I can see the status bar

Chapter 716 AGI
Sun Lien completed a "deal" about the thesis unknowingly. Judging from his behavior alone, he seems to have a little bit of "scholarship" meaning - he can decide a thesis with a few words Who will send it.Of course, in essence, Sun Lien is still far from that situation.

Before going to work the next day, Sun Lien was still thinking about his education in the dormitory.As a doctor, starting a job after graduating from a bachelor's degree basically means declaring that you can only work in a primary hospital or rural health center for the rest of your life.For today's young doctors, as long as they want to make achievements in their careers, a master's degree is the minimum requirement.

Sun Lien is more pragmatic. He chose to take the standardized training of the Fourth Academy right after graduating from his undergraduate course—he was not confident enough in his ability to take the exam.Moreover, during the one-year internship in his senior year, he really lacked enough energy to review for the postgraduate exam.

Sun Lien's original plan should be to earnestly study clinical knowledge during the three years of regular training, and find the most suitable tutor for him during the rotation of departments.But Sun Lien missed one point - the fourth hospital is a training base, yes, but it is also a pilot unit for emergency training.As a pilot unit, the training plan of the Fourth Academy is different.Regardless of whether you are in medicine or surgery, as long as you come to the fourth hospital, you must go to the emergency department for exercise.And it’s not as simple as just one round of training—every regular training student has to enter the emergency department for regular training twice in a three-year rotation career for a total of six months, one emergency rescue and one emergency outpatient.

After Sun Lien entered the fourth hospital's internal medicine training list as No.1 in internal medicine, he realized why most of the young doctors who came to take the fourth hospital's regular training were more... crooked.A total of half a year of emergency training is enough to persuade many medical students who are afraid of hardship and fatigue.

And after three months of regular training, Sun Lien got the ability blessing of the status bar as soon as he woke up.However, it was not because of this that he strengthened his determination to continue to do clinical work in the emergency department—Sun Lien was able to persist in doing emergency clinics because he was favored by Liu Tangchun.

After pondering this, Sun Li'en finally understood what Cao Yanhua meant by "having resources".How many regular trainees in the world can be remembered by the director of the emergency department in the third month of regular training?Moreover, he could become the deputy head of a diagnostic team in the first year of getting his medical license... This kind of thing is probably only in online novels in the whole world.

The reputation of the Fourth Hospital and Sun Lien in diagnosis has gradually begun to expand to other provinces.Takeda Pharmaceutical is still making continuous efforts to promote the Zhou Xiufang Comprehensive Diagnostic Center as an important development direction in the future.From this point of view, Sun Lien's resources are really not comparable to that of ordinary deputy high officials or even directors.

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"Lien, come to my office at noon today." After thinking calmly, Sun Lien realized that he already had a strong background and received a call from Liu Tangchun in the office.Liu Tangchun on the other end of the phone didn't exchange much greetings, he just told Sun Lien in a very normal tone, "Let's have dinner together at noon."

I don't know if I want to eat Vice President Liu's special claypot rice.Sun Li'en was a little bit guilty about this, but he quickly promised himself that he would arrive at Liu Tangchun's office on time.

No way, no way...Yesterday Brother Cao just talked to me about getting a doctorate. This time, Teacher Liu really wants to ask me to go to the office?Sun Lien felt itchy in his heart. If Liu Tangchun really wanted him to study for a Ph. D., then Sun Lien would naturally be willing to do so.A doctoral degree will be of great benefit to his future career, Sun Lien is very clear about this.

But that was later, at least after noon.Sun Li'en drank two glasses of ice water to suppress his restless heart.The top priority now is to treat people well.

This morning, Sun Li'en still had half of the emergency outpatient visits, and depending on the time, it happened to be the time when the outpatient clinics had not yet started and the ICU rounds began.Sun Lien decided to go to the ICU first to see how the unlucky ghost who fell from the roof of Sun City was doing.

As soon as he changed his clothes and entered the ICU, Sun Lien heard a burst of chaos.Surrounding a hospital bed were seven or eight doctors with stern faces.Sun Lien's heart suddenly "thumped"—this situation is not good, and this hospital bed...isn't this the one that Zhang Junyi's is closest to the doctor's office and the nurse's station?
After getting a little closer, Sun Lien confirmed through the status bar that Zhang Junyi was indeed lying on the bed dying.And the status bar also explained to Sun Lien earlier than other ICU doctors what happened now.

There are three states above Zhang Junyi's head that are particularly noticeable. One is the "acute gastrointestinal injury" that has occurred for about a day and the "sepsis" that has occurred for a short time. The latest state makes the doctors so nervous The direct cause of "disseminated intravascular coagulation".

Acute gastrointestinal injury, abbreviated as AGI.It is a severe symptom that often appears after critical illness and is a component of multiple organ dysfunction syndrome (MODS).It can also be a serious consequence of diseases of the gastrointestinal mucosa and the digestive system itself.All in all, acute GI injury is probably one of the most serious digestive disorders that can occur in humans.

The interior of the intestine is originally an organ with a very sufficient blood supply, and the tolerance of the small intestinal villi and mucosa to severe infection and tissue ischemia and hypoxia is also very poor.As one of the earliest and most severely affected organs, when a patient is in a critical condition, due to factors including insufficient blood supply, inflammatory response, and vascular function involvement, the patient's intestine may experience extensive intestinal mucosal damage or even necrosis.After this part of the tissue is damaged, the most direct consequence is the translocation of the intestinal flora, which leads to enterogenous infection and enterogenous sepsis.

The alcohol-rich contents of the digestive tract in Zhang Junyi's body undoubtedly exacerbated the extent of this injury.After most of his liver was removed, his body's ability to process various wastes was greatly reduced, which also increased the load on other organs in the body.

From the perspective of time alone, Zhang Junyi's acute gastrointestinal injury should be the aggravation of symptoms, but after careful consideration, Sun Lien thinks that the liver injury is probably the cause of the current mods, and the real trigger factor that leads to the mods... ...I'm afraid it really was the acute gastrointestinal injury in the first place.

Acute gastrointestinal injury often occurs in an instant. Due to the body's self-protection mechanism, Zhang Junyi's body actively constricted the blood vessels of most organs after hemorrhage, trying to maintain the blood supply of some key nodes and organs as much as possible.At the moment when the body makes this self-protection mechanism, the occurrence of acute gastrointestinal injury has already been determined.

The doctors of the Fourth Hospital did not fail to think of the occurrence of acute gastrointestinal injury, and they made a very predictable decision to use opioid analgesics on Zhang Junyi with caution.But this decision alone is not enough to prevent further deterioration of AGI.In fact, the current AGI classification of Zhang Junyi in the Department of Critical Care Medicine is only level three.When MODS occurs, patients who are determined to have AGI should be immediately reclassified as the most severe grade [-] and treated with emergency surgery as soon as possible.

But...Compared with surgical treatment of acute gastrointestinal injury, Zhang Junyi's situation is now more critical.

After acute gastrointestinal injury, Zhang Junyi's intestinal flora shifted.Large numbers of Escherichia coli, Proteus, and Klebsiella pneumoniae migrated from the rectum and colon into the small intestine.A large number of bacteria grow and reproduce rapidly here, and enter blood vessels through the damaged mucous membrane.The infection began to spread in Zhang Junyi's body, causing severe sepsis.

The endotoxin of sepsis and the tumor necrosis factor TNF released by the damaged body of sepsis work together in blood vessels to induce macrophages and endothelial cells to start releasing tissue factor.This action activates the extrinsic coagulation pathway.Factor XII activated by endotoxin also activates the intrinsic coagulation pathway.Under the combined action of the two pathways, disseminated intravascular coagulation is finally triggered.

What's worse, because a large part of his liver was removed, Zhang Junyi couldn't produce enough coagulation substances in his body.So DIC has almost just appeared, and has already entered the terminal stage.

The speed at which sepsis developed in his body was simply too fast.Although the doctors in the ICU were monitoring Zhang Junyi closely enough, it was far from enough in the face of this rate of deterioration.They were still paying more attention to the injuries of other organs in Zhang Junyi's body and the symptoms of the central nervous system.They didn't catch the signs early enough to intervene.Now... Zhang Junyi's DIC has almost entered the terminal stage.

A large amount of low-molecular-weight heparin sodium was injected into Zhang Junyi's body through the intravenous channel, but his body had already become a water balloon that was roughly sewn up.Blood began to flow out from various sutured wounds on his body, and the pressurized infusion of blood products had reached a horrifying level—eight nurses were squeezing the blood bags in their hands with all their strength, but the monitor on Zhang Junyi was still on. Constantly calling the police - his heart rate has risen to 165 times, but his blood pressure is only 90/45mmHg.

There were too many injuries on Zhang Junyi's body, and the biochemical magicians of the intensive care medicine department had exhausted all their means.But...they still couldn't stop Zhang Junyi from being dragged into the gate of hell again.

Twenty-four minutes after Sun Lien entered the ICU, the doctors stopped their rescue efforts.

"At 27:[-] in the morning, he was declared dead." The doctor on duty in the ICU looked at the wall clock in the ward, and sighed as he raised his gloved hands, which were already limp and trembling, and stained with dark red blood.

(End of this chapter)