Zheng Ren smiled, stood up, and bowed slightly. He let Chief Luo sit down while he stood in front of Chief Luo.
He was young, capable, but not arrogant and domineering. Chief Luo was very satisfied with Zheng Ren's performance.
Zheng Ren then said with confidence, "In the hospitals below, the diagnosis of intestinal obstruction is usually done through peritoneal dialysis or according to the clinical symptoms. According to the patient's family members, there were several times when they were diagnosed with intestinal obstruction, but when they went to the inpatient department, the diagnosis was overturned. My guess was that this meant that the intestinal obstruction would be resolved once he reached the inpatient department. Moreover, it healed on its own without using any medicine. "
Chief Luo listened quietly and did not interrupt Zheng Ren.
"So, I'm guessing that the patient's intestinal obstruction is only short-term and temporary. Moreover, the patient's family said that the patient got tired easily, so I guessed that the patient's skeletal and smooth muscles were affected. If that's the case, then the possibility of mitochondrial encephalomyopathy is higher. "
Dr. Shen was dumbfounded …
He had seen Zheng Ren's surgery before and knew that Boss Zheng's interventional surgery skills were quite high. Half a year ago, the ophthalmic artery resection surgery was an eye-opener for Professor Shen.
At that time, he almost licked the screen and was even scolded by Department Chief Kong.
With Boss Zheng's level, it was possible for him to be nominated for the Nobel Prize. Chief Resident Shen thought that this matter was quite reasonable.
However, was he also so good at diagnosing rare diseases?
Mitochondrial encephalomyopathy? What the hell was that? Prof Shen was confused.
As a medical doctor, he did not understand the conversation between Zheng Ren and Chief Luo at all. His face was a little red.
"So, you looked at the electromyography?" Chief Luo asked.
"In local hospitals, they basically treat the patients who have a headache and treat the patients who have a leg ache. But electromyography … Forgive me for being blunt, but in local hospitals, it's rarely done. Usually, only neurology departments do it. "
"Oh? And then? "
"Since I didn't hear from the patient's family about going to the neurology department for treatment, I guessed that the doctor in the emergency department ordered an electromyogram during one of the episodes of weakness." Zheng Ren said calmly, "This kind of examination is relatively blind, but I'm lucky enough to touch the key point."
Trying my luck …
Chief Luo was both angry and amused by Zheng Ren's straightforwardness. This little guy was really frank with his words.
As a doctor, who would be willing to admit that they had to try their luck?
However, limited by the level of science and diagnosis, even in the Imperial Capital, the diagnosis of many diseases also depended on luck, let alone in a local hospital.
This was especially true for rare diseases like mitochondrial encephalomyopathy.
This disease had nothing to do with the gastroenterology department, so Chief Luo did not study it. He was curious about how the junior doctor in front of him made the diagnosis.
Could a Nobel Prize candidate have such a powerful interdisciplinary diagnosis?
Things seemed to be getting more and more interesting.
"There's an abnormality in the electromyogram, but the abnormal electrical waves are not obvious.
The electromyography was the most common narrow-sense electromyography used in local hospitals. The percentage of polyphasic waves was usually less than 20%, but there were a few stages where it was slightly exceeded. Different muscles have different ranges of normal values, but in the short period of time I was doing electromyography, it gradually returned to normal. "
At that moment, not only Chief Resident Shen, but even Chief Luo was a little dazed.
What was Boss Zheng talking about?
"Report the conclusion by hand, such as interference phase, mixed phase, simple phase, pathological interference, etc. But if you look at the waveform, you will find that the waveform is wrong for a few seconds at the beginning," Zheng Ren said.
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's something wrong with the electromyography. It's not a neuronal problem, but a change in the muscle itself. This speculation is in line with the symptoms of general weakness described by the patient's family. There are changes in the electromyography, and occasional changes in the smooth muscle. Only mitochondrial encephalomyopathy. "
Zheng Ren was very sure. Unknowingly, Chief Luo had already believed him.
Because of his meticulous logic and the halo of a Nobel Prize candidate.
Mitochondrial encephalomyopathy was a group of rare multi-system diseases caused by abnormalities in the structure or function of mitochondria, which mainly involved the brain and muscles.
It was generally inherited from the maternal line and was mostly seen in women. The onset time was also uncertain. It could range from infancy to old age.
Because muscles and brain tissues were highly dependent on oxidative phosphorylation and other metabolism, regardless of whether nDNA or mtDNA was defective alone or both were involved at the same time, the clinical symptoms were often systemic.
However, due to the different degrees of involvement of each enzyme system and the different emphasis on clinical manifestations, mitochondrial diseases were artificially divided into two major categories: mitochondrial myopathy and mitochondrial encephalomyopathy.
The patient in front of him should have a manifestation of mitochondrial myopathy.
This was a relatively mild disease that could easily lead to death. It was mitochondrial encephalomyopathy.
"It's all speculation and inference," Chief Luo said softly.
It was as if he was asking Zheng Ren, but it was also as if he was talking to himself.
Zheng Ren's words sounded like they were shrouded in fog, but Chief Luo could hear something.
Due to his professional nature, Chief Luo's first thought was to 'find fault'!
Without hard evidence, this was the biggest problem.
However, the examination brought by the patient's family could not provide a definite diagnosis at all. If they really suspected that it was mitochondrial encephalomyopathy, they could go to a genetic test to confirm the diagnosis.
However, this was only one possibility. Zheng Ren's tone was too certain.
"No, Chief Luo." Zheng Ren pointed at the patient's information and said, "I frowned when I saw you reading the radiographic films just now. You also saw the abnormality, right?"
"It can't be said to be an abnormality. It might be an artifact, but the image of the patient's intestinal smooth muscle group does look abnormal," Chief Luo said.
"Yes, it's the abdominal CT scan. Actually, it has already provided more reliable evidence," Zheng Ren said. "Mitochondrial myopathy, in terms of imaging …"
When he talked about the CT scan, Zheng Ren's attitude was different from when he talked about the electromyography.
Chief Resident Shen knew that Little Zheng's 64-slice 3D CT scan was one of the best.
Half a year ago, after he left, Chief Kong immediately organized everyone to learn the reconstruction of the 64-slice 3D CT scan of the liver, and it quickly spread out in the clinic.
This kind of examination had long been used in the clinic. However, no surgeon had done it before. It was all done by the CT room according to the software.
At first, everyone was a little critical, but Chief Kong used an iron fist to suppress all the different opinions.
When they really did in-depth research, everyone … at least Chief Resident Shen realized the benefits of the 64-slice 3D CT scan.
Many tumor factors were released and the abnormal proliferative blood vessels were reestablished. The 64-slice CT scan with 3D-image reconstruction could be directly displayed, increasing the meticulousness of the surgery.
。 m.
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