Doctor: It's reasonable to perform surgery on yourself.

These two directors are the strongest in the group.

Of course, they are also the top figures in the imaging department in Daxia.

As for the directors of these two hospitals, they basically attend various international imaging conferences, so they are naturally not active in the WeChat group.

Han Jinxing: "I took a look and no."

Wei An: "Director Zhang, is this a patient of Dr. Xu?"

Zhang Hao: "Yes, I will upload the medical records later. I hope my colleagues can give suggestions! Fist.jpg."

Han Jinxing: "No matter how I look at it, there is no problem. Are you sure the patient has a problem with the nervous system?"

Wei An is not a real specialist. He specializes in cardiac imaging.

But Han Jinxing is doing imaging diagnosis of the nervous system, and this patient happened to hit the field he is good at.

Zhang Hao quickly replied: "Doctor Xu said yes. In addition, the patient underwent a naproxen experiment, and the cooling effect was very significant. Coupled with other manifestations of nervous system damage, it should be an intracranial tumor."

The group fell silent.

For a long time, no one spoke again.

…

Linhai First Hospital, Xu Qiu’s office in the emergency department.

After searching for several hours, he still didn’t find much valuable information.

The results of the MRI have not come out yet, and it is estimated that he will have to wait until tomorrow morning.

After considering it, Xu Qiu planned to go to the ward again.

For frontline doctors, no matter how much literature they read or how much clinical knowledge they know, they will eventually need to return to the ward and the patient.

This time, he did not check the body again.

But he talked to Tao about the patient’s past history.

When he was born, he was almost contaminated with meconium.

When he was a few months old, his nipple was sucked and became a purulent infection.

When he was six years old, he followed his cousin on a motorcycle and had an accident. The whole person turned 720 degrees in the air and fell on a haystack.

The next day, he went to eat his cousin’s feast with all his limbs intact.

When he was seven years old, he scratched his lower body and went to the hospital for sutures, and his foreskin was cut.

Ten years old…

Eleven years old…

Xu Qiu was very patient and extracted useful information from Tao, hoping to get some clues.

However, this process is very long and boring, and most of the time it is useless.

Medicine is actually an empirical discipline. Clinical diagnosis depends on the doctor's eyesight and the results reported by various examination forms.

It's not a criminal investigation.

No matter how many details there are, they actually play a very small role in promoting diagnosis.

However, Xu Qiu still chose to do this thankless task.

When there are no clues, seize every opportunity to restore the patient's health.

"Wait."

At this moment, Xu Qiu suddenly thought of something and paused.

Tao happened to talk about the story of her father being visited by six female parents when he was fourteen years old and finally beaten by seven parents. After being interrupted, she felt a little unsatisfied.

"Doctor Xu, when you were fourteen, were you beaten by a mixed group of seven?"

Xu Qiu ignored this topic and asked, "You said he scratched his genitals when he was seven?"

Ms. Tao didn't care and said, "Yes."

"Why?"

Ms. Tao was a married woman and didn't mind these topics. She said casually, "Don't think my dad broke that thing. In fact, he didn't. It is said that he was very big since he was a child. When he was seventeen or eighteen years old, there were a lot of women in their thirties pestering him. After all, the most fierce age met the most fierce you!"

Xu Qiu was not interested in these things and changed the question, saying, "Why did he shave?"

"I asked my mother-in-law, she said it was because my father had hair, he felt embarrassed at the time, so he took a kitchen knife to shave himself... Now I think it's awesome, a kitchen knife! And it is said that the kitchen knife was still used later, and it is now used in the kitchen of my mother-in-law's house. The old things are really useful..."

Xu Qiu was silent.

She is really a chatterbox. She can talk about anything.

However, after listening to Ms. Tao's description, his eyes suddenly lit up.

Seven years old, with hair?

Normal boys start to develop between the ages of ten and thirteen, so seven years old is obviously precocious.

Why precocious puberty?

At this moment, a document emerged in his mind, and the tumor mentioned in the document happened to cause mutism, precocious puberty, and cancerous fever.

At this moment, Xu Qiu suddenly felt that after going through all kinds of difficulties, he finally cleared the fog a little bit.

…

After returning to the ward, Xu Qiu quickly turned out the document.

"Correlation Analysis between Imaging Manifestations and Clinical Pathological Characteristics of Adolescent Pineal Region Tumors"

At that time, Xu Qiu ruled out the reason for this disease, on the one hand, because the age did not match, and on the other hand, the pineal tumor had necrosis and calcification, and showed short T1 and T2 signals in MR, which should be easy to find by imaging.

But at this time, with the appearance of "precocious puberty", a feature that perfectly fits the pineal brain tumor, Xu Qiu had to lean Tao Changhan in this direction.

If the tumor is small enough.

If the location is tricky enough and the CT density and MR signal are covered by cerebrospinal fluid, blood vessels and other tissues, it is possible to be overlooked!

"Wait for the results of the MRI first."

Even if it is really a pineal brain tumor, it still needs to be confirmed by MRI in the end.

Xu Qiu called Zhang Hao and told him his guess.

Director Zhang nodded solemnly: "Okay, tomorrow I will personally instruct the technician to do MR, focusing on checking whether it is a pineal gland brain tumor."

Early the next morning.

Hand over shift early as usual.

Tao Changhan's case naturally became the key case of the day and was included in the general practice discussion.

Tumor indicators, naproxen, and various neurological symptoms.

and the laxity of clinical criteria for diabetes insipidus.

These are knowledge that cannot be learned in textbooks.

In addition, several patients were sent from the cardiac surgery department.

These are all preparing for artificial blood vessel replacement.

However, the beds in the cardiac surgery department are already full, and a large number of patients who need small-diameter vascular surgeries are assigned to the emergency department in order to avoid affecting the balance of diagnosis and treatment of other diseases in the cardiac surgery department.

Before ending the shift, Wang Ping took a sip of water, cleared his throat and said: "Today is the weekly director's ward round. If you want to come later, follow me. In addition, Dr. Xu, you can go directly to Tao Changhan. He is a key patient. , make a clear diagnosis as soon as possible, I have notified people in the operating room to be ready at any time.”

Xu Qiu nodded: "Okay."

After the shift handover, Wang Ping walked to the ward with his hands behind his back.

The director's ward rounds have always been one of the most solemn programs in a department.

Whether you are a seasoned attending or an inexperienced intern, you will seize the opportunity to learn. If you can answer the director's questions correctly, your impression will increase exponentially.

In fact, it was through this method that Wang Fan stayed in Linhai No. 1 Hospital by chance.

When Wang Ping thinks about this incident, he still wants to slap himself twice...