MTL - Doctor Chen, Don’t Be a Coward!

C.310 This... who is the professional? Who is an amateur?Mar 03, 2023
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Chapter 310 This...who is the professional? Who is an amateur?

Ye Liangyu is even a little suspicious of life at this time...

To be precise, I doubt what I have learned all my life. Is it really the world's leading research in the field of neurology?

As the director of neurology, Ye Liangyu considers himself a motivated person.

Moreover, over the years, his salary has not been low, but most of his expenses are in the medical field, such as purchasing experimental drugs, purchasing the latest papers, participating in a certain clinical research at his own expense... and so on!

Ye Liangyu is only 41 years old this year. He is the youngest department director of the China-Japan Friendship Hospital, and also a future cutting-edge talent in the neurological field of the China-Japan Friendship Hospital.

but…

This paper journal was officially published yesterday, and he read it for the first time, and the reading result... was exactly the same as what Chen Nan said!

For a while, Ye Liangyu was a little dazed, and even a little... hard to accept!

Professors from the University of Plymouth, with the help of so many trust funds, took so long to research the theory, you...with no basis, you blurted it out, this kind of impact is no less than the thunder on the ground!

Ye Liangyu suddenly thought of something...Could it be...Is this a hypothesis?

After all, before any experiment starts, there will be assumptions.

Thinking of this, Ye Liangyu quickly asked: "What you said is a hypothesis or speculation, right?"

Chen Nan shook his head: "No, this is not speculation, this is dialectical treatment!"

“Speculation or assumption cannot be used as the basis of clinical dialectics to treat patients.”

"However, syndrome differentiation and treatment are different. This is a diagnosis based on the patient's symptoms, coupled with observation, hearing and questioning, and a diagnosis result given under the guidance of TCM theory!"

"There is an essential difference between the two."

Chen Nan's words were decisive, without the slightest pause.

If this is a hypothesis, it is equivalent to denying everything about Chinese medicine diagnosis and treatment.

What is the assumption?

is a kind of conjecture with certain basis.

And obviously, this is not speculation.

This is called dialectics!

The two words    refer to two completely different concepts and positions.

When Chen Nan finished speaking, the surrounding people couldn't help but feel a little moved.

This is the ward of integrated traditional Chinese and western medicine. The spleen and stomach department is an integrated traditional Chinese and western medicine department. Basically, everyone is a doctor with a rich foundation in traditional Chinese medicine.

Chen Nan's firmness and calmness made everyone feel a kind of belief in Chinese medicine.

Actually...in clinical practice, especially in wards of integrated traditional Chinese and Western medicine, it is not uncommon to question traditional Chinese medicine.

And this kind of doubt is not afraid of others' doubts, but the kind of doubts caused by my own inner instability...

Traditional Chinese medicine is relatively slow to enter, it is difficult to get started, it is difficult to master it, and it is even more difficult to keep improving!

Compared with modern medicine, it is easier to learn.

In this way, many people will inevitably have the idea of ​​emphasizing the west and despising the middle.

And what Chen Nan said really moved everyone.

But...just when everyone looked at the person at the door looking for the sound, they were stunned for a moment.

Immediately said: "Hello, Director Ye!"

And Shao Zizhen also looked at Ye Liangyu, nodded and thanked: "Director Ye, you are here."

"I'm in trouble."

Ye Liangyu smiled perfunctorily, and said hastily: "Well, Director Shao, hello."

After finishing speaking, he stared at Chen Nan meticulously, as if he wanted to see what was inside his mind.

"Who is this…"

Shao Zizhen heard the sound, chuckled, and said hastily:

"Director Ye, let me introduce you. This is Chen Nan."

"The new deputy director of our integrated traditional Chinese and Western medicine ward."

"It's not... just a few days ago, I don't know much about the situation."

"Director Ye is an expert in this field. Director Chen, let me introduce you. This is Director Ye Liangyu, Director of the Neurology Department of the Western Medicine Ward."

"Director Ye is also young and promising. He is only 40 years old, and he has already achieved quite a lot in the field of neurology. He even published an article on The Lancet, which is amazing!"

"By the way, Director Ye, please give me a diagnosis."

"After all, you are a professional!"

Shao Zizhen was very polite to Ye Liangyu.

But...Ye Liangyu suddenly laughed when he heard the sound. He looked at Chen Nan: "Director Chen, are you a Chinese medicine practitioner?"

Chen Nan nodded: "Well, my undergraduate major is integrated Chinese and Western medicine, and I have been working in Chinese medicine since then."

Ye Liangyu nodded upon hearing the sound, "Yes!"

"Director Shao, let me take a look at the medical records."

Shao Zizhen nodded, and the doctor in charge quickly handed over the medical records.

Ye Liangyu looked at it very seriously, the more he looked at it, the more strange he felt.

Is this... a GI reaction?

Poor appetite, diarrhea, and irritable bowel syndrome.

Moreover, after long-term treatment in the field of digestion, the effect is average.

Also, aphasia suddenly appeared this morning.

Brain abscess can indeed cause aphasia.

But... the situation of brain abscess is more complicated, and there are many classifications of aphasia, but the reason is basically in the dominant hemisphere.

The temporal lobe auditory region of the dominant hemisphere is related to speech comprehension, auditory analysis and other functions, and auditory agnosia occurs when it is damaged.

The parietal lobe is the cortical area responsible for cognitive activities and the conceptual basis of behavior. When damaged, tactile agnosia and body image pathology loss occur.

For cerebrovascular diseases and brain tumors, the occipital and temporal lobes are mainly supplied with blood by the middle cerebral artery, posterior cerebral artery and their branches.

But...brain abscesses most commonly occur in the frontal and parietal lobes of ISI and NSI.

This happens to be what causes the patient's aphasia.

If you want to identify, you need to start from the test results.

Aphasia is nothing more than several possibilities.

Cerebral infarction and brain tumors will have related symptoms and signs.

And brain abscess even more so.

Brain abscess will show changes in inflammatory indicators.

Although there will be no imaging changes in the early stage of the disease, but...the granulocytes and protein in the peripheral blood increase.

Of course, although an article reported that in the early stage of brain CT, it is not easy to detect, but... there are still some clues.

Unfortunately, because brain abscess patients are not so common, no matter how knowledgeable Ye Liangyu is, it is impossible to remember all of them.

He quickly asked: "Didn't the patient have a head CT when he was admitted to the hospital?"

"No." The doctor in charge nodded.

"When will the physical and chemical test results of our department come out?"

"Around ten o'clock in the morning."

Hearing this, Ye Liangyu said quickly: "Go and take the patient for an emergency head CT."

"Then wait for the result."

Although the patient is suffering from aphasia,...his comprehension is not a problem, and his hearing is not affected, but, when he speaks, there is a problem with the information processing center, which leads to what he said and the meaning he wanted to express. It's not right.

The patient is sent away, and the ward rounds must continue.

However, this time, everyone is still thinking about the aphasic patient just now.

Ye Liangyu didn't want to leave even more. He had a very important question and wanted to ask Chen Nan.

He wanted to know whether Chen Nan could find a common ground with that paper on modernization research from the perspective of traditional Chinese medicine.

Like...

The patient's damaged area is located in the temporal lobe or the parietal lobe. This is actually... also a test and trial for Ye Liangyu.

Of course, he does not have such a level to prove whether the patient is a temporal lobe or a parietal lobe.

But he... was a little curious, does Chen Nan have such ability?

"Director Chen, where do you think the damaged area of ​​the patient will be?"

After asking this question, he himself regretted it a bit!

because…

Not everyone knows the nervous system well. As the most difficult type of master in anatomy, the nervous system is the most difficult!

Besides...Ye Liangyu didn't know, if Chen Nan gave the correct answer, what a shock it would have on his mind!

But he still wants to ask!

Because, this may be related to a focus of Ye Liangyu's future development.

After Shao Zizhen heard the question, he walked forward by himself. He pretended not to hear...

After all, there are all my soldiers around here, if I can't answer, it will be somewhat embarrassing.

However, he is also a little curious, can Chen Nan answer it?

After hearing this question, Chen Nan was also a little pensive.

There are not many studies on the brain in Chinese medicine, but there are also many.

Afterwards, Chen Nan said with a smile: "Director Ye, I'm going to play tricks."

"To be honest, Chinese medicine does not study the anatomical structure of brain tissue very deeply, but... Chinese medicine habitually associates functional structure and brain tissue with each other."

"Therefore, some clues can also be obtained from the meridians and viscera."

"So, for the meticulous and meticulous research, Chinese medicine may not be as specific as modern technology research."

"Since Director Ye asked, let me briefly talk about it."

"The main symptom of the patient is undoubtedly the manifestation of the gastrointestinal tract, but... the reason is that the yang of the spleen and stomach has not been hurt too much."

"The brain is the sea of ​​qi, governing the qi of the whole body, mastering balance, balance leads to health, and imbalance leads to disease."

"There is a saying in "Primitive Medicine": The five sense organs reside on the body and are the tools of perception. The ears, eyes, mouth and nose are gathered at the head, which is the highest and easy to touch. The guidance of the ears, eyes, mouth and nose is closest to the brain, and the brain must receive it first. Feel it based on its image, send it, and keep it.”

"However, I observed the pulse just now and found that the spleen and stomach are just symptoms, and the real root of the disease is not in the internal organs."

"The head is the assembly of all yang, and the three yang meridians of the hands and feet all ascend to the head and face."

"The evil that blinds the light orifices is poison. If it is the poison of yang heat, it must have the fierceness of fire."

"The momentum of development is very fast, but...it's not like this. The patient's body is yang deficient, and the poison is caused by the corruption of his own poison."

"In this way, the general yang meridian of the whole body is involved, which is the governor channel!"

"To patrol the governor channel, you must go to the top."

"According to modern anatomical theory, the top belongs to the parietal lobe, and the parietal lobe is the cortical area responsible for cognitive activities and the cortical area that is the basis of behavior. When damaged, tactile agnosia and body image disease occur. Feeling missing."

"So, I feel that the patient's lesion should be in the parietal lobe."

"And not in the temporal lobe!"

Listening to Chen Nan's analysis, Ye Liangyu felt a little regretful.

Because...he basically heard what he said.

Director Ye, who has almost no research on Chinese medicine, only knows Chen Nan's answer at this time.

Right on the parietal lobe!

Now…

He can't wait for the patient's image data.

Time is spent in such a leisurely manner.

finally!

A doctor led the patient back to the ward in a hurry, holding the CT report in his hand, and said out of breath: "The film...the film is back!"

Shao Zizhen pretended to be walking, staggered half of his body, and glared at the doctor who came running.

Seeing this, the other party quickly expressed his understanding, and then handed it over to Ye Liangyu.

Ye Liangyu couldn't wait to catch the film, and watched it seriously.

Looking at the patient's head CT, Ye Liangyu's brows became tense.

At this time, all the doctors around are focusing on this 35x43 CT film.

Everyone is very curious, Director Chen Nan Chen, can you answer correctly?

If this is really successful... that would be amazing!

Neurology and surgery are all hegemonic in Western medicine. TCM encephalopathy has now been reduced to the point of treating insomnia, anxiety and depression.

This is also the reason why when the integrated traditional Chinese and western medicine ward was established, the department of encephalopathy with integrated traditional Chinese and western medicine was not developed.

After all... I am not good at it, so how do I study it?

If Chen Nan can really research it, this... would be amazing...

Time, at this moment, became extremely anxious.

Even Shao Zizhen, who originally wanted to make a hasty round of the house, became quiet at this moment, quietly waiting for the result.

Since he wanted Chen Nan to give the wrong answer, he also cooled down the aura of the deputy director of the ward.

But... I want Chen Nan to get the answer right, to show the prestige of Chinese medicine!

Shao Zi is really not a bad person, at best he is a bit clever.

And the time passed by every minute and every second.

Ye Liangyu suddenly sighed: "I feel...the film doesn't seem to show anything."

As soon as these words came out, everyone around was dumbfounded.

What?

Isn’t CT the gold standard?

Couldn't the patient be a brain abscess?

All guessed wrong?

what is that?

"And... I didn't see any tumors in the brain, or the performance of cerebral infarction!"

"This is weird!"

"What is this aphasia...?"

Ye Liangyu was a little disappointed, but Chen Nan said at this moment: "Why don't you, Director Ye, let me watch the movie?"

Chen Nan has professional-level CT reading experience, definitely much better than Ye Liangyu.

One is an amateur and the other is a professional. Can this be compared?

However, everyone looked at Chen Nan with strange eyes.

After all... Director Ye is an expert in the field of neurology, Director Chen... Are you not a Chinese medicine doctor?

And, so young...

Are you sure to compare your hobbies with others' majors?

Ye Liangyu also glanced at Chen Nan curiously, a little weird, but...he handed it to Chen Nan.

But there is a doubt in his mind at this time, how does Chinese medicine view films?

Could it be... 欻欻歘, gold, wood, water, fire, and earth, all those who are ready to fight are in front?

Or rest, life, injury, death, death, scene, surprise, open... eight doors?

Shaking his head, Ye Liangyu laughed at himself.

At this time, Chen Nan took the film and began to read it seriously.

The more he looked, the more dignified he became.

Suddenly, Chen Nan pointed to an area and said to Ye Liangyu beside him:

"Director Ye, look here."

"Here, there is a slightly hypodense abscess wall, do you feel it?"

After Ye Liangyu heard Chen Nan's words, her brows tightened and she began to observe carefully.

The more he looked at it, the more familiar it became...

It seems... Chen Nan's words reminded him of that paper.

Ye Liangyu was shocked like a river in his heart.

this…

Does Chen Nan really understand CT imaging?

Ye Liangyu couldn't help asking: "Director Chen, do you have any research on... imaging?"

Chen Nan smiled: "Well, in the past, Keli was a general practitioner of Chinese medicine, and it was impossible not to do films, so I learned to learn and understand a little bit!"

"Come back to business."

"To be honest, the CT image characteristics of brain abscess are judged according to the development stage of the disease. Different stages have different manifestations!

But... You see here, in the stage of envelope formation, although generally, there is not much expression.

But I concluded that there are very few patients, about 5% of the patients can see the abscess wall during the low-density edema period!

However, this symptom is not obvious, because the complete, well-defined, and uniform thickness performance seen has no obvious features, and the real table selection requires drug injection, and ring enhancement appears. "

"However, the patient's symptoms are currently appearing, but the imaging data is lagging behind and has not shown up."

"But it can be judged by this ring-shaped low-density point similar to an artifact!"

"Director Ye, what do you think?"

"Director Ye...Director Ye?"

Chen Nan's voice hadn't finished yet, but Ye Liangyu beside him was already crazy.

After hearing Chen Nan say "low-density ring shadow" and "ring enhancement", he immediately recalled the paper he read at the beginning!

That **** is the Imaging Journal of the American Institute of Neurosurgery, with an impact factor of 7.9!

This is very famous in the field of imaging!

But Chen Nan...how did Chen Nan know?

This is an article that was quoted a lot at the time...

For a while, Ye Liangyu felt that her brain was a little down, and she even looked at Chen Nan with eyes like looking at a monster...

This guy…

Is it a pervert?

Ye Liangyu tried her best to calm down, but...it was too difficult.

Who are the experts in the field of neuroscience?

Who is Chinese Medicine?

This...This situation makes Ye Liangyu feel like a role reversal...

No, no, even if it's a swap, I don't understand so much?

How should this be done?

At this time, Ye Liangyu heard Chen Nan's words, he quickly became excited, smiled awkwardly and said:

"Sorry, Director Chen... what you said is too professional, I lost my mind, I'm really sorry!"

"By the way, I seem to have seen the imaging manifestation you just mentioned in a paper, just wait a moment!"

"I'll look it up now, I remember I downloaded it."

While speaking, Ye Liangyu quickly started searching.

But... when the people on the side heard these words, they felt a little confused...

this?

What's the situation?

Director Ye Liangyu actually said Chen Nan was a professional?

Is this a joke?

But looking at the seriousness of the other party, doesn't it look like a joke?

For a while, the doctors around looked at Chen Nan, a little surprised and shocked.

This... Director Chen is a bit aggressive!

Not long after, Ye Liangyu suddenly spoke excitedly:

"That's right, all right!"

"Director Chen, what you said is exactly the same as what this paper said."

"Shall I watch the movie again?"

While speaking, Ye Liangyu hurriedly moved closer to Chen Nan, carefully watching the patient's film.

Seeing this, he felt his skull trembling with excitement.

"Look, this is the artifact mentioned in the paper, the low-density regular ring shadow, this is the abscess wall!"

"Director Chen, you are amazing!"

"I didn't expect that, your imaging level is even better than the doctor on duty!"

"too professional!"

"Sure enough, it's in the parietal lobe area!"

"Director Shao, please give the doctor's order to inject the medicine."

"It is estimated that the enhanced ring image will be seen soon."

Ye Liangyu's excitement made Chen Nan a little embarrassed.

He smiled awkwardly: "Well, yes!"

At this moment, everyone around looked at Chen Nan with a little more awe.

Everyone respects the strong.

Shao Zizhen is no exception!

Chen Nanlai is the deputy director of the integrated traditional Chinese and Western medicine ward. At first, he thought he was a related household, but now it seems... This level is awesome!

Moreover, to be able to convince this professional to lose, is this something that ordinary people can do?

Thinking of this, Shao Zi really couldn't help but sigh.

I'm a little disappointed, but...but also a little more hopeful.

He hopes that Chen Nan can truly shoulder the important task of deputy director of the integrated traditional Chinese and Western medicine ward!

In the following time, Chen Nan continued to follow Shao Zizhen to make ward rounds, but this time, Shao Zizhen cooperated very much with the hypocrisy and deception just now, and respected Chen Nan's opinion very much.

It's past ten in the morning!

The imaging data of the patient finally came out, and this time, all the physiological and biochemical tests were also released.

Ye Liangyu found Chen Nan immediately, shook Chen Nan's hand excitedly, and said with a smile:

"Director Chen, thank you so much!"

"If it weren't for you today, I guess it would be difficult to find the cause of the patient in the first place."

"You, the director of the ward, are really amazing!"

"I am convinced!"

Seeing Ye Liangyu's eyes full of sincerity, Chen Nan smiled: "You're welcome, I will inevitably trouble Director Ye in the future."

Ye Liangyu waved his hands and said with a smile: "I wish for it!"

"Today, I really opened my eyes!"

"Chinese medicine is really broad and profound. I really regretted it before."

What Ye Liangyu said was sincerely convinced.

All the medical staff around were also happy to hear that.

It seemed... Ye Liangyu was praising them.

"By the way, Director Shao, the patient will be transferred to our department."

"Director Chen, I have an unfeeling request, and I hope you can help with a consultation and give me a treatment idea."

"My suggestion is conservative medical treatment. I believe that you must have a very good plan."

Chen Nan nodded: "Okay, I will go there after my rounds are over!"

After Ye Liangyu left, Chen Nan suddenly found that everyone around him was staring at him in unison, which made him a little embarrassed.

"This...everyone, continue to make ward rounds."

Unfortunately, at this time, I don't know who took the lead, but everyone around started to applaud.

The deafening applause lasts forever!

Everyone looked at Chen Nan and seemed to see hope for the future.

With such a director here, in the future, what is there to fear?

【Ding! Congratulations, you have received collective praise from the Department of Spleen and Gastroenterology, integrated rewards, and obtained: Gastrointestinal Tumor Research Experience (Expert Level)]

Looking at the system prompt, Chen Nan was overjoyed!

This...what is missing?

This is so refreshing!

However, the voice did not end.

Another voice sounded.

【Ding! Congratulations, you have received a good review from Ye Liangyu, the rating of the review is: advanced, and the reward is: nervous system (professional level). 】

"Ho!"

"Such a generous reward?"

Chen Nan couldn't help feeling a little more secretly happy.

This ward round was very fruitful.

At noon that day, after Chen Nan left from the Department of Neurology, he bumped into Yang Fupeng again.

However, at this time, Yang Fupeng was still accompanied by a foreigner, seeming to be communicating.

After seeing Chen Nan, Yang Fupeng's eyes lit up, and he quickly grabbed Chen Nan: "Director Chen, wait a moment!"

Chen Nan stopped and looked at Yang Fupeng curiously: "Director Yang, what's the matter?"

Yang Fupeng squeezed his eyes, and whispered to Chen Nan: "See?"

"The leader in the field of tumors, this time he came to the China-Japan Friendship Hospital for investigation and research, it is said that it is for a research."

"Do you have time? Let's sit together?"

"By the way, let me introduce to you, the editor-in-chief of "Tumor Discovery", that is, the journal "Cancer Discovery", and the leader of the Cancer Research Group of Harvard University, Professor James Harken."

"He encountered a problem, and came to the China-Japan Friendship Hospital specially, hoping to find some clues in the field of integrated traditional Chinese and Western medicine."

"But...the other party doesn't agree with Yu Jinhua's idea, and he is going to leave now."

"If you are not in a hurry, let's sit together?"

Listening to Yang Fupeng's words, Chen Nan hesitated: "I... I haven't had lunch here yet."

"If the time is too long, I may not be able to hold on. After all, there are still a few Haifu knife operations in the afternoon."

"so…"

At this time, James Harken suddenly came over and looked at Chen Nan: "Professor Yang, this is..."

Yang Fupeng quickly introduced with a smile: "This is Director Chen Nan, the deputy director of the integrated traditional Chinese and Western medicine ward."

"I think you should have a lot of common language."

"Director Chen is young, but... very powerful."

Hearing Yang Fupeng's words, James Haken shook hands: "Hi, Director Chen."

He spoke this time, but he used broken Chinese.

Chen Nan smiled: "Professor James, hello, I have long admired you."

"If you have time, we can communicate later, I need to eat something, and then there will be Hifu Knife surgery in the afternoon."

"is it okay?"

James Haken heard the sound and suddenly made a special request:

"Director Chen, can... can we have a chat during the meal?"

"I don't mind..."

"I know it's impolite to interrupt your meal, but... I have limited time and I have to go back to the United States in the afternoon."

"So, sorry."

After thinking for a while, Chen Nan smiled and said, "Yes!"

"I treat you, you also have a taste of Chinese food."

While speaking, a group of people walked outside.

(end of this chapter)

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