I can see the status bar

Chapter 725
After Xu Yourong arrived at Ningyuan Airport, he immediately took Rachel to the hospital by taxi.

Although emotionally speaking, Xu Yourong felt that perhaps it would be better for Rachel to rest first.But Rachel turned down the arrangement.She insisted that Xu Yourong take her to the Fourth Court first.

"Dr. Sun has helped us so much, we have to thank you in person." Rachel, who had her hair cut short, said seriously to Xu Yourong, "And you didn't even make arrangements for changing shifts, so you came directly to America .It’s better to thank others.”

Xu Yourong looked at his wife in some confusion, and after a few seconds she asked, "Have you read too many women's novels lately? Why do you speak so strangely?"

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The arrival of Xu Yourong immediately excited the doctors in the first group.It would be a little worrying for an old colleague to leave suddenly without saying goodbye.And Xu Yourong's sudden departure was rather special - she was going to the other side of the ocean to save her lover.This added a touch of romance to Xu Yourong's actions, and most doctors had a higher degree of tolerance for romantic actions - if it weren't for the romantic touch in his heart, who would become a doctor?
Now, seeing Xu Yourong returning safely with his wife, everyone's reaction is to wish the couple first.Although same-sex marriage cannot be recognized under relevant domestic laws, the doctors of the Fourth Hospital are still willing to bless their colleagues.

On the other hand, the treatment group now really needs a doctor with extensive experience to join.Although Xu Yourong did not take the diagnosis as an advantage, her years of experience in neurosurgery at least enabled her to play a very important role in this case.

Sun Lien's first reaction when he saw Xu Yourong was also happy, and after seeing Rachel, Sun Lien's happiness was even more palpable.

"You came in a timely manner." Sun Lien quickly handed over a copy of the medical records printed by Yuan Pingan, and he said to Rachel, "Although it is somewhat inhumane to ask you to see the medical records immediately after you come back...but it is out of humanity. For the sake of rationalism, I would trouble you to work overtime during your vacation to see this patient."

"Show me?" Rachel was stunned when she received the case, and then she immediately opened the case, frowning at the dense Chinese on it, "It may take a while for me to read them all."

"It's okay, let Dr. Xu translate for you." Sun Li'en really needs extra help now.As for Tang Min's disease, guesses from both directions need to be proved. "This patient's condition is not very good, even if it is just a quick conclusion, it is very valuable."

"Cancer patients still have emergencies?" Xu Yourong on the side asked curiously, "Paraneoplastic syndrome? Wouldn't it be enough to use hormones?"

Sun Lien shook his head with a wry smile and said, "If it is confirmed that it is a tumor, I don't have to be so anxious - this child has been in the best hospital in China, but two biopsies failed to confirm whether it is a tumor. But just look at the speed of the disease's progress And the widespread distribution on the image, I think it looks like a tumor..."

Originally, according to Sun Lien's arrangement, to determine the nature of the lesion, the oncology department must be invited for consultation.But...the level of the oncology department of the fourth hospital is not outstanding, and it is far behind the liver and gallbladder surgery department and the orthopedics department.The reason is also very simple-tumor patients generally do not have any "acute symptoms".Most of them gradually deteriorated in a relatively long period of time after they were found to be suffering from the disease.

The reason why the Fourth Hospital has an oncology department is actually to serve outpatients.At the same time, it is also to meet the assessment of the top three hospitals.In fact, in terms of academic field and treatment, the oncology department of the Fourth Hospital is not very famous.The main reason that attracted Rachel to the oncology department of the fourth hospital before was that the oncology department of the fourth hospital had its own hospice care department.

"Got it." Although she was still carrying a suitcase in her hand, Rachel got into work very quickly.Especially after hearing that the patient was a seven-year-old girl, Rachel moved even faster.She dragged Xu Yourong straight to the office, and said as she walked, "Honey, you have to come and help me."

Sun Li'en originally thought about whether to say a few polite words like "You look good after you cut your hair short", but seeing Rachel's positive look, he decided to swallow these words again.He just talked to Yuan Ping'an and asked Dr. Yuan to arrange an optic nerve potential induction experiment for Tang Min before leaving.

The direction of tumor consideration was handed over to Rachel and Xu Yourong, while Sun Lien took another printed case to the Pediatric Department to directly ask Qian Hongjun.

Director Qian is on duty today.As for the pediatrics on duty... basically no different from the front line.It seems that there are always children and their families waiting anxiously outside the pediatric clinic, and the pediatric doctors seem to never be able to deal with these patients.

When Sun Lien walked through the crowd and entered the pediatrics office, he happened to see Director Qian using a steam eye mask to heat his eyes.

"I'm going to take a break now..." Director Qian heard Sun Lien's voice, he asked Sun Lien to sit down first with some embarrassment, and then pointed to his eyes and said, "I've been staring at him for a whole day, and I really can't bear it. Trouble Doctor Sun, wait a moment."

"It's okay, Director Qian, please rest first." In the hospital, when the three types of doctors behaved in such a seemingly "disrespectful" manner, they would never cause other doctors' displeasure—these three types of doctors were respectively Worked in Emergency Medicine, Pediatrics and Anesthesia.Sun Li'en took out the case at the side, then hesitated for a moment and asked, "Then... shall I read you the basic situation first?"

After getting Qian Hongjun's permission, Sun Lien quickly began to provoke the key points in the case.The child had a subacute onset and had no symptoms before the onset.Imaging examinations revealed multiple mass masses in the brain and optic nerve, but two biopsies were inconclusive.The child's current disease has further aggravated, and the vision of both eyes has basically disappeared.In laboratory tests, no decisive values ​​were obtained.

"The frontal lobe was taken in the two biopsies?" Although Qian Hongjun is not a neurosurgery expert, his years of experience allowed him to quickly discover the inappropriate place. "Why not take other parts? Didn't take samples from the optic nerve?"

"The frontal lobe was taken twice." Sun Li'en looked through the medical records and confirmed the sampling site and said, "The first biopsy was done at Yunhe, and the second was at Tongxie. But the same The association's medical records did not state why the frontal lobe was sampled."

"The first symptom of the child is vision loss. That is to say, if her optic nerve is not the first to be affected, it is also the first group of nervous systems to be affected." Qian Hongjun took out a pen from the table, and then covered her eyes with steam. With the blindfold covered, he wrote the record of "Optic nerve not sampled" in his notebook, "You continue."

"The previous treatment was basically based on hormone shock... Eh?" Sun Lien continued, "She had a lateral ventriculoperitoneal shunt at Yuanhai Hospital three months ago."

"That is to say, this child had severe hydrocephalus before." Qian Hongjun nodded, "How is the child's current situation? Just now you called me to ask about mannitol, because the intracranial pressure has risen again ?”

"The imaging examination revealed a herniation of the cerebellar tonsils." Sun Lien replied, "Eh..." He suddenly stopped speaking.Vaguely, Sun Lien felt that he might have made a mistake.

"The cerebellar tonsil hernia may be the cause of the lateral ventricle shunt." Qian Hongjun took off the steam eye mask on his face.He glanced at Sun Lien and shook his head and said, "Although you are from an emergency department, the response to this kind of problem is almost a conditioned reflex, but you have to find out first whether this symptom is new or later..." said At this point, Qian Hongjun sighed, "Forget it, it's not a big problem. It's just a bag of mannitol. As long as she is not in the active stage of cerebral hemorrhage, there is no other problem."

Sun Li'en was so embarrassed that he couldn't speak, he was indeed flustered.Even though the status bar had clearly stated that the brain herniation had occurred for several months, he still decided to intervene with mannitol... Strictly speaking, this is almost enough to be over-medicated.

"How is the child's physical examination?" Qian Hongjun had no intention of continuing to criticize Sun Lien.It is quite normal for a young doctor to make some small mistakes.The point is, how about their potential and upside.

"Light reflexes completely disappeared, consciousness is clear, and memory, orientation and calculation skills are poor." This part of the physical examination was done by Sun Lien, and his answer was very crisp, "The answer is relevant, and there is no problem with language—— But the left side is a bit weak."

"You have to ask the doctor in Shennei." Qian Hongjun hesitated and said, "The loss of light reflex is not a good thing." He was silent for a while and asked, "Have you checked the infection indicators?"

"Professor Zhang Zhifu checked it when he was in the infectious disease hospital. He took cerebrospinal fluid and peripheral blood samples and did mNGS twice, and they were all negative." Sun Lien shook his head, the way of infection has been completely blocked.

"What do you think?" Qian Hongjun nodded, "You took this patient in. What speculation do you have about her symptoms?"

Sun Lien hesitated and said, "I suspect it may be some kind of genetic disease or tumor."

"Tumors have been mentioned in the past, and the multiple intracranial space-occupying is similar." Qian Hongjun continued to ask noncommittally, "What is the reason for the genetic disease?"

"It was a child's disease, and according to the patient's family, her uncle had a similar sudden drop in vision when he was a child. However, the uncle's drop in vision disappeared on its own afterwards." Sun Li'en asked, "This is what I want to ask Director Qian for advice. I'm not good at genetic diseases. Do you think... this might be some kind of genetic disease?"

　This chapter is 3000 words, so it is a little bit late.

　　
　
(End of this chapter)