To make a diagnosis of mitochondrial encephalomyopathy, only a few questions need to be asked. Mitochondrial encephalomyopathy takes at least 36 hours to diagnose it.

Although Changning is a thriving city, it cannot be compared with those first-tier cities. There are only two companies that can perform genetic testing, and the fastest promised time frame is 36 hours.

During these eighteen hours, there was no doubt that there was a risk in taking new treatment measures for Li Yuhan. At worst, she didn't have mitochondrial encephalomyopathy, but did have some kind of infection. In the case of such meningeal irritation, there is a great risk that she will be discontinued with pulse hormones and immunoglobulins.

No matter how much support Mei Ying and Deputy Director Qian have, this is a very difficult situation. But fortunately, the hospital did not have any reservations about the support plan for Li Yuhan's family. All treatments are available – as long as the patient's family agrees.

"Before the evidence of the diagnosis comes out, out of ......caution," Sun Lien discussed with Deputy Director Qian and Mei Ying in the office, "I suggest taking a CRRT first to lower the lactate level in her body first." ”

For hyperlactic acidemia in patients, doctors generally can take treatment measures that directly target the cause of hyperlactic acid in the blood. After all, hyperlactic acidemia does not respond well to treatment, and if the patient is treated symptomatically without reversing the situation, the prognosis of the patient is generally not good.

But now, it's not that doctors can't intervene to the root cause, but they can't diagnose the patient. Under this prerequisite, targeted therapy with CRRT is feasible.

"Actually, I'd prefer to use plasmapheresis. Deputy Director Qian was a little more radical than Sun Lien, "Plasmapheresis is better for quickly lowering various creatinine and lactate in her body." The main role that CRRT can play now is to keep her situation from getting worse. ”

"It's also a plan...... But her situation is different. Sun Lien's opinion is still to seek stability, "Her creatinine level is very high, but it is not to the point where she needs to take plasma exchange." After controlling lactate with CRRT, her creatinine level dropped on its own – the current high creatinine level is just a result of hyperlactic acidemia affecting muscle tissue. ”

Sun Lien's suggestion was supported by Mei Ying, "Seek stability first, and then consider plasma exchange if there is a change in the patient's condition, or if there is a problem with the genetic site detection in the future." ”

"One more point...... Sun Lien thought for a while and said to Mei Ying, "This patient is a genetic disease, and he is only fourteen years old now...... Shouldn't I be transferred to a children's hospital or another hospital with stronger pediatrics?"

Lin Yuhan is 14 years old. As a general rule, she was already able to go to the general department for treatment. But considering that she had been suffering from the disease since she was 11 years old, and that it was a hereditary disease, a visit to the pediatrician seemed more in line with her experience and situation.

Clinics for genetic and metabolic diseases are being established in most pediatric hospitals. Compared to the departments in general hospitals, the Genetic and Metabolic Disease Clinic has a clear advantage - they have handled more patients with genetic and metabolic diseases, and they have more experience and equipment.

As far as the interests of patients are concerned, if Lin Yuhan can be transferred to these specialties, he will definitely be able to receive better treatment.

"I don't really care...... Anyway, the diagnosis is from our hospital. Mei Ying was a little helpless, "But you can also see that the economic situation of this child's family is not very good." In our hospital, there is also an all-inclusive treatment fee. Went to the Genetic and Metabolic Disease Clinic...... They may not be able to afford the treatment. ”

Having said that, what should be notified is still notified. Mei Ying sighed and called the inpatient department, and she asked the doctor in charge of the bed to talk to Lin Yuhan's parents first, and then talk about other things.

Mitochondrial encephalomyopathy is one of the most common matrilineal genetic diseases, and Zhongfu Hospital is not unable to treat it. But they also have to face the rather powerless reality that Zhongfu Hospital itself does not intend to make a name for itself as "good at treating genetic diseases".

Mei Ying's goal is to build Zhongfu Hospital into a general hospital focusing on critical care and severe trauma surgery. Although Lin Yuhan can be handed over to the Department of Internal Medicine for treatment, it is ...... If Lin Yuhan's case really makes Zhongfu Hospital famous (although this is very unlikely), the pediatric and genetic patients who come to him will probably drive the internists crazy.

"Forget it, but do good deeds, don't ask about the future. Mei Ying reluctantly made a decision, "If they are willing to receive treatment here, then they will be treated to the end." You can't just watch a little girl lose her life like this. ”

Sun Lien smiled and said in a low voice, "If Sister Mei is embarrassed, my parents can go to work." ”

·

·

·

Sun Lien adapted quickly to the change in his identity. In Zhongfu Hospital, he is not only a "non-compliant doctor" who practices beyond the scope of practice, but he also ...... It can be regarded as the "young owner" of this hospital.

Sun Hongbin and his wife bought 70% of Zhongfu Hospital's shares, and the remaining 30% was distributed to the employee stock ownership plan, from which all doctors who have worked in the hospital for more than five years will receive their share of the dividends.

From this move, it can probably be seen that Sun Hongbin and his family really plan to run this hospital well. And the main reason why they decided to enter the medical industry in the first place was to leave a way back for Sun Lien.

"The hospital is the back road for you. At home in the evening, Sun Hongbin talked openly and honestly with Sun Lien for the first time about the reason for his acquisition of the carton factory hospital. "No one knows if there will be another SARS epidemic, and if there is another outbreak of this large-scale infectious disease, your emergency department will definitely bear the brunt. ”

Sun Lien nodded, this is true. The emergency department, respiratory medicine and infectious disease department are the departments that are most vulnerable to sudden outbreaks.

"Your uncle and brother-in-law are gone because of SARS. Sun Hongbin sighed, "Your mother and I are just one child." They died in the line of duty, and the old man and your mother and I can rely on. But if something happens to you, neither of us can be relied on. He was silent for a while and then said, "If there is another SARS, all the doctors will be asked to go to the front line...... You can not go. ”

Sun Lien didn't answer, he knew that his father had something to say later. He is also very sure that if SARS happens again, he will definitely be at the forefront of the resistance - the status bar is really easy to use, and if it is used to identify virulent infectious diseases, his processing speed can be even faster than that of high-throughput special nucleic acid reagents.

"I'm not encouraging you to become a deserter. Sun Hongbin rubbed his legs and sighed, "But I want you to know that if someone threatens you with the words 'fire if you don't go to the front', you have a way back." ”

That's a ...... Deflated. If it weren't for his own home, and there was his son and his son's girlfriend sitting next to him, Sun Hongbin would never have said this. Even if he was surrounded by his own family, he still felt uncomfortable after saying such things.

"If I run ......away," Sun Lien pondered the words and asked rhetorically, "If the doctor runs away in the face of a sudden epidemic." And who else can stand out from the disease and the common people?"

"Doctors are like soldiers in war in the face of a mass epidemic. Sun Lien leaned back and said in a declarative tone, "Everyone is afraid of death, this is our natural instinct. But if a soldier runs away in fear of death on the battlefield, more people will die. The dead can be his comrades-in-arms, his friends, his relatives and lovers. He looked at Sun Hongbin a little helplessly and said, "If there is another SARS, I will not retreat, and Hu Jia will not retreat...... Maybe one or two out of millions of doctors will be scared. But more people, the vast majority of them will stay in their place. ”

"We have the disease in front of us and the people behind us. We are people's doctors, how can we run away without a fight?" Sun Lien smiled lightly, and then hugged his father's shoulder, "But don't worry, now the authority of the hospital is getting higher and higher, and the protective equipment is becoming more and more abundant." Even if there is another SARS, we will definitely win. ”