"!" Lin Yuming cursed.

Deputy Director Liu and Luo Hao were silent.

can make the mouth of the calm and spicy medical director dirty, and there is a high probability that it is a medical trouble.

After the anti-crime and anti-evil eradication, the organized medical troubles disappeared overnight, and all that remained were complaints about medical treatment and medical malpractice.

Luo Hao recalled carefully, as if there had been no malignant medical accidents recently.

Lin Yuming and Deputy Director Liu said, "Sixth, you do us a favor." ”

"Say."

"There is a pregnant woman who has been diagnosed with a problem, twins, and may not be able to save them."

"......" Deputy Director Liu was stunned for a moment, "The medical staff in your hospital?" ”

"It's not." Lin Yuming shook his head.

"That ......"

"It's an ordinary pregnant woman in the natural village below." Lin Yuming's tone was low.

Deputy Director Liu had a strange expression, and looked at Lin Yuming for 30 seconds before whispering, "Boss Lin, you keep saying that you are old...... Look at you, why are you still the same as when you were in school. ”

This bookish atmosphere, it's really hard to say old.

"No way." Lin Yuming turned around and explained, "A few days ago, I went to the hospital next door to run errands, and it was raining in autumn that day, and it was cold. ”

"There was a man in his thirties squatting at the entrance of the hospital, shirtless in the rain with his head holding his head and crying."

Deputy Director Liu guessed early on that it was Boss Lin who was soft-hearted, and he was not surprised at all.

"The family has never had children, and suddenly became pregnant 27 weeks ago, twins. However, on the latest examination, the fetus has malformations. ”

"Deformed? I said, Boss, is your heart too big? Deputy Director Liu said helplessly, "I'm just a radiologist, and I say it's an expert, so we're welcome, and the level is indeed a bit." But who can handle such a thing as fetal malformation? ”

As he spoke, Deputy Director Liu looked at Luo Hao.

"Doctor Xiao Luo, can you Xiehe handle it?"

“……”

Luo Hao was dumbfounded.

"Listen to me." Lin Yuming didn't care whether Deputy Director Liu agreed or not, and drove back directly, "I did B ultrasound twice, and the second time I stood aside and watched, I always felt that there was something wrong." ”

"But you also know that I have been out of the clinic for too long, and I can't see what it is, and recently I am asking Director Sun of the Department of Obstetrics and Gynecology to contact the experts in the imperial capital for consultation."

"And then?" Deputy Director Liu asked.

"The mentality of pregnant women collapsed first, and they were looking for death and life in the hospital."

This kind of thing, as an old clinician, should have been accustomed to for a long time. What can be done? There was only one sigh.

Deputy Director Liu thought about it and looked at Lin Yuming.

"I'm going to do a B-ultrasound to see it."

After finishing speaking, Deputy Director Liu shook his head, "Boss Lin, some time ago, my little brother held a parent-teacher conference, and the child couldn't study and was reprimanded by the teacher. Do you know how I comforted him? ”

Deputy Director Liu didn't sell off, and continued, "Generally speaking, teachers are extremely strict with their children, because they have seen talented students. But as for doctors and nurses, many of them go with the flow. ”

After a pause, Deputy Director Liu persuaded earnestly, "Because at the door of the ICU, we have all seen grief-stricken parents. ”

"It's not good to be a doctor, it's not good to be too empathetic, although Boss Lin, you went to the medical office. Anyway, back then, you helped our little brothers no matter what they did. ”

"Why are you still in this temper after so many years, Boss Lin."

"Ugh." Lin Yuming sighed again, "It looks pitiful, if you can help, you can help." Are you watching? ”

Deputy Director Liu was speechless.

That being said, he thought the same thing when he was a medical student, but when he came to society, he was pressed to the ground and rubbed for decades, and that little bit of youthful thinking has long been wiped out.

I didn't expect Boss Lin to still have this temper.

Take a look, the boss said it all. Although he thought so in his heart, Deputy Director Liu didn't think so.

He did four-dimensional and NT in his first year of medical college, and he saw countless deformed children, and pregnant women cried into tears.

For the first time, I was still a little sad in my heart, but then the sentimentality became weaker and weaker, and the whole person was numb as early as more than ten years ago.

There is a high probability that it is useless for Teacher Liu to go back, Luo Hao thought to himself.

In a blink of an eye, Luo Hao remembered the gift package given by completing the novice task system.

Sooner or later, I'll have to open it anyway, so I'll have to open it now and take a look, in case it can help.

With a thought, the gift package opened.

Brilliant light and shadow suddenly appeared, startling Luo Hao.

The system is a bit of a no-brainer, with all the bells and whistles but useless.

[Congratulations on obtaining the diagnostic assistance AI, which is now level 1 in AI computing power.] 】

Luo Hao felt like he had fallen into a big pit.

Diagnostic Assist AI, Level 1, is another place for endless upgrades.

If it's a game, then the next step is definitely to top up money. But the system is hateful in that it doesn't want money!

Luo Hao opens the diagnostic assistance AI, which is similar to the interface of ChatGPT, and the estimated operation method is similar.

"Director Lin, which pregnant woman are you talking about?" Luo Hao suddenly broke the silence.

"What for?"

"Teacher Liu and I studied hard and learned about the situation in advance."

Lin Yuming absentmindedly said a bed number, and Luo Hao contacted the doctor on duty in the obstetrics and gynecology department.

Soon, the patient's simple information was sent to his mobile phone.

The patient was admitted to the hospital for 27+2 weeks of menopause, and ultrasound examination showed abnormal development of twins for 1 day. The patient was primiparous and had monochorionic twins on first trimester ultrasound......

The doctor on duty in the obstetrics and gynecology department takes a picture of the medical records and transmits the pictures.

Luo Hao squinted his eyes and looked at the entire medical history and physical examination.

At 27+2 weeks of pregnant women, because the fetus is large enough, the recent prenatal examination found that the PSV⁃MCA of the twins was quite different, the heart of the blood supply child was enlarged, and the blood flow spectrum PI of the umbilical artery of the blood receiving child was increased.

There was a problem with the diagnosis in the lower level hospital, and it was only after coming to the mining hospital that B ultrasound made further discoveries.

The mobile phone vibrated constantly, and the admission blood test sheets were also transmitted.

After reading it, Luo Hao held his breath and looked at the system panel in the upper right corner of the field of vision.

When you read your medical history and test sheets, you can enter them into the system.

The system screen flickered with a slight stutter, and then the diagnosis was automatically generated.

Luo Hao wasn't too surprised.

Chatgpt's intelligent AI system can theoretically be used for diagnosis, and it is still being explored clinically, but there are many successful cases and many incurable diseases have been solved.

However, everything is still in the exploration stage, and it has not yet been rolled out on a large scale, and there are many problems.

The diagnostic assistance AI issued by the system package should be stronger than ChatGPT.

Luo Hao watched intently, and soon, a line of words appeared in the upper right corner of the field of vision.

[There is insufficient data to generate a diagnosis.] 】

“！！！”

Luo Hao was stunned for a moment.

This is one of the reasons why Chatgpt has not been widely used yet.

As long as the medical history is asked, it is known that the patient and the patient's family members have subjective factors to interfere with the medical history, and it is not as imagined that as long as the patient says the medical history, an intelligent AI system such as Chatgpt can give a diagnosis.

What I never expected was that the existence of such a tall system would even tell me that the information was insufficient to give a diagnosis.

This is different from what Luo Hao thought.

Looks like you'll have to ask yourself.

Although the system did not give a diagnosis, Luo Hao was not discouraged.

"Ding Dong~"

A system prompt sounds, and a task appears on the system panel.

[Emergency Mission: Rescue.]

Task content: The correct diagnosis is still in the fog, the fetus still has a chance to live, please save the fetus.

Mission duration: 3 days.

Reward: 10,000 XP. 】

10,000 XP!

Luo Hao was stunned, this is too little.

Compared to the previous reward for 10 ovarian cyst sclerosis procedures, the reward for this emergency task is about zero.

But Luo Hao understands that the novice reward in the mobile game is to guide players to recharge a 648 and a 648, and it is normal to "make profits" a little.

I didn't expect that the system full of futuristic technology would be the same as those unscrupulous game profiteers, giving sweetness at first, and then trying to see the dagger.

At the very least, do you want to give a 648 recharge entrance, Luo Hao sneered.

If the system has a recharge entrance, a 648 will give a definitive diagnosis, which seems to be good. Luo Hao is not short of money, if he can use the money to buy a diagnosis, Luo Hao is willing to do so.

Unfortunately, the system doesn't have this feature.

Damn it!

"Little Snail, you come and drive." Lin Yuming's mobile phone kept thinking, he simply stopped the car and let Luo Hao open it.

Luo Hao could only temporarily stop studying the system and concentrate on driving back to the hospital.

Along the way, Lin Yuming kept calling to ask the doctors in the obstetrics and gynecology department to reassure the patients, telling them that experts in the province were already on the way and would soon give them expert consultations.

Although Deputy Director Liu understood, he did not approve.

Poor people can be seen in hospitals every day, and social welfare institutions can hardly sit idly by, and doctors and nurses will not be able to do this for long if they are too empathetic.

Boss Lin......

I don't know how he has survived all these years, Deputy Director Liu thought to himself.

Back at the hospital, Lin Yuming took Deputy Director Liu to change into white clothes and came to the B-ultrasound room formally.

After briefly introducing the origin of Deputy Director Liu to the family of the pregnant woman, Deputy Director Liu sat down next to the B-ultrasound machine and began to do color ultrasound for the pregnant woman.

After applying the couplant, the probe fell, and after a few seconds, Deputy Director Liu's brows furrowed.

Luo Hao sat on the side, his hands on the keyboard, ready to record Deputy Director Liu's words at any time.

But his eyes glanced at the screen of the ultrasound machine, analyzing the images, trying to find useful information.

Although the system has issued few rewards for emergency tasks, as a doctor, you still have to do your best when you can treat patients.

The images are complex, with red and blue images constantly flickering.

"Intrauterine twin live fetuses, monochorionic double amniotic sacs, twin body weight is estimated to be 786/913g, and body weight is 14% poor."

Cracking sound~

As Deputy Director Liu had words in his mouth, Luo Hao recorded the complex content on the computer for the first time.

"Fetal 1: slightly thickened intrahepatic echo, increased intrahepatic portal vein and bile duct wall echo, high umbilical artery blood flow spectral pulse index of 1.33, systolic/diastolic: 4.25, decreased systolic flow velocity of the middle cerebral artery, PSV⁃MCA: 28 cm/s, velament placental sonography, vascular previa, placenta previa."

"Fetal 2: the cardiothoracic area ratio increases, about 0.37, PSV⁃MCA increases: 61cm/s, PSV⁃MCA difference: 0.93MoM."

A series of professional words came out of Deputy Director Liu's mouth, and everyone, including Director Sun of the Department of Obstetrics and Gynecology, was very confused.

The uneven level of technology is an objective fact.

There is not a test result, and everyone can come up with the right answer.

Deputy Director Liu did it here and raised his eyes to see Director Sun of the Department of Obstetrics and Gynecology.

"Director Sun, what is your diagnosis?"

Director Sun was stunned, and he didn't know how to answer.

The B-ultrasound content made by Deputy Director Liu has exceeded her cognition, and the Mining Institute is only a tertiary hospital at the prefecture and municipal level, and it does not involve such advanced content.

"Sixth, don't sell it." Lin Yuming reprimanded dissatisfied.

"I'm a doctor in the auxiliary department." Deputy Director Liu whispered.

It turned out that he was not selling Guanzi, but asking a specialist for diagnosis normally!

“……”

“……”

Indeed, Deputy Director Liu is only responsible for doing B-ultrasound, and diagnosis is the work of clinicians.

The diagnosis will be given in the report of the B-ultrasound room for ordinary diseases, but the twins in front of you certainly do not fall into the scope of "ordinary".

The atmosphere in the B-ultrasound room was heavy, and only Luo Hao was typing.

With Deputy Director Liu's B-ultrasound content, the system has given a diagnosis - twins anemia with multiple blood sequence signs combined with selective fetal growth restriction.

"Teacher Liu, look at the report card, did I miss what you said?"

Luo Hao handed over the report.

Deputy Director Liu was a little unhappy, and Luo Hao was too open-eyed, and he still cared about the report at this time.

But Luo Hao was Boss Lin's nephew after all, and Deputy Director Liu was unwilling to reprimand him for a trivial matter, so he took the report and put it aside.

With their eyes staggered, Deputy Director Liu's hand suddenly stiffened.

Twin anemia with polyhematoplasmic sequence sign combined with selective fetal growth restriction!

The lengthy diagnosis was like a sledgehammer smashed into Deputy Director Liu's heart.

This kind of extremely obscure diagnosis, not to mention a clinical student who has just graduated, has never heard of even a clinical veteran like Deputy Director Liu.

There is indeed a problem on ultrasound, but Deputy Director Liu can't give a definitive diagnosis.

However!

Luo Hao gave a clear diagnosis!

It is clearly written in black and white.

"Doctor, I ......" the pregnant woman asked sadly with tears in her eyes.

Deputy Director Liu could see in the eyes of a pregnant woman that she still had a glimmer of hope, and he couldn't bear to break her illusions.

"Once the diagnosis is made, the specific treatment will depend on the expert group to give you a conclusion after consultation."

"Is there any hope?"

Deputy Director Liu did not answer the pregnant woman's words, and he began to search in his mind for relevant information about the diagnosis.

With a thought in his mind, Deputy Director Liu suddenly realized that he had forgotten the name of the diagnosis.

！！！

What the hell!

As a well-known expert in the province, it is nothing if he can't diagnose it, after all, he is not an obstetrics and gynecology expert.

But I even forgot the diagnosis given by others, which is simply nonsense.

Deputy Director Liu read the diagnosis on the report again-twin anemia, multiple blood sequence signs combined with selective fetal growth restriction.

MD！

Is it a little more cumbersome to diagnose the hell?

Deputy Director Liu slandered in his heart.

He quietly looked at the report sheet, imprinting every word in his mind.

"Director Liu, look at the next ......," Lin Yuming asked tentatively.

"I'll give our head of obstetrics a call and ask." After Deputy Director Liu finished speaking, he was about to put down the report sheet, but his hand stiffened slightly, and then he walked out of the consultation room with the report sheet.

Lin Yuming found a quiet room for Deputy Director Liu, and Deputy Director Liu picked up his mobile phone to make a call.

"Director Li, it's me."

"I met a patient who was ...... on imaging"

Deputy Director Liu told him about the images he saw with B-ultrasound.

"The diagnosis I gave was vague, like twin anemia...... Combination of multiple blood sequences...... Selective fetal growth restriction, what do you think? ”

In the end, Deputy Director Liu still didn't remember the diagnosis, and stumbled out the report in black and white.

"Director Liu, your level is rising! Twin anemia, polyhematologic sequence signs combined with selective fetal growth restriction, such a rare diagnosis can be given. ”

Deputy Director Liu's old face turned red.

"Listen to your description, it should be this disease, which is relatively rare."

The expert on the other side of the phone only teased a sentence, then got down to business and began to talk about the condition.

"Is there a cloud over there?"

Deputy Director Liu looked at Lin Yuming with his mobile phone.

Lin Yuming nodded.

"Yes, I'll send you the cloud later, and you can take a look."

After hanging up the phone, neither of them talked nonsense, Lin Yuming called the doctor of the Department of Obstetrics and Gynecology to send the patient to Deputy Director Liu, who sent it to the experts of the first year of the Medical University.

After waiting for ten minutes, Deputy Director Liu's phone rang.

"Lao Liu, your diagnosis is right, amazing! Do NT to make you fine, cow! ”

"Don't talk nonsense, how can this disease be cured?" Deputy Director Liu asked directly.

There was a little silence on the other side of the phone, and finally a helpless voice came, "Let's talk about it this way, Lao Liu, we can't govern the province." ”

！！！

！！！

Lin Yuming and Deputy Director Liu were deeply helpless.

Although he knew that most of the diseases could not be cured, the feeling of powerlessness still wrapped the two of them like a tide, and they couldn't extricate themselves.

"Tell me, I'll see if I can figure it out." Deputy Director Liu asked.

"There are three options for fetoscopic placental vascular communication laser coagulation, radiofrequency ablation fetal reduction, and intrauterine blood transfusion. Our hospital does not have relevant equipment for the first two treatments, and there should be no mining hospital either. ”

"There are only a few hospitals in the country that have the equipment, but the operation is ...... The stakes are so high that the doctors who are willing to do can count them on one hand. The latter one has a probability of being cured, but the operation is extremely difficult, difficult, difficult! Difficult!!! ”

"Do you know?" Deputy Director Liu asked under Boss Lin's eager gaze.

"No, this rare disease is similar to malignant hyperthermia, and only the Institute of Genetics of the Maternal and Child Health Center of a top hospital will study it."

Deputy Director Liu hung up the phone, spread his hands, and looked at the sky.

Lin Yuming muttered in a low voice, "What is the fetal vascular communication branch under the fetal microscope, sixth brother." ”

"Fetoscopic placental vascular communication laser coagulation."

"Radiofrequency ablation fetal reduction, why is this surgery not serious when you hear it?"

"I guess it's turning twins into singles."

The two speculated on the treatment.

No one goes out because they don't want to face the pregnant woman and her family.

No doctor wants to say — sorry, that's the kind of thing that's been done as much as possible.

But many times it has to be said.

"Sixth, I heard that the director of your obstetrics department also said a treatment, what is it?"

"Intrauterine blood transfusion."

"Isn't this treatment difficult?"

Deputy Director Liu looked up at Boss Lin, sometimes he treated the doctors who were like relatives, and he always felt that their brains were broken.

"Boss, Miyauchi, that's Miyauchi!" Deputy Director Liu reminded.

Lin Yuming nodded, his face gradually returned to normal, and he had already made up his mind.

"Let's go."

Lin Yuming opened the door, ready to explain his condition to the pregnant woman and her family, and said what he was unwilling to say.

But as soon as I opened the door, I saw Luo Hao standing at the door.

"Director Lin, what do the experts say?" Luo Hao asked.

"The diagnosis is fine...... Little Snail, have you seen a similar patient at Xiehe? Director Lin asked.

"I have seen that there are three treatment methods for such patients - fetoscopic placental vascular communication laser coagulation, radiofrequency ablation fetal reduction, and intrauterine blood transfusion."

！！！

Director Lin looked at his nephew in astonishment.

For the first time, he felt that the Little Snail had grown up.

The smile on Luo Hao's face was like sunshine, dispelling the gloom in his heart.

Although intellectually he thought that no one in the province could do it, the smile seemed to be silently telling himself that Luo Hao could do it.

"Fetoscopic placental vascular communication laser coagulation and radiofrequency ablation fetal reduction are difficult, and our hospital does not have relevant equipment. If you go to the imperial capital, there are very few hospitals that can do similar operations, and now the doctor-patient dispute is serious, and the patient is very picky, and no one may be willing to do it. ”

"Plainly." Director Lin looked at Luo Hao seriously.

"Intrauterine blood transfusion treatment is more suitable. There is difficulty, but it is much less difficult than the first two. ”

"Can you do it?"

"Positioning, umbilical vein puncture, intrauterine transfusion. The results of all three treatment options are similar, and the industry does not say which one is particularly good. I think we can give it a try. ”

"Doctor Xiaoluo, don't talk nonsense." Deputy Director Liu said in a deep voice, "There will be fetal movements, which are still unpredictable, and umbilical vein puncture is extremely difficult." Accidentally...... Are you sure? ”

"Teacher Liu, I think I can do it." Luo Hao said confidently.

Deputy Director Liu was in a trance.

Luo Hao's energetic appearance is very similar to when he first went to the first year of medical college, he thought that he was omnipotent and treated all patients in the world.

"Doctor Xiaoluo, it's not enough to simply puncture, you come in and say." Deputy Director Liu beckoned Luo Hao in.

"I don't think I've done an intrauterine puncture, right?" Deputy Director Liu glanced at Lin Yuming.

Lin Yuming nodded.

"You talk about intrauterine puncture, assuming that your puncture is successful, I say hypothetical, what details will you encounter after success."

Both Lin Yuming and Liu Haisen felt that Luo Hao was still too young, thinking that the piercing could be successful with a calm heart and a steady hand.

As everyone knows, puncture is only the first step, and the more difficult is later.

"The fetal blood vessels of twin transfusion syndrome are relatively special, and most of the placental anastomotic vessels are small arteriovenous anastomotic branches with a diameter of <1mm, through which only 5~15ml of blood is transported to the recipient ...... every 24 hours."

Luo Hao did not have the slightest fear, and talked eloquently.

Deputy Director Liu only has a small amount of clinical experience in intrauterine blood transfusion, so he can't determine that what Luo Hao said is right.

But he couldn't tell that Luo Hao was wrong.

Recalling the B-ultrasound image, the placental anastomosis vessel diameter <1mm, which should be fine.

"Blood transfusions can't be too fast, they can't be too slow, there's a formula to calculate the speed of blood transfusions."

Luo Hao said, out of nowhere, he took out a pen and wrote a tedious mathematical formula on the paper.

"This ......"

"Just calculate the speed of blood transfusion according to this formula." Luo Hao said, "There is about a 50% chance that the fetus will stay up until 32 weeks and then be delivered by caesarean section. The overall risk is very high, but there is always a way to treat it, and it is up to Director Lin to make a decision on whether to do it or not. ”

"I'm going to talk to the patient's family." Director Lin thought about it and walked out with a calm face.

Deputy Director Liu shook his head, "Doctor Xiaoluo, you are still too young and ambitious. If it is done well, it should be; Once you fail, the responsibility is on your head. Have you ever thought about what to do in the future if you fail and the patient's family does not give up? ”

"Mr. Liu, I think Director Lin can properly solve this problem."

Properly?

Settle?

Deputy Director Liu was slightly disdainful at first, but then thought that Boss Lin was rough and fine, and a strange feeling rose in his heart.