The old man sitting in the first place was the one Li Xiyang met when he reported to the emergency center on his first day.

He turned out to be the deputy director of the inner courtyard of the emergency center!!

"Meet Dr. Li again!"

Chen Heran nodded at Li Xiyang, with a very kind smile.

At this time, Li Xiyang reacted, why did the old man say that day, 'You are Mo Kai's student'!

Presumably, the teacher greeted Dean Chen in advance.

The teacher really spared no effort to take care of himself, Li Xiyang was moved.

"Alright, everyone is here, let's get started!"

Mo Kai took Li Xiyang to sit down, and the meeting officially began.

Turn off the lights and project!

Looking at the CT film of the liver on the screen, which was full of cavities and severe wrinkles, Li Xiyang's mouth opened wide in surprise.

Not only him, but Mo Kai next to him also frowned and looked shocked.

This is the human liver?!

Mao Tong, director of the gastroenterology department, walked under the projection and said with a serious face, "The patient, female, 16 years old, was admitted to the hospital a week ago. ”

"Pre-admission symptoms: fatigue, poor appetite, yellow urine, yellow eyes, abdominal pain."

"After being admitted to the hospital, it was found that after B ultrasound examination, jaundice, edema, hepatomegaly, pain in the liver area, and abnormal liver function..."

Li Xiyang was surprised, "Acute viral hepatitis? ”

Mao Tong glanced at Li Xiyang and nodded, "That's right, so we immediately gave the patient anti-hepatitis drugs." ”

"At the initial stage of taking the medicine, everything was normal, but just yesterday, the patient suddenly vomited blood, and the emergency examination found that the patient's kidney function, digestive organ function, and respiratory function were declining sharply, and at the same time, liver failure shrunk, and a large number of nodules appeared."

"How so?"

Mao Tong shook his head.

"But when I looked through the cases, I found that our hospital had a similar case ten years ago."

The projection turned, and a CT image of another patient appeared.

The picture quality is a little blurry, and it should be that the technology was still relatively backward at that time.

However, I saw that the liver in the picture was full of holes, which was even more shocking than the previous one.

Mao Tong sighed and said slowly, "The patient's situation back then was similar to this time, the two were of similar age, and the symptoms before admission were also fatigue, yellow eyes, and abdominal pain..."

"After ultrasound examination, there was no obvious change in liver volume, and there were no abnormalities in chest X-ray and electrocardiogram."

Therefore, the initial diagnosis of the patient admitted to the hospital was: acute viral hepatitis, and the cause of fever is to be investigated.

Antitoxin, hepatoprotective, and symptomatic supportive care are given.

However, a week after admission, the patient develops irritability, asterixis, and shortness of breath.

This is followed by anuria, bleeding from the oral mucosa, and scattered ecchymosis and petechiae all over the body.

Urea nitrogen, creatinine, blood amine, blood potassium, and blood sodium were urgently tested in the laboratory, all of which were much higher than normal.

EEG shows a slowed rhythm with symmetrical high amplitude on both sides.

After symptomatic supportive treatment, he fell into a coma due to hematemesis and hematochezia, and was declared clinically dead on the 10th day after admission. ”

The projection turned again, and a piece of light appeared on the organs in the chest cavity.

Mao Tong continued, "According to the autopsy, the deceased was moderately developed, moderately nourished, the skin and mucous membranes were extremely yellowish, and no superficial lymph nodes were found to be enlarged.

Cut open the chest cavity and see 200 to 220 ml of pale yellow fluid in each side of the chest cavity,

No lesions were found in the upper respiratory tract, trachea, bronchi, or lung sections on both sides.

There was no enlargement of the trachea, bronchi, or hilar lymph nodes.

There was no obvious lesion in the pericardial cavity or in the heart.

The abdomen is distended, and there is about 300 ml of yellowish fluid in the abdomen.

The bowel is highly dilated, the esophageal and gastric mucosal varices are extensive, and submucosal hemorrhage.

There is a little coffee medicine in the gastric cavity, the intestinal mucosa is highly edema, and the submucosal blood vessels are displaced and bleeding.

The most obvious change is that the liver is severely shrunken, with extensive congestion and bleeding.

Liver section, diffuse large necrosis of hepatocytes.

Necrosis begins in the center of the hepatic lobule and spreads rapidly to the periphery.

There is no obvious regeneration!! ”

The projection is turned off and the lights in the room are on again.

Dean Chen sighed and said, "Ten years ago, I was the doctor in charge of the patient, and it has always been my regret that I could not hand over the child to my parents in good health. ”

"I didn't expect that this time, the same patient would appear again, so I urgently convened the top forces of each department, hoping that everyone would work together to prevent this kind of tragedy from happening again."

Dean Chen was a little excited, and his eyes glistened with tears.

At his age, he became more and more compassionate, and he couldn't see another family broken.

But everyone in the conference room frowned and felt powerless.

They have used all the drugs they should have used, and the treatment plan has been changed several times, but there is no effect at all.

No one wants to see a living life pass away before their eyes.

But doctors are human beings, not gods, and there are times when they are powerless to return to heaven.

"Xiao Mo, do you have any ideas?"

Dean Chen turned his gaze to Mo Kai.

When Mo Kai first went to the emergency center, Dean Chen personally guided the training.

He knew how much potential this guy had, which was why Dean Chen had called him here today.

For a while, all the chief doctors in the conference room looked at Mo Kai.

I want to see if this man of the year in the first court is really as talented as the rumors.

For a time, Mo Kai was also under a lot of pressure.

He smiled bitterly and said, "Dean Chen, you really look up to me." ”

Isn't it too hasty to let him draw conclusions based on just a few light films.

But...

Mo Kai stood up, walked to the projector and picked up the CT ray and said, "I think maybe you went in the wrong direction from the beginning, the patient is not acute viral hepatitis at all." ”

Mao Tong frowned, "Although the indications of pathogens are indeed different from common hepatitis A and B, it cannot be concluded that it is not other heterovirus hepatitis." ”

As we all know, acute viral hepatitis is an infectious disease caused by a variety of hepatitis viruses, which is highly contagious, has complex transmission routes and a wide range of epidemics.

The main types of viruses are hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis D virus, hepatitis E virus and hepatitis G virus......

Viruses A and B are the most common, but there are still many unnamed xenoviruses.

By denying viral hepatitis now, Mokai is simply denying all their previous programs and efforts.

Naturally, Mao Tong was dissatisfied.

Mo Kai just smiled, not caring about Mao Tong's attitude.

"The hepatitis virus belongs to the family Hepatophila DNA viriridae and has a genome of about 3.2 KB long and is partially double-stranded circular DNA.

In addition, the hepatitis virus is only 3200bp, which is a fairly small virus.

The genome has four ORFs, encoding the Core protein, the pre-core protein, the Pol protein, the X protein, and the S protein.

where the nucleocapsid protein of Core,

The pre-core is now unknown to what function it has, it is not necessary for viral replication, but it may be related to the suppression of the host's immune response,

The X protein is important for viral replication and has also been implicated in the development of liver cancer.

S protein is the envelope protein of the virus and is involved in the entry of the virus into the cell.

I'm just guessing that you're probably going in the wrong direction, yes or no, you just have to check the DNA sequencing of the pathological cells. ”

Dean Chen immediately looked at Huang Hai, director of the laboratory department, "Director Huang, have you sequenced the DNA of the virus?" ”

Huang Hai hesitated, "Dean Chen, what, our laboratory department is still using the first-generation sequencing technology, and the sequencing read length is only 1000bp!" ”

Chen Heran's face immediately darkened, "What is the laboratory department doing, the third-generation gene sequencing technology on the market has already come out, why are you still using the first-generation?" ”

"The laboratory department has always been the key training department of our inner hospital, where is the money allocated to you spent!!"

Dean Chen was furious.

Huang Hai lowered his head, knowing that this was the end of the day.

Mo Kai sneered, "No matter where it is, there will always be this kind of moth!" ”

"Dean Chen, our first hospital has recently installed the third-generation sequencing technology, or we will send the pathological sections to our laboratory later."

Dean Chen sighed and nodded.

Angry, he knew that now was not the time to deal with these things.

"Xiao Mo, do you have any other ideas?"

Mo Kai shook his head, "Until the type of virus is determined, let's maintain the original treatment plan." ”

Dean Chen sighed, "Okay, let's wait for the gene sequencing results to come out!" ”

The patient's condition was so bad that Dr. Chen was worried that the patient would not be able to wait for the results to come out.

At this moment, Li Xiyang pulled the corner of Mo Kai's clothes, "Teacher, I want to see that patient." ”