I can see the status bar

Chapter 750 Perfect Plan
On the other side, in the Zhou Xiufang Diagnostic Center, Sun Lien was having a somewhat difficult conversation.

"According to the evidence we have so far, as well as the evidence from the gene sequencing examination..." Sun Lien found two MRI images of Tang Min's brain from the information package on the side, and put them on the reading box, then turned around Lai said to Tang Min's parents, "We believe that Tang Min suffers from a... genetic disease. According to our investigation, there is no precedent for this disease to be discovered and diagnosed in the world."

This is very desperate news, especially for Tang Min's parents.There is no precedent for discovery and diagnosis, and the most direct manifestation is that there must be no mature treatment plan.And what's even more desperate is that they can't even judge how serious the disease is.

"We have already started contacting domestic experts." Sun Lien tried his best to appease Tang Min's parents. From a personal point of view, Sun Lien certainly hoped to give the child's family a real good news, but... as a doctor, he must Communicate the real situation to the family members of the children, so that they can have an overall understanding of the real situation. "There is already a relatively preliminary treatment plan, but because of the lack of precedent, we feel that we should consult other experts."

"Can...can she be cured?" At the end of the day, the parents were actually concerned about this one thing, "She will be fine in the future? Can...can you let her see things again?"

"It's hard to say about the problem of eyesight now." Sun Li'en thought for a while and replied, "But it's not completely hopeless." He said seriously, "But one thing is for sure-this kind of genetic disease is generally incurable. In the end The good situation is that Tang Min will be sent back to the hospital for another treatment every once in a while. Through treatment, her condition can be maintained at a level that is not life-threatening or even affects her life much."

Genetic diseases cannot be cured, which is determined by the genetic defect of the patient.The only thing doctors can do is to relieve symptoms.But fortunately, Tang Min's symptoms are not very severe and fatal. After her symptoms are relieved, she is likely to recover to a fairly good level.

But this is just Sun Lien's speculation, and it is still unfounded.At this time, one must not talk nonsense—in case such false hopes are given to others, but the reality cruelly shatters the hope...afterwards, medical troubles will be considered minor.

"What's the treatment plan? Surgery?" Tang Min's mother asked in a low voice. She lowered her head, looked at the facial tissue that had been crumpled into confetti by her hands, and said, "My baby has had three surgeries... Going down...it's too sinful."

A seven-year-old girl had three surgeries on her head.This appearance really made Sun Lien feel distressed.He could fully understand what Tang Min's mother meant when she said this - she simply loved her daughter.

"There is no need for surgery, and in fact surgery is useless." Sun Lien tried to explain in a relatively easy-to-understand way, "Her current problems are at the genetic and cellular levels, and surgery cannot solve such microscopic problems. We need Use closely monitored medication."

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Sun Lien's parents agreed to treat this kind of thing, which Sun Li'en had expected.After all, Tang Min has only one hope now.With the consent of the family members, this is only the first step of the Long March, and there is still a lot of work to be done.

The biggest problem facing the entire comprehensive diagnosis center is how to improve the treatment process.Treating patients is not a matter of talking on paper. The effectiveness of in vitro experiments does not necessarily mean that it will be effective in a physiological environment.If the in vitro experiment could be copied into the human body without difficulty and take effect, then cancer would have been conquered long ago.

"First of all, we need to solve a core problem." Sun Lien held the second general medical consultation within one day, and this time he specially invited licensed pharmacists from the Department of Pharmacy to attend.In the meeting room, Sun Li'en stood in front of the whiteboard and wrote "AQP4" in big characters.Then asked, "AQP4 protein is a high-efficiency water channel protein, but its direction of action is bidirectional-it can not only pump water into the cell, but also pump the water in the cell out of the cell membrane."

This is what everyone knows - even if they didn't know it before, under the bombardment of Yuan Pingan's high-intensity literature, everyone has some ideas about it.

"The patient's current problem is that the expression of AQP4 protein is insufficient, so she cannot maintain the water in the cells in an appropriate range." Sun Lien continued, "That is to say, she has too much water in the cells now."

There was silence in the conference room, and everyone was waiting for Sun Lien to continue asking questions.Yuan Ping'an frowned, as if he had guessed Sun Li'en's question.

"However, after we use arginine vasopressin to phosphorylate AQP4 protein, how can we ensure that these chicken blooded proteins pump water from the cell to the outside instead of the other way around?" Sun Lien wrote on the whiteboard There was a big question mark. "Although according to the slow progress of her edema, we can speculate that her AQP4 protein function is normal, but this speculation is not direct evidence. We can't start treatment rashly based on such a speculation, right? If the AQP4 protein continues to increase If the water is pumped in the cells, her condition may deteriorate dramatically in a very short time after the treatment starts. The final result will only be death."

"That is to say, we need to prove that her AQP4 protein is working normally? To prove that her AQP4 protein has the function of bidirectional transport at the same time, and can also regulate the direction of transport like a normal person?" Zhou Ce asked in the audience, "Is this not Do you need a biopsy again?"

"No...no need for a biopsy." Professor Zhang Zhifu, who had been silent all this time, suddenly said, "Just force these proteins to work the way we want. No matter what they are doing now, as long as they can work the way we want, that's fine." gone."

This is a bit of a mouthful, but it seems to be feasible after thinking about it.Xu Yourong asked, "Then what's the matter? Create a difference in osmotic pressure? Mannitol has an inhibitory effect on the expression of AQP4 protein. After using mannitol before, it increased the area of ​​edema."

"Hypertonic glucose can be used." Ma Yongfang took over, "The only disadvantage of hypertonic glucose is that it is easily metabolized by the body, and its maintenance time is much shorter than that of mannitol. But for Tang Min, this is an advantage ——If there are adverse reactions, the treatment will be terminated faster.”

Sun Li'en turned around excitedly, and wrote the seven words "hypertonic glucose dehydration" on the whiteboard, "I think it's feasible. In this way, the use of arginine vasopressin will be guaranteed."

"Then we need to use the hybrid operating room." Xu Yourong continued, "The MRI and CT scans in the hybrid operating room can ensure that we can monitor the changes in Tang Min's intracranial edema during the treatment——dehydration treatment is a burden on the nerves, The water content of her other nerve cells is still normal. It is best to stop the treatment as soon as the edema subsides to the ideal state."

"That is to say, we still have to find a drug that inhibits the action of AQP4 to make the treatment process controllable." Sun Lien nodded. After stopping the creation of osmotic pressure difference, if the AQP4 protein is still phosphorylated, they will definitely go crazy. Pump water into Tang Min's astrocytes.So we had to find a way to reverse the phosphorylation.

"Mannitol can't be used." Zhou Ce followed Sun Lien's words and continued, "Mannitol will aggravate cell dehydration and cause nerve cell damage, and it is also prone to rebound afterwards."

After the hypertonic glucose injection, all the organs in Tang Min's body will be soaked in a glucose solution with a concentration far exceeding normal.Water seeps out of the cells in this case.In the process of water seepage, the total amount of potassium, sodium, calcium and other substances in the cells remains unchanged, which will cause the osmotic pressure in the cells to be higher than normal.After the high concentration of glucose in vitro is metabolized, the osmotic pressure of the extracellular environment is lower than the intracellular osmotic pressure, and water will flood into the cells again.Even in the end, the water in the cells will be more than before the hypertonic glucose dehydration.

This situation is called "bounce phenomenon".Both mannitol and hypertonic dextrose are dehydrating agents that can cause rebound phenomena.

"So, we need to suppress the activity of AQP4 protein first, and then gradually withdraw glucose." Ma Yongfang frowned, "Have you heard of any drugs that can suppress AQP4 protein?"

"You can use trifluoperazine." Yuan Pingan gave the answer at this time, "trifluoperazine can change the membrane localization of AQP4 protein, thereby weakening the effect of AQP4 protein. Oral trifluoperazine before withdrawing glucose, Then slowly reduce the concentration and dose of the glucose infusion . . . this should minimize rebound.”

The doctors in the diagnostic center were discussing in full swing, while the licensed pharmacists who attended the meeting were stunned.As if he had received a huge blow, he looked around in disbelief for a long time before saying, "This medication plan... we can't survive."

The meeting room suddenly fell silent, and everyone focused their attention on the face of the licensed pharmacist.

Being noticed by others is actually quite an uncomfortable process, but the professional requirements made this pharmacist absolutely unable to back down.He bit the bullet and said, "The plan you gave is not just over-the-counter medication...these medication plans are experimental and unprecedented. This plan must be reported to the medical department, and the medical department asks the ethics committee for approval, and then gets the dean Approval is required to proceed..."

"We are already doing this." Sun Li'en nodded, "If you have any ideas, let's discuss it together while everyone is here now."

　In general, Luo wrote about a disease that is theoretically possible but does not actually exist.He also scratched his hair for a week and came up with a treatment plan that might work.

　　Of course, there is a sense of accomplishment, but more of it is panic... I don’t know if there are any fatal omissions in the writing process, so everyone just read it, and don’t take the content of this paragraph seriously.

　　
　
(End of this chapter)