Chapter 895: Eight thousand dollars that crushed the family
In fact, when Xu Qiu first saw the hair in the vomit, he had thought about this.
It's just that the chance of teratoma in menopausal women is very low.
In addition, the previous focus was mainly on anti-NMDAR antibodies, and the diagnosis direction was also encephalitis and other diseases.
However, with the diagnosis of primary autoimmune brain overturned, everything has to start all over again.
Integrate these three pieces of information together and think again... Could teratoma be the cause of autoimmune brain?
Or to put it another way, since it is not primary autoimmune brain, then what about secondary autoimmune brain?
Could it be that teratoma caused secondary autoimmune encephalitis!
Following this line of thought, Xu Qiu began to search for relevant literature.
After a while, a joyful expression appeared on his face.
After reading dozens of articles, he saw relevant clues in a document from sixty or seventy years ago.
The mechanism of teratoma was mentioned in it!
It was mentioned above that neural tissue may develop in teratoma.
In most cases, these nerve tissues are just empty forms, but they cannot actually play the role of real nerve cells. To put it bluntly, they are just a bunch of "corpses" that are useless.
However, a very small number of nerve tissues have certain activity.
"Perhaps, the nerve tissue in the teratoma has NMDA receptors, which will stimulate the body to produce anti-NMDAR antibodies under certain conditions?"
"No, the possibility of this kind of nerve cell producing a complete NMDA receptor is too low. Perhaps it can only synthesize part of the receptor, such as GluN1 or GluN2 subunit related antigen epitopes..."
The more Xu Qiu thought about it, the more likely it was.
Although this document did not point out that teratoma may cause encephalitis.
However, from Xu Qiu's analysis, teratoma may indeed produce antigen epitopes that can simulate receptor signals under various coincidences, and finally cause the body to produce a large number of anti-NMDAR antibodies.
And these antibodies eventually entered the central nervous system, leading to secondary anti-NMDAR encephalitis!
"This... this is too outrageous!" Shi Lian was a little confused when he learned about this tortuous pathogenesis.
Chen Qiao nodded while thinking: "Although it is incredible, it makes sense logically. Teratoma does have such a pathogenic mechanism!"
"If the hair is caused by teratoma, then why did we get nothing from the gastroscopy this time... and we did a CT scan before, and it seems that we didn't find anything."
Shi Lian was talking, and her voice suddenly paused.
She immediately thought of the diverticula she had found when she was operating on Pang Honggu.
In addition, the patient also had a fecal odor.
If these odors come from the mouth... the feces are refluxed upwards... this is a low-lying intestinal obstruction!
"If the teratoma is in the lower part of the digestive tract, gastroscopy is useless, and colonoscopy is required!" Shi Lian realized this immediately.
Seeing Xu Qiu nod, Shi Lian didn't stay for long, and hurried to the ICU to prepare a colonoscopy for the patient.
As long as the hair can be seen, it can prove that the teacher's guess is correct!
However, just when she was about to leave, she seemed to have thought of something, ran back and begged Chen Qiao away.
After eating the office, Chen Qiao rolled her eyes and said, "Is it that serious? I am alone with the teacher, can I eat him?"
Shi Lian's face was hot and she argued, "I won't think about these messy things!"
Chen Qiao looked like she was watching a wild giant panda: "Don't say you just want to hold hands with the teacher. What did you think about Children's Day? Do you want to do things that are not suitable for children?"
Shi Lian was stunned for a moment.
After finding that he was no match for Chen Qiao in driving, and the topic was getting more and more off-topic, Shi Lian hurriedly explained, "No, last time I picked up the vomit, this time I have to check the feces, anyway, it should be your turn to have fun!"
Chen Qiao gritted her teeth and said, "You are really my good junior sister!"
Shi Lian saw that she had won back a city, and a satisfied expression appeared on her face, and she nodded proudly: "My senior sister and I are like sisters, no matter what we do, we have to share half."
Chen Qiao wanted to refuse, but when she heard this, she inexplicably thought of her handsome teacher.
She nodded and said, "Okay, I'll do it... But with Wang Fan here, he's obviously more professional in this kind of thing."
Before Wang Fan became the little prince of suturing, he was an expert at picking up feces, and even had a high status in the anorectal department.
Shi Lian said nonchalantly, "Brother Wang didn't want to. I asked him to help me pick up vomit before, but in the end I did it myself... If you can get him to do it, I don't mind."
"You said it!"
Chen Qiao smiled evilly, gave Shi Lian a wink, and went straight to the doctor's office.
"Brother Wang!"
As soon as Chen Qiao came in, she went straight to Wang Fan's workstation.
The latter took off the high-end headphones he had just bought, put the pen against his ear, and said coolly: "Qiaomei, what's the matter?"
Chen Qiao showed a distressed expression: "The teacher has a patient who is suspected to be a low-positioned teratoma. The CT scan didn't show it, so I was asked to deal with it. I don't know what to do."
"Brother Xu's patient?"
Wang Fan immediately became interested, and after thinking for a while, he said: "This is not simple, just do a colonoscopy, is there anything clearer than this?"
Chen Qiao rubbed her temple painfully: "This is the problem, I'm not very good at this. I heard that Brother Wang, you were known as a talent that all anorectal doctors have to learn from. I don't know if you can do it... If not, it's okay, I'll find someone else."
Hearing this, Wang Fan stood up in a snap: "Who are you looking down on! If I can't do it, who else can handle it?"
After saying that, he quickly added the suffix in a too arrogant and aggressive manner: "Except my brother Xu!"
Chen Qiao turned around and threw a wink to Shi Lian.
The latter opened his mouth in astonishment and was petrified in the same place.
……
……
The results of the colonoscopy came out that day.
In Wang Fan's arrogant expression, clumps of hair were picked out from the feces.
At the same time, there were several unrecognizable tissues.
It looked a bit like meat and a bit like grease, but because it was soaked in feces, Wang Fan was really not in the mood to delve into it.
After the work of removing feces was done, the subsequent research would be left to colleagues in the laboratory and laboratory...
They had to be given the opportunity to show their abilities.
In short, with Wang Fan's discovery, the teratoma was preliminarily diagnosed.
Since there was no abnormality in the previous CT, only PET-CT could be done this time.
The price is very high, more than 8,000 yuan per examination, but it will hardly miss a lesion of teratoma, and even the newly grown small things can be scanned out.
The only disadvantage of expensive things is that they are expensive...
Xu Qiu was busy with the operation, and handed the task of communication to Shi Lian and the others.
"Do you still need to do the examination..." The family members heard the news and opened their mouths, somewhat unwilling to accept this reality.
More than 8,000 yuan...
For ordinary people, this is definitely not a small amount of money.
Especially the patient's family, the two sons are in their forties, with mortgages and car loans, and the youngest daughter is only in her early thirties. She and her husband have a mortgage of more than one million yuan for thirty years...
The 46-year-old eldest son sat in the corner. He subconsciously wanted to take out a cigarette, and then realized that this was a ward, so he could only sniff.
Finally, he knocked on the window, and in the sound of "dong dong dong", the man's low and vicissitudes of life came slowly.
