Square dance, an activity that has its own "aunt" attribute and naturally has a "optimistic" characteristic, has become the focus of attention of the people across the country for a time.

There is an old Chinese saying that "singing and dancing brings peace". Usually it refers to everyone singing and dancing to celebrate peace. It is mainly used to describe a peaceful and prosperous era, and the people live and work in peace and happiness. But sometimes, it also refers to whitewashing the peace and numbing themselves with singing and dancing.

Sun Lien's concerns are similar to the deep meaning of this old saying. He has always been a little worried that encouraging severe patients to stand and move slightly may show some benefits in the short term. But in the long run, no one can say whether such changes will cause more serious problems in the patient.

The human body is really a too complex precision instrument. Even experts from other industries cannot assert that this measure will definitely be better or worse. Doctors can only take one step at a time and use the most stringent monitoring methods to ensure the safety of patients or allow them to be treated as soon as possible when problems arise.

Therefore, during the first "medical stand" process that began half an hour later, more than a dozen doctors standing outside the ward stood covetously. Two rescue vehicles, one with various rescue drugs on it, and the other with a defibrillator directly.

The patient in the room saw the doctors outside the door through the door, and he suddenly became a little nervous, "What are you... what are you doing?"

"It's okay, just pretend we are not here." The doctors quickly comforted each other, and then shrank to the difficult place at the door. Yuan Ping'an in the room put his hand behind him, waved his strength, and signaled his colleagues to hide away quickly.

The patient, who was half sitting on the bed, looked suspiciously, and then muttered, "I forgot why I stood up."

"You move slowly, sit by the bed for a while before getting up." Yuan Ping'an took the opportunity to emphasize the key points of getting up again to prevent falling. According to conventional rules, the patient should lie flat for one minute after waking up, then sit up by the bed for one minute, then slowly stand up and stand for one minute. Three minutes later, then start the activity. This set of actions is mainly to prevent the patient's hypotension caused by sudden changes in position. However, the "volunteer" who agreed to participate in the trial has woken up for a long time, and this was the first minute that he had avoided the previous one.

With the breath-holding attention of the doctors inside and outside the room, the patient stood up slowly with the walking machine.

It was like a child who was learning to walk again, shaking, but stood up happily.

·

·

·

Sun Lien did not pay attention to the patient's standing movement with other colleagues. He was called out of the red zone by a sudden call - he had been in Yunhe for so long. This was the first time Sun Lien left the red zone when the n95 mask had not entered the "must change time", and then took a bath and disinfected to return to the green zone.

The phone call from Sun Lien was from Liu Pingchuan. He is not in He'an Hospital now.

He, Chen Tianyang and Song Wen are in the High-tech Campus of Tongde Affiliated Hospital.

"What's the situation?" Sun Lien rushed to the green area and asked the head nurse Zhong Yu on duty, "Why are Dean Liu looking for me in such a hurry?"

The content of Dean Liu's phone call was conveyed by Zhong Yu. According to Nurse Zhong's feedback, Liu Pingchuan's voice on the phone sounded very anxious, and the content was very simple. "Let Sun Lien immediately come to the High-tech Branch of Tongde Hospital, and the car to pick him up was already on the way."

"I don't know either." Nurse Zhong shook his head very honestly, and then handed Sun Lien's cell phone over, "Why, Director Sun, you call Dean Liu directly, please ask?"

Sun Lien nodded. No matter what Liu Pingchuan was so anxious about, it would take as fast as twenty minutes to get from Yunhe Infectious Disease Hospital to the High-tech Zone. Taking advantage of this time, he would also be mentally prepared.

"The car has arrived?" Liu Pingchuan answered the phone and said quickly, "You ask the driver to drive quickly and rush to the hospital in the High-tech Zone as soon as possible."

"I just came out of the red zone and was walking downstairs." Sun Lien clamped the phone with his shoulders and ran out with his jacket in his hand. As soon as he ran two steps, he was grabbed by Nurse Zhong, and then another ordinary medical surgical mask was added to Sun Lien's arms.

"Bring the mask." Zhong Yu reminded him, then pushed Sun Lien on the back, "Be careful on the road."

Sun Lien, who was on the phone, couldn't say thank you to the head nurse. He speeded up his pace and put on a mask for himself in a very embarrassed posture.

"...So, what's the matter?" Sun Lien asked on the phone, "Do I need to bring anything over?"

"Don't bring anything, I'm asking you to come over to attend the consultation." Liu Pingchuan said after calming down a little, "There is a patient. Dean Song and I decided to ask you to come over to participate in the consultation."

"Is it the new coronavirus? Is it very sick?" Sun Lien asked with a frown. He did not think that his "talent" in diagnosis could be of much help to a patient whose diagnosis had been clear.

"It's a confirmed diagnosis, but not just a serious problem..." Liu Pingchuan sighed, "This patient is the director of He'an Hospital..."

He'an Hospital was notified on January 21 to be designated as a designated hospital, and the old hospital area must complete the renovation and begin to treat patients in the shortest time. From 4 pm on the 21st, Liu Lianzhi never left He'an Hospital again.

As the director, Director Liu Lianzhi, who was born in the Department of Neurosurgery, led all medical staff and logistics support personnel from all over the hospital to work hard. After working hard for three consecutive days without sleep, He'an Hospital finally completed the renovation of the ward before the prescribed time limit. After taking his colleagues to complete the renovation of the ward, the middle-aged man who had just celebrated his 51st birthday and had just recovered from a cold on the 20th first brought the doctors to conduct rounds and inspections on the entire treatment area for confirmed cases of new coronavirus infection.

This is a dean who is accustomed to standing on the front line and working hard with his colleagues.

However, on January 25, just after the first round, President Liu suddenly developed chest tightness, cough, fever and asthma. His pulse oxygen saturation dropped to 88%, and his blood oxygen saturation was still lower than 93% under the support of high flow oxygen.

Because he was a doctor and the head of the first hospital of the designated hospital, Liu Lianzhi quickly got the opportunity to have a PCR test. However, this test made almost everyone's heart tremble.

The nucleic acid test result is positive.

With a positive nucleic acid test result, and the resting finger pulse oxygen saturation is less than 93%. Dean Liu Lianzhi has been classified as a severe patient since his symptoms appeared.

He was taken to the isolation ward where he took his colleagues to urgently renovate. Even though he was feeling uncomfortable and exhausted, Director Liu was still working hard to maintain his working condition. As soon as he knew that he was diagnosed, he immediately called all his colleagues one by one. He also asked the hospital's hospital infection office to intervene and conduct nucleic acid tests on all colleagues who had close contact with him. Fortunately, the nucleic acid test results of others were negative.

In the ward, Director Liu's condition began to be as serious as other confirmed patients. But unlike other patients, his condition worsened very suddenly.

On February 8, after more than ten days of treatment, Liu Lianzhi's condition improved greatly. He was able to sit by the bed to handle official duties, and even carried a thermos to the water room to fetch water. No matter what the perspective is, President Liu Lianzhi's condition is improving rapidly. Although the area of ​​the lung shadow is still quite large, at least the symptoms are much milder.

At that time, Liu Lianzhi himself felt that he was almost healed. He even refused his wife's request to accompany him. His wife was working as the head nurse in the High-tech Campus of Tongde Affiliated Hospital in Yunhe City. During this period, the only request he made to his wife was to ask his wife to send some clothes to He'an Hospital on January 23. If He'an Hospital was recognized as a designated hospital, he might not be able to go home.

However, on February 9, at noon yesterday, Liu Lianzhi's condition suddenly worsened. His inflammation index was soaring rapidly, the level of interleukin-6 had reached 194pg/ml, while the c-reactive protein was 165mg/l. At the same time, his blood oxygen saturation began to drop rapidly. With the support of six liters of pure transnasal oxygen per minute, Liu Lianzhi's finger pulse oxygen level was only 87%.

Liu Pingchuan, who was in the Department of Critical Care Medicine at He'an Hospital, immediately treated Liu Lianzhi accordingly. The hormone had been given 4 mg per kilogram of body weight, but the inflammation indicators were still not available - he also had symptoms of arrhythmia and hyperkalemia.

Liu Lianzhi has a big problem. According to Liu Pingchuan, if you want to save Liu Lianzhi's life, you must provide ecmo life support and use triple therapy including tocilizumab for him to curb the inflammatory storm.

However... He'an Hospital does not have ecmo. And Liu Lianzhi himself is not very cooperative with the treatment. I don't know if it is a cognitive change caused by hypoxia or a doctor's "self-judgment", he has always been reluctant to accept a ventilator, but instead requires more bronchodilator and cough-relieving and sputum-relieving drugs.

Seeing that the request was not right, Liu Pingchuan decisively used diazepam for Liu Lianzhi to calm down, and then forced himself to go to a positive pressure ventilator. After at least, after increasing the oxygen saturation of his finger pulse to 91%, Liu Pingchuan immediately contacted Yunhe Health Commission for help.

A front-line doctor and the director of a designated hospital were infected... This is a big deal. Although the staff of the Health Commission were so tired that they were all unknowingly, they could still react. How important is the cure of Liu Lianzhi.

If Lao Liu takes it safely, this will be an encouragement to all medical staff. If Lao Liu makes a mistake... the staff who have been on the front line will feel so uncomfortable?

He was a doctor, the director of a hospital, the backbone of hundreds or thousands of people, and the comrades who moved forward together in the fire of artillery. If even our comrades can't be taken back, then what did we come here for?

Liu Pingchuan thought this way. He is not a person who is easily influenced by his emotions, but this time, Liu Pingchuan felt that the superficial temporal artery on his head, along with the paracentric and forehead branches, were jumping. In any case, he must grab Lao Liu back.

With the help and coordination of the staff of Yunhe Municipal Health Commission, Liu Pingchuan personally led the team to the team and sent this colleague who was in neurosurgery like himself to the High-tech Campus of Tongde Affiliated Hospital. Afterwards, he called directly to convene members of Yunhe in the Joint Meeting of Experts of the Song'an Provincial Medical Team.

The national team that took over Tongde Hospital High-tech Zone was the national team. Nurses from four top hospitals in the capital, including Tonghui Hospital, and the medical team in the southern Henan Province were here to treat patients. This campus also became the top hospital with the highest medical level and medical power in the entire Yunhe.

When the car that picked up Sun Lien was parked at the entrance of the High-tech Campus, Sun Lien felt that his legs were a little weak after a long time. He took a deep breath through the mask, and then walked into the hospital gate with big strides - the next battle would not be easy, and he only hoped that his best efforts would be able to regain a glimmer of life for the President Liu, whom he had never met.

·

·

·

When Sun Lien arrived at the conference room on the fourth floor, the atmosphere in the conference room was very solemn.

"His problem now is not just an inflammation storm." The bald man who knocked on the table and emphasized the problem looked familiar. Sun Lien narrowed his eyes and identified it for a few seconds before he found out that this was indeed an acquaintance - Zhu Minhua, the chief director of the emergency department of the association.

Professor Zhu knocked on the table and said, "The most urgent task now is to stabilize its circulation system. Only when the circulation is stabilized will we have the conditions to carry out the subsequent treatment. If you can't stabilize the circulation, turn around and get immunity. What are you doing with immunity? No matter how big the immunity problem is, you won't die in a day!"

"Liu Lianzhi is already 51 years old. If he has immunity problems in his current situation, the risk of cardiovascular and cerebrovascular diseases is very high." Liu Pingchuan and his former junior brother were in a tit-for-tat way. "It's not that he doesn't engage in circulation, but that he is also stabilizing the circulation!"

Sun Lien quietly walked to Chen Tianyang and sat down. He looked at the inspection indicator data projected by the projector on the wall and the monitoring instrument data on the LCD TV in the conference room and asked, "What's the situation now?"

"I am preparing to go to ecmo, and Zhu Minhua and Liu Pingchuan are quarreling." Chen Tianyang said concisely, "Lao Liu asked for a plasma replacement immediately to cut off the ongoing inflammation storm. However, Zhu Minhua believes that the operation is too risky. Once a dialysis reaction occurs, Liu Lianzhi's blood pressure may not be able to be held back."

"Is tocilizumab effective?" Sun Lien asked frowned. Just looking at the interleukin-6 level of the test indicators, it is hard to believe that Liu Lianzhi had used tocilizumab - this drug is a very efficient interleukin-6 receptor monoclonal antibody. Logically speaking, even after using it once, Liu Lianzhi's inflammation indicator should not be so high.

"As I just discussed, the current consensus is that Lao Liu's response to tocilizumab is not very good, maybe because the main mediator of his inflammation storm is not interleukin-6." Chen Tianyang shook his head, "But the hormone effect is not good, and 240 mg has been used..."

"That is to say, the current verification substances mediating the inflammatory storm are not sensitive to glucocorticoids and have no effect on tocilizumab..." Sun Lien frowned and thought for a while and asked, "Is it interleukin-2?"

"The examination is being added, but we all think it should be." Chen Tianyang nodded, "so Lao Liu asked for a plasma replacement as soon as possible." He sighed and said, "I just suggested using a little senipi, but they all disagree."

Cenipel is a monoclonal antibody against interleukin-2 receptors, and its effect is actually similar to tocilizumab. It is usually used in clinical practice mainly for immunosuppression after liver transplantation. Chen Tianyang's suggestion was rejected very well - using Cenipel at the moment when glucocorticoids have been used to 240 mg will greatly increase the risk of rapid virus proliferation. The poor effect of glucocorticoids is now because the level of interleukin-2 is too high. However, if Cenipel is used to inhibit the concentration and effect of interleukin-2, the effect of glucocorticoids may increase exponentially. Such consequences are unbearable to Liu Lianzhi now.
Chapter completed!