My Medical Skills Give Me Experiences

【My medical skills can add experience points】【】

"After being infected with Salmonella, rehydration alone cannot solve the problem. Some patients can fight the past with their own immunity, and some patients will die of serious illness due to various reasons. Therefore, it is necessary to use medicine when it is necessary to treat it." Director Shang said As soon as the words fell, the family members next to him were terrified. "Professor Shang, you must save my husband, our family cannot live without him." The family members probably feel regretful now. How did she know that secretly drinking a bowl of chicken soup for her husband would have such serious consequences! At the thought of her husband's possible death, she couldn't stop crying. "Don't cry, don't cry! I'm teaching my doctors to treat this disease. Although your husband's condition looks serious, he was discovered in time and his condition is still under control. I believe that after taking the medicine, he will definitely It will get better soon." Director Shang tried his best to explain to the family members to appease their grief and panic. "Doctor Yu, I have to praise you again. Being able to detect the patient's abnormality at the first time, and timely and accurately diagnose the patient's salmonella infection shows that you are not only very responsible, but also your medical level has greatly improved." After appeasing the family members, Director Shang praised Yu Xin again. It is also intended to let Zhou Can understand that Gui Peisheng is not the only one under him who is capable. It was equivalent to the arrogance to kill Zhou Can. The main reason is that Zhou Can's performance is too eye-catching, and he has made great achievements again and again. He is worried that this will encourage Zhou Can's pride and is not conducive to his growth. Yu Xin looked embarrassed. She didn't diagnose the patient's salmonella infection. With her current level of diagnosis, she is simply not capable of diagnosing such a complicated cause. "I..." She gritted her teeth, ready to confess the truth. The matter of slapping a swollen face to pretend to be a fat man is ultimately false. "What's the matter?" Director Shang looked puzzled, she was never so coy. "Professor Shang, in fact, he was the doctor who diagnosed my husband's infection with that fungus. But this doctor Yu is also very serious and responsible, and he is very concerned about my husband's treatment." The family members helped to tell the truth. Director Shang immediately understood after hearing this. After arguing for a long time, it was Zhou Can who made the contribution again. He also wanted to give this kid a little pressure by praising Yu Xin. This time I'm afraid it will have the opposite effect. He is also an old man who has experienced many storms. He is calm and naturally turns his head to look at Zhou Can who is standing at the end of the bed. "Isn't Dr. Yu responsible for this patient? How did you diagnose it?" "I just gave some suggestions, and the diagnosis should coincide with Dr. Yu's. At that time, Dr. Yu had already diagnosed the cause of the disease." , I just saw that the patient's condition is not very good. To be on the safe side, I imitated your chief physician's consultation model of gathering the wisdom of many people. Call me and Dr. Duan Zifu for a consultation." Zhou Can has no shortage of such things at all. Take credit. Simply relying on the beauty of an adult, he made up a kind promise and gave her all the credit. Director Shang had a happy expression on his face after hearing this. "Well, you have done a good job. With the help of collective wisdom and joint consultation, it is indeed possible to greatly avoid misdiagnosis and missed diagnosis." Yu Xin, who was standing by the side, was still thinking about how to explain it, so as to look good. Unexpectedly, Zhou Can came up with an almost perfect excuse. In this way, no matter how much Director Shang questioned her, she would not be able to shake her credit. There is no need to worry about being defrauded by Director Shang after being found out. Yu Xin looked at Zhou Can gratefully. The latter smiled and winked at her. "Does Doctor Zhou know the pathogenic mechanism of Salmonella?" Director Shang asked him. It should be to test his basic medical skills. If it was in the past, Zhou Can might really have to answer so-so. Now, his hard-earned medical knowledge was not given for nothing. "There are many types of Salmonella. They can parasitize in chickens, cats, ducks and other livestock and poultry. Chickens are the main intermediate hosts of Salmonella. They can live in peace and harmony with chickens in chickens. But they are eaten by us humans. After entering the human body, Salmonella can effectively defend against the erosion of gastric acid with its strong defense ability." "When they are baptized by gastric acid and enter the intestinal tract of the human body with the peristalsis of muscles, they immediately find a breeding ground for reproduction. They will It quickly penetrates into the cells of the intestinal wall of the human body, divides wildly, and reproduces in large numbers. It only takes about two hours for the cells infected by Salmonella to die. At this time, Salmonella will drill out of the dead cells, spread to the surroundings, and then Use the same method to crazily destroy the normal cells of the human body and multiply them in large numbers." Zhou Can also checked professional information in order to understand the pathological mechanism of Salmonella. It is clear about every destructive process after it enters the human body, as well as the response of the body's defense mechanism. "Salmonella reproduces very quickly in the human body, and the number can increase by three to four times on average in one hour. One thousand Salmonella enters the human intestinal tract, and it only takes seven or eight hours to grow to an astonishing million or more. After another hour, that is, about nine hours, the number can reach an astonishing 4 million or more. Such a large group of bacteria crazily kills the normal cells of the human body in the intestinal tract, and at this time, the immune response mechanism of the human body will be triggered." "When the normal cells of the human body die, they will release a chemical alarm signal. At this time, the human body's immune system receives the alarm signal, and will quickly mobilize the macrophages in the human body to fight back against the invading bacteria. Macrophages The cells can automatically catch the invading bacteria and release a deadly liquid to melt them back." After listening to Zhou Can's detailed explanation, Director Shang showed a satisfied look on his face. Keep nodding and listen to Zhou Can continue. Dr. Yu also admired Zhou Can's solid medical skills. "If it is an ordinary bacterium, it will be killed soon after being captured by macrophages. But Salmonella has a powerful secret weapon. It can also release a unique chemical signal, so that macrophages can't help it. Or Said that the chemical signal they release is more like an invisibility cloak, which can make macrophages blind." "At this time, macrophages lose their function, and they will become more rampant. In humans The body continues to destroy normal cells crazily and reproduce in large numbers. As Salmonella is completely out of control in the intestinal tract, more and more normal cells die, and the alarm signal released will become stronger and stronger. At this time, the intestinal tract will produce an instinctive self Protective reaction." "This reaction is somewhat similar to enteritis reaction. The patient will feel nausea and abdominal pain. The fluid in the stomach will reflux, and the patient will feel oppressed at this time, and finally violent vomiting will occur, and part of the Salmonella bacteria will be excreted. At the same time, the intestinal tract will speed up. Peristalsis, water gathered to the bottom of the intestinal tract, and the patient suffered from violent diarrhea. Some Salmonella bacteria will also be excreted through diarrhea.” Zhou Can said that all the patients in the 73 beds had experienced these symptoms. "Doctor, after I vomited and had diarrhea, I excreted the germs. Will I be cured?" the patient asked weakly. "Vomiting and diarrhea are the responses of the body's self-protection mechanism, which can only remove part of the Salmonella bacteria, but there is no way to completely clear them out. They will multiply rapidly again in the body and kill a large number of normal cells. At this time, the patient will Feel severe abdominal cramps. This also indicates that more and more normal cells are being killed in the patient's body." "The chemical substances released by a large number of cells before dying will trigger the body's third protection response. With those chemical substances When it enters the blood, it will quickly cause muscle tissue swelling. At this time, the body's synergic cells sense the danger of the body and form an army to rush out to help the body deal with the invading bacteria." "However, those synergic cells will not directly kill Salmonella, Because they don't have this ability. The synergid cells rush to the macrophages that are inactive, like blind, stupid. They produce a special chemical that helps the macrophages revive and double in size. At this time, the macrophages seem to be activated, and they will secrete some potent venom to quickly kill the Salmonella in the body." "So, in theory, the human body does not need any drugs, and it can completely rely on its own immunity. The system eliminates the invading Salmonella. But this time may last for two to three days." Zhou Can analyzed all the pathological mechanisms, including the body's response mechanism. He looked at Director Shang. "You are just giving the patient fluid rehydration, but you are not in a hurry to use drug treatment. You want to wait and see. You want to let the patient's immune mechanism react in the third stage, and then eliminate the salmonella, right?" Zhou Can roughly guessed It was Director Shang's treatment idea. "Smart!" Director Shang nodded with a smile, his eyes full of admiration. "To deal with any kind of disease, whether it is medicine or surgery, all the treatment methods of doctors are not as powerful as the patient's own immune system. I can tell you that more than 90% of the diseases in the world cannot be cured by doctors. They can really be cured The disease is caused by the body's immune system." This is not the first time Zhou Can has heard of this treatment concept. Anyone who studies medicine knows that the cure of most diseases depends on the body's immune system. It beats all medicines. The ancient Chinese doctors in China probably knew the mystery of the human immune system long ago. Chinese medicine emphasizes the balance of yin and yang. This is very close to the immune system regulation of modern medicine. "Professor Shang, you mean that my husband can be cured without medication, right?" Although the family members don't understand these profound medical principles, they understand the general meaning. "It's hard to say for the time being. First correct the dehydration and electrolyte imbalance. Then observe closely. The patient should pay attention to heat preservation and stay in bed for more rest. It would be best if you can use your own immune mechanism to eliminate the invading salmonella in your body. In case of illness If the progress is rapid, or if there is a change, I will give him medical treatment in time. Please rest assured about this." Director Shang explained the truth to the family members, so that they can feel at ease. Otherwise, people will become so sick, and the hospital will not give medicines, and family members and patients will easily feel anxious. "Doctor Yu, please pay more attention to this patient. If you have severe chills, or other major changes in signs or symptoms, please report to me in time." Director Shang told Yu Xin. From here, we can also see how important the interns and regular trainees under the chief physician are. If there is not enough manpower, the chief physician will stare at the patients by himself? They are so busy, it is obviously impossible. Now that one Gui Peisheng is specially assigned to watch over him, the chief physician can free up time to treat other patients. "Your nursing department should also give more attention to this patient, just let him spend these two days." Director Shang explained to the nurse in charge. "Please don't worry, our nursing department will take it seriously." The status of the nurse in charge is not as good as that of the head nurse and the head nurses, and the confidence to speak is not so strong. The attitude is quite correct. "Doctor Zhou, come with me to see the patients in bed 71." Director Shang brought Zhou Can to bed 71 and asked about the patient's current condition. Then communicate with the family about the surgical plan. Zhou Can was listening on the sidelines. The whole communication process is not long. Family members have a high degree of trust in Tuya Hospital, which is a prerequisite for smooth communication. After the conversation, the family members directly agreed to the operation plan proposed by Director Shang. The original words of the family members were that it would be good to let their father drink saliva even after the operation. Once the family agrees, all that remains is to schedule the surgery. The operation time is tentatively scheduled for tomorrow morning. Followed by Zhou Can. "I'm in the outpatient clinic at one o'clock this afternoon. Dr. Zhou can practice with me in the outpatient clinic." Director Shang took the initiative to invite Zhou Can to follow him in the outpatient clinic, indicating that he has passed the preliminary test for Zhou Can. After Zhou Can got his medical certificate, he became very interested in seeing a doctor. It is of great benefit for him to sit with the superior doctor more often in the future. You can learn how the superior doctor answers various questions from patients during the consultation process, as well as the consultation process and treatment plan for different diseases. "Okay! Thank you Director Shang!" Zhou Can smiled happily. I tried my best to check the past medical history of the 71 patients and formulate the operation plan. The hard work was not in vain. Back in the office, Zhou Can was writing medical records for the patients in bed 71, when the nurse stood at the door and called him. "Doctor Zhou, another inpatient has been assigned to you to manage, with 77 beds!" Under normal circumstances, a Gui Peisheng is in charge of at least six to eight beds. Some very capable Gui Peisheng may even be in charge of more than 20 or 30 beds. In terms of bed management, the superior doctor has always been particularly perverted, frantically squeezing Gui Peisheng's labor force. They were not worried about accidents at all, anyway, they just took the patients in and handed them over to their subordinate Gui Peisheng to manage them. Zhou Can is still doing well, and the new 77-bed patient only manages two beds. The workload is surprisingly light. It is unknown to what extent it will increase in the future. The more tube beds there are, the sadder they are. All kinds of dressing changes, case writing, doctor's orders, and course of disease, etc., are enough to keep people busy. There is no time to drink saliva all day long. "I'll be there right away!" Zhou Can tapped the keyboard quickly, archived the unfinished medical records, and went to the ward to receive patients first. The hospital did not mandate that the doctor in charge of the bed must go to the ward to receive the patient as soon as possible. Anyway, the arrangement of beds is done by the attending doctor. After the patient is sent to the ward, the nurse will arrange the patient clearly. The bed doctor mainly grasps the patient's condition, prescribes the doctor's order in time, observes the reaction after medication, makes adjustments or reports abnormalities to the superior in time. As long as you have the ability to ensure that the patients you manage will not have accidents, it is fine to go to the ward only once a day. When Zhou Can came to the ward, he saw a very young female patient lying on the hospital bed. Her face was pale, her eyes were red and swollen, and she looked very haggard. UU Reading www. From uukanshu.com, the girl's dress is quite shabby. At first glance, it is the kind of chronically malnourished and poor family. There is no family member beside the hospital bed. "What's wrong with her?" Zhou Can asked the nurse. "The stomach wall tumor is stage 2, and the situation is not good." The nurse was thirty-five or six years old, with a hesitant expression. From her eyes, you can see the sympathy for this patient. "The condition is so serious, why haven't I seen her family members? The hospital stay is probably not short!" Stomach tumors can be divided into four grades. Stage 2 can no longer be treated with surgery alone, and surgery plus radiotherapy and chemotherapy are needed to achieve better therapeutic effects. Her hospitalization cycle is definitely not a day or two. Who knew that Zhou Can would be fine if he didn't ask, but when he asked, the patient burst into tears. Zhou Can was stunned and panicked. If I knew it earlier, I wouldn't have asked. It is not easy to make the patient cry now. He could only look to the nurse for help. Fortunately, in the morning, he showed his face at the department's morning meeting, and his status was much higher than the average Gui Peisheng. The nurse received his call for help, but did not stand idly by. Quickly stepped forward to help comfort the patient, "Miss Luo, we have notified your mother, she is very concerned about your safety, and said that she will rush over to accompany you as soon as possible. Don't be sad, this is not good for the condition, you know? Stomach tumor, it I am afraid that you are happy and optimistic. As long as you maintain a good mood all day long, its progress will be very slow. If you are overly sad and anxious in your heart, your immunity will be greatly reduced. Tumors like patients like this most. Because they You can take the opportunity to develop rapidly..." Nurses have rich work experience. There is also a way of persuading people. After her persuasion efforts, the patient finally stopped crying. It just looks like the mood is still very low. Zhou Can was too frightened to speak nonsense. Instead, pick up the patient's information to check. Understand the patient's condition.