medical simulator

Chapter 468 Simulation of Rare Cases (Subscribe)
"True polymyositis? Are you sure it's the name, not polymyositis?" Zhou Cheng asked Fang Yun after Zhou Cheng, Fang Yun, and Yang Yifeng got together.

Yang Yifeng also looked at Fang Yun. This is a patient that Fang Yun happened to receive when he was on duty. He is currently living in the department. The main complaints of clinical manifestations are: muscle weakness and muscle pain.

On the face, neck, chest and hands, there are red or purple rashes, plaques and edema.

This is actually a chronic disease, but the patient and his family have traveled to many places, and no one is willing to accept it.The place that is willing to accept, after treatment for a period of time, there is no special effect, and now
Fang Yun was curious, and he had enough knowledge, he thought it was a relatively rare polymyositis in rheumatology, but it invaded the joints and bones, which was a relatively rare condition. All this is simply not the case.

Fang Yun said: "Mr. Zhou, when I admitted patients to the hospital, I also considered polymyositis. The information I reported to you before was also the same."

"But after I went back and checked the information again, I found out."

"Polymyositis is an autoimmune disease with muscle weakness and pain as the main manifestations. The etiology is unclear. The main clinical manifestations are symmetrical weakness of proximal limbs, neck muscles, and pharynx muscles, muscle tenderness, and serum enzymes. A diffuse muscle inflammatory disease characterized by increased

"And because of such patients, some patients had malignant tumors before the disease, and about 20% of the patients were combined with lupus erythematosus, scleroderma, rheumatoid arthritis, Sjögren's syndrome and other autologous diseases."

"So I wondered if her skin manifestations were really a similar disease, but later, when I checked the literature, I happened to find out the diagnosis of this rarer disease."

"Osteitis polymyositis vera is a rare autoimmune disease that primarily affects the skin and muscles. Chronic muscle inflammation and cutaneous manifestations, especially of the face, neck, backs of hands, elbows, knees, and dorsums of feet."

"Then, by collecting some information, I found that the current description of it is limited to this."

"Skin involvement is rare in polymyositis.

"Osteitis polymyositis vera usually presents in proximal muscles, such as the neck, shoulders, and hips, whereas polymyositis can involve both proximal and distal muscles."

"..."

"At present, the treatment of polymyositis vera is glucocorticoids and immunosuppressants, which are consistent with the treatment of polymyositis. However, there is no better dose of the two. conclusion."

"It was precisely because of this situation that I asked Brother Yifeng what to do next." Fang Yun's previous address was Teacher Zhou Chengzhou and Brother Yang Yifeng.

"That means you can't find any information? Have you called to ask about the treatment experience or process of the hospital that has reported similar cases before?" Zhou Cheng asked again.

This is interesting. Osteitis polymyositis vera and polymyositis have similar names and similar pathological mechanisms. They are both autoimmune diseases. The drugs for treatment are also similar, but the same dosage has no effect.

Therefore, there is no empirical article data or treatment experience as a reference, so you have to explore it yourself?
Yang Yifeng said: "I sent an email and asked one of the doctors. He said that during the follow-up, the patient passed away, which should be due to the ineffective treatment."

"The number of patients with this disease is relatively small. The prevalence rate varies in different regions and countries. The global average prevalence rate is 10-2 per 10 population. In Asia, the prevalence rate may be lower. "

"So, in total, there may only be a few 10 people in the world who have been discovered."

"And because the symptoms and manifestations of this disease are more complex, and it is easy to be misdiagnosed or missed, the actual number of patients may be even more."

“这种患者的5年存活率为75%~91%，10年存活率为58%~83%。要知道它并非是癌症，所以它的存活率算是相当低的了。”

Hearing this, Zhou Cheng let out a sigh of relief!

Zhou Cheng is afraid of this kind of disease, there are only a dozen of them in the world, and he can't find it even if he searches for it at a fixed point. If this is the case, he doesn't know how many times he will have to simulate it before he can simulate the best treatment plan.

As long as there is still a certain incidence rate in the world, then this is not a problem for him.

Zhou Chengcheng said: "The prevalence rate is low, and the patients are absolutely scattered. It is indeed difficult to count empirical treatment plans. We need to do a little research on this."

"Autoimmune disease, we need to figure out its pathogenesis, especially please consult the rheumatology department. First make a temporary treatment plan, and then slowly adjust it."

"This disease should not require surgical intervention, right?"

Yang Yifeng shook his head: "Surgical intervention has not been reported yet, but the possibility of surgical treatment is not ruled out, but generally speaking, the number of autoimmune diseases involving surgical treatment is not large."

"In fact, this patient can be directly sent to the rheumatology department. We just need to wait for her antibody test results and let them deal with it. However, the number of such cases is very small, and it happens to be the disease of our orthopedics department. You can also stay and get a better understanding of this aspect.”

"Before Fang Yun found her, I had never heard of this disease."

Zhou Chengcheng said: "Let's ask the rheumatology department to take a look at it first, and then we can talk about it."

In fact, Zhou Cheng was really interested. He hadn't seen the diseases in his knowledge blind spot for a long time. This situation lasted at least for a long time.

Although it was because Zhou Cheng did not have the right to be in charge of patients, the diseases he came into contact with were all screened by other professors, but rare diseases always arouse people's interest.

Moreover, now that I have such a small ward and the right to conduct independent diagnosis and treatment activities, then?
With such a rare disease, Zhou Cheng did not intend to let her go.

It is definitely better for her to stay here than to stay in the rheumatology department. However, the normal diagnosis and treatment procedures must be perfected. Most autoimmune diseases are related to the rheumatology department, so it is better to get in touch.

After that, Zhou Cheng finally returned to the rented house with new expectations.

Fang Yun is still on duty today, so just leave it to him to be on duty in the emergency department.

One thing Zhou Cheng has to consider is that at present, in addition to the surface project that he has obtained on the surface, the funding for the special education project that he applied to Gu Huo has also come down, and the project fund for this research is not available. Not on the surface.

The main reason is that the project proposed by Zhou Cheng is a bit out of line and slightly different from the current medical education structure.

Moreover, Zhou Cheng's education method is subject to discussion, so he wants to use a less formal and gamified form first, and it is better to appear in a small number of people first, which is equivalent to asking Zhou Cheng to do a pilot.

Zhou Cheng must also pay attention to this matter.

At the same time, a new simulation after a lapse of one year started.

【The simulation starts! 】

【You already have a good reputation in the industry, you have a lot of friends, you already have some status, and then you have a strong interest in a certain disease you have come into contact with. 】

[Although you have your own clinical research project and many other research projects, you still called for help from some colleagues across the country through your academic influence and professional influence, which attracted you a lot of patients with polyosteitis vera patient. 】

[One and a half years later, you have completed your existing clinical projects, basic projects, published articles, and created a clinical center that shines in your country.It has a great impact on the field of orthopedics, and you start to make a lot of noise in China. 】

[At the same time, you were specially hired as a professor, became a doctoral supervisor, and possessed the qualifications to teach multiple masters and masters!At this time, although you announced that you are going to conquer the research field of unfamiliar diseases, no one doubts your decision. 】

[In the same year, you held a rather grand wedding. The people who watched the ceremony, and the wedding banquet were all well-known experts and professors from your country and even the world...]

[Two years later, because the treatment process of unfamiliar diseases is extremely complicated and the treatment effect is unpredictable, although a small number of patients have been cured, there are still more patients with poor prognosis, and your reputation has suffered a certain impact. 】

[The institution you are in, because of your previous achievements and your outstanding professional ability, has also given you a lot of support. You have started to develop multiple scientific research centers across the country to adjust and plan the treatment plan in multiple centers. 】

【Ten years later, because your core competitiveness is strong enough and you have spent enough money, your team finally achieved certain results and progress in the treatment of osteitis polymyositis vera. 】

[But at this time, someone finally reported the clinical trial you carried out. Some of the patients you initially received had end-stage lesions due to relatively insufficient or redundant treatment. 】

[You were investigated for evidence collection, but because of your rigorous academic style, rich experience in clinical trials and theoretical preparations before the clinical trials were launched, and the approval of the Ethics Society, you were just stopped from this project. 】

[But you, who are determined, resolutely chose to resign, go abroad, take your wife and children, and establish a clinical trial center abroad, and with crazy capital investment, you have obtained a large number of original cases...]

【You are experimenting and adjusting. 】

[The prognosis of the patients you deal with begins to show extreme changes. One-third of them recover, and two-thirds of them are predicted to have a shorter life than without treatment. 】

[After another 20 years, due to the limitation of the number of cases, your research still has not made much progress.But after you unload your existing position, everything you did before is revealed. 】

【You were condemned, expelled, arrested and imprisoned. Fortunately, your wife and children were sent back to the country before your incident happened, and the disaster was not as bad as your family members. They were not affected...】

[When you were 61 years old, you committed suicide by being demented...]

[Simulation failed! 】

[Simulation Evaluation: Crazy celebrities!You were famous and wealthy at the beginning, but the behavior you did was extremely evil, divorced from the essence of being a human being, and you used the same kind of life as the basic material of the experiment, which was horrific and never ended well. 】

【One of the following skills can be obtained】

[Experience in the diagnosis and treatment of osteitis polymyositis vera (creation - proficiency)]

[Others: None. 】

After Zhou Cheng finished watching, his mind was like water.

These words in the simulator world are hard to change his mood now.

Because Zhou Cheng in the real world knows that in the simulator world, his research results under extreme conditions and the patients he has to deal with during the research are actually the audience in the real world under the accumulation of time.

In other words, even if I don't do this in the simulator world, in reality, there must be a sufficient number of people to support the corresponding experiments, and finally reliable results can be obtained.

Therefore, this simulation is just an experience, and it is such an unfettered experience.

If it is in reality, there may be more sacrifices!
One time is not enough to come a second time, mainly because the number of cases is too small.

Medicine is already extremely complicated and cumbersome. With my current accumulation, if I want to switch to an unfamiliar field, I may not be able to break through the final entrance in my life. This is not a big deal.

There are many geniuses in this world, even if the chance is one in a million, there are still tens of thousands of geniuses in this world, and this is true in every era and every moment.

But research on medical treatments has been slow.

【…】

[Ten years later, you became the top orthopedic professor in China. Your professional ability and scientific research ability have reached the peak, but the students you accepted have all left your team one after another, and none of them stayed to study with you. of Ph.D. 】

[Also, your doctoral students have also left your unit to work in other units. 】

【…】

[20 years later, your research results will finally be effective. When your research results are successful, there is still no response, all journals will block you, and all publishing houses will keep a distance from you, because you have already Notorious, like a street mouse...]

[When the treatment plan is mature, you quit all the jobs related to medical treatment. You learn from your little friends, record your research results on the Internet, use stories and jokes as carriers, and then spend the rest of your life in retirement... ...]

[At the age of 87, your descendants were full of children and grandchildren, and died without any illness. 】

【One hundred years later, when a medical-related friend inadvertently applied your joke story to the clinic, the treatment plan was able to spread.But your name is still lost in the vast river of history. 】

[The treatment plan is finally named after your pseudonym—the treatment plan for passenger polyosteitis. 】

[Simulation ends...]

Zhou Cheng is slowly sipping tea at the moment. After extracting the relevant simulated memories and results, Zhou Cheng began to slowly deliberate on how to make this plan public in a more reasonable and effective form. , and used it on the patient in charge of his own department.

Creating something out of nothing is obviously impossible...

(End of this chapter)