Sun Lien rolled his eyes again and again, but this did not prevent Cao Yanhua from transferring the patient who was not in the emergency room to him.

Neurosurgeons are indeed a little unsure about this patient, and they are still waiting for the results of the MRI to assist in their judgment. However, looking at Sun Lien's appearance, he seems to be very interested in this patient.

Could it be a rare disease? Several doctors in the neurology department looked at each other, and this thought unconsciously popped up in their minds. Sun Lien is notorious, and they have heard of it. Seeing that this "rare disease expert" was so interested, they also began to ponder the possibility of rare diseases.

In the current Fourth Hospital, no one will treat Sun Lien as an ordinary emergency doctor. As we all know, if there is a certain patient's situation that they are not sure about, then Sun Lien is the last person they can rely on for consultation. In two months' time, the diagnostic center will be operational, and the team may become a special forces unit directly under the dean—the kind that moves where it is needed.

Dr. Cao Yanhua ignored Sun Lien's eyes at all, and after a pleasant conversation with his father-in-law on the phone, he handed over the phone with a smug face, "Dean Liu wants to talk to you." ”

If he didn't know that Cao Yanhua definitely didn't mean that, Sun Lien would have thought that Lao Cao was using the name of Dean Liu to suppress himself. After answering the phone, Sun Lien heard Liu Pingchuan's tired voice on the other end of the phone, "Do you think there is something wrong with this patient?"

"It's not that I think there's a problem, it's Dr. Cao and the other doctors who came to the consultation think there's a problem. Although it is certain that he is a little unhappy in his heart, Sun Lien still does not discount at all when answering questions, "I haven't seen the patient and the patient's family yet, and I don't know what the specific situation is." ”

"You can follow this patient's situation first. On the other end of the phone, Dean Liu was silent for a while, and then instructed, "If you think that this patient's situation is suspicious, or you feel that this patient's problem cannot be handled in the emergency department, then receive it directly to the group." ”

As the general inpatient officer, Dr. Cao Yanhua has a large number of patients on hand every day. It is fundamentally impossible for him to balance a large number of acute patients with this possible "incurable" disease. Incurable diseases require a lot of time and energy to deal with, and acute patients also require a lot of medical resources to deal with them. Whether it's from the perspective of hospital operations, or from the perspective of emergency doctors, or even from the perspective of patients, it is very inappropriate to leave them in the emergency room. Of course, Sun Lien also understood this truth, he thought for a while and said, "Then I'll take a look at it first, and if necessary, I'll take this patient next." ”

·

·

·

About 30 minutes later, the results of the MRI appeared on Sun Lien's computer screen. The image looks very ...... Abnormal. The cortical layer of the patient's brain shows significant diffuse limitation and T2 prolongation, but periventricular and occipital signaling is normal. More importantly, the anomaly actually appears to be highly symmetrical.

"Looks like multiple intracranial cytotoxic edema. The treatment team that was convened again had already gathered around Sun Lien, looking at the images on the screen, Xu Yourong first gave his opinion, "You have to consider toxic lesions." ”

"Sudden coma, preceded by intractable vomiting...... Could her vomiting be a sign of a toxic lesion?" Brunn muttered as he looked at the picture on the screen, scratching his smooth chin, "She hasn't had a cerebrospinal fluid test yet, has she?"

Sun Lien shook his head, "The person has just been sent to the hospital, and other examinations have not been done yet. He looked at Brunn with a solemn expression, "What do you think about this?"

"I didn't know that this disease is not common in China. "But I've seen two of these patients in the U.S. The presentation was similar, with sudden coma, myoclonus, and extravertebral dysfunction – and more importantly, their MRI findings all showed highly symmetrical multiple cytotoxic edema. ”

Listening to Brune's description, Sun Lien vaguely felt a little familiar. But he really didn't have a clue what the disease was.

"Do you suspect it's CJD?" Xu Yourong broke the silence first, she looked at Brune with wide eyes, "It's impossible, right? ”

"And China bans the import of beef from the United States and the United Kingdom. Brunn doesn't seem to be very confident in his own judgment either, "so I just think it's possible right now." After all, her age is also very young, which is in line with the judgment that the average age of confirmed CJD cases in the world is 28 years old. ”

Sun Lien listened to the two discuss the content of the disease, and he searched for the three letters CJD in his mind, but unfortunately, he still didn't understand what kind of disease this refers to after thinking about it for a long time.

"So...... What do you think of the disease?" After pondering for a long time, Sun Lien gave up thinking. Instead of meditating here, it's better to ask, "CJD...... What is it?"

"You don't know?" Xu Yourong looked at Sun Lien with some surprise, and then relieved again, "That's right, are you still cultivating...... And it's an emergency doctor, so it's normal not to know this. ”

CJD is an abbreviation for Creutzfeldt-Jakob disease, a progressive disease that manifests itself as a result of prion protein (PrP) infection. It is also known as cortico-striatal-spinal cord degeneration, subacute cavernous encephalopathy, etc. As a disease caused by "prion" infection, it is associated with human kuru, fatal familial insomnia (FFI), Gistmann-straussler-scheinker syndrome (GSS), as well as scrapie and mad cow disease in animals encephalopathies, BES) belong to the same category.

If you don't have a general understanding of Creutzfeldt-Jakob disease, let's take a look at the following similar diseases. They are basically the same as Creutzfeldt-Jakob disease, with the common characteristics of long incubation period, short course of disease, and high mortality rate. After being infected with a special protein particle, commonly known as prions, it undergoes structural mutations on the surface of normal nerve cells, thus becoming pathogenic prion proteins with the ability to infect. As a special pathogenic factor that does not contain nucleic acids, human understanding of prion is still too superficial. What's even more frightening is that there is no ready-made treatment for any type of disease caused by the ruan protein infection.

·

·

·

After listening to Xu Yourong explain in detail what CJD was, Sun Lien fell into a long silence, and then he raised his head and looked at Xu Yourong and asked, "What do you think...... Is this the disease?"

"I can't rule out this possibility without sufficient evidence. Xu Yourong thought about it, but still couldn't give a positive answer, "Whether it's sporadic sCJD, hereditary gCJD, or vCJD that is infected with mad cow disease." At least imaging and myoclonus match. If intractable vomiting is thought of as extrapyramidal dysfunction, it is another symptom. At the very least, this suggests that this case should be treated as a suspected case of CJD. ”

"Dr. Xu and I went to do a brain wave test for the patient, and if it was CJD, the patient's brain waves should have abnormal manifestations such as slowing down of the rhythm. Brunn scratched his chin and stood up, looking a little nervous, "Boss, go talk to the family." Use your strengths and strengths to dig out some evidence from their mouths that can help with the diagnosis...... Also, pray, I hope this patient doesn't like beef. If it's vCJD, she's dead. ”