Plasmapheresis is a way worth trying, and Sun Lien agrees with this very much.

Waiting for the results of genetic testing to come out, Tang Min's treatment will inevitably stall. It may be a good thing for herself, but her parents don't necessarily think so.

Plasmapheresis itself is a risky treatment, and Sun is not sure whether it should be done until the positive outcomes of the treatment are balanced with the collateral harm.

"I think Isabella is under a lot of pressure today. After talking about this matter, Sun Lien turned to talk to Dr. Pascal about family life, "What's wrong?"

Dr. Pascal was obviously reluctant to dwell on the here, he just shook his head with a wry smile and said, "It's just some matter, although it's not a particularly troublesome problem, but it's very energy-consuming to deal with......" He sent a sympathetic look at his wife through the wall, "This matter has been tormenting Isha for days. ”

After chatting a few more words, Sun Lien saw that the time was almost up, so he got up from the sofa. "I'll leave this case with you for now...... I understand that Lao Pa is also very busy with scientific research now, but if you can find time, you should go to the hospital and keep an eye on it. ”

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By the time Sun Lien drove back to the hospital from school, it was just past noon time to eat.

The war army spent two "observation posts" arranged by China at the school gate, and they faithfully fulfilled their duties - they contacted the war army when Sun Lien's car drove into the school.

The consequence of the contact was that when Sun Lien went downstairs and was about to drive away, he met the soldiers carrying food boxes. The war army expressed his frustration that Sun Lien had not come to him recently, and then forcibly stuffed Sun Lien with a "food box".

The box contains Sun Lien's favorite braised pork and potato stew, as well as seven or eight hard dishes, including grilled fish and stir-fried chicken thighs. The size of the entire food box is almost the same size as a computer case, the ten-centimeter-high food box has six layers, and the war army also used a two-liter travel stainless steel thermos bottle to fill a whole pot of pork ribs and lotus root soup.

"In the winter, eat something good to nourish your fat, so that you don't get sick easily. After the soldiers stuffed the food box to Sun Lien, they felt that it might not be convenient for him to move it, so he snatched the food box back and stuffed it back into the trunk of the Volvo. "If a doctor is sick, how can he treat others?"

Although the truth is quite right, Sun Lien just feels that something is wrong. A five-kilogram food box and a two-litre pork rib lotus root soup...... Is this the war army holding back its strength to stuff itself into a stomach and perforate it?

"You're not going to be able to eat so much, go back and share a share with your colleagues. The war army just explained his intention of bringing a bunch of food to Sun Lien, "I put all the dishes and chopsticks in the bag - I bought them newly, and I just washed them." When you're done with it, you can call me directly, and I'll get it back when I go to the Fourth Courtyard. ”

"Are you going to the Fourth Courtyard?" Sun Lienqi said, "Why are you going?"

"My brother was in the hospital yesterday morning, and he was examined in God. The soldier smiled and patted Sun Lien's shoulder, "He's still thinking about inviting you to a drink." ”

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Back at the hospital, Sun Lien got out of the car with a large bag and a small bag. Then he unceremoniously requisitioned a wheelchair parked in the lobby of the comprehensive diagnosis center, and it took a lot of effort to deliver this rich strategic reserve to the office.

Doctors generally eat a ...... lunch. Scattered. Whether it is in terms of time or space, everyone's food is relatively scattered. After asking around, Sun Lien found that in his treatment group, Xu Yourong was supporting a neurosurgery in the operating room, and Zhou Ce was preparing for the director's ward rounds in the kidney. Yuan Ping'an and Dr. Brunn hadn't eaten yet—the two of them were studying the literature.

Three people eat so much, it will definitely not be able to eat. Sun Lien immediately decided to bring all the doctors in the second group over for dinner.

"It tastes so good. Dr. Ma Yongfang, who usually doesn't like to chat with people, suddenly lit up his eyes after drinking the pork rib soup. She asked Sun Lien with some excitement, "Doctor Sun, where did you buy this soup?" Can you send me the name of the shop?"

"It tastes similar to Yunhe's pork rib soup. Wang Guonan nodded in praise while drinking the soup. For a doctor born in Yunhe, the highest praise for pork rib soup is that it "tastes similar to Yunhe". Just like the people of Jincheng praise the beef noodles sold in other places, the highest praise is that "the taste is similar to that of ordinary shops in the residential area of Jincheng".

Dr. Chen Xuerong is not in the group today - he has taken a leave of absence to return to his hometown. The reason is a bit sighing, and it is said that it is because Dr. Chan's grandmother passed away.

Professor Zhang didn't eat much, but he preferred to watch Brune eat with his eyes open. He slowly took half a spoonful of soup with a spoon and put it in his mouth, while wiping the pork rib soup that leaked from his lips with a tissue in his left hand. After taking a few sips, Professor Zhang put down the spoon and asked Sun Lien, "Tang Min's question, how are you doing?"

"There are already two ...... Speculation in three directions. All need to be verified. Sun Lien put down the chopsticks in his hand and said seriously to Professor Zhang Zhifu, "One is a genetic disease, which we have already sampled and sent for testing, and the results of the whole gene control will come out in about two weeks." The second is the tumor, and I plan to wait for a negative test result for a genetic disease before considering a third biopsy – a sample from the optic nerve. The third direction was only clear after I went to ask the director today......" He paused, remembering that Professor Zhang probably hadn't met Lao Pa yet, and explained, "It's Dr. Pascal, who is supposed to be in charge of the work of our comprehensive diagnostic center, and he is an expert in immunology. ”

"You mean...... Could Tang Min's illness be due to immune problems?" Professor Zhang Zhifu frowned, and then he sighed, "If only it were that simple. What are you going to do, another hormone rush?"

"......No," Sun Lien shook his head, "Dr. Pascal thinks that Tang Min may be an APQ4-negative NMO, and she may respond poorly to the shock therapy. I want to do two plasmapheresis on her to see the results. ”

"Don't worry about the cost of treatment, Takeda is there anyway. Professor Zhang nodded hesitantly, "Although there is a risk of plasmapheresis, it is at least a little more controllable than biopsy." He raised his head and looked at Sun Lien and asked, "But...... Do you really think she might be an immune disease?"

"The odds are low. Sun Lien didn't intend to hide it when his colleagues talked to each other, he shook his head directly, "Systemic immune diseases can't explain the reason why her lesions are mainly concentrated in the nervous system, and the diagnosis of NMO makes even more sense - she doesn't have symptoms of myelitis either." ”

"The total number of patients with NMO is not large enough, and we should still maintain a relatively open attitude. Professor Zhang thought for a moment, then pointed to the table and asked, "Maybe this is an entry point?"

"Entry point?" Sun Lien was a little confused, and the other doctors who were still eating also began to stop their movements and be confused together, "Cut in from the antibody?"

Yuan Ping'an suddenly asked, "The mechanism of NMO is that the APQ4 antibody attacks the APQ4 protein on the nerve, causing glial hyperplasia, right?"

As the doctor with the most literature reading in the first diagnosis group, Yuan Ping'an's questions at this time are actually more like self-questions and answers. Instead of waiting for someone else's answer, he came up with a second hypothesis himself, "If those hypointense areas are indeed not mass lesions, but mesenchymal cell edema like NMO, and she does not meet the definition of NMO at all...... This means that the disease should at least share some pathways with NMOs – they are likely to be related to the APQ4 protein. ”