Doctor of Healing

Back in the ward, Director Liu stood outside the office and waved to Zhao Zhe.

Ji Xiang pushed Zhao Zhe, turned around and wanted to leave, but was called by Director Liu.

"Xiaoji, Dr. Zhao, I want to inform you of two things." Director Liu was full of smiles, swaying in the armchair.

Ji Xiang stood in front of Director Liu with his hands down.

"First, prepare for your current project and make a notebook. I will apply for the provincial self-administration for you."

"Director, what is the provincial self-administration department?" Zhao Zhe looked confused.

Although Zhao Zhe is the old attending doctor, he doesn't understand scientific research at all, and the journals and documents with Chinese prefixes are already the limit for him.

Provincial self-administration?

That's not something an elderly attending doctor in a primary hospital can covet.

"Provincial Natural Science Foundation Project."

"!!!"

Zhao Zhe was hit by a pie that fell from the sky, and he was devoid of meat and vegetables.

No one in Yuanliao has ever touched something as tall as the provincial department.

"Xiao Ji, your qualifications are not enough. The leader of the project is Dr. Zhao, so I have no opinion." Director Liu looked at Ji Xiang and asked his opinion first.

"Director, no. And the project itself belongs to Brother Zhao. It's normal for him to be the leader." Ji Xiang replied with a smile.

"And not only is it not beneficial, but you have to work with Dr. Zhao all the time. If you have any opinions, let's discuss them. If you don't have any opinions, I will take it as your acquiescence."

This was so polite that Ji Xiang scratched his head.

"Director, I will definitely keep working, the project has already started." Ji Xiang said seriously.

Director Liu asked with a smile, "Xiaoji, do you know what you have to pay?"

Jixiang explained his understanding of scientific research that the system NPC told him.

Especially when it comes to the understanding of the oil field hospital's 30-year long-term scientific research, not only Zhao Zhe was stunned, but even Director Liu heard of it for the first time.

He knew that the Oilfield Hospital seemed to have an awesome scientific research project, but he didn't expect it to be so awesome.

Over the past 30 years, over time, dozens of top SCI articles can be derived from just one project.

Simply outrageous.

Director Liu didn't expect Ji Xiang to make such a plan.

He was silent for a few seconds, then smiled, "If this is the case, that would be the best. The second thing, Dr. Zhao."

Director Liu looked up at Zhao Zhe.

"Director, tell me." Zhao Zhe was worried.

A provincial self-administration project has already stunned Zhao Zhe, and a little doctor in Yuanliao Central Hospital who no one cares about can apply for the provincial self-administration!

When I go back, my colleagues will probably drool enviously.

But the director of the house will definitely be jealous, afraid that his life will be difficult.Do you want to refuse?Let Ji Xiang be the leader, and just get a little credit for yourself.

Thinking of this, Zhao Zhe's mouth was dry, and he wanted to let him go, but he couldn't bear it.

"I'm not a saint either." Director Liu said with a smile, "It's best to apply for a provincial self-administration from a doctor under me."

Zhao Zhe sighed in his heart, it turned out that he still wanted to make a wedding dress for someone.

"I contacted it, and it should be able to get through, and there is a high probability that it will work."

"Doctor Zhao, do you want to come to the Second Affiliated Hospital?"

"Think about it." Zhao Zhe didn't realize the meaning of Director Liu's words, so he responded casually.

"Is there any concern at home, your lover's job or something, can you accept the separation between the two places? It's the limit of my ability to transfer you here, no more." Director Liu said lightly.

Zhao Zhe was completely stunned by the second pie.

After many years of talking about tuberculosis, he was healed, and stood in front of Director Liu at a loss for what to do.

"Xiaoji, I've prepared everything for you, although this project has nothing to do with you..."

"Director, don't worry, I will do surgery and postoperative follow-up." Ji Xiang replied calmly, "The project will take at least ten years, I am very optimistic about this project, and I will try to publish the data after more details In a sub-issue of The Lancet."

"..."

This time even Director Liu was dumbfounded.

Ji Xiang really dared to think about it, the Lancet, although it is a sub-journal, but that stuff... let’s put it this way, as long as any doctor in the Second Affiliated Hospital has a document on the Lancet, it is enough to feed him for a lifetime.

Even Director Liu is jealous.

The phone rang, interrupting Director Liu's thoughts.

"Hi, I'm Liu Zhi."

"No pee, okay, I'll take a look."

Director Liu hung up the phone, stood up and said to Ji Xiang, "Xiaoji, accompany me to the consultation. That Dr. Zhao, you think about it first, after all, it is a major event in life, and tell me the news tomorrow morning."

After speaking, Director Liu took Ji Xiang to the consultation without waiting for Zhao Zhe to reply.

Although Zhao Zhe didn't express his opinion right away, Director Liu knew that he belonged to Fan Jinzhong's Huanxi, so he was stupid, so he didn't believe that Zhao Zhe would not accept such a big pie.

"Director, what patient?" Ji Xiang asked.

Director Liu was more interested in the Lancet, but he forcibly suppressed his emotions and tried to keep his tone calm, "It is said that a patient with external hemorrhoids did not urinate after surgery. He was transferred from a lower-level hospital to our Department of Nephrology. treat."

"After completing the relevant inspections, no problems were found, and he was diagnosed with acute renal failure. By the way, let us have a look."

"Oh." Ji Xiang responded.

External hemorrhoid surgery, acute renal failure, two things that Feng Ma Niu does not want to do, Ji Xiang thought about it along the way.

But Ji Xiang had no idea at all.

When I came to the Department of Nephrology, I read the medical records and the patients.

The patient underwent surgery at a local hospital because of external hemorrhoids, and was treated with ceftriaxone sodium intravenously for anti-infection after the operation (the specific dosage is unknown).

Sudden anuria 3 days ago, accompanied by bilateral low back pain, nausea and vomiting, was given antispasmodic and pain relief at the local hospital but was transferred to the Second Affiliated Hospital for treatment.

Urinary tract plain film in the outpatient clinic showed no positive stones, urinary tract CT showed mild bilateral kidney hydrops, small stones in the right kidney, renal function test showed serum creatinine 700 μmol/L, urea nitrogen 18.10 mmol/L, uric acid 480 mmol /L, no obvious abnormality was found in the electrolyte.

The medical history is very simple, and there is nothing weird about it. Ji Xiang has no idea at all.

Director Liu and the director of the Nephrology Department chatted about their respective ideas, and Ji Xiang came to the system operating room.

"teacher."

Jixiang told the system NPC about the patient's medical history and physical examination symptoms.

"That's right." The system NPC smiled slightly, "I have seen similar patients."

Ji Xiang was a little emotional, the system NPC is really experienced.

Chapter 289 Sequelae of Ceftriaxone

"The patient has small stones, but the stones will not affect urination." Director Liu said with certainty, "Director Xu, I don't think the kidney function is particularly bad. Why don't you try dialysis for a few days."

"I just don't understand why." Director Xu of the Nephrology Department frowned and said, "I know it has nothing to do with you, but..."

As she spoke, she stopped talking.

This consultation is indeed a bit nonsensical, but Director Xu has no choice but to give it a try and see if Director Liu of the Department of Urology has any ideas.

"It has nothing to do with us." Director Liu smiled and repeated.

As soon as the words were finished, Director Liu suddenly felt his foot was kicked lightly.

It's Ji Xiang!

He is reminding himself! !

Director Liu was taken aback, realizing that there might be a problem, and immediately recalled the patient's imaging data, past history, and current targeted treatment.

Nothing wrong, this patient has nothing to do with urology!

But he kept his composure, stood up and said, "That's it for now, I'll go back and think about it."

"Thanks for your hard work, Director Liu, please write a note for the consultation."

"okay."

Director Liu and Ji Xiang left the nephrology department, and as soon as Director Xu disappeared, Director Liu immediately asked, "Xiaoji, what do you think?"

"Director, the patient received ceftriaxone in the local hospital." Ji Xiang whispered.

"Ceftriaxone? There's nothing wrong with it. Broad-spectrum antibiotics are effective against Staphylococcus aureus, Streptococcus, and Pseudomonas aeruginosa. The medication at that time was considered symptomatic."

Director Liu still doesn't know what Ji Xiang is going to say.

"Director..." Ji Xiang didn't know what to say.

"Xiao Ji, just say what you have to say, and you don't have to think that I am the director." Director Liu raised his head slightly, looked at Ji Xiang and said seriously.

"The drug instructions for ceftriaxone sodium mentioned the possibility of extremely rare gallstones."

"..." Director Liu was taken aback, he didn't know about this at all.

Ceftriaxone sodium is a commonly used clinical drug, and its effect is quite good, but this drug can also form gallstones?

Director Liu was stunned.

"Theoretically, ceftriaxone sodium has a higher drug solubility and is less likely to form urinary stones.

When the blood volume is reduced, the urine flow rate is reduced, and the drug is used in large doses, the drug concentration will reach a peak in a short period of time.

Ceftriaxone ions and calcium ions in urine form ceftriaxone calcium, because ceftriaxone calcium is insoluble in water, and then crystallize in the ureter and form pseudolithiasis, leading to acute urinary tract obstruction and acute renal failure Exhausted. "(Note)

Ji Xiang recounted the theory that the system NPC told him in detail.

In fact, Ji Xiang is not very sure, the theory of system NPC is too bizarre, kidney failure can be caused by antibiotics, Ji Xiang does not quite understand.

Director Liu was taken aback when he heard that.

But Director Liu had already knelt down a long time ago, starting with the puncture of the cavernous body, and the incredible cases after that made Director Liu unable to think of questioning.

"How to diagnose?" Director Liu asked with a frown.

"Animal experiments and in vitro experiments have shown that the formation of ceftriaxone stones is positively correlated with the concentration of calcium ions and ceftriaxone in urine, and negatively correlated with the concentration of citric acid in urine."

"But for inspection, I'm afraid we don't have it in the Second Affiliated Hospital, so I'd better take a look in the mirror."

Ji Xiang suggested.

"Okay." Director Liu turned around, hesitated for a moment and picked up the phone.

"Old Gao, I, Liu Zhi, help me read the ceftriaxone instructions."

"Why do you talk so much, I may encounter a patient with problems."

"It's not an allergy. I don't know about that kind of thing. Take a look at the instructions for ceftriaxone to see if it says it causes gallbladder stones."

Director Liu was not embarrassed for questioning Ji Xiang's statement, he waited intently for the reply from the director of the pharmacy department with his mobile phone.

Ceftriaxone sodium is not metabolized in the body, 60% is excreted by the urinary system, and 40% is excreted by the biliary tract and digestive tract.

If gallstones can form in the gallbladder, so can the urinary tract, although they are quite rare.

So he cautiously asked the director of the pharmacy first.

Soon, the phone rang, and the director of the pharmacy opposite seemed surprised, and the voice was a few decibels louder.

Director Liu's orbicularis oculi muscle twitched a few times.

"I see, thanks."

After hanging up the phone, Director Liu looked at Ji Xiang in surprise.

"Xiaoji, do you read all the drug instructions? And can you memorize them?"

Ji Xiang was a little ashamed. Wherever he knew it, it was turned on by the system npc.

Seeing that Ji Xiang had a different expression, Director Liu raised his hand and patted Ji Xiang on the shoulder with a smile.

"It's a good thing. I'm not jealous of the virtuous and the capable. Xiaoji, be a mirror with me later."