As an outstanding clinical physician, Zhang Xiaoqian accumulated extremely rich experience in 65 years of clinical work from July 1921 until he saw the last patient in July 1986. , showing extremely superb skills in clinical diagnosis and saving countless critically ill patients. He is particularly good at correctly diagnosing difficult patients, correcting misdiagnosis, and bringing many patients back to life. Some cases have only been found in a few cases in the world. His own attitude towards patients has always been cordial and kind, and he works extremely patiently and carefully. Whether they are ordinary people or senior cadres; whether they are familiar colleagues or strangers, he treats them equally. He believes that only the medical ethics of serving patients wholeheartedly can be a powerful motivation for medical staff to improve their medical skills. He himself did the same, so he could achieve what he always advocated as "diligence in practice and repeated verification."
He attaches great importance to book knowledge and spends a lot of his spare time reading books and periodicals in the library and following the cutting-edge development of medicine. At the same time, he places more emphasis on clinical practice. He warned his students that the basis of clinical practice should be to observe each specific patient. Books are only indirect experiences, many of which still need to be tested in practice. Concrete analysis of specific situations is an important principle of clinical work.
His motto is "precaution, caution, fear and fear". He repeatedly taught his students to be modest and prudent, to seek truth from facts, not to be subjective or discouraged, to discover mistakes at any time, admit them, correct them, turn mistakes into correctness, and turn one-sided knowledge into something close to comprehensive. Because of this, he can start from the patient's actual situation, comprehensively and historically understand the patient's symptoms and signs, thereby discovering some important symptoms and signs that were missed in the past, and arrive at a correct diagnosis.
“Every case is a research topic”, this is a famous saying of Zhang Xiaoqian. He is strict and meticulous, and is good at treating every case with a scientific attitude, carefully considering, repeatedly deliberation, reading a lot of books, and doing in-depth research before proposing a diagnostic opinion. There are countless such examples, but only three are introduced below.
In the mid-1960s, a female patient came to Union Medical College Hospital for treatment. She had a strange symptom: she went into shock when she caught a cold. Before that, she went to another hospital for treatment. The thymol turbidity test showed that the result was highly abnormal, so she was diagnosed with hepatitis. After Zhang Xiaoqian's examination, he suspected that it was not hepatitis, but he could not draw a conclusion for the time being. Later, I learned that she suffered a massive hemorrhage during childbirth 30 years ago, and it was Zhang Xiaoqian who saved her life with a blood transfusion. Zhang Xiaoqian connected the history of 30 years ago with this symptom and immediately diagnosed it as Sheehan's syndrome. A massive hemorrhage during labor 30 years ago caused pituitary gland necrosis, leading to hypopituitarism, resulting in endocrine insufficiency and response stress defects in the thyroid and adrenal glands. Therefore, patients would go into shock when they were exposed to emergency infection. The abnormality in her thymol turbidity test was the result of hypothyroidism and increased blood lipids. Therefore, Zhang Xiaoqian gave her alternative treatment - taking thyroid tablets and adrenocortical hormone, and her condition improved quickly.
In October 1977, Chang Xiaoqian diagnosed a case of mesenchymal tumor combined with vitamin D-resistant hypophosphatemic chondrosis. This disease is extremely rare in the world. This is the 8th case reported. This is a male patient who suffered multiple pathological fractures and had difficulty standing. He was diagnosed with lumbar muscle strain and rheumatoid arthritis. He took a large amount of vitamin D and calcium. None of the medicines are effective, and the disease cannot be cured with long-term treatment. Zhang Xiaoqian carefully studied the clinical records and found a small mass in the patient's right groin. He immediately thought that the mass might secrete some kind of hormone substance and cause abnormal calcium and phosphorus metabolism. After surgical resection, the pathological diagnosis was mesenchymal tumor, and the tumor cells showed secretory granules under an electron microscope. After the operation, the patient's calcium and phosphorus metabolism returned to normal, the symptoms disappeared quickly, and there was no recurrence during follow-up one year later.
A patient was admitted to the hospital due to edema of the lower limbs with blood in the sputum. The laboratory test results showed that there were red blood cells in the urine. The doctor in charge diagnosed the patient with pulmonary-renal hemorrhagic syndrome. Zhang Xiaoqian attended the consultation, agreed with the diagnosis after the preliminary examination, and formulated a treatment plan. Afterwards, he thought over and over and decided to do further examination and found that the patient's leg veins were a little abnormal. Based on clues, he found that the patient suffered from migrating (migrating) thrombophlebitis. Phlebitis causes damage to various organs such as the lungs and kidneys, giving people a false impression. Later, he was treated according to the new diagnosis, and his condition improved quickly.