Shi Hui stood at the door and looked at Zhou Yewu, looked on the left and on the right, and after confirming that there was no one, he slowly pushed Shi Guangyao toward the outpatient room.

"Why are you still in a wheelchair? Can't you still leave when you go down?" Zhou Yewu looked at the wheelchair in Shi Hui's hand and Shi Guangyao who was slightly tired on the wheelchair, feeling a little puzzled.

Could it be that this type of rheumatoid arthritis has worsened on the way to the examination? Has the legs and feet been in trouble?

Shi Hui said helplessly: "There are too many people going downstairs to wait for the examination, and there is no place to rest. When I stand in line to do the examination, my father's legs hurt, and the nurse in the examination room borrowed us a wheelchair."

"How is the situation now?" Zhou Yewu opened the outpatient medical order system again and swiped the citizen card. The unlucky card reader failed to respond after swiping for a long time, and it seemed that there was a malfunction.

He covered his head and cursed in a low voice: "Hey, hell."

If Xu Ruobing comes to the outpatient clinic tomorrow and finds that the card reader is broken, he will not be allowed to compensate him...

However, the compensation can be slow down now, but what should the patient think about it?

Just when he was at a loss, Zhou Yewu saw a place input box on the outpatient system. He had an idea and entered Shi Guangyao's citizen card number. Fortunately, the outpatient system also has this function. You can continue to take the clinic after reading the citizen card number.

"Is it hurt so much?" Zhou Yewu asked.

Shi Guangyao opened his half-closed eyes and shook his head and said, "It's better now, it's so uncomfortable when standing."

"Give me the checklist."

"It's all here."

"It seems that there is no problem for the time being. Don't deal with it first. Take the anti-rheumatism medicine pool for a while before you follow up."

"Is this really OK?"

"Well, from the perspective of the film and symptoms, let's deal with it like this first. The test sheets of rheumatoid factors have not been released. I can only give my own judgment based on joint effusion and bone fragments for the time being."

Zhou Yewu looked at Shi Guangyao, Shi Guangyao nodded, and Shi Hui thanked him again.

I thought it would end like this...

Zhou Yewu wanted to withdraw the citizen card again, but was not ready to settle the bill, so that he could save the two of them a registration fee. Xu Ruobing is the director's account, and the fee is 30 yuan per person, which is still a bit expensive.

At this time, Shi Guangyao suddenly pointed at his legs and said unwillingly: "Why is my legs like this? I remember that my father and mother had this situation before, and they also said it was rheumatism at that time."

"Genetic factors are indeed possible. Epidemiological surveys show that rheumatoid arthritis has a genetic susceptibility." Zhou Yewu said lightly. As he knows, HLS-DRBI, gender genes, globulin genes, TNF-a genes, etc. are related to these diseases.

Shi Guangyao: "Then my parents are almost in their 90s, do they still need treatment?"

Zhou Yewu: "Judge it according to the situation. If the pain is severe, it is naturally necessary to treat it. No matter how old you are, a healthy and comfortable feeling is very important."

Shi Guangyao was a little confused, and he pinched the handle of the wheelchair tightly, and blamed himself: "I am really useless. I can't leave anything for the child, so it will only cause trouble."

The old man's eyes glanced at his daughter Shi Hui from time to time, full of guilt.

"Genetic factors are one of them, and environmental factors are also important reasons, so don't worry." Zhou Yewu suddenly frowned on the face of the girl Chunche, and comforted her.

Hearing that there were other factors that caused rheumatoid arthritis... Shi Guangyao was a little surprised: "Isn't this disease completely genetic?"

Genetics is only an important factor, Zhou Yewu said slowly: "Analyzing the pathogenesis of rheumatoid arthritis, genetics is only part of it. Environmental factors and immune disorders are all possibilities that may lead to rheumatoid arthritis."

“Environmental factors?”

"Yes, although there are currently no direct infectious factors that cause rheumatoid photoarthritis, after research, bacteria, mycoplasma and viruses can activate T and B lymphocytes, secrete inflammatory factors, produce related antibodies, and then lead to the progress of rheumatoid arthritis... Recently, a study is almost about to prove that the relationship between rheumatoid arthritis and EB virus may have an antecedent relationship."

"The EB virus causes my legs and feet to be inflexible now?"

"Well... I have this statement because more than half of the patients with rheumatoid arthritis will produce an antibody called "rheumatoid arthritis precipitin", and this antibody induces a related activation reaction, causing B lymphocytes to be activated, and then the post-IgM rheumatoid factor is produced, leading to a strong reaction."

"What about the immune... factors?"

"This is a key point. Immune disorder is the main pathogenesis of rheumatoid arthritis. After cellular immunity, activated "CD4" T cells and MHC-II-positive antigen presenting cells infiltrate the joint synovial membrane. Then some special antigens in the joint synovial tissue are activated by the antigen presenting cells, activate the immune response and show related arthritis symptoms."

"These things are so complicated, I don't understand them when I hear them."

"Well, it's a bit difficult."

"I used to be a barefoot doctor, and I would give painkillers when I encountered leg pain."

Zhou Yewu looked at Shi Guangyao in surprise, but unexpectedly, he was still a medical practitioner, so he was a little stunned.

He looked at Shi Hui, and Shi Hui smiled and said embarrassedly: "Yes, my father used to be a barefoot doctor, but later he didn't do it and did some small business at home."

"So that's it." Zhou Yewu smiled slightly: "Walk with me, hahaha, in fact, the cause of this rheumatoid arthritis is like rice in a field. How the water bag looks like depends on the seeds used. This seed is a genetic factor. If you make a seed of a super rice, your vitality will be tenacious. In addition to seeds, rice is also the environment. Planting in the fields is much better than on the mountain. This is an environmental factor. As for immune disorders, it is sometimes bitten by insects when the rice grows. If it is often bitten, it will not grow well."

Shi Guangyao understood a little at this moment.

He may not know anything else, but as long as he mentions planting rice, the old man is quite experienced.

In the past, Shi Guangyao had indeed come into contact with rice in the fields and was responsible for growing rice at home to support a family of four.

...

After chatting, Shi Guangyao was a little reluctant to leave the outpatient clinic. Zhou Yewu was always talking about the changes in the medical environment in recent years.

"The current medical environment is much better than before. At that time, when rural children wanted to study medicine, they just rely on apprenticeships, and very few could go to that university."

"Indeed, many old Chinese Chinese practitioners still use the inheritance and apprenticeship model. Western medicine has some Western experience and may think of a more complete education system."
Chapter completed!