Chapter 927 Hepatolenticular Degeneration?

Director Zhou didn't feel that Zheng Ren was making a fuss out of a molehill.

With Director Kong's relationship with 912, Boss Zheng would definitely not slap Zhu Liangchen in the face for no reason. If he was ten years younger and jumped out arrogantly, he might be hit head-on.

And the patients just now are fine, and those who should be sent to the stage have also been sent, but why is there something wrong at this time?

Judging by Zhu Liangchen's appearance, he should think the same as himself, thinking that there is nothing wrong.

Strange.

Soon, Zheng Ren and Zhu Liangchen came back.

"Ms. Zhu, I suggest postponing this surgery." Zheng Ren said, "I've seen the head scan, and I'm a bit suspicious. I want to check a few more tests, and do the surgery after confirming the diagnosis."

"Boss Zheng, what kind of illness do you think?" Zhu Liangchen was a little unhappy.

negative diagnosis? This is a standard slap in the face.

Doctors shabby each other, the deadliest attack is - he can also see a doctor?

Zhu Liangchen looked at Zheng Ren with an increasingly cold expression on his face.

"The CT of the patient's head showed symmetrical low-density shadows of bilateral lenticular nuclei. This image is relatively light and can be easily overlooked. It is considered an artifact on the CT side." Zheng Ren inserted the head CT film into the viewer.

He pointed to the CT film and said: "MRI of the head is more specific than CT, showing low signal on T1-weighted images of lentiform nucleus, caudate nucleus, midbrain and pons, thalamus, cerebellum and frontal lobe cortex and T2 Weighted images show high signal, or putamen and caudate nucleus show high and low mixed signals on T2 weighted images, and there may also be different degrees of widening of brain sulci and enlarged ventricles.”

After finishing speaking, Zheng Ren continued: "I think the patient has rare hepatolenticular degeneration. It is recommended to check the biochemical tests related to copper metabolism, serum ceruloplasmin, urine copper, and liver copper."

These inspections are relatively unpopular. There will never be a place like Haicheng. Even if you listen, you may not have heard of it.

However, the Imperial Hepatobiliary Hospital is a specialized hospital, and these tests should be available.

Hepatolenticular degeneration?

Both Zhu Liangchen and Director Zhou were stunned for a moment, and then began to think about this extremely rare disease.

This disease is due to the excessive deposition of free copper in the serum in large quantities in the liver, resulting in lobular cirrhosis.

When the hepatic lysosomes cannot hold it, copper spreads and deposits to various organs through the blood. Neurons of the basal ganglia and their normal enzymatic transporters are particularly sensitive to inorganic copper toxicity, and deposition of copper in the cerebral cortex and cerebellar dentate nuclei is also symptomatic.

Copper damage to the proximal tubules of the kidney can cause loss of amino acids, proteins, and calcium and phosphate, and the deposition of free copper in the elastic layer of the cornea produces K-F rings.

At the same time, cirrhosis of the liver can produce a series of changes of portal hypertension.

If the diagnosis is hepatolenticular degeneration... A smile appeared on Director Zhou's face.

Things are getting more and more interesting.

Zhu Liangchen's luck is not very good. The general incidence of this disease is only one in 100,000.

It still needs to be received from him, and then Boss Zheng will be asked for surgery.

Tsk tsk, this luck, really no one else.

Zhu Liangchen was a little embarrassed, his face drooped all of a sudden.

This is because the "professor" stopped the operation... In the past, I was the only one who stopped other people's operations, so no one has stopped their own operations!

"The patient has a weird expression, slurred speech, and muscle spasms, but they don't have rhythmic spasms like Parkinson's disease." Zheng Ren didn't care about Zhu Liangchen's displeasure, and told the truth, "Stop this operation, let's go first." Make a clear diagnosis. If the diagnosis is correct, give the patient D-penicillamine for a period of time, and it can be done at any time after the symptoms are relieved.”

Su Yun frowned while watching.

Flying knives in the imperial capital, let alone whether you earn money or not, you must be very cautious in every step.

They are all big names in the industry. Even if their level is not good, they can't stand the crowd. This is a different concept from flying knives in other cities.

After sweeping Zhu Liangchen's face, what will Director Kong think?

But there is nothing wrong with what Zheng Ren said. If it is really hepatolenticular degeneration, TIPS surgery is performed directly, and the patient's copper metabolism must have problems.

Alas, it's really unlucky to encounter such a situation.

Zhu Liangchen was silent for a few seconds, then nodded and said, "Then the patient's surgery should stop."

The air in the office suddenly became lighter.

The remaining two patients quickly finished reading the films. With a gloomy face, Zhu Liangchen arranged for someone to communicate with the patient's family, and then took Zheng Ren to the operation.

The atmosphere is not as harmonious as when we first arrived.

Su Yun wanted to ask Zheng Ren to ask about the situation, but Zhu Liangchen was always around and never found a chance.

When he came to the operating room, 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, but was sorted according to the age of the patients.

Since the operation requires fasting of food and water, the elderly are ranked first, which Zheng Ren also agrees with.

I went to change the lead coat and started to brush my hands. Su Yun finally seized the opportunity, grabbed Zheng Ren and asked, "Boss, hepatolenticular degeneration, is the diagnosis clear?"

"Huh?" Zheng Ren was stunned for a moment, and then smiled: "It's clear. It's not to save Teacher Zhu's face. If this patient has an operation, the venous blood will not go to the liver, and there will be less filtration of toxins. Symptoms of copper poisoning."

Su Yun nodded, as long as he is sure, there is nothing to say.

Taking care of Zhu Liangchen's face, it was Zheng Ren who was finally slapped in the face. It's just that he was a little puzzled, and asked in a low voice, "Have you ever seen a patient with hepatolenticular degeneration?"

"No."

"Then how did you diagnose it?" Su Yun asked.

It is said that the directors of the imperial capital see a hundred or eighty patients a day, and there are many intractable diseases. If one were to fight for talent, Zheng Ren might be better than everyone else. But if he fights for experience points, he may be weaker.

This is what Su Yun has been worried about.

But... Today's incident made him feel that his three views were forced to another direction by Zheng Ren again.

"Reading, shouldn't all the lesions related to the liver be written down and compared one by one?" Zheng Ren was also very surprised and said to Su Yun: "Isn't that how you see a doctor?"

"..." Su Yun really wanted to smoke Zheng Ren.

Regarding liver lesions, there must be eight hundred if not one thousand. Who can remember them all? And every time you see a patient, you have to go through it again?

This guy is really not human.

"I'm on stage, which channel is the live surgery scheduled for?"

"The third and sixth stations." Su Yun said expressionlessly.

"Oh, contact Director Kong and see when Director Kong and Professor Pei will arrive." Zheng Ren said.

"Are you still afraid that they won't be able to arrive after you finish?" Su Yun was getting impatient.

"Yes." Zheng Ren said frankly.