"Teacher, I'm ......"

She enjoys the feeling of being in the limelight, and she has never been so honored since she joined Tuya Hospital.

It was only when I was in school that I enjoyed this feeling of being admired and admired by everyone.

It's just the integrity of her heart and the strong self-esteem that spurs her on, so that she can't help but muster up the courage to clarify all this.

Because the person who really diagnosed a pregnant woman with diabetic ketoacidosis was Zhou Can.

"You're just shy! You did a very good job today, praise you as you deserve, don't feel embarrassed. Director Zhang looked at his beloved disciple with kind eyes.

Parents always think that their children are the best and the best, and those who are masters also think that their apprentices are the best.

Zhang Bihua didn't expect that this patient was not diagnosed by an apprentice.

"Teacher, in fact, the person who diagnosed this patient's abnormal blood sugar was Zhou Can, not me!" Yang Chan gritted her teeth and finally mustered up the courage to tell the truth.

Not only is she clean-looking, but her heart is also extremely pure.

What doesn't belong to her, she resolutely doesn't want.

Although she knew, even if she didn't tell the truth, Zhou Can wouldn't say anything.

However, her backbone and arrogance did not allow her to do so.

To test a person's character, just look at his attitude towards money. But to test whether a person's soul is clean or not, it must be seen whether he can withstand the test and not waver in the face of temptation.

"Zhou Can again?"

Zhang Bihua was only slightly surprised by this result.

"It's also very good that you can do it."

After praising Yang Chan, Director Zhang's eyes looked at Zhou Can who was standing at the door.

This kid always likes to sit in the corner and be silently high-profile.

"Xiao Zhou, come and share your diagnostic ideas with everyone! This patient's diagnosis is extremely valuable to learn, and it also allows these young doctors to learn your diagnosis method. ”

Zhang Bihua was not unhappy because he was robbed of the limelight by a junior.

The inch is short, and the ruler is long.

Everyone has their own strengths and weaknesses. Medicine is so vast and extensive that he will not be able to learn it in his lifetime. In addition, each doctor's diagnostic thinking, knowledge, experience, and understanding and comprehension of diseases are different, and the ability to diagnose different diseases is naturally very different.

No matter how powerful an expert is, even in the field he is good at, there are shortcomings and blind spots.

For example, in the diagnosis of this pregnant woman, even Director Zhang Bihua did not expect that the patient had diabetic ketoacidosis.

She was particularly shocked when she heard the results given by the lab.

In the face of the excellence of her juniors, she behaved very calmly.

"Dr. Zhou is too strong!"

Gao Jian watched Zhou Can shine in all directions again and made great contributions, if you want to say that your heart is not sour, it is fake.

It's just that the ability is not something you can have if you want to have it.

For now, Gao Jian has to admit that his diagnostic ability and diagnostic thinking are not as good as Zhou Can. It seems that the diagnostic experience is also far from that of Zhou Can.

"Fill up the letters!"

Du Leng snorted, his face was quite ugly.

Unexpectedly, Zhou Can made a great contribution under his nose again.

When Zhou Can asked Yang Chan to help check whether the skin of the patient's armpits and groin had discoloration, he had been figuring out Zhou Can's diagnostic ideas. It's a pity that I couldn't come up with it when I broke my brain.

It wasn't until Yang Chan suggested that Director Zhang do a blood sugar test for the patient that Du Leng realized Zhou Can's diagnostic ideas.

It's a pity that it was too late to say anything at that time.

Zhou Can was in full view of everyone, so he could only walk to Zhang Bihua's side. He glanced at Yang Chan with some stumbling eyes: "Why did you pull me out!" ”

"Just share your diagnostic ideas with everyone! How can I take your credit? She has a clear conscience, and when she reproaches Zhou Can, she is naturally confident.

She was still the proud class leader.

"Tuya Hospital really lives up to its reputation, not only the older generation of famous doctors, but also the younger generation of doctors. Is this Dr. Zhou really just a regular doctor? ”

Hu Wanjun was somewhat incredulous.

Not to mention regular doctors, even resident doctors are difficult to have such a high level of diagnosis.

Ordinary people watch the excitement, but Hu Wanjun, who is a senior expert, is nearly sixty years old, but what he sees is the doorway.

She knew how difficult it would be to diagnose a pregnant woman with diabetic ketoacidosis. A seemingly simple diagnosis is a lack of obvious symptoms, lack of testing evidence, and the patient's blood glucose has been checked before admission, showing that the blood glucose value is normal. In this case, to diagnose a patient's blood sugar problem, it takes not only extraordinary courage, but also profound medical knowledge, rich clinical experience, and extraordinary thinking ability.

All four are indispensable.

Professor Hu Wanjun rarely praises people, but at this moment, he highly appreciates Zhou Can.

"It's like a fake! Actually, I'm not as good as you think. I'm just an ordinary doctor. In Tuya Hospital, there are countless young doctors who are better than me. ”

When Zhou Can faced this top expert from Xinxiang Women's and Children's Hospital, he was neither humble nor arrogant, but he was modest but would not extinguish the prestige of Tuya Hospital.

"The patient had a test just two days ago, so why did you think there was something wrong with her blood sugar?"

Hu Wanjun asked shamelessly.

She really wanted to know Zhou Can's diagnostic ideas.

Other doctors are also waiting for Zhou Can to share.

"It's not complicated, I've treated a lot of diabetic patients, so I'm very impressed with some of the symptoms of this disease. For example, the skin is dull and brown, and even obvious skin diseases appear. In clinical diagnosis, if the skin on the neck, armpits, etc. is dark, even if it is scary, it is not possible to diagnose diabetes. ”

"It is only when this condition is present in pregnant women that it increases the chance of diagnosing diabetes. And the older the month of pregnancy, the higher the risk of developing diabetes. ”

The diagnosis of the cause is more complex than you might think.

For a single condition, it is difficult to determine what the disease is.

For example, stomach pain, it may be enteritis, uterine fibroids, or femoral hernia.

The combination of dull and brown skin in multiple places, combined with 37 weeks of pregnancy, may be associated with diabetic ketoacidosis.

"When the patient took a drink from the glass and fished it out, I immediately realized that she might also have a problem with her eyesight. After observing her words and deeds, I am even more sure of this. By this point, it was almost certain that she had diabetic ketoacidosis. ”

Zhou Can's diagnostic method is obviously much more efficient than the elimination method.

The combination of the two symptoms and the special condition of the third trimester allowed him to directly identify the cause.

"I checked my blood sugar two days ago, but why did I suddenly have a problem?" After all, Du Leng couldn't hold back the strong curiosity in his heart and blurted out a question.

As soon as the question came out, Du Leng immediately realized that his shortcomings had been exposed.

However, many people wanted to know the answer to the question he asked, so everyone's eyes did not stare at him, but focused on Zhou Can.

"The patient developed a severe upper respiratory tract infection on the fifth day before admission. This acute infection is a stressful state for the patient, and when the patient has a stressful situation, the insulin in the body becomes insufficient. Insulin, in turn, regulates hormone increases, as well as hepatic glucose release, ultimately leading to severe hyperglycemia. If the patient's food and water consumption are restricted during the two days of hospitalization to cooperate with the examination, the condition will be further exacerbated. ”

"The above is all the pathological mechanism of my dialectic. There may be omissions, please correct them. ”

After Zhou Can finished speaking, the audience was silent.

Many doctors were immersed in his analysis.

"Dr. Zhou's analysis is incisive and wonderful, and it is fully consistent with the pathological mechanism of human endocrinology."

A doctor from Xinxiang Women's and Children's Hospital couldn't help but praise.

"This case is very instructive and allows us to take into account the stress status of pregnant patients when diagnosing them in the future." Hu Wanjun, a 60-year-old expert and professor, can be said to be well-informed.

But this is the first time this rare case has been encountered.

Of course, it also has something to do with the fact that her field of expertise is gynecology, not obstetrics.

"The afterlife is terrifying! From now on, this world will be the world of you young people! Director Zhang Bihua was moved.

Her area of expertise involves obstetrics, and she didn't expect that in this case, she was not as good as a regular doctor.

As she said, there are talents from all generations, and the world is the world of young people.

The older generation will eventually come to an end.

"I'm actually a blind cat hitting a dead mouse, and I just happen to have some understanding of this kind of case." Zhou Can didn't dare to ride on the heads of these chief physicians.

All the bigwigs present are present, and none of them are simple.

……

After the infusion, the blood sugar of the pregnant woman dropped to about 14mmol/L, and the fetal heart rate became significantly stronger.

Everyone breathed a sigh of relief.

Director Zhang Bihua asked the nurse to change the normal saline solution to 5% glucose sodium chloride.

The goal is to increase the patient's calories, which is conducive to faster correction of ketones.

At this point in the treatment, the situation has basically been turned around. A large stone that weighed on the hearts of Professor Hu Wanjun and others was removed.

Their expressions relaxed slightly.

The group returned to the conference room and discussed the backlog of several difficult cases and critical cases again.

This time, Zhou Can's status has improved significantly, and no doctor in Xinxiang Women's and Children's Hospital dares to underestimate him.

As for Tuya Hospital, everyone has long seen Zhou Can's ability, and now they just admire him even more.

At this time, the patient with soreness in the lower limbs and venous embolism was also examined.

The cause of her diagnosis is deep vein embolism in the lower extremities. There were also multiple embolisms and varicose veins of the lower extremities. Considering that the patient's family was relatively poor, coupled with the poor surgical conditions of the patient, the experts formulated a drug thrombolysis treatment plan for her on the spot.

If the results are not good, then the only option is to be hospitalized for elective surgery.

The diagnosis of this patient was just a small episode, and it was not particularly difficult in the first place.

At least for the experts present, this kind of deep venous thrombothrombosis of the lower extremities is nothing.

A total of seven difficult or critical cases were backlogged, and everyone started to discuss them one by one. The atmosphere in the conference room has gradually become lively, and everyone has spoken enthusiastically.

The doctors of the two hospitals have gradually become much more harmonious from the beginning.

"We admitted a 63-year-old female patient with a CT scan that showed a mass in the upper lobe of the left lung. Considering that lung cancer is highly likely, please see if the experts present can be operated. ”

Professor Hu Wanjun motioned to the assistant to play the PPT film on the screen, and the patient's CT examination image could be clearly seen.

"This should be in the early stage of lung cancer, which is fully in line with the indication for surgery."

"I think the patient is older and traditional thoracotomy should be avoided as much as possible."

"Thoracoscopic surgery is a great option!"

Everyone, you say a word, I say a word.

Many of the doctors present were actually internists and were not good at surgery.

That is, in recent years, with the rapid development of endoscopic surgery, coupled with the pressure of the market, internal medicine has to develop interventional surgery and endoscopic surgery in order to survive.

This is why the physicians have a little say in the operation.

If you want to talk about professionalism, it is definitely a cardiothoracic surgeon who is more professional.

"The difficulty of this operation should be quite high, there are a lot of lymph nodes to be removed, and left upper lobectomy is also required. Director He Miao of the Department of Cardiothoracic Surgery of Xinxiang Women's and Children's Hospital happened to go abroad for further study. Director Zhang, can you please ask Tuya Hospital to send a powerful surgeon to come and support? ”

This lung cancer patient was left for the last discussion, and Xinxiang Women's and Children's Hospital must have made up its mind to ask for reinforcements.

It's just that the two hospitals are working together for the first time, and both are for mutual benefit. It's not easy to ask someone else's surgical team to come and help.

Don't look at surgeons in the hospital, they are always despised by internal medicine, but the treatment of many diseases cannot be done without surgery.

And there is a big difference between surgery and internal medicine.

Internal medicine, which can often fight alone, and individual heroes abound.

Surgery requires a team with a high degree of cooperation and professional quality.

Consult an internist, just go over and be alone.

Ask the surgeon to perform the surgery, especially for this kind of major surgery, which requires a team.

Not to mention Xinxiang Women's and Children's Hospital, even sub-hospitals such as Tuya Affiliated Second and Third Affiliated Hospitals are facing many difficulties if they want to borrow the surgical team from the General Hospital. The hospital has never been a hall of words, but an interest group composed of multiple departments.

It's more like a country.

Each department is like a province of the country, and a slightly larger decision needs to be discussed by everyone.

Cardiothoracic surgery is a very busy department, and there are only a few chief surgeons who can preside over major surgeries above the third level.

Xinxiang Women's and Children's Hospital wanted to ask a team to come and help it treat this lung cancer patient, but Tuya would definitely not agree.

"Director Hu, this matter is really not something I can decide. If your hospital really needs this aspect, you can directly contact the top management or cardiothoracic surgery department of Tuya Hospital. Or it is also a good option to refer the patient to Tuya Hospital for this surgery. ”

Zhang Bihua tactfully reminded the other party.

doesn't have that ability, and always thinks about eating meat, how can there be such a good thing in the world.

The best way to do things is to do what you can.

"Oh well! I will report this matter to Dean Tian before making a decision. Thank you very much for your hard work today, thank you very much for taking time out of your busy schedule to help us solve these difficult cases, and I would like to say thank you on behalf of Xinxiang Women's and Children's Hospital. ”

Professor Hu Wanjun stood up and bowed to the doctors and nurses at Tuya Hospital to thank him.

One by one, the difficult cases were solved, and their faces were obviously much more relaxed.

Back at the hotel, Xinxiang Women's and Children's Hospital is very sensible, and each doctor has specially customized fruits, supper, and the kind delivered to the room. The service was quite attentive.

The next day, Zhou Can and the experts went to the outpatient hall of the hospital for consultation.

I saw that there was a long queue in front of my desk, and there were more than twenty patients. He thought he was dazzled.

Rubbing his eyes, yes, it was indeed at Doctor Zhou Can's consultation table.

With such a big sign, it is impossible for these patients to recognize the wrong table.

Du Leng's consultation table was still the same as the previous two days, with a small queue of eleven or twelve people.

"Doctor Zhou, what were you doing last night? Your desk looks like it's going to be crowded! Deputy Director Shi asked in surprise.

"I'm a little worried about if they're at the wrong table?"

Zhou Can's words made his colleagues laugh.

"It may have something to do with yesterday's two news releases. After all, it's a news program of satellite TV. Despite its advertising nature, it is enough to attract many patients. In our seven-day expert outpatient activity, Dr. Zhou is the biggest winner! Dr. Chow, after the event, you have to have a treat. ”

Director Jiang also laughed and teased him.

"It's no problem to treat, you have the final say on what you want to eat then." Zhou Can has always been super generous when it comes to money.

But he never does anything wrong.

The money is spent where he thinks it's worth spending.

"I'm obedient, two pieces of news directly made an ordinary doctor famous and among the ranks of famous doctors, which is also too exaggerated. Shouldn't you have privately bribed a reporter from a TV station to open a small stove for you? ”

A middle-aged doctor in his forties asked sourly.

"Haha, I really have that idea. Guys, don't wake me up and keep me dreaming. The day before yesterday, I saw two patients in one day, which was really sad. ”

Zhou Can was very happy to see so many patients queuing up for treatment.

Strode over with Ji You.

Sit down at the table.

"Dr. Zhou is here!"

The family members and patients in the queue were excited and showed happy expressions.

It seems that they didn't admit the wrong table, they just came for themselves.

Zhou Can suddenly felt like he had taken a reassuring pill, and the smile on his face was more calm and confident.

It was the first time that so many patients had lined up to see him for treatment.

At this moment, he is very much like a lucky person who suddenly became rich overnight.

The effect of being on TV news is really scary.

Now that he has a little fame, he also cherishes this hard-won situation. He subconsciously looked up at the corner of the wall opposite, and did not see the TV reporter and photographer.

If you have a chance, you have to provide a big piece of news to Twilight Mantis and return the favor.

She did Zhou Can a great favor.

(End of chapter)