Chapter 336 Gold Standard
Professor Su and his party watched the video and visited the Comprehensive Orthopedics Department before leaving.
The child who was admitted to the free clinic in the classroom and was considering osteoid osteoma had already completed the surgery. His father was wandering at the door of the doctor's office. When he saw Xiaowu, he asked: "Dr. Lu, have the results of the pathological examination been released?"
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"Didn't I tell you it would take three to five days? You've asked me seven or eight times." Xiao Wu felt a little annoyed with him.
The child's father thought for a while and said, "Dr. Lu, can you move my son's examination forward? Others are not in such a hurry. Just slow it down and move him forward alone. It won't affect anything and others won't know." ”
Xiao Wu annoys people like this the most. His business is a big deal, and other people's business is not a big deal. This kind of person likes to jump in line when waiting in line. Anyway, he feels that it won't affect anything if he jumps in line alone.
"There's no way in advance. We can't rush this matter. It will make the pathologist anxious. I'll take a random look at it and you won't be able to tell me the result." Xiao Wu didn't care about it and declined him politely.
The child's father was restless and grabbed his pants with one hand: "This matter is really urgent. Do you think it is benign or malignant? What should I do if I have to wait for so long?"
"Now that you know it's urgent, why did you go there earlier? I asked you to take your child to see a doctor early. You read a few articles online and thought you were really a doctor. They said everyone can wait for three to five days, but you can't wait?" The child's mother also came over, as if she wanted to pull him back by his ears.
This couple is also a bit interesting. The husband is short and timid, and the wife is tall and big, with a bold personality. Both the couple are very disharmonious in terms of body shape and personality.
If there is a quarrel at home, the woman can probably carry the man like a chicken and spin around the house several times without the woman gasping.
The man was scolded by his wife and returned to the ward in despair. The woman apologized to Xiao Wu and then followed her back to the ward.
When someone asked about the pathology results, Song Zimo remembered that he had made an appointment with the pathology department to see Zhang Zhe's pathology slides this afternoon. Song Zimo wanted to ask Yang Ping if he wanted to go there and see them together.
Yang Ping said that it was just right to teach everyone how to read pathological slides. In the future, this is a basic skill that doctors in the department must master. Let Song Zimo and Xu Zhiliang master it first. In the future, they must be as skilled in reading pathological slides as they are in X-rays.
In some countries, such as the United States, surgeons have to look at pathological slides themselves. Sometimes the surgeon removes the tumor and sends it to the pathology room next to the operating room for frozen sections. The surgeon takes off his surgical gown and gets off the stage, and goes to the pathology room to look at it with a microscope in person. After taking sections to find out what kind of tumor it is, wash your hands and go to the stage again, and choose the appropriate surgical method based on the pathological diagnosis.
In my country, pathological slides are only seen by pathologists. Surgeons do not know how to read them, and they have not received specialized relevant education. The pathology classes during school and those few experimental classes can only be regarded as experience.
Therefore, if our country has a surgeon who can read pathological slides, it will definitely be a rare treasure.
When everyone arrived at the pathology department, they were all busy. The examination room, microscopy room, and immunohistochemistry were all busy. There were only two people in the doctor's office, Director Guan of the pathology department, and Director Shi, who had returned from retirement.
Director Shi was wearing a pair of sunglasses and sitting at the window to rest. Director Guan was reading something on the computer. When he saw everyone coming in, Director Guan recognized Song Zimo: "Young Master Song, here you are! I won't introduce you. This is for your department. Dr. Yang?”
Song Zimo and Director Guan, Director Shi, are very familiar with each other. He often comes to ask for advice on pathological slides. During holidays, he often sends Maotai and the like to the two directors to make them happy.
"Director Guan, please excuse me." Yang Ping shook hands with Director Guan.
Director Guan smiled and said: "You're welcome. We are Qingshui Yamen. We usually have little contact with you. We see a lot of pathological slides from various departments every day, but we don't know a few of them. Dr. Yang is young and promising. I still know you. Are you? Let’s take a look at the pathological slides of several recent orthopedic patients. The specimens from today’s surgery patients are still undergoing decalcification. The slides from the surgery a few days ago have been released and are ready for the camera. I’ll ask someone to show them to you.”
"Teacher Shi, is this the beautiful woman wearing sunglasses looking out the window?" Song Zimo joked with Director Shi.
Director Shi pointed at his eyes: "I've seen too much under the microscope, and now my eyes can't stand a little brighter light. In the past few years, if it was sunny, I had to wear sunglasses when I went outside. Starting this year, I have to wear sunglasses indoors as well. No, I kept crying.”
"Director Shi will stop working after this month and go home to retire." Director Guan explained.
Director Shi said: "I can't do it anymore because my eyes are not good. If my eyes can hold on, I still want to work for a few more years."
The pathology department is really a Qingshui yamen. Not only does it have no money, it is also deserted. Several doctors spend all day and night looking at pathological slides under the microscope. One doctor has to look at almost three to four hundred slides every day. He has no time to move his buttocks except for going to the bathroom at work. .
However, the pathology department of Nandu Medical University Cancer Hospital, a national cancer hospital, is much better. If a patient wants to find a doctor with better skills to see the pathology slides in private, he has to take care of it.
It's not expensive. The doctor charges a service fee of three to five hundred to help take a look.
There is no way, the pathology department is really poor, with a salary of several thousand yuan a month, if I don't do some private work, I can't live a good life.
If the patient follows the normal procedures and has pathological slides taken outside, it is impossible for a top hospital to help you look at them. If you can’t even see your own slides, why should you look at someone else’s?
The so-called pathological diagnosis is theoretically the gold standard for tumors. However, there are opinions on whether this gold is pure gold or karat gold. After all, pathological slides rely on people to see them. After reading it, the diagnosis of what kind of tumor it is, benign or malignant, and which stage of malignancy it is, all depends on human knowledge and experience, so there is a possibility of error. This possibility is very low, but it exists.
Typical and simple ones are generally fine, but when it comes to complex and atypical ones, misjudgments may occur. Even if it is not cancer, it is not unreasonable to be diagnosed as cancer.
Many patients are unwilling to be diagnosed with malignant tumors in primary hospitals. Their families find a way to find a way to take out the pathological slides from the doctor in charge and send them to the top cancer hospitals in the country. They spend 300 to 500 yuan to find a pathologist to look at them privately through connections. , please feel at ease.
The probability of misdiagnosis is not high, but it still happens. A patient was diagnosed with a malignant tumor. When he went to a top hospital, he found out that it was not a malignant tumor but inflammation. He was treated as inflammation for a period of time and recovered.
Director Shi used to be a well-known pathologist at Nandu Medical University Cancer Hospital and Director Guan’s mentor. After his retirement, he was hired by Sanbo Hospital to train young people.
At this time, a hospital employee happened to be looking for connections. He called Director Guan and wanted to ask Director Shi to help him look at the relative's pathology slides in private.
Director Shi waved his hand: "If you don't want to watch it, no one's relatives will watch it."
Some time ago, a patient's family asked Director Shi to look at pathological slides through a relationship, and gave him 500 yuan. As a result, he secretly videotaped it. After Director Shi helped to watch it, the patient's family handed the video to the hospital's disciplinary inspection office and asked for a refund of 50 yuan. One hundred yuan, said the doctor charges privately.
This thing pissed off the old man and he stopped reading, not even his relatives.
After just sitting like this for a while, dozens of specimens were received in the giant examination room, all of which were cut out in the operating room.
Carrying it in a specimen bag, there were cut out tumors, cut out parts of the liver, stomach, intestines, everything.
On the sampling table, there are several clean cutting boards, as well as rulers, scissors, tweezers and other tools neatly placed. The doctor, wearing gloves, is slicing a tumor on the cutting board.
The surgeon cuts something from the human body, which is called a specimen, and sends it to the pathology department. The doctor goes through more than ten processes such as cleaning, fixing, extracting, dehydrating, dipping in wax, embedding, slicing, staining, and sealing. , to make a pathological slice.
This pathological section can be viewed under a microscope for pathological diagnosis, that is, a diagnosis of the disease.
For a typical case, after the doctor makes a diagnosis, the director will review it; if it is difficult, experts in the department will discuss it and everyone will look at it together before a diagnosis can be made to prevent unjust cases.
"The general surgery department sent a specimen for frozen section. I have to go and take a look. I have asked people to find Zhang Zhe's pathological sections. You guys go to the microscopy room to take a look. I'll be busy first." Director Guan told everyone greet.
"Go and do your work." Yang Ping told Director Guan.
"Teacher Shi, help us take a look."
Frozen section is a rapid pathological diagnosis, and the result can be obtained within fifteen minutes, which requires a doctor's extremely high diagnostic level. Director Guan asked Director Shi to take a look together, which was more reliable.
In theory, pathological diagnosis must be guaranteed to be 100% without any errors.
Even though his eyes were bad, Director Shi still had no intention of refusing. He took off his sunglasses, rubbed his eyes, and followed Director Guan out.
The surgeon is still waiting on the stage, waiting for the pathological results to decide the next operation. If it is benign, the operation will be declared over; if it is malignant, based on the pathological results, the operation will be expanded, such as lymph node dissection.
When everyone arrived at the microscopy room, Zhang Zhe's pathological slides had been placed under the microscope, and Yang Ping asked everyone to take a look first.
This is a multi-head microscope, and Song Zimo, Xu Zhiliang and Gao Qiao all sit on it.
Under a 400-magnification microscope, the structure of bone tissue on paraffin sections is clearly visible. Osteocytes, osteoprogenitor cells, osteoblasts, osteoclasts, and bone matrix are viewed one by one.
Reading pathological slides requires patience, not letting go of any doubts, and never jumping to conclusions.
Any sloppiness or misdiagnosis may ruin the patient's life.
(End of chapter)