Eating raw meat and drinking blood from fur is the way of life of primitive humans.

After millions of years of evolution, humans have long adapted to eating cooked food and drinking boiled water. Don't look at foreigners eating steak and barbecue, they often only eat medium-rare, and even eat some raw fish. In fact, their food is fundamentally different from that of wild meat.

For example, the beef they eat will do a series of tests before it is sold in the market.

It is necessary to ensure that multiple tests for hormones, bacteria, viruses, parasites, etc. meet the standards before they are allowed to be marketed.

Like the guinea pigs used for medical experiments, they are expensive because of the strict quality requirements in all aspects.

The eight-year-old boy ate a small fish raw, which was a little too naughty.

"Kid, what kind of fish were you eating?"

"It's a goldfish bought from the market! I made a bet with a good friend and I lost. Manly, big man, that must be done by the word! So I ate a live little goldfish as promised. ”

The boy looked weak when he spoke.

But it also amused Zhou Can and others.

It's amazing that such a young child knows to keep his promises.

"Little man, where did your goldfish come from?"

Zhou Can asked with a smile.

"We got it with a net when we went to the park! I ate one of the six nets, and my good friend and I took the rest home to raise. But they all died after two days. ”

The boy said that all the goldfish were dead, and he showed a very sorry expression.

"Oh! When you eat goldfish, do you chew it up and swallow it, or do you swallow it alive? Zhou Can continued to ask.

In fact, either way, goldfish can't live.

The purpose of the inquiry is to further diagnose the problem of parasitic infection.

The oral environment and the stomach environment are completely different things.

The mouth is a breeding ground for bacteria, but the stomach is a crematorium for all kinds of bacteria. It is almost impossible for viruses and bacteria to escape the killing of gastric juices. The vast majority of parasites also do not survive in the stomach.

There are exceptions, though.

For example, schizocephalus, tapeworms, roundworms, and so on.

If he chews the goldfish first and then swallows it, the parasite may take the opportunity to hide between his teeth, etc., and then quietly invade his head through his nose or his lungs down his bronchi.

Parasites are extremely survivable and cunning, and they can quickly seize the slightest chance of survival.

"I ...... I was afraid that it would jump in my stomach, so I bit it up and swallowed it with my eyes closed. It felt fishy and bitter. He recalls eating the fish and still feels uncomfortable.

The bitter taste he tasted was probably the bite of the fish gall bladder.

Bile is bitter.

There is also the possibility of bitterness in fish feces.

Zhou Can finished asking the question and continued to look down at the information.

The patient reported repeated nausea and vomiting since eating the goldfish alive. It usually occurs within seven or eight hours of eating, and diarrhea can also occur. Pull your stomach four or five times a day.

The first hospital he visited was the local county maternity and children's hospital.

The hospital tested the patient's vomit and confirmed it to be stomach contents. Diarrhea is yellow, watery stools.

The results of the first blood routine showed that WBC (i.e., white blood cells) was 2.2*10 to the 9th power/L, and EOS% (i.e., eosinophils) was 12.3%.

These two indicators of blood tests are an important reference for doctors.

If white blood cells are abnormally high, there is an increased likelihood of infection with viruses and bacteria. Eosinophils are an important indicator of parasitic infection.

The county women's and children's hospital performed a gastroscopy on the patient, which showed mild reflux esophagitis.

It seems that this county maternity and children's hospital is not bad.

Hospitals that can do gastroscopy and colonoscopy are all a little strong.

At least in the case of county-level hospitals, it's pretty good.

Doppler ultrasonography of the abdomen reveals a small amount of fluid in the abdominal cavity.

Zhou Can took a look at the B-ultrasound examination report, and there was indeed a small amount of ascites effusion.

At the same time, the patient's spleen can be seen to be enlarged.

Generally, the spleen is enlarged, either it is enlarged or the spleen has a tumor.

However, if there is a tumor, it can be judged by low and high density shadows.

Most tumors do not have the same density as normal organs.

Moving on, the results of the urinalysis showed protein in the urine (+++).

This means that the patient's urine is strongly protein-positive, i.e., the presence of a large amount of protein in the urine, suggesting severe kidney damage.

That's all the examination done by the county women's and children's hospital, and the patient was treated with protection of the gastric mucosa and antiemetic, and the patient's condition improved and he was discharged.

However, less than a month later, the patient relapsed again, vomiting, low-grade fever, and diarrhea.

Family members may be worried about the limited medical skills of the county women's and children's hospital, so they do not dare to take their children to the doctor again. Instead, he decisively took the child to the Provincial Children's Hospital for treatment.

In fact, judging from the information on the examination and treatment methods of this county-level women's and children's hospital, its strength is not bad.

Many people think that county-level hospitals must be worse than provincial and municipal hospitals, which is actually a wrong perception.

Each hospital has its own characteristics.

If a county-level hospital has a doctor with good medical skills, then bring a team to specialize in a certain medical field. Perhaps the strength of this hospital in this medical field is no worse than that of provincial hospitals.

Upside-down is also a common occurrence.

Zhou Can has seen a township-level orthopedic characteristic hospital, which is better than a provincial-level hospital. Patients come from all over the country to see the clinic, and the cost of treatment is low, and the level of treatment in the field of orthopedics is very high.

Many bone injuries that cannot be treated in large hospitals, or those that need conservative treatment, can be treated there.

Although there are not many township hospitals and county-level hospitals of this kind of anti-heaven level, there are still some in all parts of the country. With their real skills, they have made a name for themselves.

Zhou Can then looked at the examination report and treatment plan of the second hospital.

After receiving the patient from the Provincial Children's Hospital, the patient was first checked for urine routine, which showed that the urine protein was still 3 plus.

Urine protein is so severe that it is usually caused by diseases such as lupus nephritis, glomerulonephritis, nephrotic syndrome, etc. This actually requires a high degree of vigilance. But the doctors at the first maternity and children's hospital didn't know if it was a misjudgment or what was going on, and they didn't seem to pay much attention to the results.

The second provincial children's hospital has significantly more experience in diagnosis and treatment.

After 3 pieces of urine protein were found, the patient was directly tested for ANA, and the result was negative.

ANA is an antinuclear antibody, which is an umbrella term for a complex group of autoantibody cocktails.

In medicine, it is mainly used to screen for rheumatic diseases.

For example, systemic lupus erythematosus, scleroderma, Sjögren's syndrome, rheumatoid arthritis.

The test result is negative, which can basically rule out the possibility of wind temperature disease.

The experts from the Provincial Children's Hospital were still very good, and after this was ruled out, they immediately checked the patient's kidney B ultrasound again. I guess I have begun to suspect kidney disease.

It's just a pity that after the B-ultrasound examination, no obvious abnormalities were found in the kidneys.

The experts of the provincial children's hospital checked one by one and checked the patient for a gastroscopy.

I guess I look down on the county-level women's and children's hospital a little bit. Do not believe in the gastroscopy technique of the county hospital.

This gastroscopy directly took a biopsy of the gastric mucosa, and the result was mild gastritis with occasional eosinophilic infiltration.

It is worthy of a provincial hospital, and it is also a gastroscopy, and its examination direction should be more in-depth and targeted.

Zhou Can found it quite interesting to look at the treatment process of patients in the outer hospital, as well as the diagnostic ideas of the experts in the outer hospital. You can have an in-depth understanding of the diagnosis ideas of other experts, and use their diagnostic experience to help Zhou Can improve his diagnostic level.

The attending doctor at the Provincial Children's Hospital is definitely a highly skilled specialist.

You can see it by looking at his diagnostic thinking.

Each inspection has a strong purpose.

It's not like you might think about going through all the checks first. Rather, each examination has a deep meaning.

If you don't have a good understanding of pathology, you would never have been able to do this without rich diagnostic experience.

Zhou Can is now at the level of diagnosis, so that he can see their level through the examinations done by other doctors. In the past, as long as he saw other doctors doing various examinations repeatedly, he would first scold in his heart, this black doctor, and he was making money here.

Obviously, the patient has just finished the examination for a few days, and there is still a medical reference significance, so why do you have to do it again?

In fact, not every doctor is a black doctor.

It is not excluded that doctors like Du Leng, who only understand theory and have no practical experience, will do various examinations for patients in one go. There is no purpose, it is to check for the sake of searching.

Whether it is the former or the latter, Zhou Can's current diagnostic level can basically be seen at a glance.

For example, this doctor at the Provincial Children's Hospital is 100% a very high-level specialist.

After the gastroscopy, the specialist gave the patient another colonoscopy.

The results showed no abnormality.

Specialists tried to give nutritional support to the patient, but the results were very poor.

After about a week, the specialist found that the patient's treatment was ineffective, and he may have asked other specialists from our hospital to help with the consultation.

It was particularly interesting in the end.

After consultation with experts from the Provincial Children's Hospital, the patient was examined with a kidney ultrasound.

Zhou Can wondered, didn't he just check it more than a week ago and didn't find anything abnormal? How can the experts check it again after the consultation?

Hey, don't really say it, this time the double kidney B ultrasound examination actually found a problem.

If it weren't for the fact that this hospital was a provincial children's hospital, Zhou Can would have thought that this was a black hospital with money.

Because there was no problem with the last check, it was only a few days later that the problem was found again. Isn't that?

The results of the second ultrasound showed that the patient's kidneys were slightly dilated, the bladder was not filled, the pelvic fluid was 2.6 cm deep, the rectal wall was thickened, and a suspicious mass was found on the right side.

There is such a big difference in the results of the two kidney ultrasounds.

There is only one possibility, the doctor who did the kidney ultrasound examination for the first time is a related household, and the test is a fake certificate.

The medical and technical department of a large hospital is the hardest hit area for related households.

There really are those 'amateurs'.

Any patient who encounters such an unprofessional examiner can only consider himself unlucky.

Who would have thought that a provincial hospital would have unprofessional doctors when it comes to B-ultrasound?

In itself, medical imaging tests do not require particularly high levels of expertise. That kind of half-gentleman, as long as he puts a little effort into college, he can basically do it.

Of course, doctors who have dry goods in their stomachs are not only more professional in performing imaging tests on patients, but also have a higher chance of detecting hidden lesions.

This examination revealed that the patient had a mass on the right side of his kidney.

I believe that the experts are very excited.

The patient was directly subjected to laparoscopic surgery and the mass that was suspected to be a tumor was removed.

Pathological test was teratoma.

The experts at the Provincial Children's Hospital were full of anticipation and thought that this time the cause had finally been found and the tumor was surgically removed. This kid's illness should be cured, right?

According to Murphy's Law, things tend to go in the worst direction.

The child's mass was removed, and the results of the biopsy indicated that it was indeed a tumor. But the child's symptoms do not get better, the vomiting is still vomiting, the diarrhea is still diarrhea.

It is estimated that this is the first time that this expert from the Provincial Children's Hospital has encountered such an evil matter.

What to do?

Zhou Can admired the head iron of this expert from the Provincial Children's Hospital very much, and he was not discouraged. Continue to treat the patient.

Shortly after the surgery, the patient developed symptoms such as urgency, frequency, painful urination, and lower back pain.

This means that instead of curing the child's disease, surgery to remove the tumor has created a bunch of new symptoms.

The condition has worsened significantly, and the number of symptoms has increased.

The hearts of the family members must be in retreat, can this expert do it?

It is estimated that the family will even suspect that the cut is really a tumor? Could it be that the experts in the hospital couldn't make a difference and deliberately made a tumor to deceive people?

Even though this is a provincial hospital, and it is a public hospital, it still makes the family suspicious.

However, for families, there seems to be no better option than trusting the doctor.

What's more, the specialist is still gritting his teeth and continuing to treat their children.

The specialist gave the child another plain abdominal x-ray.

This time, it was found that the patient's abdomen was at the level of qi and liquid, and the expert gave the patient sesame oil, and his condition actually improved.

After such a long time of diagnosis and treatment, it finally has a little effect.

In other words, a bunch of new symptoms came out after the operation, and after the patient was given sesame oil, the symptoms were reduced. The experts are more motivated and their confidence has returned.

The specialist began to change the way of thinking about diagnosis.

Considering that the sick child eats a live fish and eats it raw, it is more likely to be infected with parasites.

Eosinophil testing is also elevated in the patient itself.

As a result, experts from the Provincial Children's Hospital checked the patient's stool and looked for parasites.

Patients with intractable diarrhea like this must have been routinely checked as soon as they are admitted to the hospital.

This time, the specialist asked the laboratory to check the patient's stool for parasites.

For example, insect eggs, parasite corpses, and even living organisms and larvae.

Unfortunately, all efforts were exhausted to detect the parasite.

The diagnosis is in limbo.

The means that this expert should use have been basically exhausted, and if he investigates again, it is estimated that there is still no result.

And during this time, the patient's condition deteriorated again.

Not to mention the presence of protein in the urine, knee and elbow pain began to appear, and the frequency and urgency of urination became more severe. I have to urinate hundreds of times a day, and when I urinate, I will urinate a few drops, and when I have more, it will not exceed 30ml.

Symptoms such as vomiting and diarrhea are also present.

At the same time, the patient had a persistent low-grade fever.

What's even more terrifying is that because of the long-term treatment, the condition is aggravated, and the patient has developed symptoms such as shortness of breath and palpitation.

This means that the disease has affected the heart and lungs.

After treatment, most of the patients have to walk into the hospital, wrap them in body bags, and carry them away.

The experts at the Provincial Children's Hospital have run out of skills and can't think of a better way.

It is a provincial hospital, and it is a well-known expert, and it directly persuades patients to transfer to the hospital, which is really shameless to say.

However, a large hospital like this has a lot of tools to deal with all kinds of difficult problems.

For example, ask the doctor to pretend to be a family member or a relative of a patient in the same ward, pretend to be concerned about the patient's condition, and then enthusiastically tell the family that you should not be treated here! You have to go to so-and-so hospital, they specialize in treating this disease.

After hearing this, the family members must have been moved.

There is no need for the hospital to bring it up, and the family will directly request a transfer.

(End of chapter)