Subsequently, the dura mater is incised. The small sickle is cut in a cross shape.

Removal of the tumor.

Closure of the sellar floor: Occlude the sellar floor and sphenoid sinus with mashed muscle masses and fascia, and then press the sphenoid sinus and sphenoidoid recesses with a gelatin sponge containing antibiotics.

Call it a day!

Since it is entered through the nasal cavity, after the tumor is completely removed, there is no scar visible from the appearance, and there is no effect on the appearance.

For the external effect of this operation, the design is exquisite, and Feren Azmi admires it.

After the surgery, Feren Azmi was placed in the neurosurgery ward of a community hospital. Kim Hee will come to take care of her every day and take medicine according to the doctor's instructions.

Stephanie and Zhou Qiao will also come to visit the ward every day, and by the way, Stephanie will provide some psychological counseling services to prevent postoperative depression and the like.

That is, to give a worthless little gift, talk about therapy.

In the United States, it is common for a postoperative psychologist to provide services, and of course, there is a fee.

On Stephanie's side, it's now 600 dollars an hour, and you can go to health insurance, or you can just talk for half an hour.

Because of 600 knives an hour, some people may think it is expensive, but 300 knives in half an hour can be accepted by many people.

Of course, Feren Azmi is also too fat, so during psychological counseling, Stephanie suggested that after he recovers, he will come to the Iris Clinic to tailor a weight loss plan, as long as he loses weight, it is not a problem to find a girlfriend.

Feron Azmi smiled bitterly and said, "I'm still not interested in women. ”

Stephanie smiled: "This operation has just been done, how can it be so fast." It takes a while for the hormones in your body to return to normal. ”

Feren Azmi recovered very well after the operation, and it only took a week to meet the criteria for discharge.

When she was discharged from the hospital, Stephanie advised her on some precautions and asked him to come for regular check-ups in the future.

Anyway, whenever a new patient comes in, they will find a way to turn it into a regular customer. Even if you don't get sick, you will have various health check-ups, weight loss plans, physical indicator monitoring, psychological counseling, and so on in the future.

Regarding psychological counseling, it does not mean that you have to be depressed or something to come, but you can come if you are a little unhappy.

For example, there is a female client, every time she has a quarrel with her boyfriend, she will come to Stephanie to complain and ask the psychiatrist to help solve it. People have money and are happy.

……

Lizzie Charty came to San Francisco, she came to California for a vacation, and by the way, she came to visit the Iris Clinic, and then she was asked by Academician Domitry to bring something over.

Academician Dominory heard that Zhou Qiao was going back to China, so he specially asked Lizzie Charty to bring two bottles of red wine to Zhou Qiao to help bring them back to China and give them to his old friend in China, Xu Feifei, the vice president of Imperial Union Medical College.

Ms. Xu Feifei is a foreign member of the American Academy of Medicine and an academician in China.

A few years ago, Academician Xu Feifei went to Harvard University for a visit and exchange, and had dealings with Academician Domitry, so he formed a deep friendship.

"These two bottles of red wine are the treasures of Academician Dominory, which are usually not drunk by ordinary people, and it is difficult to buy them if you have money, but don't fall them." Lizzy Charty admonished with a smile. Because it is too expensive, it is not convenient to mail it.

Let your disciples send it over in person, and show more sincerity. In addition, Zhou Qiao is Chinese after all, and he may return to China in the future, and he also needs some contacts in China. Academician Dominory also took this opportunity to make Zhou Qiao familiar in front of Academician Xu Feifei.

Everyone is astonished, Academician Dominory, his net worth is amazing, these two red wines, since they are his old man's treasures, the price is naturally expensive.

Stephanie stuck out her tongue and whispered, "That Academician Xu Feifei can't be Academician Domitri's old lover, right?" ”

"Haha, it's not an ordinary relationship anyway." Lizzie Charty smiled brightly, shrugged her shoulders and said, "It is said that Academician Xu has never been married all his life and has dedicated all his energy to the cause of medicine, and the two are likely to be in love at dusk." ”

"And this?" Even Zhou Qiao was curious about that Academician Xu, so he searched the Internet on the spot.

Well, in her sixties, she has a kind smile, a blue heart, and a female scholar.

Chief physician, professor, doctoral supervisor, deputy to the 14th National People's Congress, president and deputy secretary of the Party Committee of BJ Union Medical College Hospital, Chinese Academy of Medical Sciences, vice president of Chinese Academy of Medical Sciences, and vice president of BJ Union Medical College.

"However, don't worry, the two old men are so old, even if they fall in love at dusk, there will be no offspring, and in the future, Academician Domitri's estate will have to be inherited by you!" Lizzy Charty joked.

Zhou Qiao and the three of them were speechless, why did they mention this stubble again. hurriedly explained again that the three of them definitely didn't have that mind. Let Lizzie Charty not talk nonsense, some jokes can't be opened, let Academician Domitri hear, how bad.

Lizzy Charty shrugged and said no more. However, from her disapproving expression, it can still be seen that she really thinks this way in her heart.

As an assistant to Academician Dominory, Lizzy Charty is actually one of the people who knows the most about the many thoughts of the academician.

Zhou Qiao took Lizzie Charti to visit the clinic, and at noon, everyone went to have lunch together, chatting and laughing, saying some interesting things, and having fun. Lizzy Charty said that there were friends waiting for her, and she was going to go fishing by boat in the afternoon, so Zhou Qiao and the three of them would not accompany her.

Zhou Qiao: They also have a more serious patient, and the situation is a bit tricky.

The winter sun is warm, and in the conference room on the second floor of the Iris Clinic, Zhou Qiao, Murphy, and Stephanie are watching slides, consulting patients' conditions and discussing surgical plans.

The patient was a woman surnamed Tu who had a shop in Chinatown. Business is okay. Zhou Qiao: They also went over there to take care of business.

I didn't expect it to be the other party's turn to take care of their business so soon.

Ms. Tu's family has been here for many years, and they have two children, one in the fifth grade and the other in the first grade.

Then, an elder in Ms. Tu's family had a heart attack some time ago and died due to ineffective rescue, and most of the little sisters of the same age around her also found out all kinds of problems, such as high blood pressure, heart disease, diabetes, uterine fibroids or something, so Ms. Tu was a little scared and came to the iris clinic for a comprehensive physical examination.

She had always had regular physical examinations before, but all she did was a physical examination package given by the insurance company.

Because it is a gift of insurance, the price is relatively cheap, so there are fewer items inside.

In fact, many doctors in the United States believe that the more comprehensive the physical examination items, the better, and there are many items that are harmful to the human body. The basic package given by the general insurance company only includes some simple items.

If you want to know more about your physical condition, you can consult your family doctor, who will recommend a personalized plan based on the patient's physical health.

Generally, doctors will make recommendations based on the age of the examiner.

For example, 30-40 years old, mainly focus on changes in blood sugar, blood lipids, blood pressure and weight.

For users aged 40~50, the focus of the physical examination package is blood lipids, blood glucose, electrocardiogram, abdominal ultrasound, tumor cell marker examination, etc., and for women, breast ultrasound and mammography can be examined together.

Users over the age of 50 can choose the cardiovascular and cerebrovascular disease health checkup package, the chronic disease health checkup package and the cancer prevention health checkup package.

In addition, there are gender factors, genetic factors, and the user's own physical condition, etc., which will be taken into account.

For example, women over the age of 50 can choose a physical examination package for menopause, including bone density, blood sugar, cervical spine, lumbar spine and other examinations.

Then, it has been clinically found that many diseases are closely related to genetic inheritance, such as diabetes, hypertension, coronary heart disease, cancer, etc., so if there is a family history of related diseases, you can also consider the physical examination package of the corresponding disease in advance, early detection and early treatment.

All in all, if you want a more comprehensive medical check-up, you have to spend extra money.

After Ms. Tu came to the iris clinic to make a tailor-made package, she found out the problem.

She had trouble with her neck.

The physical examination report showed that Ms. Tu had a small nodule on her right thyroid gland and was marked with a "4C" next to it.

What do the 4Cs mean?

When Ms. Tu got the report, she immediately searched it with her mobile phone, and she didn't know if she didn't search, and she was shocked when she searched it!

The soul is almost out of the body!

Because, according to the search, this situation is "very likely to be thyroid cancer".

"I have cancer? Doesn't it say that thirty is like a wolf and forty is like a tiger? I'm young, I'm in the prime of my life, why did I get cancer? Ms. Tu couldn't accept it, so she came to the Iris Clinic for help as soon as possible.

Rachel was in charge before, and Rachel saw that the condition was too serious, and immediately "transferred" Zhou Qiao.

Zhou Qiao called Murphy and Stephanie to come for a consultation, which was also a process of learning and making progress together. You can't run into a problem, so you can exchange points, right? That's a waste.

Although, he has quite a lot of points now.

After all, these girls, except for Stephanie, everyone else has more than 100 times. Murphy 100 times, that is, 2400 points, and twin girls 100 times, also 2400 points. Luoya 800 points, Stephanie also has more than 30 points, nearly 800 points, although there is consumption, but Murphy and the twin girls are more than 100 times. Now the account balance is approaching the 5,000-point mark.

Now that I think about it, 100,000 points doesn't seem out of reach either.

Finally, after discussion between the three of them, it was basically determined that the patient's nodule was R head cancer of the thyroid gland, but the lymph nodes in the lateral area of her neck were not very simple, and she needed to be hospitalized for further examination.

As a result, Ms. Tu was admitted to the hospital and placed in the general surgery ward of the community hospital. On the same day, Zhou Qiao and the three of them conducted a dynamic evaluation of Ms. Tu's thyroid ultrasound, and sure enough, a problem was found on an isolated nodule at the lower pole of the thyroid nodule on her right side.

Inside her nodule, there were clusters of microcalcifications, and dynamic ultrasound evaluation suggested that the nodule may have broken through the thyroid envelope.

"Doctor, is the condition serious?" Ms. Tu asked tremblingly.

Zhou Qiao comforted: "Don't be afraid, even if there is a situation, we can try our best to help you solve it." ”

"Doctor Zhou, don't do your best, you must do a good job!" Ms. Tu felt a little incoherent.

Zhou Qiao knew what she meant, and immediately comforted Stephanie again and again.

It's just that the situation of the other party is really dangerous.

Because, the results of the previous dynamic assessment mean that the risk of lymph node metastasis is very high.

As the examination continued, Murphy keenly found that Ms. Tu had several full-shaped lesions in the right neck area, the cortical medulla was not decomposed, and the lymph nodes with sand and granula could be seen inside, which indicated that the patient's thyroid cancer had a high probability of lateral lymph node metastasis.

Subsequently, the other party was arranged for neck CT with contrast, contrast-enhanced ultrasonography, and thyroid biopsy.

The first two results come out first, and the later biopsies take longer.

Zhou Qiao and the three of them sat in the conference room again to discuss the condition, and according to the first two results, they soon built an analysis model together.

Murphy: "Based on the point-to-point analysis of the results of the lateral cervical lymph node examination, it can be determined that the risk of lymph node metastasis in the lateral region is close to 100%, and several other small lymph nodes that may have metastases were found in the lateral area, so it can be determined that the patient's thyroid nodule is a malignant tumor of thyroid R head carcinoma, and there is a high probability of metastasis, which requires immediate surgical treatment." ”

Just when everyone was in full swing preparing for surgery, the results of thyroid puncture came out, and it turned out to be "negative"!

It's a bit embarrassing.

Murphy: "......" Am I wrong?

Stephanie grinned, and was about to gloat, quietly squeezing Murphy a few words, when suddenly her heart moved, and she groaned, "Could it be a false negative?" ”

After all, false negatives aren't out of the question.

Stephanie was also involved in the consultation process, and in all fairness, she felt that Murphy's level was still very high, especially in building analytical models and restoring patients' conditions based on data, which was often faster than her!

She needs ten minutes, and Murphy may be OK in three minutes. This, she had to admire.

Although she competed with Murphy openly and secretly, she still felt that Murphy should be right this time, and that lymph node was definitely not so friendly.

In Zhou Qiao's previous words, it is "not a good thing." ”

Zhou Qiao groaned slightly, tapped his fingers on the tabletop, and said, "Actually, if you want to confirm it, it's very simple, we can take two steps." ”

As soon as he said this, Murphy and Stephanie instantly understood. There is still a tacit understanding between the three of them. After all, day by day.

Murphy immediately exclaimed, "Another biopsy? ”

Zhou Qiao nodded.

Of course, with another biopsy, it is impossible to continue the puncture.

"Then there should be a small incision and a biopsy of the lymph nodes in the four regions of the neck. ”

After the results of this biopsy come out, it should be able to confirm whether it is a false negative or not. Ultimately, the decision on the type of surgery to be taken.

(End of chapter)