This doctor has a system

Chapter 220 218. A clear conscience
While they were discussing, Mr. Zhang from Qihui Pharmaceutical came over. He had just returned from other places and hurried over after hearing the news about Gao Feng's arrival.

"Where are Mr. Hu and Mr. Li?" Mr. Zhang was a little unhappy. He obviously didn't pay enough attention to the God of Wealth. The levels of Jing Baifeng and Kang Weidong were too low. What if they were unhappy.

"The two bosses came over to look at it. Professor Gao is going to the workshop. It doesn't make sense for them to follow. They have already made an appointment to have dinner together." Kang Weidong quickly explained.

"But you have to treat Gao Feng well. I feel that this Professor Gao is not limited to his current achievements." Mr. Zhang explained that he specifically asked some professionals for inquiries. Most people spoke highly of Gao Feng and said that this person has accumulated many talents. If you make some achievements in the next year, you will definitely be a leader in the future.

"Professor Gao is welcome to come and give guidance." Mr. Zhang shook hands with Gao Feng vigorously, trying to make the other party feel his enthusiasm.

"I heard that we are currently developing third-generation TKI drugs. How is the progress?"

"It's okay, it's going relatively well so far." Gao Feng replied casually.

"When will the preliminary finished product be available?" Jing Baifeng asked from the side.

"It will probably take another half a year." Gao Feng thought for a moment, "We still don't have enough manpower, otherwise we can advance some time."

"Half a year?!" Jing Baifeng suspected that he heard it wrong, "Are you kidding me?" In fact, he just asked casually.

"The main reason is that our project is less difficult to develop."

Is it difficult to develop third-generation TKI drugs?What's going on?Mr. Zhang, who is not engaged in specific technologies, couldn't stand listening anymore. Professor Gao's tone was a bit outrageous.

"Professor Gao, let's go one!" Mr. Zhang yelled at the wine table. It seems that this is his specialty.

"Oh, I can't drink." Gao Feng hurriedly covered his glass with his hand, "It's easy to delay things when you're drunk."

When he said this, Mr. Zhang became even more excited. He likes to fuck these people who can't drink. "This is a 30-year-old Maozi. I usually don't want to drink it. Come on, give it to Professor Gao."

Li Youliang and Li Zheng are not immune. Mr. Zhang's two assistants are fierce. Mr. Hu and Mr. Li are also working hard to persuade them to drink. They must give these three people a good drink today.

1 hours later

"Mr. Jing, look at this." Gao Feng looked at the people lying on the table and didn't know what to do. Although Li Zheng and Li Youliang were staggering, they could still move around. Mr. Zhang was vomiting and screaming, and it seemed that he would not go to the hospital. It's inappropriate.

"I called 120. The car will be here in a minute." Jing Baifeng was wiping the faces of the bosses. The scene was quite embarrassing.

"You can't drink, can't you?" He said resentfully, "If you can't drink, how can you climb down five people by yourself?"

"Extraordinary performance." Gao Feng said modestly, and the 120 ambulance arrived as he spoke.

"Oh my god." The doctor and nurse looked disgusted. "They are all fat. Come on, please help lift me up."

The strong physique finally came into use. Gao Feng slipped Mr. Zhang up like a chicken.

When he was about to leave the next day, Mr. Zhang didn't show up. Li Youliang called specifically to express concern. This was his first time here. If he really drank the boss and caused problems, he would have to go and visit.

"I'm fine." Mr. Zhang's sickly voice came over the phone, "I was careless and didn't dodge! I drank too much, otherwise you wouldn't be my opponent. Wait until I fight again next time .”

"He is very good." Li Youliang said to Gao Feng, "Except for his hard mouth, other parts of his body should be soft."
-
"Qin Hao's uncle came to our department and was hospitalized." Dong Qianqian said to Gao Feng, "It looks quite serious."

"When did you come here? Has the cause of the disease been found?"

"I came here the night before yesterday, and the cause of the disease is still unclear, so Qin Hao was in a panic." Dong Qianqian said.

The patient, a 45-year-old male, suddenly developed dizziness, chest tightness, and profuse sweating while defecating at home 2 days ago. He fainted in the toilet after having black eyes and lost consciousness for about 3 minutes. He then woke up on his own without any physical impairment. He was sent to the hospital by his family. .

The patient does not have underlying diseases such as hypertension, diabetes, or coronary heart disease.

During the treatment, the patient experienced syncope again, dizziness, and chest tightness continued unrelieved.

The doctors in the emergency department completed electrocardiogram, chest CT, head CT and related examinations for him, and found no obvious abnormalities. He was having a headache when Qin Hao ran over and said, "This is my uncle."

The emergency doctor was overjoyed that the patient had found a home, "Great, then I'll take it in for you!"

Qin Hao asked the nurse to give his uncle oxygen and put on an electrocardiogram monitor.

"Uncle, what's wrong with you? Tell me what's wrong with you."

"It's just dizziness, dark vision, and suffocation." Qin Hao's uncle looked very haggard, "Haozi, what's wrong with me?"

I also want to know what's wrong with you. Qin Hao comforted him and hurriedly gave him medical advice.

What blood routine, C-reactive protein, liver function, kidney function, cardiac enzymes, electrolytes, myoglobin, troponin, BNP, procalcitonin, infectious diseases, blood lipids, blood sugar, coagulation function + D-2 polymer, Glycated hemoglobin, blood gas analysis, etc. were all arranged.

"Why do I feel that Haozi is not very reliable?" My aunt's heart pounded as she watched the nurse draw blood one by one.

Under Qin Hao's urging, the laboratory department issued the results very quickly. The blood routine showed that the number of white blood cells was high, the percentage of neutrophils was 85%, and the inflammatory indicators C-reactive protein and procalcitonin were normal.

The blood gas analysis showed that the pH was 7.39, the partial pressure of carbon dioxide was normal, and the partial pressure of oxygen was not low. There were no abnormalities in biochemical indicators or coagulation.

From the above results, we can basically rule out the possibility of acute cerebrovascular disease, acute myocardial infarction, acute pulmonary embolism, etc. Qin Hao breathed a sigh of relief, but then frowned again.

His uncle still felt chest tightness, dizziness, cyanosis of the lips, and finger pulse oxygen saturation was low, between 85-88%. Theoretically, the finger pulse oxygen saturation should be 99-100% under oxygen inhalation to be considered normal.

"That's the situation." Qin Hao reported the condition to Gao Feng, "Currently there is no clue about the diagnosis."

Gao Feng also felt strange. Sudden dizziness and chest tightness were usually caused by cerebrovascular disease, cardiovascular disease or lung disease. Uncle Qin Hao's situation was quite special.

"Haozi, find a few more experts to show your uncle. Aunt, I'm getting old, and it's hard to find another home after I take the child with me." My aunt said to Qin Hao heavily.

"Look what you said!" Qin Hao was very dissatisfied.

"Clearly aware of everything: Wang Laishun feels very bad. He will be very anxious now. Please use your professional medical knowledge to make a clear diagnosis for him in time. You can get 15 skill points by completing the task."

The ECG monitor on the side showed blood pressure 90/68mmHg, heart rate 92 beats/min, respiration 24 beats/min, and pulse oxygen saturation 88%.
Gao Feng noticed that Wang Laishun's skin color was also a bit dark, "Does he usually have this skin color? It looks a bit dark."

"It doesn't seem like this normally." Aunt Qin Hao took a closer look, "It feels like it's gotten a lot darker these past two days."

"Do you have any hobbies?"

"Hobby?" Wang Laishun thought for a moment, "I like JK." This uncle is not very serious!
"No, I mean lifestyle habits, such as smoking, drinking, etc." Gao Feng reminded.

"He doesn't smoke or drink." Qin Hao said, "I just like JK"

"What about food?"

"I like to eat salty food. I have a strong taste." Wang Laishun said, "I don't think there is anything else."

"Where are the blood gas analysis results? Bring them over and let me take a look."

Blood gas analysis showed pH 7.39, partial pressure of carbon dioxide 38mmHg (normal), partial pressure of oxygen 326mmHg, oxygen and hemoglobin 46%, COHb 0.2%, methemoglobin 59%, and reduced hemoglobin 0.

"No, why is the methemoglobin so high?" Gao Feng found something suspicious, "What do you think?"

"Congenital methemoglobinemia? Severe intravascular hemolysis?" Dong Qianqian said.

"Hemolysis will definitely not be considered. As for congenital methemoglobinemia..." Qin Hao scratched his head, "Probably not."

"Then we have to consider toxic methemoglobinemia!" Gao Feng had an idea in his mind.

"What did you eat before you got sick? Are there any pickles or something like that?" he asked Wang Laishun.

"Eat it. My wife bought it in the supermarket."

"He ate a big bowl!" Qin Hao's aunt added, "He loves to eat this, he has to eat it every time."

"It should be nitrite poisoning."

Nitrite poisoning is mainly caused by excessive intake or misuse of industrial nitrite. The former is relatively mild.Nitrite poisoning caused by the latter is not only severe, but also has a rapid onset. Generally speaking, poisoning can be caused by ingesting 0.2 to 0.5 grams of nitrite.

"You have completed the mission of knowing everything, and you have gained 15 skill points."

The incubation period of nitrite poisoning varies, depending on the amount and concentration of nitrite ingested.The longer one lasts 1 to 2 days, while the shorter one lasts only about 10 minutes.Usually poisoned children are the first to have symptoms, manifested as cyanosis, chest tightness, dyspnea, shortness of breath, dizziness, headache, palpitations, etc.

Severe poisoning may also cause nausea, vomiting, slow heart rate, irregular heartbeat, restlessness, low blood pressure, pulmonary edema, shock, convulsions or convulsions, coma, and finally death due to respiratory and circulatory failure.

For the above-mentioned symptoms caused by eating green vegetables or eating short-term pickled vegetables recently, the skin and mucous membranes are typically blue-gray, blue-brown or blue-black, and it should be highly suspected of nitrite poisoning.

"I won't let you eat, but you have to eat. Now it's better, I feel better!" Auntie was very angry.

"Forget it, forget it, don't talk about him, he is still feeling uncomfortable right now." Qin Hao advised.

Mild cases of nitrite poisoning do not require special treatment. They can usually recover on their own after being told to rest and drink plenty of water. Uncle Qin Hao, for example, needs medication. 1% methylene blue can be given at a dose of 1 to 2 mg/kg of body weight. The dose is diluted to 5% glucose solution for intravenous infusion, and symptomatic and supportive treatment is given.

Wang Laishun was successfully discharged from the hospital three days later.

"Eat less pickles from now on and watch more JK." Qin Hao instructed.

Today's regular trainees are very busy. According to regulations, each department must take an exit exam at the end of the rotation. However, in most cases, this exam will be postponed. After all, the hospital is too busy and it is difficult to leave the regular trainee department. Can't play at all.

There is a joke that directors can have no subordinate doctors, but they must not lose the trainees.

The exit examination of the respiratory department includes a written test and a practical test. The written test covers the diagnosis and treatment of common diseases. As long as the training is well planned, most people will be fine.

The operation is relatively difficult. Thoracentesis closed drainage seems simple, but there are still many details to perform.It's easy for doctors who have been working for 2 years to master it easily, but trainees may not be so casual. Many students can't even do aseptic operations well.

Qi Nannan said that there was no pressure, she was good at this, and the simulators were pricked by her.

"Hey, classmate, don't leave. You are here to invigilate the exam. Group 7 is missing someone, so you can make up for it." The teaching secretary grabbed her.

"Qi Nannan! Why are you sitting here?" Cheng Song was a little shocked when he came back for the exam.

"Too good, I've upgraded." Qi Nannan was very proud, "Do your best, Xiao Cheng. If you fail, you will be deducted points."

...Cheng Song

"Hu Jiaran, you are not coming to the exam?" Qi Nannan sent a message to Hu Jiaran.

"I even dropped out of the training, and I still failed to pass the first-level exam." Hu Gong said arrogantly, "Brother, my career is booming now."

He is in a good mood recently, and the progress of the laboratory has far exceeded expectations. For the sake of money, Professor Tao has been very active in his work recently, and his efficiency has improved significantly.

The two newly arrived doctors also successfully integrated into the group. Many things that seemed complicated before were now broken down by others, and the people below immediately had a direction.

Hu Jiaran was planning to ask Gao Feng for guidance on the next experimental process.

"I advise you not to waste time in the hospital. At your level, it will be the same with or without you. Why not join our company directly." Hu Jiaran advised, "There is still a shortage of people here. It will be difficult to wait any longer. .”

When he said this, Qi Nannan immediately became anxious. She didn't want to continue the regular training. She was busy all day long, writing medical records, doing ward rounds, accompanying serious patients for examinations, and sometimes she had to do some chores, such as running. Take medicine and withdraw medicine.The most annoying thing is that sometimes I have to endure the white eyes of patients.

The key is that the salary is too low. Last month she was paid 3456 yuan. This amount of money cannot mobilize her enthusiasm at all.

It's reasonable for you to give me such a small amount of money just to fish, right?Qi Nannan thought to herself, not even a little bit guilty.

This is called having a clear conscience.

"Mr. Hu, what should I do if I go?"

"Buy meals for everyone, clean up and so on. When our airport is built in the future, you can also become the cafeteria aunt."

"Ah?" Qi Nannan was dumbfounded, "No, Hu Gong, I am also a college student after all. Isn't it too low of rank to do this?"

"Are you coming or not?"

"Come on!" Qi Nannan gave in. She could raise mice before. If she really became a cafeteria aunt, she would be raising people. Is this an upgrade?
In fact, Hu Jiaran was teasing her. The laboratory currently lacks a logistics staff to interface with the company's finances. Employees' attendance and various expenditure declarations need to be reported in a timely manner. The company's system is becoming more and more perfect. Zhao Xingye is stuck in this area. Very strict.

(End of this chapter)