"From this point of view, it is more supportive of my idea of locating to the meninges."

"As for the qualitative diagnosis, I mainly consider tuberculous meningitis. There is a lot of evidence to support it, such as meningeal irritation, changes in cerebrospinal fluid, lack of significant damage to the brain parenchyma, and no obvious diffuse slow waves on EEG. ”

"Of course, there are also areas that are not supported. For example, the lung examination is normal, the conjugate test is negative, the child has no history of exposure to tuberculosis patients, and so on. ”

"However, we all know that the current tuberculosis infection is very secretive, and many times, it is a transient infection of the lungs, which quickly invades the meninges. This condition cannot be ruled out. ”

"Therefore, I suggest that, in the future, the treatment should be carried out according to the tuberculous meningitis, and at the same time, the nutritional status of the child should be actively adjusted in a timely manner and the water and electrolyte imbalance should be improved. If these conditions do not improve, it is very detrimental to the treatment. ”

"As for anti-epilepsy, I recommend stopping it. After all, anti-tuberculosis drugs and antiepileptic drugs cause relatively large damage to the liver, and the child is only a kind of epileptiform seizure at best, which is not worth long-term drug treatment and can be closely observed. ”

"Director Yang, Section Chief Feng, I'll talk so much, I really hope to interact with you." Lin Lin left a "foreshadowing". He was waiting, waiting for Qiu Bin to come forward, and he didn't mind coming forward to teach him a lesson.

"Thank you very much Dean Lin for your wonderful rounds and analysis. I listened to and watched Dean Lin's ward rounds from beginning to end, and I could truly realize that Dean Lin's profound and extensive medical knowledge and his rich clinical experience are all worth learning from. ”

"Next, let's see if you have any questions, if you have, you can ask Dean Lin in person, there are not many opportunities like this." Feng Ping's words are equivalent to a concluding speech.

"Dean Lin, I would like to ask you, why do you say that this patient's seizure is only an epileptic seizure, and you do not advocate the use of anti-epileptic drugs?" Cai Xiaofeng asked first.

"Well, Dr. Chua's question is very good."

"The so-called epileptiform seizures mean that his seizures meet the criteria for epilepsy diagnosis, but the triggers of his seizures can be found in the patient."

"The most common, and the most common febrile seizure you'll see. Relatively rarely, it is the disorder of the patient's internal environment, such as acid-base imbalance, water and electrolyte imbalance. ”

"This disturbance of the internal environment can lead to abnormal electrical discharges in the patient's brain cells, which can cause epileptiform seizures. In this case, when we correct these triggers, the seizures disappear and never appear again. ”

"So, for such seizures, there is really no need to use anti-epileptic drugs. From the perspective of neurology, we can continue to observe once or twice a year, and we can do without medication under close observation. ”

"Thank you, Dean Lin, for your answer." Cai Xiaofeng was convinced of such an answer.

"Dean Lin, why did you easily deny the diagnosis of viral brain without clear evidence? Isn't this patient's performance enough to diagnose the viral brain? Qiu Bin began to speak.

"This is Xiao Cai's senior doctor, Dr. Qiu Bin." Yang Yan said to Lin Lin.

"Hello Dr. Qiu! Your question is actually universal, I once said this question when I was visiting a patient in the pediatric department of our hospital. ”

"I don't know if you feel it, but now many children are diagnosed with 'viral encephalitis' because of fever, and during the hospitalization, hormones are used, and the effect is really good."

"I would like to ask Dr. Qiu a question, what are the most important clinical features of viral encephalitis?"

"Uh......" Qiu Bin was asked.

"In our pediatric department, viral encephalitis, the main clinical features are fever, poor spirits." Qiu Bin thought about it and gave an answer.

"So, let me just say, according to Dr. Qiu's answer, is it possible that many children with fever can be diagnosed with viral encephalitis?"

The doctors present nodded in unison.

"For general viral influenza fever, the effect of short-term use of hormones is very good, but this cannot be said that such a patient is viral encephalitis."

"Viral encephalitis, as the name suggests, is definitely a virus that invades the brain, and there will definitely be signs and symptoms of brain damage. Can you see the signs and symptoms of parenchymal damage in this child today? ”

Everyone shook their heads again.

"Although there is none, isn't there a significant improvement when this child starts to be treated with hormones? Doesn't that mean he has viral encephalitis? Qiu Bin still held on.

"That's the scariest part. Dr. Qiu, do you know why this patient has been getting worse so quickly lately? Have you thought about this? If you think about it, do you still think hormones work? Do you dare to continue using hormones for this child? ”

Lin Lin's series of questions made Qiu Bin speechless, and Yang Yan applauded in her heart.

"Dean Lin, have you always been so domineering in your ward rounds?" Qiu Bin's question startled Feng Ping, he moved, and was about to speak, when Yang Yan signaled him not to interject.

"Overbearing? Dr. Qiu thinks, which sentence I just said is overbearing? Section Chief Feng, do you think my ward rounds and analysis just now are very domineering? ”

"Dr. Qiu, please be careful with your words and actions. Dean Lin has always been very serious and calmly analyzes the condition, pure academic rounds, where does the domineering come from? Feng Ping frowned and interjected.

"I've always believed that when it comes to academic discussions, you have to put aside all your identities, academic qualifications, titles, positions, and titles. Academically, these things have no value, and if anyone wants to impose these things on academic discussions, then, this person will definitely achieve nothing, and the level must be very average. ”

"When Dean Lin said this, he denied the importance of a degree." Qiu Bin thought he had grasped the point of the attack.

"Hehe, it seems that Dr. Qiu prefers to take quotes out of context. In our hospital, when recruiting talents, doctors are definitely preferred, but at the same time, we value the first degree, practical ability, and character. ”

"I have never denied that the group of doctors is a group of intelligent people. Most of the PhDs are intelligent, studious, hardworking, and open-minded. ”

Such people, knowing where their shortcomings are, will work very hard and humbly to learn from people with all kinds of academic qualifications. I admire these people very much, and they are also the real talents that I am very eager to recruit. ”