Chapter 1817

Dr Rudy knows exactly how arrogant and rude the Bruges are.

They are elegant on the surface, but dark inside. Like a snake hiding in a corner, I don't know when it will jump out and bite myself.

Rudy dared not offend the Bruch family, which was a fear from the bottom of his heart.

However, Dr Rudy wondered why Christian, who is cold and moody most of the time, should have such respect for this young Oriental doctor.

"All right." Zheng Ren casually perfunctory, "after Ms. Fandi can move, she should urge patients to do rehabilitation training and eat a lot of bitterness."

"Please rest assured that I will supervise her." Christian smiled. The wound on his face had healed, leaving only a dark spot.

Zheng Ren lamented the strong self-healing ability of this ethnic group.

Perhaps those who are less capable of self-healing have already died.

"Dr. Zheng, I heard from womel that you have your own diagnosis? I'm really lucky for Lord Roche." Christian said.

"Well, there's a diagnosis." Zheng Ren said casually, "Mr. Kerry, have all the people in the family... Who want to know Mr. Roche's condition come?"

Christian smiled. "The six branches will arrive in a few minutes. We will listen carefully to your consultation on Lord Roche. I think Lord Roche will get better soon."

Su Yun sighed.

This time, Su Yun felt a little uneasy. Boss, this product is like a very compact spring pressed by strong pressure in China. After coming out, it seems to have changed a person.

Alas, great pressure always needs to be released.

But is that really good? It doesn't matter whether the boss is crazy at Mayo Clinic or Johns Hopkins Hospital. Being great is humiliating. It's no big deal.

But here is... The risk is great, even huge.

Su Yun was very nervous.

A few minutes passed in the blink of an eye.

Several pale people with more or less dark spots on their faces, necks and hands came to the room.

Christian introduced everyone to Zheng Ren.

The internal relationship of this huge and ancient family is as complicated as the same old circuit board.

Zheng Ren is not in the mood to listen. Just make sure they all come.

Vomer saw Christian standing beside Zheng Ren, didn't say anything, but came to the front and said: "today's medical expert is from Huaxia. He is the youngest lifelong professor in the history of Massachusetts General Hospital."

Scattered applause broke out.

Womel bowed gracefully, raised her hand and made a gesture of invitation.

When Zheng Ren came to the stage, there was corresponding equipment on that side. After clicking on it, the image immediately appeared on the LED screen.

Find the picture you need. Zheng Ren said in London accent: "ladies and gentlemen, I'm glad to stand here and analyze Mr. Roche's condition."

It's quiet down there.

"I just thought, chronic variant Crohn's disease is just a joke with Mr. womel." Zheng Rendao, "now I begin to say my point of view."

There was a little noise, but not much.

"The first thing that appears in front of everyone is the image of gastroenteroscopy." Zheng Ren clicked on the image data in the computer, and Lang Sheng said, "maybe I was the same as everyone's idea at the beginning. Mr. Roche's disease was just old, and in the end, all organs of the body failed."

"But when I saw this image, I suddenly changed my mind."

Wormer was surprised that gastroenteroscopy was nothing special, just chronic atrophic gastritis and enteritis.

The doctors began to whisper.

"Gastric mucosal epithelium and glands atrophy, the number decreases, gastric mucosa becomes thinner, mucosal base layer thickens, or with pylorus gland metaplasia and intestinal gland metaplasia, or chronic digestive system diseases characterized by atypical hyperplasia. It is often manifested as dull pain, fullness, belching, loss of appetite, weight loss, anemia, etc. there is no specificity." Zheng Rendao, "very standard performance of chronic atrophic gastritis."

Su Yun feels that the boss has changed. What is he talking about here?

Just look at the patient and give an ordinary diagnosis, and the task is over.

Zheng Ren is moving the task to an unpredictable abyss.

"We are doctors. An appearance can only provide support for a certain diagnosis. We also need differential diagnosis." Zheng Ren said, "since this is not an open teaching class, I won't let you speak. Let me talk about my differential diagnosis."

"The diagnosis that needs to be differentiated most is --" Zheng Ren elongated his voice, looked around, and finally his eyes fell on womel's pale face.

"Lead poisoning!"

Zheng Ren's diagnosis was like throwing a stone into a calm pond, causing an uproar!

In the castle of Bruch, it is said that Roche Bruch is lead poisoning

Is this death?

Su Yun's face turned pale in an instant, just like Christian standing beside him.

Womel looked at Zheng Ren indifferently, with no expression on his face.

"This is just a differential diagnosis, not a diagnosis." Zheng Ren knocked on the table, "it's just a medical discussion. Please keep quiet!"

"Gastrointestinal mucosa has the ability to secrete lead. In the process of lead secretion, lead has a direct effect on gastric mucosa, destroys the regeneration ability of gastric mucosa and causes inflammatory changes in gastric mucosa.

Studies have shown that the detection rate of pathological damage of gastric mucosa in patients with chronic lead poisoning is 96.7%, and atrophic gastritis and atrophic gastritis with excessive formation can occur. Patients with chronic moderate and severe lead poisoning were initially diagnosed as superficial gastritis, and 91% turned to atrophic gastritis three years later. "

"Some people say this is speculation." Zheng Ren opened the next film and continued, "let's see the CTA image of the kidney."

"We can see that the patient's renal tubules have degenerative changes. This can be considered as a chronic change of the elderly, but it can still be considered as a manifestation of lead poisoning!

In addition, progressive interstitial fibrosis of bilateral kidneys can be seen on the CTA of the patient, which begins around the renal tubules and gradually expands outward. Renal tubular atrophy and cell proliferation coexist at the same time. "

"Lead can affect the function of mitochondria in renal tubular epithelial cells, inhibit the activities of Na +, K + - ATPase, and cause renal tubular dysfunction and even injury.

Acute poisoning mainly affects proximal convoluted tubules, including cell membrane damage, cell swelling, mitochondrial swelling, rupture and reduction of particles in matrix. An inclusion body, a complex of lead and protein, often appears in the nucleus of glomerulus.

But Mr. Roche has no similar changes, so the differential diagnosis mainly involves chronic lead poisoning. "

There was an uproar.

Womel looked at Zheng Ren coldly, and Zheng Ren also looked at him.

Four eyes crossed, Zheng Ren showed a simple and honest smile, gentle and without any aggression.

"Differential diagnosis, just differential diagnosis."