I can see the status bar

Chapter 1021 D+3 day (5)

Plasma from convalescents is of course a very precious thing at this point in time.The number of recovered patients is not large, and most of them are middle-aged and elderly people with underlying diseases-even if they are fully recovered and discharged from the hospital, plasma cannot be collected.

What's more troublesome is that it has been stipulated in the third trial version that those patients who have no upper respiratory symptoms and whose lung lesions have been greatly absorbed are now not directly regarded as clinical recovery.They also need to undergo at least two nucleic acid tests, and the dates of the two nucleic acid tests need to be separated by at least one day.

Such regulations are naturally to prevent patients who have not completely turned negative from being released from the hospital as recovered and causing new transmission.But it also objectively reduces the number of recovered patients.

Plasma from convalescents... It's really hard to get it now.

"Dean Zhang arranged for two freezers to be brought up today." After listening to Sun Lien's uninspiring explanation, Li Chengping neither expressed his agreement nor made a mockery.He just pointed in the direction of the Red Zone office and said, "I heard from Dean Zhang that there are 12 medicines for you here."

"Okay, okay." Sun Lien was overjoyed, and he grabbed Professor Li Chengping who was about to leave the cabin, "Mr. Li, you really have to do me a favor this time."

"What are you doing?" Li Chengping instinctively felt that something was wrong, but Sun Li'en, a young man... was too clever in catching the old master, so he just said a word, and stopped Li Chengping's attempt to slip away.

"I submitted a report to the Health and Medical Commission here, and I want to try tocilizumab on some patients to contain the immune storm." Sun Lien pretended to be mysterious and said in a low voice, "But I am a little uncertain about the choice of this patient. Teacher Li, please give it to the staff."

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For these elderly old teachers and doctors, the meaning of work has already surpassed their salary level.Doctors who are still working in the front line at an advanced age, and will come to Yunhe as "firefighters" in times of crisis, regardless of personal gains or losses, mainly to realize their personal value.

It would be even better if he could leave a name in the history of medicine along the way of realizing his personal value.Even if the name tag might just be an "acknowledgment" on a paper, that's fine.

Li Chengping was tricked by Sun Lien with just one word.As a veteran respiratory physician who has been working for more than 30 years and almost 40 years, what Professor Li values ​​most is "seriousness".You must be serious in academics, serious in teaching, and even more serious in clinical work.Knowing every patient in detail is the working principle he set for himself.

Such a work attitude has brought a lot of trouble and work pressure to Comrade Lao Li.Fortunately, he has been here for decades, and now he is not allowed to see patient cases, but he feels unhappy.

In the words of the graduate students in the Department of Respiratory Medicine of Ningyuan Medical College, Mr. Li is a strange old man with a particularly stubborn temper.Usually, he is smiling and has no airs. Not to mention the young mind, he also likes to hang out with young people.But as soon as he came to a field related to his major, Teacher Li became the most ferocious old man in the world.When the old man asked questions, as long as the students could be stopped by him within three sentences, Comrade Li would just bark his teeth and gnaw the students alive.

Such a person, after being fooled by Sun Lien, became the best staff member - he knew the changes in the vital signs of the patients like the palm of his hand, and among the 48 patients, whose condition had deteriorated rapidly recently and whose condition had gradually stabilized, Li Chengping felt the same in his heart. Like a mirror.

"I suggest to grab three beds, grab six beds, use tocilizumab for 11 beds, and 35 beds, and consider using recovery serum for one of them." Li Chengping said after thinking for a few seconds, "Tocilizumab Monoclonal antibody is a specific interleukin-6 (IL-6) receptor monoclonal antibody, which should have a very good blocking effect on the immune storm caused by interleukin-6. Therefore, first of all, it should be considered for those who have recently developed obvious interleukin-6 [-] increased patient use."

The reason for not using tocilizumab for patients who have maintained high levels of interleukin-6 for a long time is simple. It takes a process to induce an immune storm in the human body.It is generally believed that interleukin-6 is a very important mediator of immune storm induction, but the evil wind of immune storm is not just a simple interleukin-6.A variety of immune cells in the human body will be involved, and they will all become part of this storm.

In other words, the effect of using tocilizumab should be better in the process of patients just showing an increase in interleukin-6.For patients who have not yet experienced elevated interleukin-6, the use of tocilizumab should also have a certain preventive effect.

But for patients who have already developed an immune storm, the use of tocilizumab does not seem to have such a good effect.After all, from a mechanism point of view, the best way to curb the immune storm at this time should be plasma replacement and high-dose hormone shock.Instead of trying to rely on tocilizumab to block an important induction medium that triggers the immune storm.

"It's not impossible to give sympathetic medication to other serious patients." It seems that because of the hesitation in Sun Lien's eyes, Professor Li Chengping added, "However, my personal suggestion is to use the medication on other patients to see the effect. At least the 11th and 35th beds are not in good condition, and I think they may be transferred to severe cases at any time."

"Understood." After discussing with Li Chengping for about half an hour, Sun Lien made a decision, "I'm going to communicate with the patient... and the patient's family members, and I will start treatment immediately after obtaining their consent."

As an innovative over-the-range drug, the use of tocilizumab in order to block the immune storm is a treatment option with certain risks.Although it is a special period now, Sun Lien and all the medical staff of the medical team who came to support them are theoretically practicing in different places in violation of discipline.To put it bluntly, the previous relevant regulations are basically half-effective in the current Yunhe.

But Sun Lien insisted that to use this therapy, at least the patients and their families must be informed first and their consent must be obtained.

The seemingly cumbersome rules and regulations are not only used to protect the rights and interests of patients.At the same time, they are also an important line of defense to protect doctors.

Even under the banner of "to save patients' lives", the rights of patients as a "person" must be respected.In clinical work, the most direct manifestation of this right lies in whether patients can decide which treatment plan to use.

For example, refuse to use tocilizumab.

(End of this chapter)