I am a kryptonian doctor

Work in the emergency room is busy and fulfilling.

Just now, Yang Tian was busy with a small operation, and a child's arm was broken and a long gash was opened. Surgical suturing is required.

Originally, it would be more difficult to sew such a child. After all, the child kept crying and refused to cooperate.

Fortunately, Yang Tian was very fast and could finish it in three minutes, and the wound was sutured beautifully and neatly. I received a lot of praise from my family

"Is there any more surgery to be done?"Yang Tian walked out of the temporary operating room and asked a doctor

"Yang Tian, go and have a look at Zhang Zongrong. I think he is very busy today as he attends clinics and performs surgeries."Dr. Wang said with a smile. Since the arrival of Yang Tian in the emergency room, the entire emergency room has become a lot easier.

Because Yang Tian not only does the surgery well, but also does it very quickly. One person can be used as three people, so that The workload of many doctors has been reduced a lot.

"OK, I'll go take a look."Yang Tian walked to Zhang Zongrong's consulting room.

At first glance, there were really many patients queuing up.

At this time, Zhang Zongrong was treating a patient. At this time, he frowned nervously, picked up an examination report, looked at it, and frowned again , put it down and picked up another medical record to look at it, frowning again

"Lao Zhang, what's wrong? I see you keep frowning. Yang Tian walked in and asked with a smile.

"Xiao Yang, you're here at the right time. I've met a patient here whose cause can't be found through examination!"Zhang Zongrong said to Yang Tiandao

"oh? Let me see."Yang Tian took a look at the examination reports. Among them were intestinal examination and gastroscopy, but the examination reports proved that they were normal!

"Doctor, can't you even see what's wrong with me?"The middle-aged man patient asked with a grimace.

"How is the patient? Yang Tian asked with a frown.

"The patient has difficulty swallowing, abdominal pain, bloating, abdominal mass, jaundice or melena, etc. At first I thought it was ordinary intestinal indigestion or a stomach bug. When I heard that he also had jaundice, I thought it was appendicitis. These examination reports were all examined by him in other hospitals. But the inspection report showed that there was nothing abnormal! Zhang Zongrong said solemnly

"Doctor, when this situation first appeared, I went to the county hospital for examination and took medicine, but it didn't work.

The test results were normal.

I went to the city hospital for a checkup and it was still normal!

Then I went to another hospital in the city for a check-up, but there was still no abnormality.

Once I heard that Jiangbei First Hospital is the best hospital in the province and a famous hospital in the country, so I came...

Could it be, what's your problem? ?"The male patient said exhausted.

After going to so many hospitals, not only was the disease not cured, no, he didn't even know what the disease was, and he spent a lot of money. But in the end, it was of no use.

"Lao Zhang, can't you see it either?"Yang Tian asked the other party. Zhang Zongrong is a relatively senior attending physician and is about to be promoted to deputy director. He can't see any problem, so this patient is a bit strange!

"I can't tell at the moment. I think a comprehensive inspection of the whole system may be needed to make a judgment."Zhang Zongrong could only sigh.

He knew that a comprehensive examination would definitely cost the patient a lot of money, but there is nothing we can do about it. This disease is indeed a bit strange. Did you say you have a stomachache? There is no problem with your intestines and stomach. You said It's jaundice, but it's not appendicitis!

After hearing this, Yang Tian immediately opened the surgical diagnosis for investigation.

The next moment, a piece of information appeared in his mind - neuroendocrine tumor!

"It turned out to be this disease!"Yang Tian secretly thought: No wonder. This disease is difficult to detect!

Neuroendocrine tumors can occur in multiple organs and tissues in the body except for hair and nails. The clinical manifestations are extremely complex and changeable. The most famous case is that the disease occurs in The pancreas took away the founder of the fruit company.

Not only ordinary people, but even doctors in many small hospitals do not know enough about this disease, including its different genetic levels, biological characteristics, treatment responses, and different medications.. Therefore, misdiagnosis and failure to detect may occur.

Because it requires special examination methods, such as tumor marker examination, imaging examination and pathological examination, among which imaging examination uses endoscopy, endoscopic ultrasound, and ultrasound.、CT、PET-CT、MRI、Somatostatin receptor imaging is an important means for localizing and diagnosing neuroendocrine tumors.

Most neuroendocrine tumors are sporadic and their exact cause is currently unknown. However, a small number of neuroendocrine tumors are related to genetic factors, involving deletions and mutations in some genes, such as multiple endocrine tumors and Lindau syndrome.

According to whether the tumor has hormone secretion function and whether there are clinical symptoms caused by hormones, neuroendocrine tumors are divided into two categories: non-functional (about 80%) and functional (about 20%).

Non-functional gastroenteropancreatic neuroendocrine tumors mainly manifest as non-specific gastrointestinal symptoms or local tumor-occupying symptoms, such as progressive dysphagia, abdominal pain, abdominal distension, diarrhea, abdominal masses, jaundice or melena; functional gastric The main manifestations of enteropancreatic neuroendocrine tumors are related clinical symptoms caused by the secretion of biologically active hormones by the tumors, such as skin flushing, sweating, asthma, diarrhea, hypoglycemia, refractory peptic ulcers, diabetes, etc.

Functional gastroenteropancreatic neuroendocrine tumors are mainly pancreatic neuroendocrine tumors, including insulinoma, somatostatinoma, glucagonoma, gastrinoma, etc.

In other words, this disease is not only rare, difficult to diagnose, and has a high chance of being misdiagnosed, but it is also not easy to treat.

Clinical treatment of neuroendocrine tumors generally adopts biological therapy, chemotherapy and surgical resection. Among them, somatostatin analogues can be used as basic treatment, such as long-acting octreotide, which can reduce tumor secretion and inhibit tumors by promoting apoptosis and arresting the cell cycle. grow.

Having this disease not only costs a lot of money, but you also don’t know whether it will be successful. Anyway, this disease is very difficult to deal with!

"Yang Tian, what do you think?"Zhang Zongrong asked Yang Tian

"Let him have a neuro-tumor CT examination."Yang Tian said

"ah? Is this related to neurology?"Zhang Zongrong was stunned._Fei

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