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

"Curse?" Xu Qiu raised his head slightly.

The left eye twitches for wealth, the right eye for feudal superstition... We are scientific people, how can we believe in curses?

"What's going on?" Xu Qiu said.

Zhang Xiuyan sighed: "Don't you think I'm weird? I keep tilting my head."

"Yes, do I feel dizzy when I turn my head? Or am I in a coma?"

Zhang Xiuyan clapped her hands, "Doctor Xu, you are really amazing. I just discovered it these days. As long as I turn my head to the right, I will faint immediately. It's just like the curse in the TV series. It's terrible!"

"Faint directly?" Xu Qiu frowned.

This is really rare.

After working in the clinic for so long, Xu Qiu has encountered several people who will feel dizzy and vomit due to different body positions or excessive head movements, but he has never encountered a coma.

"Really, I'm not lying to you!"

Zhang Xiuyan was afraid that Xu Qiu would not believe it, so she shouted: "Look, Doctor Xu, look!"

As she said that, she tried to turn her head to the right.

The next second, her eyes rolled back and she collapsed.

Fortunately, Shi Lian was quick to help Zhang Xiuyan, but Shi Lian was too weak and they both fell to the ground.

Xu Qiu's eyes went dark.

Are you serious?

I didn't say I didn't believe it!

"Are you okay?" Xu Qiu stood up and helped Zhang Xiuyan up.

Shi Lian pouted.

I was the one who was acting as a cushion, why did you start caring about the patient first!

Besides...

"Teacher Xu, she, she is already unconscious." Shi Lian rubbed his arm and said.

"Oh."

Xu Qiu was silent.

This patient is really straightforward.

He said he would die if he tried it, without any ambiguity.

The patient was unconscious, so Xu Qiu couldn't do a deep examination, and just did a physical examination.

The first thing to consider must be the problem above the neck.

A touch triggered the experience of perfect vascular palpation.

Almost instantly, Xu Qiu felt an abnormally strong pulsation at the bifurcation of the right carotid artery.

She can move horizontally, but cannot be pushed up and down.

"Push a wheelchair first, wait for her to wake up, and take her for examination."

Xu Qiu wrote out several orders.

Routine blood test;

Electrocardiogram;

Color Doppler ultrasound of the heart, cranial CT, neck ultrasound, etc.

Dysphagia, fainting, pulsating mass in the neck, these symptoms together, it is difficult not to consider esophageal cancer, neck-related tumors and other problems.

Of course, abnormalities in the heart and brain also need to be ruled out.

This patient is very fresh and rare in clinical practice, but the diagnosis should not be difficult.

Medical students who study hard can give a general idea.

"Come on, Shi Lian, you talk first." Xu Qiu stopped the young intern.

The latter's shoulders trembled and he stopped: "I guess... it should be neck compression?"

"Well, be more specific."

"It is possible that the left thyroid cancer compresses the esophagus and blood vessels, stimulating the vagus nerve and causing dysphagia and coma.

It is also possible that esophageal cancer infiltrates the periphery and stimulates the vagus nerve.

Of course, the problem may also be with the pituitary gland."

The fact that Shi Lian can follow Xu Qiu proves her excellence.

She also relied on getting the first place in her major for four consecutive years to be qualified to study with Xu Qiu during her fifth year internship.

"Well, I've almost said it... Are you okay?" Xu Qiu just remembered that Shi Lian also fell.

"Teacher, I'm fine!"

"Well, go ahead..."

...

Xu Qiu's inference was correct.

Although the patient's performance was strange, it was ultimately inseparable from vagal hyperactivity.

No other abnormalities were found in the other examinations.

The electrocardiogram found sinus bradycardia.

The color Doppler ultrasound of the neck had a big problem. It can be seen that the right neck and internal carotid artery were obviously compressed and narrowed. It was undoubtedly a carotid body tumor.

Of course, ultrasound alone cannot confirm the diagnosis.

Later, a neck CT and MRI were performed to further confirm that it was a rare carotid body tumor.

The patient's tumor was located at the bifurcation of the carotid sinus and the carotid body.

The carotid enhanced CT showed that the tumor was about 2.7×2.3cm in size, which was relatively large.

The difficulty in swallowing was due to the compression of the recurrent laryngeal nerve by the tumor.

As for the coma...

It was consistent with Shi Lian's guess, and it was also compression, but it was the vagus nerve that was compressed, which led to vagus hyperactivity and caused neurological syncope.

The carotid body tumor that Zhang Xiuyan suffered from was a benign tumor, but it was very rare, with a clinical incidence of only 3 in 100,000.

There was nothing to say about the treatment method. If you have a tumor, you can just remove it surgically.

However, this tumor has a rich blood supply, and the lesion is located at the key carotid bifurcation, and the anatomical structure is very complex.

The difficulty of the operation is definitely not low.

Moreover, bleeding is not easy to control.

However, it is not so exaggerated that Xu Qiu needs to take action.

Therefore, after calling for a joint consultation, Xu Qiu handed the patient over to the director of the ENT department.

Shi Lian took a deep breath: "I didn't expect that rare diseases are so easy to diagnose."

Xu Qiu: "Rare diseases are just rare, and they are not directly related to the difficulty of diagnosis."

In clinical practice, doctors with less experience may ask patients to check all kinds of messy indicators, such as liver and kidney function, electrolytes, etc.

However, for Xu Qiu, the questioning and palpation can already initially lock the direction of the disease, and the examination can directly point to the cause of the disease.

Don't let patients spend a penny more than they should.

Other doctors may spend a lot of time and experience several comas and rescues after being admitted to the hospital, and finally think of checking the color Doppler ultrasound of the neck, CT scan and MRI of the cervical spine.

But for Xu Qiu, the first consultation is the final consultation.

…

In the afternoon, the operation was performed as usual.

However, at this time, Xu Qiu, who knew that teaching surgery could bring more proficiency, also consciously replaced experienced doctors such as Wang Fan and Zhou Hua, and began to let residents, even regular trainees and interns take the stage.

On the other hand, in the Department of Cardiac Surgery, with the end of the second phase of human surgery on Linhai small blood vessels, the trainees and famous doctors such as Joseph are about to complete the last lecture and return to their own hospitals or return to their own countries.

These doctors are elites. They have fully mastered the Linhai small blood vessel replacement at the beginning of the month. Even more than half of them have tried independent surgery and succeeded.

Today is the day to end the training.

After the operation, Xu Qiu rushed to the Department of Cardiac Surgery to give the last lesson to this group of students.

The only regret is that Joseph was not able to stay.

The reason is also simple.

The technology of small blood vessels in Linhai must be firmly controlled by Xu Qiu, and he can't get it.

And learning surgery...

Now that small blood vessel replacement has been made public, Joseph has already done it easily. If he stays here, there is really nothing to attract him.

He was born in the world's top cardiac surgery temple, and he is the strongest cardiac surgeon in the world...

If you want to make him excited, money, power, status, etc., all of these things are useless.

The only thing is that it is a surgery that is superior to him and he has not yet mastered.

In the past few months, the essence of various surgeries developed by Xu Qiu within Linyi, such as total laryngectomy, heart repair, small blood vessel replacement, etc., has been learned by Joseph.

If you want to keep a living fossil of cardiac surgery here, you have to come up with something more important.

"Everyone..."

In the conference room of the cardiac surgery department, Xu Qiu was about to start teaching the last lesson when he suddenly heard hurried footsteps outside the door.

Liu Susu interrupted the meeting, looking anxious: "Doctor Xu, a critically ill patient has come to the emergency department. Director Wang believes that it may be an aortic aneurysm, and you need to rescue him!"

"I hope you will continue to study and put the patient's health first... It's over, goodbye."

The whole audience was stunned.

This, this, this, is this your last lesson?

Suddenly, Liu Susu at the door hesitated, his eyes shuttled around the meeting room, as if looking for someone, and said at the same time: "Doctor Xu, this patient... is very special!"