This doctor has a system

Chapter 429 494. Sneeze and break the ribs
But there are also many people waiting to watch the excitement. Anyway, they are all waiting for Gao Feng to stand up and say a few words.

"I am very grateful to Professor Prampedi and all the experts for their attention." Gao Feng made a formal response to the recent uproar of public opinion through Immunity magazine.

"It's a pity that a lot of public resources have been taken up, but what I want to say here is that this article is completely based on real data and good efficacy."

“The speed with which rare disease diagnosis and treatment is established this time is indeed beyond the norm, but I can guarantee that it is real.”

For topics that everyone is concerned about, Gao Feng also gave the next solution.

"I will publish the detailed process and all data of this experiment completely, and hope that experts who are capable and concerned about this matter will repeat the experiment as soon as possible."

The editor of Immunity, Ruskin Hugh, smiled crookedly because the process and data must be published in their magazine.

For this reason, several editors-in-chief specially discussed it and decided to advance the printing time of the next issue of the magazine.

Soon, many scholars took action in response to Gao Feng, and Professor Prampedi was among them.

"I need three days to prepare for the experiment, and I will start repeating the experiment immediately."

"Are you still in the mood to sit in the clinic here?" Director Fan was stunned for a moment when he saw Gao Feng.

"The result of young scholars' desire to become famous." Someone commented online, "I could tell something was wrong."

The new mutation carried on the IL-1R1 gene made Dr. Connor, the core member of the team, shine. He came up with a wonderful idea, which was to introduce the new mutation on the IL-1R1 gene and use it in reverse. The special properties of a gene mutation can lead to improved drugs.

"Ah? Are you kidding?" The boy's father expressed great doubts about Gao Feng's words.

After repeated arguments, everyone's opinions were unified.

This is also an old pharmaceutical company that has been on the Hurun Fortune 500 list for a long time.

"I don't think Professor Gao Feng will commit academic fraud." A big brother in the industry expressed his opinion, "Because he doesn't need this at all."

Standing aside was the patient's father, who also looked worried.

Anyway, everyone is talking about it, and all this still has to wait until the results of repeated experiments come out.

This made everyone a little puzzled, but soon someone learned the reason.

If the data and treatment effects in Gao Feng's article are true and reliable, then this idea will undoubtedly have a very high success rate. That's why Regeneron Pharmaceuticals is actively involved in replicating the experiments.

"What's wrong with this?" Gao Feng felt strange at his words.

This elder brother told everyone about Gao Feng’s achievements and honors.

"It seems like he sneezed." The boy hesitated. He didn't say it before because he felt that this was not important.

"Doctor, my son was in good health before. What happened this time?"

"Hey, aren't they talking about you everywhere?" Director Fan smiled, but he soon realized why Gao Feng was so calm.

Gao Feng conducted a careful physical examination of the patient. The breath sounds in both lungs were clear, and no wet or dry rales were heard. The heart rate was 80 beats/min, regular, and no pathological murmurs were heard in the auscultation area of ​​each valve.

"You see, this step of his is very abrupt, the front is the same as the back."

"It's probably a broken rib." Gao Feng thought for a moment and said, "Have you fallen recently? Or had a violent collision with someone?"

The patient is a 16-year-old boy who is still in high school.

"I'm going to Nimei!"

As a well-known professor of immunology, I have to say that Park Guochang's scientific research skills cannot be underestimated. What he said was all practical information, and he highlighted the abrupt and coincidental aspects of the experimental process.

"I don't dare to turn over when I sleep at night."

"Were there any special circumstances before the pain?" Gao Feng asked, "Think about it carefully."

"The Chinese people are going to be in trouble." Professor Park Guochang of the Republic of Korea jumped out again, "I have read the experimental process in detail. Based on my many years of scientific research experience, the probability of passing the repeated test is almost zero."

Immediately the negative comments started pouring in again, and now even the general public got involved.

"Chest pain." The patient said with a frown. He had developed left chest pain for no obvious reason 3 days ago, and the pain was obvious when he inhaled and breathed.

"No." The boy thought carefully. He was a high school student. He usually studied and occasionally wandered under the teaching building after class. He had not done any strenuous exercise recently.

While pressing the left chest, the patient frowned.

"I fix air conditioners."

While the two were talking, a patient came.

Just as the drug development team was struggling, Gao Feng's article was published.

"Have you seen it a long time ago? What do you do?" asked the person downstairs.

"He is not yet 30 years old, so it is impossible for him to do these things that will destroy his future."

"It's completely a trace of artificial blending." He was very proud, "I can see it at a glance."

As an American company, Regeneron Pharmaceuticals was founded in 1988 by Leonard S. Schleifer, MD, a neuroscientist and assistant professor at Cornell University Medical School.

"Then he probably broke his ribs when he sneezed."

The foreigner didn't know, but he knew that the patient had indeed experienced remission after high wind treatment. There is no doubt about this.

"pain!"

In addition to some scholars, some special institutions have also participated. Regeneron Pharmaceuticals issued a statement on its official website, stating that it will participate in repeated trials as soon as possible.

In 2008, Regeneron Pharmaceuticals developed a drug, Rilonacept, which is an interleukin-1 inhibitor and is used for recurrent pericarditis, but its efficacy has certain limitations.

"You can do a chest X-ray to verify it." Gao Feng said, and Li Youliang clicked a few times, and the checklist was printed out.

Although he didn't want to believe it, the boy's father decided to take his son for a checkup first.

Can sneezing cause broken ribs?

meeting.

When you sneeze suddenly and violently, some muscles in the chest and abdomen will contract strongly, which can easily strain the muscles and even cause rib fractures.

Of course, this situation is relatively rare, and most patients are thin or osteoporotic people.

This boy is the thinner kind, commonly known as thin dog. The results of the chest X-ray came out quickly, and the results were slightly beyond Gao Feng's expectations.

"The third and fourth ribs on the left side are both fractured."

Two ribs were broken at once, and both the boy and his father were dumbfounded.

"What should I do? Is there any surgery needed?"

"That's not necessary. Although there is a fracture, there is no obvious dislocation." Gao Feng suggested that the patient use a chest strap to fix the chest and take some painkillers orally.

After seeing off the patient, a plump woman came in accompanied by her husband.

The patient's mental state was not very good, and he looked sickly. He only took a few steps and seemed to be wheezing, and his cough was obvious.

"Are you pregnant?" Gao Feng asked, noticing the patient's bulging belly.

"Yes, 18 weeks," the patient's husband responded.

The patient, 31 years old, reported that he developed fever and cough symptoms after catching a cold one month ago. He was treated with oral medication outside the hospital, but the effect was poor. He still had recurring fever and frequent coughs.

"The chest tightness is quite obvious now." The patient's husband added, "I have to take a rest after walking very far."

The doctor in the community said she might have pneumonia and gave her a week of antibiotics, but her symptoms still didn't subside.

The patient is 21 weeks pregnant. In this case, chest X-ray or chest CT examination is definitely not possible, which brings certain difficulties to a clear diagnosis.

Some doctors who lack clinical experience will be a little worried when encountering such patients.

However, Gao Feng was obviously not among them. Even without chest imaging examination, he could still obtain a lot of valuable information from the detailed physical examination.

After picking up the stethoscope and listening, Gao Feng looked a little unhappy because he found that the patient's breath sounds on the left side had disappeared.

The disappearance of breath sounds does not occur without reason. There are many reasons for it, such as large amounts of pleural effusion, pneumothorax, foreign bodies in the airway, lung tumors, etc.

He then percussed the patient's lungs and felt tentatively certain.

"It should be a large amount of pleural effusion on the left side." He told the patient and his family. "Based on the medical history and these examination results, it is most likely tuberculous pleurisy."

Generally speaking, tuberculous pleurisy is not a serious disease. Its main symptoms are 1. Symptoms of tuberculosis poisoning. Patients have varying degrees of fever, night sweats, fatigue, etc., among which fever is the most common.

2. Chest pain. Chest pain is mostly a sharp stabbing pain, often related to breathing, and is often aggravated by deep breathing. It is often an important clue for patients to find pleurisy when seeking medical treatment.

The pain is most common in the chest and ribs, and patients are often accompanied by shoulder pain, lower chest and rib area pain. Mediastinal pleurisy may cause retrosternal pain.

3. Difficulty breathing, especially when moderate or large pleural effusion grows rapidly. When there is moderate to large pleural effusion, the patient may be accompanied by atelectasis, further aggravating the symptoms of dyspnea.

There is nothing special about the treatment. It is nothing more than drainage of pleural effusion and regular oral administration of anti-tuberculosis drugs.

But the patient's situation is obviously somewhat special. She is an expectant mother who is 18 weeks pregnant, which makes it difficult.

"Won't this affect the baby's development?" The patient was a little anxious, "Doctor, can I wait until I have given birth to a baby before I can treat this condition?"

This is obviously not possible. The patient's chest tightness is now very serious. The large amount of pleural effusion has severely squeezed the left lung. Even if the disease stops progressing, she will not be able to bear it until the third trimester of pregnancy.

But will the condition not progress? The answer is obviously no.

"Wait a moment, I'll ask the obstetrician and gynecologist to come and take a look." Gao Feng decided to give up, because from his point of view, there is a high probability that the child will not be saved.

In fact, obstetricians and gynecologists say the same thing.

"If it is really tuberculous pleurisy, it is still recommended to terminate the pregnancy as soon as possible."

"Anti-tuberculosis drugs will inevitably have an impact on the baby, possibly causing developmental abnormalities or other serious consequences."

There was naturally no luck in the follow-up. Through the pleural effusion drainage test, the patient's diagnosis of tuberculous pleurisy was quickly confirmed. Gao Feng felt very uncomfortable when he saw the patient's sad expression.

But this is the best option.

Tuberculosis is an ancient disease in the eyes of many people. From "scrofula" (tuberculosis of skin and soft tissues) in ancient books to "tuberculosis" (mainly tuberculosis) in Lu Xun's works, our ancestors have struggled with it for thousands of years;
Today, the development of modern medicine, especially the invention of drugs such as isoniazid, allows us to no longer face tuberculosis with bare hands, but in fact, its ghost is still lingering, and it is far from being eliminated.

China is still a major country with tuberculosis.

As soon as Gao Feng returned to the department, he saw Fan Yulong and Zhang Zhengye discussing something in the doctor's office, and everyone was talking around.

"What's wrong?" Li Youliang stepped forward and asked.

"Hey, a seriously ill doctor had a conflict with the patient's family." Zhang Zhengye sighed, "He even called the police."

Gao Feng is a little strange, because according to common sense, doctors in the intensive care unit rarely have serious conflicts with patients' families.

In most cases, it is doctors from general wards who fight with family members.

This is because except for daily visiting hours, family members cannot see the patients lying in the intensive care unit all the time, which reduces the probability of conflicts intensifying.

In addition, most of the patients inside are breathing in but not out, and their conditions are serious, so their families should be mentally prepared.

The cause of the matter is very simple. A male patient who was seriously ill was in a serious condition. After some consideration, his family decided to give up the treatment. They lied to the patient that he would go to another hospital for treatment and asked the patient to cooperate with extubation.

After signing, when the bedside doctor went to extubate the tube, the patient thought he was transferred to another hospital after the tube was extubated. He kept saying to him: It has been troublesome for you these days. I know it is not because you are not trying your best, but because I am seriously ill.

The doctor in charge of the bed felt very uncomfortable. He hesitated for a long time when extubating the tube, and he really couldn't do it.

He knows what extubation means. Doesn't this mean that he kills people?

"If you want to pull it out yourself, I can't do it." The doctor in charge quarreled with the family members outside the door, and eventually the two sides started fighting.

"Actually, we haven't reached that point yet." Director Sun, who was seriously ill, communicated with his family again, "Give the patient a little more time, and give us a little more time."

"We want to give you time, and we don't want him to die." The family members were very emotional. "How much money have we spent!"

"Don't you yourself know how expensive your consumption is?"

Still the same sentence: The dead can walk away, but other people have to continue to live.

"The patient is too old. Even if he is rescued, what will happen?" Director Sun advised the doctor in charge, "Sooner or later, people will die."

In the end, it was Director Sun who removed the tube. The patient's breathing and heartbeat stopped within 5 minutes of being pushed out of the intensive care unit.
Hearing the miserable cries of the family members outside the door, the expression on Director Sun's face was very complicated, with both understanding and sympathy and a hint of ridicule, which finally turned into a sigh.

(End of this chapter)