Intrathecal injection is a risky treatment. Clinically, intrathecal injection is mostly used to treat central nervous system leukemia. Administered through the cerebrospinal fluid system, the drug fills the subarachnoid space on the surface of the patient's brain between four and six hours. This method of administration successfully circumvents the shielding effect of the cerebral blood barrier on chemotherapy drugs, allowing the drugs to successfully enter the circulation of various cerebral cisterns. Repeated doses by intrathecal injection can maintain the concentration of the drug in the brain.

But there are risks associated with intrathecal injections. This risk is mainly reflected in the capacity of the drug itself. Human cerebrospinal fluid (CSF) produces about 500 milliliters a day, but the individual ventricles and spine generally do not hold more than 150 milliliters of cerebrospinal fluid. These fluids themselves can effectively support the body's central nervous system, and act as an excellent buffer and remove inflammatory substances.

Disorders of cerebrospinal fluid circulation are one of the most common causes of increased intracranial pressure. Cerebrospinal fluid (CSF), generated by the abundant choroid plexus in both lateral ventricles, enters the third ventricle through the interventricular foramen and then flows into the fourth ventricle through the midbrain aqueduct. It then flows into the subarachnoid space of the brain and spinal cord through the median and lateral foramen of the fourth ventricle, and recovers cerebrospinal fluid through arachnoid granules next to the sagittal sinus. This relatively complex flow and connectivity system means that the entire cerebrospinal fluid circulatory system is far more fragile than the blood system. In general, the volume of fluid that the doctor can inject into the CSF system at one time will not exceed 60ml.

In the previous treatment, in order to allow amphotericin B to cross the brain-blood barrier as soon as possible and reach an effective concentration in the patient's brain, the treatment group has injected all patients with a total of 50 ml of amphotericin B and glucose solution twice. The interval between the two injections is two hours. And now it's only seventy minutes since the last injection.

Even if a patient had not previously received intrathecal amphotericin B, it was impossible for doctors to inject 800 mg of methylprednisolone into their lumbar spine in one go. This is physically impossible.

As for the possibility of kidney damage or lower limb and back pain in high doses of amphotericin, the doctors on the team were not very concerned about this – only living people are bothered by side effects and adverse reactions. A dead person does not complain of pain in a certain part of his body.

After getting the prompt that "dihydroartemisinin and methylprednisolone can be used together for immunosuppression", Liu Tangchun hurriedly called the medical team and asked to send artemisinin over for use as soon as possible. The intrathecal injection of methylprednisolone was temporarily postponed for half an hour. Methylprednisolone is given intravenously before artemisinin is delivered.

The next treatment process is basically to wait and see, Sun Lien and Liu Tangchun, who have been busy all day, can finally find a place to squint for a while - the two have not slept since yesterday, and they have been watching the sentry post until the early hours of the morning at night, and then rushed back to the camp of the American medical team for diagnosis and treatment. After two days of hard work, they were finally able to rest for a few hours with the support of their own people.

Sun Lien quickly fell into a deep dreamless sleep. From a state of high mental tension to a time when you can relax and sleep, people don't sleep very well. The deep sleep seemed to last only a few minutes, and when Hu Jia woke him up, Sun Lien even felt a little aggrieved - can't you let me sleep a little longer?

But when he found out that he had slept for six hours, the grievance turned into trouble, and he slept for six hours but was still sleepy, what could he do?

"We've been in contact with the country, and neither the embassy nor the State Department can help. Ms. Iweala also understands that the current situation in Polytavia is not stable. With one of the two military leaders suffering from alcoholism, she had to carry the heaviest burden as the camp's current chief. But the reality is brutal. Both the U.S. Africa Command and the Embassy in Polythanvia have expressed their "love for it" to Ms. Iwella. Conventional civil aviation, on the other hand, is unable to transport such a large number of human remains into the United States.

"We can't evacuate now, we can only wait...... Wait until it's over. Ms. Iweala looked a little frustrated, "If you can't find the body to transport the body, then you have to ...... Buried them here first. ”

"I can't help with this kind of thing. Liu Tangchun didn't care much about other things, he was just a little worried that his friend who he had just met might be buried in another country. Whatever the reason for the presence of American GIs in the area, they were also tasked with defending the camp. After all, these American doctors came to Polytavia to treat diseases and save lives. "But I can tell the Polythanvian authorities about it, and maybe it will be of some use. ”

Help people to the end and send the Buddha to the west. After talking to the camp where he was expected to arrive today, Liu Tangchun decided to cancel today's trip. Doctors who didn't make it to the U.S. camp continued to repair in the village — just in time to help the local population. When they arrived at the American camp, the doctors insisted on another night to see what was going on. If, after tonight, no one dies or not too many people die, then the treatment is effective. The rest of the work can be left to the American doctors in the camp.

What if all the patients died...... At least there's no reason for the medical team to stay, right?

"The only pity is that we can't stay here for long. Dr. Hu Chunbo was pulling the self-heating food provided by the U.S. military from the camp. The taste of this food is actually relatively average, but the biggest benefit is that you can eat it hot. To ensure safety, the canteen in the camp has not been in operation for nearly three days. "If I stay here for half a month, I will definitely make a SCI out, and maybe it can be sent to the second district. ”

"Then don't think about it. Liu Tangchun was also eating self-heating dry food, but Comrade Liu was a little unaccustomed to the menu in his hand, and he complained while eating, "Americans have really never seen the world." How can you wrap cheese in dumplings!" After throwing down the self-heating food in his hand, Liu Tangchun rubbed his hands on the wall on the side without caring about the image, "If you want to post an article, you still have to come to our fourth courtyard." Look at Xiao Sun, just after a year of training, New England has posted an article. ”

The case report by Sun and Xu Yourong has been pre-published online in New England. Cheng Wen's condition has aroused the interest of many industry experts. Although the contact information left on the article is Xu Yourong's mailbox, Sun Lien has also received a lot of calls from across the ocean these days. The people who called Sun Lien were bigger than the other, from professors from well-known medical schools to big names in the industry. There is only one question that everyone is most concerned about, "Can that little girl come to us for an immunization test?"

As with Mr. Liu's estimate, the average doctor would probably only find the case a little scary. But when it comes to the level of experts in the industry, the first thing everyone cares about is "why". Why are other people's hydatid worms dilated like blowing, but Chen Wen's case is manifested as 27 small white spots in the skull. If what distinguishes Chen's case from other cases can be found, then doctors may be able to find treatment options that can be applied to other people with hydatid infection. At the very least, some means of inhibiting the growth of hydatid cysts can be found.

This is of great significance, and it is no wonder that the big guys in China who are blushing at the national natural project are trying their best to get to the front.

"New England?!" Hu Chunbo's eyes changed again, and his eyes were full of envy and jealousy when he unconsciously looked at Sun Lien. It's like ...... It's like seeing a SCI article that no one has signed.