NOVEL WEB I can see the status bar
Chapter 1156 Backlash
Chapter 1156 Backlash
Sun Li'en issued a doctor's order for plasma exchange for Tian Kang, and asked the nurses to implement it immediately.
Tian Kang's nucleic acid was negative for many times in a row, and there was no "new coronavirus infection" status bar above his head, so Sun Lien decisively shifted the focus of treatment to his Hodgkin's lymphoma.
According to relevant regulations, all basic disease treatment expenses related to the new coronavirus will be covered by medical insurance first, and the part of the expenses borne by individuals will be borne by the government.In other words, if you are infected with the new coronavirus, and when the doctors determine that the patient's underlying disease may lead to an aggravation of the new coronavirus infection, or vice versa, then it can be included in the scope of free treatment.
But the problem is that although Tian Kang's economic situation is relatively poor, the Hodgkin's lymphoma he suffers from...in fact, it has nothing to do with the new coronavirus.According to the doctors' speculation, the new coronavirus seems to be beneficial to the improvement of his Hodgkin's lymphoma.
In other words, Tian Kang's Hodgkin's lymphoma cannot enjoy free treatment.It has been almost two months since the suspension of work and production in various industries of Yunhe.Residents’ income must be decreasing—before the epidemic, it was difficult for Tian Kang to afford the cost of chemotherapy, and now, such treatment is even worse for him.
At the same time, the North Fifth District does not have the ability to treat Tian Kang with chemotherapy.Although it is a tertiary first-class general hospital, the infectious disease hospital currently does not have a reserve of relevant chemotherapy drugs.At the same time, there is no oncologist in the medical team, which is not enough to complete the entire treatment process.
As far as Tian Kang's economic situation and health are concerned, the best situation is that he continues to be hospitalized, and the doctors try to keep him in this inexplicable "self-healing" state.No matter what mechanism his self-healing is due to, in short, try to maintain the current state as much as possible.
The first treatment of plasma exchange started, and the doctor's advice given by Sun Lien was very conservative, "One liter will be replaced first, and the follow-up treatment will wait for a while."
·
·
·
"There... may be tocilizumab in it?" Professor Zhang Zhifu finished listening to Sun Lien's report in the office. Holding an empty plasma bag, he looked at Sun Lien in disbelief and asked, "Are you sure?"
"I don't know if there are any other recovered patients' plasma." Sun Lien looked at the plasma bag that was thoroughly sterilized and sent to the yellow zone and soaked in disinfectant solution for half an hour, and shook his head, "But I'm afraid there may be some blood in this plasma bag. There is."
Tocilizumab is not a drug that can be widely used in patients.Even if it has entered the seventh edition of the trial plan, its application still has very clear indications.It should not be used for patients with mild symptoms and no severe pulmonary infection, and the laboratory test index of interleukin-6 has not increased significantly.
Plasma from convalescents is currently mainly used on severe and critically ill patients, and it can also be used on patients with rapid disease progression.So, the possible impact of a small amount of plasma mixed with tocilizumab is not very large - but it is still an urgent problem that needs to be reported immediately.
"I'll call the blood bank right now." Zhang Zhifu picked up the phone and said to Sun Li'en, "Give me a list of patients who have used tocilizumab in your department. I will pass this list to the blood bank. "
Sun Li'en suddenly thought of something, and he said nervously, "This incident...may not only happen in our ward."
Experimental treatment of severe novel coronavirus pneumonia patients with inflammatory storm using tocilizumab.The registration of this experimental group was carried out in the North Fifth District.But before the use of tocilizumab was included in the seventh trial version, Sun Lien gave two lectures in the Infectious Diseases Hospital.
Have other wards been treated with tocilizumab, and if so... how big is the scale, how many doses were used, and when was the last dose.These questions are all unknowns.
Zhang Zhifu was stunned for a moment, and then the cold sweat came down his face.
"Call the blood bank first." Sun Lien said helplessly, "At least let them confirm that the donor has not used tocilizumab before accepting the plasma donation from the recovered person."
Before that, Sun Lien opposed the early promotion of triple therapy more than once.At that time, his reason was simply "this is not in compliance."However, at the request of the team members and the urgent need of other departments to find a response to the immune storm, Sun Lien finally made a compromise.
And such a compromise is now causing a massive "negative reaction."He didn't know how many patients received tocilizumab, let alone how many of these recovered patients donated their plasma to save others.
Judging from the current plasma supply of recovered patients... the number of people who actively donate plasma from recovered patients will definitely not be small.Now we can only hope that the number of patients who have received Tozhu treatment among them is not too many.
"The half-clearance period of tocilizumab is about 20 days. As the concentration of the drug in the blood decreases, the half-clearance period will shorten rapidly. Patients who have received tocilizumab need at least 30 days after recovery It is safer to donate plasma." Sun Lien finally said, "If possible, I suggest that these patients who have received tocilizumab be specially registered and compiled, and then wait for them to wait 30 days before starting to accept plasma donation from recovered patients."
Zhang Zhifu finished calling the blood station, and then said helplessly to Sun Li'en, "Your matter...is too sudden."
"I didn't expect that either." Sun Li'en said helplessly, "The purpose of using tocilizumab is to stop the cell storm. But we don't know that the half-clearing time of this drug is so long. The original purpose is to save people. Come down, who knew they were discharged from the hospital, and after another 14 days of recovery, there would still be tocilizumab in their blood!"
According to Sun Li'en and others' initial thoughts, the 7-day discharge observation and isolation plus the 14-day recovery period, these 21 days are basically enough for various drugs to be metabolized from the human body.But ... they just didn't count the tocilizumab.
"The blood bank is like a frying pan." Zhang Zhifu said helplessly, "Hurry up and get the list out. The applications in other wards of our hospital... I will do it. Get the list out as soon as possible, so that we can know how many people there are. Humans used convalescent plasma containing tocilizumab."
"I still have to contact Roche." Sun Lien suggested, "If necessary, ask them to send the data on the half-clearance rate of the drug and the minimum effective dose."
·
·
·
Sun Li'en is in a bad mood today, very bad.
Of course, he would not blame the doctors of other medical teams for their eagerness to master a drug application to stop the inflammatory storm.He also wouldn't complain about Zhang Zhifu's various..."workaround hints".Tocilizumab has played a role and saved the lives of many patients.There is no doubt about it.
He can only blame himself for not being strong enough and not sticking to the rules—the reason why the rules are rules is because this can protect the patients who participated in the experimental treatment to the greatest extent...and also protect other people who did not participate in the experimental treatment.
He can only blame himself for being too eager and thinking too highly of himself.Isn't this the consequence of not paying attention to the regulations after the expansion?
No matter how good the original intention is, even if such regulations are no longer necessary at first, the "backlash" and "consequences" of violating relevant regulations will still exist.
Sitting in the dining room, Sun Li'en was in a daze for a long time without moving at all.Hu Jia, who was eating Roujiamo in front of him, put down the bun in his hand, and asked worriedly, "Are you okay?"
"There's something wrong." Sun Li'en sighed, "I feel that I may really be a little bloated recently."
"Bloated?" Hu Jia looked at Sun Lien seriously, and then continued to eat the Roujiamo in front of him, "Just realize that you are bloated. The moment you realize that you are bloated, you won't be bloated anymore."
Today’s Roujiamo has a lot of background. It is said that it is a condolence item sent by the Guanzhong Medical Team. In order to thank the Song’an Provincial Medical Team for the chicken soup and rice, the Guanzhong Medical Team specially brought a large number of Baijimo from their hometown. Cake embryos and stewed pork in cured sauce.Just cook the pie, chop the stewed meat and coriander and green peppers together, put it in the pie, and then put a spoonful of marinade on the meat.
Such condolence products are paired with chicken soup sent by local enterprises in Wuhan, and that is a good meal.
As medical teams from all over the country began to share their hometown delicacies with each other, the food served in the cafeteria began to become very "characteristic".The members of the National Emergency Medical Team of Song'an Province even have a little hobby every day-let's guess which medical team is sending their special products today.
The most popular night shift is Inner Mongolia milk tea, and the most popular breakfast is Ningyuan Chicken Soup and Rice.As for the snacks... everyone in Kanto and Xiangbei likes it very much.
The fried liver in the capital failed on the breakfast table of the Song’an Provincial Medical Team—everyone was not used to such a heavy visceral smell.
Hu Jia continued to eat delicious food, while Sun Lien was busy communicating with Song Wen.He really has no appetite to eat, and the tocilizumab matter is like a fishbone stuck in his throat.He really can't eat anything unless he's done with it.
"I've heard what Lao Zhang said." Song Wenwei on the other end of the phone, she had already guessed what Sun Lien wanted to say, "We are urgently counting the list here, and the list will be sent to blood in about half an hour. stand."
"I did not abide by the relevant regulations, which led to this situation." Sun Lien said with a correct attitude, "I accept all the punishments imposed on me by the organization. If necessary, I will hand over the work to Director Zhou now."
Song Wen didn't speak for a few seconds, and then asked with a smile, "Do you think your attitude is responsible? Why do I sound like you are going to retreat and threaten me with a pick?"
Sun Lien panicked when he heard the words, "No, no, Dean Song, I didn't mean that..."
"I must also know that you don't mean that." Song Wen coughed twice and said seriously, "Is there any benefit to this situation if you are dealt with now? After you are dealt with, Sun Lien, those who have received treatment will be able to recover for fourteen days. Are you going to donate blood?"
Sun Lien didn't speak.
"It's Zhang Zhifu and I's idea to popularize the treatments that haven't been tested yet. No one can blame you, nor anyone else." Song Wen said calmly, "Now that things have gone wrong, it's easy to push you out to block the gun, but It doesn't help the status quo."
What Song Wen didn't say was the scariest part.If Sun Lien is really regarded as a scapegoat, then nothing else... Sun Lien's career is likely to come to an end.This is no joke.
"I am the dean, the person in charge of this medical team, and I also agreed to promote the triple therapy within the group." Song Wen announced the final decision to Sun Lien, "If someone needs to be responsible, it must be me and not do you understand?"
"...Understood." Sun Lien sighed, "Dean Song, I'm sorry."
"I haven't been dismissed yet. Who are you crying for?" Song Wen scolded with a smile, and then said seriously, "This matter can be big or small. You just need to deal with the matter of the list honestly. Don't make any more troubles, you know?"
After hanging up the phone, Sun Li'en began to eat the Roujiamo in front of him—although it was a bit cold, it tasted really good.
·
·
·
The list is easy to handle, after all, all medical records are now connected to the Internet.What is really troublesome is the data given by Roche.
The minimum effective dose of tocilizumab, the clearance rate at low doses... all these data are Roche's commercial secrets.Especially for the clearance rate of small doses, they only have the data of animal experiments at hand, but no results of human experiments.
"That's all the data we can give at the moment." Ding Ning said to Zhang Zhifu over the phone, "The minimum dose... we can only say that if adults use less than 4mg per kilogram, the effect will be very poor, almost impossible to achieve." therapeutic purposes."
"It's as if you didn't give the data." Zhang Zhifu said angrily, "What we need to know now is when the recovered patients who have received treatment can safely donate plasma!"
"Theoretically speaking..." Ding Ning said word by word, "According to current standards, patients who have received treatment can safely donate plasma after 7+14 days."
Due to the company's decision-making, Ding Ning couldn't hand over the most core data to Yunhe.But as a Chinese, she still very much hopes to help Yunhe even a little bit.She has no right to touch the most core data.But through repeated communications with colleagues in Roche's research department, she was able to come up with a conclusion with confidence.
"For the first time, patients with a total dose of less than 800mg can be considered safe?" Zhang Zhifu thought about it, and then asked, "Are you sure there is no problem with this data?"
"Unless I am deceived by the company's research department, I have confidence in this data." Ding Ning said, "We are already preparing to carry out related enrollment experiments in Japan and Italy. The results of the use of tocilizumab in Yunhe and Safety is our top concern at the moment. You can completely trust our sincerity—if there is a problem with the use of tocilizumab, our loss will be huge.”
(End of this chapter)
Sun Li'en issued a doctor's order for plasma exchange for Tian Kang, and asked the nurses to implement it immediately.
Tian Kang's nucleic acid was negative for many times in a row, and there was no "new coronavirus infection" status bar above his head, so Sun Lien decisively shifted the focus of treatment to his Hodgkin's lymphoma.
According to relevant regulations, all basic disease treatment expenses related to the new coronavirus will be covered by medical insurance first, and the part of the expenses borne by individuals will be borne by the government.In other words, if you are infected with the new coronavirus, and when the doctors determine that the patient's underlying disease may lead to an aggravation of the new coronavirus infection, or vice versa, then it can be included in the scope of free treatment.
But the problem is that although Tian Kang's economic situation is relatively poor, the Hodgkin's lymphoma he suffers from...in fact, it has nothing to do with the new coronavirus.According to the doctors' speculation, the new coronavirus seems to be beneficial to the improvement of his Hodgkin's lymphoma.
In other words, Tian Kang's Hodgkin's lymphoma cannot enjoy free treatment.It has been almost two months since the suspension of work and production in various industries of Yunhe.Residents’ income must be decreasing—before the epidemic, it was difficult for Tian Kang to afford the cost of chemotherapy, and now, such treatment is even worse for him.
At the same time, the North Fifth District does not have the ability to treat Tian Kang with chemotherapy.Although it is a tertiary first-class general hospital, the infectious disease hospital currently does not have a reserve of relevant chemotherapy drugs.At the same time, there is no oncologist in the medical team, which is not enough to complete the entire treatment process.
As far as Tian Kang's economic situation and health are concerned, the best situation is that he continues to be hospitalized, and the doctors try to keep him in this inexplicable "self-healing" state.No matter what mechanism his self-healing is due to, in short, try to maintain the current state as much as possible.
The first treatment of plasma exchange started, and the doctor's advice given by Sun Lien was very conservative, "One liter will be replaced first, and the follow-up treatment will wait for a while."
·
·
·
"There... may be tocilizumab in it?" Professor Zhang Zhifu finished listening to Sun Lien's report in the office. Holding an empty plasma bag, he looked at Sun Lien in disbelief and asked, "Are you sure?"
"I don't know if there are any other recovered patients' plasma." Sun Lien looked at the plasma bag that was thoroughly sterilized and sent to the yellow zone and soaked in disinfectant solution for half an hour, and shook his head, "But I'm afraid there may be some blood in this plasma bag. There is."
Tocilizumab is not a drug that can be widely used in patients.Even if it has entered the seventh edition of the trial plan, its application still has very clear indications.It should not be used for patients with mild symptoms and no severe pulmonary infection, and the laboratory test index of interleukin-6 has not increased significantly.
Plasma from convalescents is currently mainly used on severe and critically ill patients, and it can also be used on patients with rapid disease progression.So, the possible impact of a small amount of plasma mixed with tocilizumab is not very large - but it is still an urgent problem that needs to be reported immediately.
"I'll call the blood bank right now." Zhang Zhifu picked up the phone and said to Sun Li'en, "Give me a list of patients who have used tocilizumab in your department. I will pass this list to the blood bank. "
Sun Li'en suddenly thought of something, and he said nervously, "This incident...may not only happen in our ward."
Experimental treatment of severe novel coronavirus pneumonia patients with inflammatory storm using tocilizumab.The registration of this experimental group was carried out in the North Fifth District.But before the use of tocilizumab was included in the seventh trial version, Sun Lien gave two lectures in the Infectious Diseases Hospital.
Have other wards been treated with tocilizumab, and if so... how big is the scale, how many doses were used, and when was the last dose.These questions are all unknowns.
Zhang Zhifu was stunned for a moment, and then the cold sweat came down his face.
"Call the blood bank first." Sun Lien said helplessly, "At least let them confirm that the donor has not used tocilizumab before accepting the plasma donation from the recovered person."
Before that, Sun Lien opposed the early promotion of triple therapy more than once.At that time, his reason was simply "this is not in compliance."However, at the request of the team members and the urgent need of other departments to find a response to the immune storm, Sun Lien finally made a compromise.
And such a compromise is now causing a massive "negative reaction."He didn't know how many patients received tocilizumab, let alone how many of these recovered patients donated their plasma to save others.
Judging from the current plasma supply of recovered patients... the number of people who actively donate plasma from recovered patients will definitely not be small.Now we can only hope that the number of patients who have received Tozhu treatment among them is not too many.
"The half-clearance period of tocilizumab is about 20 days. As the concentration of the drug in the blood decreases, the half-clearance period will shorten rapidly. Patients who have received tocilizumab need at least 30 days after recovery It is safer to donate plasma." Sun Lien finally said, "If possible, I suggest that these patients who have received tocilizumab be specially registered and compiled, and then wait for them to wait 30 days before starting to accept plasma donation from recovered patients."
Zhang Zhifu finished calling the blood station, and then said helplessly to Sun Li'en, "Your matter...is too sudden."
"I didn't expect that either." Sun Li'en said helplessly, "The purpose of using tocilizumab is to stop the cell storm. But we don't know that the half-clearing time of this drug is so long. The original purpose is to save people. Come down, who knew they were discharged from the hospital, and after another 14 days of recovery, there would still be tocilizumab in their blood!"
According to Sun Li'en and others' initial thoughts, the 7-day discharge observation and isolation plus the 14-day recovery period, these 21 days are basically enough for various drugs to be metabolized from the human body.But ... they just didn't count the tocilizumab.
"The blood bank is like a frying pan." Zhang Zhifu said helplessly, "Hurry up and get the list out. The applications in other wards of our hospital... I will do it. Get the list out as soon as possible, so that we can know how many people there are. Humans used convalescent plasma containing tocilizumab."
"I still have to contact Roche." Sun Lien suggested, "If necessary, ask them to send the data on the half-clearance rate of the drug and the minimum effective dose."
·
·
·
Sun Li'en is in a bad mood today, very bad.
Of course, he would not blame the doctors of other medical teams for their eagerness to master a drug application to stop the inflammatory storm.He also wouldn't complain about Zhang Zhifu's various..."workaround hints".Tocilizumab has played a role and saved the lives of many patients.There is no doubt about it.
He can only blame himself for not being strong enough and not sticking to the rules—the reason why the rules are rules is because this can protect the patients who participated in the experimental treatment to the greatest extent...and also protect other people who did not participate in the experimental treatment.
He can only blame himself for being too eager and thinking too highly of himself.Isn't this the consequence of not paying attention to the regulations after the expansion?
No matter how good the original intention is, even if such regulations are no longer necessary at first, the "backlash" and "consequences" of violating relevant regulations will still exist.
Sitting in the dining room, Sun Li'en was in a daze for a long time without moving at all.Hu Jia, who was eating Roujiamo in front of him, put down the bun in his hand, and asked worriedly, "Are you okay?"
"There's something wrong." Sun Li'en sighed, "I feel that I may really be a little bloated recently."
"Bloated?" Hu Jia looked at Sun Lien seriously, and then continued to eat the Roujiamo in front of him, "Just realize that you are bloated. The moment you realize that you are bloated, you won't be bloated anymore."
Today’s Roujiamo has a lot of background. It is said that it is a condolence item sent by the Guanzhong Medical Team. In order to thank the Song’an Provincial Medical Team for the chicken soup and rice, the Guanzhong Medical Team specially brought a large number of Baijimo from their hometown. Cake embryos and stewed pork in cured sauce.Just cook the pie, chop the stewed meat and coriander and green peppers together, put it in the pie, and then put a spoonful of marinade on the meat.
Such condolence products are paired with chicken soup sent by local enterprises in Wuhan, and that is a good meal.
As medical teams from all over the country began to share their hometown delicacies with each other, the food served in the cafeteria began to become very "characteristic".The members of the National Emergency Medical Team of Song'an Province even have a little hobby every day-let's guess which medical team is sending their special products today.
The most popular night shift is Inner Mongolia milk tea, and the most popular breakfast is Ningyuan Chicken Soup and Rice.As for the snacks... everyone in Kanto and Xiangbei likes it very much.
The fried liver in the capital failed on the breakfast table of the Song’an Provincial Medical Team—everyone was not used to such a heavy visceral smell.
Hu Jia continued to eat delicious food, while Sun Lien was busy communicating with Song Wen.He really has no appetite to eat, and the tocilizumab matter is like a fishbone stuck in his throat.He really can't eat anything unless he's done with it.
"I've heard what Lao Zhang said." Song Wenwei on the other end of the phone, she had already guessed what Sun Lien wanted to say, "We are urgently counting the list here, and the list will be sent to blood in about half an hour. stand."
"I did not abide by the relevant regulations, which led to this situation." Sun Lien said with a correct attitude, "I accept all the punishments imposed on me by the organization. If necessary, I will hand over the work to Director Zhou now."
Song Wen didn't speak for a few seconds, and then asked with a smile, "Do you think your attitude is responsible? Why do I sound like you are going to retreat and threaten me with a pick?"
Sun Lien panicked when he heard the words, "No, no, Dean Song, I didn't mean that..."
"I must also know that you don't mean that." Song Wen coughed twice and said seriously, "Is there any benefit to this situation if you are dealt with now? After you are dealt with, Sun Lien, those who have received treatment will be able to recover for fourteen days. Are you going to donate blood?"
Sun Lien didn't speak.
"It's Zhang Zhifu and I's idea to popularize the treatments that haven't been tested yet. No one can blame you, nor anyone else." Song Wen said calmly, "Now that things have gone wrong, it's easy to push you out to block the gun, but It doesn't help the status quo."
What Song Wen didn't say was the scariest part.If Sun Lien is really regarded as a scapegoat, then nothing else... Sun Lien's career is likely to come to an end.This is no joke.
"I am the dean, the person in charge of this medical team, and I also agreed to promote the triple therapy within the group." Song Wen announced the final decision to Sun Lien, "If someone needs to be responsible, it must be me and not do you understand?"
"...Understood." Sun Lien sighed, "Dean Song, I'm sorry."
"I haven't been dismissed yet. Who are you crying for?" Song Wen scolded with a smile, and then said seriously, "This matter can be big or small. You just need to deal with the matter of the list honestly. Don't make any more troubles, you know?"
After hanging up the phone, Sun Li'en began to eat the Roujiamo in front of him—although it was a bit cold, it tasted really good.
·
·
·
The list is easy to handle, after all, all medical records are now connected to the Internet.What is really troublesome is the data given by Roche.
The minimum effective dose of tocilizumab, the clearance rate at low doses... all these data are Roche's commercial secrets.Especially for the clearance rate of small doses, they only have the data of animal experiments at hand, but no results of human experiments.
"That's all the data we can give at the moment." Ding Ning said to Zhang Zhifu over the phone, "The minimum dose... we can only say that if adults use less than 4mg per kilogram, the effect will be very poor, almost impossible to achieve." therapeutic purposes."
"It's as if you didn't give the data." Zhang Zhifu said angrily, "What we need to know now is when the recovered patients who have received treatment can safely donate plasma!"
"Theoretically speaking..." Ding Ning said word by word, "According to current standards, patients who have received treatment can safely donate plasma after 7+14 days."
Due to the company's decision-making, Ding Ning couldn't hand over the most core data to Yunhe.But as a Chinese, she still very much hopes to help Yunhe even a little bit.She has no right to touch the most core data.But through repeated communications with colleagues in Roche's research department, she was able to come up with a conclusion with confidence.
"For the first time, patients with a total dose of less than 800mg can be considered safe?" Zhang Zhifu thought about it, and then asked, "Are you sure there is no problem with this data?"
"Unless I am deceived by the company's research department, I have confidence in this data." Ding Ning said, "We are already preparing to carry out related enrollment experiments in Japan and Italy. The results of the use of tocilizumab in Yunhe and Safety is our top concern at the moment. You can completely trust our sincerity—if there is a problem with the use of tocilizumab, our loss will be huge.”
(End of this chapter)
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