The relationship between blood and the body is the same as that between gasoline and a car.

When a car leaves gasoline, it loses its power. When the body's blood flow is not flowing, there are cells that cannot supply nutrients and oxygen to the body.

Paralysis is often accompanied by problems with the blood supply.

For example, patients with paralysis will feel that the paralyzed side is particularly sensitive to cold, poor blood flow, numbness, and so on.

"Her blood supply to her lower limbs has not been seriously affected!"

Director Yin said affirmatively.

So many doctors have seen it, if such a simple problem can't be found, wouldn't those famous doctors be in vain?

"No, no, no, I'm not talking about lower limb blood vessels, but upper limb blood vessels."

Zhou Can's eyes were firm, revealing a kind of excitement that had sought the truth.

"Problems with the blood supply to the upper limbs?"

Director Yin's brows furrowed, if he hadn't seen Zhou Can's ability, he would have scolded him, "You have to study for a few more years!" Then turn around and leave.

At this moment, he maintained great patience and even a hint of expectation.

This difficult case was one that he had not been able to solve three years ago, and three years later, he still cannot make a clear diagnosis.

The more difficult it was, the more interesting it became.

Because at his level, the normal difficulty cases are no longer challenging for him.

"Paralysis patients will naturally suffer from insufficient blood supply due to muscle atrophy. Especially the terminal limbs. To tell you the truth, I shook hands with the patient, and her hands were very cold, indicating that there must be a problem with the blood supply to her upper limbs. At the time, I was just curious. After listening to your dial just now, I was inspired. ”

Since her electrocardiogram is not too abnormal, it means that the blood supply to the whole body should be relatively balanced. So I suspect that she has a systemic blood insufficiency caused by motor neuron damage. ”

Zhou Can boldly carried out a series of inferences and dialectics.

"Well, it does. However, this does not mean much, as this weaker-than-normal blood supply is common among paralyzed patients. ”

Director Yin Hua didn't care much about Zhou Can's discovery.

One could even say that there was a slight disappointment.

The weakening of the blood supply to the whole body is just a common phenomenon that occurs in most patients with paralysis.

In the words of traditional Chinese medicine, it means that blood and qi are in vain, qi is deficient and blood is weak.

"I've looked at the reason for the patient's miscarriage that year. The patient reported that he first carried a heavy object upstairs and then felt unwell. Finally fainted at home. But the diagnosis opinion of admission to the hospital, but the blood is infected with the virus? Cranial nerve abnormalities? ”

Zhou Can clicked on a diagnosis sheet from her first admission.

This is a very original medical record.

That year, after she fainted, she was sent to the third hospital of the city by 120 ambulance according to the principle of nearby rescue.

After the miscarriage, she was paralyzed of the lower limbs, and the third hospital of the city could not diagnose the cause, so her family sent her to the Provincial People's Hospital, which had a higher level of medical care. Later, the Provincial People's Hospital also could not find the cause, and the patient was severely depressed.

The family transferred him to Tuya Hospital for further treatment.

Many patients will have such an experience, thinking that it is a minor illness, but after treatment in ordinary hospitals, it is ineffective, and in the end they can only go up one level at a time.

Three years ago, the reputation of the Provincial People's Hospital was about the same as that of Tuya, or even slightly better.

Today, Tuya Hospital has left it behind.

It has become the first hospital in the province in terms of medical level and diagnosis and treatment ability.

"Do you think the patient will have symptoms of paralysis before being admitted to the hospital?" Zhou Can said an extremely bold speculation.

"Probably unlikely. Before she is admitted to the hospital, the attending doctor will definitely do a series of tests on her. The medical level and diagnosis and treatment ability of the three hospitals in the city are not bad, and their medical quality control has always been extremely strict. If the patient had paralysis of the lower limbs at the time, it would have been written on the admission record. However, they clearly stated in the medical record book that they were paralyzed after the miscarriage. ”

Director Yin is well aware of the strength and medical style of various hospitals in the city.

At his level, he should often be invited to major hospitals to participate in some exchanges, guidance or lectures.

After coming into contact with the doctors at those hospitals, it is natural that you will have the opportunity to learn about that hospital.

"Could it be that when the patient was admitted to the hospital, the paralysis of the lower limbs was not obvious, so it was ignored? 120 Reception records state that the pregnant woman fainted in the toilet at home. ”

Zhou Can persevered in this identification.

"It's possible."

Director Yin agreed with Zhou Can's point of view this time.

"It's a pity that the three hospitals in the city lack high-level doctors who can support the pillars, so it would be nice to test the electromyography for this patient at that time."

If a pregnant woman is admitted to the hospital and has an electromyography test, it can provide a strong basis for later diagnosis.

Now that more than three years have passed, the meaning of not doing the inspection is very different.

"Director Yin, look at these inspection reports again. This is the EMG test done by Renhe Hospital in the imperial capital, and I deliberately compared it with a number of normal people's EMG monitoring reports yesterday. Qiu Jie's nerve conduction speed is not slow, but from the neck down, the intensity of the electromyography signal is constantly attenuating. Like a hill climb, the closer you get to the lower limbs, the weaker the attenuation. ”

"Then her evoked potential electromyography test, as well as the motor unit count, were not significantly abnormal."

What Zhou Can said, Director Yin had already found out.

"What do you want to say?"

Director Yin doesn't know that he has so much evidence, what exactly is it to distinguish the evidence?

Pathological diagnosis is extremely complex, especially in such difficult cases, and the difficulty of syndrome differentiation is even more frightening.

Anyone will look at the inspection data.

To find a clue from a thousand things, and then sort them out, this is the level of diagnosis.

"I think the patient's cause is a problem with the source of the motor nerves in the lower limbs. Her lesions were above the neck, and postpartum infection should have been just an illusion of the cause. ”

What Zhou Can is doing now is to see the sun and lock the real lesion.

"It could be a problem with the spinal nerves, or there could be a problem with the nerve center, the brain stem." Zhou Can further added.

[Pathological diagnosis experience value +0.9.]

His heart raced as he watched the sudden increase in experience points, and he was even more convinced that his diagnosis was correct.

His diagnosis method, which is close to blind guessing, will not be recognized by famous doctors, even high-level residents who have undergone standardized training.

However, pathological diagnosis sometimes has to dare to step out of the box, and cannot stick to the rules.

One of the biggest drawbacks of Western medicine is that it is not flexible enough.

It does all the talking in terms of examining the data.

Even with the test data, there is still a question mark after the diagnosis.

Why?

Because I'm afraid of being overthrown, I'm afraid of being slapped in the face!

Under the current medical system in China, doctors are most afraid of misdiagnosis and medical malpractice. The diagnosis is followed by a question mark, reflecting a lot of real problems.

In the final analysis, it is also a kind of lack of confidence in Western medicine.

Looking at the old Chinese medicine in the past, there are rarely any ambiguous times. Either it's your illness I can't see, please be smart. Either it is to clearly identify the lesion, write out the pathology, and then prescribe it.

"Why is it only 0.9 diagnostic experience points?"

It was the first time Zhou Can had encountered such a situation.

I've also encountered a 0.2 XP increase before. That's because the patient had multiple lesions at the same time, and he only diagnosed one.

The experience value gained this time is very close to 1, and the difference of 0.1 is likely to be due to the fact that the specific location of the lesion has not yet been clarified.

After listening to Zhou Can's diagnosis, Director Yin fell into deep thought.

A minute passed, two minutes, three minutes......

This time, it was his turn to be like Zhou Can, and fell into a 'demonic daze'.

In fact, many famous doctors have this trait.

In order to overcome a certain disease, you can forget to sleep and eat, even eat, go to the toilet, and even sleep and dream, all thinking about diagnosis and treatment.

After nearly six minutes, Director Yin followed Zhou Can's diagnosis and straightened out his thoughts again.

There was excitement in his eyes.

That's the excitement and excitement that comes after a major breakthrough in diagnosis.

"Xiao Zhou, the situation you said is entirely possible. After repeated arguments, I felt that the paralysis of this female patient was likely due to changes in the cranial cavity environment, or compression of cranial nerves. Hemangiomas, neuromas, and osteomas can basically be ruled out. ”

After all, a lot of tests have been done.

If there is a tumor in the brain, it must have been detected.

"If the patient wishes, you can ask her to come to the hospital and see me for another diagnosis. My opinion is to give her another MRI of her head. There is a high chance that the exact location of the lesion can be detected. ”

Director Yin said to Zhou Can.

If the patient is unwilling to believe Director Yin, or has no hope in Tuya Hospital and refuses to come, then there is no way.

"Okay, I'll let her know now."

"If she wants to come, she doesn't need to register, and I will explain it to the hospital when the time comes."

Director Yin gave a certain amount of convenience.

You know, his special needs expert number is very difficult to grab.

800 yuan is also a lot of money for ordinary people.

"Okay, thank you! I'm delaying you today, so go get busy! ”

Zhou Can got up and said goodbye.

"Don't say that. If you have any questions in the future, you can always ask me for advice. Today, this patient can make a major breakthrough in diagnosis, and your credit is no less than mine. Your talent for pathological diagnosis is truly unique to me. It is not an exaggeration to say that this alternative diagnostic idea that does not follow common sense is unique in the world. ”

Director Yin's attitude towards Zhou Can became more and more polite.

This kid is indeed a rare talent.

"Xiao Zhou, if you are willing to come to our neurology department, I can come forward and transfer you over. The emergency department is very good at exercising, but three months is enough. A lot of advanced medical knowledge is difficult to learn in the emergency department. The lifespan of our human beings is very short, and it is difficult to exceed 50 years for the number of years we can work. ”

"Nowadays, the medical field is becoming more and more subdivided. In his life, it is not easy to learn a subject well and study it thoroughly. A talent like you, when you go to internal medicine, your future achievements will definitely not be low. In addition, it will be easier for you to improve your academic qualifications in internal medicine. Director Tan is a first-class professor and academician level, and you can choose the teaching subjects he brings when you apply for the exam. ”

Although the words were not said thoroughly, they were basically hinting at Zhou Can.

As long as they enter the internal medicine department, the matter of improving their academic qualifications is wrapped up in them.

The evaluation criteria for first-class professors are extremely strict, and basically only academicians can meet them.

I really didn't expect Director Tan of Internal Medicine to be so good.

However, internal medicine is indeed more likely to produce achievements in academics.

Director Yin now invites Zhou Can to develop in the Department of Neurology, and promises a lot of benefits, which is enough to show that he values Zhou Can.

"Thank you for putting yourself in my shoes and thinking so much about it. I'd better mix it up in the emergency department first. Zhou Can made up his mind at the beginning to mix up his personal appearance in the emergency department.

Let those department heads who did not choose him understand that academic qualifications are not the only ones.

"Well, when the time comes, you can change your mind, you can always come to me. You can even go directly to Director Tan. He also admires you very much. Yin Hua nodded helplessly.

People don't want to develop in internal medicine, and he can't help it.

"By the way, have you chosen the direction of training?"

Even if it is a general practitioner, after being divided into departments, it is necessary to choose the direction of compensation.

"I used to want to choose the general one, but now it seems that I can only choose the emergency department, right?"

Zhou Can also didn't know much about the hospital's arrangements for them general practice trainees.

He and Jin Mingxi were both assigned to the emergency department, and they chose the direction of training, and he thought it must be the emergency department.

"It's not bad to choose emergency medicine in the direction of regular training, and I can transfer to another department in the future. As for the choice you said, I suggest not to consider it, the road is too narrow. The development prospects of general surgery are far inferior to those of neurosurgery and cardiothoracic surgery. As for internal medicine, it is also the most promising department of internal medicine and cardiothoracic medicine. ”

Director Yin actually guided him in the choice of the direction of training, which is so important to him, so he will work so hard.

"Thank you for being so kind to me. I was particularly impressed. ”

Zhou Can and Director Yin Hua also don't know each other.

met for the first time, and Yin Hua even scolded him in public. At that time, the impression of Zhou Can was also very poor.

Later, with Zhou Can's excellent performance and humility, Yin Hua's impression of him became better and better.

……

After coming out of the gods, Zhou Can called Li Xuan directly.

"Brother Brand, it's me, ...... yesterday"

"I know, Zhou Can! Come to my house today? ”

Li Yan chatted with him yesterday and was very close to him.

As soon as he opened his mouth, he directly invited Zhou Can to play.

It is estimated that he is bored enough to stay at home alone with his wife.

"I won't go today, I'm still in the regular training stage, and I need to practice my surgical ability! Alas, studying medicine is really hard! ”

Zhou Can sighed.

"Haha, who told you to choose this line of work in the first place? Regret it! ”

Li Hao laughed.

"I don't regret it, after all, I love what I do. Brother Branding, let me tell you one thing, didn't you send me my sister-in-law's inspection materials yesterday? I asked a few teachers to see it today, and after seeing it, Director Yin of Shennai made a major diagnostic discovery. His opinion is that if you and your sister-in-law want to, you can go to him again for a diagnosis, possibly to do a head MRI. ”

Zhou Can didn't dare to talk to Li Xuan anymore.

Instead, get down to business.

Otherwise, he will be able to talk about some topics of common interest later, and it will be an hour to talk.

Zhou Can also likes to chat with him, and can increase a lot of knowledge and learn a lot of things.

It's just that now it's still mainly about practicing medical skills.

Anyway, in the future, we will have time to cook wine and talk together.

"Really wow! Great! ”

When Li Xuan heard the good news, he was very excited.

Zhou Can even suspected that he jumped up happily like a child.

"I know that you are a sincere person. It's just that I didn't expect you to take my wife's illness so seriously. Brother, don't say much, this love, my brother has it in mind. Even if your sister-in-law goes for a check-up tomorrow and still can't find the cause, I still thank you for this kindness. ”

Li Zhan once almost became the president of Tianyu Interactive, and he has a strong ability to recognize people.

Don't look at him as a little uninhibited, but his talent and ability are extremely strong.

When dealing with people, I don't like to play false.

This can be felt from the chatting between the two parties.

When he chatted with Zhou Can, he never played any tricks.

"Hey, is that Director Yin's name Yin Hua?" Li Xuan seemed to remember something, and asked again.

"That's right! Looks like you remember him! When I showed him my sister-in-law's information today, he was also very impressed with my sister-in-law. He said that he was particularly sorry that he could not find out the cause of his sister-in-law three years ago. ”

"It's really him. Tomorrow I will take my wife to him. ”

Li Yan is extremely concerned about his wife's illness.

He was particularly happy to hear that the diagnosis had been discovered.

Although every time I went to the doctor, I went with hope and finally returned disappointed.

But as long as there is a glimmer of hope, he never gives up.

Indomitable.

"Director Yin said yes, so you don't have to register. It's just that I think it's better to register out of respect. ”

Zhou Can has his own code of conduct.

He believed that Li Yan would not care about the 800 yuan registration fee.

"I definitely have to register, I understand this, brother rest assured. It's that Director Yin's number is more difficult to grab, and I'm afraid that I want to cheapen those evil scalpers. ”

In recent years, Li Xuan has often taken his wife to seek medical advice.

I'm afraid that I will suffer from scalpers.

That's why I hate scalpers so much.

"There's no need to buy a number from a scalper. Anyway, it's already been said, just ask Director Yin to add a number when the time comes. Zhou Can gave them an idea.

He has a great sense of justice in his bones.

If you don't do anything about yourself, you will never encourage unhealthy tendencies.

If the patients do not buy the number from the scalper, the profession of scalper will naturally become extinct.

After ending the call, Zhou Can was very happy.

Loyalty to friends is a demonstration of trust. If nothing else, there will soon be a good result.

He also wanted to see, where was Qiu Jie's lesion? What is the cause?

I believe that with the completion of the examination tomorrow, Director Yin will definitely be able to diagnose the specific cause.

Thank you two book friends, I can't help myself, book friends 160520184633089 reward support!

(End of chapter)