Rebirth of Medicine Practices the World

"Director Ding's idea is very worthy of promotion at the hospital level. I ask Section Chief Ye to go back and consider the promotion work carefully. The medical department will take the initiative, and the directors of each department will be the main body of responsibility. It must be carried out."

"Now, let me talk about my views on this patient." Lin Lin changed the subject and began to analyze the patient.

"This patient is a middle-aged female, with subacute onset and progressive development. The main symptoms are discharge-like, severe pain, accompanied by numbness and weakness of the limbs."

"After admission, the patient's condition improved after treatment with dexamethasone. The pain was relieved and the frequency of pain decreased."

"Among the large-scale instrument examinations that the patient had, the most valuable was the head magnetic resonance examination. Although no abnormalities were found, the negative results also have great reference value for us."

"Everyone has seen that the way I induce pain in patients is actually a true reflection of the patient's usual pain. This sign is called the 'lower head electric shock sign'. There is no word pain in it, but the pain like an electric shock is very painful."

"The signs I checked today also include weakness in the left limb. Of course, this is compared to the right side. Sensory impairment in the right limb, difficulty standing with eyes closed, positive, and positive pathological signs in the left limb

, the tendon reflexes of both lower limbs were hyperactive, the biceps reflexes of both upper limbs were weakened, and the triceps reflexes were active."

"I wonder if you have noticed the difference between these two reflexes. This sign has special significance for positioning diagnosis, especially the longitudinal positioning diagnosis of the spinal cord."

"Also, the patient's joint position sense and joint movement sense of both lower limbs have disappeared, which is consistent with the difficulty in establishing signs with eyes closed."

"Based on the above symptoms and signs, in terms of localization and diagnosis, I consider that the patient's lesion is in the cervical spinal cord. From the longitudinal positioning, the lesion is centered on the fifth cervical cord and affects the upper and lower spinal cord."

"Laterally, the lesion is located on the left side and posteriorly, with damage to the posterior cord mainly affecting the pyramidal tract and sensory conduction fibers."

"Everyone must be very concerned about this patient's qualitative diagnosis, that is, what kind of disease she suffers from."

"If my judgment is correct, the patient is suffering from a not very common neurological disease called spinal multiple sclerosis. This type mainly occurs in Asian people."

"So, the next step is to do a magnetic resonance imaging of the cervical spinal cord. Currently, there is no highly targeted and specific examination method in terms of hematology and cerebrospinal fluid examination."

"In terms of treatment, the intravenous infusion of dexamethasone can be changed to oral prednisone, starting from 60 mg per day and gradually adjusted according to the patient's condition. After all, this disease requires long-term medication."

"In addition, carbamazepine can be added, and the dosage starts from 0.1 grams three times a day. During the medication, pay attention to the side effects of carbamazepine, such as rash, leukopenia, hyponatremia, etc."

"Finally, this patient can be given diazepam before going to bed at night. Firstly, diazepam can increase the pain threshold, thereby reducing the occurrence of pain. Secondly, the application of hormones causes the patient to have insomnia. Using diazepam can relieve the patient's pain of insomnia.

"

"Dean Lin, you just said that a negative MRI of the head is also very important. Does it have any special significance for this patient?" Ye Xiu listened carefully.

"Yes, it is of great significance. I just said that multiple sclerosis in Asians is mainly spinal type, but it does not mean that Asians will not have brain-type multiple sclerosis. In some patients, the brain can also be affected at the same time.

Hemispheres and spinal cord.”

"So, the negative MRI of the brain allows us to rule out the possibility of brain involvement." Lin Lin had explored this type of disease in her previous life.

"Dean Lin's analysis has opened up our thinking. It seems that we need to read more books and study. As far as I know, Dean Lin is a frequent visitor to the library and has read a large number of foreign medical journals."

"I follow Director Ding's idea just now, should we carry out special business learning in class?" Zhuo Yiming is also a person who loves to learn.

"Teacher Zhuo's suggestion is very good. Let's go back and let Director Ding do some research. The hospital will soon enter the accreditation process of a Class III A hospital, so we can't make everyone too tired."

"Should we start with one question per month? Everyone must participate and prepare. If a question is spread out, it can involve many issues. In one year, everyone can learn a lot of knowledge.

." Lin Lin gave specific suggestions.

"I agree with Dean Lin's suggestion. There are only one question per month, not many, so everyone can have enough time to prepare, and it won't make everyone too nervous and tired. Director Ding, count me in." Ling Xiaoyun expressed his attitude positively.

"Section Chief Ye and I will be very busy in the coming days. In the afternoon, Chief Ye will go to Guangcheng to study for a week. After returning, he will participate in formulating various charters and rules for the review work. Haha, stay up late.

, is expected to become the norm in the next few months.”

"Therefore, Section Chief Ye and I will not participate in this study plan for the time being. However, if you encounter special cases and you need me to participate in the discussion, you can call me at any time."

"I am very grateful to Teacher Zhuo for his suggestion, to Dean Lin for his specific suggestions, and to Director Ling for his support. I also feel that in order to improve our professional level, we must continue to learn new knowledge."

"I still remember when Dean Lin got a score of 98.5 in the English test. The efforts that Dean Lin put in were beyond our imagination. What everyone saw was how awesome Dean Lin was. But what everyone didn't see.

, it is Dean Lin who never stops learning.”

"I think Dean Lin's ward round today was really worthwhile. It not only solved clinical problems, but also pointed out the direction for us to study."

"I will definitely work with Director Ling, Teacher Zhuo and Teacher Li to work out a plan that will make our entire department active. Thank you again, Dean Lin!" Ding Feng made a concluding speech.

Ye Xiu stood up, came to Ding Feng, and said, "Director Ding, your summary is great. Haha, it's worth it. It's really worth it."

"Yes, it's even more valuable to us. You spent real money on it."

"It's worth it. These knowledge points can't be bought with money."

"Haha, Section Chief Ye, hurry up and get ready, don't delay." Lin Lin said to Ye Xiu with a smile.

"Okay, Dean Lin, I'm leaving." Ye Xiu made an OK gesture towards Lin Lin, then turned around and left quickly.

Ling Xiaoyun looked at Ye Xiu's retreating back and said to Lin Lin: "Dean Lin, looking at her, it reminds me of your past appearance. You, junior sister, look so much like you."