I can see the status bar

Chapter 1071
Hydroxychloroquine phosphate is a typical example of "new use of old drugs".Hydroxychloroquine phosphate has been the main antimalarial drug since it was invented in the middle of the last century to deal with the increasingly common drug-resistant malaria parasites.However, in the course of subsequent use, people gradually discovered that this drug has the ability to regulate the immune system.

Hydroxychloroquine is different from glucocorticoids in that it will not cause drug-induced Cushing's syndrome in the human body, nor will it seriously disrupt the normal metabolic process in the human body.At the same time, hydroxychloroquine can also reduce the dosage of hormones, lower blood lipids, and reduce the chance of side effects such as hormone-induced hyperlipidemia.

For systemic lupus erythematosus, hydroxychloroquine can participate in the metabolism of melanin and increase the body's ability to absorb ultraviolet rays.This function can slow down the probability of skin lesions in patients with systemic lupus erythematosus after being exposed to sunlight.Hydroxychloroquine can inhibit the production of prostaglandins, thereby reducing inflammation and relieving arthritis and joint pain caused by systemic lupus erythematosus.At the same time, hydroxychloroquine can also resist platelet aggregation and reduce thrombus formation, thereby reducing cardiovascular events induced by vascular damage caused by systemic lupus erythematosus.

Judging from the description alone, hydroxychloroquine is simply a magic drug for the treatment of autoimmune diseases, especially the treatment of autoimmune diseases related to hormone levels.But in fact, this oldest chemically synthesized drug still has many serious side effects that need to be vigilant—it is precisely because of these side effects that hydroxychloroquine phosphate was gradually withdrawn from the ranks of malaria treatment and turned into a treatment system Drugs for lupus erythematosus.

Years of clinical use have proved that hydroxychloroquine has a very low probability of causing retinopathy and may cause corneal disease in users.May cause itchy skin, bullous rashes and even psoriasis flare-ups.Hydroxychloroquine also has effects on the gastrointestinal tract, central nervous system and muscular system.To make matters worse, it also has side effects on the heart.

One of the main reasons why hydroxychloroquine was withdrawn from treating malaria was its toxicity to the heart muscle.Hydroxychloroquine has an accumulation effect in the human body, and large doses of this drug with a fairly good bioavailability and absorption rate can easily lead to excessive accumulation.And eventually lead to heart failure and cardiac conduction abnormalities.

The side effects are as obvious as its benefits, so when using hydroxychloroquine for immunosuppressive treatment, doctors will always prefer to combine multiple immunosuppressive drugs.This can reduce the use of hydroxychloroquine and glucocorticoids at the same time, thereby reducing the serious side effects caused by these two drugs.

In Zhang Min's case, the combined drug item she used was total glycosides of paeony.

As a traditional Chinese medicine with a long history of use, the main efficacy of total glucosides of paeony is focused on the suppression of immune function and the protection of the liver to slow down the liver fibrosis of chronic viral hepatitis.It has been found through research that total glucosides of paeony also has antispasmodic effect and anti-platelet aggregation effect.In animal experiments, total glucosides of paeony have a certain effect of slowing heart rate and lowering blood pressure
Both hydroxychloroquine phosphate and total glucosides of paeony are drugs that mainly suppress the immune system.But now, Zhang Min, who uses them at the same time, shows a different effect.This makes the doctors very excited.

But to cheer up, we must first talk about a basic principle.Just because the patients with the mildest symptoms in the ICU may suggest that some old drugs have antiviral effects, we should not ignore other critically ill patients.Research needs to be done, but daily treatment work also needs to be done.

Now most of the patients in the ICU of Yunhe City Infectious Disease Hospital are conscious, which is the biggest difference from the previous ICU.

Critically ill patients with clear or basically clear consciousness will not bring any help to treatment.This may sound callous, but it is true—many of these hypoxemic patients are restless and irritable.The fear of the new coronavirus and the fear that I might threaten my family are intertwined, and the "seasoning" of restlessness creates a chemical reaction.The result of the chemical reaction is that they do not cooperate with the treatment.

It was found that most of the patients with pneumonia caused by the new coronavirus had small tracheal sputum plugs.In the current treatment process, the medical team tends to perform sputum suction on patients more actively and frequently.This process is not comfortable, and it also needs to turn the patient in the prone position. In short, it highlights a "trouble".

If these patients are unconscious, switching between prone and supine positions is at best a laborious task.The patient is unconscious, and the process of suctioning sputum can be smoother.

But the patient is conscious and unwilling to cooperate... Then transposition suctioning will cause chaos, and even make people panting and sweating.

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Sun Lien panted heavily, feeling as if he had been soaked in sweat, his whole body was wet.

He helped turn two patients over and did ideological work for three patients—the main purpose of the ideological work was to arouse their desire to survive and actively cooperate with the doctor's treatment.Instead of struggling desperately, ask to forego treatment.

Patients can of course ask to give up treatment, at least under normal circumstances, patients have this right.But in Yunhe, their right was temporarily "on hold".

Treating patients infected with the novel coronavirus is now more than just a medical issue.It's also a public health issue, and... a political issue.

Public health issues have determined that there are currently only two situations for patients with novel coronaviruses who can leave designated hospitals—either they recover and are discharged, or...they die of ineffective treatment.In any case, it is impossible for doctors to allow a patient with a severe infectious disease to be released from the hospital without being cured.

So if the patient's request is agreed, is it okay to give up his treatment and let the patient lie down in the hospital until he dies?
This is also not possible-because the treatment of the new coronavirus itself already has great political significance in this stage of full participation and epidemic prevention.

The daily epidemic notification system established since the SARS period has now played an important role in the battle against the new coronavirus epidemic.In the face of all kinds of rumors that appear and disappear on the Internet, the daily routine briefings and press conferences held by relevant state departments have become the most authoritative and important news channel for the people to understand the fight against the epidemic.

And the number of new deaths reported every day at this meeting is already heavy enough, so heavy that it is impossible to subdivide the item of "patients refusing treatment and death".

If patients are allowed to refuse treatment, that means the death toll will continue to rise.The emotions of ordinary people who are already tense to the point of breaking will be even more tense.

At the same time, these patients who refuse to receive treatment will continue to occupy medical resources and hinder the operation of the medical system.

What's more, the restless and emotional decisions these patients make... don't really mean what they really mean.

Therefore, to appease and take care of the emotions of these critically ill patients has become the top priority of the entire medical team.In the North Fifth District, this kind of work can still be done by nurses.But now... everyone has to join in the conversation.

Fortunately, Sun Lien has a small method to deal with this situation.He took out the tablet computer donated by an enthusiastic person from the nurse's station, and said to the uncle who was lying on the bed and shaking his head slowly and continuously, "Master, let's make a discussion. As long as you are obedient and cooperate with the treatment, I will call your family." A video call, let's meet up, okay?"

(End of this chapter)