Gou is practicing medicine in the clinic

Chapter 403: I finally got a ticket to save my life. The big man is in a disadvantageous situation.

Adenomas are very distinctive.

The vast majority of adenomas are benign, slow-growing, and easily treated.In general, adenomas are not prone to malignant transformation.

But when it becomes malignant, it ceases to be human.

Breast cancer is the second leading killer of women.

Not to mention pancreatic cancer, which is known as the king of cancers and makes everyone blush.

This patient's condition is extremely special.

After Li Jingsheng's repeated inferences and the latest test results, it can be basically determined that the liver disease was the first to occur.And it is very likely to be a malignant tumor.

But primary hepatic malignant tumors tend to be huge.

In fact, even benign liver tumors are often very large.

Li Jingsheng checked the patient's chest and abdomen. Although there was a barrel chest, the abdomen was still normal.No lumps were palpable.

Among liver malignant tumors, cholangiocarcinoma and cystadenocarcinoma are characterized by slow growth and liver metastasis.

Li Jingsheng suspected that the patient might develop cholangiocarcinoma first and then develop liver metastasis.

Only when cholangiocarcinoma develops to a certain extent, a mass in the upper abdomen can often be felt.

Obvious symptoms such as fever and jaundice may occur.

The strangest thing about this patient is that he has no obvious symptoms of jaundice.

Lian Tao was worried that the patient would die, so he invited an expert from the oncology department to come over for consultation overnight.

Not long after, a fat, middle-aged male doctor with a shaved head came over.

The appearance is very ordinary.

"Let me introduce, this is Dr. Li Jingsheng from the Second Hospital, and this is Director Meng Zeran from the Oncology Department of our People's Hospital."

Lian Tao introduced the two to each other.

"Hello! Recently, I have often heard about Dr. Li's reputation for bone-setting techniques."

"Hey, that's just a side skill that can't be put on the stage. Director Meng is the one with a real reputation. I saw your name in the new edition of the textbook on tumor immunology."

Li Jingsheng has actually seen this big boss's name.

People who can compile textbooks and medical books are basically experts.Or have a very high reputation in the industry and have outstanding skills.

This is also one of the highest honors in the minds of countless doctors.

Medical technology is developing rapidly, and many theories ten years ago are wrong or have been eliminated, so the preparation and updating of teaching materials is extremely important.

"Haha, it seems that Dr. Li has a wide range of interests! When he wrote the textbook, he also wanted to spread his medical skills to more future generations. I was so busy chatting that I almost forgot about the real thing. Let's discuss the patient's condition first."

Director Meng Zeran smiled very happily.

It shows that Li Jingsheng's flattery just now made him feel very comfortable.

In fact, Meng Zeran is not the editor-in-chief of that textbook, but one of the editorial committee members.

The compilation of a textbook usually requires dozens of experts.

The number of chief editors ranges from about two to as many as five or six.

The number of editorial board members is quite large.

In terms of influence, the editor-in-chief definitely weighs a lot more.

Even so, being able to participate in the compilation of teaching materials is still what Meng Zeran is most proud of.

After seeing the patient's condition, several people sat in the lounge to discuss the cause of the patient's illness.

"Jingsheng, please introduce your diagnostic ideas! Director Meng has extremely rich experience in the field of tumors, especially in hepatobiliary diagnosis."

Li Jingsheng briefly explained his diagnostic ideas.

Meng Zeran said nothing after listening, but carefully checked the patient's blood and urine routine test results.

"White blood cells, neutrophils, and C-reactive protein are all elevated to a certain extent. Although not very obvious, they are higher than normal values. Dr. Li believes that there is a problem with the liver. I am not sure about this. But the patient's bile duct appears. problem, I support this opinion.”

After listening to Meng Zeran's opinion, Lian Tao was a little puzzled and said, "But no obvious tumor was found in the patient's abdomen! Moreover, the patient's symptoms were not obvious and there were almost no symptoms.

The patient had neither ascites nor liver enlargement, nor obvious upper abdominal pain, high fever, chills and other symptoms. "

Lian Tao himself is also a chief physician in the field of gastroenterology.

Although he specializes in gastroenterology, the gallbladder is also a part of the digestive system.

Although the gallbladder is small, its role is not small.

For example, it emulsifies fat through intestinal to liver circulation, which facilitates reabsorption in the small intestine.

You will feel uncomfortable after eating greasy food.

Without the gallbladder and liver working silently, secreting and concentrating bile, and reducing the surface tension of fat, it would be unimaginable to imagine a series of consequences.

Lian Tao also suspected that there might be something wrong with the patient's bile duct.However, the patient had no symptoms, and no abnormalities such as tumors were found on chest X-ray, so he ultimately rejected the idea of ​​a gallbladder problem during the diagnosis.

"Director Lian must have encountered patients with cholangitis, right?"

"We meet occasionally."

Lian Tao nodded in confirmation.

"Are there any early symptoms of cholangitis?"

Director Meng Zeran asked with a smile.

"Uh...it depends on the situation. Some patients will have high fever, jaundice and other problems. Some patients have no symptoms."

"This patient now belongs to a small group of special patients. According to my experience, not only is there something wrong with the patient's bile duct, but there is also a real possibility of a malignant tumor, and it is most likely to be cell carcinoma."

Meng Zeran said so definitely, there must be a reason for him.

"I suggest that the patient be tested for tumor markers immediately. After the diagnosis is clear, endoscopic ultrasonography can be performed. If the patient's conditions permit and the family agrees, PET-CT examination can be considered."

I feel like these experts are really ruthless when conducting inspections.

As long as the cause of the disease can be found, nothing else will be considered.

On the other hand, Li Jingsheng, who runs a clinic, seems a bit petty and considerate of patients and their families.

When diagnosing a disease in a clinic, giving patients an ultrasound examination or X-ray examination that costs 100 yuan, and they also have to work hard to do their ideological work.

If the fee is too high, the patient will not come next time and it will be a big loss to the clinic.

……

After investigation, it was finally determined that the patient had cholangiocarcinoma with liver metastasis.However, the overall assessment situation is quite satisfactory.

All we can say is that this patient’s life is really tough.Li Jingsheng also received the coveted huge life value reward, 1000 points.

The diagnosis in this case was so traumatizing.

It's enough to stump a lot of experts.

The main reason is that the course of the disease is too long, which greatly increases the difficulty of diagnosis.

This is a bit like police solving a case. If the crime takes too long and the clues have disappeared, it will be very difficult to solve the case.

Who would have thought that in this case of respiratory failure and heart failure, the first lesion would be the bile duct.

Li Jingsheng initially thought that the liver was the first lesion, but it was eventually found to be liver metastasis from cholangiocarcinoma.

Sometimes, it is not necessarily a good thing if the organs are close to each other.

Like this patient's liver, it was like a fish in a pond.

The successful diagnosis of this case is of great benefit to every doctor involved in the consultation.

Medicine is like this. It has a long road ahead, and we can only continue to accumulate experience so that future generations will avoid detours.

After identifying the cause of the disease, we discussed with the family and agreed to perform surgery on the patient.

The patient was scheduled for surgery the next day.

Li Jingsheng did not know the specific surgical process.I heard from Lian Tao that Anesthesia had a quarrel with the surgeon and was finally persuaded by the surgeon.

The operation was successfully arranged.

On the third day after the operation, good news came again. The patient's physical signs had not worsened and had stabilized.

But this is just a life-saving ticket for the patient.

If heart failure and respiratory failure are not resolved, sooner or later this life will not be saved.

Through this consultation, Li Jingsheng's relationship with Director Rong deepened.At the same time, I met a new chief physician.And he is the chief physician of the oncology department, which he is not very good at.

Every expansion of personal connections means that he will get more opportunities in the future.

……

The days passed quickly like this day by day.

The diagnosis and treatment business of Sunshine Clinic has become more popular than before, with more patients coming for treatment.

Being slandered by the boss of Limin Clinic not only did not bring down Li Jingsheng, but made Sunshine Clinic stronger.

Li Jingsheng is well aware of the diagnosis and treatment business.

We do not dare to expand the recruitment of doctors and nurses on a large scale, but maintain the status quo for the time being.

If he meets a particularly good doctor or nurse, he doesn't mind taking them in.

Anyway, there are plenty of places.

The one that has benefited the most is his clinic’s drug sales business.

Online drug sales more than doubled.

The offline drug sales business has not grown much, but the intra-city drug purchase business has quietly increased.

After this incident, citizens seemed to have more recognition and trust in Li Jingsheng and Sunshine Clinic.

On this day, Li Jingsheng was sitting in the Second Hospital.

His arm is now mostly healed.With the sutures removed, you can engage in some simple strength movements.

But it would take time for the wound to recover, and he still didn't dare to try any movement that was too strenuous.

As a doctor himself, he is quite proficient in surgery, so he naturally understands the wound healing period.

Several of his doctors have received a lot of training opportunities these days.

Including Yang Luqing also got some training opportunities.

But on the day Li Jingsheng was assassinated, his indifferent and timid behavior was still like a thorn between the two of them.

Although in the dangerous situation at that time, he had no obligation to step forward to save Li Jingsheng.

Because his life is also life.

People are selfish.

However, if people only talk about interests and not feelings, it will seem to be inhumane.

Liu Xian has not returned to work yet.

He wanted to come back, but Li Jingsheng scolded him and refused to let him come back.Let him rest at home for a week.

And assigned some learning tasks to Liu Xian.

Even a fool can see that Li Jingsheng has begun to take special care of Liu Xian.

"Teacher, what do you want to eat for lunch today? I will line up and prepare it for you now."

Yang Luqing is trying hard to find ways to remedy the situation and repair the relationship with Li Jingsheng.

He knew very well that if he could not get Li Jingsheng's forgiveness, it would probably end in disgrace.

"No, no, my girlfriend bought it for me! Thank you!"

Li Jingsheng was very polite to him.

The more this happened, the more uncomfortable Yang Luqing felt.

Once upon a time, the teacher also treated him like a family member.

"Ye Hui, let me help you make food!"

Yang Luqing was frustrated in his career, and he wanted to make achievements in love.

He pursued Ye Hui with Jin Yanyu, and the competition between the two never stopped.

But the current situation is getting worse and worse for him.

Since the assassination of Li Jingsheng, colleagues seem to have underestimated Yang Luqing because of his timid and selfish behavior.

Although no one said it, Yang Luqing could feel it.

"I'd better fight it myself!"

Ye Hui refused directly.

Yang Luqing felt uncomfortable again.

He walked out of the clinic silently and walked towards the cafeteria in a low mood.

(End of this chapter)