Chapter 469 Inconvenient Zhou Cheng Knowing Things
Chapter 469 Things that are inconvenient for Zhou Cheng to know (please subscribe)
Author: A lancet
Chapter 469 Things that are inconvenient for Zhou Cheng to know (please subscribe)
This treatment plan is obviously different from the previous new use of old drugs, at least it is aimed at different targets.
It was given to Gu Huo at that time. Although Gu Huo had a medical background, he had not stayed in the clinical and scientific research fields for a long time. Moreover, the purpose of those drugs at that time was to disrupt the situation and break the blockade.
Moreover, there is enough data on the application history of these drugs, and it is complicated and mottled. Almost no one can make detailed statistics, because many of the classic drugs used at that time were used on cancer patients, so in them,
It was used to treat other diseases and had anti-cancer effects, which was discovered by Zhou Cheng.
This is a new use of an old drug, so even if Zhou Cheng extracts or fabricates some data, others will not be able to find anything wrong. Even when he reviews the previous case data, he can get similar answers.
But this time, polymyoostitis vera is different. It is a rare disease.
There are not many in the world, and even fewer have been reported. It is estimated that a large number of patients have not been reported even if they have such a disease. Therefore, if Zhou Cheng wants to repeat the same tricks as the last time, it is estimated that
Very difficult.
And you can’t just finalize the plan right away. Once you finalize it, there is no underlying logic.
Moreover, the types of these drugs are the same, but the dosages are different. Therefore, the diseases targeted are different. You can’t explain the reasons clearly, and there is no support from previous research and theoretical data.
The most important thing is that Zhou Cheng has to face Yang Yifeng and Fang Yun.
These two people are very strong in terms of their professionalism and plasticity. You can't just say that you got it the same way, because others may secretly repeat it.
For example, you say this is what you summarized by checking the literature, oh, okay, I will check it when I go back. Then you can find the articles that I can’t find, and you can find the data that I can’t find.
There is a problem, brother.
Especially professional people are quite difficult to fool.
But he had to fool him, after all, this patient met him, or rather met Fang Yun, and came to the team he was in charge of. He happened to have this ability, so he couldn't ignore it just to protect himself.
So, in such a situation, you have to figure out a more appropriate plan.
That is a relatively common method in current scientific research, called drug dose step testing——
What is called step testing? It is to release the dose of the drug according to a certain isotropic gradient in cell experiments or animal experiments, and then observe the efficacy of the drug on the disease at different concentrations.
Then look for the most sensitive points.
For example, 0.1g/l, 1g/l; 10g/l...
First find the optimal order of magnitude, and then find the most appropriate drug concentration ratio in the arithmetic sequence.
This is the exploration mode of different drug concentration schemes in the clinical treatment process, which requires a large amount of data as support.
Of course, Zhou Cheng already has some basic data and knows the best ratio of treatment options. What Zhou Cheng has to do is to take the minimum number of steps and use the existing treatment options to quickly approach the best solution.
Obviously this requires certain design skills.
For now, if we temporarily repeat cell experiments or animal experiments, and then conduct clinical trials, it will definitely not be enough time for the patients currently encountered.
Simply speaking, in the current differential diagnosis of true myosoositis multiplex, the treatment options for dermatomyositis multiplex are readily available, and there are different treatment options.
Zhou Chengcheng plans to find a dose that is close to the treatment plan for myosostitis vera through exploration, and then fine-tune it, and finally adjust it to the optimal drug concentration. With such fine-tuning, even if Fang Yun and Yang Yifeng finally
I think it's too much of a coincidence, but there are signs to follow, so I won't doubt anything...
After Zhou Cheng made a plan in his mind, he went to take over Fang Yun's shift the next day.
When he first arrived at the emergency department, Fang Yun sat in the lounge full of energy and ordered a bowl of noodles for Zhou Cheng: "Teacher Zhou, haven't you had breakfast yet?"
"Are you in good spirits? Did you have a good time on duty yesterday?" When Zhou Cheng saw Fang Yun's state, he probably took a rare nap.
"It's my good luck that there are no patients. I've been sleeping since eleven o'clock until now." Fang Yun said, and smacked his lips.
"Well, that's pretty good luck." The Shonan University Affiliated Hospital has very few days without encountering an emergency. For a short period of time after the incident at the Second Hospital some time ago, the number of patients decreased slightly, but now it has also
It has basically recovered.
"By the way, Xiao Fang, what's your teacher's attitude towards you staying here now?" Zhou Cheng asked with concern.
Lei Zhong asked about Fang Yun's fate, but Fang Yun hasn't given a clear reply yet?
But before Fang Yun could answer, An Ruo walked into the duty room and poked her head in: "No one is sleeping in there, right?"
Zhou Cheng nodded: "You haven't had breakfast yet? Then you have to go and eat it yourself after get off work. Fang Yun ordered it for me in advance."
An Ruo now works at the Shonan University Affiliated Hospital. She is an anesthesiologist at the lowest level. She works in the emergency operating room of the emergency department. Yesterday was the night shift.
It should be said that An Ruo is quite tired from working three shifts now, and she is not treated specially because of her status.
Day shift, evening shift, night shift, one day off to prepare for the emergency shift, prepare for the sub-shift, all year round.
Of course, emergency and sub-shifts only need to go to work during the night shift when there are additional emergencies and extra emergencies, otherwise there will be a short chance to breathe.
Yesterday, Anruo, even the emergency department was called in to work overtime, but they were probably patients from other departments. The Shonan University Affiliated Hospital also had more than a few patients and doctors from the orthopedics department.
"I'll just come over and take a look." An Ruo dared to come in when she heard Zhou Cheng didn't respond that someone was sleeping.
Fang Yun apologized and explained: "Sister An Ruo, I didn't know you would come, otherwise I would have asked the master to send an extra serving."
The breakfast for the staff in the hospital can be delivered directly to the department by the chef. It tastes very good. It consists of original rice noodles with pickled cabbage strips and boiled lard. If you are not afraid of getting fat, a bowl of it in the morning will be very warm to your stomach.
"It doesn't matter, I'm not here to find breakfast. You had a good sleep yesterday. The entire operating room can no longer be filled with orthopedic patients. The thoracic surgery department has reserved the room." An Ruo did not sit down, but just tilted her head.
Leaning on the bed in the lounge, watching Zhou Cheng open the packaging bag of rice noodles, he said this to Fang Yun.
A private hospital means a large number of patients, almost occupying the entire emergency operating room.
"Are there many patients?" Zhou Cheng asked, while Fang Yun smiled sheepishly.
"There are quite a few, and they are all from the thoracic surgery department, not from other departments. Emergency patients from the neurosurgery department have been pushed into the operating room of the surgical building overnight, and there is no way they can take care of them. Our department is also very busy, not the emergency department and the
The deputy class members are all here to work overtime."
"Only your Department of Orthopedics is relatively free." An Ruowei was a little indignant and now began to speak for the Department of Anesthesiology.
An Ruo just came over to take a look, and then hurried back from get off work to catch up on her sleep.
If a girl who is a doctor wants to have good skin, she must find time to sleep more. Otherwise, sooner or later, her skin will age prematurely.
After An Ruo left, Zhou Chengcai talked to Fang Yun about the patient's treatment plan and said: "Fang Yun, after I went back yesterday, I checked the literature, and I found that the pathogenesis of myosostitis vera
It is similar to dermatomyositis multiplex, but the location of the attack and the severity of the attack are slightly different."
"The dosage of the currently recognized treatment plan for dermatomyositis is slightly insufficient. After checking the literature, I think we can use glucocorticoids at a dose that is 100% higher than the conventional treatment for dermatomyositis.
A dose of 80% is used as the initial treatment dose.”
"For immunosuppressants, choose a slightly lower dose, and choose 120% as the initial treatment dose."
"Then use it for a few days and observe the effect."
"Have the results of this patient's autoimmune antibodies come out? How did the laboratory department provide them..."
Autoimmune diseases can be treated with immunohistochemistry. Immunohistochemistry is quite useful whether in the treatment of tumors or in the diagnosis and treatment of immune diseases and rheumatic diseases.
Fang Yun did not doubt the treatment plan proposed by Zhou Cheng. He only said: "Mr. Zhou, immunohistochemistry usually takes a week to produce results. If it is a tumor, it will take half a month to produce the results."
"There are more major specimens."
"That's true." Zhou Cheng nodded. The Affiliated Hospital of Hunan University has a large number of patients. Immunohistochemistry does not mention specialized oncology departments, such as general surgical oncology and bone oncology. There are also professional oncology departments and geriatric oncology.
division.
"Then you can adjust the dosage of the medicine later, and then go back." Zhou Cheng explained this. He didn't mean to show off to the superior doctor. The main reason was that this matter was relatively simple, and Fang Yun was not tired.
"Okay, Teacher Zhou. I went to the laboratory directly after get off work. Brother Yifeng asked my opinion yesterday, and I agreed to go and help."
"By the way, Teacher Zhou, Professor Ning Xihua asked me to tell you yesterday that they have collected some preliminary information and data. Let you go and take a look at it. See if you can analyze anything from the current information. If not,
If you use it, you will have to collect it again."
"In addition, Professor Ning Xihua also said that Professor Liu from the Burn Department was also contacting him, and seemed to be planning to recommend a burn ointment..." After Fang Yun stood up, he helped Zhou Cheng throw away the rice noodle packaging.
Okay, after saying that, he walked out immediately.
In fact, there is an unspoken rule in the department, that is, the treatment plan within the group is determined by the superior physician. The treatment plan includes the type of drug, the dosage of the drug, and will be applied to the drugs in the department.
For example, the treatment plan here at Shonan University Affiliated Hospital is determined by the professor who leads the team.
In other words, if Ning Xihua wants to introduce any medicine, as long as Ning Xihua agrees, it will be fine.
But in fact, Ning Xihua still asked Zhou Cheng's opinion.
This may be some exchange of interests between Professor Liu and Zhou Cheng. Fang Yun knew that he was not suitable to inquire about these things, so he simply left.
Zhou Cheng didn't reply and fell into deep thought.
This Professor Liu...
After Zhou Cheng thought about it for a while, he took another look at the patient. After a physical examination, he was basically able to diagnose polymyoostitis vera, so he planned to go see Associate Professor Ning Xihua first.
However, the patient's family members followed and held Zhou Cheng's hand tightly: "Dr. Zhou, thank you. It's really hard on you and Dr. Fang. My wife's situation must be very complicated, and you need to pay more attention to it."
…”
"Don't worry, brother, we will definitely do our best. During this period, remember to eat less special proteins and eat more common proteins, such as chicken and duck meat. Eat as little special fish and snails as possible."
Autoimmunity is actually a special kind of allergy from the bottom up. It is only sensitive to factors secreted by the body, so it is autoimmune.
At this time, if you eat special proteins and an allergic reaction occurs, it will be even more troublesome.
At least during the simulation process, Zhou Cheng ate regularly and no special circumstances occurred. However, there were also some patients who worsened their condition after eating special meat, which may have aggravated the autoimmune disease.
It is also possible that you have such allergens yourself...
The middle-aged man nodded steadily.
Then I returned with a lot of gratitude...
After this, Zhou Chengcai rushed to the trauma surgery department.
However, when Zhou Cheng appeared in the trauma surgery ward, he did not find Ning Xihua and the others.
On the other hand, Zhou Cheng's student, Zhou Cheng, is still in the trauma surgery ward, searching for some cases.
"Xiao Wang, where are Professor Ning and the others? Today is not an operation day?" Zhou Cheng asked.
Wang Huan's eyes flickered and he said: "Master, Professor Ning didn't come to the department this morning."
"What about the others? None of them are here. No one came to check the ward today?" Zhou Cheng asked again.
It shouldn't be the case. Ning Xihua asked him to take the lead. How could he not be here this morning? He didn't do anything like this.
"A senior brother came and checked the room. Teacher, I heard that because today is not an operation day, Professor Ning seems to have undergone a consultation operation. I heard that it was a hospital in the Wang District."
"But this morning, not only did Professor Ning not come, it seems that even Professor Ning's teacher from the first ward of the Orthopedics Department also passed by. I don't know what happened, but I didn't dare to ask," Wang Huan said.
"When my senior brother came to check the ward this morning, he told me not to tell you this."
"Me." Wang Huan's expression was bitter. She promised her senior brother not to tell Zhou Cheng, but as soon as Zhou Cheng came, she took care of everything.
"Okay, it's okay then."
"Since it's inconvenient for me to know, I won't call you to ask. If you're okay now, let's go to the emergency department together and I'll see how you're doing with your MRI diagnosis." Zhou Cheng felt that this was a waste of time.
'Having been with Wang Huan for two months, it's time to check on her study progress.
Unexpectedly, when Wang Huan heard Zhou Cheng ask this question, his expression was straight, and he was vaguely expecting.