It was not an infection, an autoimmune disease, or organic compound poisoning. Sun Lien hugged Hu Jia and spun him around. He was so happy.
"Should I wait outside for a while before coming in?" Dr. Pascal leaned half against the door frame, looked at Sun Lien and Hu Jia with a smile and asked, "Why are you so happy all of a sudden?"
"I understand what disease Zhan Hao has!" Sun Lien said to Dr. Pascal, "It's not an autoimmune disease, it's poisoning, heavy metal poisoning!"
Heavy metal poisoning refers to poisoning caused by heavy metal elements or their compounds with a relative atomic weight greater than 65. Because heavy metals can irreversibly change the properties of protein surfaces, heavy metal poisoning often manifests as hemolysis, smooth muscle spasm, and neurological symptoms. Since the liver and kidneys are
It is the main metabolism and detoxification organ of the human body. Therefore, heavy metal poisoning can also seriously affect the health of people's liver and kidneys. In severe cases, it may even cause symptoms such as organ failure.
"It can explain all his symptoms." Dr. Pascal nodded after thinking for a moment, and then shook his head, "But, he has no way of exposure."
"I'll call everyone back first, Xiao Guo! Order a urine test to check for lead in the urine!" Sun Lien did not investigate how the patient had ingested lead. The second half of the sentence was directed at the nurse Xiao Guo.
Several calls were made to Xu Yourong and Yuan Pingan who had not yet had time to wash their hair. Even Liu Pingchuan was invited to the conference room by Sun Lien. The urine samples had been sent to the laboratory for testing, and he reported to many members of the treatment team
He explained his diagnosis. Hu Jia found an empty seat and sat down, quietly enjoying her boyfriend's performance.
"Except for heavy metal poisoning, there is no other explanation for his symptoms." Sun Lien explained his diagnostic opinions to the team members, "From the symptoms, the most consistent manifestation is acute lead poisoning. I have asked Xiao Guo
I sent the specimen for testing and the results should be available soon."
Liu Pingchuan frowned and knocked on the table, "You also said it was acute poisoning. Whose acute poisoning would show an attack nine days ago, then resolve on its own, and then attack again nine days later?"
"If it is fat-soluble compound poisoning, it may gradually increase due to nutritional intake problems. I have heard of some cases of allergies caused by fat-soluble substances. Even in the clean room of the hospital, it still cannot prevent the continued presence of fat in his blood.
The cells absorbed the stored allergic substances. Later, he reluctantly stopped by relying on high-calorie foods and continued to consume fat. But it was a continuous deterioration without such fluctuations in the middle." Dr. Pascal said his opinion, "He has never stopped consuming fat.
Another hospital was sent to us, and it took about 30 minutes on the road. It may have been a little cold after getting on and off the bus. But I don't think that the thirty minutes of bumpy and short-term coldness may cause the disease that has been relieved to return.
Even heavy metal poisoning should be impossible if the outbreak occurs."
"The most important thing is that this patient's occupation is in the retail industry. He opened a small supermarket. It is not in the smelting or metal processing industry, nor is it a heavily polluting industry such as batteries. The amount of lead required for acute lead poisoning at one time
It's very big. There has been no case of acute lead poisoning in our city in the past five years, and there have only been a few cases of chronic lead poisoning." Xu Yourong also disagreed with Sun Lien's diagnosis, "Even if he is really poisoned, it is obvious that he was hospitalized.
Without the toxic substances. In this case, he will not have another acute attack nine days later."
Sun Lien's diagnosis was often questioned by other doctors because of cheating, but at those times Sun Lien was very confident that the results of cheating could be wrong? But this time it was different. This time the diagnosis was entirely based on Sun Lien's own inferences.
The information provided by the status bar is actually very limited, and does not even exceed the existing inspection results.
Therefore, Sun Lien is a bit vain.
But Sun Lien understands the logical rules of what he has deduced best. Indeed, disease diagnosis is the same as detective reasoning. When you eliminate all other possibilities based on the existing intelligence and evidence, no matter how difficult the remaining answers are,
Believe me, they are all correct answers.
The patient's condition and blood test results were not consistent with any known infection or autoimmune disease. Zhan Hao was either poisoned by heavy metals and ingested the poison again within nine days, or he suffered from an unknown disease.
Known diseases.
The second scenario is not completely impossible, but the first scenario is obviously more likely.
"Anyway, we will know when the urine lead results come out." Having made the diagnosis entirely on his own, Sun Lien was full of confidence at the moment.
Yuan Pingan suddenly laughed, "Don't tell me, if it is really heavy metal poisoning, you may be the only one in this room who is most likely to diagnose it."
"Why?" The atmosphere in the room calmed down, and Hu Jia couldn't help but ask. Although she was quite familiar with Xu Yourong, she felt a little unhappy when she saw a group of doctors denying Sun Lien's diagnosis.
place. Now that he heard Yuan Pingan's approval, Hu Jia suddenly became curious.
"Heavy metal poisoning is not within the scope of diagnosis and treatment in our general hospitals. Especially the lead poisoning he is checking." Yuan Pingan replied, "If you are not a medical student in public medicine and occupational disease prevention and treatment, you will be exposed to the concept of 'lead poisoning'.
It was when I took the public health course in my junior year. To put it bluntly, among the doctors present, Sun Lien was the only one who could clearly remember this disease. If he hadn't thought of this aspect, we might have had to work blindly for a long time before we would even consider it."
"Actually, it's not what I thought of." Sun Lien explained with a smile, "Hu Jia mentioned to me the peeling of the coating on the thermal insulation tableware, and that's when I thought of this aspect. Wasn't it often said that peeling off the coating can lead to poisoning?
The doctor in the laboratory department also mentioned to me that the patient's blood sample showed a large number of basophilic stippling red blood cells under the microscope. The large number of basophilic stippling red blood cells is likely to be caused by heavy metal poisoning."
"If it is poisoning, we must find out whether he accidentally ingested it in his daily life or whether there was poisoning." Liu Pingchuan made a decision, "The patient is still conscious now, and his family members seem to be in the hospital as well.
.Li En, go and ask about the situation, and if necessary, notify Old Wu to come over."
Hu Jia and Sun Lien walked out of the conference room together. After the two of them got tired of each other for a minute or two, Hu Jia waved to Sun Lien and said she had to go back to rest. Sun Lien felt a strange sense of satisfaction from successfully performing in front of his girlfriend.
, walked to Zhan Hao's side.
"Doctor Sun." Zhan Hao still looked very weak, but his energy was still good. "I'm really troubling you this time."
"This is what we should do." Sun Lien pulled out a stool and sat down next to Zhan Hao's bed. "I have some questions to ask you about the cause of your illness. Please try to answer as truthfully as possible. If you don't remember or it's difficult to answer,
Yes, you must also tell me the reason."
Zhan Hao smiled bitterly and nodded, "In more than a week, I have been in pain twice. I don't want to feel this way for a third time in my life. Just ask, I promise to tell you everything."
"Before you first became ill, have you ever done any work related to metal smelting? Or entered a place that was once a factory?" Sun Lien asked starting from the simplest place. The thing that is most likely to cause heavy metal poisoning is
Air and metal dust may enter the alveoli through the respiratory tract and enter the blood during the gas exchange process in the alveoli.
"No, there is no such place near my home." Zhan Hao shook his head slightly and asked with some worry, "Doctor, I always feel that I can't see clearly with my eyes recently..."
"Visual problems should also be related to your condition." Sun Lien explained, "We need to determine the cause of your disease before we can deal with this problem in a targeted manner." Demyelinating lesions are actually very difficult to continue treatment.
The damage caused by the disease is almost irreversible. But if it can be diagnosed as early as possible and treatment is started, Zhan Hao's vision can still have a certain chance of recovery, but the degree of recovery is hard to say. Therefore, Sun Lien is not convinced, and now it is not increasing
It is a good time for patients to be mentally burdened. "During this period, have you taken any folk remedies or traditional Chinese medicines to regulate your body?" For example, medicinal materials such as lead powder, lead pill, yellow pill, Mi Tuo Monk, and Erwei Black
Chinese patent medicines such as tindan contain a large amount of lead. Sometimes, drug-induced lead poisoning is likely to occur due to errors in pharmacy preparation, or because the doctor incorrectly measures the dosage of the medicine in the prescription prescribed.
"No." Zhan Hao continued to shake his head, "My brother works in a medical school. He always talks to me about the three-part poison of medicine. Even Chinese medicine is the same. What's more, I haven't felt any discomfort recently. I take Chinese medicine.
What are you doing?"
"Then have you eaten any food recently that you have never tried before? Or drinks, medicinal wine?" Sun Lien continued to ask, he was a little panicked. There must be a contact route for poisoning. There is no contact route, this is poisonous
Could it be that the material fell from the sky and fell into Zhan Hao's mouth?
"No..." Zhan Hao wanted to deny the question, but suddenly frowned, "My neighbor from my hometown came to Ningyuan a few days ago and brought me some bacon and other things. It tasted pretty good to me."
Sun Lien immediately became energetic, "Bacon? How much did you eat last time? Have you eaten any more recently?"
"Last time... last time it seemed that my stomach started to hurt the next day after eating." Zhan Hao also realized that there was a problem here, "And the day before yesterday, I asked my brother to go back and fry the remaining half piece of bacon.
A dish. He said that since I liked the meat, he gave me all the dishes."
Bacon, then there must be something wrong with the bacon! Sun Lien suppressed his excitement and patted Zhan Hao's shoulder gently, telling him to have a good rest. Then he walked out of the emergency room quickly and grabbed Zhan Hao, who was napping at the door.
Jun. "Brother Zhan, is there any leftover bacon that your brother ate before?"
"Yes." Zhan Jun nodded. He didn't know why Sun Lien suddenly asked this question, "What's wrong?"
"In your store, right?" Zhan Jun responded affirmatively to this question, and Sun Lien said anxiously, "Go back immediately and keep an eye on this piece of bacon. I will call the police now and ask the police to come and get it... No, you
Wait for me here. I’ll ask Old Wu to come over.”
Zhan Jun was stunned for a moment and then asked, "What's going on? Why is there a police matter?"
"There may be something wrong with that piece of bacon. Someone is planning to harm your brother!" Sun Lien ran back and whispered in Zhan Jun's ear, and then left a sentence, "Wait for me here", and then ran towards Zhan Jun.
Police station.
"Old Wu! I have a big case for you!" Sun Lien pushed open the door of the police station and shouted to Old Wu who was making instant noodles in the room, "Hurry up and ask a few colleagues from the criminal investigation department to come with me.