Come on, Dr. Wu

Chapter 312 Pancreas transplant?

Unfortunately, Feng Lingling couldn't argue with Director Fang. Otherwise, it would not sound good if people got to know that she was contradicting her senior.

Moreover, she can also say that she knows how to use medicine better than Director Fang.

Everyone looked at Wu Xiaofu. It was not impossible to transfer such a troublesome case to Director Fang. After all, the person was found by the patient's family themselves and was a relative, so it would be easy to handle.

Even if something happens later, it is none of their business.

"Director Fang, you are an experienced director. The patient was admitted to the hospital because of paroxysmal abdominal pain, but during the abdominal examination, there was no obvious tenderness. You may not have seen the patient yet. The patient has already developed mild neuropsychiatric symptoms and skin lesions."

Neuropsychiatric symptoms?

Director Fang was stunned when he heard this. Everything else was easy to deal with, but the appearance of neuropsychiatric symptoms was quite serious.

In medicine, neuropsychiatric symptoms, most commonly anticipation, are manifestations of brain disease.

For example, hepatic encephalopathy is caused by severe liver damage, which leads to brain symptoms. Once such symptoms appear, we really need to consider the condition carefully. Wu Xiaofu is right. Director Fang has not seen the patient yet. He mainly looked at the medical records and examinations. The medical records did not state that the patient also had neuropsychiatric symptoms.

“But it’s in the medical record.”

"I just discovered this during my morning rounds. I just mentioned this matter during the meeting here and asked Dr. Feng to pay special attention to it. Also, I don't know if Director Fang noticed that the patient's blood/urine porphyrin is positive. I just asked Dr. Feng to tell the patient to collect urine under the sun to see the situation.

The patient's family also just reported that the color of the urine turned red."

This!
Wu Xiaofu spoke step by step, first using the symptoms to explain that the patient's condition did not seem like a simple intestinal obstruction, and now he explained the results of the blood purine test. Director Fang was indeed experienced, and if he still didn't understand what Wu Xiaofu was reminding him at this time, then he would have failed.

"You mean hemopurine disease!"

Director Fang was also a little frightened at this time. It shouldn't be that serious. The child is only sixteen years old. But after blurting out the word "hemopurine disease", Director Fang connected all the medical records and examinations he had seen before in his mind.

It is the same when seeing a doctor. It is fine when there is no doubt, but once there is doubt, all the examinations and symptoms will be related to this.

Just like now, Director Fang subjectively does not want to believe Wu Xiaofu's guidance, but the objective data makes him more and more suspicious.

Purinemia is an autosomal dominant genetic disease. The mutated gene is the ferrochelatase gene, which leads to the defect of mitochondrial ferrochelatase, causing the accumulation of protoporphyrin in red blood cells, plasma, liver and skin, and the corresponding clinical symptoms.

The main manifestation is painful photosensitivity erythema of the skin that appears in early childhood.

Involvement of the hepatobiliary system is less common, but it does exist. Current data show that the incidence of hepatobiliary system involvement is between 1% and 4%. The specific manifestations are cholestasis and chronic liver disease, and severe cases can lead to liver failure.

Well, that’s right.

If it is hemopurine disease, the patient's unexplained liver disease can be explained. If it is intestinal obstruction caused by it, then surgery cannot solve the root cause. It may destroy the existing circulatory environment and intestinal obstruction will continue to recur. At that time, his surgery will be in trouble.

Thinking of this, Director Fang’s previous insistence disappeared.

In patients with hemopurinosis, protoporphyrin is deposited in large quantities in red blood cells and released into plasma as red blood cells age. Protoporphyrin can be excreted from the liver into bile and feces, so the protoporphyrin in red blood cells, plasma, and feces of patients with hemopurinosis increases, while urine porphyrin is negative.

Therefore, during early examinations, hemopurinemia is difficult to diagnose and detect.

However, unlike cholestasis, the deposition of protoporphyrin in liver cells is highly refractive under a polarized light microscope, so additional examination of the structure under an electron microscope is necessary. If it is indeed hemopurinosis, ice crystal-like structures will appear under an electron microscope.

There is also genetic testing. After all, this is a genetic disease that involves changes in genetic genes, which can be most intuitively demonstrated through genetic testing.

"Director Fang is indeed experienced. After so many years, I believe Director Fang has seen similar patients. However, it is rare after all. Even if he has seen it, he is afraid that he has forgotten it. We have worked with the patient's family before, but the patient's family is unwilling to complete the examination.

Director Fang, since you are relatives, I am afraid I need your help in this matter."

Looking at Wu Xiaofu who had a smile on his face from beginning to end, Director Fang couldn't help but feel a chill in his heart. This guy was not a young doctor at all, he was clearly a little fox. He was afraid that Wu Xiaofu had been setting traps for him step by step since he appeared.

Now, instead of being conspicuous, he had to help Wu Xiaofu. But it was difficult for him to refuse. After all, as he said just now, they were really related to the patients. Even if they were ordinary patients, he had to think about how to get the best diagnosis and treatment for them.

What's more, they are related.

However, he was moved here in order to take the patient to his place for direct surgery without spending extra money on examinations. However, not long after he arrived, he was instigated to rebel and had to join Wu Xiaofu and others in persuading the patient's family.

It would be so embarrassing and painful to say this to others.

Moreover, the patient cannot be transferred back to another department. After all, if it really is hemopurineosis, it would be very troublesome. It would definitely not be appropriate to treat him in the hepatobiliary surgery department. I'm afraid he would have to be transferred to another department. Going back and forth would only waste time.

Ugh!
With a sigh in his heart, Director Fang could only nod bitterly.

Wu Xiaofu smiled and gestured to Feng Lingling. At this moment, Feng Lingling suddenly felt that quarreling was too much. Looking at what Wu Xiaofu did, she realized that this was a textbook way to vent anger.

And it's not just about venting anger, even venting anger is only secondary. While getting the job done, it also avoids the outbreak of breast nodules and thyroid nodules. Not only the surgery, but also this behavior and art of speaking are worth learning from.

Wu Xiaofu had no idea what Feng Lingling was thinking. After sorting out Corey's affairs, Wu Xiaofu went straight to the surgery.

During this period, Zhang Xuewen and Chen Zhendong were the ones who basically performed the surgeries. Now that Wu Xiaofu was back, he had to share some of the work, allowing Zhang Xuewen and Chen Zhendong to rest more.

This is how it is in the hospital. No matter whether you leave the hospital for some important business, as long as you leave, your work will basically fall on other colleagues. After you come back, it is best to make up for it. Otherwise, who will share the work with you in the future?

Not only Wu Xiaofu, but also Zhang Xuewen and Chen Zhendong.

night.

As soon as he finished the operation, Wu Xiaofu was taken to the Peace Hotel. Today was Rong Qiao's stage, and almost all the senior executives of the hospital were there. This time, Wu Xiaofu earned a lot of face for the hospital, because Wu Xiaofu won the championship. The next World Surgery Competition will not only be held in the First Affiliated Hospital of Donghai, but I'm afraid that many people around the world now know the First Affiliated Hospital of Donghai through Wu Xiaofu.

Especially for Chinese people, in the future, if they have any difficult and complicated diseases that cannot be solved locally, the first place they think of is the First Affiliated Hospital of Donghai. For a long time in the future, the patient resources of the First Affiliated Hospital of Donghai will definitely be the best in the country.

This alone is enough to make Rong Qiao happy.

Wu Xiaofu is so motivated that the hospital should have its own attitude, not to mention that Wu Xiaofu has made such a great contribution to the hospital. Whether it is to thank Wu Xiaofu or to win over Wu Xiaofu, this banquet must show its good intentions.

And through this banquet, Wu Xiaofu's biggest gain was probably that he jumped from being a small-time doctor to being on par with the hospital's top management, or even having a higher status.

During the banquet, Wu Xiaofu almost never stopped toasting.

Fortunately, Wu Xiaofu had a huge capacity for drinking, otherwise, he would have to go in standing and come out lying down.

On the way back, they took Yu Shifu's car. Yu Shifu called a designated driver, and Wu Xiaofu and Yu Shifu sat in the back seat.

"Teacher, I heard that the hospital intends to expand the hepatobiliary surgery department and build an E-area?"

At this time, Yu Shifu and Wu Xiaofu were not drunk at all. Yu Shifu looked at his own disciple and was also surprised. He was not drunk because he did not drink much. But Wu Xiaofu was different. Wu Xiaofu drank a lot. It can be said that Wu Xiaofu drank the most during the banquet. When he came out, he was supported by him. But the boy was pretending and was not drunk at all. How much alcohol can he have? However, when he heard Wu Xiaofu's question, Yu Shifu also laughed.

"What, do you have an idea?"

"Of course. A soldier who doesn't want to be a general is not a good soldier. If I have this opportunity, I will definitely think about it. Teacher, please give me some advice."

Yu Shifu looked at Wu Xiaofu's confident face and his domineering aura, and nodded.

"Now our First Affiliated Hospital's hepatobiliary surgery department is thoroughly famous. We don't have to worry about the source of disease in the future. It will be no problem for us to become a national key department, no, a world key department. The dean has already started planning for it.

Not only the E area, but also the F area, and the general surgery and critical care department."

Ah!
Wu Xiaofu's eyes widened when he heard this. It was such a big deal!
Yu Shifu ignored Wu Xiaofu's reaction and continued, "To expand the two wards, we must select the best and brightest to shoulder the responsibility. As for the general surgery and critical care department, since it is just the beginning, if we directly focus on the hepatobiliary surgery and critical care department, I am afraid that other departments will have opinions, so we simply focus on the general surgery and critical care department first.

In the future, all critically ill patients in general surgery will have their own intensive care units, because in the future, all critically ill hepatobiliary surgery patients in the country will probably be concentrated in our hospital. Therefore, there is no need to worry about waste in this general surgery intensive care unit.

However, although it is called a general surgery intensive care unit, once it is actually operational, I am afraid that most of the patients will be from our hepatobiliary surgery department.”

After hearing what Yu Shifu said, Wu Xiaofu almost understood. Needless to say, this is really necessary. In the future, when people talk about hepatobiliary surgery in China, I am afraid that the first thing they think of is the First Affiliated Hospital of Donghai.

Originally, the number of patients in their hepatobiliary surgery department had always been high, and there were never enough beds. Now, with his exaggeration, there would probably be even more patients in the future, and there would be no waste even if they expanded the two wards.

Well, I guess there will never be enough hospital beds.

In fact, hospitals are not afraid of opening departments at all. The key is to have support. After all, opening a department means investment, and it is not a small investment. A department requires at least twenty wards, fifty or sixty beds, and all kinds of equipment.

As for doctors and nurses, if the government does not support them and does not provide them with a staffing structure, the hospitals will have to pay their salaries. This may not be noticeable at first, but over the course of a few decades, the cost will be terrifying.

Therefore, if you want to open a department, you must have a good reason and submit it to the National Health Commission and ask the Commission for help.

This time, Rong Qiao must have taken over the leaders above. I wonder how much money he asked for, so he is so generous.

The two ordinary wards are okay, but the intensive care unit really requires a lot of investment. Wu Xiaofu can imagine how terrifying the cost is just by thinking about it.

A general tertiary hospital only has a general intensive care unit.

The better option is that the neurosurgery department will have one, and the even better option is that the cardiology department will also have an intensive care unit. After all, these two departments are always ready to accept critically ill patients, and they are really needed.

But it seems like a luxury to have a general surgeon specializing in critical care.

When other departments saw this, they thought, "If your general surgery department can set up a critical care unit, then why can't our departments?"
This time, I'm afraid that only with Wu Xiaofu's excuse can we shut up the gossips.

However, three seats became available at once, and Wu Xiaofu was no longer in a hurry.

Seeing Wu Xiaofu's thoughtful look, Yu Shifu nodded and said, "You have developed this energy now. The dean and I have discussed it. Area F will be handed over to you. When the time comes, your group will move there as a whole, and subsequent personnel will be added slowly. The hospital will give you absolute autonomy.

This is also the dean's way of winning you over. You kid, you have received such a great benefit, you can't just pat your butt and run away. "

Wu Xiaofu also laughed when he heard what Yu Shifu said.

"Teacher, I will be the head of the department now. I will never run away. I will work for a few years first, and when you retire, I will take over your position as the dean."

Yu Shifu punched Wu Xiaofu directly. "Good boy, you still dare to covet my position. However, with your ability and performance, it won't be difficult for you to become the dean in the future. Speaking of which, I have to thank you. The academician has been decided. I called you yesterday and it will be announced in the next two days. You pushed me up as well."

"Ah, then I will be the academician's disciple in the future!"

"You boy."

The next day was another day of surgery. After get off work, Wu Xiaofu returned to Wu Jinglie, who hosted a family dinner to celebrate Wu Xiaofu's success.

Wu Jinglie and his generation have the strongest sense of national honor. Seeing Wu Xiaofu bringing glory to his country in the field of medicine, Wu Jinglie is happier than anyone else, especially since he is his own grandson. At this moment, Wu Jinglie likes Wu Xiaofu more than Wu Yun.

At the outpatient clinic on Friday, Wu Xiaofu was stunned when he saw a bunch of plus signs.

Is this the price to pay for fame?
The salary was doubled. If he agreed, he would probably have to work overtime until midnight.

But Wu Xiaofu hesitated for a moment and still did not refuse the additional number. After all, they all came here because of his reputation, and he really didn't want to disappoint them.

You are young anyway, so just hold on a little longer.

"Brother, if the liver can be transplanted, why can't the pancreas be transplanted?"

This is the last plus-mark patient. A mother came with her child. The one who was speaking was the child. She was also the patient this time, a seven-year-old girl. However, the little girl now looked extremely thin, with dry skin and hair. She should be at the age of water, but she looked particularly pitiful.

Type 1 diabetes.

Diabetes is divided into three types. The most common type seen in endocrinology clinics is type 2 diabetes.

That is the common type of pancreatic islet damage, poor insulin secretion, and acquired high blood sugar. This type is more common in adults and often develops after the age of 40. After regular diet and exercise, it can usually be well controlled with medication.

But type 1 diabetes is different. It is a genetically related diabetes that often clusters in families. It is not an acquired disease, but high blood sugar levels appear from an early age, and even drug control cannot achieve good results.

Diabetes is not simply a blood sugar problem. If blood sugar is not well controlled for a long time, the liver, kidneys, heart and other organs will be affected, leading to various diseases until life is threatened. Therefore, once type 1 diabetes occurs, patients will suffer a lot.

These children are really like angels with broken wings.

"Doctor Wu, after watching your match the other day, Xiao Gang insisted on coming to see you. I also wanted to see if you could help me, so I came straight here. I'm really sorry for making you work overtime."

Meeting the child's eyes, Wu Xiaofu fell into deep thought.

Type 1 diabetes is mostly caused by genetic reasons, but the immune system is defective. The patient's pancreatic cells are destroyed, insulin secretion is poor, and the disease becomes more and more serious. If you want to maintain the condition, taking medicine is basically drinking poison to quench thirst. The only way to achieve this is to fundamentally suppress the patient's pathogenic genes.

Even if it is to be maintained, the only way is to transplant and replace the patient's damaged pancreatic cells so that the patient's blood sugar can be stabilized.

This child, obviously because of seeing a doctor for two or three years, has acquired some knowledge in this area that adults cannot understand, and he actually thought of pancreas transplantation.

Not to mention, Wu Xiaofu had never thought about this aspect before, but thinking about it now, is it really impossible to accomplish it?

Modern medicine has made great progress in transplantation.

Liver, kidney, heart, and lung transplants are becoming increasingly mature, so why can't we have a pancreas?

(End of this chapter)