Chapter 445: Using chicken feathers as arrows
The child has indeed grown up. Zhuang Yongqiang smiled and watched Zhuang Yan go out.
This patient was an old neighbor. He had not been cured for a long time and had no clear diagnosis. Finally, he found his fault.
What can I say? I could only respond vaguely and call Feng Zixuan to handle it.
But Zhuang Yongqiang didn't make this call. He wanted to see how Zhuang Yan's social skills were.
As for that disease, Zhuang Yongqiang never considered it.
There is no cure for many diseases, and they even feel that they are inexplicable. This neighbor in front of me is one of them.
A large amount of pleural effusion on the right side is most likely to be a malignant tumor or tuberculosis, and only heart failure will be considered.
However, the cardiothoracic surgeon used a chest tube to drain the pleural effusion and sent it for examination. No tumor cells were found in the effusion, and no malignant tumors were found during chest CT.
All relevant tests for tuberculosis were done, and all were negative.
The large amount of pleural effusion came out of nowhere. Zhuang Yongqiang never thought that Zhuang Yan could cure the disease. In his eyes, Zhuang Yan was still a little kid, living happily under his wings.
Zhuang Yongqiang's purpose was to ask Zhuang Yan to visit her old neighbor and calm her down.
……
Zhuang Yan got into the car humming a song, put on the headphones, and connected to Bluetooth.
The song is melodious.
One drum is used to fight against the enemy; the other drum is used to tighten the shirt.
The voice belongs to Mr. Chai, and Zhuang Yan specially edited it and listens to it occasionally.
Boss Chai is one of the living legends. Ordinary medical students would not even dare to dream of meeting Mr. Chai.
Zhuang Yan remembered what her father said about raising dogs. It was obvious that her father was trying to make the atmosphere more harmonious and avoid being rebellious, so he painstakingly thought about such a statement.
He even hesitates to defile himself.
Hehe, it won't happen, it won't happen, Zhuang Yan thought in her heart. No matter what she does, she cannot treat her senior brother as a dog, and when she thinks of dogs, Zhuang Yan thinks of Dahei, and her senior brother is much prettier than Dahei.
When she arrived at the hospital, Zhuang Yan changed her clothes first.
"Lao Meng, you are still busy."
"Huh? Why did you come back to Xiaozhuang? Corey doesn't have much to do." Meng Liangren was a little surprised.
"I came to see an old neighbor."
Meng Liangren smiled. He held the robot dog in his hand, and the robot dog's head was shiny.
"What's the disease?"
"Pleural effusion is not malignant, and there is no diagnosis."
Meng Liangren nodded and had no idea of going to see it with Zhuang Yan.
"Get up and take a walk. You always sit like this. Be careful not to get venous thrombosis in your lower limbs." Zhuang Yan said.
Meng Liangren's expression changed, and his smile was a little forced.
He thought for a while, stood up and let "Er Hei" charge, and then wiped his hands on his white clothes.
"Xiao Zhuang, don't talk nonsense. Use more auspicious words when you talk." Meng Liangren is even more daddy than Zhuang Yongqiang.
"I know!" Zhuang Yan also felt that what she said was wrong and shook her head, "Let's go and have a look at the chest department. I feel a little guilty."
"What are you guilty of?"
"Hate, you don't know, old neighbor, the first thing you say when you talk is Xiaoyan, how old are you this year? Have you found a partner? Your dad is looking forward to holding a grandson or something."
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Meng Liangren smiled.
"I was chatting with my dad, and he insisted on letting me come. He was probably going to be forced to get married."
"It hasn't snowed yet, and there's still some time before the Chinese New Year, and now I'm being forced to get married. Why should I go home if I have nothing to do?" Zhuang Yan complained.
"You didn't go shopping?"
"No, I rarely go to crowded places since the epidemic. I may have PTSD. Didn't Senior Brother say that Director Fang from Changnan is not serious? He said that he was unwilling to contact people after the epidemic. This is true. It speaks to my heart.”
The two chatted without a word. When they arrived at the Thoracic Surgery Department, Zhuang Yan hesitated for a moment. Instead of going directly to the ward, she walked into the doctor's office to greet the doctor on duty and the resident manager.
Meng Liangren smiled slightly. It seemed that Zhuang Yan was indeed disgusted with the urge to get married.
But Meng Liangren didn't say anything, he just watched Zhuang Yan quietly talking to the resident manager of the cardiothoracic surgery department.
Zhuang Yan has a strong ability to adapt. Although she talks about unimportant gossip, she no longer looks like a newly graduated graduate student to the naked eye.
Meng Liangren sat down and watched Zhuang Yan shaking her head, chatting with the hospital manager, and reading medical records and laboratory tests.
After a few minutes, Zhuang Yan picked up the phone and made a call.
? ? ?
? ? ?
Meng Liang and the resident manager of the cardiothoracic surgery frowned at the same time.
"Senior brother~~~"
Sure enough, Zhuang Yan called Luo Hao directly.
I still need to tell Zhuang Yan about this matter, Meng Liangren thought in his heart.
Especially on weekends, everyone needs private space and private time. If I think of it, I just call Luo Hao. Do I really think he is a summoned beast?
Just when Meng Liangren was thinking about something, Zhuang Yan had already reported her condition and started taking photos of the test sheets and sending them to Luo Hao.
"Please help me see what's going on."
"Yes, it's not low protein, it's not lung cancer, pleural cancer, or tuberculosis. Where did so much pleural effusion come from?"
"It seems that the ca125 in the tumor marker is a bit high."
"Senior brother~~~My great aunt has a large amount of pleural effusion on the right side..."
After saying half a sentence, Zhuang Yan stopped and listened carefully to what Luo Hao said on the other side.
"The carbohydrate antigen CA125 is a glycoprotein derived from body cavity epithelial cells and expressed in normal tissues. CA125 is usually used as a tumor marker for ovarian epithelial cancer. Its elevation can also be seen in some non-gynecological diseases."
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Zhuang Yan suddenly said a paragraph about the definition of ca125 in a "medical student" manner.
Meng Liang sighed, this quality is really high. The master's degree students of Peking University can be said to be top elites, with serious academic backgrounds.
He had always been exposed to tumor markers in clinical practice, but Meng Liangren only knew that a thorough investigation was needed on what ca125 meant, but he didn't know how specific it was.
But Zhuang Yan picked it up effortlessly.
"Is it really okay, senior brother?"
"Okay, okay, I'll take my aunt Zeng to check."
Zhuang Yan looked helpless and hung up the phone. Meng Liangren smiled in her heart.
It was probably that Professor Luo was having a two-person world with Da Nizi and was disturbed by Zhuang Yan's ignorance. He felt unhappy and casually asked Zhuang Yan to take the patient for investigation.
"Xiaozhuang, what did Professor Luo say?" Meng Liangren asked.
"My senior brother said that pleural effusion may be caused by ovarian tumors. What he said was quite serious. How come I haven't heard of it."
The resident manager of the cardiothoracic surgery department’s eyes were as wide as bells. What are you talking about? Do you think this is something a human being can say? !
It is certain that both benign and malignant ovarian tumors can cause large amounts of peritoneal effusion, which is a high probability, but pleural effusion?
No transfer, no transfer, no transfer!
The resident manager of the cardiothoracic surgery department was shouting loudly in his heart.
This is simply not something a doctor can say.
Ca125 was high, and the resident manager of the cardiothoracic surgery department also saw it, but he didn't pay attention.
There will be laboratory errors in the examination, and the patient has a large amount of pleural effusion on the right side, and everything can be mild or severe.
Even if the patient is taken for examination, a clear explanation must be given to the patient and the patient's family.
There was a large amount of effusion in the right pleural cavity. The dyspnea disappeared after drainage, but 300-500ml of drainage fluid still appeared every day. This had nothing to do with the elevated CA125.
At least that's how it seems in cardiothoracic surgery.
"Brother Chang, can you order a check-up?" Zhuang Yan asked the resident manager of the cardiothoracic surgery department.
"Xiaozhuang, go talk to the patient." Although the resident manager of the cardiothoracic surgery department complained in his heart, he had a smile on his face and sat directly in front of the computer to start giving medical orders.
If you want to check, just check. You won't offend the daughter of Dean Zhuang's family because of this matter.
Besides, from a certain perspective, Zhuang Yan can be considered a family member of the patient. The world is huge, and the patient’s family is the biggest.
Meng Liangren didn't say anything, just quietly wondering why.
Soon, Meng Liangren found that his mind was empty and blank. Not to mention whether ovarian cysts can cause pleural effusion, even Meng Liangren couldn't tell the definition of ca125.
Okay, Professor Luo asked, so we’ll check it out right away.
Zhuang Yan is riding a tiger and is unable to get off. It seems that Professor Luo's temper is getting worse and worse, so he should try to make as few phone calls as possible in the future.
"Lao Meng, what's that look in your eyes?" Although Zhuang Yan was bold and simple, she was not stupid.
At a glance, she saw the confusion and confusion on Meng Liangren's face.
"It's okay, it's okay, what kind of examination did Professor Luo say?" Meng Liangren asked.
"First do a CT scan of the middle and lower abdomen. If there are any problems, check the MRI."
"..."
"Hey, hey, Lao Meng, senior brother must have his reasons."
The resident manager of the cardiothoracic surgery department moved his lips, and he almost blurted out a sentence in his heart - there is a reason!
This is obviously because the superior doctors do not want to waste their rest time, so they ask their junior doctors to complete the relevant examinations first, and then wait for the rest to go to work.
This kind of perfunctory can't be heard. Could it be that the daughter of Dean Zhuang's family is a fool? !
It's so silly and sweet, these three words shine brightly on Zhuang Yan.
"Senior brother, there must be a point, definitely." Zhuang Yan said firmly.
Meng Liangren remembered what his boss always said - Professor Luo is not here, Lao Meng, you don't have to provide emotional value all the time.
Did Xiaozhuang even learn this? !
This is a very surprising learning ability, Meng Liangren thought to himself.
Zhuang Yan went to see the patient, but Meng Liangren did not follow.
The resident manager of the cardiothoracic surgery department did not follow. He looked at Meng Liangren jokingly, "Old Meng, Professor Luo has the final say in your family. But even if he has the final say, it won't be like this. It's over."
"Yes, what else? I can't have the final say." Meng Liangren sensed a hint of provocation and answered without hesitation.
"But the patient has pleural effusion on the right side. Don't you think it won't help even if there is a problem with the ovary?"
"I don't think so." Meng Liangren automatically stood in Luo Hao's perspective, "If you see any abnormal indicators, you must continue to check. Has Director Xu not checked the ward yet?"
The resident manager of the cardiothoracic surgery department was startled. He felt the light and shadow of swords from Meng Liangren's words.
It's normal for departments to have conflicts. He hasn't said anything yet, so why is Lao Meng so anxious? Director Xu was also brought out.
Seeing that, if he said something unpleasant again, Lao Meng would argue with him, even going so far as to "splatter five steps" with him.
The resident manager of the cardiothoracic surgery department was somewhat envious of Professor Luo.
Look at people! Look at your own home again.
My own professor always slanders Director Xu behind his back, saying that Director Xu has such a good temper that he cannot beat him with three sticks.
And before he could say anything wrong about Professor Luo, Lao Meng was about to fall out.
He is no longer the old attending physician who was transferred to the First Hospital of the Medical University, the resident manager of the cardiothoracic surgery department thought to himself.
When he kept a straight face, Meng Liangren actually looked a bit dignified as a senior doctor.
"If there is a problem, investigate it. I think Professor Luo is right."
"Okay, okay, yes, yes, yes," the resident manager of the cardiothoracic surgery department said perfunctorily.
However, the clay figurine also had a somewhat earthy temper. The resident manager of the cardiothoracic surgery department was unhappy, so he followed him to see the CT scan results.
When nothing happens, I will at least say something to ridicule Professor Luo.
Emmm, please say a few words. After all, I still want to get some papers from Professor Luo.
Say something...
Forget it, what's there to say? Professor Luo just wants to conduct normal investigations and not make any mistakes.
The resident manager of cardiothoracic surgery has many thoughts in his mind.
Along the way, he watched Zhuang Yan and Meng Liangren communicating quietly, feeling a little envious in his heart.
As a hospital manager, I don’t have to worry about scientific research and papers. What a great thing it is. Why did Meng Liangren, the old attending physician who was transferred from the hospital, run into this?
As for the patient, the resident manager of the cardiothoracic surgery department didn’t think about it at all.
The patient had massive pleural effusion on the right side!
What does it have to do with ovaries? If there is one thing, it is a relationship that cannot be fought with eight poles. Professor Luo must have said this casually, and the doctor below used chicken feathers as arrows.
But the resident manager of the cardiothoracic surgery department had mixed feelings when he saw that both Meng Liang and Zhuang Yan were performing "without physical objects."
Look at the doctors under Professor Luo, even if Professor Luo is not here, they still pretend to be presentable, as if this is really happening.
Envy, envy.
Professor Luo's chicken feathers are like a commanding arrow for them. They say they need to do the inspection, and there is no ambiguity in the execution.
Soon, an image appeared on the screen in the CT operation room.
Zhuang Yan stood behind the technician, but Meng Liangren didn't notice anything at all. While chatting with the technician, he reached out to the mouse and started operating it.
"Tumor!" Zhuang Yan said loudly when she saw Meng Liangren found the tumor.
The resident manager of the cardiothoracic surgery department was stunned.
Is there really a tumor? !
Fuck!
What is going on!
There was a huge tumor in the patient's left pelvic cavity, about 10cm in diameter. Such a large tumor does not require any film-viewing skills at all, it just appears on the machine so neatly.
The resident manager of the cardiothoracic surgery department felt that his hands were a little numb. It was really an ovarian tumor.
Is this a misdiagnosis? It probably doesn't count, he comforted himself in his mind.
Medical insurance has run out of money. As long as there are no necessary reasons to complete relevant examinations, medical insurance will not agree.
Do you need a full body checkup first when you are hospitalized? If you do this, it will be like laying a small landmine for yourself. Who knows when you will step on it.
"Senior brother is right!" Zhuang Yan was a little excited, "Lao Meng, Lao Meng, look at what I said."
Zhuang Yan shook Meng Liangren twice, who was sticking out his butt and holding a mouse in a weird posture, and then took out his mobile phone to video chat with Luo Hao.
In the video, Luo Hao is sitting cross-legged in the open space of the panda house. On the left is a bamboo. The head of the bamboo is resting on Luo Hao's lap. Luo Hao is gently stroking the bamboo with his left hand.
On the right is Wang Jiani. Da Nizi's head is resting on Luo Hao's right shoulder, and she is holding Zhu Da in her arms.
What a heartwarming picture.
It seems that a family of n is on an outing and vacation.
Zhuang Yan felt guilty and apologetic. Senior brother is usually very busy and rarely has time to go to Ha Dong Panda House. It is hard to find time on weekends, but he still has to cause trouble for senior brother.
"Xiaozhuang, don't have too many inner dramas. It's just a medical appointment. What's your expression?"
Luo Hao on the other side of the video was smiling, and the sun seemed to have splashed out of the screen.
"Is there a tumor in the ovary?" Luo Hao asked.
"Well, look at the picture, senior brother."
"Don't shake your hands, let me take a look." Luo Hao rubbed the bamboo while looking at the image.
"Looking at the images, it should be an ovarian thecocytoma. Most of them are benign tumors and are not a big problem."
A minute later, Luo Hao said gently.
"Ovarian theca cell tumor? What should we do next?" Zhuang Yan asked, and then she immediately remembered her father's "dog-raising theory."
She then subconsciously put this "wrong theory" into practice.
"Brother, you are so amazing! You actually knew it was ovarian thecocytoma just by listening to my medical history report."
"Huh? Xiaozhuang, who did you learn such greasy words from?" Luo Hao was a little confused.
"Are you greasy? I just think you are awesome and you speak from your heart."
"It's not distracting at all. It looks oily and greasy at first glance. It's not good. I'll say goodbye next time."
"Let's go! I'm really distracted!!" Zhuang Yan wanted to show Luo Hao, but she felt bad the next second and stopped, "Brother, my aunt Zeng has a large amount of pleural effusion on the right side, and now she has medical insurance. The review is strict, and examinations that are not related to the current disease are rarely performed. When you said you wanted to do a CT scan of the middle and lower abdomen, did you think that there must be something wrong with the ovary, and that it was a large amount of pleural effusion on the right side caused by ovarian thecocytoma? "
The resident manager of the cardiothoracic surgery department almost hit his head on the computer screen.
Is flattery so straightforward?
Is this really a good thing? !
Professor Luo was obviously being perfunctory. He was not his patient anyway, so he said casually...
Before the thought of the cardiothoracic surgery resident manager disappeared, Luo Hao nodded slightly, "Yes, the large amount of effusion in the right pleural cavity is indeed caused by ovarian thecocytoma. Not bad, Xiaozhuang, your derivation ability has improved."
Gan!
The resident manager of the cardiothoracic surgery department was stunned.
What did Professor Luo say? Does he know it?
Is there a relationship between ovarian thecocytoma and massive right pleural effusion? ! What a joke.
That's not what you say in casual nonsense.
In fact, the resident general of cardiothoracic surgery was very unconvinced. If it weren't for the pressure from medical insurance, he would have done a gynecological examination on the patient long ago. How could he wait until Professor Luo said it?
But this is only secondary. The main reason is that there is no relationship between ovarian thecocytoma and pleural effusion.
The resident manager carefully recalled all the diseases in his specialty. Except for malignant tumor metastasis, there should be no cases like what Professor Luo said.
The dissatisfaction in his heart had already overflowed, "Professor Luo, can you explain in detail what is going on?"
The resident manager of the cardiothoracic surgery department was not stupid and would not directly challenge Luo Hao.
After all, I will ask people to write papers in the future, but if I have questions, there is nothing wrong with asking by the way.
"Yes, this situation of pleural effusion caused by ovarian thecocytoma is just enough to write a paper, Mr. Chang, right."
"Yes, yes." The resident manager of the cardiothoracic surgery department nodded repeatedly, feeling confused.
"Go back to the office, it's not convenient to talk here."
The resident manager of the cardiothoracic surgery department was a little confused. Professor Luo was so sure that he didn't know whether it was true or false for a while.
Back at the doctor's office, Zhuang Yan made a video call again.
In the video, Wang Jiani had already left with Zhu Da in her arms, while Luo Hao was still sitting cross-legged, with Da Hei appearing in his field of vision.
Luo Hao held a bamboo shoot in his hand and threw it into the air. Dahei quickly ran out, jumped into the air, and grabbed the bamboo shoot in his mouth.
But the bamboo lay motionless on Luo Hao's lap like a sculpture.
The movement and stillness of Dahei and Bamboo actually carry a hint of beauty.
"Senior brother, I didn't disturb you." Zhuang Yan was a little worried.
"Don't bother me. Da Nizi is taking Zhu Da to drink some milk. I'm going to tell you about Meg's Syndrome."
Meg's Syndrome?
The resident manager of the cardiothoracic surgery department immediately secretly took out his mobile phone and typed in the words Meig syndrome.
But the name that came out of the search terms made him startled.
Meige syndrome is a clinically rare neurological disease and a type of segmental dystonia.
Also known as idiopathic blepharospasm-oromandibular dystonia syndrome.
First reported by French scholar Henry Meige in 1910, it mainly causes blepharospasm, various forms of dystonia of facial muscles, mandible and cervical muscles, and is more common in middle-aged and elderly people.
Isn't this a neurological disease? There is a close relationship between ovarian thecocytoma and pleural effusion!
Is Professor Luo talking nonsense? !
And he said no!
Zhuang Yan put up her phone in a formal manner, took a step back, found a chair and sat down, as straight as a primary school student.
Similar to her, Meng Liangren sat down in front of his mobile phone like a medical student.
The resident manager of the cardiothoracic surgery department was very upset. It was obvious that Professor Luo was talking nonsense.
"That's it..."
Just as Luo Hao was about to explain, the resident manager of the cardiothoracic surgery department couldn't bear it anymore and asked, "Professor Luo, Meige syndrome seems to be a relatively rare neurological disease."
"Oh, you are talking about Meige syndrome, m, e, i, g, e." Luo Hao said a few letters and smiled, "My English speaking is not very good, I'm sorry."
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"???"
"???"
"I'm talking about Meigssyndrome, m, e, i, g, s, similar in pronunciation, but they are two diseases."
Fuck!
The resident manager of the cardiothoracic surgery department was stunned.
“It’s better to call it Meigs syndrome, but when I was at Concordia, everyone called it Meigs syndrome, so I got used to it.”
Luo Hao didn't mind the questioning from the resident manager of cardiothoracic surgery, but smiled shyly, "My Xiehe family also has some bad habits, I'm sorry."
"..." The resident manager of the cardiothoracic surgery department was stunned. He lowered his head, picked up his mobile phone and started searching for Meigs syndrome.
Oh shit!
The English language is a mountain of shit. When searching for Meigs syndrome, the resident manager of cardiothoracic surgery found the explanation.
He looked down at the explanation on his phone and was stunned. This kind of thing really happened. Professor Luo was not talking nonsense. What he took out was not chicken feathers, but real arrows.
"Sometimes a large number of auxiliary examinations are still needed. Nowadays, medical insurance is under great pressure. There is no other way but to improve the technical level and be targeted, so that the people at the medical insurance center have nothing to say."
"!!!"
(End of chapter)