Professor Su and his party finished watching the video and visited the Department of Comprehensive Orthopedics before leaving.
A child admitted to the free clinic in the classroom was shown to be considering osteoid osteoma. The operation had been completed. His father was wandering at the door of the doctor's office. When he saw Xiaowu, he asked: "Dr. Lu, have the results of the pathological examination been released?"
"Didn't I tell you that it would take three to five days? You have asked me seven or eight times." Xiao Wu felt a little annoyed with him.
The child's father thought for a while and said: "Dr. Lu, can you move my son's examination forward? Others are not in such a hurry. Just slow it down and move him forward alone. It won't affect anything and others won't know.
of."
Xiao Wu annoys this kind of person the most. His business is a big deal, and other people's business is not a big deal. This kind of person likes to jump in line when waiting in line. Anyway, he feels that it won't affect anything if he jumps in line alone.
"There's no way in advance. We can't rush this matter. It will make the pathologist anxious. I'll take a random look at it and you won't be able to tell me the result, okay?" Xiao Wu didn't argue with him and declined him politely.
The child's father was restless and grabbed his pants with one hand: "This matter is really urgent. Do you think it is benign or malignant? What should I do if I have to wait for so long?"
"Now that I know it's urgent, what are you doing? I asked you to take your child to see a doctor as soon as possible. You read a few online articles and thought you were really a doctor. They said three to five days and everyone can wait, but you can't wait?"
The child's mother also came over, as if she wanted to pull him back by his ears.
This couple is also a bit interesting. The husband is short and timid, while the wife is tall and big, with a bold personality. Both the couple are very disharmonious in terms of body shape and personality.
If there is a quarrel at home, the woman can probably carry the man like a chicken and spin around the house several times without the woman gasping.
The man was scolded by his wife and returned to the ward in despair. The woman apologized to Xiao Wu and then followed her back to the ward.
When someone asked about the pathology results, Song Zimo remembered that he had made an appointment with the pathology department to see Zhang Zhe's pathology slides this afternoon. Song Zimo wanted to ask Yang Ping if he wanted to go over and see them together.
Yang Ping said that it was just right to teach everyone how to read pathological slides. In the future, this is a basic skill that doctors in the department must master. Let Song Zimo and Xu Zhiliang master it first. In the future, they must be as proficient in reading pathological slides as they are in X-rays.
In some countries, such as the United States, surgeons have to look at pathological slides themselves. Sometimes the chief surgeon removes the tumor and sends it to the accompanying pathology room next to the operating room for frozen sections. The chief surgeon takes off his surgical gown and gets off the stage, and goes to the pathology room to look at it with a microscope in person.
After taking sections to find out what kind of tumor it is, wash your hands again and go to the stage, and choose the appropriate surgical method based on the pathological diagnosis.
Pathological slides in our country are all seen by pathologists. Surgeons do not know how to read them, and they have not received specialized relevant education. The pathology classes during school and the several experimental classes can only be regarded as experience.
Therefore, if our country has a surgeon who can read pathological slides, it will definitely be a rare treasure.
When everyone arrived at the pathology department, they were all busy. The examination room, microscopy room, and immunohistochemistry were all busy. There were only two people in the doctor's office, Director Guan of the pathology department, and Director Shi, who had returned from retirement.
Director Shi was wearing a pair of sunglasses and sitting at the window to rest. Director Guan was reading something on the computer. When he saw everyone coming in, Director Guan recognized Song Zimo: "Mr. Song, here you are! I won't introduce you, this is for your department.
Dr. Yang?"
Song Zimo and Director Guan, Director Shi, are very familiar with each other. He often comes to ask for advice and view pathological slides. During holidays, he often sends Maotai and the like to the two directors to make them happy.
"Director Guan, please excuse me." Yang Ping shook hands with Director Guan.
Director Guan smiled and said: "You're welcome. We are Qingshui Yamen. We don't usually have much contact with you. We see a lot of pathological slides from various departments every day, but we don't know a few of them. Dr. Yang is young and promising. I still know you. Are you?
Let’s take a look at the pathological slides of several recent orthopedic patients. The specimens from today’s surgery patient are still undergoing decalcification. The slides from the surgery a few days ago have been released and are ready for the camera. I’ll ask someone to find them for you.” p>
"Teacher Shi, is this the beautiful woman wearing sunglasses looking out the window?" Song Zimo joked with Director Shi.
Director Shi pointed at his eyes: "I've seen too much under the microscope, and now my eyes can't stand the brighter light. In the past few years, if it was a sunny day, I had to wear sunglasses when I went outside. Starting this year, I have to wear sunglasses indoors as well. The light is too strong."
No, I kept crying."
"Director Shi will stop working after this month and go home to take care of himself." Director Guan explained.
Director Shi said: "I can't work anymore because my eyes are not good. If my eyes can hold on, I still want to work for a few more years."
The pathology department is really a Qingshui yamen. Not only is there no money, it is also deserted. Several doctors spend all day and night looking at pathological slides under the microscope. One doctor has to look at almost three to four hundred slides every day. He has no time to move his buttocks except for going to the bathroom at work.
.
However, the pathology department of Nandu Medical University Cancer Hospital, a national cancer hospital, is much better. If a patient wants to find a doctor with better skills to see the pathology slides in private, he has to take care of it.
It's not expensive either. The doctor charges three to five hundred for his services to help.
There is no way, the pathology department is really poor, with a salary of several thousand yuan a month, if we don't do some private work, we can't live a good life.
If the patient follows the normal procedures and has pathological slides taken outside, it is impossible for a top hospital to help you look at them. If you can’t even see your own slides, why should you look at someone else’s?
The so-called pathological diagnosis is theoretically the gold standard for tumors, but there are opinions on whether this gold is pure gold or karat gold. After all, pathological slides rely on people to see them.
After reading this, the diagnosis of what kind of tumor it is, whether it is benign or malignant, and which stage of malignancy it is, all depends on human knowledge and experience, so there is a possibility of error. This possibility is very low, but it exists.
Typical and simple ones are generally fine, but when it comes to complex and atypical ones, misjudgments may occur. It is not unreasonable to be diagnosed as cancer when it is not cancer.
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Many patients are unwilling to be diagnosed with malignant tumors in primary hospitals. Their families find a way to find a way to take out the pathological slides from the doctor in charge and send them to the top cancer hospitals in the country. They spend three to five hundred and find a pathologist to help them in private through connections.
, please feel at ease.
The probability of misdiagnosis is not high, but it still happens. A patient was diagnosed with a malignant tumor. When he went to a top hospital, he found out that it was not a malignant tumor but inflammation. He was treated as inflammation for a period of time and recovered.
Director Shi used to be a well-known pathologist at Nandu Medical University Cancer Hospital and was Director Guan’s mentor. After his retirement, he was hired by Sanbo Hospital to train young people.
At this time, there happened to be a hospital employee who was looking for connections. He called Director Guan and wanted to ask Director Shi to help him look at the pathology slides of his relatives in private.
Director Shi waved his hand: "If you don't want to watch it, no one's relatives will watch it."
Some time ago, a family member of a patient asked Director Shi to view pathological slides through a relationship and paid him 500 yuan. As a result, he secretly videotaped it. After Director Shi watched it with his help, the patient's family handed the video to the hospital's disciplinary inspection office and asked for a refund of 50 yuan.
One hundred yuan, said the doctor charges privately.
This incident offended the old man and he stopped reading, not even his relatives.
Just after sitting like this for a while, dozens of specimens have been received in the giant examination room, all of which were cut out in the operating room.
Carrying it in a specimen bag, there were cut out tumors, cut out parts of the liver, stomach, intestines, everything.
On the sampling table, there are several clean chopping boards, as well as rulers, scissors, tweezers and other tools neatly placed. The doctor, wearing gloves, is slicing a tumor on the chopping board.
The surgeon cuts something from the human body, which is called a specimen, and sends it to the pathology department. The doctor cleans, fixes, extracts, dehydrates, waxes, embeds, section, stain, seal, and other more than ten processes.
, in order to make a pathological slice.
This pathological section can be viewed under a microscope for pathological diagnosis, that is, a diagnosis of the disease.
For a typical case, after the doctor makes a diagnosis, the director will review it; if it is difficult, experts in the department will discuss it and everyone will look at it together before a diagnosis can be made to prevent unjust cases.
"The general surgery department sent a specimen for frozen section. I have to go and take a look. I have asked people to find Zhang Zhe's pathological sections. You guys go to the microscopy room to take a look. I'll be busy first." Director Guan told everyone.
Say hello.
"Go and do your work." Yang Ping said to Director Guan.
"Teacher Shi, please help us take a look."
Frozen section is a rapid pathological diagnosis, and the result can be obtained within fifteen minutes, which requires a doctor's extremely high diagnostic level. Director Guan asked Director Shi to take a look together, which is more secure.
In theory, pathological diagnosis must be guaranteed to be 100% without any errors.
Even though his eyesight was bad, Director Shi still had no intention of refusing. He took off his sunglasses, rubbed his eyes, and followed Director Guan out.
The surgeon is still waiting on the stage, waiting for the pathological results to decide the next operation. If it is benign, the operation will be declared over; if it is malignant, based on the pathological results, the operation will be expanded, such as lymph node dissection.
When everyone arrived at the microscopy room, Zhang Zhe's pathological slides had been placed under the microscope, and Yang Ping asked everyone to take a look first.
This is a multi-head microscope. Song Zimo, Xu Zhiliang and Gao Qiao all sat on it.
Under a 400-fold microscope, the structure of bone tissue on paraffin sections is clearly visible. Osteocytes, osteoprogenitor cells, osteoblasts, osteoclasts, and bone matrix can be viewed one by one.
You need to be patient when looking at pathological slides, never let go of any doubts, and never jump to conclusions hastily.
Any sloppiness or a misdiagnosis may ruin the patient's life.
