White armor

Chapter 591 From a poor boy from the countryside to a relative

Miao Youfang stared at the panel in front of him in a daze.

After a lot of diagnoses, the final result is that one plus one may not equal two.

Sure enough, this illusory thing in front of me is useful, but not absolutely useful.

For some minor problems, it is definitely a powerful weapon, the kind that can shock the whole audience and make everyone drop their eyes when it is taken out.

But this time, although the patient's main complaint was only black stools, the panel gave countless diagnoses. There were so many diagnoses that it was dizzying, and Miao Youfang couldn't even arrange them in order.

Even with a magic weapon, he couldn't crush everyone, which made Miao Youfang extremely disappointed.

It seems that clinical practice is more complicated than I imagined.

Miao Youfang felt empty.

Although Mr. Luo did not come up with the answer himself, he wanted to ask a certain chief inspector of Jiangsu and Zhejiang Province for help, but...

Miao Youfang felt a little dazed when he thought of this. What the hell was the general ward round? He had never heard anyone talk about it before.

"Xiao Miao, not bad." Luo Hao smiled slightly and took another look at the bloody urine sample. "It's amazing that you can think of porphyria."

"Teacher Luo, I..."

"Clinical experience is very important. Many diseases interact with each other. Here, I'll give you this patient. Follow him and give me a condition analysis. Remember, it should be detailed."

"???"

Miao Youfang was stunned.

"Professor Luo's medical records need to be entered into the computer system so that they can be used for AI diagnosis in the future." Meng Liangren explained to Miao Youfang in a low voice.

Ai diagnosis, Miao Youfang was stunned.

"Professor Luo and the University of Technology's project uses AI for diagnosis. Who knows, someday AI robots will be able to act as doctors," Meng Liangren explained.

"Oh oh oh." Miao Youfang's expression looked a little better.

"Not long after deepseek came out, there was an AI hospital in Shanghai. I haven't seen it, so I don't know if it's a gimmick. But what Professor Luo did is definitely not a gimmick."

"Okay, that's it." Luo Hao clapped his hands, "Then you guys get busy, I'll go do it."

Luo Hao turned around, but saw a gloomy face.

Yang Jinghe?
"Director Yang, what's wrong with you?" Luo Hao was a little surprised.

"Damn, I feel uncomfortable. I guess you have finished teaching the students and came to see if you have left. I want to chat with you."

“???” Luo Hao looked Yang Jinghe up and down and saw that he indeed looked bad and gloomy, as if he was about to explode in the next second.

"Then let's go out for dinner. What's going on, Director Yang?" Luo Hao asked. "I still have to call Director Liu. He has a patient coming to see me this afternoon and he just asked about the diagnosis."

Luo Hao changed his clothes and called Liu Haisen to explain the situation while walking.

The patient's MRI showed small arteriovenous malformations in the brain, but the risk of bleeding and epilepsy was not very high.

Speaking of epilepsy, Yang Jinghe's expression looks even worse.

After Luo Hao finished the call, Yang Jinghe complained, "Xiao Luo, a patient over there had epilepsy after the particles were released, and the patient's family insisted that it was caused by these particles. Don't you think this is bullshit?"

"What position do you work in?" Luo Hao asked casually.

There are so many clinical complications that it is difficult to tell whether it is epilepsy or not.

"It was done near the pancreas, through the stomach." Yang Jinghe suppressed his unhappiness and said in a muffled voice, "He thinks with his stomach. His brain has grown into his stomach!"

Luo Hao paused for a moment, thinking, "Director Yang, how about we go see your patient first?"

"Huh?" Yang Jinghe was startled. "A neurotic patient, no, a mentally ill patient and a bunch of mentally ill family members, what's so good about that?"

"Well, let's go take a look." Luo Hao said with a smile, "We have to solve the problem after all."

Yang Jinghe was suspicious. How come Luo Hao was so confident immediately after she described the process? He even urged her to go see the patient.

"Xiao Miao!" Luo Hao turned around and waved to Miao Youfang who was a little confused in the office.

"Teacher Luo."

"Let's go to the consultation." Luo Hao called.

Yang Jinghe was stunned. Miao Youfang? He knows nothing.

This matter involves the handling of medical disputes. If Luo Hao takes Meng Liangren with him, it would make some sense.

But Miao You is only in his fifth year of college and is obviously a greenhorn.

Suddenly, Yang Jinghe's mind moved. Could it be that Miao Youfang had caught Professor Luo's eye? Was he going to help him gain clinical experience? !

I am!

In an instant, the way Yang Jinghe looked at Miao Youfang changed. That poor relative had grown up to be a very pretty person, with the appearance of a rare talent among men.

"Wait for me a moment, Director Yang."

Luo Hao went back to change his clothes. He was not in a hurry to leave. He and Yang Jinghe went to the radiotherapy department to see the patients.

"Professor Luo, do you think they are trying to extort money?" Yang Jinghe asked in a low voice as they walked on the road.

He highly suspected Luo Hao's psychological assessment that the patient's family who were causing trouble were similar to the family instigated by Wen Youren.

Director Wen said ~
Director Wen said~~
Yang Jinghe has also seen that video, it is so magical, and I don’t know who made it. To be honest, Professor Luo’s staff is really full of talented people.

In an instant, a flame of hope rose in Yang Jinghe's heart.

"Director Yang, I'll take a look first. I can't say whether it can be solved or not." Luo Hao did not take on too much responsibility, but gave a very stupid reply.

"Yes, yes, we must see the patient first." Yang Jinghe responded with a smile.

By the way, I took a look at Miao Youfang. Seeing that Miao Youfang had fallen into Professor Luo's eyes, I decided to go find him at home for dinner in the evening.

As for the dates with other girls today, just postpone them, Yang Jinghe thought to herself. How could a girl be as important as Professor Luo?

Not to mention Professor Luo, even compared with Miao Youfang, whom Professor Luo favored, the girl became dust.

"Director Yang, how many granules did the patient have during the operation? What medicine did he use after the operation?"

"..."

Yang Jinghe could only give a rough idea and felt a little embarrassed.

He didn't expect that Luo Hao would actually help him solve the problem. He just came here to complain.

"It's okay, it's okay. I'll go take a look." Luo Hao comforted Yang Jinghe.

Yang Jinghe nodded, came to the department and went straight into the director's office.

Luo Hao first read the medical records, and then he specifically asked Miao Youfang to stand behind him and read with him.

But Luo Hao saw things so quickly that Miao Youfang felt dizzy.

Medical records, surgical videos, and various test reports.

Half an hour later, Luo Hao finally understood what the problem was.

"Director Yang, let me take a look at the signed nursing record."

Yang Jinghe didn't even ask a single question, he just took whatever Luo Hao wanted.

The head nurse came over with the nursing record sheet. Luo Hao took it with both hands with a smile and read it page by page.

There is an electronic version of the nursing record, but Luo Hao wants to see the version signed by the nurse.

The time when the medicine was changed was recorded to the minute and signed by the nurse on duty.

After reading it all, Luo Hao felt confident.

"Xiao Miao, what do you think the problem is?" Luo Hao asked.

"..."

"..."

Miao Youfang and Yang Jinghe both fell silent.

Does Professor Luo really think Miao Youfang can know?
Just kidding.

Especially Yang Jinghe, he originally thought that Professor Luo was here to mediate the medical dispute, what if he had some means that he couldn't use?

But I didn't expect Luo Hao to see a doctor, have a consultation, and even test Miao Youfang.

"It's okay, let's go take a look and tell me when we come back." Luo Hao took Miao Youfang to see the patient.

Yang Jinghe followed beside him with a sullen face.

Although the patient's family was extremely uncooperative and even pushed him, Luo Hao was not angry at all. He just conducted a normal physical examination, asked about the patient's medical history, and then returned to Yang Jinghe's office.

"Xiao Miao, go ahead and speak." Luo Hao looked at Miao Youfang.

Yang Jinghe was suspicious.

That's it?

Is the patient's epilepsy a disease caused by surgery?

He went over it in his mind many times but couldn't come up with any reason.

The only possibility is that the pancreatic tumor causes abnormal insulin secretion, similar to an insulinoma.

but!
Yang Jing and Zao both noticed this and checked the patient's blood sugar every time he had an attack, and it was always normal. Theoretically, epilepsy has nothing to do with blood sugar.

Does Miao Youfang really know the answer?
Yang Jinghe's eyes also fell on this poor relative of his.

Well, at this time, Yang Jinghe already regarded Miao Youfang as his own relative, not that poor boy from the countryside.

"Teacher Luo..."

"Why do you think so much? Just say whatever you want to say. It doesn't matter if you are wrong. I am here for you." Luo Hao said vaguely.

Miao Youfang seemed to be encouraged. He calmed himself down and said, "Looking at the medical records and the physical examination, I suspect it is... I suspect it is... I suspect it is..."

Luo Hao frowned and looked unhappy.

“It’s antibiotic encephalopathy.”

"Is that right?" Luo Hao smiled. "It is indeed antibiotic encephalopathy, Director Yang."

Antibiotics, encephalopathy?

When these two words were put together, Yang Jinghe had no idea what they meant.

He has been using antibiotics for nearly 30 years and has never seen any antibiotic encephalopathy. Besides, why can antibiotics cause encephalopathy?

Countless questions swirled in Yang Jinghe's mind.

"Xiao Miao is good." Luo Hao smiled, "Can you explain it?"

Miao Youfang is a little bit stupid, but not just any stupid. He feels that Teacher Luo is simply a devil.

It seemed like I had been fooled. "Director Yang." Luo Hao did not embarrass Miao Youfang. Seeing that Miao Youfang did not speak, unlike the day when he diagnosed Madron's disease and quickly spoke one, two, three, four, five, he smiled slightly and looked at Yang Jinghe.

"Professor Luo, please go ahead." Yang Jinghe said cautiously.

"That's right. The possible mechanism of cephalosporin antibiotic encephalopathy is that after cephalosporin antibiotics enter the central nervous system, they competitively inhibit the inhibitory neurotransmitter receptors of γ-aminobutyric acid, also known as γ-GABA, in the brain, resulting in increased excitability of neurons.

This may lead to a series of central nervous system symptoms, and in severe cases may cause epileptic seizures or even death.”

Just as Yang Jinghe was about to ask a question, Luo Hao continued speaking.

"There are three main groups of patients who are prone to similar situations. The first is epileptic patients: cephalosporin antibiotics can induce epileptic seizures."

"The second type is patients with chronic renal failure and hemodialysis: cephalosporin antibiotics are excreted less through the kidneys, causing the drug to accumulate in the body, and conventional doses can also cause neurotoxic reactions."

"The third group is the elderly over 65 years old: their liver and kidney functions decline, their half-life is prolonged, and their blood drug concentration increases; they are affected by geriatric diseases such as arteriosclerosis, their blood-brain barrier function decreases, and drugs easily enter the cerebrospinal fluid, etc."

"Professor Luo, can I interrupt you for a moment?" Yang Jinghe said politely.

"Director Yang, you are too polite. Please go ahead."

"I have treated at least several thousand elderly people over the age of 65. This is the first time. If what you said is true, antibiotic encephalopathy should be a common disease. This is a bit contradictory." Yang Jinghe asked with a frown.

He said whatever he wanted to say and asked directly.

Yang Jinghe is a wonderful person who understands people's hearts. He is very clear about Professor Luo's behavior and habits, so he doesn't hide anything.

"Here, the nursing record sheet. The answer is on it."

Yang Jinghe was stunned. Could it be that there was something wrong with the static speed? !
Can……

"Director Yang, generally speaking, a fast classic heart rate will lead to acute left heart failure, which is the kind of sitting breathing, coughing up phlegm, and hemoptysis. But in rare cases, antibiotic encephalopathy will occur, which is the case of the patients in your department."

Yang Jing and silence.

"According to domestic literature reports, the drugs that can cause cephalosporin antibiotic encephalopathy mainly include: cefoperazone sulbactam, cefepime, ceftriaxone, ceftazidime, cefuroxime, cefazolin, etc."

“A common feature of these antibiotics is high renal clearance.

For example, cefepime is a fourth-generation cephalosporin that has a higher incidence of encephalopathy in patients with renal insufficiency, which may be related to the fact that it is almost entirely excreted through the kidneys.

For example, although ceftriaxone is excreted through both the liver and kidney channels, it can easily pass through the blood-brain barrier and cause antibiotic encephalopathy. It is best to avoid using it in patients with chronic renal failure.”

"I guess the nurse in the department should adjust the drip rate to less than 60 drops per minute when giving the drip. This is basic common sense that she should know."

When Luo Hao said this, his tone became heavier and he threw the question to Yang Jinghe.

Yang Jinghe nodded and said nothing.

"It's possible that the patient's family members made the adjustment themselves, but there is no video surveillance in the ward, so if you want to get evidence, you can make a big deal out of a small matter. Director Yang, please find a way yourself."

"Okay!" Yang Jinghe said in a deep voice.

After Luo Hao explained it, Yang Jinghe immediately understood what it meant.

"Then I'll leave first?" Luo Hao smiled, "It's a small matter. As long as we have a diagnosis and follow the clues, it's not difficult to solve."

"Professor Luo, I have a question for you. How serious is antibiotic encephalopathy?" Yang Jinghe asked puzzledly.

"Not many, but there are many reports of various cases. There is no special treatment, just stop the antibiotics and you will be fine. This patient should have had the needle inserted into the stomach, so he needed antibiotics for three days after the operation. In fact, if I don't come, he will be fine in a few days."

"If that happens, I will be confused and even more upset." Yang Jinghe politely sent Luo Hao to the door, and finally looked at Miao Youfang.

"Director Yang, are you going to handle this matter?"

"Ah."

"Xiao Miao, you stay and learn." Luo Hao said directly to Miao Youfang, "This kind of thing is a high-end clinical topic, and many professors who lead the group have no experience. Director Yang is an expert in this area."

"Yeah." Miao Youfang nodded.

"By the way, shut up and read more. Director Yang is an expert in this area. If you don't understand something, don't say anything and go home and ask Lao Meng." Luo Hao reminded.

"Yeah." Miao Youfang nodded seriously.

Seeing Luo Hao leave, Yang Jinghe patted Miao Youfang on the shoulder and said, "Youfang, that's great. You got Professor Luo's recognition so quickly."

"It was a coincidence. I was lucky." Miao Youfang replied politely.

"I'll go home for dinner tonight after I finish arranging things. By the way, where are you living recently?"

"Fire escape."

"Didn't you rent a house?" Yang Jinghe frowned.

"Ms. Meng was just about to take me to look at a house, but I don't have a place to live yet."

"Don't bother, come home with me." Yang Jinghe said, "I happen to have a house near the hospital."

Miao Youfang raised his eyebrows. Although he had never worked in society, he knew that housing prices near the hospital were not cheap.

"By the way, how did you diagnose antibiotic encephalopathy?"

"It's written in the book." Miao Youfang said perfunctorily.

Yang Jinghe nodded and sighed, "You are really lucky. You woke up in time and got such a high score. After receiving guidance, you are still motivated. The key is that you can seize the opportunity. You are lucky."

Miao Youfang didn't talk much and didn't know how to communicate with this distant relative who usually looked down on him.

But no matter what, Yang Jinghe was familiar with this to the core.

Miao Youfang didn't say anything, but Yang Jinghe wouldn't stay silent either. Besides, it was he who instructed Miao Youfang to look for Luo Hao, and no one could deny that.

While Professor Luo is still in the First Hospital of Medical University, I should do this favor firmly.

In the future, Yang Jinghe won't have any use for Miao Youfang, but what if?

Yang Jinghe didn't mind playing a casual move.

At this moment, compared with the distant relative who had the audacity to visit him on New Year's Eve, Miao Youfang had become a different person.

Yang Jinghe called the head nurse to her office and asked her to call all the nurses whose names were on the signature form.

The head nurse was so frightened that her legs were shaking and she was trembling.

But Yang Jinghe didn't scold her.

Although it was obviously a misunderstanding caused by the nurse's operational error, Yang Jinghe still maintained a good temper and just tried to solve the problem.

After getting confirmation from several nurses, Yang Jinghe knew that the patient's family must have adjusted the drip speed privately.

He called the contact person, and the next morning the original patient was discharged and went home, and a new patient was admitted.

The scene of the patient's family adjusting the drip speed was quickly recorded and fell into Yang Jinghe's hands.

With reason, evidence and logic, Yang Jinghe suppressed the matter.

Another day passed, and the patient no longer had epilepsy. The patient's family was also sure that what Yang Jinghe said was right, and they were too embarrassed to continue making a fuss, so they were discharged from the hospital.

Yang Jinghe did not put this patient on the blacklist and decided not to admit him again.

After finishing these things, Yang Jinghe breathed a sigh of relief.

Professor Xiao Luo is really awesome! Yang Jinghe sighed inwardly.

I am considered an old expert and a provincial famous doctor, but I didn't even know that there is such a thing as antibiotic encephalopathy.

What a hell.

It would have been fine if she didn't know, but Miao Youfang actually knew, which gave Yang Jing a surprise.

These days, Yang Jinghe brought Miao Youfang home for dinner, and then gave Miao Youfang the key to a nearby house directly.

It was obvious that someone occasionally stayed there, and there was a faint fragrance wafting through the room.

But Miao Youfang had no experience and had no idea what this place was used for.

Yang Jinghe didn't mention it either, he just paid a little more attention to this distant relative.

In the evening after solving the problem, Yang Jinghe called Miao Youfang home for dinner.

Miao Youfang didn't talk much. He answered whatever Yang Jinghe asked, his eyes full of the clear stupidity of a young man.

Yang Jinghe didn't take it seriously. After dinner, Miao Youfang said goodbye and Yang Jinghe sent him to the elevator. He didn't go home until the elevator closed.

"Old Yang, why did your attitude towards Youfang change so much? Just because Professor Luo thinks highly of him?"

"Yeah, what else?" Yang Jinghe sat on the sofa, looking for TV programs out of boredom.

Today's television is really unbearable to watch. No wonder all TV stations are struggling to survive.

Yang Jinghe knows a TV host who has started working on an audio book project with his team and has asked Yang Jinghe to help find the relevant copyrights.

The type who doesn't care whether there is a date or not.

"Can he have a future?"

"Now it seems that way." Yang Jinghe recounted what happened a few days ago. "Professor Xiao Luo looks young, but he is actually very experienced. When he invited Youfang to the consultation, I felt that something was wrong. Youfang is really lucky."

"That's great." Yang Jinghe's lover was happy.

"I will often invite Youfang home to have dinner together from now on."

Yang Jinghe's lover was stunned.

Does that mean Lao Yang also has to go home for dinner more often?

"This child is good. Our children may not be as successful as Youfang. It's good for him to learn from him." Yang Jinghe said calmly, "By the way, I rented a house for Youfang near the hospital."

"Well, Lao Yang, you are thoughtful."

"Well, I gave you some pointers at the beginning because of your kindness. All the things that came after that were made by people on their own." Yang Jinghe said, "I think even if I try to curry favor with Professor Luo, I don't have a chance. He has everything he needs. Now, a great opportunity has fallen from the sky."

"You."

"What do you mean by 'me'?" Yang Jinghe rolled his eyes. His lover shuddered and tried to smile.

"It's all for the sake of the child." Yang Jinghe sighed. "Professor Luo is not even 30 years old yet. If he works hard and can pass the postgraduate entrance exam of PUMC like Youfang, I will have to ask him to accept me even if I have to kneel down at his doorstep."

“Is 400 points difficult?”

"It's difficult, forget it. I'll be satisfied if I can get 330." Yang Jinghe sighed, "If I can't pass, Professor Luo will have plenty of resources to use when he returns to the capital.

If children want to venture out in the future, they will have to go abroad. Bringing all the things that have been formed in China abroad is just like bringing the southern model to the north 30 or 40 years ago.”

"Old Yang, your children and grandchildren will have their own blessings."

"No, he is my son Yang Jinghe. All the favors I have accumulated with Professor Luo are for the child. Otherwise, why do you think I would bother with this? I don't want to go to the capital, and I don't have the hope of becoming the dean."

When Yang Jinghe thought about the future, her heart began to palpitate.

The future is bright, and who knows, maybe someday I’ll really have to confront Professor Luo about this.

I just hope that Miao Youfang will still remember my kindness and be able to help me by then.

(End of this chapter)