Taking up space in the brain? Sun Lien rubbed his eyes, but the display on the status bar did not change. That's what the status bar floating above the patient's head really said.
What? Sun Lien took out the MRI report again. The image above clearly showed that there was no abnormality in the patient's brain.
An MRI was done at 3 o'clock yesterday afternoon, and no abnormalities were found. Another one was done at 9 o'clock this morning, and no abnormalities were found. After completing the examination at around 9:30, Zhou Jun, according to the Department of Rheumatology and Immunology,
The doctors’ opinions adjusted the patient’s medication...
During the five and a half hours of adjusting the medication, what happened to cause this change? Sun Lien frowned. He didn't need the status bar prompts to guess that this was probably the main cause of the patient in front of him. At least it was
One of the main reasons.
"Have you checked the cerebrospinal fluid pressure?" Sun Lien walked to the side of the patient and asked Zhou Jun. When collecting cerebrospinal fluid, the cerebrospinal fluid pressure is generally not measured. Unless the patient has obvious signs of increased intracranial pressure. And the brain
The occurrence of space-occupying lesions basically means that the patient's intracranial pressure will increase. Checking the cerebrospinal fluid pressure at this time, although there will be some risks, will make it easier to clarify the patient's symptoms.
"No, I'll ask Xiao Guo to check." Zhou Jun nodded, "What other checks are needed?"
"I want to talk to the patient's family." Sun Lien frowned. He actually didn't have any other ideas. But the status bar currently prompted a useful help. Before confirming it through cerebrospinal fluid, he really didn't have any other tests.
It can be done. After all, the patient's current vital signs are quite stable, and nothing was seen on the imaging examination five and a half hours ago. Even if the condition changes, it probably won't be life-threatening immediately.
If he continues to stay at the scene, he will have to face Zhou Jun's constant questioning. Sun Lien does not want to put himself on the fire. Choosing to communicate with his family now is the best way to avoid disaster.
"The family members are in the small conference room. You can go directly there." Zhou Jun nodded and communicated with the family members to understand the patient's medical history. This is a routine method. But sometimes the patient's family members are easily in front of them because of anxiety or other factors.
Some important information is missed in several conversations with doctors. Multiple conversations can help patients and family members calm down their anxiety, and it is easier for doctors to discover some special points in each conversation.
The person who came to the hospital with Yang Jianqiang was his wife. Yang Jianqiang himself is an ordinary programmer. Due to the special nature of his work, although he usually lives in Ningyuan, the company he works for is far away in Shanghai. Mrs. Yang is an out-and-out programmer.
She is a Taoist Shanghai woman. She used to be Yang Jianqiang's boss. During her work, she was gradually attracted by this man from science and engineering who had no hair but a great sense of humor. In the end, she gave up her management position and followed Yang Jianqiang to settle in Ningyuan.
However, this woman who usually pays great attention to her appearance now has greasy and messy hair, her face is covered with acne breakouts, and her eye bags are deep and large. She looks like she is in her forties or fifties.
"Doctor..." When Mrs. Yang saw Sun Lien approaching, she immediately stood up from her seat nervously. "Old Yang... how is he?"
"The situation is relatively stable. But we are still trying other diagnostic solutions." Sun Li'en pointed to the seat and motioned to Mrs. Yang to sit down first. "Don't worry, I have some questions to ask you."
Mrs. Yang was anxious, "Our old Yang has been sent to the hospital all day and night. Why haven't you figured out what disease he has?!"
"That's why I came to ask." Sun Lien said seriously, "He has received a bone marrow transplant before and has been using immunosuppressants to prevent the allogeneic transplanted bone marrow from being attacked by the immune system." Sun Lien glanced at Mrs. Yang
, "You know this, right?"
Mrs. Yang nodded, then started covering her face and crying.
"Based on the situation you described before, I still have some questions to ask. These questions may be related to your husband's condition." Sun Lien sighed. Although he wanted to comfort the family members in front of him, he had to finish the interview as soon as possible.
It will not take long for Xiao Guo to conduct a cerebrospinal fluid pressure level test. Once he finds that the result is abnormal, he will immediately send the patient to the imaging department for examination.
Mrs. Yang tried her best to calm down. She nodded to Sun Lien with red eyes, "Just ask."
"The patient reported that he started to have fever a week ago and also had symptoms of fatigue." Sun Lien looked at the case and racked his brains to think about the problem, "Did he have any special symptoms before this week? Trauma, difficulty moving, starting from
Get forgetful...anything different from usual is fine."
Mrs. Yang lowered her head and began to try hard to recall any unusual experiences her husband had had before. But no matter how hard she tried, she could not provide even a hint of suspicious information.
"It's okay. It's okay if you can't think of it." Sun Lien had to stop asking again and comforted his family members. The main difficulty in diagnosing Yang Jianqiang's patient is actually reflected here. In the existing examination system, most of
The tests all rely on the body's own immune system to react and label antigens. This is the so-called antibody test. It has to be said that the immune system in the human body is actually a very efficient and sensitive defense system. They will target various
Antigens produce specific antibodies, and these antibodies are used to label the antigens, thereby guiding immune cells to eliminate the antigens.
In modern medicine, doctors can use these antibodies floating in the blood to determine what has invaded the human body and what has caused the disease. By examining the antibodies, the antigens can be clarified, and corresponding treatments can be adopted by clarifying the antigens.
This is the basic treatment process of modern medicine.
However, this method did not work as it should on Yang Jianqiang.
Immunosuppressants suppressed the cellular immune function in his body, and Yang Jianqiang also received T-lymphocyte depletion drugs after bone marrow transplantation. This further weakened his body's immune system's ability to resist and mark antigens.
Yang Jianqiang's immune system is unable to resist antigens and cannot mark them. This means that not only is his body defenseless, doctors are unable to help them. Until now, the doctors have not figured out what is happening.
What triggered Yang Jianqiang's symptoms.
"Let's see..." Sun Lien comforted him for a while. After seeing that the comforting effect was not obvious, he suddenly had an idea. "Can you tell me about Yang Jianqiang?"
"What?" Mrs. Yang was stunned. She thought she heard wrongly.
"Can you tell me what kind of person Yang Jianqiang is?" Sun Lien took out his notebook and pen. "Please tell me what you know about him. You can start anywhere." He looked up.
He looked at Mrs. Yang and said seriously, "Please tell me, I'm ready."
Yang Jianqiang is a technical geek who loves life. This is Mrs. Yang's evaluation of her husband. He is humorous, kind, generous and has an incomparable enthusiasm for life. He likes to make furniture by himself and repair electrical appliances at home.
He even likes to do it himself, grafting and cutting fruit trees at home, even though he has no experience or knowledge in this field.
The Yang family is full of Yang Jianqiang’s homemade handicrafts, and they are all of different types. From the homemade sofa, to the homemade wool felt, and even the cat climbing frame on the ceiling in the corner of the Yang family, Yang Jianqiang himself made it bit by bit.
"Do you have pets at home?" Sun Lien suddenly became energetic when he heard this. This was something that was not mentioned in the medical records before.
"No." Mrs. Yang shook her head a little lonely, "Lao Yang wanted to raise a cat, so before decorating the house, he had already designed these cat climbing frames and the like. But we were planning to have children at that time, so
I haven’t raised it since.”
"You don't have pets...?" Sun Lien's excitement subsided, but he still managed to pull himself together and asked, "How long have you been preparing for pregnancy?" Mrs. Yang and Yang Jianqiang are not too young.
"More than two years." Mrs. Yang lowered her head, "We went to the hospital for a checkup. I had some difficulty implanting in bed."
In other words, Yang Jianqiang did not have any reproductive system problems before. Sun Lien once again ruled out one direction. However, these did not seem to be of direct help to the diagnosis.
"I'm still a little concerned about the cat climbing frame." Sun Lien pondered for a while and asked directly, "When doing carpentry and the like, does he use any varnish or spray to protect the wood?"
Mrs. Yang shook her head, "We stayed away from all chemical agents when we were preparing for pregnancy. Lao Yang never used varnish in his woodworking. If anti-corrosion was needed, he would use a spray gun to bake the wood over to create carbonization anti-corrosion.
"
"Why a cat climbing frame?" Sun Lien continued to ask. There was no purpose anyway. Maybe if he kept asking like this, he would be able to get some clues. "Has he ever raised a cat before?"
"Before we met...Old Yang should have raised a dog." After trying to recall it, Mrs. Yang replied uncertainly, "It's just that before he went to Shanghai to apply for a job, the dog was taken by a car.
He was run over to death. Well... He said that his grandmother had a white cat before. A big white cat with blue eyes and very beautiful. But that was almost thirty years ago."
There didn't seem to be anything suspicious? Sun Lien sighed. It seemed that the conversation had not made any progress. I wonder how Xiao Guo's inspection was.
"Brother Sun." Just as he was thinking about it, Xiao Guo suddenly poked his head out of the emergency room and waved to Sun Li'en, "The cerebrospinal fluid pressure is 210mm/h2o, which is a little high."
"Send to the CT room, and then do another MRI." Sun Lien suddenly stood up from his seat, "Prepare two bags of mannitol..." He suddenly remembered something, "Where is Dr. Pascal?"
"Lao Pa should be outpatient at the rheumatology and immunity department today." Xiao Guo replied, "Do you want me to call him over?"
"No, you go make arrangements for the imaging examination. I'll ask Lao Pa to come over and hold the line." Sun Lien quickly made the arrangements, said sorry to Mrs. Yang, and rushed directly to the duty desk.