Gong Yulan's son is gone.

He had just entered the third year of high school. Although it was summer vacation now, the school opened summer cram schools and improvement classes. In order to avoid the hot summer days and be able to connect the past and the future during the two school periods, most of these classes were opened in early July and late August.

After all, he was preparing for the upcoming senior high school, so he didn't dare to be careless.

This is also a small episode. In a seemingly tragic family, it is indeed a blessing to have such a calm and rational child.

The child's quality is indeed good, at least his personality meets Qi Jing's requirements. But even if he is interested in him, he is really younger. If he really wants to enter Danyang Medical College, at least he has to spend a year. Including five years of undergraduate and master's degree, he has to enter the field of medicine, at least ten years.

Take your time.

Gong Yulan was sent away, and Qi Jing's internship and teaching was over, but the intern was still a little unsatisfied and had many questions.

b: "Why are there any attachment lumps in her belly? Could it be that lump is bleeding?"

Qi Jing: "Although the rupture and bleeding of the adnex tumor cannot be ruled out, I prefer blood clots produced after chronic bleeding of other organs."

c: "What's going on with the patient's swelling? What kind of feeling is it?"

Qi Jing: "That's because internal bleeding accumulates in the lower abdomen, forming blood clots and stimulating the body."

a: "Then why does urine hcg have false positives?"

b, c was stunned and couldn't help but turn his head to look at the little girl:???

If a false positive is false positive, it is actually a rare but normal thing to have false positives in laboratory tests. As for why false positives are false positives, it seems to have nothing to do with clinical practice.

"this......"

Qi Jing looked at the girl who asked the question and said with a smile: "Your questioning angle is very tricky. Don't make things so difficult for superior doctors in the future when you enter the clinical clinic. If you are a petty and vengeful person, things will become troublesome."

b: "That's right, aren't you just quarrel? Isn't it good to ask something that has something to do with the diagnosis?"

c: "Fortunately Senior Qi doesn't care, otherwise..."

"Wait, don't understand it wrong. Although I'm laughing now, it doesn't mean I don't care!" Before he finished speaking, Qi Jing retorted, "I've always been a little scrupulous, but this time I happened to know the answer."

hcg is divided into two subunits: α and β. Generally, the α subunit is tested. However, the amino acid number and amino acid arrangement of α subunits are almost the same as thyroxine, follicle-stimulating hormone, luteinizing hormone, and luteinizing hormone, so cross reactions will occur during detection and false positives will occur.

One is non-invasive and the other is cheap, so in 2004, it was more likely to use urine tests.

After all, the probability of false positives is indeed not high, and in the hands of experienced doctors like Qi Jing, the flaws can be seen immediately.

If the gestational sac develops for more than 40 days of pregnancy, you should be able to see the germ, and some can even see the beating of the bud heart. But in Gong Yulan's B-super description of obstetrics, only the echo group is left.

Although it may also be due to interference from surrounding tissues, doubts accumulate little by little.

The laboratory tests used biochemical knowledge. Listening to the messy subkinesis hormone, the three students' minds were a little confused. Before they could react, Qi Jing started asking his own question: "You guys have finished asking, it's my turn to next."

"Although the person has been sent away now, there is no diagnosis. Let's talk about differential diagnosis."

"Didn't Teacher Gu Liang say that just by exploring the abdomen, you can make a clear diagnosis?"

"Yes, it can be solved by going to the operating table, why bother..."

"Why do you have to do this in one go?" Qi Jing expressed a completely different view from clinical practice. "Indeed, the patient has nothing to do with the emergency department after being sent away. But was there no in-depth investigation in the entire diagnosis and treatment process just now? Did Teacher Huo Yan not omit it when she was undergoing a physical examination? Now differential diagnosis can correct this error well."

“Is it too early to diagnose differentially?”

"It's too early?" Qi Jing said, "Your Teacher Hu Dongsheng was able to keep up with the teaching idea when he entered the clinical internship. Teacher Gao Jian, who just took your classmates to intern, discovered a pulmonary infarction that no one else found was not long after he went to clinical practice."

"But we have just finished the diagnosis, and we haven't touched both women and children inside and outside."

Qi Jing frowned. In his opinion, this statement was not a reason at all, so his face darkened and his tone became heavier:

"The brain is stubborn and doesn't turn around? It's all your fault that you haven't learned anything. You are now facing general surgery, which is very clear intraperitoneal bleeding. The large amount of the foundation of surgery has been consolidated in the basic medical school. You have learned departmental and bureaucratic solutions. Where are the blood vessels and which organs are more tender and prone to bleeding, don't you know?"

"Well..."

"Splenish? Or liver?"

"Gastric Intestinal Canal? Pancreas? Kidney?"

"I'm stupid. The pancreas and kidneys are deep in the pancreas. If something happened to the pancreas, the spleen would have been broken long ago." Xiao A said, "I think since it is a mass in the attachment area, it may also be related to the ovaries."

The organs in the belly are tossed and turned. If you want to find the cause, it is directly directed by surgery to detect the disease. However, the thinking link provided by Qi Jing cannot be saved. Only by repeatedly thinking about the cases and organizing the causes of mistakes can you develop a sound diagnostic idea.

This is the method Qi Jing has been using for so many years. It is precisely because of this that he can see something wrong with the patient at the first time.

After seeing a few people discussing for a while, there were many answers, but they couldn't explain clearly, so he simply left the differential diagnosis as an internship homework to the three interns. At the threshold of entering the senior year and senior year, and having a solid theoretical foundation, it is not too difficult to learn the Four Great Vajras by yourself.

"Whoever can do this question alone can come to me for the second internship, or go to your teacher Ji."

"All right."

......

The amount of bleeding reaches the point of hemorrhagic shock. The bleeding area should be rich in blood supply, and there must be shallow abdominal organs that lack strong muscle protection. Compared to the spleen, it is more likely to rupture and bleeding. The next one is the liver, and of course, it may also be caused by peritoneal tear.

The reason for the rupture is probably the impact of external forces.

The entire illness is like a group of gangsters robbing banks, wanting to sweep the vault. It is impossible to rob a bank alone. It is neither efficient nor safe. It is easy to be easily stopped by the guards coming from around, and the entire plan is strangled in the cradle.

So he needs obedient teammates with strength, those who need to release the news, and also design escape routes and drivers, and the most important thing is the insider.

The effect of external forces is a fully armed breakthrough team with live ammunition. They rushed into the bank, suppressed everyone, and then rushed straight to the vault. The lock-opening experts in the team will start to slowly tear the outer cover of the spleen and prepare for the heavy bleeding in the vault.

During this period, some people in the bank called the police, and some people escaped in the chaos. However, not many people could actually escape from the bank. It is difficult to distinguish who is the victim and who is the robber's inner demon.

"Abdominal pain": Someone went into the bank and hijacked many people.

"Under belly swelling": theirs is not simply taking hostages, they have other purposes.

"Attachment block", "Urine hcg": The robbers are real robbers, they came for a bag of diamonds in the safe on the fifth floor.

"Liquid Dark Zone": They were indeed for diamonds. There were only two people watching on the first floor, and the others rushed to the fifth floor.

"A fairly stable vital signs": They did want to have ideas about the vault, but no one could open the vault's password lock, so they gave up.

The insiders weaved a bag of diamonds. If the police really believed it, the vault would be hollowed out and they would be left with the underground passage that had been dug long ago. When the police reacted again, the robbers had already opened the manhole cover in the alley two blocks away and poked their heads out, and finally fled the scene in the prepared car.

The doctor who is treated is the police. You must tell who is the insider and who is the real cause of the disease and find a way to make a breakthrough as soon as possible.

If you really believe the Diamond on the fifth floor and most enemies gather on the top floor, you have to call helicopters like obstetricians and gynecologists to make airborne breakthroughs. But if it is to rob the vault, it will be different. Because you don’t know where the vault is, it will be troublesome at this time, and it is still more beneficial to attack from the main gate.

As for the safety of the hostages hijacked by the robbers, it depends on the skills of the surgeons who have made breakthroughs.

Where is the "treasury" of the lesions? It will take only to know after the operation is over. Qi Jing is not in a hurry, because Qu Jie was too anxious when he left, and the medical record was also placed in the external emergency room.

When everything is settled, he should come back to find this booklet, and then he will know the truth.

......

Qi Jing returned to the clinic and sat on his chair: "Director, you have all sent it away."

"I won't come." Wang Ting guessed following Qi Jing's usual behavior before.

"I don't know the seven people I kicked off before, so I might go to Ji Qing. The three I taught just now are pretty good. If nothing unexpected happens, I'll come." Qi Jing sighed and explained his "work" report. "Actually, they are all okay. At least they have a demand for learning. By the way, has the medical school improved the college entrance examination scores for admission?"

"How can I know this?"

In fact, Wang Ting didn't care whether the interns would come or not, he just felt it was troublesome. It was not easy to bring two interns, but if the interns came again, they would probably be in a mess. That is, today is leisurely enough, if they were a little busy...

"Wait!" Wang Ting pulled down the newspaper, looked at Qi Jing and asked, "What do you mean when you said you gave Ji Qing just now?"

"Just let Ji Qing take it." Qi Jing explained, "You know me, I don't like doing this kind of thing very much."

"No! Ji Qing will have several night shifts next. If they all go to find him, wouldn't they have to make a fuss that night?" Wang Ting slapped the newspaper on the table, "You have to take this matter over to me, no matter what method is used!"

Qi Jing smiled wryly and explained: "Director, they just lack experience and are not stupid."

"Are you teasing me?" Wang Ting pointed to the waste checklists and prescriptions in the trash can, "Look at the new batch of interns, it's not as good as the previous class. I have been copying prescriptions for several days, and I don't know which one to choose for the checklist. The blood pressure measurement is actually incorrect. I feel tired when I ask you to buy a lunch box at noon. It's really worse than the other class..."

In 2004, the interns in the hospital entered the post-80s era, which was the first generation of only children, and were nicknamed the "beat generation" by the post-60s and 70s.

Because these only children enjoyed the sustenance and care of the whole family, their childhood was much more comfortable than their parents. If someone sheltered from the wind and rain, they naturally experienced fewer hardships. Therefore, they just entered society and could not keep up with the work requirements, and laziness and scattering became synonymous with them.

In fact, there are many versions of this statement, which are widely circulated in the mouths of teachers and company superiors.

As time goes by, the statement becomes more and more mysterious, and it has a hint of inheritance. Because when the post-90s generation begins to enter society, this sentence "the beating generation" comes to the mouth of the post-80s generation who has already gained a foothold in society.

At the end of the evolution, a generation will collapse almost every five years, one will collapse.

When the post-90s first entered the clinical internship, Qi Jing was promoted to the chief attendant and got the position of the general duty. The interns usually do more often, and they are "deeply hated" their behavior. But when I think back to my youth, I was actually just a little bit of it, just a comfortable childhood and never experienced social beatings.

"Growing up always requires a process." Qi Jing comforted with a smile.

"Hmm?" Wang Ting couldn't help but take a sip of tea and looked incredible, "When did you feel so easy to talk to?"

"Old Ji is on night shift at night. If I can't control it, I'll come and have a look."

Qi Jing opened his phone and was about to tell him the great "good news". However, as soon as he took the phone, his phone ringing rang. When he saw the caller ID, he was Cai Ping who was far away to Beijing for a meeting.

Wang Ting frowned and looked at it, and asked, "Who?"

"It's Director Cai." Qi Jing smiled and answered the phone and asked, "Hey, Teacher Cai, is there any news?"

However, the originally kind and kind middle-aged woman's voice was replaced by another male voice, plain, cold, without any fireworks: "I am Huang Xinghua, Cai Ping should have mentioned me, so I'll give up on the introduction, let's talk about serious matters."

It is indeed the same as what Cai Ping said, without even a word of nonsense.

Qi Jing is a junior and is interested in the consultation, so he nodded.

"I heard that you have some knowledge of parasites. I have read the paper and it is okay." Huang Xinghua didn't drag on the slightest, and quickly told him the purpose of calling. "But your level is too low, and the patient is far away in Africa. I wonder how much do you know about Africa?"

"I'm pretty familiar with it." Qi Jing took out Xiao Yu, the real god. "My mother went to Africa to provide assistance. She has heard about her experience since she was a child, so she was very interested in this aspect after studying medicine."

He hesitated for a moment and sighed: "Since you can't tell the specific content, you can only solve it by asking questions."

Qi Jing didn't know how this guy understood it, but asking a question was indeed a good way to quickly understand other people's strength, because he had been using it himself. So when Huang Xinghua made this proposal, he happily accepted it.

"Teacher Huang, ask."

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Chapter completed!