Chapter 753

Zheng Ren smiled, stood up, bowed slightly, asked Director Luo to sit down, and stood in front of Director Luo himself.

Young, capable, but not arrogant, Director Luo is still very satisfied with Zheng Ren's performance.

Zheng Ren then said eloquently: "In the hospitals below, intestinal obstruction is usually diagnosed with orthostatic peritoneal dialysis or based on clinical symptoms. 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 in the inpatient department. And it is the kind that will be cured without medicine.”

Director Luo listened quietly, without interrupting Zheng Ren's words.

"So, I guess the patient's intestinal obstruction is only short-term and temporary. In addition to the patient's family members saying that the patient is prone to fatigue, I guess whether the patient's skeletal muscles and smooth muscles are affected. If so, then yes Mitochondrial encephalomyopathy is more likely."

Dr. Shen was dumbfounded...

He had seen Zheng Ren's operation, and knew that this Boss Zheng had a very high level of interventional surgery. Half a year ago, the ophthalmic artery cannulation operation opened Dr. Shen's horizons.

At that time, I almost licked the screen and was trained by Director Kong.

With Boss Zheng's level, it is possible to be nominated for the Nobel Prize. Dr. Shen thinks this is quite reasonable.

However, is he also good at diagnosing rare diseases?

Mitochondrial encephalomyopathy? What the hell is that? Dr. Shen was suddenly confused.

As a doctor of medicine, he didn't understand the conversation between Zheng Ren and Director Luo at all, and his face was a little red.

"So, you just read the EMG?" Director Luo asked.

"In local hospitals, doctors basically treat headaches and feet. However, electromyography tests... IMHO, in local hospitals, very little is done, and neurology is usually done."

"Oh? And then?"

"Because I haven't heard from the patient's family members about the medical history of going to the neurology department, I guess that the emergency doctor ordered an electromyography examination during a severe episode of myasthenia." Zheng Ren said frankly: "This kind of examination is relatively blind. But it was just luck that touched the key."

try your luck...

Director Luo felt annoyed and funny at Zheng Ren's directness, this little guy was really frank.

As a doctor, who wants to admit to taking chances?

However, limited to the level of science and diagnosis, even in the imperial capital, there is an element of chance in the diagnosis of many diseases, let alone in local hospitals.

Especially rare diseases like mitochondrial encephalomyopathy.

This disease has nothing to do with gastroenterology, so Director Luo didn't study it. What he was curious about was how the little doctor in front of him made the diagnosis.

Can a Nobel Prize candidate make such a powerful interdisciplinary diagnosis?

Things seem to be getting more and more interesting.

"There are abnormalities in the electromyogram, but the abnormal electric waves are not obvious.

The electromyography is the most common narrow-sense electromyography in local hospitals. The percentage of polyphasic waves generally does not exceed 20%, but there are several stages with a slight excess. Different muscles have different normal value ranges, but during the short period of EMG, it has gradually returned to normal in the later period. "

At this time, not only Dr. Shen, but even Director Luo was in a daze.

What is Boss Zheng talking about?

"The report only writes conclusions 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 for a few seconds at the beginning is wrong." 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 is something wrong with the electromyogram, not neuronal, 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 electromyogram and smooth muscle abnormalities. The only disease that occasionally changes is mitochondrial encephalomyopathy."

What Zheng Ren said was very certain, and before he knew it, Director Luo believed it.

Because of the meticulous logic, but also because of the halo of the Nobel Prize candidate.

Mitochondrial encephalomyopathy is a group of rare multi-system diseases mainly involving brain and muscle caused by abnormal structure or function of mitochondria.

It is generally maternally inherited, more common in women, and the time of onset is not certain, it is possible from infancy to old age.

Because muscle and brain tissue are highly dependent on metabolism such as oxidative phosphorylation, whether nDNA or mtDNA is deficient alone or both are involved, clinical symptoms are often systemic.

However, due to the different degrees of involvement of 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 a manifestation of mitochondrial myopathy.

This is relatively mild, and it is likely to cause death of the patient. It is mitochondrial encephalopathy.

"Is it all speculation and inference?" Director Luo said softly.

It seemed to be asking Zheng Ren, and it seemed to be talking to himself.

Zheng Ren's words sounded cloudy to those who didn't understand, but Director Luo could hear something.

Due to the nature of his profession, Director Luo's first thought was to "find faults"!

There is no hard evidence, and this is the biggest problem.

However, the examination brought by the patient's family members could not provide a definitive diagnosis at all. If you really suspect mitochondrial encephalomyopathy, you can go for genetic testing to confirm the diagnosis.

But this is only a possibility, Zheng Ren's tone of voice is too sure.

"No, Director Luo." Zheng Ren pointed to the patient's information and said, "I frowned when I read this film just now. You must have seen the abnormality."

"It can't be said to be abnormal, it may be an artifact, but the image of some parts of the patient's intestinal smooth muscle group does look problematic." Director Luo said.

"Yes, it's the abdominal CT, which has actually provided relatively reliable evidence." Zheng Ren said: "Mitochondrial myopathy, in imaging..."

Speaking of CT scans, Zheng Ren's attitude was different from that of EMG.

Dr. Shen knew that Boss Xiaozheng's 64-slice 3D CT was a must.

After he left half a year ago, Director Kong immediately organized everyone to learn the reconstruction of 64-slice 3D CT of the liver, and it was quickly rolled out in the clinic.

This test has long been used clinically. But before, there was no surgeon to do it at all, and the CT room did it according to the software.

At the beginning, everyone was a little slanderous, but Director Kong suppressed all dissenting opinions with an iron fist.

After really in-depth research, everyone... At least Dr. Shen realized the benefits of 3D reconstruction of 64-row 3D CT.

Many tumor-released factors and re-established abnormal blood vessels can be directly displayed by 64-slice CT three-dimensional reconstruction, which increases the meticulousness of the operation.