I can see health

Chapter 822 Absolute Evidence!

Oncology.

show the classroom.

At this moment, everyone's attention was on Lu Chen.

Those who are familiar with Lu Chen, those who are not familiar with Lu Chen, are looking forward to what different opinions will come from Lu Chen's mouth?

Director Tang of the oncology department looked at Lu Chen with burning eyes.

No one knew that he and Professor Ouyang were actually close friends.

During the usual gatherings, Professor Ouyangming mentioned Lu Chen to him many times.

Director Tang was naturally very curious about this outstanding young man.

It was brought up in public today, and Lu Chen will be the last to answer this question.

In addition to the test, it is more of a help!
Those present here are all directors or deputy directors of various departments, showing their faces in front of everyone.

There are not many opportunities like this!

Naturally, Lu Chen didn't know the hidden story behind this.

For him, no matter what the reason, he is willing to accept the challenge.

The condition of the tumor patient in front of him was just a small challenge for him.

What Lu Chen is most afraid of is diagnosis!

His system comes with a "diagnostic" function.

Only when the diagnosis is correct, the system will pop up a prompt.

Therefore, in Lu Chen's mind, he had already thought about most of the diagnosis possibilities.

As long as the diagnosis of this patient exists in the current medical field, then Lu Chen can diagnose it.

……

Lu Chen stood up and looked around at everyone.

"It's a great honor to stand here today and share my views on this patient with you."

"Director Huang was right before. This patient can't rule out coronary heart disease just from the symptoms of dyspnea, electrocardiogram, and troponin."

Director Tang was slightly disappointed.

He originally thought that Lu Chen had some special opinion, but he didn't expect it to be the same!

At this time, Lu Chen changed the topic, "However, my next opinion may be different from Director Huang's!"

"Huh?" Director Tang frowned, becoming interested.

In the demonstration classroom, the other doctors also turned their attention to Lu Chen again.

"The patient's coronary artery CTA showed that the anterior stenosis was only 40% narrowed." Lu Chen said slowly, "From the analysis of the mechanism of coronary heart disease, this degree of stenosis will definitely not cause serious symptoms, such as myocardial infarction. , heart failure, etc.”

"In this regard, Director Huang's opinion is that the coronary microcirculation is an obstacle, but I think that any disease must first start with a monistic idea!"

Medical monism, in simple terms, is to use one disease to explain all the symptoms and signs!
Huang Xiaofeng heard the words and couldn't help interrupting: "Director Lu, what is the relationship between tumors and heart disease? I think it is very likely that the patient may have coronary heart disease before, but the symptoms are not obvious After getting a tumor, the body suffered a trauma, which aggravated the coronary heart disease!"

Huang Xiaofeng's remarks are not without reason.

Many doctors present echoed and agreed with this view.

Lu Chen smiled, "I don't deny Director Huang's idea. But I want to put forward some small opinions of my own!"

"Okay, tell me, let's all listen!"

Huang Xiaofeng looked at Lu Chen, wanting to see what other reasons this young man could come up with? !
Lu Chen stopped paying attention to Huang Xiaofeng, but walked up to the stage, came to the bed doctor's place, and operated the PPT projection of the projector.

He first returned the PPT to the interface of the three electrocardiograms.

Everyone is a little puzzled, haven't you seen this picture just now?

Why read it again?
Just listen to Lu Chen slowly said: "All auxiliary examinations must be fully combined with clinical significance to be meaningful."

"Director Huang is right. These three ECGs look like very typical myocardial infarction ECGs. The first and second ECGs are AVR, V1-V3, V3R-V5R lead ST-segment elevation, and the whole vector is going to Right deviation, very much like a left main lesion."

"The third ECG showed extensive ST elevation in the precordial and inferior leads, which also looked very similar to a myocardial infarction."

"In the above two cases, if it is a myocardial infarction, it must be a very serious myocardial infarction. Then, the patient has no symptoms of progressive ischemia, no obvious chest pain, and no very dangerous clinical manifestations!"

Lu Chen paused, "In other words, the electrocardiogram is seriously inconsistent with the clinical symptoms! This shows that the diagnosis of coronary heart disease is in the wrong direction!"

After Lu Chen finished speaking, the audience fell silent!
No one expected that this young Director Lu would directly overturn Director Huang Xiaofeng's diagnosis!

Coronary heart disease diagnosis...wrong!
This left everyone dumbfounded.

Director Tang of the oncology department became more and more excited as he listened.

Although Lu Chen didn't finish speaking, he could feel the confidence in Lu Chen's words.

This confidence is something that no one else present has.

The people that Professor Ou Yangming admired are really two brushes!

"Did everyone overlook a very important thing?" Lu Chen continued, "The patient is a tumor patient, and is undergoing targeted therapy and immunotherapy!"

"I guess, this patient is likely to have myocarditis caused by immunotherapy!"

As soon as the voice fell, the system popped up a reminder.

"Congratulations, the completion of the system upgrade has increased!"

At the same time, everyone present was puzzled.

"Myocarditis induced by tumor immunotherapy?"

Everyone knows about myocarditis, but myocarditis caused by immunotherapy...

This is beyond their cognition!

Even for oncologists, they have never heard of it!
"Director Lu, can you explain this disease to everyone." Director Tang said quickly.

"Okay, no problem." Lu Chen nodded slightly, then took out his phone.

Everyone was a little confused, only to see that Lu Chen connected his mobile phone to the projector.

Lu Chen began to introduce: "This is a document I read last month, which was published in The Lancet."

The papers are all in English, but everyone is a bigwig in the medical industry, so it is not difficult for them.

"This paper is to study the side effects of immunotherapy. Immune myocarditis, as the name suggests, is a drug for tumor immunotherapy. While treating the tumor, it will also damage the patient's cardiomyocytes!" Lu Chen picked out the key point of the paper, " Among the many adverse reactions, myocarditis caused by immunotherapy is a side effect that doctors are very unwilling to see."

The incidence of immune myocarditis is 0.06%-3.8%.

Although the incidence rate is relatively low, it has the characteristics of high lethality.

The fatality rate of immune myocarditis is as high as 39.7%-50%!Once it happens, nearly half of them will be life-threatening.

"After reading this article, let's read the second article!" Lu Chen switched to another article, "This paper is also published in the New England Journal, the top journal in the cardiovascular field."

"Researchers warn patients using immunotherapy to be highly vigilant against the occurrence of immune myocarditis. Since the symptoms of this adverse reaction are not specific, it is easy to be ignored or mistaken for other underlying diseases!"

After reading the two documents, there was no sound in the classroom.

What makes you awesome is not how good you are.

But after telling your reasons, you can find the corresponding evidence!

Compared with Lu Chen, Huang Xiaofeng's diagnosis now pales in power.

Director Tang smiled gratifiedly, but he felt a little more sad in his heart.

The good news is that this young man, Lu Chen, is really extraordinary!
Sadly, Huaxia's research still lags behind foreign countries after all!
When will this situation be reversed?
Director Tang looked at Lu Chen in front of him, feeling hopeful for no reason.

　Myocarditis caused by immune check inhibitors has been raised in China in recent years.

　　The country's first guidelines were issued last year.

　　The content written in the article lags behind the reality.

　　After all, I can't invent a new research field out of thin air.

　　
　
(End of this chapter)