Oncology Physician Life

Chapter 5 Chapter 04 Pediatric Pleuropulmonary Blastoma

The door of the consulting room was pushed open, and Sun Renyi, the 54-year-old surgical emergency director, walked in with strides.He looked at Jiang Li in the consulting room with a smile, and said, "Surely this is Professor Jiang invited back from Anderson by the old dean, right? I saw Professor Jiang's resume at the hospital meeting, and it really is a young and talented woman. Don't let the eyebrows, it's different from Anderson, the ability and the state are different."

"Director Sun, we must take care of this child now, take out the fluid in the right chest, otherwise the child will be very dangerous." Jiang Li said calmly.

"It needs to be dealt with, but we still need to consult with the professors of tumor surgery first. Everyone can formulate a comprehensive plan. We can't just say a word from Professor Jiang. If something happens, we can't be responsible in the emergency department."

Jiang Li frowned, but did not refute.

Sun Renyi gave Li Ming a wink: "Professor Ji Hanji and Professor Li are here today. You go and ask the people from the tumor to come for consultation."

Office of the Associate Director of Surgical Oncology.

Lu Jiajia was originally an intern in tumor surgery, so of course he was sent by Director Sun from the surgical emergency department.It's just that Li Ming went to call Professor Li from Zhongwai, and "good intentions" left the master of Zhongwai to her.

Who in the whole hospital does not know that Professor Ji Hanji is the most stern, with an inaccessible face all day long, and there is no intern who is not afraid of him.

Standing in front of the lit office door, Lu Jiajia could only bite the bullet and knock on the door.

"Come in," Ji Han's rather indifferent voice came from inside.

Lu Jiajia pushed the door open, and under the bright incandescent lamp, Ji Han's slender figure was standing beside the hanger, just taking off his white coat and getting ready to get off work.

This week, Professor Ji stayed on until three or four in the morning every day.

Seeing this situation, Lu Jiajia secretly groaned, hoping that he would not think that he was the one who delayed him from getting off work.

Ji Han turned his head, saw that it was an intern doctor from tumour, he looked familiar, and asked aloud, "Is there something wrong?"

Lu Jiajia organized the language: "Surgical emergency C2 please consult urgently. In the evening, Dr. Li Ming from the emergency department admitted a child with a fracture in the welfare home. On the way, he suddenly suffered from ventricular fibrillation and had difficulty breathing. There was a foreign body in the chest on the CT scan. Director Sun from the surgical emergency department It is suspected to be a tumor, and it cannot be judged accurately, so..."

"What's the patient's condition?" Ji Han's voice remained indifferent, but his eyes swept past Lu Jiajia's dodging eyes, "Also, you are an intern in tumor surgery, why did you go to the surgical emergency room late at night?"

"I..." Lu Jiajia really had a hard time answering. She groaned secretly and forced herself to explain her condition. "The patient suddenly fell into a coma due to ventricular fibrillation and said that he had difficulty breathing. In addition, this child is a special patient who suffers from spinal muscular atrophy. But it is SAM III type, and he started to develop generalized muscle weakness at the age of six, and currently he can only travel in a wheelchair."

"Spinal muscular atrophy?" Ji Han took off his new suit and put on a neat white coat again.

"So the patient's first treatment was Dr. Li Ming from the emergency department of surgery? He was also the one who identified the foreign body in the child's chest? Do you know the specific blockage of the foreign body?"

"Well, according to the CT scan images, the patient's thoracic foreign bodies are very densely surrounded near the heart, and they are compressing the airway between the two lungs. The right lung is severely deformed and can no longer enter the air, the left lung airway is squeezed, and the right chest is compressed The tumor is filled with secretions..." She saw Ji Han's eyes squinting behind the gold-rimmed glasses, and hurriedly lowered her head, not daring to meet his gaze.

After putting on everything and picking up the stethoscope on the table, Ji Han leaned over her and walked outside: "Go downstairs and see the patient first."

Lu Jiajia hurriedly followed behind his tall and thin figure, always half a step behind, not daring to overstep.

With her head down, she could only see the pair of black leather shoes under the tall figure in front of her, stepping on the empty corridor, making a "tapping" sound.

Lu Jiajia followed behind him step by step, and continued: "The patient's first treatment should not be Dr. Li Ming, but Professor Jiang Li. After all, the foreign body in the child's chest was diagnosed and confirmed by Professor Jiang Li... By the way, it was Professor Jiang Li who diagnosed it today. When I came back, I was responsible for picking her up. The director of teaching in the hospital said that after Professor Jiang entered the job, I will work as an intern under her. Professor Jiang is very powerful, and he is the MD Anderson Cancer Center..."

Suddenly, the figure in front stopped suddenly, and Lu Jiajia didn't stop the brakes, and instantly bumped into Ji Han's thick back.

Ji Han frowned suddenly, looked at the elevator door that just opened, hesitated for a few seconds, and then walked in.

Lu Jiajia gritted her teeth, her forehead hurt from the bump, and she didn't dare to ask Ji Han why she stopped suddenly, so she could only bite the bullet and follow the elevator.

In the elevator, she didn't dare to look at Ji Han next to her, she just felt that her intern career might be ruined by today's collision.

I don't know if Deputy Director Ji will remember himself?
It's best for him not to remember that the fate of all the interns outside the hospital is in the hands of this "big god". If he writes a few words in the internship report that shouldn't be written, then her doctor's intern career will be over. up.

…………

In the C2 clinic of the surgical emergency department.

Little Jiang Hao has already woken up, and the nurse put the pillow behind him to make him sit up as straight as possible so that he won't look so uncomfortable.Another nurse helped him organize the ventilator connected to the intubation tube, and monitored the status of the ventilator at any time, and contacted the doctor on duty immediately if he had difficulty breathing.

Little Jiang Hao's eyes widened, filled with fear.His breathing rate was more than twice as fast as normal.The "humming" sound accompanying his breathing could be clearly heard throughout the ward.

Jiang Li frowned, Xiao Jiang Hao's condition was getting worse all the time, this situation indicated that he was in danger of death at any time, just letting him lie down, could cause a lump to block the airway and suffocate him.

Besides, giving him any sedative would also kill him.

In the current situation, surgical resection of the tumor is the most impossible. Although chemotherapy can eliminate the tumor, it takes time.

The problem is, little Jiang Hao has no time, how can she buy time for this child?

Professor Li Chunrong from tumor surgery can be regarded as a respected senior with more than 20 years of medical experience in tumor surgery. He is also one of the academic leaders of the laboratory of cancer and erosion principles in the hospital.

At this time, Li Chunrong, the anesthetist for the tumor, three residents, and a resident who was on duty in the pediatrics department tonight were all called over.When everyone learned that this was probably a child with cancer, there was a rare silence.

Compared with the 400 million adult cancer patients per year, childhood cancer patients are very rare, but they are also a huge number. In China, there are nearly 4 new childhood cancer patients every year. On average, there is one child cancer patient in 400 children. !
At the same time, more than 1 children die of childhood cancer in China every year, and there are survivors of childhood cancer in one million families in China.

Due to intensified social and environmental pollution, changes in lifestyle, and improved cancer detection levels, the number of childhood cancer patients in China has continued to rise.

In China, cancer is already the second leading cause of death for children under the age of 15, second only to accidental injuries.On the contrary, in the United States, due to the popularization of safety measures, accidental injuries have been greatly reduced, and cancer has become the number one killer of children in the United States.

From an economic point of view, curing a child patient can save nearly 50 years of life. Therefore, whether it is emotional, scientific, or the future of the country, conquering childhood cancer is of infinite value, but unfortunately, it is the opposite. The investment and research on childhood cancer is very backward all over the world, and in China, it is almost negligible.

The pediatric resident shook his head directly after watching the film. In the five years he worked in the hospital, he rarely encountered such patients, and he was unable to give professional treatment methods and methods.

Professor Li Chunrong, who suffered from the swelling, is 53 years old, and the hand holding the film was showing blue veins due to the force. "The lump has grown to such a large size, why did I only find it now?"

Mother Jiang of the orphanage had tears in her eyes: "There are more than 100 children in the hospital, and the funds are limited. The little Jiang Hao suffers from spinal muscular atrophy. The old director works a lot of part-time jobs in order to see the children. The child must feel sorry for the old headmaster, he is usually uncomfortable and stiff, but he didn't expect to have a tumor, why is his life so hard! He has to bear this at such a young age!"

Professor Li Chunrong sighed: "What a child can do is often beyond the imagination of adults. He is very brave."

Jiang Li glanced at the crowd and said out loud, "The child's condition is very dangerous now. The lump may block the airway between the two lungs at any time, causing suffocation and death. The top priority is that we should take emergency measures to ensure the child's breathing is unblocked."

After listening to her words, everyone in the small conference room turned their attention to the female doctor in her early thirties in the corner.

Director Sun from the emergency department of surgery met everyone's puzzled eyes and explained: "This is Professor Jiang Lijiang, whom the old director specially invited back from Anderson, and he will soon be the director of the new Pediatric Oncology Department in our hospital."

"It turns out to be Professor Jiang, who has been famous for a long time." Professor Li Chunrong catered briefly, "Since Professor Jiang is an expert in childhood cancer research in the United States, do you have any suggestions?"

Jiang Li's gaze turned to the CT image on the map reader: "I suspect that this is a typical case of childhood pleuropulmonary blastoma, also known as PPB. , and is significantly different from adult lung cancer. Adult lung cancer is mainly concentrated in four categories: small cell lung cancer, lung adenocarcinoma, lung squamous cell carcinoma, and large cell lung cancer. Most of them are related to smoking and air pollution, while children's lung cancer occurs the most It is an extremely rare type of cancer such as pleuropulmonary blastoma and lung carcinoid."

"Are you sure it's children's pleuropulmonary blastoma?" Professor Li Chunrong paused for a moment, "I have been engaged in cancer research in the oncology department for more than 20 years, and I have rarely heard of this rare type of cancer before, but in recent years this The number of patients with rare childhood cancers has increased geometrically in China, and I went to Zhejiang to do research a year ago, and I heard the medical team there talk about such rare childhood cancers.”

(End of this chapter)