Chapter 518 Life is a person of Union, death is a person of Union!
"Of course, this is just a differential diagnosis." Boss Chai added.
Luo Hao: "It's just that the possibility is relatively high."
Boss Chai: "The images on ct may also be artifacts."
Luo Hao: "More inspections are needed."
One old and one young, one young, one sentence, Chen Yan's eyes were a little blurry, and he seemed to see their figures overlapping, combining them into one.
Time seems to have never left traces on Mr. Chai, and Luo Hao seems to have experienced the baptism of time long ago, and retains his peak physical strength based on his full experience.
Gradually, Chen Yan heard some tricks.
Chen Yan finally understood why Professor Luo was so slutty in his daily life. This should be the result of Boss Chai’s words and deeds.
The top expert, the editor of textbooks, and the vice president of the Academy of Engineering, was clear at first and blurred at the time of diagnosis.
This is something Chen Yan absolutely did not expect.
Even though this behavior is a standard behavioral norm for doctors, Chen Yan still feels unacceptable.
In his imagination, shouldn’t Boss Chai be just a matter of saying a word and give a confirmed diagnosis after just a glance at the movie, just like the beginning?
What a dog.
"Is it necessary to clear the intestines?" Boss Chai looked at Luo Hao.
"Boss, no, there is a great possibility of considering parasites. I agree with you. Just clean the enema and have a colonoscopy to take a look."
Boss Chai stopped talking, but looked at Chen Yan.
Chen Yan had already twisted his beard without realizing it and was thinking about ct films.
Is there any problem with the film? No problem, I have seen it at least three times, and there is no misdiagnosis.
But why are they...
It was not until Old Chai looked at him that Chen Yan let go and accidentally lost a beard.
"Old Chai."
"Go and give the doctor's advice." Boss Chai glanced at the time, "When is the time for the Zhuzi to get off work?"
"Five o'clock." Luo Hao replied with a little regret.
"Oh, that's fine, and you're not in a hurry. When you send the patient, take me around and tell me about the functions and functions of the new robot."
Chen Yan seized the time to get busy.
All the doctor's instructions were taken to the nurse to perform with his own eyes.
Boss Chai rarely visits clinical trials in person. He has retired. More things like this, Boss Chai is like a archway, just placed there for future generations to admire.
With such an opportunity for clinical guidance, Chen Yan will definitely not lose his mind.
Even Chen Yan called the endoscopic room one by one, and the emergency endoscopy was required to have an operation room.
43 minutes later, Chen Yan brought the patient to the surgery room.
"Now clinicians are all cows and horses. In the old society, when they were hungry, people couldn't eat enough, so there was nothing for cows and horses to eat. Boss, I heard that too."
"You have a lot of complaints. Just say something, don't be sarcastic."
After Chen Yan called, he soon heard the voices of the old and the young coming in the corridor.
"After working in clinical practice for a long time, especially when you are woken up in the middle of the night, you will always get up. You can't show it at that time, and you must end up in your heart and become a classy taste."
"Didn't you tell me what kind of store you open near the hospital in the future? Why did you go off topic as you said it? You're even more distracted than me, an old man."
"Boss, am I talking about it? You said I complain a lot, let me explain."
Chen Yan raised his hand unknowingly, twisted his beard and stroked it one by one.
Professor Luo and Boss Chai have a close relationship far beyond his imagination.
This dialogue pattern is like a junior who travels home, chats with his grandfather, and talks about what he has seen recently.
It is quiet and has no purpose, just chatting and accompanying the old man to relieve his boredom.
This...
"I saw that the Zhejiang doctor opened a series of coffee shops. When you are hungry, you can eat less and work more. Now the doctors have to buy coffee before checking the room, so they can provide similar things at their own expense."
"The store opened so early?"
"Yes, they provide coffee for clinicians. At 7 o'clock in the morning, the first cup of coffee came out. It is said that their daily turnover is 60-70% sold during the morning."
"The people who buy it are all doctors from Zhejiang Doctor."
Zhejiang Doctor, Boss Chai hasn't been there for many years. Even if he goes, he will never be able to get into such details.
"Oh? Is the amount so large? I didn't see it at the door of our Union." Old Chai said.
"In front of the Union, the land rent is too expensive and I can't get the capital back. In 2023, Zhejiang Yi Coffee sold 360,000 drinks throughout the year, with a daily order volume of 1,200 orders. A chief physician's annual consumption of Zhejiang Yi Coffee reached tens of thousands of yuan."
"So many."
"Its boss seems to have something to do with Zhejiang Medical People. He just opened a store. What's the first big order?"
"Emmmm, the order from the union, employees give coffee on their birthdays? No." Boss Chai seemed a little hesitant.
"Hahaha, boss, it also sells all kinds of baked food, which is cake. The cakes given by employees on their birthdays are all from it."
"Is the union? I know that I can't use it yet. I have to pay every year." Mr. Chai also began to complain.
As they were talking, the two of them had already arrived at the door of the Shu Room.
Chen Yan shivered, pulled off a beard and bowed quickly, "Old Chai, you are here."
"Well, it's quite fast, Director Chen is good." Boss Chai smiled and gave a smile of approval.
The two of them no longer talked about the coffee shop in front of Zhejiang Medical University, and they didn't continue to talk about the shop because they started because there are thousands of birthday cakes every year.
Luo Hao was quick-witted and began to prepare for things to apply before the surgery.
This time, Luo Hao did not avoid suspicion as usual, but just whispered a few words to the doctor in charge of the endoscopy room, then went to put on clothes and gloves to start colonoscopy.
"Huh? Xiaoluo, the one you just mentioned seems to be a homophone."
"Ah?" Luo Hao was about to take surgery, but when he heard the boss say this, he turned around and was stunned, but then he narrowed his eyes, "Yes, Zhejiang Yi Coffee is homophonic to Zhejiang Yi Coffee."
"Yi is taken from Cang Geng Yufei in the Book of Songs, which shines with his feathers. It is homophonic and has culture, which is good." Boss Chai said, "Okay, let's go here and start the surgery."
What is this? Chen Yan didn't understand the communication between Boss Chai and Professor Luo Haoluo at all.
After entering under the colonoscopy, Luo Hao chatted with the patient while staring at the TV screen and looking at the things around him.
Because the intestines are not fully cleared, scattered feces can be seen in the intestines, but no one cares about these.
"Your face is different from the skin on your body. Your face must have been sunburned. Where did you go to play with your family during the holidays?"
"I went to the plateau and saw the Potala Palace." The patient replied.
"Oh, is that fun? I heard that after a young man goes there, he will have a few more drips in the hospital during the day and go to dance with an oxygen tube at night."
Holding an oxygen pump to dance? ! Chen Yan heard about something similar for the first time.
Isn’t that a dying person? Nowadays, young people are so fancy to death? Altitude sickness, that's altitude sickness.
"I didn't. I went with my parents, and they didn't let me go. I said I wanted to see the blue sky over there and purify my mind."
"Has it been purified?"
"No, especially after I knew that many things were made of human skin, I felt a little disgusted."
"The three views are correct, it's good." Luo Hao suddenly stopped, "Boss, look."
There is a white spot in the patient's intestines.
The white is light and looks like a pseudo-film that adheres to the intestinal wall.
"Well, based on past history, it should be a beef tapeworm."
Past history?
What past history?
Chen Yan was stunned.
He has experienced many battles and can be said to be the kind of experienced doctors and experts that ordinary people can imagine.
But he could understand the communication between Luo Hao and Mr. Chai, but he didn't know why.
Does the patient have a past history of beef tapeworm?
Even if that piece of white is not a pseudo-film on the inner wall of the intestine, but a tapeworm, pork tapeworm should be the most common.
"Old Chai, how do you judge that the parasite in the intestine is a beef tapeworm?" Chen Yan bent his waist and asked humbly.
"Little...Dr. Luo just asked about his past history, didn't you hear it?" Boss Chai turned his head and looked at Chen Yan.
"Holding the oxygen pump to dance?" Chen Yan blurted out.
"No, Director Chen." Luo Hao took over the topic, "Tapeworm, you know that some of the dried yaks on the snowy plateau are made of raw yak meat, which may cause beef tapeworm disease."
"Since I suspect it is a tapeworm, I have to ask if I have been there."
"I just asked, I've been there and the time is probably right. Especially those who go with the elderly, I'll probably come into contact with local specialties. Getting off the car to take photos and buy specialties is also a habit for the elderly."
"!!!"
Chen Yan was really confused this time. He thought about it and asked, "Professor Luo, why isn't it a pork tapeworm?"
"For pork, we basically eat it after it is cooked. The probability of getting sick is not high, and the market has a monitoring department. Although we don't work much, we have to do something."
"Dr. Luo, don't be sarcastic. Why did you learn so many bad habits shortly after you arrived in clinical practice?" Boss Chai scolded.
"Yeah, yeah." Luo Hao responded obediently. He did not operate, and held the tapeworm with his pliers, but continued to send the colonoscopy inside.
"You haven't heard of eating raw pork jerky, Director Chen."
So that's the case, Chen Yan was a little confused and nodded.
"Bean and pork rarely appear now. If the pig farmer in my house produces bean and pigs once, it will be very worried. The pork can only be left to eat at home to save waste."
“…”
Chen Yan was silent. It turned out that Professor Luo was not just chatting, but was asking about past history.
Although it is a induced question, it has a purpose and hits the point, but there is nothing to complain about.
But why didn’t Professor Luo take the “pseudo-film” but continue to walk inside with the colonoscopy?
If you don’t understand, ask, and Chen Yan and Luo Hao have nothing to be implicit.
"Professor Luo, why don't you take tapeworms?"
"If the intestinal tapeworms have to be beaten out, if they are pulled off, they will likely rekindle."
Chen Yan only took out the pork tapeworm surgery, but the number of times was not many, and he knew little about the relevant knowledge.
I didn't expect there were so many statements here. "It's rare for us to see, it's common in snowy areas. I also heard from Boss Xia, so I really took it with my own hands..."
After all, the patient did not have general anesthesia, and Luo Hao said half of the words, and the rest was self-evident.
"I think the patient's eosinophilic spheres on the test sheet are not high."
"Generally, beef tapeworms are not tall, and this is still a slight difference from pork tapeworms." Luo Hao said.
As the colonoscopy went in, I gradually came to the appendix position.
The patient had an appendectomy, and the local anatomy was changed, and the appendix cavity was not seen.
But the intermittent white "pseudo-film" ended here.
"Boss, it turns out that I was at the position of the appendix. No wonder the right lower abdomen is in pain." Luo Hao said.
"Brother, what is that?" the patient asked.
"It's a tapeworm, a parasite. It drills in the suture point where you used to have an appendectomy, so you've always felt pain in the lower right abdomen."
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"There is no diverticulum, it's a coincidence." Boss Chai said lightly, "Take it out for testing, and it will be fine if you use the medicine for two days."
"Hey."
Luo Hao responded obediently, and then began to lightly tap the ileo-blind area with pliers.
Chen Yan knew that there must be a saying that "click" this time. Professor Luo Haoluo just said that he would "knock" the head of the tapeworm, but he didn't expect that it was really "knock".
After knocking, the white began to move. Luo Hao operated the colonoscopic forceps in his hand and clamped a white "pseudo-film".
Then the colonoscopy stepped back little by little, and you can see that the white "pseudo-film" is continuous under the lens.
The reason why it looks discontinuous when you look in the mirror is that some of the "pseudo-film" fits closely with the intestines, which looks like one. It is difficult for the naked eye to observe the difference between tapeworms and intestinal walls.
As the colonoscopy continued to go out, Chen Yan's hand gradually touched his chest.
He has now confirmed that he has read it wrong, it is indeed a tapeworm, not a pseudo-membrane.
But the tapeworm was a little long, Luo Hao's colonoscopy had been out for a while, and the insect's body was still being uncovered.
This is too long.
The longest pork tapeworm Chen Yan has ever seen is only 10-20cm. At that time, a tapeworm that is nearly 20cm was taken out and he took photos as a souvenir.
But the beef tapeworm in front of me was visually at least 50cm and was still spreading.
"How come it is so long!" Chen Yan murmured to himself while twisting his heart-protecting hair.
"The longest tapeworm is about 100-120cm. I have seen a tapeworm about 150cm. Unfortunately, it was in a lower-level hospital that time. I forgot to say that the nurse lost it directly and left no clinical information, so I can't count it." Boss Chai said with some regret.
"I guess this is about 90cm-100cm. Boss, are beef tapeworms in the snow areas so long?"
"Not it, it should be a coincidence."
Luo Hao was chatting, but his hand speed did not slow down and he "pulled" the beef tapeworm.
A complete beef tapeworm appeared in front of you in one day.
"Please lay a blue order." Luo Hao said.
The nurse immediately spread a blue sterile sheet on the ground as the doctor's instructions. Luo Hao then placed the beef tapeworm on it and straightened it so that Mr. Chai could watch it.
Just as Luo Hao expected, the beef tapeworm is about 100cm long.
"Eat more raw pumpkin seeds when you go back." Luo Hao said while placing the beef tapeworm.
"Brother, are you talking to me?" The patient looked at the bugs pulled out from his body, and heard Luo Hao say raw pumpkin seeds and asked in confusion.
"Well, I'm telling you, and I'm also telling Director Chen."
"Raw pumpkin seeds can cure parasites, is this true?" Chen Yan asked blankly.
"Of course it's true. The Chinese medicine's anti-worm medicine basically contains raw pumpkin seeds. There is also betel nut, but the side effects of this thing are too great. It's not good for a little girl to eat betel nut, so let's forget it."
Boss Chai took out his cell phone and started taking photos as if he hadn't heard Luo Hao's doctor's advice.
One-meter-long beef tapeworm is extremely rare, and even Boss Chai has rarely seen it.
"This insect, Dr. Luo, you're ready." Boss Chai said, "After the test, the whole test must be sent to Union Health after the treatment."
"Boss, my doctor's college..."
"What's your doctor's degree? You haven't gone to 912 yet, so why don't you take UnionPay?! Leave a photo and do PPT, and the specimens must be kept at UnionPay Medical College. Your doctor's degree is your doctor's degree. You are a UnionPay, and you are a UnionPay, and you die from UnionPay!"
Boss Chai spoke decisively and could not be negotiated at all.
Luo Hao just said it casually and immediately responded to this matter.
Chen Yan knew that this should be used as a clinical specimen and would be taught to students in the future. In this story, perhaps I also appear as the background.
But this background is not so glorious.
But who could have thought of it?
I thought the patient was pretending to be sick and had a psychological behavior, but I didn't expect that a one-meter-long beef tapeworm was taken out from my intestines.
"Director Chen, have I gone to explain to the patient's family?" Luo Hao politely solicited Chen Yan's opinions.
But based on the chat content between Luo Hao and Boss Chai just now, it is not difficult for Chen Yan to find that from now on, this beef tapeworm has become Luo Hao's treasure and should not leave his sight.
Professor Luo never takes it as he is self-righteous when the boss explains things.
Chen Yan felt a little sorry for his doctors who had this enlightenment.
The next thing is simple, it's just dealing with the endgame.
The young patient had a normal colonoscopy, and he didn't even need to rest when he came down, and he was about to leave when he jumped.
But she was still pushed out by Chen Yan in a wheelchair.
After all, if you have an operation, you need to have the awareness of the patient after the operation.
"Old Chai, do you think what medicine is more suitable after the operation?" Chen Yan was still "humble" and asked Boss Chai for advice.
"How many days should be given for anti-inflammatory treatments, which is not enough. In addition, Dr. Luo said that raw pumpkin seeds should be given, plus magnesium sulfate for three days orally. In addition, betel nuts have been taken for a while, and the little girl doesn't smoke. Do you think too much about treating the disease?
I won’t get addicted for three days, eat it! ”
"Okay, okay, it's a combination of raw pumpkin seeds + betel nut + magnesium sulfate." Chen Yan repeated.
In my memory, when I was in school thirty years ago, the teacher seemed to have talked about this treatment.
But I have never used it. Today I am the guide to take medicine. Chen Yan seems to have returned to several years ago and become a student sitting in the classroom listening to the class.
Chen Yan cheered up and wrote down all the prescription.
"It's Dr. Luo's technique. Generally speaking, tapeworms can only remove about 1cm of pieces." Old Chai explained.
"?!" Chen Yan was stunned.
"Let me say that, pumpkin seeds and Penang Lang act as insects in segments, one is the first part of the action and the other is the latter part of the action, which makes the insect paralyzed, and then it will be pulled out as soon as magnesium sulfate is bleeded."
"Of course, according to Dr. Luo's surgery, it should not be so troublesome, but be cautious and give it a few days."
"Okay, okay." Chen Yan nodded repeatedly to agree.
"In the future, if you encounter similar patients, you can also use this combination of medication. The principle is similar, but parasitic diseases are rare now, and clinicians almost return them to the teacher."
Old Chai smiled, and Chen Yan felt a pain in his heart, as if he had just pulled out a bunch of heart-protecting hairs.
The patient just happened to let Boss Chai take a look, but unexpectedly something happened to him. The old man confirmed the diagnosis and asked Professor Luo to remove the tapeworm intact.
After sending the patient back, Luo Hao and Boss Chai also left to see the gimbal surgery.
Chen Yan was about to get what he wanted. With a photo with Mr. Chai, he solved another patient who had a diagnosis error.
Everything is perfect.
"Dongdongdongdongdong~"
Just as Chen Yan was admiring the photo of himself and Mr. Chai, a rapid knock on the door sounded.
Before Chen Yan could speak, Director Shi from the endoscopic room pushed the door open and came in.
"Where is Professor Luo?"
"Ah?"
"Where are the bugs!"
“…”
When Chen Yan saw Director Shi who was yelling anxiously, he felt something was wrong.
"It's just a bug. Why are you doing so anxious?" Chen Yan said, "Little Luo took it out. Is the bug? Old Chai said that he must send it back to Union Health for teaching in the future."
"Where are their people?"
"What's the hurry? Come and sit down and say."
Director Shi hesitated for a moment, but reason still defeated his emotions.
He also knew that he had been like this, and Luo would probably say a few perfunctory words to him, after all, it is more important to accompany Boss Chai.
After thinking it through, Director Shi sighed deeply.
"What's wrong with you, Director Shi?"
"Oh, don't mention it." Director Shi said, "You don't understand."
I don't understand? !
Chen Yan's hair was blown up all over his body, just like Director Li met a wild dog.
"It's true. I've taken the parasite, but I've never taken the whole one. Parasite... How to say it, it's not an exaggeration to describe it as a blow-bang. With a little force, the parasite will be pulled and broken, and never been taken out. At least, I can't do it."
"Uh, it's so disgusting to say that parasite blowing can be broken, so change the adjective." Chen Yan said contemptuously.
"Carved on tofu? Anyway, the connection between the segments of that thing is very crisp. It breaks with a little force and can only be taken out one by one."
"!!!"
Chen Yan opened it with his hands, but he didn't expect that Professor Luo would still hide so much content after his spare time in the operation.
"I just want to see and ask Xiao Luo for advice on how to operate and how to deal with parasites." Director Shi sighed, "I have something to do today, so I will throw all the matters back and take a look."
"You probably can't see the insects. Ronaldo should have been soaked in formalin. Boss Chai wants it. Ronaldo must be afraid that you can't pull it out of your eyes when you see it." Chen Yan said with a smile.
"Ah? I don't."
"That's not OK. Professor Luo just said to me, my doctorate, and Boss Chai directly cursed and scolded Professor Luo so hard that he scolded him."
Speaking of this, Chen Yan was vaguely thinking of Boss Chai saying that life is the person of Union, death is the person of Union.
For a moment, I was eager for a long time.
(This chapter ends)