godfather of surgery

Chapter 336 The Gold Standard

Professor Su and his party watched the video and visited the General Orthopedics Department before leaving.

The child admitted to the free clinic in the demonstration classroom, who is considering osteoid osteoma, has already completed the operation. His father wandered around the door of the doctor's office. When he saw Xiao Wu, he asked, "Dr. Lu, have the results of the pathological examination come out?"

"Didn't I tell you that it would take three to five days? You've already asked seven or eight times." Xiao Wu felt a little annoyed at him.

The child's father thought for a while and said, "Doctor Lu, can you advance my son's examination? Others are not in such a hurry, so just take it easy and advance him alone. It won't affect anything, and no one else will know. of."

Xiao Wu annoys this kind of person the most. His business is a big deal, and other people's business is not a big deal. Usually queuing, this is the kind of person who likes to jump in line. Anyway, he feels that jumping in line alone doesn't affect anything.

"There's no way to advance it. You can't rush this matter. It makes the pathologist anxious. After a random look, you won't be allowed to say yes?" Xiao Wu didn't bother with him, and politely refused him.

The child's father was restless and grabbed his pants with one hand: "This is really urgent. Do you think it is benign or malignant? What should we do if we have to wait so long?"

"Now that I know I'm in a hurry, why did I go early and tell you to take your child to see a doctor earlier? You read a few articles on the Internet and think that you are really a doctor. They say that everyone can wait for three to five days, but you can't?" The child's mother also came over, as if she wanted to pull him back by his ears.

This couple is also interesting. The husband is short in stature and looks timid, while the wife is tall and big, with a bold personality. No matter in terms of body shape or personality, the two couples are very inconsistent.

If there is a quarrel at home, it is estimated that the woman can carry the man like a chicken cub, and go around the house a few times, and the woman will not pant.

After being scolded by his wife, the man went back to the ward in despair, while the woman apologized to Xiao Wu, and then followed back to the ward.

Hearing someone asking about the pathology results, Song Zimo remembered that he had made an appointment with the pathology department. He was going to see Zhang Zhe's pathology slides this afternoon. Song Zimo wanted to ask Yang Ping if he wanted to go and see it together.

Yang Ping said that it is just to teach everyone to look at pathological slides. In the future, this is the basic skill that doctors in the department must master. Let Song Zimo and Xu Zhiliang master it first, and then look at pathological slides as proficiently as X-rays.

In some countries, such as the United States, surgeons have to look at pathological sections themselves. Sometimes the chief surgeon removes the tumor and sends it to the supporting pathology room next to the operating room for frozen sections. After slicing and figuring out what kind of tumor it is, wash your hands and go on stage again, and choose the appropriate surgical method based on the pathological diagnosis.

Pathology slides in my country are read by pathologists, and surgeons do not know how to read them, nor have they received any special education. The pathology courses and experimental courses in school can only be regarded as experiences.

Therefore, if our country has a surgeon who can read pathological slides, it is definitely a rare treasure.

When everyone arrived at the pathology department, they were all busy in the macroscopic examination room, microscopic examination room, and immunohistochemistry. There were only two people in the doctor's office, Director Guan of the Department of Pathology, and Director Shi who was rehired from retirement.

Director Shi was wearing a pair of sunglasses and was sitting by the window to rest. Director Guan was watching something on the computer. When he saw everyone coming in, Director Guan knew Song Zimo: "Mr. Song, here we come! No introduction, this is from your department Dr. Yang?"

Song Zimo and Director Guan are very familiar with Director Shi. He often comes to ask for advice on pathological slides. He often sends Moutai to the two directors during the holidays to make them happy.

"Director Guan, I'm sorry." Yang Ping shook hands with Director Guan.

Director Guan smiled and said: "You're welcome, we are Qingshui Yamen, and we don't have much contact with you. We read a lot of pathological slides in various departments every day, but we don't know a few of them. Dr. Yang is young and promising, and I still know you. Let’s take a look at the pathological slides of several recent orthopedic patients. The specimens of patients undergoing surgery today are still undergoing decalcification.

"Mr. Shi, is this the beautiful woman looking out the window wearing sunglasses?" Song Zimo joked with Director Shi.

Director Shi pointed to his eyes: "I've seen too much under the microscope, and now my eyes can't take it with a little brighter light. In the past few years, if it was sunny, I had to wear sunglasses outside. Starting this year, I have to wear sunglasses indoors. The light is affected by it." No, keep on crying."

"Director Shi will stop working after this month, and go home to take care of the elderly." Director Guan explained.

Director Shi said: "I can't do it anymore, and my eyes are not good. If my eyes can hold on, I want to work for a few more years."

The pathology department is really a Qingshui yamen, not only has no money, but also is deserted. A few doctors look at pathological slides under a microscope all day long. One doctor has to look at about three or four hundred slides every day. Apart from going to the bathroom at work, he has no time to move his buttocks. .

However, like Nandu Medical University Cancer Hospital, a national cancer hospital, the situation of the pathology department is much better. If a patient wants to find a doctor with better skills to read the pathology slides in private, he has to take care of it.

It's not expensive. The doctor charges three to five hundred labor fees to help you take a look.

There is no way, the pathology department is really poor, with a salary of several thousand yuan a month, without some private work, there is no way to live.

If the patient follows the normal procedure and the pathological slides are done outside, it is impossible for the top hospitals to help you look at them. If you can’t read your own slides, why do you still look at other people’s?
The so-called pathological diagnosis is theoretically the gold standard for tumors, but there are also opinions about whether this gold is pure gold or K gold. After all, pathological slides depend on human inspection.

After reading it, the diagnosis of what kind of tumor, benign or malignant, and the stage of malignancy all depends on people's knowledge and experience, so there is also the possibility of making mistakes. This possibility is very low, but it exists.

Typical and simple ones are generally fine, but when encountering complex and atypical ones, misjudgment will occur. It is not uncommon to be judged as cancer if it is not cancer.

Many patients are not reconciled to being diagnosed with malignant tumors in primary hospitals. The family members find a doctor in charge to find a way to take out the pathological slides and send them to the top tumor hospitals in the country. It costs three to five hundred, and asks the relationship to find a pathologist in private for help. , please rest assured.

The probability of misdiagnosis is not high, but there are still cases. Some patients were diagnosed with malignant tumors, and they were taken to top hospitals for a look: it was not malignant tumors, but inflammation, and they were cured after being treated for a period of time according to inflammation.

Director Shi used to be a well-known pathologist at Nandu Medical University Tumor Hospital and was Director Guan's mentor. After retiring, he was hired by Sanbo Hospital to train young people.

At this time, a hospital worker happened to be looking for a relationship. He called Director Guan, and wanted to ask Director Shi to help him look at the pathological slides of his relatives in private.

Director Shi waved his hand: "If you don't look at it, you won't look at it, and no one's relatives will look at it."

Some time ago, a family member of a patient asked Director Shi to look at the pathological slides, and gave 500 yuan, but secretly videotaped it. After Director Shi helped to watch it, the patient’s family members handed over the video to the discipline inspection office of the hospital and asked for a refund of 500 yuan. , Said that the doctor charged privately.

This incident angered the old man, so he didn't watch it, no matter whose relatives he was, he didn't watch it.

After sitting like this for a while, dozens of specimens have been received in the giant examination room, all of which were cut from the operating room.

Carried in a specimen bag, there are excised tumors, excised parts of the liver, stomach, intestines, everything.

On the sampling table, there are several clean cutting boards, as well as rulers, scissors, tweezers and other tools neatly placed. The doctor is wearing gloves and is slicing a tumor on the cutting board.

The surgeon cuts out a thing from the human body, which is called a specimen, and sends it to the pathology department. The doctor will clean, fix, draw materials, dehydrate, soak in wax, embed, slice, dye, seal these things, etc. More than ten procedures , to make a pathological slice.

This pathological section can be viewed under a microscope for pathological diagnosis, that is, the diagnosis of the disease.

In a typical case, after the doctor makes a diagnosis, the director will review it; if it is difficult, the experts in the department will discuss it, and everyone will look at it together, so that a diagnosis can be made at the end to prevent unjust and wrongly decided cases.

"The general surgery department sent a specimen for frozen section. I have to take a look. Zhang Zhe's pathology section has been found by someone. You go to the microscope examination room to see it. I'll do it first." Director Guan told everyone greet.

"Go and do your work." Yang Ping told Director Guan.

"Teacher Shi, help me take a look."

Frozen section is a rapid pathological diagnosis, and the result will be available within 15 minutes, which requires a very high level of diagnosis. Director Guan asked Director Shi to take a look together, which is more secure.

In theory, pathological diagnosis must be guaranteed [-]% without a single error.

Even though his eyes were bad, Director Shi still didn't intend to refuse at all. He took off his sunglasses, rubbed his eyes, and followed Director Guan out.

The surgeon is still waiting on the stage, waiting for the pathological results to determine the next operation. If it is benign, the operation will be declared over; if it is malignant, according to the pathological results, an extended operation will be required, such as lymph node dissection.

When everyone went to the microscope examination room, Zhang Zhe's pathological slides had been arranged under the microscope, and Yang Ping asked everyone to look at them first.

This is a multi-head microscope, and Song Zimo, Xu Zhiliang and Gao Qiao all sat on it.

Under a microscope with a power of [-] times, the structure of bone tissue on the paraffin section is clearly visible. Osteocytes, osteoprogenitor cells, osteoblasts, osteoclasts, and bone matrix can be seen one by one.

Looking at pathological slides requires patience, never let go of any doubts, and never jump to conclusions hastily.

Any sloppy, one misdiagnosis may ruin the patient's life.

(End of this chapter)