Doctor: It's reasonable to perform surgery on yourself.

The caller was his granddaughter.

She is also in the medical field. She grew up in a medical family and showed amazing medical talent very early.

She is also very beautiful, with blonde hair and blue eyes, and her legs are well-proportioned and slender, a full 93 cm, which can kill a group of European and American supermodels in seconds.

The relationship between the grandfather and grandson is very good. When they chat, they always say "mother f*ck" to each other, even though the granddaughter's mother is Joseph's daughter-in-law and Joseph's mother is the granddaughter's grandmother.

"What?" Joseph answered the phone and saw Yang Yuen still following Xu Qiu and grinning, with a helpless look on her face.

Fortunately, his granddaughter is not like this silly girl.

"Grandpa, was the doctor who operated on you handsome?"

"..."

Why do I have an ominous premonition.

Joseph said: "It's none of your business?"

"My dear grandpa, are you working with him now? Can you introduce him to me?"

Joseph's face turned green. He has a great granddaughter. What should she learn? She won't be the same as Yang Yuen!

The granddaughter continued to act like a spoiled child: "I watched a video on YouTube these two days and only then knew what he looks like. Grandpa, don't you want to hold your great-grandson, and a mixed-blood one at that!"

Joseph: "Get lost!"

"Old bastard, if you don't want to help, then don't help. I'll find a way myself!"

The voice was so loud that it echoed directly in the quiet corridor.

Joseph was so angry that his hands were shaking.

The previous mouth was fine for grandpa, why did he turn against him so quickly?

Thinking of the last sentence of his granddaughter, he suddenly became a little worried.

That guy has the same personality as Joseph, he is the kind of person who will go all the way to the end, even if he takes the wrong road, he will not be satisfied until he sees a dead end.

I'm afraid she will fly over!

Joseph quickly called his son and told him to keep an eye on his granddaughter.

Otherwise...

He was really afraid that his granddaughter would be like Yang Yuen, and would stay in Linhai First Hospital and refuse to leave!

...

Joseph's mood was disturbed by a phone call, and he forgot what he wanted to ask. He turned around and went to see Fan Fuguo who was admitted a few days ago.

Although he came to study cardiac surgery, his status was such that even Dean Wang Shengde was not enough for him to fight.

Although he had no temper in front of Xu Qiu, he was irritated by Yang Yuen every day and vomited blood, looking like an ordinary old man.

But in fact, many of the surgical procedures he pioneered in cardiac surgery have benefited countless patients so far, and the entire Daxia medical system has to be courteous to him.

It is not too much to say that hospitals all over the world have to worship him as a god.

It is very reasonable to be domineering in a small Linhai First Hospital.

"Are the results of 14-3-3 protein out?"

These days, although Xu Qiu has laid a net and prepared to conduct a large-scale scan of various viruses, Joseph still insisted on his opinion and did a cerebrospinal fluid biochemistry and 14-3-3 protein test on the patient.

He used his identity to contact the laboratory of Tiandu Tiantan Hospital, opened a special channel, and transported it by manpower, and the results will be available immediately today.

Joseph couldn't wait for the report to be sent back, so he called directly.

The feedback was quickly given: 14-3-3 protein was positive.

He went to Xu Qiu's office to retrieve the patient's cerebrospinal fluid biochemistry and found that the levels of S-100 protein and Tau protein were also significantly increased!

Joseph was very excited: "Guess what the conclusion of 14-3-3 protein is?"

Xu Qiu: "Positive."

"Yes, positive! Three indicators are positive, is this not enough to diagnose Creutzfeldt-Jakob disease?"

Xu Qiu shook his head.

The reason why he didn't let Joseph waste time checking 14-3-3 protein was because the diagnostic value of these tests was not high.

With master-level experience in the diagnosis and treatment of rare diseases, he naturally has a unique set of judgment methods.

Although 14-3-3 protein is sensitive, it is not only Creutzfeldt-Jakob disease that can cause positive results.

More accurately, like Professor Yan's case, the imaging report is still used.

Joseph didn't take it seriously and said, "There's nothing wrong with the imaging report. The lace sign of the DWI sequence is indeed much stronger than the FLAIR sequence!"

"The lace sign is just a tiny little point."

Xu Qiu calmly pulled out a stack of information and pushed it in front of Joseph.

This is a more in-depth study of CJD, which also includes a comparison of CT and MRI films of Fan Fuguo and other patients with real CJD.

Xu Qiu said, "Did you see it?"

"What...do you mean?"

"The role of the lace sign can only be to exclude.

If the lace sign of the DWI sequence is weaker than FLAIR, CJD can be excluded.

But on the contrary, it just happens to be consistent, but it cannot be used as a basis for diagnosis!"

Joseph's pupils contracted slightly.

The four CJD patients he treated all had DWI stronger than FLAIR, which really only means that the probability of CJD is small when it is weak, but the reverse is not necessarily true.

After all, there may be a large number of patients whose DWI is also stronger than FLAIR, but they are not CJD in the end.

The key is...

These theories were heard for the first time even by him.

There are too few patients with CJD, and there are few conclusive conclusions and definite evidence-based research in the academic community. How did Xu Qiu become so sure?

"It is impossible to diagnose CJD, but you can't rule it out, right?" Joseph thought for a long time, but was still unwilling to give up his judgment.

"Let's go back to imaging."

Xu Qiu touched his pocket.

Joseph was stunned. Your pocket is empty. What are you touching?

"I'll give it to you, I'll give it to you!" He guessed what Xu Qiu was going to do, and offered the red pen he had just bought last night.

Xu Qiu took it and drew on the images of Fan Fuguo and the CJD patient.

"This is the image of CJD, with asymmetric high signals in the bilateral basal ganglia and cortex.

These three patients also have high signals in the caudate nucleus of the striatum, thalamus and putamen.

And this is Fan Fuguo!

His basal ganglia, caudate nucleus of the striatum, four highly sensitive parts, all have uniform signals!"

"But... his three cerebrospinal fluid biochemical proteins are significantly elevated!"

"What is the essence of CJD?" Xu Qiu asked the most core question.

"Essence? Prions."

Joseph is very familiar with this. As long as there are prions, the diagnosis of CJD is basically settled.

The existence of prions can just make 14-3-3 protein and S100 protein increase continuously, which is the most commonly used detection method in clinical practice.

Xu Qiu shook his head: "These three markers, like the lace sign, can only be used as negative exclusion.

If they are not elevated, it is highly likely not CJD.

But they are elevated - these three are also the products of neuronal apoptosis. All diseases that can cause neuronal damage may cause the elevation of these three proteins, and it is impossible to specifically distinguish the existence of prions!"

Joseph held these images in his hand for comparison, and felt dry mouth.

He felt as if he had suddenly realized something.

The diagnostic procedure of CJD seemed to become clear all of a sudden, and the disease was no longer shrouded in fog, but was unveiled by Xu Qiu's conclusions one after another.

However, after thinking carefully, Joseph found something even more desperate.