I can see the status bar

Chapter 1121 Vaping Pneumonia

"He's with you now?" Dr. Pascal was a little surprised after receiving a call from Sun Li'en in Ningyuan.He confirmed to Sun Li'en again, "Bernard Xu, the oncologist at Hopkins Hospital, is he in Yunhe now?"

"To be more precise, he is right next to me now." Sun Li'en said with a smile, "The story here is very exciting. If you want to tell it, it will probably take tens of thousands of words."

"Then don't talk about it." Dr. Pascal said with a smile on the other end of the phone, "Save me some phone bills."

As a joke, the next thing is serious business.Dr. Pascal asked Sun Lien, "I heard...the Infectious Disease Hospital has already done a pathological autopsy?"

"Two cases." Sun Lien corrected, "There was a patient in my ward who failed to be rescued in the afternoon, and her family members agreed to the autopsy request."

"The results of pathological anatomy are very important, especially the results of cell structure damage on lung tissue-this is very likely to reveal the damage model caused by the new coronavirus." Dr. Pascal said seriously, "Since Bernard Now you are also in Yunhe, you can refer to his opinions more. Oncologists themselves also need to have a considerable degree of research on pathology, and his level is definitely acceptable."

After talking a few more words with Sun Lien, Pascal suddenly turned around and asked, "Is Brunn next to you?"

"Yes." Sun Li'en nodded, "What's the matter?"

"You...forget it, I'll talk to him directly." Dr. Pascal sighed, "Please give him the phone number."

When Bruen answered the phone, he said "hmm" a few times, then suddenly frowned and asked, "Are you sure?"

The atmosphere at the whole table was a little bit wrong again.

"Okay, I see." Bruen was silent for a while, handed the hung up phone to Sun Lien, stood up and said, "Sorry, I have to leave first..." He moved his body Walking outside, after taking two steps, he suddenly turned around and said to Bernard who was beside him, "Xu, come here, I have something to tell you."

The two left the restaurant together, Xu Yourong and Sun Li'en looked at each other, not knowing what happened.

"Did I act a little...excessively?" Xu Yourong picked up a piece of chicken again and put it in her mouth to chew. She ate and said to Sun Li'en, "Isn't it going to scare him?"

"It's not enough to be intimidated." Sun Li'en smiled, "But it's a bit embarrassing for sure."

Whether you are a man or a woman, when you find that the current partner of the person you once liked is sitting opposite you, and there is a posture of "I want to see what kind of ivory you can spit out of your mouth", it will be embarrassing. Kind of a little sick.Fortunately, everyone is a civilized person, and there are more urgent and urgent tasks waiting for them-there is really no need for internal strife now, not to mention... From the description, Bernard is still the one who was dumped .A relationship didn't even have a bud, and was trampled to death by Rai Qiu - even if Xu Yourong wanted to be jealous, he couldn't find a suitable entry point.

"So, what do you think of this person?" After joking with Xu Yourong, Sun Lien asked his own question, "Do you feel uncomfortable working with him in the same team?"

The short-term introduction of a newcomer will definitely have an impact on the operation of the original team.Whether the impact is good or bad requires a more detailed analysis.And what Sun Lien is more worried about now is this problem - Xu Yourong is not a person who is particularly good at dealing with interpersonal relationships.At least in his impression, Xu Yourong didn't have this kind of talent.

Not being good at dealing with interpersonal relationships is not a big problem in a department with stable personnel relations.After all, Xu Yourong and the other doctors are basically fine.After getting used to each other, you won't even misunderstand each other's intentions, which will cause trouble.

But Bernard's situation is still different... Although his intentions are noble, he may have some personal grievances with Xu Yourong.Once personal grievances turned into conflicts, it would be troublesome.

So, Sun Lien suddenly asked such a sentence, and at the same time, he also clearly showed his attitude, "If you think there may be problems in cooperating with him, then I will directly refuse him to join, and then let him work in other groups —or just let him volunteer."

"I'm fine." Xu Yourong shook her head and said, "Rachel has dated other people before, both men and women—I'm almost the same." She smiled at Sun Li'en, "We're already married, so before It is not important. As a colleague, I believe that Bernard must have a sufficient professional level, and he will have no problem joining."

"Then I'm relieved." Sun Li'en nodded, and then he showed a "gossip" smile, "You didn't ask Rachel, what's the story between her and Bernard before?"

Xu Yourong took a "unfathomable" look at Sun Lien and asked, "What do you think Rachel looks like? Is she good-looking?"

If Hu Jia was by his side, this might be a proposition.

However, head nurse Hu is currently participating in training in a small conference room. It is said that nursing experts from the National Health and Medical Commission are conducting unified nursing training for nurses across the country.So, now my fiancée is not around.

"It looks good." Since there is no danger of being beaten to death, Sun Li'en can speak the truth boldly.However, while telling the truth, he felt that he also had the responsibility to make this colleague feel at ease, "But it's not my type-it's pretty good-looking."

"That's fine." Xu Yourong didn't make any other comments on Sun Lien's desire to survive, she just spread her hands, "A good-looking person is good-looking, no matter what gender she likes, this is always inevitable .Since it looks good, there must be someone who likes it. This is an objective factor, and it cannot be transferred by people's subjective will."

"I can vaguely feel a hint of imperceptible pride in your tone." Sun Li'en rolled his eyes, "Even if your wife is pretty, you don't need to say so many times, right?"

"Huh?" Xu Yourong looked at Sun Li'en in surprise, "Isn't it the spouse's duty to repeatedly emphasize that his wife is beautiful in front of others?"

"...Let me guess, the one who told you this 'obligation' is Rachel, right?" Sun Lien rubbed his forehead with his hand, "Sister, I'm already eating dinner, so there's no need to stuff dog food into my mouth Yes, really."

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Today's live broadcast started at 08:30 in the evening. Sun Lien, uncharacteristically, came to Brunn's room 10 minutes before the live broadcast.The purpose of coming early is not to confirm the content of the live broadcast with Lao Bu in advance.He planned to come and ask before the live broadcast started, if something happened to Brunn.

The "personality" of Lao Bu is very full.At the same time, he himself is quite "full".This physical "fullness" is absolutely inseparable from Dr. Brun's usual habits.

Bruen is a delicious person, which fundamentally determines that he cannot be a Puritan—after all, he can't bear the days of only drinking water and eating black bread.

Lao Bu's "deliciousness" is also reflected in his respect for food.Even though he was about to throw up after eating elbows, he still insisted that food should be treated as it should be.He would rather donate the food to those in need with his own money than sit by and let it expire and be thrown away.

This kind of Bruen left the restaurant after answering the phone, leaving behind a plate of unfinished dishes—this made Sun Lien very worried.He was worried that something might have happened to Lao Bu.

So, 10 minutes earlier than usual, Sun Lien strolled to Brunn's room and knocked on the door.

The room was still as tidy as ever, and Bruen was used to at least re-laying the sheets and quilts when he woke up.And every time the used teacup is cleaned immediately, the mouth is facing down on the table.

However, when he entered the room, Sun Lien noticed keenly that the cups beside him did not seem to have been cleaned, and they were just placed on the table with their mouths open.

"Are you okay?" Although there was no indication on the status bar, Sun Lien still thought that something was wrong with Old Bu, "I see that you are not feeling well after answering the call from Dr. Pascal."

"I might not be the only one who is not so good." After closing the door, Bruen sat on the bed and rubbed his head in frustration. He said to Sun Lien, "Pascal called me just now, and he said …my nephew was in close contact with a confirmed case of COVID-[-] who was evacuated to Lackland Air Force Base and he was quarantined."

"Your nephew?" Sun Lien was a little surprised, Bruen had never mentioned his family to him.

"He just got vaping pneumonia three months ago." Bruen sighed and said, "This little bastard...he doesn't know how much THC-containing e-liquid can cause serious damage to the lungs." He shook his head helplessly, "Well, the abuse of addictive substances is also a tradition of the Fitzgerald family."

"E-cigarette pneumonia?" Sun Lien had heard of this term. In the fall of last year, a severe pneumonia disease named "EVALI" suddenly broke out inexplicably in the United States.But the disease somehow never broke out outside the United States.

"According to the CDC's research, the possible pathogenic mechanism of e-cigarettes is mainly related to the excess of heavy metals caused by vitamin E acetate, THC, or electric heating in e-cigarettes." Brunn said, "But I always feel that this study There may be something wrong." He scratched his head and said, "Regardless of its specific mechanism, Larry's lungs did suffer severe damage before. Now that he has been in close contact with the confirmed case, I'm really worried about his condition .”

"Relax." Sun Li'en thought for a while and persuaded, "Close contact does not necessarily lead to infection. Although the infectious disease of pneumonia caused by the new coronavirus is highly contagious, it is not 100% contagious." Making Brunn feel a little better, Sun Lien picked up the topic again, "You said that there is a problem with the research on vaping pneumonia... Where is the problem?"

"Neither of these two reasons can explain why vaping pneumonia only occurs in the United States." Brunn said, "More than 95% of e-cigarettes in the United States are produced in China. If the disease is caused by excessive heavy metals, then Last year, China should have found sporadic cases."

Sun Li'en thought for a while, then nodded and said, "This is indeed a bit strange. I see that there are quite a few young people in China who use electronic cigarettes. But I have never heard of similar patients in the Fourth Hospital."

The CT manifestations of vaping pneumonia are very similar to those caused by viral pneumonia.If patients with vaping pneumonia really appeared in China, then the direct reporting system of "pneumonia of unknown cause" that has been proven to be effective again in this Yunhe epidemic will inevitably get news.In other words, there must have been no e-cigarette pneumonia epidemic on a scale similar to that in the United States in China.

"Through the situation in China, we can rule out the possibility of excessive heavy metals in the smoke causing vaping pneumonia." Brunn nodded and said, "Then the only suspects are THC and vitamin E acetate-according to the CDC, These two things should actually be highly correlated.”

Vitamin E acetate is widely found in THC-containing e-juice, and it is essentially a somewhat viscous additive base solvent.Adding vitamin E acetate to THC-containing e-liquid can effectively improve the effect of THC dissolution—while reducing the precipitation of THC, it can also maintain the taste of the smoke.

Such additives are used in a large number of e-cigarette manufacturers in the United States, and vitamin E acetate can be widely seen even in e-cigarettes popular in many European countries.However, Europe has not reported as many vaping pneumonias as the United States - they have only a small number of suspected cases of vaping pneumonia.

As a synthetic addictive substance, THC has a very large number of "user groups" among young Americans.Canada, which has also legalized the use of THC, has no reports of vaping pneumonia.

According to the CDC, vitamin E acetate was detected in 51 samples after alveolar lavage of all 48 patients with e-cigarette pneumonia, and coconut oil and limonene were monitored in the other two cases.Combined with the CT features of vaping pneumonia, it suggests that the lesions are mainly concentrated in the lower part of the lungs, so this strange disease seems to be considered as "aspiration lipid pneumonia".

"And among all the cases of e-cigarette pneumonia, the proportion of gastrointestinal symptoms is frighteningly high, and the diagnostic criteria are also loose." Bruen continued, "If you don't count the cases of loss of appetite, there are almost 11% of them. Patients with vaping pneumonia have diarrhea and abdominal pain. The diagnostic criteria for this disease is that they have used e-cigarettes within 90 days before the onset of the disease, and there is no other reasonable explanation to explain their lung disease symptoms.” He sighed, “Just this Diagnostic criteria, this kind of symptoms...maybe there are patients with pneumonia caused by the new coronavirus among them."

Sun Lien rolled his eyes, "According to Yunhe's ability to spread, if vaping pneumonia is pneumonia caused by the new coronavirus, then the entire United States should be full of infected people by now." Although for Brunn's joke Not very cold, Sun Lien still felt that he had to make it clear to this colleague, "The main users of e-cigarettes and THC are young people, and the main people who get sick are also young people. This is inconsistent with what we observed in Yunhe. .”

"Among the more than 2000 patients with the disease, the oldest was 75 years old." Brunn rolled his eyes and said, "The median age of the disease was 49.1 years old, 52% of the patients who died were obese, and 41% had heart disease. Disease... Isn't this consistent with Yunhe's situation? Patients with underlying diseases have a higher mortality rate."

"Patients with underlying diseases will have a high mortality rate from any disease." Sun Lien spread his hands, "Okay, I want to open up a little bit. Your nephew may not be infected because of close contact. What's more, if vaping pneumonia is really It is caused by the new type of coronavirus, so shouldn’t your nephew already have antibodies? Then his situation is safer, isn’t it?”

"That makes sense." Bruen sighed, then stood up from the bed. He moved his body and said, "Shouldn't it be time to prepare for the live broadcast? You go sit down first, and I'll tidy up a bit. We'll start right away."

(End of this chapter)