"Fifth, the patient still has a relatively normal menstrual cycle, but the menstrual flow is significantly reduced. What's more, the patient said that before menstruation, the lubrication of the secret area deteriorated significantly. ”

"How bad is it? It is so bad that the patient is unable to complete the life of intercourse with her husband at all, so bad that the patient has severe pain when she has sex with her husband, and so bad that she refuses to have sex with her husband and is afraid of her husband's touch. ”

"Sixth, let me tell you some of the things I have seen in my physical examination. The mucous membranes in the patient's mouth are very dry, and several ulcer lesions can be seen. ”

"The patient's teeth are partially blackened and the gums are receding. The mucous membranes of the throat wall are also very dry, and the eyes are also dry, with almost no moisture from tears. ”

"The neurological examination is consistent with what Dr. Yip reported. The muscle tone of the limbs is low, the muscle strength is grade 4, the tendon reflexes are weakened, and the pathological signs are negative. The skin of the extremities appears dry and slightly scaly. Other neurological examinations are unremarkable. ”

"I don't know, after I said so much, do you have any ideas, or do you have any new ideas for the diagnosis of this disease." Lin Lin deliberately paused to hear everyone's opinions.

Silence, in the office, deathly silence!

Everyone knows that what Dean Lin said must have a clear direction, and these are indeed there. But no one can think of a neurological disorder that explains these signs and symptoms.

"These signs and symptoms can only be 'dug up' by a 'ghost' like Dean Lin. Even if Dean Lin 'digs' it out now, my mind is still blank about the diagnosis of this patient. Ling Xiaoyun had to admire this "genius" who he wanted to get it very much, but couldn't get it.

"Director Ling has spoken out our hearts. In front of Dean Lin, we were like elementary school students. Ding Feng is quick to talk.

"Don't be presumptuous, through the discussion of this case, I will give you a reminder. If you want to become a skilled doctor, deep, extensive and solid knowledge of internal medicine is indispensable, and everyone must pay attention to it. ”

"I suggest that Director Ding add the content of diseases in the internal medicine system to the regular assessment of the department in the future. The score for these contents can be either a total score or a reference score. ”

"Okay, let me tell you about the most obvious characteristic of this patient, which I can sum up in one word: dryness!"

"Tears are reduced, eyes are dry; decreased saliva, dry mouth, frequent blockage of the parotid duct, ulcers of the oral mucosa, tooth deterioration; It may be that the fluid in the osteoarticular cavity is reduced, causing pain when the patient moves the joint; The decrease in secretion in the secret area leads to the dryness of the secret place, and the patient does not dare to have sex with her husband......"

"You may have noticed a special situation from what I just said, that is, the patient's exocrine gland function has decreased significantly."

"Of course, the patient's lesions also damaged the peripheral nerves, which is why the patient was admitted to our neurology department."

"So, to sum up, the patient is a disease characterized by dryness, and this disease, which exists in internal medicine, is called 'Sjögren's syndrome', which is an autoimmune disease."

"In this disease, exocrine gland damage is predominant, but multisystem damage can also occur. At present, there is no cure. ”

"To confirm it, you can do a simple test, which is to check whether the patient is positive for anti-SSA or anti-SSB antibodies. In my opinion, this patient must be positive. ”

"Such patients can consider hormone therapy to relieve the patient's symptoms. It makes sense to stay in our department for treatment. ”

"Of course, if you don't want to observe the patient's response to treatment, you can also ask the endocrinologist to consult and refer to them. Hehe, I guess they're really going to want to get this patient. ”

"I often say that the patient is the best teacher of a doctor. If you have never been in contact with such a patient, you will not read the relevant books, let alone think in this direction. ”

"The two patients we discussed today are very meaningful. In fact, these two patients are related to our neurology department, but the cause is the disease of other systems. ”

"Of course, the final result will not be determined until it is checked. However, hehe, I have always been very confident in my judgment. Director Ding, I'll wait for you to report the results to me. ”

Lin Lin found that since stepping into the management of the hospital, many things in her previous life have changed her original trajectory, including the patients she sees, which are very different from before.

However, with Lin Lin's decades of rich clinical experience, these cases are difficult for him.

"Thank you very much, Dean Lin! During today's ward rounds, Dean Lin brings us a wealth of knowledge and unique thinking methods. Every ward round of Dean Lin is equivalent to brainwashing us, washing our solidified thinking and bringing us a new way of thinking and methods. ”

"I don't know what people think, but I always think that if Dean Lin is free, I really like to come back every week to participate in and guide our difficult case discussions."

"For example, today's case of Dr. Ye, although it was put forward temporarily, after Dean Lin's rounds, the knowledge we learned from it is no less than the first case."

"I am very impressed by what Dean Lin just said, that is, 'patients are the best teachers'. Therefore, we should treat patients well and treat them with respect. ”

"Finally, let us thank Dean Lin for a very shocking lesson with warm applause." After Ding Feng finished speaking, everyone immediately applauded together.

Lin Lin hurriedly gestured to everyone to stop applauding.

"Everyone, please be quiet, this is the ward, if we are not quiet, how can we make the companions quiet?"

"Thank you, Director Ding, for your high praise! Hehe, Director Ding and everyone, don't forget, I'm a member of the Department of Neurology. In this life and this life, I was born as a neurologist, and I died as a ghost in neurology. ”

"Uh...... Dean Lin, how can you talk like that? You have to live forever, and you've always been our talent. Ling Xiaoyun was used to seeing Lin Lin's words amazing.

"Hehe, Director Ling, in this world, there is no one who can live forever. Qin Shi Huang can't do it, and no one else can do it in the future. Okay, let's go separately and quickly put the plan we just discussed into action, I'm an anxious person. After Lin Lin finished speaking, she stood up.

When Ding Feng saw it, he also stood up, accompanied Lin Lin, and left the neurology ward.

Lin Lin's ward rounds today, from asking for medical history, physical examination, to analysis, set off a shocking wave in the Department of Neurology. Everyone was impressed by Lin Lin's extensive knowledge, quick thinking, delicate thinking, and rigorous logical thinking.