Chapter 1817： Just a differential diagnosis

How arrogant and rude the Bruch family is, Dr. Rudy is clear.

They are superficially elegant, but they are very dark inside. Like a snake hiding in the corner, I don't know when I will pull out and bite myself.

Rudy did not dare to offend the Bruch family. This is a fear from the bottom of my heart.

But why most of the time, the indifferent and moody Christians would be so respectful to this young oriental doctor, Dr. Rudy would not understand.

"Okay, you can do it." Zheng Ren is perfunctory. "Ms. Van Dy, after she is active, urges patients to do rehabilitation training and suffer a lot."

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

Zheng Ren feels the powerful self-healing ability of this ethnic group.

Perhaps the person who has a little self-healing ability has already died.

"Dr. Zheng, I heard that Wormell said that you have your own diagnosis? It is really lucky for Roche." Christian said.

"Well, there is a diagnosis." Zheng Ren said casually: "Mr. Kerry, in the family... who wants to know Mr. Roche's condition, have you come?"

Christian smiled. "The six branches will come within a few minutes. We will listen carefully to your consultations with Roche, and I think that Roche will soon get better."

Su Yun sighed in his heart.

This time, Su Yun was a little embarrassed. The boss is like a very compact spring that is under strong pressure in the country. It seems to have changed since it came out.

Oh, huge pressure is always going to be released.

But is this really good? Whether at the Mayo Clinic or at Johns Hopkins Hospital, it doesn't matter if the boss is crazy. Awesome is a shame, no big deal.

But here is... the risk is great, it can even be said to be huge.

Su Yun is very embarrassed.

In a few minutes, the blink of an eye passed.

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

Christian introduced everyone to Zheng Ren.

This large and ancient family, the internal relationship is just like the same old circuit board, intricate.

Zheng Ren also did not have the heart to listen, as long as it is determined that it will come.

Volmer looked at Christian standing next to Zheng Ren, but did not say anything, but came to the forefront and said: "The medical expert who consulted today is from China. He is the youngest tenured professor in the history of Massachusetts General Hospital. ”

The sparse applause sounded.

Woomer's graceful bending, raising his hand, made a gesture of asking.

Zheng Ren came to the stage, and there was a corresponding device on the other side. After the point was opened, the image appeared on the big screen of the led.

Finding the picture that I need, Zheng Ren said in English in London: "Ladies and gentlemen, I am very happy to stand here and analyze Mr. Roche's condition."

The following is quiet.

"I just thought about it. Chronic mutated Crohn's disease is just a joke with Mr. Wormell." Zheng Rendao, "Now I started to talk about my point."

Slightly buzzing, but not big.

“The first thing that appears in front of everyone is the image of the gastrointestinal tract.” Zheng Ren opened the video information in the computer and said: “Maybe I started with the same thoughts. Mr. Roche’s illness is only older. In the end, the body's organs are exhausted."

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

Woomer is a bit strange, gastrointestinal mirrors are nothing special, just chronic atrophic gastritis and enteritis.

The doctors began to whisper.

"The gastric mucosa epithelium and gland atrophy, the number is reduced, the gastric mucosa is thinned, the mucosal base layer is thickened, or the pyloric gland metaplasia and intestinal gland metaplasia, or chronic digestive system disease characterized by dysplasia. Upper abdomen pain, fullness, suffocation, loss of appetite, or weight loss, anemia, etc., no specificity." Zheng Rendao, "very standard chronic atrophic gastritis."

Su Yun thinks that the boss seems to have changed a person. What is he talking about here?

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

And Zheng Ren is making the task go to an unpredictable abyss.

"We are doctors, a kind of appearance can only provide some kind of diagnosis support, we still need differential diagnosis." Zheng Rendao: "In view of this is not a public teaching class, so I will not let everyone speak, let me talk about my Differential diagnosis."

"The diagnosis that most needs to be identified is --" Zheng Ren stretched his voice, looked around, and finally his eyes fell on the white face of Woomer.

"lead poisoning!"

Zheng Ren’s diagnosis is like throwing a stone into a calm pond, and it’s a big uproar!

In Bruch Castle, Roche Bruch is lead poisoning...

Is this dead?

Su Yun’s face was instantly pale, like the Christian standing next to him.

Woomer looked at Zheng Ren indifferently, and there was 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!"

"The digestive tract mucosa has the ability to secrete lead During the process of lead secretion, lead directly acts on the gastric mucosa, destroying the ability of gastric mucosal regeneration, and causing inflammatory changes in the gastric mucosa.

Studies have shown that the detection rate of gastric mucosal pathological damage in patients with chronic lead poisoning is 96.7%, and atrophic gastritis and atrophic gastritis may be associated with the formation. Patients with chronic moderate to severe lead poisoning were initially diagnosed with superficial gastritis, and 91% switched to atrophic gastritis after three years. ”

"Some people say that this is speculation." Zheng Ren opened a film and continued: "Let's see the cta image of the kidney."

"We can see that the patient has a degenerative change in the renal tubule. There is a chronic change in the elderly that can be considered as a result of lead poisoning!

In addition, the patient's cta can be seen in the bilateral renal progressive interstitial fibrosis, starting around the renal tubules, gradually expanding outward, tubular atrophy and cell proliferation coexist. ”

"Lead can affect the function of mitochondria in renal tubular epithelial cells, inhibit the activity of na+, k+-atp enzyme, etc., causing renal tubular dysfunction and even damage.

Acute poisoning mainly affects the proximal convoluted tubules, which may cause cell membrane damage, cell swelling, mitochondrial swelling, rupture, and reduction of intragranular particles. An inclusion body often appears in the nucleus of the glomerular cell, which is a complex of lead and protein.

However, Mr. Roche does not have a similar change, so the differential diagnosis mainly involves chronic lead poisoning. ”

The audience is at a loss.

Woermei looked at Zheng Ren coldly, and Zheng Ren also turned his eyes to him.

With four eyes in hand, Zheng Ren reveals a honest and honest smile, gentle and without any aggressiveness.

"Differential diagnosis is just a differential diagnosis."

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