In fact, it is not easy for a hospital to hold a large-scale case discussion. On the one hand, it is necessary to coordinate the working hours of each doctor, and at the same time, it is necessary to have a complex case that cannot be obtained after multiple consultations.

Sometimes, in order to find a common rest time, you can only place the meeting at noon or at night.

Of course, there are also examples of giving up the work at hand for consultation, but they all fall into the category of critical illness. Ye Han is now lively and definitely does not belong to this category.

This matter is not easy in China. Even if Qi Jing is domineering, he has to talk about some basic principles. Now in Japan, it is even more difficult to defeat local snakes, and this is even more so. Moreover, his dragon looks weak and has barely reached a certain level after being packaged in Japanese yen.

So it is obviously impossible to hold a case discussion meeting on the same day.

In fact, Miyao was already pretty good. He just gave money at noon and met Qi Jing at 1:00 in the afternoon. In the first sentence, he wanted to know what Qi Jing was going to do. He could collect the money first, but he had to do things after collecting the money, and the most basic industry morality must be. Ask a reason, if he couldn't do it himself, he would still have to pay back the money.

Qi Jing didn't go around the circle and immediately expressed his request, one of which was the case discussion.

"I hope I can call several directors from other departments."

After Miyao knew that he was also a doctor, he understood Qi Jing's thoughts on the cause of the disease, but after hearing this, he shook his head: "These doctors on our fourth floor can listen to you, but it is obviously not possible to hold a large-scale discussion meeting."

"It's okay to call one or two." After the flu storm, Qi Jing has now slowly focused on several myopathies, "It's best to be an expert in immune rheumatism."

Miyao did not shake his head again this time, but replaced it with three fingers on his right hand: "Everyone is the director, it's not appropriate for me to get the money. If you are anxious, you must have to feel it. Of course, if you are not anxious, it wouldn't be bad if you wait for a few more days. It's just that her symptoms are so mild and there is no problem with the examination. In fact, it's enough to check out the outpatient clinic, and there is no need to be hospitalized at all."

When translating this passage, Luo Sanguan specially used the four words "dip rain and dew" to clarify the "original pronunciation" of Miyano.

Qi Jing knew that it was not impossible to call someone, so he needed to pay out several more than 500,000 yuan, which was really not cost-effective.

Moreover, in his opinion, Ye Han's chance of getting an autoimmune disease is not high, because her lower limb muscles do not feel much pain, and tenderness is only weakly positive. It is impossible for a systemic disease to choose to attack the upper and lower bodies separately, obviously this is more likely to be a local lesion.

But compared with other patients, the scope of Ye Han's lesion is quite large.

Since there are not many doctors in Japan, I will choose local ones. After leaving Miyano's office, Qi Jing called Ji Qing. At 2:00 pm, the seven people gathered in the diagnosis department again.

Since Qi Jing hung up the phone a few days ago, they have been staying where they live, not idle at all, and almost turned over all the books they can read.

Since the myopathies mentioned earlier have been temporarily rejected by Qi Jing, let’s change the thinking and extend outward from muscle pain, low fever, weight loss, constipation, and fatigue. Among them, muscle pain is the main symptoms, covering simple muscle pain, to immune system diseases, metabolic diseases, and some infections that can affect muscles, etc.

Some of them even dug up a report of a drug causing myotoxicity a few years ago.

"Well, this has been dug out?"

Qi Jing was a little surprised when he heard what Ji Qing said. He vaguely remembered that it was a very sensational news at that time, and he also heard about it. Finally, the other party studied it and when using these drugs, muscle pain became a regular consultation content.

But that was the past. Those who could have such knowledge in 2006 were definitely not ordinary people: "Can our in-house website check documents?"

"It's not OK. The Internet definitely didn't issue a competition with Dan Medical University." Ji Qing said, "He went to the school to check it out."

"It's quite easy to learn, what's the name?"

"Lin Yi."

Qi Jing had never heard of this name. The person in the breast fluid he had taken before was mediocre, and he could only be considered to be a level of promotion. If Ji Qing hadn't helped lower the passing line, he would have been home like everyone else.

Qi Jing is not disgusted with this persistence in pursuing answers: "Is it a student? Which school is from? Dan Medical University? Or..."

"Danyang University of Traditional Chinese Medicine." Ji Qing said with a smile, "He is a doctor of integrating traditional Chinese and Western medicine and has been working in Danyang Traditional Chinese Medicine Hospital. We met him when Danyang Hospital had a communication with them in traditional Chinese and Western medicine last time. He had not graduated yet."

As soon as he finished speaking, Lin Yi, who was standing beside him, interrupted: "That was before, I had resigned last week."

"Have you resigned?" Ji Qing was shocked, "Didn't they just let you go to the deputy senior? Why did you say yes?"

"I don't care about professional titles. Anyway, this kind of thing can always be obtained. It's not that traditional Chinese medicine is bad. I'm just not satisfied with the working environment and the source of the disease there."

Lin Yi took a sip of water to moisten his throat and continued, "It was a fate to be here. When Dr. Ji talked about Teacher Qi, he left a deep impression on me. When he made the decision to resign, it still had an impact on me."

"Resignation is not a bonus for me." Qi Jing had no intention of being moved, "All strengths speak."

"I am only interested in cases. After all, I am not from Western medicine, so it is reasonable for me not to stay."

"Hey, I can't say that." Qi Jing's behavior is different from others. "If you really have the ability, I will force you to keep if you don't keep it at that time. You can't help it."

“…So that’s it, okay.”

Five hundred thousand yen brought Qi Jing the experience of a landlord as a wealthy person. Now the doctor's office on the fourth floor has become his own hall. He even made a long distance by phone from the hospital without regard for the expenses:

"Among what you said, the history of statin medication mentioned by Lin Yi the most illuminated my eyes. Let's talk about this first." (1)

Lin Yi got the right to speak and picked up the manuscript that had been prepared long ago: "statins have the effect of lowering lipids, which can indirectly prove that she has lost weight, and can also prove that her muscle aches through this article by FDA in the United States."

"You mean rhabdomyolysis?" For Qi Jing, this disease is so familiar that he encounters one or two cases almost every month.

Lin Yi did not say anything at all: "The literature does not say that rhabdomyolysis will definitely occur. This should be the most serious case. If the side effects are not effective, this mild muscle pain may indeed occur."

"If it's really as you said, what should I do next?"

"To check liver and kidney function, we also need to check serum creatine kinase (ck) to determine whether it has reached the level of rhabdomyolysis."

"No, it's quite complete to think of this, and the preparation is pretty good." Qi Jing has always been stingy with praise. If you can say this, you have already confirmed his ability. "It's a pity for someone like you to learn Chinese medicine."

Lin Yi did not answer this question positively, but said: "I think the integration of Chinese and Western medicine will be a major trend in the future."

"Trends can only be used by it. I can't control it. Let's go back to the patient." Qi Jing suddenly turned around and gave him a shot. "Why are the pain areas concentrated on her upper limbs? This is not the dissolution caused by trauma and squeezing injuries, but because of the drug, it should be systemic, right?"

Lin Yi had never thought about this question and immediately didn't know how to answer it.

However, Qi Jing's question did not end: "If she hadn't taken statins?"

"Have you eaten?"

"The drugs she carries with don't have statins, and she is not fat at all, so there is no need to take this medicine." Qi Jing explained, "The most important thing is that you must check the muscle pain, and her ck count is not high."

"Can you be sure?"

"When you are hospitalized, you will take medicine according to the hospital's unified standards. There is no such medicine on the doctor's order. Unless Ye Han takes it secretly, otherwise..." After saying a lot, Qi Jing recalled Ye Han's appearance when he took celecoxib and immediately said, "I watched it several times, but there was no statin in the medicine box."

Lin Yi had a good idea, but he couldn't stand the scrutiny. It was not until this time that Qi Jing provided a new situation, chest pain.

"Myscholar infarction?"

The first thing many people think of is coronary heart disease and myocardial infarction. Although it is an elderly disease, it has become increasingly young.

"No, the electrocardiogram is checked, there is only premature beat..." Qi Jing looked at the electrocardiogram report in her hand and said while thinking, "She seems to have a little premature beat, and her heart rate seems to be a little problem. But there must be no myocardial infarction, and the enzyme spectrum is all normal."

"This is a identification of chest pain."

"Yes, it's better to rule out the identification of chest pain after myocardial infarction." Qi Jing added, "Although I tend to be on the problem of muscle itself, chest pain should be more rigorous. I will compare the answers I had prepared before. What is the problem."

"By the way, has the previous fever subsided?" Ji Qing asked in a slight mouth.

"Didn't I call you before and say it was flu? The fever subsided this morning, otherwise she wouldn't have been discharged from the hospital here."

"Well, the girl is going to be discharged from the hospital?"

"Um."

"Then why did you hold a case seminar?"

"I just used some tricks, there's no problem." Qi Jing said with a smile, "Now I've kept her again. If I don't get a result, I won't let her go."

This is the first time Ji Qing heard that a doctor forced a patient to be hospitalized. Although Qi Jing said it was a small trick, as long as he touched his hands, he could be so small. I can't think about it in depth. Ji Qing knew the tricks inside very well, but after just a little bit of it, he gave up.

He does whatever he likes, meddling in other people's business won't end well...

Ji Qing grabbed the teacup beside him, poured two sips of tea into his mouth, and said as if nothing had happened: "Will the low fever be eliminated?"

"Prevent it for the time being."

When everyone heard the news that the originally tricky fever was removed, they breathed a sigh of relief: "That's not an infection..."

Qi Jing did not directly deny this statement. Body temperature is the most basic reaction of the body to deal with infection. No fever means there is no stimulation of the infection, or the reaction can be ignored. He did not dare to make a rash diagnosis. After thinking about it, he said: "It is not necessarily true, sometimes parasite infections do not have such a big reaction."

"She doesn't look like this."

"It's really not like it." Qi Jing shook her head, "Forget it, let's not talk about this, but focus on the muscles and ribs. She said that the ribs were a bit strange before she was discharged from the hospital in the morning."

"Will there be any problems with both lungs?"

"Well, I took a chest radiograph when I was hospitalized, and I will get it when the department discusses it later." Qi Jing said, "If the chest radiograph is clean enough, I have to make an appointment with a CT before checking it out."

Because of the addition of chest pain, the diagnosis has expanded from the original musculosis to the lungs and mediastinum. Because the tumors have a variety of properties, tumors may further affect the surrounding tissues when they grow in these places. Moreover, paratumor syndrome is not a decoration, and any messy symptoms will occur.

The main problem now is that chest x-ray, which is the lifeblood of all problems.

The afternoon time passed by.

Soon, the intra-department consultation on the fourth floor began.

Miyano also made the 500,000-yuan flower worth the money. Although he couldn't call those heavyweights, he still brought in many internal physicians on other floors.

Based on Miyano's experience, Ye Han's body is indeed the same as Qi Jing said, which is a bit strange.

However, there is always a priority in his medical practice. Such patients are just simple muscle pain and are not Japanese. There is no need to stay in their hospital for treatment. If you really want to thoroughly investigate the cause of the disease, you can go back to the United States and pay so much medical insurance, and the conditions are definitely better than those of Japan.

"Yamada, have you brought the movie?"

"Here's here." Yamada twitched Ye Han's x-ray film from the information bag, turned on the reader, and inserted it in, "It's this one. I finally got it from Teacher Takahashi. He checked it twice and kept saying that it was no problem, and I looked at it..."

Suddenly Qi Jing made a move to silence him, then stared at Ye Han's lungs and frowned.

He thought of the information that Qiu Xueting gave him before, Ye Han had 58 kilograms, but he had measured it several times, and the girl was not that heavy at all. Now that he saw the breast x-ray, the mystery suddenly solved.

"Brother Luo, there is something wrong with this movie."

“Are there any problems?”

"Here." Qi Jing pointed to the clean lungs in front of him, and then drew a circle on it, "Did you see it? In fact, it was already very obvious under the light."

Luo Sanguan is a major in imaging. Although he focuses on CT, there is actually not much difference between X-ray and CT. It is all connected. After Qi Jing's snatching, he immediately knew what the problem was: "So that's the case...the lesions are here?"

"From the scope, it should be here."

"It's so weird."
Chapter completed!