Although Lin Zhixing is a deputy senior, this is just a title he left more than ten years ago. If he was willing to return to China, he would have been the chief director of the first subject with his qualifications, and would not be worse than anyone present. If he had been working abroad for so many years, no one could compare with him in terms of his contributions to medical aid to Africa.

So during the video exchange, Huang Xinghua rarely felt humble, and the chief professors below naturally brought his title to the same level as his.

Qi Jing is just a hospitalized doctor, so it is indeed inappropriate to speak like this.

Of course, if we put aside the relationship between superiors and subordinates and change the doctor-patient perspective, Qi Jing’s words are actually not wrong, and he also expressed the voices of the following people.

The practice of giving up easily when encountering difficulties in treatment is to say that it is not taking up medical resources and saving time and cost. To put it bluntly, it is simply distrust the doctor's success rate of treatment and compromise on the disease. At least from the perspective of consulting doctors, Lin Zhixing is unqualified as a patient.

Doctors who have worked in clinical practice will encounter such patients from time to time. Whenever they see them, they will feel a sense of regret and always want to wake them up.

In fact, Qi Jing has long been accustomed to such patients. Over time, he has become natural. He has to worry about it if he loves to cure it in normal times. But in front of him is a chief doctor who has been fighting with the God of Death for decades, his colleague. Seeing him throwing his arms to the God of Death, Qi Jing felt uncomfortable.

Lin Zhixing always felt a sense of being sarcastic when he heard this sentence. But after working in Africa for so many years, he had long worn away the arrogance he had cultivated in China before, and he seemed extremely peaceful. He looked at the young man in the corner of the wide-angle camera, held his glasses, and asked Huang Xinghua next to him:

"The person I just talked about is..."

"This child is called Qi Jing. He is actually the one who recommends changing the centrifugal concentration into a thick and thin blood diaphragm." Huang Xinghua introduced with a smile, "If you want to talk about parasites, he is better than everyone sitting."

"Oh?" Lin Zhixing still had a smile in his surprise. "Someone can make Professor Huang praise him like this? Those three questions..."

Huang Xinghua nodded: "He answered all three questions you gave correctly."

"All right? This..." Even as calm as Lin Zhixing, he couldn't help but be surprised. "This is my experience in practicing medicine in Africa for more than ten years. Professor Huang is also very clever in designing the questions, and even made some minor changes. It is already very good to be able to answer one question correctly. All three questions are correct?"

"Well, all right, there are almost no mistakes." Huang Xinghua once again affirmed Qi Jing's ability.

Lin Zhixing was puzzled: "Doctor Qi looks very young. Did he go to Africa when he was a child?"

"My mother has been there." Qi Jing replied before Huang Xinghua, "It doesn't matter whether I am strong or not. What matters now is the insects in your body."

Lin Zhixing nodded, breathed a sigh of relief, and then focused on the identification of the Silkworms: "The staining of Gisam that Sara had just made failed. I guess there was something wrong with the dye. How should I identify it in this case?"

Qi Jing said: "Whether to dye or not is not necessarily a problem with dye. This should be because the microfilariae have a sheath membrane, which blocks the dye from entering the body."

"I certainly know that the hydrocele blocks the stain."

Lin Zhixing immediately retorted: "But when doing centrifugal concentration in the morning, the Gisam dyeing used can be dyed. Because the last dyeing was blurry, Sarah deliberately changed to a new dye this time to achieve the best effect. Who knew that it would end up like this..."

Dyeing agents are very ordinary chemical products, and can be prepared by themselves after being mixed in the laboratory.

In China, it is basically impossible to dye or color dye. But now Lin Zhixing is extremely backward in Africa, and almost all products rely on imports. Not to mention the shortage of quantity, accidents may occur after long-term transportation.

There are really too many problems in the local area, forcing people to think about the worst outcome.

Old-style microscopes without imaging technology, use broken high-power lenses casually, lacking enough parasite antibody detection... Now it's the colorant turn, and it seems nothing wrong.

"But this is the new dye? Why did it break?"

"Yes, the problem with the dyeing agent only affects the dyeing effect. I have never heard of it that it will cause failure."

Qi Jing sighed: "Methanol is required for preparation of Gisam, with a boiling point of only 60 degrees, and it has volatile and strong water absorption. It is indeed insufficient stability. However, the highest temperature record in Africa has not exceeded 60, and it is not rainy now, and the air is not drying well. I think there should be no big problem with the dye."

After listening to Qi Jing's explanation, Lin Zhixing also felt something was right and asked quickly: "What's the problem?"

"The problem should be with centrifugal concentration." Qi Jing explained, "centrifugal concentration has a certain chance of destroying the microfilariae hydrocele. If the hydrocele was not present before, the staining would naturally be successful. However, the thick blood membrane used this time, the hydrocele was completely preserved."

Lin Zhixing thought of the hydrocele, but did not expect the possible consequences of centrifugal concentration.

"Even if you know the reason for the ineffective dyeing, you cannot change the fact that the ineffective dyeing." Lao Zhang said at this time, "There are many dyes in clinical practice, and you can still pick and choose in China. You can try other dyeings instead. But in that ghost place, it's really too difficult."

"Yes, Lao Zhang is right. Dr. Lin, come back."

"Go back to the country and have a peaceful treatment, and then go back after you recover."

If Qi Jing was not present and after listening to the advice of these colleagues just now, Lin Zhixing might have really been cruel to return to China. But the analysis just now made him clearly realize Qi Jing's strength. As long as the young doctor didn't speak, there would be hope.

Lin Zhixing sighed and put his last hope on Qi Jing: "Think about other ways first, Dr. Qi, is there any dye that can penetrate the microfilariae hydrocele?"

Qi Jing nodded: "Yes, yes, but there is no need."

“No need?”

"Yes." Qi Jing spread his hands and said, "The insect species have been basically clarified, so there is no need."

"Ah? That's clear?"

Qi Jing nodded again and continued, "If you want to be more secure, it is not impossible to have another re-examination for a diagnosis. Now local time should not be past two o'clock in the afternoon, and you should be able to draw a conclusion if you do another blood diaphragm. However, Dr. Lin has been given a lot of injections these two days, so I'll forget it."

His words made dozens of experts present confused. He was discussing how to identify microfilaria germ species just now, and how did it be clear after a few sentences?

Qi Jing just looked at Sarah's hand-drawn drawings throughout the whole process. The source of information obtained by everyone is the same. What's more, just Sarah's painting skills, if you take out this picture sheet, no one will think it is a microfilariae.

The diagnosis was so sudden that they didn't have time to react and didn't even have time to prepare.

"What kind of filaria?" Huang Xinghua asked.

"Roa Roa nematode." Qi Jing replied, "If it weren't for the failure of dyeing this time, it would have taken some trouble to identify the insect species. It could be considered a blessing in disguise, and the sheath became the key."

The next thing became his unilateral speech time.

Eight species of filariasis, Ban's Wuce nematode, Malay Bruce nematode, Timor-Legendum, Roaroa nematode, often appear Manson nematode, Eurozanii, Chain-tail Manson nematode, and Roaroa nematode.

Among them, it can be divided into two parts based on sheath or not. The first four categories have hydrocele, while the last four categories have no hydrocele. This structural characteristic of microfilaria alone allows Qi Jing to easily eliminate half of the insect species.

But the next structural distinction is the top priority.

If it is Qi Jing who looks at the microscopic examination results, even if it is not dyed, it can still be distinguished from the length of the microfilariae body, the tail shape and the aspect ratio of the head gap.

For example, the length of the Roaroa nematode is between 240-270μm, and it is of medium size among the filaria. The only ones with its length that have intersections with it are Ban's Wuce nematode and the chain tail Manson nematode. At the same time, it is also the only two of the eight species with round tails, and the other is the Manson.

Among them, nuclei can be seen in the tail and body of microfilariae, while the nucleus-free head gap seems particularly shorter than other insect species. As long as you observe and inspect the photos frequently, it is actually very easy to identify.

But Sarah's handmade drawings are really not satisfactory, and she can't even draw the most basic form, so it's even more impossible to see anything valuable from these three paintings.

In fact, Qi Jing's diagnosis has to start with Lin Zhixing's symptoms.

There are three types of filaria that can parasitize subcutaneous tissue, namely the chain tail Manson nematode, the roaroa nematode and the roaroa nematode. The chain tail Manson and the roaroa have no sheath, so it can be basically confirmed from the symptoms alone that it is the roaroa.

If there is still a possibility of misdiagnosis based on only one method of exclusion, then we can consider it from another perspective.

According to the law of microfilariae entering peripheral blood, it can be roughly divided into three categories: night-appearing periodicity, day-appearing periodicity and non-periodity.

The centrifugal concentration method performed by Sara can eliminate the three types of silkworms that appear periodically at night, such as Ban's Wuce nematode, Malay Bruce nematode and Timor-Leste Bruce nematode. Among the remaining five kinds of silkworms, it is very coincidental that only Roaroa has a hydrocele.

Qi Jing's differential diagnosis ideas are clear, and everyone can only applaud and admire.

Huang Xinghua didn't know what he had experienced in the past few days, and he basically didn't use praise words. He used them countless times in the past two days. Perhaps he was more silent in front of Qi Jing and had never said much, but he talked a lot with the chief professors around him.

"Doctor Lin, if you are worried, you can draw blood again for a blood diaphragm." Qi Jing suggested, "As for dyeing, you should have Rui's staining liquid there, right?"

"Rui's? The most commonly used type?" Lin Zhixing nodded, "There must be something here."

"That's good, just use Rui's dyeing." Qi Jing said, "Although Rui's dyeing is the most common dyeing method, it has a strong penetration of the microfilariae membrane that Gisam cannot penetrate, and you should be able to see the obvious insect body structure."

"Okay, I'll go to test it now."

The next result was exactly the same as Qi Jing said. Rui's blue-purple dye successfully entered the insect body. Through Lin Zhixing's detailed description and hand-drawn sketches, Qi Jing can be sure that he was infected with the Roaroa nematode.

After the diagnosis is over, treatment must be kept up.

More than ten years ago, there was no basis for molecular biology detection, and the diagnosis of filariasis was only three axes for adult morphology, peripheral blood larvae microfilariae morphology, and antibody detection. Africa naturally lacked the last axe, and the larvae in the remaining two axes had been completed by Qi Jingzhu, leaving only adults.

Roaroa nematodes are also called eye worms locally because they not only parasitize in the subcutaneous tissue of the human body to form lumps, but also go to the surface of the eye from time to time for an outing.

Judging from Lin Zhixing's symptoms, the adults did not leave the skin and should have been hidden in the lump.

"Go to the surgery department first and find someone to cut it off." Qi Jing observed the lump on Lin Zhixing's wrist and said, "Surgery stripping is the most direct way."

"Okay." The clear diagnosis made Lin Zhixing feel a lot more energetic, "Which should I choose for drug treatment?"

"Ethamine is the safest, but the effect is average." Qi Jing thought about it and asked, "Do you have ivermectin there? It is the broadest spectrum of anti-parasitic drugs and is effective for all kinds of filaria."

Lin Zhixing shook his head: "I'd better use ethylamine, as it happens that there is still stock in the pharmacy."

"No!" Qi Jing immediately stopped him, "Ethylamine has been proven to destroy the body surface defense of microfilariae and help the human immune system destroy the insect body. The special proteins produced after the insect body disintegrate may cause a strong allergic reaction. The reaction of the Roaroa nematode is the strongest of the eight kinds of filariae."

Lin Zhixing has gradually become accustomed to Qi Jing's knowledge of parasites. He did not expect that he had been a pillar of local hospitals in Africa for so many years, and in the end he still had time to rely on others.

"Then what medicine should I take?"

At this time, Huang Xinghua said: "Doctor Lin, it doesn't matter. I will report your situation tomorrow. Within a week, ivermectin will be delivered to your hands."

"Thank you."

Lin Zhixing breathed a sigh of relief, recalling that he had hesitated between doctors abroad and domestically. Now it proved that his decision was correct. Sarah beside him also laughed happily: "I have to tell Shawn this news as soon as possible, and he will definitely be shocked."

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