I can see the status bar

Chapter 129 Secondment
The one who answered Sun Lien's question was Professor Zhu Minhua who had been eavesdropping from a little distance away.

"There is this equipment in the courtyard." He walked towards Sun Lien and asked curiously, "Do you think it is necessary to use this method now?"

The full name of mNGS is "Metagenome Next Generation Sequencing Technology", which is a relatively cheap, relatively mature and fast detection technology for gene detection.Different from the first-generation technology, mNGS adopts high-throughput inspection technology. Although mNGS produces results much faster than traditional technologies, it still takes more than 24 hours to complete a thorough comparative inspection.And although this set of technology is "relatively cheap", the cost is still frighteningly high.If Lu Xuexin's cerebrospinal fluid sample is used for mNGS testing, the cost of the reagent kit alone will be close to 2 yuan.

But there is a reason why people are expensive.The mNGS technology that can simultaneously detect nearly 7000 viruses, fungi and bacteria in samples is indeed the most direct means to determine Lu Xuexin's cause at present - no pathogens were detected in the smear, which means that the infection of Lu Xuexin's brain is likely to be a kind of Fastidious or unculturable bacteria.It is basically an extravagant hope to perform bacterial culture on the extracted cerebrospinal fluid to determine the pathogen through traditional means.When the broad-spectrum antibacterial drugs meropenem and ceftriaxone are ineffective, mNGS has indeed become the only rapid detection method.

"Even if we arrange for a neurosurgeon to perform a biopsy on the patient's brain abscess and then do bacterial culture, it will take at least three days." Sun Lien explained calmly, "According to the medical history, the patient's brain infection should be It was four days ago. Including the incubation period of the bacteria, it was only five or six days. After these few days, the patient developed from no infection to multiple brain abscesses, and also developed meningitis. The patient's immune system is still suppressed If it drags on for another three days, who knows how far the brain abscess will progress. Even if she survives by chance, serious sequelae are almost inevitable."

Speaking of this, Sun Li'en looked at Lu Xuexin on the bed with some regret, "She is still very young, it would be a pity if the family members cannot afford the inspection fee due to financial problems..."

Zhu Minhua was silent for a while, then suddenly laughed. "It's not without reason that Lao Liu stuffed his successor into your team." He changed from his previous coldness, and a gentle smile appeared on his fair and round face, "The young man's level is not bad."

Yuan Ping'an looked at his mentor, and then at Sun Li'en who was stunned.Also laughed.

"This patient's situation is indeed quite special." Zhu Minhua walked to Lu Xuexin's bed, and gently patted the fence at the foot of the bed, "The symptoms of this encephalitis are also very unique." He glanced at his student Yuan Ping'an said with some dissatisfaction, "Xiao Yuan, I usually tell you to follow up the papers published by other people, you must have not read them, right?"

Yuan Ping'an was a little confused by Zhu Minhua's sudden criticism, but it is true that he was lazy and didn't read the paper during this period of time.He lowered his head and said embarrassedly, "It's really a little short of time."

"Time is tight, you still have time to go out with your girlfriend." Zhu Minhua was amused, he looked at his student with helplessness and sadness. "You kid wants to go to Shenwai. I'm afraid it's not only for the future, but also for Xiaohua, right? Let me tell you, there are strict rules in the hospital that you can't fall in love with her in the same department. If you really want to be with her for a long time , then settle down and work in the emergency department."

Yuan Ping'an was startled at first, then responded with a wry smile.

"There is more." Zhu Minhua nodded again, "You are only 31 years old this year, and you have become the chief resident of our association. This resume is enough for you to be a deputy chief physician in other places."

Listening to Zhu Minhua's words, Sun Li'en suddenly felt something was wrong.

"Did you send your resume to the Fourth Central Hospital last night?" Zhu Minhua asked with a smile.

Yuan Ping'an was really frightened, "Mr. Zhu...I..."

"Someone is watching the network department in our courtyard." Zhu Minhua waved his hand and blocked his explanation. "You use the computer in the courtyard to send your resume, and the people at the Internet Department told me." He turned to Sun Lien and asked with a smile, "Doctor Sun, what do you think of my student?"

Only then did Sun Lien come to his senses. He looked at Yuan Ping'an and was shocked, "You are the fellow doctor who sent your resume?"

Yuan Pingan nodded with a bitter face.In fact, he didn't even think about working under Sun Lien. His purpose of sending his resume was actually to get Sun Lien to contact him, and then he would put on a good show to vent his anger.Who would have thought that Zhu Minhua would find out about his laziness!

"I just heard that Dr. Sun is very good. You should learn more from him." Zhu Minhua didn't wait for Sun Lien's answer. Yuan Pingan has been studying with him for more than eight years.The five-year doctor of clinical medicine plus three-year doctor of scientific research double degree has been obtained.Now is just the best stage for him to improve his clinical experience.

But Yuan Ping'an has always made Zhu Minhua a little dissatisfied, perhaps because Yuan Ping'an studied neurosurgery from undergraduate to postgraduate.His ability to diagnose and deal with emergencies has always been relatively weak.On these issues, Sun Li'en was many times stronger than Yuan Ping'an.With the same information and the same symptoms, Sun Lien can propose a diagnosis and treatment plan that is more suitable for the patient.

Especially when encountering a patient like Lu Xuexin, this shortcoming is even more obvious-in fact, making an accurate diagnosis of Lu Xuexin is more important than taking medication based on experience in advance.This is not because Yuan Ping'an's professional level is poor, but his diagnostic thinking still belongs to the category of specialists.In Zhu Minhua's view, what emergency doctors need to do is to quickly stabilize the patient's vital signs without any medical history, and then quickly diagnose the type of disease the patient may be suffering from based on the symptoms the patient exhibits.Then, with the assistance of a specialist, the patient is treated accordingly.After the situation is basically under control, he will be transferred to a specialized ward for follow-up treatment.This is also the plan advocated by the emergency mode of the Fourth Central Hospital.

It is a pity that under the big tree of the Tongxie, Zhu Minhua knows better than anyone that it is impossible for the Tongxie to change its policy of running a hospital - this policy has lasted for nearly a century, and has led the Tongxie into a World-renowned hospitals and medical universities.Backed by a big tree, although you can enjoy leisurely in the shade, it is really impossible to start a new stove.The prestige of Tongxie and the achievements of Tongxie determine that the emergency department of Tongxie can only be used as a "pretreatment" unit before other specialties.It is simply impossible to turn to dominate the operating mode of the hospital.

Yuan Ping'an needed to change his way of thinking about diagnosis, but Zhu Minhua himself had no good way to do it.It is no problem to let him teach professional knowledge and guide scientific research.But Zhu Minhua asked himself that he didn't have the ability to change the way of thinking of an adult.

That being the case, it is better to let him go to the pilot unit of the large emergency department to try.

In fact, even if Yuan Pingan hadn't sent that resume, Zhu Minhua planned to contact Liu Pingchuan.See if you can send your disciples to Ningyuan Fourth Central Hospital to study.Perhaps under his own watch, Yuan Ping'an's diagnostic flaws wouldn't be such a big problem.But what if he had to go to another hospital?What if you retire?
Yuan Ping'an is a good doctor, but he works very hard.And he's really doctor material, too.Zhu Minhua himself would not be able to forgive himself if he had any problems in his future work because of this defect.

Sun Li'en looked at the pair of master and apprentice, and suddenly felt that he had become Liu Tangchun.After walking around and taking a shower in other people's hospitals, they just hired a hospital manager?When I go back to the hospital, Director Liu might give himself a bonus!

"Mr. Zhu..." Yuan Ping'an also understood Zhu Minhua's meaning, and he asked in shock, "You mean..."

"You should go outside and have a look." Although Zhu Minhua was still smiling, there was an irresistible bleakness in his eyes. "The Fourth Central Hospital is one of the few large emergency pilot hospitals in China. It just so happens that you and Liu Pingchuan still have some unfinished fate, so it's not bad to try it." He patted Sun Lien on the shoulder, "Don't think Xiao Sun is not as good as you at a young age." Zhu Minhua said seriously, "Do you know how you are worse than others?"

Yuan Pingan muttered, "I don't know..." Although he also knew that Sun Lien's diagnosis was better than his own, but as a doctor of Tongxie, and his working years were many years longer than Sun Lien's, the pride in his heart would not fade away in a short while. go down.

"He is still young, has a talent for diagnosis, and his thinking has not yet become a stereotype." Zhu Minhua sighed, "Being a doctor is different from other professions. We need experience, but we also abandon experience. Every patient's situation is different. Similarly, blindly relying on experience will only harm you and the patient in the end.”

Sun Lien's face was almost red from the praise.

"You must have a meticulous logical deduction ability, the clearest overall view, and sufficient professional knowledge in order to become an excellent emergency doctor." Zhu Minhua said earnestly to Yuan Ping'an, "Now you have enough professional knowledge. But the overall situation and logical reasoning ability are not strong enough. Go to the Fourth Central Hospital to have a look, and come back after learning something."

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Regarding Yuan Pingan's personnel secondment and other professional issues, Zhu Minhua patted his chest and said that he could handle it by himself.Afterwards, he left Sun Li'en with a confused face, and Yuan Ping'an with a tangled face.

"Lu Xuexin's mNGS is already in the process. The results are expected to be available tomorrow." Before leaving, Zhu Minhua seemed to want to let Sun Lien not worry. "When the result comes out, I'll ask Xiao Yuan to tell you."

"So... I'm going to follow you in the future?" Yuan Ping'an didn't have much resistance to being seconded to the Fourth Central Hospital, but it happened so suddenly that he still hadn't recovered.

Sun Li'en patted him on the shoulder, "Doctor Yuan, trust me. Over the past few days, I have been more shocked than you."

　Today's second update... Huh, it's really not easy.

　　
　
(End of this chapter)