Sleepless Doctor

The latest website: "Boss, you violated the principle of sterility!"

"Bellak, please recite the sterile principles of the operating room to me." Wu Mian squatted on the ground, muttering.

"First, the operator's back below the waist and above the shoulders and below the edge of the operating table should be regarded as a bacterial zone and should not be touched."

"second……"

"third……"

"Eighteenth, if the surgeon needs to change positions, he should take a step back and then turn back to back to another position. If you need to change to the opposite side, you need to move from the left side of the instrument table to the opposite position."

"Tell me, which aseptic principle I violated? Did you think it out of thin air? Or if you didn't hit you with the hemostatic forceps for a few days, you felt uncomfortable." Wu Mian put down the sterile sheet on the patient's foot. Stand up and ask, "What disease do you consider?"

"Uh... intestinal perforation, acute peritonitis," Professor Barack replied.

"how come?"

"ulcer."

"How did the ulcer come?" Wu Mian asked while watching Professor Barak's operation, without any thoughts of brushing his hands on the stage.

"According to the theory of the brain-gut axis, it is generally believed that after the cerebral cortex receives adverse external stimuli, the blood vessels and muscles of the intestinal wall are spasm, which makes the intestinal wall cell nutrition disorder and the resistance of the intestinal mucosa decreases, making the intestinal mucosa vulnerable to digestion. Liquid digests and forms ulcers."

Professor Barak’s basic skills are solid. Wu Mian asked what he asked and answered casually without hesitation.

"What you are talking about is mainly duodenal ulcer, not colon ulcer." Wu Mian squinted his eyes to see Professor Barak's operation, only to talk about the condition and did not raise any objections to the procedure.

"Boss, you must have a definite diagnosis, what is it?" Professor Barak was familiar with Wu Mian, he asked.

"Tell me, why call me." Wu Mian did not answer, but continued to ask Professor Barak.

"When I checked the patient, I felt that something was wrong. He had too many red macules on his body! Boss, when I saw it at first glance, I felt that the patient was alienated, and then the surface symptoms would appear."

"Don't be nonsense, this is Huaxia, some jokes can't be played." Wu Mian said lightly, "Your first instinct is very keen, and the source of the patient's intestinal disease is indeed related to the red macules on the surface of the skin."

"Praise the great Barak!" Professor Barak looked at the opposite screen intently, skillfully operating the endoscopic device to remove the intestines. But the tone of his speech was extremely excited, and the language and movement were separated, as if two completely different people.

"I guessed it!"

"No, I guessed it. At the time, you just said that the patient was alienated, but I didn't think it was right, so I called the boss."

"How could it be, obviously you were..."

The two Baracks quarreled.

"Shut up, this is the third time I have said it." Wu Mian said, "Is the scope of excision confirmed?"

"Boss, I personally went to the endoscopy room and looked at the entire colonoscopy record. I only need to remove a 34cm intestine."

"It's still too long, you just need to sew up the broken intestines."

"My god! Are you crazy boss!" Professor Barack said in surprise, "Did you not have a colonoscopy? The patient's colon ulcer is too heavy, I doubt whether there will be cancer. No, no Will it, but there is already cancerous tissue."

"Bellak, do you doubt the boss's judgment? Is it true that wearing protective clothing and performing emergency operations every day causes you to have cerebral ischemia and hypoxia, causing you to forget that the boss's words in the medical team are the truth?"

"No, I insist that a part of the intestine needs to be removed. 34cm is the shortest way I can think of. If it is less, patients will continue to relapse after surgery."

"Barack, no need." Wu Mian said, "The patient's diagnosis is malignant atrophic papulosis. Of course it is a preliminary diagnosis. To confirm the diagnosis, you need to remove a piece of epidermal tissue after the operation.

"Malignant atrophic papulosis? Is it skin cancer?"

"Barack, that's it? You deserve to say that you are the world's top expert? I feel that you need to go back to Massachusetts Medical School to study for another five years. It is hard to imagine that your basic knowledge is so weak." Wu Mian coldly Said.

Zheng Kaixuan was sweating profusely when Wu Mian said this.

He and Professor Barack believe that malignant atrophic papulosis is a skin disease and has nothing to do with intestinal ulcers.

It seems that Teacher Wu is usually too polite to himself... Zheng Kaixuan thought helplessly.

"Boss, believe it or not, except for dermatologists in Massachusetts, no one knows the existence of malignant atrophic papulosis?!" Professor Barack argued.

"That's because you don't know, do you want to make a bet? I'll call now. If anyone knows, you..."

"Oh, no! Only those **** in Cleveland will bet with you!"

"Sew it on, rinse, and the operation is over. By the way, don't forget to cut a pathological specimen and I will do intraoperative freezing."

"What about the patient?"

"Send back to the ward, I will talk to the doctor here about the next treatment plan." Wu Mian said.

"It's amazing, boss, what is malignant atrophic papulosis? Why does maculopapular disease cause intestinal problems?"

"This is a disease of skin-intestinal or other organ endoarteritis followed by thrombosis. There is no definitive evidence of pathology and genetics for the time being, but the diagnosis is okay, and there are relevant clinical treatment standards. ."

"Boss, you are so knowledgeable!"

"You know too little. I remember that 3 years ago, specifically on October 22, 2017, Tom's medical team admitted a patient ~www.wuxiaspot.com~ which is a very typical malignant atrophic papulosis. At that time, I Speaking to Tom, but he insisted on cutting off the 80cm intestine."

"I remember that the patient died later! Poor little guy, he was only 22 years old."

"The cause of the disease is still unknown. Some think it is related to autosomal dominant inheritance, autoimmune abnormalities, decreased fibrinolytic activity, and lentiviral infection. Tom didn't think I was right, so he rejected my opinion, that **** fellow !" Wu Mianping said flatly, "but he can be misdiagnosed, you can't, you are a member of my medical team."

"Boss, are you sure?"

"It is confirmed that this disease can be divided into two types, skin-type malignant atrophic papulosis and systemic malignant atrophic papulosis.

The skin type accounts for about 1/3, which only shows skin lesions without systemic lesions, and can survive for more than 14 years. Systemic malignant atrophic papulosis often involves multiple system organs within weeks to several years after the appearance of the rash, with a high fatality rate. "

"So, try to make the patient less affected by the operation, which is very good for future recovery."