"Director Leng, I think Ling Feifei, who is eleven beds, can her deworming treatment be stopped for a while?"

After the big round on Monday morning, at the regular meeting of the department, Tian Lu solemnly proposed.

"Suspend deworming treatment?"

Stunned, he asked in surprise, "Is that the little girl who was diagnosed with neurocysticercosis?"

"It's me!"

Zhang Jie, the deputy chief physician, raised his right hand with a somewhat ugly face. Before the ward round, Tian Lu had communicated with him, but Zhang Jie, who was full of confidence in his diagnosis, did not care, but politely refused the other party's request, saying that he would observe it for a few days, but he didn't expect this Tian Lu to mention it directly at the department meeting!

This made Zhang Jie's face look a little unpleasant.

glanced at Tian Lu, and said coldly: "Tell me about the patient's situation, as well as the basis for your current treatment plan!"

"Okay. ”

Zhang Jie hurriedly flipped through Ling Feifei's medical records, stood up and said loudly: "The patient, a fifteen-year-old female, was treated in a local hospital eight months ago for headache symptoms with no obvious cause。。。。。。 ”

"According to the recommendation of Dr. Tajiro at the time of admission, the patient was screened for fecal parasites, blood routine, biochemical tests, serum cystic antibody test, cranial CT and cranial MRI, and the results were as follows。。。。。。 ”

"To sum up, my diagnosis was neurocysticercosis, obstructive cerebral edema and upper respiratory tract infection, so I was given deworming, dehydration and anti-infective treatments, and now I have been taking the drug for two days, and the infection symptoms have improved, and the headache symptoms have also been relieved. ”

After speaking, he glanced at Tian Lu lightly, and Zhang Jie sat back on the chair.

After listening to Zhang Jie's report, his cold brows also furrowed.

Judging from the patient's medical records and the examination results after admission, there seems to be no problem with Dr. Zhang Jie's treatment plan, at least Leng Yan also agrees, why did Tian Lu recommend stopping the drug?

The nurses didn't say anything for the time being, and the other doctors also pondered carefully, trying to find out why Tian Lu suggested stopping the medicine.

After pondering for a moment, he waved his hand coldly and said, "Xiao Tian, tell me what you think!"

Under the complicated gaze of everyone, Tian Lu stood up unchanged and said in a deep voice: "According to the existing medical history and examination results, there is no problem with Mr. Zhang Jie's treatment, but the patient has been hospitalized three times before, all of which are the same treatment plan, but there is still a recurrence of headaches, indicating that the deworming effect is not good, so I think other options must be considered." ”

As soon as these words came out, except for Leng Yan and Li Qiang, another deputy chief physician, who had a thoughtful look on their faces, the other doctors all showed a look of disapproval.

It's only been two days of medication, so why are you jumping to such conclusions?

The cold index finger tapped rhythmically on the knee, and he was secretly thinking in his heart.

"And what about your proposal?"

After a moment, Leng Yan suddenly asked in a deep voice.

"Ventricular puncture!"

Tian Lu did not hesitate to give his own judgment that is consistent with the system!

His eyes lit up, and he asked coldly: "Do you suspect that it is ventricular cysticercosis?"

"Yes!"

Tian Lu nodded and said: "If it is in the fourth ventricle, the decomposed worm body after the death of cysts can cause severe ependycarditis and aggravate hydrocephalus, so I recommend temporarily stopping deworming treatment and doing a ventricular puncture to see first."

"But the current test results do not support your judgment!"

Seeing the look on Leng Yan's face, Zhang Jie hurriedly stood up and said, "The CT scan did not see it, especially the MRI examination results, and the cephalic segment was not found in the fourth ventricle." ”

Everyone's eyes returned to Tian Lu's face.

"Yes, it was not found, because the cyst wall is thin, the CT value of the capsular fluid is similar to that of the cerebrospinal fluid, and the contrast scan is not enhanced, so it is difficult to show cysts on CT and lacks specific changes. However, CT results show that the whole ventricular system is enlarged, and the bilateral lateral ventricles, the third ventricle, and the midbrain aqueduct are significantly dilated, and the fourth ventricle is particularly cysticly dilated, which is one of the symptoms. ”

Speaking of this, Tian Lu took a breath and then explained: "And although MRI is one of the most effective means of examination for neurocysticercosis, not all MRI images can see the cystic scolice, and the reports of this are also different in the literature of various countries. Because the cyst fluid in intraventricular neurocysticercosis is dense and signaling, it is easy to diagnose in patients with scolices and difficult to diagnose in patients with no ganglion, and only manifests as ventricular enlargement and obstructive hydrocephalus. ”

"So I think it's necessary to have a ventriculocentesis CT scan to make sure!"

As soon as Tian Lu's words fell, the office suddenly fell into silence, everyone was seriously considering Tian Lu's suggestion, after all, what he said still made some sense, didn't he?

After pondering for a while, he turned to Zhang Jie coldly and asked, "Xiao Zhang, what do you think?"

After all, Ling Feifei's chief physician is Zhang Jie, and Leng Yan still has to give him enough respect.

"I, I'm still sticking with my previous treatment plan. ”

After hesitating for a moment, Zhang Jie still insisted: "Although Xiao Tian's proposal is very reasonable, but the trauma of ventricular puncture is greater, I think it is better to treat conservatively first and see the effect." ”

The fingers on the cold knees were rhythmically tapping again.

Indeed, according to the existing examination results, Zhang Jie's treatment plan is currently the most secure, but considering Ling Feifei's previous medical history, Tian Lu's consideration is not unreasonable, and it is a little difficult to make a decision for a while.

Tian Lu's mouth moved, but he finally fell silent. He has already said everything that should be said, as for the final plan, one is to see the chief physician Zhang Jie, and the other is to see the director cold, for the time being, this is all he can do.

Under the gaze of Tian Lu, suddenly, the tapping of his fingers stopped.

"Follow Zhang Jie's plan first, and carry out drug treatment!"

He stood up coldly and said in a deep voice: "If the condition recurs again after treatment, follow Xiao Tian's plan for ventricular puncture!

A hint of disappointment faintly rose in Tian Lu's heart, while Zhang Jie breathed a sigh of relief.

"If not, that's it, let's dismiss!"

The doctors and nurses dispersed in a hurry, those who should go to the ward went to the ward, and those who should go to the operating room went to the operating room, and soon, only Leng Yan and Tian Lu were left in the office.

"Oda, your consideration is very reasonable, but 。。。。。。 ”

Looking at Tian Lu, Leng Fang's serious expression eased and said with a smile.

"I understand, Director. ”

Tian Lu said with a wry smile: "The determination of the treatment plan is a process of weighing and considering, and my plan does lack strong evidence support, let's take a look first." ”

"Hmm!"

patted Tian Lu's shoulder heavily, and said with a cold smile: "I will ask Zhang Jie to pay close attention to his condition, after a hard day, go back and rest." ”

After speaking, Leng Yan hurried to the operating room. He has a major operation today, and I'm afraid it will take a few hours to do it, so I can't waste more time here.

Is this all there is to it?

Just like the old lady who insisted on going home back then, she knew that she was right, but she could only do nothing?

Tian Lu sat quietly on the chair, and after a while, an inexplicable look gradually appeared in his eyes.

。。。。。。

There weren't many things to do last night, and Tian Lu was not very duty, and after taking a good bath, he felt full of vitality again, changed his clothes, and walked straight out of the hospital.

There are some things that can't be rushed, and they should be loosened when it's time to loosen up.

Looking at the time, it was indeed very early, and after pondering for a while, Tian Lu simply took the subway and came to the Medical College of Beijing Normal University.

After receiving the call, Tong Xiangyang hurriedly ran out, and when he saw Tian Lu, his face turned into a flower: "Xiao Tian, you came just in time, the laboratory has been vacated for you, but the equipment and instruments are not in place yet, why don't I take you to see it first?"

"Of course then!"

As soon as Tian Lu heard that the laboratory would be vacated so soon, he was overjoyed, and hurriedly said: "But I'll just go and see for myself, you are so busy, you don't need to accompany me!"

"What are you busy with, even if you are busy, I will definitely accompany you when you come!"

Tong Xiangyang laughed and walked towards the depths of the corridor with Tian Lu.

The laboratory is in the penultimate room in the innermost, facing the sun, the room is not small, about 50 square meters, but because it used to be used as a warehouse, now after it has been emptied, there is nothing, but it looks like it has just been cleaned and looks very clean.

"How's it going?"

Tong Xiangyang asked with a smile.

When Tian Lu came last week, he also saw this house, but at that time the house was full of sundries, and the feeling was naturally different from now, and under the joy of his heart, Tian Lu nodded again and again: "Satisfied, so satisfied, Teacher Tong, thank you so much!"

"It's good to be satisfied, it's good to be satisfied!"

Tian Lu was satisfied, Tong Xiangyang was naturally very happy, for this outstanding young man in front of him, he liked it from the bottom of his heart. Like Leng Yan, Tong Xiangyang, who has worked in the school for half his life, has a feeling for the Institute of Neurobiology that is far from being comparable to others, so for outstanding young people, he not only does not have the slightest jealousy, but is willing to give the greatest support and help.

The development and growth of the institute is one of his lifelong wishes, and for this reason, he feels that these things provided for Tian Lu are not worth mentioning at all.

Tong Xiangyang said with a smile: "Except for those consumables, the table instruments and everything are old, but I will definitely check them before sending them to ensure that they can be used normally, you can rest assured." If everything goes well, you will be able to use this laboratory after the National Day, hehe, I will get you an access card again, and you won't have to call me when you enter and exit. ”

"There's no rush for this, just take your time. ”

After speaking, Tian Lu hesitated for a moment and said, "In addition, Teacher Tong, there is something I want to consult with you. ”

"Say it. ”

Tong Xiangyang waved his hand happily.

Tian Lu nodded and said, "That's the case, I've heard that our Institute of Neurobiology accepts a lot of basic eight-year students to do projects every year, and everyone will choose a mentor, right?"