Chapter 1654: with translation of chapter title

"Look here." Zheng Ren pointed at the image and said: "Typical manifestation of hepatic schistosomiasis; the imaging feature of cirrhosis is incomplete septal cirrhosis, with the liver surface appearing granular or nodular, nodules varying in size, diameter about 1–10 mm."

Check if we missed that the liver surface is granular or nodular, with nodules of varying size, about 1 to 10 mm in diameter. We covered.

Now line 2:

Schistosome eggs massively deposit in the liver, especially in the small branches around the portal vein tributaries, causing fibrosis around the portal vein branch system, particularly around the 2nd, 3rd, and 4th order branches, which is the so-called trunk-type cirrhosis.

We'll use Zheng Ren? Not present.

We will translate the term meaning "portal vein branch system", translating its "portal vein" part as "portal vein". It is not in the glossary, but we can translate its meaning.

2nd, 3rd, 4th order branches -> 2nd, 3rd, 4th order branches. We'll keep numbers.

fibrosis -> fibrosis.

trunk-type cirrhosis -> trunk-type cirrhosis.

Now produce translation:

"Schistosome eggs massively deposit in the liver, especially in the small branches around the portal Vein tributaries, causing fibrosis in the portal vein branch system, particularly around the 2nd, 3rd, and 4th order branches, i. e., trunk-type cirrhosis."

Check if we missed especially in the small branches around the portal vein tributaries. We captured especially in the small branches around the portal vein tributaries. Good.

Now line 3:

Cross-section shows white fibrous nodules of varying size around branches of all levels; severe fibrosis can cause branch occlusion; contraction of these nodules can deform the liver; the liver surface shows the characteristic block-like groove appearance of this disease, uneven, with indistinct boundaries.

We'll need to handle "Clarity" using glossary term "Clarity". We'll translate "boundaries lacking clarity" as "boundaries lacking clarity". We'll use "Clarity" as noun.

Now translate rest.

Cross-section shows -> Cross-section shows. (We'll use "shows").

around branches of all levels there are white fibrous nodules of varying size -> around branches of all levels there are white fibrous nodules of varying size.

severe fibrosis can cause branch occlusion -> severe fibrosis can cause branch occlusion.

contraction of these nodules can deform the liver -> contraction of these nodules can deform the liver.

the liver surface shows the characteristic block-like groove appearance of this disease -> the liver surface shows the characteristic block-like groove appearance of this disease.

uneven -> uneven.

boundaries lacking clarity -> boundaries lacking clarity.

Now combine.

We'll produce:

"Cross-section shows white fibrous nodules of varying size around branches of all levels; severe fibrosis can cause branch occlusion, and contraction of these nodules can deform the liver, making the liver surface show the characteristic block-like groove appearance of the disease, uneven, with boundaries lacking clarity."

Check if we missed any nuance: block-like groove appearance we translated as block-like groove appearance. Good.

Now line 4:

"Exactly, that's……" Su Yun said, suddenly stunned.

Su Yun -> Su Yun.

We'll translate: "Exactly, that's……" Su Yun said, suddenly stunned.

But we need to keep the trailing ellipsis? The original has "Exactly, that's……" with two dots? Actually Chinese uses two dots? It's "……". We'll keep as "……". We'll translate as "Exactly, that's……" Su Yun said, suddenly stunned.

We'll produce:

"Exactly, that's……" Su Yun said, suddenly stunned.

Now line 5:

After 1.2 seconds, he suddenly said, "You mean the symptoms are too severe, like the portal vein is completely blocked, but the abdominal CT shows a difference?"

After a pause of 1.2 seconds, he suddenly spoke. The "he" refers to Zheng Ren, following Su Yun's previous line.

Thus we translate: "After 1.2 seconds, he suddenly said: 'You mean the symptoms are too severe, as if the portal vein is completely blocked, but the abdominal CT shows a difference?'"

Zheng Ren smiled.

We will translate "portal vein completely blocked" for the phrase meaning complete blockage of the portal vein, and "but the abdominal CT shows a difference" for the contrast in abdominal CT findings.

Now line 5:

After 1.2 seconds, he suddenly said: "You mean the symptoms are too severe, as if the portal vein is completely blocked, but the abdominal CT shows a difference?"

Now line 6:

Zheng Ren smiled.

Zheng Ren laughed.

Now line 7:

Talking with smart people saves effort; I only mentioned a few points, but Su Yun could think of almost everything that followed.

We'll keep Zheng Ren? Not mentioned. The line is generic: "Talking with smart people saves effort; I only mentioned a few points, but Su Yun could think of almost everything that follows."

Now translate:

Talking with smart people saves effort; I only mentioned a few points, but Su Yun could think of almost everything that follows.

Now line 8:

No need for me to waste words.

Speaker is Zheng Ren.

No need for me to waste words.

Now line 9:

"Yes, just as you said, I'm considering a heart problem." Zheng Ren then inserted the chest CT into the viewer.

We'll keep Zheng Ren.

Translate: "Exactly, just as you said, I'm considering a heart problem." Zheng Ren then placed the chest CT on the viewer.

We need to keep "chest CT" as chest CT.

Now line 9:

"Exactly, just as you said, I'm considering a heart problem." Zheng Ren then placed the chest CT on the viewer.

Now line 10:

"There is a large amount of fluid in both lungs, making the pericardial cavity unclear. However, here the density is off, and the cardiac shadow is also large. Try converting it, and you can find a problem in the right atrium." Zheng Ren pointed at the film, somewhat excitedly said.

We'll keep Zheng Ren.

Translate: "Both lungs have a large amount of fluid, making the pericardial cavity unclear. But here, the density is wrong, and the cardiac shadow is also large. Try converting it, and you'll find a problem in the right atrium." Zheng Ren pointed at the image, saying excitedly.

Su Yun realized the situation was out of control.

Now line 10:

"Both lungs have a large amount of fluid, making the pericardial cavity unclear. But here, the density is wrong, and the cardiac shadow is also large. Try converting it, and you'll find a problem in the right atrium." Zheng Ren pointed at the image, saying excitedly.

Now line 11:

Su Yun realized that the situation could no longer be controlled.

Su Yun discovered that the situation was already out of control.

He also noticed the patient's cardiac shadow was large, but his diagnosis was heart failure causing pericardial effusion, resulting in an enlarged cardiac shadow.

The first diagnosis, definitely portal hypertension.

But Zheng Ren's diagnosis was completely opposite to his own, and this was precisely Su Yun's area of expertise.

Not being able to see it is really excessive.

Su Yun stared at the film, Zheng Ren said: "Bedside cardiac ultrasound machine."

After he said that, the operating room outside the ward was a sheet of silence.

Zheng Ren smiled, then said it again in the local language. Only then did the doctors at the national hospital realize he was talking to himself.

The patient is vomiting blood; what's the point of doing a cardiac ultrasound?

He had a different opinion, was about to speak, but immediately realized these people were gu masters.

He also didn't dare to voice his opinion and suggestions, hurriedly went to push the cardiac ultrasound machine.

Zheng Ren patted Su Yun, saying: "Stop looking; just do a cardiac ultrasound and you'll understand."

Su Yun felt somewhat troubled, his mind occupied with Chu Nu Ang Sai's chest and abdominal images.

A typical upper GI bleed, portal hypertension—how could the Boss diagnose it as a heart disease?

Could it be that he was deceived by rumors of gu worms fed on heart‑hot blood?

Su Yun pondered this as he and Zheng Ren went to the ward.

A thin, emaciated patient sat on the bed, struggling to breathe the oxygen from the oxygen mask.

Although the oxygen flow had been turned up high, his lips were still bluish‑purple, and he was suffocated to the extreme.

Seeing Zheng Ren enter, the patient struggled to take off his own oxygen mask.

A young man nearby tried to stop him, but he slapped the young man's hand.

Although near death and lacking strength, the young man, frightened, quickly lowered his head and kept apologizing.

"You…… are Zheng Lao Ban, right?" Chu Nu Ang Sai asked with effort.

Zheng Ren nodded and asked: "Are the symptoms of breathing difficulty very severe?"

Zheng Lao Ban, greeting. Chu Nu Ang Sai clasped his hands, made a respectful gesture, and said: "My junior brother was just in a hurry; he's usually overbearing, please forgive him."

"Are you Chinese?" Zheng Ren asked curiously as he listened to him speak.

"My ancestors were; I consider myself of Chinese descent." Chu Nu Ang Sai forced a smile, trying to express his goodwill: "I originally wanted to invite you to have a look, but Song En has been overly indulged by me, and… please forgive him."

After two requests for forgiveness, Zheng Ren smiled.

"May I examine you?" Zheng Ren asked.

"Please." Chu Nu Ang Sai said.

The physical examination was simple and clean, like a Shou Bing, pleasing to watch.

Soon, Zheng Ren finished the examination, confirming his judgment.

The patient sat upright, breathing; sclera obviously yellowed, neck Vein distended, hepatojugular reflux (+); wet Luo sound heard in the lower right lung, abdomen distended, shifting dullness (+), liver edge at the xiphoid and finger breadth, severe edema of both lower limbs.

The System Panel's diagnosis, besides typical portal hypertension, also included an unimaginable diagnosis—cardiac foreign body!

Zheng Ren really didn't want to deal with these gu masters, and didn't know what benefit there would be in receiving their worship.

As for worms, even without trypophobia, Zheng Ren felt a slight apprehension; let alone worms, even the mudfish taken out during a Shou Bing in Hai Cheng, he handled with great care.

But Chu Nu Ang Sai before him, in Zheng Ren's eyes, was not a master at all, merely a patient.

Facing a patient, no matter how afraid, one must steel oneself to see and treat the disease.

He took a deep breath, then asked: "Do you know your condition?"

"Zheng Lao Ban, please have a seat." Chu Nu Ang Sai said: "I was just about to tell you this."

Zheng Ren nodded and sat on the chair at the head of the bed.

The chair was very comfortable, seeming to be of a higher standard than 912 no matter which hospital you go to.

Zheng Ren also knew that this cannot be compared.

"Zheng Lao Ban, my ancestors are from the Miao region." Chu Nu Ang Sai said: "Coming to Nanyang, it's already been nearly a thousand years."

"The ancestors passed down secret methods; because they used heart‑blood to raise gu, they often suffered backlash, becoming a major heart problem."

Saying this, he forced a smile: "A heart problem, indeed a serious heart problem."

Perhaps he was too agitated, perhaps something was tugged, perhaps his oxygen consumption was high; his breathing immediately became deep and labored, Zheng Ren hurriedly fastened the oxygen mask, wondering whether to first insert a chest tube to drain the pleural fluid.

Even the national hospital—how could it not treat pleural effusion?

Perhaps it's also because these doctors themselves fear gu masters; since Chu Nu Ang Sai sought Zheng Lao Ban for treatment, they were happy to avoid getting involved.

After taking a few breaths of oxygen, Chu Nu Ang Sai felt somewhat better.

He removed the oxygen mask and said: "Starting from my grandfather's generation, we have been pondering how to make Improvement. After all, you know, modern technology's Progress of a thousand miles a day, we must keep up with the times."

Su Yun burst out laughing.

Chu Nu Ang Sai smiled, raised his head and asked: "Young man, what should I call you?"

"Su Yun." Su Yun laughed and said: "You're right. Traditional Chinese medicine, in the Republican era, many concepts had not yet been proposed. Now when we say it, everyone thinks it's an old saying passed down, but actually it keeps up with the times."

"Mm, you're a perceptive young man." Chu Nu Ang Sai said: "So, after paying the price of three generations, I finally found the key to success."