When the patient's condition is too complicated and there is no problem in various indicators, Qi Jing likes to take out the entire disease and flip it. In the past, he would occasionally sit in front of the computer with the Internet or intranet information in the hospital for a day. But now that he has a follower, the protagonist of the book will naturally not fall on himself.

"Start from a, look slowly, look slowly, and list the symptoms separately." Qi Jing turned the entire collection through the catalog and came to the first page of the text, "The first one, Abadi's sign, let's start."

Gao Jian looked at the page blankly, feeling helpless: "How long does it take to look for..."

He thought Qi Jing wanted to use these two books himself, but he didn't expect that the person he used in the end was himself.

In the past, when Gao Jian was bored when he read textbooks, he would go to his father's study to read such comprehensive books. But every time he started high and left low. At the beginning, he was almost wiped out with confidence in less than an hour.

"Look for it slowly." Qi Jing flipped through another collection of microorganisms, "I'll read it with you. The infection of the child in the emergency room is inexplicable and troublesome."

Gao Jian looked sideways at the book in front of Qi Jing, and the first one at the beginning was also the word "A": "What is Salmonella Abadina..."

Qi Jing pressed his chin and turned his head over: "You still have the things I have to pay attention to? You have more than 1,000 pages, and you can't finish half of them if you don't hurry up and watch them all night."

The situation of the two patients they faced was really strange.

There are nodules on one chest x-ray, and the entire nodule can't be inflammation even if it is not a tumor. But apart from inflammation, nodules produced by other lesions are not so easy to subside, let alone subside on their own.

The other one has symptoms of infection but no infection foci. Although there is a fever, the body temperature is still good. Moreover, the infection is not long and the situation does not seem to be serious, but it triggers shock. The entire shock process is very rapid.

Neither case is simple, but both lack a perfect explanation.

In the case where Lu Zishan took over, is the patient cancer? If it is not cancer, then what is the nodule? What exactly is the child in the emergency room infected? Bacteria, virus, or parasite?

Qi Jing asked: "What class will you do tomorrow?"

"Shit the middle class." Gao Jian turned the pages.

"Then stay up all night tonight and go back to bed tomorrow morning for the whole morning." After Qi Jing said that, he seemed to have thought of something, and asked again tentatively, "Where is your father..."

"Oh, it's okay, he's just getting older and getting a little menopause." Gao Jian didn't take this seriously at all.

The long time for the two of them to read books began, and they just sat at their desks and flipped through pages. Sometimes when they saw a slightly matched entry, they would write down it.

They are all of them who are particularly calm and read books.

Needless to say, Gao Jian is often distracted and bored when reading books, but once he brings a strong purpose to read, his attention will be in a state of concentration for a long time. The two of them had a simple supper all night and drank two glasses of water, but their eyes never left the book in front of them.

During this period, no matter whether an ambulance came to 120 or a patient at the door was unconscious, it had nothing to do with them.

In a flash, it was 0 o'clock in the middle of the night.

Today's night shift was Qin Xuefeng and Chen Xiao. They had never stopped since 7 o'clock in the evening. They were not able to rest on the chair for a while until early eleven o'clock.

"The person with a heart attack at the door took it away?" Qin Xuefeng stood beside the water dispenser and drank a glass of water and asked, "Is the result a result?"

Chen Xiao slid the cold fried noodles, wiped his mouth and looked at the report on his hand: "The frontal lowering branch was blocked by 90 yuan, and it was ready to be sent to the heart. The situation should be good. I just sent the abdominal pain as a chest pain. I was sent to the next door. It should be cholecystitis."

"Oh, that old lady who doesn't speak very well? How about the electrocardiogram?"

"The electrocardiogram is pretty good, and there is a little atrial fibrillation, which is not serious." Chen Xiao ate the noodles with a few bites of hot water, which was considered to be a supplement to the second half of the night. "The fried noodles in the cafeteria are still so unpalatable. Should Teacher Qin give you one?"

"I'll forget it." Qin Xuefeng shook his head, "I'll wait for the morning porridge and salted eggs."

"Then these two." Chen Xiao looked at Qi Jing and Gao Jian who were not too far away from him. "They have been looking at them for six hours and seem to have not found the answer."

Qin Xuefeng sighed, picked up the course record of Chang Zhijun's son and said, "The condition is not very stable now, and the medicine cannot be stopped at all. I think I still have to listen to Director Cai and have another re-examination as soon as possible."

"Didn't Director Wang say to wait for the morning?"

"I'm afraid he won't be able to survive in the morning, and it's too late to rescue him. How can I check it out?"

"Okay, I can't make the decision on this matter, I have to listen to you." Chen Xiao was still hospitalized after all, and Qin Xuefeng was not the one Zhang Jieyi at the time. "It just so happens that it's okay now, why don't you send it to the CT room now?"

The two made a simple decision and prepared to go to the emergency room to chat with Chang Zhijun. Unexpectedly, Qi Jing said, "Wait, I'll go with you."

"Okay, let's talk to Chang Zhijun first. You can just go to the CT room and wait for us."

After Qin Xuefeng finished speaking, he left the clinic and Chen Xiao wanted to go, but before leaving, he had to explain the matter to the two interns. If something went wrong with the patient in the observation room, he had to ensure that he could get the news as soon as possible.

"Let's go and change your brain together." Qi Jing patted Gao Jian on the shoulder.

"No, you go."

"That's OK." Qi Jing looked at the diseases he had recorded neatly in the notebook, and nodded with a smile, "I will tell you if I have the results here."

"Um."

......

Chang Wenhan was still lying calmly on the hospital bed and was pushed into the medical technology building by a nursing worker. Qi Jing did not go to the CT room first, but followed the bedside and read the ICU disease course record written by the doctor in the emergency room.

The course of emergency treatment is different from that of ordinary wards. A paragraph is written every 12 hours to record vital signs and provide data support for possible rescues in the future. Therefore, the data during this period can directly reflect the patient's recovery or worsening process.

"Doctor Qi, how about my son?"

After a fight with Ji Qing in the afternoon, Chang Zhijun had a lot of affection and trust in Qi Jing. Even if the doctor in the emergency room had discussed his son's condition with him just now, he still hoped that he would listen to Qi Jing again, which might be a little different.

"Voliconazole is not effective, and the body temperature has always existed." Qi Jing shook his head, "I am blunt, your son's condition is still on the decline."

"Then...is there any way to help me?"

"Let's check it out first. If necessary, you may have to do mri." Qi Jing looked at him and said, "We are all professional doctors, and no one will give up on him earlier than you."

"Thank you, thank you."

After reading the course of the disease, Qi Jing put his eyes on various laboratory test reports. The eosinophils in the blood routine were the most abnormal ones in all data. Before, in the first hospital, the eosinophils were only two times higher, and the amplitude was not large. However, since he was admitted to Danyang Hospital, he has undergone three re-examinations from 3:00 pm to now, and each time the eosinophils were high.

"Is it really a parasite?"

Qi Jing asked Chang Zhijun before that his son's lifestyle was regular, and he had never eaten raw food or travel history in another place. With his family's tutor, he must wash his hands before and after meals. His family's financial ability and social level are not likely to contact patients who have returned from the Asian, African and Latin American epidemic areas, and the possibility of parasite infection is very low.

Moreover, parasites are not bacteria and will not cause septic shock.

In addition to parasites, it is allergic to cause eosinophilia. Is it allergic?

Allergies are a common disease of internal emergency. Qi Jing has not considered it. It can even be said that all internal emergency doctors have considered it. However, during the entire course of Chang Wenhan's illness, the possibility of allergies is lower than that of parasites.

He suffered a craniocerebral injury and intracranial hemorrhage and went to the first hospital for surgery after he suffered a brain injury. Since then, he has completely cut off contact with the outside world.

Judging from past history, the patient has no history of allergies. The antibiotics he uses now are similar to those in the first hospital, and he has not experienced allergies. The only difference between voriconazole is only added after shock, so allergies are almost impossible.

However, Qi Jing is not completely clueless now, as in the afternoon. After adjusting his thinking for several hours, he now has a partner of doubt.

Since both reasons seem impossible, let's take them together.

Shock is caused by allergies, and allergies are caused by parasites. Perhaps this brain trauma surgery stimulated the parasites lurking in the patient's body, forcing them to further stimulate the patient's body.

As for the situations Chang Zhijun said that he would not be infected with parasites, he could only blame him for "lying".

"Where to do first?" ct technician stood beside Chang Wenhan and asked the three doctors in the operation room.

"Before you, you will do your chest and abdomen after finishing your head."

At this time, Qi Jing inserted his mouth: "Just just sweep the whole body, maybe the problem lies in what part is still worrying about at this time."

"That's right, epiglottis and limb muscles may also become targets of infection." Qin Xuefeng said to the microphone, "Sweep the whole body directly. If you can't find the problem, you have to go to the next door to try your luck."

"Okay, just sweep the whole body, or start from the head."

As the bed moved forward, Chang Wenhan was sent into the CT machine. Cross-sectional images began to appear in the operating room screen. Starting from the parietal bone, the brain tissue after the trauma gradually appeared in front of everyone...

"The bleeding skull was indeed absorbed, but no infection skull was found." Qin Xuefeng looked at the screen and said, "The operation was indeed very clean. I saw that the child's scalp was also beautifully sutured. There was very little drainage fluid from the waist pool in the postoperative course."

"The First Hospital is really strong, and there are so many three-level three-level people in Danyang that are worse than us."

"Qi Sen might have been like this before becoming the dean, but it may not be true now." Qin Xuefeng looked at Qi Jing with interesting interest, "I said Xiao Qi, you have such a good resource in your hands, why don't you go to Shenwai to develop? In the future, there will only be more and more cerebral hemorrhage. Shenwai is definitely a golden rice bowl."

Qi Jing didn't reply to his words, and seemed to have not heard the problem in his mind at all. His eyes were just looking at the screen, and suddenly he said: "This sinus is a bit strange, and the upper forehead sinus just now was the same."

The patient's brain has passed the scanning area, and now the cross-section reaches the area where the nasal sinus is located. The performance of these two areas on CT is different from that of ordinary people, and there is a problem. After saying that, Qi Jing switched the film forward a few pictures, and the upper forehead sinus also seemed to have problems.

"There are some honeycomb changes in the sinus. Is it sinusitis?" Chen Xiao asked.

"It's possible." Qin Xuefeng nodded, "Director Cai is amazing enough. He guessed that the infection needs to be further deepened before it can be discovered on imaging examinations."

"Sinusitis?" Qi Jing frowned, "The changes in sinusitis are not so messy. This honeycomb-shaped hollow looks like it was after some kind of surgery."

"It may be left behind after the tumor rupture." Qin Xuefeng added.

"But this is a fifteen-year-old child, how could it be cancer? And the patient has symptoms of infection and the body temperature rises, which cannot be explained."

"Isn't you encountered an inflammation caused by paraneoplasty before? Anton syndrome has also appeared. Sometimes the symptoms of paraneoplasty in young people are much more serious than those in elderly people, and the inflammatory reaction is much more serious."

"But I have never seen parane tumor syndrome cause inflammation and cause septic shock." Chen Xiao pointed to the nasal cavity scanned by CT and continued, "The sinus just now is similar to the nasal cavity. I think it is sinusitis, and the atrophic rhinitis in the nasal cavity is just atrophic rhinitis."

"The most severe atrophic rhinitis I have ever seen is just like that. How could this child be so powerful!"

Chen Xiao and Qin Xuefeng were discussing each other aside, while Qi Jing kept silent from the beginning and watched the ever-changing ct films quietly.

At this time, the CT machine had scanned the throat. After several cross-sectional pictures that looked very normal, Qi Jing suddenly pressed the pause button: "These are more concave than the ones just now."

"Hmm?" Chen Xiao didn't understand, "What does it mean?"

"Your places are the nasopharynx and the throat below, and it should be smooth pipes on the surface, but if you connect these CT pictures together..."

Qi Jing switched these films back and forth repeatedly, and the images that kept appearing became animations in their eyes, and then he discovered the strange parts: "Why did these places become uneven?"

"I haven't encountered such a patient for a long time." Qi Jing asked with a smile, "How did this child's brain trauma come from?"

"how come?"

Qin Xuefeng and Chen Xiao shook their heads one after another. Who would discuss the cause of the trauma from a patient with septic shock? "It might be a car accident, maybe it was a falling from a high place."

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Chapter completed!