This doctor has a system

Chapter 371 436. Become CEO and marry Bai Fumei

Now Dr. He is under greater pressure. If the patient is gone, his family may not be able to accept it.

Gao Feng is not opposed to the use of such expensive antibiotics, but he feels that the cause should still be found instead of constantly strengthening anti-infection efforts.

"Then what do you think we should do?"

"Do a colonoscopy," Gao Feng suggested, "take a blood sample and send it to NGS."

Colonoscopy at this time? Dr. He, who is in charge of the bed, is a little embarrassed. The patient's current physical condition is very bad, and the risk is too high.

Before a routine colonoscopy, you need to cleanse your intestines, which simply means drinking laxatives. Otherwise, the intestinal tract is full of gastrointestinal tract, and the intestinal mucosa cannot be seen under the mirror.

It was not that I had not considered performing a colonoscopy on the patient before, but the stools he pulled out were all yellow-green. Director Ding of the Department of Gastroenterology felt that the procedure was in vain.

Blood NGS has been sent before, and the ICU of the Provincial Medical Center is still very active in the application of this new technology. Of course, the private efforts of the manufacturer are definitely indispensable, which cannot be said.

"NGS didn't find any problems." Dr. He took out the report for Gao Feng to read. "It said that the sequence number of E. coli was too high."

This makes no sense. There are many bacteria in the intestines of normal people, and E. coli is one of them.

Director Fan has benefited greatly from previous projects sponsored by Gao Feng, so he has a very good sense of Gao Feng.

Of course, if you just like a rougher feeling, then just pretend I didn't tell you.

Compared with bronchoscopy, colonoscopy is ahead in all aspects. This thing is big, thick, long, and black.

"It's okay, just tell them. I told their director." Gao Feng was too lazy to do science popularization at this time.

However, he didn't ask carefully. Anyway, this requires family members to pay in advance, so there is no possibility of defaulting on the bill.

"But no definite evidence has been found," he said.

"Director Fan." Gao Feng shouted.

However, the patient is now in a shallow coma and cannot experience this feeling, which is a pity.

"Let me make one for him." Director Ding of the Department of Gastroenterology thought for a moment and said.

Director Fan has been with Dean Guo for a long time, and now that the latter has succeeded in taking the position, he naturally has to give him an explanation. He is currently the deputy director of the Department of Infectious Diseases, and is waiting for the old director to retire and take over.

This is the God of Wealth, you have to deal with him well!

Dr. He called to urge him, and the manufacturer was naturally very concerned and sent a young man over in advance.

When passing by the third floor, Gao Feng heard a noise, and then saw a large group of people in white coats hurriedly heading to the laboratory.

There is nothing wrong with the first one, but Dr. He doesn't know much about the improved acid-fast staining.

"Wang Banxian has said that my dad will have a big disaster this year, and there is a high probability that he will not be able to overcome it." The patient's son said, "This is fate. Let's do our best."

"Do you think he may have a parasitic infection?" Gao Feng asked, "I studied this with my tutor when I was in graduate school, and I feel that this aspect cannot be ruled out."

Soon, NGS manufacturers came to the hospital. They usually came twice a day to collect specimens, once in the morning and again in the evening before get off work. Small hospitals usually treat patients once a day or once every few days.

At this time, you must use the special function: money ability.

Thank you for your outstanding contribution to the doctor-patient relationship, he said with tears in his eyes.

"What about the colonoscopy?"

Doctor He was instantly grateful to the unknown Wang Banxian.

Anyway, the feeling of pushing it in is hard to describe. Whoever does it knows.

"Take some and send it for testing." Gao Feng said. This was absolutely child's play for Director Ding, and he successfully completed the task.

"The main reason is that I have no clue." Gao Feng sighed helplessly. He was a little frustrated. This patient spent so much money, and if the cause of the disease still cannot be found, it would really make everyone lose face.

Soon, the colonoscopy revealed: segmental mucosal changes in the cecum and ascending colon, suggesting suspected special infection.

"Let's wait and see." Director Fan said, "Didn't you ask me to check the project today? I hope I can find something."

If your family members say some unpleasant things, you may be too embarrassed to refute them.

Doctor He quickly wrote it down.

"What's wrong? Director Gao?" Director Fan from the Department of Infectious Diseases came over with a smile. His attitude towards Gao Feng was very kind.

Director Ding did it very gently. If the patient has diarrhea for a long time, there must be congestion and edema in the intestinal mucosa. If the operation is rough, it may cause intestinal bleeding.

"Do it again." Gao Feng said, "Do it more comprehensively. You checked too little."

Dr. He couldn't help but communicate with them about his condition again, and the other party acted very reasonable.

The two chatted for a few more words and then walked back.

"When the NGS manufacturer comes over, you ask him to come to me." Gao Feng told Dr. He, "Also, when the stool is sent to the laboratory, you tell them to use modified acid-fast staining. one time."

The young man who ran the errands calculated that it cost more than 4 yuan.

Soon the nurse in the endoscopy room pushed the instruments over. The digestive endoscope and bronchoscope of the Provincial Hospital were of the same brand: Olympus. The host is also common, the main difference is the mirror.

Segmental changes also make everyone's eyes brighter: this may be the source of the problem.

Here’s a reminder, whether it’s getting a checkup or doing something else, if you want to take an unconventional path in life. You should be gentle when passing through this passage.

The family members handed over the money without asking any questions.

Director Fan then remembered that the other party was a graduate student in gastroenterology.

"Give me your check list." Gao Feng said. He picked up a pen and drew many circles on the list. "These items must be checked."

"The leader seems to be Director Chu of the laboratory department." Li Youliang said, "I am usually a very calm person, but why do I look so flustered today?"

It can't be said that he was in a panic. Gao Feng also noticed it just now. It seems that it is more appropriate to describe it as excited.

Something big must have happened in the laboratory, and it's most likely a good thing.

Gao Feng was a little curious now.

"I'll go take a look." Li Youliang, who understood the boss's needs, rushed out immediately.

After a few minutes, he ran back panting.

"Holy shit! There are people in the laboratory department!" Li Youliang said out of breath, "They said they found red blood cells with nuclei."

"Nucleated red blood cells?" Gaofen was a little confused, but he wasn't so excited.

Whether red blood cells have a nucleus depends on their stage of development. Immature red blood cells in the bone marrow have nuclei, while mature red blood cells do not.

The red blood cells in peripheral blood are mature red blood cells, so they have no nucleus and are biconcave disc-shaped.

"Isn't it unusual to find nucleated red blood cells in the blood?" He said, "Patients with blood diseases may have this possibility."

"It was said to be found in urine." Li Youliang said.

"Fuck!" Gao Feng couldn't help but cursed, then he ran to the laboratory. Nucleated red blood cells found in urine? ? ? This was a major medical discovery that could shock the whole world. Gao Feng didn't believe it.

Director Chu of the laboratory department was looking at urine specimens under a microscope. In fact, he had already seen it twice, but he still couldn't believe his eyes.

This is not urine, this is SCI+Lancet+nature waving to him, and a Nobel Prize is not impossible!

This will be a major event that will subvert the medical world! Director Chu's breathing became a little heavy when he thought of this.

"Let's see!" Gao Feng squeezed in. Thanks to the transformation of the Bingwang auxiliary system, no, the medical auxiliary system, his physical fitness was good, and some thin dogs blocking the way were easily squeezed away by him. .

The thin dogs were a little unhappy at first, but when they saw it was him, they all subconsciously smiled on their faces.

"Who is this person?" someone asked in a low voice.

"You don't even know this? Director Gao of the general practice." A person next to him said to him, "Excellent person."

"How awesome is it?"

"If you want to be considered a human being, you are nothing but a fool at best."

"Then I'm quite important." The man said happily.

"I was wrong. You can only be considered a loser."

"Director Gao, come and take a look." Director Chu's face turned red, "Red blood cells in urine! Nucleated ones!"

Gao Feng quickly stretched his head up. Under a high-power electron microscope, he could see disc-shaped red blood cells. He looked closely and saw that there was indeed a nucleus in the middle of the red blood cells.

Gao Feng also became excited now. He quickly turned the microscope again and looked at other aspects.

"What do you say?" Director Chu asked.

"What a great discovery! Director Chu." Gao Feng was also very excited, "Where did you get the specimen?"

"A patient was brought here this morning." Someone said next to him.

"Find him quickly." Director Chu said excitedly. He was really curious, who is he? The red blood cells in urine are nucleated!

He couldn't wait to meet this strange man.

Soon, the people below contacted the patient.

The patient is a 56-year-old middle-aged man with a thick bandage on his head.

"Comrade, are you okay?" Director Chu asked.

"What do you think?" the patient said angrily after being stunned for a moment. He was really unlucky recently. He was rubbed by a car while waiting for a traffic light. A big piece of skin was wiped off his head, and it still hurts. Still sitting.

"You have a problem with your urine." Director Chu said unfazed by his attitude, "We have made a major discovery in it."

The patient was a little panicked when he heard what he said. What does a major discovery mean?

"Isn't it just hematuria?" he asked nervously, "Are there any other major findings?"

Director Chu was about to continue talking, but the observant Gao Feng on the side noticed something was wrong.

"How did you know there was hematuria?" He said abruptly, "We didn't tell you the results when we called you just now."

"This..." The patient's face changed and he muttered for a long time, unable to speak.

"Hurry up and tell the truth!" Li Youliang yelled next to him, "Did you do something bad? Otherwise we will call the police!"

Director Chu frowned, doing something bad? Call the police? What is this all about? Shouldn't we get to the bottom of this nucleated red blood cell?

This is a major event that shocked the scientific community!

When I figure out the reason, I will be promoted and raise my salary, become the dean, become the CEO, kick out the yellow-faced woman, marry a beautiful woman, and reach the pinnacle of my life!

"Don't call the police! I said it's not okay!" the patient said.

? ? ? everyone

It turned out that the patient was hospitalized for several days after being grazed by a car. He originally thought that he would definitely get some compensation after suffering such a big crime.

Unexpectedly, someone from the insurance company took a look and said that his injuries were very minor, and it was considered a minor injury to hold him to death.

The most they can do is to reimburse the hospitalization expenses and a few days of lost work expenses. Don’t think about the rest.

The patient was not happy now. He felt that he was seriously injured.

After being advised by an expert, he decided to fake hematuria, so that he could say that he had suffered internal injuries, and maybe he could get a little more compensation.

However, there was a small problem during operation.

He was asked to add some of his own blood to it, but he was afraid of pain, so he added some chicken blood.

It's all blood anyway, so the results must be similar, or so he thought.

Director Chu’s nose was almost crooked with anger. SCI, Lancet, Nature, and Nobel were all gone!

"Get out!" he yelled at the patient.

"Okay, okay, I'm leaving." The patient said dejectedly, "Don't call the police, I won't do the test."

Such a big oolong incident happened, and everyone was a little bit dumbfounded. Seeing that Director Chu was in a very bad mood, everyone dispersed in an instant like birds and beasts.

Gao Feng comforted Director Chu, who was still cursing, and left the laboratory department.

Two days later, the NGS results of the patient with diarrhea in the central ICU came out, and Gao Feng received a call from Dr. He immediately.

"What do you think it is?" The other party gave it a try.

"Parasite?" Gao Feng guessed.

"Oh, I'm really impressed by you." Doctor He's admiration was like a torrent of river water.

High-throughput sequencing (NGS) of blood samples showed that there were a large number of Cryptosporidium gene fragments in the patient's blood. The laboratory's modified acid-fast stain of stool also pointed to the same result: Cryptosporidium.

Cryptosporidium is a tiny coccidial parasite. Normal people are often infected due to unclean diet, swallowing water while swimming, and failure to pay attention to hand hygiene after touching pets. The main symptoms are acute gastroenteritis: mucus discharge. Watery stools, sometimes accompanied by obvious abdominal pain, nausea, vomiting, low-grade fever and anorexia;

However, the course of the disease is generally self-limiting and can heal on its own within a few weeks.

But for people like this patient who have had organ transplants, Cryptosporidium can be fatal.

Chronic watery diarrhea is difficult to control and can last for several months, accompanied by symptoms such as vomiting, epigastric cramps, and weight loss. In recent years, with the increase in organ transplant surgeries, Cryptosporidium parvum has become one of the important pathogens endangering the lives of patients receiving organ transplants.

When reviewing the patient's life history with the patient's family, we found that on the day he started having diarrhea, the patient had bought snacks on the street because he was greedy.

The cause of the disease is finally clear, but the treatment is once again in trouble: the current treatment plan needs to be changed, how should new medical orders be issued?

In previous treatment-related cases, they were usually children with primary immunodeficiency or kidney transplant patients. Infection after liver transplantation was very rare, and there were no relevant guidelines to refer to.

Doctor He was very worried and quickly called Gao Feng and others over.

"This is not easy to do," said the director of the Department of Infectious Diseases. "We have no experience in this area before."

The Department of Infectious Diseases had no experience in this area, let alone the central ICU. Dr. He's joy at the clear diagnosis disappeared instantly.

"If there is no guide, we can check if there are any reports of individual cases." Gao Feng comforted.

The entire medical team began to review all the case reports that had been published in the academic community in recent years and were available for reference, and finally found a case of a CD40L-deficient infant who was diagnosed with Cryptosporidium infection and completely recovered after treatment. The treatment plan for this child is: azithromycin + nitazoxanide.

The nitazoxanide in the report made everyone's eyes light up, and everyone immediately found the instructions for using this drug.

Liver transplant patients do not have more medication contraindications than ordinary patients. But the drug description is like a bucket of cold water poured on everyone's face: nitazoxanide is the only approved anti-cryptosporidium drug in the world, but it has not been approved in China; and its use is not recommended for people with immune deficiencies.

(End of this chapter)