White armor

Chapter 55 Jiang Xiaoyu in the Valley of the Evil (Leader’s Awesome Dad will be updated)

"Director Chi, the patient's picture is very typical. It should be that the cancer is in the late stage." Gu Huaiming apologized, "Maybe the needle biopsy is not deep enough. I will go back and take a look and do one myself."

"Okay, if you have new specimens, just call me directly."

Director Gu returned to the ward with the pictures of the specimens under the microscope. He thought about it for a long time, but in the end he did not contact Dr. Zou.

What the patient's family members fear most is not that the patient is seriously ill and will not be cured, but that they give hope at one moment and are disappointed at the next.

It's like an emotional roller coaster, and even good people have to be torn to pieces.

Many family members of patients are driven crazy by this kind of disappointment and hope, causing many medical disputes.

Although Dr. Zou was his own doctor and did not consider medical disputes, Gu Huaiming was still cautious and did not tell her an uncertain answer.

After hesitating for a while, Gu Huaiming picked up the phone and called Luo Hao.

"Dr. Luo, I am Gu Huaiming."

"Director Gu, are the pathology results out? Is it inflammatory?" Luo Hao asked directly.

Gu Huaiming really didn't know where Luo Hao's inexplicable confidence came from.

But okay, Luo Hao guessed it right this time.

"You guessed it right, Dr. Luo, Director Chi found no tumor cells under the microscope."

Luo Hao held the phone and smiled slightly. The diagnosis on the system panel in front of him had changed.

Although it was still a preliminary diagnosis and the content was still a space-occupying lung lesion, the differential diagnosis had changed.

In the past, Talaromyces marneffei infection ranked first in differential diagnosis, but with the improvement of test results, the diagnosis of adult immunodeficiency diseases mediated by anti-interferon-γ autoantibodies has been mentioned first.

Luo Hao became more and more confident.

The system is really easy to use. As expected, I pissed off so many old people. It took me another two years to open it after I insisted on returning to the mine manager.

No matter what happens in the future, as far as this case of "late stage lung cancer" is concerned, the system's diagnostic assistant AI is simply too smart.

"Director Gu, have the fungal beta-D-glucan test results come out? Is it a strong positive?" Luo Hao asked.

Gu Huaiming opened his computer workstation and pulled up Dr. Zou's grandfather's test report.

Just as Luo Hao "guessed", the fungal β-D-glucan test result was strongly positive.

"Strong positive, yes."

"I think it's not a malignant tumor, but an inflammatory change. As for the inflammatory changes caused by the disease, we have to look at it again." Luo Hao's voice came, and Gu Huaiming's eyebrows wrinkled.

Dr. Luo Haolo is so arbitrary?

Who gave him the courage to directly conclude that it was not a malignant tumor!

Gu Huaiming certainly does not want the patient to have a malignant tumor, but doctors must be objective and neutral.

It must be that little guy Luo Hao hopes that Dr. Zou's grandfather will be okay, Gu Huaiming thought in his heart.

"Dr. Luo, since it's not a malignant tumor, what do you think it is?"

Luo Hao fell silent at this time.

Gu Huaiming shook his head. Luo Hao was indeed as he had guessed, and he had no idea at all.

"Director Gu." Luo Hao's voice interrupted Gu Huaiming's thinking.

"Say, Dr. Luo."

"I asked about the medical history last night. The patient had a history of eating bamboo rats, and he was considered to be infected by Talaromyces marneffei." Luo Hao said, "But today I have a new point of view."

"Talcobacter marneffei infection?" Director Gu suddenly became energetic. He completely ignored Luo Hao's last sentence and focused on the infection caused by Talarobacter marneffei caused by bamboo rats.

He has met several patients with Talaromyces marneffei infection. Looking at the symptoms and looking at the films, they are indeed manifestations of late-stage cancer.

In addition, the patient had a history of eating bamboo rats, the fungal β-D-glucan was strongly positive, and the pathological examination found no cancer cells, etc., a flash of lightning flashed in Director Gu's mind.

The previous haze dissipated, revealing a clear sky.

Gu Huaiming had begun to favor the diagnosis of Talaromyces marneffei infection as correct.

Unknowingly, Director Gu's lips raised.

"Director Gu, let me contact Xiehe Gene Laboratory for a test."

"No need." When Gu Huaiming heard that it was Xiehe, he felt a little disgusted.

Was the South Tower of 912 worse than the Marshal's Mansion? Or is 912 West Hospital now worse than Xiehe?

Luo Hao, a bastard boy, a poorly raised wolf cub, was born with the concord mentality of looking down on all the doctors in the world.

"Gu..."

"I'll do a comprehensive check first and then contact you." Gu Huaiming said flatly.

"Okay." Luo Hao didn't insist, and agreed according to Gu Huaiming's words, "Director Gu, you must tell me if there are any results."

"Don't worry, I will tell you as soon as possible."

After hanging up the phone, Gu Huaiming didn't even dare to tell his boss Luo Hao's suggestion.

If the boss hears this, he will inevitably be unhappy again.

The elderly man was diagnosed with a high possibility of Talaromyces marneffei infection. Director Gu immediately began to find experts from the Department of Respiratory Medicine, Rheumatology and Immunology, and the Department of Infectious Diseases to come to the west building for hospital-wide consultation.

All the information was in front of him, and the opinions given by top experts after consultation coincided with Gu Huaiming's ideas.

Talarobacter marneffei infection!

Then continue the examination to make a clear diagnosis.

Really, Gu Huaiming complained, I wonder if eating bamboo rats can make them sick easily.

He clearly remembered that he had received a patient when he was young. The X-ray showed that he had late-stage cancer and was accompanied by progressive weight loss. The patient was already extremely thin.

Surgery was not possible, the only option was chemotherapy.

However, the effect of chemotherapy is very poor, but people always survive. The cancer seems to be in the advanced stage forever.

Finally, out of desperation, the family brought the patient to 912 for a visit.

After many examinations, the patient was diagnosed with Talaromyces marneffei infection, and his condition improved after symptomatic treatment.

Although this case has nothing to do with cardiothoracic surgery, Gu Huaiming remembers this incident and always asks if he has a history of eating bamboo rats every time he sees a patient.

If it was really an infection caused by Talaromyces marneffei but surgery was performed, it would be a lot of fun.

Inspection is in progress.

Talaromyces marneffei appears in the form of hyphae at 30°C and in the form of yeast at 37°C.

It is easier to change from yeast form to hyphae form, and it only takes 1 to 2 days to grow broom-like branches and produce red pigment.

Two days later, under the microscope in the laboratory, there was still no change in the specimen.

Gu Huaiming then began various examinations - taking bone marrow smears, lung tissue biopsy specimens, skin infiltration smears, intestinal mucosal biopsy tissue, omentum biopsy tissue, lymph node biopsy tissue, and performing periodic acid staining, Wright's staining or hexamine staining After silver staining, microscopic examination and fungal culture were performed.

However, whether the ELISA method is used to detect Talaromyces marneffei cell wall mannoprotein MP1P antigen in peripheral blood, or the indirect immunofluorescence method is used to detect Talaromyaceae marneffei-specific antibodies in peripheral blood;

Or use dot blot ELISA, latex agglutination test, or lateral flow immunochromatography to detect TM antigen in urine, and the results are all negative!

Gu Huaiming was exhausted mentally and physically.

From full of confidence to extremely disappointed, it only took 2 days.

Dr. Zou's side is filled with good news: the patient with aortic dissection is offline and will be transferred out of the intensive care unit in one day.

But there has been no progress in my own inspection.

Gu Huaiming brushed his face again and invited directors and experts from relevant departments to sit down and discuss their opinions.

2 days ago.

Everyone believed that the patient was most likely to be infected by Talaromyces marneffei, but now faced with the results of a comprehensive and over-medical examination, the experts fell silent.

All test results excluded Talaromyces marneffei infection and malignancy.

But what is that?

The one-hour and forty-minute consultation was inconclusive.

Gu Huaiming was helpless.

He thought of Luo Hao and muttered softly, "Do you really want to go to Xiehe?"

"Director Gu, what are you talking about?" an expert said unhappily, "With these examinations, can they make a diagnosis at Xie Xie?"

"Oh." Gu Huaiming shook his head, "That's it for today. Thank you for your hard work. I'll tell Dr. Luo."

"By the way, I heard that Dr. Luo had a little incident a while ago. What happened next?" asked the director of the Department of Rheumatology and Immunology.

Gu Huaiming had already dialed Luo Hao's phone number.

There was a beeping sound, and Gu Huaiming took the time to reply, "It's okay, it's all over a long time ago. Luo Hao is a very clever guy, and the procedures are very well prepared, at all..."

"Hello, Director Gu." Luo Hao's voice came out.

Several experts had knowing smiles on their faces.

"Dr. Luo, we have done all relevant tests for Talaromyces marneffei infection, and there are no positive signs." Gu Huaiming had no choice but to tell the truth.

"Director Gu, I have looked at all the recent examination results. The patient may have a typical intractable disease." Luo Hao said, "I have some considerations of my own, which are not very comprehensive."

"You're welcome, Dr. Ronaldinho." The director of the Rheumatology and Immunology Department directly interrupted Luo Hao.

"Hello, Teacher Zhu, you're here too," Luo Hao greeted.

"You're welcome, tell me what you think." The director of the Department of Rheumatology and Immunology asked.

"The first consideration for difficult and complicated diseases is rheumatism and immune diseases, but if you are here, I won't think so."

"You can try genetic testing. I think the patient may have interferon-γ receptor deficiency."

"Huh? What defect?" Director Gu and Director Zhu of the Department of Rheumatology and Immunology asked in unison.

"Interferon-gamma receptor deficiency disease."

Some people have already taken out their mobile phones and started searching for related diseases.

For ordinary people, using a mobile phone to see a doctor is just a matter of scaring themselves.

Anyone who can get out of Baidu is the unscrupulous traffic who has paid advertising money.

But serious doctors definitely don’t use Baidu. They log on to professional websites to search for relevant papers and other information.

"Director Gu, Teacher Zhu, I think it's better to send the specimen to Xiehe's genetic testing laboratory." Luo Hao said, "I've already finished talking about that. Can you guys take a look?"

Director Gu frowned.

"Are you sure?" Director Zhu of the Department of Rheumatology and Immunology asked.

The doctor who only specializes in rheumatology and immunology has always despised doctors from other departments for not knowing how to treat diseases. Now he wants Luo Hao to teach him to be a doctor. This makes Director Zhu very difficult to accept.

"It should be confirmed." Luo Hao said, "Generally, interferon-γ receptor deficiency affects developing infants and AIDS patients, but patients with gene defects also occasionally develop the disease."

"This disease is so complicated that there is no hint, and clinical tests cannot confirm it. We can only rely on guesswork and genetic testing to confirm the diagnosis."

Luo Hao said while looking at the confirmed diagnosis given by the system diagnostic assistant AI - interferon-gamma receptor deficiency.

The system has been certified. Do you have any questions?

Luo Hao was determined and explained in a calm tone, "The patient's general immune function was not abnormal in the laboratory examination.

Further examination revealed that exogenous IFN-γ had a reduced ability to induce TNF-α production in peripheral blood mononuclear cells of children and heterozygotes without clinical manifestations. "

The experts from the 912 related departments had smiles on their faces at first, as they were indulging the little guy and wanted to see what Jiang Xiaoyu, the legendary Valley of the Evil One, had become like now.

But as Luo Hao spoke in more and more detail, with more certainty and professionalism, the experts began to become serious.

Thirteen minutes later, Luo Hao finished speaking.

"To sum up, I think the diagnosis of interferon-gamma receptor deficiency is very likely."

The experts looked at each other.

Before the initial diagnosis of Talaromyces marneffei infection, no one could do the clear analysis and diagnosis like Luo Hao.

After all, it is only a preliminary diagnosis, and no one can be sure that it is an infection caused by C. marneffei. Luo Hao is extremely confident in his diagnosis of interferon-γ receptor deficiency.

"Okay, Dr. Luo." Gu Huaiming had no choice but to respond, "I will send someone to collect the specimens and send them to Xiehe Gene Laboratory. Leave me a message later to let me know who to send the specimens to."

After hanging up the phone, Gu Huaiming was thoughtful.

"Dr. Luo's basic skills have not been delayed since he returned home," one person said.

"Yeah, it's strange. Not only is there no delay, I feel that Dr. Luo is much stronger than before."

"Could it be that there are particularly many patients in his hometown?"

There are different opinions.

All experts know Luo Hao and are quite interested in him.

This stems from the fact that a long time ago, a few big guys happened to have the idea of ​​recruiting students one year.

At their age, they should have given up the thought of accepting students long ago. Even if they are called doctoral tutors, they will never teach people step by step. They are basically taught by their senior brothers.

But that year happened by chance.

Some people even speculate that it is because of the chain reaction caused by sunspot explosions.

Luo Hao was lucky. His college entrance examination scores ranked first among medical students in the country, attracting the attention of bigwigs who were interested.

After all, I was at Union Medical College, and the big guys from Union Medical College were the first to get there.

The strange thing is that the other big guys shouldn't have gone to Xiehe to grab people, but they just took a fancy to Luo Hao that year.

It was like love at first sight.

Therefore, the name Dr. Luo is remembered by many people in the circle.

In addition, Luo Hao did not stay in any hospital in the imperial capital after graduation, which made the urban legend even more exciting and bizarre.

Now when they encounter a strange and rare disease, everyone has an idea after listening to Dr. Luo's explanation - it turns out that there is really no love for no reason in this world.

Even though Luo Hao's reasons for diagnosing interferon-γ receptor deficiency were not very sufficient, everyone present appreciated his clear logical thinking and clinical analysis techniques.

Back then, the big guys tried to rob people to no avail, and in the end they had to compromise with each other.

Some people also laughed at themselves and said that these big guys are the evil people in the Valley of the Evil and they want to teach Jiang Xiaoyu what they have learned throughout their lives.

Luo Hao is Jiang Xiaoyu.

Looking at it now, Luo Hao is quite a bit authentic.

"Director Gu, please let me know when the results come out." Director Zhu of the Department of Rheumatology and Immunology stood up and said, "You must tell me as soon as possible."

"Start a group and talk directly to the group." Some people have already started to set up a group.

Gu Huaiming sighed.

Do you really want to go to Concord?

Forget it, just go.

Union Medical College has invested considerable energy in the diagnosis and treatment of many rare diseases.

For example, malignant hyperthermia, a rare disease caused by anesthesia, has been studied most thoroughly in China by Union Medical College.

Specific medicines are also available at Xiehe.

Interferon-gamma receptor deficiency? It's not that 912 can't diagnose when they arrive, it's just a little slower. Gu Huaiming makes excuses for 912 in his heart.

But if you want to get the results as quickly as possible, you have to go to Xiehe Gene Laboratory.

……

……

"Sister Zou, thank you." Luo Hao bowed slightly to express his gratitude.

"It should be done, you're welcome." Dr. Zou said calmly, "Dr. Luo, do you think my grandfather's diagnosis is correct?"

"Let's see the results. I'm already urging you. You'll know in about 12 hours. But no matter what rare disease it is, it's definitely not cancer." Luo Hao said firmly.

Dr. Zou breathed a sigh of relief.

The elderly are already old. Even if they suffer from genetic diseases, it doesn't matter. Symptomatic treatment is required.

As long as the cancer is not in the advanced stage, the elderly have a very high probability of living a long and healthy life.

"I will send the patient to the general ward. Sister Zou, take a good rest and don't be in a hurry to go back." Luo Hao said, "Believe me, we will wait for the genetic test results tomorrow."

"Okay, I'll go back to the hotel to take a shower and have a good sleep. I'm afraid I'll faint when I go home in this state. I won't be able to help much and will become a burden." Dr. Zou laughed at himself.

Luo Hao sent the patient back to the general ward.

Being transferred from the ICU to the general ward 3 days after the biggest cardiothoracic surgery operation was almost a miracle for the mine manager.

This is thanks to Director Gu Huaiming's surgery and Dr. Zou's postoperative care.

Indispensable.

After the patient was transferred out of the ICU, this patient was considered to have come to an end. Luo Hao's attention was focused on interferon-γ receptor deficiency disease.

Interferon-gamma receptor deficiency is similar to Cthulhu. It is indescribable and cannot be diagnosed through medical history. It can only be diagnosed by luck in the genetic laboratory.

Therefore, the diagnosis of this disease is rare, and those who can accurately diagnose it are the lucky ones.

If the definite diagnosis given by the diagnostic assistant AI this time is correct...

Thinking of this, Luo Hao felt a little excited in his calm heart.

That means you have a sharp weapon!

An invincible weapon!

Luo Hao urged his friends in the group to hurry up and get the results.

It didn’t take 12 hours, but the results came out 10 hours later. The diagnosis was clear, it was interferon-γ receptor deficiency!

Diagnostic auxiliary AI is really a magical tool!

Luo Hao was particularly pleased.

Picking up the phone, Luo Hao called Gu Huaiming.

"Director Gu, the results have just come out. Dr. Zou's grandfather has been diagnosed with interferon-gamma receptor deficiency."

"What?" Gu Huaiming couldn't believe it.

"It's an interferon-gamma receptor deficiency disease. The error in the genetic test results should be very small. I've already urged for a re-examination."

"Uh..." Gu Huaiming was stunned.

Luo Hao actually gave the correct diagnosis.

He did not doubt that Luo Hao's words were lies. No doctor would joke about such a thing.

Authenticity is beyond doubt.

"For treatment, I recommend transferring to Union Medical College. Union Medical College has a research group that specializes in projects for patients with interferon-gamma receptor deficiency. Do you think it's okay?"

Director Gu heard the word "you" in a trance.

Luo Hao is very familiar with him, and he regards him as the boss's close disciple. The senior brother takes care of the junior brother, teaching him all his skills.

Luo Hao usually calls himself "you". Where did "you" come from?

I am not that stingy. In terms of diagnosis and treatment of some rare diseases, Union Medical College is strong.

Forget it.

Director Gu shook his head helplessly, "Okay, I will transfer the patient to you as soon as your verification results come out."

"Director Gu, I will send Dr. Zou back to the Imperial Capital today. The patient has been transferred to the general ward. Thank you."

"polite."

The two exchanged a few words indifferently, hung up the phone, and Gu Huaiming announced the results in the group that had just been established a few days ago.

Contrary to expectations, Gu Huaiming thought that the diagnosis of interferon-γ receptor deficiency would cause huge shock and everyone would actively discuss it.

But the group was deserted, as if no one saw the message he sent.

After waiting for another ten minutes, Gu Huaiming couldn't help but send a message.

[Have you seen the results? 】

[See, I have never studied this disease, so I don’t dare to show my disgrace. 】

This was said by Director Zhu of the Department of Rheumatology and Immunology.

Then everyone copied and pasted this sentence and started swiping the screen.

Very speechless.

Gu Huaiming suddenly felt that it was interesting. Director Zhu usually spoke very arrogantly, probably because no one except me knew how to treat patients.

I never thought you, Lao Zhu, would have such a day!

Director Gu thought for a while, but instead of calling, he went directly to his boss's house and reported the recent events to his boss face to face.

I think the boss would be very happy to know that Luo Hao did not neglect his studies after returning to his hometown, but instead worked hard and diligently.

……

……

Luo Hao looked at the system panel with a smile.

The diagnostic assistant AI is really easy to use, and it’s not just easy to use!

Although it is not possible to give a direct diagnosis, various examinations are still required, but it can find the truth among the complexity.

That's a cow!

He is one step closer to returning to Concord.

Dr. Zou was not excited when he told Dr. Zou the good news. In the past few days of contact with Luo Hao, Dr. Zou had developed a strong sense of trust in Luo Hao based on his professional judgment.

This is a doctor's intuition.

After sending Dr. Zou away, Luo Hao breathed a sigh of relief.

Unexpectedly, Fengxue admitted a patient that day, and it took so many days to barely solve the problem.

After relaxing, Luo Hao turned his attention to the long-term main mission.

Among the two members of the medical team, Cui Mingyu is in trouble every day. He has done more surgeries than himself. Luo Hao was very satisfied with this.

And another member...

Chen Yong was holding his mobile phone, chatting on WeChat with a happy face and residual images on his fingers.

Luo Hao frowned.

If this were the case, wouldn't the "establishment" of the medical team be given to Chen Yong in vain?

I've been busy recently, but Chen Yong took the opportunity to be lazy. It's too much! !

"Chen Yong, are you busy?" Luo Hao asked with a smile.

"Is something wrong?" Chen Yong asked angrily without raising his head.

"I'll give you a question. If you learn it, you can ask the girls."

"What interesting questions do you have?" Chen Yong couldn't hide his disdain for Luo Hao.

"There was a green frog who was still watching TV at 7 o'clock in the morning. Suddenly, someone knocked on the door 7 times. It turned out that it was the frog's good friend who brought a surprise breakfast.

He brought seven of the frog's favorite things: chocolate pie, cheese, chocolate candies, bread, fried rice, milk, and live flies!

What do you think the frog should open first? "

"What? Say it again."

(End of this chapter)