This doctor has a system

Chapter 367 432. This is a stupid kid

This is true, Gao Feng thought to himself. He saved a young man's life. These 10 skill points were well spent.

Just lose some money this time.

"Your outstanding performance has been highly recognized by Xu Chengcai, Ma Liang, and others. You have received 23 skill points."

"You have received unparalleled gratitude from the family of Deng XX and gained 10 skill points."

Oh, no loss this time!
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"His second aunt, why are you here?" Gao Ma said enthusiastically.

The second aunt is a neighbor of Gao Feng's family, and the relationship has always been relatively good. When Gao's father and mother came, the keys to the house were all left in the second aunt's house.

"I'm bringing my grandson here to see a doctor." The second aunt said with a little sadness on her face. Her grandson is over 2 years old this year, and now is the time to run and jump.

But the second aunt recently discovered that something was wrong. Compared with others of the same age, her grandson seemed a bit stupid, and sometimes he would ignore people even when he barked several times.

The mother whose child works out of town searched on Baidu online and diagnosed herself with autism.

"Why don't you go to the Children's Hospital? It's more professional there." Gao Feng asked.

Gao Feng picked up his finger and flicked it on the child's forehead. He exerted a little force. The latter was eating an apple when he felt a sudden pain in his forehead and was startled.

Sandunzi is the nickname of the second aunt's son. He did not look very clever when he was young. Gao Feng even cheated others into eating candy.

The second aunt decided to take her grandson to the children's hospital for a check-up. In her heart, she felt that it was better to have autism, and the disease could at least be cured. How should I treat this stupid kid?

woo woo woo woo

After the second aunt left, Gao Ma held her little grandson and looked around.

His little mind was a little confused as to why he was beaten just now.

"Second Aunt, don't worry, the child is definitely not autistic."

Autism mainly manifests itself as social interaction impairment, communication impairment, and restricted, stereotyped, and repetitive behaviors. When you are hurt, you generally cannot seek protection or escape.

The second aunt's heart suddenly died.

"Oh, you don't understand." The second aunt took the little grandson's hand and said, "I was wondering if you were here, so I came here to take a look first."

The general practice clinic welcomed a 67-year-old male patient.

"Son, my grandson shouldn't be a stupid kid."

As he grows up, he looks much better, and he is what people often call an honest person.

"From intelligence to speech, he lags behind his peers. This is obviously a developmental delay." Gao Feng thought about it and said, "You must intervene as soon as possible, otherwise I may not be able to keep up with school in the future."

Gao Feng also noticed his second aunt's grandson. His growth seemed to be normal, and his height and weight were within the standard by visual inspection.

"That's definitely not the case." Before Gao Feng could speak, Gao's father was unhappy, "The kid from his second aunt's family just followed his father. You forgot, Sandunzi was stupid when he was a child."

"He doesn't know how to eat by himself yet," said the second aunt, "and he can't speak as smartly as anyone else."

The second aunt breathed a sigh of relief, and her hanging heart was finally relieved.

"It shouldn't be autism." Gao Feng said, "Look, he will seek protection and escape. Autism is not like this."

"I'm going to give the child a little test." He said to his second aunt, who naturally had no objection.

"He should be just a stupid kid." Gao Feng continued.

This is a tall and thin old man from the countryside. He seems to be in good health and often goes out to work.

The child looked at Gao Feng and took two steps back. He glanced around at everyone. When he saw that no one had any reaction, he quickly threw himself into grandma's arms.

But in the past two years, he often felt uncomfortable, sometimes sleepy, sometimes flustered, and each attack lasted from several minutes to dozens of minutes.

Worried that there was a heart problem, his daughter took him to the cardiology department first. The cardiology outpatient doctor performed myocardial enzyme test, electrocardiogram, cardiac ultrasound and other tests on him, but found no major problems.

The patient then had liver function, blood lipids, routine blood tests, and kidney function tests. The results showed that there were some abnormalities in transaminases, so he was sent to the gastroenterology department for a look.

But there were too many patients in the gastroenterology department, and the triage nurse suggested that they call a general department.

"Director Gao of the general practice is the best at treating these difficult and complicated diseases, and his level is very high." The nurse said to the patient and his family, "Let's go quickly."

Gao Feng looked at the patient's test results and found that the increase in transaminases was not very obvious.

肝损伤有九大原因：1.病毒性肝炎和非嗜肝病毒感染；2.酒精性肝损伤；3.药物或者毒素引起的肝损伤；4.脂肪肝；5.遗传和代谢性疾病引起的肝损伤；6.心脏和血管疾病引起的肝损伤；7.寄生虫病引起的肝损伤；8.自身免疫性疾病引起的肝损伤；9.不明原因引起的肝损伤。

After carefully asking about the medical history, Gao Feng learned that the patient drank two taels of white wine every day for many years. This situation requires vigilance for alcoholic liver disease.

Then he asked about his usual medication situation, and the patient told him that he needed to drink 5-6 packets of headache powder every day, and he would feel uncomfortable if he didn't drink it.

Drug addiction! Gao Feng thought of this situation immediately.

The patient's palpitation, lack of energy, and general discomfort should be due to drug addiction, which is also called headache powder addiction!

Headache powder contains caffeine, which can cause addiction if used for a long time. If you don’t use it, you will feel uncomfortable all over. This is the same as drug addiction!

"Why do you take headache powder?" Gao Feng was a little confused.

It turned out that the patient had difficulty working because of his old age. A fellow worker told him that taking headache powder not only cured headaches, but also reduced fatigue.

That's when he tried it, and it really worked! However, the dosage of the medicine increased from occasional consumption to 3 packets a day at the beginning. After more than three years, the dosage has reached 5-6 packets a day! You can't get by without it.

Gao Feng told him that he had to quit drinking and the headache powder also needed to be gradually reduced and eventually quit. Otherwise, in addition to being addictive, this headache powder will also damage the gastrointestinal mucosa and even the liver.

From his face, Gao Feng could see some embarrassment. Probably, quitting this "drug" was really difficult.

"Hey, it's not easy either." After the patient left, Li Youliang sighed.

At the age of 67, it is logical that it is time to enjoy their old age in peace, but in some rural areas with poor economic conditions, these elderly people still need to go out to work.

This situation may not change in the short term.

The next patient who came in was a 16-year-old high school student who was accompanied by his mother.

He suffered from repeated high fever for 4 days. He had previously been treated at the Provincial Hospital's Respiratory Medicine Clinic, where he took an influenza antigen test and was diagnosed with influenza A.

After taking oseltamivir capsules, my body temperature slowly dropped, but today I suddenly developed pain in my legs and was unable to walk normally.

This frightened the child's parents, so they quickly brought the patient over. "Director Gao, how could she have leg pain if she has influenza A?" The child's mother was very puzzled, "It's difficult to walk now!"

Gao Feng took a closer look at the patient and found that his mental state was okay. No obvious abnormalities were found during the physical examination. However, the patient complained of pain when his leg muscles were squeezed.

After asking about it, the patient's physical condition was generally good. Apart from suffering from influenza A, there was nothing special about him recently.

From the perspective of disease monism, Gao Feng considered that the patient's symptoms should still be caused by influenza A.

"Check the muscle enzymes." He suggested that the patient may have suffered skeletal muscle damage caused by influenza A. The patient's mother quickly took her child to have blood drawn.

The results came out more than 2 hours later. CK (creatine kinase) was greater than 1000IU/L and myoglobin was 1103ng/ml. The patient was finally diagnosed with rhabdomyolysis.

Rhabdomyolysis is a group of clinical symptoms in which muscle damage causes the destruction and disintegration of striated muscles, causing intramuscular components including creatine kinase, myoglobin, aldolase, lactate dehydrogenase and electrolytes to enter the extracellular fluid and blood circulation. syndrome.

The disease includes clinically asymptomatic creatine kinase elevation and life-threatening extreme creatine kinase elevation, electrolyte imbalance and acute kidney injury.

After learning of the diagnosis, the patient's mother was very worried. Gao Feng quickly comforted her and asked her to go to hospital now.

In this case, outpatient treatment is definitely unrealistic. If the condition changes, life may easily be in danger.

In fact, the patient's condition was quite serious. His pain in both legs actually worsened after he was admitted to hospital. Laboratory tests also revealed that his kidney function was also damaged.

However, due to the timely treatment, and after treatment with peramivir against influenza virus, rehydration, and correction of electrolyte imbalance, the patient's pain in both legs gradually decreased, he gradually returned to normal walking, and was eventually discharged from the hospital smoothly.

Z big laboratory

The progress in the laboratory has been rapid these days, and Gao Feng's "inadvertent" guidance has greatly accelerated the progress of the experiment.

Hu Jiaran was still in a daze, and the people below had already mentioned animal experiments.

"Animal experiment?"

"That's right." Yue Penghui said, "The recently synthesized substrate is very stable and basically consistent with what we expected. I think it can be entered into animal experiments."

"But it seems that everyone hasn't fully understood the antisense technology yet, right?" Dr. Lu next to him was a little doubtful. In his opinion, going directly into animal experiments was really a bit risky.

The high target specificity of antisense oligodeoxynucleotides surprised the participants. Everyone is still working hard to verify its principles. Dr. Lu believes that the technology should be thoroughly understood before moving forward.

"The technology must be thoroughly understood, but the trial progress cannot be stagnant." Hu Jiaran knew that his boss was eager to develop this drug.

"Let's do this. You pick a group of people to continue digging into the antisense technology, and the rest of the people will move forward according to the original plan." He made a decision quickly.

The subjects of animal experiments are still our old friends: mice.

The fate of these cute and fluffy animals seems to be very tragic. Because they are cheap, they are the first to be thought of in any experiment.

Unless they are really unsuitable, they cannot escape the fate of experimental subjects.

Qi Nannan came to the laboratory to help again. She has been happier recently.

There was nothing she could do about it, people were in high spirits during happy events. She had a good chat with Liu Zhuocang, who came for an interview some time ago. The two of them still had many topics in common.

From the chat, she felt that the other party was a bit old-fashioned and conservative, and the poor economic conditions made Liu Zhuocang a little over-mature.

But in Qi Nannan's view, this is not a shortcoming. She has good looks and a decent personality, which is most suitable for a girl like her with average looks.

Wait for me to take a closer look at it. If you really come to Z State, I’m afraid you won’t be able to escape from my clutches.

"The quality of these cuties is good." Qi Nannan said, gently stroking a white mouse.

"Aren't they all the same?" said a bespectacled employee next to him who was new to the job this year. "It looks like the size is about the same as the previous batch."

"There is still a difference. The hair of this batch is obviously more shiny." Qi Nannan picked it up for him to see, "You seem to be a bit bigger too."

As she spoke, she subconsciously pinched the white mouse's neck and gave it a strong squeeze.

Just hearing a "click", the little cutie became silent.

"Okay, you, you... what are you doing?" The new employee looked at her inexplicably.

"I'm sorry, I couldn't control my hands just now." Qi Nannan was a little embarrassed. She forgot that she was here to raise mice.

"It's not my fault, the neck of this gadget is too fragile." She forcefully explained to the employee wearing glasses, "If it were as thick as your neck, I would definitely break it off constantly."

She also wanted to touch the other person's neck.

"Sister, do you have some sense of boundaries?" She was shocked and stopped standing next to her.

I'm obviously younger than you, okay? Qi Nannan felt a little angry.

Little four-eyed dog!

The principle of animal experiments is not complicated. First, a group of mice with similar physiques are selected, then the value of SMN protein in the mice is measured, and an average value is obtained. Then everyone has to intrathecally inject the synthesis into the carefully selected mice. of substrate.

Wait for a period of time and then repeat the test to observe whether the SMN protein value increases.

The above is the work of most migrant workers in scientific research.

During this period, some mice will be selected and directly killed to detect the inclusion of exon 2 in the intrathecal SMN7 messenger ribonucleic acid (mRNA) transcript. This is the work of Dr. Lu, Zhao Kang and others.

However, the operation of intrathecal injection is not simple. Li Youliang also tried it several times, but the success rate was low.

They need to secure the mouse firmly to the operating table first. The mouse was placed on its back, and the skin of the injection area on the back was shaved and disinfected.

Use the thumb and index/middle finger of your non-dominant hand to grasp the iliac bone of the mouse and fix it on the surgical board in a clean table. At the same time, cover the upper body of the mouse with sterile gauze or towel to keep it calm. After grasping the mouse, maintain tension on the skin of the mouse's back between the thumb and index finger.

Use the thumb or index finger of your dominant hand to feel the intervertebral space at the midline of the bilateral iliac bones, and use your fingernail to make an indentation to indicate the intervertebral space at L5-L6 as the injection site.

Rotate the base of the tail slightly to indicate the midline of the spine. Before injection, adjust the bevel of the needle toward the animal's head.

How can I put it, it is somewhat similar to SM anyway.

(End of this chapter)