Time is another key in this case.

Tang Min's symptoms began to progress again - this morning's MRI prompted that the previous low signal area showed signs of enlargement. The doctor in the imaging department compared for a long time before confirming that the previous two low signal areas had expanded by about one millimeter.

Although there are all progress in imaging, Tang Min has not shown any discomfort at the moment. She is still as depressed but in good condition as usual. However, the progress in imaging makes all the doctors who are concerned about her progress in their hearts.

After she started hospitalization, Tang Min received a full set of medical supervision. Even the food she ate every day was actually adjusted and formulated by the Department of Rheumatology and Immunology and Nutrition. They specially chose a combination that would not induce allergic reactions based on Tang Min's previous multiple abnormal immunologic assays. It seemed that it was a bit of a big deal, but the doctors still hoped to avoid any discomforts as much as possible. No one knew whether these discomforts would aggravate the condition again.

As a result, Qian Xiaowan Xiao, Tang Min's symptoms began to progress after being admitted to the hospital. Moreover, according to previous imaging records, this progress occurred after she was admitted to the fourth hospital - before she was admitted to the fourth hospital, several low signal areas in her skull expanded by 2mm within three months.

Progressing rapidly in a short period of time is a matter that needs to be paid attention to. However, Sun Lien and others studied together for a whole afternoon, but still failed to determine what was causing the progress.

"We basically never used medicine for her..." Zhou Ce, who was exhausted after the director's rounds, looked a little more haggard after studying various examinations for the afternoon. He looked at the thick examination report and only two lines of medication records and groaned, "How do you think this lesion occurs? Will the magnetic influence of MRI lead to deepening organic lesions?"

"Since I have received this patient, I feel that the knowledge I have learned is not enough every day." Sun Lien put down the information at hand, and then grabbed his hair in pain. "I heard the teacher talk about the aqp4 protein a few times when I was in school. The specific mechanism... I was so dark about it."

"Finally there is something you don't know." Xu Yourong turned on the mockery mode, and she was also a little bit over the work she was responsible for - especially after just having a difficult neurosurgery. "I thought you knew everything, Team Leader Sun."

Sun Lien looked at Xu Yourong with some guilt. He had long known that his basic knowledge was not solid enough. So when he was following the group, he deliberately made up for more than a year of clinical knowledge. But this knowledge...it seems not enough now.

"I think your requirements for Dr. Sun are too high." Dr. Bruen rubbed his stubble face with his hand to scratch itch, and then expelled Sun Lien, "Sun is just a doctor who has been in the industry for less than three years. You can't expect a recruit to save the world, right? Even Hollywood knows that the one who can really save the world must be the old Marines who have been in the battlefield." He put down the case in his hand, then frowned and said, "Has the patient's family used her medicine? I didn't find any suspicious situations in the records."

"Definitely not." Sun Lien shook his head. Before entering the hospital, Professor Zhang had already communicated with Tang Min's parents. They did not intend to seek any "folk remedies" or "magic medicine". On this issue, Tang Min's parents are still very reliable - parents who are reserved about modern medicine will probably not spend a whole year taking their children to many hospitals for treatment.

"It's better to be sure." Dr. Bruen knocked on the table and pressed Sun Lien. "If the child's parents have not returned any medicines, then we can only suspect that mannitol or MRI has had an adverse effect on her - she hasn't used contrast agent yet."

Yuan Ping'an did not participate in their discussion. He was still looking down at various documents, trying to find relevant papers that support or oppose his hypothesis. When he heard this, Yuan Ping'an suddenly raised his head and frowned and asked, "What?"

Dr. Bruen rolled his eyes and repeated what he said, he added, "I really don't think the 1.5t mri can have such an impact on the human brain." The implication is that mannitol may only cause this impact.

"But...mannitol is a dehydrating agent." Sun Lien frowned and asked, "If the dehydrating agent causes a change in placeholding, wouldn't that mean... these low signal shadows are not edema?"

Low signal shadow is edema rather than a vascular-rich tumor placeholder. This inference is the core key to supporting Dr. Pascal's diagnosis of negative NMO with anti-AQP-4 antibody. If it is determined that this low signal shadow is not edema, it is equivalent to completely rejecting Pascal's diagnostic direction.

"Who knows." Bruen patted his belly, then continued to bow his head and began to chew the case. "The changes in the intracranial placeholding cannot be caused by blood collection, right? After excluding all other options, no matter how incredible the remaining options are - it is the correct answer. Isn't this the basic principle of reasoning?"

Zhou Ce criticized Bruen without hesitation, "The prerequisite is that you can list all the options - we have not even figured out whether this disease is spontaneous or secondary, congenital or acquired. With a dark look, how can you be sure that we have listed all the possibilities? What if it is some kind of unknown disease?"

Although it sounds like arguing... all the doctors present have to admit that Zhou Ce's argument is actually quite reasonable.

Yuan Ping'an pressed a few keys on his computer, and then a burst of "crunching" sounds in the entire office. Accompanied by this burst of sound, Yuan Ping'an stood up and said, "Although I can't be completely sure yet, I think I have found a possibility that looks credible."

He walked to the printer and sent the paper he had printed to Sun Lien and others. This is a related paper from the Third Affiliated Hospital of Yangcheng Medical College, titled "The Effect of Mannitol on the Expression Level of Channelin 4 in Ischemic Brain Edema Water".

"We skip the experimental content and look at the conclusion first." He said to everyone with the paper, "Mannitol has an inhibitory effect on aqp-4."
Chapter completed!