Start as an Emergency Physician

The sequelae of cyclosporine are all based on one patient by one, but where there is a certain sequelae, then there must have been such patients.

Although cyclosporine has improved survival rates, a small number of patients have become blind and affected for life, and some people have even died from it.

This is not unacceptable for some patients who have a heart and lung transplant, but it is a fatal blow for those who do not reach an advanced stage and whose organs are transplanted only to improve their quality of life.

Of course, for Chen Jianguo, a lung transplant had to be done.

The choice of immunosuppressants is also related to his life after the operation is completed, and the degree of immunosuppression should be controlled, and a balance should be found between reducing the probability of rejection and preventing foreign bacterial infection, so as to completely save Chen Jianguo.

Zhou Yuan didn't think about it for too long, this operation, which could have been completed in about eight and a half hours, was delayed by Zhou Yuan to ten hours, one of the reasons was that Zhou Yuan was evaluating Chen Jianguo's physical condition.

The choice of immunosuppressant must vary according to the patient's own situation, and there is no best, only the most suitable.

Zhou Yuan thought about it for a while, and then said methodically: "First carry out intravenous infusion of methylprednisolone, the specification is 0.5~1mg/(kg·d) for two days, then stop the infusion, and start oral prednisone at a dose of 0.5mg/(kg·d), and gradually reduce the dose." "

Methylprednisolone is an anti-inflammatory drug, which is mainly used for the rescue of critical diseases, and can also be used for endocrine disorders and so on. Of course, the most widely used is organ transplantation in clinical practice.

Reducing the amount of prednisone taken orally is to prevent complications from long-term use.

Zhou Yuan continued: "After oral administration, change azathioprine 1~2mg/(kg·d) to maintain a white blood cell count greater than 3.5×109/L. On the second day after surgery, oral cyclosporine 5 mg/(kg·12h) was started at the same time. Maintain plasma concentration at 250~300ng/ml. "

He did not use cyclosporine, which is the most widely used in clinical practice, and Chen Jianguo's body could no longer withstand serious complications.

Zhou Yuan chose some milder immunosuppressants, and also combined some other drugs to prevent serious low immune complications.

For example, oral cyclosporine, taken after immunosuppressants, can reduce nephrotoxicity and greatly reduce the harm of immunosuppressants to the body.

Jiang Li had surprise on his face, Zhou Yuan's medication method was very similar to Professor Chen Jingyu's, but he could feel that Zhou Yuan seemed to be better at handling details...

The head nurse who rushed to the scene was even more surprised, she had been dealing with postoperative care for 40 years, and she was very familiar with various drugs, and the administration method proposed by Zhou Yuan was definitely the most suitable for Chen Jianguo!

She nodded and wrote it down, and immediately pushed Chen Jianguo to prepare for nursing.

Of course, the head nurse only has experience in the nature of the drug, but if she is really asked to dispense and administer the medicine, it is still very difficult.

The division of labor between doctors and nurses is different, the doctor's order is prescribed by the doctor, and the nurse only follows the doctor's order, and their task is not only to carry out according to the doctor's order, but also to check the reasonableness of the doctor's order.

Therefore, the doctor is good at co-ordination, and the nurse mainly has amazing identification and review ability, she can see that Zhou Yuan's administration method is very appropriate, but if she wants to prescribe a medicine, I am afraid it is not as good as the senior attending physician.

"Doctor Zhou, Director Yuan and Dean Zhan are here, and they want to meet you. Jiang Li glanced at his phone and said.

Zhou Yuan originally planned to go back to rest, but when he heard Director Yuan, he was stunned for a moment: "Director Yuan Shao, Director Yuan?"

"Yes, you've seen him before, and he went to Yanjing to find you. "

Zhou Yuan twisted his somewhat stiff neck, nodded and followed Jiang Li to the conference room.

The conference room had already been emptied, leaving only Yuan Shao and Zhan Ting.

There was a knock on the door, Yuan Shao and Zhan Ting stood up at the same time, and when they looked at each other, they both saw the excitement in each other's eyes.

"Please come in. Zhan Ting, as the host, said.

Zhou Yuan and Jiang Li appeared at the door.

"Long time no see. Yuan Shao said hello to Zhou Yuan rarely.

Zhou Yuan smiled in return.

Jiang Li was very eye-catching, and said, "I'll leave first without me." "

As he spoke, he quietly closed the door of the conference room, and only Zhou Yuan and three people were left in the conference room.

"Sit down. Zhan Ting sat down first and said.

The three of them sat down, and Zhou Yuan was still a little confused.

How did you come across two national-level characters with a random throwing knife... One is from the Education Bureau and the other is from the Health and Family Planning Commission.

The Education Bureau has nothing to do with Zhou Yuan, but recently due to toe transplantation and thumb surgery, he occasionally came into contact with the textbook editorial committee.

However, the Health and Family Planning Commission is directly related to Zhou Yuan, and the hospitals across the country are under the management of VIA, and the doctors' jobs are in the hands of the Health and Family Planning Commission.

"There was a recent meeting on whether you would be interested in getting involved in the National Lung Transplant Program. Jantine said.

Yuan Shao next to him had already been prepared, but when he heard that Zhan Ting invited Zhou Yuan to participate in the meeting, he was still shocked in his heart!

Any plan, as long as it has something to do with the country, may be a great plan related to the livelihood of millions of people!

From a medical point of view, it may not be so amazing, but what about the "atomic bomb research program" and "nuclear submarine research program"?

The National Lung Transplant Program is on the same level as these programs!

As the chairman of the Health and Family Planning Commission, Zhan Ting specially invited someone, basically hoping that the other party would join the plan.

Medical research, which is not an old expert in fifty or sixty years old, an old scholar in his seventies or eighties dragging a half-old body out of the middle, young scholars and doctors have no experience at all and are not competent!

At Zhou Yuan's age, he was favored by Zhan Ting as a seedling of the national lung transplant program, which is definitely the first time!

Zhou Yuan was also a little flattered, he naturally knew the meaning of Zhan Ting's words.

However, Zhou Yuan has no interest in these things, and he only has one idea now, which is to refine the toe transplantation and reconstruct the thumb on hand, create a modified reconstruction after finger transplantation, and conduct in-depth research in psychiatry.

Zhan Ting seemed to see Zhou Yuan's thoughts, and immediately said, "We don't want you to be buried on the operating table!"

Yuan Shao's face was embarrassed, and he said: "I asked you to join the Medical Association of Country Z before, but you didn't go to the meeting at all, and those people were going crazy when they wanted to see you, and they looked at your sign every day at the meeting..."

Zhou Yuan: ???

Yuan Shao: "Oh, it's not a sign, a place will be reserved for you during a meeting, and the sign on it says your name." "

Zhou Yuan: ...

Zhan Ting pondered, and after a long time, he raised his head, stared at Zhou Yuan, and said in a solemn tone: "The national lung transplant program has been included in the country's future plan as a major scientific and technological project, and many scientists from country Z are committed to conquering this field of natural science, including academicians of the Chinese Academy of Sciences, lung transplant experts, physiologists, thoracic surgery experts, and so on. "