Xinxing Hospital, Uncle Wang's ward.

Xinxing Hospital is located in the eastern district of Lianhai City, and is the largest hospital in Lianhai City after the First People's Hospital.

Uncle Wang had fallen into a coma on the hospital bed, and Uncle Ge stayed by the bedside.

Outside the ward, Gu Yanan was talking to Nan Hanfei about the situation in the past few days.

Nan Hanfei's face was heavy, and he told about his experience with Uncle Ge and Uncle Wang in the past few days, "A few days ago, on my way to work, I found Uncle Ge and Uncle Wang arguing in the woods where they often walk birds, and I went to persuade them to fight.

After the two uncles were separated, they went home separately.

Later, Uncle Ge felt relieved, and went to visit Uncle Wang's residence again, and found that Uncle Wang was talking to himself alone at home.

Uncle Ge saw that something was wrong, so he called an ambulance and sent Uncle Wang to a nearby Xinxing Hospital.

After various examinations at the hospital, the doctors at Xinxing Hospital initially suspected viral encephalitis, but after a round of examination, they did not find any virus on the body.

Later, he was diagnosed with senile dementia, and the doctor prescribed medicine, preparing to let Uncle Wang go home and take medicine to recuperate, but when he was about to be discharged from the hospital, Uncle Wang suddenly fell into a coma.

The doctor felt that something was wrong and said that Alzheimer's disease would not progress so quickly, and I also thought that Uncle Wang was very sick, so I called you. ”

Uncle Ge heard the voice in the ward, and also walked out, and said to Gu Yanan: "Old man Wang's illness is indeed strange, the doctor said that it was Alzheimer's, but how can Alzheimer's disease be so fast, it has only been a few days, and the person has fallen into a coma." ”

Uncle Wang is an old man who lives alone, and he usually has more contact with Uncle Ge, Uncle Ge is familiar with Uncle Wang's situation, Gu Yanan asked, "Uncle Ge, when did you start to think that Uncle Wang was wrong?" ”

Uncle Ge: "About four months ago, once I went to Old Man Wang's house to deliver something to him, and after waiting for a long time, he stayed in the toilet and didn't come out, and that time it took him more than two hours to go to the toilet, is this something that ordinary people can do?"

Another time, I went to his house and found him brushing his teeth in that bathroom for more than half an hour.

Two days ago, in the grove where we often walk birds, Old Man Wang had a fight with me, and we did it, Xiao Nan knew. ”

Uncle Ge looked at Nan Hanfei, Nan Hanfei nodded, and added, "That quarrel happened to be encountered by me, and Uncle Wang has indeed been prone to emotions recently. ”

Gu Yanan thought to himself that the recent symptoms of Uncle Wang mentioned by Uncle Ge and Nan Hanfei were all manifestations of abnormal emotional behavior in the early stage of Creutzfeldt-Jakob disease.

Could it be that Uncle Wang is also Creutzfeldt-Jakob disease?

Although Gu Yanan strongly suspected this in his heart, he had doubts about the Creutzfeldt-Jakob disease case caused by cosmetics investigated in the past two days.

In the case of Wu Gang's purchase of imported cosmetics, the people infected by prions were all young women, aged between 20 and 40, and Uncle Wang was an old man in his sixties, which did not match his age.

Gu Yanan asked: "Does Uncle Wang usually use imported cosmetics?" ”

Uncle Ge shook his head, "Where does Old Man Wang usually use any cosmetics?" The toothpaste and toothbrush he usually uses are the kind sold at a discount in the supermarket, which is purely domestic. The only face oil I used in the morning was an old domestic brand I gave him two years ago. ”

Gu Yanan also felt that Uncle Wang's disease was not the same source of infection as the Creutzfeldt-Jakob disease caused by Zhang Li's cosmetics.

But Uncle Wang's current symptoms are very similar to those of Creutzfeldt-Jakob disease, and in order to confirm, Gu Yanan has to look at Uncle Wang's case first.

Xinxing Hospital, Uncle Wang's attending doctor's office.

Uncle Wang's attending doctor is a middle-aged man in his forties, thin in size, with a pair of glasses, and a temperament similar to Gu Jiashu, but not as tall as Gu Jiashu.

asked for Uncle Wang's medical records from the attending doctor, Gu Yanan took a closer look and found that Uncle Wang's symptoms were very similar to Wang Li's.

Gu Yanan looked at the medical records and frowned slightly.

The attending doctor knew Gu Yanan's identity and knew that she was from the CDC, and saw her frowning slightly, so he explained, "When the patient was first admitted to the hospital, we suspected encephalitis from his CT images, and differentiated infectious and non-infectious diseases, and excluded common infectious diseases, including purulent encephalitis, viral encephalitis, tuberculous meningitis, and fungal meningitis.

The patient had a normal body temperature at the time of admission, no history of fever or cold before the onset of the disease, no obvious abnormalities in cerebrospinal fluid biochemistry routine and cryptococcal latex agglutination test, negative meningeal irritation, and no obvious evidence to support infectious disease.

For non-infectious diseases, autoimmune encephalitis, paraneoplastic syndrome and Alzheimer's disease are mainly considered in combination with the clinical manifestations of patients.

Because the patient has progressive central nervous system symptoms and progressive dementia, the initial clinical diagnosis of Alzheimer's disease is preliminary. ”

Gu Yanan: "The patient's disease progressed too quickly to meet the clinical manifestations of Erzheimer's disease, have you considered that it may be Creutzfeldt-Jakob disease?" ”

The attending doctor's face was slightly embarrassed, "We have also considered this, but Creutzfeldt-Jakob disease is extremely rare, and we lack experimental means to diagnose it, so we ......"

Gu Yanan: "We have an experimental method for detecting prions, and we can send a patient's cerebrospinal fluid sample to the CDC, and the results will be available tomorrow." ”

Attending doctor: "Thank you very much, I will immediately arrange for someone to send the patient's cerebrospinal fluid sample to the CDC laboratory." ”

Gu Yanan: "You're welcome, this is also the work of our CDC. ”

——

Lianhai Center for Disease Control and Prevention, Laboratory.

As soon as the Creutzfeldt-Jakob disease experiment caused by purchasing cosmetics ended, Xinxing Hospital sent Uncle Wang's cerebrospinal fluid sample, and Lu Li worked overtime overnight and came out with the test results in the morning of the next day.

Uncle Wang's cerebrospinal fluid sample detected 14-3-3 protein.

Combined with Uncle Wang's clinical symptoms, it is recommended to diagnose sporadic Creutzfeldt-Jakob disease.

A wave has not settled, and another wave has risen.

The Creutzfeldt-Jakob disease caused by cosmetics is not over yet, and Uncle Wang doesn't know what caused the Creutzfeldt-Jakob disease.

Once confirmed, Gu Yanan began an epidemiological investigation.

Because Uncle Wang was already in a coma, his previous living habits could not be told from Uncle Wang's own mouth, so the epidemiological investigation started with the most familiar person around Uncle Wang, Uncle Ge.

Gu Yanan learned about Uncle Wang's usual living habits from Uncle Ge.

Uncle Ge talked about his friend and gushed endlessly, "Old man Wang's wife went early, and his children were not around, so he was usually alone, very similar to me, and the two of us usually talked better, so we became very good friends." ”

Gu Yanan asked, "Has Uncle Wang had surgery before?" ”