medical simulator

If it is in reality, there may be more sacrifices!

One time is not enough to come a second time, mainly because the number of cases is too small.

Medicine is already extremely complicated and cumbersome. With my current accumulation, if I want to switch to an unfamiliar field, I may not be able to break through the final entrance in my life. This is not a big deal.

There are many geniuses in this world, even if the chance is one in a million, there are still tens of thousands of geniuses in this world, and this is true in every era and every moment.

But research on medical treatments has been slow.

【…】

[Ten years later, you became the top orthopedic professor in China. Your professional ability and scientific research ability have reached the peak, but the students you accepted have all left your team one after another, and none of them stayed to study with you. of Ph.D. 】

[Also, your doctoral students have also left your unit to work in other units. 】

【…】

[20 years later, your research results will finally be effective. When your research results are successful, there is still no response, all journals will block you, and all publishing houses will keep a distance from you, because you have already Notorious, like a street mouse...]

[When the treatment plan is mature, you quit all the jobs related to medical treatment. You learn from your little friends, record your research results on the Internet, use stories and jokes as carriers, and then spend the rest of your life in retirement... ...]

[At the age of 87, your descendants were full of children and grandchildren, and died without any illness. 】

【One hundred years later, when a medical-related friend inadvertently applied your joke story to the clinic, the treatment plan was able to spread.But your name is still lost in the vast river of history. 】

[The treatment plan is finally named after your pseudonym—the treatment plan for passenger polyosteitis. 】

[Simulation ends...]

Zhou Cheng is slowly sipping tea at the moment. After extracting the relevant simulated memories and results, Zhou Cheng began to slowly deliberate on how to make this plan public in a more reasonable and effective form. , and used it on the patient in charge of his own department.

Creating something out of nothing is obviously impossible...

Chapter 467 Things That Are Inconvenient for Zhou Cheng to Know

This treatment plan is obviously not the same as the previous old medicine and new use, at least for different targets.

It was Gu Huo who was given at that time. Although Gu Huo had a medical background, he hadn't been in the field of clinical and scientific research for a long time. Moreover, the meaning of those drugs at that time was to disrupt the situation and break the blockade.

Moreover, there are enough data on the application history of these drugs, and they are 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 their cases For the treatment of other diseases, the anti-cancer effect was produced, which was discovered by Zhou Cheng.

This is an old medicine with a new use, so even if Zhou Cheng extracted or fabricated some data, others would not be able to find out what was wrong, and even when he reviewed the previous case data, he could get a similar answer.

But this time the osteitis vera is different, it is a rare disease.

There are not many people in the world, and there are very few reports. It is estimated that even if a large number of patients have such diseases, they have not been reported. Very difficult.

And you can't directly finalize the plan when you come up, you have finalized it, there is no underlying logic.

Moreover, the types of these drugs are the same, but the doses are different, so the types of diseases targeted are different. You can't explain the reason clearly, and there is no previous research and theoretical data to support it.

The most important thing is that what Zhou Cheng has to face are Yang Yifeng and Fang Yun.

These two people, whether it is professionalism or plasticity, are very strong. You can't say that you came here as you are, and others may repeat it secretly.

For example, you said that this is based on your literature review, oh, okay, I will check it when I go back, and if I can’t find it, you can find articles and data that I can’t find. You can find it. There is a problem, brother.

Special professional people are quite difficult to fool.

But I have to be fooled, after all, this patient met himself, or Fang Yun, and came to the team he was in charge of. He just happened to have this ability, so he couldn't just ignore it for self-protection.

Then, under such circumstances, it is necessary to carefully figure out a more appropriate plan.

That is a relatively commonly used method in current scientific research, called the step-by-step trial of drug dosage——

What is a stepwise test is to release the dose of the drug according to a certain proportional gradient in cell experiments or animal experiments, and then observe the curative effect of the drug at different concentrations on the disease.

Then find the most sensitive point.

For example, 0.1g/l, 1g/l; 10g/l...

Find the optimal order of magnitude first, and then find the most appropriate drug concentration ratio in the arithmetic progression.

This is the exploration mode of different drug concentration schemes in the process of clinical treatment, which requires a large amount of data as support.

Of course, Zhou Cheng already has some basic data and knows the ratio of the best treatment plan. What Zhou Cheng has to do is to take the smallest number of steps and use the existing treatment plan to quickly approach the best plan. Obviously this requires some design skills.

As far as the present is concerned, it is definitely not enough time to temporarily repeat cell experiments or animal experiments, and then conduct clinical trials for the patients encountered so far.

And simply, in the current differential diagnosis of osteitis polymyositis vera, the treatment plan for dermatomyositis is ready-made, and there are different treatment plans.

Zhou Chengcheng intends to find a dose close to the treatment plan for myosteitis vera through exploration, and then make fine-tuning, and finally adjust to the optimal drug concentration. Such fine-tuning, even if Fang Yun and Yang Yifeng finally I think it's too coincidental, and there are signs to follow, so I won't doubt anything...

After Zhou Cheng made a plan in his heart, he took over Fang Yun's shift the next day.

When he first arrived at the emergency department, Fang Yun was sitting in the lounge full of energy, and even ordered a bowl of noodles for Zhou Cheng: "Mr. Zhou, haven't you had breakfast yet?"

"Are you in good spirits? You were on duty yesterday?" Seeing Fang Yun's state, Zhou Cheng probably took a rare late sleep.

"It's good luck, there are no patients. I have been asleep since eleven o'clock." Fang Yun said, and then smacked his powder.

"Well, that's pretty lucky." The Affiliated Hospital of Shonan University rarely has an emergency call. In the short period of time after the incident in the Second Hospital some time ago, the number of patients decreased slightly, but now it is still there. has basically recovered.

"By the way, Xiao Fang, what is your teacher's attitude towards you staying here?" Zhou Cheng asked with concern.

Lei Zhong asked about Fang Yun's future, but Fang Yun hasn't given a clear answer yet?

But Fang Yun hadn't answered yet, An Ruo touched into the duty room at this moment, and poked his head in first: "Is there no one sleeping in there?"

Zhou Cheng nodded: "Haven't you had breakfast yet? Then you have to eat it yourself after get off work. Fang Yun ordered in advance for me."

An Ruo is currently working in the Affiliated Hospital of Shonan University, an anesthesiologist at the most basic level, and is on duty in the emergency operating room of the emergency department. Yesterday was the night shift.

It should be said that An Ruo is quite tired on duty now, working three shifts, and she has not been treated specially because of her status.

Day shifts, evening shifts, night shifts, emergency shifts, and assistant shifts, all year round.

Of course, the emergency and sub-shifts only need to go to work in the late night shift, when there are extra emergencies and extra emergencies, otherwise there will be a short respite.

Yesterday's An Ruo, the emergency department was called to work overtime, but it is estimated that they are patients from other departments. The Affiliated Hospital of Shonan University also has more than a few patients and doctors from the orthopedics department.

"I'll come over and have a look." An Ruo dared to come in when she heard that Zhou Cheng didn't respond that someone was sleeping.

Fang Yun explained apologetically, "Sister An Ruo, I didn't know you would come, otherwise I would ask that master to give me an extra copy."

The breakfast of the staff in the hospital can be delivered directly to the department by the master. It tastes very good. Original rice noodles, sauerkraut sticks, and boiled lard. If you are not afraid of getting fat, a bowl in the morning is especially warming.

"It's okay, I didn't come here looking for breakfast. You had a good night's sleep yesterday, and the whole operating room can't be filled with patients from the orthopedic department. The thoracic surgery department is reserved." An Ruo didn't sit down, but leaned forward. Leaning on the bed in the lounge, watching Zhou Cheng open the package of rice noodles, so the other party said.

A private room means a large number of patients, almost occupying the entire emergency operating room.

"A lot of patients?" Zhou Cheng asked, while Fang Yun smiled sheepishly.

"There are quite a few of them, and they are all from the Department of Thoracic Surgery. There are no other departments. The emergency patients of the Neurosurgery Department have been pushed into the operating room of the Surgery Building overnight. They can't take care of them at all. Our department is also very busy. It is not the emergency department and the The sub-class has come to work overtime."

"Your orthopedic department is relatively free." An Ruo was slightly indignant, and now she started to speak for the anesthesiology department.

An Ruo just came over to take a look, and then hurriedly got off work and went back to catch up on sleep.

If a girl who is a doctor wants to have good skin, she must take time to sleep more, otherwise, she will suffer from premature skin aging sooner or later.

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 out that the pathogenesis of myosteitis vera is It is similar to multiple dermatomyositis, but the location of the attack and the severity of the onset are slightly different."

"The current recognized treatment plan for multiple dermatomyositis, the dose is not enough, and after I checked the literature, I think we can use 80.00% higher dose of glucocorticoid than the conventional treatment of multiple dermatomyositis dose as the initial therapeutic dose."

"For immunosuppressants, choose a slightly lower dose, choose 120% of the dose as the initial treatment dose."

"Then use it for a few days and observe the effect."

"Did the patient's autoimmune antibody result come out? How did the laboratory give it..."

For autoimmune diseases, immunohistochemistry can be performed. Immunohistochemistry is very useful whether it is 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, but said: "Mr. Zhou, immunohistochemistry usually takes a week to come out, and if it is a tumor, it takes half a month to get the results."

"There are more major specimens."

"That's true." Zhou Cheng nodded. The Affiliated Hospital of Shonan University has a large number of patients. Immunohistochemistry does not mention specialized oncology departments, such as general surgery oncology, bone oncology, and specialized oncology and geriatric oncology. division.

"Then you can adjust the dosage of the medicine later, and then go back." Zhou Cheng explained this, and he didn't intend to put on the spectrum of the superior doctor. The main reason is that this matter is relatively simple, and Fang Yun is not tired.

"Okay, Mr. Zhou. I went directly to the laboratory after get off work. Brother Yifeng asked my opinion yesterday, and I agreed to help."

"By the way, Mr. Zhou, Professor Ning Xihua asked me to tell you yesterday that they have collected some preliminary information and data, and asked you to take a look at the current information and see if you can analyze it. If not If you want to 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 in contact with him, as if he was going to recommend a burn ointment..." Fang Yun stood up and helped Zhou Cheng throw away the package of rice noodles Yes, after saying that, he walked out immediately.

In fact, there is an unspoken rule in the department, that is, the treatment plan in the group is determined by the superior physician. The treatment plan includes the type of drug, the dosage of the drug, and the drug that will be applied in the department.

For example, the treatment plan here at the Affiliated Hospital of Shonan University is determined by the professor leading the group.

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 for his opinion.

This may be the exchange of interests between Professor Liu and Zhou Cheng. Fang Yun knew that he was not suitable for inquiring about these things, so he simply left.

Zhou Cheng didn't answer, and fell into deep thought.

This Professor Liu...

After Zhou Cheng thought for a while, he went to see the patient again. After doing a physical examination, he decided to go to Associate Professor Ning Xihua first after the diagnosis of osteitis polymyositis was basically confirmed.

However, the patient's family members followed and held Zhou Cheng's hand tightly: "Dr. Zhou, thank you, you and Dr. Fang have really worked hard. 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 of time, remember to eat less special protein, and eat common protein, such as chicken and duck, and eat less special fish and snails."

Autoimmunity is actually a special kind of allergy from the bottom level, but it is only sensitive to the factors secreted by itself, so it is autoimmune.

At this time, if you eat special protein and have an allergic reaction, it will be even more troublesome.

At least Zhou Cheng ate regularly during the simulation, and there were no special circumstances. However, there were also some patients who aggravated their condition after eating special meat, possibly exacerbating their autoimmune disease.

It may also be that you have such allergens yourself...

The middle-aged man nodded steadily.

And then return with gratitude...

After that, Zhou Cheng rushed to the trauma surgery department.

However, when Zhou Cheng appeared in the trauma surgery ward, he didn't notice Ning Xihua and the others.

On the contrary, Zhou Cheng, Zhou Cheng's student, is still in the trauma surgery ward, searching for some cases.

"Xiao Wang, what about Professor Ning and the others? Isn't today the surgery day?" Zhou Cheng asked.

Wang Huan said with flickering eyes, "Master, Professor Ning didn't come to the department this morning."

"What about the others? None of them are here. Didn't anyone come to check the ward today?" Zhou Cheng asked again.

It shouldn't be so, Ning Xihua asked himself to speak, how could it be possible that he wasn't here this morning?Didn't do that.

"A brother came to check the room with him. Teacher, I heard that because today is not the day of surgery, Professor Ning seems to have received a consultation operation. I heard that it is in a hospital in the Wang District."

"But this morning, not only Professor Ning did not come, it seems that even Professor Ning's teacher in the first ward of the orthopedics department passed by. I don't know what happened, but I dare not ask." Wang Huan said so.

"When the senior brother came to make the rounds in the 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 when Zhou Cheng just arrived, she entrusted Zhou Cheng with everything.

"Okay, that's all right."

"Since it's inconvenient for me to know, then I won't call to ask. If you're okay now, let's go to the emergency department together. I'll see your MRI diagnosis and how you're doing." Zhou Cheng felt that this 'stocking 'I've been with Wang Huan for two months, so it's time to see her study progress.

Unexpectedly, when Wang Huan heard Zhou Cheng's question, his expression was upright, with a hint of anticipation.

"Good teacher!"

Chapter 468 Amputation

"Master, how to see the nerves and blood vessels at the MRI level? I think it is difficult to see these two structures clearly." After answering some questions from Zhou Cheng, Wang Huan explained the doubts in his heart.

"Senior Brother Peng Lingli and Senior Brother Guo Lin also found it extremely difficult to see the deformation of nerves and blood vessels." In order to explain that he didn't work hard, Wang Huan pulled these two together for comparison.

First look at the report, second look at the lesion, third look at the anatomy, and fourth look at the level...

By being able to see the anatomical level, you can distinguish the shape of different tendons and muscles, such as ligaments and muscles.

But if you want to see the level of nerves and blood vessels, you need to read the original MRI film more carefully!

This kind of in-depth content is no longer something that a doctor in the imaging department can read, and a specialist doctor who is not qualified enough can't see the corresponding out-of-shape.

Not only the knowledge of anatomy and film reading is required, but also some more professional knowledge to assist.