This doctor has a system

Chapter 507 570. Drawing big pictures every day, bah!
The boss shared with his subordinates the exact words he had been scolded for, and immediately felt much better.

"Watch out for those rubbish!"

"We must deal with it strictly and severely according to the law!"

Officer Zhang was sweating in the hot weather. After hanging up the phone, he couldn't help but look back and met Gao Feng's deep eyes.

"Hello, Professor Gao."

"Thank you for your hard work, Officer Zhang."
-
"How is it?" Academician Bao asked, "Is everything going well?"

"Everything is fine." Gao Feng replied with a smile.

"That's good." Academician Bao was very happy. "Take a good rest for two days. The journey must have been very tiring."

After saying goodbye to teacher Gao Feng, he went to the laboratory again. It was a busy scene inside. Dr. Gong was overjoyed to see him and asked him several questions.

Gao Feng was very satisfied. The fact that he could ask these questions showed that the progress was faster than he had imagined.

When I came out of the laboratory, it was already past 8 o'clock in the evening. Just as Li Youliang and I sat down to eat something, Zhang Zhengye called.

"Gao Feng, where are you?"

"I'm eating outside." Gao Feng replied, "What's wrong?"

"Will you come to the department tomorrow? I want you to see my nephew's film."

Could it be some difficult or complicated disease? Gao Feng thought, and he immediately agreed.

The laboratory is still brightly lit at this moment.

Wang Liang is doing his regular overtime work.

"Brother Liang, can two people really develop feelings for each other after spending a long time together?" a team member asked.

This team member spent a lot of effort to pursue his girlfriend, who was moved by his actions and agreed. Now that he has calmed down, he wants to regret it.

He thought of many ways and did a lot of work, but now that they have been together for quite some time, they still feel a little distant.

"A man and a woman?"

"What do you think?" said a team member. If two men can develop feelings for each other after spending a long time together, then no one would dare to work overtime with you here so late at night.

"Of course that's true. They say love grows over time." Wang Liang replied while shaking the beaker.

"What if there is no love?"

"That's because you didn't do it long enough." Wang Liang said.

Gao Feng came to the office early the next morning. Zhang Zhengye was already there. When he saw him, he turned on the computer without saying a word.

The patient is Zhang Zhengye’s nephew, who is only 36 years old this year. He underwent a physical examination at his unit a few days ago, during which a mass was found in his right lung.

Gao Feng carefully looked at his chest CT scan: there was an obvious mass in the right lung, combined with atelectasis of the right middle lobe. The right middle lobe bronchus was completely blocked, and part of the lower lobe bronchus was also affected.

Based on the imaging findings, such lesions are almost certainly tumors.

The good news is that there is no obvious mediastinal lymph node enlargement and the clinical symptoms are not obvious.

But the boundary is not very smooth, and the benignity may be relatively small.

"I thought so too." Zhang Zhengye sighed. His nephew was so unlucky.

The next step is to do an enhanced CT thin-layer scan and make an appointment for bronchoscopy.

The patient's name was Zhang Qiang. When he saw several people coming in, he tried hard to put on a smile, but Gao Feng still noticed that he looked a little depressed.

This is normal. After all, he is only in his 30s. You can imagine the pressure he must be under when he suddenly finds out that he may have a cancer.

Fortunately, Zhang Qiang has a relative who works in a big hospital, which brings some comfort to his confused heart.

"Don't look so sad. Imaging examinations cannot be used as a basis for a diagnosis." Director Zhang said comforting words that he himself did not believe.

"Weiye, I saw an old doctor on the Internet who is the best at treating lung tumors." Zhang Qiang's mother said, "Do you want to go see him?"

"I think it's quite close, and it won't take too long."

"You are just talking nonsense!" Zhang Zhengye was a little speechless. It would be fine for most people to have such thoughts, but he is the deputy chief physician of the Department of Respiratory Medicine of Xhe, and he didn't expect that his sister would be like this.

"He has a secret recipe, passed down from his ancestors, and has cured many people." Zhang Qiang's mother showed him her cell phone.

"Just treat these mysterious things as news." Zhang Zhengye was too lazy to take a look.

There are endless reports of various miracle cures and miracle drugs in China's written and online media, with a new batch popping up every once in a while.

Some claim that they can cure high blood pressure without side effects in just a few courses of treatment, some claim that they can cure diabetes in just a few days, and some claim that they can cure various tumors.

If these miracle cures and miracle drugs were real, then the world's medical problems, including cancer, would probably have been almost conquered.

But I don’t know if you have noticed a very interesting phenomenon: almost all the miracle doctors and miracle drugs are hidden among the people.

You can't meet a miracle doctor or find a miracle medicine in the best tertiary hospital in the country.

Why is it that these miracle doctors who hold miracle drugs that have solved world-class medical problems, such as those who can cure cancer, almost all hide in small clinics and hospitals, or even simply practice medicine without a license?
That depends on different people’s opinions.

Perhaps they are indifferent to fame and fortune, or are too selfish and unwilling to benefit the vast number of patients.

The results of the enhanced CT scan came out very quickly. Gao Feng let out a light exclamation after opening it.

"What's wrong?" Zhang Zhengye asked.

“It looks better than I thought.”

"Better than expected?" Zhang Zhengye was a little puzzled.

"Yes." Gao Feng replied, "It may be a tumor with a lower malignancy."

Zhang Qiang had a mass in his right lung near the hilum. Generally speaking, if it is central lung cancer, squamous cell carcinoma is the most common, followed by small cell carcinoma.

Because the mediastinal lymph nodes were relatively clear and the possibility of small cell carcinoma was low, Gao Feng initially thought that squamous cell carcinoma was more likely.

But enhanced CT provided more information, and patient Zhang's middle lobe bronchus was basically blocked.

The outer wall of the dorsal bronchus has also been affected, and the side of the opening close to the middle lobe bronchus also seems to be affected. This is not good. A simple middle lobe resection will definitely not be able to completely remove the tumor.

But the edge of the tumor was quite smooth, and Gao Feng discovered that the surrounding tumor did not flatten the pulmonary artery.

The nearby blood vessels were not invaded, compressed, or deformed by the tumor, which indicates that the tumor is weakly invasive and does not conform to the imaging manifestations of normal squamous cell carcinoma.

"We can look forward to the results of the bronchoscopy." Gao Feng said.

Zhang Zhengye admired his eloquent talk very much. He had been working for nearly 20 years, and everyone knew what kind of hospital Xhe was.

Therefore, Zhang Zhengye has always had a slight sense of superiority. He feels that his level is definitely among the top few among his peers.

But facing the young Gao Feng, this sense of superiority had long disappeared. He could not understand why the other party could get so much information from the same film.

Even those big names in the imaging department who have been reviewing films all their lives are probably only as good as this.

"Then let's wait for the results of the bronchoscopy." Zhang Zhengye felt relieved. The bronchoscopy went smoothly. When the endoscope entered the middle trunk and bronchus, the culprit was immediately seen.

The lumen of the middle bronchus is blocked by a neoplasm. The surface of the neoplasm is honeycomb-like and rich in blood vessels. It does not appear to be benign at first glance.

Now Zhang Zhengye's face turned a little ugly.

He performed the biopsy patiently, and when he saw that there was no bleeding, he withdrew the mirror.

Everyone knew that the patient was his nephew, and they all felt some sympathy.

Gao Feng, who was standing aside, seemed to be thinking about something. To be honest, he had not expected the performance under the bronchoscope.

Central lung cancer is not like small cell lung cancer. It is less invasive and cannot even press on the pulmonary artery. Its edges are still so smooth.

However, the lesion was clearly malignant under bronchoscopy.

This is still quite strange.

Gao Feng thought about it and felt that the possibility of squamous cell carcinoma was very small. Instead, it was more likely to be a borderline tumor or a benign tumor with a lower degree of malignancy.

He shared his ideas with everyone.

“It could be a carcinoid, or if it’s not possible to differentiate between typical and atypical carcinoids, then the diagnosis could be a neuroendocrine carcinoma.”

"That's a possibility," a director hesitated. In fact, he thought it should be a highly malignant squamous cell carcinoma or small cell carcinoma, but what Professor Gao said seemed to make sense.

A group of doctors in training started chattering about the topic.

"Can this kind of information be revealed from this film?" A man looked at Zhang Qiang's chest CT scan from left to right.

"Professor Gao can do it, but we definitely can't." Another doctor said with a smile, "I still need to read the report from the imaging department most of the time."

The interpretation of imaging is not simple. Most doctors have not worked in the imaging department systematically. As for the little knowledge of imaging that they learned in college, those who understand it know it well.
You don't really think it can be used for medical treatment, do you?

Many doctors’ attainments in imaging come from their superiors. Generally speaking, your superior’s level of reading determines your level of reading.

There are some people who can break this limitation, but they are few and far between. It is not easy to find a good teacher at work.

You have to spend a lot of time studying, and the second is to read more.

"Professor Gao, could you tell us about chest CT?" A young doctor said, then felt that his suggestion was a bit abrupt. "I just said it in the heat of the moment." His face turned red.

"Sure, I have time today." Gao Feng said with a smile. As his status increased at a visible rate, he hadn't given lectures to his students for some time.

"Let's first look at the normal chest CT findings"

"Under your earnest guidance, Cai Changning and Yan Ziyan's imaging skills have improved, and you have gained 5 skill points," the system prompted.

It seems that everyone did gain something, although not much, Gao Feng thought.

Le Xiaochun from the Pathology Department was looking at a specimen intently, and he was a little undecided.

"Old Yao, come and take a look."

Director Yao stepped forward to take a look and found obvious cell atypia, but no nuclear division was observed.

"It's hard to say. We still need to do immunohistochemistry."

"That's what I thought, too." Le Xiaochun said, "The patient seems to be a relative of Director Zhang of the Respiratory Department."

"I don't think it's a typical malignant tumor." Director Yao judged based on his experience, "You'd better call and ask about the patient's medical history in detail and combine it with the clinical data."

Three days later, the final result came out. The pathology report stated: bronchial carcinoid. It is recommended to radically remove the specimen and conduct a comprehensive evaluation.

Zhang Zhengye was a little happy when reading the report. Carcinoid is not a rare disease, but the incidence rate is also very low. In his nearly 20 years of practice, he has only seen two cases.

The symptoms of the two patients were more obvious, including dyspnea, hemoptysis, cough, etc.

Surgery is the preferred treatment for carcinoid tumors. The location of the lesion on Zhang Qiang's lung was acceptable and the size was not large. After evaluation, the thoracic surgery department felt that it could be performed under thoracoscopy.

"It is a single-port thoracoscopic right lung middle and lower lobectomy and lymph node dissection."

"You have to take the trouble to do this. This is my nephew." Zhang Zhengye said to the director of thoracic surgery who came for consultation, "Have a preoperative discussion with the whole department before the operation and think through every step of the operation."

"Be sure to cut it cleanly and within safe limits."

"If you want anesthesia, ask Director Yue. I trust him to do it."

"By the way, we need to arrange a single room for us."

"No, you're asking for trouble?" The head of thoracic surgery wanted to spit in his face. "You're asking for so many things, why don't you just give me a red envelope?"

"That would be harmful to you," Zhang Zhengye said, "How could I do such a thing?"

The final pathological results still indicated carcinoid, and Zhang Qiang and his family finally felt relieved.
-
In the office of a medical company, the boss and a young employee are battling.

"Where did you go after get off work last night?!"

"It's already time to get off work, why are you caring about me?" said the young man.

"What do you mean?" the boss was furious. "You can leave after get off work? I haven't even left yet!"

"It's your freedom if you don't leave. No one will care if you live here."

The boss was shocked, he had never met such a great employee.

"How can you talk to Mr. Ai like that?" Someone nearby said, "Look how angry Mr. Ai is."

"Lackneck!" said the young man.

"What did you say?!"

"You are a lackey."

Mr. Ai was even angrier now, "People like you don't have any gratitude at all!"

"I work diligently and don't slack off, so why should I feel grateful to the company?" the young man asked. "I've given so much, and it's good enough that the company doesn't feel grateful to me!"

"You're just making empty promises every day. Ugh!"

"Young people should not be too concerned about gains and losses in the workplace!" President Ai taught, "I went through the same thing when I was young."

"If you don't care about gains and losses in the workplace, will you care about it at the crematorium?" the young man retorted, "You'll care about how well you roast yourself, right?"

"Fire him!" President Ai yelled, "Today, no, get him out now!"

The young man snorted coldly when he heard this, turned around and went to pack his things.

"Mr. Ai, this...isn't inappropriate?" someone whispered.

"Isn't this inappropriate?!" Boss Ai was furious. "Didn't you see how he talked to me?"

“But Xiao Dong is in charge of the company’s two major projects right now,” the man said, “I’m afraid if he leaves.”

(End of this chapter)