There is no need to be too normal to be a doctor
Chapter 94 Fear from college students!
Chapter 94 Fear from college students! (Please subscribe)
In the ensuing anatomy experiment skill assessment, Chen Gong "lived up to expectations" and got the rabbit experiment.
I don’t know if it’s destiny.
Or the rabbit ate too much, causing gravity.
Since it was a rabbit, there was no reason why Chen Gong couldn't get through it, otherwise he would really be sorry for the spirit of the rabbits in his belly.
So, after Chen Gong successfully concluded and completed the assessment.
The examiner glanced at Chen Gong intentionally or unintentionally: "Have you eaten too much rabbit?"
This question made Chen Gong obviously stunned for a moment.
"What...what do you mean?"
The two examiners heard this, looked at each other, and smiled.
One of the older ones said with a bit of a smile:
"First of all, the experiment was successful, you don't need to be nervous."
"What I want to say is that in fact, there is no need to remove the glands during experiments."
"Hehehe...you understand what I mean, right?"
These words made Chen Gong blush immediately.
The examiner smiled slightly: "Go ahead."
Chen Gong scratched his head in embarrassment, stood up and left.
The other party's meaning is actually very clear.
Chen Gong also didn't expect that he would become addicted to eating rabbits these days, and would habitually remove his glands.
Why remove it?
because……
Glands are animal secretory tissues, which often contain some hormones or secretions. If the glands are retained, there will be an odor when cooking, and this odor is difficult to remove.
Therefore, Chen Gong habitually removed the glands every time he did experiments.
Unexpectedly... now that the exam is here, I have retained this bad habit.
……
After the exam, Chen Gong drove towards the school.
On the way, Chen Gong passed by a gas station and was wondering whether to fill up the tank.
Suddenly I remembered something...
This looks like...a tram!
This made him a little helpless, and Chen Gong didn't know how to express his gratitude.
So, when Chen Gong passed by, he stopped at the entrance of the supermarket and bought some nuts and milk for Yang Li. The price was not expensive, and it looked like "three or four west".
A little expression of my feelings!
In this assessment, no matter what, Yang Li helped him a lot, especially during this period of bloody battles. She took Chen Gong in the laboratory and taught him a lot. Chen Gong was also a little grateful.
After putting the things in the trunk, Chen Gong returned to the car.
but……
After the car turned around, before it could move forward, it heard a bang.
Chen Gong looked up and realized that an electric car had hit the bumper of the car in front.
This time, Chen Gong was shocked.
This is not my car!
Moreover, the car should be purchased new, and many plastic films on the interior have not been removed.
result……
Is this a car crash?
Chen Gong suddenly felt helpless.
He quickly turned off the engine and got off the car. Before Chen Gong could go over to see the situation, he saw an aunt riding an electric bicycle pointing at Chen Gong and yelling:
"How did you drive?"
"Didn't you see us coming on a bicycle?"
The woman was slightly chubby and had a fleshy face. Her eyebrows were raised as she spoke. She pointed at Chen Gong and cursed loudly, spraying spittle everywhere.
And the key... there is a five or six-year-old child in the back seat of the electric car.
After the electric car crashed, the little girl fell directly to the ground due to the huge inertia.
But soon... the little girl stood up.
"Grandma, are you okay?"
The little girl glanced at her grandma worriedly.
Only then did the woman realize how handsome her granddaughter was. She suddenly panicked and parked the car in a hurry. Then she walked aside, bent down, patted the little girl's dust, and said distressedly:
"Honey, are you okay!"
"Grandma was scared to death..."
When Chen Gong saw this, he sighed helplessly.
However, at this time, he suddenly discovered that when the little girl fell to the ground, she was hit by a landslide on the concrete floor. The pants on the right knee were torn, and some blood seeped out from around it, soaking through the white pants.
"Is your leg okay?"
Chen Gong also felt sorry for the child and asked quickly.
The little girl lowered her head and said carefully:
"I'm fine."
"Uncle, I'm sorry..."
"I was talking to grandma so that she didn't notice you, and then I hit your car..."
But after the woman heard this, her expression suddenly changed. She grabbed the child hard and held it in her arms. Then she glanced at Chen Gong with wide eyes:
"Why are you distracted!"
"I don't."
"I walk this road every day, and I can ride it even if I close my eyes."
When the little girl heard her grandma's words, she was stunned for a moment. She wanted to explain, but her grandma held her tightly, so... she could only lower her head silently.
At this time, Chen Gong also checked the bumper of the car in front. The bumper obviously showed signs of being hit. Fortunately, there was no major problem with the air intake grille.
The paint on the car has been peeled off a bit. If you touch up the paint, it shouldn't be a big problem.
However, this was not his car, so Chen Gong could only go back and explain to Yang Li.
After all, it is a new car, so it is possible that people will feel distressed.
However, Chen Gong looked at the woman and said directly:
"Sister, one size equals one size."
"In today's society, it doesn't mean that loud voices are justified."
"As the elder of your child, I think at the very least you need to clearly distinguish between right and wrong."
"Actually, the problem with the car is not big. The child also suffered some skin injuries. You are also fine."
"You take the child to bandage it as soon as possible."
"I don't need to hold you responsible, and I can repair the car myself, but... I think you should set a correct example for your children."
"Wrong is wrong!"
"My car was not started from start to finish, and the driving recorder clearly recorded everything that happened before and after the car."
"Also, if you look up, there are cameras everywhere."
"If you continue to mess around, I will have no choice but to call the police."
At this time, several onlookers came over.
Many of them also saw what happened and couldn't help but say: "Sister, if you are blackmailing people, it will be meaningless."
"The young man doesn't care, so don't be arrogant and unreasonable."
"The child saw it. This has ruined the child's education, but it is wrong."
"That's right, I'm going to videotape you like this!"
At this time, someone raised the camera, and the elder brother next to him quickly said: "Young man, stop filming."
"What a big deal. If it goes viral online, what will you do to other people's children?"
"The kid is right!"
"That's right, the child is so obedient. Hurry up and take the child to clean the wound. His pants are bleeding."
……
Listening to the words of the people around her, the woman's face turned blue and purple.
She had a dark face and wanted to explain, but when she opened her mouth, she found that she was surrounded by enemies on all sides.
"Humph!"
The woman couldn't help but snorted at everyone, and then looked at Chen Gong with an apologetic look.
She wasn't trying to quibble, she just... simply didn't want to lose money.
Since Chen Gong didn't pursue the matter, the woman didn't say anything more.
The little girl stood up, limped to Chen Gong, stood on tiptoes and wanted to speak.
Seeing this, Chen Gong quickly bent down and looked at the little girl: "Are you okay?"
The little girl grinned, showing two missing front teeth, and whispered in Chen Gong's ear:
"I'm sorry, uncle...we were wrong."
"Thank you for not embarrassing grandma."
"Grandma is like that because the family has no money...that's why..."
While talking, the little girl reached out and took out something from her pocket and stuffed it into Chen Gong's hand: "Uncle, don't let grandma see it."
"This is the pocket money she gave me through frugality."
"Mom said that if you do something wrong, you must apologize and make compensation."
"There's not much money... I hope uncle won't be angry..."
"I only have so much money."
Chen Gong heard the sound and saw a few ten-dollar notes and a few scattered dollars that the little girl put into his hand. He originally wanted to return it to the other party, but seeing the little girl's stubborn appearance, he put it away.
At this time, Chen Gong looked down and saw that the blood on the little girl's leg had stained the area in front of the calf red.
This made him obviously stunned for a moment.
Why was there so much blood?
Is the wound quite deep?
Chen Gong suddenly frowned slightly.
"Sister, let's do this. You park the electric car aside and I'll take you and the child to bandage it first, okay?"
When the woman saw the blood on her granddaughter's leg, her expression suddenly changed and she became a little panicked.
"Okay...ok...thank you...thank you, young man."
"Just now...Auntie was wrong just now!"
"Auntie apologizes to you."
Chen Gong waved his hand, now is not the time to hold people accountable.
The woman parked the car and got into the car with the little girl in her arms.
After getting in the car, the woman took off her coat and spread it on the chair, fearing that the girl's blood would stain Chen Gong's car.
Chen Gong saw this and remained silent.
perhaps……
The woman's initial behavior was indeed wrong.
But...why would she make such a choice?
Just touch up the paint and apologize, it cost more than 200 yuan, the meaning of compensation is the same, and it’s over.
Is 200 yuan a lot?
Or……
not much!
For most people, it's affordable.
This question is actually similar to... Is 79 yuan too much?
not much!
Everyone can take it.
However, for most people, this little money can solve many problems.
To put it bluntly, people are starting to become cautious in their consumption.
Three or four years ago, they could spend as much as they wanted without caring because they could earn it back tomorrow.
However, after these three or four years, everyone suddenly discovered that money... is not easy to earn.
And there are more and more surprises.
The pace of life is getting faster and faster, and the level of consumption is getting higher and higher. People are starting to consume cautiously.
The pace of this society is getting faster and faster. People are working hard to make money, but they find that the harder they work, the harder they have to work.
It's not that people don't work hard to make money, but... they find that it's getting harder and harder to make money even though they work hard.
Under the heavy pressure of society, people's spirits are tense, and if they are not careful, they can easily break their defenses.
It might just be a trivial statement.
It can cause emotional excitement.
Because everyone is too tired and tired.
It’s also because everyone discovered that even though they are working hard, why are they still so tired from living?
Just like the 79 yuan that made everyone break the defense.
Is it because everyone can’t take it out?
Not!
It's because those who are above us no longer feel the pressure of life, the struggles of ordinary people, and the scars of ordinary people struggling for life.
But at this time, the other party, standing on the level of capital, said something like "reflect on it".
Can this be done without breaking the defense?
We work hard to keep up with life, but we are told that we are not working hard enough.
Is it possible that we still have to risk our lives?
Just like the old man at this time.
Why is she so emotional?
Chen Gong knew it very well.
She is scared!
Her anger, breakdown, and anger are all disguises of her fear.
She is afraid of losing money...
That's it.
Right and wrong, doesn’t she know?
of course I know!
But she also knows that a few hundred dollars in compensation is not a small amount to her. It may be two months of his old age pension. She will face criticism from her children, and may even cause an internal conflict in the family to break out. Let your son and daughter-in-law have a fight.
does it worth? !
For a few hundred dollars, she would give up her face because she was afraid...
Save money and you can do a lot of things.
The problem was not big, and Chen Gong did not pursue the matter initially. However, if the woman persisted, Chen Gong would not mind using legal weapons.
But he felt the 47 yuan and [-] cents compensated by the little girl in his hand.
Forget it!
……
The car soon arrived at the gate of a community hospital.
Chen Gong left the woman to register and quickly walked towards the emergency room with the child in her arms.
When the doctor on duty at the surgery saw the condition of the little girl's leg, he couldn't help but froze for a moment and became a little panicked.
"Hello, the child fell to the ground just now. I was thinking of scratching his skin, but I never expected that he would bleed so much."
"Please help me to deal with it."
"It would be best to find out why there is so much blood."
The emergency surgeon is quite young, almost 40 years old. His hair is messy and his white coat is not very clean.
After seeing the little girl's condition, he nodded quickly: "Well, sit down first and let me take a look."
While talking, the man took off the little girl's shoes.
Then the pants are tight and cannot be rolled up.
Chen Gong simply said: "Just cut it open."
The doctor heard the sound, nodded, and cut open the trouser leg with scissors, exposing the wound.
After seeing the girl's wound, the doctor immediately comforted him: "Don't worry."
"Just a simple scratch."
"I'll just debridement and bandage you."
When Chen Gong looked at the little girl's calf, there were indeed traces of slipping and friction on the cement floor.
The epidermis was obviously damaged, blood oozed out, and no particularly deep wounds could be seen.
The man laughed and said, "I scratched my skin a little bit. There are many blood vessels under the skin, so it's just bleeding a little more."
While talking, the man started rinsing with hydrogen peroxide.
After rinsing, Chen Gong also saw clearly the specific condition of the girl's legs.
At first, he was worried about pebbles getting stuck in. After all, the road was not very clean and his pants were torn.
But after inspection, nothing was found.
After rinsing, the man brought the iodophor: "Little girl, it hurts a little, please bear with it for a while."
As he spoke, he began to use tweezers to hold cotton balls soaked in iodophor to disinfect the area around the wound.
The opponent's technique is quite light and his technique is also very skillful.
The girl was also very strong, she didn't cry, her little mouth was pressed tightly, and she didn't say a word.
After disinfection and sterilization, debridement is completed.
The level of debridement in men was acceptable.
Also very careful.
Chen Gong looked at the condition of the girl's legs and couldn't help but ask:
"Doctor, this is just a scratch on the skin, it won't bleed so much, right?"
The man suddenly laughed: "Haha!"
"Are you the child's father?"
"So young!"
"You, don't worry. It's a small problem. It's normal for children to bump into each other. After debridement, just bandage it."
Chen Gong heard this and shook his head: "Under normal circumstances, knee skin trauma will not cause so much bleeding."
"I suggest you check it out."
"How about you give me medical advice?"
The man was obviously hesitant: "I have been a doctor for so many years and have bandaged so many children. It will be no problem."
"You have to believe me."
However, Chen Gong patiently explained:
"Bleeding from skin trauma on the knee is due to damage to the epidermis and capillaries in the dermis."
"But it's been more than ten minutes since the girl was bruised and I brought her here."
"It stands to reason that this kind of dermal bleeding can stop on its own within ten minutes."
"But when you were debriding, we saw blood oozing out. Isn't this unreasonable?"
"How about you give me medical advice?"
The man looked at the girl's condition and was obviously a little stunned.
"Doctor's order?"
"What...what doctor's orders are you going to give?"
"Are you afraid of infection? How about... I prescribe some anti-inflammatory drugs?"
The man said hesitantly.
After Chen Gong pondered for a moment, he said, "I think a blood test will be done to see how the blood items are."
"Is it a lack of platelets, causing some disorders in coagulation?"
"In other words, you can check for coagulation."
The male doctor was obviously stunned by Chen Gong's words: "This...isn't necessary?"
At this time, Chen Gong suddenly discovered that some bruises began to appear in the unscratched area next to the little girl's knee.
"Look, doctor, there's a bruise here."
The male doctor was stunned for a moment: "Isn't it normal to have bruises after a fall?"
The girl's grandmother heard the sound and nodded quickly: "Yes, this... this should be normal, right?"
Chen Gong heard the sound and said directly: "No, it's not normal."
"It wasn't there just now."
"Look, it's still bleeding. It's obviously abnormal."
"This could be bleeding under the skin."
"This is obviously not normal behavior."
The male doctor was also a little unhappy at Chen Gong's words.
"I told you, it's okay, it's just a skin injury."
"Isn't it normal for you to bleed a little and have a bruise after a bump?"
"Why are you so... so stubborn?"
"I am a doctor and you are a doctor."
When Chen Gong heard this, he was not angry, but said seriously: "You are a doctor, so... I will give you some advice."
At this time, the little girl's grandmother also said quickly: "This... young man, don't be angry."
"Adults and children are different, right..."
"It's just a bruise, it's okay."
"Each person has his own constitution!"
"The child is quite healthy. The school organized a unified physical examination just a few days ago."
"It's okay, no need to draw blood."
"Thank you, doctor."
When the male doctor heard this, he also glanced at Chen Gong: "My child, don't be too serious!"
"Don't Baidu, that's what it is!"
"Just bandage it, it's not a big problem."
"I asked you to tell me that, if you don't check anything, it will cost hundreds of dollars."
Chen Gong patiently explained: "This is not about money, and I didn't question you."
"I think that any disease is justified, and the symptoms should follow the situation."
"There's no way there's unexplained bleeding and hemorrhage."
"This kind of medicine is not rigorous."
The man laughed at Chen Gong's stubborn attitude: "Haha, medical student?"
Chen Gong nodded: "Yes!"
The man shook his head: "Son, seeing a doctor is not as simple as what the book says."
"Don't become a nerd."
Chen Gong shook his head: "No, this is not a nerd."
"Any symptoms need to be analyzed theoretically."
"Under normal circumstances, a wound like this kind of epidermal abrasion will scab within 5-10 minutes and the bleeding will stop automatically."
"And the patient's condition is obviously not normal behavior. In this case, shouldn't other factors be considered?"
"I think even the slightest illness or doubt needs to be explained."
"Otherwise, the current situation cannot be explained at all."
At this time, several people had gathered around.
Several young nurses also pointed here and watched carefully.
The man was also a little angry: "Why can't you explain it clearly?"
Chen Gong said seriously: "First of all, there is no way to explain the long-term bleeding and the inability to scab!"
"Secondly, there is a lack of effective evidence as to the cause of subcutaneous bleeding."
When the man heard this, he immediately laughed angrily: "Okay!"
"You young man."
"You are neither a family member nor a doctor in our hospital."
"You have no clinical experience, and you haven't learned anything. You just think you're great, right?"
"I can't convince you."
"Or else."
"You you on the line?!"
When everyone around him heard this, they immediately looked at Chen Gong with a little more amusement in their eyes.
When Chen Gong heard the voice, he was stunned for a moment: "Is it okay?"
The male doctor was also stunned: "What can I do?"
Chen Gong said seriously: "Didn't you say that if I can do it, I will do it?"
"I can!"
The male doctor and several young nurses around him were completely dumbfounded.
Good guy!
Are you really going? !
The community hospital is not big to begin with, and there are only so many people coming and going.
Naturally, it quickly attracted the attention of many people.
Here, the girl's grandmother saw this situation and quickly pulled Chen Gong aside.
"This... young man!"
"Thank you."
"Do you really think these tests are necessary?"
"Will it be..."
Chen Gong carefully explained the situation to the woman: "Auntie, has this happened to children before?"
"When the skin is broken, there will be more bleeding, and it will be slower to stop the bleeding."
"Or... nosebleeds, bleeding gums, etc."
After the woman heard this, she suddenly thought of something and said quickly:
"There is one thing I remember."
"Didn't he change his teeth?"
"One day after I lost a tooth, the bleeding took a while to stop."
"Does that count?"
When Chen Gong heard this, he nodded immediately: "That's right!"
"That's the anomaly."
"This is unlikely to happen to normal people. Generally, there are platelets in the blood, which will form blood scabs to stop bleeding."
"Look now, there's still a little bit of blood oozing out from your legs."
"If you look at the child again, the bruises around the knees are more obvious."
"The range is also larger. This should not be a normal situation."
Hearing Chen Gong's words, the woman looked down and her eyes widened:
"It seems so!"
"Doctor, please take a blood test."
"Look at the bruises around my baby's knees."
"What's going on here?"
The doctor was obviously stunned.
The family members have now expressed their opinions. Although subcutaneous bleeding after abrasions is normal, the range is a bit larger.
The man was stunned for a moment: "Wait a moment, let me call a consultation?"
Chen Gong said directly: "Let's give the doctor's orders first!"
"First, give the doctor's orders. First, do a blood test to check the platelet status, and then check the coagulation."
"Then prescribe a hemostatic spray to stop the bleeding on the knee."
"Secondly, place a consultation order and invite a doctor from the hematology department to come down for a consultation."
"Finally, I suggest doing an electrocardiogram to check for heart problems." "Otherwise, I'm afraid it will waste time if I wait until the consulting doctor comes."
Hearing Chen Gong's words, everyone around looked at Chen Gong.
What he said just now is obviously not from an outsider.
It seems that it is really quite good!
After hearing this, the male doctor nodded, stopped refusing, and quickly issued a medical order.
At this time, the old man no longer worried about money.
I quickly ran to pay the fee.
Chen Gong took the child for a checkup.
Soon...
The blood was drawn and an electrocardiogram was done.
The consulting doctor also arrived.
There is a 40-year-old female director of the hematology department named Wang Lei.
"Director Wang, why are you here?" The male doctor smiled awkwardly.
Wang Lei smiled: "I happened to have time, so I came over. What's going on?"
Chen Gong held the child in his arms and walked over quickly:
"Hello there!"
"Hello, what's going on? Baby."
Wang Lei lowered her head, saw the little girl's wound, and asked with a smile.
The male doctor on the side explained the whole story.
After listening, Wang Lei continued to look at the child's wound. It was still not completely scabbed.
"how long it has been?"
Chen Gong glanced at the time: "Half an hour."
When Wang Lei heard this, she couldn't help but nodded: "Young man, your analysis makes sense!"
"This situation needs to be checked."
“Never miss a disease just because of habitual thinking.”
"Look, it's been half an hour. Under normal circumstances, the rupture of dermal capillaries needs to be completely scabbed."
"But it hasn't happened yet, which means there is an abnormality in the coagulation function."
"We have to find out why."
"Are you studying medicine? How do you know so much?"
Chen Gong nodded: "I am from Shanhe Medical University."
"Sophomore."
When Wang Lei heard this, she immediately laughed: "Shanhe Medical University!"
"Top student."
"Today, our hematology department just invited a hematology expert from Shanhe Medical University to come for a consultation."
"It's great that you can think of this."
Wang Lei wears a pair of black-rimmed glasses. Although she can't be called very beautiful, her short shoulder-length hair and lean eyebrows give her a neat look.
After everyone waited for a while, the blood test results came out quickly.
The nurse ran over with the results.
"Director Wang, look, it's normal!"
Wang Lei also took the blood routine report and looked at it.
Basically everything is normal.
The most critical platelet count is 110.
Normal value of platelets: (100 to 300)×10^9/L.
Now, although the little girl's 110 is not high, it is definitely not low either.
The male doctor on the side couldn't help but said: "I think... this is normal. After all, people's physiques are different."
"Clinical treatment can't be exactly the same as in the book, right?"
"Is it okay to go to the doctor with a book in hand like this?"
Wang Lei frowned slightly, seeming to be thinking about something.
But Chen Gong shook his head: "Wait for the blood to coagulate."
"That's the key."
Although Wang Lei is the director of the hematology department, the hematology department of this community hospital is obviously not a large department.
The academic level is average and there are only 20 beds.
Wang Lei herself just passed the associate-senior professional title exam this year, and the hospital has not offered her a job yet.
Domestic community hospitals, regardless of city size, actually have some serious problems.
It is the relative lag in medical standards.
Most graduates with master's or doctoral degrees from medical schools are rarely willing to work in community hospitals.
Even if they come, they are basically concentrated in big cities, such as Beijing, Shanghai and Guangzhou.
Compared with the overall level of Shanhe Province, Shanyang City, the provincial capital, is only a new second-tier city.
The level of community hospitals is also somewhat average.
Wang Lei is already quite powerful.
While everyone was waiting, scabs began to slowly form on the little girl's legs.
The male emergency doctor on the side looked much better now, and even looked at Chen Gong with a little smile in his eyes.
While speaking, he shook his head intentionally or unintentionally.
Chen Gong was not angry about this.
Because he knows very well that this is a common situation among doctors in many ordinary small hospitals in China, who have inertial diagnosis and treatment thinking.
Basically, I don’t pay much attention to some minor issues.
The male doctor couldn't help but said: "I told you, there is really nothing wrong with it."
"This is not good!"
"The bleeding has stopped."
"There is no infection. Just take a good rest for two days and it will be fine."
"It's not necessary to go through this long process, right?"
Not long after, the nurse brought in a coagulation test.
The four items of coagulation are one of the clinical examination items of the laboratory department and belong to the examination of thrombotic diseases.
The four blood parameters include prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen (FIB).
The purpose is to understand whether the patient's hemostatic function is defective.
The time for activated partial thrombin is 44 seconds, and the normal time is 25-37 seconds.
The prothrombin time is 17 seconds. Similarly, the normal time is: 11-14 seconds.
Fibrinogen is 3, which is within the normal range (2-4).
Thrombin time is 14 seconds, normal time is 12-16 seconds, normal indicator.
Now, the four coagulation results have come out, two of which are completely normal, and the thrombin time is also normal, which is a key indicator.
Now the activated partial thrombin time and prothrombin time are longer.
However, it is not much beyond the normal value.
Theoretically speaking, although this coagulation function is abnormal, it...can't be considered a big problem.
The male doctor in the emergency department remained silent after seeing this.
He doesn't know much about this, so he doesn't have much say.
Just looking at Wang Lei: "Director Wang, is this situation serious?"
The little girl's grandmother also looked at Wang Lei nervously: "Director, how are you doing?"
"Child...are you okay?"
At this time, Wang Lei couldn't help frowning and thinking.
"There is obviously a problem with the coagulation function."
"I think……"
"Still... we should check it in detail. The four items of coagulation can only explain some basic problems. However, we need to further observe whether there is any deficiency in coagulation factors or some special plasma components."
"Also, have you had your liver function tests done?"
"Has the child had any diseases before?"
The hematology department mainly targets people, in fact, in many cases it is children.
Children's hematological diseases have become the focus of many hospitals.
This is inseparable from the consideration of diet, defense, and other comprehensive circumstances.
At this time, seeing the child's condition, Wang Lei couldn't help but ask:
"The coagulation function is abnormal now, which is obviously not normal behavior."
"Are the child's parents here?"
"I think it's best for them to conduct a detailed inspection. If there is nothing wrong after the inspection, we can relax."
"However, this test cannot rule it out!"
While talking, Wang Lei looked at Chen Gong:
"Boy, you are very good!"
"Being able to judge clinical situations through some phenomena is an ability that a clinician should have."
At this time, Chen Gong asked curiously: "Can I take a look at the test report?"
Wang Lei handed it to Chen Gong.
It was now around six o'clock in the afternoon.
It's almost time to get off work.
Chen Gong looked at the test results and suddenly became pleasantly surprised.
Because he is so familiar with these things.
He discovered that the subject of biochemistry and clinical examination are really inextricably linked.
It can even be said that laboratory science is based on biochemistry.
Coagulation function involves, whether it is prothrombin, thrombin, or fibrin...
These are all part of the coagulation test.
The patient now has an activated partial thromboplastin (APTT) time that has increased by 7 seconds.
The prothrombin time (PT) was more than 3 seconds longer than normal.
The fibrinogen level is basically 3, and the normal level is 2-4!
The thrombin time was also normal.
Chen Gong seems to remember a calculation announcement...
This is an exploration of the prothrombin depletion correction test.
Although the changes in coagulation factors II, VII, IX, and X are not currently known, and no correction experiments can be seen.
However, a specific effect size can be calculated from the coagulation time.
Think of it...
Chen Gong quickly walked aside, picked up a pen and started calculating quickly on the paper.
About...10 minutes passed.
Chen Gong ran over excitedly.
The child's grandmother also called the child's parents at this time to inform them.
Wang Lei seemed to be communicating with the woman there.
The little girl sat there in despair, her eyes full of loss.
"what happened?"
Chen Gong smiled.
The little girl sighed: "Mom and dad are probably going to quarrel again..."
Chen Gong was stunned for a moment: "Why?"
The little girl pouted: "My father lost his job last year and now drives a taxi, and my mother works as a housekeeper."
"Mom and dad have a hard time every day."
"Dad often comes home late."
"Hey……"
"Actually, it's okay if you fall, so you don't have to dance. I don't like it anyway."
"A few days ago, my mother asked my father for money for a dance class, and she got into an argument with my father."
"I saw my father crying on the balcony."
"Grandma is reluctant to spend money..."
"I spent all the family's money."
"I just heard the doctor say that I still have to be hospitalized. I really want to spend a lot of money..."
As he spoke, the little girl's tears streamed down her face.
The pain in her knees only made her purse her lips and remain silent.
But...at such an old age, I have to cry so sadly because of spending money.
Chen Gong was helpless when he saw this.
He patted the little girl on the back: "It's okay."
"No more examinations, and we don't need to be hospitalized."
"Uncle, I'm telling you, you... must be a picky eater because you don't eat well!"
"So, vitamin deficiency!"
"You have to eat well from now on."
The little girl's eyes widened: "Really?!"
Chen Gong nodded: "Of course it's true!"
"Just wait, I'll go talk to Director Wang."
While speaking, Chen Gong stood up and walked over directly.
"Director Wang, excuse me."
Wang Lei saw Chen Gong coming over, nodded and smiled: "Well, what's the matter?"
Chen Gong said seriously: "Actually, Director Wang, I don't think the child has an abnormality in the coagulation factor."
"And it's not a liver problem."
"What is that?" Wang Lei looked at Chen Gong curiously.
Chen Gong directly took out what he had calculated.
"This is the result of the inferred calculation of the coagulation effect of APTT."
"The patient's condition should be that the coagulation effect is reduced due to vitamin K deficiency."
"The thing in my hand is a discussion on the coagulation effect DCP in biochemical polymer calculations.
"Of course, my suggestion is to check again and confirm the diagnosis!"
"I think...there is no need to be hospitalized, right?"
Wang Lei looked at the densely packed indicators in Chen Gong's hand and was immediately dumbfounded.
There are completely incomprehensible formula calculations on the paper.
There are also various English letters...
to be frank!
Wang Lei really can't understand.
"What... what does this mean?"
Chen Gong looked at Wang Lei and was stunned for a moment: "Huh?"
He didn't expect that Wang Lei wouldn't understand.
Not the director?
Wang Lei also blushed at Chen Gong's expression.
She coughed and said, "Sorry, I...I really can't understand."
"Are you still learning these things in... medical school?"
Chen Gong coughed and explained: "This is actually biochemistry and molecular biology... almost the same."
"Let me explain it to you."
“The most sensitive indicator of vitamin K deficiency is the presence of des-gamma-carboxy-prothrombin (DCP) in plasma, and DCP is commonly known as PIVKA (protein induced by vitamin K deficiency or antagonism), which can be used with appropriate Antibodies were measured. There were no antibodies in the plasma of healthy people.”
"The research I conducted also revolves around this."
"With the four functions of coagulation, we can actually diagnose that the patient is deficient in vitamin K."
Wang Lei was stunned when he heard Chen Gong's words.
"Is college... so difficult now?"
"At that time...we...we still had to learn this?"
Wang Lei felt an unprecedented sense of crisis.
Are college students so good now?
Will they...have a way out in the future?
……
When she was about to say something, she suddenly saw a figure walking towards her.
Wang Lei quickly said hello:
"Professor Sun, is the outpatient clinic over?"
"Thanks for your hard work!"
Sun Weihong smiled: "Well, it's over,"
Wang Lei suddenly thought of something and said quickly: "By the way, Director Sun, could you help me consult a patient?"
"She's right there."
"This is the patient's test result."
"The situation is like this..."
Sun Weihong frowned. After listening, he quickly walked to the little girl and consulted seriously.
In a moment!
He looked at the results, pondered for a moment, and then said to Wang Lei:
"There is no need to do other examinations for now!"
"Do a plasma antibody test."
"Check the DCP. Can your hospital do it?"
"I think the patient's condition may be relatively simple and not a complex coagulation disorder."
"Look at this indicator, APTT and PT simply increase by less than 13. In this case, the physical signs and medical history should be combined."
"Based on symptoms, signs and medical history, the diagnosis of vitamin K deficiency may be suspected, and the diagnosis can be made when PT and PTT are prolonged!"
"So, I think the patient should have a simple vitamin K deficiency."
"Although our blood diseases are more complicated, there is no need to do too many tests and assistance."
"The inspection must be carried out accurately."
When Wang Lei heard Sun Weihong's words, she was stunned for a moment and blurted out instinctively: "Huh?!"
"Really are!"
Sun Weihong was stunned for a moment: "What do you mean?"
Wang Lei didn't know whether to laugh or cry. She really didn't expect that this college student...and a sophomore at that, really got the answer right? !
"Well, Director Sun, I'm sorry!"
"That's right. The young man just said the same thing."
"He said that the child may have a reduced coagulation effect caused by a lack of vitamin K."
When Sun Weihong heard this, she became curious.
You know, he was able to tell because he just participated in an international conference in the first half of this year.
During the meeting, there was an introduction to the latest indication effects of DCP.
but……
It is difficult to give an accurate answer simply by relying on this inspection.
So, for a moment, he looked at the boy beside him curiously.
"Hello."
"Excuse me...how did you judge?"
"By the way, my name is Sun Weihong, director of the Hematology Department of the First Affiliated Hospital of Shanhe Medical University."
Chen Gong heard the voice and nodded quickly: "Hello, Teacher Sun."
"I am Chen Gong, a sophomore student at Shanhe Medical College."
"That's my speculative process."
Sun Weihong took the paper curiously and read it carefully.
only……
At first sight, Sun Weihong's eyes widened.
"Is this... coagulation effect inference calculation?"
Chen Gong nodded:
"I calculated the coagulation effect based on the four indicators of coagulation and speculated on the changes in DCP..."
"According to guidelines, the most sensitive indicator of vitamin K deficiency is the presence of des-gamma-carboxy-prothrombin DCP in plasma."
"So, I just..."
"I think the patient may simply be deficient in vitamin K."
Sun Weihong looked at Chen Gong in surprise: "Where did you learn this?"
Chen Gong smiled awkwardly: "This is biochemistry!"
"However, I saw the specific formula from the information and did some calculations."
"I didn't expect that I could actually figure it out."
Sun Weihong was completely numb.
"Are you a sophomore today?"
Chen Gong nodded: "Yes, sophomore in clinical school."
Sun Weihong swallowed and tried to calm down, but... could this be calm?
You know, this announcement aside.
Able to understand biochemical processes thoroughly.
Can accurately predict DCP changes.
it's all...
What level?
"You still study this in college now?"
Chen Gong coughed and said, "I started studying biochemistry in my sophomore year."
As soon as these words came out, Sun Weihong's expression was very exciting.
After pondering for a moment, he said, "Chen Gong, right?"
"not bad!"
"Can you give this paper to me?"
Chen Gong nodded: "Of course."
Sun Weihong nodded and smiled: "Can you leave me your phone number?"
"I'd like to chat with you when it's more convenient, okay?"
Chen Gong nodded: "I can't ask for it."
While talking, the two left their contact information.
At this time, Sun Weihong walked up to Wang Lei, chatted for a few words, got up and left.
Wang Lei looked at Chen Gong and gave a thumbs up:
"you are great!"
"Director Sun has praised you."
Chen Gong smiled: "Director Wang, you're welcome."
"Actually...it's nothing."
"It's just some university stuff, just showing off."
"The real diagnosis depends on you."
At this time, the child's parents also came.
After Wang Lei finished explaining the situation, he said, "You should thank this young man properly!"
"If he hadn't insisted."
"To be honest, I can't find out at all today."
"The child is most likely suffering from a vitamin K deficiency."
"However, we still need to clarify the specific details and whether there are other symptoms."
"All right?"
Hearing this, the child's parents quickly expressed their gratitude.
At this time, the man took out 500 yuan from his pocket and handed it to Chen Gong:
"Thank you!"
"Boy!"
"I'm sorry, my mother offended you today."
"As a result...you have been so helpful after all this running."
"Thank you so much!"
"It's not much money. You can go back and touch up the paint. I think it's a new car. This... I'm really sorry."
Chen Gong excused himself, stuffed the money into the little girl's pocket, winked with the little girl, got up and left.
Chen Gong is not short of this money.
but……
The other party's attitude made him very comfortable.
He got up and walked outside.
At this time, Wang Lei was still immersed in what Chen Gong had just said.
A little worried, a little scared.
Nowadays college students are so powerful...
What should I do if I don’t study hard in the future?
The male emergency doctor also apologized to Chen Gong in embarrassment.
There was a sense of urgency in my heart.
The habitual diagnosis and treatment rules he was so proud of seemed to have failed!
in fact……
Sun Weihong was sitting in the car, feeling equally uneasy.
good guy...
I'm still proud of myself.
I also think that with the blood of mountains and rivers, I am the most awesome!
but……
Today a child, a sophomore, taught him a lesson.
It's really amazing!
no no no...
I'm not going to eat tonight, I'm going back to reading!
Sun Weihong suddenly felt a sense of urgency and pressure in his heart.
The waves behind the Yangtze River push the waves in front, and they really have to beat the waves in front to death on the beach!
……
……
ps: My father-in-law was hospitalized for surgery, and I had to run back and forth, so I was delayed for some time. I'm sorry.
12000 delivered, I can only write so much today, please forgive me.
From now on, the update time will be tentatively set at around 7 p.m. every day.
It is convenient for everyone to fix it.
(End of this chapter)
In the ensuing anatomy experiment skill assessment, Chen Gong "lived up to expectations" and got the rabbit experiment.
I don’t know if it’s destiny.
Or the rabbit ate too much, causing gravity.
Since it was a rabbit, there was no reason why Chen Gong couldn't get through it, otherwise he would really be sorry for the spirit of the rabbits in his belly.
So, after Chen Gong successfully concluded and completed the assessment.
The examiner glanced at Chen Gong intentionally or unintentionally: "Have you eaten too much rabbit?"
This question made Chen Gong obviously stunned for a moment.
"What...what do you mean?"
The two examiners heard this, looked at each other, and smiled.
One of the older ones said with a bit of a smile:
"First of all, the experiment was successful, you don't need to be nervous."
"What I want to say is that in fact, there is no need to remove the glands during experiments."
"Hehehe...you understand what I mean, right?"
These words made Chen Gong blush immediately.
The examiner smiled slightly: "Go ahead."
Chen Gong scratched his head in embarrassment, stood up and left.
The other party's meaning is actually very clear.
Chen Gong also didn't expect that he would become addicted to eating rabbits these days, and would habitually remove his glands.
Why remove it?
because……
Glands are animal secretory tissues, which often contain some hormones or secretions. If the glands are retained, there will be an odor when cooking, and this odor is difficult to remove.
Therefore, Chen Gong habitually removed the glands every time he did experiments.
Unexpectedly... now that the exam is here, I have retained this bad habit.
……
After the exam, Chen Gong drove towards the school.
On the way, Chen Gong passed by a gas station and was wondering whether to fill up the tank.
Suddenly I remembered something...
This looks like...a tram!
This made him a little helpless, and Chen Gong didn't know how to express his gratitude.
So, when Chen Gong passed by, he stopped at the entrance of the supermarket and bought some nuts and milk for Yang Li. The price was not expensive, and it looked like "three or four west".
A little expression of my feelings!
In this assessment, no matter what, Yang Li helped him a lot, especially during this period of bloody battles. She took Chen Gong in the laboratory and taught him a lot. Chen Gong was also a little grateful.
After putting the things in the trunk, Chen Gong returned to the car.
but……
After the car turned around, before it could move forward, it heard a bang.
Chen Gong looked up and realized that an electric car had hit the bumper of the car in front.
This time, Chen Gong was shocked.
This is not my car!
Moreover, the car should be purchased new, and many plastic films on the interior have not been removed.
result……
Is this a car crash?
Chen Gong suddenly felt helpless.
He quickly turned off the engine and got off the car. Before Chen Gong could go over to see the situation, he saw an aunt riding an electric bicycle pointing at Chen Gong and yelling:
"How did you drive?"
"Didn't you see us coming on a bicycle?"
The woman was slightly chubby and had a fleshy face. Her eyebrows were raised as she spoke. She pointed at Chen Gong and cursed loudly, spraying spittle everywhere.
And the key... there is a five or six-year-old child in the back seat of the electric car.
After the electric car crashed, the little girl fell directly to the ground due to the huge inertia.
But soon... the little girl stood up.
"Grandma, are you okay?"
The little girl glanced at her grandma worriedly.
Only then did the woman realize how handsome her granddaughter was. She suddenly panicked and parked the car in a hurry. Then she walked aside, bent down, patted the little girl's dust, and said distressedly:
"Honey, are you okay!"
"Grandma was scared to death..."
When Chen Gong saw this, he sighed helplessly.
However, at this time, he suddenly discovered that when the little girl fell to the ground, she was hit by a landslide on the concrete floor. The pants on the right knee were torn, and some blood seeped out from around it, soaking through the white pants.
"Is your leg okay?"
Chen Gong also felt sorry for the child and asked quickly.
The little girl lowered her head and said carefully:
"I'm fine."
"Uncle, I'm sorry..."
"I was talking to grandma so that she didn't notice you, and then I hit your car..."
But after the woman heard this, her expression suddenly changed. She grabbed the child hard and held it in her arms. Then she glanced at Chen Gong with wide eyes:
"Why are you distracted!"
"I don't."
"I walk this road every day, and I can ride it even if I close my eyes."
When the little girl heard her grandma's words, she was stunned for a moment. She wanted to explain, but her grandma held her tightly, so... she could only lower her head silently.
At this time, Chen Gong also checked the bumper of the car in front. The bumper obviously showed signs of being hit. Fortunately, there was no major problem with the air intake grille.
The paint on the car has been peeled off a bit. If you touch up the paint, it shouldn't be a big problem.
However, this was not his car, so Chen Gong could only go back and explain to Yang Li.
After all, it is a new car, so it is possible that people will feel distressed.
However, Chen Gong looked at the woman and said directly:
"Sister, one size equals one size."
"In today's society, it doesn't mean that loud voices are justified."
"As the elder of your child, I think at the very least you need to clearly distinguish between right and wrong."
"Actually, the problem with the car is not big. The child also suffered some skin injuries. You are also fine."
"You take the child to bandage it as soon as possible."
"I don't need to hold you responsible, and I can repair the car myself, but... I think you should set a correct example for your children."
"Wrong is wrong!"
"My car was not started from start to finish, and the driving recorder clearly recorded everything that happened before and after the car."
"Also, if you look up, there are cameras everywhere."
"If you continue to mess around, I will have no choice but to call the police."
At this time, several onlookers came over.
Many of them also saw what happened and couldn't help but say: "Sister, if you are blackmailing people, it will be meaningless."
"The young man doesn't care, so don't be arrogant and unreasonable."
"The child saw it. This has ruined the child's education, but it is wrong."
"That's right, I'm going to videotape you like this!"
At this time, someone raised the camera, and the elder brother next to him quickly said: "Young man, stop filming."
"What a big deal. If it goes viral online, what will you do to other people's children?"
"The kid is right!"
"That's right, the child is so obedient. Hurry up and take the child to clean the wound. His pants are bleeding."
……
Listening to the words of the people around her, the woman's face turned blue and purple.
She had a dark face and wanted to explain, but when she opened her mouth, she found that she was surrounded by enemies on all sides.
"Humph!"
The woman couldn't help but snorted at everyone, and then looked at Chen Gong with an apologetic look.
She wasn't trying to quibble, she just... simply didn't want to lose money.
Since Chen Gong didn't pursue the matter, the woman didn't say anything more.
The little girl stood up, limped to Chen Gong, stood on tiptoes and wanted to speak.
Seeing this, Chen Gong quickly bent down and looked at the little girl: "Are you okay?"
The little girl grinned, showing two missing front teeth, and whispered in Chen Gong's ear:
"I'm sorry, uncle...we were wrong."
"Thank you for not embarrassing grandma."
"Grandma is like that because the family has no money...that's why..."
While talking, the little girl reached out and took out something from her pocket and stuffed it into Chen Gong's hand: "Uncle, don't let grandma see it."
"This is the pocket money she gave me through frugality."
"Mom said that if you do something wrong, you must apologize and make compensation."
"There's not much money... I hope uncle won't be angry..."
"I only have so much money."
Chen Gong heard the sound and saw a few ten-dollar notes and a few scattered dollars that the little girl put into his hand. He originally wanted to return it to the other party, but seeing the little girl's stubborn appearance, he put it away.
At this time, Chen Gong looked down and saw that the blood on the little girl's leg had stained the area in front of the calf red.
This made him obviously stunned for a moment.
Why was there so much blood?
Is the wound quite deep?
Chen Gong suddenly frowned slightly.
"Sister, let's do this. You park the electric car aside and I'll take you and the child to bandage it first, okay?"
When the woman saw the blood on her granddaughter's leg, her expression suddenly changed and she became a little panicked.
"Okay...ok...thank you...thank you, young man."
"Just now...Auntie was wrong just now!"
"Auntie apologizes to you."
Chen Gong waved his hand, now is not the time to hold people accountable.
The woman parked the car and got into the car with the little girl in her arms.
After getting in the car, the woman took off her coat and spread it on the chair, fearing that the girl's blood would stain Chen Gong's car.
Chen Gong saw this and remained silent.
perhaps……
The woman's initial behavior was indeed wrong.
But...why would she make such a choice?
Just touch up the paint and apologize, it cost more than 200 yuan, the meaning of compensation is the same, and it’s over.
Is 200 yuan a lot?
Or……
not much!
For most people, it's affordable.
This question is actually similar to... Is 79 yuan too much?
not much!
Everyone can take it.
However, for most people, this little money can solve many problems.
To put it bluntly, people are starting to become cautious in their consumption.
Three or four years ago, they could spend as much as they wanted without caring because they could earn it back tomorrow.
However, after these three or four years, everyone suddenly discovered that money... is not easy to earn.
And there are more and more surprises.
The pace of life is getting faster and faster, and the level of consumption is getting higher and higher. People are starting to consume cautiously.
The pace of this society is getting faster and faster. People are working hard to make money, but they find that the harder they work, the harder they have to work.
It's not that people don't work hard to make money, but... they find that it's getting harder and harder to make money even though they work hard.
Under the heavy pressure of society, people's spirits are tense, and if they are not careful, they can easily break their defenses.
It might just be a trivial statement.
It can cause emotional excitement.
Because everyone is too tired and tired.
It’s also because everyone discovered that even though they are working hard, why are they still so tired from living?
Just like the 79 yuan that made everyone break the defense.
Is it because everyone can’t take it out?
Not!
It's because those who are above us no longer feel the pressure of life, the struggles of ordinary people, and the scars of ordinary people struggling for life.
But at this time, the other party, standing on the level of capital, said something like "reflect on it".
Can this be done without breaking the defense?
We work hard to keep up with life, but we are told that we are not working hard enough.
Is it possible that we still have to risk our lives?
Just like the old man at this time.
Why is she so emotional?
Chen Gong knew it very well.
She is scared!
Her anger, breakdown, and anger are all disguises of her fear.
She is afraid of losing money...
That's it.
Right and wrong, doesn’t she know?
of course I know!
But she also knows that a few hundred dollars in compensation is not a small amount to her. It may be two months of his old age pension. She will face criticism from her children, and may even cause an internal conflict in the family to break out. Let your son and daughter-in-law have a fight.
does it worth? !
For a few hundred dollars, she would give up her face because she was afraid...
Save money and you can do a lot of things.
The problem was not big, and Chen Gong did not pursue the matter initially. However, if the woman persisted, Chen Gong would not mind using legal weapons.
But he felt the 47 yuan and [-] cents compensated by the little girl in his hand.
Forget it!
……
The car soon arrived at the gate of a community hospital.
Chen Gong left the woman to register and quickly walked towards the emergency room with the child in her arms.
When the doctor on duty at the surgery saw the condition of the little girl's leg, he couldn't help but froze for a moment and became a little panicked.
"Hello, the child fell to the ground just now. I was thinking of scratching his skin, but I never expected that he would bleed so much."
"Please help me to deal with it."
"It would be best to find out why there is so much blood."
The emergency surgeon is quite young, almost 40 years old. His hair is messy and his white coat is not very clean.
After seeing the little girl's condition, he nodded quickly: "Well, sit down first and let me take a look."
While talking, the man took off the little girl's shoes.
Then the pants are tight and cannot be rolled up.
Chen Gong simply said: "Just cut it open."
The doctor heard the sound, nodded, and cut open the trouser leg with scissors, exposing the wound.
After seeing the girl's wound, the doctor immediately comforted him: "Don't worry."
"Just a simple scratch."
"I'll just debridement and bandage you."
When Chen Gong looked at the little girl's calf, there were indeed traces of slipping and friction on the cement floor.
The epidermis was obviously damaged, blood oozed out, and no particularly deep wounds could be seen.
The man laughed and said, "I scratched my skin a little bit. There are many blood vessels under the skin, so it's just bleeding a little more."
While talking, the man started rinsing with hydrogen peroxide.
After rinsing, Chen Gong also saw clearly the specific condition of the girl's legs.
At first, he was worried about pebbles getting stuck in. After all, the road was not very clean and his pants were torn.
But after inspection, nothing was found.
After rinsing, the man brought the iodophor: "Little girl, it hurts a little, please bear with it for a while."
As he spoke, he began to use tweezers to hold cotton balls soaked in iodophor to disinfect the area around the wound.
The opponent's technique is quite light and his technique is also very skillful.
The girl was also very strong, she didn't cry, her little mouth was pressed tightly, and she didn't say a word.
After disinfection and sterilization, debridement is completed.
The level of debridement in men was acceptable.
Also very careful.
Chen Gong looked at the condition of the girl's legs and couldn't help but ask:
"Doctor, this is just a scratch on the skin, it won't bleed so much, right?"
The man suddenly laughed: "Haha!"
"Are you the child's father?"
"So young!"
"You, don't worry. It's a small problem. It's normal for children to bump into each other. After debridement, just bandage it."
Chen Gong heard this and shook his head: "Under normal circumstances, knee skin trauma will not cause so much bleeding."
"I suggest you check it out."
"How about you give me medical advice?"
The man was obviously hesitant: "I have been a doctor for so many years and have bandaged so many children. It will be no problem."
"You have to believe me."
However, Chen Gong patiently explained:
"Bleeding from skin trauma on the knee is due to damage to the epidermis and capillaries in the dermis."
"But it's been more than ten minutes since the girl was bruised and I brought her here."
"It stands to reason that this kind of dermal bleeding can stop on its own within ten minutes."
"But when you were debriding, we saw blood oozing out. Isn't this unreasonable?"
"How about you give me medical advice?"
The man looked at the girl's condition and was obviously a little stunned.
"Doctor's order?"
"What...what doctor's orders are you going to give?"
"Are you afraid of infection? How about... I prescribe some anti-inflammatory drugs?"
The man said hesitantly.
After Chen Gong pondered for a moment, he said, "I think a blood test will be done to see how the blood items are."
"Is it a lack of platelets, causing some disorders in coagulation?"
"In other words, you can check for coagulation."
The male doctor was obviously stunned by Chen Gong's words: "This...isn't necessary?"
At this time, Chen Gong suddenly discovered that some bruises began to appear in the unscratched area next to the little girl's knee.
"Look, doctor, there's a bruise here."
The male doctor was stunned for a moment: "Isn't it normal to have bruises after a fall?"
The girl's grandmother heard the sound and nodded quickly: "Yes, this... this should be normal, right?"
Chen Gong heard the sound and said directly: "No, it's not normal."
"It wasn't there just now."
"Look, it's still bleeding. It's obviously abnormal."
"This could be bleeding under the skin."
"This is obviously not normal behavior."
The male doctor was also a little unhappy at Chen Gong's words.
"I told you, it's okay, it's just a skin injury."
"Isn't it normal for you to bleed a little and have a bruise after a bump?"
"Why are you so... so stubborn?"
"I am a doctor and you are a doctor."
When Chen Gong heard this, he was not angry, but said seriously: "You are a doctor, so... I will give you some advice."
At this time, the little girl's grandmother also said quickly: "This... young man, don't be angry."
"Adults and children are different, right..."
"It's just a bruise, it's okay."
"Each person has his own constitution!"
"The child is quite healthy. The school organized a unified physical examination just a few days ago."
"It's okay, no need to draw blood."
"Thank you, doctor."
When the male doctor heard this, he also glanced at Chen Gong: "My child, don't be too serious!"
"Don't Baidu, that's what it is!"
"Just bandage it, it's not a big problem."
"I asked you to tell me that, if you don't check anything, it will cost hundreds of dollars."
Chen Gong patiently explained: "This is not about money, and I didn't question you."
"I think that any disease is justified, and the symptoms should follow the situation."
"There's no way there's unexplained bleeding and hemorrhage."
"This kind of medicine is not rigorous."
The man laughed at Chen Gong's stubborn attitude: "Haha, medical student?"
Chen Gong nodded: "Yes!"
The man shook his head: "Son, seeing a doctor is not as simple as what the book says."
"Don't become a nerd."
Chen Gong shook his head: "No, this is not a nerd."
"Any symptoms need to be analyzed theoretically."
"Under normal circumstances, a wound like this kind of epidermal abrasion will scab within 5-10 minutes and the bleeding will stop automatically."
"And the patient's condition is obviously not normal behavior. In this case, shouldn't other factors be considered?"
"I think even the slightest illness or doubt needs to be explained."
"Otherwise, the current situation cannot be explained at all."
At this time, several people had gathered around.
Several young nurses also pointed here and watched carefully.
The man was also a little angry: "Why can't you explain it clearly?"
Chen Gong said seriously: "First of all, there is no way to explain the long-term bleeding and the inability to scab!"
"Secondly, there is a lack of effective evidence as to the cause of subcutaneous bleeding."
When the man heard this, he immediately laughed angrily: "Okay!"
"You young man."
"You are neither a family member nor a doctor in our hospital."
"You have no clinical experience, and you haven't learned anything. You just think you're great, right?"
"I can't convince you."
"Or else."
"You you on the line?!"
When everyone around him heard this, they immediately looked at Chen Gong with a little more amusement in their eyes.
When Chen Gong heard the voice, he was stunned for a moment: "Is it okay?"
The male doctor was also stunned: "What can I do?"
Chen Gong said seriously: "Didn't you say that if I can do it, I will do it?"
"I can!"
The male doctor and several young nurses around him were completely dumbfounded.
Good guy!
Are you really going? !
The community hospital is not big to begin with, and there are only so many people coming and going.
Naturally, it quickly attracted the attention of many people.
Here, the girl's grandmother saw this situation and quickly pulled Chen Gong aside.
"This... young man!"
"Thank you."
"Do you really think these tests are necessary?"
"Will it be..."
Chen Gong carefully explained the situation to the woman: "Auntie, has this happened to children before?"
"When the skin is broken, there will be more bleeding, and it will be slower to stop the bleeding."
"Or... nosebleeds, bleeding gums, etc."
After the woman heard this, she suddenly thought of something and said quickly:
"There is one thing I remember."
"Didn't he change his teeth?"
"One day after I lost a tooth, the bleeding took a while to stop."
"Does that count?"
When Chen Gong heard this, he nodded immediately: "That's right!"
"That's the anomaly."
"This is unlikely to happen to normal people. Generally, there are platelets in the blood, which will form blood scabs to stop bleeding."
"Look now, there's still a little bit of blood oozing out from your legs."
"If you look at the child again, the bruises around the knees are more obvious."
"The range is also larger. This should not be a normal situation."
Hearing Chen Gong's words, the woman looked down and her eyes widened:
"It seems so!"
"Doctor, please take a blood test."
"Look at the bruises around my baby's knees."
"What's going on here?"
The doctor was obviously stunned.
The family members have now expressed their opinions. Although subcutaneous bleeding after abrasions is normal, the range is a bit larger.
The man was stunned for a moment: "Wait a moment, let me call a consultation?"
Chen Gong said directly: "Let's give the doctor's orders first!"
"First, give the doctor's orders. First, do a blood test to check the platelet status, and then check the coagulation."
"Then prescribe a hemostatic spray to stop the bleeding on the knee."
"Secondly, place a consultation order and invite a doctor from the hematology department to come down for a consultation."
"Finally, I suggest doing an electrocardiogram to check for heart problems." "Otherwise, I'm afraid it will waste time if I wait until the consulting doctor comes."
Hearing Chen Gong's words, everyone around looked at Chen Gong.
What he said just now is obviously not from an outsider.
It seems that it is really quite good!
After hearing this, the male doctor nodded, stopped refusing, and quickly issued a medical order.
At this time, the old man no longer worried about money.
I quickly ran to pay the fee.
Chen Gong took the child for a checkup.
Soon...
The blood was drawn and an electrocardiogram was done.
The consulting doctor also arrived.
There is a 40-year-old female director of the hematology department named Wang Lei.
"Director Wang, why are you here?" The male doctor smiled awkwardly.
Wang Lei smiled: "I happened to have time, so I came over. What's going on?"
Chen Gong held the child in his arms and walked over quickly:
"Hello there!"
"Hello, what's going on? Baby."
Wang Lei lowered her head, saw the little girl's wound, and asked with a smile.
The male doctor on the side explained the whole story.
After listening, Wang Lei continued to look at the child's wound. It was still not completely scabbed.
"how long it has been?"
Chen Gong glanced at the time: "Half an hour."
When Wang Lei heard this, she couldn't help but nodded: "Young man, your analysis makes sense!"
"This situation needs to be checked."
“Never miss a disease just because of habitual thinking.”
"Look, it's been half an hour. Under normal circumstances, the rupture of dermal capillaries needs to be completely scabbed."
"But it hasn't happened yet, which means there is an abnormality in the coagulation function."
"We have to find out why."
"Are you studying medicine? How do you know so much?"
Chen Gong nodded: "I am from Shanhe Medical University."
"Sophomore."
When Wang Lei heard this, she immediately laughed: "Shanhe Medical University!"
"Top student."
"Today, our hematology department just invited a hematology expert from Shanhe Medical University to come for a consultation."
"It's great that you can think of this."
Wang Lei wears a pair of black-rimmed glasses. Although she can't be called very beautiful, her short shoulder-length hair and lean eyebrows give her a neat look.
After everyone waited for a while, the blood test results came out quickly.
The nurse ran over with the results.
"Director Wang, look, it's normal!"
Wang Lei also took the blood routine report and looked at it.
Basically everything is normal.
The most critical platelet count is 110.
Normal value of platelets: (100 to 300)×10^9/L.
Now, although the little girl's 110 is not high, it is definitely not low either.
The male doctor on the side couldn't help but said: "I think... this is normal. After all, people's physiques are different."
"Clinical treatment can't be exactly the same as in the book, right?"
"Is it okay to go to the doctor with a book in hand like this?"
Wang Lei frowned slightly, seeming to be thinking about something.
But Chen Gong shook his head: "Wait for the blood to coagulate."
"That's the key."
Although Wang Lei is the director of the hematology department, the hematology department of this community hospital is obviously not a large department.
The academic level is average and there are only 20 beds.
Wang Lei herself just passed the associate-senior professional title exam this year, and the hospital has not offered her a job yet.
Domestic community hospitals, regardless of city size, actually have some serious problems.
It is the relative lag in medical standards.
Most graduates with master's or doctoral degrees from medical schools are rarely willing to work in community hospitals.
Even if they come, they are basically concentrated in big cities, such as Beijing, Shanghai and Guangzhou.
Compared with the overall level of Shanhe Province, Shanyang City, the provincial capital, is only a new second-tier city.
The level of community hospitals is also somewhat average.
Wang Lei is already quite powerful.
While everyone was waiting, scabs began to slowly form on the little girl's legs.
The male emergency doctor on the side looked much better now, and even looked at Chen Gong with a little smile in his eyes.
While speaking, he shook his head intentionally or unintentionally.
Chen Gong was not angry about this.
Because he knows very well that this is a common situation among doctors in many ordinary small hospitals in China, who have inertial diagnosis and treatment thinking.
Basically, I don’t pay much attention to some minor issues.
The male doctor couldn't help but said: "I told you, there is really nothing wrong with it."
"This is not good!"
"The bleeding has stopped."
"There is no infection. Just take a good rest for two days and it will be fine."
"It's not necessary to go through this long process, right?"
Not long after, the nurse brought in a coagulation test.
The four items of coagulation are one of the clinical examination items of the laboratory department and belong to the examination of thrombotic diseases.
The four blood parameters include prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen (FIB).
The purpose is to understand whether the patient's hemostatic function is defective.
The time for activated partial thrombin is 44 seconds, and the normal time is 25-37 seconds.
The prothrombin time is 17 seconds. Similarly, the normal time is: 11-14 seconds.
Fibrinogen is 3, which is within the normal range (2-4).
Thrombin time is 14 seconds, normal time is 12-16 seconds, normal indicator.
Now, the four coagulation results have come out, two of which are completely normal, and the thrombin time is also normal, which is a key indicator.
Now the activated partial thrombin time and prothrombin time are longer.
However, it is not much beyond the normal value.
Theoretically speaking, although this coagulation function is abnormal, it...can't be considered a big problem.
The male doctor in the emergency department remained silent after seeing this.
He doesn't know much about this, so he doesn't have much say.
Just looking at Wang Lei: "Director Wang, is this situation serious?"
The little girl's grandmother also looked at Wang Lei nervously: "Director, how are you doing?"
"Child...are you okay?"
At this time, Wang Lei couldn't help frowning and thinking.
"There is obviously a problem with the coagulation function."
"I think……"
"Still... we should check it in detail. The four items of coagulation can only explain some basic problems. However, we need to further observe whether there is any deficiency in coagulation factors or some special plasma components."
"Also, have you had your liver function tests done?"
"Has the child had any diseases before?"
The hematology department mainly targets people, in fact, in many cases it is children.
Children's hematological diseases have become the focus of many hospitals.
This is inseparable from the consideration of diet, defense, and other comprehensive circumstances.
At this time, seeing the child's condition, Wang Lei couldn't help but ask:
"The coagulation function is abnormal now, which is obviously not normal behavior."
"Are the child's parents here?"
"I think it's best for them to conduct a detailed inspection. If there is nothing wrong after the inspection, we can relax."
"However, this test cannot rule it out!"
While talking, Wang Lei looked at Chen Gong:
"Boy, you are very good!"
"Being able to judge clinical situations through some phenomena is an ability that a clinician should have."
At this time, Chen Gong asked curiously: "Can I take a look at the test report?"
Wang Lei handed it to Chen Gong.
It was now around six o'clock in the afternoon.
It's almost time to get off work.
Chen Gong looked at the test results and suddenly became pleasantly surprised.
Because he is so familiar with these things.
He discovered that the subject of biochemistry and clinical examination are really inextricably linked.
It can even be said that laboratory science is based on biochemistry.
Coagulation function involves, whether it is prothrombin, thrombin, or fibrin...
These are all part of the coagulation test.
The patient now has an activated partial thromboplastin (APTT) time that has increased by 7 seconds.
The prothrombin time (PT) was more than 3 seconds longer than normal.
The fibrinogen level is basically 3, and the normal level is 2-4!
The thrombin time was also normal.
Chen Gong seems to remember a calculation announcement...
This is an exploration of the prothrombin depletion correction test.
Although the changes in coagulation factors II, VII, IX, and X are not currently known, and no correction experiments can be seen.
However, a specific effect size can be calculated from the coagulation time.
Think of it...
Chen Gong quickly walked aside, picked up a pen and started calculating quickly on the paper.
About...10 minutes passed.
Chen Gong ran over excitedly.
The child's grandmother also called the child's parents at this time to inform them.
Wang Lei seemed to be communicating with the woman there.
The little girl sat there in despair, her eyes full of loss.
"what happened?"
Chen Gong smiled.
The little girl sighed: "Mom and dad are probably going to quarrel again..."
Chen Gong was stunned for a moment: "Why?"
The little girl pouted: "My father lost his job last year and now drives a taxi, and my mother works as a housekeeper."
"Mom and dad have a hard time every day."
"Dad often comes home late."
"Hey……"
"Actually, it's okay if you fall, so you don't have to dance. I don't like it anyway."
"A few days ago, my mother asked my father for money for a dance class, and she got into an argument with my father."
"I saw my father crying on the balcony."
"Grandma is reluctant to spend money..."
"I spent all the family's money."
"I just heard the doctor say that I still have to be hospitalized. I really want to spend a lot of money..."
As he spoke, the little girl's tears streamed down her face.
The pain in her knees only made her purse her lips and remain silent.
But...at such an old age, I have to cry so sadly because of spending money.
Chen Gong was helpless when he saw this.
He patted the little girl on the back: "It's okay."
"No more examinations, and we don't need to be hospitalized."
"Uncle, I'm telling you, you... must be a picky eater because you don't eat well!"
"So, vitamin deficiency!"
"You have to eat well from now on."
The little girl's eyes widened: "Really?!"
Chen Gong nodded: "Of course it's true!"
"Just wait, I'll go talk to Director Wang."
While speaking, Chen Gong stood up and walked over directly.
"Director Wang, excuse me."
Wang Lei saw Chen Gong coming over, nodded and smiled: "Well, what's the matter?"
Chen Gong said seriously: "Actually, Director Wang, I don't think the child has an abnormality in the coagulation factor."
"And it's not a liver problem."
"What is that?" Wang Lei looked at Chen Gong curiously.
Chen Gong directly took out what he had calculated.
"This is the result of the inferred calculation of the coagulation effect of APTT."
"The patient's condition should be that the coagulation effect is reduced due to vitamin K deficiency."
"The thing in my hand is a discussion on the coagulation effect DCP in biochemical polymer calculations.
"Of course, my suggestion is to check again and confirm the diagnosis!"
"I think...there is no need to be hospitalized, right?"
Wang Lei looked at the densely packed indicators in Chen Gong's hand and was immediately dumbfounded.
There are completely incomprehensible formula calculations on the paper.
There are also various English letters...
to be frank!
Wang Lei really can't understand.
"What... what does this mean?"
Chen Gong looked at Wang Lei and was stunned for a moment: "Huh?"
He didn't expect that Wang Lei wouldn't understand.
Not the director?
Wang Lei also blushed at Chen Gong's expression.
She coughed and said, "Sorry, I...I really can't understand."
"Are you still learning these things in... medical school?"
Chen Gong coughed and explained: "This is actually biochemistry and molecular biology... almost the same."
"Let me explain it to you."
“The most sensitive indicator of vitamin K deficiency is the presence of des-gamma-carboxy-prothrombin (DCP) in plasma, and DCP is commonly known as PIVKA (protein induced by vitamin K deficiency or antagonism), which can be used with appropriate Antibodies were measured. There were no antibodies in the plasma of healthy people.”
"The research I conducted also revolves around this."
"With the four functions of coagulation, we can actually diagnose that the patient is deficient in vitamin K."
Wang Lei was stunned when he heard Chen Gong's words.
"Is college... so difficult now?"
"At that time...we...we still had to learn this?"
Wang Lei felt an unprecedented sense of crisis.
Are college students so good now?
Will they...have a way out in the future?
……
When she was about to say something, she suddenly saw a figure walking towards her.
Wang Lei quickly said hello:
"Professor Sun, is the outpatient clinic over?"
"Thanks for your hard work!"
Sun Weihong smiled: "Well, it's over,"
Wang Lei suddenly thought of something and said quickly: "By the way, Director Sun, could you help me consult a patient?"
"She's right there."
"This is the patient's test result."
"The situation is like this..."
Sun Weihong frowned. After listening, he quickly walked to the little girl and consulted seriously.
In a moment!
He looked at the results, pondered for a moment, and then said to Wang Lei:
"There is no need to do other examinations for now!"
"Do a plasma antibody test."
"Check the DCP. Can your hospital do it?"
"I think the patient's condition may be relatively simple and not a complex coagulation disorder."
"Look at this indicator, APTT and PT simply increase by less than 13. In this case, the physical signs and medical history should be combined."
"Based on symptoms, signs and medical history, the diagnosis of vitamin K deficiency may be suspected, and the diagnosis can be made when PT and PTT are prolonged!"
"So, I think the patient should have a simple vitamin K deficiency."
"Although our blood diseases are more complicated, there is no need to do too many tests and assistance."
"The inspection must be carried out accurately."
When Wang Lei heard Sun Weihong's words, she was stunned for a moment and blurted out instinctively: "Huh?!"
"Really are!"
Sun Weihong was stunned for a moment: "What do you mean?"
Wang Lei didn't know whether to laugh or cry. She really didn't expect that this college student...and a sophomore at that, really got the answer right? !
"Well, Director Sun, I'm sorry!"
"That's right. The young man just said the same thing."
"He said that the child may have a reduced coagulation effect caused by a lack of vitamin K."
When Sun Weihong heard this, she became curious.
You know, he was able to tell because he just participated in an international conference in the first half of this year.
During the meeting, there was an introduction to the latest indication effects of DCP.
but……
It is difficult to give an accurate answer simply by relying on this inspection.
So, for a moment, he looked at the boy beside him curiously.
"Hello."
"Excuse me...how did you judge?"
"By the way, my name is Sun Weihong, director of the Hematology Department of the First Affiliated Hospital of Shanhe Medical University."
Chen Gong heard the voice and nodded quickly: "Hello, Teacher Sun."
"I am Chen Gong, a sophomore student at Shanhe Medical College."
"That's my speculative process."
Sun Weihong took the paper curiously and read it carefully.
only……
At first sight, Sun Weihong's eyes widened.
"Is this... coagulation effect inference calculation?"
Chen Gong nodded:
"I calculated the coagulation effect based on the four indicators of coagulation and speculated on the changes in DCP..."
"According to guidelines, the most sensitive indicator of vitamin K deficiency is the presence of des-gamma-carboxy-prothrombin DCP in plasma."
"So, I just..."
"I think the patient may simply be deficient in vitamin K."
Sun Weihong looked at Chen Gong in surprise: "Where did you learn this?"
Chen Gong smiled awkwardly: "This is biochemistry!"
"However, I saw the specific formula from the information and did some calculations."
"I didn't expect that I could actually figure it out."
Sun Weihong was completely numb.
"Are you a sophomore today?"
Chen Gong nodded: "Yes, sophomore in clinical school."
Sun Weihong swallowed and tried to calm down, but... could this be calm?
You know, this announcement aside.
Able to understand biochemical processes thoroughly.
Can accurately predict DCP changes.
it's all...
What level?
"You still study this in college now?"
Chen Gong coughed and said, "I started studying biochemistry in my sophomore year."
As soon as these words came out, Sun Weihong's expression was very exciting.
After pondering for a moment, he said, "Chen Gong, right?"
"not bad!"
"Can you give this paper to me?"
Chen Gong nodded: "Of course."
Sun Weihong nodded and smiled: "Can you leave me your phone number?"
"I'd like to chat with you when it's more convenient, okay?"
Chen Gong nodded: "I can't ask for it."
While talking, the two left their contact information.
At this time, Sun Weihong walked up to Wang Lei, chatted for a few words, got up and left.
Wang Lei looked at Chen Gong and gave a thumbs up:
"you are great!"
"Director Sun has praised you."
Chen Gong smiled: "Director Wang, you're welcome."
"Actually...it's nothing."
"It's just some university stuff, just showing off."
"The real diagnosis depends on you."
At this time, the child's parents also came.
After Wang Lei finished explaining the situation, he said, "You should thank this young man properly!"
"If he hadn't insisted."
"To be honest, I can't find out at all today."
"The child is most likely suffering from a vitamin K deficiency."
"However, we still need to clarify the specific details and whether there are other symptoms."
"All right?"
Hearing this, the child's parents quickly expressed their gratitude.
At this time, the man took out 500 yuan from his pocket and handed it to Chen Gong:
"Thank you!"
"Boy!"
"I'm sorry, my mother offended you today."
"As a result...you have been so helpful after all this running."
"Thank you so much!"
"It's not much money. You can go back and touch up the paint. I think it's a new car. This... I'm really sorry."
Chen Gong excused himself, stuffed the money into the little girl's pocket, winked with the little girl, got up and left.
Chen Gong is not short of this money.
but……
The other party's attitude made him very comfortable.
He got up and walked outside.
At this time, Wang Lei was still immersed in what Chen Gong had just said.
A little worried, a little scared.
Nowadays college students are so powerful...
What should I do if I don’t study hard in the future?
The male emergency doctor also apologized to Chen Gong in embarrassment.
There was a sense of urgency in my heart.
The habitual diagnosis and treatment rules he was so proud of seemed to have failed!
in fact……
Sun Weihong was sitting in the car, feeling equally uneasy.
good guy...
I'm still proud of myself.
I also think that with the blood of mountains and rivers, I am the most awesome!
but……
Today a child, a sophomore, taught him a lesson.
It's really amazing!
no no no...
I'm not going to eat tonight, I'm going back to reading!
Sun Weihong suddenly felt a sense of urgency and pressure in his heart.
The waves behind the Yangtze River push the waves in front, and they really have to beat the waves in front to death on the beach!
……
……
ps: My father-in-law was hospitalized for surgery, and I had to run back and forth, so I was delayed for some time. I'm sorry.
12000 delivered, I can only write so much today, please forgive me.
From now on, the update time will be tentatively set at around 7 p.m. every day.
It is convenient for everyone to fix it.
(End of this chapter)
Tap the screen to use advanced tools
Tip: You can use left and right keyboard keys to browse between chapters.
You'll Also Like
-
Furious Dragon Slaying System
Chapter 790 2 hours ago -
Monster clones from all over the world
Chapter 347 2 hours ago -
Multiverse Dimensional Shop
Chapter 888 2 hours ago -
Dragon Ball: Enforcer of the Divine Realm
Chapter 109 2 hours ago -
Dragon Ball: I Gather Destruction to Infinity
Chapter 201 2 hours ago -
Online Games: My Theft SSS Level
Chapter 885 8 hours ago -
Hogwarts Blood Curse Martial Arts
Chapter 432 8 hours ago -
Provoke him? His guild is all god-level, so he's going to beat him on the head?
Chapter 311 8 hours ago -
Thriller: I created an alien asylum
Chapter 117 8 hours ago -
Dark Skeleton King
Chapter 922 8 hours ago
