This doctor has a system

Chapter 451 516. No one told me!

"Everyone, please express your opinion." The host said, "The patients and their families are very anxious. If it doesn't work, they will go abroad."

"The level abroad may not be better than ours." A director said dissatisfied, "What age are we in, and the moon in foreign countries is rounder?"

"The key is that our condition keeps recurring, and it's understandable that the patient wants to change places." Someone said something next to him.

"Okay, let's not go too far off topic. Let's see a doctor." The host interrupted the conversation of several people.

"Everyone has seen the patient. Her general condition is still OK. The main purpose of this discussion is the next step of diagnosis and treatment plan."

"Is there any problem with the patient's diagnosis? How to adjust the next treatment plan?"

This patient's situation is relatively complicated. He has been having fever for such a long time and the lesions in his lungs have changed repeatedly. The diagnosis is indeed not very clear, which is a headache.

"I think we should consider infectious diseases." A director of the Department of Infectious Diseases spoke up. He was a bald man wearing glasses, and it was obvious at first glance that he was highly professional.

"The probability of lung tumors is almost zero, and the malignant characteristics of the lesions are not obvious. I still prefer the recurrence of tuberculosis."

Academician Bao's expression suddenly changed. The old man used to have a good temper and was calm in dealing with things. But now I just can’t listen to others saying that Gao Feng is not good.

"Okay, I'll call Huaxin." Academician Bao felt strange in his heart. What does this mean? I'm not good at it?

"Lao Sun is about to retire, so time is precious." A director of the Respiratory Department saw Academician Bao unhappy and quickly spoke up, "But that's not what he said."

Gao Feng responded with the same smile.

"Okay." System.

"Difficult and complicated diseases: Liu Fei's condition is indeed a little complicated, but as long as you search carefully, you can still find some clues. If you make a clear diagnosis, you can get 30 skill points, and if you fail, 10 skill points will be deducted."

Everyone had high expectations for him, but they were still a little disappointed when they heard this.

"Master, this is a doctor." Uncle Zhang said quickly, "A very capable person." After he finished speaking, he showed an apologetic smile to Gao Feng.

"Old Sun, are you getting old and having trouble with your brain?"

For some reason, Gao Feng didn't have the same surprise in his heart as before when he found the correct diagnosis. It seemed that this task was quite simple for him.

Other people's opinions are similar. For medical records with long and complicated treatment times, the examinations are often very comprehensive, and most of the possibilities have been thought of. Even multi-disciplinary discussions may not necessarily be able to solve the problem. Find the problem.

Sometimes, you have to wait until the disease has progressed to a certain stage before you can find the culprit.

"Uncle Zhang, cows and horses." The little boy from the Toyota Alphard pointed at Gao Feng and said.

"You can talk, but you can't talk nonsense." Academician Bao made a concluding speech, "We must pay attention to unity."

"Professor Gao Feng is best at treating these difficult and complicated diseases." Director Fan said to everyone, "It just so happens that he has been in our hospital during this time. Let's see what he says later."

"Isn't this a waste of time?" said a director of the Department of Infectious Diseases named Sun. His voice was neither loud nor quiet, and everyone around him suddenly looked over.

"I agree to have another puncture and see how the pathology report turns out."

"Pulmonary Hodgkin lymphoma."

"You guys?" Director Sun of the Department of Infectious Diseases was shocked, "Nima, what's going on?" Have I dug up the ancestral graves of you people? Each one speaks harder than the other!
"I'm also not interested in people." He muttered for a long time, "What's wrong? You don't want to let anyone talk anymore?"

"Although the lesions were absorbed some time ago, it is likely to be complicated by infection."

Is it because my current rank is too high?

Director Sun is also a veteran. He has had many opportunities to go further before, but when the leader thinks of his character,
"He talks about everything without any hesitation," said the younger director. "Believe it or not, he doesn't even know that Professor Gao is a student of Academician Bao."

His words caused heated discussion among the people.

"You have gained 30 skill points." The system issued the reward simply and neatly.

"It's very possible that she has cancer-related fever."

"No wonder Lao Sun can't become a director. He has such emotional intelligence." A younger director whispered to the person next to him, "I'm even worried for him."

During the discussion between several directors, Gao Feng quickly arrived at the scene. He looked at the medical records carefully and then went to examine the patient.

This disciple satisfied him so much that he didn't like others talking nonsense about him.

A director named Qin from the Department of Rheumatology and Immunology had doubts about the previous autoimmune antibody test. He believed that tuberculosis and bacterial infections would also affect the accuracy of the results.

"Yes, if you are really in a hurry, don't come here next time. You are the best one." Another director said.

Like the previous herpes zoster patient, her initial symptom was chest pain. It was impossible for anyone to get a correct diagnosis from the beginning. The only way to be sure was to wait for the herpes to appear.

"Director Sun, if you are in a hurry, please leave first. I don't think you have any constructive opinions." Someone echoed, turning around and smiling at Academician Bao.

"I feel that what the directors said makes sense." He said during his speech. "Although the current inspection is very complete, it still seems to be a bit foggy."

"Oh, is it a waste of time for others to say a few words? Didn't you just talk a lot of nonsense?" Director Fan from the rare disease clinic spoke up before Academician Bao.

"Academician Bao, where is Professor Gao Feng?" Director Fan from the rare disease clinic asked, "Let him also say a few words."

"But I still have some ideas." Gao Feng didn't care about Director Sun's opinion, "Can the surgeon just cut off this piece?"

Academician Bao felt very comfortable and responded with a warm smile.

"I think we still need to do another puncture and send it to pathology." A director of the Department of Respiratory Medicine said, "The tumor cannot be ruled out. There is necrosis and cavities inside."

"Why not? Lao Sun never cares about these things. I don't know if he is stupid."

"No way?"

"System, can I take a guess first?" Gao Feng asked. The name of a disease suddenly popped into his mind just now.

"After the previous anti-tuberculosis treatment, the lesions were obviously reduced significantly." Director Sun of the Department of Infectious Diseases sneered at Gao Feng's words, "What is the point of resection?"

Academician Bao also frowned. From his experience, the possibility of lung cancer is very small. If it is not lung cancer, resection seems a bit drastic.

Although he didn't like Director Sun's speech a little, what the other party said seemed to be reasonable.

"The results will be more accurate if the lesions are removed and sent to pathology." Gao Feng considered, "Also, I think PHL needs to be ruled out."

"PHL?" Some directors looked confused.

PHL, also known as pulmonary Hodgkin lymphoma, is a rare malignant tumor outside the lymphatic hematopoietic system. It only accounts for 0.5% to 1% of malignant lymphomas. Domestic and foreign literature are mostly case reports.

The disease is divided into two types: primary and secondary. Primary is very rare, and most are secondary. They are caused by direct infiltration, spread or dissemination from lymph node lesions in the mediastinum, hilus or other parts to the lung parenchyma. Due to the lack of specificity of clinical symptoms and imaging manifestations, the clinical misdiagnosis rate is high, and pathological examination is the main basis for the diagnosis of PHL.

"How could it be PHL?" Director Sun of the Department of Infectious Diseases spoke louder, "Do you understand or not?!"

Academician Bao's frown deepened. He didn't like Director Sun's speech very much.

“The histological feature of this disease is that classic RS cells are seen in a background of multiple reactive inflammatory cells. RS cells and atypical RS cells are the true tumor cells of HL.

The pathological types of PHL mainly include tuberous sclerosis type and mixed cellular type. Among them, tuberous sclerosis type is the most common type of classic type, accounting for about 60% to 70%. "

"Moreover!" Director Sun emphasized his tone, "The rare manifestations of this disease are nodules or masses with cavities, pneumonia and lung consolidation, and the imaging manifestations are mainly cavities or cysts.

"The formation of cavities is caused by necrosis within the tumor, and miliary pulmonary lymphoma is even rarer!"

The scene was very quiet for a while.

"This old grandson still has something in his stomach." Someone whispered.

"Yeah, I just checked it and it's very comprehensive."

"But it must have made Bao Yuan morale angry. Look at the old man's face turning green."

Academician Bao's brows furrowed into the Chinese character "Sichuan". He disliked Director Sun's speech very much and had a negative opinion of this person.

"Isn't this high level of talent a bit exaggerated?" A director said softly to the familiar person next to him, "You are so young, why don't I believe that your clinical level will be very high?"

"No, no, Professor Gao does have two skills." The other party replied, "I asked him to see patients before, and he has real skills."

"Really?!"

Gao Feng suddenly admired Director Sun. The incidence rate of pulmonary Hodgkin's lymphoma was very low, but when he talked about it, he felt like he could easily get it.

"Has Director Sun studied this before?" he asked humbly.

"Yes, I have diagnosed a patient like this before." Director Sun's tone revealed a little bit of pride.

That was 7 years ago. The patient was a 55-year-old middle-aged woman. She had visited many hospitals all over the world and traveled abroad before she was finally diagnosed with him.

They also gave him a plaque with the four characters "Miaoshou Rejuvenation" written on it, which he still has.

"But the low incidence rate does not mean that it does not need to be ruled out." Gao Feng said, "Based on the existing test results, the probability of PHL is still quite high."

"Haha, have you ever encountered such a patient before?" Director Sun smiled, "I think you are quite young."

"We have previously developed treatment plans for patients with refractory large B-cell lymphoma." Gao Feng replied, "I also paid attention to Hodgkin's lymphoma at that time."

"The difference between these two diseases is huge." Director Sun said, "You have little clinical experience, so you still need to study hard later."

Academician Bao's face turned even more ugly. It was only green at first, but now it is black and green.

But Director Sun obviously didn't realize that he continued to talk to Gao Feng in a lecturing tone.

"I'm still somewhat sure." Gao Feng said, "If this piece can be cut off, there should be no problem in confirming the diagnosis."

"Then talk to the patient? Cut it off and take a look?" the doctor in charge said.

"This is not nonsense." Director Sun was interrupted by Academician Bao before he finished speaking.

"I think it's okay! Let's talk to the family members now!" Academician Bao said simply, "Even if it's not PHL, cutting it off will help with diagnosis!"

Director Sun obviously had an opinion, but when he saw Academician Bao's cold eyes, he didn't dare to say anything.

"Why does Academician Bao defend Gao Feng so much?" he asked the director next to him in confusion.

"I am a student of Academician Bao!" The director looked at him like he was a fool, "You don't know?!"

"I don't do it!" Director Sun was shocked, "No one told me!"

"Then did you not know who this Gao Feng was before?"

"Don't talk about before, even now I don't know who he is." Director Sun was stunned for a while, "What? Is he famous?"

"I just talked about the matter. Academician Bao won't hate me for this, right?" Director Sun said.

"That's not true." Halfway through the director's words, he suddenly saw Academician Bao staring at Director Sun coldly, "It's hard to say, I think. Who knows?"

The patient and his family quickly agreed to the suggestion of surgical removal of the upper lung lesions. It was obvious that the patient was suffering from the fever.

"Arrange the surgery as soon as possible. If it is PHL, then we will have to organize everyone to learn more." Academician Bao instructed the doctor in charge, "Mr. Sun must come to participate when the time comes."

"Okay." The doctor in charge responded quickly, "But what if it's not PHL? Are we still allowed to come?"

"Then why are you here?" Academician Bao said dissatisfiedly, "When you have that time, you can think of a solution for the patient! Humph!"

"Okay, okay." The doctor in charge broke into a sweat.

After everyone left, the doctor in charge sighed helplessly.

"This Director Sun almost made me scolded."

"Old Sun is indeed a little bit." Someone in the department laughed, "Academician Bao obviously protects his student, he doesn't seem to be able to tell."

Gao Feng accompanied Academician Bao through the small garden downstairs, where some patients and family members were enjoying the sunshine and fresh air, which made people feel full of vitality.

There are two or three little birds hanging on the branches. Sometimes they chirp happily, sometimes they rest quietly on the branches, giving people a kind feeling.

"The scenery here is not bad." Gao Feng said casually.

"It's been like this for decades." Academician Bao stopped and looked around, "I remember there was a lake in front of it, why is it gone?"

"Last year, a tumor patient was put in," Xiong Huaxin said, "and he came up on his own two days later."

The hospital later simply filled it in.

"That's a pity." Academician Bao said.

Gao Feng didn't know whether he was talking about the lake or the patient, or both.

(End of this chapter)