Autopsy is the basis of medical identification and has an irreplaceable role in resolving medical accident disputes that occur with unknown causes of death or objections to the cause of death. At the same time, it is also a summary and summary of medical failures, and can reproduce the patient's status when he is attacked by a disease at the pathological level.

Ordinary criminal autopsy can be completed by forensic institutions with pathological anatomy. For medical disputes, many medical institutions or medical schools can also do it.

But the female driver was in different situations this time, and it was indeed a bit difficult for the autopsy personnel who did not understand hijack disease.

After consultation with the CDC, Renhe Hospital finally decided that the CDC would complete the autopsy.

However, the CDC was helpless this time when facing hijabic disease. Those in-service chief inspectors who are qualified to understand the pathology have no experience in dissecting the corpse of patients with hijabic disease. In the end, Lu Zishan thought of one, which solved the dilemma of insufficient manpower experience.

That was an old forensic doctor, a grandmother-level figure. When Danyang was having sex with hooks, she was the main examination. It can be said that she was very skilled in hooks. Now after retirement, she is idle at home, accompanying a few children and enjoying family life.

Early in the morning on November 9, Qi Jing and Lu Zishan met and called a taxi to the Center for Disease Control and Prevention.

"How did you know such a big shot?" Qi Jing was a little curious.

"I have checked a case file from more than ten years ago. The person who was signed by the forensic doctor, named Xu Ruying, is 62 years old this year." Lu Zishan explained, "I talked to her about that case several times. She is a very amiable old lady."

"This age must have had hijack disease."

"It's not OK to have touched it, but I have to have a test. I heard that autopsy for leukopathy is very troublesome."

"It's quite troublesome. Not only do you need to dissect the whole body's organs and analyze the pathological development of each system, but you also need to do a large number of pathological sections for histocellular examination. The best result is to clarify the cause and find the hijab body at the same time."

“What about the worst?”

"It's hard to say, but it shouldn't be that unlucky..."

The original autopsy was not disclosed to outsiders, and was handled internally by professional autopsy staff. Finally, a professional autopsy report was given to the family and the hospital.

However, Qi Jing made a lot of contribution this time and also helped the CDC a lot. In addition, Lu Zishan is very familiar with the main examination, so he was directly put in. He came here mainly because he was interested in autopsy recently, and also wanted to see how much damage the hook body would cause to the human body.

However, he, a living doctor, always felt a little out of place when standing in front of the dead body.

Even if I had dissected the general teacher during class at Dan Medical University, that was a few decades ago. Moreover, the corpse that had been treated and frozen by formalin was very different in terms of touch and appearance of the internal organs of the body.

The cold temperature in the anatomy room and his strong curiosity forced Qi Jing to concentrate.

It is not easy to see an autopsy with your own eyes. A big shot is still the one who takes the lead in the examination. He should be able to learn a lot...

Qi Jing stood in front of the body and looked for feelings. What was passing by his mind were pages of forensic autopsy maps that he had seen day and night, and he didn't know what he was mumbling in his mouth.

Lu Zishan ran to Xu Ruying and greeted her.

At first glance, the two of them did not have any politeness in their ordinary working relationships. When they called Lu Zishan, they didn't even have a respectful word. Instead, they sounded more like chatting between grandparents and grandchildren.

Old Mrs. Xu was wearing a white coat and doing full protection work.

Today is her return to the dissection table after seven years. She is a little nervous, but more of it is the excitement brought by familiar memories. Of course, in addition to the dissection table and the body, Xu Ruying also cared about the young man who had just entered the door.

Seeing Lu Zishan and him appear when they entered the door, the old lady had already guessed the identity of the visitor.

At this time, she couldn't help but look at Qi Jing again, and then she couldn't help asking the girl beside her: "Zishan, is this your boyfriend? It looks pretty good and easy to learn."

"Yes." Lu Zishan nodded, "Grandma Xu, he doesn't know what's going on recently. He is particularly interested in autopsy. It doesn't matter if he asks him to come?"

"It doesn't matter, it's all about looking at it anyway, and you don't use a knife or write a report." Xu Ruying began to prepare the autopsy tools and continued, "I heard that he was the doctor who discovered that the hijacked disease was spreading this time. In order to further study the pathological changes in the patient's body, it is normal to go to the autopsy and dissection room to see it."

"Um."

Xu Ruying was naturally happy for her when she saw her happy appearance, but due to years of life experience, she still didn’t have much smile on her face, which was completely different from when she was at home: “Don’t blame Grandma Xu for being too talkative. Men are too smart and not easy to control. Especially for your boyfriend, once you lose interest, you will..."

Lu Zishan knew very well what Qi Jing needed, and seemed to have been prepared for this: "Don't worry, I'm a good idea in this."

"Just think it's OK."

Xu Ruying finally laughed and didn't say anything. She looked at a helper beside her and said, "Get ready to start, bring a recorder board and a recorder."

"good."

This is a new forensic doctor who has just graduated for a few years. This time he was specially sent to help him learn more skills and to help Xu Ruying.

He seemed to have many common problems with forensic doctors, and they all liked the one-acre and three-point land in the dissection room, and did not want to be touched by others. Qi Jing's sudden appearance did not bring him much favor. During the ten-minute preparation period, his eyes kept glancing at Qi Jing.

As for Lu Zishan...

Men have always had double standards when facing men and women, especially such great beauties, let alone.

Due to work, Xu Ruying has always had great demands on young people and could not tolerate sand in her eyes. If she was negligent, she would catch her and say a scolding. Obviously, the young forensic doctor's approach exceeded her bottom line: "What are you looking at?"

"Oh, no, nothing."

Xu Ruying's smile just now was taken back: "I don't know what background you are, nor why they sent you here. But I want to emphasize one thing, don't hold me back later, if you can't do it well, get out of here immediately."

The young man nodded.

"Have you seen information about leukopathy?"

"See it." said the young man, "This time it is a cerebrovascular leukopathy, which mainly attacks the blood vessels at the base of the skull, causing the endothelium to lose elasticity, which further causes blood vessel rupture and bleeding."

Xu Ruying felt that there was nothing wrong with her attitude gradually eased: "The preparations before the autopsy are also very important, so don't look around in the future."

"I just think it's strange. Why does a doctor have to see an autopsy? If a person dies, it shouldn't have anything to do with them."

"Why do you care about so much? We have a tight time. Don't stand there, hurry up and do things."

"oh......"

Autopsy is a technical job, but it is definitely not high-end. After all, it is much simpler to use a knife on a dead person than a living person. However, in order to ensure absolute objectivity and fairness, autopsy has become a tedious job, and its rigor directly determines the final result.

Leptospira is slightly different from other microorganisms and can invade all organs of the body.

Although clinicians have a lot of clinical symptoms, they are not fluoroscopic eyes after all, and they can only judge where the leukobody disease exists through the symptoms. If you want to really find the leukobody, clinicians have considerable limitations and need to rely on autopsy and pathological examination to find the real culprit.

For the female driver, Qi Jing judged that he had bleeding from the anterior cerebral artery first, and then there was a car accident, with the lesion area in the brain.

However, Xu Ruying's examination method did not have the concept of being serious first and then being light, so she directly chose to open the chest to check the heart and lungs. Before taking the surgery, in order to improve the "interestingness", she also asked a question: "Which organ do you think of the deceased's organ is the most damaged?"

"Brain."

"I also think it's the brain. After all, I have repeatedly bleeded many times, and my brain tissue has been extremely oppressed."

"Haha, you can watch it." Xu Ruying used bone scissors to cut the ribs on both sides and cut the entire front chest into a flip. "After entering the chest cavity, three point-shaped bleeding appeared on the surface of the lung membrane of the deceased, and two spot-shaped bleeding foci were seen on the cut surface, and the feeling of twisting hair was weakened."

"There are already pulmonary bleeding."

"It's pretty good." Xu Ruying glanced at Qi Jing who spoke and said, "In the past, when I saw people with serious lung bleeding, these bleeding spots would melt into a large area."

"Is there still serious edema in those alveoli?" Qi Jing asked along her thoughts.

"Yes, there may be some lymphocyte infiltration in the small bronchials."

Compared with the lungs, the heart examination is simpler, but the results are still the same. In the epicardial membrane, spot-like bleeding in the left endoventricle, and mild edema of the myocardial interstitial interstitial.

"Take the mark and select the location information, and do a microscopic examination later." Xu Ruying handed over the two tissue sections he had just obtained to the young forensic doctor around her, and said, "Focus on the infiltration of inflammatory cells and edema."

"Okay, I'll write it down." The most popular thing in the visceral area is the three parts, the lungs, liver and kidneys. Xu Ruying's next stop is the liver located below the lungs.

The old lady is so skillful that she is jealous and very sensitive to weight. After removing the liver, she just raised her hand and guessed its approximate weight, which is exactly the same as Qi Jing: "This liver is heavy, about 1850g." (1)

In clinical practice, no doctor will care about the weight of a person's liver. But in autopsy and anatomy, weight represents the lesions of the organs.

"It seems that the liver has not been avoided."

"The left lobe of the liver rupture and bleeding, and the liver lobe structure disappeared." Xu Ruying briefly described the lesion area he saw, and then prolonged the lobe septal incision, revealing the internal conditions of the liver, "Mixed steatosis, multifocal necrosis..."

Qi Jing looked at the pathological phenomenon exposed in front of her after the dissection and said, "I'm afraid at the last moment of her life, multiple organs could not withstand the attack of the hook body and collapsed all over the line."

"Maybe." Xu Ruying cut a few portions of liver around the rupture and handed it to her assistant, "I will stain several specimens later." (2)

"good."

Next to the liver is the digestive tract, pancreas and spleen.

There is no problem with the digestive tract, and the pancreas only has slight edema, and the weight does not change much. Relatively speaking, the spleen is more serious. Not only is the capsule tight, but the entire spleen also looks very swollen from the cross section.

"Oldly, do microscopic examination and levaditi staining."

"Um."

After examining the entire viscera, Qi Jing did not see any serious damage. Even the rupture in the liver just now could not be compared with multiple cerebral hemorrhage.

But when the deceased's kidneys were moved out of his body, Qi Jing was a little surprised, and he didn't expect that the most serious problem would be here.

Severe bleeding under the capsule of both kidneys, forming a large number of hematomas, which looks like being blown from a distance. After gently incision, you can see many point-shaped bleeding points and infarction foci on the cut surface.

"This kidney..."

"The severe renal bleeding and kidney failure caused by the hook body will be useless even if the kidney is saved." Xu Ruying leaned against the body in front of her and could see how she was treated. "I guess there will be many hook bodies here, let's check it."

"Um."

The young assistant looked at the inside of the body being emptied, suddenly thought of a special part and asked, "Teacher Xu, I heard that hijacked body disease will cause gastrocnemius pain. Do you still need to do a muscle slice examination?"

"Muscles? Muscles can be ignored."

After Xu Ruying finished speaking, she wanted to put her target on the face of the corpse, but thinking that she seemed to have a poor answer, she explained: "What I mean is that muscle slices are not important, but that they do not apply to the deceased."

"What is the cause of gastrocnemius myalgia?"

"That's because..." Xu Ruying couldn't answer this question, so she could only look at Qi Jing.

Qi Jing did not disappoint her and answered slowly: "The hook body stimulates the body to produce tumor necrosis cytokines, IL-10, hook body hemolysin, cell wall lipopolysaccharides, etc., causing rhabdomyolysis, bleeding and necrosis in the human body, so gastrocnemius muscle pain will occur."

"Doesn't that mean there is a problem with the muscle?" The young forensic doctor was a little confused.

"It's just some substances that cause the muscles to change, so there is no hook in the muscles." Qi Jing explained with a smile, "It's like eating hot pot. Some people concentrate on meat, and some people like yellow throats. Leptospira are people who like yellow throats. They specialize in blood vessels and have little interest in muscles."

"It's worthy of being a doctor who can see hiccups at a glance, and he said it thoroughly."

Xu Ruying was not stingy with her praise, and while saying that, she picked up a swinging electric craniotomy device from her side: "The next thing is the brain, multiple cerebral hemorrhage, and the location of the disease is also very clear, which is the anterior cerebral artery. Then let's look for the anterior cerebral artery first and peel off the entire blood vessel."
Chapter completed!