White armor

Chapter 289 Clinical Practice Must Be "Greasy"

Chen Yong did not ask why. After the emergency department drew blood and gave him symptomatic treatment, he took the blood collection tube and went straight to the emergency room for testing.

Without wearing a mask, Chen Yong stood in the emergency laboratory, chatting and laughing while waiting for the test results.

Blood potassium 1.87mmol/L!

Hypokalemia!

No wonder he looked listless and his electrocardiogram also had problems. It turned out to be caused by hypokalemia!

When the results were handed over to the emergency doctor, the doctor looked at Chen Yong with a strange look in his eyes.

After being given the appropriate treatment, Chen Yong finally felt relieved.

"Let's go eat!"

"Brother Yong, why did you think of calling Senior Brother Luo?" Zhuang Yan came over and asked Chen Yong.

"I feel like something's wrong, but I don't know what it is, so of course I have to call someone." Chen Yong answered as a matter of course.

"There's something wrong with the patient. I calculated that he might die suddenly in two hours. Once you have a confirmed diagnosis, just ask Luo Hao directly."

Chen Yong has summed up a set of effective "clinical experience".

"..."

"..."

Meng Liangren and Zhuang Yan were sweating profusely.

This way of "confirming the diagnosis" sounds extremely unfamiliar, and it is the first time I have seen it in clinical practice.

"Brother Yong, are you accurate?"

"Of course, there is no problem with the six-line hexagram, except that Kaiyuan Tongbao is not used. For this little thing, there is no need for Kaiyuan Tongbao, just count with your fingers."

"Then calculate it for me." Zhuang Yan believed it.

"If there is nothing wrong, then there is no fortune telling." Chen Yong said with a smile, "Brother Yong, I will perform a magic trick for you later."

"Tsk~~~You call this clinical experience?"

"Of course!" Chen Yong ignored the sarcasm in Zhuang Yan's words and answered as a matter of course, "As for calling people, it was all taught by Luo Hao. We came back from abroad and went to the Union Hospital to take a look, and we happened to encounter an incident of mushroom poisoning."

Zhuang Yan listened attentively and attentively.

"I was standing at the back at the time. No matter what others did, I couldn't do it. But I believed in Luo Haoxing, and I thought this was a good opportunity to show off in front of others!"

"and after?"

"Luo Hao made a phone call directly and asked his senior fellow from the gastroenterology department who worked in Nanyun Province to come out. Later, an emergency doctor came with a mobile phone in front of him and made a video consultation, and gave a diagnosis directly."

"The doctors in Nanyun Province do have rich clinical experience. They can give medications and treat symptoms according to the phantoms seen by patients."

"I was stunned at the time. Is this possible? Later, Luo Hao was thick-skinned and told me that this was clinical experience. He also said that hospitals in various places have their own specialized projects."

"He doesn't even mention his Union Medical College anymore. His face changes very quickly."

Tsk tsk, Zhuang Yan imagined the scene at that time and felt longing for it for a moment.

"I learned this from Luo Hao. If a patient has a problem, I can tell with my fingers that it's a serious problem, so I'll call someone. This is all clinical experience, learn from it."

With that, the three of them walked out of the emergency building.

Meng Liangren agreed deeply with Chen Yong's words.

After a few months of contact, Meng Liangren has already integrated into the medical team. Even though Luo Hao often goes out, Meng Liangren never dares to be negligent when he reports on his work via WeChat every morning and evening.

The medical team operated so smoothly, so smoothly that Meng Liangren felt it was unreal.

Even in an infectious disease hospital, although the patients' conditions are not serious, there will be some problems every now and then.

But Professor Luo's medical team was so stable that it made people feel dazed and unreal.

Later, Meng Liangren figured it out. Many difficult diagnoses were given by Professor Luo in the first place.

With targeted treatment, it would be strange if the condition is not stable.

What Dr. Chen Yong said makes sense. If you have any questions, just ask, even if it means "counting on your fingers."

The three of them ate nearby, and halfway through their meal, Luo Hao came back.

"Shall I give you an extra set of bowls and chopsticks?" Chen Yong asked.

"No, I just finished eating." Luo Hao ordered a bottle of Baishuishan tea, opened it and took a sip.

"Luo Hao, how did you judge?"

"Chen Yong, how did you judge that?"

Luo Hao and Chen Yong asked in unison.

"You speak first."

"You speak first."

The two paused, then spoke in unison.

Meng Liangren lowered his head and ate the rice in the bowl.

This is so synchronized, so sweet. Although Meng Liangren doesn't have this hobby, he knows Zhuang Yan does.

There are some things that Zhuang Yan can do but he can't, so he tries his best to concentrate on eating, as if he has no impression of anything happening around him and can't see it at all.

"That's right." Seeing that Luo Hao stopped talking, Chen Yong repeated his theory.

"Oh? This works too? I remember that in the Plum Blossom Divination, it is said that there is no need to draw a hexagram."

"Yeah, there's something wrong. An old ox is pulling a cart to bring a patient for treatment. It would be too much if we don't tell a fortune." Chen Yong shouted.

"Oh, that's it." Luo Hao groaned, "Go back and teach me."

"What about you? I think there is very little information. I need you to at least take a look at it." Chen Yong asked his doubts, "But you gave a direct answer. Is it your clinical experience in the medical record database of the Union Hospital?"

"Yes."

"Tell me."

"Macrolide antibiotics can cause QT interval prolongation by affecting the function of potassium ion passage, thereby causing arrhythmia, especially for patients with arrhythmia and tachycardia."

"The U.S. FDA has also issued a warning notice: Azithromycin may cause abnormal changes in cardiac electrical activity, leading to potentially fatal arrhythmias."

“Glycyrrhizic acid is the glycoside compound with the highest content in licorice, which can be hydrolyzed into glycyrrhetinic acid in the human body and produce a wide range of pharmacological effects.

For example, it increases the level of hydrocortisone in the blood, and hydrocortisone has a similar effect to aldosterone, causing water and sodium retention, affecting electrolyte balance and leading to hypokalemia. ”

"These two drugs should not be used together. Compound licorice tablets will increase the effect of azithromycin on electrolytes and cause hypokalemia."

"When I first thought of the situation you described, it was ion disorder. Then, after I heard about these two drugs, I concluded that it was most likely caused by hypokalemia."

The two people's judgments are exactly the same.

The whole process seems to be not serious, but it is precisely this not serious way of seeing a doctor that has created a hidden danger.

Meng Liangren took out a notebook and wrote on it that azithromycin + compound licorice tablets cause hypokalemia.

"Old Meng, are you ready to go back and do some research?" Luo Hao asked with a smile after seeing Meng Liangren's actions.

"Well, although compound licorice tablets are not common now, they are still available in small clinics in villages and towns." Meng Liangren nodded and explained, "I have a bad memory. If I don't write it down now, I will forget it."

"Brother, why are the compound licorice tablets no longer available?" Zhuang Yan asked, "I remember eating them often when I was a kid. They were quite useful."

"That's a good question." Luo Hao praised.

“???” Zhuang Yan looked at Luo Hao stupidly, not knowing what the problem was.

"Old Meng, explain it." Luo Hao smiled as he looked at Meng Liangren who was performing without props.

"Ahem~" Meng Liangren coughed twice. "Compound licorice tablets should be called licorice-flavored compound opium. They are fruit-flavored psychotropic drugs. A few years ago, someone bought a large number of compound licorice tablets and made them in a traditional way. He was arrested."

"Oh? What are you refining? Isn't it a prescription drug? Can I continue refining it? Why do I feel like an alchemist?" Zhuang Yan blinked her big eyes, full of clear stupidity.

"Kid, Old Meng has already told me that it's licorice-flavored compound opium. Opioid drugs, what do you think we should refine?" Luo Hao explained softly.

Some things couldn't be explained clearly, so Luo Hao could only gently nod at Zhuang Yan.

"Oh oh oh." Zhuang Yan nodded repeatedly. She was just naive, and she immediately understood after Luo Hao's reminder.

"Later, it was stipulated that a doctor's prescription was required to buy the medicine. I didn't take it seriously at the time, but the infectious disease hospital soon ran out of the medicine."

Without waiting for Zhuang Yan to ask, Meng Liangren began to explain.

After all, there is this newbie here, and if you can't explain it clearly she will ask, which is very troublesome.

"Because it involves something that cannot be touched, and because something went wrong with this medicine, the hospital leaders simply cut off the sale of compound licorice tablets. If they cut it off and don't sell it, then there will be no problem."

"Isn't this just laziness?" Zhuang Yan was stunned. "This is simply too much!"

"Oh." Luo Hao smiled.

Zhuang Yan's clarity and stupidity are simply a breath of fresh air in the medical team.

If he didn't say anything, Meng Liangren was an experienced doctor and a seasoned man, nothing could move him. As for Chen Yong, he was holding his phone, not knowing whether he was chatting with Lao Liu, his face was full of excitement, and he didn't care about this at all.

Only Zhuang Yan was angry and stupid.

This is not good, it can easily lead to high blood pressure.

"There are many things involved here. Xiaozhuang, you can go home and ask Dean Zhuang." Meng Liangren was vague.

"Old Meng, please tell me about it. My dad won't talk about it." Zhuang Yan started to act coquettishly.

The cry of "Lao Meng" was heart-wrenching.

"Emmmm, tell me." Luo Hao made the final decision.

"I didn't do any research on purpose. I just opened a pharmacy with someone at that time..."

"Oh? Old Meng, do you have this experience? Running a pharmacy was quite profitable in the past few years." Luo Hao asked.

"It's not bad to make some money. I took the pharmacist exam specially." Meng Liangren said with a smile, "The infectious disease hospital doesn't make money. I had a family to support at that time. It's not like now when one person feeds the whole family, so I didn't think about those things at all."

"Old Meng, you've said too much." Chen Yong was beaming with joy, and at this moment he interrupted, "Are you saying that Luo Hao doesn't make money for you? You're such a sneaky trickster Luo Hao, be careful that he might bear a grudge against you."

"How can there be..."

"Go on, ignore him, he's just a scoundrel." Luo Hao said with a smile, "What happened next?"

"First, you need to register your ID card to prescribe compound licorice tablets, which needs to be entered manually. It's troublesome, and the salesperson is unwilling to sell it."

"Secondly, you need a doctor's prescription. Although I am qualified, I am still cautious when it comes to this type of drug. I just want to make some money, but I don't want to break the law."

"Thirdly, 100 tablets cost 10 yuan, the efficacy is good, cheap, the quantity is large enough to fill you up, but the commission is small. The salesperson later simply hid the compound licorice tablets and said they didn't have them."

"Ah?!" Zhuang Yan was stunned.

In her world, cheap and effective medicine is king, and salespeople should be willing to sell it.

Unexpectedly, not only large public hospitals do not sell compound licorice tablets, but even small pharmacies do not sell this medicine.

"The pharmacy has a series of assessment systems, which were created by my partner. They are quite practical." Meng Liangren said honestly.

It sounds like it has nothing to do with compound licorice tablets, but in fact, they are very closely related.

"Anymore?"

"Selling other drugs would earn more commission, so the salespeople were willing to sell them. It was hard for me to manage them, after all, there were performance requirements, and the partners also wanted to make more money. So, I quit later."

Meng Liangren sighed.

"Aren't hospitals and pharmacies places for saving lives and healing the wounded?" Zhuang Yan asked.

"Don't be silly. It costs money to save the dying and the wounded. Who will pay?" Chen Yong said disdainfully. "Look at the old man today. He sat in a bullock cart and was pulled by an old ox that could die at any time. Does he have money to treat his illness?"

"I can advance the payment." Zhuang Yan's eyes flashed.

"Stop making trouble." Luo Hao tapped the table. "There are so many similar things happening in the hospital. Your solution can't solve them." "Then what should we do?!" Zhuang Yan was a little anxious.

It can be seen that Zhuang Yan is indeed a newly graduated graduate student who has not yet been polished by society and shed her youthfulness.

Even if Dean Zhuang teaches by example, it won’t work.

"Luo Hao, solve it for her to see." Chen Yong continued chatting on his phone with a cheerful look on his face.

Luo Hao glared at Chen Yong fiercely.

"It's not that difficult, you just have to find the right path."

"road?"

"We are a publicly owned hospital. We must never forget this at any time," Luo Hao said seriously.

"..."

"..."

Not only Zhuang Yan, but even Meng Liangren was stunned.

We are all family members sitting together, why is Professor Luo still speaking in a high-sounding tone?

Luo Hao picked up his phone and sent a message.

"Who is it for?"

"Director Feng."

"Is our hospital paying for it? The emergency department might not be happy." Meng Liangren suggested in a low voice.

"There are many ways. The hospital has a quota every year, but this disease is too minor and doesn't cost much money. The hospital's quota is reserved for patients with serious or critical illnesses." Luo Hao smiled and said, "Targeted poverty alleviation, treating diseases is also one of them."

Meng Liangren didn't quite understand what was going on here.

There are huge differences between regions in similar matters, so he simply kept his mouth shut.

"Eat." Luo Hao said, "Don't go hungry. If you don't have enough, just add more dishes. It's my treat."

"You're treating me to an expensive meal. This meal is too cheap." Chen Yong said again.

After a few minutes, Luo Hao was a little surprised that Feng Zixuan didn't reply to his message.

He glanced at his phone and realized it was still early, so there was no time to rest.

strangeness.

"What? Director Feng didn't reply to your letter?" Chen Yong asked.

"Well, usually I reply within seconds. I don't know what big thing happened in the Medical Department today. I guess they are busy." Luo Hao said what he meant.

Meng Liangren sighed inwardly.

The director of the medical department replies to a doctor or a professor's message within seconds. No matter who says it, it sounds unreal.

But Professor Luo said so, and it made sense.

"I'll call Uncle Feng." Zhuang Yan took out her cell phone.

"Forget it, Director Feng should be busy. I'll go find him tomorrow." Luo Hao smiled, "Where's Lao Huangniu?"

"Give it to Xiaoshuai." Chen Yong replied.

"I'll go check on the old ox later." Luo Hao said with some emotion, "I heard from Boss Xia that the old ox understands human nature."

"Do I need Boss Xia to tell me? I know everything." Chen Yong said.

"Especially those with names, they cannot eat meat and must be buried after natural death." Luo Hao ignored Chen Yong and spoke very seriously.

"???"

"???"

"With a name, there is a bond and aura. Don't you know?" Luo Hao asked.

“I seem to have heard of some, as to names bestowed, but they are probably given by powerful beings.” Chen Yong was a little vague.

"Ordinary ones have feelings too. So don't give people names lightly, right?"

Luo Hao's statement may sound like nonsense at first glance, but upon closer inspection, it does make some sense.

"That old ox knelt down before me." Chen Yong said seriously, "I accepted its kneeling, and I will pay for it."

"No, I'll teach Xiaozhuang this time. In clinical practice, you need to learn to be flexible in many things, just like Lao Meng."

Meng Liangren wasn't sure whether Professor Luo was praising him or insulting him, so he just lowered his head and smiled.

"Old Meng is a slippery, ruthless old chief physician. I didn't say that. My master described himself."

"It's better to be a little greasy. How can a greenhorn with a lot of passion survive in society?"

Chen Yong curled his lips. Zhuang Yan did not agree with what Senior Brother Luo said.

"Brother Luo, getting mixed up in society... I didn't expect you to say that. We want to build a beautiful China, not get mixed up in society, not get mixed up in society!"

Luo Hao glanced at Zhuang Yan and smiled slightly.

"I will teach you how to perform skin incision and suturing, ligation and hemostasis, deep knotting, and precise anastomosis. I will also teach you how to perform preoperative planning, anatomical levels, intraoperative decision-making, and perioperative management. I guarantee that you will be able to perform surgery independently, with superb skills, and be a master in surgery for five years. How do you do that?"

"Ah? Great!!!" Zhuang Yan was excited.

"I will teach you how to establish pneumoperitoneum, insert the trocar steadily, and walk through the gaps without bleeding. I will teach you how to use all kinds of instruments and how to use new auxiliary programs just right. I will ensure that you keep up with the times, reap the full benefits, and become a rising star who makes a big splash. How do you do?"

"!!!"

Zhuang Yan was dumbfounded. Senior Brother Luo actually wanted to teach so much!

"Bioinformatics analysis, meta-study, prospective review, everything is within your grasp. Reagent preparation, electrophoresis column, flow cytometry, transgenic mice. I guarantee that you will achieve fruitful research results, get funded by the National Natural Science Foundation, be young and promising, and overtake others. How do you do?"

Gan!
Zhuang Yan cursed in her heart.

She finally realized that Senior Brother Luo was joking.

"Old Meng, which one do you want to learn?" Seeing Zhuang Yan staring in amazement, Luo Hao turned to ask Meng Liangren.

"Hehe." Meng Liangren just smiled but didn't say anything.

"Old Meng, just say whatever you want to say." Luo Hao raised his eyebrows.

"Professor Luo, what you taught is what everyone wants to know, but in the end it probably becomes something that cannot be spoken of." Meng Liangren clicked on Luo Hao's puzzle.

"What can't you say?" Zhuang Yan asked.

"you guess."

Zhuang Yan shook her head.

"Teach you to be eloquent, to take the source of the disease; to exploit the cattle and horses, to plunder the results; to fabricate data, to defraud funds; to collude with merchants, to cling to the powerful. How do you do it?"

Luo Hao asked softly.

"!!!"

"It's basically like this. How do the academic tycoons come about? At the beginning, they were all serious, but in the end, they colluded with businessmen, clung to the powerful, and exploited the rich and powerful."

Zhuang Yan was stunned.

She thought about it, took the pen and book from Meng Liangren, and said, "Brother, please say it again."

Luo Hao just smiled and said it was just a joke, there was no need to take it so seriously.

Meng Liangren's cell phone rang. He glanced at Luo Hao and saw that Luo Hao was "training" Zhuang Yan, so he picked up the phone and started operating it.

Chen Yong was curious and came over to take a look.

"Meng, you do this kind of thing!"

"Huh? What is Lao Meng doing?" Luo Hao asked.

"Writing a good review for Pinxixi!" Chen Yong almost jumped up, "Luo Hao, I said the medical team doesn't make much money! Look at Lao Meng, he even went against his conscience to write a good review for 2 yuan."

"My conscience is worth one dollar, and there is profit of two dollars. It's not difficult to write one stroke at a time." Meng Liangren explained with a smile.

Luo Hao turned a deaf ear to Chen Yong's words.

The money earned from a trip to India is enough for Lao Meng to use for a long time, and the income at the First Hospital of Medical University is actually not low.

Although all the hospitals in the medical system appear to be Grade A, they are actually quite different.

Working in a top hospital in the province like the First Hospital of Medical University, Meng Liangren can earn more than 2 yuan a month. Although he is not rich, he is definitely not poor.

One could even say it's quite moisturizing.

Especially after Meng Liangren "figured it out", he realized that as a single man, he didn't have to support a family, and that little bit of money was enough for him to live a carefree life.

In fact, it was easy for Meng Liangren to get married and have a family. He was a doctor at the First Hospital of Medical University, honest and steady, and had a good income, which were all plus points.

But Luo Hao doesn't want to care about so many things. Does he think he doesn't have enough things to do?

It was enough to annoy Luo Hao that he had to go there alone regardless of whether Lan Ke was dead or alive.

[As the saying goes, a man is a boy until he dies~~~]

The phone rings.

"Hello, Director Feng."

"Oh, okay. I'll have a bite to eat across from the hospital. I'll be right there."

"Okay, let's meet and talk."

Luo Hao put down his phone and asked, "Chen Yong, are you going home tonight?"

"Lao Liu is on duty. I will bring her food and then go back to the dormitory." Chen Yong has turned "home" into "dormitory."

"Okay, you guys are busy." Luo Hao stood up, "Xiao Zhuang, come with me."

"Okay!"

Zhuang Yan knew that Senior Brother Luo wanted to teach her his clinical experience, so he called her.

Things like establishing pneumoperitoneum, spaced walking, and preventing bleeding all take time and surgery, so there's no rush.

On the contrary, this kind of "greasy" social experience is what I lack the most.

Knowing her senior brother's purpose, Zhuang Yan happily followed Luo Hao.

"Brother Luo, you really don't want to go to the surgical demonstration."

After not speaking for a minute, Zhuang Yan couldn't help but ask.

"Don't go."

"Why? If you go there to have surgery, you can become famous. When you have overseas consultations, world-renowned experts will call you and you will have to call them bro, bro."

"I have too much on my hands to handle it. You are still young and can't help me. If you were an experienced surgeon, I would leave the surgery to you and maybe you would have time."

Zhuang Yan was stunned. Was all the responsibility on her?
cut~
After they talked for a few words, they fell silent again. Luo Hao had no intention of finding a topic to talk about, and Zhuang Yan didn't want to make herself boring. She just calmed down and prepared to learn how to be "greasy" like Brother Luo.

When he arrived at the door of the Medical Department, Luo Hao was startled to see a clerk sweeping the floor in Feng Zixuan's room.

The teacup was broken, and the clerk was cleaning it carefully and cautiously, not daring to make any noise.

Oh?
Angry? Feng Zixuan, who is always gloomy and cruel, would also get angry?
No wonder Feng Zixuan hasn’t left so late.

Luo Hao understood Feng Zixuan's working style, and there were actually not many things that could make him angry.

"Xiao Luo, I'm here." Feng Zixuan looked calm and greeted him with a smile.

But Luo Hao felt a chill wind around him. If it weren't for his strong yang energy, he would have started shivering at this moment.

(End of this chapter)