[Ding, new mission, use the treatment plan provided by the system to cure Xiao Yunyun, and at the same time launch a long-term controlled trial, and publish the research on the treatment of Kawasaki disease in the "Lancet" magazine. Mission reward: unlock 3 gold coin chess pieces, mission period, 6 moon

Special reminder: For chess pieces with 3 gold coins or above, in addition to surgical procedures above level 4, it also includes theoretical research on basic diseases and new drug formulas.】

Seeing the three-star chess piece, so powerful, Tanglou was very excited, but the most important thing now was to treat Xiao Yunyun first.

"Mr. Mu, Director Shen, I have indeed found out that Xiao Yunyun has Kawasaki disease before, and also attached a conventional treatment plan. If I could have confirmed the diagnosis as soon as Mr. Mu returned to the office, it would have been too late to start treatment. However, By a strange combination of circumstances, I happened to go to the orthopedics department for an operation, so I missed the best time for Xiao Yunyun's treatment."

Hearing what Tanglou said, Shen Bingbing blamed herself more and more. Mr. Mu also frowned and was in great pain. It would have been better if his condition had been discovered earlier.

When the master and the disciple were both blaming themselves and running out of ideas, Tang Lou quickly said: "Actually, there is not nothing we can do now."

"How to say?"

Shen Bingbing didn't care and grabbed Tang Lou's arm and looked at him expectantly.

"I also have a method to treat Xiao Yunyun, but it has not been clinically verified."

Tanglou directly signaled Shen Bingbing and Mr. Mu to sit at the desk together. He took a piece of paper from the side and started writing on the back. While writing the precise dosage of treatment, he explained to Mr. Mu and Shen Bingbing. .

"The conventional plan, which you both must know, is to treat patients with aspirin, which is to take 50 mg·kg-1·d-1 orally in 3 times. Then, according to the change in the child's body temperature, the drug dosage is appropriately reduced, 2 Reduce it to 3-5 mg/kg per day in about 8 weeks. On this basis, take gamma globulin treatment. The specific usage is: a dose of 2 g/kg gamma globulin is slowly infused intravenously for 8-12 hours. If the effect is not obvious, Keep it on and reuse it once."

After hearing Tanglou's precise explanation of the conventional treatment plan, Mr. Mu nodded.

Shen Bingbing also listened very attentively. At least so far, Tanglou's statement was very correct.

"However, now that I have missed the opportunity for treatment, I want to try methylprednisolone and gamma globulin treatment. The gamma globulin usage is the same as above; the methylprednisolone usage is: the dose is 2mg·kg-1·d-1, After continuous intravenous infusion for 5 days, switch to oral prednisone at 2 mg/kg per day for 14 days."

After Tanglou talked about the optimization plan, he also wrote down the medicines and their usage and dosage in his hand, and prescribed them to Director Shen.

Looking at Tanglou's plan, Shen Bingbing looked serious. She had never heard of methylprednisolone in the treatment of Kawasaki disease, but she still knew something about the drug: "Methylprednisolone is usually used for critical erythema. Lupus, also used in rheumatic diseases and allergic diseases."

Mr. Mu also added: "Methylprednisolone is also used in immunosuppressive treatments, including organ transplantation and blood diseases. It is even used to prevent nausea and vomiting caused by cancer chemotherapy. Generally, the scenarios where it is used are very critical. Ordinary doctors rarely dare to use it."

Mr. Mu and Shen Bingbing looked at Tanglou at the same time. It was very risky to propose a treatment plan that had not been clinically proven. At least, Tanglou had to convince them from the treatment mechanism.

Of course, Tang Lou also understands that surgery is no joke. The patient's death due to no known cause and the patient's death caused by the doctor's use of wrong drugs are completely different concepts.

Director Shen is not a passionate young man. He has no sure plan and would rather the patient not be cured.

Unless Tanglou can explain the truth, then they can negotiate with the patient. Now there is an original treatment plan, but there are risks. Of course, there is also a high possibility of cure. Only after the family members sign and agree can they dare to carry out treatment. .

Feeling the gazes of the two old doctors, Tanglou stopped wasting time:

"The cause of Kawasaki disease, which is mucocutaneous lymph node syndrome, is not completely clear. Clinically, it is generally believed to be an abnormal immune response caused by infection. After the disease, if it is not treated effectively in time, it may cause damage to the coronary arteries. , in severe cases, it may also lead to coronary artery aneurysm and thrombosis, which ultimately threaten the life safety of the child. Clinical treatment of this disease generally adopts drug treatment, and the common treatment options are gamma globulin and aspirin treatment. And it can achieve certain clinical effects."

“The principle is that gamma globulin can block the IgFc receptors on the surface of monocytes and vascular endothelial cells, and effectively block the IgFc receptor immune response, or produce a specific antibody to respond to antigens and toxins. Neutralize it, thereby promoting the recovery of the acute inflammatory response and alleviating damage to the coronary arteries."

Hearing Tanglou's detailed and professional explanation, both Shen Bingbing and Mr. Mu couldn't believe it. This was just the understanding of a young man under thirty years old, and this was just the beginning.

Tanglou spoke very quickly: "Aspirin can control cyclooxygenase and reduce the production of prostaglandins, so as to block the formation of platelet thromboxane A2; this drug has anti-platelet aggregation and anti-infection effects. ..”

When he heard this, Mr. Mu nodded in agreement. This is also the most commonly used treatment plan internationally.

"Then what is the principle of the improvement plan you mentioned?"

Mr. Mu is also very curious about the medical field and asked eagerly.

Tanglou nodded and continued to explain: "These two drugs can indeed achieve certain curative effects under normal circumstances. However, they have their own shortcomings, that is, the incidence of coronary artery disease is relatively high, and Xiao Yunyun because of If the diagnosis is misdiagnosed for too long, the coronary arteries will soon be in danger of dying. If simple and conventional treatments are used, it will not help at all."

"So you suggest adding methylprednisolone to the treatment of aspirin and gamma globulin, which can effectively avoid and reduce the occurrence of coronary artery disease."

Mr. Mu was more experienced than Shen Bingbing and immediately understood Tanglou’s intention of using methylprednisolone.

"Yes, and methylprednisolone can also play a role in reducing indicators such as white blood cell count (WBC), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in children."

Mr. Mu recalled that the comparison of patients who used methylprednisolone before and after treatment was indeed as Tang Lou said.

"Is this really enough?"

Mr. Mu still had some doubts.

Tanglou smiled slightly and said very confidently: "In the acute phase of children with mucocutaneous lymph node syndrome, the inflammatory response in the body will undergo abnormal changes, such as monocytes, macrophages, and T lymphocytes being abnormally activated, leading to inflammatory mediators Abnormal release of inflammatory cytokines, such as CRP; this situation can damage vascular endothelial cells to a certain extent and cause related inflammatory cells to be stimulated, followed by a vicious cycle, further exacerbating inflammation, and ultimately causing vascular endothelial cells to suffer from prolonged In a damaged state. In this regard, effective control of the inflammatory response and reduction of the release of inflammatory factors can have a positive impact on disease treatment. Methylprednisolone can play a positive role that cannot be ignored in controlling the inflammatory response. .”

Tang Lou’s last words finally shattered Mr. Mu’s suspicion. The old man stood up and held Tang Lou’s hand excitedly: “Yes, yes, methylprednisolone has significant effects on anti-inflammatory and immunosuppressive treatments. Curative effect. Bingbing, I think it works!"

"Bingbing, let's quickly communicate with the patient's family according to Dr. Xiao Tang's treatment plan and start treatment immediately. We hope the patient can recover within one course of treatment."

Mr. Mu stood up, pulled Shen Bingbing and rushed to the ward.

"Okay, okay."
Chapter completed!