Over the years, Sun has traveled back and forth between the hospital and the medical school many times, especially after the start of the internship. But this is the first time that I have traveled from the hospital in a police car, and several police cars are walking together.

After explaining the discovery to the police comrades, Sun Lien also got into the police car with him, and the police car also pulled Zhan Jun and Lao Wu all the way to the medical school.

It stands to reason that Sun Lien should not be involved, after all, he is also a doctor, and it is enough to let his family call the police after discovering the problem. But the trouble was that Sun Lien was excited for a while, and directly asked Lao Wu to call his colleagues from the criminal investigation, and then he became the policeman. Therefore, Sun Lien was also taken to the war army barbecue by the police. From a medical point of view, Sun Lien really needs to get a sample of bacon for testing. Although Zhan Hao's symptoms are most consistent with acute lead poisoning, it still cannot be ruled out that there are other toxic substances, so the bacon must be tested for poison as soon as possible.

"What did the war army do?" Zhao Baoan at the gate of the medical school looked at the police car rushing in, and muttered a few words to himself in some surprise.

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Finding the remaining bacon went well, but when Sun Lien tried to get a small sample, he encountered a series of obstacles.

"It's evidence, Dr. Sun. Lao Wu reluctantly interrupted the argument between Sun Lien and the criminal investigation team, "Doctor Sun, the evidence found by the police must not be divided into pieces for you to inspect the substances." We will do a poison test, and if necessary, we will notify you as soon as the results are available. ”

Sun Lien was still a little dissatisfied, "If we don't do a poison test immediately and clarify the source and type of toxic substances, how can we do targeted treatment? The poison tests in our hospital and medical school are also recognized by the judicial system, so can't we do it directly in the medical school?"

Of course, if Sun Lien's suggestion can be adopted, there will be no controversy and conflict. The police system has the practices of the police system. Especially as a violent agency and law enforcement agency, the police system takes the rules and procedures very seriously, and there are strict procedures for the presentation of evidence and the preservation of evidence. In order to protect the integrity and credibility of the evidence, and even to ensure the confidentiality and suddenness of the criminal investigation, it is impossible for them to do poison testing according to Sun Lien's "assumptions" under any circumstances.

After several failed attempts, Sun Lien sighed and gave up his intention to convince the other party again. In fact, it can be seen that the police also seem very helpless. Everyone is here to save people, but the means are different.

"In addition to urine lead, a bone aspiration and trace element test are added. Sun Lien made a WeChat call to Xu Yourong, "The police put away the bacon and didn't let us do a poison test." ”

"The results of urine lead and blood lead came out and confirmed acute lead poisoning. Xu Yourong replied an answer that Sun Lien didn't expect, "Is it necessary to continue to do other tests?"

Sun Lien pondered for a while and insisted on his opinion, "I still have to do it." We can't get a sample to test, and we can't determine the specific toxic substance. I'm worried that the other party is poisoning the substance is impure or more than one - the symptoms of heavy metal poisoning are too similar, and it is better to check it again out of an abundance of caution. ”

"Got it. Xu Yourong's answer was very direct, "I'll let people do it right away." ”

"Also, the treatment of lead removal and liver protection should not be stopped, and the suspension red blood cells for hemolysis should also continue to be transfused. Sun Lien said eagerly, "Contact the Municipal Occupational Disease Prevention and Control Institute, and if necessary, ask the experts in their institute to come for consultation." ”

After Sun Lien finished the phone call for a while, the police of the criminal investigation team, who was still a little contemptuous of him, asked curiously, "You are the attending doctor? Why do you look so young? How do you usually maintain the doctor?"

"Three times a week on duty overnight, three meals are basically impossible to eat regularly, and occasionally have to face medical troubles, the basic salary is 2,000 a month, and it takes three hours to write cases every day. Sun Lien casually summarized the content of his usual work.

"So miserable?" the detective was taken aback, "It's almost catching up with us! How old are you?"

"Twenty-five. Sun Lien showed a smile towards the criminal police who was about to die suddenly, "I guess you must be older than me, so big brother, please do a poison test as soon as possible after you go back." ”

"I'm two years older than you. The criminal policeman, who looked to be at least thirty-eight years old, also showed a smile that was about to die suddenly, "Let's go back and get a forensic doctor to do a test, brother, don't worry, if he doesn't make a result, I'll pull him to stay up all night with me." ”

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There is not much to say about lead removal treatment, it is all standard procedure. 1 gram of calcium edetate disodium can be added to 250ml of 10% glucose for intravenous infusion. As a commonly used water-soluble chelating agent, calcium edetate disodium can be chelated with a variety of bivalent and trivalent metals at the same time, and has the best therapeutic effect on lead poisoning. It can also have a stimulating effect on copper, zinc, iron, manganese, cobalt and other heavy metals.

As for the reason why the "symptomatic treatment" of the second hospital can be effective, everyone in the treatment team finally figured out the reason after discussion - reduced glutathione is also one of the first-line drugs for the treatment of lead poisoning. Reduced glutathione can be combined with lead hydrogen phosphate in the liver and excreted from the body. During the first acute lead poisoning, due to the severe impairment of Zhan Hao's liver function, the Second Hospital increased the dosage of reducing glutathione in the targeted treatment. Only then did he barely control the level of lead in Zhan Hao's body without heavy metal chelators. However, the actual effect of this treatment is still quite limited, and the blood lead level in Zhan Hao's body is still seriously exceeded, but it does not continue to manifest as acute poisoning. And this is why after eating the suspected poisoned bacon for the second time, Zhan Hao's symptoms will reappear, and they will appear more ferocious than before - the already high blood lead level is raised again, which makes the onset even more serious.

"Chelating agents can minimize subsequent damage to the organs in his body, but they have little practical effect on the nervous system that has already caused the damage. Sun Lien's treatment team was in a meeting, and Xu Yourong was too lazy to preside over it, so the person who spoke was replaced by Yuan Ping'an. "Although we have identified the cause of Zhan Hao, the situation is still not optimistic. Nerve damage is irreversible, and we should be able to successfully save the patient's life, but for a young adult, such a life is obviously not a quality of life. ”

"If you read so much literature, you should know that there are not many means at our disposal in this situation. Dr. Pascal yawned, "There doesn't seem to be much other choice than neurotrophic drugs and hyperbaric oxygen chambers." ”

"Even if it was a cell transplant, we didn't even know the exact location of his demyelinating injury, and it was impossible to arrange a surgical plan. What's more, our hospital does not have corresponding experimental treatment arrangements. Xu Yourong added, and then shook his head with some regret, "We are doctors, not immortals." ”