Rebirth of Medicine Practices the World

"From this point of view, it further supports my idea of ​​locating it in the meninges."

"As for the qualitative diagnosis, I mainly consider tuberculous meningitis. There is a lot of supporting evidence, such as meningeal irritation signs, changes in cerebrospinal fluid, brain parenchymal damage is not obvious, and no obvious diffuse slow waves are seen in the electroencephalogram, etc.

wait."

"Of course, there are also areas that are not supported. For example, the lung examination is normal, the binding bacterin test is negative, the child has no history of contact with tuberculosis patients, etc."

"However, we all know that today's tuberculosis infection is very secretive. Many times, it is a transient infection of the lungs and soon invades the meninges. This situation cannot be ruled out for this child."

"So, I suggest that the next step is to treat tuberculous meningitis, and at the same time, actively and promptly adjust the child's nutritional status and improve the water and electrolyte imbalance. If these conditions are not improved, it will be very detrimental to the treatment."

"As for anti-epileptic drugs, I suggest stopping them. After all, anti-tuberculosis drugs and anti-epileptic drugs cause considerable damage to the liver. The child has an epileptic seizure at best, which is not worthy of long-term medication and can be closely observed.

"

"Director Yang, Section Chief Feng, that's all I'll say. I hope to interact with you all." Lin Lin left a "foreshadowing". He was waiting for Qiu Bin to show up, and he wouldn't mind stepping forward to teach him a lesson.

"Thank you very much for Dean Lin's wonderful ward rounds and analysis. I listened to and watched Dean Lin's ward rounds from beginning to end. I can truly appreciate that Dean Lin's profound and extensive medical knowledge and his rich clinical experience are very important.

, are all very worthy of learning from all of us.”

"Next, let's see if you have any questions. If so, you can ask Dean Lin in person. Such opportunities are rare." Feng Ping's words were equivalent to a concluding speech.

"Dean Lin, I would like to ask you, why do you say that this patient's seizure was just an epileptic seizure, and you do not advocate the use of anti-epileptic drugs?" Cai Xiaofeng asked first.

"Well, Dr. Cai's question is very good."

"The so-called epileptiform seizure means that his seizure meets the diagnostic criteria for epilepsy, but the trigger for his seizure can be found in the patient."

"The most common febrile convulsions are the ones you see most. Relatively rare ones are disorders of the patient's internal environment, such as acid-base balance disorders, water and electrolyte disorders."

"This kind of internal environment disorder can cause the patient's brain cells to discharge abnormally, thereby causing epileptic seizures. In this case, when we correct these triggers, the seizures will disappear and never appear again."

"Therefore, there is really no need to use anti-epileptic drugs for such attacks. You can continue to observe them. From a neurology point of view, for attacks that occur once or twice a year, we can closely observe them without using drugs.

"

"Thank you, Dean Lin, for your answer." Cai Xiaofeng was convinced by this answer.

"Dean Lin, why did you easily deny the diagnosis of viral brain without clear evidence? Isn't this patient's performance not enough to diagnose viral brain?" Qiu Bin began to speak.

"This is Xiao Cai's superior doctor, Dr. Qiu Bin." Yang Yan said to Lin Lin.

"Hello, Dr. Qiu! Your question is actually universal. I once asked this question when I was checking on a patient in the pediatric department of our hospital."

"I don't know if you are aware of this, but now many children are diagnosed with 'viral encephalitis' because of fever. During hospitalization, hormones are used, and the effect is indeed very good."

"I would like to ask Dr. Qiu a question, what are the main clinical features of viral encephalitis?"

"Uh..." Qiu Bin was stunned by the question.

"In our pediatric department, the main clinical features of viral encephalitis are fever and poor energy." Qiu Bin thought for a while and gave an answer.

"So, let me just say, according to Dr. Qiu's answer, can many children with fever be diagnosed with viral encephalitis?"

After hearing this, the doctors present nodded unanimously.

"For general viral colds and fevers, short-term use of hormones is very effective, but this cannot be said to indicate that such patients have viral encephalitis."

"Viral encephalitis, as the name suggests, the virus must invade the brain, and there will definitely be symptoms and signs of brain damage. In today's child, can you see the symptoms and signs of brain parenchymal damage?"

Everyone shook their heads again.

"Although not, but didn't this child improve significantly when he started taking hormone treatment? Doesn't this mean that he has viral encephalitis?" Qiu Bin still persisted.

"This is the scariest part. Dr. Qiu, do you know why this patient has worsened so quickly recently? Have you thought about this problem? If you have, do you still think hormones are effective? Do you still dare to continue using hormones for this child?

?”

Lin Lin's series of questions left Qiu Bin speechless and Yang Yan cheered in her heart.

"Dean Lin, are you always so domineering in your ward rounds?" Qiu Bin's question startled Feng Ping. He moved and was about to speak, but Yang Yan signaled him not to interrupt.

"Overbearing? What did Dr. Qiu think I just said was overbearing? Chief Feng, do you think my ward rounds and analysis just now were overbearing?"

"Dr. Qiu, please pay attention to your words and deeds. Dean Lin has always analyzed the condition very seriously and calmly. How can he be overbearing in purely academic rounds?" Feng Ping frowned and interjected.

"I have always believed that when it comes to academic discussions, everyone must put aside all identities, academic qualifications, professional titles, positions and various titles. Academically, these things have no value. If anyone wants to use these things to impose on academic discussions, then,

This person must have accomplished nothing, and his level must be very average.”

"When Dean Lin said this, he was denying the importance of degrees." Qiu Bin thought he had grasped the main point of the attack.

"Haha, it seems that Dr. Qiu prefers to take quotes out of context. When our hospital recruits talents from outside, we will definitely give priority to doctors with doctorates, but at the same time, we value first academic qualifications, practical abilities, and character."

"I have never denied that the PhD community is a gathering of smart people. Most PhDs are smart, studious, diligent and open-minded."

"Such people know their shortcomings and will work very hard and humbly learn from people with various academic qualifications. I admire these people very much, and they are the real talents I am eager to recruit."