Doctor: It's reasonable to perform surgery on yourself.

"Where are the family members?" Xu Qiu stood up and threw the gloves he had just finished the examination into the medical waste bin.

"Here, there!" A woman in her thirties quickly stood up.

She looked a little panicked and her behavior was full of restraint. She was obviously the patient's youngest daughter.

It can be seen that she is well taken care of and is not someone who can take on many tasks.

"Discuss with the family, and if possible, stay in the ICU for two days first." Xu Qiu explained the purpose.

The patient's current condition is quite complex.

In addition to the unexplained cardiac arrest, there were previous problems with liver and kidney function, but the source of the disease has never been found.

However, in the past few weeks, the liver and kidney functions had improved inexplicably. Xu Qiu wanted to investigate, but completely lost the clue.

Now all that's left is cardiac arrest.

Xu Qiu had a hunch that these mysterious symptoms should all come from the same disease.

In addition, the patient also had bradycardia...

Combining various factors, Pang Honggu could only insert a tube and install a temporary pacemaker. No matter what, she could save her life first to avoid the next cardiac arrest.

Even if every time the beating stopped, doctors would come to the rescue in time.

Pang Honggu's body could not withstand so many chest compressions.

For example, just now, Wang Fan broke two of Pang Honggu's ribs.

This is an inevitable side injury of standard cardiopulmonary resuscitation, and even Xu Qiu is no exception.

After being sent to the ICU and intubated, at least you don't have to worry about the patient's heart rate returning to zero.

"Okay...I'll call Big Brother and the others right now!"

Although Pang Honggu's little girl is not very mentally capable, she moves very neatly.

After a while, she called her eldest brother's phone number. The three children discussed in the group and finally agreed to be transferred to the ICU.

Only then did Xu Qiu and others let go of the stone in their hearts.

ICU is not cheap.

The main reason for letting Pang Honggu in is to prevent cardiac arrest. The cost for one day is actually not expensive. It costs a thousand dollars at most, which is incomparable to the tens of thousands or tens of thousands per day for large households.

However, this is a comparison.

Ordinary people, who dares to say that four-digit medical bills a day are cheap?

Therefore, not many people are willing to enter the ICU clinically.

Pang Honggu's family members have such financial strength and cooperate with the treatment without making any noise or fuss. Any doctor would be jealous of the family members of this kind of patient.

"The main reason is Dr. Xu's personal charm..."

"Indeed, if it had been anyone else, the family would have suspected that the doctor had taken thousands of dollars in commission!"

"I have a headache when I say this... This patient's expenses must have exceeded the reimbursement limit of DRGs. I just don't know if it exceeds 20,000 to 30,000 yuan, or 10,000 to 200,000 yuan..."

"Damn DRGs, Ma Pi, luckily I'm in the clinic and our hospital is not short of money, so our wages won't be deducted!"

"Hey, I seem to know why Pang Honggu has been treated in other hospitals for so long!"

"With conservative treatment, it actually doesn't cost a lot of money, and the risk is very low. But when it comes to skin flap transplantation and eradication, the patient has so many underlying diseases, and the risk is so high that even if the gods come, the standard will be exceeded! Other hospitals are not like our clinic. Doctor, if their doctor hires someone to do a skin flap transplant, the doctor will have to cover the excess money himself!”

"Gan, stop talking!"

All the doctors present could see that the reimbursement was unreasonable.

Next year, when authorities discover that almost all hospitals are exceeding the standard, they will naturally raise the upper limit.

…

In the office.

After the examination failed, Xu Qiu returned to the office, opened the medical record interface as a habit, and scanned the inpatients in the department.

Soon, I saw Pang Honggu’s page again.

A "new" prompt popped up.

Xu Qiu was startled... There is a new inspection report!

He quickly opened it.

This is a serum immunological test done last week.

Similar to items such as cerebrospinal fluid culture, comprehensive serum immunology tests are also of a type that cannot be done quickly. It takes about a week to get the results.

Swish——

After the page expanded, Xu Qiu scrolled up and down.

Unsurprisingly, it was full of negative antibodies.

Suddenly, Xu Qiu's fingers froze in mid-air.

He stared at an indicator on the screen.

Anti-NMDAR antibodies: (+)!

Positive!

A little red among the greenery, and among countless negative antibodies, the only positive one was finally found!

Xu Qiu's mind quickly flashed with relevant knowledge about NMDAR...

NMDAR, also known as glutamate receptor.

It is closely related to synaptic plasticity and learning and memory. It is a unique dual-gated channel that is both controlled by membrane potential and can be controlled by other neurotransmitters.

When the receptors function normally, glutamate can be produced in large quantities, and the brain can normally process language, behavior, thinking, learning, memory, etc.

Once a problem occurs, a series of central system diseases may follow.

Neurodegenerative diseases common in the elderly, such as Alzheimer's disease, Parkinson's disease, epilepsy, and even rare multiple sclerosis, are all closely related to glutamate.

Moreover, glutamate receptors are mainly distributed in brain areas such as the hippocampus, prefrontal cortex, amygdala, and hypothalamus, and the autoantibodies they produce are the only specific serotype against NMDAR encephalitis.

Once the anti-NMDAR receptor is positive, the NMDAR content in the body will decrease rapidly, and neurological symptoms will naturally appear.

Xu Qiu's analysis has finally yielded preliminary results.

He leaned back in his chair and continued to ponder.

Now the cause of epilepsy, headache and other symptoms can be found, and they are temporarily classified as the autoimmune brain with anti-NMDAR receptor positive markers.

But the key is where the cardiac arrest came from.

Xu Qiu read the medical records over and over again, but did not find any new clues.

"In addition to cardiac arrest and neurological diseases, there is also acute gastroenteritis..."

However, he prescribed metoclopramide, also known as metoclopramide, to Pang Honggu, and her condition has improved a lot under the treatment of the drug.

In the medical records, Pang Honggu vomited a few times at the beginning and once last week, and she has not vomited at all in the past few days.

As for vomitus...

Xu Qiu carefully checked Shi Lian's records.

In the most recent vomiting, the patient's vomitus was gastric contents, and there was no coffee-colored substance or blood clots, so there was nothing worth paying attention to.

At this moment, he suddenly noticed a note in brackets.

"A small group of hair was found in the vomitus, and pica was ruled out later."

Seeing this, Xu Qiu instinctively skipped it.

After all, it was a ruled out disease.

But his eyes suddenly stopped moving, staring at the "little ball of hair", and fell into deep thought.

If it's not pica, where did the hair come from?

The problem is not to rule out pica, but to find out the source of the hair!

Xu Qiu turned on his mobile phone and sent a message to Shi Lian: "Come to my office."

A few minutes later, Shi Lian appeared at the door of the office in high spirits, her eyes shining, and her face full of expectation.

What's wrong with your expression of "Teacher, please do something to me"?