In the emergency department of Ningyuan Fourth Central Hospital, the situation is a little chaotic.

Director Liu was directly suspended by Dean Song because of his negligence in management and because of the leadership responsibilities that medical staff need to bear in their professional exposure. Now the emergency department of the entire Fourth Central Hospital is in charge of the newly promoted Zhou Jun.

Doctors demand a lot from their leaders. To be a good leader of a department, in addition to having a good professional level, you must also be able to convince the public, so that doctors can feel that they have a backer. From this point of view, Liu Tangchun is indeed a very qualified section director, and Zhou Jun ...... It seems to be a lot less confident.

The most important point is that Zhou Junlai is a little too young to be the head of the department. He is just thirty-five years old and not married. There are several veteran emergency doctors in the department who are in their forties this year, and their professional titles are high enough. In the eyes of the first-line and second-line doctors, these veteran emergency doctors are more trustworthy than Zhou Jun.

The reason why the emergency room can barely run is not the credit of Zhou Jun. It's that these emergency doctors feel that Zhou Jun's appointment is not expected to last forever, and Dean Song will still have to invite Lao Liu back in the future, so he will work as if he has given some face.

Although Liu Tangchun expressed his support for Zhou Jun several times in this matter, the other doctors had their own small abacus. Comrade Liu's success in poaching everywhere depends not only on the superior salary and welfare system that the Fourth Central Hospital can provide. To put it bluntly, at the level above the attending physician, everyone's income is actually about the same.

The nature of the Fourth Central Hospital itself makes it a lot more comfortable for these professional emergency doctors to be useful, and they don't have to run in with doctors from other clinical disciplines. Compared with the institutional superiority of the Fourth Central Hospital, Liu Tangchun's personal charm is actually the key.

Although Lao Liu usually doesn't have a proper line and looks like he is swaggering and foolish, anyone who knows Lao Liu has to admit that Liu Tangchun has a strong personal charm. In order to protect the calves, they dare to bare their teeth with the vice president or even the dean; if there is a medical quarrel, they dare to go up directly to the front and be tough instead of shrinking back and letting the situation worse; in order to solve the problem of the shortage of medical staff, they would rather give up their old faces than dig up talents to come back; in order to train new people, they can even follow up cases with new people and boldly delegate power. To be honest, being a section director is very simple, but to be a good section director, responsibility and determination are indispensable.

Zhou Jun has made a decision, but he has not yet shown his chances to take responsibility.

Zhou Jun is now in a hurry to recall Sun Lien, in fact, to a certain extent, it is also an internal signal - I will continue the style of Director Liu during his tenure and not overly interfere with and change the operation of the department.

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"You're here. At three o'clock in the afternoon of the next day, Zhou Jun, who saw Sun Lien, blurted out, and there was a feeling of relief between the words.

Sun Lien straightened the white coat on his body a little unnaturally, "Teacher Zhou...... You don't have to be in such a hurry, right?" Sun Lien has been working hard for a week, and his physical and mental exhaustion is light. Yesterday, I played with Hu Jia, Xu Yourong and others in Ninghu for a day, which made Sun Lien suddenly feel alive. Life can be very beautiful.

"Human lives matter. Zhou Jun succinctly explained the reason for his urgent recall, "What about Dr. Xu?"

"She said to go and see Dean Liu first......" Sun Lien spread his hands, and asked instead, "In the past two days, Dean Liu has not come to the emergency department to stare?"

"If he can come over and keep an eye on it, he won't be Liu Pingchuan. Zhou Jun was obviously very dissatisfied with Comrade Lao Liu's passive sabotage. "Just staring at his one-third of an acre of land, and doing research seminars with the doctors in Corey all day long. After all, the academic dean is engaged in academics, and if you let him focus on clinical work, he is not used to it. Speaking of the back, Zhou Jun turned around and began to say good things for Liu Pingchuan.

However, this can also prove from another angle how much pressure Zhou Jun is under now. At the beginning, Dean Song's work adjustment had obviously taken into account that Zhou Jun's seniority was not deep enough, and he was afraid that it would be difficult to convince the public. Therefore, Liu Pingchuan was "exiled" from his neurosurgery to the emergency department. It's just that this handsome middle-aged and elderly woman probably didn't expect that when she was busy with various meetings, Liu Pingchuan, an old boy, would dare to disobey the yang and the yin, and the dead skin and face would be out of the gods.

Liu Pingchuan came to such a hand, but he didn't have an opinion on Zhou Jun. He just couldn't let go of the department he had brought up. But the direct consequence of the play sung by Liu Pingchuan was to roast Zhou Jun on the fire alone. He was happy, but Zhou Jun was anxious to pull down his hair one by one. If it weren't for the achievements of the past few years, coupled with the support of Comrade Lao Liu, I am afraid that the doctors below would have been ready to rebel a long time ago.

"Mr. Zhou, the patient ...... you said on the phone yesterday" is something like hospital operation, and Sun Lien can't interfere with it, and he has no interest in these things. It's just that Zhou Jun is his teacher, and he will be his direct brother in the future. In public and private, Sun Lien has to do something for him. And now, the only thing Sun Lien can do is to do his duty as a doctor and treat patients well.

"This patient...... Zhou Jun sighed, "It's troublesome." ”

"Is the condition serious?" Sun Lien was a little mentally prepared for this, if the condition was not serious, Zhou Jun would not rush to call him back from a phone call on the edge of Ninghu.

"In a sense, it's serious. Zhou Jun took out a medical record folder and handed it to Sun Lien. "I've asked Director Huang to see it, but he doesn't have a clue. The imaging department checked the MRI twice from yesterday to today, and there was no signal enhancement, and they didn't know what was wrong with this patient. ”

Sun Lien opened the medical record folder, and he had probably read the contents last night.

The patient's name is Yang Jianqiang, 34 years old. Two days ago, he was admitted to the emergency room of the Fourth Central Hospital, which had just reopened, due to high fever. After careful screening at the fever clinic, the suspicion of avian influenza was ruled out and he was transferred to the emergency room for treatment.

The patient reported that he had a fever since a week ago, during which time he took several antipyretics but did not respond well. At the same time, the patient also has symptoms of fatigue and blurred vision for more than 20 days. After an ophthalmologic consultation, it was confirmed that the patient's eye structure was normal, and the ophthalmologist gave the consultation opinion that neurological problems should be considered.

After the emergency department is admitted, the patient is first classified as a secondary patient and a series of tests are initiated. However, there are no abnormalities in blood count and immunology. In addition to the slightly higher liver function, the only thing worth noting is that because the patient had undergone a bone marrow transplant for leukemia a year earlier, his CD4 lymphocyte content was much lower than normal, and the test result was 157/UL, indicating that the immune system was severely suppressed.

After determining that the patient had a low CD4 lymphocyte count, the emergency department immediately tested the patient for HIV antibodies, and the result was determined to be negative. Zhou Jun judged that the severe suppression of the patient's immune system was caused by the anti-rejection drugs taken by the patient.

After consulting with the Department of Hematology, the emergency department adjusted the patient's original immunosuppressant to a triple inhibition regimen of mycophenolate mofetil, methylprednisolone, and basiliximab. However, the adjusted immunosuppressant regimen only reduced the patient's alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and other indicators to normal. The patient continues to have a fever, and fatigue and blurred vision do not improve.

And just after Zhou Jun and Sun Lien made a phone call, the patient developed a new symptom - confusion.

"This should be God's internal control. Sun Lien looked at the thick stack of inspection documents and became worried, "Don't accept it?"

Director Huang said that he didn't have a clue. Zhou Jun shook his head with a bitter face, "We are considering whether to simply send the patient's examination sample to the academy for an mNGS test." ”

mNGS detection is the last resort for non-imaging tests in modern medicine. Using this tactic is basically equivalent to the doctors surrendering and admitting defeat - sorry, I really don't know what you are infected with, so we plan to test all the more than 7,000 known pathogens and see what jackpot you have won.

"Can the patient afford the cost?" Sun Lien frowned, the patient had just undergone a bone marrow transplant a year ago, and the price of this treatment was not cheap. Continuing to take anti-rejection drugs throughout the year is also a heavy burden for many families. mNGS testing is extremely costly, and they may not be able to afford it.

"So it's being considered. Zhou Jun sighed, since becoming this deputy director, he may have sighed more times in the past few days than in the previous half of his life combined, "Teacher Liu said that you have your own unique views on these more troublesome diseases, so I want you to give it a try first." ”

From a certain point of view, Sun Lien, who has a status bar, is indeed much easier to use than mNGS, and the biggest advantage of Sun Lien's brand checker is that it is cheaper. It costs 10 yuan to register a number, and as long as the patient has medical insurance, the part he bears is only about 2.8 yuan. Compared with the price of starting from 50,000 or 60,000 yuan for a set of mNGS examinations, and the medical insurance does not report a penny, Sun Lien is really much cheaper.

"I'll give it a try. "Encountering this kind of case that the bigwigs can't handle, Sun Lien himself is also very unhappy. Before entering the emergency room to see the patient, he also deliberately asked, "Has Yuan Ping'an seen it?"

"Dr. Yuan has come to see it. Zhou Jun frowned, "After studying for a long time, he said that he was going to check the information." As a result, from last night to now, there is still no conclusion. ”

Sun Lien's heart moved slightly, and it was estimated that Yuan Ping'an already had a suspicious direction. He was going to meet with Yuan Ping'an again after seeing the patient to see what he thought.

"Yang Jianqiang, male, 34 years old, has multiple occupancy masses in the brain. Sun Lien walked into the emergency room and found that a symptom that he didn't expect jumped out of the patient's status bar.

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