This doctor has a system

Chapter 546 609. Trip to Sweden
Doctors once thought that Geng Feiyu was the 14th case of idiopathic multicentric Castleman's disease reported so far, but he felt that it should not be so few, as some patients passed away without even knowing what disease they had.

People always have some regrets at the end of their lives. A week ago, Geng Feiyu returned to China in a depressed mood. He wanted to meet some old friends and talk about the past. He never thought that he would meet the person who changed his life in this ordinary restaurant.

"you are?"

"This is Professor Gao Feng from our Provincial People's Hospital." Secretary Li Youliang immediately introduced.

"Hello, Professor Gao!" Geng Feiyu stepped forward and shook hands vigorously with Gao Feng. "I didn't expect that doctors in China are so capable!" He exclaimed. "I visited many hospitals abroad before I was finally diagnosed."

"Are you taking any treatment now?" Gao Feng asked.

"I used cocktail therapy." Geng Feiyu answered calmly, "But the effect is not good, and the doctor no longer recommends that I continue using it." Cocktail therapy puts a huge strain on the human body, and if it is used too frequently, the side effects alone can kill a person.

Gao Feng felt a little heavy-hearted. This young man's luck was really bad. Castleman's disease was incurable, which was a very cruel fact.

"Savior: Although Geng Feiyu only knows how to go to bars, play with cars, and sleep with women, he is a good boy. Please be his savior. You will get 50 skill points by completing the task." The system issued a task.

Gao Feng frowned immediately. It was obvious that this damn system was trying to trick him.

This is Castleman's disease! He would probably consume a lot of skill points just to look up the information, but he could only get 50 skill points by completing the task. He would never do this task.

But when he saw the other person's swollen body and gray eyes, he felt a little bit reluctant.

Seeing Gao Feng coming back so early, Li Xinyao went to take a shower on her own initiative. Relatives came to visit a few days ago, and her husband must have been holding it in too much.

After she washed up and entered the room, she found Gao Feng already asleep on the bed. Gao Feng was not actually asleep, he was checking information in the system space.

Because of the rare disease clinic, he had read almost all the diseases in the rare disease catalog, which is why he could guess what disease Geng Feiyu was suffering from at a glance today.

Like most rare diseases, the medical community has not done much research on Castleman disease. There is no way around it. The sample size is simply too small, and anything we can do is very limited.

However, based on current research and consensus, many experts believe that the immune system messenger interleukin-6 is the key to the onset of Castleman's disease. When lymph nodes secrete excessive amounts of IL-6, the immune system becomes abnormally hyperactive, leading to the onset of Castleman's disease and causing strong local or systemic inflammatory responses.

However, some experts believe that this consensus may not be accurate. A professor at the University of Minnesota once used sildenafil on several patients with the disease.

This is a monoclonal antibody drug that can block the binding of human interleukin-6 to the human interleukin-6 receptor, inhibiting human interleukin-6 and thereby inhibiting cell growth.

Logically speaking, it should have a significant therapeutic effect on Castleman's disease. After all, in principle, this drug can block the pathogenesis of Castleman's disease.

Unfortunately, the condition of these patients was not significantly controlled after the use of siltuximab, which has also made industry insiders critical of the current research and consensus on Castleman disease.

Gao Feng also felt that there was a big problem. If IL-6 was really the culprit causing Castleman disease, the disease should not have recurred after taking sutuximab.

The facts show that the currently recognized IL-6 pathogenesis model is not reliable in the face of real cases.

And there was another very important discovery. Thanks to his good memory, he always felt that he had seen the lymph node pathology images of Castleman disease before.

This is very strange!
Gao Feng was very sure that he had never come into contact with this type of patient before, and he fell into a deep sleep while thinking.

The next morning, he came to the pathology department.

"Director Gao, I'm sorry for not welcoming you in person!" Director Ding came up happily with a chest strap tied around his chest.

"What are you doing?"

"Don't mention it." Director Ding felt his chest aching again when he talked about this. He was lying in bed sleeping a few days ago when his two-and-a-half-year-old grandson poked his head out and pushed the door open and walked in.

Seeing his grandfather sleeping on the bed, the little guy climbed onto the bed nimbly. Due to his young age, he couldn't stand steadily and one knee landed directly on Director Ding's chest.

Poor Director Ding, who is old and weak, could not bear this. He almost died on the spot. He went to the hospital for an X-ray and found that the fourth rib on the right side was fractured. Fortunately, the dislocation was not very obvious, and now he is undergoing conservative immobilization treatment.

"Help me take a look at this." Gao Feng took out the lymph node pathology image of Castleman disease. "I seem to have seen a similar pathology report before."

Director Ding put on his glasses and looked at it for a long time. Finally, he said unsurely, "Why does it look like the lymph node image of a patient with an autoimmune disease?"

This sentence was like a thunderclap in Gao Feng's mind, immediately bringing back his memories. He remembered that half a year ago he had seen such an image in the rare disease clinic of Xhe Hospital. It was a patient with systemic lupus erythematosus.

Systemic lupus erythematosus is a chronic diffuse connective tissue disease with an unknown etiology that can affect multiple systems throughout the body. Patients produce a large number of autoantibodies in their bodies, causing the immune system to attack their own tissues, causing damage to multiple organs and tissues throughout the body.

Many patients will develop butterfly-shaped regional erythema on the bridge of the nose and the cheekbones on both sides, which is called butterfly erythema.

"Lupus? Castleman's disease?" Gao Feng fell into deep thought. Could these two diseases have similar pathogenesis?
Could it be that the enlarged lymph nodes are the result of the disease rather than the cause?
Gao Feng's mind was in a mess and he didn't know what to do next.

"Do we need to cancel today's outpatient clinic?" Li Youliang asked.

"Do not."

"Doctor, I've been treated here before." said a fat lady.

"is it?"

Li Youliang on the side began to check the previous medical records, but found nothing.

"When was the last time you saw a doctor?" Gao Feng asked.

"Two months ago." The eldest sister said, "I felt weak all over."

Li Youliang entered his ID number again, but it still showed blank.

“This doesn’t have your information.”

“Could it be because I cancelled my account at that time?” the elder sister said, “I felt that what you said was wrong, so I cancelled my account.”

... Gao Feng

"So what's wrong with you today?"

"Your blood sugar is high," said the eldest sister. "It's 12 even when you're fasting!"

That is indeed a bit high. Fasting blood sugar generally does not exceed 6.1mmol/l.

"Have you had diabetes before?" Gao Feng asked.

"No!" the eldest sister was sure.

“Have you ever measured your blood sugar before?”

"No."

Obviously, in the eldest sister's mind, no check-up means no disease.

"Then why did you think of checking your blood sugar this time?"

"Hey, someone hit me." said the eldest sister. She was walking on the sidewalk three days ago when she was hit by a turning car and her arm was broken on the spot.

The traffic police came and issued an accident report, finding the other party fully responsible. This was unacceptable, and they had to investigate the whole matter.

My eldest sister stayed in the hospital for two days and had a full body check-up, and found that her blood sugar, blood lipids, and blood pressure were all high.

"Then go to the corresponding department's outpatient department for treatment." Gao Feng said, why are you coming to me?
"I feel that my high blood sugar, high blood lipids and high blood pressure were probably caused by the car accident." The elder sister said, "Please give me a certificate so that I can ask her to pay compensation."

"Sister, is it possible that your three highs are caused by your diet?" Li Youliang said.

"You are a student, stop talking nonsense!" The fat lady was anxious. "We can't issue a certificate here." Gao Feng explained calmly, "You can go to the endocrinology clinic or the hypertension clinic for consultation."

"I've been to the endocrinology department," the elder sister said, "and they said I have a lot of problems, so they asked me to come to the general practitioner department."

Damn it! Who the hell is this, Gao Feng thought, looking for trouble with me.

However, the aunt was not too thick-skinned. After being rejected, she did not make a fuss, but walked away with a look of regret.

The next patient who came in was a 62-year-old man who looked timid.

"My son went to the car to get his cell phone," he said, standing at the door.

"Uncle, please sit over here." Gao Feng smiled at him, "Are you feeling unwell?"

"No...no." The old man was obviously a little nervous and spoke incoherently.

"Please don't be so formal. Just treat it like you're at home. Talk slowly about anything you have to say."

"I had tuberculosis before, and my son wants me to have another checkup."

It turned out that the old man had suffered from tuberculosis when he was young. He took medicine for a while without knowing why, but due to the poor financial conditions of his family, he never had another checkup.

But he himself didn't feel any discomfort, except for coughing a few times every day.

The son is quite ambitious and has earned a lot of money after graduating from college. He wants to take his old father for a health check-up.

"Do you smoke?" Gao Feng asked.

"You can have one." said the old man.

……

"drink wine?"

"Now?" the old man asked.

……

The old man really treats this place as his own home and is not at all shy at this moment.

After careful questioning, Gao Feng learned that the patient occasionally drank alcohol, but was a heavy smoker, smoking at least 10 cigarettes a day.

“How much can you draw at most?”

The old man stretched out a finger.

"One box?"

"Keep smoking." The old man replied.

Very good! Thumbs up for the old man.

After the patient's son came over, Gao Feng prescribed a chest CT scan for the old man.

When the results came out, Gao Feng was shocked to find that nearly 2/3 of the old man's right lung was damaged, which was obviously caused by tuberculosis.

"Don't you usually pant?"

"I'm fine at other times, but I only feel out of breath when I'm working on the construction site," said the old man, who has been experiencing out of breath for more than 30 years.

Gao Feng didn't know how he could bear it despite having a damaged lung and doing heavy physical labor. Perhaps it was because of his love for his son.

"I will quit smoking in the future."

Gao Feng saw a few more patients intermittently during the rest of the time. They were all simple questions, and Gao Feng felt a little bored. When he was going downstairs after the outpatient clinic, someone came up to greet him. Gao Feng thought quickly in his mind and realized that it was Director Yue of the Hematology Department.

"Director Gao, I have a relative who is hospitalized at your place. Please take care of him."

This is a distant relative who has nothing to do with the relationship, but since he has found him, he has to say a few words, otherwise he might say something nonsense when he returns home.

"Your relative's words are not very nice." Li Youliang said on the side.

Director Yue’s relative is a patient with coronary heart disease. He had two stents placed in his heart before. This time he was admitted to the hospital because of an angina attack after work.

The patient is quite strange. The previous doctors repeatedly told him not to do heavy physical labor, but he just wouldn't listen. Now he carries sacks in the town every day. The key is that his family is well-off, and he is a typical person who is willing to endure hardship.

The family members are even more bizarre. After arriving at the hospital, they act like stupid uncles, pressing the bell at every turn and wanting the nurses to do all the work of taking care of the baby's excrement and urine.

The nurses in the entire department frowned when they mentioned this family.

“Look at what this has caused…” Director Yue was very embarrassed.

The three of them chatted for a while, and Gao Feng seemed to remember something.

"Director Yue, do you know about Castleman's disease?"

"Castleman's disease?" Director Yue thought for a moment and said, "I saw a case of this before when I was doing further studies in Beijing."

"How is the patient now?"

"If the reincarnation went smoothly, you should be able to speak now."

……

That was two years ago. Not long after the diagnosis, the patient was taken away by his great-grandmother.

"He's quite young, what a pity!" Director Yue sighed.

"I met a patient a few days ago." Gao Feng told him about Geng Feiyu's condition.

"He's quite pitiful, but at least he has experienced everything." Director Yue said that many people work hard all their lives and still cannot drive a luxury car or pick up beautiful women.

"Is there any progress in the international fight against this disease?"

"I haven't heard of it..." Director Yue thought for a moment, "But this disease seemed to have been mentioned in a recent meeting." He began to look through his phone, "I'll send it to you."

"World Conference on Blood Disease Communication?"

"That's right." Director Yue confirmed. "There seems to be a sub-session with the same topic. The speaker is said to be an expert who has been studying Castleman disease for a long time."

"Are you going? If you go, we can be companions." Director Yue and Director Chang of the department planned to attend.

"I'll go back and think about it." Gao Feng hesitated and said, "I'll contact you if I go."

The World Blood Exchange Congress is held in Sweden, a country located on the Scandinavian Peninsula and one of the five Nordic countries.

The capital of Sweden is Stockholm. It borders Norway to the west, Finland to the northeast, the Skagerrak and Kattegat to the southwest, and the Baltic Sea and the Gulf of Bothnia to the east.

Gao Feng thought about it and decided to attend the meeting. The reason was simple: Sweden was the venue for the Nobel Prize.

(End of this chapter)