These young people in the classroom are elites among young doctors from all over the world, otherwise they would not have been sent to Seattle to attend this grand event. Most of them have just entered the clinical stage for not many years and lack clinical experience, but have a very good knowledge reserve. The so-called newborn calf, this asymmetry between experience and theoretical knowledge, has brought them to a stage where their self-confidence is extremely inflated.

If these doctors had not experienced the first two levels, these doctors would not take Qi Jing's words seriously.

However, now, Qi Jing has established some prestige, and Coent has also affirmed his ideas before. So even if this sentence is just spoken, it is impossible to say that it is completely unacceptable.

What does "spy" mean?

Does it refer to the patient's past history or the revolving infections he is suffering from? What has this spy done to the patient's body? Did it induce the attack direction of bacteria and viruses, or is it raging in the patient's body?

"Spy means..." Qi Jing shook his head and said with a smile, "Actually, I can't say it right now."

"Can't say it? I thought you already had the answer..." Beth thought Qi Jing had found the truth earlier than him, but after hearing what he said, he sighed: Fortunately, there is still a chance.

"Then you always have a target of doubt, right?"

Qi Jing continued to shake his head: "Not yet."

"There is always evidence of suspicion?"

"I'm really embarrassed." Qi Jing smiled, "No."

......

This guy is really guessing?

The doctors here fell into deep thought, without doubting the target and without evidence, and even dared to say something illusory in front of Coent. This is a venue for discussion on critical cases, and it is not a place where gamblers can make their whole body guesses their size.

Coenter didn't care much.

He came here for a discussion meeting to listen to other opinions. No matter what the content is, he just needs to have some connection with the patient. Qi Jing's words did bring some different ideas to Coent, but they were just a way of thinking and were not of great use for the time being.

Moreover, clinicians are always the first priority for patients.

It is necessary to find the mastermind behind the scenes, but it is also important to keep the front line. Instead of taking the diseased command, the front battlefield was directly destroyed. This practice of both sides injuring and exchanging positions is meaningless.

"Soy-sauce-colored breast fluid is really rare."

"I have never seen it before, but some clues can be seen from the urine." Beth explained, "There are some hemolytic factors for the broad bean disease, rhabdomyolysis, and the paroxysmal sleep hemoglobinuria that Mr. Qi had previously added. They all had a certain degree of hemolytic factors that destroyed red blood cells and released the hemoglobin in it."

"These hemoglobins are oxidized to n-ferrohemoglobin, the most common of which are burgundy and soy sauce."

It is not easy to tell the reason for the color of soy sauce. Beth's level is obviously higher than that of others. It's just that there are many bacteria that can cause hemolysis, but few can reach this level.

"Is there a large area of ​​hemolysis around the lungs?"

"It may not be the hemolysis caused by the current situation..." Beth suddenly thought of something and guessed, "If the patient had had adhesions and pleural effusions in the lungs under the dual effects of flu pneumonia and Creber pneumonia, the patient's lungs would have been developed long ago. This puncture might have only drained out old bloody pleural effusions."

Everyone nodded after hearing this.

What Beth said is not common, but she has a doubt, and she has a reasonable and well-founded statement. The content is completely in line with the actual situation of the patient. If Qi Jing said just now, this long paragraph may have changed.

"You mean that pleural effusion and pneumonia are completely unrelated events. We also had this kind of consideration at the beginning." Coenter affirmed her courage to imagine, but immediately shook her head and told the truth. "After discovering pleural effusion, he was given a drainage tube, and then this liquid was flowing out. The color did not fade, nor did the amount."

If it is an old injury, the pleural effusion will be transient and the amount will not be much. If the amount is sufficient and there is still persistence, it means that the source of the pleural effusion is the current infection stake.

Speaking of soy sauce color, a bacteria popped up in Qi Jing's mind.

If we look at the normal infection immunity model, this bacteria should never appear on the patient. But if we add a feature that is equally impossible to appear in the previous one, the two will be combined into one, and the whole thing will make sense.

“Can you really erase the memory?”

Qi Jing said to himself inexplicably, making Xu Jiakang beside him very embarrassed.

This master's graduate who entered the third level with the prompts of his peers has gradually been unable to keep up with the rhythm from purple urine bag syndrome. It is really because the patient's condition is too long and complicated, not only clinical, but also in the literature.

"What does erasing memory mean?" Xu Jiakang asked Qi Jing with a smile, but he did not expect him to give him an answer.

Qi Jing didn't leave him alone.

The answer still needs some verification and cannot be explained clearly for the time being, but the prompt can be said a few more words: "You can't follow the course of the disease that the old man said. It's useless to use one's brain. If you want to make a reasonable diagnosis, you can only give up the treatment process temporarily."

"What else can I discuss without discussing treatment for infection cases? And no matter what, symptomatic treatment is always the top priority."

"This is a case discussion, and we are not his responsible doctor." Qi Jing explained, "Instead of keeping a close eye on how to correct the infection that is happening in the patient's body, it is better to jump out of the entire course of the disease. We must consider it from the overall perspective and pick up the details that have passed and sort it out."

“Overall? Details?”

Xu Jiakang didn't know what he meant, so he just said his feelings: "Overall, the patient is spending constant infection and cure, and he feels that the vaccine has not played any role in him."

"What do you think is the key?"

Xu Jiakang shook his head. In his eyes, every infection is an independent individual and has no special features. If you have to say something in common, it is a vaccine. Whether it is yellow fever or influenza, the vaccine injected into the patient's body seems to have evaporated directly, leaving no trace.

It is actually not easy to figure this out. Thinking deeper is a blind spot in knowledge and it will not be published in the literature until more than ten years later.

It seems that the patient's condition is very complicated, and Coent also made a detailed division of the progress of the condition.

However, as long as you dig deep into the patient's initial cause, the entire course of the disease is actually not complicated. According to Qi Jing's judgment, the course of the disease can be divided into three sections, but the division point is completely different from what Coent said.

The first paragraph is from the injection of the yellow fever vaccine to the infection before yellow fever, and the second paragraph is from the beginning of the yellow fever infection to the end of the viral encephalitis, and the third paragraph after the encephalitis is cured.

The key point of the entire course of the disease was that viral encephalitis.
Chapter completed!