The person who answered Sun Lien's question was Professor Zhu Minhua, who had been eavesdropping from a distance.
"There is this set of equipment in the courtyard." He walked towards Sun Li'en and asked curiously, "Do you think it is necessary to use this method now?"
The full name of mngs is "Metagenomic Second Generation Sequencing Technology", which is a relatively cheap, mature, and fast genetic testing technology. Unlike the first generation technology, mngs uses high-throughput testing technology. Although it is
With traditional technology, mngs can produce results much faster, but it still takes more than 24 hours to complete a thorough comparative test. And although this technology is "relatively cheap", the cost is still scary. If Lu Xuexin's cerebrospinal fluid is used
For samples to undergo MNGS testing, the cost of the reagent set alone will be close to 20,000 yuan.
But it’s expensive for a reason. The MNGS technology, which can detect nearly 7,000 viruses, fungi and bacteria in samples at the same time, is indeed the most direct way to determine the cause of Lu Xuexin’s disease. No pathogen was detected in the smear, which means that Lu Xuexin’s brain was infected.
It is likely to be a fastidious or unculturable bacterium. It is basically a hopeless hope to conduct bacterial culture on the extracted cerebrospinal fluid to identify the pathogen through traditional means. In the case where the broad-spectrum antibacterial drugs meropenem and ceftriaxone are ineffective
, mngs has indeed become the only rapid detection method.
"Even if we now arrange for a neurosurgeon to conduct a puncture biopsy of the abscess in the patient's brain and then do bacterial culture, it will take at least three days." Sun Lien explained calmly, "According to the medical history, the patient's brain should be infected.
It was four days ago. Including the incubation period of the bacteria, it was only five or six days. Over the past few days, the patient had developed from no infection to multiple brain abscesses, and was also complicated by meningitis. The patient's immune system was still suppressed.
If the condition is delayed for another three days, who knows how far the brain abscess will progress. Even if she is lucky enough to survive by then, severe sequelae are almost inevitable."
Having said this, Sun Lien glanced at Lu Xuexin on the bed with some regret, "She is still very young. It would be a pity if the family cannot afford the examination due to financial problems..."
Zhu Minhua was silent for a while, and then suddenly laughed. "It's not without reason that Lao Liu put his successor into your team." He changed from his previous coldness, and a gentle look appeared on his round, fair face.
With a smile, "The young man is pretty good."
Yuan Pingan looked at his mentor, then at the stunned Sun Lien. He also laughed.
"This patient's situation is indeed quite special." Zhu Minhua walked to Lu Xuexin's bed and gently patted the railing at the foot of the bed. "The symptoms of this encephalitis are also very unique." He glanced at his student.
Yuan Pingan said with some dissatisfaction, "Xiao Yuan, I usually ask you to follow up on other people's published papers, but you must not have read it, right?"
Yuan Pingan was a little confused by Zhu Minhua's sudden criticism, but it was true that he had been lazy and not read the paper during this period. He lowered his head and said embarrassedly, "I am really pressed for time."
"Time is tight, you still have time to go out with your girlfriend." Zhu Minhua was happy. He looked at his student, a little helpless and a little sad. "Your kid wants to go to Shenwai. I'm afraid it's not just for the future.
The future is also for Xiaohua, right? I can tell you, there are strict rules in the hospital, and you cannot fall in love in the same department. If you really want to be with her for a long time, then just settle down and work in the emergency room."
Yuan Pingan was surprised at first, and then responded with a wry smile.
"Also." Zhu Minhua nodded again, "You are only 31 years old this year, and you have become the chief resident of our association. This resume is enough for you to become a deputy chief physician elsewhere."
Listening to Zhu Minhua's words, Sun Lien suddenly felt that something was wrong.
"Did you send your resume to the Fourth Central Hospital last night?" Zhu Minhua asked with a smile.
Yuan Pingan was really frightened now, "Teacher Zhu...I..."
"Someone is keeping an eye on the network department in our hospital." Zhu Minhua waved his hand and blocked his explanation. "You used the computer in the hospital to send your resume. The people in the network department have already told me.
He turned to Sun Lien and asked with a smile, "Dr. Sun, what do you think of me as a student?"
Only then did Sun Lien react. He looked at Yuan Pingan and was shocked, "Is that you the fellow neurosurgery doctor who sent the resume?"
Yuan Pingan nodded with a grimace. In fact, he had no intention of working for Sun Lien at all. The purpose of sending his resume was actually just to let Sun Lien contact him proactively, and then he would show off and vent his anger. Who would have thought that he
Zhu Minhua actually found out about this laziness!
"I listened just now. Dr. Sun is very good. You should learn more from him." Zhu Minhua didn't wait for Sun Lien's answer. Yuan Pingan has been studying with him for more than eight years. He has a doctorate in clinical medicine for five years.
The three-year dual degree of scientific research and doctor of medicine has been obtained. Now is the best stage for him to improve his clinical experience.
But there is one thing about Yuan Pingan that has always made Zhu Minhua a little dissatisfied. Perhaps because Yuan Pingan studied neurosurgery from undergraduate to graduate school. His diagnostic ability and ability to deal with emergencies have always been relatively weak. On these issues,
, but Sun Lien is countless times better than Yuan Pingan. With the same information and the same symptoms, Sun Lien can come up with a diagnosis and treatment plan that is more suitable for the patient.
Especially when encountering patients like Lu Xuexin, this shortcoming becomes more obvious. In fact, it is more important to make an accurate diagnosis of Lu Xuexin than to prescribe medication based on experience in advance. This is not because of Yuan Pingan's poor professional level.
It’s just that his diagnostic thinking still belongs to the category of a specialist. In Zhu Minhua’s view, what emergency doctors need to do is to quickly stabilize the patient’s vital signs without any medical history, and then quickly treat patients based on their symptoms.
The type of disease that the patient may suffer from is diagnosed. Then, with the assistance of specialists, the patient is given targeted treatment. After the situation is basically under control, the patient is transferred to a specialist ward for follow-up treatment. This is also advocated by the emergency model of the Fourth Central Hospital
plan.
It is a pity that, living under the big tree of Tongxie, Zhu Minhua knows better than anyone else that Tongxie cannot change its policy of running a hospital. This policy has lasted for nearly a century and has single-handedly brought Tongxie into the world.
Well-known hospitals and medical universities. Backed by big trees, although you can leisurely roam in the shade, it is simply impossible to start a new business. The prestige of Tongxie and the achievements of Tongxie determine that Tongxie’s emergency department can only
As a "pre-treatment" unit before other specialties, it is simply impossible to dominate the hospital's operating model.
Yuan Pingan needs to change his diagnostic thinking, but Zhu Minhua himself has no good way to do this. It is no problem for him to teach professional knowledge and guide scientific research. But if he is asked to transform an adult's thinking model, Zhu Minhua asks himself whether
This ability.
In this case, it is better to let him go to a pilot emergency unit to try.
In fact, even if Yuan Pingan did not send that resume, Zhu Minhua also planned to contact Liu Pingchuan to see if he could send his disciple to Ningyuan Fourth Central Hospital to study. Maybe under his care, Yuan Pingan's diagnostic defects would not be
It would be a big problem. But what if he goes to another hospital? What if he retires?
Yuan Pingan is a good doctor, and he actually works very hard. And he is indeed qualified to be a doctor. If this shortcoming causes him to have any problems in his future work, Zhu Minhua himself will not be able to forgive himself.
Sun Lien looked at the pair of masters and apprentices, and suddenly felt that he had become Liu Tangchun. After walking around the hospital and taking a bath, he found a chief resident? When he returned to the hospital, Director Liu might have written for himself.
bonus!
"Teacher Zhu..." Yuan Pingan also understood what Zhu Minhua meant. He asked in shock, "What do you mean..."
"You should go outside and take a look." Although Zhu Minhua was still smiling, there was a hint of desolation in his eyes. "The Fourth Central Hospital is one of the few major emergency pilot hospitals in the country. It just so happens that you
There is still some unfinished fate between you and Liu Pingchuan, so it would be a good idea to give it a try." He patted Sun Lien on the shoulder, "Don't think that little Sun can't compare to you at such a young age." Zhu Minhua said seriously, "I know you are better than me.
Are they missing somewhere?"
Yuan Pingan said calmly, "I don't know..." Although he also knew that Sun Li'en was better at diagnosis than him, but as a doctor of the same association, and his working experience was many years longer than that of Sun Li'en, his pride would not fade away in a short time.
Going down.
"He is still young, has a talent for diagnosis, and his thinking has not yet become a stereotype." Zhu Minhua lamented, "Being a doctor is different from other professions. We need experience, but we also abandon experience. Every patient's situation is different.
Likewise, blindly relying on experience will only harm you and the patient in the end."
Sun Lien's face almost turned red after being praised.
"You must have rigorous logical reasoning ability, the clearest overall view, and sufficient professional knowledge to become an excellent emergency doctor." Zhu Minhua said earnestly to Yuan Pingan, "Now you have enough professional knowledge.
But my ability to see the overall situation and logical reasoning is not strong enough. Let’s go to the Fourth Central Hospital and have a look, and then come back when you have learned something.”
Regarding professional issues such as Yuan Pingan's personnel secondment, Zhu Minhua patted his chest and said that he could handle it himself. Afterwards, he left behind a confused Sun Lien and a confused Yuan Pingan.
"Lu Xuexin's MNGS is already being done. It is estimated that the results will be available tomorrow." Before leaving, Zhu Minhua seemed to want to let Sun Lien not worry. Zhu Minhua specifically added: "When the results are available, I will ask Xiao Yuan to follow you.
Say."
"So...I'm going to work with you from now on?" Yuan Pingan actually didn't have much resistance to being seconded to the Fourth Central Hospital, but it happened too suddenly, and he still hadn't recovered.
Sun Lien patted his shoulder and said, "Doctor Yuan, believe me. Over the past few days, I am much more shocked than you."