After the patient left, Director Zheng got up and held Zhou Can's hand tightly.

"Dr. Zhou, thank you for coming over and helping! The diagnosis of this case is very difficult, and when the results of the small bowel perfusion test are available, you will have to continue to help with the diagnosis. ”

Zheng Hongtao treated Zhou Can so politely, because the diagnosis of this disease needs to rely heavily on Zhou Can.

There is also this kind of disease that cannot be cured by big hospitals outside, if he can crack it and cure the patient, it will be very beneficial to him.

The authority and popularity of experts are consolidated little by little by diagnosing and treating difficult cases in related fields and publishing high-level papers with high influence.

The nine-story platform starts from the soil, and the wood that hugs it is born at the end of the millennium.

Famous doctors never grow overnight.

The kind of people who become popular by relying on one or two cases and are called 'miracle doctors' are mostly 'miracle doctors'. There are many fraudsters, and there is no real miracle doctor.

Patients travel thousands of miles to seek treatment, and what they pay is nothing more than an IQ tax.

Of course, there is a miracle doctor who may have real skills. That is some hidden Chinese medicine practitioners, they may not have a medical license, they may be cynical, they may look more like a charlatan.

However, they have mastered some lost TCM skills, which really relieve the suffering of patients.

And there is an essential difference between this kind of miracle doctor and charlatans.

They do not treat diseases and save people for the purpose of making money, they charge low fees, and they will even be like ancient Chinese medicine, when they encounter poor patients, they will not take a penny. Losing money to treat patients just to help them relieve their pain.

Charlatans are all kinds of routines and scams, such as what 'works to cure diseases', or a certain earthwork to cure all diseases, and so on.

But all of them, without exception, are all deceiving people to pay IQ taxes in the past.

Even after their treatment, the patient really feels that the body seems to be much better, but in fact it is just a psychological effect.

From a medical point of view, those medicines that cure all diseases, without exception, are all fake drugs, health care products, and drugs that specifically deceive people into paying IQ taxes.

From Zhou Can's professional point of view, drugs that can really cure diseases have strong toxic side effects.

They can only treat a small type of disease, not a cure-all.

Most of these drugs are prescription drugs and are difficult for patients to buy.

When a doctor prescribes medicine, he also needs to consider it again and again, and only after considering it holistically can he dare to prescribe a prescription.

After Zhou Can came back from the outpatient room, he continued to go back to the office to write medical records, the course of the disease, and check the doctor's orders.

As he became more and more proficient in prescribing medical orders independently, he clearly felt that his experience and knowledge were insufficient. In addition to increasing the frequency of consulting with senior physicians, he has thought of many other ways to quickly increase the level of medical advice.

Strive to read books every day, and greedily supplement basic medical knowledge, that's for sure.

There is also the use of authority to look through the past treatment cases in the department. Take a look at the medical orders issued by Director Shang, Director Zheng, Deputy Director Shi and others, and learn from their handling experience.

It's a great idea.

After watching each case, you can get 1 experience point for pharmacological syndrome differentiation and 1 experience point for pathological diagnosis.

It's a lot of work.

Near 6 o'clock in the afternoon, the patient with diarrhea and diabetes insipidus finished the small intestine perfusion test, and the family found Director Zheng Hongtao with the results. Then Director Zheng directly took the results to the office to find Zhou Can.

After all, he is a chief physician, and in front of his family, he repeatedly asked Zhou Can for help, and his face was somewhat unbearable.

So he sent his family back and came to Zhou Can alone with the test results.

The analysis and diagnosis of such difficult cases are extremely difficult.

He asked Zhou Can to discuss, but the doctors didn't laugh at him or anything like that.

Besides, there are more doctors who come to Zhou Can for help all day long.

Now even those little nurses in the department are looking for Zhou Can for help one by one.

For example, when intubating patients, or when doing intravenous indwelling, it is difficult to find the blood vessels of some obese patients.

They all came to Zhou Can for help.

The beautiful little nurse in her twenties screamed one by one, and Zhou Can really couldn't wipe her face and didn't agree.

Unless they're particularly busy, they'll go over and help them.

You can earn experience points, and you can also gain their gratitude, why not!

In particular, for the intubation and endotracheal intubation operations, you can earn 1 point of experience points for each operation completed. If you're lucky, you might even get an extra bonus of 10 XP points you put in.

"Dr. Zhou, according to the small intestinal perfusion test, it is proved that the patient has a large amount of water and electrolyte secretion in the intestine, and the diagnosis of secretory diarrhea can be preliminarily made."

Zheng Hongtao showed him the test results.

The patient also had a stool test and a bacterial culture, which was negative.

This excludes the possibility of chronic bacterial inflammation of the gut.

There are four common types of diarrhea, namely secretory diarrhea, osmotic diarrhea, exudative diarrhea, and abnormal diarrhea caused by gastrointestinal disorders.

Exudative diarrhea is actually what is often referred to as inflammatory diarrhea.

For example, enteritis.

Therefore, stool routine and bacterial culture are very diagnostic. The culture is negative, and exudative diarrhea can now be ruled out.

Small intestinal perfusion helps them directly target the patient for secretory diarrhea.

"The patient's stool routine showed that potassium, sodium, chloride, and bicarbonate excretion were all significantly higher than normal. The highest is even twenty times exceeded. No wonder the patient's body can't resist it. ”

Zhou Can really sympathized with this patient, after so many days, ordinary people would have prolapsed their anuses.

"If it weren't for the fact that the young man was in his twenties, he was the strongest physically, and I am afraid that he would have already been admitted to the intensive care unit. Now that the type of diarrhea has been basically determined, the next step is to investigate the cause of diarrhea. ”

When Director Zheng and Zhou Canji discussed their condition, they were completely at the same level.

This patient's disease is difficult to treat because every diagnostic idea has an invisible wall.

For example, hypokalemia is detected and alkalosis is known. But if you find this step, it will be difficult to make a deeper breakthrough.

Now I have changed the direction of diagnosis, directly checked diarrhea, and done a small intestinal perfusion test and stool routine, which has been determined to be secretory diarrhea. However, the cause of the diarrhea is still mysterious.

There are so many causes of secretory diarrhea.

This requires Zhou Can to clear the layers of fog and keep the truth from the false.

The reason why pathological diagnosis is difficult is that when encountering some complex diseases, the real cause is as hidden as the answer to the application question. Only by answering the problem step by step will it be possible to find the correct answer in the end.

Zhou Can's mind quickly flashed one cause after another that could cause secretory diarrhea.

Cholera, a notorious Class A infectious disease that has claimed countless lives in ancient times.

Even today, with the advanced medical technology, cholera is still a dangerous disease.

The patient had diarrhea that persisted for several days, and the symptoms matched those of cholera.

The second disease that comes to mind is pancreatic endocrine tumors. Pancreatic cancer is called the king of cancer, but it is not for nothing. The unexplained diarrhea it causes can pull the patient to the point where the anal prolapse is severe and the plug can't be plugged in.

During the training in the intensive care medicine department, Zhou Can had seen patients who pulled their intestines out.

The third thing that comes to mind is carcinoid syndrome, which is also associated with cancer.

From here, it can be seen that if someone has diarrhea for a long time, then it is necessary to go to the hospital for a check-up. Because this kind of long-term diarrhea is very much associated with cancer.

All cancers are diagnosed and treated early.

In some developed countries, the incidence of cancer is actually very high.

However, they pay great attention to physical examination, and their consumption concept is completely different from the simplicity and frugality of the Chinese people. When they have money, they want to travel where they want to go and buy something that interests them.

Spending in advance and overdraft consumption is a normal little thing in their eyes.

Even if the people in China have some pain and itching, as long as it is not particularly serious, they usually rarely take the initiative to go to the hospital for examination.

Because they are afraid to spend money, they are afraid of delaying their work.

The fourth disease that came to mind for Zhou Can was medullary thyroid cancer. Because the patient has hypokalemia and diarrhea at the same time, both of these can be very similar to the symptoms of medullary thyroid cancer.

In addition to the above four diseases, which can cause hypokalemia and severe diarrhea, there are also colonic villous adenomas, which can also cause severe diarrhea.

In just a few moments, Zhou Can's mind had already listed six or seven diseases that were highly similar to the patient's symptoms, or that could match them.

What kind of disease is it requires further examination.

Just blood routine, urine, stool routine, small intestine perfusion test and other examinations can provide too little diagnostic evidence.

"Director Zheng, can you apply for an abdominal ultrasound examination for the patient?"

Zhou Can has diagnosed this step, and he has been unable to diagnose it.

"Applying for an abdominal ultrasound is no problem. What is your current diagnostic thinking? ”

Zheng Hongtao understands that Zhou Can has a purpose every time he makes a new application for inspection.

But this time, he was a little incomprehensible, and he didn't know which item Zhou Can wanted to check the patient?

"I want to see if there is a tumor in the patient's abdominal cavity. I have just analyzed the diseases that can cause secretory diarrhea in patients, and several of them are related to malignant tumors. There are still too few test data to make further diagnoses. Doing abdominal ultrasound may or may not be able to make new progress. ”

Zhou Can said truthfully.

"It's really possible that this kind of persistent diarrhea is related to cancer, so it's good to check the abdominal cavity. I hope it's not cancer, the young man is still so young, it seems that he is still a single-parent family. His mother raised him and trained him to be a college student, and finally entered the society to work officially, and he got such a disease, and he really picked and broke the hemp rope, and his bad luck was looking for a miserable person! ”

Director Zheng Hongtao sighed long.

He has been a doctor for so many years, and he has seen too many human tragedies and tragedies.

I have seen a lot, not only is it not numb, but it is more open-minded than the Bodhisattva in the temple.

No matter who went to the temple to burn incense and ask for Buddha, the Bodhisattva never spoke.

There may be no gods or Buddhas in the world, but people in the world still believe in them.

If nothing else, just because you are born as a human being, you will always face different hardships and troubles in your life, and you need a faith to strengthen your beliefs.

After going through too many situations where a doctor is powerless, the mindset will change unconsciously. He is full of compassion for the world and silently tries his best to help patients.

When you really can't help, you can only choose to be bearish.

"It's time to get off work today, and the medical technology department must be off work. I can only arrange for the patient to have an abdominal ultrasound examination tomorrow morning. ”

Director Zheng took the results of the patient's small bowel perfusion test and arranged the next step of examination.

Zhou Can went to the ward to inspect the twelve patients in the tube, and in general they were all good. There are three patients who can be discharged from the hospital tomorrow, and another two who are scheduled for interventional treatment tomorrow. Four had endoscopic surgeries. The remaining three are in the conservation phase.

Through these 12 patients, it is not difficult to find that even in the Department of Gastroenterology, most of the patients are not purely medicated.

Instead, interventional, endoscopic surgery, and minimally invasive surgery are needed for treatment.

The reason why there are fewer patients treated with pure medicine in the inpatient department is because many of these patients take medicine home to take it.

It is possible to avoid hospitalization as much as possible without hospitalization.

After taking the medicine for a period of time, you can come to the hospital for a follow-up.

After checking the ward and completing the handover, Zhou Can didn't care about dinner and hurried back to the apartment where he lived.

From afar, I saw Su Qianqian's BMW car parked in a parking space on the side of the road.

"Doctor Zhou!"

After Wei Fang received professional security training, his observation ability is far stronger than that of ordinary people. From afar, she found Zhou Can, and then walked quickly forward.

"Let's go, follow me upstairs!"

There was no expression on Zhou Can's face.

"Didn't you ask you to stop calling me Doctor Zhou? In the future, you can call Brother Zhou, Brother Can, and Big Brother. ”

For Wei Fang's work, Zhou Can is still quite satisfied.

She is just a little too axial, so that she can choose some more intimate titles when calling Zhou Can, but she always insists on calling him Doctor Zhou. And with Zhou Can, he is always so respectful and restrained.

went upstairs into the apartment where Zhou Can lived, and Jin Mingxi had not come back yet.

Compared with Zhou Can's relatively fixed commuting time, Jin Mingxi enjoys the treatment of ordinary trainees, and all kinds of overtime make him more and more busy.

I want to talk to Wei Fang about some confidential things today, and it's okay if Jin Mingxi is not there.

Otherwise, you can only go to the car and talk about things.

After Wei Fang entered the room, Zhou Can closed the door.

She was alone in a room with Zhou Can, but she didn't have any nervousness. didn't seem to be worried about what Zhou Can would do to her at all.

In fact, Zhou Can's character is indeed guaranteed.

"Sit!"

He gestured to Wei Fang.

"Drink water, please!"

poured Wei Fang another glass of boiled water, which made Wei Fang very flattered and hurriedly got up to take it.

"I came to you today because I have a very important thing for you to do. This packet of medicinal powder is colorless and tasteless, and you will find a way to put it in Hu Wei's drink when you meet that Hu Wei tomorrow. This person dares to betray Jinyu Interactive, and there are so many things, he must be cunning, you must be careful when you take the drug. As much as possible, leave no handles behind. ”

Zhou Can cleaned up the enemy and gave full play to the advantages of studying medicine.

"Don't worry, this is not some poison, as long as you don't leave any handle and act carefully, there will be no legal risks. The box where they talk will be deliberately unmonitored, but you still have to be careful. If you can't do it, give up. ”

Let Wei Fang do this, Zhou Can also made a decision after thinking about it again.

At present, she is the only person who can use it around Qianqian, and who can be trusted.

"You have almost saved almost all of my life, and in the past two years, you have given me a superior life that I can't even imagine. I can do anything for you, if you or Miss Su are in danger, I can use my body to block bullets for you at critical moments. I don't ask for anything else, if something happens to me, I just ask you to do your filial piety for me and give my grandmother a pension. ”

Wei Fang said something he had never said in an extremely sincere tone.

She didn't say it, Zhou Can also believed that she would really use her body to help Su Qianqian block bullets at a dangerous moment.

That's what she does.

"Your grandmother doesn't have to worry about her old age at all, if you really have an accident one day, I will treat her like a grandmother. But as an employer, I have to tell you in all seriousness that in addition to protecting you, you should also protect yourself. Your life is just as important and precious as your shallow life, you know? ”

Zhou Can said to her very seriously.

"Hmm!"

Although there was no expression on her face, the fluctuations in her eyes were revealed, and she was deeply moved by Zhou Can's words.

"There are two servings of the powder, so that in case of special circumstances, you can remedy it in time. After Hu Wei drinks the drink, you don't have to be nervous, he won't have any symptoms in a short period of time......"

Zhou Can has always been young and old, steady and mature.

Some possible accidents are taken into account.

As long as Hu Wei takes this medicine, he will have the opportunity to control this 'fang' in turn.

When the time comes, Hu Haikun will definitely be played to doubt his life.

(End of chapter)