This doctor has a system

Chapter 226 214. Dong Qianqian’s highlight moment
"President, do you want to continue moving forward with this matter?" Qianye asked, "I think it is very bad to use these crooked ways. After all, we still have a cooperative relationship with Fengxin Technology."

The catalytic substrate is something the company cannot lose at this stage. Professor Takeda has been clamoring for Fengxin Technology to fulfill the contract in a timely manner.

"If we piss off the other company, our research and development of monoclonal antibody drugs will be severely restricted."

"It may even jeopardize the company's long-term interests."

President Fujimoto Kimura nodded in agreement. He did not object to evil ways, but this thing was always a auxiliary. Their company could survive for hundreds of years because of its huge investment in research and development and the vast majority of its employees. Identify with the accepted company core value system.

"So be it, don't lose the big for the small."

Chiba and Arakawa Takudai walked out of the president's office together.

"Arakawa-kun, I advise you to just collect intelligence honestly from now on, and please don't interfere in specific matters at will." Chiba said, "Your reckless behavior is likely to cause us huge trouble."

"The China of today is not the China of 20 years ago. Their supervision in all aspects has become increasingly strict."

"When you are collecting intelligence, it is best to isolate yourself so as not to go in and step on the sewing machine."

"You don't have to worry about it." Arakawa Takudai obviously didn't appreciate his kindness. Why do I step on a sewing machine? Do you know how cautious I am in doing things?
Dong Qianqian was smiling happily as she accepted the patient's banner. The gold-rimmed banner had eight characters written on it: "Excellent medical skills, Hua Tuo is reincarnated."

"Look at what kind of banner you are sending!" she "complained", "This is what I should do."

"Dr. Dong, thank you for saving my dad's life. Thank you so much." A young man was very excited.

The matter started 2 weeks ago, when she was invited to the nephrology department for consultation.

This is a patient with acute renal failure. The patient has been in the hospital for more than two months. His current condition is relatively stable, but he has to come to the hospital for dialysis twice a week.

"I've been having a cough these past few days, and a chest CT showed a lung infection." The bedside doctor said to Dong Qianqian, "Can you tell me what antibiotics are more suitable?"

Dong Qianqian carefully looked at the chest CT and combined with the results of blood routine, she felt that the pneumonia was not serious.

In the past, she must have simply auscultated the patient's lungs and then wrote a consultation opinion. Doctors in large hospitals are very busy, and some things are really not done so meticulously.

But following Gao Feng these days, she gradually developed a good habit of comprehensive physical examination.

"There are a few crackles in the lungs, which is consistent with the signs of pneumonia."

"Hey, you can't hear any vascular murmur on his ventral side, but the murmur on his back is very obvious and very loud."

Dong Qianqian was a little curious. This was obviously a problem. She ran to the doctor's office and looked through the patient's medical records carefully.

"Why is your blood pressure always so high?"

"It should be renal hypertension." The bed doctor said, "The patient has no history of hypertension before."

No, if it is renal hypertension, why is the blood pressure still high after dialysis?But if it is not renal hypertension, then why is there no history of hypertension before?

Moreover, the medical instructions showed that the patient had recently been pumped with urapidil, but his blood pressure did not drop significantly.As an antihypertensive drug, urapidil is used to treat hypertensive crisis (such as a sudden increase in blood pressure), severe and extremely severe hypertension, and refractory hypertension. It has a strong antihypertensive effect.

"The reason is really unclear." The bed doctor said, "The ultrasound shows that his renal arteries are not narrowed."

"Could it be that the report was wrong? Or maybe I didn't see it clearly?" Dong Qianqian said loudly, "There was a loud murmur on the patient's back."

"No way?" The bed doctor thought it was impossible.

Dong Qianqian immediately called Gao Feng and told him about the patient's condition.

"Is there a loud murmur in the renal artery auscultation area? Then we still need to consider renal artery stenosis."

"But the color Doppler ultrasound was not reported." Dong Qianqian said.

"Were you there when the color Doppler ultrasound was done?" Gao Feng asked, "Go and check it again. It's best to follow it in person."

After hanging up the phone, Dong Qianqian immediately communicated with the bed doctor, who was quite moved by her responsible attitude.

"Wait a minute, I'll shake someone up."

"No, I have a day off today, why are you looking for me? I won't go!" Director Yuan Dezhao of the color ultrasound room was not very happy. He only had one day off in a week, and you still called him. Are you polite?
"You see well."

"The patient can't survive without you."

"We clinicians need highly skilled sonographers like you."

"You are flattering me!" A smile appeared on Director Yuan Dezhao's face, "I will be there in 20 minutes."

"Where does the former director live?" Dong Qianqian said, "It's not appropriate to ask someone to come here if it's far away."

"The family members live in our hospital. His wife is still working today, and his son is in college, so he is very free." The doctor in charge said with a smile. The former director's wife was a nurse in their department.

"This is a big problem. Who made the report?" The expression on Yuan Dezhao's face was very ugly.

"Color Doppler ultrasound at the community hospital? Forget it, their machine is not good, and sometimes I don't blame the doctor."

The patient's aorta is blocked below the renal artery. One side of the renal artery is blocked and one side is stenotic.

Dong Qianqian and the doctor in charge of the bed were both shocked, "That's not right. Is it okay for the patient to walk and run? Where does the blood in the arteries of his lower limbs come from?"

The former director immediately took the ultrasound probe and looked forward, and found that the arteries in the patient's lower limbs were compensated from the small collateral vessels in the abdomen.

The truth was finally revealed. The patient's acute renal failure was due to a blood vessel problem.

"Turn around, once I perform the operation on you, you might not need weekly dialysis in the future." The doctor from the vascular surgery department said to the patient.

"Uuuuuuuuuuu, are you telling the truth?" The patient cried out, tears and snot flowing out from his nose.

This patient is quite pitiful. His family's financial situation is not good. He usually sells fast food on the roadside and is exposed to the sun and wind all day long. His child has just entered college.After suffering from acute renal failure, he suddenly lost his ability to work. Dialysis twice a week was a heavy burden on his family.

The patient once had thoughts of committing suicide.

After he was transferred to another department, the vascular surgery department successfully opened his narrowed renal artery. The patient's urine output increased that afternoon. Within a few days, his creatinine dropped to normal and his blood pressure returned to normal.

"Thank you." The patient bowed solemnly to Dong Qianqian when he left.

"Today is really my highlight moment." Dong Qianqian was very happy. This day was also a turning point in the patient's fate. Life with dialysis and without dialysis is completely different.

"In view of the outstanding performance of the subordinate doctor, you have obtained 2 skill points." The system prompted.

What about this good thing?Gao Feng was extremely happy.
-
In the afternoon, Gao Feng received a call from his second aunt's brother who was far away in the capital. He and Li Xinyao had met each other once when they got married. "Uncle, what can I do for you?"

"Your sister has a heart disease, and the doctor here said it's quite serious." Gao Feng's uncle was very worried.

His daughter just entered kindergarten this year. During the physical examination, she found a heart problem. She went to the community hospital for a check-up. The doctor was dumbfounded at the time.

"How did you survive?"

"Ah?" Uncle Gao Feng's mind went blank, "Doctor, what do you mean?"

"Your daughter needs to go to a big hospital for treatment." The doctor in the community is still very responsible. "Let's go to Anzhen Hospital. They are very good at cardiovascular disease."

He took his daughter to the Department of Cardiology of Anzhen Hospital, and the outpatient director Han Zhiqing ordered a cardiac ultrasound.

After the results came out, Director Han was dumbfounded. This was the first time he had seen such a willful heart in so many years of work.

"Let's go to the hospital first. We have to discuss it." He considered, "The problem is quite complicated."

The department held a multidisciplinary consultation the next day. Everyone was shocked when they saw this case. Many people expressed their opinions. The final conclusion was: it was recommended that the patient be discharged.

"She will need Rashkind surgery first, then BT shunt surgery, then Glenn surgery, and then Fontan surgery. The key is that she is not fully recovered yet." Han Zhiqing communicated to Uncle Gao Feng, "She can't be discharged for observation. .”

"No, if you can do the surgery, then do it."

"Let me tell you the truth, any operation named after a foreigner is not easy to perform. The risk is not as high as usual. It has to be done four times! You think about it for yourself." Director Han said, "I mean since Now this heart can still function, so don’t recruit it yet.”

"And the cost of this surgery is too scary, you can't afford it."

"So, I want you to help me take another look." Uncle said to Gao Feng, "The child is so young, we can't just leave her alone."

Gao Feng felt very heavy. Anzhen Hospital was one of the best in the country in terms of cardiovascular disease. They all said so, so there probably wasn't much that could be done.

"Send the inspection report over and let me take a look."

Cardiac color ultrasound: tricuspid valve atresia
Ventricular septal defect (subcrestal type)
Atrial septal defect (ostium secundum type)

right ventricular dysplasia
Small inner diameter of pulmonary artery and stenosis of pulmonary artery orifice

Seeing this report, Gao Feng was dumbfounded. What kind of heart is this?It’s so fantasy!
Can people survive with these diseases?In theory, death was inevitable, but by chance, the combination of these diseases allowed the patient to survive.

The tricuspid valve exists between the right atrium and the right ventricle. Blood needs to flow from the right atrium to the right ventricle through this valve. If the tricuspid valve is atretic, this pathway is blocked.

Just imagine, if your respiratory tract is blocked, can you still survive?The answer is definitely no.

But at this time, a miracle happened. The patient had a defect in the atrial septum. The atrial septum is the septum between the left atrium and the right atrium, which is like a wall.But now a window has been opened in this wall, and the blood from the right atrium can flow to the left atrium through this gap.

The blood from the left atrium flows to the left ventricle through the mitral valve. According to common sense, the blood from the left ventricle should directly enter the aorta at this time.

But if common sense is followed, the patient will not survive. Why?

Because the blood flowing from the right atrium to the left ventricle is venous blood, the oxygen content in it is very low, so the blood directly entering the aorta cannot meet the normal needs of the body.

What should I do?
When the operation came, the patient also had a ventricular septal defect.
The blood in the left ventricle flows into the right ventricle through the gap.

It is equivalent to saying that the blood that was supposed to enter the right ventricle from the right atrium through the tricuspid valve made a large circle and although it was completely destroyed, some of it finally entered the place where it was supposed to arrive.

As for the small inner diameter of the pulmonary artery and the stenosis of the pulmonary artery orifice, this is also an indispensable part of the patient's survival.

This is because the pressure in the left ventricle is very high. When it contracts, blood ejects very quickly. Originally, the pulmonary artery cannot withstand such pressure.

But now its diameter has become thinner, the entrance has become narrower, and the pressure problem has been perfectly solved.

This heart stuck bug 4 times and successfully kept the patient alive.

Gao Feng was really shocked. Life will always find a way out. It turned out that this sentence was true.

"Her situation is too complicated." Gao Feng said, "I'll ask experts in this field."

He immediately went to the cardiac surgery department.

"Fuck!" Director Zhang from the Department of Cardiothoracic Surgery couldn't help but curse.

"Is there any good way?" Gao Feng asked.

"No, it is recommended to observe at home." Director Zhang answered without any hesitation, "You may die faster if you put in the effort."

"The patient's current condition is still good. Although he has asthma after exercising, it is not serious, which is acceptable."

"How long can you live?"

"It's hard to say. If you are lucky enough, you should be fine if you live to adulthood, but you will definitely not be able to get married and have children." Director Zhang said.

"She will not be able to do strenuous activities like normal people in the future, and she will eventually die of heart failure."

"It's okay to live to adulthood." Uncle Gao Feng breathed a sigh of relief, "At least the child can see the scenery he wants to see, which is less regretful."
-
"Peng Hui, let me introduce you to someone." A colleague came over and said, "My cousin is about the same age as you."

"Okay, when will we arrange to meet?" Yue Penghui was very positive, but he had no choice but to be greedy by Wang Liang.

"You don't even know how nice it is to have a girlfriend." Wang Liang said.

"Unlike us elders, girls are extremely soft." Wang Liang said.

"It smells delicious, and my wife is very well-behaved." Wang Liang said.

"I can't explain some things in detail, but I understand everything." Wang Liang said.

"Shut up, are you still sleeping?" Yue Penghui was annoyed, "It's said in the song that women are tigers. You are just confused by the other party now."

"You will suffer it in the future!"

He said this, but he was extremely greedy in his heart.The girl he was chatting with before suddenly stopped talking to him. He was just wondering, but he didn't expect that she would make an official announcement in the circle of friends two days later.

He turned out to be the spare tire.

(End of this chapter)