The answers to many mystery stories always seem so illusory before they are revealed, but once the pipe-smoking detective talks about it in the fireplace and single-seat sofa, readers often have two feelings: "Is this okay?"
"...Yes!"
If Rawls' illness was written into a story, most readers would still be confused, "What on earth is this author trying to say?"
The two original documents found by Sun Lien are the basic evidence to prove his inference. His reasoning still needs to be proved by decisive evidence, but the two original blood routines are a prerequisite for his entire diagnosis. If these two blood routines are not used,
The results obtained quickly by the analyzer showed that Sun Lien's bold speculation was nothing more than a rootless phantom.
"Two hours?" General Peng, whose momentum was suppressed, frowned, "Doctor Sun, if you feel that you do not have the ability to judge the condition, I can have someone prepare to transfer you to another hospital now." He thought that Sun Lien was doing this.
Giving up on oneself.
Sun Lien smiled and shook his head, "I have some thoughts about his disease now. If the test results later are different from what I thought, then I will be considered incompetent." He said to General Peng, "If you have anything else to do,
You can go now, I'll make arrangements to check. The new test results will be out in two hours."
"So... what do you understand?" Xu Yourong stood at the door of the small conference room. As soon as Sun Lien went out, he was startled by the ambush of Deputy Chief Physician Xu. Xu Yourong did not start because of Sun Lien's almost falling action.
What a joke, she asked Sun Lien seriously, "Dr. Yuan and I have been discussing it with Zhou Ce for a long time, but we still can't figure out what's wrong with this patient."
Sun Lien slowly climbed up while holding on to the wall. He used his mind to pull back half of the soul that had drifted out of his mouth, and sighed, "Sister Xu, scary people can scare people to death." He was previously attacked by the man who came looking for the dog in the middle of the night.
The feeling of being frightened half to death by the drug dealer girl returned to Sun Lien's body. Without looking in the mirror, Sun Lien could guess that his head must be in a state of "excessive adrenaline secretion".
"Your sudden inspiration is scary." Xu Yourong seemed to be really shocked, although it wasn't obvious from the outside. "The three of us, and even Rachel, together can't make a reliable guess about the direction. You
I dare say that I can find out the reason in two hours..."
Sun Lien had to correct Xu Yourong's misunderstanding, "I mean, my guess can be confirmed within two hours. If it is not confirmed after more than two hours, there is no need to let others continue to waste it.
Anyway, I don’t have any other ideas now.”
Xu Yourong was stunned for a while, "So you are planning to make a desperate move and break the pot?"
"The first half is correct, but the second half is not what it said." Sun Lien corrected Xu Yourong's usage of idioms in a fit of laughter and tears, "I am quite confident in this guess."
"What on earth is it?" Xu Yourong couldn't help it anymore, "Is it intravascular hemolysis caused by pneumonia?"
"No, in fact, if you discuss it with Dr. Pascal instead of a few of them, you might be able to come up with an answer." Sun Lien smiled very cheaply and sarcastically, "Foreigners always say that you can't care about skin color.
Don't care about race. But they always overcorrect and ignore the patient's biggest characteristic, he is black."
"Is it related to race?" Xu Yourong was a little confused, "But race theory..."
Sun Lien interrupted Xu Yourong's speech for the third time, dumbfounded, "I'm talking about objective physiological differences, not the basis for genocide. He is a black man, so his hemoglobin content should be about 15% to 30% higher than ours.
%. Also because he is a black man living in a falciparum malaria area, this group has evolved a physiological defense mechanism to deal with malaria."
Xu Yourong suddenly realized it, and he and Sun Lien said in unison, "Sickle cell disease!"
Although he knew the answer, Xu Yourong still didn't believe in Sun Lien's judgment. "It shouldn't be right? Didn't you do two blood tests? The sickled red blood cells are very obvious under the microscope..."
Sun Lien took out the two routine blood test sheets he held in his hand, "That's why I dared to make this speculation after seeing these two test sheets. Whether they were issued by the hospital at the training ground or the laboratory department of our hospital,
All routine blood test reports use a blood cell analyzer."
The blood cell analyzer is a good thing. Both the training ground hospital and the laboratory department of the Fourth Central Hospital use five-part blood cell analyzers. Only about 20 microliters of peripheral blood is needed, and the analyzer can report the patient's status within one minute.
15 blood cell indicators, and report the whole blood C-reactive protein index within three minutes. It is fast, highly accurate, and has complete items. This greatly eases the laboratory doctors to prepare blood smears and then count the cells bit by bit under the microscope.
pain. At the same time, because a small number of blood samples are required, patients can also avoid more pain. But the most important thing is that most blood test items can be completed within three minutes. This response speed makes the blood cell analyzer
A life-saving tool in the emergency department.
But the problem is that blood cell analyzers cannot identify shape defects in red blood cells.
Although more advanced blood cell analyzers can already identify abnormal cell tissues such as giant platelets, sickle cells still do not fall within the scope of blood cell analysis. Generally speaking, patients with sickle cell disease or sickle cell anemia
Patient diagnosis still relies on the eyes of the laboratory doctors. Unless sickle cells are seen in the blood smear, it is impossible for the laboratory department to report this symptom to the doctors.
The laboratory departments of the training ground hospital and the Fourth Central Hospital fell into this blind spot. The content they detected using the blood cell analyzer could not completely cover Rawls' symptoms, and also covered up his main disease.
Go on. This kind of error keeps doctors going down the dead end of infections and autoimmune diseases. The most frustrating thing is that sickle cell disease and sickle cell anemia are both very rare diseases in China.
The disease has its highest incidence in Africa.
According to research, the medical community generally believes that sickle cell disease is caused by the replacement of the amino acid glutamic acid at position 6 of the beta chain in the patient's chromosome with valine, forming abnormal hemoglobins and replacing the normal hemoglobin. Due to oxygen
When the partial pressure decreases, the hemoglobin S molecules interact with each other to form a spiral polygon, which will twist the original normal red blood cells into sickle cells. Because the mechanical shape of the sickle cells changes, the cells themselves are more likely to undergo hemolysis, or