Doctor of Healing

"Good director."

Director Liu didn't hesitate anymore, and turned back to look for Director Xu.

"Director Liu, why are you back? Did you drop something?" Director Xu of the Department of Nephrology was startled.

"Xiaoji reminded me, I suddenly remembered something."

Director Liu "translated" Ji Xiang's words again. Although there were some missing things, Director Xu, who was in his mind, could understand.

"Director Liu, why haven't I heard of it?" Director Xu questioned without hesitation.

"Prepare to be a mirror, take a look, no matter what is going on, it will be clear at a glance."

"Make a mirror?" Director Xu was stunned, she didn't understand why a mirror was made.

"Director Xu, you haven't made a diagnosis, and you don't know what's going on. I propose a possibility and you still don't believe it." Director Liu immediately lowered his face, "If you don't want to, I'll go back. I'm tired after a day of surgery. Die, who wants to use the mirror in an emergency."

"Don't introduce!" Director Xu immediately apologized, "Director Liu, look at you. I just don't understand why you are still angry. You are not like this usually, don't be stingy."

She checked the information when she was about to send the patient to the urology department.

After using ceftriaxone for so many years, Director Xu, like Director Liu, did not know that there was a possibility of stone formation.

"Director Liu, is there any other diagnostic method?" Director Xu asked casually.

"Xiaoji, tell me." Director Liu was proud.

"The most reliable way to diagnose ceftriaxone stones is infrared spectroscopic analysis, but our Second Affiliated Hospital has not yet carried out such examinations.

Diagnosis still needs to be combined with the patient’s medical history. When a patient develops symptoms of renal colic after recent use of ceftriaxone sodium, accompanied by sudden oliguria or anuria, the first consideration should be the possibility of acute postrenal renal failure caused by ceftriaxone stones. possible. "

"While unlikely, it does happen from time to time."

"..."

Director Xu felt bad after hearing Ji Xiang's explanation.

What Ji Xiang said was so professional that he didn't even understand what he heard, which made Director Xu a little embarrassed.

……

……

Note: Ceftriaxone caused gallbladder stones was written earlier in the live broadcast room, but I didn’t know that it could also cause kidney disease. I was surprised when I read the paper.

Source quoted from - Journal of Clinical Urology, Issue 2015, 3.

Chapter 290

Suspicious, Director Xu took the patient to the Department of Urology for ureteroscopy.

The patient came to the small treatment room of the Department of Urology for anesthesia. Ji Xiang placed the patient in the lithotomy position, with both lower limbs turned outward and raised, and the upper body lying flat.

"Don't be nervous, just take a look, it will be a little uncomfortable but not serious." Ji Xiang comforted with a smile.

"Doctor, I... can't die." The patient asked worriedly.

"How do you think about death? It's just a small problem." Ji Xiang asked while posing for the patient.

"I saw other people after I was hospitalized..." the patient hesitated to speak.

"It's okay." Ji Xiang smiled, "When I was in school, a classmate had an appendectomy, and after the operation, a small crystal-like rash appeared on his body. At that time, we joked that his relics popped out. While researching what it is."

"What is that?"

the patient asked.

Director Xu also had a dewy head. After the appendectomy, a rash appeared on the skin, which was still crystal-like. Could it be that there were really many relics coming out of the skin.

"The dermatologist took a look and said it was crystal prickly heat. Just say that the name of this disease is so sloppy, it looks like crystal and it is called crystal prickly heat, right?"

"Can it be cured?"

"My classmate didn't dare to be exposed to the wind after the operation, and was simply covered." Ji Xiang laughed, "After the dermatologist saw it, he gave us a lecture, saying that there was nothing wrong with it, and we scared the patients. "

Hearing Ji Xiang's explanation, the patient's mood improved.

Director Liu has long been used to Jixiang talking to patients before the operation, which is really similar to Colonel Wang.

With Ji Xiang as an assistant, Director Liu inserted a ureteroscope with thick and thin wires into the bladder.

Under the microscope, it can be seen that the urine in the bladder is turbid with white flocculents, white crystals can be seen at the bilateral ureteral orifices, and the bilateral ureters are full of white debris-like crystals throughout.

Director Liu knew in his mind that such a fragmentary thing would not be visible on CT.

The patient did not urinate because the ureter was blocked and there were calcified crystals in the kidney.

Seeing is believing, Jixiang's previous judgment was correct.

"Is that so, Doctor Xiaoji." Director Liu gave Ji Xiang a look.

Ji Xiang nodded after seeing the changes under the mirror, and didn't say much.

"Let me see."

Director Xu came over.

She was dumbfounded when she saw white debris-like crystals all over her vision.

Just now she also found the instructions for ceftriaxone, which clearly stated that there is a very low probability that it may cause gallstones.

Now stones are also seen in the kidney, and they are still fragmented crystal-like substances, and the answer is ready to come out.

"Use sodium bicarbonate to alkalize the urine." Director Xu asked tentatively.

After all, he is the chief director of the Department of Nephrology in the provincial capital, so it is not difficult to treat him after knowing the ins and outs.But Director Xu still asked Director Liu and Ji Xiang, and did not make any claims.

She has never seen a similar situation, so she should be more cautious.

Director Liu caught a glimpse of Ji Xiang nodding his head slightly, and he said, "Well, alkalize the urine first, and rehydrate according to the amount of urine."

The mirror was pulled out, the double J tube was placed and the patient was sent back.

Director Liu was curious, so he didn't rush home when he got off work, so he went to the Nephrology Department to take a look.

After alkalinizing the urine, the patient's anuria symptoms were quickly relieved, and he had urinated about 1400ml in just a few hours.

The Department of Nephrology has started fluid therapy for the patient.

That's really the case, Director Liu's experience value +1.

No one expected that the commonly used ceftriaxone would have such serious complications.

"Director Liu, amazing!" Director Xu praised.

"It's okay." Director Liu said with a smile.

He scolded the old fox in his heart, and Director Bai's intentions were clearly revealed.

Just like the current situation, not to mention how Ji Xiang gave the diagnosis, the ability to deal with things alone surpassed the two clinical directors, Director Xu and himself.

Director Bai put in so much effort, in fact, to keep Ji Xiang behind, no matter how much more he might do.

If you can't stay, you should also find a doctor who has a good relationship with Jixiang and call him anytime and anywhere.

He even has the face to push himself to apply for Ji Xiang's provincial self-administration, it is clear that the medical department can get the greatest benefit.

Director Liu chuckled, but was not angry.In the bureau set up by Director Bai, everyone has benefits and contributions.

Calling a doctor from a lower-level hospital, Director Bai can indeed do it, but he will definitely pay a terrible price.If it was him, he would definitely not be as determined as Lao Bai.

Seeing it now, it was all worth it.

Lao Bai's vision is still unique, and Director Liu admires it very much.

"Director Liu, is that little doctor next to you new here?"

"No, it's Doctor Guipei. Ji Xiang, have you heard of it?"

"The one who broke the record in the martial arts competition?" Director Xu's eyes lit up.

"Ah."

"Where do we go to the next department? Hurry up and come to our Nephrology Department while it's hot." Director Xu was a little anxious.

"Don't even think about it." Director Liu laughed, feeling a little hazy in his heart.

Sure enough, when they saw a good seedling with good ability, everyone wanted to grab it.Fortunately, I acted early, and even did not hesitate to lure Zhao Zhe to save the country with a self-promotion project.

"Director Liu, I think that child is okay."

"That's right, I fell in love with this kid right away." Director Liu put on a bole look.

"What are you so proud of? They will be transferred to the next subject soon." Director Xu looked down on Director Liu's old-fashioned and reassuring look, and knocked out a sentence.

This is indeed a problem, but if it goes according to the current plan, it should be feasible.

Director Liu happily prepared to get off work, and when he returned to the department, he saw Zhao Zhe standing at the door of his office with a sad face, frowning like a philosopher.

If he didn't know, he would have thought this middle-aged man was a family member of the patient.

"Doctor Zhao, what's the matter?" Director Liu asked.

"Director, I...I..."

Director Liu felt a little cold when he saw Zhao Zhe's constipated face.

Will there still be grassroots doctors who refuse to come to the Second Affiliated Hospital and stay there to die alone?Seeing that Zhao Zhe is not doing well in his hometown, a young doctor on duty can hate him as much as he wants, what can't he let go of?

"Doctor Zhao, come in and say."

Entering the director's office, Director Liu pretended to be relaxed and asked, "It's okay, if you can't come, you can't come, I can find someone else to do it."

"..." Zhao Zhe blushed with restraint.

He suddenly became unable to speak because he was so talkative, he looked like he had a swollen throat, and Director Liu's hands were so itchy that he wanted to give him a tracheotomy.

"Speak slowly, don't rush."

Zhao Zhe was obviously very nervous, his hands were trembling a little, and he pressed hard on Director Liu's desk, his nail beds were pale.

Director Liu sighed inwardly, probably because there is a tigress in the family, and he disagrees with the separation of the two places.

Director Liu has seen similar things.

Chapter 291 Deformity

"I can come." Zhao Zhe held back three words dryly.

Director Liu looked at the constipated Zhao Zhe dumbfounded.

This guy said it because he was too excited, not because he couldn't come, so he had this expression.

"Does your wife agree?" Director Liu asked.

"I've been divorced for a long time, and I have an elder brother." Zhao Zhe said, "Both my parents are in good health, so I don't need to ask others, as long as I think it's okay."

It was the first time Director Liu asked about Zhao Zhe's family affairs, and only then did he know that he was still single.

In retrospect, when I went to Zhao Zhe's home in Yuanliao City to look at scientific research materials, it was indeed messy and unorganized, and I didn't see Zhao Zhe's lover.

But this is a private matter and has nothing to do with Director Liu.

"Then go through the formalities." Director Liu said, "Talk to Xiaoji and explain all the operations here."

"En!" Zhao Zhe nodded vigorously.

After leaving Director Liu's office, Zhao Zhe still seemed to be dreaming, his feet were a little floating, and he was stepping on the cotton without any effort.

He is no longer young, he has already accepted his fate.

In this life, it is my destiny to be an attending physician in Yuanliao until retirement.As for others looking down on it, or whether the paper can be published, it is already a trivial matter.

Zhao Zhe was only interested in new things, and felt a momentary sense of satisfaction when the patient smiled and bowed to himself after being treated.

Only for a moment did Zhao Zhe think that he was the protagonist.

He never thought that he could be transferred to the Second Affiliated Hospital because of such a research for more than ten years!

Seeing Ji Xiang changing clothes and preparing to go home, Zhao Zhe excitedly held Ji Xiang's hand.

"Xiaoji, Xiaoji, I'm coming to the Second Affiliated Hospital!"

"I know, I just heard from Director Liu." Ji Xiang said, "Congratulations, Brother Zhao."