White armor

Chapter 4 Level 1 Diagnostic Assistance AI
"Fuck!" Lin Yuming cursed.

Deputy Director Liu and Luo Hao unanimously remained silent.

If the calm and experienced medical director can make his remarks dirty, it is most likely a medical incident.

After cracking down on gangsters and eradicating evil, organized medical troubles disappeared overnight, leaving only complaints about medical issues, medical malpractice, etc.

Luo Hao recalled carefully that there seemed to be no serious medical accidents recently.

Lin Yuming and Deputy Director Liu said, "Lao Liu, do us a favor."

"Say."

"There is a pregnant woman who has been diagnosed with a problem and has twins. She may not be able to save them."

"..." Deputy Director Liu was stunned for a moment, "The medical staff in your hospital?"

"No." Lin Yuming shook his head.

"That……"

"She is an ordinary pregnant woman from the natural village below." Lin Yuming spoke in a low voice.

Deputy Director Liu had a strange expression and looked straight at Lin Yuming for 30 seconds before whispering, "Boss Lin, you keep saying that you are old... Look at you, why are you still the same as when you were in school?" .”

It’s really hard to say that this kind of bookishness is old.

"There's no way." Lin Yuming explained while turning around, "A few days ago I went to work at the Medical Consortium Hospital next door. It was raining that day and it was very cold."

"There was a man in his 30s squatting at the door of the hospital, shirtless and holding his head in the rain, crying."

Deputy Director Liu guessed early on that Boss Lin was soft-hearted and was not surprised at all.

"That family has never had children. They suddenly became pregnant 27 weeks ago with twins. But the latest check revealed that the fetuses were malformed."

"Deformity? Boss, is your Holy Mother's heart too big?" Deputy Director Liu said helplessly, "I am an imaging doctor, and I'm not polite if you say I am an expert. My level is indeed a bit high. But fetal malformations such as Who can handle this matter?"

With that said, Deputy Director Liu looked at Luo Hao.

"Dr. Xiao Luo, can you Xiehe handle it?"

"..."

Luo Hao was speechless.

"Listen to what I have to say." Lin Yuming drove back directly regardless of whether Deputy Director Liu agreed or not, "I did two B-ultrasounds. The second time I stood aside and watched, but I always felt that something was wrong. "

"But you also know that I have been out of clinical practice for too long and can't tell the truth. Recently, I have asked Director Sun of the Obstetrics and Gynecology Department to contact the experts in the Imperial City to help with consultation."

"Then what?" Deputy Director Liu asked.

"The pregnant woman's mentality collapsed first, and she is looking for life and death in the hospital."

This kind of thing, as experienced clinicians, should have been accustomed to it for a long time.What can be done?There was only a sigh.

Deputy Director Liu thought for a while and looked at Lin Yuming.

"I'm going to do an ultrasound."

After finishing speaking, Deputy Director Liu shook his head, "Boss Lin, my little brother held a parent-teacher meeting some time ago. The child didn't pay attention to his studies and was scolded by the teacher. Do you know how I comforted him?"

Deputy Director Liu did not show off and continued, "Generally speaking, teachers have extremely strict requirements for their children because they have seen outstanding gifted students. But as for doctors and nurses, many of them just let nature take its course."

After a pause, Deputy Director Liu persuaded with earnest words, "Because we have all seen grieving parents at the entrance of the ICU."

"When you are a doctor, it is always not good to be too empathetic. Although Boss Lin, you went to the medical office. Back in the day, no matter what happened to us little brothers, you would help us."

"Why do you still have this temper after all these years, Boss Lin?"

"Oh." Lin Yuming sighed again, "It looks pitiful, so I'll just help if I can. Are you just watching?"

Deputy Director Liu was speechless.

That's what he said. He thought the same way when he was a medical student, but after being pressed to the ground and rubbed for decades in society, all that youthful thought had long been wiped out.

I didn't expect Boss Lin to still have this temper.

Take a look, the boss said.Although he thought so in his heart, Deputy Director Liu disagreed.

He did four-dimensional and NT in his first year of medical school, and saw countless deformed babies and pregnant women crying.

The first time I felt a little sad, but later on the sadness became weaker and weaker, and I had become numb as early as more than ten years ago.

There is a high probability that Teacher Liu will be useless if he goes back, Luo Hao thought.

Suddenly, Luo Hao remembered the big gift package given by the system for completing the novice mission.

It has to be opened sooner or later anyway, so I will open it now and take a look, just in case it can be of any help.

With a thought, the gift package was opened.

The gorgeous light and shadow suddenly appeared, startling Luo Hao.

The system is a bit unscrupulous, with some fancy but useless stuff.

[Congratulations on obtaining the diagnostic auxiliary AI, your AI computing power is now level 1. 】

Luo Hao felt like he had fallen into a big pit.

Diagnostic auxiliary AI, level 1, is another place for endless upgrades.

If it is a game, then you will definitely need to top up money.But the system is terrible because it doesn’t cost money!
Luo Hao opened the diagnostic assistant AI, which has an interface similar to chatgpt, and the operation method is probably similar.

"Director Lin, which pregnant woman are you talking about?" Luo Hao suddenly broke the silence.

"What?"

"Teacher Liu and I will study hard and understand the situation in advance."

Lin Yuming absently mentioned a bed number, and Luo Hao contacted the doctor on duty at the obstetrics and gynecology department.

Soon, the patient's simple information was sent to his mobile phone.

The patient was admitted to the hospital due to menopause at [-]+[-] weeks, and ultrasound examination showed that the twins had abnormal development for [-] day.The patient was a primipara, and early pregnancy ultrasound showed monochorionic twins...

The doctor on duty at the obstetrics and gynecology department took pictures of the medical records and transmitted the pictures.

Luo Hao squinted his eyes and read the entire medical history and physical examination.

The pregnant woman was 27 + 2 weeks old. Because the fetus was large enough, the recent prenatal check-up found that the twin twins had a large difference in PSVMCA, the heart of the donor baby was enlarged, and the umbilical artery blood flow spectrum PI of the recipient baby was elevated.

There was something wrong with the diagnosis at the lower-level hospital, and it was only after going to the Mining Hospital that B-ultrasound made further discoveries.

The mobile phone vibrated constantly, and the blood test sheets for admission to hospital were also sent one after another.

After reading this, Luo Hao held his breath and looked at the system panel in the upper right corner of his field of vision.

When you read your medical history and laboratory test orders yourself, these information have already been entered into the system.

The system screen flickers with light and shadow, and is slightly laggy, and then a diagnosis is automatically generated.

Luo Hao was not too surprised.

Chatgpt's intelligent AI system can theoretically be used for diagnosis. It is still being explored clinically, but there are many successful cases and it has solved many difficult and complicated diseases.

However, everything is still in the exploratory stage and has not yet been rolled out on a large scale. There are many problems.

The diagnostic assistant AI provided in the system gift package should be better than chatgpt.

Luo Hao watched intently, and soon, a line of words appeared in the upper right corner of his field of vision.

[Insufficient data to generate a diagnosis. 】

"!!!"

Luo Hao was startled.

This is one of the reasons why Chatgpt has not been widely used.

As long as you ask about the medical history, you will know that the medical history stated by the patient and the patient's family is interfered by subjective factors. It is not imagined that as long as the patient tells the medical history, an intelligent AI system such as Chatgpt can give a diagnosis.

What I never expected was that such a powerful being as the system would actually tell me that there was insufficient information to make a diagnosis.

This is different from what Luo Hao thought.

It seems that I have to ask myself.

Although the system did not give a diagnosis, Luo Hao was not discouraged.

"Ding dong~"

A system prompt sounded, and then a task appeared on the system panel.

[Emergency Mission: Rescue

Mission content: The correct diagnosis is still in the fog, and the fetus still has a glimmer of hope. Please save the fetus.

Mission time: 3 day.

Task reward: 10000 experience points. 】

The experience value is 10000 points!
Luo Hao was shocked. This was probably too little.

Compared with the previous rewards for performing ten ovarian cyst puncture and sclerotomy surgeries, the rewards for this emergency mission were approximately zero.

But Luo Hao understands that the novice rewards in mobile games guide players to recharge 648 by 648, and it is normal to "give profits" a little.

I didn't expect that a system full of futuristic technology would be like those unscrupulous game profiteers, giving sweets at first, but then going out of control.

At the very least, there should be an entrance to recharge 648, Luo Hao sneered.

If the system has a recharge entrance, a 648 will confirm the diagnosis, which seems good.Luo Hao is not short of money. If he can use money to buy diagnosis, Luo Hao is willing to do so.

Unfortunately, the system does not have this function.

hateful!

"Xiao Luohao, you drive." Lin Yuming kept thinking on his cell phone, so he simply stopped the car and let Luo Hao drive.

Luo Hao could only temporarily stop studying the system and concentrate on driving back to the hospital.

Along the way, Lin Yuming kept calling, asking the obstetrics and gynecology doctors to reassure the patients and tell them that experts from the province were on the way and would provide them with expert consultation soon.

Although Deputy Director Liu understood it, he did not approve it.

We see all kinds of pitiful people in the hospital every day, and social welfare agencies almost sit back and do nothing. If doctors and nurses are too empathetic, they will not be able to stay in this profession for long.

Boss Lin...

I don’t know how he survived all these years, Deputy Director Liu thought to himself.

Back at the hospital, Lin Yuming took Deputy Director Liu to change into white clothes and formally came to the B-ultrasound room.

After briefly introducing the background of Deputy Director Liu to the family members of the pregnant woman, Deputy Director Liu sat next to the B-ultrasound machine and began to perform color ultrasound on the pregnant woman.

After applying coupling agent and lowering the probe, Deputy Director Liu frowned within a few seconds.

Luo Hao sat aside with his hands on the keyboard, ready to record Deputy Director Liu's words at any time.

But his eyes glanced at the screen of the B-ultrasound machine, analyzing the images and trying to find useful information.

Although there are very few rewards for emergency missions issued by the system, as a doctor, you still have to go all out when you can treat patients.

The image is complex, with red and blue images constantly flashing.

"Intrauterine twin live fetuses with monochorionic and diamniotic sacs, the body weight of the twins is estimated to be [-]/[-]g, and the body weight difference is [-]%."

crackling~
As Deputy Director Liu muttered words, Luo Hao immediately recorded the complex content on the computer.

"Fetus [-]: The intrahepatic echo is slightly thickened, the intrahepatic portal vein and bile duct wall echoes are enhanced, the umbilical artery blood flow spectrum pulsatility index is high, the value is [-], systole/diastole: [-]; middle cerebral artery contraction The flow velocity decreased during the period, PSVMCA: [-]cm/s, velamentous placenta sonographic image, vasa previa, placenta previa state."

"Fetus [-]: The cardiothoracic area ratio increased, about [-], PSVMCA increased: [-]cm/s, PSVMCA difference: [-]MoM."

A series of professional words came out of Deputy Director Liu's mouth, and everyone including Director Sun of the Obstetrics and Gynecology Department was confused.

Differences in technical levels are an objective fact.

There is no test result and everyone can come up with the correct answer.

When Deputy Director Liu reached this point, he looked up at Director Sun of the Obstetrics and Gynecology Department.

"Director Sun, what is your diagnosis?"

Director Sun was stunned and didn't know how to answer.

The content of the B-ultrasound performed by Deputy Director Liu was beyond her knowledge. The Mining Hospital was only a municipal-level tertiary hospital and did not involve such advanced content.

"Lao Liu, don't show off." Lin Yuming scolded dissatisfied. "I'm a doctor in the auxiliary department." Deputy Director Liu whispered.

It turns out that he was not trying to show off, but was asking a specialist for a diagnosis normally!
"..."

"..."

Indeed, Deputy Director Liu is only responsible for doing B-ultrasounds, and diagnosis is the job of clinicians.

Ordinary diseases will be diagnosed in the B-ultrasound room report, but the twins in front of me definitely do not fall into the "ordinary" category.

The atmosphere in the B-ultrasound room was heavy, with only Luo Hao typing away.

With the B-ultrasound of Deputy Director Liu, the system has already given a diagnosis - twin anemia with polyhematological sequence syndrome combined with selective fetal growth restriction.

"Teacher Liu, take a look at the report sheet and see if I missed anything you said."

Luo Hao handed over the report sheet.

Deputy Director Liu was a little unhappy, and Luo Hao was too indifferent. He was still paying attention to the report card at this time.

But Luo Hao was Boss Lin's nephew after all. Deputy Director Liu was unwilling to reprimand him for a trivial matter, so he took the report sheet and put it aside.

Their eyes crossed, and Deputy Director Liu's hand suddenly stiffened.

Twin anemia polyhematological sequence syndrome combined with selective fetal growth restriction!
The lengthy diagnosis was like a sledgehammer hitting Deputy Director Liu's heart.

This extremely rare diagnosis has never been heard of, let alone a clinical student who has just graduated. Not even a clinical veteran like Deputy Director Liu has ever heard of it.

The B-ultrasound showed that there was indeed a problem, but Deputy Director Liu could not give a definite diagnosis.

however!
Luo Hao gave a clear diagnosis!
It is clearly written in black and white.

"Doctor, I..." the pregnant woman asked sadly with tears in her eyes.

Deputy Director Liu could see in the pregnant woman's eyes that she still had a glimmer of hope, and he couldn't bear to break her illusion.

"Now that the diagnosis is made, the specific treatment needs to be decided by an expert group after consultation."

"Is there hope?"

Deputy Director Liu did not answer the pregnant woman's words. He began to search for relevant information about the diagnosis in his mind.

As soon as he thought about it, Deputy Director Liu suddenly realized that he had forgotten the diagnosis name.

!!!

This is so special!

As a well-known expert in the province, it doesn't matter if he can't diagnose it. After all, he is not an expert in obstetrics and gynecology.

But I even forgot the diagnosis given by others. This is simply ridiculous.

Deputy Director Liu read the diagnosis on the report sheet again - twin anemia with polyhematological signs combined with selective fetal growth restriction.

MD!

Does the diagnosis of ghosts need to be more complicated?

Deputy Director Liu cursed in his heart.

He looked at the report quietly, imprinting every word in his mind.

"Director Liu, look at the next step..." Lin Yuming asked tentatively.

"I'll call the director of our obstetrics department and ask." After Deputy Director Liu finished speaking, he was about to put down the report sheet, but his hand froze slightly, and then walked out of the clinic with the report sheet.

Lin Yuming found a quiet room for Deputy Director Liu, and Deputy Director Liu picked up his mobile phone and made a call.

"Director Li, it's me."

"I met a patient, imaging..."

Deputy Director Liu explained the images he saw using B-ultrasound.

"The diagnosis I gave is rather vague, like twin anemia...the combination of polyspermia syndrome...selective fetal growth restriction, what do you think?"

In the end, Deputy Director Liu failed to remember the diagnosis. He took the report sheet and read it out in black and white.

"Director Liu, your skills have improved greatly! You can provide such a rare diagnosis as twin anemia, multiple blood quality syndromes and selective fetal growth restriction."

Deputy Director Liu blushed.

"From your description, it seems that this disease is relatively rare."

The expert on the other side of the phone only made a joke, then got back to business and started talking about his condition.

"Are there clouds over there?"

Deputy Director Liu looked at Lin Yuming with his cell phone.

Lin Yuming nodded.

"Yes, wait a minute and I will send you the cloud. You can take a look at it."

After hanging up the phone, neither of them said anything nonsense. Lin Yuming asked the doctor who came to the obstetrics and gynecology department to send the patient's cloud to Deputy Director Liu, who then sent it to the first-year medical expert.

After waiting for a full 10 minutes, Deputy Director Liu's phone rang.

"Lao Liu, your diagnosis is right, it's amazing! I turned you into a sperm during the NT surgery, awesome!"

"Don't talk nonsense, how to treat this disease?" Deputy Director Liu asked directly.

There was a little silence on the other side of the phone, and finally a helpless voice came, "Let's put it this way, Lao Liu, we can't cure it in our province."

!!!

!!!

Lin Yuming and Deputy Director Liu were deeply helpless.

Although they knew that most diseases could not be cured, the feeling of powerlessness still enveloped the two of them like a tide, making them unable to extricate themselves.

"Tell me, let me see if I can think of a way." Deputy Director Liu asked.

"There are three options: laser coagulation of the communicating branches of the placental vessels under fetoscopy, radiofrequency ablation to reduce the fetus, and intrauterine blood transfusion. Our hospital does not have relevant equipment for the first two treatments, and the Mining Hospital probably does not either."

"Only a few hospitals across the country have relevant equipment, but the operation... is extremely risky, and the number of doctors who are willing to do it can be counted on one hand. The latter one has a probability of being curable, but the operation is extremely difficult, difficult, difficult! Difficult! !!”

"Do you know him?" Deputy Director Liu asked under Boss Lin's eager eyes.

"I don't know. This rare disease is similar to malignant hyperthermia. Only the genetic institute of the maternal and child health center of top hospitals will study it."

Deputy Director Liu hung up the phone, spread his hands, and looked at the sky.

Lin Yuming muttered in a low voice, "What kind of placental vascular communication technique is used under fetoscopy, Lao Liu."

"Fetoscopic laser coagulation of communicating branches of placental vessels."

"Radiofrequency ablation fetal reduction, why does this surgery sound so unfair?"

"I guess turning twins into singletons."

The two speculated about the treatment.

No one goes out because they don’t want to face pregnant women and their families.

No doctor wants to say - I'm sorry, I tried my best.

But many times I have to say it.

"Lao Liu, I heard that the director of your obstetrics department also mentioned a certain treatment. What is it?"

"Intrauterine blood transfusion."

"Isn't this treatment difficult?"

Deputy Director Liu looked up at Boss Lin. Sometimes when he faced doctors who treated patients like family, he always felt that their brains were broken.

"Boss, inside the palace, that's inside the palace!" Deputy Director Liu reminded.

Lin Yuming nodded, his face gradually returned to normal, and he had made up his mind.

"Let's go."

Lin Yuming opened the door, preparing to explain his condition to the pregnant woman and her family members, and to say the words he didn't want to say.

But as soon as he opened the door, he saw Luo Hao standing at the door.

"Director Lin, what do the experts say?" Luo Hao asked.

"The diagnosis is OK... Xiaoluohao, have you seen similar patients in Xiehe?" Director Lin asked.

"I have seen that there are three treatments for this type of patients - fetoscopy laser coagulation of the communicating branches of the placenta, radiofrequency ablation fetal reduction, and intrauterine blood transfusion."

!!!

Director Lin looked at his nephew in shock.

For the first time, he felt that the little snail had grown up.

The smile on Luo Hao's face was like sunshine, dispelling the haze in his heart.

Although he rationally believed that no one in the province could do it, that smile seemed to be silently telling himself that Luo Hao could do it.

"Fetoscopic laser coagulation of the communicating branches of the placenta and radiofrequency ablation to reduce the fetus are difficult, and our hospital does not have the relevant equipment. If you go to the Imperial Capital, there are very few hospitals that can perform similar surgeries. Nowadays, doctor-patient disputes are serious, and it is difficult to choose the right patient." If the challenge is too great, no one may be willing to do it.”

"Simply put." Director Lin looked at Luo Hao seriously.

"Intrauterine blood transfusion treatment is more suitable. It is difficult, but it is much less difficult than the first two."

"Can you do it?"

"Positioning, umbilical vein puncture, and intrauterine blood transfusion. The three treatment options have similar effects. The industry has not said which one is particularly good. I think we can give it a try."

"Dr. Xiao Luo, don't talk nonsense." Deputy Director Liu said solemnly, "There will be fetal movement, which is unpredictable. Umbilical vein puncture is extremely difficult. If you are not careful... are you sure?"

"Teacher Liu, I think I can do it." Luo Hao said confidently.

Deputy Director Liu was in a daze.

Luo Hao's energetic look was very much like when he first entered the medical school as a freshman. At that time, he thought he was omnipotent and could cure all the patients in the world.

"Dr. Xiao Luo, simple puncture is not enough. Come in and tell me." Deputy Director Liu greeted Luo Hao to come in.

"I think the Mining Institute has never done intrauterine puncture, right." Deputy Director Liu glanced at Lin Yuming.

Lin Yuming nodded.

"Tell me about intrauterine puncture. Assuming that the puncture is successful, I'm going to say hypothetically, what details will you encounter after success."

Both Lin Yuming and Liu Haisen felt that Luo Hao was still too young and thought that a calm mind and a steady hand would lead to a successful puncture.

As everyone knows, puncture is only the first step, and the more difficult part comes later.

"The fetal blood vessels in twin-to-twin transfusion syndrome are quite special. Most of the placental anastomosis vessels are tiny arteriovenous anastomosis branches with a diameter of <[-]mm. Through these small anastomoses, only [-]-[-]ml of blood is transported to the recipient every [-] hours..."

Luo Hao talked without any fear.

Deputy Director Liu only had a small amount of clinical experience in intrauterine blood transfusion and could not determine whether Luo Hao was right.

But he couldn't tell that Luo Hao was wrong.

Recalling the B-ultrasound images, the diameter of the placental anastomotic blood vessels was <[-]mm, so there should be no problem.

"Blood transfusion cannot be too fast or too slow. There is a formula to calculate the blood transfusion speed."

As Luo Hao spoke, he took out a pen from nowhere and wrote down a complicated mathematical formula on the paper.

"This……"

"Just follow this formula to calculate the blood transfusion speed." Luo Hao said, "There is about a 50% chance that the fetus will survive until 32 weeks and then have a caesarean section. The overall risk is very high, but there are always ways to treat it. Whether it should be done or not depends on Lin Lin. The director makes the decision.”

"I'm going to communicate with the patient's family." Director Lin thought for a while and walked out with a sullen face.

Deputy Director Liu shook his head, "Dr. Xiao Luo, you are still too young and act on your own initiative. If you do a good job, it is what you should do; if you fail, the responsibility will be on you. Have you ever thought about it? If you fail, the patient's family will not let you go. What to do next?”

"Teacher Liu, I think Director Lin can properly solve this problem."

proper?

solve?

Deputy Director Liu was slightly disdainful at first, but then he thought that Boss Lin was a rough man but also a fine man, and something strange arose in his heart.

(End of this chapter)