With the participation of Zheng Chusheng, Chen Gong's research on interstitial medicine has taken a step closer.

On the way back, he directly opened the diamond treasure chest he had just obtained.

【Ding! Congratulations, your imaging has been upgraded to lv4. 】

Chen Gong's face was overjoyed when he heard this.

At best, his imaging is in the early reaches of lv2, but he didn't expect this diamond treasure chest to directly break through his skills to lv4.

Is lv4 powerful?

In this way, the backbone-level imaging knowledge is enough for Chen Gong to have comprehensive strength in the face of clinical practice.

This level is enough for him to stand alone in the emergency center hospital.

Even compared to the directors of some hospitals, it is not far behind.

All in all, this time, the harvest was great!

The most important thing is that after Zheng Chusheng joined, Chen Gong's scientific research territory has also increased a lot.

To build a mature translational medicine platform, Chen Gong needs experts in various fields to join.

In this way, the construction of this platform can be more perfect, and the core strength of translational medicine can be better developed.

After the construction of the translational medicine platform is completed, it can usher in a blowout of innovation!

After returning to the hospital.

Before Chen Gong could rest, he heard a noisy sound on the side.

Looking for prestige, he found that it was Zhao Xi and a man who were arguing.

"You can't just let a patient go out of the hospital so casually!"

"The situation is unknown now, what if it gets worse?"

"It's likely life-threatening!"

The man looked to be forty or fifty years old, his hair was slightly sparse, and under a pair of gold-rimmed glasses, he had a "very learned" expert atmosphere.

That's right!

This person is Sun Jizhou, the director of the second emergency department.

Sun Jizhou is 48 years old this year, and he ushered in the development of his life and career in his natal year, and after being transferred from the children's hospital, he served as the director of the second emergency department.

Although after the construction of the emergency center hospital, there is no detailed division of the six emergency departments for individual groups.

However, because of his innate advantages in the children's hospital, Sun Jizhou completely took on the banner of pediatric emergency after entering the second emergency department.

I have to say!

This direction is cleverly opened.

Because it is difficult to hang the number of women and children in Shanhe Province, and the strength of other women and children's hospitals is uneven, and it is difficult to describe it.

Therefore, Sun Jizhou seized this opportunity and made an instant effort!

In less than three months, the walls of the second emergency department were covered with pennants.

In fact, in life, the easiest to harvest pennants is often a few diseases, the first is obstetrics, the second is gynecology, and the third is pediatrics.

It is said that the quality of our people needs to be improved, but in fact...... Doesn't this happen to show that the quality of our people is very high?

We have always been at the forefront of society when it comes to caring for women and children.

At least our country's male compatriots are still good.

Therefore, after Sun Jizhou came here, it can be said that he gained fame and fortune.

When people have fame and fortune, they are naturally easy to satisfy.

When Sun Jizhou was a provincial mother and child, he was only a deputy director.

In this way, in three months, Sun Jizhou was full of director style.

In fact......

It doesn't matter.

The most important thing is complacency.

The reason why Sun Jizhou did not become a director at this age is that his own strength actually needs to be improved.

Coming here, no one else is more powerful than him, and it is easy to achieve self-aggrandizement.

Now Sun Jizhou has a feeling that he can't listen to words.

Today's time......

In the third emergency department, after Zhao Xi returned from the construction site, he encountered a special patient.

A husband and wife, because the child does not sleep, always crying, unable to eat milk, and the most important thing is that the body temperature is low, and the breathing is short, snoring, the child's face is a little red, and the lips are slightly bruised.

This made both husband and wife a little anxious and hurried to the emergency department.

Although Zhao Xi made up for some knowledge of emergency medicine, he ...... The understanding of pediatrics is still insufficient.

Fortunately, during this time, Zhao Xi also had good contacts with the staff of other departments.

So I took the patient and family to the second emergency department in the hope of receiving treatment.

Outcome......

It was also a little difficult to invite the doctor who came for consultation, so it was suggested that Zhao Xi find Director Sun Jizhou to take a look.

But after reading this, Director Sun also took blood, and did not diagnose any special diseases.

In addition, there are many people in the outpatient clinic, and Sun Jizhou also feels that there is nothing wrong with the child, is the body temperature low?

35.6 degrees Celsius, which is basically normal.

These are not a basis for diagnosis and treatment, and the patient's respiratory, cardiopulmonary function is normal.

In this way, the young husband and wife, holding their six-month-old child, tense all morning.

It was more than two o'clock in the afternoon, and there was still no diagnosis and treatment result!

So, I found Zhao Xi again.

Zhao Xi's current medical thinking has changed significantly from before.

Naturally, he would not jump to conclusions, and, according to Chen Gong's judgment, Zhao Xi quickly discovered the child's tongue.

When a child cries, the strength of the tongue is abnormal.

This discovery, after being caught by Zhao Xi, was a little nervous.

Hurriedly waited for Sun Jizhou to get out of the outpatient clinic and was ready to ask.

Sun Jizhou was busy all morning, and went to the outpatient clinic at more than two o'clock, not to mention that the whole person was tired, and there were many people at the door.

After Zhao Xi came, he asked Sun Jizhou to take a look at the examination, and said that he would let Sun Jizhou check it out to see if there was anything missing.

After all, the child's lips are now slightly bruised, his breathing is also very fast, and the most important thing is that his body temperature is not coming up for a long time.

It stands to reason that in such weather, the anal temperature must at least go up, right?

But...... There was no response for a long time.

And the husband and wife finally came up from the village, and they originally planned to go to the province to see the women and children.

But......

I can't hang up for half a day!

Today, the condition suddenly worsened, and the child cried endlessly, so he called 120 at the hotel and sent it here.

Zhao Xi is also very helpful to the other party, so he can't care so much about talking to Sun Jizhou in a hurry.

And Sun Jizhou looked at the patients around him, and was counted down by Zhao Xi for a while, and suddenly became a little annoyed and angry.

He looked at Zhao Xi and said with a serious face:

"Comrade Zhao Xi!"

"You're a lesbian, I don't want to quarrel with you."

"If you think you can see this disease, you can see it yourself."

"I know my own level of diagnosis and treatment, and I don't need you to judge."

"How to see a doctor is my business, and how to diagnose is also my conclusion."

"If you don't believe me, you can choose to leave and choose someone else."

Sun Jizhou's words were lukewarm, but Zhao Xi was a little helpless at this time.

"It's not!"

"Director Sun, I don't have any opinion on you."

"You're an expert, I know!"

"However, this patient's condition is really not fine, if you diagnose it like this, there is likely to be a problem."

"I wish you could take a closer look, what if something is missing?"

At this time, Sun Jizhou directly picked up the inspection results and report, and said with a somewhat impatient face:

"I've said it all, it's okay, it's okay!"

"The cardiopulmonary function is normal."

"I think it's obviously a normal situation."

Chen Gong heard the sound and walked over.

Although he didn't have lunch at this time, he ...... When you encounter such a thing, it is more important than eating.

At this time, Wu Xueyu walked over: "Director Chen, you're back." ”

Chen Gong nodded: "Hmm!" ”

"By the way, Xiao Wu, are you okay?"

Wu Xueyu nodded: "It's okay, what's wrong?" Director. ”

Chen Gong smiled: "That's the case, you go and order takeout for me, I just had surgery and didn't eat." ”

"I'm a little hungry!"

"Well, just order a little rice, and the dish will be light."

This May day has become a little hotter.

Wu Xueyu glanced at Zhao Xi not far away, and then nodded: "Okay director!" ”

"Sister Xi hasn't eaten yet, I'll order it together!"

After speaking, Wu Xueyu got up and left.

Chen Gong walked over at this time.

The husband and wife stood aside with their children in their arms, their faces full of shame and embarrassment.

Seeing Zhao Xi being criticized and accused by Sun Jizhou, it was obvious that the two of them were very unhappy.

They always feel like they're dragging each other down.

Because...... This is not the first time that their child has been in this situation, and the two have also been examined in the hospital.

Indeed there were no problems that came out!

This time, I also came to see the experts to see what was going on.

Outcome...... But there was such a thing.

At this time, Zhao Xi's eyes were already red.

She immediately looked at Sun Jizhou and asked with a serious face: "Director Sun, is there no other means for diagnosis and treatment of diseases besides instruments?" ”

"Did you do a physical examination of your child?"

"How many times did you look at the child from beginning to end?"

"I'm not accusing you, I'm hoping for ...... We have a specialist consultation, you can take a good look and at least give a suggestion. ”

"It's not like that, just send people away."

"The emergency department is busy, but ...... Every patient who comes is a patient. ”

"If you're too busy, there's no need to register so much, right?"

"Now that you've registered, don't you at least need to take a look?"

Hearing Zhao Xi's words, Sun Jizhou looked at the people around him, and he couldn't get off the stage.

He frowned directly and said, "I'm off work!" ”

"I have a limited level of this patient, and I really can't find out the problem."

"Go back, I think it's okay."

"Don't be like these dolls, listening to the wind is rain, children are not as fragile as you think."

Chen Gong walked over at this time, looked at Zhao Xi with red eyes, patted the other party's shoulder and said with a smile.

"Alright, Xiao Zhao!"

"Let's go back first, Director Sun has also worked hard."

"More than 100 patients in a morning, it's really hard, and the number of emergency departments is more than the number of outpatient clinics."

"However, Director Sun's level is still there."

"Since you dare to come up with this diagnosis, you can be responsible for this diagnosis."

"Right? Director Sun! ”

Hearing this, Sun Jizhou suddenly chuckled in his heart.

Of course he knew Chen Gong.

As the rising star of the emergency center hospital, who doesn't know Chen Gong?

What's more, translational medicine is so popular, this seems to be the future of hospitals!

No, hearing Chen Gong say this, Sun Jizhou was also speechless for a while.

He Chen Gong didn't say a word, and got up and left directly.

At this time, two young people in their twenties hugged their daughters and hurriedly bowed to Zhao Xi to apologize.

"I'm sorry, I'm sorry!"

"Doctor Zhao, I'm sorry for your trouble."

"Hey...... I'm so sorry! ”

Zhao Xi shook his head when he heard this: "It's okay, this is as it should be, he accepted our consultation, and he will treat us." ”

Chen Gong was silent.

In fact, Sun Jizhou is a person with great ambitions and talents, and he is greedy for merit and fame.

Originally, when I was in the province of women and children, I was suppressed, but when I came here, I seemed to have a sense of villain's ambition.

The outpatient department of the emergency department is generally for emergency patients.

But this Sun Jizhou regarded this place as an ordinary outpatient clinic, and even went to advertise and pull patients.

As a result, a large number of pediatric patients have been brought in.

Although it is not wrong to see a doctor, but ...... In this way, who do emergency patients go to?

For example, the young couple in front of them, after they came, they couldn't register at all, and they couldn't even divide the points, but went to the third emergency department.

After Zhao Xi finished speaking, he looked at Chen Gong: "What can you do?" ”

Chen Gong looked at Zhao Xi's somewhat anxious eyes and asked, "Carry the child to the disposal room, and I'll see what's going on." ”

Hearing Chen Gong's words, the husband and wife were obviously stunned for a moment.

Because Chen Gong is too young.

is much younger than Zhao Xi.

Compared with Director Sun just now, he didn't know how many rounds it was smaller.

Is this okay?

Although the two were worried, they ...... At this point, they had no other choice.

After entering the disposal room.

Chen Gong asked the family to put the child on the treatment bed.

Then he glanced at Zhao Xi, took the stethoscope from her neck, put it on the child's chest and listened.

It didn't take long!

Chen Gong's face became grim.

This may really be the same as Zhao Xi said, there is a problem......

The child's heart rate is very fast, it is about 160!

Although it is normal for a child's heart rate to be fast, it is ...... Basically, it is maintained between 110-130.

Even if it's on the fast side...... That's about 140.

And right now, this kid has 160!

This means that the child has mild hypoxia.

Subsequently, Chen Gong hurriedly asked: "Did you do a color ultrasound?" ”

"Heart's."

Zhao Xi nodded hurriedly: "It's done, no problem!" ”

"Except for a faster heart rate, I can't find the cause."

"However, I always feel that when a child cries, there is something wrong with his tongue."

When Chen Gong heard this, he immediately took out a tongue depressor and flashlight from his pocket.

Hold down the child's tongue and observe.

He worries if there is edema in his throat or if there is something else blocking his airway.

But......

This inspection did not reveal anything else!

What's going on?

At this time......

Chen Gong also frowned a little, and the child also had a blood test, but ...... But there are no other anomalies.

What's going on?

There should be a reason for this typical hypoxia!

Could it be...... Pressure in the abdomen?

At this time...... When Chen Gong touched it, he suddenly felt that his body temperature was low!

Zhao Xi looked at Chen Gong and looked a little anxious: "How is it?" ”

Chen Gong shook his head: "Take off the child's clothes." ”

"Measure armpit temperature and anal temperature!"

There is a certain difference between the armpit body temperature and the anal temperature, the normal body temperature under the armpit is usually between 36 degrees and 37 degrees2, but the anal temperature is about 0.5 degrees higher than the body temperature under the armpit, mainly because the anus is closer to the internal organs of the body.

So, in general, the difference between axillary temperature and anal temperature is positive.

About ten minutes later!

Zhao Xi finished measuring and looked at Chen Gong with a solemn face.

"The armpit temperature is only 35.1 degrees Celsius."

"And the anal temperature is only 34.7 degrees Celsius!"

The difference between axillary temperature and anal temperature changes from positive to negative!

Chen Gong was shocked by the news.

Because the child's rectal temperature is less than 35 degrees Celsius.

This is obviously problematic!

And at this time...... Zhao Xi suddenly added: "When I measured just now, the armpit temperature was 35.5 degrees Celsius!" ”

"Lowered ......"

After Chen Gong listened, this time, there were more doubts in his heart.

Body temperature, heart rate, respiratory ...... There are anomalies.

This means that something is wrong with the vital signs!

It seems that there is no problem at the moment, but in fact...... There may already be risk factors.

You know, this body temperature, if it continues to develop, will form a hypothermic shock.

It's possible!

When the human body is at low temperatures, it will enter a state of shock.

And hypothermia in children is enough to kill the existence.

Don't think that your child's fever is the most dangerous, in fact...... Low temperatures tend to be more dangerous!

But now, Chen Gong can't find the cause at all.

What the hell is going on?

At this time, Chen Gong's entire spiritual power was unprecedentedly concentrated.

My mind is also frantically thinking about various reasons.

Suddenly!

At this time, the child began to cry again.

Chen Gong looked at it and found that when the child was crying, the contraction of the tongue decreased.

This discovery made Chen Gong suddenly have an idea.

He hurriedly said to the child's mother: "Take off all the child's clothes!" ”

Hearing Chen Gong's words, the two were obviously stunned for a moment.

Subsequently......

They hurriedly began to undress.

Time passes minute by minute.

Chen Gong immediately lowered his head and began to seriously examine the child's body parts.

The child's crying made the process more difficult, he was very uncooperative, and it seemed that Chen Gong was in some pain when he moved him.

The child cried heartbreakingly, and his heart rate skyrocketed.

The child's mother cried.

Let's be honest!

For children who are six months old, it is very difficult to check.

Because he doesn't have any ability to express himself, the only way he can express himself is to cry!

But...... No one knows how he feels!

This makes the difficulty of diagnosis and treatment proportionally more difficult.

The terrible voice echoed in the hallway.

Even Sun Jizhou, who came back from dinner at this time, couldn't help frowning when he heard it.

Sun Jizhou was unwilling to offend Chen Gong.

But......

Today's events made him a little uncomfortable.

After waiting for a while, Sun Jizhou didn't say a word, and returned directly to the director's office of the second emergency department.

He thought, when you can't make up your mind, come back to me!

At this time, Chen Gong, when he was inspecting, finally had a harvest.

He was pleasantly surprised to find that there seemed to be some symmetrical induration on the back of the child's neck.

This induration is not obvious, or cannot be called induration.

But...... A skin lesion.

Refractory cereus edema.

There doesn't seem to be anything else abnormal, just that this part of the skin doesn't color and feel different.

Even, if you can't look at it carefully, you may not be able to find it.

Fortunately, Chen Gong's perception is relatively high.

He found it.

Because the child is fat, the lesion is inside the fold of flesh at the back of the neck.

Chen Gong hurriedly asked, "How long has this been?" ”

When the child's parents heard this, they were obviously stunned.

How long?!

When the child's mother saw it, she suddenly said, "It seems to have been a while." ”

"I thought it was the kid sweating from the heat."

"And then here's the flesh folds, and they're broken, and that's it......"

When Chen Gong heard this, he shook his head directly.

He felt that this disease, he had seen in the book.

Chen Gong then searched for other parts of his body.

Sure enough, it didn't take long for Chen Gong to see that there were some skin lesions on the child's back and shoulders.

These lesions are not pitted, but rather a slight induration sensation and lose the texture and appearance of the skin as it should be, with a shiny, waxy surface.

Chen Gong took a deep breath!

It occurred to him that there was a disease.

Sclereosis!

Also known as skin sclerosis.

This disease is very special.

Scleredema is a rare condition of unknown cause, usually benign passage.

It can be said that it is extremely rare!

For so many years, it was not even recorded in emergency books.

If it weren't for Chen Gong reading too many books, he might not have thought of it.

It's a systemic rheumatic disease!

That's right, it has something to do with immunity.

It is characterised by the sudden onset of generalized symmetrical severe edematous induration of the skin.

The lesions are characterised by changes similar to those that occur during the edema phase of systemic scleroderma.

The disease usually resolves spontaneously within 6~12 months, but can occasionally last for decades.

The disease doesn't seem to have much of a risk.

But......

But it can also be fatal!

Early symptoms are not typical, poor early breastfeeding, low crying, low response, body temperature < 35°C after exacerbation, and < 30°C in severe cases.

The difference between axillary temperature and anal temperature changes from positive to negative!

These are the early manifestations.

The minimum body temperature is 30 degrees Celsius!

It's a hard question to think of.

In the late stage, there will be multiple indurations throughout the body, and the swelling is symmetrical, followed by the lower limbs, buttocks, cheeks, two upper limbs, back, abdomen, chest, etc., and in severe cases, the limbs are stiff and unable to move.

It can even damage the function of multiple organs.

In addition to this, there is another point, which is hypothermia!

Compared with older infants, neonatal shock has some particularities, characterized by more complex etiology, rapid progression of the disease, inconspicuous symptoms, difficult diagnosis, and when blood pressure drops and symptoms are obvious, the condition is often irreversible and the mortality rate is high.

Therefore, it is extremely important to understand the characteristics of neonatal shock and early diagnosis.

Chen Gong was even a little scared at this time!

Let's be honest......

In this child's case, the induration is not obvious, but the change in body temperature is obvious.

If the cause cannot be identified from the body temperature, this is the key point that can definitely lead to the patient's shock.

That's when ......

Suddenly, Wu Xueyu walked in, and he was accompanied by a middle-aged man.

After the other party saw Zhao Xi, he smiled slightly: "Xiaoxi, I'm sorry, I'm late!" ”

Zhao Xi hurriedly raised his head and said, "Senior brother, you're here!" ”

"Quick, help me see this."

"This is our Director Chen."

And the man also smiled slightly and nodded at Chen Gong: "Director Chen, hello." ”

"I am the pediatric director of the city's maternal and child department, Shi Lei."

Zhao Xi squeezed his eyes at Chen Gong at this time.

Chen Gong suddenly became enlightened, he knew that Teacher Xiao Zhao had started his shaking technique.

But......

Chen Gong was also speechless.

He found that Zhao Xi's shaking technique is really powerful, from skin surgery, plastic surgery, to pediatrics, there are even senior brothers?

Who is his teacher?

And at this time......

After Zhao Xi explained his condition, the other party was obviously also in deep thought.

Because of this situation, it was obvious that he was silent.

The patient's condition, he is really a little difficult.

Shi Lei hurriedly said at this time: "Take your temperature again!" ”

Soon, temperature checks began.

Ten minutes later!

Shi Lei looked at the armpit temperature, and his face suddenly changed: "It's only 34 degrees?!" ”

"So fast!"

"Why is it falling so fast!"

After finishing speaking, Shi Lei's face became more and more solemn.

He turned to look at the family: "Hello! ”

"The child's situation may be more anxious."

"I'll be honest, there are a few things you need to prepare!"

"Now immediately arrange for the transfer to the hospital, go to the city women and children, we have to have a detailed examination when we are admitted to the hospital."

"Your child aside, all other symptoms aside, the temperature of this condition is ...... It is an extremely dangerous existence in itself. ”

"If you don't pay attention to it, you are likely to suffer a big loss!"

"It can even cause hypothermia!"

Hearing Shi Lei's words, the patient's family immediately panicked.

The woman's tears poured out at this moment, and she quickly nodded at the man:

"Doctor, could you please save the child?"

"We're willing to pay as much as you want!"

"What the hell is going on?"

"The child is fine...... How is this all right? ”

Hearing this, Shi Lei also said with some seriousness:

"I don't have an accurate answer to this disease at the moment!"

"I'm sorry, but many clinical diseases are very special."

"But...... I feel that it has something to do with immunity. ”

"I want to have my child's immune system checked carefully after admission."

At this time, Chen Gong had to give a thumbs up, this Shi Lei is really a little level.

Although there is no exact answer, there are many clues that can be gleaned from these things.

At this time, Chen Gong suddenly said to Shi Lei:

"Director Shi."

"I think the child's situation is a bit similar to variant scleredema."

"It's variant sclerosis."

"You see, in these areas, I've found induration, and ...... The child's hypoxia manifestations, I suspect that the induration occurred inside the tongue! ”

"And the child's pain is also a pain response to the internal tissues and bones caused by rheumatic factors."

(End of chapter)