During an exciting case discussion, I suddenly called a guy who was addicted to games and turned on hands-free, which was surprising and really inappropriate. However, when the name of "Li Zhiyong" appeared in front of everyone, this so-called inappropriate situation became "so that's it."

This is the strength of Li Zhiyong, director of the University of Imaging Science and Technology of Danyang Hospital. At a time when modern medicine is increasingly relying on imaging examinations, everyone knows the weight of an imaging director who has the highest reading efficiency.

Moreover, young people who can talk to Li Zhiyong must have this clinical diagnosis ability. Otherwise, let alone talking about games, I'm afraid I can't even say anything.

"Why did you go to the first yard?"

Seeing that he was thinking about the game, Qi Jing felt a little embarrassed. After all, he was not here to discuss the game with Li Zhiyong. Turn off the hands-free time, Qi Jing picked up his phone again: "Director Li, you can play the game console casually, I don't rush to ask for it, but you have to do me a favor now."

When he saw the caller ID of his mobile phone just now, Li Zhiyong was still worried. Now that he knew that Qi Jing was not on the game console, he was in a good mood. He raised his legs and looked at the game screen in his hand, and joked: "Have you encountered trouble in the first yard? I think you are having a lot of fun."

Qi Jing smiled and said, "It's okay."

Since the last genetic patient Luo Tang took over, Li Zhiyong has been concerned about Qi Jing’s usual interests.

The game can definitely count one, but in addition, it seems that only the job is left. However, the job he likes is different from the job of an ordinary clinician. Others look for a doctor when they are patients, but they go to the patient by themselves.

"Are you tired of chasing patients like this? Why don't you come back and play games with me? This last level is a bit difficult."

"Director Li, the game is interesting only by yourself." Qi Jing said with a smile, "But if there is a problem with the patient, it is better to brainstorm and solve it as soon as possible."

Li Zhiyong could understand what he meant and pressed the pause button reluctantly: "I'm convinced you, tell me, what patient?"

A most promising imaging expert in Danyang and even surrounding provinces, his views are enough to change the direction of case discussion. After obtaining Li Zhiyong's consent, Qi Jing turned on the hands-free again and talked about the patient's situation.

"Huh, it's a bit interesting." Li Zhiyong laughed twice and said, "I don't know the messy principles in clinical practice, but you said there are small nodules on the chest x-ray, which is very interesting. Are they scattered? How big is it?"

"At the beginning, three, 2-3mm, clear boundary."

"What about now?"

"The size is similar, but the number is a little larger, and there are also hollow shadows."

"The hollow...it took only ten years to develop, cancer is impossible, infection." Li Zhiyong paused and added, "Chronic infection may be a chance pathogenic bacteria."

Qi Jing was busy in the first hospital for more than two hours, and copied the medical records and pretended to be an intern. In the end, Li Zhiyong's words were not as heavy as a single word. However, his efforts were not in vain. If Li Zhiyong wanted to say this, the breast radiograph that was reviewed was crucial.

Without it, Li Zhiyong would probably not be able to say why.

"Director Li is almost the same as I think." Qi Jing suddenly looked at Xie Zongpei and the two senior directors who came to consult. The smiles slowly made people feel uncomfortable, "I think the diagnosis should be decided."

"Yo, will there be a diagnosis so soon?"

"Well, does Director Li think it looks like non-tuberculous mycobacterium?" Qi Jing asked.

"Hiss~ After you mentioned it, it's really similar." Li Zhiyong replied, "You just said that there was a lung infection and then spread to the skin. Now it invades the bones, which is very similar to the style of non-tuberculous mycobacterium. Kansas will cause such small nodules. I've seen two cases before, and it's possible for bird intracellular complexes. By the way, are there any other infections besides these three places?"

Qi Jing looked at the earliest symptoms on the record board: "The first problem with teeth was that they all fell out in more than two years."

"If this is combined, it will basically not run away."

Li Zhiyong has seen chest X-ray changes in patients with non-tuberculosis, but the number is very small. For the doctor's work experience, it is really "lucky" to find a rare patient, and it is impossible not to be excited: "There are several types of non-tuberculosis Mycobacterium that cause dental infection and loss. What is the name... Oh, my memory is getting worse and worse as I get older."

As an imaging doctor, even if you can understand this step, you will only be one or two steps away from reaching the pinnacle.

Qi Jing did not continue to say it, but pulled Xie Zongpei, who was sitting beside him, in: "Director Li, which one do you think is more likely to be compared with Actinomycetes nocaria or Mycobacterium non-tuberculosis?"

“Noka?Actiflora noka?”

"right."

"The infectivity of this bacteria is not that light, and the process cannot be so slow. The lung infection foci is even less likely to be such a small nodule. Generally, there are large areas of suppurative pneumonia, and then the lung tissue is necrotic, and finally it develops into a pus cavity." Li Zhiyong directly rejected this view, "It would be better to say that he has miliary tuberculosis than to choose Noka."

"Director Li, you are joking again. Miliary-like tuberculosis is so dangerous, how can it last for so long?"

"You just provided the two chest x-rays before and after, or oral, and didn't give any other tips. I can think that non-tuberculosis mycobacterium is already amazing." Li Zhiyong thought for a while and asked, "By the way, where is the bone? You said there is an infection on the bone, what is the X-ray performance?"

"If you have bones, you should have a result soon."

The infection dent was not found on the bones before, so Qi Jing asked the radiology department to do an x-ray of the limbs before. As soon as he finished speaking, the phone on Li Xin’s hand rang.

"Hey, I'm in the radiology department."

Li Xin hurriedly asked, "Director Liu, how are you doing?"

"Xiao Li, I've finished filming here, there's really something on my bones!"

After hearing this, Li Xin's head buzzed. Now that bone damage is damaged, the initial osteoporosis diagnosis can be completely eliminated. This shows that this kid's judgment is correct, and the possibility of infection is almost 100%. In the field of infection, with Li Zhiyong standing by, Xie Zongpei's judgment has a chance of winning, I am afraid anyone with discerning eyes can see.

"What's wrong?" Xie Zongpei asked quickly when he saw that he had no voice.

"Director Liu said there was bone damage."

Being pressed by Qi Jing and Li Zhiyong, Xie Zongpei was really unable to sit still at this moment. He got up and took the microphone himself and asked, "Old Liu, it's me, Xie Zongpei. Where is the patient's bone damage? Is it a suppurative change?"

"Inflammation is on the knee! But there are no abscesses."

Liu Mo looked at the two femoral films in his hand and described: "You can see that the bone cortex is layered, which should be osteoporosis. There is obvious inflammatory changes in the suprapaeal capsule, and arthritis is quite serious. You can also see a horizontally low density line at the metaphyseal next to the patella. I guess it was caused by the infection and the pathological fracture that was finally formed."

There are only changes after inflammation, but no abscess foci, and the concealment of this infection is really stronger.

Liu Mo continued: "If the patient can walk normally now, he will feel pain and soreness in his knees. However, his femoral head was necrotic before, and his spinal compression fractures were unable to move now, so the symptoms were significantly delayed."

If it is really like he said, the nocaria mentioned by Xie Zongpei is a bit untenable, because both tuberculosis and nocar must form an abscess cavity.

"Old Liu, are you reading it wrong?"

"How is that possible? Even the doctor who just came to read the film has seen some tricks. The pathological fracture line is too obvious."

Xie Zongpei finally breathed for half an hour. He lost the case discussion: "Thank you, Lao Liu, I will treat you to dinner when I have time."

"I'll be spared after eating. I want to know more about what kind of infection the patient is than eating?"

Liu Mo is also a person with a temperament. When he sees such a patient, he can't just watch two movies and let go. He has to ask why, otherwise the unresolved answer will suffocate him to death.

Moreover, for him, although Qi Jing’s previous requirements were too much, they were very effective after following them. A few X-rays determined the infection site, which was already very worthwhile. Therefore, Qi Jing naturally became the object of Liu Mo’s inquiry:

"Is that young man still there just now? I want to ask two questions!"

young people......

This young man almost beat me up...

Xie Zongpei's face was thrusting, feeling sincerely unhappy, but he still had a smile on his face: "Okay, that's it, I'll chat if I have time in the future, goodbye."

After saying that, he hung up the phone.

"Ah? Hey, Xie Zongpei, you haven't said my question yet, what do you mean?" Listening to the blind voice coming from the phone, Liu Mo was so angry that he suddenly became angry, "Who is this person? Treat me as a tool? I am also the director of the first department after all, so I threw it away after using it?"

Liu Mo and Xie Zongpei are old friends, and this misunderstanding can be said to be completely unreliable in the future. For Xie Zongpei, what he cares more about now is the face of orthopedics. He was a full-level boss and was outputted by a young man who had just entered the novice village and lost in the end. He had no place to put his old face.

Of course, self-esteem depends on self-esteem, and his job is still a doctor. For Qi Jing, who has almost diagnosed the cause, the minimum respect must be given. It is impossible to scold him. If he doesn’t have this little bit of stomach, how can he be the leader of a subject?

Moreover, with the familiar relationship between this child and Li Zhiyong, his status is doubtful.

You should know that Li Zhiyong never watches films in the outer hospital. This is his rule. Even if the first hospital is at the same level as Danyang Hospital, if he wants to read it personally, he must reshoot it. But now he hasn't even watched the original film, and just listened to a child's oral statement and actually gave the answer.

I'm afraid this trust cannot be explained in just a few words. If Qi Jing had not used respectful titles when they communicated, Xie Zongpei would have misunderstood that the two were father-son relationships.

Father and son...

By the way, father and son...

Xie Zongpei suddenly thought of Qi Jing's identity. However, how did he withdraw from this discussion and end the entire case discussion in a smooth manner, and it would be best to remain calm.

"Director Liu said that some patients had inflammation in their knees and also caused pathological fractures, which should be a slow-developing inflammation. The possibility of non-tuberculous mycobacterium is not small, and of course Noka cannot be completely ruled out." Xie Zongpei said with a smile, "Next, we will collect some specimens and send them to the Centers for Disease Control and Prevention to determine the strains and sensitive antibiotics."

"But....."

Seeing that Qi Jing had to stick to his previous treatment point, Xie Zongpei raised his hand and stopped him: "I understand what you mean, but the inflammation on the patient's knee is not too serious. The antibiotic you are going to use is quite a bit of side effects, and the diagnosis and medication is really inappropriate."

Qi Jing sighed. Now there is X-ray as evidence, and Li Zhiyong and his judgment have basically been confirmed. There is no need to continue to get entangled.

Moreover, the current situation is not good for him. As the end is approaching, he has to prepare for his departure.

From the beginning, he directly attacked the director of the Orthopedics University, and then found two major directors of skin and breathing one after another. Until finally, he automatically took the imaging directors of two junior high schools. After such a big stir, Qi Jing felt a little unsure, and his purpose also changed from finding the truth of the cause to "escape".

"You have a solid clinical foundation and can dig deeper from mild chronic cough step by step..."

Xie Zongpei said this very well, and it was basically the highest evaluation given by the chief director to the hospital. But Qi Jingfang was praiseworthy. Once praised, it would mean that the discussion meeting was over. It also shows that the other party’s suspicion of his identity was rising sharply.

So it is best not to respond now, and you also have to give yourself a reason to not respond.

"Hey, Director Li, that's so urgent? I'll be back now!"

Anyone can pretend to be stupid. Qi Jing picked up his cell phone and said this to the microphone, using Li Zhiyong, who had already hung up the phone and played games as his shield.

This slightly abrupt sentence caught Xie Zongpei off guard.

A young doctor from Danyang Hospital, who is only about 25 years old, actually has such exaggerated clinical diagnosis ability. Just look at his face and keep his name behind.

"May I have your name?"

Qi Jing didn't expect Xie Zongpei to be so direct. The door was far away, and Li Xin even stopped him. It was impossible to just leave like this. Isn't it just a name, just say it. Anyway, Qi Sen scolded him with a lot of thunder and little rain, and it's no big deal.

"My surname is Qi, and my name is..."

Suddenly, a face flashed through Qi Jing's mind, and it was Huo Zhiye who was sitting aside and quietly watching him. A simple word "Qi" made two strangers who had never met nervous at the same time.

Damn! Why did I forget him? That white coat is still in his hands!

It's over! It's nothing to argue about the condition, but once someone instigates others to steal medical records, it will be a big deal. At least Qi Sen won't let him go easily.

Qi Jing never thought that his surname would become an obstacle, Qi...

what to do......

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Chapter completed!