First a doctor. WWw.QuANbEn-XiAoShUo.COmTo treat people, the most important thing is to learn to seduce the phenomenon of addiction.
A patient has a stomachache. Can you tell where the pain is? Then determine the cause based on the location;
For example, Xu Ze has found through color ultrasound that this patient has obvious gallstones and the gallbladder is also swollen. It can basically be determined that this patient's abdominal pain is mainly caused by this gallstone.
But being a doctor is not such an easy profession. Seeing a doctor is not such a simple matter. Xu Ze was just trying to cope with this assessment, but he forgot something very important for a doctor. That is, in addition to major illnesses. It is also necessary to conduct differential analysis of other diseases, because abdominal pain like this can be caused not only by gallstones, but also by gastritis and even pancreatitis.
At present, Xu Ze can confirm that it is mainly gallstones. However, other possible diseases must also be ruled out. Although the possibility of coexistence with other diseases is relatively low, as a doctor. Don't ignore it just because of the possibility; because many times, just a little problem is not paid attention to, which leads to serious consequences.
Now Xu Ze suddenly remembered this problem. Although it shouldn't be a big problem, for him who is always cautious and responsible for his patients, this is an issue that cannot be ignored.
So he calmed down again, started the color ultrasound, and scanned the patient's stomach and pancreas.
Color ultrasound can effectively determine the overall changes in the pancreas and stomach. Through this examination, we can roughly determine whether there are any abnormalities.
The results of the color ultrasonography gave him some relief. No major problems were found in the patient's stomach, and the pancreas was very smooth on the outside, and there seemed to be nothing abnormal about it.
Xu Ze was almost relieved at this time. However, I remembered the newly-emerged blood amylase function among the three-level system functions recently, so I successfully performed it on the patient.
This blood amylase test is a standard test to rule out pancreatitis. As long as this test is done, you can completely confirm whether there is a problem, and it is much more accurate than a simple color ultrasonic scan.
Following his order, he quickly popped out a thin needle of cow hair from the ring on the index finger of his right hand that was holding the patient's pulse gate, and lightly pricked the patient's wrist. Without the patient's knowledge, he extracted the needle. A small amount of blood was tested.
"Oukou Gong" Xu Ze looked at the red value displayed on his glasses. I couldn't help but frowned. The blood amylase level was obviously above the standard. This patient actually had pancreatic syndrome.
However, the main diagnosis is gallstones, and the second diagnosis is pancreatitis; traditional Chinese medicine diagnosis. The diagnosis of cholelithiasis should present no problems.
He stood up slowly at that moment, nodded to the impatient senior national players in front of him, and then said: "President Guo. I have completed the examination."
Hearing Xu Ze's words, all the senior national players nodded slowly, and Wang Lao national player saw the serious but still confident look on Xu Ze's face and breathed a sigh of relief.
Originally, when Wang Laoguo player saw Xu Ze's hesitation, he saw that Xu Ze was indeed weaker than the other rookies in Chinese medicine. He was worried about whether Xu Ze could pass the test smoothly; but now, although Xu Ze is spending more time It took some time. But it seems that he is still very confident, which naturally makes him feel a little relieved.
Wang Laoguo player is not too concerned about Xu Ze's failure to pass the test, and he doesn't care much about the impact on his reputation. What he cares about is that the young man in front of him is indeed very good. If he can't pass this assessment and get the practicing certificate, it will be really bad. What a shame.
Dean Guo looked at the solemn young man opposite, then nodded gently and said, "Okay, now that the diagnosis has been completed. Xu Ze, please answer the diagnosis and treatment plan for this patient."
"The patient's main symptoms are epigastric pain, bitter mouth and oily taste. Symptoms include thin yellow tongue coating and stringy pulse. Western medicine physical examination shows mild tenderness in the right upper quadrant. Murphy's sign is positive. Therefore, TCM diagnosis should be considered: cholelithiasis, liver stagnation and qi stagnation. The treatment principle is to soothe the liver and regulate qi, and the prescription is: Bupleurum soothing powder, and for acupuncture: take the Riyue, Qimen, and gallbladder points, plus Zusanli and Zhongxiao,"
Speaking of this, Xu Ze couldn't help but narrow his eyes slightly. Looking at the expressions of the senior national players above, I saw the old national player Wang smiling and nodding lightly. I was relieved in my heart. As long as this is correct, then I don't have to worry.
Next comes aspects of Western medicine diagnosis and treatment. For Xu Ze, it couldn't be simpler. Xu Ze, who was in a relaxed mood, continued with a faint smile: "Western medicine diagnosis considerations: acute cholecystitis, gallstones; the possibility of acute pancreatitis is not ruled out." Hepatobiliary color Doppler ultrasound, Routine blood tests, blood amylase and other examinations were conducted. In terms of treatment, cefoladine and ofloxacin were temporarily used for anti-infective treatment, and cimetidine was used to suppress acid and Wangkou was used to relieve spasm and relieve pain."
"If relevant examinations confirm the presence of gallstones. Depending on the patient's physical condition, it is recommended to perform surgical treatment while effectively anti-infection and suppressing gastric acid to protect the pancreas."
After hearing what Xu Ze said, Director Guo frowned slightly. Director Guo always followed Chinese medicine. Although he has gradually accepted Western medicine in recent years, he still resisted the surgeries that Western medicine is good at.
Because in his opinion, if it can be treated conservatively and using traditional Chinese medicine to help pass the stones, it is naturally the last resort. After all, Western medicine is simple to perform surgery. But after all, it is a matter of killing three thousand enemies and losing eight hundred. It is inconsistent with traditional Chinese medicine.
But at this time, although he was not satisfied with the treatment method proposed by Xu Ze, the operation fell into the category of Western medicine after all. Naturally, he could not easily deny it. He immediately turned to look at the two doctors from Capital Medical University. Professor, wait for their judgment.
Dean Guo looked at Professor Tang Wuyou and Professor Jiang Lingyun, only to find that they were looking at Xu Ze with a hint of surprise in their eyes.
Dean Guo was stunned and couldn't help but asked the two professors, "Two professors, please comment."
Tang Wuyou and Jiang Lingyun looked at each other, and then Jiang Lingyun nodded and said with a smile: "Mr. Guo, this son's diagnosis and diagnosis are very close. The diagnosis of acute cholecystitis and gallstones is very clear, and The treatment plan is clear,"
Hearing Professor Jiang's words, Dean Guo was stunned for a moment, seeing the young man Xu Ze in front of him. Could it be that the attainments in Western medicine have really reached such a superb level
The old national player Wang next to him also smiled gently. Xu Ze finally did not disappoint him.
However, the few people next to him were especially Guo Yujian. Looking at Xu Ze, Jing admired Fan in his eyes. They all study Chinese medicine, but to be able to reach this level in Western medicine is naturally beyond their reach.
Especially Guo Yujian, at this time, he also restrained the proud look on his face.
While he was in shock, he heard Professor Jiang suddenly say: "It's just,"
"But what?" Dean Guo was stunned again, but he didn't find it strange at all. Although Xu Ze seemed to be very skilled in Western medicine, he was still too young after all, and there might still be some flaws. The heat will be a bit different.
At the moment, I feel a little happy. If Xu Ze has no problems at all in this round of assessment, but he can do so well in the assessment of rookie Chinese medicine as a Western medicine student, then this will be a blessing to everyone here. His face is not pretty either.
Moreover, originally his grandson Guo Yujian had already won the first place today, and he had to compete with him for face. But if Xu Ze can achieve such good results this round, then he will be able to compete with his carefully cultivated ten-year-old son. Nian's grandson was running neck and neck, so naturally he felt uncomfortable.
It seems that there are still some omissions in Xu Ze's answer. Immediately, he breathed a sigh of relief and said with a smile: "Professor Jiang is in charge of judgment today. He should speak his mind, but there is no harm in saying it. If Xu Ze's diagnosis is inappropriate, Professor Jiang should be the one to make suggestions."
Jiang Lingyun smiled and nodded, then smiled curiously at Xu Ze and asked, "Doctor Xu, right?"
"Professor Jiang, I am Xu Ze!" Xu Ze was stunned when he saw Jiang Lingyun's appearance. I have doubts in my heart, is what I said wrong
"Dr. Xu, the basis for your diagnosis of acute cholecystitis and gallstones just now is very clear. The diagnosis is also very good; but how can you be sure that he has the possibility of acute pancreatitis?" Professor Jiang looked at Xu Ze, very surprised. asked with some surprise and curiosity.
Hearing Professor Jiang's words, Xu Ze felt a little strange in his heart, and asked secretly: "Don't these two professors know that the patient may have acute pancreatitis?" Looking at Professor Jiang's appearance. Xu Ze had some confidence in his heart. The two professors must have seen this patient in advance, but they did not conduct detailed examinations and examinations in all aspects. That's why we haven't determined this conclusion.
However, Xu Ze certainly didn't say that he confirmed the diagnosis by giving the patient blood amylase. Of course. He was prepared. I had already thought of a way to defend myself.
He immediately smiled and said: "Professor Jiang, the patient reported that before the onset of abdominal pain, he ate a large amount of greasy fried rice and beer, and then abdominal pain occurred later; such overeating and abdominal pain after drinking alcohol can cause cholecystitis. One of the factors for the attack; but there is also the disease of acute pancreatitis that must be considered, because the first article on this condition in internal medicine has mentioned that overeating and drinking alcohol can lead to this comparison. critical illness"
"So, I think that although it can be concluded that there is a high possibility of cholecystitis and gallbladder stones through a positive Murphy's sign, this situation cannot be ruled out, and the possibility is not considered. Therefore, I raised this complication. "
Hearing Xu Ze's analysis, Professor Jiang and Professor Tang Wuyou looked at each other in surprise. However, they did not expect that Xu Ze could even remember such a shocking statement in the book. So clear. And it can be analyzed so clearly,
Not even the two of them were in a hurry. He could analyze the situation in a short time without even paying attention to it. This young man is really extraordinary.
Thinking of this, Jiang Lingyun sighed and nodded towards Xu Ze, then turned to look at Dean Guo aside and sighed: "Mr. Guo, these young people of yours are amazing. It is not easy to diagnose such a complex situation with just one method. It is not easy either.
Hearing Professor Jiang's words, Dean Guo's expression froze. He naturally did not expect it. Professor Jiang. However, it actually allowed Xu Ze to compete for a few points. Even two old experts in the field of Western medicine praised him so much.
At the moment, he could only stroke his beard and smile dryly: "Looking at the emergence of talents in the younger generation, I am very happy and happy."
After saying that, he could only comment with a smile: "Xu Ze performed well today. The evaluation is excellent. All rookies passed the test smoothly. Director Lin, please announce the overall situation of this assessment."
The deputy director of the National Medical Examination Center, Lin Zhiben, smiled and nodded. Just as he was about to speak, an old man next to him suddenly smiled and interrupted: "Mr. Guo, just now Brother Wang said that Xu Ze has acupuncture skills. For the sake of gain, we don’t know if we can have a look today, and I wonder what everyone thinks?”
Hearing the old man's words, Xu Ze secretly frowned. It seemed that he, who majored in Western medicine, had come to participate in the assessment of this rookie Chinese medicine practitioner, but he had achieved such good results and had stolen the limelight from these rookies. He was indeed a big tree. Zhao Fan and all the old national players next to him naturally nodded in agreement after hearing this proposal. After all, Wang Yibo first praised Xu Ze's acupuncture skills. If you don't take a look today, Naturally, there is some regret;
And this kid is like this today. The results are also better than those of most rookie Chinese medicine practitioners. If this kid doesn't have that ability, it can be regarded as a slight pressure on him, so that old guys like myself will not be too shameless.
Seeing that everyone agreed, Wang Laoguo player also smiled helplessly and could not object to everyone taking Xu Ze to the exam again.
Dean Guo also looked at Xu Ze with a smile and said: "Xu Ze, Brother Wang is very impressed by your acupuncture skills. We are also very curious. Why don't you show it to this patient today?" how?"
Seeing all the old men looking at them with smiles on their faces, but showing no room for objection, Xu Ze had to smile bitterly. You still have your certificate in your hands, how can you not agree to it
At that moment, he could only nod his head and said: "Since the senior teachers want to test me, I will naturally comply."
The old men heard that although Xu Ze's words were somewhat dissatisfied, they did not dare to object. They all smiled smugly at each other, and then said: "Of course that's good, let's get started."
Xu Ze took a breath, knowing that if he didn't show his hand today, it would be difficult to explain. These few in front of me were all senior national players, so I had no choice but to give them some face, so I immediately took out the silver needle I always carried with me and prepared to take action.