Gou is practicing medicine in the clinic

Chapter 181 Make another contribution, surgery invitation

The evening before yesterday, Professor Wu was able to take the initiative to wait for him in the outpatient clinic, and intentionally repaired the relationship with Li Jingsheng.

It shouldn't be that far.

Of course, the best way is to become stronger.As long as Li Jingsheng can perform better in the Second Hospital, Professor Wu will naturally weigh the consequences of offending him.

As long as she is not a hungry ghost, she will definitely give up her perverted thoughts about Ou Qinglan.

Judging from the fact that Professor Wu looked very calm and rational when Li Jingsheng took Ou Qinglan away at the drinking party that night, Professor Wu is a sensible old hooligan.

He probably won't do things that cost too much.

Li Jingsheng and Ou Qinglan went to the consultation room together, maybe out of consideration of influence, or because the girl has a thin skin, she walked in front.

Did not dare to walk side by side with Li Jingsheng.

Even so, it still caused those nurse girls to cast strange eyes and smile ambiguously.

It is quite normal for young male and female doctors and nurses to fall in love.

It's just that as colleagues, it's inevitable to make fun of it.

When the two parties achieve a positive result, everyone will send blessings together.

Whether it is a doctor or a nurse, it is a very hard and boring profession.Find a little fun now and then, this is a rare happy time for everyone.

With a thin skin, Ou Qinglan couldn't resist the strange looks from the nurses, so she stepped into the consultation room.

Li Jingsheng didn't care.

Having opened the clinic for nearly a year, his face has long since worn thick, and he has become very mature, and he doesn't care what other people think of him at all.

As long as you are doing well.

Entering the consultation room of the Orthopedic Surgery Department, Professor Wu was already sitting at the main seat.

Ruan Xiaoqin and two other doctors were also present.

Ou Qinglan sat in the last seat, who was more ladylike.

There are also three interns or regular trainees sitting there, all very young.

The second group is very weak. Ruan Xiaoqin is probably the stronger one under Professor Wu.

The third strongest among the remaining people is Dr. Qin, who is infinitely close to the strength of attending.

The others are basically shrimp soldiers and crab generals.

This shows that the strength of the second group of orthopedic surgery is very weak, with a single force and a lack of middle and senior doctors.

If the other groups of orthopedic surgery are in the same situation, it means that the strength of the whole orthopedic surgery department of the Second Hospital is not good.

Many of these people present have met face to face.

All of these people were present at the wine bureau that night.

The number of people is not small, and there are eight people in total.

It's just that there are no great masters.

Li Jingsheng originally thought that the diagnosis level of orthopedic surgery was only at the level of a senior resident doctor, so he should not be ranked in the second group.

Hehe, now it seems that there is no problem for him to rank fourth.

If the extraskeletal diagnosis is upgraded to another level and reaches proficiency, it will immediately rank among the top three.

It is not difficult to understand that the female patient who was rescued the day before yesterday had a poorly stitched leg wound.

"Professor Wu, I have nothing to do anyway, can you come in and study?"

"welcome!"

Professor Wu forced a smile on Li Jingsheng.

Li Jingsheng unceremoniously sat down beside Ou Qinglan.

Professor Wu on the stage twitched twice, looking down at the information.

did not say anything.

Compared with the attitude towards the two of them the day before yesterday, it seemed like a different person.

This is the usefulness brought by the display of strength.

Seeing Li Jingsheng's great potential, Professor Wu changed his attitude towards him.

"Sorry, I'm late!"

Doctor Qin hurried in.

Then he sat down in an empty seat next to Ruan Xiaoqin.

He is the number three in the second group, which can also be seen from the seating arrangement.

Seeing that Li Jingsheng also came to the consultation room and sat with Ou Qinglan, he was full of depression.

"Everyone is here, let's start! The first case discussed, the patient underwent open reduction, internal fixation with plates and screws, and ulnar head transplantation in our hospital more than a year ago. Stretch out the palm of your hand, the pain is severe..."

Professor Wu started to play the PPT.

"Dr. Ruan, you are in charge of this patient. Do you have any good surgical plans and suggestions?"

"I have given it to Dr. Ou, who is my subordinate, and let her practice her clinical diagnosis and treatment skills. Doctor Ou, tell me your opinion."

Ruan Xiaoqin is too cunning.

Cases that he couldn't handle by himself were thrown to the doctors below.

"Dr. Ou's medical license has passed the exam. Although he is still in the training period and has not yet graduated from the master's degree, he is about to graduate soon. At that time, he will be an official resident doctor of our orthopedic surgery department, and he will practice his clinical diagnosis and treatment ability. It's still necessary."

It turned out that she hadn't graduated yet, no wonder she was coerced by Professor Wu to participate in the wine bureau that night and couldn't refuse.

Postgraduate masters in medicine, if they are specialized masters, they will have four certificates in one when they graduate, and they can apply for jobs directly.

Unless you enter the top three hospitals such as People's Hospital and Qiaobang Hospital, you may be required to train for another one to three years, and you will be allowed to work after passing the qualification.If you go to an ordinary third-level hospital, you can basically apply for a job after graduation.

Ou Qinglan stood up and said nervously, "I... only have some basic solutions. The current patient's cause is caused by enlarged osteophytes. Surgery should be the only solution."

She basically said nothing.

Professor Wu was expressionless and shook his head slightly.

"Sit down!"

Obviously, he was not satisfied with Ou Qinglan's answer.

He looked at Ruan Xiaoqin and Doctor Qin, there were only two generals under his command.

"Doctor Qin, you have studied this case for a long time, let me tell you your opinion first."

Ruan Xiaoqin gestured in the tone of a senior.

"I think that the osteophyte stimulates the surrounding soft tissue to cause the patient's pain. Moreover, the patient's wrist soft tissue is swollen, and surgery to remove the osteophyte is the first choice. The only difficult thing now is the recurrence problem. I also ask the two superior doctors for advice."

Doctor Qin talked about it, but also did not give a solution to the problem.

Just pointing out the key issues.

He naturally kicked the ball back to the two superior doctors.

There is a strict doctor hierarchy in the hospital. When encountering problems that cannot be solved, interns and regular trainees can find resident physicians, and resident physicians can find attending physicians, and attending physicians can find chief physicians.

This is only right and proper.

Therefore, the chief physician has no strength and cannot lead the group at all.

Otherwise, I will be slapped in the face every day, and I will lose face!
Professor Wu is able to lead the group, largely because of his special skill in bone cement treatment.

In the Second Hospital, he was the only one.

"Dr. Li and Dr. Ou sat together and discussed for so long, and there should be some gains, right? Why don't you talk about it."

Ruan Xiaoqin now grabs a shield if he can.

Even Li Jingsheng, a guest, was arrested by him.

"I?"

Facing the eyes of everyone, Li Jingsheng could only stand up.

It must be mentioned here that according to the rules, it is more polite to stand up and speak out of the respect for the superior doctors.

It depends on personal wishes.

Everyone speaks standing up, and there is only one resident doctor who is independent and self-important, and that must be a loss of points.

Doctor Qin looked at him slightly mockingly.

Seeing Li Jingsheng's surprised expression, he guessed that Li Jingsheng must have been unprepared.

Then wait to make a fool of yourself.

Among the dwarfs, he was the general. His performance was better than Li Jingsheng, and he could win back some favors in front of Ou Qinglan.

"I am not good at orthopedic surgery, so I would like to share some immature suggestions. If there are any mistakes or omissions, please correct me by the superior doctors."

Since I asked him to talk about it, let me express my opinion.

It's just a discussion anyway.

He ignored Dr. Qin's mocking eyes.

"I checked the literature and found that this kind of osteophyte on the bone stump is almost an inevitable disease of surgery. It is inevitable. The reason is that the bone stump is unstable, and when it shakes, it stimulates the periosteum and soft tissue, which leads to subperiosteal bone formation. I think For a radical cure, I think the osteophyte cannot be removed only during the operation, otherwise it will definitely recur. It is best to remove the bone stump together with the surrounding periosteum.

Of course, I have never done this kind of operation. I would like to ask Professor Wu to correct me if it is feasible. "

Li Jingsheng talked eloquently and gave a less specific operation plan.

But the direction and goals are clear.

The bone stump, osteophyte and periosteum were all removed.

Professor Wu's eyes hidden behind the glasses suddenly lit up, and he couldn't help looking at Li Jingsheng with a look of extreme admiration.

"The key to osteophyte formation is the periosteum. Removing the periosteum together seems bold, but it is actually feasible. This treatment plan is in line with my point of view. After the operation is completed, it should be able to be done once and for all to avoid recurrence."

The whole place was dead silent.

Doctor Qin looked at Li Jingsheng with disbelief. He couldn't believe that such an advanced surgical plan and clinical knowledge of orthopedic surgery came from Li Jingsheng's mouth.

The other doctors looked at him equally in shock.

Several interns even looked at Li Jingsheng with admiration, as if Li Jingsheng was the goal of their future efforts.

Ruan Xiaoqin's face became a little weird, he really didn't expect Li Jingsheng to be so strong.

Ou Qinglan laughed like a flower.

"You can, you can answer such a difficult question, and really give a solution!"

Beauty is in the eye of the beholder.

When she looks at Li Jingsheng now, everything is pleasing to her eyes, and she feels that he is the only man in the world.

It's her dish.

"Hey, that's just a mistake."

Li Jingsheng laughed dryly.

It would be nice if one day I could achieve something tangible and become a member of that international medical forum.

Only by becoming a member can we have the opportunity to discuss medical problems with those top international surgeons.

I felt that I had the courage to give the operation plan just now, and got the affirmation of Professor Wu, so I should have gained life points.

He secretly checked, 107.

He was rewarded with 50 health points.

And the proficiency of extraskeletal diagnosis +10.

This is too cool.

"Let's discuss the second case. This patient is only 18 years old. Three years ago, she had intermittent pain in her right wrist, which would be relieved on its own in a few days. Recently, the pain has worsened and her forearm rotation is limited, which has seriously affected her life and study. Come to our hospital for treatment."

The PPT slideshow is played on the big screen.

It can be seen that the X-ray of the patient shows that the proximal pole of the scaphoid and the radial side of the lunate are attenuated with neat margins.

"This case is difficult to diagnose. The cause is unknown now."

Professor Wu said, and played the second slide, this time it was a CT film.

The patient's wrist was also taken.

In terms of clarity, the carpal bones shown on X-rays are a little clearer, especially the outline of the bones.

The film effect looks whiter.

The rendering of CT is a little darker, but the details are more accurate.

If it is not difficult to understand the cause, it is impossible to check CT for the patient, because the price is much more expensive.

CT showed a hypodense area at the scapholunate joint.

Li Jingsheng thought to himself, the diagnosis of this kind of bone disease makes me touch my bones!
The effect of small-level bone palpation is no worse than that of CT.

Patients can also eat less radiation and spend less money.

After checking the X-ray and CT, the conclusions drawn are actually similar.At this time, it may be suspected that the patient has a tumor, and the possibility of malignancy is high.

Therefore, Professor Wu gave the patient a more advanced examination, MRI.

As a result, T2W1 showed uniform high signal at the scapholunate joint, suggesting that the lesion was fluid.

I have to say that the modern inspection equipment is quite good, and the cause of this patient has been found out.

Even Li Jingsheng, who is half-level, already knew that the patient had a ganglion cyst in the carpal bone.

"After reading the third slide, I believe you already know the diagnosis. That's right, it is an intraosseous ganglion cyst, which is just a relatively ordinary tumor. It is not a malignant tumor. Before it was found out, I would replace it The patient sweated a little, fearing that it was a bad tumor."

Although Professor Wu's personal morality in terms of men and women is very poor, he still retains the original intention of a doctor for patients.

This also made Li Jingsheng know him again.

There are no absolute bad guys or good guys in the world. In the final analysis, they are all for their own selfish desires.

"This time, everyone can speak freely and talk about the operation plan."

Professor Wu convened a discussion with his doctors, and after solving the most difficult case, the second case seemed to be for teaching rather than discussion.

It can be seen that he has put some painstaking efforts in training these doctors under his hands.

"I'll say it first!"

Dr. Qin lost a game to Li Jingsheng, at this moment he seized the opportunity to stand up and rush to perform.

"Most ganglion cysts are approached from the back of the hand, but the CT and MRI of this patient can accurately confirm that the tumor is located on the palm side, so I think it is better to choose the palm side approach..."

Dr. Qin's surgical experience is really not a cover.

It is quite rich.

I must have seen more than one ganglion cyst operation, and may even participate in many cases.

After he finished speaking, Professor Wu nodded with satisfaction.

"Well, not bad. Xiao Qin usually worked hard, and I will try my best to train you for this operation when the time comes."

Doctor Qin was overjoyed when he heard this.

I was so happy that I couldn't close my mouth.

"Thank you Professor Wu for your cultivation! I will definitely study harder and strive to become the pillar of the second group as soon as possible."

Professor Wu nodded repeatedly.

Ruan Xiaoqin smiled and boasted beside him, "Dr. Qin is already the pillar of our second team, what are you waiting for!"

"Haha, I don't dare to take these two words now, at least I will have to wait until I am promoted to an attending physician before I dare to think about it. At present, the pillars of the second group are only Dr. Ruan and Professor Wu."

The two kiss each other's asses.

"Doctor Li, don't say a word! Also tell me your opinion."

Dr. Qin was very proud of being praised by Professor Wu.

He gave Li Jingsheng a provocative look.

"I don't have any opinion, but if I haven't discussed the operation with the patient yet, I can try manual therapy in the past, and maybe the operation can be avoided."

Li Jingsheng said lightly.

Ganglion cysts, if severe, can only be treated with surgery.

If it is not serious, some can be massaged directly by pressing it down.

When Dr. Qin heard that Li Jingsheng could treat with manipulation, he couldn't help but laugh.

I thought I was awesome, but I didn't expect that people don't need surgery at all, just massage and massage can get it done.

However, only Dr. Xu and Li Jingsheng have the highest level of manipulative orthopedic reduction.

Other doctors in orthopedic surgery, including Director Hua, are also skilled in this area.

"Manipulative treatment is fine, there is no need to create side effects. Moreover, the patient's cyst is larger, and surgical treatment will be more thorough."

Professor Wu directly refused to allow Li Jingsheng to try manual therapy.

This is for the benefit of the department.

How much does manual therapy cost?
50 yuan?

Up to 200 yuan tops the sky.

The total cost before and after an operation is less than 2000 yuan, which is a shame for his title of director.There is a high probability that it will reach more than three thousand.

In fact, most tumors, even if they are benign, are basically five thousand and up.

The bigger ones are difficult to deal with, that is, the jump of ten thousand and ten thousand.

"Let's discuss the third case..."

Professor Wu was also worried that his doctors said he looked ugly, so he immediately turned to the discussion of the third case.

"I have to go back to work in the outpatient clinic. Goodbye everyone."

Li Jingsheng glanced at the time, it was almost one o'clock, and he had to go back to the clinic quickly.

"Dr. Li, if you have time after work later, you can come over to participate in the osteophyte removal operation. I will give you some opportunities to practice properly depending on your ability."

Professor Wu stopped him.

This man is really interesting.

Is it because Li Jingsheng played a neutral role in formulating the surgical plan for this case, giving some benefits?
Or don't want to owe Li Jingsheng love?
There is also a deeper consideration, to repair the relationship with Li Jingsheng, and even win over this kind of talent to the second group?

"Doctor Ou will also participate at that time."

Seeing that he hesitated, Professor Wu added another sentence.

When other residents had the opportunity to perform this kind of operation, they rushed to do it.

Li Jingsheng is not an ordinary resident doctor, he has an attitude of indifference, which makes Professor Wu very depressed, so he can only move out Ou Qinglan, a beauty.

"Haha, okay, I'll come over after work in the evening."

The beauty trap has been used, and it will not work if you don't agree!
……

Back at the outpatient clinic, Li Jingsheng's bone-setting technique is a grand slam this time, and there are no shortcomings, just one word, do it.

For every patient who comes, one is cured.

His life value and the proficiency of various bone-setting techniques are increasing rapidly.

Dr. Xu was watching from the side, feeling really relieved.

Even his originally pale and sickly face looked much better.

Seeing that the apprentice is so promising, he quickly learned all the techniques of bone setting. It must be a joy to be a teacher!

There is a successor.

Busy until 05:30 in the evening, all the patients have been dealt with.

There was one case that could not be cured, so he had to be hospitalized for surgery.

Everything else is done.

Not all fractures and joint dislocations can be treated with manipulative reduction.

Many of them are incurable and must be treated by means of surgery, steel plates, screws, and traction.

After get off work, Li Jingsheng went directly to the cafeteria to eat.

Then go straight to the orthopedic surgery inpatient department, ready to participate in the operation.

(End of this chapter)