This doctor has a system

Chapter 243 231. I will beat you to death with a stick today (please give me a monthly ticket)
Medical care is no different from most industries. If you talk too much, people will only give you superficial respect.

But if you can talk it out and do your job beautifully, over time, everyone will definitely trust you.

Because of his skill points, Gao Feng always likes to explain the problem thoroughly every time he helps others solve a problem. He is also afraid that the other party will not understand.Every time he spoke truthfully and followed his instructions, the patient's problem was indeed solved.

His prestige increased day by day, and it was not all because of Director Shen that everyone admired him.

"Although the diagnosis is clear, the cause of the disease always needs to be found. The patient is so young and when he comes to us, we must give him an explanation." said the doctor in charge.

He was very unhappy. What happened to Ai Hongkai?You don’t have to come if you don’t want to come, I didn’t invite you.You came here uninvited and said you were wasting your time.

This man is really a badass!

Gao Feng obviously felt that the other party was coming for him. He was a little confused. He was so kind to others every day, but he was still a kid who scattered money. Are you embarrassed to target me?

Because of him, the performance of the respiratory department has also improved in terms of distribution coefficient, and everyone has benefited. What are you dissatisfied with, Ai Hongkai?
Of course Ai Hongkai was dissatisfied. He felt very uncomfortable when he saw Gao Feng's success in the respiratory department day by day.

He was a doctor from Beijing Medical University and could be admitted to the hospital at that time. Why he came to Hnan Provincial People's Hospital was not because he would rather be the head of a chicken than the tail of a phoenix.

There are too many talented people at Peking University. Although he is excellent and his mentors value him very much, it is too difficult to get ahead.It's different with H Nan. His academic qualifications and school background are still very impressive.

In fact, this was indeed the case. When he came to the hospital for an interview, the hospital leaders all thought highly of him. He was given a lot of cakes and Ai Hongkai was fed well.

Director Shen also thought highly of him at first. Considering that he had been engaged in scientific research for a long time and had average clinical skills, he specially arranged for him to be rotated for severe respiratory disease.

The rotation was going well, and when the high wind came, he was like the sun covering up the light from Ai Hongkai.

Gao Feng was doing well in scientific research and had developed a natural talent. His clinical skills were even better than his own, and he even became a billionaire. Ai Hongkai felt that his days in the provincial medical field were over.

He really couldn't bear it today and wanted to confront Gao Feng head-on.

"Dr. Ai, what do you think is the cause of the patient's illness?" Gao Feng was not angry. On the contrary, he hoped that Ai Hongkai would dance more realistically, so that maybe the system could issue a slap in the face task or something.

"What could it be? It's an infection."

That's it?Gone?Gao Feng was a little disappointed. This man wanted to be a thorn in the side and didn't review his lessons in advance. He just said these two sentences in vain, which made him a little confused.

"Dr. Ai, no, please tell us about the situation where bronchiectasis requires further special examination to determine the cause." Gao Feng wanted to give him a chance, but he did not regard the other party as an opponent of the same level at all.

Ai Hongkai's face was a little red, and he really couldn't explain. In the past, patients with this kind of bronchiectasis were treated with regular anti-infective treatment, and little attention was paid to the cause of the bronchiectasis.

This is because bronchiectasis cannot be reversed over time. What can we do if we know the cause?
"We are a teaching hospital, and there are many graduate students in the department. Sometimes we have to think more deeply about the pathogenesis of some diseases." Gao Feng said calmly, "Let me briefly explain to you, the graduate students Go back and read some more books."

"When patients with bronchiectasis have clinical features of PCD, it is recommended to screen for PCD. The detection methods include testing of nasal exhaled nitric oxide concentration, nasal mucosal biopsy, and high-speed video microscopic analysis to measure ciliary swing frequency."

“If patients with bronchiectasis have clinical features of arthritis or other connective tissue diseases, it is recommended to detect rheumatoid factor, anti-cyclic citrullinated polypeptide (CCP) antibodies, antinuclear antibodies, and ANCA, etc.”

"For patients with bronchiectasis and a history (or symptoms) of gastroesophageal reflux or aspiration, it is recommended to undergo gastroscopy, gastroesophageal pH testing, esophageal impedance testing, etc. to screen for gastroesophageal reflux disease."

"Patients with limited lesions should pay attention to the medical history (such as whether there is congenital bronchopulmonary dysplasia, pulmonary sequestration), and it is recommended to undergo bronchoscopy to exclude intratracheobronchial lesions or foreign body obstruction. Patients with dry cough as the main manifestation can also be Perform bronchoscopic aspiration of lower respiratory tract secretions and bronchoalveolar lavage, and perform microbiological culture on the samples.”

"If patients with bronchiectasis have recurrent multi-site or opportunistic infections, specific antibody deficiencies (such as CVID, specific polysaccharide antibody deficiency) need to be ruled out. The baseline level of Streptococcus pneumoniae capsular polysaccharide-specific antibodies can be measured. If patients with bronchiectasis have Based on the clinical characteristics of CF, it is recommended to perform 2 sweat chloride tests and

Ai Hongkai's face turned pale. A small bronchiectasis, is it so particular?His master's and doctoral projects were all in the direction of tumors, and he really didn't know much about bronchiectasis.

And deep down, he looked down on these "minor illnesses".It’s great to engage in oncology. There are many hot spots, many topics, many funds, and a lot of money.

"This patient is 18 years old. CT imaging shows that the lesions are mainly in the upper lungs. In addition to bronchiectasis, there are centrilobular nodules, tree-in-bud sign, patchy shadows, fibrous cord shadows, nodular shadows, etc.

Imaging does not rule out tuberculosis and non-tuberculous mycobacterial infection, but routine testing of PPD/T-SPOT is negative and does not support tuberculosis infection, and sputum and BF acid-fast staining and mycobacterial culture are negative, TB-DNA, TB-RNA , Xpert and other tuberculosis molecular biology tests are all negative, and negative NTM-PCR does not support tuberculosis/non-tuberculous mycobacteria infection.After improvement, rheumatism and immunity related tests were all normal.

Although IgE is elevated, blood routine EOS is normal, and Aspergillus fumigatus m3 in the ABPA set is normal, which does not support the diagnosis of ABPA.

The sputum and BF culture results showed that multidrug-resistant Pseudomonas aeruginosa is one of the common pathogens of bronchiectasis. Combined with repeated infections since childhood and repeated use of antibiotics, it is consistent with the clinical practice.

No other clues related to sinusitis, joint pain, rash, acid reflux, etc. "

"Based on the above clues, the patient has been suffering from recurrent lung infections since childhood, and the possibility of bronchiectasis should be considered as congenital diseases such as PCD or CF. Since the patient has no visceral transposition, etc., and the bronchiectasis is mainly in the upper lungs, bronchiectasis Column-like high-density shadows (more mucus secretion) can be seen inside, which does not rule out cystic fibrosis (CF)."

Cystic fibrosis (CF) is an autosomal recessive disease caused by mutations in the CFTR gene.

CFTR gene variation mainly affects the function of chloride ion channels, causing increased mucus secretion in the respiratory tract, pancreas, and sweat glands. Therefore, classic CF clinically manifests as bronchiectasis mainly distributed in the upper lobe, pancreatic dysfunction, and increased chloride ion secretion in sweat.

Gao Feng finished speaking in one breath and felt a little tired. Li Youliang on the side quickly took a bottle of mineral water, opened it and handed it to him.

"Dr. Ai, what I said is not perfect. Do you have anything to add?"

You little boy, if you dare to shame yourself in front of me, I won't take care of you!I'll beat you to death with a stick today.

Ai Hongkai said nothing.

"Do you remember?"

No one said anything. You talked too much. Our poor brains cannot accept so much knowledge at the same time. Many graduate students only feel drowsy.The quality of this batch of students is not good. Gao Feng is a little disappointed. I have talked so much about co-writing, but I can’t get a bit of wool out of it, right?
"Your erudite and professional medical knowledge has had a profound impact on Ai Hongkai, and you have gained 5 skill points." The system prompted.

This Dr. Ai is still somewhat capable. Gao Feng suddenly felt that it was normal for such a person to be dissatisfied with him. He could not be beaten to death with a stick.

Those who can contribute skill points are all my family members, so I can’t let my family members feel cold.

"Dr. Ai, I am planning to launch a scientific research project in the near future. You might as well participate in it," he said.

Ai Hongkai was a little surprised and confused. What did this person mean? Shouldn't he pursue the victory at this time and continue to verbally attack me?
"I am planning to conduct a study on the incidence of bronchial asthma, which will be carried out in two months. Are you free?"

"I should have it, right?" Ai Hongkai was very hesitant. Is there some conspiracy?he thought to himself.

"That's okay. The project will be divided into two experimental groups. You will lead one group and Dong Qianqian will lead another group. I will send you the process after a while." Gao Feng was very happy. He had gained something today. Ai Hongkai Being able to bring him 5 skill points at once shows that the opponent is by no means a mediocre person like Guo Yuxin.

After the show ended, Li Youliang asked his question.

"How can you be so nice to him?"

"He is the number one person of his age who openly questions you. At this time, he should be taught a lesson and let everyone know the consequences of disobeying you!"

"You say that as if I'm some kind of big boss." Gao Feng said with a smile.

Aren't you?Li Youliang thought.

"Besides, he's not the first one. Wasn't there Shi Peiyuan before?"

Li Youliang laughed, "If you didn't mention it, I would have almost forgotten about this person."

In fact, Shi Peiyuan did a pretty good job in the scientific research department, and Xiong Huaxin left a lot of things to him. The latter is now an excellent scientific research migrant worker. Maybe if he accumulates for a while, his rank will be raised one level.

"Peiyuan, did you know that Gao Feng in your department is now completely developed!" Xiong Huaxin said. Shi Peiyuan had just reported to him the progress of the experiment.

"It's the first imitation and has passed clinical trials. Do you know how much the licensing fee is?"

"I'm afraid I'll scare you if I tell you."

"Are you curious!"

I'm curious about your uncle's size. Shi Peiyuan picked up his things and left.

"2 million a year!" Xiong Huaxin's voice came over, "Peiyuan, are you shocked?"

Shi Peiyuan shook slightly and left without saying a word.

"This kid has quite a strong determination." Xiong Hua thought confidently. He was shocked when he first learned about the licensing fee. Ordinary people would never earn so much money in a few lifetimes.

When Shi Peiyuan returned to his residence, he took several deep breaths. His hands were shaking a little, and he slowly turned the beads with his right hand. Perhaps due to excessive exertion, his fingers looked extremely white.

"The orioles in the Jade Palace of Jinling crow at dawn, and the flowers on the Qinhuai Water Pavilion bloom early. Who knows how easy it will be for the ice to disappear! I watched him build the Zhulou, watched him entertain guests, and watched his tower collapse!" He said softly.

If Gao Feng were here, he would definitely look at Shi Peiyuan with admiration. Not only did this kid memorize Buddhist scriptures, but he could also compose poems.

As expected of a doctor, his brain is very good.

"Where are you? Come to my office." Dean Guo called.

After hanging up the phone, Gao Feng was a little puzzled. The fully degradable biovalve had just been reported to him two days ago. What did he want to do with him now?

"Dean Guo, congratulations." He said after knocking on the door and entering.

"Congratulations or not." Dean Guo said with a happy expression on his face, "Dean is not easy to do. I only feel the pressure now, but it is not as easy as when I was the deputy before."

It sounds nice, I really want you to be the deputy all the time, I guess you can jump up, Gao Feng thought to himself.

"How are you doing in the Department of Respiratory Medicine?" Dean Guo asked.

"It's good. Director Shen thinks highly of me." Gao Feng was stunned for a moment before replying. Don't you know very well how I am doing? Why do you ask so suddenly?
"The hospital is planning to establish a general medical department. Do you have any ideas?"

General medicine is a comprehensive medical professional discipline oriented to the community and families that integrates clinical medicine, preventive medicine, rehabilitation medicine and humanities and social disciplines. It is a secondary clinical discipline.

General practitioners, also known as family doctors, are new doctors who have received specialized training in general medicine. They are health service providers who perform general medical care and provide high-quality, convenient, cost-effective and integrated medical care to individuals, families and communities. Health care services, doctors who carry out comprehensive and responsible management of life, health and disease.

General practice means everything, including internal medicine, surgery, gynecology, pediatrics, otolaryngology, dermatology, etc.For many things, once the breadth becomes wider, the depth will definitely become shallower. This is an eternal truth.

However, sometimes some things may violate this rule. Gao Feng knows one thing. It is usually short and small, but at critical times.
Shouldn’t general practitioners be in community hospitals? "Gao Feng was a little puzzled. Setting up a general medicine department in a tertiary hospital sounds a bit unreliable.

As we all know, the departments of large tertiary hospitals are very detailed. In small county hospitals, orthopedics may be just one department, but in provincial hospitals, orthopedics is subdivided into trauma orthopedics, spine orthopedics, joint orthopedics, sports medicine orthopedics, hand surgery, Foot and ankle surgery, etc., can be further subdivided if necessary.

The more detailed the analysis, the more professional the doctors doing it will be. This is also the reason why many patients come to the provincial hospital for treatment.

Nowadays, a general medical department is established in a large tertiary hospital with very detailed professional departments. Isn't this a reversal of history?
"I don't know anything about this." Gao Feng replied. He was a little confused. Why did Dean Guo tell him this?Is it possible that this matter is going to happen to him?
(End of this chapter)