Today's Ningyuan is still very cold, and there are snowflakes in the sky. It was cold enough to freeze Equestria's feet to the point of third-degree frostbite in four hours. However, it was obviously outside, and the entrance of the nuclear medicine department of the Fourth Central Hospital was crowded. Many doctors and students from the Department of Imaging, Nuclear Medicine, Infectious Diseases, and the School of Public Health Administration came to the meeting. They were all very curious about the Gamma Knife program - in a way, the nature of the treatment plan was the same as the 3D printed atlantoaxial replacement surgery in the Capital Association. Both are first-time treatment options performed on humans. Moreover, compared with atlantoaxial replacement, the gamma knife scheme is actually more difficult and risky.

Radiation requires the first time, and surgery allows the surgical regimen to be adjusted as it progresses. This alone made the gamma knife scheme suddenly distance itself from the replacement technique. One can be slowly adjusted to try, while the other is a one-shot deal. What's more, the Gamma Knife program wasn't even proposed by a hospital specializing in oncology or infectious diseases – it was a treatment plan proposed by a large general emergency center!

The nuclear medicine department has never been the flagship department of a large emergency center hospital. Even if the fourth central hospital is a key point in the province, it is also a regional demonstration unit. However, the nuclear medicine department of the four hospitals is only barely "nominated" in the annual rankings, and it cannot even enter the top five in the region.

If you want to use an analogy, this feels like the Shanghai Mental Health Center is preparing to do atlantoaxial replacement surgery before the capital association. Although the mental health center is also a comprehensive tertiary hospital, and its strength is not weak, they can still rank in the top 100 hospitals in the country. However, this kind of difficult spine surgery and neurosurgery is not their main business direction, and the "industry reputation" of their department does not support them to do this kind of surgery rashly.

But a major emergency center is not the same as a mental health center. Yang Jianqiang's treatment is imperative, and he does not dare to delay it at all. The attending physician on duty at the nuclear medicine center simply does not dare or is qualified to get started. So I first made a phone call to the deputy director, and when the deputy director heard the treatment plan, he simply slipped the director out of his home.

Although Zhao Hua, the director of the Nuclear Medicine Center, has rich experience, emergency gamma knife treatment requires him to irradiate cerebral toxoplasmosis lesions when he is under-evaluated. This kind of thing that he had never done before made him feel a little uncounted. In line with the principle of "the more you watch the excitement, the less panic you will have", Director Zhao Hua called two professors from the School of Infectious Diseases and Parasitology of Ningyuan Medical College after a few phone calls. At the same time, Professor Zhang from the Military Preventive Medical College of the Three Military University, who was in the P4 laboratory of the School of Public Health of Ningyuan Medical College, was also invited to do an exchange - although Professor Zhang is engaged in medical protection research, his doctoral supervisor is a well-known radiation disease research expert in the country. It's good to ask someone to check the radiation plan!

Director Zhao Hua is calling for foreign aid on the phone, while on the other side, Zhou Jun and the others are also seeking support from industry experts as much as possible. Calls for help came one after another, and finally I found Wang Hongjing, chairman of the All-Army Nuclear Medicine Professional Committee of the Fourth Military University. After a series of phone calls for help, the number of medical staff who decided to visit gradually rose to more than 50 now.

In this group, there are more than a dozen professors, seven or eight associate professors, and in addition to Sun Lien, the lowest degree is also a master's student. Sun Lien, who has never been a school bully, stood on the periphery of the crowd, I don't know if it was because the weather was too cold, or because he was suppressed by the spirit of a school bully, his hands were a little trembling.

"It's so lively?" Sun Lien was shaking like a Parkinson's patient on the side of the crowd, and Director Wang Jianpei, who came to see the excitement, saw this kid at a glance. Since Director Wang installed the takeaway software on his mobile phone, he has three meals of mutton vermicelli soup a day, and the one he eats is called a comfortable one. Naturally, Sun Lien is also a lot more pleasing to the eye. Now seeing that Sun Lien is a little out of place with his surroundings, he smiled and came over and patted him on the shoulder. "This crowded place should be hot, why did you kid freeze like this?

"Director Wang. Sun Lien hurriedly nodded towards Wang Jianpei, according to seniority, this is his future uncle, and he can't be lazy in terms of etiquette. What's more, Director Wang has an excellent amount of food, and he killed Sun Lien for almost 200 yuan in one meal last time. If this is to be eaten again, it will be very bad. "I ...... I was just a little nervous. ”

"What are you nervous about?" Wang Jianpei was a little puzzled, and then laughed, "It's not that you went on stage to take the gamma knife." Just look at the excitement. ”

Sun Lien replied honestly, "This treatment plan...... It was I who said a lot to Director Zhou......"

"Director Zhou?" Wang Jianpei frowned and pondered for a while before he realized that Sun Lien was talking about Zhou Jun. Then he wondered, "You came up with the idea of irradiating Toxoplasma gondii with a gamma knife?"

Wang Jianpei's loud voice drifted out along the cold north wind for a long time, and many experts present suddenly turned their heads and looked at Sun Lien and Wang Jianpei curiously. Especially the people who pay more attention to Sun Lien, everyone seems to want to see how many arms and legs the doctor who dares to take this kind of treatment method has grown.

Sun Lien was already nervous, but when he was stared at by this group of bigwigs, his hands trembled even more. But before it was his turn to defend anything, a flatbed truck was pushed out of the passage next to the apron. Surrounded by doctors in white coats, they propped up two white sheets on top of the flatbed with their hands, and followed them like moving tents. Zhou Jun pushed the cart at the back of the car, while Liu Pingchuan and others held up white sheets—and the other nurses nervously monitored the cardiopulmonary monitor placed next to the bed.

Yang Jianqiang has a throat stuck in his mouth. When Sun Lien saw this moment, he felt a chill in his heart.

Could it be that the cerebral edema area at the base of Yang Jianqiang's skull has squeezed into the brain stem, causing his breathing to be suppressed?

After taking a closer look, Sun Lien's heart was a little relieved. Although the throat is plugged in, it is not connected to the respirator, commonly known as a "leather ball". It seems that it should be a precautionary measure to prevent the deterioration of his condition - once Yang Jianqiang shows symptoms of respiratory failure, this can at least grab a little time to insert his throat.

Mrs. Yang was at the front of the line. Like the Valkyrie in Norse mythology, she held a long sword and an umbrella in her hand, trying her best to block the wind and snow for the doctors behind her and her husband.

"You're pretty fast. The group walked to the door of the nuclear medicine center, Zhou Jun raised his head, and at a glance saw Sun Lien standing on the outermost side of the team. He beckoned to Sun Lien, "The patient you diagnosed, the treatment plan you proposed, what's the matter? Once the matter comes out, you will pretend to be fine?" Zhou Jun feigned anger, "Why don't you hurry up and push the bed?"

The senior brother is angry, and of course the junior brother has to behave. Sun Lien ran to the bed in three steps and two steps, and began to push the bed with his head down. And the eyes of the surrounding school bulls seemed to be a little hotter.

The radiation treatment plan for Gamma Knife has been finalized in the conference room. Considering that there is only one chance for treatment, the experts of the Fourth Central Hospital, after extensive consultation with professionals in the industry, did not adopt a relatively conservative total amount of radiation. Instead, a single-point radiation dose of 170 Gy per minute for the abscess area, 80 Gy per minute for the edema area, and a total radiation dose of 1000 Gy were adopted.

This amount of radiation is more than five times the prescribed dose for the general clinical treatment of brain tumors, and it is extremely risky for any patient to receive such a large dose of radiation. Although the Gamma Knife has the characteristics of accurate radiation area, it has little damage to other organs. However, it is still not possible to completely prevent the rest of the patient's tissues from being affected. This effect is especially pronounced in the presence of large amounts of radiation.

For Yang Jianqiang, there are three deadliest risks of gamma knife. First, radiation can cause severe damage to his small intestinal villi, which is the main cause of most acute radiation sickness. Second, there is the delayed damage to microvessels that may occur after high doses of radiation. When this damage occurs in an area of the brain, microangioedema is likely to occur, which can lead to cerebral thrombosis or insufficient blood supply. The third risk is that under high doses of radiation, it may cause the death of associated brain tissue.

Of the three risks, the first can be avoided by precise control of the radiation range, and the second can be avoided with enhanced anticoagulation after treatment. But the third risk is a bit difficult to deal with.

The main means of avoiding the third risk in clinical practice is multiple irradiation. Normal brain tissue is more tolerant to radiation than tumor tissue. Irradiation of around 80 Gy can cause fatal damage to tumor tissue, but the impact on normal brain tissue is not so severe. In general, about six hours after irradiation, brain tissue affected by the 80Gy dose of irradiation can begin to repair itself. Therefore, when treating large or multifocal brain tumors, the course of radiation therapy is generally divided into three days or even longer. Receiving a certain amount of radiation every day to protect normal tissues and kill tumors at the same time.

But Yang Jianqiang did not have this opportunity. It is not clear whether multiple radiation has a sufficient killing effect on toxoplasma. And it's unlikely that he'll have the opportunity to take the number of treatments apart. For him, there is only one chance to survive or die. One radiation can suppress Toxoplasma gondii, and he may still survive. If the radiation is too strong to cause serious complications, or if the radiation is not strong enough to allow Toxoplasma gondii to continue to multiply, Yang Jianqiang is dead.

Sun Lien, Zhou Jun and others sent Yang Jianqiang to the Gamma Knife bedside. Several young and strong male nurses worked together to lift him to the bed. The rest is left to the professionals. Sun Lien and Zhou Jun went to the rest room outside the Gamma Knife treatment room together, and the two of them fidgeted together and drank tea - the water heater in the nuclear medicine department is probably a little problematic, and the temperature of the water used to make tea is not even as hot as the water used to soak the feet. A pinch of tea leaves floated on the water, and the two of them didn't drink it, and they didn't drink it.

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