I can see health

Chapter 783 Beriberi

"Beriberi? Moss feet?"

Jin Miao stared at Lu Chen in surprise, making sure Director Lu was not joking.

"Do you know the principle of beriberi?" Lu Chen asked back.

Jin Miao paused, and said slowly: "Beriberi is a thiamine deficiency, that is, vitamin B1 deficiency, a fungal infection of the beriberi and feet."

"Well, yes, I know this." Lu Chen nodded slightly.

Thiamine, or vitamin B1, is an essential cofactor for carbohydrate metabolism and energy production.

It is found primarily in beans, meats (except cured meats), brown rice, and grains made from whole grains, but in very low amounts in polished rice, dairy products, fruits, and vegetables.

"But, Director Lu, what does this have to do with the patient with heart failure just now?"

Jin Miao looked puzzled.

Beriberi, heart failure, can't get in touch at all!
Lu Chen smiled and continued: "Drinking alcohol for a long time and relying on high-calorie, low-nutrient convenience food will increase the risk of thiamine deficiency. Thiamine deficiency will affect the production of adenosine triphosphate and cause adenosine to accumulate in the body."

"I remembered. I learned it in school. Long-term consumption of rice flour can lead to thiamine deficiency. That's what I said!"

However, Jin Miao was still very puzzled.

"Director, even if he has thiamine deficiency, how can it be related to heart failure?"

Lu Chen said seriously: "You only know one thing, not the other."

"Thiamine deficiency, which can manifest as cognitive impairment (eg, Wernicke's encephalopathy), peripheral neuropathy (dry beriberi), heart failure (cardiovascular beriberi or wet beriberi)."

Jin Miao suddenly realized.

"That is, thiamine deficiency will cause various effects on different organs or systems?"

"That's the reason." Lu Chen nodded, "The patient's nervous system and heart failure are all caused by this!"

On the feet, that's beriberi.

On the heart, it is heart failure.

Nervously, it is Wernicke encephalopathy.

Wernicke's encephalopathy is a metabolic disease of the central nervous system caused by thiamine deficiency, which is common in chronic alcoholism. Symptoms include external ophthalmoplegia, mental abnormalities, and ataxia.

"But this is just my inference!" Lu Chen said, "This kind of cardiac change manifests as a decrease in ejection fraction, which is indistinguishable from dilated cardiomyopathy. Although myocardial edema seen with enhanced cardiac magnetic resonance T2 signal has certain value, this Such a change doesn’t happen very often.”

Although the system has popped up a reminder that the completion of the system upgrade has increased, which indicates that Lu Chen's diagnosis is correct, but clinically, evidence must be produced.

Jin Miao asked suspiciously, "Can't we identify them by testing the level of thiamine in the blood?"

Lu Chen shook his head slightly: "It can be tested, but the blood test has limitations in diagnosing thiamine deficiency."

"First, thiamine levels are greatly affected by recent calorie intake; second, thiamine levels in whole blood are less than 1% of the total body weight, and even reduced plasma thiamine levels cannot truly reflect thiamine deficiency."

"Although it can be checked by measuring the activity of erythrocyte transketulase, this test is not widely used."

"To put it simply, our hospital is temporarily unable to perform this test."

Jin Miao frowned: "Can't diagnose?"

Lu Chen smiled, "We can make a therapeutic diagnosis. Vitamin B1 costs 100 cents a piece, and it's not expensive. Take ten pieces ([-]mg) a day. It's water-soluble anyway, so you're not afraid of overdose."

"Okay." Jin Miao nodded immediately and began to issue medical orders.

"However, the treatment of heart failure still needs to continue." Lu Chen said, "While treating the symptoms, we should also cure the cause."

"Ah."

Although there is no diagnosis yet, Jin Miao already believes in this diagnosis in his heart.

After working under Lu Chen for so long, he knows Director Lu Chen's clinical ability too well.

Outsiders only know that Lu Chen is capable of TAVR surgery, but only Jin Miao knows that the most terrifying thing about Lu Chen is his clinical ability to solve cases.

No matter how complicated and difficult the medical records are, once in Lu Chen's hands, all kinds of clues will become clear immediately!

"Director Lu, you are really amazing!"

Jin Miao couldn't help but flattered her.

However, he was flattering from the bottom of his heart.

"Pay attention to those little details." Lu Chen smiled, "Don't ignore it, many clinical diagnoses are hidden in it."

"Yeah." Jin Miao nodded quickly.

"Digging deeper, some studies have found that heart failure may lead to thiamine deficiency, and supplementing thiamine may help improve left ventricular function and quality of life." Lu Chen laughed, "It's just possible, and there are still debates. You can research further and publish papers.”

Jin Miao's eyes lit up, isn't this a good research topic?
"Director Lu, if you have such an idea, why don't you study it yourself?"

Lu Chen smiled, "There are so many good topics, I don't have time to cover everything, I have to spend my time on the most valuable things."

"Yeah." Jin Miao nodded.

Since Director Lu Chen doesn't like this subject, he really likes it!

TAVR surgery has to be done, but the promotion still depends on the thesis!
He can't wait to go back to the dormitory now and start researching this "cardiovascular beriberi".

……

Lu Chen got off work, but received an unexpected call.

The caller ID showed a name I hadn't seen for a long time, Gu Xinyue.

"Old Gu?" Lu Chen answered the phone and asked.

"Lu Chen, are you in Guanghai?" Gu Xinyue's voice came, the voice was still a little cold.

"That's right." Lu Chen nodded and joked with a smile, "What's wrong? Do you want to join me?"

Unexpectedly, Gu Xinyue replied without hesitation: "Yes, I want to come to you."

"What?" Lu Chen was a little confused.

After graduating, Gu Xinyue stayed in a tertiary hospital in Kyoto. I heard that she was doing well. Why did she suddenly want to come to Guanghai?
"I want to come to your place." Gu Xinyue repeated again.

Lu Chen didn't ask the specific reason. He knew that Gu Xinyue might have something to hide, so he replied, "This year, we have a vacancy in the department. I can contact you for you, but the interview and examination procedures need to be carried out normally."

"No problem, I'll pack up and come over right away."

After saying this, Gu Xinyue hung up the phone, leaving Lu Chen with a confused face.

Coming to Guanghai in such a hurry, something must have happened!
Lu Chen thought for a while, then called Wang Zihao who was also in Kyoto.

When Wang Zihao returned from studying abroad, he also stayed in Kyoto to work.

"Lu Chen, didn't Lao Gu tell you about this?" Wang Zihao asked in surprise when he received a call from Lu Chen.

"We haven't had much contact recently, he didn't say anything!" Lu Chen said, "What happened, why did Lao Gu come to my place?"

"Oh, it's a long story..."

Lu Chen frowned, "Let's make a long story short."

Wang Zihao sighed, and said: "Lao Gu was cheated by the director of their department. One of the surgical patients in charge of the bed had an accident. The director was the surgeon, and he was the second assistant. In the end, the director pushed all the responsibility to Lao Gu!"

Hearing this, Lu Chen fell silent.

For this kind of thing, Lao Gu has no back, so he can only swallow his anger.

But when this happened, it would definitely be impossible to continue to stay in the department!
　I took some time to do physical therapy today, and my neck pain is much better.

　　Thank you for your concern.

　　
　
(End of this chapter)