"Curse?" Xu Qiu looked up slightly.

The left eye twitches wealth, the right eye feudal superstition... Can we still believe in curses when we talk about science?

"What's going on?" Xu Qiu said.

Zhang Xiuyan sighed: "Don't you think I'm very strange, I keep tilting my head."

"Yes, will you feel dizzy when you turn around? Or will you be in a coma."

Zhang Xiuyan clapped her hands, "Doctor Xu, you are really amazing. I only discovered this these few days. As long as I turn my head to the right, I will faint immediately. It's just like the curse mentioned in the TV series, it's so terrible!"

"Discover directly?" Xu Qiu frowned.

This is really rare.

After doing so long clinical practice, Xu Qiu has encountered several different positions, or has excessive head movement, and will feel dizzy and vomiting, but he has never encountered coma.

"Really, I didn't lie to you!"

Zhang Xiuyan was afraid that Xu Qiu would not believe it, and shouted: "Look, Dr. Xu, look!"

As she said that, she tried to twist her head to the right.

The next second, her eyes rolled and she collapsed.

Fortunately, Shi Lian was quick-witted and immediately supported Zhang Xiuyan, but the former was too weak and the two fell to the ground in unison.

Xu Qiu's eyes turned black.

Are you really here?

I didn't say I didn't believe it!

"Is it okay?" Xu Qiu stood up and helped Zhang Xiuyan up.

Shi Pouted.

It was obviously me who was working as a meat pad underneath, so why did you care about the patient first?

Besides...

"Teacher Xu, she, she is already in a coma." Shi Lian rubbed her arms and said.

"oh."

Xu Qiu was silent.

This patient is such a cheerful person.

He died just by saying that he wanted to try it, without any ambiguity.

The patient was in a coma, and Xu Qiu could not have an in-depth examination, so he just did a casual physical examination.

The first thing to consider is the problem on the neck.

Once touched, the experience of perfect vascular palpation was triggered.

Almost instantly, Xu Qiu felt an abnormally strong pulsation at the bifurcation of the right carotid artery.

It can move horizontally, but cannot push up and down.

"Push a wheelchair first, wait for her to wake up and take her to have a checkup."

Xu Qiu put out several orders.

Blood routine;

electrocardiogram;

Heart color ultrasound, craniocerebral CT, neck ultrasound, etc.

Difficulty swallowing, fainting, and pulsating lumps in the neck. These symptoms add up to make it difficult not to consider esophageal cancer, neck-related tumors and other problems.

Of course, abnormalities in the heart and brain also need to be ruled out.

This patient is very new and rare in clinical practice, but the diagnosis should not be difficult.

Medical students who study hard can say something roughly.

"Come on, mercy, you can talk about it first." Xu Qiu called the young intern.

The latter's shoulders shook for a moment and stopped: "I guess... it should be a neck compression?"

"Yeah, be specific."

"It is possible that the left thyroid cancer compresses the esophagus and blood vessels, stimulating the vagus nerve to cause dysphagia and coma.

It may also be that esophageal cancer invades the peripheral, stimulating the vagus nerve.

Of course, the problem may also lie in the pituitary gland.”

Shi Lian was able to be with Xu Qiu, which proved her excellence.

She also relied on winning the first place in her major for four years in a row to be qualified to study with Xu Qiu during her internship in her junior year.

"Well, it's almost done... are you okay?" Xu Qiu remembered that Shi Lian fell down.

"Teacher, I'm fine!"

"Yeah, go..."

...

Xu Qiu's inference is not wrong.

Although this patient's behavior is strange, it is inseparable from hypervagal nerve.

There are no exceptions in other checks.

Electrocardiogram found sinus rhythm hypertrophy.

There is a big problem with color ultrasound in the neck. You can see that the internal carotid artery in the right neck is obviously compressed and narrowed, and it is undoubtedly a carotid artery body tumor.

Of course, ultrasound alone cannot be diagnosed.

Later, a neck CT and nuclear magnetic field were performed, which further confirmed that it was a rare carotid body tumor.

This tumor of the patient is located at the bifurcation of the carotid sinus and carotid artery body.

Carotid artery enhanced CT showed that the tumor size was about 2.7×2.3cm, which was considered relatively large.

Dysphagia is because the tumor compresses the recurrent laryngeal nerve.

As for coma...

Consistent with Shi Lian's guess, it is also oppressing, but it is the vagus nerve, which leads to hypervagal nerve and causes neurotic fainting.

The carotid body tumor that Zhang Xiuyan suffered from is a benign tumor, but it is very rare, with a clinical incidence rate of only three in 100,000.

There is nothing to say about the treatment method. If the tumor has grown, surgical removal can be performed.

However, this tumor has abundant blood supply, and the lesions are just in the critical carotid artery bifurcation, and the anatomy is very complex.

The difficulty of the surgery is definitely not low.

Moreover, bleeding is not easy to control.

However, it is not so exaggerated that Xu Qiu needs to take action.

Therefore, after a joint consultation, Xu Qiu handed the patient over to the director of the ENT department for treatment.

Shi Lian took a deep breath: "I didn't expect that a rare disease is so easy to diagnose."

Xu Qiu: "Rare diseases are only rare and are not directly related to the difficulty of diagnosis."

Clinically, doctors who are not experienced enough may ask patients to check various messy indicators, such as liver and kidney function, electrolytes, etc. ωωw..net

However, for Xu Qiu, consultation and palpation can already determine the direction of the disease initially, and examinations directly point to the cause of the disease.

The money that shouldn't be spent will not be allowed to spend more than the patient.

Other doctors may have a long time to go through a coma after being admitted to the hospital. After several comas were unconscious and rescued, they finally thought of checking the color ultrasound of the neck, cervical spine CT and MRI.

But here in Xu Qiu, the first diagnosis is the final diagnosis.

...

In the afternoon, the surgery was as usual.

However, at this time, Xu Qiu, who knew that teaching surgery could bring more proficiency, also consciously replaced experienced doctors such as Wang Fan and Zhou Hua, and began to let residents, even regular trainees and interns go on stage.

On the other hand, in the cardiac surgery department, with the second phase of human surgery for Linhai Small Vessel, the further study doctor and famous doctors such as Joseph are about to complete their last lecture, return to their own hospital, or return to China.

These doctors are all elites and have fully mastered the Linhai small blood vessel replacement surgery at the beginning of the month. Most of them have even tried independent surgery and have been successful.

Today is the day to end your further study.

After the operation, Xu Qiu rushed to the cardiac surgery department to teach the last lesson to the group of students.

The only regret is that Joseph was not left behind.

The reason is simple.

Linhai's small blood vessel technology must be firmly controlled by Xu Qiu's hands, and he would not be able to get it.
To be continued...