My daily work as a doctor: My treatment value is increasing.

After a period of training, Lu Renxin and Jiang Zhaoning both passed the colonoscopy examination.

Director Yuan and Director Huang of the Department of Gastroenterology have already made arrangements to add a group of trained new staff to the endoscopy center's schedule.

This provides Lu Renxin with an additional source of healing value.

However, out of responsibility to the patients, they were initially cared for by Wang Yong.

Hearing this arrangement, the two, who were initially worried and apprehensive, felt much more relaxed. After all, it was a skill they had just learned, and it was definitely not feasible to operate it independently right away.

Wang Yong wasn't responsible for the hands-on work; he was only responsible for watching the two of them from behind, checking for any problems with the steps or operations, and finally confirming whether their diagnosis was correct.

The monitor in the colonoscope room clearly displays the inside of the human body.

Lu Renxin switched his hands back and forth, skillfully manipulating the colonoscope handle while constantly adjusting the position of the lens.

As the colonoscope went deeper, they could see that the intestinal mucosa, which should have been smooth and flat with clear blood vessel patterns, was now shockingly disturbing.

Starting from the rectum, the condition spreads inwards, with the vascular patterns becoming blurred, disordered, or even disappearing, replaced by diffuse, large-scale, continuous mucosal congestion and edema.

The inside of the intestinal cavity was a bright red color, as if it had been scorched by fire, and there was a lot of yellowish-white purulent secretion attached to the walls.

He manipulated the camera very carefully, trying to avoid the intestinal wall, but the space inside the intestines was so small that it was really hard to avoid.

This resulted in a force that would not normally damage the intestinal wall being applied to this patient, causing the fragile mucosa to bleed even with just a swipe.

"It's so brittle, and there's obvious contact bleeding."

Lu Renxin's expression suddenly turned serious: "No, we can't let any more blood flow. I have to be more careful."

He became even more cautious in his movements as he zoomed in on the camera.

After finally reaching the most severely affected area, one can see large areas of mucosa eroded and ulcerated.

"It feels like ulcerative colitis." That was his first reaction after seeing the whole picture.

This is a chronic, nonspecific inflammatory bowel disease, which can be understood as an overreaction of the intestinal mucosa.

The immune system is like a warrior guarding the body, preventing attacks from invaders. In a normal person, the gut contains bacteria and food residue, which are the residents of the city.

If these warriors defending the city make a mistake and mistake ordinary residents for enemies, they will attack the machine body in a frenzy, causing lesions to occur in the mucous membranes.

Wang Yong stared at the screen and thought it was a great teaching case.

He turned to look at Jiang Zhaoning and Lu Renxin, his tone serious: "You've both seen the symptoms under the microscope, so tell me, what diagnosis should this patient receive?"

Jiang Zhaoning answered almost without hesitation, having already prepared her answer, and blurted it out without thinking:

"Based on the extensive, continuous, shallow ulcers under the microscope, and the fragile mucosa that bleeds easily, ulcerative colitis is suspected," she answered crisply.

Just like his first impression, Lu Renxin nodded slightly in agreement.

"And what about you, Xiao Lu?" Wang Yong's gaze shifted to him.

"Why did you ask that, Brother Wang? Is there a trap?" Lu Renxin frowned slightly, not answering immediately.

He silently wondered, "Is ulcerative colitis the only condition? What about the symptoms of other diseases?"

After a few seconds, he spoke slowly and cautiously, "I also tend to think it's ulcerative colitis, but..."

He paused, then added, "A diagnosis cannot be made solely based on a colonoscopy, as other diseases present with highly similar symptoms."

"For example, in the acute phase of ischemic bowel disease, there will also be extensive intestinal mucosal congestion, erosion, and patchy bleeding, as well as chronic bacterial dysentery..."

Lu Renxin presented the primary diagnosis in a clear and organized manner, and also pointed out other diseases that are easily misdiagnosed and have highly similar manifestations.

Wang Yong's eyes instantly showed approval.

Jiang Zhaoning also glanced sideways. Compared to her own thoughts, Lu Renxin's considerations were clearly more comprehensive, mature, and meticulous.

She felt frustrated: "Why didn't I think of that? I only naturally thought of common ailments. Why didn't I consider other possibilities?"

Wang Yong's words were full of affirmation: "Xiao Jiang makes quick judgments, grasps typical microscopic features, and has a very solid foundation."

He changed the subject, his expression turning serious, and instructed, "But I'm not asking you questions today to test your basic skills. You will soon be able to perform colonoscopies and make diagnoses independently."

"I want to remind you that you need to consider many factors when writing a diagnosis. You can't just assume that the patient's disease is a common disease or an easy disease to get."

"Patients come in for a colonoscopy to get a diagnosis. The documents we write are legally binding. Endoscopic images are just a reference. No matter how typical or resembling ulcerative colitis may be, we cannot make a definitive diagnosis directly."

Wang Yong relaxed and praised, "Lu Renxin did a great job in this respect. He knows how to think one step further, he is not limited by appearances, and he can immediately make connections to disease identification. His clinical thinking is very stable."

He pointed to the congested and eroded intestinal mucosa on the screen and patiently explained, "You must always remember to consider the patient's complete medical history."

"When we perform a colonoscopy, we only see one aspect of the patient. The patient's age, symptoms, signs, etc., are all recorded in the outpatient and inpatient medical records."

"Taking a closer look won't waste time. Take ulcerative colitis as an example. Its colonoscopy findings are similar to other diseases, but it has typical symptoms—pain, diarrhea, and blood."

"Diarrhea" refers to recurrent diarrhea, in which patients have increased bowel movements, often with mucus and pus. "Blood" may also be accompanied by fever, weight loss, anemia, or fatigue.

"Pain" refers to intermittent dull pain in the lower left abdomen or lower abdomen, sometimes accompanied by a feeling of incomplete evacuation—patients usually feel abdominal pain and want to go to the toilet, but after defecating, they feel that they have not emptied their bowels completely and want to defecate again.

The symptoms of bacterial dysentery and hemorrhagic enteropathy are different. One is paroxysmal colic accompanied by obvious systemic symptoms, while the other is characterized by bloody stools resembling meat washing water, red bean soup, or jam.

"You can't just rely on the microscopic findings to make a diagnosis. Don't be lazy; take a closer look at the medical history of outpatients or inpatients for a more accurate diagnosis," Wang Yong patiently advised.

Upon hearing this, Jiang Zhaoning lowered her head slightly and silently memorized the teaching. She realized that she had been too hasty and had overlooked the key clinical approach.

Lu Renxin stood quietly to the side, listening attentively, his mind becoming increasingly clear: "I must be more meticulous and thorough in the future!"

To further assess the severity of the patient's condition, he then used biopsy forceps to take several tissue samples from the lesion site for pathological examination.

[Congratulations, host, you have successfully completed one colonoscopy. Treatment value +13]