This doctor has a system

Chapter 282.
"By the way, what antibiotics did your uncle use over there?"

"Let me ask." Zhao Yujie quickly called.

"Ceftriaxone sodium combined with vancomycin."

"Ceftriaxone sodium?" Gao Feng's eyes lit up. He seemed to understand what was going on. "I think there may be no need for any more surgery."

"Why?" Li Xun was a little confused. Isn't ceftriaxone sodium a third-generation cephalosporin that is very common in clinical practice?Can patients with calculus cholecystitis avoid surgery?
"Ceftriaxone sodium has a rare adverse reaction." Gao Feng explained, "It can increase the risk of gallbladder stones and urinary tract stones."

"The main component of stones is ceftriaxone calcium salt, and the formation mechanism has not been fully understood so far." In fact, the formation mechanism of most diseases is still not clear yet.

"The possible cause is that the chemical structure of ceftriaxone sodium contains anionic groups such as sodium amide and sodium carboxylate, which easily form insoluble precipitates when it comes into contact with calcium ions in the human body."

“When passing through the gallbladder or kidneys, due to the concentrating effect of the gallbladder on bile and the kidneys on urine, its concentration in the gallbladder and kidneys increases significantly, thus forming a supersaturated solution, which in turn causes ceftriaxone to form a large amount of calcium ions. The insoluble calcium salt of ceftriaxone precipitates, and the precipitates accumulate to form stones.”

"Is it so magical?" Li Xun said that this was the first time he knew this knowledge.

"Then anyway, since the stones have formed, don't they need to be taken out?" Zhao Yujie asked her own question.

"It's generally not necessary because this process is reversible." Gao Feng explained to everyone.

"After stopping the drug, as the concentration of ceftriaxone decreases, the ceftriaxone salt gradually dissolves again, so the previously formed stones generally disappear on their own within 90 days of stopping the drug. This is different from ordinary stones, so it is called "Reversible stones" or "pseudolithiasis." "

"Furthermore, in your uncle's case, vancomycin alone should be fine, and ceftriaxone sodium can be stopped."

"Then I'll ask my family to communicate with the doctor over there." Zhao Yujie was very anxious. It would be great to save the uncle from being stabbed.

"What are you talking about?" Wang Dalong from the General Surgery Department of the County Hospital couldn't believe his ears. Gallbladder stones caused by drugs?are you kidding me?
"Hahaha." Since he had no professional training, Dr. Dalong couldn't help laughing on the spot.

This made the atmosphere a bit awkward.

"Doctor, we don't understand either. It was my niece who said it." Zhao Yujie's uncle explained.

"Oh, is your niece also a doctor?" Wang Dalong asked, "Where does she work?"

"She is a nurse at the Provincial People's Hospital."

"That's it." Wang Dalong considered, "There is a big difference between nurses and doctors. Nurses are mainly responsible for nursing matters. As for treatment, you must still listen to the doctor."

"Then we listen to you." Zhao Yujie's uncle felt that what he said made sense. In his impression, Zhao Yujie was still the little girl who squatted at the door and cried every day.

Back at the doctor's office, Wang Dalong told this incident as a joke to his colleagues, thinking it would make everyone laugh.

"I think the nurses at the Provincial Hospital are of relatively high quality in all aspects, and they should not talk nonsense." Unexpectedly, an older doctor was the first to speak up.

"I haven't heard of any medicine that can cause gallbladder stones." Someone hesitated, "Did she say which medicine it was?"

"How about I ask again?" Wang Dalong hesitated.

"Ceftriaxone sodium?"

"Read the manual quickly!"

"It really does! It was mentioned above that a rare side effect may occur in clinical application: gallbladder symptomatic ceftriaxone calcium salt deposition!"

"Damn it! The provincial medical department is awesome! How can a nurse have this level of skill?" A doctor was shocked. He had been working for more than 10 years, and this was the first time he knew that ceftriaxone sodium had this side effect.

"Director Zhao, have you met him before?"

Director Zhao, who has been working for more than 30 years, shook his head when he heard this, "I've never seen it before. It's mentioned in the instructions. It's a rare side effect."

"How can we be so lucky in this small place like ours?"

"I think we still need to observe. Maybe it's not caused by ceftriaxone sodium?" Someone expressed a different opinion, "The patient may have had gallbladder stones before."

What he said made sense. After hearing this, Wang Dalong flipped through his phone and made a call to the imaging department.

Generally, when a patient undergoes chest CT, the imaging doctor will scan down an extra distance. Part of the liver and gallbladder can be seen in this extra distance.But it will not be displayed when the film is released.

"Old manager, please help me take a look at Zhao Yuzhu's CT. The hospitalization number is 29973. It was done twice. Can you see if the complete gallbladder was scanned in the first chest CT."

"If so, help me take a closer look to see if there are any gallbladder stones at that time."

"There are no stones." The old manager gave a definite opinion.

"What about the second abdominal CT?"

"There are stones this time."

"Hey, that's not right. I see that your two CT scans were less than a week apart!" the old manager said.

"Can gallbladder stones form so quickly? It seems unscientific."
-
Provincial emergency department

Director Hu from the General Surgery Department and Director Liu from the Vascular Surgery Department were looking at each other.

"Old Liu, do you dare to pull it out?" Director Hu asked.

"I don't dare, do you dare?" Director Liu
"I don't dare either."

"What should we do?" Director Hu was a little helpless.

"I don't know either." Director Liu was also worried.

"Gao Feng!" The two looked at each other and suddenly felt happy in their hearts.

The emergency patient, female, 22 years old, was stabbed in the waist with a dagger by one of her boyfriends because of an emotional dispute.

"Such a long dagger?" Gao Feng was very surprised, "Is this for killing pigs?"

"Looks like..."

The patient will lie on his side on a flat car, accompanied by two male family members. A CT scan has been done, and the situation is not optimistic. On imaging, it can be clearly seen that two relatively thick blood vessels have been penetrated by a dagger.

The patient's general condition is okay, blood pressure is normal: 118/80mmHg, heart rate is slightly faster: 108 beats/min, breathing is 16 times/min, and pulse oxygen saturation is 99%.
"With such a thick blood vessel broken, bleeding is unavoidable when the dagger is pulled out." Director Hu communicated the condition with the family members nearby, "The operation is very risky, you must be aware of this situation."

A male family member said with worry on his face, "Doctor, you have to treat her well."

The other one just started crying.

Director Hu had a headache for a while, "Okay, come over and sign. Who are you all like her?"

"I'm his boyfriend."

"Me too."

"How many boyfriends does she have?!!" Director Liu broke his guard, "Where is her family?"

"Her husband is stuck on Jingsan Road right now. It will probably take more than 10 minutes," a boyfriend said. "Okay, let's prepare for the surgery first." Director Hu tried to calm down, "Wait until her husband comes and then sign."

About 15 minutes later, a man with a green light on his head came to the door of the operating room, "Doctor, how is my wife?"

"This will be fine, but the location where the dagger was stabbed is very dangerous, and the operation is very risky." Director Liu explained to him, "Look at these two blood vessels."

The man signed it simply, "Sorry to trouble you."

Director Liu looked at this gentle man and felt very sorry for him. He was hesitating whether to say a few words when he saw the man walking towards the two "boyfriends".

Isn't it going to be a fight?He was a little worried.

Then he saw the three people hugging each other, "Don't worry, I think Xiaohui will be fine." The man comforted the two.

I am Nima..
I may really be old. Director Liu walked into the operating room with complicated emotions.

The operation went extremely smoothly, and Gao Feng couldn't even help. After the wound expanded, several people made adequate plans, but when the dagger was pulled out, they found that there was very little bleeding.

"She is indeed a woman who has had four men." Director Liu praised, "Luck and strength coexist!"

"It's too small." Director Hu said.

"What's too small?" Director Liu
"The pattern is smaller." Director Hu said, "It doesn't have to be just 4! With her ability to make her husband and boyfriend get along harmoniously, I wouldn't be surprised if she has 8 men."

"What ability?" Gao Feng asked, "If I remember correctly, she seemed to have just been stabbed by her boyfriend, right?"

"It seems that the old saying that everything comes down to three things is true!" Director Liu
"What did you say? Don't you want to continue the training?" Qi Nannan's father's eyes widened, "What kind of trouble are you going to make?"

"Isn't it because I haven't found a good job in my training?" Qi Nannan was not afraid of him at all. "Now that I have found a job, why do I need to continue my training?"

"I don't care what you say, you go back to the hospital immediately." Dad Qi was very angry. "I asked your uncle to say hello. When you finish your training, you will go to work in the obstetrics and gynecology department of our county hospital."

"This is an iron rice bowl! Do you know how many people are watching?"

"Where's my mother?" Qi Nannan asked.

"She went out to buy groceries." Dad Qi replied, "Qi Nannan! I'm talking to you! Are you listening?"

"I'm going to find my mother." Qi Nannan left home with a small bag on her back.

"Rebellious girl!" Qi's father was extremely angry. He had known that he was not used to raising her before, but now he has no deterrent effect in front of his daughter.

"How could you just skip the regular training casually?" Qi's mother also looked anxious, "You are the one who is going to the regular training, and you are the one who quit midway!"

"Why don't you have any perseverance? You must give me a reasonable explanation today!"

"My job is quite good now." Qi Nannan quickly explained that she could deal with her father, but she didn't dare to be presumptuous in front of her mother, who really knew how to slap her.

"There was a teacher who founded a company before, and I..."

"That's the situation." Qi Nannan said, and she also showed her bank card balance to her mother.

"With so much money, is the nature of the job regular?" Qi's mother was a little surprised.

"Look what you said." Dad Qi was speechless, "With your daughter's figure and appearance, I don't think she can find an irregular job."

"What you said, you are really my biological father!" Qi Nannan, who was drinking porridge, almost choked to death.

The place where Qi Nannan was born is a typical fifth-tier small county in China. It looks shabby, but the pace of life is very slow. Qi's father is an electrician at the power supply bureau, and Qi's mother is a primary school teacher.

She also has a younger brother who is currently in his third year of high school with average grades and is in a state of limbo.

"Sister, why are you back?"

"What's wrong, you're not happy when I come back?" Qi Nannan gave him a slap in the face, "Who asked you to put a bunch of broken things in my house?"

"It wasn't me, it was our mother who let it go." The younger brother felt a little aggrieved.

"Shut up, that's all yours."

Qi Nannan stayed at home for five days, but she felt uninterested. Most of the peers she knew were not at home. Those who were at home were already married and had children. There was no common topic at all.

This is also the reason why many people are always used to staying in big cities. They are used to a fast-paced life. Suddenly returning to a small county with a slow pace will be very uncomfortable, especially when they are alone.

"You must at least get a bachelor's degree." Qi Nannan told her younger brother, "If you don't pass the exam this year, just repeat it."

"Then what if you fail to pass the exam if you repeat the exam?" Qi's father said at the side.

"Then kill him!" Qi Nannan said fiercely, "Do you know that the current warehouse managers in our company all have bachelor's degrees?"

"Ah?" The younger brother opened his mouth, "Is it so exaggerated in a big city? Besides, are there really undergraduates who work as treasury managers?"

Of course there is, it’s your sister and me, Qi Nannan thought to herself.

"Don't underestimate treasury management. There are many professional things nowadays, and you won't be able to learn them even if you don't go to college for a few years."

When she returned to Z University, she found that most of the people had returned, and some people had not even rested.

"Have you gone back for a blind date?" Hu Jiaran asked.

"No, blind dates usually take place at the end of the year, right?" Qi Nannan replied, "Have you gone on a blind date?"

"Yes, Brother Youliang introduced me to a doctor from the hospital." Hu Jiaran looked a little confused, "I met him a few times, but he didn't seem to call me."

"Come and check the chat history for me and see if you can analyze in detail whether there is any problem with my communication."

"I guess I can't help." Qi Nannan was a little unhappy, "I've never been in love."

"It's okay. Although you are physically a woman, you are still a woman." Hu Jiaran pulled her away and said, "Just start with a woman's thoughts and see if she is interested in me."

"The lab will continue to be busy soon. If it doesn't work, I won't talk to her. It's so tiring to find topics every day!"

"Dating is very tiring." Qi Nannan said, "If you are afraid of being tired, it is best not to find a girlfriend."

"That said, it's not good to sleep alone all the time." Hu Jiaran was very confused, "My mother was urging me some time ago."

"There's a huge problem with your chatting style!"

“When people ask you what you are doing, they don’t necessarily want to know what you are doing.”

"What she may want to express is that I am free at the moment, or she may be complaining to you in a subtle way that you have not talked to her for a long time."

"And even if you are doing an experiment, you don't need to explain the specific experimental conditions to her one by one, right?"

(End of this chapter)