Chapter 1330

"Zhang Yuan, if you are not satisfied with my work, you can transfer me to the community clinic or the branch hospital. I'm under too much pressure for you to hold the knife like this. The director of Gastroenterology has cried several times. "

If the director of endocrinology is ten years younger, she is definitely a little enchanting young woman.

It's not her face, but her expression that can't be ignored. It can't be described, but it can inadvertently reveal a feeling that makes men jingle. Really, it's no exaggeration at all.

This kind of women, if they read more books and have a little bookish spirit, really, what Dongzi's milk tea sister and all kinds of stars are absolutely no less than them. Moreover, the endocrine director feels like a childe's wife in a big house.

Because he has a childe, he is tough, but because he has a father-in-law and a little weak, he wants to play a little temper.

Zhang Fan looked at her and didn't speak. His face hasn't changed much. It's good to have pressure, and it's even better to have shame. The dead pig is not afraid of boiling water. I'm like this. What can you do to me? Come on, I'll fork my legs and don't move. What can you do to me!

"Now there are 16 doctors in endocrinology. Five of them run companies at home. They drive either Audi or Mercedes Benz at work. There is also the daughter-in-law of the boss of a winery. She says her blood sugar is low after a little extra shift.

The others are either the director's wife or the director's daughter-in-law. What do you want me to do! The last time I did a sugar tolerance test, one was more tired than the other, so I didn't pay overtime. It's hard for me. Don't I want to be a good director.

It's hard for me! "

These objective factors she said do exist.

The smaller the city is, sometimes the more concentrated some characters are, and the pressure is relatively small. These people, you give less money, they really don't move. They just press the button and wait for retirement. You need this job to save face when you ask her to resign. After all, an energetic daughter-in-law is a housewife, which seems too shameless.

Zhang Fan must not be happy to give more money.

"Tell me about yourself. You have published several papers in core journals in recent years. You are the director of Endocrinology, not a retired doctor such as opening a long-term clinic. Look at you, the director of Endocrinology who was the first batch of students sent to the capital to study.

I went with you in the same batch. If it's far away, was dean Yan Xiaoyu a classmate with you at that time? Not to mention the position, look at the achievements of others in recent years, and look at yourself. I think you spend more time turning fashion magazines than you do turning periodicals.

Look at your office. Can you turn up the latest endocrine journal? Think for yourself! "

After that, Zhang Fan got up and left. The director of endocrinology was about to be trained to cry. Watching Zhang Fan go up the 16th floor according to the elevator, the director of Endocrinology said with a cry: "who said Zhang Yuan was coming to endocrinology? I'm going to tear her mouth today!"

When I heard that Zhang Fan had entered the endocrinology department, the directors of various internal medicine were relieved. Men and women all know that. Just a few times, when he gets tired, the back will be relatively relaxed. The most afraid thing is the first three times.

In particular, the director of the Department of Gastroenterology felt that she had passed the test. When she heard that Zhang Fan entered the internal medicine building in the morning, her heart almost jumped out of her mouth. As a result, Zhang Fan went to endocrinology.

"You say that Zhang Yuan is not as fierce as president ou. Why do I always feel frightened when I face Zhang Yuan."

"It's probably because Zhang Yuan is young!"

After the director and head nurse of gastroenterology department learned that Zhang Fan had entered the endocrine system, they stood at the door of the elevator and said a few words casually.

Then the director of the digestive department took the doctors to the ward round.

As a result, we haven't checked a few patients yet. The head nurse came, "here comes the hospital Zhang, here comes the hospital Zhang, and he has arrived at the nursing station!"

The director of Gastroenterology didn't feel like peeing.

We all think that the system is cruel. In fact, the medical industry is more cruel.

For example, if you fail to compete in the system, you can transfer a department or even a unit, but the medical treatment is different.

Especially in the tea vegetable hospital, now the tea vegetable hospital is the only one. Your department director is really going to be exempted. You have no place to go.

When you are in the Department, the new director and colleagues can't carry out their work. The new director will definitely propose to the leader to let you leave.

But where can you go? Go to China hospital? To the branch? Or go to the community clinic and be an outpatient director?

Therefore, the current situation of tea vegetarians is that they can only go up and down. Once they come down, they will be really ashamed unless they change places.

Zhang Fan clearly expressed his dissatisfaction with internal medicine at the doctor's meeting. It didn't give Ouyang Ren Li face at all, let alone Yan Xiaoyu later.

In particular, those who named names said Gastroenterology and endocrinology. In Zhang Fan's words, they are capable of doing things and can't leave.

"Zhang Yuan..." the director of the Department of Gastroenterology looked at Zhang Fan nervously and said hello.

"Continue the rounds!" Zhang Fan didn't talk much.

Just behind the doctor group, followed the ward round, while the head nurse followed around Zhang Fan, secretly looked at Zhang Fan's face and guessed Zhang Fan's mood.

The doctors in the Department of Gastroenterology are active at this time. The director is afraid of Zhang Fan, so they are not afraid. Some even have to show up in front of the leaders.

Therefore, when the director asks questions, one answer is better than another. Especially after Zhang Fan said that he was dissatisfied with the gastroenterology department, the doctors made some efforts privately.

"Abdominal pain, the tube bed doctor said, how does this abdominal pain form?" No. 9 hospital bed, the patient has perennial chronic abdominal pain and idiopathic abdominal pain.

Idiopathic, in fact, to put it bluntly, you just don't know the reason. Anyway, people are here. You don't know where they come from or go.

Dr. Wu, a senior vice senior in the Department of Gastroenterology, has been suppressed in the vice senior position because the number of places in the hospital is limited.

In the past, I didn't participate in the struggle in the Department. Especially in the competition for drug dealers, he never cares.

Since the hospital became better and better, he also had ideas in his mind.

When the director of Gastroenterology asked a question, the resident was just about to speak. He spoke directly because he was the superior doctor of the bed doctor.

"For abdominal pain, we should first clarify the mechanism of abdominal pain. The total area of gastrointestinal epithelial cells is larger than that of tennis courts. In such a large area, there are complex neurons and ganglia. It has between 10 million and 100 million neurons, which is equivalent to the total number of neurons in the spinal cord.

Moreover, this is an independent nervous system, which has complex and systematic interaction with the central nervous system.

According to the current research, the development of symptoms of irritable bowel syndrome has a clear relationship with intestinal nerve, autonomic nerve and central nerve, especially in... "

Old Wu Yue said that the more he felt, the more he said, the more profound. The director of Gastroenterology turned green, but he had to pretend to listen very carefully.

Other doctors didn't know what to think, but Zhang Fan listened very carefully.

In a word, everyone has everyone's understanding, not to mention this kind of internal medicine disease, one person has one person's view, and the senior doctor who has studied this kind of medicine has absolutely great experience through a lot of clinical experience.

This is what Zhang Fan needs most now. The treatment of medical diseases is diversified, which is different from surgery.

Although surgery is also said to be diversified, it is still relatively single compared with internal medicine.

Always think of ways to cut around the lesion. Even if the current minimally invasive intervention, in fact, the ultimate goal is the focus.

Internal medicine is different.

So Zhang Fan listened carefully at the end.

Irritable bowel syndrome. Many people have heard of this disease. It is actually similar to cardiac functional syndrome. Clinically, most abdominal discomfort diseases are classified as irritable bowel syndrome.

Therefore, some patients feel comfortable after taking a certain kind of medicine, and their intestines are comfortable. Then they recommend their medicine to another patient. As a result, the other patient can't discharge his stool for a week after eating it, and even wants to put an eel into it to dredge it.

In fact, this is a disease. Although it is a name, it is not a disease.

The disease kills you, but it also makes you uncomfortable. According to evidence based medicine in Jin Mao Kingdom, 16 of IBS in the Jin Mao kingdom were women with irritable bowel syndrome, and the incidence rate of women was higher than that of men. People over 60 years old have a lower incidence, and 30% of patients have spontaneous symptoms that disappear over time.

Moreover, the trouble is that many patients with irritable bowel syndrome rarely seek medical treatment. Once they enter the tertiary hospital, 40% to 60% of the patients often have mental symptoms, especially those who have received physical abuse or sexual (a) abuse, are more likely to develop severe irritable bowel syndrome.

Another special point is that those who have experienced psychological trauma in childhood are prone to this symptom.

For example, constipation and abdominal distention, sometimes you are not greedy and eat too much. Maybe you are a patient with irritable bowel syndrome. But you don't know.

"What about treatment? According to the routine treatment, does this disease need the intervention of psychotropic drugs? "

Zhang Fan asked questions. When Lao Wu finished, Zhang Fan asked questions at the first time. At this moment, all the people stood at attention and turned to Zhang Fan.

Is this going to be mad again? What ordinary doctors think.

Is this the right eye? This is the director's idea.

"No, the golden Maoist countries prefer to give psychotropic drug intervention. Although my data is relatively small and has no reference value, I found that there is no difference between the life of patients and that of normal people after I took over the first IBS patient that year.

And the doctor's comfort and explanation seem to be more effective than drugs in the treatment of this disease. Our current treatment tends to favor symptom treatment. Constipation treatment constipation, diarrhea diarrhea, pain, give antispasmodic drugs.

But I did a single blind trial. After I treated the patient with placebo, I gave a lot of explanation and comfort. The patient said that the drug effect was good! "

Doctor Wu looked at Zhang Fan and said.

"Nonsense!" Zhang Fan whispered.

When Dr. Wu heard this, his face darkened. Zhang Fan turned and left, but when he left, he added: "this experiment is to apply for the experiment fund of the hospital. Don't do it next time!"

"Good!" Only Lao Wu himself knows the taste in his heart. But there is hope.

Zhang Fan left in a hurry because the gastroenterology department in the system had to start testing again.