White armor

Chapter 213 explains the incomplete writing

"The patient's coronary artery is fine." The surgeon paused slightly, a little impatiently.

"Hello, I am Dr. Luo from Xiehe." Luo Hao introduced himself softly.

Concord?

Concord!

The doctor's expression immediately changed. Although he was not too expressive, he still gave Luo Hao enough respect.

"The patient has no history of Kawasaki disease, rheumatic diseases, syphilis and other diseases. The cardiac color ultrasound does not show the apical spherical changes of Takotsubo cardiomyopathy and the prolongation of the QT interval of the electrocardiogram. There is no diffuse systolic dysfunction of virus-related myocarditis."

A series of professional words made the doctor serious.

"You think it's time to do surgery. Don't withdraw the tube yet, but do a drug challenge test?"

"You doubt it?"

"Recent guidelines believe that since MINOCA is a provisional diagnosis, the standard is that no obvious stenosis is found during coronary angiography, but at this time it should be clear whether the myocardial injury is caused by ischemic or non-ischemic causes."

If the examination is incomplete or done hastily, the Department of Circulation Medicine at the Aviation General Hospital will be looked down upon and degraded.

"..."

"Can……"

Luo Hao firmly refused to admit this kind of ranking.

"Of course, I said it before, I believe you." Luo Hao smiled, "Besides, you don't know how capable you are?"

If he could do this accidentally, Luo Hao considered sending Chen Yong back to Qingcheng Mountain or Longhu Mountain, Laoshan Mountain, or Wudang Mountain to cultivate his mind.

After listening to a few words, the surgeon solemnly agreed and went over to continue the operation.

Luo Hao spoke very vaguely, but his meaning was quite clear.

"Are you also a circulatory physician?"

"What did you say?"

In addition, the coronary angiography results were also normal, which further made Chen Yong feel uneasy.

Chen Yong didn't hide either. He just sighed worriedly.

The surgeon pondered.

Although the patient is just a student, there are countless teachers behind him, and he may not be sure which one of the experts in the Teito University Department will give him the correct diagnosis at a glance.

It's not that I don't believe that Chen Yong doesn't have this ability, after all, the luck value of 101+5 is clearly displayed on the system panel.

The Department of Cardiovascular Medicine at Union Medical College is slightly weaker. In some rankings, it is even on the edge of the top ten, slightly lower than the First Hospital of the Medical University.

"Ask Wang Yang's classmate in the same dormitory about his recent situation." Luo Hao felt that the medical history was not enough, "The more detailed the information, the better, okay."

"Non-obstructive coronary myocardial infarction needs to be ruled out. The angiography has been done. Let's do an acetylcholine challenge test. What do you think?"

"It was fine, but it suddenly stopped. I didn't see any problems during the angiography." Chen Yong didn't listen to what Luo Hao said at all, and murmured in frustration, "It must be my fault."

"Okay." The surgeon compromised directly, but still insisted on defending, "I guess it will be fine."

Watching Zhuang Yan go to "ask for medical history", Chen Yong sighed again.

"Chen Yong really has nothing to do with you." Luo Hao said.

"Zhuang Yan!" Luo Hao shouted.

"Luo Hao, do you think it really has nothing to do with me?" Chen Yong asked Luo Hao in a low voice.

Luo Hao patted Chen Yong on the shoulder to express comfort.

The surgeon was a little embarrassed. Luo Hao brought out the latest guide. He didn't know how to deal with it.

"Otherwise, the patient still has pain in the precordial area, which is difficult to explain. After all, he is a graduate student in the Department of Medicine at Teito University. If the diagnosis is not clear, he still has to go back to one of the affiliated hospitals."

"Didn't I just become a little stronger? I can't control it well. I'm afraid that a joke will..."

"Yes! Senior brother, don't worry."

"It should... definitely have nothing to do with you, don't worry." Luo Hao glared at Chen Yong, "The examination hasn't been completed yet. Just because there is no problem with the angiography does not mean that there is really no problem."

Luo Hao also knew that if he had to perform the surgery himself, he would hate it when someone was gesticulating.

"Idiot." Luo Hao cursed.

Chen Yong was worried. Even if Luo Hao ridiculed him and laughed at him, he was still worried.

"Oh, please stop comforting me." Chen Yong was very frustrated, "It's all my fault."

Luo Hao mainly believed that Chen Yong was kind and had no reason to do this.

This thing is indeed a coincidence, a very coincidence, and the other party is a strong young man, so there shouldn't be any problems.

Luo Hao looked at Chen Yong, this idiot, and was speechless. He didn't believe that Chen Yong could give a young man a heart attack with just a snap of his fingers.

"Know a little bit."

The chain of contempt within the medical system exists, and the chain is quite clear.

"Senior brother, I'm here." Zhuang Yan stood up and came to Luo Hao.

"Except for Union Medical College, students from other medical schools have poor foundations." Luo Hao scolded with disdain.

After a few curses, Chen Yong finally became more energetic.

"Brother!"

Zhuang Yan ran back.

"What's the matter?"

"Wang Yang had a gastrointestinal cold and diarrhea yesterday." Zhuang Yanhui reported, "But can this cause myocardial infarction?"

"What medicine did you take?"

"Montmorillonite powder + levofloxacin + clarithromycin."

Zhuang Yan's level is still good, and she doesn't ask questions one after another.

understood!

A comfortable smile appeared on Luo Hao's face, "It's about clarithromycin."

"???"

"???"

Chen Yong immediately took out his mobile phone and searched for the instructions for clarithromycin.

"1. Mainly include oral odor (3%), gastrointestinal reactions such as abdominal pain, diarrhea, nausea, and vomiting (2% to 3%), headache (2%), and transient elevation of serum aminotransferase.

2. Allergic reactions may occur, ranging from drug eruption and urticaria to severe allergies and Stevens-Johnson disease.

3. Hepatotoxicity and pseudomembranous enteritis caused by Clostridium difficile are occasionally seen.

4. There have been reports of transient central nervous system adverse reactions, including anxiety, dizziness, insomnia, hallucinations, nightmares or confusion. However, the relationship between the cause and the drug is still unclear. "

"Luo Hao, there is no side effect of causing myocardial infarction." Chen Yong said doubtfully after reading it.

"The description is incomplete."

"grass!"

"Let's wait for the results of the stimulation test." Luo Hao didn't explain. He returned to the chair and sat down, stretching his legs, making a circle with his hands in front of him, and circling his thumbs continuously.

"What's going on? I see it's written in the contraindications below - it's contraindicated in patients with certain heart diseases, including arrhythmia, bradycardia, Q-T interval prolongation, ischemic heart disease, congestive heart failure, etc. ." Chen Yong came over with his cell phone.

"A very rare situation." Luo Hao said seriously.

Chen Yong knew what the next sentence would be. But this time it involves him, and Chen Yong can't hide even if he wants to.

"But it is rare in other hospitals and cannot be diagnosed. It is a common disease in my family, Xiehe." Luo Hao said.

"!!!"

Sure enough, Chen Yong’s guess was not wrong at all!
Luo Hao really said that.

This piece of shit!
"Does your aunt Xiehe who cleans the house know about it?" Chen Yong asked disdainfully.

"I can't say everything, but the hygienists in the circulatory and emergency department will definitely know." Luo Hao said firmly, "When the stimulation test results are obtained, don't worry, it's a drug allergic reaction and it has nothing to do with you."

"Please tell me in detail."

"There's nothing to say. Simply put, the allergic reaction to clarithromycin causes the activation of mast cells, macrophages and T lymphocytes, synthesizing and releasing inflammatory mediators.

A syndrome of peripheral vasodilation, lowered blood pressure, decreased coronary blood flow, arrhythmia, coronary spasm, coronary atheromatous plaque erosion, rupture or coronary stent thrombosis, also known as allergic myocardial insufficiency. blood syndrome. "

"The scientific name is Kounis syndrome."

"..."

"..."

Chen Yong and Zhuang Yan both looked confused.

Luo Hao sighed, the diagnostic assistant AI is really useful, and I feel good after using it.

And inseparable.

Now the diagnostic assistant AI is being upgraded, and I don’t know what to integrate with it. If the diagnostic assistant AI hadn't been working, I would have been able to "see" that Wang Yang had a myocardial infarction at the airport.

Although nothing serious happened, it was still a bit dangerous.

The facts were almost as Luo Hao "expected". The surgeon came out half an hour later and the acetylcholine provocation test was positive!
Luo Hao told the surgeon his judgment.

Clarithromycin was discontinued and combined therapy with nitrates and calcium channel blockers was initiated.

A few hours later, Wang Yang's symptoms were significantly relieved, and Luo Haobian left with Wang Jiani, Chen Yong, and Zhuang Yan.

With a correct diagnosis, the treatment that follows is less important.

As long as there are no allergens, "myocardial infarction" will be cured even without medication.

"Luo Hao, it really has nothing to do with me." Chen Yong's expression was very complicated, with relief mixed with a little bit of disappointment.

Luo Hao understands Chen Yong's mentality very well. He is afraid that his brother will have a hard time and that he will drive a Land Rover.

People are always confused.

"It's okay, isn't it?"

"Clarithromycin has such side effects, why isn't it written in the instructions?!" Chen Yong became more active, and his tone of voice changed significantly.

"There are many similar situations, not just about clarithromycin." Luo Hao said, "It's not a side effect, it's an allergy. Some people are even allergic to water. You can't give pure water an instruction manual to explain the situation."

"What else happened?" Chen Yong asked.

"Disease factors, such as angioedema, asthma, vasculitis, hay fever, etc.; environmental factors, such as insect bites, plant cuts, latex, diesel, etc.; food factors, such as shellfish, tuna, kiwi fruit, etc.; drug factors, antibiotics, Contrast agents, anti-tumor drugs, non-steroidal drugs, glucocorticoids, proton pump inhibitors, etc.

The most common cause is antibiotics, followed by insect bites. "

"Occasionally, patients will have a similar situation during chemotherapy. I once arranged a table for Teacher Pan to perform embolization surgery at Xiehe University. The patient was allergic to chemotherapy drugs and had ST-segment changes. Teacher Pan told me."

"..."

Chen Yong was a little disappointed.

Every time Luo Hao "showed off" how awesome Union College was, he would blankly wonder if his life would be any different if he had worked harder in high school and got admitted to Union College.

Although there is a high probability that I will still go abroad and go to Qingcheng Mountain, it is still much better to tell people that I am a graduate of Xiehe University.

Ugh.

Chen Yong sighed deeply in his heart.

"Chen Yong." Luo Hao asked in a low voice. "how?"

"If you have the will, can you do it?" Luo Hao asked a confusing question.

"I don't know." Chen Yong shook his head, "I can't do it even if I want to harmonize the society and eliminate gangsters. Do you want me to become a gangster? Or do you want to open a private hospital where everyone who comes is sick? Am I rejuvenating?"

"You are so dark. I just asked you casually, but you actually thought of that."

Luo Hao said, suddenly his heart moved.

"Any of you do this?"

"Of course, there are many evil ways." Chen Yong said, "But I am different. I am a disciple of a famous sect from Qingcheng Mountain."

"The disciple of the chef."

"That's also a disciple! Which branch of the People's Liberation Army is the strongest? It's not the cooking soldiers. It's the same in Qingcheng Mountain in my family. The disciples in the rear kitchen are the strongest, even those from the outer sect."

Seeing Chen Yong return to normal, Luo Hao breathed a sigh of relief.

"Let's go, I'll treat you to some bean juice."

"do not want!"

"do not want!"

"Okay."

Only Wang Jiani said happily.

"Da Nizi, are you stupid? You will regret it if you drink that Douzhier thing!"

"Luo Hao shouldn't give me something bad to drink." Wang Jiani said with big eyes flashing.

"emmmm." Luo Hao thought for a while, "Then let's go eat hot pot. There is a good hot pot restaurant under Sanyan Bridge. Director Qin likes to go there."

A hearty meal.

Luo Hao was also very hungry in India. Together with Chen Yong and Technician No. 66, the three of them ate 20 plates of meat in one go, leaving Wang Jiani and Zhuang Yan stunned.

In the poor land of India, Luo Hao didn't even dare to touch unfamiliar water, let alone eat hand cakes and other meat foods.

Now that he is back and has cooked the mutton, Luo Hao feels extremely happy.

This kind of happiness is as real as it is, and it is so thick that it cannot be dissolved.

"Are you being treated so harshly like this in India? It's so miserable. I feel like you are just asking for food." Wang Jiani was surprised.

Luo Hao was a little helpless, and Wang Jiani was very glad that she did not go to India with Luo Hao.

After eating and drinking, go back and rest.

Luo Hao took Wang Jiani to visit the two bosses early the next morning, left a message for Principal Wang, and then got on the plane home.

When the plane was taxiing, Luo Hao turned on his phone and saw a series of missed calls.

Uh, what's going on?
The call was from Geng Qiang.

Luo Hao quickly replied.

Geng Qiang must be looking for him because there must be something urgent.

"Brother Geng, I'm on a plane and just landed. What's wrong?"

"An investor is sick. He may be acclimatized. I'm thinking of having a look at you." Geng Qiang's words were calm, but Luo Hao could hear some urgency.

Thinking about it, if he was not in a hurry, Geng Qiang would definitely not call him alone, and there would be a series of missed calls.

"Okay, I'm going to take a look. Where is he?"

"The ICU of the First Hospital of Medical University."

Hey!
I'm already in the ICU, so why don't I worry?

"I'll be there soon." Luo Hao hung up the phone, "Da Nizi, help me get my luggage. I'll go to the ICU as soon as I get off the plane."

"Chen Yong, come with me."

"Lao Liu, help Dannizi deliver the things."

Luo Hao immediately made arrangements.

Seeing Luo Hao's serious face, the others knew that there must be a difficult patient.

After getting off the plane, Luo Hao hugged Wang Jiani gently and said, "I'll see you when I'm done."

"Ok!"

Luo Hao left quickly.

"What patient?"

"I don't know the specific illness, but I guess the investor suddenly fell ill and is now in the ICU."

"Foreigners are so fragile," Chen Yong said.

"???"

"I feel that they are not fully evolved and have numerous allergies." Chen Yong went through the gossip, "I know a girl in the UK. She was severely lactose intolerant and had diarrhea after drinking milk. Later, she went directly to the hospital. ”

Uh.

Luo Hao's thoughts flew to the other side of the sky.

I already know that I am lactose intolerant, but I still want to be exposed to it. Is it because of the small lactose content?
It seems possible, otherwise why would Chen Yong add the words "serious" before lactose intolerance when describing his little girlfriend.

Just this sentence exposed many problems.

"What are you thinking!" Chen Yong saw Luo Hao's expression and understood instantly.

"The lactose content is just that, isn't it?" Luo Hao asked.

"That much?"

"0.62 milligrams per milliliter. Calculated according to the general standard upper limit of 5 milliliters, it is only 3 milligrams. Will I be allergic? Do I still have to go to the hospital? Did the ambulance go there? Or did you take it there on a broom."

"!!!"

"Actually, China doesn't know much about allergies. Maybe it's because life has just improved in the past few decades." Luo Hao said, "Otherwise, if you don't even have enough to eat, how could there be so many allergies? What do you think?"

Chen Yong was shocked by Luo Hao's previous calculation. He was calculating carefully and didn't hear clearly what Luo Hao was saying.

"I have been in contact with a patient who is allergic to garlic. He only needs to take garlic orally..."

"Just eat garlic. If you say take it orally, I always feel weird." Chen Yong put aside his severe lactose allergy and corrected him.

"Well, abdominal pain will occur less than 10 minutes after eating garlic, and the pain will subside after about 20 minutes."

"How did you cure it later?"

"Just don't eat it." Luo Hao smiled, "But what you said is similar to what a senior brother said. He went to Canada to study and said that people there have various allergies. Peanut allergies are the most common, and some even 's murders exploited peanut allergies."

"I've seen people allergic to eggs!" Chen Yong said.

"That's really unfortunate. It's okay if I don't eat peanuts. If I don't eat eggs, I always feel like I'm missing something."

The two entered the parking lot while chatting.

Before leaving the country, Luo Hao drove the sign 307 and parked it in the parking lot of the airport. At this time, he just drove away.

"There are many medical records of egg allergy in Xiehe's case library, but there is something strange."

"What's weird."

"Those patients will be allergic to eating ordinary eggs, but they are fine eating tea eggs. So when it is found that the allergen is eggs, most patients will deny it. After all, not many people could eat eggs in the past, and many families made tea eggs."

"Why are tea eggs not allergic? Is there anything in tea that can neutralize allergens?"

"I don't know. I'm not interested in this research. If you are interested, you can think about it carefully."

Tea eggs are not allergic, but ordinary eggs are. Is it related to tea?
Chen Yong began to think about it.

"By the way, a foreign nutritionist came to China to give a speech a few years ago, and I happened to listen to one." Luo Hao started 307, and the Daniel's voice was still so nice.

"He said that peanut allergy is rare in our country because of insufficient medical conditions and the peanut allergy gene has been naturally eliminated."

"Bullshit!" Chen Yong said scornfully, "Those foreign devils know how to turn around and say our genes are not good."

Luo Hao smiled. He always felt that Chen Yong was bullied when he was in school in the UK, or discrimination would be a more accurate description.

Otherwise, he wouldn't behave so extreme.

The words he just said sounded a little uncomfortable to Luo Hao, but as if he had touched Chen Yong's inverse scales, the guy immediately started to scold him.

"It is said that during the Ming Dynasty, peanuts were grown on a large scale and used as food rations, and then the allergenic genes were gradually eliminated." Luo Hao repeated the nutritionist's words.

Chen Yong was extremely disbelieving and could not express his disbelief.

Luo Hao felt refreshed when he drove the car. It may be because he returned to China. He didn't need to be careful like he was in India, and he felt relaxed.

Even Luo Hao felt that there was a sweet smell in the air.

When will I come to see Boss Ding from Piyang, or go home to see my mother and uncle?

Luo Hao stopped chatting with Chen Yong about allergies, and did not guess in advance what kind of disease the people admitted to the ICU had. He drove all the way back to the First Hospital of the Medical University.

Go back to the department and change clothes.

He saw Shen Zizai face to face. Shen Zizai had just come out of the ward in white clothes with his hands behind his back.

"Ronald, you're back!" Shen Zizai grinned, "I told you it was time to come back."

"Hello, Director Shen." Luo Hao stepped forward and bowed respectfully.

"Hey, don't be so polite." Shen Zizai said with a smile, "I took a look at the film and found that the tumor planted by Chen Jiao's seeds has shrunk significantly, and the effect is particularly good. The pain caused by bone metastasis has almost disappeared, and there is no need to take painkillers. Painkillers have significantly improved the quality of life, which is good.”

"Well, the effect of internal radiation therapy is quite good, and the side effects are relatively small. I will evaluate it later and see where and how many seeds are suitable for planting this time."

Luo Hao said and came to the duty room to change clothes.

Just as Shen Zizai was about to say something, he suddenly remembered Luo Hao's words and was a little surprised, "Then what are you doing now?"

"ICU, they say a foreigner is seriously ill. I want to take a look."

Shen Zizai had a strange expression on his face.

Luo Hao could see clearly, "Director Shen, what's wrong?"

"It's bad, I suggest you don't go." Shen Zizai said, "That foreigner was accompanied by a health doctor from the Mayo Clinic, and the results became worse and worse. I think the doctor from the Mayo Clinic seems to be blaming us. On the First Hospital of Medical University.”

"..."

"The recent talk is that our medical equipment is not good enough, so there is no clear diagnosis, resulting in the treatment getting worse. The foreign devil is not good enough."

"Director Shen, what disease does he suspect?" Luo Hao asked.

"It seems to be carcinoid syndrome, but it doesn't get better despite the appropriate treatment. The foreign devils are so difficult to take care of, and you didn't even see it." Shen Zizai said angrily.

"I'd better take a look." Luo Hao smiled and glanced at his lucky value.

101+5, it is possible to know it at a glance.

Shen Zizai didn't stop him. He just told Luo Hao the relevant situation. When Luo Hao insisted, he followed Luo Hao upstairs.

"Don't worry, if the foreigners scold you, I will scold you back." Chen Yong patted his chest, "What I learned when I was in school were all ancient proverbs. And I joined a few clubs in London, and I know they broke the rules. Very understanding.”

"Oh? A club? The kind that opens an imp?"

"roll!"

(End of this chapter)