Zheng Ren smiled, stood up, bowed slightly, and asked Director Luo to sit down, while he stood in front of Director Luo.
Young and capable, but not arrogant and domineering, Director Luo is still very satisfied with Zheng Ren's performance.
Zheng Ren then talked about it: "In the hospitals below, standing abdominal dialysis or clinical symptoms are usually used to diagnose intestinal obstruction. According to the patient's family members, intestinal obstruction was diagnosed several times, but the diagnosis was overturned in the inpatient department. I Guess, this means that the intestinal obstruction will be resolved when you go to the inpatient department. And it will be cured on its own without taking medicine. "
Director Luo listened quietly without interrupting Zheng Ren.
"So, I guess the patient's intestinal obstruction is only short-term and temporary. In addition, the patient's family said that the patient gets tired easily, so I have to guess whether the patient's skeletal muscle and smooth muscle are both affected. If so, then yes Mitochondrial encephalomyopathy is more likely."
Dr. Shen was stunned...
He had seen Zheng Ren's surgery and knew that Boss Zheng's interventional surgery skills were quite high. A little over half a year ago, Dr. Shen's eye-opening surgery was performed on the ophthalmic artery.
I almost licked the screen at that time and was even scolded by Director Kong.
It is possible for Boss Zheng to be nominated for a Nobel Prize at his level. Dr. Shen thinks this is quite reasonable.
However, is he also so good at diagnosing rare diseases
Mitochondrial encephalomyopathy? What the hell is that? Dr. Shen was confused for a moment.
As a doctor of medicine, he didn't understand the conversation between Zheng Ren and Director Luo at all, and his face turned red.
"So, you just looked at the electromyogram?" Director Luo asked.
"Local hospitals basically treat headaches and foot pain. But electromyography tests... IMHO, in local hospitals, very little is done, and they are usually only done by the neurology department."
"Oh? What then?"
"Because I haven't heard from the patient's family about the history of going to the neurology department, I guess it was when the emergency doctor prescribed an electromyography test during a major attack of weakness." Zheng Ren said calmly: "This kind of test is relatively blind, but I just hit the key by chance.”
Try your luck…
Director Luo felt angry and funny about Zheng Ren's directness. This little guy was really honest when he spoke.
As a doctor, who is willing to admit to trying his luck
However, limited to the level of science and diagnosis, even in the imperial capital, the diagnosis of many diseases is still based on luck, let alone in local hospitals.
Especially rare diseases such as mitochondrial encephalomyopathy.
This disease has nothing to do with gastroenterology, so Director Luo did not study it. What he was curious about was how the little doctor in front of him diagnosed him.
Can a Nobel Prize candidate perform such a powerful interdisciplinary diagnosis
Things are starting to look more and more interesting.
“There are abnormalities in the electromyogram, but the abnormal electric waves are not obvious.
The electromyography performed is the narrow electromyography most common in local hospitals. The percentage of multiphase waves generally does not exceed 20%, but there are several stages where it exceeds slightly. Different muscles have different normal value ranges, but during the short period of doing electromyography, they gradually returned to normal in the later stages. "
At this time, not only Dr. Shen, but also Director Luo was in a daze.
What is Boss Zheng talking about
"The report only contains handwritten conclusions, such as interference phase, mixed phase, simple phase, pathological interference, etc., but if you look at the waveform, you will find that the waveform for a few seconds at the beginning is wrong." Zheng Rendao.
Silence, when Zheng Ren stopped talking, there was silence in the director's office.
Soon, Zheng Ren's voice broke the silence again.
"My judgment is that there is something wrong with the electromyogram, not neuronal, but a change in the muscles themselves. This speculation is consistent with the symptoms of general weakness described by the patient's family. There are changes in the electromyogram and smooth muscles. The only disease that occasionally changes is mitochondrial encephalomyopathy.”
What Zheng Ren said was very certain, and Director Luo already believed it without knowing it.
Because of the rigorous logic and the aura of being a Nobel Prize candidate.
Mitochondrial encephalomyopathy is a group of rare multisystem diseases that mainly affect the brain and muscles caused by mitochondrial structural or functional abnormalities.
It is generally inherited from the maternal line and is more common in women. The time of onset is also uncertain, ranging from infancy to old age.
Because muscle and brain tissue are highly dependent on metabolism such as oxidative phosphorylation, whether ndna or mtDNA is defective alone or both are affected at the same time, clinical symptoms are often systemic.
However, due to the different degrees of involvement of each enzyme system deficiency and different clinical manifestations, mitochondrial diseases are artificially divided into two categories, namely mitochondrial myopathy and mitochondrial encephalopathy.
The patient in front of me should be suffering from mitochondrial myopathy.
This is a relatively mild disease that can easily lead to death of the patient and is mitochondrial encephalopathy.
"Are they all guesses and inferences?" Director Luo said softly.
It seemed like he was asking Zheng Ren, but also like he was talking to himself.
Zheng Ren's words sounded vague and confusing, but Director Luo picked up some flavor.
Due to the nature of his profession, Director Luo's first thought was to "find faults"!
There is no solid evidence, which is the biggest problem.
However, the examination brought by the patient's family could not provide a definite diagnosis at all. If you really suspect mitochondrial encephalomyopathy, you can get a genetic test to confirm the diagnosis.
But this is only a possibility, Zheng Ren's tone of voice was too sure.
"No, Director Luo." Zheng Ren pointed to the patient's information and said, "I frowned when you read this picture just now. You must have seen something abnormal too."
"It cannot be said to be abnormal, it may be an artifact, but the images of some parts of the patient's intestinal smooth muscle group do appear to be abnormal." Director Luo said.
"Yes, abdominal CT has actually provided relatively reliable evidence." Zheng Rendao: "Mitochondrial myopathy, in terms of imaging..."
When talking about CT films, Zheng Ren's attitude is different from when talking about electromyograms.
Dr. Shen knew that Boss Zheng was unrivaled in doing 64-slice three-dimensional CT scans.
After he left half a year ago, Director Kong immediately organized everyone to learn the reconstruction of 64-slice three-dimensional CT of the liver, and it was quickly rolled out in clinical practice.
This kind of examination has long been used clinically. But before, there were no surgeons to do it. It was all done by CT labs based on software.
At first, everyone was a little bit slanderous, but Director Kong suppressed all different opinions with an iron fist.
After truly in-depth research, everyone... At least Dr. Shen realized the benefits of 64-slice 3D CT 3D reconstruction.
Many tumor-releasing factors and re-established abnormally proliferating blood vessels can be directly displayed using 64-slice CT three-dimensional reconstruction, which increases the detail of the surgery.