Leukemia, this is the only knowledge of countless people about blood diseases. Incurable, painful, hopeless, the most incurable disease of cancer...... Leukemia has been demonized over the past few decades, even to the point of being terrifying.

Actually, leukemia is not that scary. As a disease with 10 subtypes, most leukemias can be controlled with drugs and radiation therapy. Only M0 type acute myeloid leukocytosis with minimal differentiation and MAL acute mixed leukemia have a poor prognosis.

Regardless, leukemia is still a difficult disease to treat. Especially when the condition appears in the elderly, treatment is even more constrained—with the exception of M3 leukemia, almost all leukemia treatments rely on bone marrow transplantation.

In order to avoid rejection of the transplanted bone marrow, in addition to taking anti-rejection drugs that suppress the immune system after the transplant, the doctor also needs to kill the patient's own bone marrow through radiation therapy before transplantation.

Give radiation therapy to an 88-year-old man with multiple underlying diseases and a high probability of infection?

Sun Lien's heart was full of turmoil, and he could only silently pray for the old man on the hospital bed, if he was infected, he must be infected. At least if it's an infection, then there's still the possibility of a bot. But if it's really leukemia, there's no way around it.

Zhou Jun has worked in the hospital for many years, and over the years, countless patients with acute leukemia have been admitted to the emergency room. And the final situation of these patients, Zhou Jun also knows in his heart - among the patients who were sent to the emergency room because of acute leukemia, those who can get out of the emergency room by themselves are only afraid of counting them on two hands. And there is not a single one who can live for five years after this.

After a long silence, Zhou Jun said in a low voice, "Wait for the results of the examination." He paused, "I'll contact Professor Li to see if there are any beds in the hospital's hematology department that can accept them." ”

Ningyuan Medical College has a long history, and the Department of Transfusion Medicine under the School of Biotechnology is strong. Professor Li, who is also the director of the Department of Hematology of the Fourth Central Hospital, is a leader in the field of tumor immunity.

Zhou Jun agrees with Sun Lien, and now it is just a two-choice situation, either leukemia or lung infection. He looked bitter and said astringently, "I really didn't expect it......"

I didn't expect my grandmother to suffer this kind of sin, I didn't expect that I would face this kind of trouble, I didn't expect that one day, I would be so powerless.

"The results are in. Xu Yourong, who had been guarding the CT room, walked out and said to the master and apprentice who were worried, "Pleural effusion, there are about 800 milliliters." At the same time, there is also an effusion in the abdomen, about 300 ml, and there are signs of splenomegaly. She looked worried, "Doctor Zhou, this doesn't look like an infection." ”

Sun Lien patted Zhou Jun's shoulder and said to Xu Yourong, "Solve the pleural effusion first, make a fluid extraction for the old lady, and then arrange a bone marrow puncture." ”

Zhou Junqiang cheered up, "I'll go to Professor Li and ask about the hospital bed." He took two steps into the distance, dragged his father, turned to Sun Lien and said, "Lien, the old lady will ask you." ”

Sun Lien nodded and didn't say anything. Xu Yourong, who was standing beside him, was not a little dissatisfied after being called, but was a little curious, "Do you have any doubts?"

"These symptoms are combined, and I don't feel very good. Sun Lien was careful not to use the word "leukemia", and he carefully said with his words, "If it's just an infection, fluid in the abdomen and a change in mental status can't be justified." If it's an autoimmune disease, it doesn't progress so quickly. If it is a simple cardiopulmonary circulatory disease, there is no source of fluid in the abdomen. He sighed, "Eliminate all three, and that's the answer." ”

"Tumor?" Xu Yourong raised his eyebrows, "But there is no fever." ”

"Just like when Kaoru Kobayashi was diagnosed, the symptoms were masked. Sun Lien said helplessly, "After sitting in the cold wind for several hours, she had a hypothermia. ”

"I'm going to schedule another blood tumor marker test. Xu Yourong understood what Sun Lien meant, and she suddenly paused, "The old people are eighty-eight years old......

"Treatment is definitely risky. Sun Lien also sighed, "I hope it's not M0 parting." ”

Zhou Xiufang's routine blood test results were waiting in the emergency room. Consistent with the indication in the status bar, the hemoglobin of the elderly is only 65g/L, which is nearly half lower than the reference value. Immunoglobulin IgG is as high as 63.1 g/L, which is about four times the reference value.

In the emergency room, Nurse Zhong used a syringe to draw Zhou Xiufang's first pleural effusion. A large 100-milliliter syringe pumped out a full four tubes. One of the tubes was also sent to the laboratory for pleural fluid cytology.

There was no other way but to wait, and Sun Lien had never felt so powerless. He sat behind the duty desk in a daze, looking at the patients lying on the hospital bed. Sun Lien even hated his incompetence a little, if he could study a little more, he would be more serious when he was in medical school...... Maybe you'll be able to figure it out.

"What are you thinking?" Xu Yourong walked over with two stacks of materials, saw Sun Lien in a daze, and couldn't help but ask curiously, "What are you thinking about diagnosing about?"

"I regret that I didn't pay attention to the lectures when I was in school. Sun Lien squeezed out a smile from his face, "If I had listened carefully at the beginning, maybe there would have been some way." ”

Xu Yourong Qi said, "Domestic undergraduates are so powerful now?

Sun Lien was choked and almost didn't catch his breath.

"First of all, it is necessary to make a clear diagnosis, and to make a clear diagnosis, we need to wait for further results from the laboratory department. Xu Yourong shrugged his shoulders, "In the past, it was difficult for a clever woman to cook without rice, but now you don't talk about rice, you don't even have a stove." What's the use of listening carefully?"

Although Xu Yourong spoke directly, he was reasonable. Sun Lien suddenly felt that the pressure in his heart was much less.

"We are doctors, not gods. Xu Yourong put two stacks of materials in front of Sun Lien and continued, "Many patients don't even have a correct diagnosis, and they die quickly because of the progress of the disease, and you have done a very good job." She patted the information she brought, "These are the resumes of people who are interested in interviewing." She paused and continued, "Brune and Pascal's resumes are also in there, but since Director Liu is so interested in them, I suggest that at least let them come for an interview first." ”

"Interview?" Sun Lien pointed to himself in a daze, "I'm going to interview them?"

"You are the leader. Xu Yourong found a stool to sit down and tapped the table with his hand, "If you don't come for an interview, will I come?"

"I thought I would just hire someone to join me. Sun Lien picked up the resume in front of him, still feeling like he was dreaming, "I was just interviewed a few months ago, and now I'm going to interview someone else?"

Xu Yourong chuckled, "Then you'd better quickly adapt to this role change." "Interviews are an important part of the process, and candidates will learn about the future of the team and what they care about – such as your diagnostic skills." ”