medical simulator

"If you don't have much pain, then I can stop your painkillers, but the hormones have to be reduced, and you can't stop suddenly, for fear of causing a rebound. But you will also control the dosage."

"Fang Miaomiao, I still need to do some physical examinations for you. You just cooperate and talk, don't think about activities." Zhou Cheng explained clearly to Fang Miaomiao.

Fang Miaomiao nodded, while Muyin and Fang Chujun who came over were all talking about Dr. Zhou's hard work.

Although the two of them didn't know how difficult Fang Miaomiao's recovery was now, no one in Chang City dared to take over, and even after the operation, they couldn't do Zhou Cheng's confidence. The gap between doctors is sometimes huge.

After more than ten minutes, Zhou Cheng tested the multiple areas of Miaomiao's lower limbs respectively, and found that Fang Miaomiao's recovery was better than what he had seen on the MRI before. up to five.

This is much faster than he expected.Zhou Cheng then said: "Starting today, you have to start oral medicine. Now that some nerve fibers have contributed to the connection, you need to start oral nerve growth medicine. Taking it at the beginning does not have much effect. But now Probably just right."

"Also, when you recover in the future, you should pay more attention to these..."

Barabara, Zhou Cheng talked a lot, but Fang Chujun and Muyin listened very carefully. It was not difficult, but rather cumbersome. However, the escort they hired was quite professional, so she already had a small notebook Got it down.

He also asked Zhou Cheng some quite professional questions, Zhou Cheng was slightly surprised.

Then Fang Chujun said that the escort used to be a rehabilitation teacher, but later found out that the escort earned more than the rehabilitation teacher, so he changed careers.

Zhou Cheng didn't speak, but nodded, and discussed the treatment plan with Lu Bin. In fact, it was Zhou Cheng who relayed the change of the treatment medicine to Lu Bin, and Lu Bin didn't dare to have other opinions.

After the ward round, Fang Chujun and Muyin once again expressed their invitation to Zhou Cheng for a meal. Zhou Cheng did not directly refuse this time, but said: "Mayor Fang, let's talk about the meal after Fang Miaomiao recovers. Then we can get together and have a light meal.”

"Now you are the family members of the patient. This is against the rules. I'm really sorry."

Yes, doctors can make friends and eat, but if you eat with the patient's family members, you will be accused, and you can't tell.Even though he knew that Fang Chujun and others were unlikely to sue, Zhou Cheng didn't want to cause trouble.

Cannibals have short mouths and soft hands!

After Zhou Cheng left, Fang Miaomiao stared at her father, "Dad, isn't this Doctor Zhou really good?"

Fang Chujun nodded: "Of course, you were asked to study medicine before, but if you didn't, Dr. Zhou's current strength in the medical field is equivalent to that of a top programmer in your industry, at least at the same level as the great master you usually call , and possibly even stronger."

Fang Miaomiao is a computer student.

"Oh!" Fang Miaomiao nodded thoughtfully, a little bit shy.

Fang Chujun and Muyin glanced at her, and said comfortingly, "Don't think about anything else, just take a good rest."

Then, Fang Chujun and Muyin walked out of the ward in a tacit understanding. Muyin first said, "Have you noticed that Miaomiao looks at Dr. Zhou differently?"

"Don't think so much, she's still young, besides, Dr. Zhou will definitely not fall in love with a patient. In professional terms, this is called empathy." Fang Chujun still understands something.

"En." Mu Yin didn't say much.

……

"Doctor Zhou, I saw your expression just now. Is Fang Miaomiao's recovery better than we expected?" Lu Bin's observation and cognition are much stronger than Fang Miaomiao's family members in medicine, so The tone is quite excited.

Seeing Lu Bin's tone, Zhou Cheng said, "Indeed, Director Lu, if you want to post a case, this is a good example. I can cooperate."

Zhou Cheng thought that Lu Bin wanted to say this.

Lu Bin quickly shook his head: "No, no, Doctor Zhou, we don't dare to say this. If you want to do it, you have to take the lead, and we can do it together. Me, it's only now that the stone in my heart has fallen to the ground."

"This Fang Miaomiao's relationship is unusual. I'm afraid that it will cause a lot of trouble and medical disputes."

Companion to a monarch is like a companion to a tiger. Fang Chujun is not a monarch, but he is also in power. Contacting such a person constitutes a medical relationship. If it is done well, it will definitely be meaningful.

Lu Bin knew that there were no fewer than several people, and he sat on the bench. It is absolutely impossible for everyone to understand your difficulties from a professional medical perspective.

Even if you can't find anything wrong with you, but others are going to mess with you, you have to leave.

Zhou Cheng didn't continue Lu Bin's topic, but turned around: "Director Lu, we can write a case report (case report). Now that it's done, we can still explain to everyone that there is such a thing in this world. of."

"Also, Director Lu, if I talk about this case again tomorrow, I don't know if it will waste your time."

If there are cases, it is very meaningful to talk about, and everyone can understand and be more interested.

"Yes, there must be." Lu Bin was overjoyed when he heard that!

What kind of surgery is this? Replantation of amputated limbs is much more difficult than simple replantation of amputated limbs. Zhou Cheng is willing to talk about it. Even if he can't learn all of it, he has learned some. When dealing with similar problems in the future, It will be able to lift weights with ease.

The reason why amputation exists is that the leg cannot be saved.

If you can save the limbs that others can't, then you are awesome, this is objective!

"Doctor Zhou, look, do we have to prepare something? I'll ask Xiao Qin to prepare it." Lu Bin hurriedly said as if to please.

Before, Zhou Cheng led a teaching round, but Qin Ming said that Zhou Cheng was a little unhappy, because their understanding and depth of the disease were not enough. Others are ready to teach, but you are not ready to learn. Isn't that just high-level gazing at flowers?

What's the point?

Teaching is an active process, and learning must also be an active process. If you are taught passively, you cannot learn at all.

"You don't need too much preparation, you can search for some relevant literature, but because of the rush of time, the courseware I may prepare will be a bit rough!" Zhou Cheng said.

Then, Zhou Chengcheng rejected Lu Bin's dinner invitation and went to Zhang Zhengquan instead.

I don't drink, and I have to do courseware at night, so I resolutely don't drink.

Zhou Cheng originally wanted to have a meal with Zhang Zhengquan, but during the meal, Zhang Zhengquan suddenly said, "Zhou Cheng, tell me, why don't I recruit Director Zhang from Changshi No. [-] Hospital to our company?"

"What are you going to do? Others have done a good job." Zhou Cheng raised his eyebrows and asked.

"It's not for nothing. Tell me, Director Zhang. He has a master's degree in joint surgery and a doctorate in spine surgery. He came here to deal with trauma. It's like beeping a dog."

"Just yesterday, and today, I went to talk to Director Zhang, and found that he was really depressed, so I thought, anyway, if you come to our company, I will pay twice his current annual salary. Three times is not a problem." Zhang Zhengquan felt a little fucked up.

Zhou Chengcheng said: "No, you must not do this. If Director Zhang wants to, it is his own choice. If you make a move in the middle of it now, you are taking advantage of others. Director Zhang is a good doctor, no matter whether he is He would have been a good doctor if he hadn't been doing his job."

"Now there are not enough high-end medical talents in Changcheng, and you still poach them."

"Is this a waste of talents?" Zhang Zhengquan insisted on his own thoughts.

"As long as it is in a state of being needed, even if it is not what you are best at and good at, it is not an excessive waste."

"Eat well, don't do this kind of thing, really, otherwise if people regret it in the future, you will become a villain, there is no need for that." Zhou Cheng persuaded.

Whether it is a waste, Zhou Cheng also thinks it is a waste, but this is a reality.

Just like him, isn't he also in an idle state now?If he really does things according to his ability, it is not enough to exhaust himself to death. He can do many orthopedic operations, but he can only do part of them.

To meet the needs of some people, one needs to work hard enough and desperately!

"Okay, I still think this is a talent, and it's a wrong place in trauma surgery." Zhang Zhengquan sighed.

"I'm trying and exploring now. Don't do anything else. Quan Zi, it's just right. After a while, we're going to make a project without a patent. We need some money. Can you invest in it first?" Zhou Cheng wanted to ask Ask, is Zhang Zhengquan willing to engage in that basic subject.

"What subject? How much?" Zhang Zhengquan was extraordinarily arrogant.

"Maybe there are a lot, more minimally invasive fractures than before, but if you can do it, the country will not treat you badly, and the world will not treat you badly either." Zhou Cheng lowered his voice and said so seriously.

Not to mention other things, even if this project does not win the Nobel Prize, after it has caused a sensation all over the world, the country's scientific research department will reward it very generously. A matter of national power.

In an instant, Zhang Zhengquan became interested: "How much is your budget?"

"It may cost 7000 to [-] million." Zhou Cheng felt a little guilty.

This is not small money.

However, the complete development of this project will cost more than this, and it is thankless, and it is impossible to have any patents. However, the hidden benefits and benefits it brings are tens of millions, or even thousands of dollars. It is impossible for a billion to compare!

Zhou Cheng can go directly to Minister Gu to get the money, but Zhou Cheng still hopes to use this opportunity to make a name for his brother's company.

"Small, no problem. Just tell me when you need it. Our company also has a scientific research department. I give them a budget of [-] million for the time being. It can be increased at any time!" Zhang Zhengquan didn't care at all.

A research patent on minimally invasive fractures has been evaluated by Zhang Zhengshu. The value is at least [-] billion or more, and this is continuous. When there is no fracture, there will be no market.

And as long as people are still alive, fractures will always exist, no matter for various reasons, that's it!

"Well, okay. Thank you, Quan Zi." Zhou Cheng thanked Zhang Zhengquan.

"Hey, why are you being so polite?" Zhang Zhengquan was a little embarrassed. He was doing badly now, and all he had was a few rotten money. Of course, the rotten money was very useful.

"Quanzi, you have to know that it is very difficult to get funds for research, and it is not certain whether it will produce results, or it may be in vain!" Zhou Cheng said.

If we really have to wait for state funding, even if Zhou Cheng asks for money, it will definitely take a certain amount of time. If Zhang Zhengquan is not there, Zhou Cheng's previous project may not have officially started yet!

"That's true, but it doesn't matter. Let's use the money we have, but don't spend it recklessly. Just like what we ordered today, it's a bit wasteful."

"Brother Zhou Cheng, let me tell you, I am still very frugal in my personal life now. I pay myself according to the wages paid by ordinary employees of our company, excluding meetings, entertainment, etc., which is the deposit route. Ask the company for reimbursement .”

"Other than that, I use this salary for all the money. Well, even if the company reimburses me, if I eat a meal, I will deduct [-], and if I take a taxi, I will deduct [-]. "

"If you eat by yourself and pay for it yourself, you can count it alone." Zhang Zhengquan said like a treasure.

"You're free." Zhou Cheng couldn't laugh or cry when he heard this.

"This is called life, brother. You can't experience the taste of it." Zhang Zhengquan looked indifferent, as if he was an outsider.

Zhou Cheng rolled his eyes: "I still don't realize that I am a poor person, a real poor person, no savings, no so-called reimbursement, if I buy something that is completely beyond my own wealth, I can only stare blankly."

"You've got a lot of experience."

Zhang Zhengquan was taken aback when he heard the words: "Brother Zhou Cheng, your opinion is very important, I want to write it down!"

Chapter 336 Intractable Diseases!

Zhou Cheng couldn't understand Zhang Zhengquan's happiness, and Zhang Zhengquan certainly couldn't understand Zhou Cheng's distress.

After the farewell, Zhou Cheng returned home first, and continued to sort out the corresponding theories of the basic anatomical structure. This thing will soon start a formal research project, and it has to be sorted out.

In addition, Zhou Cheng also found the arthroscopic joint-preserving surgery of the shoulder joint, knee joint and hip joint and its application in the previous document, and sent it to Director Zhang Jin.

Of course, in this plan, Zhou Cheng also added the corresponding concept of tumor treatment, which is a hybrid application.

The concept of tumor treatment has been relatively mature. Although it has not been carried out in the clinic, the experiment is effective. Chu Hanbo has published the corresponding article in the journal, which belongs to the follow-up research topic that can be further deepened and used for reference.

Zhou Cheng has been thinking about this matter for the past two days, and after mixing it up, he sent it to Zhang Jin.

Then, Zhou Chengcheng continued to sort out the basic anatomical theory. This is a major event, and there is no rush, but it is more tangled.

Moreover, this project is a long-term project. Zhou Cheng might as well spend two or even three years to complete it.

But this is the whole topic. If you only start from the perspective of orthopedics, it should be almost finished in half a year to a year, and then the data will be published as an article.

This is the first project that Zhou Cheng independently developed. The funds raised by himself are controlled by himself, and he is no longer living in others like before.

Time was tight, and at [-]:[-], An Ruo sent another message.

Zhou Cheng also started chatting with An Ruo.

At [-]:[-], after An Ruo fell asleep, Zhou Cheng started his simulation again.

It's just that, in the simulated world, Zhang Zhengquan, who was forced by Zhou Cheng, failed to reach a very high level. Zhou Cheng could only sigh with emotion. I don't know if there is a problem with his teaching theory, or Zhang Zhengquan's talent in medicine is really limited.

Ignore it for now, let's go to sleep first.

The next day!

This is a Friday, except for yesterday's operation day, today should be very free.

However, Director Lu Bin said yesterday that Quan Zhuolin's group has a very complicated case that needs to be discussed in the department. The main reason is that Zhou Cheng can give some advice.So Zhou Cheng didn't leave early.

Today was supposed to be Director Quan Zhuolin's operation day, Monday and Friday are all for Quan Zhuolin this month, and Director Tong only has one surgery day on Wednesday.

After the three groups finished checking the rooms, Lu Bin and Tong Xun did not leave, but stayed in the department and participated in the discussion of the problem.

As soon as the bed doctor reported the medical records, everyone frowned.

"A 2-bed patient with septic arthritis. He had undergone internal fixation of a femoral neck fracture with hollow nails in a prefecture-level city hospital before, and an infection occurred after the operation."

"Before the debridement operation, he was infected with multi-resistant bacteria, had high blood pressure, and mild diabetes. The blood sugar level was well controlled before the operation. On the second day after the operation, the blood sugar level soared to 13.2mmol/L."

"Especially the blood sugar level after dinner, the highest was 17.2mmol/L."

"At present, there are no traces of pus in the wound, but the results of the bacterial culture of the drainage fluid in recent times are a bit messy. It seems that the results of the bacteria cultured are different each time, and the sensitive antibiotics are also inconsistent."

"So the current antibacterial regimen has been changed from cefuroxime to piperacillin, and now polymyxin is used. However, the results of bacterial culture taken two days ago showed that among the currently sensitive antibiotics, polymyxin Sensitivity is average, vancomycin is sensitive."

"I asked for a consultation from the pharmacy department yesterday. The consultation opinion stated that polymyxin should be stopped, vancomycin should be changed, levofloxacin should be added, and rifampicin should be taken orally. The patient did not see tuberculosis. The doctor on duty yesterday No, I don't know whether to follow the consultation opinion for the time being." The doctor in charge explained his views on the consultation opinion while introducing.

Of course, it may also be that he had a problem with the doctor on duty yesterday. This patient was obviously very difficult, but the doctor in charge ignored it, and did not prescribe the medicine that should have been prescribed.

However, just after Xie Limin, the doctor in charge of the bed, Quan Zhuolin began to popularize science: "In addition to being used for Mycobacterium tuberculosis, rifampicin is also commonly used for the antibacterial treatment of Staphylococcus aureus. Oral rifampicin is very effective in joint infection. It is effective. It is not just for anti-tuberculosis, but for broad-spectrum antibiotics."

Quan Zhuolin probably saw Xie Jian go to casually comment on the consultation opinions of the deputy chief physician of the pharmacy department, so he warned him in advance not to think too much.

Xie Limin immediately shut up obediently, and honestly wrote the corresponding doctor's order on the paper, which needs to be followed later.

He really didn't know this unpopular knowledge.

Quan Zhuolin then asked: "Doctor Zhou, Director Lu, and Director Tong, what do you think of this patient?"

When Lu Bin heard this, he said: "The current anti-infection plan should be changed according to the consultation opinions of the pharmacy department. For patients with septic arthritis, if the bacteria develop multi-resistance, then the effect of vancomycin is relatively good. of."