On Tuesday morning the next day, Yu Zhiming, who came to Huashan Hospital with dark circles under his eyes, took the suspected ALS patient admitted yesterday afternoon for a confirmatory examination.

This guy is a 1.7-meter-tall otaku who weighs 17 and is thirty-three years old.

He describes himself as a veteran gamer and also plays games as a way to earn money to support his family.

According to him, he can not leave the house for a month or two, and he does not know the changes in the four seasons outside.

If it weren't for the atrophy of the arm muscles, which seriously affected his game playing, he really didn't want to come to the hospital for a checkup.

Seeing that this guy is a happy person who is content with a game and doesn't care about what will happen in the future, Yu Zhiming secretly sighed, a typical optimistic and contented flat school.

That's how the mentality can be done for a month or two without leaving home, but anyone who changes a little enterprising will definitely be depressed......

In addition to clinical symptoms, the diagnosis of ALS is mainly electromyography, plus imaging and neuropathological examinations.

Yu Zhiming was busy all morning, and after the patient's various examination results came out, he happily found Qi Yue.

"Teacher, the test results are out, the main indications do not match, it is not ALS."

Qi Yue took a stack of inspection materials, and looked at the image map, and said, "It's really not ALS." ”

He noticed Yu Zhiming's smiling appearance, and couldn't help but smile and ask, "This test result means that your initial diagnosis is wrong." ”

"You've been diagnosed wrong, so what's so happy?"

Yu Zhiming said with a smile: "I still wish that my cancer premonition was all wrong." ”

"If it's ALS, his life will be over, and I'm happy to see such a diagnosis wrong."

Qi Yue smiled lightly and asked again: "Since the test results ruled out ALS, what is your new diagnosis?" ”

"Teacher, it's Hirayama's disease."

Hirayama disease, also known as juvenile distal upper extremity muscular atrophy, is a benign self-limited motor neuron disease.

It is clinically very similar to ALS.

Yu Zhiming pointed out the main indications on the electromyography and MRI images one by one.

"Teacher, his electromyography shows neurogenic damage, and his cervical spine has obvious reverse arch."

"According to my analysis, this is the reverse arch of the cervical spine caused by the patient's unscientific long-term sitting posture, which compresses the spinal cord, and then causes ischemic and hypoxic injury of motor neurons in the anterior horn of the spinal cord."

"Based on these test indications, combined with the patient's clinical characteristics, I am sure that he has Hirayama disease."

"The treatment plan is anterior cervical internal fixation, combined with postoperative rehabilitation."

Qi Yue nodded with satisfaction and said, "This time, your diagnosis is correct, and the treatment plan is okay." ”

"This minor operation can be done by Dr. Han."

After a pause, Qi Yue mentioned again: "Zhiming, although you are my student, there is no need to challenge incurable diseases at the beginning, you can start with the diagnosis and treatment of common diseases and typical diseases. ”

"Before you run, you have to walk steadily."

Yu Zhi knew that this was the teacher beating himself, and he was a little rash.

He admitted his mistake and said, "Teacher, I know it's wrong, next time I go to the emergency department, I will pick one or two suitable patients." ”

Qi Yue also taught: "Medical skills are never quick, and the accumulation of experience must start from one basic case after another......

Yu Zhiming looked well-behaved, which made Qi Yue enjoy the boss's teacher addiction for a while.

Just as Qi Yue waved his hand to let Yu Zhiming leave, he heard this guy suddenly ask a question.

"Teacher, Qiu Yi once wanted to be your student?"

Qi Yue snorted and said, "He once came to me in the year he graduated. ”

"I turned him down on the grounds that I never accepted graduates with no work experience."

Yu Zhiming sighed and asked again: "I heard that he is coming back from his study abroad." ”

"When the time comes, he still has this idea, teacher?"

Qi Yue smiled meaningfully and asked rhetorically, "Are you afraid that I will accept him as a student and challenge your status?" ”

"How so?"

Yu Zhiming looked righteous and said, "I wish the teacher could take a few more students, so that I can get past the addiction of the senior brother." ”

"Besides, I've never been afraid of competition."

"If someone is chasing and urging, you will be more motivated and run faster."

Qi Yue smiled and said, "Even if he still has the idea of learning from me, I won't accept it." ”

"Why?"

Yu Zhiming asked curiously, and then continued: "I heard a lot about Qiu Yi last night. ”

"With a deep family history, a scholar, the first young doctor, such a student, I don't know how many people rush to accept it."

Yu Zhiming asked tentatively: "Teacher, have you really never been interested in him?" ”

"Or is there another reason?"

Qi Yue said slowly: "Such an excellent young doctor, if I say that I have not been moved, it is hypocrisy." ”

"Just ......"

Qi Yue stopped and warned first: "I'm just telling you this, don't spread it around." ”

Yu Zhiming immediately said: "Teacher, I can keep secrets very well, and I will never talk nonsense." ”

Qi Yue said softly: "I've seen some of that guy's case diagnosis and treatment plan, what do you say?" ”

"He's too risky, but the reality is that there is a more secure cure."

"Thinking about his constant honors and news along the way, it should have something to do with his personality and want attention."

"He's not the type of student I want......"

At nearly twelve o'clock in the morning, Yu Zhiming returned to the big office and saw a fruit basket on his desk.

Zhou Mo introduced: "Patient Zhang Zhe sent it. ”

Zhang Zhe underwent ICD minimally invasive implantation surgery last Friday, and after observing no abnormal reaction for three days, he was allowed to be discharged from the hospital.

Another patient related to Yu Zhiming, Xu Feng, who had a massive attack of herpes virus, was also discharged from the hospital last Friday and went back to his hometown medical institution to recuperate.

Zhou Mo continued: "He was discharged from the hospital this morning. ”

"Some friends and colleagues couldn't take away the fruit basket, so they specially sent you one to express their gratitude."

Yu Zhiming glanced at Zhou Mo and said, "You don't have to say the last sentence." ”

"What you said seriously lowered my mood and happiness, as well as the sincerity of the other party."

Zhou Mo grinned and said, "This is normal, many patients will give fruits and flowers that they can't take away to doctors and nurses when they are discharged from the hospital." ”

"I've seen it all, Dr. Yu, your fruit basket is the best and most expensive among the several fruit baskets he gave out."

"Look, there's also a boutique little durian."

Yu Zhiming waved his hand in disgust and said, "I don't eat durian, if you like to eat it, take it quickly." ”

Zhou Mo was not polite at all, in addition to durian, he also took a few other fruits......

At half past one in the afternoon, Yu Zhiming received a gift from the Department of General Surgery.

Freshly cut off two-thirds of the stomach.

The patient's stomach had been invaded by a tumor, and surgery to remove more than half of the stomach was a desperate move to save his life.

The removed stomach was to be disposed of as medical waste, but for Yu Zhiming, it was like a treasure.

He can do all kinds of destructive tests he wants, looking at the pathological features of various parts of the stomach after cancer......

Yu Zhiming stayed in the center's laboratory, enjoying the joy of knowledge acquisition until he was interrupted by Zhou Mo at five o'clock in the afternoon.

Zhou Mo covered his eyes, not daring to look at the bits and pieces on the operating table.

"Dr. Yu, the vice president of the Peking University School of Medicine is here."

"The director asked you to go to his office......