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Amyotrophic lateral sclerosis, also known as motor neuron disease, is the gradual weakening and atrophy of the muscles, limbs, trunk, chest, and abdomen of the muscles, including bulbar innervation, after injury to upper and lower motor neurons.

Li Han has not been practicing medicine for a long time, and he has never met a patient with amyotrophic lateral sclerosis, and he would not have paid attention to this disease if it were not for the recent rise of the ice bucket challenge. After playing the Ice Bucket Challenge, when uploading the video, he couldn't help but search for relevant information by the way, only to realize that there were many people who had this disease, and he knew about Hawking's case until now, and thought it was a relatively rare disease. He still thinks that he is a good doctor, but he is not even good at common sense, and he can't help but feel hot on his face.

Seeing him check these information, Gavin's eyes lit up and asked, "Han, you are also a doctor, what is going on with this ALS?" Is there no cure at all? ”

Li Han let out a long sigh and said, "It seems like this, I haven't been exposed to this kind of disease, and I don't know very well, it would be better if there was a patient for me to study." However, doctors all over the world are helpless about this disease, and I am afraid that it will be difficult. He hadn't met a patient who made him helpless, and he had seen so many old Chinese medicine doctors with medical skills that were not as good as him, plus those tips in the secret book, which made him very confident in his medical skills and wanted to challenge the high difficulty.

That's just talking, Li Han took this to heart, turned his head and went to the ranch, everyone was still waiting to eat the legendary very delicious flying dragon bird.

I drove to Lake Windermere Villa and took a detour to Oxford. Send Lydia back to school. It's a bit too cold to live by the lake in winter, but fortunately, Li Han is now cold and heatless. The heat and cold didn't mean much to him anymore, but a few little ones were shivering by the wind, and the other ones were better, especially Phoebe, who didn't go to the backyard at all, the wind blowing from the lake was really strong and cold, and she was going to be blown away.

The first few times he had been to Windermere had been in spring or summer, and this was the first time he had been to the Lake District in winter. It's really the best place in the English countryside, and I didn't expect it to be so beautiful in winter. The ground has been frozen hard, the ground has no greenery, and only bare branches are left on the broad-leaved trees, but there is another bleak beauty. Even if the wind blowing on the surface of Lake Windermere can freeze people's noses, it still makes people can't help but stop and enjoy the scenery.

He had come here on the impromptu side, and it was almost five o'clock by the time he arrived at Windermere. Winter in England is short, it has been dark for more than an hour, so I can only rest first, and then go to Old Tom tomorrow to ask about the ranch.

The next day happened to be Sunday, and the old Tom's son brought his wife and children to visit and had not yet returned to the city, and listened to Li Han's intention. Daxi, he was worried that his father would not leave this land to live with him in the city, if his mother was still there, he still lived alone in the country at such an age, and the nearest neighbor was a few miles away. It's really reassuring.

Old Tom was reluctant to accept the pasture handed down from his ancestors, but he couldn't withstand his son's persuasion. The little grandson also hugged his thighs and said that he wanted to live with his grandfather, so he agreed half-pushed.

Li Han was afraid that he would look back and be reluctant, so he immediately called his lawyer Joseph, Joseph was the one who helped him go through the formalities when he first arrived in Beijing, anyway, he didn't know anyone, since his uncle felt that he could be trusted, Li Han continued to use it. After some bargaining, the lawyers of both sides also arrived, Joseph had already made up the same agreement in the office, just fill in the price, signed under the witness of the lawyer, the ranch was surnamed Li from now on, and the formalities were handed over to Joseph to handle as usual.

"I'm not in a hurry to buy cattle and sheep in this winter, you deal with it slowly, and when you're done, just tell me." Li Han is not the kind of unreasonable person, whether it is a cow or a sheep, he always has to give time for people to get rid of it. Originally, it was most convenient for Li Han to take over by himself, but he didn't want to raise so much, and if he took over some of them, the rest of the old Tom still had to find a buyer, so it was better to simply buy cattle and sheep by himself. As for the aviary for raising flying dragon birds, it won't take long to build, not to mention the introduction of bird species from Huangguo, and I don't know how long it will take, so I'm not in a hurry. Then he asked, "I can't take care of this ranch myself, do you know anyone who is good at raising cattle and sheep?" I need to hire someone to live on the ranch for a long time and help me manage it. I'm not familiar with this place, and I'd like to ask you to help introduce a suitable person, as long as the person is competent and trustworthy, the salary can be negotiated. ”

Old Tom thought for a moment and said, "There is a man named John twenty miles south of here, in his forties, who used to have a small ranch, a little older than me, because something happened to him and needed money, so he sold the ranch and was looking for work, but it seems that he is not in Windermere these days, if you will want to meet him, I will let him contact you." ”

Of course Li Han agreed, no matter what, he always had to take a look, and he would talk about it when it was good or not.

A few days after returning to London, Benedict called and said: "I know a person with ALS, and he has also heard of your reputation, knows that you are a good doctor, and heard that you want to study ALS, and he is willing to cooperate." ”

Li Han was overjoyed and said, "That's great, where is he?" I'll go over and check his pulse first. "Since it is a person with ALS, it must be inconvenient to travel, of course, you have to go to the doctor.

Benedict said, "In New York." ”

"Huh?" Li Han was speechless, did he have to cross the Atlantic when he went out for a consultation?

Benedict hurriedly explained: "He is willing to go to England to live temporarily, so that you can study the condition." "Didn't I come to New York to participate in the show, and I happened to see McLean participate in the Ice Bucket Challenge as the first ALS person on Facebook, so I contacted him." ”

Although Benedict is the spokesperson of several charitable foundations, none of them have anything to do with amyotrophic lateral sclerosis, and he will go out of his way to contact McLean, of course, because Li Han said that he wants to study this disease. Although Benedict is usually a little bit better, he has nothing to say to his friends, he is careful and considerate, Li Han has a secret, he is not unaware, he killed a vampire in front of him, but he never asked about spells.

The next day, McLean sent him an email, saying that he would come to London for the next week, and made an appointment for the first appointment in 5 days, and then said something about bothering him in the future. A few days later, someone moved in at 97 Charlotte Street, and a man in a suit came to the clinic to invite Li Han over.

No. 97 Charlotte Street was originally a family of four, but I didn't know where to move a week ago, and the house was not listed for sale.

Benedict contacted this Ryan just on a temporary basis, and he could buy a house to live in in a day, and he didn't know what this Ryan family did, it seemed to be both rich and expensive. Li Han touched his chin and felt that this time it was quite cost-effective, he could study ALS, and probably make a lot of money for diagnosis. Although no matter how much the consultation fee is now, it is a drop in the bucket, but it is also money!

When he entered the house, someone who looked like a female assistant came and led him to the master bedroom on the second floor, a brown man was sitting in a wheelchair, next to a computer and a wire connected to his throat, Li Han didn't understand science at all, but felt that this device looked similar to that used by the great physicist Hawking.

Seeing Li Han come in, Ryan struggled to smile at him, but he couldn't hook the corners of his mouth, so he could only use the computer to say in a mechanical voice: "I'm sorry, Dr. Li, there is no way to greet you in person." ”

Li Han hurriedly waved his hand and said, "Mr. Lane, please don't be polite, I need to check your pulse first, you can calm down." ”

Li Han has also done some homework these days, and the cause of amyotrophic lateral sclerosis is still unknown, and 2o% of cases may be related to heredity and genetic defects. In addition, some environmental factors, such as genetics and heavy metal poisoning, may cause motor neuron damage. At present, the main theories are the accumulation of neurotoxic substances, glutamate accumulation between nerve cells, and over time, causing nerve cell damage; Free radicals damage nerve cell membranes and nerve growth factor deficiency, making it impossible for nerve cells to continue to grow and nourish.

In the early stage of amyotrophic lateral sclerosis, you may only feel some symptoms such as weakness, flesh jumping, and easy fatigue, and gradually progress to generalized muscle atrophy and difficulty swallowing, and finally respiratory failure. In the initial stage, if you do some symptomatic treatment, exercise appropriately; For example, pay attention to the function of the respiratory tract and digestive tract. If saliva is profuse, a small amount of antihistamine may be given; If there is a lot of phlegm, nebulized inhalation and phlegm-reducing drugs can be given; If there is a depression, it is treated with antidepressants. In addition, it is necessary to turn over more often to prevent pressure sores. If eating disorders occur, nasogastric feeding or percutaneous gastrostomy is given.

When breathing is not smooth, regular oxygen or a dual positive pressure ventilator can be used to help breathing, and when further respiratory failure occurs, a tracheostomy is required and an artificial ventilator is used. Looking at Ryan's symptoms, he has reached the point of respiratory failure, but he doesn't know how long he has been on the artificial ventilator.

At present, neurotrophic factors, antioxidants such as vitamin E, vitamin C, creatine, coQ1o, etc., are being used in combination with Lirutai to provide protective treatment for amyotrophic lateral sclerosis. However, these treatments have yet to be confirmed by clinical trials, and scientists are also conducting actual research on gene therapy for the disease, but it is only a study and there is no progress yet. Therefore, ALS can still be said to be a terminal disease, if Li Han can really find a cure, then the achievement is completely different from what it is now, and maybe there is no problem with the Nobel Prize in Medicine.

After carefully taking the pulse for at least 1o minutes, after the diagnosis, the left hand was changed to the right hand, and the assistant asked the assistant to read the medical records for a long time, and then said: "I have to go back to study it first, and then come over to prescribe a pulse for me when there are results." ”

ps: I'm sorry, I'm sorry, I went out with my sister for a Mid-Autumn Festival dinner today......