Zheng Ren smiled, stood up, bowed slightly, and asked Director Luo to sit down, while he stood in front of Director Luo.

Young, capable, but not arrogant, Director Luo is still very satisfied with Zheng Ren's performance.

Zheng Ren then said: "In the following hospitals, the diagnosis of intestinal obstruction is generally done with upright abdominal dialysis or according to clinical symptoms. According to the patient's family, several times he was diagnosed with intestinal obstruction, but the diagnosis was overturned in the inpatient department. I guess that means that by the time you get to the inpatient unit, the intestinal obstruction is solved. And it's the kind that doesn't use medicine and heals himself. ”

Director Luo listened quietly and did not interrupt Zheng Ren's words.

"So, I guess the patient's intestinal obstruction is only short-term, temporary. Coupled with the fact that the patient's family said that the patient gets tired easily, I have a guess that the patient's skeletal and smooth muscles are affected. If this is the case, then there is a greater possibility of mitochondrial encephalomyopathy. ”

Dr. Shen was stunned......

He had seen Zheng Ren's surgery and knew that the level of Boss Zheng's intervention was quite high. Half a year ago, the ophthalmic artery opening surgery opened Dr. Shen's eyes.

At that time, I almost licked the screen, and I was trained by Director Kong.

It is possible that Boss Zheng can be nominated for the Nobel Prize at this level, and Dr. Shen thinks this is quite reasonable.

However, is he also good at diagnosing rare diseases?

Mitochondrial encephalomyopathy? What the hell is that? Dr. Shen was confused all of a sudden.

As a medical doctor, he didn't understand the conversation between Zheng Ren and Director Luo at all, and his face was a little red.

"So, you just watched the electromyography?" asked Director Luo.

"Local hospitals are basically headache doctors. But EMG is a ...... for this test IMHO, in local hospitals, the amount of work done is very small, and it is generally done by neurologists. ”

"Oh?

"I didn't hear from the patient's family about the history of going to the neurology department, so I guessed that it was an electromyography test prescribed by the emergency doctor during a major attack of weakness. Zheng Ren said calmly: "This kind of inspection is relatively blind, but it hits the key by chance." ”

Chance......

Director Luo felt angry and funny about Zheng Ren's directness, this little guy was really frank when he spoke.

Who wants to admit to luck when they are doctors?

However, limited to the level of science and diagnosis, even in the imperial capital, there is an element of luck in the diagnosis of many diseases, let alone in local hospitals.

In particular, mitochondrial encephalomyopathy is a particularly rare disease.

This disease has nothing to do with gastroenterology, so Director Luo did not study it. He was curious about how the little doctor in front of him diagnosed him.

Nobel Prize candidates, can they make such a powerful interdisciplinary diagnosis?

Things are starting to get more and more interesting.

"Electromyography, there is an abnormality, but the abnormal electrical waves are not obvious.

Electromyography is the most common kind of narrow electromyography in local hospitals, and the percentage of multiphasic waves is generally not more than 20%, but there are several stages, and there are slight excesses. Different muscles have different normal ranges, but in the short time of doing EMG, they have gradually returned to normal in the later stage. ”

At this time, not only Dr. Shen, but even Director Luo was in a trance.

What is Boss Zheng talking about?

"The report only writes the conclusions by hand, such as interfering phase, mixed phase, simple phase, pathological interference phase, etc., but if you look at the waveform, you will find that at the beginning, there are a few seconds of waveform that is not right. Zheng Rendao.

Silence, when Zheng Ren stopped talking, there was silence in the director's office.

Soon, Zheng Ren's voice broke the silence again.

"My judgment is that the EMG is problematic, not neuronal, but a change in the muscles themselves. This presumption is consistent with the symptoms of generalized weakness described by the patient's family, with changes in electromyography and occasional changes in smooth muscles, except for mitochondrial encephalomyopathy. ”

Zheng Ren said very surely, and unconsciously, Director Luo already believed it.

Because of the meticulous logic, but also because of the aura of the Nobel Prize candidate.

Mitochondrial encephalomyopathy is a group of rare multisystem diseases with brain and muscle involvement caused by abnormalities in mitochondrial structure or function.

It is generally inherited from the maternal line, is more common in women, and the time of onset is uncertain, from infancy to old age.

Because muscle and brain tissues are highly dependent on metabolism such as oxidative phosphorylation, clinical symptoms are often systemic, regardless of whether nDNA or mtDNA are defective alone or both.

However, due to the different degrees of enzyme deficiency and involvement, the clinical manifestations have different emphasis, and mitochondrial diseases are artificially divided into two categories, namely mitochondrial myopathy and mitochondrial encephalopathy.

The patient in front of him should be a manifestation of mitochondrial myopathy.

This is a relatively mild and easy to cause death in patients, and it is mitochondrial encephalopathy.

"It's all speculation and inference. Director Luo said softly.

It's like asking Zheng Ren, and it's like talking to yourself.

Zheng Ren's words sounded like clouds and mountains and fog if he didn't understand, but Director Luo heard a little taste.

Due to the nature of his profession, Director Luo's first thought was to "find fault"!

There is no hard evidence, and this is the biggest problem.

However, the tests brought by the patient's family cannot provide a definitive diagnosis at all. If mitochondrial encephalomyopathy is suspected, genetic testing can be done to confirm the diagnosis.

But this is only a possibility, Zheng Ren's tone of voice is too affirmative.

"No, Director Luo. Zheng Ren pointed to the patient's information and said, "I frowned when I watched you read this film just now, did you also see an abnormality?" ”

"It can't be said to be abnormal, it may be an artifact, but the patient's intestinal smooth muscles, some of the images do look abnormal. Director Luo said.

"Yes, it's abdominal CT, which has actually provided more reliable evidence. Zheng Rendao: "Mitochondrial myopathy, ...... in imaging"

Speaking of CT films, Zheng Ren's attitude is different from that of electromyography.

Dr. Shen knew that Boss Xiao Zheng did 64-slice 3D CT, which was a must.

Half a year ago, after he left, Director Kong immediately organized everyone to learn the reconstruction of 64-slice 3D CT of the liver, and it was quickly rolled out in clinical practice.

This kind of test has been used in clinical practice for a long time. But before, there were no surgeons to do it, and it was all done by the CT room according to the software.

At first, everyone was a little slanderous, but Director Kong suppressed all the different opinions with an iron fist.

When it really took a closer look, everyone ...... At the very least, Dr. Shen realized the benefits of 64-slice 3D CT 3D reconstruction.

Many tumor release factors and re-established abnormal hyperplastic blood vessels can be directly displayed with 64-slice CT 3D reconstruction, which increases the degree of detail of the operation.

。 m.