Chapter 262 This is a malignant tumor, send to jail
"The patient had enlarged abdominal lymph nodes, plus cervical lymph node tuberculosis. I think the diagnosis of concurrent splenic tuberculosis made by the second hospital during the follow-up examination had some basis."
Zhou Can said carefully.
"Does Dr. Zhou also think it is complicated by splenic tuberculosis? I also think that this diagnosis is tenable and anti-tuberculosis treatment should be continued. Because tuberculosis is a chronic disease that is difficult to treat and requires long-term medication to see results."
The attending physician Huang Xinggui spoke.
The treatment cycle for many diseases is very long. For tuberculosis, the medication period is usually more than half a year. Some patients are even seriously ill and need to take medication for one or two years.
"Well... I just think that the second hospital's re-examination diagnosis has some basis, but I don't agree with this result. The patient's initial examination results are very similar to tuberculosis, but the patient now complains of occasional pain in the bones and joints throughout the body. This symptom is actually worthy of vigilance. When I was a resident in orthopedics, I came across two cases of unexplained pain in the bones and joints, and both were eventually diagnosed as malignant tumors."
Zhou Can received regular training in multiple departments, working under the chief physicians, and the benefits gradually began to show.
As the saying goes, only by seeing more can one know more.
He worked with the chief physicians to diagnose patients, perform surgery and treatment on them, and so many chief physicians taught him everything they knew.
Although the total training time is less than two years, the accumulation of various medical knowledge and clinical experience learned is already considerable.
Especially in the diagnosis and treatment of difficult and complicated diseases, his combined diagnosis and treatment experience and knowledge from multiple departments make his diagnosis level far superior to that of ordinary doctors. Even many deputy chief physicians and chief physicians cannot compare with him.
This is also why many chief physicians still find ways to go to other departments or even other hospitals for further studies after becoming famous.
Because they clearly feel their own lack of knowledge in daily diagnosis and treatment.
In particular, the lack of medical knowledge and clinical experience in certain areas will become a shortcoming for them, seriously lowering their diagnosis and treatment level.
"Doctor, you are saying that my disease might be a malignant tumor, right?"
The patient's nerves immediately tensed up.
"That's not necessarily true. I just think it's necessary to do another CT scan and check the spleen area. The ultrasound scan you did at the last hospital showed multiple solid lesions. In fact, judging from the film, there should be low-echo or low-density areas, but they are not very obvious."
Zhou Can explained.
Without the final examination results, he certainly wouldn't dare to say anything to the patient.
If you suspect it might be a certain disease, then there is nothing wrong with it.
When doctors diagnose patients, they are trying to separate the true from the false. They screen and exclude all suspected diseases one by one, and finally leave the real cause, and then give the right treatment.
B-ultrasound uses ultrasonic waves for examination and imaging, while CT uses radiation to perform multi-layer scanning and tomographic imaging of the human body.
Different tissues and organs of the human body absorb X-rays to different degrees, and finally form images of different densities. CT uses this principle to examine the various organs of the human body. It has a higher resolution than ordinary X-ray examinations for diseases of various organs, obtains more imaging information, and has a greater role in disease diagnosis.
Many people think that CT examination is an upgraded version of X-ray examination, but this is not entirely correct.
X-ray scanning is a plane projection examination of a certain part of the body, while CT is a continuous multi-layer scan of a certain part of the body. The imaging principles are different.
CT is a very good examination method to detect whether there are low-density areas in this organ.
In medicine, considering the economic affordability of patients, doctors often choose B-ultrasound and CT, two relatively low-priced tests, for clinical diagnosis. The results of the two tests can be referenced to each other, which is of great significance for medical diagnosis.
"Xiao Zhou's diagnostic skills are getting better and better! His diagnosis is basically the same as mine. Here is the application for CT scan. You can pay for it and do the scan. You don't have to wait in line after getting the result. Just come in and see me. I'm not here this afternoon. If you're late, you can come to the inpatient department of the Department of Gastroenterology to see me. If I'm not here for something, you can go see Dr. Zhou."
Director Shang is completely pushing Zhou Can to the front line.
Zhou Can wanted to protest against such an honor, but finally he moved his lips and swallowed his words.
Seeing the examination application form written by Director Shang, Zhou Can finally understood that Director Shang had already found out the problem and was just trying to train the diagnostic abilities of several students.
"Okay, thank you! Thank you, Dr. Zhou!"
The family member took the examination application form, thanked Director Shang, and then thanked Zhou Can separately.
These two family members are too realistic.
In fact, Huang Xinggui also contributed to the diagnosis, but they did not thank him.
People always only care about things that are closest to their own interests.
Director Shang said that if he was away for some reason, the patient would have to take the test results to Zhou Can.
Therefore, the family members must maintain a good relationship with Zhou Can.
After the patient left, Huang Xinggui still asked in confusion, "Director Shang, the patient's symptoms and existing test results clearly indicate that it is tuberculosis! Why do you and Zhou Can both suspect that the patient may have a tumor?"
The other three graduate students were also quite puzzled.
Qiu Chengyu looked at Zhou Can with a very complicated look.
He watched Zhou Can quickly climb up from the position of 'doorman' on the first day to his current position step by step.
Today, Zhou Can's status has even surpassed that of Huang Xinggui, the attending physician.
Whether Zhou Can was sent to the cardiovascular department to replace Director Shang for consultation, or he was told that if the patient could not find Director Shang, he could directly take the test results to Zhou Can for further diagnosis. This shows that Zhou Can's position in Director Shang's heart has far surpassed Huang Xinggui.
You know, before Zhou Can came, Huang Xinggui was an arm that Director Shang relied on very much.
The two female graduate students, Xie Lin and Luo Jingyi, would privately consult Zhou Can whenever they encountered difficult problems.
For no other reason, it was because Zhou Can was about the same age as them, easy to talk to, and could always help them answer their questions.
"Xiao Zhou, please help them solve their doubts."
Director Shang picked up the teacup and drank tea.
Teachers are very lazy and will never do anything themselves if they can ask their doctors to do it for them.
Perhaps it is because the example of Zhuge Liang in ancient times who did everything himself and was worked to death left too deep an impression on the world.
"I have three ideas for diagnosis! First, the B-ultrasound during the patient's follow-up examination showed a low-density area in the spleen. Although it is not obvious, it is a bad signal for tuberculosis patients and deserves vigilance. Second, the patient reported occasional pain in the bones and joints of the whole body. This unexplained pain in the bones and joints of the whole body is also dangerous and is often a precursor to leukemia and malignant tumors."
Zhou Can did not hide anything and shared his diagnostic ideas with everyone.
"Finally, the patient's bone marrow showed obvious active proliferation, with a granulocyte-to-erythrocyte ratio of 7 to 1. This value is slightly higher than the normal value and can be easily overlooked. However, for many malignant diseases, the granulocyte-to-erythrocyte ratio will only be alarmingly high when it develops to a serious stage. In the early stages, it is often not obvious."
After he stated the three diagnostic points in succession, everyone was convinced.
Huang Xinggui said with a look of sudden enlightenment, "I see, I see. Doctor Zhou not only has a solid foundation in medicine, but is also extremely meticulous and is able to make comprehensive use of his clinical experience in multiple fields. I am convinced today."
"Haha, these magic potions of Doctor Huang have made me feel so light-footed!"
Excessive humility is equal to pride.
Sometimes being too humble can easily make people dislike you.
It's good to be humorous occasionally.
This seemed to be the first time someone praised Zhou Can for his solid medical knowledge.
It also shows that Zhou Can has made good progress in his intensive medical knowledge studies over the past two years.
After this patient left, he continued to see new patients.
The numbers that Director Shang issues every time he sees patients are basically fixed, but there are always some patients who are very resourceful. After knowing that he is seeing patients, they will find various ways to get additional numbers.
We were busy until almost noon, when everyone was getting ready to get off work. The patient with enlarged spleen came over after the examination.
"Professor Shang, the CT results are out. Please help me take a look."
This patient is really amazing. He waited in line and completed the CT scan in about an hour.
Director Shang took the film and found that the CT results were much clearer than the B-ultrasound.
Multiple low-density areas in the spleen can be seen at a glance.
"The situation is not good. I recommend a laparotomy to further confirm the diagnosis. It is very likely that the spleen will need to be removed to save life."
What Director Shang said this time was very serious.
His tone was also quite serious, and his face showed a hint of solemnity.
At his level, he would not easily tell a patient to remove an organ. He would only do so if he thought it was extremely dangerous.
"Professor Shang, what is my mother-in-law's illness?"
The patient's daughter-in-law seemed relatively calm, but the patient's son was nervously supporting his mother, looking extremely panicked.
"It can be basically concluded that there is a tumor in the spleen, and there is more than one. It's just that because it is hidden and the existence of the tumor is covered by lymph tuberculosis, the first two hospitals failed to find it. While the tumor is small now, surgery is the best way to save life. The spleen is surrounded by important organs and dense lymph nodes, so malignant tumor cells are very easy to metastasize. Once it spreads, it will be troublesome."
Director Shang tried hard to persuade the family and the patient to agree to the laparotomy.
If necessary, remove the spleen directly.
This operation will definitely have a certain impact on the patient's body, but it is much better than dying from cancer in the future.
Without this surgery, the tumor in the spleen may spread throughout the body in two to three years at most.
At that time, the patient will not only live in great pain, but will also lose the opportunity for surgery.
We can only use medication to relieve pain as much as possible and improve the quality of the patient's life in the later stages.
"Didn't my mother-in-law have tuberculosis? How did she develop a spleen tumor?"
The family still finds it difficult to accept this fact.
"It is very possible that tuberculosis has caused gene mutations in malignant tumors. The older the patient is, the more likely it is for gene mutations to occur. She now has two diseases: tuberculosis and a large number of small tumors in her spleen."
Director Shang explained to her.
Doctors usually don't say the word "cancer" directly in front of patients.
Replace it with malignant tumor or very bad situation or something like that.
Oncogene mutation is an important cause of cancer.
During a person's life, cells are constantly renewed. Every time a new cell is produced, it is accompanied by DNA replication and the transmission of genetic information.
We humans generate more than 10 billion new cells every day, and inevitably a certain proportion of wrong cells will be generated. Some of these wrong cells die, while others gain unlimited life and unlimited replication capabilities. This is the origin of "cancer cells".
The appearance of cancer cells does not necessarily develop into cancer.
Because our bodies have a variety of protective mechanisms, the most important of which is the tumor suppressor gene.
Only when tumor suppressor genes are lost or disabled can cancer cells take root in the human body and eventually become tumors.
Why are young people less likely to get cancer, while older people have a higher risk of cancer?
This is mainly because the immunity of the elderly decreases.
In addition, the more times cells are renewed, the higher the probability of error.
No one knows when the patient's spleen tumor appeared. Some cancer cells can quietly lurk and grow in a sleazy way, waiting patiently like Sima Yi in the Three Kingdoms period. They will not take advantage of the situation until the patient's body has a defensive flaw, and then they will quickly grow into a malignant tumor.
After listening to Director Shang’s explanation, the two family members finally agreed to Director Shang’s proposal of conducting an exploration first and then deciding whether to remove the spleen depending on the situation.
Since it involves surgical operation, Director Shang directly recommended the patient to go to general surgery for further treatment.
Generally speaking, for patients who are not admitted to the hospital and whose treatment plans are beyond the scope of this department, it is usually recommended that the patients be transferred directly to the corresponding department for treatment.
Instead of using the medical resources of two departments, the patient underwent a multi-department joint surgery.
…
After the consultation, Zhou Can went to the cafeteria to eat with his colleagues.
Compared with the busy surgeons, internists are also busy but not as busy. Surgeons usually have to take turns eating and even often miss meal times.
For surgeons, it is simply a luxury for them to eat together, as is the case with internists.
If we talk about the busiest department, surgery is not even ranked first.
The busiest department is the Department of Critical Care Medicine, which is a department that races against life all the time, and the medical staff are always under tremendous work pressure. When rescuing critically ill patients with sudden conditions, it often requires many doctors and nurses to be busy and running.
Only those medical staff who have experienced it personally can understand the busyness and tension.
While eating , Zhou Can's surgery vibrated twice.
When he is working in the hospital, he usually keeps his cell phone in silent mode.
I took it out and saw that it was a message from my girlfriend Su Qianqian.
"Honey, Hu Wei called me just now. He asked me to meet him at John's Western Restaurant."
After Zhou Can finished talking with Li Lao, Zhou Can went online to look at the negative news about Su Qianqian. They kept popping up like mushrooms after rain, and most of them were posted by a person with the ID "Former employee of Jinyu Interactive".
The remaining rumormongers either forward rumors without any scruples or make up stories with exaggerated content in order to gain traffic.
What people say is scary.
Su Qianqian must be under tremendous psychological pressure facing these rumors.
But she never took the initiative to mention it to Zhou Can.
When the two of them had a tryst, she always reported good news but never bad news.
Zhou Can knew clearly that she was worried that telling Zhou Can those things would affect Zhou Can's work, so she chose to bear it alone.
Of course, facing these rumor mongers and the overwhelming pressure from public opinion, Jinyu Interactive will definitely not sit idly by.
In fact, Jinyu Interactive has already secretly helped her deal with those malicious slanders and rumors.
As her boyfriend, Zhou Can has every obligation to protect his woman from harm.
Stand up when she needs you most and be her strongest support.
For this reason, Zhou Can specially invited her to his dormitory two days ago and hugged her to have a good talk about this matter.
In addition to comforting her, Zhou Can also thought of ways to help her.
Tell her that if the traitor Hu Wei who left Jinyu Interactive calls her, she should notify Zhou Can immediately.
After waiting for so many days, Hu Wei finally couldn't help but contact her.
This also gave Zhou Can the opportunity to act according to plan.
He wants to play a big game and fight Hu Haikun behind the scenes.
So what if he is the richest man? He has a dirty background and is stirring up trouble everywhere. He even wants to play dirty tricks to kick Zhou Can out of Jinyu Interactive, and now he is targeting Zhou Can’s girlfriend.
Zhou Can’s policy has always been neither to cause trouble nor to be afraid of trouble.
Since Hu Haikun has already stepped on his head and pissed and shit on him, he should just send Hu Haikun to jail like he did to Mr. Qian of Beihai Langxing Media Company.
This person has a criminal history of being involved in evil and gangs, and his crimes are too numerous to list. If they are verified, even if he is not shot, he will have to spend the rest of his life in jail.
"When will you meet?"
Zhou Can sent her a message back.
"I would not meet with such a person, but you asked me to be hypocritical with him, so I agreed to meet him at around 2 o'clock tomorrow afternoon."
She trusts Zhou Can extremely.
After Zhou Can talked to her that day, she felt very happy. Which woman doesn't want her boyfriend to protect her?
Everything went according to Zhou Can's plan.
"Very good. If it's convenient, ask Weifang to come to my place. I have something for her to do."
"Okay! I'll ask her to wait for you downstairs in the dormitory after get off work."
"Tell her to call me when the time comes. Also, don't leave the company when Wei Fang is not with you! Hu Haikun is a man who will do anything to achieve his goals, so you must be extremely careful."
Zhou Can warned her.
If Su Qianqian fell into the hands of such a person, one could easily predict what would happen to her.
