It’s nearly nine o’clock in the morning, Thursday, October 10th.
Yu Zhiming came to the Zhizhen Building of Huashan Hospital, and first took the elevator to Takeda Shuhiro's ward on the sixth floor.
After not seeing each other for a few days, Yu Zhiming noticed that this guy seemed to have lost twenty pounds, and his face was wrinkled and haggard. Besides, he was eighty-eight years old, so no one would doubt him.
After accepting the other party's feeble wedding blessing, Yu Zhiming gave him a physical examination.
The inspection results are still satisfactory to Yu Zhiming...
Yu Zhiming came to the third underground floor and was surprised to find that there were quite a lot of people in the big office.
Ding Ye, Zhou Luo, Shen Qi, Sui Chi, Duan Yi, Qiu Yi, Gong Yue, Shen Yiyi and others gathered together.
"There are so many people here, can we discuss the condition?"
Yu Zhiming saw that almost everyone had a copy of the disease information, so he asked casually and looked at Ding Ye.
"When will you return to Germany?"
"I've booked my flight for this Saturday."
Ding Ye replied, shook the disease information in his hand, and said: "Teacher, we are discussing one of Shen Qi's patients. A twenty-year-old college student, his intelligence and memory have improved in more than a year. There has been a significant decline, but no abnormalities were found in various physical examinations."
After a pause, Ding Ye asked curiously: "Teacher, I am newly married, and my wife has just found out that she is pregnant..."
Yu Zhiming knew what this guy wanted to ask, so he interrupted: "I made an appointment with someone to talk about something, so I stopped by to take a look."
He looked at Zhou Luo, Duan Yi and others again, and said, "There is no need to bother with Takeda Shuhiro."
"The next step for him will be to focus on physical recovery, and we will try to have him discharged from the hospital like a normal person in a week."
"Yes, teacher!" Zhou Luo, Duan Yi and others responded in unison.
Yu Zhiming looked at the whiteboard and saw that it listed one possibility after another, such as craniocerebral trauma, brain atrophy, tumors, cerebrovascular disease, malnutrition, poor metabolism, poisoning, drug abuse, epilepsy, autoimmune encephalopathy, depression, and adverse reactions. Living habits, etc.
Yu Zhiming discovered that the words "Alzheimer's Disease" on the whiteboard were highlighted.
"Do you suspect Alzheimer's disease?"
Shen Yiyi was the first to speak: "Dr. Yu, the current youngest diagnosed case of Alzheimer's disease is actually 21 years old."
"The patient we have has symptoms such as mental decline, memory loss, personality changes, etc. that are consistent with the typical symptoms of Alzheimer's disease."
"The cognitive and neuropsychological tests performed on the patients, including their sense of direction, reasoning and judgment, language skills and attention, etc., also meet the diagnostic criteria for Alzheimer's disease."
"However, the brain imaging data does not support this. CT and PET medical imaging examinations showed no imaging signs such as temporal lobe atrophy, amygdala volume reduction, or cerebral amyloidosis."
Shen Yiyi further explained: "But I think this is probably because the patient is too young. After all, her brain begins to age at her age."
Brain nerve cells stop dividing and growing after birth.
Starting from the age of twenty, you will gradually age, losing 0.8% of your brain cells every year, and the number will decrease selectively depending on the type and location of nerve cells.
By the age of sixty, the number of nerves and cells in the cerebral cortex decreases by 20%-25%, which may be the main cause of Alzheimer's disease, memory loss, insomnia, and the inability to control emotions.
Yu Zhiming looked at Qiu Yi and Gong Yue.
Qiu Yi glanced at Gong Yue and then said: "From the current examinations, the patient only showed symptoms, but no physical abnormality that caused these symptoms was found."
"The Alzheimer's disease proposed by Shen Yiyi is indeed very possible, but unless there is a conclusive basis for the diagnosis, I will not agree with the diagnosis of Alzheimer's disease."
Duan Yi took the words and said with an unbearable expression: "That's right, she is only twenty years old. She is really suffering from Alzheimer's disease. She will be finished in her lifetime."
Yu Zhiming rolled his eyelids and criticized: "Duan Yi, is this your first day as a doctor? What kind of disease does the patient have? Can you change it if you can't bear it or not?"
Duan Yi stuck out her tongue, took another step to the side, and hid behind Ding Ye.
Yu Zhiming looked a little speechless and Duan Yi was unwilling to talk to her. He glanced at the many possibilities on the whiteboard again.
"Since no physical abnormality can be found through various examinations, perhaps her symptoms are caused by external reasons."
Yu Zhiming pondered and asked: "Did her change happen in the past year or so? Can I think that it happened after she went to college?"
Shen Qi's eyes lit up and he said: "Teacher, she is now in her third year of college. The fact that she was admitted to Binhai Normal University back then shows that her intelligence level at that time was still acceptable."
"Perhaps it was the environmental factors after entering university that caused her mental decline?"
Duan Yi reminded: "Speaking of going to college, I still remember the patient's father once said that she performed abnormally when she was admitted to college. With her past academic performance, she could have passed 211. If she performed better, she could have passed 985."
"Perhaps, the college entrance examination did not perform abnormally?"
Yu Zhiming said: "Then do an environmental investigation at the patient's home and school to see if the suspicious cause can be found."
When facing illness, almost everyone will ask: Why do I get sick? Why me?
Some people drink, smoke, eat meat, have irregular work and rest schedules, and live such unhealthy lifestyles, yet they can still live to be ninety-nine.
But there are also people who don't smoke, don't drink, don't stay up late, and still love to exercise, but they end up getting seriously ill.
Is this illness due to environmental factors? Or is it fate?
A foreign university conducted a 24-year follow-up survey on tens of millions of people.
They found that among the 560 diseases investigated, 58% were affected by genetic factors, 40% of which were significantly affected. 32% of the diseases were affected by environmental factors, of which 25% were significantly affected.
Judging from their research, the cause of the disease is mainly internal and external.
However, except for congenital diseases, most diseases are the result of the interaction between innate genes and acquired environment.
Therefore, in the diagnosis of difficult and miscellaneous diseases, environmental investigation is an important task in disease diagnosis.
But doctors rarely do this work.
The main reason is that doctors are too busy. Half an hour can be allocated to a patient every day, which is very good. Even the consultation is so-so, and there is still time to go to the patient's home and workplace to conduct environmental surveys...
Yu Zhiming was secretly happy.
Once again, he relied on his wisdom, rather than his ability to explore the body, to provide them, a group of outstanding young doctors, with an idea to solve the problem.
He walked into the soundproof office with a face that showed no problem, and made preparations for the next appointment.
Gu Qingran made an appointment for him. At 10:30 in the morning, he would meet with the heads of three insurance companies to answer their questions...