godfather of surgery

Chapter 1136 Now is not the right time to chat
The results of the genetic test report for the patient in the Department of Neurology have come out. According to the genetic test analysis, this is a hereditary epilepsy and the patient's gene is located on the Y chromosome.

The Y chromosome comes from his father, which means that his father's side also has a similar genetic disease, but according to his father, as far as he can remember, there has never been a case of epilepsy in his family.

The symptoms of epileptic seizures are very typical and easy to identify. If Tong Yongqian's father did not lie, this would be another contradiction.

Since the family’s Y gene carries the disease gene, why are there no cases in the entire family?

There must be something wrong when something is abnormal. Things that violate the laws of physics and logic either mean that there is something wrong with the thing itself, or that the basis for reasoning - the law, has a problem and the law needs to be changed.

Epilepsy, which should have been inherited from the maternal side, is now inherited from the paternal side. This case is like a detective solving a case, full of mysteries.

Although the child's life was saved, the diagnosis has not yet been fully clarified, and the symptoms of epilepsy are still occurring, which shows that epilepsy has nothing to do with infection, or at least the connection is not strong, but there are other reasons.

Just when everyone thought it was a genetic disease, the result satisfied everyone. It was indeed a genetic disease, and the answer was very clear. The genetic gene was on the Y chromosome, and the Y chromosome came from the father, but his genetic disease appeared on the mother's side, which was completely inconsistent with the laws of genetics.

This is biologically unreasonable. What if her mother has the rare XXY chromosome? Generally, XXY chromosomes eventually show male physiological characteristics. Even individuals with androgen deficiency may only have different degrees of feminine secondary sexual characteristics. In this way, if it is male physiological characteristics, how can it be a woman and have children?

This case is quite interesting, so Yang Ping brought it out for discussion to improve everyone's ability to diagnose difficult and complicated diseases. The diagnosis of difficult and complicated diseases actually tests the breadth of knowledge. If one has a broad knowledge base, one can fully cover possible diseases in one's mind every time one diagnoses a disease. In this way, one can start with common diseases, screen them one by one, and naturally end up with rare diseases without missing any.

Once there is a blind spot in knowledge, the correct diagnosis will fall within the diagnostic blind spot and the doctor will not be able to obtain the correct diagnosis no matter what.

Without a correct diagnosis, there can be no correct treatment.

Regarding Tong Yongqian's condition, if Yang Ping and Director Xu had not known about primary amoebic meningitis at the time, the patient would not have been saved.

The conference room of the institute was packed with people, and everyone started to discuss this neurology case. In fact, it is a daily routine for the institute to discuss cases from various departments, because the doctors trained here must have cross-disciplinary knowledge. Many researchers in the laboratory are not clinical doctors, and they are also very interested in coming to listen, expand their knowledge, and try to reduce their blind spots in medical knowledge.

Clinical medicine and basic medicine cooperate to discuss cases together, which is a model that is completely impossible in other hospitals. Now in the conference room, in addition to clinical doctors and laboratory researchers, there are also doctors and masters from Nandu Medical University. Everyone is very active and expresses their opinions. Anyway, they will not be laughed at if they don’t speak well.

"Whether it is a genetic disease or not, and from which side it comes, we can get the answer by testing the genes of his parents. If the cost is a concern, we can do it for them for free," said a doctor from the Genetics Laboratory of Nandu Medical University.

In fact, he is right. It is very simple, but the technical requirements are relatively high. Most people will not do it. Most hospitals do not have laboratories for genetic research and cannot conduct complex and comprehensive genetic testing. Sanbo Hospital relies on the genetics laboratory of Nandu Medical University, which makes it very convenient to carry out genetic testing.

"By the way, we can verify their relationship. If they are not related, the basis for speculation based on genetic pedigree will no longer exist."

Another doctor said.

The prerequisite for inference based on genetic pedigree is that the patient must be related to the people in the genetic pedigree. If there is no real relationship, then the patient is out of genetic relationship and naturally cannot be inferred according to this pedigree.

"It is ethically risky to do this. We don't want to cause a bloodbath because of one case." A researcher in the laboratory expressed his concerns.

Li Guodong, a doctor in the ward, said: "This is not within the scope of our consideration. We are just making a medical diagnosis. This is necessary to clarify the diagnosis."

Xia Shu said: "The current medical model has changed from the biomedical model to the bio-psycho-social medical model. We need to think about problems from the three dimensions of biology, physiology and society, so we must also take into account social ethics. We cannot only look at the problem from a biological perspective. It is best to ask his parents for their opinions on whether to continue the examination. When asking for their opinions, it is best to talk to their parents separately. Only when both parties agree can the test be done. As long as one party disagrees, the test cannot continue, otherwise it will inadvertently cause a family tragedy."

This is indeed a troublesome matter. If we continue to investigate and find out that the child is not his biological child, it will cause great harm to his father. This is something that must be considered.

If we stop here and do not continue to check, the disease that causes his epilepsy will not be diagnosed and he will not be able to get the correct treatment.

"Yes, after all, genetic pedigree is an indirect diagnostic method and cannot directly explain the problem."

"Just like doing scientific research, we have to pay attention to ethical issues, otherwise it's easy to fail."

"I really hope to continue the research. Either there is something wrong with the child's kinship, or some of our basic theories on genetic diseases need to be revised. I really hope it is the latter, so that we may be able to find flaws in the existing theory, improve it, or even discover a new genetic theory."

Everyone is eager to try to figure out the contradictory phenomena in this case and hopes to thoroughly clarify it.

In fact, in scientific research, this kind of curiosity and passion for exploration is very important. Many innovations are based on seizing such subtle anomalies to conduct research and finally achieve results.

After the discussion, Yang Ping told Director Xu of the Department of Neurology the opinions of the institute's discussion. Director Xu also supported further examinations to find out the truth of the matter. Although the symptoms of central nervous system infection have been cured, the symptoms of epilepsy are still there. The frequency of attacks is not as high as before, but it still exists, indicating that the cause of the epilepsy symptoms has not been eliminated.

Director Xu later asked Tong Yongqian's father about it, and he recalled that the epileptic seizure occurred after he was exposed to fresh water in the wild. This medical history is very important, and it directly defines that epilepsy has no direct relationship with amoeba infection, and there are other reasons. It's just that epilepsy and amoeba are mixed together. If you don't understand these logics carefully, it's easy to confuse the two.

Director Xu talked to Tong Yongqian's parents. He accepted Yang Ping's suggestion and talked to them separately instead of together.

Tong Yongqian's father agreed to continue the examination, hoping that further examination could clarify the cause of the epilepsy so that targeted treatment could be provided. After all, the child is only fourteen years old. If the cause is not clarified now and treatment is delayed, it will be too late for regret in the future.

However, Tong Yongqian's mother firmly disagreed with the examination. She initially used the cost as an excuse, but Director Xu told her that the examination could be free. She said she didn't want to go through this anymore and couldn't give a reasonable reason. Even when Director Xu continued to persuade her, she got angry and directly accused Director Xu of messing around and leading them to do some meaningless experimental examinations.

Through the conversation, Director Xu roughly understood what was going on. If she continued investigating, something might really go wrong. She was a doctor, not a detective. Since the family members did not want to be examined, she had to give up.

However, only half of Tong Yongqian's condition has been clarified, and the other half has not been figured out, which may leave hidden dangers. Director Xu asked their parents to sign an informed consent before being discharged from the hospital.

Due to various reasons, this special case was not examined further and only half of the diagnosis was made, which inevitably left some regrets. This forced the neurologist to think about how to describe this case that was only half diagnosed when writing the case report.
-
The sensation caused by the paper published by Sanbo Research Institute has not yet subsided and the popularity remains high.

Sanbo Hospital can only publish an announcement online, claiming that this new tumor treatment method has not yet entered clinical trials, and the specific effect is still unknown. Please do not over-interpret it. As for the case reports in the paper, they are just case reports and have no statistical significance. In addition, the side effects of the new treatment are currently unknown, and laboratory technology is still a long way from clinical application.

After the announcement was released, the number of calls from the institute gradually decreased.

Professor Mannstein, who was far away in Germany, made a breakthrough in his research on spinal cord injury under the guidance of Yang Ping's space theory. Using mice as experiments, he saw under a microscope that a very small number of cross-sections of the spinal cord cut by a sharp knife were filled with original cells, and a very small number of nerve fibers were repaired by original cells.

This is an extremely important discovery. If the research continues and if the experimental results can be expanded and repeated, Professor Mannstein is likely to win a second Nobel Prize. Of course, these two Nobel Prizes need to be shared with Yang Ping because he used Yang Ping's theory.

In the past, Professor Mannstein's research had been stagnant because no matter what he did, he could not succeed within the existing medical theory framework. Later, when Yang Ping published the space-guided gene theory, he suddenly realized and finally found the secret of original cell repair - there is a mysterious power deep in life that can guide cells in specific locations to differentiate into specific types, and the process of cell division and differentiation can be built according to the preset spatial configuration.

This theory is like a beacon in the distance, pointing Mannstein in the right direction.

In the middle of the night, Yang Ping picked up his vibrating cell phone with sleepy eyes. He was worried that it was an emergency surgery. He hadn't performed an emergency surgery for a long time, but his emergency response capabilities were still there.

However, at first glance, it was a call from abroad. I wonder which patient or family member was consulting about K virus treatment. During this period, all their mobile phone numbers had been leaked, and they had not dared to turn on their phones. Only recently, when things got a little better, did everyone dare to turn on their phones.

Yang Ping hung up the phone directly, but the phone was very persistent. It kept calling again and again. In total, Yang Ping hung up more than ten times. Yang Ping simply turned off the phone.

"Why is the phone turned off?"

Professor Mannstein from Germany looked confused. He walked back and forth in the laboratory with his fists clenched. He was so excited.

Even if only a few nerve fibers are repaired, this is a breakthrough from zero. Now it is only a few, but in the future it may be countless.

"No, you must get through on the phone!"

Manstein continued to call Yang Ping, but the phone was turned off, so he started calling Professor Yang in the group.

But Yang Ping’s phone was turned off, so he couldn’t see WeChat at all.

The next morning, Yang Ping turned on his phone and saw hundreds of new messages in the WeChat group. Mannstein was being beaten up in the group.

[Mannstein! What are you crazy about? Do you know what time it is in China now? Why are you arguing with Professor Yang at this time?]

[Even if it's an emergency operation, Professor Yang can't fly over to save the stage now. ]

[If you make any more noise, I'll kick you out. ]

【Did you take the wrong medicine? 】

【Group leader! Kick him. 】

Then a series of red envelopes were thrown out.

【Wait, look at how this guy performs, we should give him a chance to reform. 】

[Yes, we should not judge patients by one blow when treating them. Everyone makes mistakes sometimes.]

[This group is tolerant and should allow for small mistakes made under impulse.]

It turned out that it was Professor Maninstein who called last night. Yang Ping took a look and found that Professor Maninstein had sent many WeChat messages to announce the good news. His experiment had achieved a breakthrough and he saw three nerve fibers that had been successfully repaired by the original cells under a microscope.

He is indeed a scientific research madman. He actually discovered three nerve fibers. Others would not be so careful and would not have such perseverance.

This means that he is one step closer to the success of his crazy head-changing experiment.

Mainstein's head transplant experiment has been ethically banned in many countries, but this guy has always had a special liking for this experiment. The purpose of his research on spinal cord injury is to prepare for his head transplant experiment, and he is going further and further on this path.

"professor!"

Manstein finally dialed Yang Ping's number.

"Your theory of spatially oriented genes is amazing. Under its guidance, my spinal cord research experiment has made a breakthrough. Guess what I saw?"

It’s better not to play this guessing game so early in the morning.

"Just tell me what you saw." Yang Ping was too lazy to argue with him.

"I saw nerve fibers repaired by the original cells, three in total. I really saw it. What filled the port were the original cells arranged in an orderly manner, not various cells that formed scars. They miraculously repaired the broken nerve fibers, professor! I am so excited now. I will not be able to sleep in the next 24 hours, if not 48 hours, or even longer. I have already drunk a few bottles of beer. It's great." Mainstein was obviously not normal now.

"Congratulations, but I have to go to work now." Yang Ping hung up the phone.

Wait until he calms down before talking to him. In his current bad mental state, Mannstein is not suitable for chatting.