I can see the status bar

Chapter 978-7 D-day

This chapter is the 9th chapter updated for the leader Xingyun Ruoyu, after this chapter, there are still 3 chapters to be updated

The test kits of Yuhua Biotech were sent to the Fourth Hospital in large quantities.The staff of the Ningyuan City Center for Disease Control and Prevention also came to the Fourth Hospital to start research.

Sun Lien spent a lot of time collecting medical history.But for him, the most noteworthy thing at present is the status bar prompt on the 63-year-old grandma who has lived in Ningyuan for a long time.

(Novel coronavirus infection, 47.18.42) For Sun Lien, this reminder was like a thunderbolt that suddenly fell from the sky.This means that the new coronavirus is likely to have been transmitted from person to person.

The reason why "probably" is still used instead of "certainly" is that the laboratory has not yet completed the whole genome sequencing of the virus.

Before the completion of the whole genome sequencing, even Sun Lien, who was open, could not assert that the child's grandmother was infected by the in-laws, the child, or his son and daughter-in-law.This involves very serious etiological and epidemiological investigations that must be treated strictly.

But from Sun Lien's point of view, it is hard for him to believe that the infection of the child's grandmother came from other sources.The vehicles they drove were loaded with some personal luggage and packaged vacuum food—that was not the box the CDC used to transfer positive samples.

This is a very dire situation.The virus is likely to be capable of human-to-human transmission, but doctors and scientists still know little about it.

Preventing and studying this virus is the work of the majority of scientific researchers.As for the doctors, what they are most concerned about now is how to treat these patients.

Among the "three families of six" people, five people clearly showed symptoms.And under the test of the trial kit, the six people conducted a total of [-] nucleic acid tests.All but the little boy tested positive three times.

In order to clarify the family's diagnosis as soon as possible, Dean Song also took great pains - she not only snatched Director Huang Wenhui from her own floor, but also called several professors from the Respiratory Research Institute of the School of Clinical Medicine in the college. .Together with these professionals, she squats in the remote consultation center outside the comprehensive diagnosis center. As long as there is inspection data, as soon as it is released, the consultation room here will immediately start analysis.They saw the test results even earlier than Sun Lien.

"The mNGS has not finished running yet?!" After asking mNGS for the fourth time within an hour, Song Wen began to look a little restless, "What about other pathogen tests?"

"Cultivation and microscopic examination will take longer, and other PCR tests are in progress." Sun Lien replied calmly, "Dean Song, we need time to confirm,"

"Hurry up." Song Wen took a deep breath, and then forced himself to calm down, "The faster the detection of other pathogens, the better, but we must pay attention to the accuracy."

Song Wen is more concerned about the issue of diagnosis. If these six people are diagnosed, it means that Ningyuan and even the entire Song'an Province must sound the alarm and start to take this transmission incident seriously.Sun Lien focused on treatment.

There are currently five infected people showing symptoms. Although the ten-year-old child was also infected with the new coronavirus, and the infection time was quite long, he did not have any symptoms.

Fever, cough, sore throat, lethargy, fatigue, diarrhea... none of these symptoms.This kid named Zhou Yuze looked completely healthy and normal.

If his appearance of running back and forth in the isolation ward with excess energy every day is also regarded as a symptom, it can even be said that he is a little too healthy.

Regarding the treatment of this group of patients, Sun Lien and the doctors in the respiratory department had somewhat different opinions.Based on the experience of dealing with SARS in those years, the Department of Respiratory Medicine suggested using glucocorticoids in advance to reduce the possible lung damage of patients, while Sun Lien felt that "three reasonable" lessons should be considered to control the dosage of glucocorticoids. Before the obvious drop in blood oxygen saturation, antiviral treatment, symptomatic treatment and supportive treatment are the main treatments.

"Three early and three reasonable" was an important guiding ideology for Chinese doctors to fight against the SARS virus.In the earlier days, this formulation was "five early", that is, "early diagnosis, early isolation, early treatment, early use of corticosteroids, and early ventilator".However, in the follow-up summary, Academician Zhong of the Institute of Respiratory Research believes that "three mornings and three reasonable" are more appropriate.

The three early refers to "early diagnosis, early isolation, and early treatment", while the three reasonable are "rational use of corticosteroids, rational use of ventilators, and reasonable treatment of complications".

This guideline has very important practical significance.For the containment of infectious diseases, the "three mornings" are the bottom line that must be achieved.Only when the "three mornings" are implemented, can respiratory or droplet-borne infectious diseases be blocked.

And three reasonable, it is the key to reduce the pain of patients and improve the cure rate.

From SARS back then, to MERS later, and now to the new coronavirus.Human beings have not yet invented specific drugs against coronavirus infections.From the beginning to the end, there is actually only one thing doctors can do - to help patients get over it.That's all.

Viral infection itself causes massive cell death.However, during the infection process, immune cells phagocytose the infected cells in large numbers, and the damage caused is also very serious.

Early large-scale use of hormones can indeed alleviate the damage caused by immune cells.But that doesn't help with damage from viral infections.It may even make the infection get faster and worse.

"Although they have upper respiratory symptoms now, the symptoms are not serious." Sun Lien communicated with Director Huang Wenhui through the computer in the office. "Using hormones right now will not have a very good effect."

"The biggest characteristic of coronavirus infection is that it progresses quickly. Once it manifests, it will be a serious injury." Director Huang argued, "Now you can see that their symptoms are still stable, but a CT scan shows ground-glass opacities and nodules in the whole lung. ——It’s not that their symptoms are not serious, but they haven’t become serious yet. It will be too late when they show up!”

"Their infection status can be judged from a side by C-reactive protein." Sun Lien still did not budge. He was very clear that there were omissions in what Director Huang Wenhui said-but he could not produce evidence of omissions now.

According to the prompt in the status column, among the six infected persons, the oldest three—that is, Zhou Yuze's grandma, grandpa, and grandma—had high levels of C-reactive protein.The C-reactive protein of grandpa and grandma are 55.6mg/L and 34.2mg/L respectively.And grandma's C-reactive protein level is also 44.9mg/L.This suggested that a more serious infection had occurred in their bodies.

But for the remaining three people, including Zhou Yuze's parents and himself, the C-reactive protein did not exceed the reference value.Zhou Yuze's CRP level was 0.2mg/L, his father's CRP level was 4.9mg/L, and his mother's CRP level was only 0.5mg/L.

Considering that although the course of the disease is different, Zhou Yuze's grandmother and grandparents have more obvious symptoms, Sun Lien vaguely feels that the immune level of the patient may be a very important difference.

But he needs more evidence to prove it.At least you can't use hormones on Zhou Yuze's parents and him.

"According to the experience of SARS, the spike protein of the coronavirus will bind to the ACE2 receptor." Sun Lien said, "I suggest that they be given symptomatic treatment first, and then use ACE2 receptor antagonists to prevent further infection of the virus."

"No." Director Huang Wenhui immediately rejected the request, "The binding force between the spike protein of the new coronavirus and the ACE2 receptor has not been determined, and you cannot guarantee that receptor antagonists can compete with the spike protein. This idea is very good. , but it must go through enough experiments before it can be used in humans." She took a deep breath and said, "In this way, the patient's condition progress is closely monitored, and a CT scan is performed every eight hours. And blood oxygen saturation is monitored for 24 hours—— If there is volatility, then intervene immediately."

Sun Li'en nodded, he thought there was nothing wrong with this suggestion.

Director Huang Wenhui was a person who experienced SARS. Although she was very young at that time, she was the one who fought SARS head-on on the front line.Her vigilance against the coronavirus is high, but that doesn't mean her responses and actions are the most appropriate.

The over-emphasis on this disease may make her actions a little... overreacting.

The entire treatment group, including consulting respiratory and critical care physicians, agreed on this protocol strategy.Later, Song Wen made a concluding speech on the "remote" consultation.

"At all costs, do your best to treat it." Dean Song said seriously, "We can talk about the cost and other issues later. We can even consider free of charge - the point is, you have to sum up a set of experience, a set of methods, A set of plans can be used by other doctors and nurses." She said solemnly, "This set of plans can save lives! We must attach great importance to it and do our best!"

(End of this chapter)