It turns out that this kind of man who is extremely ruthless to himself is really ruthless from beginning to end. Despite the completion of the epidural, it is still difficult to stop the bleeding in a delirious patient, who is really not very cooperative.

The cystoscope entered the bladder through the broken urethra that had completed hemostasis, and through the screen, Dr. Cao saw a mass of metal-like strips. Because of the difficulty in urinating, the patient's bladder is very full, and probably because of the long-term fullness, this necklace forms a large ball in the patient's bladder. It is absolutely impossible to pull it out, and it is absolutely impossible to physically do so.

Dr. Cao sighed and began to operate the endoscope to play a puzzle game - what is the relationship between this piece of metal chain and the other end of the metal chain?

Time passed little by little, epidural anesthesia is often referred to as spinal anesthesia, and the anesthesia process has no effect on the patient's consciousness. And this patient, who has not been mentally stable, began to show some irritability. Fortunately, the nurses and Dr. Cao continued to reassure the patient, and although he was impetuous, he was still able to lie still in bed.

"Almost. Forty-eight minutes later, Dr. Cao Xin finally untied the necklace that had been clumped together, and then slowly pulled it out of the patient's bladder.

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"Then you didn't even look at the subsequent surgery, so you came to me directly to complain?" Sun Lien asked with a smile, "Severance and reconnection is at least a third-level operation, right?

"I gave up the opportunity to be a helper. Dr. Cao smiled, "Anyway, I did the cystoscopy, so it's good to let my junior brother go on stage." ”

"I've seen a lot of patients today, but God forbid, they're not that serious. Sun Lien sighed and pointed to the stack of outpatient credentials inserted on his desk, "The most serious thing is the lobar pneumonia I told you just now, and I was transferred to the respiratory department." ”

"Are there still beds in the respiratory department?" the doctors in the hospital chatted, and the most common topic of conversation was whether there were still beds in certain departments. "In the winter, when respiratory diseases are high, can they still free up beds?"

Speaking of this problem, Sun Lien also felt a little toothache. "There's no place...... I had to put someone in the emergency room first. The Department of Respiratory Medicine also felt that it was necessary for this patient to be admitted to the hospital for treatment, after all, although the patient was not very old, he had a long-term smoking history. And because the amount of rusty sputum is relatively large, the manifestations of cervical vein dilation can already be observed.

Although it has not yet reached the point of respiratory distress syndrome, the situation is still not to be underestimated. But the respiratory medicine department really can't make up beds - not to mention the wards in the inpatient department, even the bed in the treatment room has a patient. No extra beds are allowed in the corridors of the inpatient departments of medical units above the second level, and patients should be shunted to lower-level hospitals as much as possible. But none of these patients are now able to meet the discharge criteria. And the new patient has an emergency department number - the emergency department cannot refuse to accept patients.

"Then you'll have to worry about it. Dr. Cao spread his hands and expressed helplessness, "The first diagnosis is responsible." If this patient doesn't go to the respiratory department for a day, you're going to be responsible. ”

After chatting for a while, Dr. Cao suddenly received a phone call.

"Huh?" he paused for a moment, then abruptly stood up from his seat, "Have you contacted the pharmacy department?"

Sun Lien smelled something wrong from Dr. Cao's intense movements. He also stood up with a frown.

"Got it, I'll ask right away. Dr. Cao sighed, hung up the phone and started sending WeChat.

"Brother Cao, what's wrong?" Sun Lien asked with some curiosity, "Is there anything you need help with?"

"it......" Dr. Cao Xin, who has always been calm, scolded, "The patient I had surgery on had a malignant high fever!"

Sun Lien looked dazed, "What?"

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Malignant hyperthermia is a very serious genetic disorder. It is also the only serious disease known that can cause death from conventional anesthetic drugs.

As a subclinical condition, malignant hyperthermia does not have any signs or symptoms until it develops. In these patients, there is a defect in the calcium channels in the skeletal muscle cell membrane, which can cause an abnormal increase in the release of calcium ions when exposed to volatile inhalation anesthetics or depolarizing muscle relaxants, and only then does malignant hyperthermia erupt violently.

Patients with malignant hyperthermia begin to have tonic contractions of the skeletal muscles throughout the body. The contraction of the skeletal muscles of the whole body explodes with tremendous energy, which prompts the patient's body temperature to rise uncontrollably and rapidly, and causes the patient to be in a state of hypermetabolism.

The patient's body temperature rises rapidly to around 45°C to 46°C, and hypercapnia develops in a hypermetabolic state. At the same time, it is accompanied by tachycardia and a sharp increase in blood pressure, heavy sweating, and increased blood potassium.

In other words, the body at this time intends to burn itself to death.

The trouble is that general clinical cooling methods are difficult to have sufficient effect on malignant hyperthermia, and eventually the patient will die due to organ failure.

Because it is an idiopathic disease in anesthesiology, Sun Lien basically has no understanding of it. And Brother Cao sent a message asking for help in the exchange group of doctors in major hospitals, and quickly explained to Sun Lien what the situation was now.

"The specific drug for the treatment of malignant hyperthermia is called dantroleline. Cao Xin didn't even have the time to wipe his sweat, he was still typing quickly. "The problem is that this medicine is not only available in our hospital, but also in hospitals in the province. ”

Dantrolorine is a specific drug for malignant hyperthermia. But there is no introduction, no production, and even no batch number in China.

Even if you go through the green channel and buy dantrolene from abroad, it will take at least two to three years to enter the customs after a single drug approval inspection. The shelf life of dantrolene is only three years. The drug expired and became useless after entering the country, which also led to the fact that there was no reserve plan for dantrolene in domestic hospitals.

As for the domestic imitation, the road is even longer and more difficult. After all, a total of 16 cases of malignant high fever have been reported in 15 to 16 years. Invest a lot of money in imitation, but you may face the embarrassing situation of not being able to recover the cost at all. As a profit-seeking enterprise, pharmaceutical companies will certainly not touch this hot yam.

Sun Lien thought about it, and suddenly remembered that Takeda Pharmaceutical was preparing to acquire Shire Pharmaceutical—isn't Shire Pharmaceutical a company specializing in the production of orphan drugs? or...... Can you call Kobayashi for help?

Without further ado, fight now.

However, Sun Lien did not know that the two companies that could produce dantrolene were both American companies.

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"President......" Kobayashi's secretary quietly walked into the room and leaned into Kobayashi's ear and whispered something. Kobayashi is now sitting in a conference room at Shire Pharmaceuticals in Dublin, Ireland, where he is negotiating further with Shire Pharmaceutical's senior negotiators on the M&A deal. This damn group of Irishmen didn't know what was going on, and not only did they refuse to agree to the $64 billion merger offer, but they also wanted more — like a seat on Takeda's board.

Kobayashi Feng is also a businessman who is used to seeing strong winds and waves, but this kind of thing can only be reached if both parties agree. If there is a brain hole between the two parties to the transaction, the whole transaction may be completely ruined.

Kobayashi Feng is thinking about whether to throw Sun Lien out as a killer weapon now.

"Dantroline?" he asked his secretary, frowning, "do we have this drug in our company?"

"Nope. The secretary's voice was very low, "It's an orphan drug produced by an American company." ”

Kobayashi Feng thought for a moment, and suddenly said, "Bring the phone in, and let the translator come in." ”

The secretary turned around and walked out of the conference room, and Kobayashi said to the vice president of Shire Pharmaceuticals opposite, "Mr. Aaron, I suggest that the discussion be suspended for a while, there is a call for help from China that has reached me, I would like to ask you to listen with me." ”