I can see the status bar

Chapter 1108 For Coming (Blood Donation Plus Series 079, 080)

本章是为了感谢书友“李氏乐官”和书友“c299792458”在2021年4月28日和2021年4月2日所捐献的全血而加更。

"Under the premise of an inflammatory storm, I strongly oppose your idea." Dr. Pascale said after pondering for a moment, "The top priority now is to calm the inflammatory storm in the patient's body as soon as possible."

Using immune-boosting drugs like Thymopentin during an inflammatory storm is murdering the patient.If it were someone else, Dr. Pascal might have started cursing.But Sun Lien's situation is different - he is good at dealing with diseases that lack a systematic diagnosis and treatment plan.

Obviously, the current situation is that Sun Lien has a patient with a new type of coronavirus infection on hand, and in order to deal with the virus, he must stimulate the patient's immune system.

But the immune system is firing on all cylinders in the wrong circumstances—otherwise there would be no such thing as an inflammatory storm.If Sun Li'en hadn't been embarrassed to a certain extent, he would never have thought of giving immune-enhancing drugs to patients with inflammatory storms.

"The inflammatory storm needs to be suppressed immediately. In comparison, the damage caused by the virus is much slower." Dr. Pascal said seriously, "Virus damage means lung damage. Carry out lung transplantation. But the immune storm will damage the patient's systemic organs in a short period of time, even including the systemic blood vessels. At that time, there will be multiple blood clots, and it will be impossible to save them."

As an expert in the field of immunology, Dr. Pascale has a subconscious habit.When any patient comes to him for consultation, the first question that Pascal is most concerned about is always "whether the injury involves blood vessels".

Regardless of the immune system disorder, involvement of blood vessels means a poor prognosis.After all, such damage means that the immune system disorder in the patient's body has reached a very serious level.Vascular damage, like nervous system damage, is irreversible.

Damage to the lining of blood vessels does not repair, it just persists and causes hemodynamic abnormalities.It is like a stone suddenly appearing in a flowing river-all kinds of silt will accumulate around the stone and cause problems such as sediment deposition.And when this "damage" is reflected in blood vessels, it will manifest as arterial plaque or thrombus.

When the smooth inner wall of blood vessels is damaged, there is no other way to reduce the probability of thrombus or plaque except for continuous use of anticoagulant drugs and blood lipid-lowering drugs.And even if the corresponding drugs are used, there is still no guarantee that the patient will not have an abnormal blood vessel-it can only reduce the risk, but it is impossible to guarantee that it will not happen.

For doctors in the Department of Immunology and Rheumatology, the most terrible damage caused by the immune system is the damage of blood vessels and nerves.Nerve damage directly affects the patient's quality of life and cannot be repaired.Vascular damage is also irreparable and will continue to threaten the patient's life for the rest of his life.

"You also said that the patient has a history of coronary heart disease." Dr. Pascal tried to persuade Sun Lien on the phone, "Now it is imperative to calm down her immune system immediately. If the active level of the immune system continues to be stimulated, her blood vessels will be damaged. It is very likely to cause a second or even a third myocardial infarction in a short period of time."

Sun Lien sighed, "Understood." He still asked a little unwillingly, "Is there any way to use monoclonal antibody drugs like tocilizumab to suppress her immune system first, and then continue to use other immune systems?" Stimulus package?"

"The immune system is the most complex and elusive system in the human body." Dr. Pascal said helplessly, "My research is in this direction, but I must admit that until now, I still have nothing about the response of the immune system." We know. We have observed some responses of the immune system, but what mechanism is the source of such a response, and how to control the mechanism... This is still a fog. Precise regulation of the immune system has always been the direction of our industry's efforts , but... this direction is still far from seeing the dawn."

"Understood." Sun Li'en sighed and hung up the phone. He didn't expect to find any miraculous treatment plan from Pascal.After all, tocilizumab can already be regarded as a stroke of genius, and one cannot greedily pray for miracles to happen twice at the same time.

Sun Lien sent the content of the discussion to Professor Li Chengping who was on duty, and expressed his thoughts, "I personally think that the plan to control blood pressure and blood lipids has positive significance, and we should consider the treatment plan after the lung damage exceeds the control level— — Lung transplantation should be a viable option.”

"I will discuss the lung transplant plan with the experts of the medical team in eastern Zhejiang, but organ transplantation requires not only a high enough level, but also some good luck." Professor Li Chengping replied with a voice, in which Sun Lien could clearly hear Li Chengping’s voice was also a little tired when he came out, “Let’s prepare for the worst, but don’t give up our efforts. I’m going to restart the hormones for the first bed. Plasma exchange can’t be done anymore. Finally, there is some plasma from convalescents. One more replacement and it’s all gone.”

"You bother." Sun Li'en replied, then thought for a while and added, "Let's think of a way. If it doesn't work, please ask a higher-level consultation to try again."

In fact, there is no other use for higher-level consultations.Sun Li'en was very sure of this - Sister Pan's situation was actually not complicated, it was just that her illness was too long and too serious.Experts from all over the country gather in Yunhe, and as long as you apply for a consultation, you will definitely be able to get expert discussions.But this discussion... is unlikely to lead anywhere else.

"Whether it's useful or not...you have to walk three times if you can't get through." Sun Lien sighed, filled out the consultation application form, and sent it to Song Wen. "President Song, I am applying for a high-level consultation here, please arrange it."

"Understood." Song Wen quickly returned a message to Sun Lien, "I will arrange it until tomorrow morning, and I will tell you as soon as I have a conclusion."

After sending the news, Sun Lien leaned against the wall of the corridor to take a break, but unexpectedly, a reporter carrying a camera suddenly appeared in front of Sun Lien.

"Doctor Sun, we took a picture of the discussion meeting just now, is it convenient for you to talk to us now?" The reporter who is in charge of carrying the camera is the one I saw in the reaction force just now, please ask Sun Lien to take one more when he usually goes to work Choreographer for Action Camera Replacement.And the other... Sun Li'en was a little distorted when he saw the other person's face.

Isn't this the reporter sister who sent herself to the provincial station before!

"It doesn't seem too good for me to say that I don't have time, right?" Sun Li'en asked after a wry smile, "I just have one request—you can use the material you took, and can you stop showing my face? On TV?"

"I've let it go once before." The reporter's sister asked with some confusion, "Do you have any dissatisfaction, Dr. Sun?"

I'm not too happy with you guys putting me on TV.It's okay for Sun Li'en to think about this kind of thing, but it is absolutely impossible to say it.However, after using the status bar for so many years, apart from being more familiar with the diagnostic ability and the treatment of various sub-specialties, Sun Lien's biggest improvement is his ability to "talk nonsense".

If he was asked to make up a nonsense on the spot when he was still in school, Sun Li'en would be so blushing that he would not be able to say a word for a long time.But now, without any hesitation, he pointed to the pimples on his face that had been repeatedly rubbed by wearing an N95 mask and said, "This kind of scene is not beautiful, and the family members are more likely to worry." He looked at the reporter seriously. Dao, "I can also understand the professional ethics requirements of the media teachers to catch the news, but...can we all understand each other? I have no problem accepting interviews, but if I want to appear on camera...or should I just forget it?"

Better not be on TV for the rest of your life!Sun Li'en roared in his heart, but still maintained a polite smile on the surface, "I'm really afraid that my family will be worried after seeing me like this on TV."

The reporter sister and the editor-director brother who was carrying the camera looked at each other, then nodded, "No problem, let's use Dr. Sun's voice as a narration, is that okay?"

"It's no problem." Sun Li'en breathed a sigh of relief, as long as he doesn't go on TV, he can do two somersaults on the spot - of course, he doesn't make a guarantee that he won't turn over.

"We noticed something when we were listening to the consultation meeting just now." The sister of the reporter asked holding the microphone, "Is the case discussed in the consultation our Yunhe medical staff?"

"Yes." Sun Li'en nodded heavily, "Although I can't tell you which hospital she is from, what I can tell you is that she is a nurse in the emergency department. He is one of the health care workers most at risk of infection in Crane Medical System.

"Is...is she seriously ill? How many medical staff are infected in our Yunhe?" The reporter's sister hesitated and asked, "Do you know this data, Director Sun?"

"She is receiving ECMO life support treatment." Sun Lien replied, "If the illness is not serious, then we will not use the last resort. As for the number of infections among medical staff you mentioned, I don't have this data, and I don't know the data. There are no estimates for your reference..." He paused and said, "But I have seen two infected medical staff, one is the case we consulted today. The other...he is our cloud The dean of the Crane Hospital. I only found out about this situation during the consultation."

"What is our current consultation standard? Will the medical staff get the consultation first?" The reporter continued to ask, "Or is it that everyone is queuing up and whose turn is it?"

"We will first try to solve the cases within the medical team. But the new coronavirus is a pathogen that we have never encountered before, and we are not very familiar with the symptoms and consequences it causes. So when we encounter difficulties Cases, critically ill patients and dead patients, we will discuss and study the cases. It is not that medical staff can get preferential treatment, but because of the status of medical staff, we often have no way to focus on treat."

Sun Li'en sighed and talked about Liu Lianzhi's story. Of course, he omitted Liu Lianzhi's personal information.

"The dean is first and foremost a doctor who took the lead. But he was also unfortunately infected with this disease." Sun Li'en sighed, "We have used almost all means to save this great doctor. This includes the current The 'antiviral solution' with the highest probability of being effective at the stage - plasma from convalescents."

"However, the effect of convalescent plasma is not good. This may be because the antibody titer in the patient who donated the plasma is not very high." Sun Li'en said this, and his tone suddenly trembled uncontrollably.A strong feeling of sadness and grievance suddenly surged up from his heart, causing his voice to choke.

"If it is an ordinary patient, we will continue to apply for convalescent plasma without hesitation until the patient is cured-life does not distinguish between high and low, and our current treatment only depends on who needs it more. But because he is a medical staff, Because he is the dean, the treatment team dare not apply for plasma anymore..." Sun Lien was silent for a long time and then sighed, "I can understand the reasons for other doctors' hesitation, but I really can't convince myself to give life to me. High or low. At least he should get the same treatment as other patients, at least... he should be able to apply for another plasma, right?"

The sister of the reporter was silent for a long time, and then said, "I also think... there should be no specialization because of the status of the patient. Whether it is special preferential treatment or special 'rearring', it is not fair enough." She gave Handed Sun Lien a facial tissue, and after Sun Lien's mood stabilized for a while, he asked, "Dr. Sun, if you feel uncomfortable, then our interview can be suspended..."

"Forget it, I'm fine." Sun Li'en shook his head and said, "It's just that the pressure has been a little bit lately, and these patients are not in good condition, so I was a little excited for a while..." He looked at the patient with some embarrassment The sister of the reporter asked, "How about I answer the question just now again? You probably won't be able to use this answer."

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Back in his room at night, Sun Li'en looked at the night sky outside the window, and his mood calmed down a little.

The future is hard to predict, so don't bother trying to predict the future.Sun Lien benefited a lot from Professor Wu's slap in the face.Being a doctor is like this. Although it is a matter of life and death, you can't take these things too seriously when you are resting.

If you can't effectively distinguish your working state from your resting state, then this doctor will definitely not be able to work for too long - if you think about work even when you are resting, your energy will be completely exhausted soon .The special nature of the profession of doctors determines that if doctors lose their love and enthusiasm, ordinary work will instantly become unbearable torture.

Better rest is for better work.And efficient work is precisely to be able to rest at ease.

　The chapter name is correct

　　
　
(End of this chapter)