After sending Wei Fang away, Zhou Can was also full of expectations for the effect of this medicine.

Whether it really works or not, it's hard to say at the moment.

After Hu Wei eats it, he waits about 72 hours to know if it works. The recipe was learned from Director Wen of the Department of Neurosurgery.

At that time, Director Wen was just raising up and gave Zhou Can this prescription. Moreover, this prescription was not researched by Director Wen, but passed on to Director Wen by Director Wen's mentor before his death, so that he could continue his research.

The speaker has no intention, but the listener has the intention.

Zhou Can felt that it was very magical, so he wrote down this formula, and there was no clinical trial after learning it.

It's not bad to use Hu Wei as a free drug tester.

……

The next day, close to 10 o'clock in the morning, the patient with diarrhea and diabetes insipidus lined up to complete the abdominal ultrasound examination.

Director Zheng had already explained that he was going to do two important endoscopic surgeries in the operating room in the morning, and the patient could go directly to the inpatient department to find Zhou Can after getting the examination results.

This difficult case is really unbearable for ordinary people.

The patient's mother took the test results to find Zhou Can.

Who knew that after Zhou Can took the B-ultrasound results and read them, he was silent for a long time.

"Dr. Zhou, can you find out the cause of my son's illness? Is his illness serious? ”

Family members may also be a little panicked.

This is a mother's love for her son. It was not easy for her to raise her son alone.

Her son is her lifeblood and her hope for life.

Zhou Can could clearly feel her anxiety and nervousness.

"Judging from the results of the ultrasound examination, the situation is not very good. Ultrasonography showed multiple space-occupying lesions in the liver. This means that the patient is likely to have pancreatic endocrine tumors. ”

Before the B-ultrasound examination, Zhou Can hoped that the patient would be fine.

Now it's going in the direction he least wants to see.

Pancreatic endocrine tumors can be divided into functional and non-functional tumors.

Non-functional tumors do not produce neuroendocrine substances and do not cause specific clinical symptoms in patients.

Obviously, the patient's diarrhea is so severe that it must be a functional tumor.

It is not clear which type of tumor it is.

Insulinoma, gastrinoma, glucagonoma, vasoactive intestinal polypeptide secretion tumor, somatostatinoma, etc., can occur.

Pancreatic cancer can be qualified to be called the king of cancer, and it has its own terrible aspects.

When the mother of the patient with the "tumor ......" heard this, she had a frightened and painful expression on her face. Then he put his hands on his forehead and temples, and his body began to shake, as if he could no longer stand firmly.

"Don't get excited, don't get excited. It is still only suspected that it may be a pancreatic endocrine tumor, and this is not the final result. ”

Zhou Can could only say some words against his will to appease his family.

In fact, he knows very well that the results of B-ultrasound have basically confirmed that the patient has pancreatic endocrine tumor, and it is likely to have spread.

At least in the medium term.

This means that after the patient is diagnosed, it is likely that there will be no chance of surgery.

What cancer kings are best at is not giving patients a chance to live.

Do not give the doctor any chance to resuscitate.

Even if it is just to control its growth, it will not be given a chance.

Zhou Can quickly stood up and helped the woman sit down in the doctor's office chair.

Then he walked to the door and beckoned to the nurse's station, "Xiaoli, if you're not busy, come and help." ”

The nurses in the Department of Gastroenterology have asked Zhou Can for help many times, and Zhou Can is very familiar with them.

In addition, Zhou Can is young and golden, and he is generous, and from time to time he invites all the nurses to drink milk tea and barbecue after work.

It must be explained that he invited the nurses to have a barbecue after work, and he would not come there.

Instead, he gave a lead payment, and he reimbursed him the next day.

Don't look at these female nurses in the Department of Gastroenterology, they are all beautiful and have a high level of education, but it does not affect their psychology of taking advantage of small advantages.

Every time I hear that Zhou Can has a treat, even if he doesn't go to work, he has to form a team to come over to eat barbecue.

However, their quality is still quite high, they love to take advantage of small advantages, and they are not greedy. After eating Zhou Can's things, they will also give back. In addition to paying special attention to Zhou Can's affairs at work, sometimes they will also use their way to reciprocate.

For example, stuffing two biscuits for Zhou Can, or putting a bag of snacks in his pocket.

It really made him laugh and cry.

In the hearts of girls, it is very enjoyable to steal some snacks at work. It's just that for Zhou Can, he usually almost never eats snacks except for eating some fruit.

On the one hand, they are very busy with work and study, and on the other hand, there is still a big difference between men and women in this regard.

The female nurse named Xiaoli ran over, "Brother Zhou, what do you order?" ”

"Well, the female family member inside almost fainted after learning that her son might have a pancreatic tumor, and you can help by the side. If you fall and get hurt, or if something happens, you won't be able to tell. ”

Zhou Can is really not good at helping people as a man.

Despite the fact that this female family member is already fifty years old. But he had to pay attention to the impact.

Give a dog a bad name and hang him.

These days, a distorted photo can easily ruin a doctor's future.

For example, a while ago, in the process of rescuing patients, nurses played with mobile phones. Anyone with a little brain knows that when rescuing a patient is so urgent, what doctor or nurse dares to sit next to him and play with his mobile phone without taking the patient's life seriously?

It was later found out that the nurse was not playing with her mobile phone, but was trying to contact doctors in related fields to come to the rescue, and used her mobile phone to coordinate rescue materials.

However, the family was angry with the female nurse because of the patient's death, and took photos of her and exposed her on the Internet.

It eventually caused an uproar.

Fortunately, the truth was later found out, and the female nurse was innocent.

In reality, there are too many things for doctors and nurses to sweat and cry.

The female nurse is still very comfortable with people, and under Xiaoli's comfort, the family's mood slowly stabilized. It's just that the sadness shrouded in the eyebrows and eyes can't be erased.

This patient is under the responsibility of Director Zheng, and now that there has been significant progress in diagnosis, Zhou Can feels that it is necessary to report to Director Zheng in a timely manner.

Even if Director Zheng may be operating on the patient, there is no way.

Zhou Can decisively dialed Director Zheng's mobile phone.

"Doctor Zhou, is it that the patient with diarrhea and diabetes insipidus has already found out the results?"

"The exact cause is not yet known. However, the abdominal ultrasound of the patient's abdomen has already indicated multiple space-occupying lesions in the liver! ”

Zhou Can reported the patient's situation.

"That's a terrible thing!"

After listening, Director Zheng was silent for a few seconds, and then he let out a long sigh in a heavy voice.

Medical predictions are sometimes as accurate as scientific predictions.

The higher the level of the doctor participating in the diagnosis, the more accurate the prediction will be.

Before the B-ultrasound, Zhou Can predicted that the patient's disease was likely to be a malignant tumor. In the end, it came true.

"It's really heart-wrenching. Do you think it's still necessary to do a plasma hormone level measurement? Although the ultrasound results are not good, the final diagnosis is still two to three steps away. ”

Zhou Can asked Director Zheng about his next diagnosis and treatment plan.

"Do it! After doing this, you can determine the type of pancreatic tumor. ”

Director Zheng readily agreed.

"I don't think there is any suspense about the results of the plasma hormone level measurement, and now there is one last glimmer of hope, further imaging tests to see if the tumor has metastasized. If there are no metastases, or only to the surrounding lymph, there may be an opportunity for surgery. I recommend another CT scan to focus on the chest, abdomen and neck. ”

In the case of pancreatic tumor metastasis, the lymph in the neck of the human body is the most abundant, and it is the key screening target.

There are also organs in the chest cavity that are also very susceptible to involvement.

It's like a neighbor's house burning down, and the neighboring houses are easily affected.

When a tumor occurs in an organ or tissue site, it is often the adjacent organ or tissue that suffers first.

"Okay! I arranged for Huang Liang to open the inspection application form and send it over immediately. The work of communicating with the family will take care of you. ”

This patient has almost always been diagnosed by Zhou Can and Director Zheng, and only the two of them know the patient's condition best.

Huang Liang ran errands, it was okay to send an inspection application form, and it was too difficult for him to do communication work for his family.

The application for inspection was issued quickly.

Zhou Can's communication with his family was also very smooth.

When the results of plasma hormone level measurement came out, Zhou Can found that the patient's plasma VIP and SST were significantly increased.

The VIP value, that is, the vasoactive intestinal peptide value, has reached an astonishing 300-890, you know, the normal person is only about 60. The VIP measurement in this patient was more than ten times higher than normal.

The SST value is often referred to as somatostatin, reaching a terrifying 600-2500ng/L, and the normal value is about 25. It exceeded the standard by a full hundred times.

When he saw this result, Zhou Can's heart sank directly to the bottom.

If only I could have found him earlier.

However, if you look for him earlier, maybe at that time he was far from reaching the current level of diagnosis, and he was not able to diagnose the cause of the patient.

Plasma hormone levels can now be used to determine that a patient has a mixed tumor that secretes VIP and SST.

Now I finally understand why the patient has secretory diarrhea.

Vasoactive intestinal peptides are widely found in the nervous tissues of the digestive tract system and in pancreatic endocrine cells.

It has a number of physiological effects, including a relaxing effect on smooth muscle, stimulation of bile sweat secretion, and stimulation of intestinal secretion of water and electrolytes.

Elevated vasoactive intestinal peptide is the main cause of secretory diarrhea.

As for somatostatin, it is mainly distributed in the thalamus, pancreatic D cells, and small intestine.

Its main effect is to inhibit the secretion of the digestive system.

The SST value of patients exceeds the standard by 100 times, which can cause steatorrhea. However, the patient also has secretory diarrhea, which can be partially counteracted.

Now the real cause of the patient's diarrhea and diabetes insipidus has been found.

It's the truth that comes out.

The only prayer is that in the subsequent CT scan, the tumor has not metastasized significantly.

It backfired, and the CT results were quickly delivered to Zhou Can.

Shows mass lesions in the body of the pancreas and metastatic lesions in the liver. Clinical practice has shown that the middle of the patient's main pancreatic duct has been completely obstructed.

Abnormalities are also found in the supraclavicular lymph nodes.

Without the need for a pathological biopsy, Zhou Can was sure that the patient's tumor had metastasized to the liver and supraclavicular lymph nodes.

After investigation, it was confirmed that it was a metastatic neuroendocrine tumor.

Seeing such a bad test result, Zhou Can's heart was already half cold. However, he still had one last glimmer of hope and offered to give the patient a surgical exploration to see if there was still a chance of removal of the pancreatic tumor.

A cure is out of the question.

At the very least, it can prolong the life of the patient.

After surgical exploration, the neck of the patient's pancreatic body was several times larger than normal, and the tumor invaded the surrounding tissues and had metastasized to the liver, and the patient completely lost the opportunity for surgery.

When the patient was pushed out of the operation, the patient's mother was already waiting anxiously outside the operating room.

Immediately greeted him.

"Dr. Zhou, is my son's surgery okay?"

In fact, she already had a very bad premonition in her heart. Her face was pale and her hands were shaking uncontrollably when she was questioned. It's like a ninety-year-old man with an uncontrolled body.

Before the surgical exploration, Zhou Can had already told her.

If it is determined that there is still a chance for surgery, she will be asked to sign a new surgical consent form and directly remove the tumor.

If there is no chance of surgery, then the only way to make the patient spend the last days of his life as little painful as possible.

The operation was over so quickly, and no one asked her to sign the consent form for the operation, and she could already feel the results.

"You push the patient back to the ward first, and I'll talk to the family about the patient."

Zhou Can said to the nurse and Physician Huang Liang.

Zheng Hongtao was originally responsible for this patient, and out of responsibility and morality, Zhou Can has been working hard to run around and be busy for the patient.

It's a pity that in the end, I can only do my best, and I can't resist the mandate of heaven.

In the face of this advanced neuroendocrine tumor patient, Zhou Can was powerless, and Tuya Hospital was powerless.

At the level of medicine in today's world, there is no way to cure such patients with advanced cancer.

It is difficult to even prolong the life of the patient.

Considering the patient's family situation, as long as the doctor has a little conscience, he will not let the family continue to sell the house and empty the savings for the patient's treatment. Because that's not something money can do.

The end result will only be empty of people and money, and there will be no hope.

When a patient is diagnosed with cancer, doctors generally do not tell the patient directly, or even intentionally avoid it. As for whether the family tells the patient or not, that is the family's business.

Zhou Can led the family members to sit down on the row of chairs in the aisle.

"After surgical exploration, your son's tumor has metastasized in multiple places and has reached the advanced stage of cancer, which means that the opportunity for surgery has been lost. What our hospital can do is alleviate his pain as much as possible. ”

After listening to this, the family members grabbed the edge of the chair with one hand and closed their eyes, their expressions extremely painful.

A whimper came from deep in her throat, and tears welled up like beads of broken thread, sliding down her slightly rough cheeks.

It can be seen that at the age of fifty, many wrinkles have climbed on her face.

If it is a well-maintained woman, who lives a carefree life, has a healthy lifestyle, and actively exercises and fitness, she may look similar to a woman in her thirties.

This woman's face has aged like this, her face is haggard, and she has lived too hard.

Now, she will be in even greater pain because of her son's cancer.

It's very worrying to watch.

"Doctor Zhou, how long will my son live?"

She tried to wipe away her tears, but she couldn't.

As soon as I wiped it off, it gushed out again.

"If nothing else, I should live for about three months. In the advanced stage of cancer, because the cancer cells invade the tissues and organs of the body, it will cause great pain to the patient, so you should let him eat and drink as well as possible! Those who smash pots and sell iron do all kinds of expensive treatments, and I personally don't recommend it. ”

Zhou Can will not make money without conscience, and does not guarantee that other hospitals and other doctors will not.

In particular, some private hospitals will not give up until the last drop of blood pressure of the patient's family is squeezed out.

There are too many things to treat a terminal cancer patient and treat millions.

A hospital is not a hospital that belongs to a single person, it is a collective. As long as the family is willing to pay for it, the hospital will never object to the doctor's behavior. Instead, they will be in favor and acquiescing.

After all, any hospital needs to make money, and only when it makes money can it run stably.

The performance of a department is closely related to the income of doctors.

There is no doctor or nurse who doesn't want to have a good life.

"Only...... Three months to live ......"

When the patient's mother heard this, she almost fainted on the spot.

It took a long time for her to breathe, and then she hid her face and cried, whimpering and whimpering.

Zhou Can dared to deal with no matter how difficult the condition was, but in the face of the crying and despair of his family, he seemed a little helpless.

The woman's crying also attracted the attention of many people.

Zhou Can was even more uncomfortable sitting here.

If you talk to your family about this kind of thing later, you have to be in the office. Otherwise, it's too embarrassing.

Fortunately, his popularity was good, and a nurse walked over quickly.

"Doctor Zhou, what is she?"

She had a nervous breakdown when she learned that her son had terminal cancer and only three months to live. Help comfort her. ”

Zhou Can seemed to grasp a life-saving straw.

The usual milk tea and barbecue are finally not in vain.

(End of chapter)