Chapter 456 Lao Meng, why are you panicking?
“Biopharmaceuticals are really so different?”
“During the epidemic a few years ago, I heard a teacher from the pharmacy group say that originally, There is a gap of 20 years, but the RNA vaccine is not ready for clinical use and is used globally. Various clinical feedback data can directly mature this type of drug. "!" Meng Liangren was surprised.
He had no idea this was happening.
Zhuang Yan swayed her high ponytail while gossiping with Meng Liangren, listening to the voice from the navigation on her mobile phone, and drove towards the orphanage.
When I arrived at the orphanage, I saw several children playing in the yard from a distance. Meng Liangren had a smile on his square face.
At this time, Meng Liang was particularly relaxed, with a warmth all over his body, which was different from that in the hospital.
Zhuang Yan stopped the car and heard the sound of iron chains in her ears.
? ? ?
Iron chain?
Orphanage?
All kinds of bad suspicions suddenly came to mind, and Zhuang Yan was a little angry.
"Hey!" Meng Liangren shouted loudly.
"Uncle Meng~" the little girl called.
"Eh, eh, eh." Meng Liangren said eh three times.
The smile on his face was already overflowing, and Zhuang Yan felt that the words he just said were particularly appropriate on Meng Liangren.
"I brought you delicious food." Meng Liangren got out of the car and took a few bags of snacks. "I can't give you too much. I'm going to see your dean."
Dean She was a widowed middle-aged woman who usually took care of the yard. Feng Zixuan was concerned about Luo Hao's affairs and deliberately found such a relatively good and supportive orphanage.
The children dispersed and gathered around Meng Liangren. Only then did Zhuang Yan see a big raccoon flower chained to a small stone pier.
Fuck!
Zhuang Yan had only seen similar situations in short videos, but she never expected to see them with her own eyes.
Big Lihua was covered in tendons and looked at Meng Liangren with squinted eyes, filled with murderous intent.
It is more like a very small tiger than a cat.
Zhuang Yan felt that the big raccoon flower, whose eyes were not locked by the Qinling Jackal, was even more fierce.
Oh my god, what the hell is this.
"This is yours, one bag for each person, and the rest will be given to the dean. She will share it with you when the time comes." Meng Liangren said with a smile, "These are jars of big flowers."
As he spoke, Meng Liangren closed the trunk, took out a bottle of canned cats bought at I Pet Me, opened it, and placed it 3 meters away from the big raccoon flower.
"Dahua, I'm here to see you." Meng Liangren had a flattering smile on his face.
That flattering and flattering smile came from deep in his heart, and it could be seen that Meng Liangren was afraid of this cat.
"..." Zhuang Yan was speechless.
Are you going to starve the big raccoon flower to death? The guy was chained up with a cement block behind him.
But the next second, a splashing sound was heard, and the iron chain behind Da Lihua was straightened, and she walked step by step towards the jar that Meng Liangren opened.
Zhuang Yan’s eyes straightened.
The tendons on Big Lihua’s body were taut, and she looked fierce, as if even an iron chain couldn’t lock her.
No wonder Lao Meng put the canned cat so far away, and no wonder the big raccoon flower was locked up.
It is probably because Lao Meng visited the children before and ate the big raccoon flower.
But you have to suffer a loss. You can't find an opportunity to kill the big fox.
Then again, if there is no iron chain, it is still unclear whether Meng Liangren can beat this big raccoon flower.
Meng Liangren put down the jar and when he saw the big raccoon flower approaching, he hurriedly left.
Zhuang Yan stared blankly at the big raccoon flower. The cement block behind her weighed thirty or forty pounds, leaving a white mark on the ground.
There are many white marks on the cement floor, some of which have turned into small channels, probably caused by the dragging of big civet flowers.
This is too fierce!
“Meow~~~”
A cat meows.
The big civet cat paused, Zhuang Yan followed the cat's meow and looked over, and saw a huge civet cat appearing on the edge of the wall.
The orphanage is relatively old, and there are still traces of barbed wire left on the walls from decades ago. The civet cat standing on it actually gave Zhuang Yan a feeling of being condescending and looking down on all living beings. .
It looks familiar, Zhuang Yan thought after seeing the mouse in the mouth of the civet cat.
With a flash of lightning in her mind, Zhuang Yan thought that this was none other than the director of the Food Street Rat Control Office!
It and it are actually the same family?
Ga.
Director Li jumped down with the mouse in his mouth, walked lightly, and threw the mouse in front of the big civet flower. Then he walked to the can and smelled it. With a flick of his little paw, he put the can in front of the big civet flower. .
This was the first time Zhuang Yan saw a cat eating a mouse.
Somewhat bloody.
And the big raccoon flower is very strong. A mouse is just an appetizer at most, and adding a can is not enough.
Zhuang Yan even suspected that the giant raccoon flower could eat all the iron outer packaging of the can. Its stomach had evolved to the point where it could easily digest iron. At least that was what Zhuang Yan thought.
But no matter how ferocious the big civet flower is, it is just a civet cat, not a bamboo.
Bamboo can be eaten and digested, but civet flower cannot.
The iron-eating beast does not call for nothing.
Director Li and the big civet flower from the orphanage were chatting meowly. The big civet flower was not willing to talk to Director Li and seemed to talk less.
Zhuang Yan especially wanted to bring Luo Hao over at this time.
It would be great if my senior brother was here and could translate the words between them to myself.
Not long after, Meng Liangren’s hearty laughter came from the room.
"Dean Wang is working hard. I am busy with work and don't have much time to see them."
"Seeing that the children have grown taller and stronger, I know that Dean Wang is interested."
"This is what should be done. Doctor Meng, you are too polite."
"Our leader told me, by the way, I brought 20 bamboo peripheral dolls in the trunk, one for each of the children, and the rest You can keep the rest.”
During the conversation, Meng Liang and Dean Wang came out.
Dean Wang is nearly 50 years old, but he looks like someone in his 30s. He does not look old. But the smile on her face was gentle, not aggressive, and she seemed to be living a good life.
I guess it saves the children too.
Meng Liang chatted with Dean Wang for a while, watched the children eating snacks, and watched Da Lihua chatting with Director Li. The time was quite gentle.
About an hour later, Meng Liang and Zhuang Yan left the orphanage.
After saying goodbye to the dean, Meng Liangren turned the heads of the children one by one and told them to be obedient and study hard before getting in the car.
"Lao Meng, how often do you come here? I see you are very familiar with the dean."
"I came here twice, both after get off work. I added the dean's WeChat account. A few days ago, the dean’s relatives were waiting in line for hospitalization and sent me a message. I went to see Director Chen.”
"Eh? You didn't tell your senior brother?" Zhuang Yan was a little surprised.
"Professor Luo is busy. If I tell Director Chen about this little thing, he will give me face. The operation has been completed long ago, and it is said that Director Chen personally performed it." Meng Liangren said with a smile.
The words were a little broken, but Meng Liangren was rare and relaxed.
"Hey."
"Xiaozhuang, when I was young, my parents talked about their expectations in the future. What career do you think would be good?" Meng Liangren suddenly asked.
"Doctor, what about... scientists?"
"No, it's the driver. Those who hold the steering wheel and the scalpel were all good professions in their time."
"? ? ”
Zhuang Yan tightened her hands and held the steering wheel, as if holding the steering wheel became a good career?
“You weren’t there at that time. A Santana cost more than 200,000 yuan, and you couldn’t buy it or drive it if you had the money. If you need a car for something at home, you can get one or two cars. A great show, unlike now where parking is a hassle.
In recent years, there have been more and more trams, and even Mercedes-Benz and BMW have started to sell at a reasonable price. "Meng Liangren explained.
"The world is changing so fast. ”
“Actually, it’s okay. Doctors have always been a profession that people need. Don't look at what people in the south say. I have classmates there who will come back during the Chinese New Year and give us a blast. "
"Blow..."
Zhuang Yan didn't finish asking, the phone rang.
"Hello?"
She was driving, Bluetooth was connected, and she didn't see who was calling.
"Xiaozhuang, it's me."
A man's voice came.
Zhuang Yan frowned, her expression somewhat displeased. Meng Liangren noticed the change in Zhuang Yan's mood, but said nothing. Instead, he turned his head and looked at the neon lights outside the window.
"Is something wrong?"
"I seem to have encountered a medical dispute..." the caller said coquettishly.
As he spoke, there was a faint sound of sobbing from the other side of the phone, which seemed to support his words.
"Hey, are you okay? You always brag about how awesome you are when you are in school, and you have a medical dispute less than half a year after starting work?!"
The other side of the phone was silent.
Silence seemed to have a power that made both Meng Liang and Zhuang Yan feel uncomfortable.
After a few seconds, Zhuang Yan asked, "What's going on?"
"The first patient I treated was an inguinal hernia. There will be no problem with the surgery, for sure!" the man explained. He said, "But things keep happening after surgery. Mercury has been retrograde recently. Why do we encounter such troublesome patients?"
Although Zhuang Yan was a little impatient, she still listened patiently.
"Oh, let's not talk about this. I originally thought that I could be closer to you in the provincial capital, but..."
The muscles on Meng Liangren's square face twitched.
"The patient's family was about to complain, and they just scolded me. You Northeasterners are really cruel."
"What do you call us Northeasterners! We can't even cure an indirect inguinal hernia. Well, you still have the nerve to say it!" Zhuang Yan scolded mercilessly.
"I... just say goodbye to you and prepare to resign."
"Where is the patient?"
"It depends on what the medical commission decides. It's probably a medical accident, and it's definitely not a liability accident." The man explained, but his voice became lower and lower, lighter and more ethereal.
Faintly, that sobbing sound came again, as if it was haunted. The old man was crying. Meng Liangren felt a little contemptuous in his heart. He gritted his teeth fiercely and his masseter muscles bulged.
“You didn’t ask the teacher?”
“It’s the same surgery, but there is constant bleeding after the operation, but there is no serious problem with coagulation. I pulled our director up to stop it I got blood once, but then... Oh. Forget it, let's not talk about it. Xiaozhuang, if you don't let me call you Xiaoyan, then..."
"But shut up now. Why are you so big-hearted? How long has it been before you still have time to entertain yourself?" Zhuang Yan scolded, "I'll call my senior brother and you can send me the patient's relevant information."
"Dr. Luo?"
"Sure."
The other side of the phone was silent again, and there was a faint sound of rattling on wood.
“What are you doing!”
"I don't need him to help me." Zhuang Yan's classmate said bitterly.
"Hey, you are a doctor. This is treating diseases, and it is not your private matter. Besides, if you don't look for your senior brother, who can you look for? Just you, who can you look for!" Zhuang Yan was also a little angry, His tone became increasingly unkind.
I don’t know if it was Zhuang Yan’s scolding or because she was angry, but the other side of the phone fell silent for once.
6◇9◇书◇Bar
A few seconds later, with a sigh, the phone was hung up.
"Who is it?" Meng Liangren asked.
"A classmate who has been chasing me fell ill in the imperial capital, and my senior brother saw him." Zhuang Yan explained.
“He was also assigned to come to the provincial capital?”
“I originally said that I was going back to the south, but for some reason I followed him to the provincial capital. I was too lazy to see him, and I couldn’t get rid of him no matter how hard I tried. It’s like chewing gum.”
The muscles on Meng Liangren’s square face twitched twice.
Zhuang Yan was not in the mood for small talk and was too annoyed. Meng Liangren did not say anything and returned to the First Hospital of the Medical University in silence.
Meng Liangren got out of the car and waved his hand.
Zhuang Yan, who was sitting in the driver's seat, did not look at him. She picked up her mobile phone, and the bright light of the mobile phone shone on her face, which was a little cold.
Meng Liangren felt lost and was about to turn around and go back to the ward to work when he suddenly heard Zhuang Yan shouting, "Lao Meng, wait for me."
"Hurry up and go home and rest."
"He sent me the information. I will sort it out and send it to my senior brother, and wait for me to park the car."
Zhuang Yan did not park the car in the underground parking lot, but parked it casually in the parking space at the entrance of the inpatient department. .
If it were Meng Liangren, he would not be willing to give it up.
It is said that parking here costs 5 yuan an hour.
Since the house failed to sell at a high price, many things have been eaten and lost. Meng Liangren knew it well.
Even the hospital in front of us is expected to be depressed for a while.
Originally, the 100,000 surgeries performed by the Medical University First Hospital a year sounds magical. In Chen Yong’s words, it is a manifestation that exceeds the current economic support capacity.
What did Professor Luo say at that time?
Meng Liangren was stunned when Zhuang Yan ran over, swung her high ponytail, and patted Meng Liangren on the shoulder hard, "Let's go, Old Meng."
"Oh .”
"My classmate was very annoying. He chased me for three years. He placed flowers under the dormitory three times and made love to me in person."
"There's something wrong. Isn't this coercion? Abominable moral kidnapping." There are others who are making noises, why are we together?"
Zhuang Yan babbled as she pressed the elevator button.
She inadvertently glanced at Meng Liangren from the corner of her eyes, observing Lao Meng's face.
"What about you?" Meng Liangren remained calm.
"I definitely can't agree. Isn't there something wrong with this? When I was a child, my dad told me that the more this happens, the more you have to refuse. Once you soften your heart, you will suffer a lot in the future."
" Huh? It turns out that it was your father who told you that you have such an idea. "Meng Liang is deeply concerned, and Dean Zhuang's words and deeds are really useful."
How many girls can't bear the pleading and just agree to it? In the end, most of them probably end badly.
What was originally a matter of course has turned into a moral kidnapping, which is really boring.
“My dad also taught me a lot of things. When I go out, face is not the most important thing, especially when encountering similar things.”
The origin of family education does make sense, Meng Liangren thought in his heart.
For a thin-skinned girl, she might just accept it half-heartedly. As for the future, who would have thought.
In the past, at the infectious disease hospital, the new doctors were often coerced by nurses.
Once the young doctor who just came had a good idea, but he never agreed. Finally, the nurse stood on the window sill and said she didn't agree and jumped down.
This is nothing.
Meng Liangren was a little confused, and memories from the past came to his mind.
"Old Meng, what are you thinking about?" Zhuang Yan asked.
"I didn't think about anything. I just thought that there was no big problem with coagulation and subcutaneous bleeding." Meng Liangren explained casually.
"Hey, when you go back, help me sort it out and let my senior brother take a look. I don't want to help him. A man can't handle his own mess, so what can I do to help? But the patient suffers No, what do you think, Lao Meng?”
Meng Liangren scratched his head.
It's really not easy to be a doctor. Whenever your values come up, if you say no, you have an antisocial personality.
When he arrived at the office, Meng Liangren called Erhei over, held his shiny head, and gradually felt more at ease.
Zhuang Yan held up the phone and said, "Lao Meng, how do you do it? I asked you to remember? The disease history records there are so rough that I can't read them. At a glance, there are even typos in them, not to mention the faults. Two. If you take this medical record to a lawsuit, one will lose.”
"You tell me, I'll remember it, and then we'll discuss it together and show it to Professor Luo. But it's late today, and it's not an emergency. Let's go early tomorrow morning. Professor Luo hasn't had a good night's sleep in Hadong for a long time."< br>
“Yes, senior brother is too busy.”
The patient is a 35-year-old male who is usually in good health and has no history of high blood pressure, diabetes, or heart disease. He was admitted to the hospital due to a left inguinal hernia and underwent tension-free repair of the indirect hernia under spinal anesthesia.
The patient had an appendix surgery ten years ago and recovered well, with no history of other surgeries or trauma.
Hernia repair surgery itself is the most basic minor surgery, on the same level as appendectomy.
Generally speaking, hospital managers are not willing to do it, but it is normal for them to make one before leaving when they meet a motivated and hard-working graduate student.
Normally, it would not be a problem for a graduate of Peking University with a master's degree to perform such a minor surgery. However, on the first day after the operation, he discovered a subcutaneous hematoma and a cyst-scrotum hematoma near the surgical area.
At that time, it was thought that the patient had been bruised or crushed, but the patient denied any trauma and no special treatment was given.
Similar situations are actually not uncommon, and have not attracted the attention of clinicians and superior doctors.
When the dressing was changed the next day, it was found that the bruising on the waist and the edema in the vagina had basically remained unchanged, and obvious edema was also found at the incision, accompanied by subcutaneous blood stasis.
Considering that there was bleeding from the incision, three sutures were removed in the dressing room and about 150 ml of blood stasis was removed.
But Zhuang Yan’s classmate did not find any obvious active bleeding. He also called the leading professor to take a look, but he did not see any obvious bleeding.
After debridement, the incision was packed with iodophor gauze and bandaged with pressure.
On the third and fourth days after the operation, there was still a small amount of blood stasis in the incision when the dressing was changed. Each time the blood stasis was removed, iodophor gauze was used for packing and compression.
When the dressing was changed on the fifth day, the blood stasis in the incision was significantly reduced. 200 ml of normal saline + 160,000 units of gentamicin injection were given to rinse the incision, and then wrapped with sterile gauze.
From the sixth day onwards, there was no more blood stasis or obvious bleeding when changing the dressing. The wounds also gradually shrank. I was discharged from the hospital on the fifteenth day after the operation, and the wound was closed about twenty-five days later.
Up to here, everything is still normal.
Similar situations have not happened before. Especially when Meng Liangren first arrived in the clinic, he occasionally encountered patients whose appendix surgery caused fat liquefaction.
The treatment process is similar, that is, exploration, constant dressing changes, disinfection, drainage, infection prevention, etc.
But, if there are no accidents, accidents will still come.
About a month and a half after the wound was closed, wound infection and pus began to appear again. I was given dilation and drainage at the outpatient clinic, and the dressing was changed every day. However, the infection continued for 25 days, with good and bad times, and the wound never healed.
At this time, even the director of their department saw the patient and considered deep infection. After communicating with the patient and the patient's family, he planned to remove the patch, completely debridement of the incision, and perform laparoscopic indirect inguinal hernia repair. .
but!
Again, if nothing else, the accident happened again.
During the operation, it was found that the patient's lesion had invaded the inner ring and laparoscopic repair could not be performed.
I had no choice but to call the director to the stage. After taking a look, I decided to enter through the original incision, take out the original patch, thoroughly debridement, and place a latex tube near the inner ring opening for drainage, and then layer it. Suture the incision.
After the operation, there was thick juice coming out, and then it was the same as last time, but soon new blood started coming out.
Now the patient's family couldn't sit still. After a series of exchanges and exchanges, as the patient's condition gradually worsened...
When writing this, Meng Liang and Zhuang Yan were both a little confused.
A hernia got worse? !
Yes, not to mention the patient’s family, even the two people who were far away in the First Hospital of the Medical University found it hard to believe that the patient’s condition would progress in this direction.
The gauze is wet every day, and the bleeding volume is estimated to be more than 100 ml/day.
After consultation, it was considered that there was a problem with the patient's coagulation function and it was recommended that the patient go to a higher-level hospital. The patient and his family members refused.
So he was given an infusion of 400 ml of fresh plasma, and the bleeding situation improved slightly, but it was the same two days later.
The cycle repeats itself, and the attitude of the patient and his family members quickly deteriorates.
This is not difficult to imagine.
It’s just a hernia and it can’t be cured!
Where can I go to reason?
Time is like a big millstone, gradually wearing away people's patience.
Until the patient was admitted to the ICU, the emotions of the patient’s family members erupted like a volcano.
Looking at the laboratory test sheet, the patient's activated partial thromboplastin time (aptt) among the four coagulation parameters was increased, and the value was not very high, only 45. Pt and everything are normal.
Zhuang Yan stared at this value and wondered for a long time.
"Old Meng, have you ever seen this kind of situation?"
"It's harmful..." Meng Liangren put Erhei's head in his head and smiled bitterly, "I have never seen it before. I used to be an old man at the infectious disease hospital. As an attending physician, I don’t see as many patients as you did during your internship or graduate school. "More."
"But I always feel that you are experienced."
"..."
"Besides, Lao Meng, why are you a little panicked?" The corners of Yan's lips raised and she stared at Meng Liangren closely.
"???" Meng Liangren was silent.
"I'm going to the ICU to take care of patients with paraquat poisoning. You were stunned and said I wanted to go home. It's such a mess. What are you thinking about?" Zhuang Yan pressed forward step by step.
Her eyes were fixed on Meng Liangren without blinking, as if Meng Liangren had made some mistake.
Lao Meng didn't panic at first, but when Zhuang Yan looked at him like this, his hair suddenly became slightly panicked to the tips of his toes, and his heartbeat changed. The severe arrhythmia made Meng Liangren feel palpitations.
(End of this chapter)