Back in 2002 as a doctor

"By the way, I encountered a special case, and even I almost misdiagnosed it."

Zhou Congwen racked his brains to ponder all kinds of gossip, and stopped whenever Shen Lang's EEG fluctuated slightly, and continued to tell stories to Shen Lang after it stabilized.

"A 62-year-old female patient underwent aortobifemoral bypass grafting for abdominal aortic aneurysm, followed by coronary stent implantation for unstable angina.

Come to our emergency department in about 10 days. "

"She said she had muscle aches and radiating pain near the left costal arch. My first feeling was that the patient lay down too much after the operation, which caused costochondritis and intercostal neuralgia."

As he said that, Zhou Congwen sneered.

This is a misdiagnosis that he has cherished for a long time, in order to tell a story to Shen Lang, he now uses it to tell the story.

"She has no fever or urinary symptoms. Her lower abdomen is soft, and she has no symptoms of abdominal pain. As for the kidney area, there is no percussion pain. Oh, I should have included this when talking about the urinary system."

"I thought it was fine after the physical examination. At that time, the doctor said that the examination was random, and I was more sure that the patient was fine, so I took an electrocardiogram and sent the patient back."

"It's also my fault. I can't complain about doing more inspections. It's my fault."

"Three days later, the patient came to me again, saying that the condition was getting worse."

"I ordered a test and thought there would be nothing unusual at the time.

However, her laboratory tests revealed—severe leukocytosis 27 cells/mm000, elevated CRP to 3 mg/L, changes in liver function tests, and positive urinalysis, including leukocytosis, microscopic hematuria, and bacteriuria. "

"It scared me to death at that time." Zhou Congwen laughed, "This is a proper misdiagnosis. How could my Professor Zhou be misdiagnosed, right?"

Speaking of this, Shen Lang's EEG changed slightly.

Even a large amount of sedative drugs could not suppress Shen Lang's slander and complaints about Zhou Congwen's words.

"After being admitted to the hospital, other further examinations were performed on the patient.

CT urography showed that the proximal 6mm stone in the left ureter caused rupture of the ureter, urinary extravasation in the delayed phase, and a large amount of blood in the renal pelvis and calices, resulting in enlarged left retroperitoneal hematuria with a good shape and a size of 11×9×12cm clot. "

"Symptomatic treatment was undertaken and emergency endoscopic drainage was successfully performed with insertion of a JJ stent and the Foley catheter remained in place."

"Fortunately, my subsequent treatment was relatively timely, and the urology department was not dismantled, and the diagnosis was that the ureter was ruptured by ureteral stones. Spontaneous rupture of the ureter is rare."

Zhou Congwen talked about rare diseases, but Shen Lang's brain waves didn't change much.

This……

Zhou Congwen was a little puzzled.

This is a misdiagnosed medical record that I have treasured for many years, how could Shen Lang not be interested?

After telling this story, Zhou Congwen told Shen Lang another emergency rescue in which his heart stopped beating 89 times.

Shen Lang was still quiet, and his brain waves didn't change a bit.

"I'll tell you something interesting, don't tell others." Zhou Congwen thought for a while, then changed direction.

"One year, an old man with terminal cancer was hospitalized, and the patient's children and granddaughter came to see him after eight o'clock in the evening. The patient's daughter-in-law said that his niece was not in good health, so let me take a look."

"The lips are cyanotic, and the nail bed also has problems. The heart auscultation did not confirm the major events, but the patient... let's put it this way, I didn't see any problems at the time. I asked the girl to have a thyroid B-ultrasound. I think it was caused by hyperthyroidism. of."

"Not to mention the diagnosis. The girl was 17 years old at the time. One month later, she came to me directly and asked for my phone number."

"I know she's interested in me, but she's too young to break the law."

Shen Lang's EEG began to fluctuate, faster and more obvious than before.

Zhou Congwen sighed, Shen Lang is simply interested in gossip, and has no fluctuations in the diagnosis and treatment of various rare diseases that he is excited about.

Is this a doctor?

This is also a doctor!

"After that, I will treat him with courtesy, and it will be fine when the child grows up."

"We'll keep in touch once in a while when she's in college. Once I went to a meeting and she came straight to me."

"Talk about it... It scared me so much that I didn't even dare to answer. It's all going on here."

"Emmmm, you definitely want to talk about your appearance. Let me tell you, the girl's appearance is at least 9 points, and she has a great figure, but I'm not that kind of person."

Zhou Congwen said with a little embarrassment.

Shen Lang's EEG fluctuated again after calming down a bit.

Zhou Congwen shut up, he knew how to communicate with Shen Lang, so he was quiet for half an hour.

"One more thing. In the future, you have to keep a distance from the people in the factory. In the hospital, you also have to keep a distance from the people in the pharmacy department."

"Some medicines can be purified to produce illegal things. We rarely touch these things in clinical practice, but the people who work on medicine..."

Zhou Congwen intermittently told Shen Lang a few related gossips, especially the incident involving Xiangya. Shen Lang's brain waves almost flew up. Shen Lang's gossip heart.

Chapter 1238 A Good News

The night passed peacefully.

Early the next morning, Mr. Huang and the seriously ill people from 912 came to take over.

Shen Lang lay quietly on the hospital bed, the EEG seemed so stable under the control of the medicine.

It's just that no one knows what terrible things Shen Lang is experiencing under the water.

When Zhou Congwen reported the situation, Mr. Huang took him to check the laboratory values ​​of the morning, fine-tuned the doctor's order, and sent Zhou Congwen back to sleep.

Looking at the system panel in the upper right corner of his field of vision, Zhou Congwen felt a little distressed.

But after all, it was a task issued by the system, especially the huge X above 100%, which gave Zhou Congwen some confidence.

This is equivalent to the little guy of the system stamping the judgment that the mortality rate of rabies is not [-]%.

It is always good to have a glimmer of hope. If Shen Lang still fails under the care of himself, his boss, and the 912 intensive care unit, Zhou Congwen has nothing to do.

Life,

This is fate.

As the days passed, Shen Lang was lying on the hospital bed like a vegetable, and the daily laboratory tests did not improve at all.

Even Zhou Congwen felt hopeless.

It was not until the seventh day that the turning point appeared.

The titer of anti-rabies virus antibody in Shen Lang's serum began to rise gradually!

This means that Shen Lang's body immunity has gradually gained the upper hand in the process of fighting the virus!

Holding the test sheet, Zhou Congwen's hands began to tremble uncontrollably, as steady as an old dog.

"It's okay, you go back to sleep." Huang Lao said lightly.

"Boss, you said that the rabies antibody will not disappear suddenly." Zhou Congwen asked a very unprofessional question.

This possibility exists, but it is not considered in terms of probability.

But the question from Zhou Congwen's mouth can prove how messed up his mind has become.

"Concern makes chaos." Huang Lao glanced at Zhou Congwen, and said lightly, "Go back to rest and observe for two days. If the antibody titer in the serum gradually rises, you can reduce the dosage of ketamine; midazolam can also be replaced by a longer dose. Diazepam."

"The specific situation needs to be analyzed in detail. That is the most dangerous time. If you can wake up, you will wake up. If you can't wake up... the possibility is relatively small."

Hearing what his boss said, Zhou Congwen finally let out a sigh of relief.

Maybe Shen Lang will still have various abnormal nervous system reactions, such as chorea and other sequelae, but it is better to be alive than dead.

And this was said by his own boss, with some kind of authority.

Deng Ming was so shocked that he couldn't speak after seeing the test results. He knew the whole process of treatment very well.

The increased antibody concentration in the serum means that Shen Lang's body's immune function is fully turned on, and the rabies virus in his body is being cleaned up.

After Zhou Congwen left, Deng Ming asked, "Boss, can you really live?"

"It looks like this now, the probability is over 50.00%." ​​Mr. Huang stood at the foot of the bed with his hands behind his back, squinting at Shen Lang who was lying on the bed.

"It's really..." Deng Ming murmured.

"Unbelievable?" Huang Lao smiled, "There are so many unbelievable things, you have to believe in the complexity and tenacity of the human body structure."

"But this is rabies with a 100% mortality rate."

"I've told you countless times that the 100% mortality rate is just an approximation. Paraquat, isn't it also said to have a 100% mortality rate above a certain amount? There is also a precedent for resuscitation recently." Huang Lao said slowly.

Deng Ming knew about this.

"Don't be stubborn." Huang Lao said, "The world is moving forward. Tuberculosis used to be a terminal disease with a very high mortality rate. Now it is."

"What the boss said is true." Deng Ming was directly persuaded, and said with a smile.

He knows very well what the boss will do next, which must be to instill values.

But Mr. Huang didn't say much, he let out a sigh of relief.

"Boss? Still worried?"

"After all, there are not many successful cases, and it depends on Shen Lang's own immune system. This kind of thing is simply a matter of fate."

Deng Ming did not reject this kind of statement. The old clinic would not be as ignorant and fearless as a novice, thinking that doctors can solve all problems.

What's more, we are now facing rabies, a virus with a fatality rate...almost 100%.

"This child is full of vitality, I don't think it's a big problem." Mr. Huang finally made the final decision.

……

……

In the office of the chest department, the work of the medical team is still going on.

It's just that no major surgery has been performed recently, and all of them are wedge cuts.With Professor Chen Houkun watching, wedge cutting is also a basic operation, and there is nothing difficult about it.

Xiao Kai also paid great attention to the selection of patients. Any patient with difficulty was told to wait until there was a definite news from Shen Lang, and to wait for Zhou Congwen to recover.

What you need to do now is to be steady and determined.

Xiao Kai sat in the office, looking at the doctors in the medical team working with a sinking face, feeling a little complicated.

"Dean Xiao, what did Professor Zhou say today about the titer of the rabies virus antibody?" Peng Yiming asked.

"I don't understand either, but that's what you think." Xiao Kai said vaguely.

What exactly Peng Yiming was thinking in his heart, whether he knew it or not, no one could guess.

"President Xiao, I heard Huang Lao said that the treatment for Shen Lang was according to the Milwaukee therapy, you said..." Li Ran asked.

Halfway through the question, he didn't continue to ask, for fear of getting some bad answers from Xiao Kai.

"Old Mr. Yu Min, do you know?" Xiao Kai suddenly changed the subject.

"I know, someone who studies hydrogen bombs." Li Ran was a little surprised.

"I heard a gossip from Professor Zhou. It is said that many years ago, Mr. Huang chatted with Mr. Yu. Mr. Yu's student wanted to publish a popular science article and showed it to Mr. Yu."

Everyone paused and listened attentively.

"After reading it, Mr. Yu said that although there are no secrets involved, there are some contents... It is said that India was researching hydrogen bombs at that time, and some contents may inspire Indians to speed up their research process."

"what?"

"I remember Professor Zhou described it this way—Old Yu said that we found the way in three months, and the Indians estimated that we could do it in three years. After three years, we will publish it after they understand the research."

"and after?"

"It's been 15 years, and I still don't believe it." Xiao Kai said, "So there is a saying in that circle - don't trust Indians."

The medical team had been dull for a week, Xiao Kai told a joke, and with today's "good news", everyone finally relaxed a little.

"The same goes for medical treatment. We were inspired. As for the specific treatment process, Professor Zhou Congwen Zhou and Mr. Huang made a plan based on Shen Lang's physical condition. Whether it will work or not, no one is sure."

"But!" Xiao Kai changed the topic.

"Since there is good news, it proves that it is effective. Let's work hard and be careful. Just don't add trouble to Professor Zhou at this time."

"Remember it!"

Chapter 1239 I'm Born To Be Useful

Shen Lang is in the ICU, life or death is unknown.