ALL NOVEL I can see the status bar
Chapter 32 Cushing's Syndrome
Chapter 32 Cushing's Syndrome
It's not because the mother is so strong that she looks tall in Sun Li'en's eyes - Shen Qingmei is indeed a tall and strong woman.
I didn't have much impression of Sun Li'en when I met Sun Lien a few times before, but now I look carefully, Shen Qingmei, who is at least 1.7 meters five, is indeed tall - she is even half a head taller than Director Liu.
"Wait a minute." Sun Lien stopped Shen Qingmei who was about to leave.
Shen Qingmei wiped her tears, "What else?"
"This..." Sun Lien organized his words, "How tall is your husband?"
"1.8 meters eight." Shen Qingmei asked in confusion, "Why do you ask this suddenly?"
"Director Liu, I know what Chen Wen's illness is!" Sun Lien rushed into the emergency room, and he shouted excitedly to Liu Tangchun.The sound was so loud that it attracted the attention of many medical staff around.
"Oh? Tell me." Liu Tangchun smiled.The scene of the excited young doctor raising his hands and shouting "I got it" excitedly is really contagious.
"It wasn't warfarin that caused Chen Wen's skin damage and necrosis, but her hypercalcemia." Sun Lien seemed to have a thousand words but didn't know where to start. He explained incoherently, "Her blood clots, her mental symptoms, even obesity and developmental retardation...Chen Wen is less than 1.4 meters tall now, and these all make sense!"
"So?" Liu Tangchun asked, "What's your diagnosis?"
"She has Cushing's syndrome, and her body has been secreting excessive hormones!" Sun Lien pointed to Chen Wen who was lying on the bed, "There is no need for gangrene resection, as long as the high blood calcium and high hormone levels in her body are corrected." Already!"
Liu Tangchun listened carefully to Sun Lien's explanation, nodded with a smile, and then shook his head. "Blood tests don't suggest her high hormone levels. And Cushing's syndrome doesn't lead to a hypercalcemic state. She doesn't have central obesity, she doesn't have the typical buffalo hump, and your diagnosis is weak."
"The high hormone level caused by Cushing's syndrome is periodic. We took Chen Wen's blood test when she was just admitted to the hospital. Without continuous monitoring, it is easy to miss her high hormone level period." Sun Lien explained, He saw Chen Wen lying on the hospital bed, and saw the newly added "high corticotropic hormone" status in her status bar. "Children with Cushing's syndrome do not necessarily have central obesity, but also developmental delay and general obesity. As long as her high hormone levels are resolved, she will recover!"
"At least one blood test is needed to confirm that she does have symptoms of high hormone levels." Liu Tangchun thought for a while, but still shook his head and said, "The traditional high-dose dexamethasone test takes two days, and she can't wait that long. I guess In two hours at most, her gangrene would break through the abdominal wall. Blood tests to detect hypercalcemia were too late."
"If it's Cushing's syndrome, she can still be saved. If it's not Cushing's syndrome, she will still face life-threatening after we remove her breast tissue." Dr. Cao Yanhua, who treated Chen Wen, also agreed with Sun Lien's opinion. View. "Xiao Sun's view on the state of hypercalcemia is reasonable. I think at least calcitonin can be considered."
"If Cushing's syndrome has not been diagnosed, it cannot be treated according to Cushing's. This is a matter of principle." Liu Tangchun still insisted and refused to give in. "Diagnostic treatment is strictly limited, and children with Cushing's syndrome are definitely not one of them. Just because there is no evidence It is even more unacceptable to treat it as a rare disease without a diagnosis. Before there is no solid evidence, I cannot agree to this kind of treatment.”
"Then give her an MRI." Sun Lien made a decisive decision, "This is not a treatment, nor is it an invasive examination. It's just an MRI, right?"
"You're really dizzy." Liu Tangchun finally couldn't help but reprimanded in a low voice, "What are you going to use MRI for? Check her blood calcium index, or check her hormone level?"
"I'm going to use MRI to find the culprit of Cushing's syndrome." Sun Lien said to Liu Tangchun without flinching, "As long as the tumor is found, Cushing's syndrome can be confirmed."
Liu Tangchun was silent.Dr. Cao Yanhua and Sun Lien stood together, waiting for the final verdict.
"Go ahead." Liu Tangchun nodded. "I hope you're right."
After entering the monitoring room with Sun Li'en and others, Brother Luo sat down in the chair. "Xiao Sun, you sit too, do you want to drink Coke?"
The MRI monitoring room is probably the most comfortable place in a hospital.There is a separate bathroom, a department-specific refrigerator, a sofa, and even a small second floor with two single beds for the video dogs on duty to take a nap at night.
With the Ice Coke in his hand, Sun Lien didn't rush to unscrew the lid, but sat in front of the monitor impatiently, "Brother Luo, saving a life is like putting out a fire, hurry up."
"I also want to go faster." Luo Ge pressed a few buttons, leaned back on the chair behind him, and said helplessly, "But this is the fastest speed now. MRI won't kick it twice because of you." It's going to be faster."
Sun Li'en unscrewed the Coke and took a sip of the carbonated drink.The urgency seemed to be calmed down by the cold and stimulating liquid. "Start from the head and sweep her pituitary gland."
In fact, the "high corticotropic hormone" displayed in the status bar has directly and unmistakably explained the location of Chen Wen's lesion.She should have a tumor on her pituitary gland.
High adrenocorticotropic hormone, the English abbreviation is "ACTH".Secreted by the pituitary gland.As the name suggests, it directly acts on the adrenal glands of the human body, leading to the proliferation of adrenal glands on both sides and triggering a large amount of cortisol secretion.Its abnormal secretion is the main cause of Cushing's syndrome.
The excessive secretion of ACTH can only be caused by abnormalities in the pituitary gland.Although increased ACTH is also an important manifestation of primary adrenergic insufficiency, Chen Wen's symptoms are clearly not consistent with this disease.Therefore, Sun Li'en dared to challenge Director Liu directly, insisting that Chen Wen suffered from Cushing's syndrome.
Since it was suspected that there was a lesion in the pituitary gland, Luo Ge naturally chose the MRI scanning procedure specifically for the sella region of the brain.The scanning layer thickness is specially adjusted to the standard of 1mm.
"Found it." The nuclear magnetic resonance machine made all kinds of strange roars, and ten minutes later, Luo Ge shouted excitedly from the monitoring room.He grabbed Sun Lien who was relaxed, and while shaking Sun Lien, he said excitedly, "You are amazing!" He ignored the Coke in Sun Lien's hand and scattered it all over the floor.
"I'll arrange surgery right away." Sun Li'en also smiled, and Chen Wen finally escaped the fate of mastectomy.
Finally solved the first case.My current mood is more exciting than Luo Ge who saw the tumor.
(End of this chapter)
It's not because the mother is so strong that she looks tall in Sun Li'en's eyes - Shen Qingmei is indeed a tall and strong woman.
I didn't have much impression of Sun Li'en when I met Sun Lien a few times before, but now I look carefully, Shen Qingmei, who is at least 1.7 meters five, is indeed tall - she is even half a head taller than Director Liu.
"Wait a minute." Sun Lien stopped Shen Qingmei who was about to leave.
Shen Qingmei wiped her tears, "What else?"
"This..." Sun Lien organized his words, "How tall is your husband?"
"1.8 meters eight." Shen Qingmei asked in confusion, "Why do you ask this suddenly?"
"Director Liu, I know what Chen Wen's illness is!" Sun Lien rushed into the emergency room, and he shouted excitedly to Liu Tangchun.The sound was so loud that it attracted the attention of many medical staff around.
"Oh? Tell me." Liu Tangchun smiled.The scene of the excited young doctor raising his hands and shouting "I got it" excitedly is really contagious.
"It wasn't warfarin that caused Chen Wen's skin damage and necrosis, but her hypercalcemia." Sun Lien seemed to have a thousand words but didn't know where to start. He explained incoherently, "Her blood clots, her mental symptoms, even obesity and developmental retardation...Chen Wen is less than 1.4 meters tall now, and these all make sense!"
"So?" Liu Tangchun asked, "What's your diagnosis?"
"She has Cushing's syndrome, and her body has been secreting excessive hormones!" Sun Lien pointed to Chen Wen who was lying on the bed, "There is no need for gangrene resection, as long as the high blood calcium and high hormone levels in her body are corrected." Already!"
Liu Tangchun listened carefully to Sun Lien's explanation, nodded with a smile, and then shook his head. "Blood tests don't suggest her high hormone levels. And Cushing's syndrome doesn't lead to a hypercalcemic state. She doesn't have central obesity, she doesn't have the typical buffalo hump, and your diagnosis is weak."
"The high hormone level caused by Cushing's syndrome is periodic. We took Chen Wen's blood test when she was just admitted to the hospital. Without continuous monitoring, it is easy to miss her high hormone level period." Sun Lien explained, He saw Chen Wen lying on the hospital bed, and saw the newly added "high corticotropic hormone" status in her status bar. "Children with Cushing's syndrome do not necessarily have central obesity, but also developmental delay and general obesity. As long as her high hormone levels are resolved, she will recover!"
"At least one blood test is needed to confirm that she does have symptoms of high hormone levels." Liu Tangchun thought for a while, but still shook his head and said, "The traditional high-dose dexamethasone test takes two days, and she can't wait that long. I guess In two hours at most, her gangrene would break through the abdominal wall. Blood tests to detect hypercalcemia were too late."
"If it's Cushing's syndrome, she can still be saved. If it's not Cushing's syndrome, she will still face life-threatening after we remove her breast tissue." Dr. Cao Yanhua, who treated Chen Wen, also agreed with Sun Lien's opinion. View. "Xiao Sun's view on the state of hypercalcemia is reasonable. I think at least calcitonin can be considered."
"If Cushing's syndrome has not been diagnosed, it cannot be treated according to Cushing's. This is a matter of principle." Liu Tangchun still insisted and refused to give in. "Diagnostic treatment is strictly limited, and children with Cushing's syndrome are definitely not one of them. Just because there is no evidence It is even more unacceptable to treat it as a rare disease without a diagnosis. Before there is no solid evidence, I cannot agree to this kind of treatment.”
"Then give her an MRI." Sun Lien made a decisive decision, "This is not a treatment, nor is it an invasive examination. It's just an MRI, right?"
"You're really dizzy." Liu Tangchun finally couldn't help but reprimanded in a low voice, "What are you going to use MRI for? Check her blood calcium index, or check her hormone level?"
"I'm going to use MRI to find the culprit of Cushing's syndrome." Sun Lien said to Liu Tangchun without flinching, "As long as the tumor is found, Cushing's syndrome can be confirmed."
Liu Tangchun was silent.Dr. Cao Yanhua and Sun Lien stood together, waiting for the final verdict.
"Go ahead." Liu Tangchun nodded. "I hope you're right."
After entering the monitoring room with Sun Li'en and others, Brother Luo sat down in the chair. "Xiao Sun, you sit too, do you want to drink Coke?"
The MRI monitoring room is probably the most comfortable place in a hospital.There is a separate bathroom, a department-specific refrigerator, a sofa, and even a small second floor with two single beds for the video dogs on duty to take a nap at night.
With the Ice Coke in his hand, Sun Lien didn't rush to unscrew the lid, but sat in front of the monitor impatiently, "Brother Luo, saving a life is like putting out a fire, hurry up."
"I also want to go faster." Luo Ge pressed a few buttons, leaned back on the chair behind him, and said helplessly, "But this is the fastest speed now. MRI won't kick it twice because of you." It's going to be faster."
Sun Li'en unscrewed the Coke and took a sip of the carbonated drink.The urgency seemed to be calmed down by the cold and stimulating liquid. "Start from the head and sweep her pituitary gland."
In fact, the "high corticotropic hormone" displayed in the status bar has directly and unmistakably explained the location of Chen Wen's lesion.She should have a tumor on her pituitary gland.
High adrenocorticotropic hormone, the English abbreviation is "ACTH".Secreted by the pituitary gland.As the name suggests, it directly acts on the adrenal glands of the human body, leading to the proliferation of adrenal glands on both sides and triggering a large amount of cortisol secretion.Its abnormal secretion is the main cause of Cushing's syndrome.
The excessive secretion of ACTH can only be caused by abnormalities in the pituitary gland.Although increased ACTH is also an important manifestation of primary adrenergic insufficiency, Chen Wen's symptoms are clearly not consistent with this disease.Therefore, Sun Li'en dared to challenge Director Liu directly, insisting that Chen Wen suffered from Cushing's syndrome.
Since it was suspected that there was a lesion in the pituitary gland, Luo Ge naturally chose the MRI scanning procedure specifically for the sella region of the brain.The scanning layer thickness is specially adjusted to the standard of 1mm.
"Found it." The nuclear magnetic resonance machine made all kinds of strange roars, and ten minutes later, Luo Ge shouted excitedly from the monitoring room.He grabbed Sun Lien who was relaxed, and while shaking Sun Lien, he said excitedly, "You are amazing!" He ignored the Coke in Sun Lien's hand and scattered it all over the floor.
"I'll arrange surgery right away." Sun Li'en also smiled, and Chen Wen finally escaped the fate of mastectomy.
Finally solved the first case.My current mood is more exciting than Luo Ge who saw the tumor.
(End of this chapter)
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