I can see the status bar

Chapter 782

Tongxie deserves to be the number one hospital in the country.After receiving the call, Zhu Minhua quickly got in touch with the NKT research team of this hospital.After two back-and-forth transfers of information, the experimental group of Tongxie clearly expressed the opinion of "agreeing Tang Min to be included in the treatment".

Entering the experimental group for treatment also has a special advantage—the enrolled experimenters do not need to pay for the treatment.This is good news for Tang Min's family.

Before sending Tang Min out of Ningyuan, Sun Li'en and the others still had an important task to complete.That is the second treatment for Tang Min's AQP4 protein deficiency syndrome.

According to the observation during this period, Sun Li'en and others can basically confirm that Tang Min's treatment effect is quite stable.Judging from the current results, after receiving the first treatment, it takes about five years for the disease to progress to the point where treatment intervention is required again.The therapeutic effect was beyond everyone's expectations.After reaching this conclusion, Sun Lien was stunned for a while, and then recalculated with Yuan Pingan.In the end, the two were surprised to find that there was nothing wrong with the estimation, and the values ​​they calculated were correct.

"Isn't the speed of deterioration wrong? If she didn't intervene, wouldn't she have developed the disease in about seven years?" Yuan Ping'an was quite puzzled by this.Tang Min developed the disease at the age of seven, which means that from the moment she was born, the space-occupying edema area in her brain began to grow gradually.But after one treatment, the progress of the disease slowed down... This result made him a little puzzled.

"Intracranial glioma can lead to increased expression of AQP4 protein in surrounding tissues." Sun Lien explained. "This proves that our judgment is correct from another aspect - she did have a glioma. After the tumor appeared, the expression of AQP4 protein in the surrounding area was increased. But the increase was not enough to support the tumor to continue to grow and invade other brain tissue, and then the tumor was absorbed. But after the absorption, the increased expression of AQP4 protein brought by the tumor did not disappear immediately-they continued to be highly expressed for a period of time."

The tumor brought high expression of the AQP4 protein to the surrounding area, and then gradually fell apart on its own.It's like an enthusiastic crowd who does good deeds without leaving a name-although this enthusiastic crowd is essentially a perverted murderer who kills without blinking an eye.But it did have a good effect on Tang Min's primary symptoms.

"According to the original plan, we will remove her tube this afternoon." Sun Lien made the final decision, "Let Yourong complete the operation after removing the lateral ventricle drainage tube—under the influence of anesthesia, her gastrointestinal motility function Restricted, not conducive to the termination of phosphorylation. Formal treatment should wait for two days after she recovers."

Sun Li'en is now the team leader and also Tang Min's doctor in charge.As long as there are no fundamental problems with his decision, other doctors in the group will not object at all.

After deciding on Tang Min's treatment, Sun Li'en started scratching his hair again.What made him worry this time was another patient, Lu Chunyu.

"What are you going to do with Lu Chunyu's treatment?" Yuan Ping'an also switched to the second case. He stretched, then tapped the cover of the case with a pen and said, "It's been two weeks since the drainage operation. It's still going up."

"I called the liver and gallbladder in the morning, and Director Zhao also felt baffled." Sun Lien twisted his stiff neck and said helplessly, "He put the words down, if he can miss such a simple drainage operation, tomorrow He went to the dean to report his resignation."

"No way..." Yuan Ping'an's eyes widened, "Surgical recurrences and sequelae always exist. Even if there are any problems, it can't be said that Director Zhao made a mistake."

Sun Lien rolled his eyes, "This is called rhetorical tricks, do you understand rhetorical tricks?" He figured out that Yuan Ping'an and Xu Yourong got along very well recently, and the result was that his EQ, which was originally above the passing line, was visible to the naked eye. decline.I can hardly hear the joke now.

"...Oh." Yuan Ping'an blinked, and turned the topic back a little bluntly, "What should I do next? Her bilirubin has reached 140 micromolar, and it must be dealt with."

"There's nothing I can do about it." Speaking of this patient, Sun Li'en also felt a little headache. "Give her ursodeoxycholic acid, contact the liver and gallbladder, and ask them to do another imaging to see if the drainage tube is blocked."

In terms of immunology, the waists of ten Sun Lien tied together are not as thick as one hair of Dr. Pascal.But Sun Lien, who has a slender waist, couldn't help but have some strange thoughts—is Lao Pa's diagnosis really all right?
Based on the information found by Yuan Ping'an and Sun Lien's own study, AIH+PBC overlap syndrome is a disease that is more likely to appear in AIH patients.This ratio is not too low. AIH patients mainly suffer from liver cell damage, while Lu Chunyu's lesions showed bile duct damage.Therefore, the diagnosis of AIH+PBC overlap syndrome is not wrong.

The patient can be treated according to the relevant report, but the expected effect is not obtained.This made Sun Li'en a little puzzled.Bile drainage did not have the desired effect, of course, this may be due to individual differences.However, once gastric varices appear in patients with PBC, the three-year survival rate is only 58%.If bile drainage is not working, what should be done next?Ignore the risk of massive bleeding from peptic ulcer and force hormone therapy?Or simply declare "I can't help it", and then put Lu Chunyu on the liver transplant waiting list to finish?
Sun Lien didn't know what to do, but he still wanted to do something.Therefore, he prescribed ursodeoxycholic acid treatment for the patient.

Ursodeoxycholic acid, Ursodeoxycholic (UDCA) is a drug used in primary biliary cirrhosis (PBC).However, recent studies have shown that the efficacy of ursodeoxycholic acid on primary biliary cirrhosis is closely related to disease progression.In the early stages of PBC, patients generally respond well to UDCA.But when it comes to stage III-IV, even high doses of UDCA can't improve the patient's symptoms and liver function.It can be said that this is a specific drug that can only be used for early PBC.

Lu Chunyu has already appeared symptoms of portal hypertension and gastric varicose veins.This means that her PBC has progressed to between the third stage of progressive fibrosis and the fourth stage of cirrhosis.This stage is already in the middle and late stages, and theoretically speaking, UDCA will not have any effect on her treatment.

But Sun Li'en really couldn't come up with any good way to deal with it.His purpose is also very simple, UDCA is a cell protection drug with membrane stability and anti-apoptosis.At the same time, it can also reduce the expression rate of tissue fusion complex in the liver cell membrane and cytoplasm of PBC patients.It has a certain role in protecting liver cells.

UDCA can’t improve the symptoms, but at least it can protect the liver and slow down the progress of the disease, right?With such an attitude, Sun Lien prescribed ursodeoxycholic acid and decided to ask the hepatobiliary surgery department to check the patient's biliary tract again.

Hopefully the drainage tube is twisted and blocked.Sun Li'en prayed in his heart, and then encountered another difficulty - if this is really blocked, Director Zhao should not be so stubborn that he really resigned, right?
(End of this chapter)