I can see the status bar

Chapter 524

The ideas are different, but at least the means at the beginning are the same.Before the patient came to the fourth hospital together with other materials, none of Sun Lien and others could figure out what went wrong with the patient.

"After the person arrives, I'll take him to do an MRI." Xu Yourong took the initiative to accompany him for the examination, which was rare, "Do you want to come, Dr. Sun?"

Sun Li'en thought for a while and shook his head, "I'm going to go to the pharmacy department again." He stretched, and took another sip of black coffee by the way.

Xu Yourong was taken aback when he heard the words, and quickly looked down to find the case report, "Has Qian Aiwu's condition repeated?"

"Ah?" Sun Lien was also a little confused by Xu Yourong's reaction, and after a few seconds he realized where Xu Yourong made a mistake, "No, no, I want to ask about phenobarbital and Zoyla Mechanism of action of racetam."

"You want to rule out the cause through this, don't you?" Xu Yourong suddenly realized, and then stopped looking for information, "I thought something was wrong with Qian Aiwu again."

Qian Aiwu is now the most concerned object of all the doctors in the comprehensive diagnosis center.The reason is also very simple - in various senses, her situation is even more pitiful than that of Xiao Yanran.The pain caused by disease is already the simplest and easiest injury.Her pair of sons and daughters are overly beautified by describing them as "turning against each other" - one of their eyeballs has been lost, which can be summed up by "turning against each other"!

Qian Aiwu's mood is very low every day, and he even eats a lot less than normal needs.In order for her to recover as soon as possible and to allow her to consume enough calories and protein, Bruen had to prescribe a nutritional solution for her again as a supplement.With previous experience this time, Brunn at least knows to record the total amount of food Qian Aiwu eats every day, and then ask the nutrition department to calculate the total amount of nutrients and calories that need to be supplemented at around [-] pm.

Although she was awake, the difficulty of nursing and follow-up treatment was no less difficult than when she was in a coma.

"A doctor from the psychology department will come over this afternoon to do a pre-evaluation." Zhou Ce reminded from the side, "According to the results of the evaluation, she may be given medication or psychological intervention."

"It's best not to take medicine." Sun Li'en scratched his head, "It's antibiotics and nutrient solution, plus psychotropic drugs... God knows if there will be any weird drug reactions."

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"The mechanism of action of these two drugs is still unclear. There are two popular hypotheses for phenobarbital - but there is still a lack of conclusive evidence. As for levetiracetam, in addition to knowing its molecular form and mainstream antiepileptic drugs There is not even a relatively convincing hypothesis except that the medicines are different." Han Wenping sat in the office with a tea set in front of him, and he pushed a cup of tea to Sun Lien, "Why did you suddenly remember to ask this? "

"Ah?" Sun Li'en was very disappointed. He still wanted to infer the condition of Shen Xi's cousin through these two ineffective antiepileptic drugs. "There is a case that will be sent to our department in the afternoon for examination and treatment. I will preview it in advance."

"Preview?" Han Wenping was thoughtful, "This patient doesn't respond to phenobarbital and levetiracetam?"

"Yes." Sun Li'en nodded, took a sip of the tea in the cup, the taste was not bad, and the tea tasted a unique fragrance, "His epilepsy is still very stubborn, and one side of his limbs is numb - the range of numbness is still extending."

Han Wen calmly listened to Sun Lien's general description of the case. He tapped on the table lightly, muttered something to himself, and then said to Sun Lien, "Have you heard about the two mechanism hypotheses of phenobarbital?" Is it?"

Sun Li'en shook his head honestly, if he had known about it, he wouldn't have come directly to the pharmacy department for advice, "I just saw the case and found that the patient's epilepsy symptoms were unusual, so I hurried to ask first. "

Another main reason why Sun Lien was a little nervous about this case was the dosage of the medicine.The Second Hospital has thought of many ways to suppress Shen Xi's cousin's seizures, and the dosage of phenobarbital and levetiracetam has approached the upper limit prescribed by the Pharmacopoeia.He had encountered this familiar feeling before—Gao Yan, a patient with acute methamphetamine poisoning with grass-green urine, had shown a similar situation after being admitted to the hospital.

Gao Yan did not undergo an autopsy later, and the exact type of nerve damage he suffered is unclear.But the kind of epilepsy that cannot be suppressed by drugs is really impressive.

"There are two hypotheses on the mechanism of action of phenobarbital. One is to act on the GABA receptor on the post-synaptic membrane to prolong the opening time of the Cl- channel, which leads to the hyperpolarization of the nerve cell membrane and reduces its excitability; the other It acts on the presynaptic membrane, reduces the permeability of the presynaptic membrane to Ca2+, and reduces the release of Ca2+-dependent neurotransmitters (NA, Ach, glutamate, etc.)." Han Wenping continued to serve tea to Sun Lien , continued, "Let us first assume that one of these two hypotheses is correct."

Sun Li'en nodded. The presynaptic membrane or the post-synaptic membrane are the main structures for nerve cells to receive and transmit nerve impulses.Neurotransmitter disruption, or blockade, of these two structures in order to stop abnormal firing of nerve cells in a certain area could of course have the effect of suppressing epilepsy.

"If phenobarbital is ineffective, it means that the abnormal discharge may not be caused by abnormal nerve impulses." Han Wenping took a sip of tea and thought thoughtfully, "It is not because of receiving or transmitting wrong nerve impulses." Impulsive, but for other reasons."

"It's not a problem with neurotransmitters, nor is it a problem with ion channels." Sun Li'en followed Han Wenping's train of thought and speculated, "In other words, it is possible that the epilepsy is caused by glial cell abnormalities?"

"It's possible. Of course, it's just a possibility." Han Wenping nodded, "For details, you still have to ask a doctor in Shennei for consultation. After all, our inference is only based on the existing mechanism of action of phenobarbital." There is a basis for one of the conjectures to be correct. If your inspection results overturn these two conjectures, then you can publish another article with five or six points."

In China, doctors always have such a "bad habit". Every time they make a new discovery, everyone's first reaction is to ask "how can this thing post an article?" Ponder "What is the clinical significance of this finding?"

There is no way, everyone is an occupational disease patient forced out by this current system.

"I see." Sun Li'en nodded. After Director Han's analysis, he had some guesses about Shen Xi's cousin's condition. "After the patient arrives, I'll see if I need to arrange a consultation." He stood up Come on, and said with a smile, "Director Han, thanks to your help this time. I'll treat you to dinner later."

"Bring me to dinner? Okay." Han Wenping laughed, "But I have to call someone by name to let you find someone to accompany you—the boy named Luo from the Imaging Department who had dinner with you last time is in your comprehensive diagnostic center now, right?"

Sun Li'en nodded, and then he was a little puzzled, "You want to take Brother Luo with you?"

"Yeah." Han Wenping nodded, "Director Wei recently had a project to cooperate with a manufacturer in Japan. He wanted to recruit a doctoral student to focus on this project... After dinner last time, he felt that your department That Ronaldinho in the movie is not bad."

(End of this chapter)