Auto chess in the operating room

Chapter 271 Reward: Unlock 3 Gold Coin Pieces
[Ding, new task, use the treatment plan provided by the system to cure Xiao Yunyun, and at the same time start a long-term controlled trial, publish the research on the treatment of Kawasaki disease in "The Lancet", task reward: unlock 3 gold coin chess pieces, task period, 6 pieces moon
Special reminder: Chess pieces with more than 3 gold coins, in addition to surgical procedures above level [-], also include theoretical research on basic diseases and new drug formulas. 】

Seeing the three-star chess piece so powerful, Tang Lou was also very excited, but the most important thing now is to treat Xiao Yunyun first.

"Mr. Mu, Director Shen, I have indeed found out that Xiao Yunyun has Kawasaki disease, and attached a conventional treatment plan. If I could have been diagnosed immediately when Mr. Mu returned to the office, it would be too late to start treatment. But By accident, I happened to go to the orthopedics department for an operation, so I missed the best time for Xiao Yunyun's treatment."

Hearing what Tang Lou said, Shen Bingbing blamed herself more and more. Mr. Mu also frowned, and it was also very painful. It would have been better if he had discovered the illness earlier.

When the master and apprentice blamed themselves and had nothing to do, Tang Lou hurriedly said, "Actually, it's not that there is nothing we can do now."

"How to say?"

Shen Bingbing didn't care about anything, grabbed Tang Lou's arm and looked at him expectantly.

"I still have a method to treat Xiao Yunyun, but it has not been clinically verified."

Tang Lou directly motioned for Shen Bingbing and Mr. Mu to sit at the desk together, while he took a piece of paper from the side and wrote on the reverse side. While writing the exact treatment dosage, he explained to Mr. Mu and Shen Bingbing .

"The conventional plan, which you both must know, is to treat the patient with aspirin, which is to take 50 mg·kg-1·d-1 orally in 3 times. Then, according to the change in the child's body temperature, the drug dosage is appropriately reduced, 2 Reduce to 3 to 5 mg/kg per day in about 2 weeks. On this basis, gamma globulin treatment is adopted. The specific usage is: a dose of 8 g/kg gamma globulin is slowly infused intravenously for 12 to 1 hours. If the effect is not significant, , reuse once."

Hearing Tang Lou's precise description of the conventional treatment plan, Mr. Mu nodded.

Shen Bingbing also listened very attentively. At least so far, what Tang Lou said was very correct.

"However, because I missed the opportunity for treatment, I want to try methylprednisolone and gamma globulin. The gamma globulin is used in the same way as above; the dosage of methylprednisolone is 2 mg·kg-1·d-1, After continuous intravenous infusion for 5 days, prednisone was changed to oral administration, 2 mg/kg per day, for 14 days.”

After Tang Lou finished talking about the optimization plan, he also wrote down the medicine and dosage in his hand, and prescribed it to Director Shen.

Looking at Tang Lou's plan, Shen Bingbing looked serious. She had never heard of methylprednisolone in the treatment of Kawasaki disease, but she still knew something about it: "Methylprednisolone is usually used in critically ill erythema. Lupus, also used in rheumatic diseases. Allergic diseases."

Mr. Mu also added: "Methylprednisolone is also used in immunosuppressive treatment, including organ transplantation and blood diseases. It is even used to prevent nausea and vomiting caused by cancer chemotherapy. Generally, the scenarios where it is used are very critical. Ordinary physicians rarely dare to use it."

Mr. Mu and Shen Bingbing looked at Tang Lou at the same time. It would be very risky to propose a treatment plan that has not been clinically proven. At least, Tang Lou had to convince them from the treatment mechanism.

Of course, Tang Lou also understands that surgery is not a joke. The death of the patient due to an unknown cause and the death of the patient caused by the wrong drug used by the doctor are completely two concepts.

Director Shen is not a hot-blooded young man. He has no sure plan and would rather the patient die.

Unless Tang Lou can tell the truth, then they can negotiate with the patient. Now there is an original treatment plan, but there are risks. Of course, there is also a great possibility of cure. Only after the family members sign and agree, they dare to carry out the treatment .

Sensing the eyes of the two old doctors, Tang Lou didn't waste any more time:

"Kawasaki disease, that is, the etiology of mucocutaneous lymph node syndrome is not completely clear. Clinically, it is generally believed that it is an abnormal immune response caused by infection. After the disease, if it is not treated effectively in time, it may lead to coronary artery damage. In severe cases, it may also lead to coronary aneurysm and thrombus, which will eventually threaten the life of the child. Clinically, the treatment of this disease generally adopts drug therapy, and the common treatment options are gamma globulin and aspirin. And a certain clinical effect can be obtained.”

"The principle is that gamma globulin can block the IgFc receptors on the surface of monocytes and vascular endothelial cells, and effectively block the immune response of IgFc receptors, or produce a specific antibody for antigens and toxins. Neutralize it, which in turn promotes recovery from the acute inflammatory response and alleviates damage to the coronary arteries."

Hearing Tang Lou's detailed and professional explanation, both Shen Bingbing and Mr. Mu couldn't believe it. This is just the cognition of a young man under 30 years old, and this is just the beginning.

Tang Lou spoke very quickly: "And aspirin can control cyclooxygenase and reduce the production of prostaglandins, so as to block the formation of platelet thromboxane A2; this drug has the effect of anti-platelet aggregation and anti-infection"

When he heard this, Mr. Mu nodded in agreement. This is also the most commonly used treatment plan in the world.

"Then what is the principle of the improvement plan you mentioned?"

Mr. Mu is also very curious about the medical field and asked eagerly.

Tang Lou nodded, and continued to explain non-stop: "These two drugs can indeed achieve certain curative effects under normal circumstances. However, they have their own shortcomings, that is, the incidence of coronary artery disease is relatively high, and Xiao Yunyun because of If the misdiagnosis is too long, the coronary artery is almost dying, and if it is simple and practical, conventional treatment will not help at all.”

"So you suggest adding methylprednisolone on the basis of aspirin and gamma globulin treatment, which can effectively avoid and reduce the occurrence of coronary artery disease."

Mr. Mu is more experienced than Shen Bingbing, and he immediately understood Tang Lou's intention of using methylprednisolone.

"Yes, and methylprednisolone can also play a role in reducing white blood cell count (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and other indicators in children."

Mr. Mu recalled that the comparison before and after treatment of the patients who used methylprednisolone before was indeed as Tang Lou said.

"Is this really enough?"

Mr. Mu still had some doubts.

Tang Lou smiled and said very firmly: "In the acute stage of children with mucocutaneous lymph node syndrome, the inflammatory response in the body will undergo abnormal changes, such as abnormal activation of mononuclear macrophages and T lymphocytes, resulting in inflammatory mediators. It is related to the abnormal release of inflammatory cytokines, such as CRP; and this situation can damage the vascular endothelial cells to a certain extent, and cause the related inflammatory cells to be stimulated, and then a vicious cycle occurs, which further aggravates the inflammation, and finally leads to long-term exposure of vascular endothelial cells. In the damaged state. In this regard, effective control of the inflammatory response and reduction of the release of inflammatory factors can have a positive impact on the treatment of the disease. And methylprednisolone can play a positive role that cannot be ignored in controlling the inflammatory response .”

Tang Lou’s last words finally shattered Mr. Mu’s suspicion. The old man stood up and held Tang Lou’s hand excitedly: “Yes, yes, methylprednisolone has significant effects on anti-inflammatory and immunosuppressive treatments. .Bingbing, I think it will work!"

"Bingbing, let's hurry up and communicate with the patient's family according to Dr. Xiao Tang's treatment plan, and start treatment immediately. I hope the patient can be cured within a course of treatment."

Mr. Mu got up, dragged Shen Bingbing to the ward.

"Good good."

Shen Bingbing also had a big stone in her heart, and with a treatment plan, she could see the outcome in two weeks.

(End of this chapter)