I can see the status bar

Chapter 1076 Hope in the Cracks
Although Sun Lien was a little depressed about this result, he was not unconvinced.Several experts are top experts in the industry, and their experience and treatment ideas are a model for young doctors like Sun Lien to learn from.

It is not impossible to use high-risk medical methods, but the premise is that the overall benefit of the patient is greater than the risk in the state of high-risk medical treatment.Although Lu Liping's situation is dangerous and urgent, it is still too risky to embolize the veins of the liver to prevent the return of potassium-rich blood.

After returning to the ICU, Sun Lien received the CT results that Yuan Pingan took urgently to do. It was indeed the same as the prompt on the status bar. The patient's right anterior lobe of the liver had a relatively large area of ​​low CT value, indicating tissue necrosis.

Hemodialysis continued, while the treatment plan for Lu Liping was adjusted to supportive treatment and symptomatic treatment.Everyone can only continue to suffer together to see if they can help Lu Liping get through this test.

The doctors have already done everything they can, and whether they can survive in the future depends only on Lu Liping's own ability.

On the other hand, the treatment plan for Zhang Min has also been put on the agenda again.Although the doctors are still arguing over which drug between hydroxychloroquine phosphate and total glucosides of paeony played a role, the most important thing for Zhang Min now is to reverse the infection situation and completely destroy the disease before the new coronavirus completely destroys the disease. Before her lungs, stop the virus infection.

This kind of thing... is easier said than done.Among the current antiviral drugs, none of them are confirmed to be effective.In the fifth version of the trial plan issued just yesterday, the National Health and Medical Commission recommended that aerosol inhalation of interferon-α, lopinavir/ritonavir, or addition of ribavirin could be tried for treatment.

Nebulized inhalation of α-interferon is a routine treatment for respiratory viral infections.Interferon (IFN) is accelerated as a multifunctional cytokine with broad-spectrum antiviral, antiproliferative, and immunomodulatory activities, and is mainly divided into three types: α, β, and γ.The α-interferon aerosol inhalation mentioned in the guidelines refers to the direct use of α-interferon for injection as an aerosol inhalation.This treatment plan is mainly for various types of pneumonia caused by viruses, especially for acute upper respiratory infection, herpetic angina, acute bronchiolitis, viral pneumonia, and hand, foot and mouth disease.

Alpha-interferon itself has no direct effect on viruses, it mainly induces cells to produce antiviral protein factors, thereby producing antiviral effects.In other words, interferon can prompt the body to prepare for virus invasion and infection as soon as possible, but it cannot directly kill or inhibit virus reproduction.

Lopinavir/ritonavir is a drug similar to "amoxicillin-clavulanate potassium".It consists of two drugs, lopinavir and ritonavir, which interact with each other to achieve better therapeutic effect.And its main mechanism of action is to block the division of the Gag-PoI polyprotein, allowing the virus in the cell to be released in advance, becoming an "immature, non-infectious virus particle".This feature allows lopinavir/ritonavir to have an antagonism against retroviruses.

The combined use of ribavirin is more like an attempt to combine broad-spectrum antiviral drugs on the basis of targeting retroviruses.Lopinavir/ritonavir itself is a drug against retroviruses and lentiviruses. Although it is speculated from the mechanism that it may also have a certain effect on the new coronavirus, which is also an RNA virus, this effect...it also It's just "possible".

Humans still know very little about the new coronavirus, and this state is likely to last for years or even decades.Just relying on "probably effective" to recommend it can also prove from the side that we need effective anti-virus methods.

In Zhang Min's case, the regimen of lopinavir/ritonavir may be more appropriate.This drug is aimed at patients with acquired immunodeficiency syndrome, and it is just right for Zhang Min, who is immunocompromised.The only thing that Sun Lien needed to ponder was whether this plan would work.

Lopinavir/ritonavir is metabolized in the human liver and is therefore contraindicated in patients with severe hepatic insufficiency.Lv Liping, who has severe hepatitis, has no chance to use this treatment plan.

This is also where Sun Lien has a headache now.He still has a bag of plasma from recovered patients that he has not used, and this bag of plasma... so far, it can only support one patient.

Is it for Zhang Min, who has a surprisingly slow spread of the virus, which may suggest that a certain drug she is using has a virus-inhibiting effect; or is it for Lu Liping, who has severe hepatitis and whose blood potassium is so high that she can hardly hold it down?
It's a hellish nightmare to choose a pair of doctors like this.You know, plasma from convalescents may not necessarily be effective.In this environment, you have to face the huge moral test of "determining who can survive and who can't", and choose one of the two patients to use the plasma of the recovered person... It's too uncomfortable.

From the perspective of the patient's condition, there is no doubt that Lu Liping received plasma treatment from convalescents—Zhang Min can still walk on the ground.Although Lv Liping's advanced age and severe hepatitis seriously restrict her prognosis, but only in terms of the severity of her condition, she really needs this convalescent plasma very much.

Perhaps after suppressing the proliferation of the virus, Lv Liping's blood oxygen condition can be improved rapidly, and her liver can also take the opportunity to recover.

But from the perspective of prognosis, it is the most appropriate choice to use convalescent plasma for Zhang Min.She basically has no other problems. She only needs to control the infection of the new coronavirus, and then she can gradually wait for the situation to improve and even be discharged from the hospital.However, starting from the "cost-effectiveness ratio", Zhang Min should be the most suitable patient for treatment with convalescent plasma.

This problem not only stumped Sun Lien, but also stumped the entire medical team.

"This plasma... I don't know who to use it for." The medical team started a small meeting.Doctors from Departments 1 and 2 of the Comprehensive Clinic of the Fourth Central Hospital got together for an impromptu meeting.At the meeting, everyone exchanged information about the patients they were managing.After discussing for about 10 minutes, everyone reached a consensus on only two issues-first, Zhang Min or Lu Liping should be treated with convalescent plasma.Second, they don't know who it is for.

"You guys can really do it." Sun Li'en said a little angrily, "Listening to what you have to say is like listening to what you have to say. You have been talking for a long time, and you have been talking about it for a long time. Is there any need to discuss this kind of thing? I want to talk about it now. What I want is the solution, not to listen to you and re-analyze what you already know!"

"To solve this problem, the quickest way is to get some more blood plasma." Wearing protective clothing, Xu Yourong calmly kicked the problem back to Sun Lien, "Director Sun, why don't you go to the plasma collection station and wait for a while to see if you can do it." Can't we bring back a few more therapeutic doses of plasma from recovered patients?"

Sun Li'en glared at Xu Yourong, "If you want to kill me, just say so. Go to the harvesting station to enjoy the autumn wind? Don't you know that there are reporters waiting outside that place?"

Yunhe is now the most concerned place for 14 billion people across the country, not one of them.In order to respond to the concerns of ordinary people across the country, almost all state-level media across the country are desperately trying to find people in Yunhe.And these reporters have become gods with the most sensitive sense of smell one by one.The Yunhe City Infectious Disease Hospital, which may appear to be the most risky and dangerous place to outsiders, has become an area where reporters try to come in.

The place where the North Fifth District is located has been attacked by four waves of reporters from provincial and national stations.In principle, all electronic products used in the red zone must remain in the red zone for permanent storage.But the TV reporters just came up with the magical method of "sending a GOPRO in, and throwing the machine into the disinfectant solution when taking it out".Only then did the scene in the red zone be put on the TV screens of thousands of households for the first time.

After this battle, Sun Li'en's impression of traditional media practitioners has been greatly changed.It's just that he is still a little... afraid and wary of those reporters.To be honest, their perspective and sense of smell are too sensitive.Not to mention whether Sun Li'en could really get plasma from recovered patients if he really went to the plasma collection station, I'm afraid that if he appeared in the 500-meter area around the plasma collection station, he would be directly pressed to the ground by the reporter friends.

Then he even asked about his inner entanglement when he was three years old when he wet the bed and his parents found out about hiding the bed sheets.

It's fine if you only ask about personal matters, but... Sun Lien is even more afraid that the reporters will ask about other things.

As a doctor, he cannot disclose patient privacy.As the leader of a medical team, he couldn't show even the slightest bit of discouragement.As an interviewee, he needs to answer every question raised by these media teachers who represent the concerns of the people of the country.As a member of the Communist Party, he needs to use television to let compatriots across the country understand that infectious diseases are preventable, controllable and curable. As long as scientific principles are followed, this invisible and intangible disease is not invincible.

We will win, and we will win.Such determination is actually not the most urgent thing right now.Sun Lien felt that he might be the one who lacked confidence.It's not that he lacks confidence in the final victory, he just feels... a little tired.

"I... I'll think about it when I go back." Sun Lien was silent for a few seconds, and then announced the end of the meeting, "Everyone hold on, we can rest tomorrow."

There are currently only 12 patients in the North Fifth District. If the North Sixth District is included, there are only 28 people in the two wards who are still hospitalized and their conditions are not serious.After being on duty in the ICU ward for two days this time, the first batch of members of the National Emergency Medical Team of Song'an Province who arrived in Yunhe were able to get a full three-day vacation.

There is another weapon that Sun Lien uses to boost morale, "Starting tomorrow, the hotel will routinely serve chicken soup and rice, and the supply is unlimited!"

The entire ICU ward was filled with excited discussions and hopes.Even a few hours later, Sun Lien could still hear the promises made by the team members to the patients - "When you get better, I will bring you some specialties from our hometown, chicken soup and rice, it's delicious!"

(End of this chapter)