Chief Zhou did not think Zheng Ren was making a mountain out of a molehill.
With his relationship with Department Chief Kong of the 912, Boss Zheng would definitely not slap Zhu Liangchen's face for no reason. If he was ten years younger and had jumped out arrogantly, he might have been hit head-on.
Moreover, there were no problems with the patients just now. Those that should be sent to the operating table had already been sent up. Why did something have to happen at this time?
Looking at Zhu Liangchen's expression, he should have the same thoughts as him, thinking that there was nothing wrong.
That was strange.
Soon, Zheng Ren and Zhu Liangchen walked back.
"Professor Zhu, I suggest postponing this surgery," Zheng Ren said. "I've seen the radiographic films of the head and I have some doubts. I want to do a few more tests and confirm the diagnosis before performing the surgery. "
"Boss Zheng, what illness do you think it is?" Zhu Liangchen was a little unhappy.
Reject the diagnosis? This was a standard face-slapping gesture.
Doctors ridiculed each other, and the deadliest attack was — did he know how to treat patients?
Zhu Liangchen looked at Zheng Ren, and his expression became colder and colder.
"The CT scan of the patient's head shows bilateral lenticular hypodensity. This image is relatively faint, so it's easy to ignore. The CT scan thinks it's an artifact. "Zheng Ren inserted the head CT scan film into the radiographic film viewer.
He pointed at the CT scan and said, "The RI of the head is more specific than that of the CT scan. The RI of the lentiform nucleus, caudate nucleus, mesencephalon and pons, thalamus, cerebellum, and frontal cortex are characterized by low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. The putamen and caudate nucleus also show high and low mixed signal intensity on T2-weighted images. There are also different degrees of sulci widening and ventricular enlargement."
After that, Zheng Ren continued, "I think the patient has a rare form of hepatolenticular degeneration. It is recommended to check for biochemical tests related to copper metabolism, serum ceruloplasmin, urinary copper, and liver copper."
These examinations were relatively unpopular. A place like Sea City didn't have it at all. Even if they had heard of it, they might not have heard of it.
However, the Imperial Capital's Hepatobiliary and Pancreatic Hospital was a specialized hospital. These tests should be available.
Hepatolenticular degeneration?
Zhu Liangchen and Chief Zhou were stunned for a moment. Then, they began to recall this extremely rare disease.
This disease is caused by excessive free copper deposition in the serum in the liver, resulting in lobular cirrhosis.
When the lysosomes of liver cells could not hold the copper, the copper was dispersed and deposited in various organs through the blood. The neurons of the basal ganglia and their normal enzyme transport were particularly sensitive to the toxicity of inorganic copper. The deposition of copper in the cerebral cortex and the dentate nucleus of the cerebellum also produced symptoms.
Copper damage to the proximal tubules of the kidney can lead to the loss of amino acids, proteins, calcium and phosphate, and deposition of free copper in the elastic layer of the cornea produces K-F rings.
At the same time, cirrhosis can produce a series of changes in portal hypertension.
If it was diagnosed as hepatolenticular degeneration … Chief Zhou smiled.
Things were getting more and more interesting.
Zhu Liangchen's luck wasn't that good. The probability of this disease occurring was one in a hundred thousand.
He still had to take it into his hands before looking for Boss Zheng for surgery.
Tsk tsk, this luck is really unparalleled.
Zhu Liangchen was a little embarrassed. His face immediately drooped.
He was stopped by the "professor" … In the past, he was the only one who stopped other people's surgeries. No one ever stopped his own surgeries!
"The patient's expression is strange, his speech is slurred, and his muscles are spasming, but it doesn't look like the rhythmic spasm of Parkinson's disease." Zheng Ren did not care about Zhu Liangchen's unhappiness and told the truth. "Let's stop this surgery and make a clear diagnosis first. If the diagnosis is correct, let the patient take d-penicillamine for a period of time. After the symptoms are relieved, we can do it at any time. "
Su Yun frowned as he watched from the side.
Not to mention whether or not he could earn money from freelance surgeries in the Imperial Capital, he had to be very careful with every step he took.
They were all big shots in the industry. Even if their standards were slightly lower, they could not help but have a wide range of contacts. This was a completely different concept from running freelance surgeries in other cities.
What would Chief Kong think if he embarrassed Zhu Liangchen?
However, there was nothing wrong with what Zheng Ren said. If it was really hepatolenticular degeneration, there would be problems with the patient's copper metabolism if he directly performed TIPS surgery.
Sigh, he was really unlucky to encounter such a situation.
Zhu Liangchen was silent for a few seconds, but he still nodded and said, "Then let's stop the surgery for this patient."
The air in the office immediately became lighter.
The remaining two patients quickly finished reading the radiographic films. Zhu Liangchen's face was gloomy. He arranged for someone to communicate with the patient's family and then brought Zheng Ren to the surgery.
The atmosphere was not as harmonious as when he first arrived.
Su Yun wanted to pull Zheng Ren to ask about the situation, but Zhu Liangchen was always by his side. He never found a chance.
When they arrived at the operating theater, Hu Yanhui had already prepared the equipment for the live broadcast of the surgery and was waiting for the live broadcast of the surgery.
The order of the surgery did not take into account the live broadcast of the surgery. Instead, it was arranged according to the patient's age.
Because they had to fast water during the surgery, the older ones were arranged at the front. Zheng Ren also agreed with this point.
He went to change his lead apron and began to scrub his hands. Su Yun finally seized the opportunity. He pulled Zheng Ren and asked, "Boss, is the diagnosis of hepatolenticular degeneration clear?"
"Huh?" Zheng Ren was stunned for a moment, then he smiled and said, "It's clear. It's not that I want to embarrass Teacher Zhu, but if this patient has undergone surgery, the venous blood will not flow in the liver. Without the filtration of toxins, it is very likely that the symptoms of acute copper poisoning will appear. "
Su Yun nodded. As long as it was confirmed, there was nothing more to say.
He took care of Zhu Liangchen's face. In the end, the one who was slapped in the face was still Zheng Ren. However, he was a little puzzled and asked in a low voice, "Have you seen a patient with hepatolenticular degeneration?"
"No."
"Then how did you diagnose it?" Su Yun asked.
Logically speaking, the chief physicians in the Imperial Capital saw hundreds of patients a day, and there were many difficult and complicated diseases. If it was a competition of talent, Zheng Ren might be stronger than everyone. However, if it was a competition of experience points, he might be a little weaker.
This was also what Su Yun had always been worried about.
However … what happened today made him feel that his worldview had once again been forcefully twisted by Zheng Ren in another direction.
"Reading a book. Shouldn't you write down all the diseases related to the liver and then compare them one by one?" Zheng Ren said to Su Yun in surprise. "Isn't that how you treat patients?"
"…" Su Yun really wanted to slap Zheng Ren.
There were at least 800 if not a thousand diseases related to the liver. Who could remember every single one of them? Moreover, he had to go through every patient he saw?
This guy really wasn't human at all.
"I'm going on stage. Which channel is the live broadcast on?"
"The third and sixth," Su Yun said expressionlessly.
"Oh, contact Chief Kong and see when Chief Kong and Professor Pei will arrive," Zheng Ren said.
"Are you afraid that they won't be able to arrive after you're done?" Su Yun was already a little impatient.
"Yes," Zheng Ren said frankly.
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