Doctor: It's reasonable to perform surgery on yourself.

The child's tender voice echoed in the corridor:

"Is this the house where grandpa will live in the future?"

At the age of five, he didn't understand anything. He just pointed at the cemetery leaflets circulated by his elders.

The picture shows rows of towering tombstones, with a space of about one square meter to prevent ashes.

None of the middle-aged people present answered.

At this time, grandma, who had been silent in the corner, smiled tiredly and said, "Yes, grandpa will live in it from now on."

The child's expression immediately became sad and he said, "But this door is so small. Grandpa likes houses with study rooms."

Everyone was stunned.

They had lived with their father for so many years and never knew that he still had such thoughts.

The old lady's nose felt sore. She hugged her grandson with red eyes and said comfortingly: "It's not small anymore. It's spacious inside. There's a study room, a yard, and you can grow vegetables, and everything."

Xu Qiu and others were silent.

The ruthlessness and indifference of middle-aged children did not cause them much emotional fluctuation.

But one end of the group, the old man and the child, the former is beaten like an old scalper by life, and the latter, with their ignorance and longing for seeing the world for the first time, are often the two groups that touch people's hearts the most.

"Before you choose a cemetery, treat your illness first."

Xu Qiu took a step forward and interrupted the family members' argument.

The International Friendship Hospital only suspected Creutzfeldt-Jakob disease and did not diagnose the patient themselves. What was the rush?

The fat middle-aged woman urged: "If it can be cured, treat it. If it can't be cured, just take it back. It will also save you having to buy a hearing aid..."

"Say less, he is your father!" The old lady finally couldn't listen any more and interrupted with a sigh.

"My father, my father, when you forced me to drop out of school to support my elder brothers, younger brothers and younger sisters, why didn't you say that I was also your daughter? Now you remember that he is my father?"

Xu Qiu sighed.

This is why he never participates in any conflicts between family members.

Every family has sutras that are difficult to recite. There is no absolute right or wrong. It is enough for doctors to be able to see the patients in front of them and see the diseases beneath the surface.

…

"The patient's name is Fan Fuguo, he is 72 years old. His main complaint at the first diagnosis was consistent with the records of Creutzfeldt-Jakob disease, which were mental symptoms such as restlessness.

This patient is obviously more serious. He has depression and abnormal vision in both eyes. Considering that he may have central nervous system lesions, the disease has progressed to the middle and late stages..."

In the conference room, Xiao Liu acted as the host, introducing patients to Xu Qiu, Joseph and others.

However, whether it was Xu Qiu or Joseph and other famous doctors, they all stared at the copied medical records in their hands.

For them, no matter how good the narrative is, it is not as accurate and reliable as a report that uses data to speak for itself.

"Abnormal vision in both eyes..."

Xu Qiu was slightly startled.

When he first saw the old man, he thought he just couldn't hear. His eyes were moving very actively and he should be able to see clearly.

But he didn't expect that the other person was actually living in a dark world with no sound and no light. He didn't even have a family member who could hold his hand. He was only accompanied by the pain and torture caused by an unknown disease.

Just thinking about it is suffocating.

Abnormal vision... This is very similar to Luo Di.

One of the symptoms of the brain-eating amoeba infected by Luodi is its invasion of the central nervous system, affecting the transmission path between visual signals and the brain center.

As a neurological disease, although cases of Creutzfeldt-Jakob disease are rare, careful analysis can reveal such symptoms.

However, clinically, no one would infer this.

Just like if the patient complains of cough, it is impossible for a doctor to directly suspect lung cancer. Instead, the patient will be investigated for common pharyngitis, bronchitis, etc. one by one.

For Fan Fuguo:

More than two months ago, his MRI at the county hospital showed non-specific demyelinating lesions in the brain.

Later, the condition worsened, and when it was delivered to Xiao Liu, several more tests were performed. As a result, symmetrical diffuse paraventricular white matter and subtemporal lobe gray matter hyperintensities were found in the FLAIR and MRI T2 sequences——

Multiple sclerosis should obviously be suspected first.

This is an inflammatory demyelinating disease of the central system, which can affect the brain, spinal cord white matter, subcortical structures, etc. If not treated in time, the patient's neurological function will be irreversibly damaged, resulting in loss of muscle coordination and vision loss. , loss of function and other symptoms.

Another feature is that it is an autoimmune disease.

And this is one of the most difficult types of disease to diagnose.

Xiao Liu did have two brushes. He nodded and said: "I did not diagnose Creutzfeldt-Jakob disease at the first time. Instead, I investigated it as multiple sclerosis."

The records in the medical records were basically consistent with the diagnosis of multiple sclerosis.

Fan Fuguo's subsequent cerebrospinal fluid IgG oligoclonal band test was positive for type 3.

Joseph smiled faintly, "Not only the oligoclonal bands, but also consistent additional bands were found in the blood and cerebrospinal fluid. Do you know what this means?"

After saying that, he looked around the whole place.

Director Huo shook his head.

Yang Chenxi didn't know the details of these majors.

Yang Yuen propped up his chin, "What, professor, we are all cardiac surgeons. How could you possibly know if you ask questions about rare diseases in God!"

Director Huo, Xiao Liu and others stared.

Damn it, we are in God, and we don’t even know it!

"Where's Dr. Xu?" Joseph looked at Xu Qiu with twinkling eyes.

Xu Qiu was unusually calm and calmly described: "Systemic inflammatory reaction."

Joseph frowned. Is it really a decathlon? He actually knows such tricky knowledge points?

Xu Qiu had no intention of competing with Joseph. His attention was entirely on the patient.

After quickly scanning the first case, he no longer obsessed with the data, but stood up and came to Fan Fuguo's side to conduct a detailed physical examination.

The patient's cerebrospinal fluid examination showed more abnormalities than Xu Qiu imagined.

In addition to those mentioned above, there is also a positive measles antibody index in the MRZ reaction of multispecific B cell immunity.

In addition, after being sent to Linhai International Friendship Hospital, the patient received high-dose methylprednisolone treatment.

However, the patient's condition suddenly took a turn for the worse in the past few days, and he developed severe extrapyramidal symptoms.

Xiao Liu quickly re-examined, and this time found progressive symmetrical subcortical hyperintensities in the temporal lobe, occipital lobe and parietal lobe in FLAIR and T2 sequences... This was no longer related to multiple sclerosis.

Subsequently, Xiao Liu and several deputy directors in the department considered acute disseminated encephalomyelitis, reversible posterior leukoencephalopathy, etc.

However, after extensive comprehensive screening for autoimmune diseases, infectious diseases, brain surgery, such as brain tumors and other related diseases, as well as various tumor indicators, there were no further clues.

This time Xiao Liu was smarter and specifically checked whether there was any problem with Fan Fuguo's muscle tone. He also did several thymoma-related examinations to rule out the thymoma that Professor Yan had missed.

Only then do you dare to report suspected Creutzfeldt-Jakob disease...