A little cold, which is no more common, did not expect to bring a huge disaster to this young and beautiful girl.

She was sick for two years.

With modern medical care, even a severe cold is not a big deal. I bought a box of medicine at a roadside pharmacy and was cured quickly after taking it.

But the girl was sick at the age of seventeen.

Seventeen or eighteen years old is the age when the body is the most resistant, and the body is full of vitality and vitality.

Zhou Can realized that the girl's body must have an immune decline or immune deficiency, so that the body's defense system would be broken by a small cold.

Almost all intractable diseases have a common characteristic, and patients are still not well after being treated in multiple hospitals.

Many difficult cases begin as minor ailments, and they are good at disguising themselves as if they were big enough to make the patient let their guard down. For example, low-grade fever, slight pain, or some mild physical discomfort and so on.

They are like endless weeds, which become more and more cut, and finally become a disaster, completely crushing the patient's body and taking the patient's life.

The kind of disease that is critical from the beginning, although it is terrible, is easier to diagnose because the lesion is obvious.

At best, the treatment is tricky.

The difficulty of such difficult cases is to find the real cause. Once the cause is found, it is equivalent to finding the lifeline of the disease, and a box of medicine for a few cents may cure the disease.

Many patients who have been listed as special needs experts believe that they have a deep understanding, find a general doctor, do all kinds of examinations, and eat a basket of expensive drugs, but their condition does not improve.

Then I listened to someone and hung up the number of a certain expert.

Hey, the specialist didn't ask for any more tests, and after some diagnosis, he prescribed a box of five cents.

The patient muttered in his heart, is this expert reliable?

It can't be a brick house, right?

I went home and tried to take my medication as prescribed, and a week later, the unthinkable happened.

The body feels noticeably better.

I continued to insist on taking the medicine, and after half a month, the disease that could not be cured for a long time was cured. Since then, this patient has said that it is really fragrant to be a specialist.

I just hate that I didn't hang up the expert's number at the first time when I got sick.

So much so that I ate a lot of expensive and useless drugs, and did a lot of unnecessary tests, and was used as a guinea pig by those ordinary doctors, which is really unjust.

This patient was undoubtedly lucky.

He met a specialist who happened to be good at treating his disease.

Otherwise, it's hard to say what the final outcome will be.

There are not a few unlucky patients whose mild symptoms are treated as severe cases.

This female patient's small cold has not been cured for two years, and it is unbelievable to say it.

Zhou Can took the patient's examination data and looked at it carefully.

The senior doctors are very happy that these young doctors are eager to learn.

The patient's erythrocyte sedimentation rate was 39 mm/first hour. Glutamate aminotransferase is 170 U/L, aspartate aminotransferase is 137 U/L, and alkaline phosphatase is 320 U/L......

After Zhou Can read this checklist, he immediately suspected that there was something wrong with the patient's lymphatic system.

The patient was given roxithromycin anti-infective therapy in the first hospital, but the results were very poor.

Later, he did a bone marrow aspirate and B-ultrasound examination in the outer hospital.

Since these examinations were done in the outer hospital, Du Leng asked the patient to do a bone piercing again, and the family did not scold the mother, which is really good.

Bone puncture results show active hyperplasia.

Abdominal ultrasound suggests polyps in the gallbladder.

Splenomegaly.

Lymphadenopathy at the hilar part of the liver.

Sure enough, as Zhou Can predicted, there was a problem with the lymphatic system.

He went on to look at the tests that the patient had done in the hospital.

Later, after the hilar lymphadenopathy was found to be swollen, the experts in the outer hospital asked the girl to make up the lymph node ultrasound.

The results showed that lymph node enlargement occurred in both necks, axilla, and groin.

Enlargement of lymph nodes in so many locations indicates that it is likely to be a systemic lesion.

The problem is worse than expected.

If it is just a fire, bilateral cervical lymphadenopathy is more common.

Colds are divided into wind chill and wind heat.

Wind heat is the fire and the invasion of wind evil, which belongs to the double disease.

The experts in the hospital were not vegetarians and followed the clue of swollen lymph nodes to perform an inguinal lymph node biopsy on the patient.

The result is reactive hyperplasia, with immunohistochemistry showing hyperplasia of T, B, and histiocytes.

This can basically lock in the possibility of virus infection.

Specialists from other hospitals gave hepatoprotective and antiviral therapy to the patient.

This is symptomatic treatment and is common in medicine.

The patient's condition improved after treatment. Unfortunately, the good times did not last long, and after less than ten days, the patient had a fever again, and it was a high fever of more than 40 degrees, and he had a cough.

The family rushed the patient to the hospital again for treatment, and it was the same specialist who was found.

Because the last treatment had a certain effect, the family's trust in that expert was extremely high.

After receiving the consultation, the specialist immediately prescribed a request for a routine blood test for the patient.

After the blood Rt examination, the proportion of lymphocytes was found to be increased to 47%, and the bone marrow aspirate found no abnormality, and the AST was checked, 43U/i.e., aspartate aminotransferase.

If you look at it, you will definitely check ALP, which is alkaline phosphatase, which reaches 141U/L.

Blood and sputum cultures were then examined, and it is estimated that the specialist still suspects that the patient has a viral or bacterial infection.

After not gaining much, the experts from the outer hospital were a little confused, and applied for abdominal CT for the patient.

It is estimated that this expert only checked an abdominal B ultrasound last time, and he felt that there were certain limitations.

Examination of the lesion is not clearly stated.

So I did a CT this time.

The results showed that the patient had an enlarged liver, fatty liver, a still large spleen, and a hypodense lesion in the left adnexal area.

Seeing this result, Zhou Can sighed in his heart, if the experts left many high-tech medical examination instruments, I am afraid that they would be directly beaten back to the diagnosis and treatment level of primitive society.

Take this female patient as an example, the expert only did abdominal B ultrasound last time, and did not find that the patient had fatty liver and ovarian lesions.

CT results show hypodense lesions in the left adnexal area, which are actually ovarian tumors or cysts.

This time, the experts from the outer hospital were afraid of being slapped in the face, so they gave the patient a liver puncture and sent him for pathological examination.

Examination results show mild hepatocyte turbidity, small foci of steatosis, and scattered punctate necrosis.

The manifold area is mildly dilated with more lymphocytic infiltration.

Minor destruction of the leaflet perimeter plate.

Lymphocytic infiltration was also found in the hepatic sinusoids.

The final diagnosis was given by the experts of the hospital as chronic hepatitis, fatty liver, and gallbladder polyps.

Once again, the patient was given hepatoprotective therapy and anti-infective therapy.

The patient was hospitalized in the hospital for nearly four months and was discharged after his condition improved.

During this period, the patient's fever was not cured.

From high fever to low fever, until discharge from the hospital, it is still low-grade fever.

After discharge, hepatoprotective therapy was continued.

After the patient returned home, he often developed a fever at night, even reaching more than 38 degrees.

In this way, after another half a year, the patient had red eyes, blurred vision, buzzing in the right ear, and severe hearing loss for no reason. Stuffy nose.

The girl's mother saw that her daughter's condition had not been cured, and now the symptoms were much worse than the first one.

She was worried that there would be more serious problems if she went to that specialist for treatment, so she changed hospitals this time.

The doctors at that hospital couldn't find the cause for three days.

So the girl's mother had to go to the outer court specialist again.

This time, after receiving the consultation, the experts from the outer hospital spoke very tactfully. This means that he has been practicing medicine for decades and has never encountered such a difficult disease. In view of the deterioration of the girl's condition, the family is advised to visit Tuya Hospital or other major hospitals.

This routine is too similar to the Golden Basin Foot Washing City of the Great Soldier.

The specialist had learned everything he had learned in his life, but he still couldn't cure the girl. If it continues to be governed, it will be a matter of putting people's lives on the table and smashing signboards.

Therefore, the specialist from the outer hospital advised the family to take the patient to the specialist of the other hospital in 'Huohuo'.

This kind of thing has been done by many doctors.

The girl's mother originally wanted to go to Tuya Hospital to hang up an expert number, but who knew that the expert number was very difficult to grab.

It happened that this time I heard that a large number of experts from Tuya Hospital would come to Xinxiang Women's and Children's Hospital, so I hurried over with my child.

At first, when I saw Professor Zhang Bihua from the Department of Obstetrics and Gynecology and doctoral students graduated from famous overseas universities, this mother felt very happy. I thought I had finally come to the right place.

Who knew that Du Leng prescribed a number of examinations for her daughter, and had a lot of professional medical knowledge of various diseases.

In the end, I found out that this returnee doctor was a silver-like wax gun head.

The theoretical knowledge is very strong, but the actual diagnostic ability is terrible.

"Director Zhang, can my daughter's disease be cured?"

The girl's mother had also heard of Zhang Bihua's name, and at this moment, she was almost desperate for her daughter's illness.

"Don't worry, no matter how difficult the disease is, as long as you find the real cause, you can get rid of it by prescribing the right medicine. With so many of our experts here, there is the strong medical strength of Tuya Hospital. Even if the experts we are present today cannot find the cause of the disease, we will ask the relevant experts at the main hospital to carry out a special consultation and do their best to cure your daughter. ”

Zhang Bihua gently comforted the mother who was on the verge of collapse.

"Yang Chan, you give the patient a physical examination."

Considering that the patient is a young woman, it is preferable for a female doctor to do a physical examination.

Yang Chan gave the patient a physical examination.

Body temperature 38 degrees, obvious fever. pulse 115 beats/minute, blood pressure 110/80 mmHg, palpable soft lymph node in the right groin, mobile. The conjunctiva of both eyes is mildly hyperemic, the palpebral conjunctiva is not hyperemic, edema, the sclera is normal, and xanthochromia is not present.

The pharynx is mildly congested, the left tonsils are enlarged with pus on them, and the gag reflex is present.

The patient has weakness in both lower extremities, unsteadiness on standing, and pain on both sides of the feet and the soles of the feet.

In addition, the patient has some hearing impairment.

"Considering that your daughter has symptoms such as unsteadiness on her feet and weakness in her lower limbs, she needs to have an electromyography to check the peripheral nerves of her upper and lower limbs, her hearing, and the sympathetic nerves of her upper and lower limbs. In the ear and throat, Dr. Du has prescribed a CT scan of the sinuses, which showed inflammation in the right ethmoid sinus and bilateral maxillary sinuses. MRI of the head showed thick mucosa of both maxillary sinuses and ethmoid sinuses, and bilateral middle ear mastoiditis......"

Director Zhang read all the examination materials and asked Yang Chan to do a comprehensive physical examination of the patient and give further diagnostic opinions.

In fact, Du Leng basically asked the patient to do all the examinations that should be done.

Including sinus CT, cranial MRI and more.

After Director Zhang finished speaking, he looked at the other two experts.

"Director Jiang, Director Shi, do you have anything else to add?"

This patient's condition has been complicated by the fact that it has lasted for more than two years, which has led to multiple lesions in the body.

Zhou Can couldn't help but sigh, if it were an ordinary family, I am afraid that he would have stayed at home and taken some Chinese medicine or something, and took conservative treatment.

Because many families find it difficult to afford excessive medical bills.

When they fail to respond to treatment in a major hospital, they will assume that the same outcome will be achieved in other hospitals.

So will choose to resign to fate.

Jiang and Shi, the two chief physicians, both shook their heads.

This case is so complex and tricky that it is really daunting at their level, and there is no way to give any constructive advice.

"Doctor Zhou, what about you? Any good opinions? ”

Because Zhou Can performed extraordinary in two cases in succession, Zhang Bihua attached great importance to his opinion.

"Can I touch her neck?"

Zhou Can made a request to answer the question.

When Yang Chan was doing a physical examination for the patient just now, he had been watching from the side.

In this case, even if he wants to touch the patient's neck, he has to take into account the difference between men and women. If there is a misunderstanding, it will not be good.

"Yes, you can't be a doctor! Dr. Chow just gave my daughter a check-up. ”

When the family members were diagnosed by Du Leng just now, they actually secretly observed the situation on Director Zhang's side.

Zhou Can performed extremely well in the diagnosis of the obese woman, and the diagnostic opinions he gave were even more clever than those of several experts. made the female family member particularly impressed by Zhou Can.

The trust in Zhou Can is quite high.

"Thank you for your trust and understanding!"

Zhou Can walked up to the female patient, his face slightly serious.

"If I feel pain when I touch it, you can tell me right away."

He said to the female patient.

"Okay!"

The female patient's voice is very delicate, and her middle qi is obviously insufficient.

After speaking, Zhou Can reached out and touched her slender neck. The skin is very delicate, which is more conducive to Zhou Can to feel whether there is a lump under the skin.

He reached the side of his neck to his throat and the surrounding area.

"Ah...... It hurts, it hurts......"

The female patient suddenly let out a cry of pain.

Zhou Can nodded, as if he had expected it.

"With a little patience, I'll try to be as light as I can. I want to see the size of the tumor and if there is still a tumor around. ”

What I just touched was actually the pharynx.

After some exploration, he did not touch any other lumps or make any new discoveries.

"Dr. Zhou suspects she has a tumor in her pharynx?"

Director Zhang asked in surprise.

The female patient and her mother admired the young doctor's medical skills.

"She should have a tumor in her throat, and it may not be very large. I recommend that after further investigation, the tissue of the tumor should be taken for pathological examination. Feeling that lymphoma is likely to be great. ”

Zhou Can said in a rather determined tone.

Some lymphomas are extremely insidious and very difficult to detect. In particular, lymphangiomas, the smallest lymphatic vessels may be less than 1 millimeter in diameter. Even an MRI may not be able to detect it.

Director Zhang looked at the family.

"Do you think it's okay to do a pharyngeal mass test?"

"Yes, yes. This Dr. Zhou is so good that he can know that there may be a tumor in my daughter's throat without any instruments. ”

Family members praised Zhou Can.

For her, as long as the cause of her daughter's illness can be found, it doesn't matter how many tests she does.

Families with good economic conditions are never worried about how much medical expenses are spent, but only about whether the disease can be cured.

In fact, the richer the person, the stronger the risk awareness, and the various commercial insurance they buy are very complete.

If a critical illness really occurs, after being reimbursed by medical insurance and commercial insurance, I can't spend much money.

On the contrary, it is the poor people who need to support their families with a meager salary every month, and it is the norm to be overstretched. There is really no extra money to buy commercial insurance that is not cheap.

In the event of a major illness, they often face the end of selling their house and car to see a doctor.

It is not uncommon for people to return to poverty due to illness.

The patient went for a check-up.

"Dr. Zhou's clinical experience and clinical diagnosis ability are very good!"

Gao Jian said to Zhou Can with bitterness.

Needless to say, in the diagnosis of these difficult cases, he failed completely.

Zhou Can has made meritorious contributions one after another, and has major diagnostic results, and he, a highly talented student of Imperial Capital Medical University, has not even had a chance to speak even after nearly two years of training in Tuya's internal medicine department.

It's not that he doesn't want to say it, but his ability is limited, and he can't give any constructive advice at all.

"Doctor Gao, don't praise me so hard, I don't have any other weaknesses, I just don't praise me." Zhou Can's self-deprecating response made everyone smile.

"Kodaka, let's go. Dr. Zhou's strength is strong, and that is also practiced. I told you that diagnosing patients is the best way to learn. ”

Director Jiang said to Gao Jian.

After finishing speaking, he also glanced meaningfully at Du Leng's table, which was not far away, and had changed from lively to deserted.

(End of chapter)