Zhang Ren looked at the faces of several people and smiled. It was understandable that he was the same way when he received his first salary.
At that time, I was still recording offer 1.
Time flies so fast, two years have passed.
"Boss, this is the paper."
In the office, Peng Xia handed the paper to Wu Xiaofu, which was about the single-port laparoscopic liver tumor resection that Wu Xiaofu had done before.
Now that Wu Xiaofu has innovated surgical techniques, all the writing of the thesis has been left to Peng Xia.
For small skills, in order to train Peng Xia, Wu Xiaofu directly asked Peng Xia to sign as the first author. For this kind of technology, which is the first in the world, even if Wu Xiaofu asked Peng Xia to sign as the first author, Peng Xia would not dare. After all, this It's not like Wu Xiaofu teaches him once and he can learn it.
However, Wu Xiaofu did not have much time to write the paper, so the first draft was basically written by Peng Xia. Then Wu Xiaofu told Peng Xia his revision opinions, and then slowly finalized the final draft.
Although the workload is greater, Peng Xia enjoys the process because when Wu Xiaofu tells him how to make changes, he also teaches him a lot of relevant knowledge, giving him more theoretical knowledge about this type of surgery.
After leaving the office, Wu Xiaofu went directly to the Department of Gastroenterology.
The director of the Department of Gastroenterology just got a call. A patient asked him to come over and take a look.
"Director Liao, what's going on?"
Wu Xiaofu didn't know what the case was like. After all, he just wanted Wu Xiaofu to come and have a look privately, so no formal consultation order was issued.
Director Liao is the director of Area C of the Department of Gastroenterology. He is less than fifty and can be said to be absolutely young and promising.
Not to mention other things, the other doctors and nurses in the Department of Gastroenterology were in a daze when they saw Wu Xiaofu and Director Liao standing together. It seemed that reality was gradually telling them that the hospital no longer only determined skills and status based on seniority and age. .
Just like the two in front of me, and some other young doctors in the hospital.
Director Liao's situation can definitely be said to be young at the level of department director. As for Wu Xiaofu, it can only be said to be too young.
"This is a patient who was admitted to us a week ago. The patient has some conditions, so I would like to ask you to see if it is a surgical disease, and if you can provide me with some ideas."
Wu Xiaofu nodded when he heard this. This was not the first time he and Director Liao had dealt with each other. Gastroenterology and hepatobiliary surgery are actually the internal and external parts of the digestive system, and they are closely integrated. Wu Xiaofu often invited Director Liao or Dr. His doctor came to consult.
In the hospital, helping each other is the norm.
Wu Xiaofu followed Director Liao to the ward, which was a separate ward. The patient was a young man. Without Director Liao saying anything, one of his doctors had already begun to explain the condition.
"Director Wu, the patient is a young male, 30 years old, who was transferred from an outside hospital because of 'fever for 3 days and disturbance of consciousness for 1 day'. Because of the patient's disturbance of consciousness, the patient's father stated the condition on his behalf. < br>
According to the patient's father's statement, the patient traveled to Taiwan 2 weeks ago. The day before returning to China, the patient went to a local bar and had a party all night. He said he drank to pieces. When he woke up, the patient found that he had slept in a small forest. , all the cash on his body was gone, and there was a strange card in his wallet.
The patient didn't pay attention at the time. Later, when the patient felt something happened to him, he searched for this card online. It didn't matter. After searching, he discovered that it was a Thai "poison".
According to the description on the Internet, if you stare at the eyes of the witch master on the card for a long time, you will feel that your soul will be gradually sucked into her eyes, and some supernatural phenomena will also occur, such as auditory hallucinations, sound impairment, etc. wait.
What scares patients the most is that there are reports on the Internet that some people have committed suicide because of this.
After the patient saw this, he was frightened to death and quickly threw away the card. However, that night, the patient could not sleep no matter how hard he slept. He began to think wildly again, thinking about the Thai poison. The more he thought about it, the more frightened he became. Can't move anymore.
It can be said that the picture of Thai Poison is all in my mind, and I can't make any sound. I can only make a few strange sounds, struggle hard, and disappear after a few seconds.
But after returning home, patients often dream about the face on the card and wake up from their sleep. ”
Um?
Wu Xiaofu was a little confused when he heard this little story. He looked at Director Liao with questions in his eyes: What's going on? Witchcraft and poison have come out. How can we be superstitious in a harmonious society? What's more, this thing is Tell me in the story how it came out of the doctor’s mouth.
What card? Isn’t this a psychological suggestion, and then a nightmare appears?
Well, it is a sleep disorder characterized by repeated experiences of extremely disturbing dreams such as anxiety, fear, and anger during sleep, resulting in restless sleep. Either you want to wake up but find it difficult to wake up, or wake up and find it difficult to fall back asleep.
Considering the patient's situation, and from what I heard, it doesn't seem like the patient has a problem with the Department of Gastroenterology, so why is the patient admitted to the Department of Gastroenterology?
Director Liao noticed Wu Xiaofu's eyes and felt a little helpless. He rolled his eyes at the young doctor and said, "Just talk about those stories a little bit and focus on the key points."
"Ah, oh, that's it. Three days ago at night, the patient suddenly developed chills and high fever without obvious triggers. The maximum temperature reached 40°C, accompanied by symptoms such as headache and muscle aches all over the body. So he went to the local community for a routine blood test. The white blood cells were 6.14, the neutrophil percentage was 79.9%, the hemoglobin was 150, and the platelets were 109. It was considered an upper respiratory tract infection.
The local hospital gave oral Tamiflu, acetaminophen, and Pudilan oral liquid treatment at that time. At that time, the patient's body temperature was able to drop to normal, but there was still recurrence.
One day ago, the patient again developed chills and high fever of 41°C, accompanied by sudden unconsciousness and twitching of limbs for 2-3 minutes.
I quickly called 120 and a bus came to our place. ”
Listening to the description, Wu Xiaofu nodded, "Then I shouldn't have transferred to the respiratory department when I came here. Why did I end up in your department?"
Director Liao was even more helpless after hearing this.
"You think I do, but the patient's father insists that the patient is poisoned and that the poison is in his stomach. Let us find a way to take a look. As for going to the respiratory department, his family insists on not letting him. He said he was seen in the respiratory department before.
Continuing to go to the respiratory department, that is, that trick will definitely be useless. The family members firmly believe that the poison is in the stomach, and the top priority now is to find a way to drive out the poison. ”
this!
Wu Xiaofu felt a little outrageous when he heard it. There were poisonous insects in his stomach. Well, it was not impossible. Although he felt outrageous, Wu Xiaofu quickly convinced himself that the respiratory department of the local hospital had already given medication, but the high temperature still could not be controlled. Yes, it's accompanied by other symptoms.
In this case, it is really possible that it is not an upper respiratory tract infection. If it is not bacteria, fungi, or viruses, then it is really possible that it is some parasites.
After all, it is still possible in Thailand.
However, Wu Xiaofu was not in a hurry to say anything, and continued to look at Director Liao, waiting for his description later. If it was really a poisonous insect, Director Liao would not call him over. If it is time to deworm the insect, if it cannot be dewormed, just give it to him directly. He had gone to undergo surgery, why bother calling him over?
"I was unwilling to admit him at the time, but after his family contacted Dr. Sun, I had no choice but to admit him. After being admitted to the hospital, I also asked for consultation from the respiratory department and gave the patient fluids, physical cooling, Anti-inflammatory and other treatments, but the temperature still cannot go down. It has been basically 39°C for the past two days. You have also seen the situation, patient. He was still confused and had shortness of breath, flushed skin all over his body, and sweating profusely. During the morning rounds, the patient's neck was slightly resistant, his pupils were about the same round shape, about 3 mm in diameter, he was slow to react to light, and his breath sounds were thick in both lungs. More crackles can be heard in the right lower lung, the heart rate is 120 beats/min, and the heart sounds are low
In accordance with the instructions of the respiratory department, we have intubated the patient for mechanical ventilation.
But the family members were anxious and asked us to quickly see where the worms were, but there were no obvious abnormalities in the head CT scan, chest CT scan, and abdominal B-ultrasound.
On the contrary, the inflammatory indicators are still high, the creatinine is also high, and the liver function is also high.
Therefore, we still think that the infection is a problem, but now we are giving Tylenol + vancomycin + ganciclovir to fight the infection, but the patient still has a high fever and the temperature was 42°C when we just took it.
In fact, I have also considered some possibilities. The patient has a clear history of exposure to tropical jungles. Although it may not be poisonous poison or the like, it may also be some insect-borne diseases. However, you know that the results of such tests are slow to come out.
There is also a lot of pressure on the patient's family. I know your abilities well, so I thought of asking you to come and take a look. Don't pick on me for not writing a consultation form for you. Don't tell me, I don't even know what's on the consultation form. How should I write this? After so many years of illness, this is the first time our gastroenterology department has admitted such a patient. ”
When Director Liao said this, his expression was really helpless and helpless.
Well!
Not to mention that Director Liao was helpless, Wu Xiaofu was also helpless when he heard this. Isn't this just dragging him over to be a dead horse and become a living doctor?
But there was no inspection support, and he didn't have much confidence.
This is what Western medicine is like. Evidence theory requires intuitive inspection results. Without inspection results, everything can only be experimental treatment. Just like the anti-inflammatory treatment during this period, it is actually experimental treatment.
After all, the bacterial culture has been negative for so long.
Wu Xiaofu stepped forward to see the patient's condition. He had fever and sweating, and a history of exposure to tropical jungles. He looked a little familiar.
I took my pulse with my hand, it was so weak!
Wu Xiaofu couldn't help but be shocked when he found his pulse. To be honest, with this pulse condition, it was believed that he was about to die soon.
In other words, there is indeed such a pathogen in the patient's body, and it is continuously acting, and the effect is very strong. According to Director Liao's medical history, it only took a few days for the patient to get sick, and it progressed too quickly.
etc!
Wu Xiaofu suddenly thought of something. He had seen too many cases during this period. Because he had to compile treatment guidelines, the cases he saw were not only from hepatobiliary surgery, but also from other departments, and there were also many rare cases. .
Wu Xiaofu has basically seen some cases that are rarely seen in China.
The patient's symptoms are somewhat similar to...
"Malaria!"
Um!
Wu Xiaofu spoke in a very low voice, but Director Liao still heard him, "Director Wu, are you sure?"
Wu Xiaofu looked at Director Liao, "Are you also suspicious?"
"Well, I also asked for consultation from the Department of Infectious Diseases before. The Department of Infectious Diseases also said it might be malaria, but the pathogen test didn't come out, so I'm not sure. But if it's really malaria, it would be really troublesome. ”
Yes, if it was really malaria, it would be troublesome.
Malaria is Plasmodium infection, which is a parasitic disease. It is actually rare in the East China Sea.
There are four types of human malaria parasites: Plasmodium vivax, Plasmodium falciparum, Plasmodium malariae, and Plasmodium ovale.
The main ones that can be seen in China are Plasmodium vivax and Plasmodium falciparum. The other two species are relatively rare. Even if they are seen, most of them are cases imported from abroad.
The clinical characteristics of patients are very similar to those of malaria, with periodic and timed attacks of chills, high fever, sweating, and antipyretic attacks that can occur many times, and eventually anemia and splenomegaly may occur over time; falciparum malaria can also cause severe and even fatal dangers. attack.
If it is considered that the patient has malaria, now it is also necessary to consider that the patient may have falciparum malaria.
Moreover, malaria is generally divided into incubation period, chill period, fever period and sweating period. Judging from the symptoms of the patients, not all of them have entered the sweating period. It progresses so quickly, and it is definitely a malignant type.
There are generally three dangerous types of malaria: cerebral malaria, hyperthermia, and gastrointestinal malaria.
The cerebral type is the most common, with symptoms similar to encephalitis and meningitis, including headaches, fever, and varying degrees of consciousness disorders. If not treated in time, the disease will continue to develop, leading to cerebral edema, respiratory, circulation, kidney problems, and other symptoms. Functional failure, rapid death, and case fatality rate as high as 50%.
If it is malaria, the patient may have this dangerous cerebral type.
"Have you been tested for malaria parasites?"
In addition to these symptoms and epidemiological evidence, the most important clinical diagnosis of malaria is protozoa examination.
This is the most important evidence for diagnosis. Blood smears or tissue fluid smears are collected by skin scraping, which are also the most commonly used.
Director Liao nodded quickly when he heard this.
"It's done, it's done. It will probably be out in a day or two, but we can't just wait for the examination. We still have to do the treatment that needs to be done."
Wu Xiaofu stared at Director Liao, "Brother Liao, I'm afraid you didn't invite me for consultation, but you asked me to share the responsibility with you."
At this time, Wu Xiaofu also realized that he was a dead horse and a living doctor. He was here to share the responsibility. The patient's family was under a lot of pressure and they knew the hospital leaders. They had been admitted to the Department of Gastroenterology for so long. No results were seen, but the condition became worse and worse.
Malaria is an infectious disease that can be transmitted through mosquito bites, mother-to-child transmission, and blood. If Director Liao thought it might be malaria from the beginning, it would be fine if he took the necessary protection, but if he discovered it later, he might not be able to recover now. There may be some hidden dangers.
At that time, if the patient has some problems again and the pressure from all aspects is reduced, Director Liao will really suffer.
And now in the hospital, who doesn't know that Wu Xiaofu has a strong background? As long as Wu Xiaofu is willing to help and talk, it will be very relieved. (End of chapter)