After Xu Yourong arrived at Ningyuan Airport, he immediately took Rachel to the hospital by taxi.

Although emotionally speaking, Xu Yourong felt that maybe Rachel needed to rest first, and it would be better to rest. But Rachel rejected the arrangement. She insisted that Xu Yourong take her to the Fourth Courtyard first.

"Dr. Sun has helped us so much, we have to thank us in person. Rachel, who had cut her short hair, said seriously to Xu Yourong, "And you didn't even arrange the shift change, so you came directly to the United States." I have to thank them for that. ”

Xu Yourong looked at his wife with some confusion, and after a few seconds, she asked, "Have you been watching too many female frequencies lately?"

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Xu Yourong's arrival made the doctors in the first group suddenly excited. The sudden departure of an old colleague would have been a little worrying. And Xu Yourong's sudden departure is more special - she is going to the other side of the ocean to save her lover. This adds a touch of romance to Xu Yourong's actions, and doctors are mostly more tolerant of romantic actions - if it weren't for that hint of romance in their hearts, who would have been doctors?

Now, seeing Xu Yourong returning safely with his wife, everyone's reaction is to bless the couple first. Although same-sex marriage cannot be recognized under the relevant domestic laws, the doctors of the four hospitals are still willing to bless their colleagues.

On the other hand, the treatment team now does need an experienced doctor. Although Xu Yourong does not have the advantage of diagnosis, her years of experience in neurosurgery at least allowed her to play a very important role in this case.

Sun Lien's first reaction when he saw Xu Yourong was also happy, and after seeing Rachel, Sun Lien's joy was even more overflowing.

"You came at a better time. Sun Lien hurriedly handed over a medical case printed out by Yuan Ping'an, and said to Rachel, "Although it is somewhat inhumane for you to come back and immediately look for you to see the case...... But for humanitarian reasons, I would like to ask you to work overtime on vacation and look at this patient. ”

"Show me?" Rachel was stunned for a moment when she received the case, and then she immediately opened the case and frowned at the dense Chinese on it, "It may take a little time if I read it all." ”

"It's okay, let Dr. Xu translate for you. "Sun Lien is really in need of extra help right now. For Tang Min's disease, speculation in both directions needs to be proven. "This patient is not doing well, and even a quick conclusion is valuable. ”

"Tumor patients still have emergencies?" Xu Yourong on the side asked curiously, "Paratumor syndrome?

Sun Lien shook his head with a wry smile and said, "If it is determined to be a tumor, I don't need to be so anxious - this child has gone around in the best hospital in China, and two biopsies have not been able to determine whether it is a tumor." But just looking at the speed of disease progression and the wide distribution of images, I feel like a tumor......"

Originally, according to Sun Lien's arrangement, to determine the nature of the lesion, it was necessary to invite the oncology department to come for consultation. But...... The level of oncology in the four hospitals is not outstanding, and it is inferior to that of hepatobiliary surgery and orthopedics. The reason is also very simple - cancer patients generally do not have any "acute symptoms". They are more likely to gradually deteriorate over a relatively long period of time after the disease is discovered.

The reason why the four hospitals have oncology departments is mainly to serve outpatient patients. At the same time, it is also to meet the assessment of tertiary hospitals. In fact, in terms of academic field and treatment, the oncology department of the four hospitals is not very well-known. The main reason that attracted Rachel to the oncology department of the four hospitals was that the oncology department of the four hospitals had its own hospice department.

"Got it. Even though she still had a suitcase in her hand, Rachel was still in working condition very quickly. Especially after hearing that the patient was a seven-year-old girl, Rachel's movements were even faster. She directly dragged Xu Yourong to the office, and said as she walked, "Honey, you have to come and help me." ”

Sun Lien was originally thinking about whether to say two polite words such as "You look good after cutting your hair short", but looking at Rachel's positive appearance, he still decided to swallow this sentence back into his stomach. He just said to Yuan Ping'an and asked Dr. Yuan to arrange an optic nerve potential induction experiment for Tang Min before leaving.

The direction of consideration for the tumor was given to Rachel and Xu Yourong, while Sun Lien took another printed case to the pediatric department to find Qian Hongjun directly.

Director Qian is on duty today. And the pediatrics are on duty...... It's basically the same as the previous line. Outside the pediatric clinic, it seems that there are always patients and families waiting anxiously, and pediatricians can never seem to finish dealing with these patients.

When Sun Lien walked through the crowd and entered the pediatric office, he happened to see Director Qian using a steam eye mask to warm his eyes.

"I'll take a little rest......" Director Qian heard Sun Lien's voice, he was a little embarrassed to let Sun Lien sit down first, and then pointed to his eyes and said, "I've been staring at it for a day, and I really can't bear it." Trouble Dr. Sun, you wait a bit. ”

"It's okay, Director Qian, you can rest first. In a hospital, there are three types of doctors who work in the emergency, pediatrics, and anesthesia positions when they behave in such a seemingly "rude" manner, which is not to upset the other doctors. Sun Lien took out the case on the side, then hesitated for a moment and asked, "What about ......it?" Shall I read you the basic situation first?"

After getting Qian Hongjun's permission, Sun Lien quickly began to provoke the focus of the case. The child has a subacute onset and no symptoms prior to the onset of the disease. Imaging studies revealed multiple masses in the brain and optic nerve, but neither biopsy yielded valuable results. At present, the child's disease has further worsened, and binocular vision has basically disappeared. In laboratory tests, no decisive values were obtained.

"Both biopsies were taken from the frontal lobe?" Although Qian Hongjun is not an expert in neurosurgery, his years of experience allowed him to quickly find something that is not suitable, "Why don't you take other parts?

"Both times it was taken from the frontal lobe. Sun Lien flipped through the cases and determined the sampling site and said, "The first biopsy was done in Yunhe, and the second was a biopsy done at Tongxie. However, the medical records of Tongxie do not explain why the samples were taken from the frontal lobes. ”

"The child's first symptom is decreased vision, which means that her optic nerve is the first to be affected, if not the first, to be affected. Qian Hongjun took out a pen from the table, and then wrote a record of "optic nerve not sampled" in his notebook with both eyes covered by a steam blindfold, "You continue." ”

"The previous treatment was basically based on hormone shocks...... "Eh?" Sun continued, "she had a lateral ventriculoperitoneal shunt at Yuanhai Hospital three months ago. ”

"That is, the child had previously had severe hydrocephalus. Qian Hongjun nodded, "How is the child's condition now? You called me just now to ask about mannitol, is the intracranial pressure rising again?"

"Imaging tests suggest cerebellar tonsillar herniation. Sun Lien replied, "Uh......" He suddenly stopped talking. Vaguely, Sun felt that he might have made a mistake.

"Cerebellar tonsillar herniation may be the cause of the lateral ventricular shunt. Qian Hongjun took off the steam blindfold on his face. He glanced at Sun Lien and shook his head and said, "Although you are from an emergency department, and your response to this kind of problem is almost a conditioned reflex, you also have to find out first, whether this symptom is new or later......" Speaking of this, Qian Hongjun sighed, "Forget it, there is no problem." It's just a bag of mannitol, and as long as she's not in the active phase of a cerebral hemorrhage, there's nothing else wrong with it. ”

Sun Lien was speechless, and he was indeed panicked. Even though the status bar had made it clear that the brain herniation had been occurring for several months, he decided to intervene with mannitol...... Strictly speaking, that's almost enough for excessive medical treatment.

"How is this child's physical examination?" Qian Hongjun had no intention of continuing to criticize Sun Lien. Young doctors, it's normal to make small mistakes. The point is how much they have potential and where they can rise.

"The reflection of light is completely absent, he is conscious, and his memory, orientation and calculation are poor. This part of the examination was done by Sun Lien, and his answer was very crisp and neat, "There is no problem with the language to answer the question - but the left muscle strength is a little weak." ”

"You have to ask God's physician about this. Qian Hongjun hesitated for a moment and said, "It's not a good thing that the reflection of light disappears." He was silent for a moment and then asked, "Have you checked the indicators of infection?"

"Professor Zhang Zhifu checked it when he was in the infectious disease hospital, and took cerebrospinal fluid and peripheral blood samples to do mNGS twice, both of which were negative. Sun Lien shook his head, the path of infection had been completely blocked.

"What do you think?" Qian Hongjun nodded, "You took this patient in, what speculation do you have about her symptoms?"

Sun Lien hesitated for a moment and said, "I suspect it may be some kind of genetic disease or tumor." ”

"In the past, tumors said that there were multiple intracranial masses like this. Qian Hongjun continued to ask noncommittally, "What is the reason for genetic diseases?"

"The child was ill, and according to the patient's family, her uncle had a similar sudden loss of vision as a child. However, my uncle's vision loss subsided on its own and disappeared after that. Sun Lien asked, "This is what I want to ask Director Qian...... I'm not good at genetic diseases. Do you think...... Could it be some kind of genetic disease?"