"Huh?" Su Yun bluntly blew a puff of smoke into Chief Yu's face. "It sounds like something big has happened."
Zheng Ren was also very curious.
"The patient's eldest son is Chief Liu's friend. He's now living in the special ward," Chief Yu said. "So, the patient is under my care."
He was worried about the other professors in charge of the group. Chief Miao had an accident and was replaced by a new chief. There would probably be a fight in private.
Chief Liu had just come up and his foundation was not stable. If one thought about this kind of thing carefully, they could think about it for a day.
However, Zheng Ren was not interested in these things at all. He was concerned about what kind of hematuria would make Chief Yu worry.
Hematuria was usually caused by stones or tumors.
It was definitely not that simple to make Chief Yu feel troubled. As for some common factors, Zheng Ren did not consider them. This matter was probably very complicated. Perhaps it was caused by some rare disease.
"Tell me about the situation," Su Yun asked.
"The patient doesn't have any positive signs. The old man was still taking care of the daily work of a listed company before he was hospitalized."
"Oh? He's quite rich. A listed company. Tsk tsk, "Su Yun praised.
"I'm asking for the medical history. Focus," Lin Yuan said.
"How am I not focused? This is part of the past, "Su Yun said disdainfully." Do you know how many people you have to see every day to manage a listed company? How much alcohol do you drink in a month? Does the company go public directly or buy a shell company to go public? "
"…"
"Stop fooling around. Listen to Chief Yu." Zheng Ren felt a little annoyed. It was not enough for Su Yun to nag. Now that there was an opponent who was not his match, he was even more talkative.
"The patient was admitted to the hospital half a month after complaining of hematuria. Routine urine examination: occult blood (+ + +), protein (+ + +); abdominal ultrasound: liver is large, right hepatic vein dilated, spleen large, a small amount of peritoneal effusion. Urinary ultrasound: prostate hyperplasia and stones.
"At that time, I was considering whether he had nephrotic syndrome or urinary tuberculosis.
"Urine protein greater than 3.5 g/d; plasma albumin less than 30 g/L. Neither of these, right?" Lin Yuan asked.
"Listen to the medical history carefully. Don't interrupt," Su Yun said disdainfully.
Zheng Ren felt a headache.
"Yes, neither. Tuberculosis is also considered negative," Chief Yu replied carefully. Mr. Yu answered carefully. He couldn't figure out the background of the long-legged beauty who had just joined the medical team.
Quarreling with Brother Yun wasn't something an ordinary person could do.
"Chief Yu, please continue. Ignore them." Zheng Ren was deep in thought.
"Serum tumor markers: normal range; Multiple urine smears for acid-fast bacilli: negative; Chest X-ray: right pleura thickening and calcification; Electrocardiogram: sinus rhythm, normal electrocardiogram; Lower abdomen CT: inferior vena cava and its branches dilated, hepatic vein branch dilated; small amount of ascites."
"Wait a minute, the chest radiograph shows pleural thickening? Does the patient have a past history? "Zheng Ren stopped Chief Yu from speaking.
"No, I've asked in detail. I also felt that there was something wrong with the chest X-ray, so I gave the patient a CT scan. Chest CT showed thickening of the pleura, calcification of adhesions, and slight thickening of the pericardial wall. "
"I'll take a look at the radiographic films later," Zheng Ren said.
"What do you suspect?" Su Yun did not want to quarrel with Lin Yuan. He calmed himself down and asked.
"It's hard to say. The hematuria needs to be checked for congestive heart failure, but there's only a small amount of calcification, so it won't lead to heart failure. Moreover, from Chief Yu's description, I can guess that the old man is in good health and won't have a serious problem like congestive heart failure, "Zheng Ren analyzed.
"Yes, Chief Zheng is right. The patient's body is quite good," Chief Yu said. "Before he was admitted to the hospital, he was said to be able to play table tennis for two hours."
"Damn …" Su Yun was surprised. "How old is the patient?"
“72。”
It was definitely not congestive heart failure, Zheng Ren concluded.
Heart failure was due to the low pumping or filling function of the ventricles. The cardiac output could not meet the needs of the body's metabolism, causing insufficient blood perfusion to the tissues and organs. At the same time, pulmonary circulation and systemic circulation congestion would occur. It was a clinical syndrome of various heart diseases that had developed to a serious stage.
Usually, this kind of situation occurred when the patient had reached the point where the disease was beyond cure.
However, playing table tennis for two hours the day before could not be considered as congestive heart failure.
"Let's take a look at the radiographic films first," Zheng Ren said.
"I'll look for it." Chief Yu turned on the computer in his duty room and began to look for the patient's radiographic films.
Zheng Ren pondered the patient's condition in his mind. It was not a tumor, not a stone, not … What exactly was it?
"Chief Yu, what do you think it is?" Su Yun asked.
"I see the old man every day, but when I went to see him yesterday and today, I always felt that he was pretending to be sick." Chief Yu did not hesitate and directly said his truest thoughts.
"Hematuria?" Su Yun and Lin Yuan asked at the same time, puzzled.
"It might be due to oral medication, causing hematuria," Zheng Ren said. "Since Chief Yu doesn't have any diseases to consider for the time being, I'll add this as well."
"Is that necessary?" Lin Yuan asked.
"You've never seen insurance fraud before?" Su Yun looked at Lin Yuan disdainfully. Seeing her blank face, he knew that she was a rookie. She only knew how to analyze the condition and had not evolved to the point of considering human nature.
Chief Yu pulled out the radiographic films and gave up his seat.
Zheng Ren did not stand on ceremony. He sat down and began to roll the mouse wheel.
Zheng Ren looked at the radiographic films frame by frame and pondered bit by bit. Zheng Ren became more and more confused.
The patient's radiographic information was just like what Chief Yu had just introduced. There was not much to see. It was definitely not a tumor. There was a small problem with the liver, and the pressure on the portal vein did not seem to be very high.
Logically speaking, there should not have been continuous hematuria.
"Chief Yu, why do you suspect that the old man is pretending to be sick?" Zheng Ren asked.
"His body is too good. I can't find a reasonable explanation," Chief Yu said. "Once, when I went for a ward round, the old man went to the bathroom. I wanted to see the situation of his urination, but he directly flushed it away with water."
"It's a matter of personal hygiene. What's there to see?" Lin Yuan asked doubtfully. "If you want to see it, just check the urine routine and you'll know soon."
"Lin Yuan, it's not like that," Zheng Ren said lightly. "What Chief Yu said makes sense. But Chief Yu, did you find aminopyrine, phenytoin sodium, rifampicin, phenol red, and other drugs beside the patient?"
Chief Yu shook his head.
"That's not right. If it was caused by oral medication, how could there be red blood cells in the urine routine?" Lin Yuan asked, grabbing a loophole.
"Just get some blood from your fingertips, the kind used to measure blood sugar. It's very easy to get red blood cells in the urine. "Zheng Ren was still looking at the radiographic films. The light and shadow flashed past, so focused.
Lin Yuan was stunned.
Did he really have to make it so complicated? He even dripped blood from his fingertips into the urine for the routine urine test … But thinking about it carefully, it was really possible.
Other than the serious patients in the ICU, the urine was left by the patients themselves. If he wanted to tamper with it, there were plenty of opportunities.
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