Chapter 235: The strongest treatment is autoimmunity, which made the patient cry
"After being infected with Salmonella, rehydration alone cannot solve the problem. Some patients can fight it with their own immunity, while others will become seriously ill and die for various reasons. Therefore, medication must be used when necessary."
As soon as Director Shang finished speaking, the family members nearby were frightened.
"Professor Shang, you must save my husband. Our family cannot live without him." The family members must be regretting their decision now.
Little did she know that secretly giving her husband a bowl of chicken soup would have such serious consequences!
When she thought about the possibility of her husband's death, she couldn't stop her tears from flowing.
"Don't cry, don't cry! I'm teaching my doctors how to treat this disease. Although your husband's condition looks serious, it was discovered in time and his condition is still under control. I believe he will get better soon after taking the medicine."
Director Shang tried his best to explain to the family members and comfort their sadness and panic.
"Doctor Yu, I must praise you again. You were able to discover the patient's abnormality immediately and promptly and accurately diagnosed the patient with Salmonella infection. This shows that you are not only very responsible, but also have made great progress in your medical skills."
After comforting the family members, Director Shang praised Yu Xin again.
He also intended to let Zhou Can know that he had more than one capable trainee under him.
It is equivalent to killing Zhou Can's arrogance.
The main reason was that Zhou Can's performance was too eye-catching and he made great achievements one after another. He was worried that this would encourage Zhou Can's pride and be detrimental to his growth.
Yu Xin looked embarrassed.
It was not she who diagnosed the patient with Salmonella.
With her current diagnostic level, she is simply not capable of diagnosing such a complex cause of the disease.
"I……"
She gritted her teeth and prepared to confess the truth.
All the pretense of being rich is ultimately empty talk.
"What's wrong?"
Director Shang looked puzzled, she was never so shy normally.
"Professor Shang, he was actually the doctor who diagnosed my husband with that bacteria. But this Doctor Yu is also very serious and responsible, and he is very attentive to my husband's treatment."
The family members helped to tell the truth.
After hearing this, Director Shang understood it instantly.
After all the fuss, it turned out that Zhou Can was the one who made the contribution. I was thinking of putting some pressure on this kid by praising Yu Xin.
I'm afraid this time it will have the opposite effect.
He was also a boss who had experienced many ups and downs. He remained calm and naturally turned his head to look at Zhou Can who was standing at the end of the bed.
"Isn't this patient in the care of Doctor Yu? How did you manage to diagnose him?"
"I just gave some suggestions. The diagnosis should coincide with Dr. Yu's. At that time, Dr. Yu had clearly diagnosed the cause of the disease, but seeing that the patient's condition was not good, for the sake of safety, he followed your chief physician's consultation mode of gathering the wisdom of many people. He asked Dr. Duan Zifu and I to consult together."
Zhou Can doesn't lack this little credit at all.
I decided to help her out, made up a good promise, and gave all the credit to her.
After hearing this, Director Shang showed a happy expression on his face.
"Well, you did a great job. With the help of collective wisdom and joint consultation, we can indeed greatly avoid misdiagnosis and missed diagnosis."
Yu Xin, who was standing nearby, was still thinking about how to explain it in a way that would save face.
Unexpectedly, Zhou Can came up with an almost perfect excuse.
In this way, no matter how much Director Shang interrogates her, her contribution will not be shaken.
There is no need to worry about being found out by Director Shang and being considered to have deceived him.
Yu Xin looked at Zhou Can with gratitude.
The latter smiled and winked at her.
"Doctor Zhou, do you know the pathogenic mechanism of Salmonella?" Director Shang asked him.
Probably they wanted to test his basic medical skills.
If it were in the past, Zhou Can might have given a perfunctory answer. But now, the medical knowledge he had learned was not given in vain.
"There are many types of Salmonella. They can parasitize in chickens, cats, ducks and other livestock and poultry. Chickens are the main intermediate hosts of Salmonella. They can live peacefully with chickens in their bodies. But after being eaten by humans, Salmonella can effectively resist the erosion of gastric acid with its strong defense ability."
"After being baptized by gastric acid and entering the human intestines with the peristalsis of muscles, they immediately find a breeding ground. They will quickly penetrate into the cells of the human intestinal wall, divide wildly, and multiply in large numbers. In just about two hours, the cells infected by Salmonella will die. At this time, the Salmonella bacteria will drill out of the dead cells, spread around, and then use the same method to frantically destroy the normal cells of the human body and multiply in large numbers."
In order to understand the pathological mechanism of Salmonella, Zhou Can even looked up professional materials.
We can clearly see every destructive process it undergoes after entering the human body, as well as the response of the body's defense mechanism.
"Salmonella multiplies very quickly in the human body, increasing three to four times in number in an hour. Once a thousand salmonella enter the human intestine, it only takes seven or eight hours for the number to grow to more than one million. After another hour, that is, about nine hours, the number can reach an astonishing four million. Such a large group of bacteria will frantically kill normal cells in the human body in the intestine, which will trigger the body's immune response mechanism."
"When normal cells in the human body die, they release a chemical alarm signal. At this time, the human immune system receives the alarm signal and quickly mobilizes the macrophages in the human body to fight back against the invading bacteria. Macrophages can automatically capture the invading bacteria and release a deadly liquid to melt them back."
After listening to Zhou Can's detailed explanation, Director Shang's face showed satisfaction.
He kept nodding and listened to Zhou Can continue.
Dr. Yu also admired Zhou Can's solid medical foundation.
"If it is a common bacterium, it will be killed quickly after being captured by macrophages . But Salmonella has a powerful secret weapon. It can also release unique chemical signals that make macrophages helpless against it. In other words, the chemical signals they release are more like an invisibility cloak that can make macrophages blind."
"At this point, the macrophages lose their function and become even more rampant. They continue to frantically destroy normal cells in the human body and reproduce in large numbers. As the Salmonella completely loses control in the intestines, more and more normal cells die and the alarm signals released become stronger and stronger. The intestines will then have an instinctive self-protection response."
"This reaction is somewhat similar to enteritis. The patient will feel nausea and abdominal pain. The fluid in the stomach will reflux, and the patient will feel stuffy and eventually vomit violently, expelling some salmonella. At the same time, the intestines will speed up peristalsis, water will gather at the bottom of the intestines, and the patient will have severe diarrhea. Diarrhea will also help expel some salmonella."
The patient in bed 73 had experienced all the symptoms Zhou Can described.
"Doctor, if I vomit and have diarrhea and expel the germs, will my illness be cured?"
The patient asked weakly.
"Vomiting and diarrhea are responses of the body's self-protection mechanism. They can only clear out some Salmonella, but cannot completely eliminate them. They will rapidly multiply again in the body and kill a large number of normal cells. At this time, the patient will feel severe abdominal cramps. This also indicates that more and more normal cells are being killed in the patient's body."
"The chemicals released by a large number of dying cells trigger the body's third protective response. As those chemicals enter the blood, they quickly cause muscle tissue to swell. At this time, the body's helper cells sense the danger to the body and will form an army to rush out to help the body fight the invading bacteria."
"But those helper cells will not kill the Salmonella directly because they do not have the ability to do so. The helper cells will rush to those macrophages that have lost their activity and are like blind and stupid people. They will produce a special chemical substance to help the macrophages regain their activity and double their size. At this time, the macrophages will be like a cheat, and they will secrete some strong venom to quickly kill the Salmonella in the body."
"So, in theory, the human body does not need any drugs and can completely rely on its own immune system to eliminate the invading Salmonella. However, this time may last two to three days."
Zhou Can analyzed all the pathological mechanisms, including the body's response mechanism.
He looked at Director Shang.
"You only gave the patient fluids, but did not rush to use medication. You wanted to wait and see. You wanted to allow the patient's immune system to have a third-level response and then eliminate the Salmonella, right?"
Zhou Can roughly guessed Director Shang's treatment idea.
"clever!"
Director Shang smiled and nodded, his eyes full of admiration.
“For any disease, whether it’s medicine or surgery, all the treatment methods doctors use are not as powerful as the patient’s own immune system. I can tell you that doctors cannot cure more than 90% of the diseases in the world. What can really cure diseases is the human immune system.”
This treatment concept was not the first time Zhou Can had heard of it.
Anyone who studies medicine knows that the cure for most diseases depends on the human immune system.
It beats all medicine.
Ancient Chinese traditional Chinese medicine practitioners may have known the secrets of the human immune system long ago.
Traditional Chinese medicine focuses on the balance of yin and yang.
This is very close to the immune system regulation in modern medicine.
"Professor Shang , what you mean is that my husband doesn't need any medication to get better, right?" Although the family members did not understand these profound medical principles, they understood the general meaning.
"It's hard to say for now. First, correct the dehydration and electrolyte imbalance. Then observe closely and ask the patient to keep warm and rest in bed. It would be best if the body's own immune system can eliminate the invading Salmonella. If the disease progresses rapidly or changes, I will give him medication in time. Please rest assured about this."
Director Shang gave the family members a guarantee to put their minds at ease.
Otherwise, if the patient is so sick and the hospital refuses to give medication, both the family members and the patient will easily become anxious.
"Doctor Yu, please keep a close eye on this patient. If the chills are severe, or if there are other major changes in physical signs or symptoms, please report to me immediately."
Director Shang reminded Yu Xin.
This also shows how important the interns and trainees under the chief physician are. If there is a shortage of manpower, will the chief physician keep an eye on the patients himself?
They are so busy that it is obviously impossible.
Now we have a resident trainee assigned to keep an eye on the patient, so the chief physician can free up time to treat other patients.
"Your nursing department should also pay more attention to this patient and let him get through these two days."
Director Shang also gave instructions to the head nurse.
"Please rest assured, our nursing department will take this seriously." The head nurse's status is not as high as that of the head nurse and the chief nurse, so she is not as confident when speaking.
The attitude is quite correct.
"Doctor Zhou, come with me to see the patient in bed 71."
Director Shang took Zhou Can to bed 71 and asked about the patient's current condition. Then he discussed the surgical plan with the family.
Zhou Can was listening on the side.
The whole communication process was not long.
Family members have a high level of trust in Tuya Hospital, which is a prerequisite for smooth communication.
After the conversation, the family members immediately agreed to the surgical plan proposed by Director Shang.
The family members' original words were that it would be good even if their father could have a drink of water after the operation.
After the family agrees, all that remains is to schedule the surgery.
The surgery is tentatively scheduled for tomorrow morning.
Followed by Zhou Can.
"I will be seeing patients in the outpatient clinic at 1pm this afternoon. Dr. Zhou can follow me and gain experience in the outpatient clinic."
Director Shang took the initiative to invite Zhou Can to see patients with him, which meant that he had passed the initial test on Zhou Can.
After Zhou Can obtained his medical license, he became particularly concerned about seeing patients.
Following the senior doctors in their consultations will be very beneficial for them to be independent in the future. They can learn how the senior doctors answer various questions from patients during the consultation process, as well as the consultation process and treatment plans for different diseases.
"Okay! Thank you, Director Shang!"
Zhou Can smiled happily.
I took great pains to check the medical history of the patient in bed 71 and develop a surgical plan, and my efforts were finally worth it.
Back in the office, Zhou Can was writing the medical record for the patient in bed 71 when the nurse stood at the door and called him.
"Doctor Zhou, another inpatient has been assigned to you, bed 77!"
Under normal circumstances, a trainee is in charge of at least six to eight beds.
Some highly capable interns may even be in charge of more than 20 to 30 beds. When it comes to managing beds, senior doctors are always particularly perverted and madly exploit the labor of interns.
They don't worry about anything going wrong at all. They just admit the patients and leave them to the management of their interns.
Zhou Can is doing well at the moment, and with the new patient in bed 77, he is only in charge of two beds.
The workload was surprisingly light.
As to what extent it will increase in the future, it is unknown.
The more beds there are, the more miserable it is.
Changing the dressings, writing medical records, writing medical instructions, writing medical records, etc., are enough to keep people busy. There is no time to even drink a sip of water all day long.
"I'll be right there!"
Zhou Can typed quickly on the keyboard, filed the unfinished medical record, and went to the ward to receive the patient first.
The hospital does not have a mandatory requirement for the doctor in charge of the bed to go to the ward to receive the patient as soon as possible. Anyway, the attending physician is responsible for arranging the bed. After the patient is sent to the ward, the nurse will arrange the patient clearly.
The attending physician is mainly responsible for understanding the patient's condition, prescribing medical advice in a timely manner, observing the reactions after medication, making adjustments, or reporting any abnormalities to superiors in a timely manner.
As long as you have the ability to ensure that nothing happens to the patients under your management, it’s okay to go to the ward only once a day.
Zhou Can came to the ward and saw a young female patient lying on the bed. She looked pale, with red and swollen eyes, and looked very haggard. The girl was dressed rather shabby.
You can tell at first glance that he is suffering from long-term malnutrition and comes from a poor family.
There was no family member by the bed.
"What's wrong with her?"
Zhou Can asked the nurse.
"It's stage II gastric wall tumor, the situation is a bit bad." The nurse was about thirty-five or thirty-six years old, and she looked like she wanted to say something but hesitated.
From her eyes, one can see sympathy for the patient.
"How come I haven't seen her family members since her condition is so serious? I'm sure she'll be in the hospital for a long time!"
Gastric tumors can be divided into four grades.
Stage II can no longer be treated with surgery alone and requires surgery plus chemotherapy to achieve better treatment results.
Her hospitalization period was definitely not just one or two days.
It would have been better if Zhou Can hadn't asked this question. As soon as he asked, the patient started crying.
Zhou Can was suddenly confused and a little panicked.
I wouldn't have asked if I had known.
Now the patient is crying, which is not a good thing to deal with.
He had no choice but to look to the nurse for help.
Fortunately, he showed up at the department's morning meeting in the morning and his status was much higher than that of ordinary interns.
The nurse received his call for help but did not stand idly by.
He quickly stepped forward to help comfort the patient. "Ms. Luo, we have informed your mother. She is very concerned about your safety and said that she will come to accompany you as soon as possible. Don't be sad. This is not good for your condition, you know? Gastric tumors are afraid of you being happy and optimistic. As long as you keep a good mood all day long, its progress will be very slow. If you are overly sad and anxious, your immunity will drop significantly. Tumors like patients like this the most. Because they can take the opportunity to develop rapidly..."
Nurses have extensive work experience.
He is also good at persuading others.
After her efforts to persuade him, the patient finally stopped crying, but he still looked very depressed.
Zhou Can was so frightened that he didn't dare to say anything anymore.
Instead, pick up the patient's information and check it yourself.
Understand the patient's condition.
