Qi Jing was sitting on a chair in the reading room, with many imaging doctors sitting around him nervously reading the movie. Li Zhiyong sat in the corner on the other side, holding the piece of paper given by Qi Jing in his hand, looking back and forth between the sun and the shadows, looking left and right, hesitating for a long time, but hesitating for a while, but hesitating for a long time without giving the answer.

Gradually, he sat on the chair, facing out the window, as if he was immersed in several imaging pictures.

Here are doctors who have worked with Li Zhiyong for many years, and I have never seen him hesitate so much. The patient's condition must be very complicated.

Qi Jing came over and wanted a suggestion. There was a serious patient waiting for diagnosis in the emergency room. His time was not rich. After a while, Qi Jing couldn't wait, so he could only get up and come to him and asked, "Director Li, what do you think after all?"

Li Zhiyong seemed to be in a daze, but was awakened by this question. He sighed, put down the image in his hand, and did not answer Qi Jing's question directly. Instead, he asked: "Did you have any trouble recently? Have you broken up with your girlfriend? Or do you think Wang Ting is too bored?"

"No..." Qi Jing shook his head.

"Oh, I understand, it must be your parents who forced you to get married! Lao Qi is too impatient. You can't delay your career because of these mundane things..."

Qi Jing was asked inexplicably by him. Seeing that he was talking more and more outrageous, he immediately replied: "It's not like this, I've been pretty good lately."

Li Zhiyong was a little disbelief and frowned and looked him up and down a few times: "Is that okay?"

"It's okay! Ask me what I do?"

"Oh, Xiao Qi, you have retreated!" Li Zhiyong slapped the image on the table, "This is early lung cancer. Can't you even see such obvious characteristics? You have to come to me specifically? If I want to ask such stupid questions by those under my subordinates, I would have crushed the paper into a ball and smashed them in the face."

"Actually, things are a bit complicated..." After being educated by him, Qi Jing didn't know where to start for a while.

"I set you at S level at the beginning. You have to know that the S level of imaging in the entire hospital should not exceed one hand, which shows how high my expectations for you are." Speaking of this, Li Zhiyong flipped through his thick palm and said seriously, "If you hadn't performed too brilliantly before, you might not even get a B level now."

Qi Jing didn't expect that he also had a hobby to rate others, and asked with a smile: "Where am I now?"

"b..." Li Zhiyong hesitated for a while, but still made some reservations, "A, it depends on your performance in the future."

In fact, from the perspective of misdiagnosis, few people misdiagnosed lung cancer, while more people misdiagnosed lung cancer into pneumonia.

The imaging manifestations of a type of pneumonia lung cancer are the same as those of ordinary pneumonia, with a lung parenchymal lesions, which at first glance are no different from pneumonia. At this time, experienced imaging doctors will recommend combining clinical practice, or taking pneumonia first, and then writing a ca, which cannot be ruled out, and further improving the examination.

After seeing this imaging diagnosis, the doctor should first check whether the patient has clinical symptoms of pneumonia, and then decide whether to check further.

There are two types of further examinations: one is a lung biopsy, and the other is a petct that slowly appeared in China after 2000.

If this type of misdiagnosis is, it means that the doctor or imaging doctor has insufficient experience and is not rigorous in the diagnosis. In this environment, it is no problem to lose the lawsuit and pay for a lesson.

However, the patient's condition is the opposite, and the lung image is the most typical manifestation of lung cancer.

An isolated irregular nodule lesion can be seen on the chest radiograph, with a rough edge, burrs and spinous changes. After CT re-examination, it was also found that there was a rich blood supply next to the nodule lesion, resulting in "pulmonary vascular clustering signs".

With just these changes, if there is one less one, Qi Jing and Li Zhiyong will not be so sure.

When a little experienced doctor will experience these, he will be more likely to get lung cancer at the end of the examination report. Please further improve the Petct examination or biopsy to confirm the diagnosis.

An old director like Li Zhiyong may also be called in the diagnosis. After all, it is for the patient to see, so it must be rigorous. But if a doctor calls for a verbal inquiries, he will say "it's cancer."

"Pneumonia?" Li Zhiyong was a little strange after hearing the summary of the disease development mentioned by Qi Jing, "It's impossible, this is obviously cancer."

"I also think eighty or ninety-nine images."

"More than 80% or 90%, 100 cases of this kind may be cancerous!"

Qi Jing's eyes lit up and he asked with a smile: "Director Li, you are not confident, there are still 5 cases?"

"How can this be called lack of confidence? Those five cases have no money for surgery and chemotherapy. Anyway, if you don't have surgery or biopsy, you won't be able to do pathology without a biopsy. If you don't have a pathology report, you won't be able to diagnose it correctly." Li Zhiyong leaned against the chair cushion, crossed his legs, looked at the image several times, and then asked: "Didn't you say that the patient is very rich? The hospital didn't ask him to do petct?"

"That hospital didn't have petct, so I went to other hospitals."

Petct is a CT machine that adds Pet technology and can reflect cell biochemical and metabolic information.

Because cancer cells are very metabolized very vigorously, often several times that of normal cells, compared with MRI and simple CT, Petct is more inclined to diagnose cancer cells, and is the most accurate test in imaging.

The disadvantage is that the inspection is expensive. Whether it is part or the whole body, the cost is not low.

Because the cost does not apply to medical insurance, this kind of examination method is the last killer weapon of imaging, and it is exclusive to rich people.

If a patient wants to save money, he can choose to take a biopsy. After all, pathological diagnosis after biopsy is the gold standard for the diagnosis of tumors.

"Isn't it over to do a biopsy directly? Rich people are very particular." Li Zhiyong said, "Even if Petct is found to be cancer, according to his personality, he will definitely have to have a biopsy before he dares to go to the operating table."

Qi Jing said, "A few days between changing hospitals, he seemed to have some symptoms of coughing and sputum."

"Did you see the actual film of pneumonia?"

"No, I saw this lesion slowly being absorbed." Qi Jing pointed to the milky white shadow on the image and said, "From the symptoms, it is indeed very similar to the slowly improving pneumonia, but I don't think it's that simple."

"The lesion disappears and the condition is improving by itself, so it has nothing to do with me." Li Zhiyong suddenly lost interest and took out his cell phone, "If you want to ask further, you have to go to Luo Tang."

Li Zhiyong picked up his phone and opened the small game inside.

"Director Li, what did you say just now?" Qi Jing was stunned, his eyes staring straight at the table, but he asked, "The condition will improve by itself? Cancer?"

"Maybe, modern medicine has just begun to develop, there are too many unknown things, who knows what strange things will happen?" Li Zhiyong smiled, put his thumbs on the phone button, looked up and wanted to look at Qi Jing and talk more, but Qi Jing had already left the reading room.

"Where are people?"

"Just leaving." Several film-reading doctors pointed to the door on one side.

......

Leaving the reading room on the second floor of the Medical Technology Building, Qi Jing walked directly to the stairs and ran to the emergency room inward. At the same time, he called Ji Qing: "Hey, Lao Ji, think about what you can do..."

Before he finished speaking, Ji Qing shouted excitedly: "Qi Jing, are you embarrassed to call me? There are more than 300 emails in your email address. You asked me to finish reading in one night? Are you a human?"

"Uh..." Qi Jing blinked and forgot about this matter, "By bye, see you tomorrow."

After hanging up the phone, he changed his body: "Have you got off work?"

"I'm on duty today, what's wrong?"

"On duty..." Qi Jing thought for a while, "Which department are you in now?"

“Puwai 8th floor.”

"The ward duty should be quite easy. You can sneak into Tong Miao's director's office and look for his computer to check the Internet..."

"Today, the 8th floor is an emergency night shift." Hu Dongsheng clamped his mobile phone with his shoulder and held the surgical record board in one hand, while writing the postoperative course record, "I just had an intestinal obstruction, and there was an acute cholecystitis soon. I only have 10 minutes of free time."

Qi Jing sighed: "Where is Gao Jian?"

"He is in the emergency department of the surgery department now, and the intestinal obstruction he just handed over to me." Hu Dongsheng thought for a while and continued, "But he should have gotten off work long ago."

Qi Jing smiled: "It seems that he has to work overtime today."

Hu Dongsheng knew that there was a very interesting case when he heard his tone. He just watched Gao Jian solve the puzzle, but he had to pull the hook next to the operating table. He was really unwilling to accept it: "When the cholecystitis is finished, I will take the time..."

"Don't make trouble, be on duty with peace of mind." Qi Jing immediately killed the messy thoughts in his head, "I wish you a happy operation."

After hanging up the phone again, Qi Jing flipped out the address book and found Gao Jian's mobile phone number.

After the three rings rang, someone answered the phone. Qi Jing said without thinking, "Hey, Xiao Jianjian, congratulations on being favored by God. I am afraid I have to work overtime today. Within half an hour, I hope to see it in the emergency room..."

Maybe Qi Jing was too nagging, and the dull voice in the phone receiver was a little impatient, so he simply interrupted him directly: "I am Gao Jian's father."

dad?

Qi Jing was stunned in the emergency corridor and stood blankly for two seconds. Unexpectedly, Gao Jian's cell phone would not be by his side: "Uh, uncle, I'm sorry, I didn't know it was you just now. I hope I could pass on a message for me, so I said..."

"You are Qi Jing, are you?"

The middle-aged man had no intention of communicating, and asked the question very directly. Qi Jing didn't know what the other party was thinking for a while, so he admitted it without thinking too much: "Yes, it's me."

"Gao Jian is already very tired after one day of internship. I hope you don't disturb him again."

As soon as he finished speaking, the other party hung up the phone without even saying hello.

Qi Jing rarely encounters such a thing. He listens to the blind voice in his ear and wants to laugh: "Every family has a difficult sutra, and it seems that Gao Jian's family is not peaceful."

Without Ji Qing and missing his left and right hands, he had to do what he thought of just now.

The most stored textbooks in the internal emergency treatment room, and the diagnosis of pharmacology, physiology and pathology between women and children inside and outside are books that they need to read and deepen their memory from time to time. In addition, there are emergency diagnosis procedures and first aid medication manuals in various medical journals, etc.

There are many missing books, but the most useful thing for Qi Jing now is the disease collection query system.

Danyang Hospital has hundreds of computers in the entire hospital, but only a small number of them can access the Internet, and the rest can only work on the local area network in the hospital. This disease query system will only be available in at least ten years, and now it can only be replaced by books.

Originally, he wanted to go to a medical bookstore outside the hospital to see if there were any similar alternatives.

The medical bookstore specializes in serving undergraduate interns. It is not large in area, but it contains a lot of medical books. If there is not there, I can only go to the library of Dan Medical University to try my luck.

Unexpectedly, just as he was about to leave, Gao Jian called back.

"Hey, Uncle Gao, I disturbed you just now." Qi Jing's tone slowed down, his tone raised, and he sounded like a child who had just entered elementary school. "If you have any more instructions, just say it."

"Brother Qi, I'm sorry, I was taking a shower just now." Gao Jian seemed a little embarrassed, "What's the matter with me?"

Qi Jing thought of his father's attitude just now, and obviously didn't want his son to come back: "If it's inconvenient, let it go, I can solve it alone."

"No, it's okay." Gao Jian was a little excited.

Since Wu Zhenggen was idle for two months after he was diagnosed, they have not encountered any difficult and complicated diseases. He and Hu Dongsheng could only practice while internship, and their brains were almost rusted.

"Are there any interesting cases?"

"This time I'm a little troublesome. If you really want to come, I'll go to the bookstore outside the hospital to find out if there are any books like disease collections." Qi Jing thought for a while, and added, "If you need a microbial collection, you can buy it together."

"Oh, actually, I have these two books at home." Gao Jian said with a smile, "It's right in my dad's study."

"..." Qi Jing was stunned, "Have both?"

“All!”

Qi Jing heard it clearly in his ears: "If you can't bring it out, forget it, just go and buy it. There should be... in the bookstore..."

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Chapter completed!