I can see the status bar
Chapter 503 Trauma
Chapter 502 Story
OTCD, except that it looks very close to the abbreviation of over-the-counter drugs, the two actually have no other relationship.In genetics, it also has a long and somewhat embarrassing name-Ornithine Carbamoyltransferase Deficiency (OTCD).
OTC is the abbreviation of ornithine formyltransferase, and ornithine formyltransferase deficiency is a common type of urea cycle disorders (Urea Cycle Disorders, UCDs).This is an X-linked recessive genetic defect in the ornithine formyltransferase gene.
Due to a genetic mutation, the ornithine formyltransferase in the patient's body malfunctions, and the process of the urea cycle is blocked.Ammonia cannot be excreted in the form of non-toxic urea, thus causing hyperammonemia.High blood ammonia can have serious negative effects on the brain.Because excessive ammonia accumulates in the body and blocks the tricarboxylic acid cycle, the patient will experience cerebral edema, extensive astrocytic swelling in the brain, and polymorphic changes in liver mitochondria.And then there is a series of symptoms such as vomiting, coma, lethargy and so on.
OTCD perfectly fits all of Chen Tianyi's symptoms, and more importantly, it can also explain why her onset was so late - strict vegetarianism led to her limited daily protein intake.And she did not show severe neurological symptoms at birth, but showed hyperammonemia when she grew up.This may also mean that her OTCD is not a "complete defect" like other mutations - the OTC content or activity in her liver must be lower than that of ordinary people, but it is also higher than other OTCD patients.
After getting this suggestion, which was almost a reference answer, Sun Li'en suddenly realized, and fell into a kind of subtle depression.
If he went to see the patient before coming to the pediatrics department, Sun Lien would be [-]% sure that a reminder like "high blood ammonia level" would appear on the top of Chen Tianyi's head.Although it is still difficult to deduce OTCD based on high blood ammonia, at least there is a direction to work hard.
If you take a look at the status bar first... Sun Lien suddenly shook his head vigorously.This kind of thinking is very dangerous, and it is easy for people to lose their motivation and even motivation to work hard.After all, the status bar is an unconventional method, and Sun Lien himself doesn't know if it will suddenly fail at an important moment.If you suddenly find that the status bar disappears one day, and there are no patients who need to be rescued, it’s fine—the big deal is to resign and go home, and hold Hu Jia, who may look disgusted, as a second-generation ancestor who eats and waits to die.But what if there are patients who need the status bar to save lives?
We can't be satisfied with the current achievements, and we can't just focus on emergency and emergency medical diseases.Sun Li'en secretly made up his mind that when the matter is almost over, he must mention it to Dean Wu and include genetic diseases in the diagnostic test.
For science students, textbooks are not necessarily required to improve the application level, and it is actually okay to brush up the questions.
·
·
·
"OTCD?" Xu Yourong and Brunn said these four letters in unison after hearing Sun Lien's request on the phone to test the patient's blood ammonia level.The two looked at each other, and suddenly realized, "Yes!"
"Director Qian's level is still high." Sun Li'en quickly put the credit on the hairless monster on the phone, "I just glanced at the image, and then doubted it in this direction. I watched the MRI for about 30 seconds. "
Xu Yourong interjected, "We'll do the blood ammonia test right now. According to President Liu's request, we'll take care of this patient in the future, right?"
Sun Lien was in a bit of trouble, "Dean Liu didn't say it clearly, he meant that we should hand over this patient to us to see the situation first, and then take him in if necessary." He paused and asked, "The conservative treatment plan for this patient is not good. It’s simple, just give her arginine and sodium benzoate after the diagnosis, right?”
"If you want to cure it, you can only do liver transplantation." Dr. Brunn frowned. "The gene therapy for OTCD failed in the 90s. There have been no other clinical trials since then."
"Besides treatment, we also need to find out the cause of her sudden onset of OTCD, right?" Xu Yourong added, "If she had kept a strict vegetarian diet, she shouldn't have made such a big progress all of a sudden."
Sun Li'en thought for a while, "You should do blood ammonia, liver function, and urine orotic acid tests for her first. After the diagnosis results come out, call me, and I will talk to the parents to see what their willingness to treat is. Sample."
"Then where are you going now?" Bruen keenly noticed Sun Lien's intention to be lazy, "If you go to the cafeteria, remember to bring me a roast duck rice."
"I... I'm going to the ICU." Sun Lien had the illusion that he was back in the university dormitory again.He managed to break free from this illusion, and said angrily to Brunn, "If you want to eat roast duck rice, go in line yourself!"
Roast duck rice is another masterpiece recently launched by the chef of the Jiangxi boss in the canteen of Siyuan.It has successfully defeated many other competitors in the canteen of the Fourth Courtyard, and successfully promoted to become the most popular lunch and dinner in the entire Fourth Courtyard.There are countless people queuing up to buy every day, and there are even diners who come here admiringly and takeaway boys queuing up to run errands.If you want to eat roast duck rice once, you have to queue for more than an hour.Although Bruen is greedy, he is more afraid of the trouble of queuing.So as long as he seized the opportunity, he would always try to get Sun Li'en or Xu Yourong to help bring the meals.
"Line in line by yourself? Forget it." Bruen didn't mean "shame" at all, "You are going to the ICU now to see that patient with retroperitoneal necrotizing fasciitis?"
Sun Lien sighed helplessly on the other end of the phone, "It's like what Dean Song said—one eyeball and the rest of a filial daughter's life have already been put in. No matter what, you have to have some snacks."
After hanging up the phone, Sun Lien appeared at the door of the ICU.Under the "cover" of a group of security guards, Sun Li'en sneaked into the ICU. Outside the door of the ICU, the bloodstains on the ground had been cleaned up by the cleaning aunts, but Zhao Ming's family members gathered at the door.Although the overall order is still guaranteed, the tense atmosphere in the air still reminds Sun Lien to be cautious.
"There is no change in the patient's condition at present." The doctors in the ICU have known for a long time that Sun Lien has been "entrusted with important tasks" by Song Wen, so it is not surprising that he reappeared in the ICU in a short period of time—doctors from the Department of Critical Care Medicine In fact, I have more sympathy for Sun Lien. "It's okay, if there is any change, we will call you directly. Don't worry about running here all day long."
"I don't feel relieved if I don't come to see it." Sun Li'en smiled wryly. Although he had full trust in his colleagues in the Department of Critical Care Medicine, he still walked up to Qian Aiwu and looked at the status bar on top of her head.After confirming that Qian Aiwu's symptoms were not getting worse, he felt a little relieved.
"What is this?" After reading the status bar, he lowered his head and saw a small blue card next to Qian Aiwu's pillow.
"That..." The ICU doctor looked a little emotional, "It was brought by the patient's son-in-law, saying that the patient's grandson wrote a small card, wishing grandma a speedy recovery." He sighed, "The patient's son-in-law just arrived I took a trip, put down the card and pre-deposited [-] yuan for treatment—the family’s story made me feel very uncomfortable.”
(End of this chapter)
OTCD, except that it looks very close to the abbreviation of over-the-counter drugs, the two actually have no other relationship.In genetics, it also has a long and somewhat embarrassing name-Ornithine Carbamoyltransferase Deficiency (OTCD).
OTC is the abbreviation of ornithine formyltransferase, and ornithine formyltransferase deficiency is a common type of urea cycle disorders (Urea Cycle Disorders, UCDs).This is an X-linked recessive genetic defect in the ornithine formyltransferase gene.
Due to a genetic mutation, the ornithine formyltransferase in the patient's body malfunctions, and the process of the urea cycle is blocked.Ammonia cannot be excreted in the form of non-toxic urea, thus causing hyperammonemia.High blood ammonia can have serious negative effects on the brain.Because excessive ammonia accumulates in the body and blocks the tricarboxylic acid cycle, the patient will experience cerebral edema, extensive astrocytic swelling in the brain, and polymorphic changes in liver mitochondria.And then there is a series of symptoms such as vomiting, coma, lethargy and so on.
OTCD perfectly fits all of Chen Tianyi's symptoms, and more importantly, it can also explain why her onset was so late - strict vegetarianism led to her limited daily protein intake.And she did not show severe neurological symptoms at birth, but showed hyperammonemia when she grew up.This may also mean that her OTCD is not a "complete defect" like other mutations - the OTC content or activity in her liver must be lower than that of ordinary people, but it is also higher than other OTCD patients.
After getting this suggestion, which was almost a reference answer, Sun Li'en suddenly realized, and fell into a kind of subtle depression.
If he went to see the patient before coming to the pediatrics department, Sun Lien would be [-]% sure that a reminder like "high blood ammonia level" would appear on the top of Chen Tianyi's head.Although it is still difficult to deduce OTCD based on high blood ammonia, at least there is a direction to work hard.
If you take a look at the status bar first... Sun Lien suddenly shook his head vigorously.This kind of thinking is very dangerous, and it is easy for people to lose their motivation and even motivation to work hard.After all, the status bar is an unconventional method, and Sun Lien himself doesn't know if it will suddenly fail at an important moment.If you suddenly find that the status bar disappears one day, and there are no patients who need to be rescued, it’s fine—the big deal is to resign and go home, and hold Hu Jia, who may look disgusted, as a second-generation ancestor who eats and waits to die.But what if there are patients who need the status bar to save lives?
We can't be satisfied with the current achievements, and we can't just focus on emergency and emergency medical diseases.Sun Li'en secretly made up his mind that when the matter is almost over, he must mention it to Dean Wu and include genetic diseases in the diagnostic test.
For science students, textbooks are not necessarily required to improve the application level, and it is actually okay to brush up the questions.
·
·
·
"OTCD?" Xu Yourong and Brunn said these four letters in unison after hearing Sun Lien's request on the phone to test the patient's blood ammonia level.The two looked at each other, and suddenly realized, "Yes!"
"Director Qian's level is still high." Sun Li'en quickly put the credit on the hairless monster on the phone, "I just glanced at the image, and then doubted it in this direction. I watched the MRI for about 30 seconds. "
Xu Yourong interjected, "We'll do the blood ammonia test right now. According to President Liu's request, we'll take care of this patient in the future, right?"
Sun Lien was in a bit of trouble, "Dean Liu didn't say it clearly, he meant that we should hand over this patient to us to see the situation first, and then take him in if necessary." He paused and asked, "The conservative treatment plan for this patient is not good. It’s simple, just give her arginine and sodium benzoate after the diagnosis, right?”
"If you want to cure it, you can only do liver transplantation." Dr. Brunn frowned. "The gene therapy for OTCD failed in the 90s. There have been no other clinical trials since then."
"Besides treatment, we also need to find out the cause of her sudden onset of OTCD, right?" Xu Yourong added, "If she had kept a strict vegetarian diet, she shouldn't have made such a big progress all of a sudden."
Sun Li'en thought for a while, "You should do blood ammonia, liver function, and urine orotic acid tests for her first. After the diagnosis results come out, call me, and I will talk to the parents to see what their willingness to treat is. Sample."
"Then where are you going now?" Bruen keenly noticed Sun Lien's intention to be lazy, "If you go to the cafeteria, remember to bring me a roast duck rice."
"I... I'm going to the ICU." Sun Lien had the illusion that he was back in the university dormitory again.He managed to break free from this illusion, and said angrily to Brunn, "If you want to eat roast duck rice, go in line yourself!"
Roast duck rice is another masterpiece recently launched by the chef of the Jiangxi boss in the canteen of Siyuan.It has successfully defeated many other competitors in the canteen of the Fourth Courtyard, and successfully promoted to become the most popular lunch and dinner in the entire Fourth Courtyard.There are countless people queuing up to buy every day, and there are even diners who come here admiringly and takeaway boys queuing up to run errands.If you want to eat roast duck rice once, you have to queue for more than an hour.Although Bruen is greedy, he is more afraid of the trouble of queuing.So as long as he seized the opportunity, he would always try to get Sun Li'en or Xu Yourong to help bring the meals.
"Line in line by yourself? Forget it." Bruen didn't mean "shame" at all, "You are going to the ICU now to see that patient with retroperitoneal necrotizing fasciitis?"
Sun Lien sighed helplessly on the other end of the phone, "It's like what Dean Song said—one eyeball and the rest of a filial daughter's life have already been put in. No matter what, you have to have some snacks."
After hanging up the phone, Sun Lien appeared at the door of the ICU.Under the "cover" of a group of security guards, Sun Li'en sneaked into the ICU. Outside the door of the ICU, the bloodstains on the ground had been cleaned up by the cleaning aunts, but Zhao Ming's family members gathered at the door.Although the overall order is still guaranteed, the tense atmosphere in the air still reminds Sun Lien to be cautious.
"There is no change in the patient's condition at present." The doctors in the ICU have known for a long time that Sun Lien has been "entrusted with important tasks" by Song Wen, so it is not surprising that he reappeared in the ICU in a short period of time—doctors from the Department of Critical Care Medicine In fact, I have more sympathy for Sun Lien. "It's okay, if there is any change, we will call you directly. Don't worry about running here all day long."
"I don't feel relieved if I don't come to see it." Sun Li'en smiled wryly. Although he had full trust in his colleagues in the Department of Critical Care Medicine, he still walked up to Qian Aiwu and looked at the status bar on top of her head.After confirming that Qian Aiwu's symptoms were not getting worse, he felt a little relieved.
"What is this?" After reading the status bar, he lowered his head and saw a small blue card next to Qian Aiwu's pillow.
"That..." The ICU doctor looked a little emotional, "It was brought by the patient's son-in-law, saying that the patient's grandson wrote a small card, wishing grandma a speedy recovery." He sighed, "The patient's son-in-law just arrived I took a trip, put down the card and pre-deposited [-] yuan for treatment—the family’s story made me feel very uncomfortable.”
(End of this chapter)
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