This doctor has a system

Chapter 242 230. Dare to challenge Gao Feng without looking at how much he weighs.

Zhou Gaojin's symptoms are not very typical. His hepatosplenomegaly is not obvious, there is no obvious melanin pigmentation on his skin, and his face looks quite white.

"It's so rare that you let me get it?"

"The Chosen One?"

Zhou Gaojin looked depressed.

"Let's not talk about the chosen one, how did you come into contact with the sandfly?" Dong Qianqian was a little curious.

Adult sandflies usually inhabit dark, windless places indoors and outdoors, such as house corners, wall cracks, livestock sheds, underground kilns, cave dwellings, bridge openings, etc.

The same species of sandfly can show different habitat habits due to different environments. For example, the named subspecies of Chinese sandfly is a domestic type in plain areas, inhabiting human houses and livestock houses; in the northwest plateau, it is a wild type, which is more common in various species. Inside the cave.Sandflies have weak mobility and their activity range is generally within 30m.

"Aren't you an employee of the Science and Technology Bureau? You should work in the office, right?"

Zhou Gaojin was a little embarrassed. Their science and technology bureau was just a decoration. He was so idle all day long that he would leave as soon as he got to work. He didn't even return to work in half a month.

"Some time ago, I went fishing on the river embankment with some colleagues. I was responsible for making nests. At that time, I felt as if I had been bitten by something."

"I didn't care at the time. Who knew I would get kala-azar."

Some fishermen are called "nest-making immortals". They rely entirely on making nests for fishing. If they exchange 10 pounds of bait for a small fish, without them, more than half of the fish school may starve to death.

"Hey, that's not right. Why is my colleague okay?" Zhou Gaojin was unhappy, "Why? It's my fault for co-authoring, right?"

"The chosen one." Dong Qianqian comforted, "It's not without its benefits. At least I succeeded in losing weight."

"That's true." The family members echoed at the side, "In the past, I just shouted slogans to lose weight, and I couldn't lose 2 kilograms in a year. But I have lost dozens of kilograms in this month. The effect is too outstanding."

It's just that the price was a bit too high, costing tens of thousands here and there.

Once the cause is clear, the next step is treatment.

The first-line treatment for kala-azar is sodium antimony gluconate, which is a specific treatment for Leishmania infection.

But what everyone didn't expect was that the hospital did not have this medicine.Dong Qianqian called the Provincial Center for Disease Control and Prevention, but received no reply.

"I haven't seen anyone get it for many years. The previous batch of drugs have expired." The staff said on the phone, "If it doesn't work, I will give you the manufacturer's phone number. You can contact him."

What makes people even more distressed is that after finally contacting the manufacturer of the drug, they said that the manufacturer has closed down.
"What the hell, what should I do?" Zhou Gaojin almost cried. Isn't this just a prank on him?
Fortunately, after asking around, we found that there was a manufacturer that produced sodium antimony gluconate. Zhou Gaojin’s family booked a ticket overnight to go to the production site and finally bought the medicine.

After standard medication, the patient's body temperature began to drop on the fourth day. After 9 days of treatment, Zhou Gaojin's body temperature was completely normal.After second-generation metagenomic sequencing, it was found that the Leishmania protozoa in his body had disappeared, his weight had not dropped, his complexion had recovered, and all indicators on review had improved.

After 21 days of hospitalization, Zhou Gaojin was finally discharged and returned home.

"The strange fever task has been completed, and you have obtained 15 skill points." The system issued the reward.

Gao Feng was a little dissatisfied. He felt that he did a good job, so why did he deduct 5 skill points?

"It is not recommended to rely too much on high-tech detection methods." the system explained.

"You fart!" Gao Feng retorted, "High technology is invented to be used. Besides, this patient's condition is very bad, and there may not be any accidents if he is delayed."

"Hurry up and return my 5 skill points to me!"

The system didn't kill him.

"Let's go out and have a good time!" Zhou Gaojin held on to Dong Qianqian and Gao Feng.

"No need."

"It's really not necessary."

"I have to express my gratitude." Zhou Gaojin was a little dissatisfied, "I don't want to give you any red envelopes, and I don't want to go to eat. What do you want to do?"

"Oops, who sent the banner? It seems that it is not hung tightly and is about to fall off." Dong Qianqian said.

"It's pretty solid." Gui Peisheng looked up.

"Patients just like to give these things, but in fact it is not necessary. Hanging the pennant takes up space, and it has no particularly huge effect." Dong Qianqian continued.

"Yes! There's no real way to eat." Zhou Gaojin said, "Let's go eat Haidilao?"

"No!" Dong Qianqian turned away and left. This person had been having a fever for too long, and his brain was obviously burned out, so he couldn't hear what he was saying.

"Why don't you send me a banner?" Gui Peisheng said to Zhou Gaojin, "Teacher Dong seems to really want it."

"Look at you, I already said I don't want it, so why are you still giving me away?" Dr. Dong Qianqian's face burst into laughter, "You're giving me two sides at once. Aren't you spending money indiscriminately?"

How hypocritical, Zhou Gaojin thought to himself, if you want you to speak directly, there is no point in talking about it.

Two Banners is much cheaper than Haidilao, which saves money.

"Quickly, take pictures." Dong Qianqian called Gao Feng over, and a graduate student took a few photos with his mobile phone.

"This doesn't work, the focus is not right, it's all blurred."

"Change your phone and take a few more pictures. You're not good at taking photos."

"You have received the heartfelt thanks from Zhou Gaojin and his family, and you have received 2 skill points." The system prompted.

Gao Feng is very satisfied. Now it has become his habit to send discharged patients downstairs, and most of the time he gets results.

Of course, there are also some old people who say thank you with their mouths but are completely insincere in their hearts.
-
Noon, Z University Pharmaceutical Laboratory
"What to eat?" Wang Liang asked.

"Braised chicken?" Yue Penghui
"Let's change it to another one. This is what I ate yesterday."

"Lanzhou noodles?"

"Let's go back to the braised chicken." Wang Liang sighed. They had almost eaten it all around the school, and the taste was just the same. He didn't want to go downstairs at noon now, and just wanted to order a takeaway.

"Eat less at noon, and I'll invite everyone to make skewers in the evening." Hu Jiaran walked out of the office. The test progress has been very fast these days, and Mr. Hu is very satisfied.

"Hu Gong is mighty!"

"Hu Gong Gao Yi!" A group of people began to flatter him.

"Brothers, I have a question about playing basketball. I don't know if I should talk about it or not?" A voice rang.

Hu Jiaran was about to leave, but when he heard this, he turned around and came back.

"Come on, as long as it's playing ball, we're all interested."

"What kind of protective gear do you usually wear when playing ball?"

This is a good question, and everyone started a lively discussion.

"I won't take them with me. We have strong control. When the time comes, we can just withdraw outside the circle and take action."

"Me too!"

In fact, most players still wear them because it involves safety issues. A small oversight on the court may be related to human life, so you should not be careless.

Someone named Fu Xingyuan summarized it.

"Choosing a good protective gear is like a tiger in the water, a bird in the forest, and a bird in the forest."

"So my suggestion is, first, choose the appropriate size based on the size of your shooting hand to prevent the protective gear from breaking."

"Second, pay attention to the material. Most protective gear is made of natural rubber, but some players are allergic to natural latex and can choose other materials."

"If the opponent doesn't mind, you can choose some protective gear with wolf-like protrusions on the surface, which can expand the range of the cylinder, increase the intensity of confrontation, and make it difficult for the opponent to defend."

After learning another useful piece of knowledge, Hu Jiaran left with satisfaction.

At 10 o'clock in the morning, in the respiratory department classroom, a case discussion within the department was in full swing.

Patient, female, 18 years old

The patient had recurrent cough, sputum, yellow purulent sputum and white sticky sputum in the past six months. The cough was obvious at night, accompanied by chest tightness and shortness of breath. There was no fever, night sweats, hemoptysis, nausea and vomiting, no nausea and vomiting, and no headache. At first, he did not pay attention to it. I have had a cough for the past month, and the expectoration has worsened.

He was hospitalized in the District People's Hospital from 10.15 to 11.18. He was given anti-infective treatment and improved slightly, but he relapsed in the short term. From 11.25 to 12.17, he was hospitalized again in a hospital in Puyang City. He was given ceftazidime combined with amoxicillin and clavulanate potassium to fight infection. His cough improved. Because tuberculosis cannot be ruled out, he came to our hospital today for outpatient treatment.

The financial conditions of the patient's family are not good. His mother died of cervical cancer in his early years, which cost a lot of the family's savings.My father's education level is not high and he is currently engaged in some manual labor. His income can only support the family's normal expenses.

It was my aunt's wish to come to the Provincial People's Hospital to see a doctor this time. She felt very uncomfortable seeing her niece like this and wanted to go to a big hospital to see her again.

Since the onset of the disease, the patient has been eating well, sleeping well, has normal bowel movements, and has not lost physical strength or weight.

He was in good health in the past and denied any history of tuberculosis, chronic gastric disease, or hepatitis B.

Physical examination: body temperature 36.5°C, pulse 90 beats/min, respiration 20 times/min, blood pressure 105/66mmHg.She is clear, with no jaundice on the skin and mucous membranes of the whole body, no palpable swelling of superficial lymph nodes, clear breath sounds in both lungs, and moist rales can be heard, regular heart rate, no pathological murmurs, soft abdomen, no tenderness, and no pain in both lower limbs. Swelling, negative pathological signs

Auxiliary examination: Discharge summary from a hospital in Puyang City: blood routine was normal, nine respiratory tract infection pathogens were normal, biochemistry was normal, PCT0.08ng/ml↑, BNP was normal, and electrocardiogram was normal.

12.10 Chest CT: Scattered patchy consolidation, spots, fibrous shadows, nodular shadows, bronchiectasis, and tree-in-bud sign were seen in both lungs. The lesions were distributed along the airways, which was better than the lesions in 10.15 CT.The flow velocity decreases in the middle stage of lung function, indicating small airway dysfunction.

Examination on admission: normal blood routine, normal coagulation test, normal PCT, normal D-Dimer, normal hcrp, normal stool routine, normal biochemistry, HBA1C 5.2%, ESR 36.0 mm/h, and urinalysis was normal. PPD was negative, MPCP was negative, A-immunity was normal, G+Gm+ endotoxin was negative, HBV, HCV, HIV and syphilis were negative.

C6 negative, total IgE 558 iu/ML, allergen negative.

The patient seems a bit taciturn, but according to the child's aunt, the girl has good grades in high school and should have no problem getting a bachelor's degree.

Most children from poor families are not confident and even have low self-esteem. This girl is a single parent and has become even more taciturn after being hospitalized this time.

After admission, the doctor in charge actively performed a bronchoscopy on her. The results showed that the walls of the bilateral main bronchus and each leaf segment of the bronchus were mildly to moderately congested and swollen, the mucosa was slightly rough, and a small amount of viscous white gray pus was scattered along the wall. , intermittent overflow of the left upper branch and middle lobe bronchus during coughing, clear it, make the lumen unobstructed, and lavage the middle lobe bronchus.No specific new creatures were seen.

Endoscopic diagnosis: bronchial inflammation (moderate), injection of medicine. BF STB (-) 3 times. Under the BF cytology microscope, many neutrophils and a few degenerated and necrotic ciliated columnar epithelial cells were seen.Mold smear negative, Xpert negative. T-SPOT negative.

Sputum culture showed multidrug-resistant Pseudomonas aeruginosa.

The doctor in charge introduced the medical history in such detail that many trainees almost fell asleep.

"We invite everyone here this time to discuss why patients suffer from bronchiectasis." The doctor in charge said the purpose of this discussion.

The patient's diagnosis of bronchiectasis is clear, and the high-resolution CT shows it clearly, but why did she suffer from this disease at such a young age?
As we all know, the main cause of bronchiectasis is infection. If the inflammation of the bronchi and lungs is not controlled in time, and the exudate blocks the trachea, it will lead to the formation of bronchiectasis.

But this patient was quite strange. She had no obvious prodromal symptoms before the onset of the disease, but gradually began to cough and expectorate without fever.

Many directors, including Director Shen and Director Zhao, did not come to this case discussion. There was a meeting where everyone was called over, and the meeting was chaired by Gao Feng.

"This case is still very necessary to discuss." As usual, Gao Feng wanted to say a few words first to mobilize everyone's enthusiasm for speaking.

Suddenly a discordant voice rang out, "I don't think there is any need to discuss it."

Hey, who is this?Gao Feng was shocked. How dare anyone in the respiratory department speak against him now?I wonder if he is a popular person in front of Director Shen and other directors.

The person speaking seemed to be about the same age as him, a relatively handsome young man.

Gao Feng was a little confused, where did this person come from? He seemed to have never seen him face to face.

"Ai Hongkai, the newly recruited doctor this year." Li Youliang said to him in a low voice, "I was in severe respiratory condition before and was just transferred here."

"Dr. Ai, do you have any advice?" Gao Feng said with a slight smile.

"I dare not take it seriously. I think the diagnosis of the patient's condition is very clear. It is ordinary bronchiectasis. It is inappropriate to waste everyone's time here."

"I have more than 10 patients under my name, and some of them are in serious condition. I think there is no need to waste time in such meaningless discussions."

The scene was very quiet for a while, and everyone was shocked. This man was so fierce, he dared to say anything.

"This guy is definitely going to be in trouble. He dares to challenge Gao Feng and doesn't care how much he weighs." Someone whispered.

"It's just that if a newcomer dares to be so arrogant, he really doesn't take us old people into consideration."

Although Gao Feng has only been in the hospital for less than a year, he has already established a high prestige in the department by solving difficult cases time and time again.

(End of this chapter)