I can see the status bar

Chapter 811 Dead End (Blood Donation Plus Series 037)

This chapter is added to thank the book friend "Memories Embedded in the Crescent Moon" for donating 2019 blood components from 2020 to 12.After that, there are two more chapters for him.

Sun Li'en didn't realize that he had become the "most valuable" investment target that Xiao Linfeng said.It's already one o'clock in the morning, but he still stays up late in the office with the lights on.

Ji Xiuying's question has become a mess.Sun Li'en looked at the thick stack of medical records and felt that his brain was hurting.

The case records are very detailed, but the detailed case records cannot help Sun Lien find any clues to diagnose the disease.The more he looked at it, the more inexplicable he became, and the more he looked at it, the more clueless he became.

Judging from the current inspection report, Ji Xiuying's various indicators are not too abnormal.Her white blood cell count rose slightly to 11.9*10^9/L, and the proportion of neutrophils also increased a little.Only this C-reactive protein is too high - 241.6mg/L, which is 8 times higher than the reference value of [-]mg/L.

From the results of the blood test, white blood cells, neutrophils, and C-reactive protein all increased, especially if the C-reactive protein increased so much, it should not be a viral infection that caused her to get sick.It's more like some kind of bacteria.But Sun Lien was still a little uncertain.The reason is also very simple. If it is a bacterial infection, the five-year repeated infection is still just a low-grade fever and cough... This is a bit unreasonable.

Bacteria are microorganisms that multiply very quickly.Under the right environment, some bacteria can even complete a division and reproduction within 20 minutes.Five years of repeated infections, and hormones to suppress the immune system, if the patient is infected with bacteria, he should have had severe symptoms of bacterial infection once or twice.

Could it be...not bacteria?
This assumption lifted Sun Lien's spirits.If it wasn't bacteria, but other pathogens, that would explain the slow progression.

Although chronic inflammation caused by bacterial infection is not without.But that kind of inflammation generally occurs in patients with normal immunity but who have not gone to the hospital for a long time.

After suffering from tumor, Ji Xiuying received chemotherapy for a period of time.Her immunity level must not be too high.And after ten months of anti-tuberculosis treatment, she used hormones on and off for almost two years.With such a low immune level, it is unlikely that the bacterial infection will still be able to fight the immune system [-]-[-]-or else the bacteria will be more tricky in the first place?

Every time the patient got sick, it was after the immune level dropped... Sun Lien suddenly stopped tapping on the table.He seemed to have grasped something vaguely.

First of all, Ji Xiuying underwent cancer surgery and received chemotherapy for a period of time... Did she get sick after the chemotherapy ended?

There is no record of Ji Xiuying's chemotherapy after tumor surgery in the case.Sun Li'en thought about it for a while, and called Rachel directly.

"Do you know what time it is?" The bell rang for a long time before Rachel answered the phone feebly.On the other end of the phone, she said angrily to Sun Lien, "Dr. Sun, if you have any urgent and urgent questions, you should go directly to the doctors in the emergency department or the intensive care department—our oncology department has no emergencies."

"Ah... sorry, I forgot the time." Sun Lien really didn't realize that it was already past one o'clock in the morning.All he can think about now is to figure out the time sequence quickly. "Let me consult you... What is the chemotherapy plan after the second stage of endometrioma adenocarcinoma and total resection of the uterus and bilateral appendages? How long will it last?"

"Use the TC plan." Although she was still angry and angry, Rachel was very serious and serious when answering professional questions. "Chemoplatin and paclitaxel are the chemotherapy drugs. A course of six weeks, paclitaxel is used every week, and carboplatin is only used in the first and fourth weeks. After completing the six-week course of treatment, take a week off, and then start a new course of treatment from the beginning .It usually lasts for four courses.”

"That is to say..." Sun Lien quickly pressed a few times on the calculator, "A total of four six-week chemotherapy courses, and three one-week rest periods, a total of 180 nine days?"

"You can use the calculator for this kind of specific calculation." Rachel probably heard that Sun Lien had no other professional questions to ask, so she hung up the phone without any hesitation.And also sent a text message ten seconds later, "Stop disturbing me to sleep!" to protest.

Sun Li'en was not unhappy at all, he was busy calculating the timetable.

Ji Xiuying performed "hysterectomy and bilateral adnexectomy" on September 9, six years ago.Chemotherapy is usually started within a month after surgery.That is to say, Ji Xiuying will start receiving chemotherapy on October 4th at the latest.

按照10月4日开始治疗计算，11月14日时她完成了第一个六周的化疗，然后开始就是为期一周的休息时间。11月21日重新开始化疗……

According to Sun Lien's calculations, May 5 five years ago was the day when Ji Xiuying's last chemotherapy ended.Two months later, she was re-entered the hospital for examination because of cough, low-grade fever and white sputum.

This direction of reasoning... seems to be a joke!Sun Li'en regained his spirits immediately.He continued to organize according to the timetable of "end of treatment to fever again".In October five years ago, Ji Xiuying started to receive anti-tuberculosis treatment. After nine months of treatment, another month later, in September four years ago, she had a fever again.

Only this time, Ji Xiuying didn't go to the hospital for an examination right away.Instead, she chose to take her own medicine for treatment - based on Sun Lien's experience, Ji Xiuying probably received some traditional Chinese medicine treatment during this period.However, the traditional Chinese medicine treatment still did not work, so one year later, in August three years ago, she underwent another CT scan, which showed that the lesions in both lungs had progressed.

In September three years ago, Ji Xiuying started taking methylprednisolone for treatment, and a CT scan showed that her condition had improved a month later.This treatment lasted until March two years ago.Half a month after stopping the drug, re-examination CT showed that the lesions in both lungs had progressed again.

This time she started oral prednisone, and in May two years ago, a month after starting oral prednisone, CT showed her condition improved again.But after taking prednisone orally for about five months, Ji Xiuying developed one of the serious sequelae of steroid use - femoral head necrosis.The hospital performed a femoral head replacement on her and stopped her prednisone regimen.When the drug was stopped, Ji Xiuying's condition was stable.

In May last year, Ji Xiuying started taking medicine again because she was worried about relapse.This time, she continued to take the medicine for five months, with 5mg orally per day for the first three months and reduced to 20mg for the next two months.Two months after cutting off her medication, she started experiencing fever and cough again.

It's relevant here!Sun Lien's eyes widened, and he excitedly drew several circles on "Lifuping".

Before the first attack, Ji Xiuying's body was in a state of immunosuppression.During the illness, it happened that her immune system was recovering.

The same goes for the second attack—rifampicin, one of the triple therapy drugs for tuberculosis, is immunosuppressive.It also caused Ji Xiuying's immune system to be suppressed.When the disease occurs, it is also the immune recovery period.

Oral methylprednisolone is the same reason - symptoms are relieved after immunosuppression, and symptoms reappear after immune recovery.The oral prednisone is quite special—the entire immunosuppressive process was unexpectedly interrupted by necrosis of the femoral head.

However, the last attack can still be regarded as the same process as the previous process-the patient did not take the medicine regularly, which caused the initial decrease in the level of immunosuppression not enough, and after the self-reduction of the medicine, the immune system began to recover.

In other words, every attack is accompanied by the recovery of the immune system!Sun Li'en thought of this, and suddenly lost his mind.

After the immune system recovers, it is very natural for immune cells to attack pathogens.This alone... seems not enough to deduce what the pathogen that infected Ji Xiuying is.

The diagnostic process seems to have reached a dead end.

(End of this chapter)