professor Mo said, "Come with me for surgery." Surgery can be done, and the skills of Rausch are also tested. ”

Ji Xiang didn't know if it would work, and glanced at the small staff in the medical department.

"Lao Deng, I, Mo Chenggui." Professor Mo had already dialed the phone, "Are you in charge of the skills test today?" ”

"What's wrong, old Mo?" Professor Deng, who was on the other side of the phone, asked.

"I have 32 outpatient surgeries today, and I just caught a freshman in regular training to help me." Professor Mo said with a smile, "His level is good, if you want to see the operation, come to the outpatient operating room." ”

"That's not good, other ......"

"Isn't this a holiday?" Professor Mo interrupted the other party, "The children in the school are all in a hurry to come at this time, woo woo, the operation is really not finished." ”

"......"

"Last time, you came to me in the middle of the night to help, saying that you invited me to drink, but you still haven't believed me. You can help me with this, don't leave after work today, I invite you. ”

The guy on the other side of the phone had given up his resistance.

The self-regulation of the trainee exam is just like that, and Professor Mo strongly promotes it, and this bit of face still has to be given.

"I've taken a leave of absence." Professor Mo hung up the phone and looked at the little staff member in the Science and Education Office.

The little clerk's lips moved, and he didn't dare to refute.

Not only the Second Affiliated Hospital, but almost all the professors in the surgical group have some way in the society, and if it weren't for the arrangement of the superior leaders, no one in the agency would want to offend them in vain.

Make a good fate, who knows when a stone will come out of the kidney and ask Professor Mo.

It's just a regular training exam.

Professor Mo took Ji Xiang out of the office building, and at this time, Professor Mo did not have his previous aggressive posture, but asked cautiously, "Doctor Xiao Ji, what is the case analysis ......?"

"Mr. Mo, I happened to meet a similar patient with my substitute teacher when I was interning." Ji Xiang's face was not red at all when he lied, he was very calm, as if it was true.

That's a coincidence, isn't it?

It only took 0.1 seconds for Professor Kemo to accept Ji Xiang's explanation.

This is the most plausible possibility, and there is no other possibility.

Professor Mo had heard how difficult that case was back then.

At the wine table, he listened to Professor Deng of the Department of Orthopedics speak countless times, and every time Deng Chaohong said it, his saliva splashed and he was proud.

I never expected to be "easily" solved by a small rule Pearson.

Wrong!

Mo Chenggui thought of this question, thought of Deng Chaohong, and thought of Dean Zhao, and a line had been straightened out.

It is estimated that Dean Zhao will arrange for his son to go to the orthopedic department, and Deng Chaohong will take him, and he will stay in the orthopedic department in the future. Director Sun had heard about this, so he chose one of Deng Chaohong's most proud cases as the exam question in the exam.

Although it's useless, it can't be said to be a snake to add to it, and Mo Chenggui is not surprised that the people in the agency have these careful thoughts.

He didn't like it, but he didn't object to it.

"Doctor Xiaoji, you take a look twice today, don't be in a hurry to get started, let's do a skin circumcision under a stapler."

"Teacher Mo."

"Huh?"

"I first learned about pouch surgery under a stapler." Ji Xiang explained.

“……”

"I'm more familiar with instruments than hand sutures." Ji Xiang said in an affirmative tone.

“！！！”

Professor Mo was stunned.

Is this what a trainee should say?

"Teacher Mo, there is one thing I don't understand, I want to ask you."

"You say." Professor Mo glanced at Ji Xiang with interest.

Cutting the skin bag with instruments, the operation is simpler, and he believes that what Ji Xiang said is true. If that's the case, it's really a pillow when you're dozing off.

"Why do I have to do the manual suturing two days ago, and I have to have an instrument surgery today?" Ji Xiang asked.

"Huh." Professor Mo let out a sigh of relief after hearing Ji Xiang's question.

This question proves that Ji Xiang is just a rookie with great talent, not an old monster who has traveled through the legend.

"Doctor Xiaoji, do you know the establishment of doctors?"

"You know, the doctor of the Second Affiliated Hospital should be a career editor." Ji Xiang replied vaguely.

"Yes, it's not." Professor Mo didn't sell Guan Zi either, and explained to Ji Xiang as he walked, "I haven't had a career editor for a long time, and I haven't retired a single one, and now most of them are outsourcing to third parties." ”

"Outsourcing?"

"Save money." Professor Mo sneered, "Don't talk about this, let's talk about career editing." There are four categories of undertakings, not to mention the rest, and the doctors of the hospital belong to the differential appropriation division. ”

"The establishment of the difference is a kind of business establishment, which is allocated by the government, and the treatment is linked to the income to a certain extent, such as hospitals and some scenic spots."

"But you know what, appropriations...... Hahaha. ”

As he spoke, Professor Mo laughed.

Ji Xiang didn't know what he was laughing at, and was a little puzzled.

"The state regulations are stipulated, and the difference in funding that really falls to the second affiliated court is only 18-23%."

"So little."

"That's not all." Professor Mo said, "In the public health epidemic prevention incident in the past few years, the city and province did not use medical insurance, but asked the hospitals for advance payment, and they have not paid it back until now. ”

“……”

"I owe 200 million two to our Second Affiliated Hospital, and several other similar hospitals are probably the same amount."

Ji Xiang was silent, he didn't understand what Professor Mo said.

"Why don't you use health insurance, because there is no money for health insurance. A stapler is 1680, either full or 80% reimbursement. Just cut a leather bag, spend so much, the medical insurance department will definitely not do it. ”

"Oh, then don't do it." Ji Xiang Road.

"It's not that simple." Professor Mo smiled, "The common people know about reimbursement, and it's not up to us to have the final say." But if you reimburse too much, the medical insurance will not settle for us, and the excess money will be deducted from the hospital, and the hospital will deduct money from the department. ”

"We are indeed treating the sick and saving people, and we can also help the poor patients occasionally. But just earn so many melons and two dates, and you have to fill them back......"

It's so complicated, Ji Xiang feels a little pain in his brain.

The things that Professor Mo said didn't seem to be the same thing as the medical treatment he knew, and Ji Xiang instantly threw these things away as useless information.

"Everyone wants to be a good person and take benefits, but doctors and hospitals are caught in the middle, and it is difficult to be a person." Professor Mo said.

"Then why are there so many suture surgeries today?" Ji Xiang asked.

"Patients don't do it, now that counseling is so developed, we can't tell patients that we won't." Professor Mo spread his hands helplessly.

"Besides, if we don't do it, other hospitals will do it, and if we don't do it, we won't have anything to eat in the end. Neutralize it with hand stitching, we belong to the seam life, dancing with shackles. ”

"Mr. Mo, I heard that the equipment is very profitable."

"That was before the collection, and there was no money after the collection." Professor Mo said very blandly.

"You ......"

Ji Xiang remembered Professor Mo's cigarette.

"Earn money to go to a private hospital, and that is the only way to do surgery is to make money." Professor Mo was not as happy as Colonel Wang, but said calmly, "But you are young, don't worry, let's practice the operation first." ”