"Director Leng, I think the deworming treatment for Ling Feifei in bed 11 can be temporarily suspended?"

After the ward rounds on Monday morning, at the regular meeting of the department, Tian Lu proposed solemnly.

“Suspension of deworming treatment?”

Leng Lie was startled and asked with some surprise: "Is it the little girl who was diagnosed with neurocysticercosis? Who is his doctor in charge?"

"it's me!"

Deputy Chief Physician Zhang Jie raised his right hand with an ugly look on his face. Before the ward round, Tian Lu had communicated with him, but Zhang Jie, who was confident in his diagnosis, did not care and declined the other party's request.

It was just a matter of observation for a few days, but I didn’t expect that Tian Lu would bring it up directly at the department meeting!

This made Zhang Jie's face look a little ugly.

He glanced at Tian Lu and said categorically: "Tell me about the patient's condition and the basis for your current treatment plan!"

"OK."

Zhang Jie quickly opened Ling Feifei's medical records, stood up and said loudly: "The patient is female, fifteen years old. She went to a local hospital eight months ago due to headache symptoms without obvious triggers..."

"According to the advice of Dr. Tian Lu when he was admitted, the patient was screened for fecal parasites, routine blood tests, biochemical tests, serum cysticercosis antibody test, brain CT and brain MRI, etc. The test results are as follows...

"

"To sum up, my diagnosis was neurocysticercosis, obstructive cerebral edema and upper respiratory tract infection, so I was given deworming, dehydration and anti-infective treatment. I have been taking the medicine for two days now, and the infection symptoms have improved and the headache symptoms have also been relieved.

"

After saying that, Zhang Jie looked at Tian Lu lightly and sat back on the chair.

After listening to Zhang Jie's report, Leng Lie frowned.

Judging from the patient's medical records and the examination results after admission, there seems to be nothing wrong with Dr. Zhang Jie's treatment plan. At least Leng Lie agrees with it. Why did Tian Lu suggest stopping the medication?

Leaving aside the nurses, the other doctors were also thinking carefully, trying to find out the reason why Tian Lu suggested stopping the medication.

After just thinking for a moment, he waved his hand coldly and said: "Xiaotian, tell me what you think!"

Under the complicated gazes of everyone, Tian Tian stood up without changing his expression and said in a deep voice: "According to the current medical history and examination results, there is no problem with Teacher Zhang Jie's treatment, but the patient has been hospitalized three times before, and all the symptoms were the same.

Although the treatment plan is still there, the headache still occurs, indicating that the deworming effect is not good, so I think other plans must be considered.”

As soon as these words came out, except for Leng Lie and the other deputy chief physician Li Qiang, who looked thoughtful, the other doctors all showed a look of disapproval.

I've only been on medication for two days, why did I jump to such a conclusion?

His cold index finger tapped rhythmically on his knee, and he was thinking secretly in his heart.

"What about your suggestion?"

After a moment, Leng Lie suddenly asked in a deep voice.

"Ventriculography!"

Tian Lu gave the same judgment as himself and the system without hesitation!

His eyes lit up and he asked coldly: "Do you suspect ventricular cysticercosis?"

"Yes!"

Tian Lu nodded and said: "If it is in the fourth ventricle, the cysticercus' lysed worms after death can cause severe ependymitis and aggravate hydrocephalus, so I suggest temporarily stopping the deworming treatment and doing a ventricle first

Let’s take a puncture and take a look.

"But the existing test results do not support your judgment!"

Seeing the expression on Leng Lie's face, Zhang Jie quickly stood up and said, "We didn't see it on CT, especially the MRI results. We didn't find the scolex in the fourth ventricle."

Everyone's eyes returned to Tian Lu's face.

"Yes, no findings were found. Because the cyst wall is thin, the CT value of the intracystic fluid is similar to that of cerebrospinal fluid, and the contrast-enhanced scan has no enhancement, so it is difficult for CT to show cysticercosis and there is a lack of specific changes. But the CT results show that the whole ventricular system is enlarged

, significant dilation of the bilateral lateral ventricles, the third ventricle and the midbrain aqueduct, especially the cystic dilation of the fourth ventricle, which is one of the symptoms."

Having said this, Tian Lu took a breath and then explained: "Although MRI is one of the most effective examination methods for cerebral cysticercosis, not all cysticercosis scolex can be seen on all MRI images. In this regard, various countries have

Reports in the literature are also inconsistent. Because intraventricular cysticercosis cyst fluid shows the density and signal of cerebrospinal fluid, it is easy to diagnose those with scolex, but difficult to diagnose those without scolex, which only manifests as ventricular enlargement and obstructive hydrocephalus."

"So I think it is necessary to perform ventriculocentesis and CT scan to confirm!"

As soon as Tian Lu finished speaking, the office suddenly fell into silence. Everyone was seriously considering Tian Lu's suggestion. After all, there was some truth in what he said, right?

After pondering for a moment, Leng Lie turned to Zhang Jie and asked: "Xiao Zhang, what do you think?"

After all, Ling Feifei's doctor in charge is Zhang Jie, so Leng Lie still has to give him enough respect.

"I, I still stick to the previous treatment plan."

After hesitating for a while, Zhang Jie insisted: "Although Xiaotian's suggestion is very reasonable, ventriculotomy is relatively traumatic. I think it is better to give conservative treatment first and see the effect."

The fingers on the cold knees started tapping rhythmically again.

Indeed, according to the current examination results, Zhang Jie's treatment plan is currently the most reliable. However, considering Ling Feifei's past medical history, Tian Lu's consideration is not unreasonable, and Leng Lie is a little difficult to make a decision for a while.

Tian Lu moved his lips, but finally fell silent. He had already said everything that needed to be said. As for the final plan, one would depend on the chief physician Zhang Jie, and the other would depend on the director Leng Lie. For the time being, he could

That's all I can do.

Under Tian Lu's gaze, the finger tapping suddenly stopped.

"First follow Zhang Jie's plan and carry out drug treatment!"

Leng Lie suddenly stood up and said in a deep voice: "If the condition recurs after treatment, follow Oda's plan for ventriculocentesis! Do you have any questions?"

Tian Lu felt a hint of disappointment in his heart, while Zhang Jie breathed a sigh of relief.

"If not, that's it, let's call it a night!"

The doctors and nurses dispersed in a hurry. Those who should go to the ward went to the ward, and those who should go to the operating room went to the operating room. Soon, only Leng Lie and Tian Lu were left in the office.

"Xiaotian, your consideration makes sense, but..."

Looking at Tian Lu, Leng Lie's serious expression softened and he said with a smile.

"I understand, Director."

Tian Lu smiled bitterly and said: "Determining a treatment plan is a process of measurement and consideration. My plan does lack strong evidence support. Let's take a look first before talking about it."

"Um!"

He patted Tian Lu's shoulder heavily and said with a cold smile: "I will ask Zhang Jie to pay close attention to his condition. It's been a hard day, so go back and rest."

After saying that, Leng Lie hurried to the operating room. He had a major surgery today and it would take several hours to complete, so he couldn't waste any more time here.

Is this the only thing that can be done?

Just like the old lady who insisted on going home, she knew she was right, but she had no choice but to do anything?

Tian Lu sat quietly on the chair. After a while, an inexplicable look gradually appeared in his eyes.

...

There weren't many things going on last night, and Tian Lu's shift wasn't very hard. After taking a nice shower, he felt that his whole body was suddenly full of energy again, so he put on his clothes and walked straight out of the hospital.

Some things can't be rushed. You should relax a bit when it's time to relax.

Looking at the time, it was indeed very early. After thinking about it for a while, Tian Lu simply took the subway and came to the Medical College of Capital University.

After receiving the call, Tong Xiangyang hurriedly ran out, and when he saw Tian Lu, his face turned into a smile: "Xiao Tian, ​​you came just in time, the laboratory has been set aside for you, including equipment and instruments.

It’s not there yet, how about I take you to see it first?”

"Of course that's good!"

When Tian Lu heard that the laboratory had been vacated so quickly, he was overjoyed and said quickly: "But I can just go and have a look myself. You are so busy, so you don't have to accompany me!"

"What are you busy with? No matter how busy you are, I will definitely accompany you when you come!"

Tong Xiangyang laughed and walked deeper into the corridor with Tian Lu.

The laboratory is in the penultimate room in the innermost room, facing the sun. The room is not small, about fifty square meters, but because it used to be used as a warehouse, now that it has been emptied, there is nothing.

After some cleaning, it looked very clean.

"How is it? Are you satisfied?"

Tong Xiangyang asked with a smile.

Tian Lu also saw this house when he came last week, but the house was full of clutter at that time, so the feeling was naturally different from what it feels now. Feeling happy, Tian Lu nodded repeatedly and said: "Satisfied, so satisfied."

,Teacher Tong, thank you so much!”

"As long as you are satisfied, that's good! As long as you're satisfied, that's good!"

Tian Lu was satisfied, and Tong Xiangyang was naturally very happy. He liked the outstanding young man in front of him from the bottom of his heart. Like Leng Lie, Tong Xiangyang, who had worked in the school for half his life, was very interested in the Institute of Neurobiology.

His feelings are far beyond what others can compare with, so for outstanding young people, he not only has no jealousy at all, but is willing to provide the greatest support and help.

The development and growth of the research institute is one of his lifelong wishes. For this reason, he feels that the things provided to Tian Lu are not worth mentioning at all.

Tong Xiangyang said with a smile: "Except for those consumables, the tables and instruments are all old, but they will be checked before delivery to ensure that they can be used normally. You can rest assured. If everything goes well, after the National Day

You can use this laboratory now, haha, I will get you an access card later, so you don’t have to call me when entering or exiting."

"Don't rush this, just take your time."

After saying that, Tian Lu hesitated for a moment and said, "In addition, Teacher Tong, there is something I want to ask you about."

"Say it."

Tong Xiangyang waved happily.

Tian Lu nodded and said: "That's right, I heard someone say that our Institute of Neurobiology accepts a lot of basic eight-year students to do projects every year, and everyone will choose a mentor, right?"
Chapter completed!