I can see the status bar

Chapter 270 Actors
The speed of doing GBM testing depends on the inspection method.To be honest, there are really not many hospitals that can do GBM antibody testing, and even fewer hospitals can do the more advanced colloidal gold method.The Fourth Central Hospital can only do it - check antibodies through immunofluorescence technology.It takes half a day from the delivery of the specimen to the result of the test.

The result of kidney biopsy is much faster-it mainly depends on how long it takes for the pathologists to recognize what the specimen is.

Doctors in the pathology department have always called themselves "doctors among doctors". Whether it is internal medicine or surgery, the diagnosis of many diseases depends on their observation and judgment under a microscope.If someone can tell what kind of animal a hair belongs to by a single hair, then this person must be a pathologist.

This time, this group of doctors who like to find evidence under the microscope found a very disappointing result. "Crescents were formed in 50% of the samples, and immunoglobulin G was deposited linearly along the glomerular capillary loops under the electron microscope."

The crescent is a crescent-shaped body formed around the capillary plexus by the significant proliferation of epithelial cells in the wall layer of the glomerulus and accumulation into layers.It usually means that the kidneys have been severely damaged.The loop-like deposition of immunoglobulin G proved Sun Lien's guess—this is a typical case of pulmonary hemorrhage-nephritic syndrome.

Pulmonary hemorrhage-nephritic syndrome itself is extremely difficult to be diagnosed initially.Basically all pulmonary hemorrhage-nephritic syndrome will be misdiagnosed as other diseases at the first diagnosis.Two or three days after the patient was admitted to the hospital, the symptomatic treatment did not improve, and the doctors began to suspect pulmonary hemorrhage-nephritic syndrome.

Not because of how difficult the disease is to diagnose—a kidney biopsy can almost certainly diagnose about 80% of cases of pulmonary hemorrhage-nephritic syndrome.The main reason is that the incidence of the disease itself is not high, and the symptoms of patients are too similar to diseases such as tuberculosis, idiopathic pulmonary hemosiderosis, polyarteritis nodosa, and systemic lupus erythematosus.Moreover, the disease progresses rapidly and the prognosis is poor. Many patients may not even be found out the cause of the disease until they die.However, limited by the domestic environment, most of the family members of patients will not choose autopsy to clarify the cause of the disease when they are patients.So it's hard to tell what the true incidence is.

Because the condition is too featureless, and the process is very vicious, this also leads to many times, the doctor has no time to consider other possibilities, and has to face the fact that the patient died.In fact, even Zhou Jun, Xu Yourong, Zhou Ce, Yuan Ping'an, and even Dr. Pascal almost fell into this trap - before the results came out, they still insisted that Wang Lin's main problem was infection.

Sun Lien was happy for 2 minutes just now, and then suddenly realized a bigger problem.

Wang Lin's status column clearly stated that he had Staphylococcus aureus infection.

For pulmonary hemorrhage-nephritic syndrome, patients need to receive high-dose glucocorticoid shocks, combined with immunosuppressants and plasma exchange, in order to effectively relieve symptoms and prolong life.But the treatment simply added fuel to the fire for the infection.Staphylococcus aureus infection can cause very serious diseases, ranging from lung abscess, sepsis to systemic multi-organ failure. If the bacterial infection is not suppressed with antibiotics immediately, Wang Lin's death is only a matter of time.

But for the treatment of infection, it means that no immunosuppressive action can be performed.Otherwise, antibiotics will not only fail to exert their due effect, but may continue to aggravate the original kidney damage due to nephrotoxicity or hepatotoxicity.

It was another dilemma, and Sun Lien grabbed his hair in pain.The most troublesome thing is that the culture results of the lung lavage fluid have not yet come out, and now only he knows that Wang Lin also has Staphylococcus aureus infection.

You can't treat it based on this result alone, you must wait until the culture of the lavage fluid is done.Sun Lien made a decision.

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"Staphylococcus aureus infection?" In the laboratory, Zhao Jianguo put down the newspaper in his hand and looked out from above his glasses.The laboratory doctor holding the examination report at the door nodded, "It's the examination request from Dr. Sun Lien from the emergency department."

Upon hearing the words Sun Lien, Zhao Jianguo frowned.He took off the reading glasses on his face, pondered for a moment and said, "Give me a copy of all the examination results and information of this patient."

The laboratory doctor was taken aback for a moment, then nodded.When he turned around and was about to walk out of Zhao Jianguo's office, Zhao Jianguo spoke again behind him. "Give him back the test results in two hours."

After about 20 minutes, all the inspection results of Wang Lin appeared on Zhao Jianguo's desk.He picked up the report and read it roughly, then suddenly stopped at the results of the kidney biopsy.The expression on his face was very complicated, ranging from shock to confusion and a hint of jealousy.

"Pulmonary hemorrhage-nephritic syndrome was diagnosed at the first diagnosis, and Staphylococcus aureus infection was also cultured?" He muttered to himself, then shook his head with a smile, "I don't know if he was lucky or Bad luck." Zhao Jianguo's plan is very simple, after the doctor confirms the type of the patient's disease, he will directly start deciding on the treatment.For pulmonary hemorrhage-nephritic syndrome, the most mainstream and most effective treatment plan is immunosuppression and high-dose corticosteroid shock combined with blood replacement.But as long as Sun Lien dared to use these treatments, the patient would definitely die.Without the control of the immune system, the Staphylococcus aureus that had infected Wang Lin's lungs would kill him in the shortest possible time.

Obviously, the laboratory has been asked to carry out bacterial culture, but before the results came out, it was switched to immunosuppressive treatment.This definitely qualifies as malpractice—the doctor failed to avoid a risk that had been foreseen.Based on this alone, as long as the patient dies and he instigates the family members to sue, he, Zhao Jianguo, will be able to throw Sun Lien into the [-]th hell without even getting his hands dirty, and he will never be able to recover.

If it was placed half a month ago, he would definitely have done this.Just because Sun Lien instigated Liu Pingchuan to conflict with him, Zhao Jianguo was determined to kill Sun Lien.One item of the laboratory is his independent kingdom, and it is absolutely not acceptable for someone to act wildly in one-third of an acre of land—even if it is the vice president who comes to act wildly.Can't deal with Liu Pingchuan, if he doesn't suppress Sun Lien, how can he continue to maintain his position in the examination department?

But this half month is different.Kobayashi Feng of Takeda Pharmaceutical entrusted several relationships and hired Zhao Jianguo's son and daughter-in-law into the company.There is basically no need to do anything every month, and the two can get a salary of about 600 million yen.Of course, such a generous remuneration is not for nothing. Xiao Linfeng directly stated that Zhao Jianguo should provide all of Sun Lien's examination and diagnosis records, and he must provide "the most exciting ones".

Xiao Linfeng is probably planning to praise Sun Lien.Take this young and promising little doctor to a high position, and then wave the flag for Takeda.This is Zhao Jianguo's final judgment on Xiao Linfeng's series of actions.He also had to admit that Xiao Linfeng had really good eyesight.In the past half a month, Sun Lien has diagnosed many difficult patients in succession.This time it was even more extraordinary, he even made the first diagnosis of pulmonary hemorrhage-nephritic syndrome.

Zhao Jianguo's heart was actually very contradictory, and he was really happy if he really wanted to punish Sun Li'en.But the job that the son and daughter-in-law just got will definitely be ruined.But if you follow Xiao Linfeng's baton around, and when Sun Lien really gains a foothold, who knows if he will turn around and find trouble for himself?

After pondering for a while, Zhao Jianguo sighed and decided to go to Sun Li'en himself.In case he starts immunosuppressive treatment, I can use this report to sell him a "concealed report" favor.If not, then just use this report to show your importance to the emergency department.You can get both ways, advance and retreat.That's what Zhao Jianguo's old fritters are planning.

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"The blood routine report an hour ago has made it very clear that the HB (hemoglobin) is 55g/L, and we have already transfused eight units of suspended red blood cells to him. If it continues, he will die!" Yuan Pingan said at the meeting The room turned towards Sun Lien urgently, "The test results have confirmed your guess, it is indeed pulmonary hemorrhage-nephritic syndrome. Why not treat it immediately?"

"The patient's WBC (white blood cell) count is also increasing, reaching 11.4×10^9 cells/L." Sun Lien is still trying to convince Yuan Pingan, "He probably has other problems. At present, the most likely Sex is contagious."

Dr. Pascale is also against immediate immunosuppressive therapy, "Patients with autoimmune diseases may have ANGA (anti-neutrophil antibodies) in their blood and, although very uncommon, are , It may also cause ANGA to be produced in the patient. That is to say, the level of white blood cells in his body may be higher than the data we have seen. Before the results of the lung lavage fluid test come out, I also recommend postponing immunosuppressive treatment. It was worth the wait."

Zhou Jun sat on the stool and sighed. He said seriously to Sun Lien, "If you are free recently, you should really find some temple to worship. The incidence rate of one in a million can be encountered by you. With such good luck, why don’t you go to buy a lottery ticket?”

"The odds of winning a lottery are 140 in 21 and 20. Judging from the numbers, it is at least [-] times harder than this patient." Xu Yourong was reading a paper, and after hearing Zhou Jun's words, she added without changing her expression. Go in, "When Dr. Sun encounters this patient [-] times, he should buy a lottery ticket."

Sun Li'en was meowed by these big bosses, and he didn't dare to say a single unnecessary word.Anyway, as long as you don't give Wang Lin glucocorticoids, Sun Li'en will admit it even if you piss him off for another two hours-the existence value of Dr. Guipei is to pretend that his grandson is pissed off by the superior doctor.It's also a good deal to save a life while performing normal duties.

The door of the conference room was suddenly pushed open, and a middle-aged man who looked quite energetic came in from the door. He looked around nervously, and opened his mouth to ask, "Has Wang Lin's treatment started?"

(End of this chapter)