I can see the status bar

Chapter 196 Treatment Plan
In any case, Sun Lien still has the psychological quality of losing but not losing.Who has successfully graduated from Ningyuan Medical College for five years, who is not a ruthless character who travels back and forth in the mountains and seas?Even if he felt that he didn't have enough time to study, Sun Li'en had to show off his high fighting spirit and the young doctor's fearlessness.

"All right, all right, stop pouting." Liu Tangchun expressed disdain for Sun Lien's resolute expression, "I called you here, mainly to arrange things after you enroll. Although it's only December, we have to wait It’s a bit late to join the group in June. I discussed it with Zhou Jun, starting tomorrow, you will report to the research group.”

"Going tomorrow?" Sun Li'en was a little taken aback, "But I'm on duty..."

"This is a special case for you kid." Liu Tangchun said with a serious face, "Anyway, you won't be able to go back to the emergency room for a while. Even if you go to the emergency room every day, it's inconvenient without the right to prescribe—Zhou Jun can't just give you You sign and soak in the hospital every day, right?"

It's a prescription thing again.Sun Li'en sighed, he didn't have the right to prescribe, and he had to find a superior doctor to supervise any emergency treatment for the patient.If you want to prescribe a medicine, you have to find someone to sign it first.This is not just a troublesome issue - if there is any emergency and it is too late to find a superior doctor, Sun Lien will have to take the risk of practicing medicine without a license to save people.On a larger scale, this is considered a criminal offense.

"Starting tomorrow, the medical office will adjust your schedule to be the same as Zhou Jun's." Liu Tangchun arranged, "Just be his little follower. You should follow him when he comes to the hospital. When he goes to the academy You also go with him. Usually use his prescription rights, and follow him honestly in the college to get familiar with the research group first—don’t be lazy!” Liu Tangchun said seriously, “I will come back when you are in the second year of graduate school. If you find that your foundation is weak, then you just wait to be dealt with!"

These old things in the medical school are all feudal paternalistic, and if you are allowed to go east, you are absolutely not allowed to go west.Not even in your head.Although it is easy to cause conflicts between students and tutors, it is also easy to cause the problem of "restricting academic innovation".But if the relationship between the two parties is relatively harmonious from the beginning, such as Liu Tangchun and Sun Lien, the feudal patriarchal style may not necessarily be a bad thing.One will take care of everything with all his heart, while the other is grateful and accepts all arrangements.

So, sometimes a little change in perspective can turn a bad thing into a good thing.And sometimes, good things happen at the wrong time and place, often causing a bunch of bad things.

For example, Yang Jianqiang, who was in a coma, had his immune system resume normal operation, and as a result, he might lose his life.

"The edema area of ​​the brain is progressing rapidly, and empyema has begun to appear." Zhou Jun held the CT picture retaken just 10 minutes ago, with an extremely serious expression.

The immune system is not a toy car that can be pushed around in a child's hands.It takes a long time for the system to start and stop.Even though the dosage of hormones has been increased, Yang Jianqiang's immune system is still strengthening.There are still a few hours before the peak of immunity, and after that, hormones can re-suppress his immune system back to a relatively low state.

However, this also means that Yang Jianqiang's immune response will continue to increase.Judging from the current CT images, empyema has already occurred in four of the eight edema areas.Although the amount of pus is not very large now, at this rate, before his immune system is suppressed, the pus in the brain will cause great pressure on his brain, the midline shifts or the brain Hernias are very likely.Taken to the extreme, there may even be problems such as white matter lacerations.

And that's not counting other infections lurking in various organs.Zhou Jun glanced at Yang Jianqiang lying on the bed, and sighed again.

Although the PRC evidence has not yet come out, looking at these symptoms, Zhou Jun also agrees with Sun Lien's opinion.This is indeed a rare case of Toxoplasma infection in patients, and it is clear that the infected organ is not just the brain-this is a case of systemic infection.

The prognosis of toxoplasmic encephalopathy itself is not bad. As long as sulfadiazine and pyrimethamine can be used in time for targeted treatment, most patients can be discharged safely.But the prerequisite is that there is only one abscess, and the abscess has basically stabilized at the time of onset, and no other organs are infected with Toxoplasma gondii.

There were four abscesses in the eight edematous areas, and the infection status of other organs is not yet clear.Putting these two together, Yang Jianqiang's survival rate has dropped from about 70% before. As for how much chance he will have... Zhou Jun's most optimistic estimate is about 10%.

Nine deaths, this is the most optimistic estimate.It's not that Zhou Jun underestimated the probability because of his conservative personality. In fact, the 10% figure was a conclusion reached after a multi-department joint consultation in the hospital.

"It's very troublesome." The doctor in the ICU first expressed his opinion. "Whether his vital signs are stable does not depend on our support methods. Even if he is on ECMO and maintains his cardiopulmonary function and even liver and kidney functions, but if the brain abscess cannot be resolved, the person will still die if the device is withdrawn. It’s okay to delay the situation, we are good at this, but is there any need to delay?”

Liu Pingchuan also participated in the consultation on behalf of the neurosurgery department, and his attitude was more positive, "The empyema can be extracted through the sampling needle method to relieve intracranial pressure. We have the certainty of performing the operation, but the trouble is the injury during the operation. Moreover, this position..." He pointed to the area near the base of the skull on the projector with a laser pointer, "There is no way to start here, the risk of the operation is too great."

The doctors of the Department of Infectious Diseases gave a not-so-good news, "Even if sulfadiazine and pyrimethamine are combined, regardless of the speed at which the drug can kill Toxoplasma, even if the drug is allowed to cross the brain-blood barrier, the blood concentration will reach the peak. It also takes at least three hours. Now that the drug is administered, it may be too late.”

There was a silence in the conference room, and everyone fell silent.Even with the treatment of Toxoplasma gondii infection, Yang Jianqiang would still not be able to survive based on the current rate of deterioration of his condition.Even if Shenwai relieved his intracranial pressure at great risk, the possible damage would still be unacceptably large.More importantly, that edematous area near the skull base area is inoperable.Once the edema in this area turns into an abscess and starts to squeeze the brainstem, it is absolutely irreparable.

"Is radiation okay?" Just when everyone was silent, Zhou Jun suddenly remembered Sun Li'en's suggestion.That seemingly absurd suggestion of radiation therapy has now become the only viable treatment option. "Using radiation therapy to suppress the toxoplasma in the skull can at least buy us some treatment time."

"The dose is not easy to determine, but it may be feasible in theory." Liu Pingchuan, as the chief director of Shenwai, usually comes into contact with a lot of brain cancer patients.He is no stranger to cranial radiation, and after making a rough estimate, Liu Pingchuan suddenly got excited. "Ask the doctors in the oncology department to take a look."

"Director Zhou!" The door of the meeting room was suddenly pushed open, and Yuan Pingan, who had been checking the information for a day and night, broke in.He had huge dark circles under his eyes and his hair was messed up like it had been planed by a cat.But the flaws in appearance did not affect his excitement, "I found it! The patient should be toxoplasmic encephalopathy!"

PS: (For some reason, the PS book ad, which was triggered by carrots and intimidation, turned out to be a female channel...)
"My Boyfriend in Hanfu" has more girlfriends wearing Hanfu,
Do you know what it's like for your boyfriend to wear Hanfu?

A handsome man in elegant Hanfu walked over.

Su Min walked up to him and circled around him, shaking his head: "My lord is missing one important thing today."

"What is it?"

"Nature is mine..."

Before Su Min finished speaking, she was hugged into her arms.

"All of you are mine."

　There is an advertisement for pushing books, which is not a paid content.

　　
　
(End of this chapter)