NOVEL WEB I can see the status bar
Chapter 1155
Chapter 1155
Tian Kang is a patient with underlying diseases.
He has kidney failure, he has advanced Hodgkin lymphoma and now he has the novel coronavirus.With the combined forces of the three diseases, his life has been facing a huge threat.
In order to save his life, the medical team decisively gave him a convalescent plasma treatment plan.
And the problem lies in the blood plasma of the convalescents—Sun Lien really didn't expect that the status bar could mislead his thoughts to such an extent.
Unfortunately, Dr. Chen Xuerong's words came true.There was indeed something unusual in that convalescent plasma.
This plasma was collected at the apheresis station of Yunhe Infectious Disease Hospital on February 2, and after processing, it was transfused into Tian Kang's blood the next day.
Although the blood bank and the biological company kept the information of the plasma donors confidential, Sun Lien knew very well who the plasma belonged to. On the 27th, there was one and only one donor in the apheresis station of Yunhe City Infectious Disease Hospital. The first place is Qian Guojian who took a photo with Sun Lien before he was discharged from the hospital.
Qian Guojian also received a tocilizumab treatment one week before he was discharged from the hospital, and his cumulative tocilizumab dosage was 1200mg.According to previous calculations, the half-clearance rate of 800mg tocilizumab is about 23 days.It took him 21 days from the last time he received tocilizumab injections, to the time he recovered and was discharged from the hospital to donate plasma.In other words, the tocilizumab in Qian Guojian’s body should have been at a relatively high level at that time—the total amount of tocilizumab in his plasma must have been greater than 600 mg.
There is a total of about 4000ml of blood in the human body, and Qian Guojian donated two units of plasma, which is 400ml.Even if the total amount of tocilizumab on duty in his body is only 600mg, two units of convalescent plasma contain at least 60mg of tocilizumab.
For other patients infected with the novel coronavirus, although a little tocilizumab in the plasma of recovered patients is not a good thing, compared with the antibodies in the plasma, a little monoclonal antibody that suppresses the immune system is definitely more beneficial than harmful .
But for Tian Kang... the situation may not be so optimistic.
If Dr. Bernard's reasoning is correct, then one of the main reasons for the shrinkage of the lymph nodes in Tian Kang's body, which was originally swollen due to hematological cancer, is probably the human immune response caused by the new coronavirus infection.
Although the specific mechanism of immune response leading to tumor shrinkage is still unclear, there are only a few possibilities - under the "introduction" of the new coronavirus, the body's immune cells re-recognized the tumor.Or a large number of immune cells rushed around, and then formed an indiscriminate attack in the swollen lymph nodes, and this attack happened to make Tian Kang's lymph nodes begin to shrink.
Whatever the possibility, such a response builds on that of the immune system in the first place.
Tocilizumab is a very efficient monoclonal antibody that can effectively block the interleukin-6 receptor.Although it is still uncertain whether Tian Kang's current lymph node shrinkage is related to the immune response mediated by interleukin-6, accepting this kind of immunotherapy without symptoms itself means risk.
Sun Lien rushed to Tian Kang's ward in three steps at a time, and then began to observe the status bar above his head.
Strictly speaking, the status bar did not induce Sun Lien's thinking through malicious methods.It doesn't seem to be such a bad taste yet.But at the same time, the status bar does miss a potentially very important issue.
All other patients who received triple therapy did not have the words "immunosuppression" directly on their heads, and the feedback on the status bar for the use of tocilizumab was to put the four words "immune storm" on the patients' heads that might not be so obvious. Get a little lighter, that's all.
Therefore, there is no special reminder on the top of Tian Kang's head.Even the state of "Stage IV Hodgkin's Lymphoma" was as dim and translucent as ever.
Sun Lien blinked for a long time, until his eyes were a little dry, but he didn't see any changes from the status bar.
The translucent is still translucent, the beating numbers are still beating, and it is impossible to see whether it is getting better or worse.
Now, it is necessary to consider the problem from other angles.
To terminate the effect of tocilizumab, it has to be done by plasma exchange.The metabolism of tocilizumab in the human body does not pass directly through the liver and kidneys, nor can it be eliminated by traditional methods such as diuresis, excretion, and adsorption.The molecular size that can be removed by hemodialysis is generally about 50 nanometers. For such tiny protein molecules whose size is generally less than 10 nanometers, only direct plasma exchange can achieve the purpose of quickly reducing the content in the body.
In other words, the current matter is a separate multiple-choice question-perform plasma exchange, or just continue to wait and see.
The purpose of using plasma exchange is to ensure that Tian Kang's adult Hodgkin's lymphoma, which seems to be miraculously improving, continues to "miracle".The reason for not using plasma replacement is to ensure the level of the new coronavirus immunoglobulin from Qian Guojian that has been infused into Tian Kang's body, as well as the naturally produced antibody level in his body that is highly sensitive to the new coronavirus.
Tian Kang's infection problem is basically no longer necessary to worry about-he has shown negative throat swabs in three consecutive nucleic acid tests in three days.
According to the previous standards, Tian Kang can basically be considered for discharge.But now Sun Li'en is not so sure-under the intervention of tocilizumab, whether Tian Kang's immune system has produced enough antibodies still needs to be questioned.Under the effect of this "question mark", Tian Kang's follow-up treatment must be more careful.Previously, China had reported the first case of nucleic acid "Fuyang" from a recovered coronavirus patient.
Although these "Fuyang" cases do not need to be too tense in Sun Lien's view, this does not prevent many people from worrying.In order for these recovered patients to return to life better after being discharged from the hospital, the number of such "Fuyang" cases must be pushed back.
Fuyang of recovered patients with pneumonia caused by new coronavirus infection does not mean that they have excreted live virus from their bodies.In fact, Sun Lien personally believes that such Fuyang is more likely to be that they excreted some dead virus fragments, which were then identified as positive by PCR amplification.
In other words, Tian Kang still needs to be hospitalized for a period of time, at least until his lung lesions shrink to Sun Lien's satisfaction, he still needs to wait until he is discharged from the hospital.
Continue to wait for the next period of time?
For Hodgkin's lymphoma, the treatment options are actually relatively mature.After two cycles of ABVD chemotherapy (doxorubicin, bleomycin, vinblastine, dacarbazine), the 36-month progression-free survival rate was above 78%.If PD1 monoclonal antibody is used, the single agent effective rate is as high as 82.7%.
In short, Hodgkin's lymphoma is one of the tumors with the highest cure rate at present.As long as it can be detected, diagnosed and treated early, the cure rate of patients can be close to 80%.Even at an advanced stage, there are still a range of treatment options that offer a high chance of controlling disease progression.
So...how should I choose now?Should Tian Kang try his luck in a treatment plan with a high recovery rate, or should he start plasma exchange immediately and try his best to ensure that his self-healing process continues?
Sun Lien fell into distress.
"Doctor Sun?" Just as Sun Lien was distressed, Tian Kang seemed to wake up.He stared at Sun Li'en standing at the foot of his bed with bewildered eyes, and asked a little puzzled, "Is there something wrong?"
"Ah... nothing special." Sun Li'en shook his head, and then asked suddenly, "Is your family worried when you come to the hospital this time?"
"Hey... I'm sure I'm worried. But I don't worry too much about it." Tian Kang coughed, and then said, "I have a lot of serious and minor illnesses on my body, which drags the baby down. Don't panic if you die. Just take it as a relief for the doll!"
Sun Lien blinked and asked, "How can you think so? Your child must hope that you will get better too."
"Hey, being sick is expensive." Tian Kang shook his head lightly, "I have to go to dialysis every week, even if I have medical insurance, it costs two hundred and dozens of dollars a time. The cost of chemotherapy is even higher, and a course of treatment costs seven to eight Thousands."
"You can live here with peace of mind." Sun Li'en nodded, "Don't worry, the national medical insurance will reimburse you, and you won't be charged for hospitalization here!"
(End of this chapter)
Tian Kang is a patient with underlying diseases.
He has kidney failure, he has advanced Hodgkin lymphoma and now he has the novel coronavirus.With the combined forces of the three diseases, his life has been facing a huge threat.
In order to save his life, the medical team decisively gave him a convalescent plasma treatment plan.
And the problem lies in the blood plasma of the convalescents—Sun Lien really didn't expect that the status bar could mislead his thoughts to such an extent.
Unfortunately, Dr. Chen Xuerong's words came true.There was indeed something unusual in that convalescent plasma.
This plasma was collected at the apheresis station of Yunhe Infectious Disease Hospital on February 2, and after processing, it was transfused into Tian Kang's blood the next day.
Although the blood bank and the biological company kept the information of the plasma donors confidential, Sun Lien knew very well who the plasma belonged to. On the 27th, there was one and only one donor in the apheresis station of Yunhe City Infectious Disease Hospital. The first place is Qian Guojian who took a photo with Sun Lien before he was discharged from the hospital.
Qian Guojian also received a tocilizumab treatment one week before he was discharged from the hospital, and his cumulative tocilizumab dosage was 1200mg.According to previous calculations, the half-clearance rate of 800mg tocilizumab is about 23 days.It took him 21 days from the last time he received tocilizumab injections, to the time he recovered and was discharged from the hospital to donate plasma.In other words, the tocilizumab in Qian Guojian’s body should have been at a relatively high level at that time—the total amount of tocilizumab in his plasma must have been greater than 600 mg.
There is a total of about 4000ml of blood in the human body, and Qian Guojian donated two units of plasma, which is 400ml.Even if the total amount of tocilizumab on duty in his body is only 600mg, two units of convalescent plasma contain at least 60mg of tocilizumab.
For other patients infected with the novel coronavirus, although a little tocilizumab in the plasma of recovered patients is not a good thing, compared with the antibodies in the plasma, a little monoclonal antibody that suppresses the immune system is definitely more beneficial than harmful .
But for Tian Kang... the situation may not be so optimistic.
If Dr. Bernard's reasoning is correct, then one of the main reasons for the shrinkage of the lymph nodes in Tian Kang's body, which was originally swollen due to hematological cancer, is probably the human immune response caused by the new coronavirus infection.
Although the specific mechanism of immune response leading to tumor shrinkage is still unclear, there are only a few possibilities - under the "introduction" of the new coronavirus, the body's immune cells re-recognized the tumor.Or a large number of immune cells rushed around, and then formed an indiscriminate attack in the swollen lymph nodes, and this attack happened to make Tian Kang's lymph nodes begin to shrink.
Whatever the possibility, such a response builds on that of the immune system in the first place.
Tocilizumab is a very efficient monoclonal antibody that can effectively block the interleukin-6 receptor.Although it is still uncertain whether Tian Kang's current lymph node shrinkage is related to the immune response mediated by interleukin-6, accepting this kind of immunotherapy without symptoms itself means risk.
Sun Lien rushed to Tian Kang's ward in three steps at a time, and then began to observe the status bar above his head.
Strictly speaking, the status bar did not induce Sun Lien's thinking through malicious methods.It doesn't seem to be such a bad taste yet.But at the same time, the status bar does miss a potentially very important issue.
All other patients who received triple therapy did not have the words "immunosuppression" directly on their heads, and the feedback on the status bar for the use of tocilizumab was to put the four words "immune storm" on the patients' heads that might not be so obvious. Get a little lighter, that's all.
Therefore, there is no special reminder on the top of Tian Kang's head.Even the state of "Stage IV Hodgkin's Lymphoma" was as dim and translucent as ever.
Sun Lien blinked for a long time, until his eyes were a little dry, but he didn't see any changes from the status bar.
The translucent is still translucent, the beating numbers are still beating, and it is impossible to see whether it is getting better or worse.
Now, it is necessary to consider the problem from other angles.
To terminate the effect of tocilizumab, it has to be done by plasma exchange.The metabolism of tocilizumab in the human body does not pass directly through the liver and kidneys, nor can it be eliminated by traditional methods such as diuresis, excretion, and adsorption.The molecular size that can be removed by hemodialysis is generally about 50 nanometers. For such tiny protein molecules whose size is generally less than 10 nanometers, only direct plasma exchange can achieve the purpose of quickly reducing the content in the body.
In other words, the current matter is a separate multiple-choice question-perform plasma exchange, or just continue to wait and see.
The purpose of using plasma exchange is to ensure that Tian Kang's adult Hodgkin's lymphoma, which seems to be miraculously improving, continues to "miracle".The reason for not using plasma replacement is to ensure the level of the new coronavirus immunoglobulin from Qian Guojian that has been infused into Tian Kang's body, as well as the naturally produced antibody level in his body that is highly sensitive to the new coronavirus.
Tian Kang's infection problem is basically no longer necessary to worry about-he has shown negative throat swabs in three consecutive nucleic acid tests in three days.
According to the previous standards, Tian Kang can basically be considered for discharge.But now Sun Li'en is not so sure-under the intervention of tocilizumab, whether Tian Kang's immune system has produced enough antibodies still needs to be questioned.Under the effect of this "question mark", Tian Kang's follow-up treatment must be more careful.Previously, China had reported the first case of nucleic acid "Fuyang" from a recovered coronavirus patient.
Although these "Fuyang" cases do not need to be too tense in Sun Lien's view, this does not prevent many people from worrying.In order for these recovered patients to return to life better after being discharged from the hospital, the number of such "Fuyang" cases must be pushed back.
Fuyang of recovered patients with pneumonia caused by new coronavirus infection does not mean that they have excreted live virus from their bodies.In fact, Sun Lien personally believes that such Fuyang is more likely to be that they excreted some dead virus fragments, which were then identified as positive by PCR amplification.
In other words, Tian Kang still needs to be hospitalized for a period of time, at least until his lung lesions shrink to Sun Lien's satisfaction, he still needs to wait until he is discharged from the hospital.
Continue to wait for the next period of time?
For Hodgkin's lymphoma, the treatment options are actually relatively mature.After two cycles of ABVD chemotherapy (doxorubicin, bleomycin, vinblastine, dacarbazine), the 36-month progression-free survival rate was above 78%.If PD1 monoclonal antibody is used, the single agent effective rate is as high as 82.7%.
In short, Hodgkin's lymphoma is one of the tumors with the highest cure rate at present.As long as it can be detected, diagnosed and treated early, the cure rate of patients can be close to 80%.Even at an advanced stage, there are still a range of treatment options that offer a high chance of controlling disease progression.
So...how should I choose now?Should Tian Kang try his luck in a treatment plan with a high recovery rate, or should he start plasma exchange immediately and try his best to ensure that his self-healing process continues?
Sun Lien fell into distress.
"Doctor Sun?" Just as Sun Lien was distressed, Tian Kang seemed to wake up.He stared at Sun Li'en standing at the foot of his bed with bewildered eyes, and asked a little puzzled, "Is there something wrong?"
"Ah... nothing special." Sun Li'en shook his head, and then asked suddenly, "Is your family worried when you come to the hospital this time?"
"Hey... I'm sure I'm worried. But I don't worry too much about it." Tian Kang coughed, and then said, "I have a lot of serious and minor illnesses on my body, which drags the baby down. Don't panic if you die. Just take it as a relief for the doll!"
Sun Lien blinked and asked, "How can you think so? Your child must hope that you will get better too."
"Hey, being sick is expensive." Tian Kang shook his head lightly, "I have to go to dialysis every week, even if I have medical insurance, it costs two hundred and dozens of dollars a time. The cost of chemotherapy is even higher, and a course of treatment costs seven to eight Thousands."
"You can live here with peace of mind." Sun Li'en nodded, "Don't worry, the national medical insurance will reimburse you, and you won't be charged for hospitalization here!"
(End of this chapter)
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