"What are you going for? Use a sniper rifle to kill the sniper in the woods opposite!"
Professor Zhang shouted anxiously.
Zhang Lin turned his head and groaned, not daring to move at all. He held the phone and froze in a certain movement.
"Old Zhang——Professor Zhang!"
There is sweat on the forehead, and if you are caught by Old Man Zhang, the outcome will be tragic. If you don’t button a button properly, you will be criticized. You don’t know what will happen to you when you play this game.
"Professor Zhang, look, you have nothing to do this afternoon, just relax."
Zhang Lin was about to cry but had no tears. His pleading tone was stuttering, and he almost used all his courage to squeeze out these words.
"Professor Zhang——"
"We won't dare to do it next time!"
Xiaowu and Fatty Liang begged for mercy together, sitting cross-legged on the bed, their posture was a bit awkward, but they didn't dare to move.
"Hit me, what are I doing?" Professor Zhang pointed at Zhang Lin's mobile phone.
Fight?
What to fight?
Zhang Linsi has been offline.
"It's time to get off work now. Come, let's go together." Professor Zhang took out his mobile phone and sat down on the chair next to the desk.
Real or fake? Everyone was confused and found that their IQ was obviously not enough.
"Close the door and lock it!" Professor Zhang shrewdly pointed towards the door with his chin.
Zhang Lin slid down from the bed stiffly, taking each step he took and looking back, waiting for Xiao Wu and Fatty's intentions.
Xiaowu and Fatty were obviously also offline and had no idea. What did Old Man Zhang mean?
Lock the door and turn the handle to confirm.
"Hurry up and form a team. The old lady will urge you to go home for dinner later." Professor Zhang waved.
——
Director Han was busy for a while, returned to the office, and saw that Yang Ping had not gotten off work yet: "Just take a rest after get off work, as long as there is someone on duty."
Yang Ping said: "Professor Zhang just came over."
"Where?" Director Han asked.
Yang Ping walked to the door and looked into the corridor: "I was here just now, but in a blink of an eye, no one was there anymore."
Director Han also looked outside and said, "It's okay. Let him wander around by himself. His legs are completely normal. I saw him doing Tai Chi in the park again in the afternoon. In a few days, he will come over to our place to help."
When we go out to the outpatient clinic, I asked for another nurse to come over to the operating room, Zhou Can! There is only one anesthesiologist for the time being."
Zhou Can is good, he doesn’t do things sloppily, and he is smart and quirky. Director Han can choose people.
"It's enough for the moment. We'll wait for more surgeries." Yang Ping knew that it was difficult to recruit people, and the operating room was also short-staffed. This was because Director Han had enough dignity to recruit people so smoothly.
"There is a patient with advanced liver cancer in Huaqiao Building. It has metastasized throughout the body and has metastasized to the spine, chest 1 to chest 4. The pain in the chest is severe now, and morphine doesn't work. It may be caused by the metastases invading the stretched nerve roots. Director Kong asked me to go over for consultation.
"Would you like to go and have a look together?" Director Han was preparing to go to the consultation.
"Okay, let's go together now?" Yang Ping was very interested.
"Oh, also, the academic conference is being prepared. You have to be responsible for the operation here. Director Tan has not arranged a specific division of labor for you. It is enough with their help. You can safely complete the operation here." The two of them walked as they walked.
Chat.
When we arrived at the doctor's office of the Department of Internal Medicine in Huaqiao Building, Director Kong was waiting, his face glowing with pride.
"Thank you for your hard work. I have advanced liver cancer and metastases throughout my body. I have metastases in my spine. Now I have severe pain in my chest. Morphine can only stop the pain in the liver area, but the pain in my chest cannot be stopped. The pain department has installed an intravenous analgesic pump.
It doesn’t work, I’ll go with you to have a look.”
When liver cancer metastasizes throughout the body in the late stage, there is no other solution except pain relief and supportive treatment to improve the final quality of life.
The patient's face was sallow, he was breathing oxygen, and he was lying on the bed in a semi-recumbent position. His facial muscles were twitching, and beads of sweat were rolling down his forehead. It was heart-wrenching to watch.
The patient's family member, his daughter, a tall young woman who looked mature and capable, was by the bedside with a very sad and helpless expression.
Director Han performed a physical examination on the patient and briefly asked about the pain.
"Please, everyone!" The patient's daughter bowed.
"Let's study it." Director Kong comforted the patient.
After seeing the patient, several people left the ward, washed their hands, and returned to the doctor's office.
"In this case, why don't you go to ICU?" Director Han was surprised.
"The patient refuses to be admitted to the ICU. Once his life is in danger, he refuses to be intubated or rescued. He has signed an informed consent form and only requires analgesia." Director Kong explained.
"This patient may require hospital-wide consultation and out-of-hospital consultation. The family will invite experts from Annex 1 and Annex 2 to come for consultation, and Professor Su Qingyun will also come," Director Kong added.
Professor Su Qingyun is the Dean of the First Affiliated School, Chairman of the Orthopedics Department of Nandu Province, and a popular candidate for academician.
At this time, the patient's daughter came over and knocked on the office door.
"Come in!" Director Kong asked her to sit down.
"This is Miss Ning, Mr. Ning's daughter." Director Kong introduced.
Mr. Ning is the patient just now. According to Director Kong’s introduction, this patient has a good background. He is a well-known rich man in G city. His group’s business involves banking, finance, securities, insurance, etc.
Miss Ning's eyes were red and slightly swollen. She said sadly: "My father can't survive much longer. I just want him to suffer less and walk with more dignity."
As she spoke, Miss Ning wiped her tears with a tissue several times: "If he hadn't been waiting for my brother, he probably wouldn't have been able to hold on long ago and would have made things difficult for everyone. Please!"
Miss Ning clasped her hands together.
"We will try our best to find a solution." Director Kong comforted her.
Returning to the Department of Comprehensive Orthopedics, Director Han called up the patient's imaging data: "Xiao Yang, take a look, is there any good way?"
"According to the location of the pain area, the pain area is concentrated at the sternal angle. It should be that the anterior branch of the thoracic 2 nerve root has been invaded and stretched. You see, CT and MRI have shown that the thoracic 2 nerve root has been invaded and stretched by the tumor.
There is no way to do an internal tube in the spinal canal at this site. If the plane is below chest 4, a tube can be placed to anesthetize the plane below, but this level is not suitable. Once anesthetized, breathing will be seriously affected and a ventilator will be required." Director Han pointed to the electronic device.
Image on the reader screen.
"How about highly selective nerve root block?" Yang Ping suggested.
Director Han shook his head: "It's very difficult! You see, the tumor blocks the puncture. Even if there is no tumor block, it is impossible to accurately penetrate the sheath of the nerve root. Once the anesthetic leaks out, it will cause spinal anesthesia.
The effect is the same, affecting breathing."
"Blood vessels can also be found through three-dimensional reconstruction of CT angiography. Nerves cannot be found through angiography. It would be easier to find the relationship between the spatial direction of the nerves and the tumor," Yang Ping said.
"It's not easy to handle. Even if you know the spatial relationship, how can you guarantee that you can penetrate into the nerve sheath?" Director Han said.
The system that had been silent for a long time beeped again. Yang Ping thought it would no longer issue single tasks. It turned out that the difficulty of tasks had increased, and the less difficult ones were included in daily tasks.
"This patient cannot be solved by our department alone. We will soon have consultations with the whole hospital and outside the hospital. Let's wait for the general consultation. Let's take a rest after get off work." Director Han is also getting off work.
Anyway, Yang Ping had nothing to do when he went back. Director Han applied for VIP permission for him before the course started. He went into the computer to retrieve the patient's information, read it from beginning to end several times, and thought hard.
The focus of this patient is that spinal anesthesia cannot be used for analgesia. If a nerve root block is performed, it must be foolproof and accurately puncture the thoracic 2 nerve root sheath. This is so difficult that it is almost impossible to achieve. It is only theoretically said.
Just saying.
So what should we do?
Yang Ping thought for a long time, and after much deliberation, he settled on nerve root block, otherwise there would be no solution to this problem.
---
"Why are you such a noob?" Old Man Zhang scolded Zhang Lin.
Zhang Lin scratched his head and laughed.
Old Man Zhang's cell phone rang: "No more playing, the old lady wants to eat."
He stood up and left, then turned around and said, "Can't play during working hours? You can play after get off work!"
After walking a few steps and opening the door, he turned back and said, "Remember! Not during working hours!"