Since 1981 Health School

Chapter 653: Artificial Kidney + Artificial Liver

Chen Qi wanted to laugh seeing everyone's dejected look:

"Yes, it is hemodialysis, but artificial kidney technology like hemodialysis alone is not enough, and an artificial liver technology is also needed. The focus of treatment is not only to remove the arsenic toxin in the patient's body and blood, but also to let the patient There are liver cells that can grow back until they can regain their function."

Artificial liver + artificial kidney?

To doctors in the eighties, this sounded like fantasy.

Hemodialysis is understood as an artificial kidney, so what the hell is a worker's liver? What is the principle of operation? How about alternatives? Don't tell me you've seen it, you've never heard of it.

But it is a huge problem for others, but it is a very simple matter for Chen Qi.

Because whether it is a continuous renal replacement therapy dialysis machine (CRRT) or an artificial liver support system (ALSS), both of these machines are available in his space hospital.

This kind of thing that looked like black technology in the 1980s is a routine equipment in major hospitals in 2022, and the operation is also very simple and the degree of automation is very high.

But how to use these machines is a very headache for Chen Qi.

After all, these machines are all cross-generational, not to mention that they don’t exist in China, even in foreign countries. Such a large machine can’t be hidden even if you want to hide it. How can you explain that this thing suddenly appeared?

In case of being stabbed out, it will be another dispute, especially under the premise that some teams want to control everything, any accidents are not allowed by them.

It wasn't until after get off work in the afternoon that Chen Qi thought of a way to get the best of both worlds.

"Who was originally scheduled tonight?"

Wu Guoliang, a junior surgeon, and Yang Caisheng, a junior internal medicine doctor, raised their hands weakly: "Dean, we are on duty tonight."

Chen Qi chuckled and shook his hands:

"Let's go, let's count your luck. You don't need to be on duty tonight. Dr. Lan and I are on the night shift. In addition, let me tell everyone that Dr. Lan and I will be on the night shift for the next week. In addition Nursing class, Chen Li and Yang Xiuxiu work hard, and stay with us on the night shift for a week."

Wu Guoliang and Yang Caisheng couldn't believe their ears, because only the little doctor was on the night shift for the leader, but they had never heard of the dean's department director being on duty for the little doctor.

Is it possible that this is the dean's temptation? Can not be ignorant of flattery.

"Dean, we, we are on duty, there is no problem."

Chen Qi said sincerely: "It's okay, you usually work very hard. This time, let Dr. Lan and I do it for a week first, and then you go."

The two little doctors wanted to say something, but they were suddenly pulled gently by head nurse Liu, signaling them to listen to the dean.

As for Chen Li and Yang Xiuxiu, of course they have no objections. The dean named them to work the night shift. This was not to punish them, but to represent the dean's trust in them.

Because often when the African team is on the field, it is Dean Chen who has some technology or equipment that he does not want others to know.

This kind of trust can only be enjoyed by the confidant of the confidant.

Lan Lijuan is such a smart woman, once she heard her husband's arrangement, she knew that he must be making trouble in the middle of the night, so she also nodded:

"Then I'll go back first and settle down the two little ones before I come to work."

Chen Qi looked at his watch: "No hurry, come over after 9:00 p.m., I'll take care of it first."

The dean said so and arranged it. Whether the other doctors were curious or didn't care, they all got off work obediently. The dean's secret is not something outsiders can know casually.

When everyone left, they could still see Dean Chen thinking about several monitors.

At 8 o'clock in the evening, Lan Lijuan came over early with a few thermos buckets:

"Chen Qi, come here, this is the pork rib soup stewed by the elder sister for you, you have something to eat first, are we going to fight all night without sleep?"

As soon as Chen Qi picked up the spoon, it fell on the table, with a frightened expression on his face:

"Honey, don't scare me, we're all in the middle of the night, and my old waist can't bear it after a night of hard work."

"Bah, what are you thinking?" Lan Lijuan blushed.

Chen Qi chuckled, picked up the spoon and continued to drink the soup, while Lan Lijuan re-read the day's course record and examination report.

Waiting until midnight, when the handover of the hospital's night shift and the next night shift was completed, and the whole hospital was silent, Chen Qi stood up at this time, and then sneaked out of the ward.

After a while, Lan Lijuan, Yang Xiuxiu, and Chen Li, who were bewildered, saw Chen Qi pushing some kind of machine over, which was tightly wrapped with cloth.

"Don't just watch, push this machine in, Chen Li, you go and guard the door, no one else is allowed to enter or leave tonight."

Just as Lan Lijuan and Yang Xiuxiu took over the mysterious machine, Chen Qi went back outside again, and after a while, pushed another machine tightly wrapped in cloth.

When the two machines were pushed into Fu Zhenzhen's ward, Chen Qi took a piece of newspaper and blocked the glass on the door tightly.

Chen Li was guarding at the entrance of the inpatient department, and Yang Xiuxiu was guarding at the door of the ward. It was double insurance. There were only two people left in the ward, Chen Qi and Lan Lijuan, and Fu Zhenzhen who was in a coma.

Lan Lijuan was confused: "Chen Qi, who are these two machines?"

Chen Qi peeled off the two pieces of cloth with a swish, revealing two machines that Lan Lijuan had never seen before, which looked very complicated in structure.

"Lijuan, keep it secret. I smuggled these two machines in from abroad. They are still in the laboratory research and development stage, so they cannot be seen by outsiders. If the secrets are leaked, it will be very troublesome."

Lan Lijuan nodded, Chen Qi has always been elusive, and she can get all kinds of machines and medicines, she is no stranger to it.

"Look, this machine is an artificial liver, its full name is Artificial Liver Blood Purification Technology. Its function, as you can tell from the name, is to temporarily replace the damaged liver to perform various functions. This includes cleaning the liver jaundice and toxins, and supplement the coagulation factors and proteins that need to be synthesized by the liver itself.”

At this moment, Lan Lijuan's heart was already beating wildly with excitement.

Because she felt that she had come into contact with the world's top medical equipment, and the equipment that could replace the liver was extraordinary.

"Chen Qi, what is the working principle of this machine?"

"This stuff is simple and easy to say, but difficult to say. Let's describe it this way. Artificial liver blood purification technology refers to plasma replacement and blood adsorption technology, which means that inflammatory substances or toxins dissolved in the blood are absorbed to a body with a rich surface area. on solid matter.

Then the inflammatory substances and poisons are removed from the blood, so the artificial liver technology is specially used for blood detoxification. It uses the method of exchanging blood to remove the toxins in the patient's plasma, and replaces the toxin-containing plasma of the patient with healthy plasma, and replaces about 50% of the whole body's plasma each time.

Look at this whole set of equipment, which actually includes the principles of plasma exchange, hemodialysis, hemofiltration, blood plasma perfusion, molecular adsorption circulatory system, and continuous blood purification treatment, which is very, very complicated. "

In fact, Lan Lijuan could only understand half of it, and Chen Qi knew that too.

Chen Qi also removed a dialyzer, which was a long cylindrical shape. When opened, it was filled with tiny white filaments, like a Taoist whisk.

"Look, my wife, these white fibers are actually hollow inside. The principle of dialysis lies in it, just like pickled eggs. Think about it, we put salt around the eggs, After a while, the eggs will become salty, right?

This shows that the salt molecules can cross the egg shell and enter the egg. Based on this principle, we need to remove the toxins in the blood. This is the principle of diffusion. After we draw out the blood, the blood will go through this hollow fiber.

Then the dialysate goes from the outside. The wall of the hollow fiber is like an egg shell, with holes. Then the toxins in the blood enter the dialysate outside the hollow fiber through this hole, and finally the dialysate washes away the toxins. . "

Lan Lijuan still half-understands, she knows the general principle, but she knows how to do it in detail, this is a very complex project.

Chen Qi introduced himself excitedly.

"Look, my wife, this is a blood pump, this is an APF continuous blood filter, this is an albumin pump, this is a bilirubin absorber, this is activated carbon, and here, this is where the dialysate is installed, here It is the place where waste water is discharged.

The addition of this series of equipment is equivalent to a cycle to remove protein-bound and water-soluble toxins in the blood.

The equivalent of this machine is the liver, which removes a large amount of toxic substances from the body of patients with liver failure, and can replace the detoxification and metabolism of the damaged liver.

At the same time, it can also let her liver rest, and then let the liver cells slowly repair themselves.

After Lan Lijuan got excited, she heard another question:

"Chen Qi, according to you, the artificial liver can completely replace the artificial kidney, because the whole set of equipment for the artificial liver includes hemodialysis."

Chen Qi thought for a while and said:

"The basic principles are similar, but when you think about it, the main function of the liver is to detoxify, while the main function of the kidney is to detoxify. There is still a difference. Moreover, artificial lungs cannot be used for a long time, and there are still certain side effects."

Lan Lijuan is a physician, and her mind is more delicate, so she asked:

"Now there are artificial livers and artificial kidneys, but are there artificial lungs and artificial hearts?"

"Yes," Chen Qi replied without hesitation.

"The artificial lung can also be called Yekemo. The English full name is Extracorporeal Membrane Oxygenation, or ECMO for short. This thing is amazing. It can completely replace the heart and lungs. In theory, as long as you have money and keep using Yekemo, you can never die."

But expensive is really expensive. Once Ye Kemo is turned on, the start-up cost of this machine alone is 50,000.

Then use the minimum consumption of 20,000 per day, the general median is about 60,000, and the most expensive one day is 100,000, which is trivial.

Focus on the key points and take the test, this is the cost of one day.

If your grandfather has never climbed a snow-capped mountain, or your father does not have a coal mine, ordinary people simply cannot afford it.

There used to be a mayor in Wanwan Province, who was a doctor of intensive care medicine, and he was the famous "Ye Kemo expert".

Major domestic hospitals later introduced a large number of Ye Kemo, but too few doctors know how to use it, and it is regarded as the top high-tech equipment among medical equipment.

After Lan Lijuan heard Chen Qi's words, she didn't speak for a long time, but just looked at the two machines in front of her in a daze.

Chen Qi is relatively rough and has been fiddling with these two machines. Some dialysate and heparin need to be installed manually, so he didn't notice the abnormality of his wife.

It was only after a long time that Lan Lijuan said leisurely:

"Chen Qi, are you saying that the medical and technological gap between China and foreign countries is really that big?"

With the injection in his hand, Chen Qi didn't know how to answer for a moment, and he finally discovered his wife's loss of mood and inner self-doubt at this time.

"Well, how do you say this? If only in terms of medical equipment, our country is actually far behind. This kind of backwardness is in all aspects, and it is not only backward now, but will continue in the foreseeable next 40 years. behind.

But in terms of medical technology, our country is not completely backward. For example, the hepatobiliary surgery performed by Professor Wu Mengchao is absolutely world-class. Another example is the Helicobacter pylori project that you are leading, which is also a world-class level.

In addition, look at my endoscopy level, is it also world-class? Those foreigners have to go to Yuezhong to see a doctor, so we Hua people are not stupid. On the contrary, the Chinese people are too smart, too smart.

For example, the research and development of this dialysis machine may cost hundreds of millions, or even billions and tens of billions. Some people think that since I can buy it for hundreds of thousands or millions, why should I invest hundreds of millions? 100 million to research and develop? How good it is to save this money to eat, drink, and put it in your personal pocket.

Let’s use another analogy. Later, we were able to manufacture domestic hemodialysis instruments. The localization rate was 80% and we tried our best to brag about it. As a result, except for the outer shell, which was made by ourselves, all the core equipment inside were imported. , All of our high-tech instruments will be paralyzed. "

(As of 2022, hemodialysis equipment and consumables mainly include dialysis machines, dialyzers, perfusion sets, hemodialysis tubing, hemodialysis powder, etc., 90% of which are imported.)

Chen Qi is a reborn person. He has more than 30 years of memory ahead of this era, so he can see it more clearly.

The two couples sat on the chair together, worrying together, and Chen Qi once again raised his middle finger to those "foreign compradors" who advocate trade, industry and technology.

These traitors who lurk in the country and have a certain right to speak, finally let our country be choked by foreign countries at a critical moment and become quite passive.

At this time, the monitor suddenly issued a "beep beep" prompt sound, which awakened the couple from their deep thoughts.

Chen Qi slapped his forehead: "Damn, I almost forgot about the business because I was so worried about the country and the people. Come on, my wife, today I will teach you how to operate the artificial liver and artificial kidney for my husband. Let's fight all night!"