Chapter 1686: with translation of chapter title

Fetch Zheng Lao Ban; I originally just wanted to see his superb dissection technique.

But who would have thought Zheng Lao Ban would not follow the routine, not looking for the site of cerebral hemorrhage, but instead directly discovering carotid artery thrombosis via dissection.

"Zheng... Lao Ban, what do you mean?" Li Zhaosen couldn't speak clearly.

"The deceased himself had carotid artery atherosclerosis, with poor blood vessel elasticity; during the process of dodging and fighting, the neck underwent violent movements such as excessive extension or lateral bending."

The sudden violent tug on the carotid artery caused tearing of the carotid intima, leading to thrombus formation and occlusion of the lumen.

Brain tissue, due to blood vessel occlusion or partial detachment of thrombus embolizing intracranial branches, suffered acute cerebral ischemia, resulting in multiple large-area infarcts.

Zheng Ren slapped the knife in front of Li Zhaosen, directly took off his gloves, and said crisply.

"" Everyone was stunned.

"Boss, carotid intimal tear has a low incidence; how did you think of that?" Su Yun asked, frowning.

"The disease progression is weird; unexplained incontinence of urine and feces, the considered condition is mainly carotid intimal tear syndrome." Zheng Ren said casually.

"How do you know?" Su Yun cared about this point.

"When you hadn't gone to the Emergency Department yet, there was a similar patient in the observation room, later sent to the medical university." Zheng Ren said offhandedly; anyway, Su Yun arrived at the Emergency Department a few days after him, so whatever he said was taken as fact.

If you have the ability, go back to Hai Cheng to look up the case; Zheng Ren believes Su Yun isn't that idle.

Su Yun was just asking casually; he didn't really think about what Zheng Ren said.

A clear chain of logic: if there's a chance to do dissection, one would certainly look at the carotid artery. In this regard, Su Yun would not doubt his own boss's intelligence.

That guy, his EQ is low, but his IQ is certainly not low—just a bit lower than mine, Su Yun thought.

"Zheng Lao Ban, this..." Li Zhaosen, being inarticulate, didn't know what to say.

"Huh?" Zheng Ren tilted his head to look at him, smiled, and said, "What's up?"

"Traumatic carotid artery occlusion and cerebral infarction lead to completely different judgments in court. The forensic examiner must be cautious; you... can you be sure?" Li Zhaosen said softly.

Zheng Ren carefully observed his expression, feeling he wasn't defending the other party but merely asking him to be more cautious.

Perhaps in Li Zhaosen's view, my judgment seems a bit forced, but in my view, it's as clear as day.

Indeed, for something like an autopsy, how would one find a top domestic diagnostic and Shou Bing expert to do it?

A top Shou Bing expert charges tens of thousands for one procedure; with this time, it'd be better to go practice Flying Knife. Who would pay for the autopsy fees?

This time it's just luck; I might as well teach Li Zhaosen a few things.

This person's dissection technique is very skilled, but an autopsy absolutely cannot be done relying solely on dissection.

Corresponding clinical knowledge and disease progression will provide many clues.

From his attitude toward the medical record, Zheng Ren could guess a thing or two.

"That's right." Zheng Ren turned around, took off his white coat, and said: "Traumatic carotid artery occlusion refers to blunt or sharp instrument injury to the neck, excessive extension or lateral bending of the neck, or skull fracture involving the petrous part of the temporal bone, etc., causing tearing or rupture of the carotid intima, resulting in complete thrombotic occlusion."

"This disease is divided into open and closed types; the patient's... the deceased's condition is relatively easy to distinguish."

"That... Li Teacher, just doing dissection isn't enough; if the deceased came from the hospital, we should still look at the medical record more. Some descriptions in the record can infer many situations." Zheng Ren said.

"" Li Zhaosen silently looked at Zheng Ren, face full of grievance. But he wasn't dissatisfied; rather, he was more confused.

After that day's ESD dissection, Li Zhaosen's attitude toward Zheng Ren had skipped over plain, friendly, respectful, reverent, and went straight to worship.

Zheng Ren found Li Zhaosen interesting and was willing to say a few words to him; while washing his hands, he said: "Just as clinical practice has differential diagnosis, forensic examiners certainly do too. Both are cerebral infarction; traumatic and pathological still have differences."

"What differences?" Li Zhaosen asked like a student.

"First, there is a clear history of head and neck trauma; the site of external force easily causes excessive extension or lateral bending of the neck."

"Second, there is a latent period between injury and onset. The patient just now had a 2-3 day latent period; during the latent period, the patient was completely fine. This is also my main basis for judging the patient as having carotid intimal tear syndrome."

"Third, after onset, mild hemiparesis, unilateral sensory disturbance, and aphasia may appear; some may also develop Horner syndrome. This is not obvious in the medical record, because county-level hospitals find it hard to make a targeted judgment."

"Fourth, cranial CT shows unilateral or bilateral multiple large areas of cerebral softening foci, inconsistent with the typical sites of the latter."

"Fifth, autopsy reveals rupture of the carotid intima and thrombus formation."

Zheng Ren has the thinking of a standard science student; his one-two-three-four-five explanation directly left Li Zhaosen bewildered.

What the hell is this?

Although I didn't understand, that feeling of not being enlightened lingered in my heart. Zheng Lao Ban is truly professional; Li Zhaosen felt immense admiration.

Although I am a doctor, others directly crush me in autopsy.

"Zheng... Lao Ban, speak slowly, I'll take notes." Li Zhaosen had an expression of admiration.

Unlike Liu Zewei's old-hand type, Li Zhaosen is the kind of person who is single-minded; he writes everything on his face rather than hiding it in his heart.

Zheng Ren thought Li Zhaosen was a bit obsessed, obsessed with Technique, but he's still a decent person.

He said it bit by bit slowly; after Li Zhaosen recorded it, Zheng Ren only then realized he could have used a WeChat voice message.

"Zheng Lao Ban, the Corpse Teacher brought the specimens." Zhou Chun Yong answered a call and said.

Upon hearing the words 'Corpse Teacher', Li Zhaosen's ears perked up.

"Good." Zheng Ren and Li Zhaosen said: "Li Teacher, then we..."

Just as he said that, Zheng Ren's phone rang.

【They said quickly write a love song, for both refined and popular tastes……】

Zheng Ren answered the phone: "Dean, I..."

"Hmm, I'm at the medical university." Zheng Ren's expression immediately became solemn; seeing this, Zhou Chun Yong felt a shudder in his heart.

An ominous premonition quickly rose in his heart.

"Okay, I'll rush over right away!" Zheng Ren said solemnly.

"Boss, what's wrong?" Su Yun asked.

"An employee working overseas was injured locally, a gunshot wound. After simple treatment he was sent back to the country; it's been eight days and they still can't find the bullet. Vice President Yuan asked me to come for a consultation, to see if we can discover anything." Zheng Ren said this and then hurried away.

"Zheng Lao Ban..." Zhou Chun Yong's voice was very small, getting smaller and smaller.