Back in 2002 as a doctor

"Doctor Xiao Zhou, they are all anti-platelet aggregation drugs. Your Director Wang is also a doctor, and you have taken care of yourself well. Maybe you have been too nervous recently, so..."

"Director Teng, can you ask if it's Tigrelo?" Zhou Congwen asked lightly.

"What?" Teng Fei was taken aback.

"A sort of……"

Zhou Congwen paused for a moment. He saw a strange expression on Teng Fei's face, and knew that Director Teng didn't hate him out of politeness.

It was inappropriate for a young doctor to speak directly in front of the director of the provincial capital. The disparity in status made him really disrespectful.

"Xiao Zhou, tell me why." Chen Houkun felt a little embarrassed, and out of trust in Zhou Congwen, he answered directly.

Director Teng was taken aback, and Lao Chen was too used to it... No, it seems that he is not used to it.

The little doctor in front of him is even recruited by Academician Chu, so there must be something beyond ordinary people.

"Doctor Zhou, tell me."

"Ticagrelor produced by AstraZeneca has just been put on the market, and the effect is not bad."

"Ticagrelor is doing well in phase III trials as an adjunct to aspirin in DAPT regimens.

But although ticagrelor is effective and safe, the drug still has some side effects, of which dyspnea is the most common. "

Difficulty breathing……

Both Teng Fei and Professor Chen were stunned. Not only had they never heard of the medicine, but were the side effects so weird?

"About 10% to 15% of patients experience dyspnea, which is generally mild or moderate and fully reversible.

In addition to breathing difficulties, another side effect is bradycardia.

During the first week of treatment, about 6% of patients experienced ventricular asystole of more than 3 seconds, and about 2% of patients experienced ventricular asystole of more than 5 seconds. "

Such detailed data made Teng Fei startled.

Looking at Zhou Congwen's indifferent expression on his young face, he seemed to be just stating a fact, regardless of whether he believed it or not.

The more this happened, the more Teng Fei felt that it was impossible to lie to herself.

It's no good for him to lie to himself, isn't it.

Moreover, such professional data can't be compiled by ordinary people, but professionals don't need it.

"This kind of adverse reaction is rarely reported now, and even if it occurs, it lacks reliable clinical relevance. But I have read some related research reports, which show that ticagrelor may cause severe bradycardia."

"What about the mechanism?" Teng Fei asked subconsciously.

People who engage in medical treatment are like this, willing to get to the bottom of it.

After all, it is for people to eat, and it is three-point poisonous, so it is impossible to be cautious.

After asking, Teng Fei felt a little regretful. According to Zhou Congwen's analysis, sinus inactivity should be a very serious and rare complication, and the pharmaceutical team of AstraZeneca may not have figured it out.

"The mechanism of ticagrelor-induced bradycardia is not yet fully understood. It increases adenosine levels by inhibiting ENT1 transporter cellular adenosine uptake, and may have a direct cardiac inhibitory effect on rhythm and conduction." Zhou Congwen faintly Said.

"..." Teng Fei was stunned.

Do you know this?

"That's basically it. I highly suspect that Director Wang is taking ticagrelor. Other drugs have no clear side effects of sinus quiescence."

"Really?" Teng Fei looked at Zhou Congwen in surprise.

"Really." Zhou Congwen nodded. "Director Teng, if you are interested, you can ask the manufacturer of ticagrelor. They should have data from overseas human experiments. Sinus inactivity is not common, but it does exist."

"But..." Teng Fei was a little puzzled.

"Stop the medicine first, no, first ask Director Wang if he bought ticagrelor." Zhou Congwen said.

That's right, she was so confused as she was talking, Teng Fei was curious, so she turned around and left without asking the little doctor.

"Xiao Zhou, is what you said true?" Chen Houkun was lost in confusion.

It is said that he is a heart surgeon, and he is familiar with this kind of heart medicine to the bone.

Although it is definitely not as meticulous as Director Teng Feiteng, Zhou Congwen didn't know the name of the medicine, which is a bit too much.

"Professor Chen, I've said it many times, and it's true."

"Why didn't you remind Lao Wang in Jianghai City?" Chen Houkun subconsciously asked a heartbreaking question.

"He didn't tell me. According to us, he belongs to the kind of patient who is extremely uncooperative and has the worst medical compliance."

"..." Chen Houkun was speechless, Zhou Congwen's description left him speechless.

"I'm still rich and afraid of death, so I took unapproved medicine." Zhou Congwen continued with a smile.

"Xiao Zhou, don't you want to go see Old Wang?"

"no."

"Then you come..."

"I'm afraid he will die just like that." Zhou Congwen said seriously with a smile.

Afraid that he... just... died...

Chapter 0154

It was hard for Chen Houkun to imagine that there was such a deep hatred between Zhou Congwen and Wang Chengfa that it would reach such a point.

"Xiao Zhou, it can't be."

"Brother Chen, I'm a surgeon. As the director, I'm not obliged to give every doctor the opportunity to perform surgery, but I can't deliberately get stuck. Cut off my career, what do you think of this?" Zhou Congwen said lightly.

Zhou Congwen has a first-class mind, but there are two hurdles that cannot be bypassed, so that his mind cannot be understood.

This is not something that Chen Houkun can persuade with a few light words.

And Zhou Congwen's words reminded Chen Houkun of Zhang You.

But he is a good old man, and he doesn't have too much resentment in his heart.Now it seems that Zhang You may have taken a wrong step and gave up the thoracoscopic surgery to himself.

It can be regarded as wrong and wrong.

Just as she was talking, Teng Fei hurried in, her white clothes rustling like background music.

"Xiao Zhou, the patient was indeed taking ticagrelor. It is said that a relative brought it back from abroad." Teng Fei said excitedly, and then whispered, "I guess the drug dealer bought it for him."

Zhou Congwen didn't care who bought it, he was here, and Wang Chengfa didn't want to die so easily.

"Well, heart sinus quiescence should generally be a complication of ticagrelor. Stop the drug and switch to 60mg of prasugrel per day."

"But what if it's not good?" Teng Fei was still worried, after all, the person standing in front of her and speaking was a young doctor in his early 20s.

"Installing a temporary pacing lead can guarantee the patient's safety if sinus heart stillness occurs. If it's not good, then go to the imperial capital, and I can't help it."

I can't help it, these five words are said with ease and atmosphere, as if Zhou Congwen is an academician guiding his students to work.

Teng Fei was startled for a moment, then nodded helplessly.

Although the little doctor in front of him spoke in a loud tone, what he said was indeed reasonable.Install temporary pacing leads first, then look for ways to fix the problem.

If not, go to a higher-level hospital.

Because it was the first time she encountered something similar, she didn't think of a pacing lead.This is very simple and logical. Zhou Congwen said something and Teng Fei immediately understood what to do.

Even if there is no effect after changing the dressing, installing a pacing lead can ensure that the patient can go to the imperial capital smoothly.

Zhou Congwen was a little emotional, he looked at Teng Fei.

According to the later statement, Teng Fei belongs to the big front wave, the kind who eats the bonus of cardiac interventional surgery from beginning to end.

If she is more ambitious and establishes a medical equipment company, all the equipment will be taken from her family and she will earn more.

It is undeniable that because of the appearance of people like Teng Fei and others, the average life expectancy in the whole country has been extended by at least 0.5 years.

At least!

But this kind of big frontier is still a little immature now, and he didn't even think of the temporary pacing lead, so Zhou Congwen thought of it naturally in his heart.

It's just that the word immature was described by a "little" doctor like him, which seemed a bit inappropriate.

"Then I'll go first." Zhou Congwen smiled at Teng Fei, "Brother Chen, you have to speak at the dinner tonight."

"Well, don't look at my jokes." Chen Houkun nodded embarrassingly.

"I won't go." Zhou Congwen directly refused.

"Ah? You don't want to participate?" Chen Houkun wondered, "Why?"

"At that time, I can go back and tie a few knots."

"Uh……"

"Let's go." Zhou Congwen bowed his hands and left the Department of Circulatory Medicine leisurely, and he didn't even visit Wang Chengfa's ward.

"Old Chen, how do you know him? Who is he?"

After Zhou Congwen left for a long time, Teng Fei asked blankly.

Chen Houkun couldn't answer this question, so he could only smile wryly.

……

……

Zhou Congwen went downstairs and glanced at the time. It seemed that it was a bit late today and it was not suitable.

He didn't know the process of claiming prizes. In his previous life, he had to keep a low profile when reading novels, and he had to wear hats and masks.Zhou Congwen was speechless even if he wanted to look like a robber to receive an award.

Zhou Congwen didn't really understand the specifics, and he didn't care much about the "mere" 6000 million yuan.

I've seen it before, is it so low-key with a little money of more than 6000 million?

In a few years, the National Natural Science Foundation of China will be small, and Zhou Congwen will receive about one billion private donations every year.

Zhou Congwen took out his mobile phone and called Liu Xiaobie.

"Baby, what are you doing?"

"Busy, have you finished the meeting?" Liu Xiaobie asked.

"I don't have enough time today, give me a few hours tomorrow."

There was a pause on the phone, Zhou Congwen could see Liu Xiaobie's vigilant gaze from nothingness.

"I'm going to get a check tomorrow, so you can get it for me."

"If you lie to me, the consequences will be disastrous. Tsk tsk, Zhou Congwen, are you ready?"

"..."

After a long time, Liu Xiaobie asked suspiciously, "You picked it up while walking on dog poop? That's not okay, people..."

"Told you that I won the sports lottery."

"Don't make trouble, how big a prize do you have to win..." As he said that, Liu Xiaobie hesitated for a moment, and suddenly asked, "The top 8 in the World Cup? They said there were [-] bets to win the prize. Is it really you?"

"Yeah, it's been said more than 800 times."

"I'll go! I passed by that lottery shop, and a big red banner was pulled out at the door. The person written on it is really you?!"

"Hey, see you tomorrow morning." Zhou Congwen said with a smile, "By the way, do you know any medical device manufacturers?"

"Boss, do you want to invest? I'm the best choice." Liu Xiaobie's voice became much gentler, like the catkins blown by the wind, and the girl who climbed the tree in a daze disappeared.

"We'll see each other later."

Zhou Congwen walked out of the Second Hospital of the Medical University leisurely, with his hands hunched over, without any youthful vitality.

……

"Hello, Xiaokang from AstraZeneca? Ask you something."

Teng Fei couldn't wait to start consulting about the medicine.

"Ticagrelor is your company's drug, how is the effect?"

The business manager's kind and enthusiastic explanation came from the other side of the phone immediately, but what she said was not what Teng Fei needed to know.

"Xiao Kang, wait a minute, what I want to ask is whether ticagrelor may cause sinus bradycardia or even sinus quiescence in patients."

Although he didn't see the expression on the other side, Chen Houkun felt embarrassed when he found out that Manager Kang.