A doctor who travels through two eras

Chapter 313: Treating Tuberculosis with Traditional Chinese and Western Medicine

Pan Ye distributed the paper information of the two medicines to the first person present.

The overseas doctors from the two hospitals took the information with confusion and quickly browsed through it, wanting to see what the Chinese medicine hospitals could do.
Lin Sanqi continued to deceive:

“To be honest, I have a very strong medical team behind me, but don’t ask me where it is.

According to our team's research, if only the isoniazid + streptomycin model is used, the tuberculosis treatment rate is only 33%, less than half, and the side effects are very huge.

For example, operations on the liver and kidneys can cause strong ototoxicity and easily lead to deafness in patients, especially children.

In order to continue selling the drug, the streptomycin manufacturer has been covering up this serious side effect. You can find out this shocking inside story by simply going to a pediatric department and asking around.

It's not just the side effects. The course of this dual therapy takes about 24 months.

If you encounter stubborn tuberculosis, the course of the disease will be extended, which will not only increase the financial burden on the patient, but also make it difficult for some patients to bear the harm of related complications. After all, the longer the medication is used, the more toxic the drug is. "

The doctors who studied abroad nodded one after another, obviously having no objection to the views put forward by Lin Sanqi.

Lin Sanqi explained while moving slowly among the crowd, making sure everyone could hear what he said.

"So our team made a comprehensive reform based on isoniazid + streptomycin and found the quadruple therapy of isoniazid, rifampicin, pyrazinamide and ethambutol.

We found that the combination of these four drugs has a better effect and a shorter treatment period. Of course, this is not just empty talk. We have relevant data, which are all written in the materials. "

(The data is absolutely true, Lin Sanqi copied the existing information)

However, as people who have studied abroad and have a rigorous attitude towards modern medicine, the 20 doctors present at the Union Medical College and Digital Hospital were skeptical. They did not believe everything Lin Sanqi said.

Lin Sanqi didn't care. After all, every word he said and every piece of information he provided had been tested for decades. They were absolutely authoritative and credible, and could stand the test of time and clinical practice. So he was full of confidence:

"Regarding the two new drugs, rifampicin and ethambutol, I would like to briefly explain them here:
Rifocol is a broad-spectrum antibiotic that has a strong antibacterial effect against Mycobacterium tuberculosis and is also effective against Gram-positive or Gram-negative bacteria, viruses, etc. It is mainly used to treat tuberculosis, meningitis and Staphylococcus aureus infections.

Ethambutol is an antibacterial and anti-tuberculosis drug. Its mechanism of action is that it can penetrate into the mycobacteria and interfere with the synthesis of RNA, thereby inhibiting the reproduction of bacteria. It has a very clear inhibitory effect on mycobacteria in the growth and reproduction stage.

Let me give you another example. Isoniazid, rifampicin, pyrazinamide, and ethambutol, these four drugs, have their own responsibilities and roles in the treatment of tuberculosis. I will use the analogy of fighting a war to describe it:

For example, "isoniazid" is a pioneer in the fight against tuberculosis.

As a powerful anti-tuberculosis drug currently on the market, we first use isoniazid as the vanguard to attack the tuberculosis bacteria and bombard them to suppress the enemy's arrogance.

And "Rifampicin" can be regarded as the main force in treating tuberculosis.

Because rifampicin has a more comprehensive bactericidal effect, it even has a certain killing effect on some broad-spectrum drug-resistant bacteria. This drug is the key to killing large groups of Mycobacterium tuberculosis.

"Ethambutol" is a blocking force in the anti-tuberculosis program.

This is mainly because it will not produce poor drug resistance with other anti-tuberculosis drugs, that is, the treatment plan with it can enhance the efficacy of the entire treatment plan and delay the development of bacterial resistance.

If during the treatment process, you encounter stubborn tuberculosis bacteria trying to escape, ethambutol can eliminate them at the targeted point and prevent them from breaking out.

Finally, "pyrazinamide" is a scavenger among anti-tuberculosis drugs. Its biggest feature is that it can kill tuberculosis bacteria in cells.

Because tuberculosis bacteria are very tenacious, even if they are engulfed by the macrophages, the king of the immune system, they may still survive and proliferate, and even burst and kill the macrophages.

This is a rather terrifying ability, which means that tuberculosis bacteria can travel in the blood with the help of macrophages and spread throughout the body. Spreading to the brain and causing meningitis can be fatal.

Pyrazinamide is an antibiotic that can kill tuberculosis bacteria in every corner of the body, preventing deserters or any lurking troublemakers. It is a real scavenger.

Our research shows that if these four drugs are used in combination, the average patient can be completely cured in just 6 months, with a cure rate of almost 95%.

Of course you will say, didn’t you say it is 100% curable?

You are all Western medicine doctors, and you know that excessive use of antibiotics for a long time will lead to drug resistance. Among the four drugs I just mentioned, three are bactericidal drugs and one is an antibacterial drug. They will easily lead to drug resistance over time.

At this time, we need to use second-line drugs. We will talk about second-line drugs later. As long as we master the quadruple therapy, we can cure most tuberculosis. This is where my confidence comes from. "

After listening to this, the doctors who studied abroad were silent for a long time.

Everyone was evaluating the logic of these four medicines, as well as the loopholes in medical theory and pharmacology, but after thinking for a long time, they all felt that what Lin Sanqi said seemed very reliable.

At this time, Yang Guang couldn't help but raise his hand and asked:

“Director Lin, we have understood your explanation. Now there is only one question left. You have written so many clinical cure data, but you cannot provide the source of the data. Therefore, even if you publish the paper, it will not be recognized.

So we need your data in China, such as how many patients you have treated, what is the cure rate, etc. Of course, you can't just give us the data you say, this requires the patient's medical records, including chest X-rays, sputum culture reports, etc. "

As soon as Yang Guang said this, the other doctors nodded.

Lin Sanqi thought to himself, these 20 doctors were indeed not as easy to fool as the newly graduated college students and apprentices. No wonder they all ended up in a miserable state, because they would question every word others said, did not believe in authority, and bravely raised objections.

Perhaps in this era, people who are too sober are not popular.

But Lin Sanqi had received modern education and understood what tolerance meant, so he did not feel offended at all by Yang Guang's bluntness.

Lin Sanqi knew that it was the first day he met them and he could not convince them at all, nor could he establish his authority in one day.

What's more, he doesn't need this kind of authority worship. We are all doctors and independent individuals. There is no need for personality cult. As long as everyone does their best, it will be enough.

"Doctor Yang, this is a good question. Let me first tell you about the current situation in China. I have used quadruple therapy to treat 11 people, one of whom is my future father-in-law and the father of Comrade Pan Ye.

The result of this first case can be determined as recovery. Both the X-ray and the subsequent sputum examination confirmed the absence of tuberculosis. I have the specific case and examination form here and you can check them at any time.

Of course I know that one case does not mean anything, and there is a rare phenomenon that tuberculosis can heal itself.

So in our tuberculosis department, oh yes, everyone in the hospital is better to call themselves tuberculosis patients, and never talk about tuberculosis all the time. There is no other way. After all, we are a traditional Chinese medicine hospital. We have to listen to whoever feeds us, and we still have to reflect the characteristics of traditional Chinese medicine. "

Hehehe~~~
Everyone in the yard chuckled.

There is a Western medicine department in a traditional Chinese medicine hospital. This is the first time in China and everyone is quite curious about it.

"At present, our tuberculosis department has temporarily admitted 8 patients, 2 of whom are Ma Lianliang and Zhao Yanxia, ​​both famous actors. The other 8 are employees of our Chinese medicine hospital. After a month of treatment, they have achieved very good results.

Ma Lianliang's condition is more serious, reaching type II hematogenous disseminated pulmonary tuberculosis, so the treatment course is longer; while Zhao Yanxia has almost no clinical symptoms, which means she is an asymptomatic virus carrier. "

At this time, Bi Xinglong suddenly interrupted:
"Wait, Director Lin, you just mentioned type II hematogenous disseminated pulmonary tuberculosis. What kind of tuberculosis is this? We have never heard of it before."

Lin Sanqi blinked and looked at the other doctors: "You haven't heard of type II hematogenous disseminated pulmonary tuberculosis?"

"no!"

"There are Type II, and Type III and IV?"

Lin Sanqi nodded: “It’s true!”

Both sides stared at each other in amazement. Then Lin Sanqi understood that this was probably caused by the information gap between the two eras. In this era, the classification of tuberculosis should not have existed, or had not yet been formed?
Thinking of this, Lin Sanqi quietly took out a 2022 edition of "Infectious Diseases" from his backpack and turned to the fifteenth chapter "Tuberculosis". Sure enough, he found the following passage in the textbook:

"Based on the pathogenesis and clinical characteristics of tuberculosis, the Tuberculosis Branch of the Chinese Medical Association revised and formulated a new classification system for tuberculosis in my country in 1998."

There are five types in total: primary pulmonary tuberculosis (type I), hematogenously disseminated pulmonary tuberculosis (type II), secondary pulmonary tuberculosis (type III), tuberculous pleurisy (type IV), and extrapulmonary tuberculosis (type V).

Lin Sanqi could recite the five-type classification, but it was the first time he knew that the classification was not formulated until decades later.

Seeing that Lin Sanqi was in a daze, Pan Ye, who was sitting next to him, gently pushed him:
"Everyone is looking at you, why are you daydreaming?"

Lin Sanqi suddenly slapped his thigh:
"Okay, okay, okay, it's good to work with professionals. Look, our chat today can already publish several papers. For example, the research group on tuberculosis typing can publish more than ten papers."

Then Lin Sanqi became a little worried again. How could he publish his paper? There was no communication with developed countries these days, and he didn’t even have a way to submit his paper.

When the doctors from the two hospitals present heard the paper, their eyes widened.

Ordinary doctors only think about how to cure diseases, while higher-level doctors think about how to summarize the experience gained from treating diseases, or summarize the abnormal phenomena found in clinical practice through scientific research.

Then publish the paper.

The significance of a paper is not only that one can go down in history, but more importantly, it can be read by doctors all over the world, so that everyone can learn new knowledge and skills, and then apply them in clinical practice, thus jointly promoting the development of medicine.

Of course, the number of papers published and the level of medical journals can also reflect a doctor's status in the medical community.

Each of the 20 doctors present hopes to have his own research group and publish his own paper.

Bi Xinglong asked excitedly, "Director Lin, can we set up our own research group in the Chinese Medicine Hospital? Will the hospital allow it and provide funding?"

Lin Sanqi waved his hand and shook his head:

"Don't worry, don't worry. We will definitely set up a research group, but not now, and we don't need the hospital's consent. We can just organize it ourselves. What's important now is curing the disease. In your words, we need a large number of patients."

As soon as these words were spoken, everyone calmed down.

Yes, it is not that easy to do research projects. It requires equipment, funds and support from leaders. It is better to be down-to-earth and be a "worker".

Yang Guang stood up at this time, and then Cong Sheng, Fu Jinsheng, Jin Yuchun and nine other doctors also stood up:

"Please Director Lin give us the order. We will ensure that we complete the task."

The doctor from Union Hospital was quite embarrassed and quickly stood up: "Director Lin, we will do whatever you say."

Lin Sanqi knew that the people in the Digital Hospital might not necessarily believe in him, but they were better disciplined and more obedient, so they were willing to follow his orders.

The doctors at Union Hospital are under someone else's roof and have to bow their heads. Who knows what they are complaining about in their hearts.

Building trust requires a process and an opportunity.

“Okay, since we are all colleagues and senior doctors, I won’t be polite.

In this way, our 20 doctors will be divided into four wards, with five doctors in each ward. You will form your own teams and elect a department director. I have a thick skin and will temporarily serve as the director of the large ward.

In addition, I have 7 newly assigned college students here. They are both interns and department staff. Among them, Comrade Pan Ye is my fiancée, and I will be taking care of her personally. The remaining 6 college students will be divided into four departments.

There are also 24 soldiers from our traditional Chinese medicine hospital, 6 in each department.

These soldiers are like trainees. They have no medical knowledge and no foundation. I hope you can take on the responsibility of teaching them and help them become excellent medical workers."

The 20 overseas doctors all nodded in agreement.

Both the Union Hospital and the Digital Hospital have their own "medical schools", and these doctors usually supervise students, so this is not a difficult task for them.

Yang Guang asked: "So how do we proceed with our next work?"

Lin Sanqi gestured to Pan Ye again, and Pan Ye began to distribute materials again:
"You should all be able to operate the X-ray machine, blood cell analyzer, coagulation analyzer, and biochemical analyzer, right? I don't need to hire someone extra to do it, right?"

The crowd chuckled again: "Don't worry, Director Lin, we all know how to operate it. As long as there are parts, we can repair it ourselves."

Hehehe~~~
“Okay, as long as everyone knows how to operate it, it’s easy. The process for admitting patients is the same. After admission, a comprehensive examination is carried out and the condition is assessed. However, the treatment plan is different from other hospitals.

First, when you use this four-in-one medicine, don’t be fooled by the fact that it is a Chinese medicine pill. In fact, the real secret inside is a Western medicine pill. It is called ethamidine, pyrazine, and rifampicin tablets. I have combined four anti-tuberculosis drugs into one.

It is very simple to take Ethylamine, Pyrazine and Rifampicin Tablets. Just one pill a day is enough. You will write a doctor's prescription and the nurse will deliver it to the patient's bedside on a regular basis every day.

In addition, the rifampicin and ethambutol in Ethambutol-Pyrazine-Rifampicin Tablets are my personal patented drugs, which are still in the application process, so it is best to keep it confidential and announce it to the outside world as "Tuberculosis Pills" to prevent it from being stolen by patients with bad intentions for research.

Therefore, the nurses and interns will have to work hard and watch the patients swallow the medicine with their own eyes and not let them smuggle it out of the hospital without permission. If it flows overseas, my loss will be great and your thesis will be ruined.

Even worse, if our tuberculosis department can no longer operate, I can still pat my butt and continue to be the head of the purchasing department, but all of you here will be demoted to farmers to farm and herd sheep. "

Lin Sanqi said this with a smile, but his meaning was not polite at all.

People’s hearts are hard to predict, so we have to say some ugly things in advance.

"In addition, my Ethylamine, Pyrazine, and Rifampicin Tablets also have very serious side effects, such as damage to liver and kidney function, gastrointestinal reactions, and effects on the nervous system.

What Pan Ye just sent is the instructions for Ethylamine, Pyrazine and Rifampicin Tablets. You can take a careful look at it. You are all senior doctors and should know how to identify and treat.

Oh, regarding treatment, we need to give full play to the role of traditional Chinese medicine. For example, for the most common and most serious liver damage, such as a sharp increase in alanine aminotransferase, aspartate aminotransferase, and jaundice, we can seek help from traditional Chinese medicine.

I know some of you don’t believe in Chinese medicine and think it’s witchcraft, but I don’t think it’s necessary to be so extreme. Western medicine has its advantages, and Chinese medicine has its uses. We should give full play to the advantages of both medicines to better serve patients.”

In fact, even in 2013, Western medicine did not have any particularly good liver protection products. Commonly used products were polyene phosphatidylcholine, adenosine methionine, sulfopronin enteric-coated tablets, etc.

There are also mainstream Western medicines such as ursodeoxycholic acid, liver protection tablets, silybin capsules, compound glycyrrhizic acid injection, etc., which are all closely related to traditional Chinese medicine.

Therefore, among liver protection drugs, Chinese patent medicines occupy a considerable portion, such as Tianma Qufengbu Tablets, Qiju Dihuang Pills, Fuzheng Huayu Capsules, Ganluoxin Pills, etc.

However, the quality of Chinese patent medicines varies greatly. Many liver-protecting medicines actually increase the burden on the liver, which has caused many people to lose trust in traditional Chinese medicine.

Now that Lin Sanqi has the best "Twelve Men's Traditional Chinese Medicine Team" in his hands, it would be a waste of talent if he doesn't use it.

At that time, Western medicine kills bacteria, while Chinese medicine maintains health; Western medicine treats the root cause, while Chinese medicine treats the symptoms;

This is definitely the best way to integrate Chinese and Western medicine.

Soon, 20 doctors formed four tuberculosis wards.

The director of Ward 1 is Bi Xinglong from Union Hospital, and the director of Ward 2 is Cai Chunhua; the director of Ward 3 is Yang Guang from the Digital Hospital, and the director of Ward 4 is Fu Jinsheng.

These four directors were elected by the doctors themselves, including the head nurse and director of the nursing department. This free management style is very popular among doctors and nurses in the two hospitals.

However, every doctor has a question mark in his mind about how good the medical skills of Lin Sanqi, the director of the intensive care unit, are.

Then an accidental event made Lin Sanqi become a legend in the health system and quickly established his own authority.

In the master bedroom on the second floor of the Nordic Snow Country Embassy, ​​there were bursts of violent coughing...

(End of this chapter)