I can see the status bar

Chapter 639 Restricted Conditions

The results of bone biopsy and lymph node biopsy were sent to Dr. Jiang and Sun Li'en almost one after another.Looking at the inspection report, the two heaved a sigh of relief.

Not leukemia.

The result of bone biopsy indicated that the bone marrow hyperplasia was obviously active, which was a bad sign.But the lymph node biopsy pulled the eyes of the two physicians straight away from the leukemia.

Lymph node biopsy revealed acute suppurative lymphadenitis.

Sun Li'en got the inspection report in the sailor's dormitory.When he got the report, he was chatting with the sailor who cleaned the dormitory.After hearing the sound of footsteps, the sailor with the mop jumped up from the bed and dragged the mop back and forth on the ground. All in all, he looked enthusiastic about his work.

After seeing that it was Dr. Jiang, the sailor dropped the mop and heaved a sigh of relief, "I was scared to death. I thought it was the company commander."

Doctor Jiang usually likes to chat with these little soldiers, but today he is not so interested.He shoved the inspection report into Sun Lien's hand, and said anxiously, "It's not leukemia, it's an infection!"

Sun Lien lowered his head and read the report, his eyebrows furrowed together.Leukemia does not cause acute suppurative lymphadenitis.It must be an infection.

He blinked, and suddenly remembered the female patient he and Hu Haibo took over to treat together—the bacterial meningitis patient named Leni.

After switching to meropenem, the female patient improved at a speed visible to the naked eye.However, due to changes in the situation, the female patient was taken out of the hospital by her family after three days of treatment.Hu Haibo and Sun Li'en didn't figure out what kind of bacteria she was infected with until the end.

But Lena and Kobayashi's situation is a bit similar-they have both been treated with other antibiotics, and these antibiotics have not helped their condition.

"We need to clarify the pathogen of the infection as soon as possible." Sun Lien communicated with Dr. Jiang and decided to speed up the progress of the test. "Blood culture alone is not enough, sputum culture must also be done."

"You still think he has a respiratory infection?" Dr. Jiang was slightly taken aback. After seeing the CT, he gave up the idea of ​​doing sputum culture on Kaoru Kobayashi. No infection focus can be seen on CT, which means that the infected bacteria may not be collected just when the sample is collected.For this check, he had other ideas. "I think...how about a full body scan?"

"He is infected, so let's do PET..." Sun Lien was about to refuse this request, but he suddenly thought, and then slapped himself on the thigh, "That's right! Let's make a PET!"

One of the characteristics of military hospitals is that when treating sick or injured soldiers, they often spare no effort and do not consider the cost.As long as the soldiers need it, no matter how expensive the treatment is, it will be available.

But the Fourth Central Hospital where Sun Lien works is different.When they prescribe an examination in the hospital, they not only need to consider whether the patient needs it, but also weigh whether the price of the examination can be afforded by the patient and their family members.Some too expensive and time-consuming inspection items, even if the patient’s condition can be checked immediately, the doctors in the local tertiary hospitals may not be able to prescribe them. to the opposite effect.

This is why Sun Lien refused the PET scan, but he quickly realized it.There is no charge for PET scanning on Daishan Island.Even if he had to charge, with Takeda Pharmaceutical's net worth, Kobayashi Kaoru would never be unable to afford the inspection fee.Now that PET scan is performed, not only can the location of the infection focus be determined, but also whether there is a solid tumor on Kaoru Kobayashi's body can be determined again.Of course, Sun Li'en would not object to such a good thing with multiple actions.

"Then I'll make arrangements." Dr. Jiang nodded, and was about to turn around to leave, but was called back by Sun Li'en, "Can we...can do mNGS on board?"

Sun Li'en didn't intend to cut corners, he asked this question out of caution.Although so far, there is no concrete evidence to prove that Kaoru Kobayashi has an autoimmune system disease, but the three positive antibodies on the status bar really make him feel a little uneasy.If Kobayashi has an autoimmune system disease, the probability of infection with opportunistic pathogens will increase significantly.Many of these opportunistic pathogens are resistant to one or more antibiotics.

If it is really an opportunistic pathogen... Sun Lien is really worried about whether he can run into an antibiotic that happens to be effective before the bacteria kill Kaoru Kobayashi.If you want to be safe, the best way is to directly use mNGS technology to determine the type of pathogenic bacteria.

"This... can't be done on the ship." Unexpectedly, Dr. Jiang showed a somewhat embarrassed expression, "mNGS is usually used too rarely, and when this ship was designed... there was no such technology."

Daishan Island started the pre-design work in 05, officially started construction in 06, launched in 07 and delivered to the troops in 08.The first application of mNGS technology to detect the source of infection began when a 13-year-old child developed severe hydrocephalus and epilepsy after traveling to Puerto Rico in 14.Clinicians were puzzled and finally decided to seek more advanced technical help.The mNGS technology also started at that time, and it was first applied to find the source of human infection.

In the end, the 14-year-old patient was determined to be suffering from leptospirosis.The whole process was also published in the "New England Journal of Medicine" that year.And in 16, this technology was officially introduced into China and began to be widely used.

As for the Daishan Island, which started design work in 05, it is impossible to leave enough space for the technical equipment that entered the country 11 years later.

"If it must be done, it can only take samples from the ship, and then airlift them to Tanzania, and then send the samples to South Africa by civil aviation or fixed-wing aircraft." As a military doctor, Dr. Jiang is very familiar with the mission execution area where he is located . "Politanvia does not have relevant technology and equipment for mNGS testing, nor does Tanzania and Mozambique. The nearest one is probably South Africa—or else it has to be sent to Dubai."

"This..." Now it was Sun Lien's turn to suck his teeth. He only knew that the Daishan Island was designed and built according to the level of a "third-class hospital".But I didn't expect that the equipment here would be affected by the design age of the ship and the special environment of the ship's hull - Sun Li'en was shocked by the lack of MRI on board.

"Let's do a PET scan first." Sun Li'en sighed, the conditions are limited, so he can only choose what can be done first and then say, "I'll go talk to the family members, at least find out what was used for him before. Let's talk about antibiotics."

(End of this chapter)