White armor

Chapter 445: Using Chicken Feathers as a Command
The child has indeed grown up. Zhuang Yongqiang smiled as he watched Zhuang Yan leave.

This patient is an old neighbor. He had been treated for a long time but had not been cured. There was no clear diagnosis yet, and finally the disease came back to him.

What could he say? He could only respond vaguely and call Feng Zixuan to handle it.

But Zhuang Yongqiang didn't make this call. He wanted to see how socially capable Zhuang Yan was.

As for that disease, Zhuang Yongqiang had never considered it.

Many diseases cannot be cured, and some people even feel that the illness is inexplicable. The neighbor in front of you is one of them.

If there is a large amount of pleural effusion on the right side, the most likely candidates are malignant tumors or tuberculosis, and only then will we consider heart failure or something like that.

However, the cardiothoracic surgery department inserted a chest tube to drain the pleural effusion and sent it for examination. No tumor cells were found in the fluid, and a chest CT scan also did not reveal any malignant tumors.

Relevant tests for tuberculosis were also done, and all were negative.

The large amount of pleural effusion came out of nowhere. Zhuang Yongqiang never thought that Zhuang Yan could cure the disease. In his eyes, Zhuang Yan was still a little kid, living happily under his wings.

Zhuang Yongqiang's purpose was to let Zhuang Yan visit the old neighbors and calm their emotions.

……

Zhuang Yan got into the car humming a song, put on her headphones and connected to Bluetooth.

The song is melodious.

One drum beat means preparation for battle; two drum beats mean the battle robes are tightened.

The voice belongs to Mr. Chai, and Zhuang Yan edited it specially and listens to it occasionally.

Boss Chai is one of the living legends. Ordinary medical students can hardly even dream of meeting him.

Zhuang Yan thought of the theory of raising dogs her father had said. It was obvious that her father had painstakingly come up with this theory in order to create a more harmonious atmosphere and prevent her from rebelling.

Even at the cost of defilement.

Hehe, not really, not really, Zhuang Yan thought to herself. No matter what, she could not treat her senior brother as a dog. And when she thought of dogs, Zhuang Yan thought of Dahei. Her senior brother was much more handsome than Dahei.

When she arrived at the hospital, Zhuang Yan changed her clothes first.

"Meng, you're still busy."

"Huh? Why did you come back to Xiaozhuang? There's not much work to do in the department." Meng Liangren was a little surprised.

"I'm here to see an old neighbor."

Meng Liangren smiled. He was holding a robot dog in his hand. The robot dog's hair was shiny and oily.

"What's wrong with you?"

"Pleural effusion, they said it's not malignant, and there's no diagnosis."

Meng Liangren nodded, and had no intention of going to see it with Zhuang Yan.

"Get up and take a walk. You keep sitting like this. Be careful not to get venous thrombosis in your lower limbs." Zhuang Yan said.

Meng Liangren's expression changed and his smile seemed forced.

He thought about it, stood up and let "Erhei" charge, then wiped his hands on his white clothes.

"Xiao Zhuang, don't talk nonsense. Say more auspicious words in your daily conversation." Meng Liangren is even more fatherly than Zhuang Yongqiang.

"I know!" Zhuang Yan also felt that what she said was a little wrong and shook her head. "Let's go to the chest department. I feel a little guilty."

"What are you guilty of?"

"Oh, you don't know. When old neighbors talk, the first thing they say is "Xiao Yan". How old are you this year? Have you found a partner? Your dad is looking forward to having a grandson."

Meng Liangren smiled.

"I was chatting with my dad, and he insisted that I come. I guess he wants me to get married."

"It hasn't snowed yet, and there's still some time before the New Year, and I'm already being urged to get married. Why should I go home if there's nothing else to do?" Zhuang Yan complained.

"You didn't go shopping?"

"No, I seldom go to crowded places since the love epidemic. I might have PTSD. Didn't my senior say that Director Fang of Changnan doesn't speak seriously? He said that he didn't want to contact people after the love epidemic. This hits the nail on the head."

The two chatted casually and came to the thoracic surgery department. Zhuang Yan hesitated for a moment and did not go directly to the ward. Instead, she walked into the doctor's office and greeted the doctor on duty and the chief resident.

Meng Liangren smiled slightly. It seemed that Zhuang Yan was indeed disgusted by being urged to get married.

However, Meng Liangren did not say anything. He just watched Zhuang Yan talking to the chief resident of the cardiothoracic surgery department quietly.

Zhuang Yan has a strong ability to adapt. Although she only talks about unimportant gossip, it is obvious to the naked eye that she no longer looks like a newly graduated graduate student.

Meng Liangren sat down and watched Zhuang Yan shaking her head while chatting with the resident manager and looking at the medical records and test reports.

After a few minutes, Zhuang Yan picked up the phone and made a call.

???

???

Meng Liangren and the chief resident of the cardiothoracic surgery department frowned at the same time.

"Senior brother~~~"

Sure enough, Zhuang Yan called Luo Hao directly.

I still need to tell Zhuang Yan about this matter, Meng Liangren thought to himself.

Especially on weekends, everyone needs private space and private time. When you think of it, just call Luo Hao. Do you really think he is a summoned beast?

While Meng Liangren was thinking about something, Zhuang Yan had already reported the patient's condition and started taking photos of the test results and sending them to Luo Hao.

"Help me figure out what's going on."

"Yes, it's not low protein, it's not lung cancer, pleural cancer, or tuberculosis. Where does all this pleural effusion come from?"

"It seems so. The tumor marker CA125 is a bit high."

"Brother~~~My aunt Zeng has a large amount of fluid in the right chest cavity..."

After saying half a sentence, Zhuang Yan stopped and listened carefully to what Luo Hao said.

"The carbohydrate antigen CA125 is a glycoprotein derived from the epithelial cells of the body cavity and expressed in normal tissues. CA125 is usually used as a tumor marker for ovarian epithelial cancer. Its elevation can also be seen in some non-gynecological diseases."

Zhuang Yan suddenly spoke like a "medical student" about the definition of CA125.

Meng Liangren sighed, this quality is really high. The master's students of Peking University Health Science Center can be said to be top elites, with formal professional training.

Meng Liangren had always been exposed to tumor markers in clinical practice, but he only knew that he had to conduct a thorough investigation on what CA125 meant, but he was not clear about any more details.

But Zhuang Yan did it effortlessly.

"Is it really okay, brother?"

"Okay, okay, I'll take my Aunt Zeng to check it out right away."

Zhuang Yan looked a little helpless and hung up the phone, while Meng Liangren smiled in his heart.

It was probably because Professor Luo was enjoying his time with his daughter and was disturbed by Zhuang Yan's ignorant behavior. He was unhappy and casually asked Zhuang Yan to take the patient for a check-up.

"Xiao Zhuang, what did Professor Luo say?" asked Meng Liangren.

"My senior brother said that it might be an ovarian tumor that caused the pleural effusion. What he said sounded quite serious. How come I have never heard of it?"

The chief resident of the cardiothoracic surgery department had his eyes wide open. What are you talking about? Listen to me. Is this something a human being can say? !
It is certain that both benign and malignant ovarian tumors can cause a large amount of peritoneal effusion, with a high probability, but what about pleural effusion?
No transfer, no transfer, no transfer!

The chief resident of the cardiothoracic surgery department was shouting loudly in his heart.

This is simply not something a doctor would say.

The Ca125 was high, and the chief resident of the cardiothoracic surgery department also noticed it, but he didn't care.

There will always be laboratory errors in any examination, and the patient had a large amount of fluid effusion in the right side of the chest, so everything has its mild and severe consequences.

Even if you take the patient for a check-up, you must give the patient and his or her family a clear explanation.

There was a large amount of fluid accumulation in the right pleural cavity. The dyspnea disappeared after drainage, but there was still 300-500ml of drainage fluid every day, which had nothing to do with the elevated CA125.

At least that's what cardiothoracic surgery seems to be like.

"Brother Chang, can you please prescribe an examination for me?" Zhuang Yan said to the chief resident of the cardiothoracic surgery department.

"Xiao Zhuang, then you go and talk to the patient." Although the chief resident of the cardiothoracic surgery department was complaining in his heart, he had a smile on his face and sat down in front of the computer to start giving medical orders.

If you want to investigate, just do it. You won’t offend Dean Zhuang’s daughter over such a small matter.

Besides, from a certain perspective, Zhuang Yan is also a family member of the patient. The world is big, but the family members of the patient are the most important.

Meng Liangren didn't say anything, but just quietly wondered why.

Soon, Meng Liangren found that his mind was empty. Not to mention whether ovarian cysts can cause pleural effusion, Meng Liangren couldn't even tell the definition of CA125.

Okay, since Professor Luo asked me to do so, I’ll check it out right away.

Zhuang Yan is in a dilemma. It seems that Professor Luo's temper is getting worse and worse. She should try to call him less often in the future.

"Old Meng, what are you looking at?" Although Zhuang Yan is careless and simple, she is not stupid.

She saw at a glance that Meng Liangren's face was full of confusion and bewilderment.

"It's okay, it's okay. What kind of examination did Professor Luo say he wanted to do?" Meng Liangren asked.

"First do a CT scan of the middle and lower abdomen, and if there is a problem, do an MRI."

"..."

"Hey, hey, hey, Lao Meng, Senior Brother must have his reasons."

The chief resident in cardiothoracic surgery moved his lips and almost blurted out what was in his heart - there's no bullshit about that!
It is obvious that the senior doctor is unwilling to waste his rest time, so he asks the junior doctors under him to complete the relevant examinations first, and the rest will be dealt with after work.

If she can't even understand this kind of perfunctory response, is it possible that the daughter of Dean Zhuang is a fool? !
She is really naive and innocent. These three words shine brightly on Zhuang Yan.

"Brother, you must have a point, for sure." Zhuang Yan said confidently.

Meng Liangren remembered what his boss always said: "Professor Luo is not here, so you don't have to provide emotional value all the time, Old Meng."

Could it be that Xiaozhuang has even learned this? !
This is a very surprising learning ability, Meng Liangren thought to himself.

Zhuang Yan went to see the patient, but Meng Liangren did not follow her.

The chief resident of the cardiothoracic surgery department did not follow. He looked at Meng Liangren jokingly and said, "Meng, Professor Luo is the one who has the final say in your family. But even if he has the final say, it shouldn't be like this. It's over."

"Yeah, what else? I can't have the final say." Meng Liangren heard a hint of provocation and answered without hesitation.

"But the patient has right-sided pleural effusion. Don't you think it would be useless even if we find out that there is a problem with the ovary?"

"I don't think so." Meng Liangren automatically and consciously stood in Luo Hao's shoes. "If we see any abnormal indicators, we must continue to check. Has Director Xu not done his rounds yet?"

The chief resident of the cardiothoracic surgery department was stunned. He sensed the gleam of swords in Meng Liangren's words.

It was normal for departments to have conflicts. Why did Lao Meng get so angry before he even said anything? He even brought up Director Xu.

It seemed that if I said anything unpleasant again, Lao Meng would have a serious argument with me, even at the risk of blood splattering five steps away from me.

The chief resident of the cardiothoracic surgery department was somewhat envious of Professor Luo.

Look at other people's homes! Then look at your own home.

The professor who led the group always criticized Director Xu behind his back, saying that Director Xu had too good a temper and that nothing could be said even if he was beaten with three sticks.

Before he could say anything bad about Professor Luo, Old Meng turned hostile.

He is no longer the old attending physician who was transferred to the First Hospital of Medical University, the chief resident of cardiothoracic surgery department thought to himself.

When he had a stern face, Meng Liangren actually had some of the authority of a senior doctor.

"If there is a problem, we need to investigate. I think what Professor Luo said is correct."

"Okay, okay, that's right, that's right." The chief resident of the cardiothoracic surgery department said perfunctorily.

However, even clay people have their own temperament. The resident chief of cardiothoracic surgery was unhappy, so he went to see the CT scan results.

When everything is fine, I will say a few words to ridicule Professor Luo.

Emmm, let me say a few words. After all, I am still thinking about getting some of Professor Luo’s papers.

Say something...

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Forget it, what's there to say? Professor Luo is just doing a normal checkup, there's nothing wrong.

The chief resident in the cardiothoracic surgery department had a lot of thoughts in his mind.

Along the way, he watched Zhuang Yan and Meng Liangren communicating in a low voice, and felt a little envious.

As the chief resident, he doesn't have to worry about scientific research and papers, which is a great thing. But how come Meng Liangren, the senior attending physician who was transferred here, ran into this problem?

As for the patient, the cardiothoracic surgery resident chief didn’t think about it at all.

The patient has a large amount of fluid in the right pleural cavity!

What does it have to do with the ovaries? If there is any relationship, it is completely irrelevant. This must be something that Professor Luo said casually, and the doctors below took it as an excuse.

But the chief resident of the cardiothoracic surgery department felt mixed emotions when he saw Meng Liangren and Zhuang Yan performing "without props".

Look at the doctors under Professor Luo. Even when Professor Luo is not there, they still act very seriously, as if it really happened.

Envy, envy.

To them, Professor Luo's chicken feathers are like a command. If they say they will conduct an inspection, they have to do it, and there is no ambiguity in their execution.

Soon, the image appeared on the screen of the CT operating room.

Zhuang Yan stood behind the technician, but Meng Liangren was not shy at all. While chatting with the technician, he reached out for the mouse and started operating.

"Tumor!" Zhuang Yan said loudly when she saw Meng Liangren found the tumor.

The chief resident of the cardiothoracic surgery department was stunned.

Is there really a tumor?!

I am!

What's happening here!
The patient had a huge tumor in the left pelvic cavity, about 10 cm in diameter. Such a large tumor did not require any film reading skills at all, it just appeared on the machine.

The resident chief of the cardiothoracic surgery department felt a little numbness in his hand, and it turned out to be an ovarian tumor.

Is this a misdiagnosis? Probably not, he consoled himself.

The medical insurance company has run out of money, and will not agree to conduct relevant examinations unless there are sufficient and necessary reasons.

Do you want to get a full body checkup when you are hospitalized? If you do this, it is like burying a small landmine for yourself, and who knows when you will step on it.

"Brother is right!" Zhuang Yan was a little excited, "Lao Meng, Lao Meng, look at what I said."

Zhuang Yan shook Meng Liangren, who was sticking out his butt, holding the mouse in his hand and in a strange posture, and then took out his mobile phone to video chat with Luo Hao.

In the video, Luo Hao is sitting cross-legged in the open space of the panda house. On his left is a bamboo with the head of the bamboo resting on Luo Hao's legs. Luo Hao is gently rubbing the bamboo with his left hand.

On the right is Wang Jiani, the big girl’s head is resting on Luo Hao’s right shoulder, and she is holding Zhu Da in her arms.

What a warm picture.

It seems like a family of n is on a picnic or vacation.

Zhuang Yan felt guilty and apologetic. Her senior brother was so busy that he seldom had time to go to the panda house. She finally had time on the weekends, but she had to trouble him.

"Xiao Zhuang, don't be so emotional. I'm just seeing a doctor. Why do you have that expression on your face?"

Luo Hao on the other side of the video was smiling, and the sunlight seemed to have splashed out of the screen.

"Is there a tumor in the ovary?" Luo Hao asked.

"Well, look at the image, brother."

"Don't shake your hands, let me take a look." Luo Hao rubbed the bamboo while looking at the image.

"Looking at the images, it should be an ovarian theca cell tumor. The vast majority of them are benign tumors, so it's not a big problem."

A minute later, Luo Hao said gently.

"Ovarian theca cell tumor? What should we do next?" Zhuang Yan asked, and then she immediately remembered her father's "dog-raising theory."

She then subconsciously put this "wrong theory" into practice.

"Brother, you are amazing! You knew it was an ovarian theca cell tumor just by listening to my medical history."

"Huh? Xiaozhuang, who did you learn such greasy words from?" Luo Hao was a little confused.

"Greasy? I just think you're awesome, and you speak from your heart."

"Not at all thoughtful, looks greasy at first glance, not good, no next time."

"Gone! You really took it seriously!" Zhuang Yan wanted to show it to Luo Hao, but she felt something was wrong the next second, so she stopped. "Brother, my aunt Zeng has a large amount of fluid in the right chest cavity. Nowadays, medical insurance audits are strict, and examinations that are not related to the current disease are rarely done. When you said you wanted to do a CT scan of the middle and lower abdomen, did you think that there must be something wrong with the ovaries, and that it was a large amount of fluid in the right chest cavity caused by an ovarian theca cell tumor?"

The chief resident in cardiothoracic surgery nearly hit his head on the computer screen.

Is flattery so direct?
Is this really a good idea?!

Professor Luo was obviously just being perfunctory. After all, the patient wasn't his, so he just said...

Before the cardiothoracic surgery resident's thoughts disappeared, Luo Hao nodded slightly, "Yes, the large amount of fluid in the right chest cavity is indeed caused by ovarian theca cell tumor. Not bad, Xiaozhuang, your deduction ability has improved."

Gan!
The chief resident of the cardiothoracic surgery department felt dizzy.

What is Professor Luo talking about? Does he know it himself?
Ovarian theca cell tumor is related to large amount of effusion in the right pleural cavity?! What a joke.

That's not how you say random nonsense.

In fact, the resident chief of cardiothoracic surgery was very dissatisfied. If it were not for the pressure of medical insurance, he would have performed a gynecological examination on the patient long ago. Why would he wait until Professor Luo said that?
But this is only secondary. The main reason is that there is no possibility of connection between ovarian theca cell tumor and pleural effusion.

The resident chief thought carefully about all the diseases in his specialty and, except for the metastasis of malignant tumors, there should not be the situation that Professor Luo mentioned.

The dissatisfaction in his heart had already overflowed, "Professor Luo, can you tell me in detail what happened?"

The chief resident of the cardiothoracic surgery department is not stupid and will not directly provoke Luo Hao.

After all, you will be asked to write papers in the future, but if you have any questions, there is nothing wrong in asking them.

"Sure, this case of ovarian theca cell tumor causing pleural effusion is just right for writing a paper, Mr. Chang, right?"

“Yes, yes, yes.” The chief resident of the cardiothoracic surgery department nodded repeatedly, feeling confused.

"Let's go back to the office. It's not convenient to talk here."

The chief resident of the cardiothoracic surgery department was a little confused. Professor Luo was so sure that he didn't know whether it was true or not.

Back in the doctor's office, Zhuang Yan made the video call again.

In the video, Wang Jiani had already left with Zhu Da in her arms, Luo Hao was still sitting cross-legged, and Dahei appeared in his field of vision.

Luo Hao took a bamboo shoot in his hand and threw it into the air. Dahei ran out quickly, soared into the air, and grabbed the bamboo shoot in one bite.

The bamboo lay on Luo Hao's legs like a sculpture, motionless.

There is a hint of beauty in the movement and stillness of Dahei and Zhuzi.

"Brother, I hope I didn't disturb you." Zhuang Yan was a little nervous.

"Don't bother me. Da Nizi is taking Zhu Da out to drink milk. I'll just tell you about Meg's syndrome."

Meig Syndrome?
The chief resident in cardiothoracic surgery immediately took out his cell phone and typed in the five words "Meg's syndrome".

But the name that came up in the search term surprised him.

Meige syndrome is a rare neurological disease in clinical practice and a type of segmental dystonia.

Also known as idiopathic blepharospasm-oromandibular dystonia syndrome.

It was first reported by French scholar Henry Meige in 1910. It mainly causes various forms of dystonia of the eyelid spasm, facial muscles, mandible and neck muscles, and is more common in middle-aged and elderly people.

Isn't this a neurological disease? It has nothing to do with ovarian theca cell tumor and pleural effusion!

Is Professor Luo talking nonsense? !

Still saying no!

Zhuang Yan, however, put her phone up very formally, took a step back, found a chair and sat down, sitting upright like a primary school student.

Similar to her, Meng Liangren also sat down in front of his phone like a medical student.

The chief resident of the cardiothoracic surgery department was extremely annoyed. It was obvious that Professor Luo was just talking nonsense.

"That's it..."

Luo Hao was about to explain when the chief resident of the cardiothoracic surgery department couldn't help but ask, "Professor Luo, Meige syndrome seems to be a relatively rare neurological disease."

"Oh, you mean Meige syndrome, m, e, i, g, e." Luo Hao said a few letters and smiled, "I'm sorry, my spoken English is not very good."

"???"

"???"

"I'm talking about Meigs syndrome. m, e, i, g, s. They sound similar, but they are two different diseases."

I am!

The chief resident of the cardiothoracic surgery department was stunned.

"It's better to call it Meigs syndrome, but when I was at Union Hospital, everyone called it Meigs syndrome, so I got used to it."

Luo Hao did not mind the questioning of the chief resident of the cardiothoracic surgery department, but smiled shyly, "My Union Hospital also has some bad habits, I'm sorry."

“…” The chief resident of the cardiothoracic surgery department was stunned. He lowered his head and started searching for Meigs syndrome on his phone.

Oh shit!

The English language is such a shit mountain that the chief resident in cardiothoracic surgery found an explanation when searching for Meigs syndrome.

He looked down at the explanation on his phone and was stunned. This actually happened. Professor Luo was not talking nonsense. What he took out was not chicken feathers, but a real order.

"Sometimes a lot of auxiliary examinations are still needed. Now the medical insurance is under great pressure. There is no other way but to improve the technical level and do it in a targeted way so that the people in the medical insurance center have nothing to say."

"!!!"

(End of this chapter)