Since 1981 Health School Chapter 639

  Chen Qi explained to the big names in the field of burn surgery in front of him for a long time.

   Several bigwigs have their own ideas. For example, Professor Peng, as the creator of the Southwest formula, is gratified that the Yuezhong Hospital can inherit the Chongqing formula and find out his own routine.

  The two hospitals can be regarded as teachers from the same school, and they are their own people.

  But Professor Ni is disdainful in his heart. Shanghainese have their own pride.

  Ni Zhihua does not admit that the Chongqing formula is better than the Shanghai formula, and now he has a "Vietnam formula", which makes him even more dissatisfied with the rural hospital of Yuezhong.

   I already rolled my eyes a few times in my heart.

  On the contrary, Professor Zhu Lianggong from Jishuitan Hospital, Professor Wang Qizheng from the Second Hai Medical Hospital, and Professor An Yongchun from Xiangya Hospital viewed the "Vietnam-China formula" more from a neutral perspective.

  But it is obviously impossible to say which formula is better based on Chen Qi's one-sided opinion.

  The reason why the Chongqing formula stood out later and became the mainstream supplement formula in Huaguo, this is also a big wave, after decades of testing.

  But there is one biggest difference in the "Vietnam Formula" in front of us, that is, the Yuezhong Hospital uses full-instrument monitoring, which is the first in China.

  Professor Peng put on the glasses, carefully looked at the constantly beating data on the display screen, looked at it very carefully, and his mind was also calculating quickly.

  Professor Wang Qizheng kept urging:

"Comrade Chen Qi, come on, tell us in detail what is the meaning of the data on your two monitors? And what are the wires connected to the patient? I think this should be your Yuezhong Hospital treating burns. The trick, right?"

  The old man is joking.

  Chen Qi smiled and introduced for these old men:

"The data on this display is mainly to monitor vital signs, such as heart rate, blood pressure, and pulse oxygen. The breathing curve shows the patient's breathing type. According to the breathing curve and breathing frequency, the patient's breathing status can be understood. ,

   There is also an electrocardiogram band. When monitoring the heart rate, it can also detect the blood supply of the heart. It is mainly to observe the ST segment to diagnose the blood supply of the heart. In this way, the bedside electrocardiogram may be canceled, and we can know any fluctuations in the heart at the first time. "

  The ECG monitor is not a new gadget, but the ECG monitor of Yuezhong Hospital is a new product, which is very close to the ECG monitors of later generations and is very advanced.

   That's not what these old men can touch.

   You must know that the education these old professors received was in the period of the Republic of China, and after decades of isolation, they really don't know much about these advanced things.

  It can be said that throughout the 1970s and 1980s, there was a whole era of gap between domestic medicine and foreign mainstream medicine, and the gap was huge.

  Chen Qi saw that several old professors were listening seriously, so he continued to explain the second monitor:

"Look, this machine is a hemodynamic monitor. It is called PICCO in English. It is very advanced and is in the process of being promoted abroad. Its working principle is to measure hemodynamics by using transpulmonary thermodilution technology and pulse wave profile analysis technology. Monitoring and capacity management.

  For example, this data is to measure a single cardiac output, and obtain continuous cardiac output by analyzing the area under the arterial pressure waveform curve, and measure a single cardiac output CO by thermodilution method.

  The area under the arterial pressure waveform curve is automatically analyzed by the computer of the instrument to obtain continuous cardiac output PCCO, and at the same time, the intrathoracic blood volume ITBV and extravascular lung water EVLW can be calculated.

   Among them, ITBV has been proved to be a repeatable, sensitive and more accurate indicator of cardiac preload than PAOP, right ventricular end-diastolic pressure RVEDV, and central static pressure CVP. "

  Chen Qi is now like a fake foreign devil, a few English words drift out from time to time when he speaks.

   It is also fortunate that these professors are top doctors after all, and they were taught in English instead of Russian when they were students, otherwise Chen Qi would have to translate for a long time.

  "All the data on the monitor are displayed in front of us. Through hemodynamic monitoring, our doctors can make rapid and accurate judgments on the patient's condition, curative effect and prognosis, and use them to guide the treatment process to achieve satisfactory results.

  For example, in our burn surgery rehydration, some professors don't like to hear something. Now the habit of domestic doctors is to completely follow the rehydration formula, and replenish as much as calculated, regardless of whether the patient is dead or alive, whether the supplement is too much or too little.

With these advanced instruments, we can adopt a personalized fluid replacement plan, which varies from person to person. How much fluid to supplement and what type of fluid to supplement depends on these data. We can supplement what the body lacks. Is this right? More scientific and more effective? "

   After Chen Qi finished speaking, the expected applause did not ring out.

  The old professors all looked serious, as if someone owed them tens of dollars and didn't pay them back.

  Chen Qi was a little confused: "Teachers, you are..."

  Professor Peng came back to his senses and asked angrily:

   "Comrade Chen Qi, is there really such a big gap between domestic and foreign medical care? Is our system really outdated?"

  Chen Qi really wanted to say yes, you really can't keep up with the times both in clinical and theoretical aspects.

  Of course he didn't dare to say that. If he really wanted to say that, if a few old professors had a heart attack, then Yue TCM Hospital would have a lot of fun.

"Professors, it's not that you are outdated, but that medicine is always improving. We can't just focus on clinical practice. The consequence of emphasizing clinical practice and neglecting scientific research is that there is no way to make progress at all. We can only look at the backs of foreigners forever. .”

   What Chen Qi didn't say was that not only was this gap not corrected, but it got bigger and bigger. It has to be said that this is a great regret, and it is what Chen Qi wants to make up for in this life.

  Professor Zhu laughed at himself:

"Scientific research is important, but scientific research requires a lot of funds and a relaxed scientific research environment, but what do we have? When I open my eyes, I think about how many patients the department will admit today? How much business? How much profit? How much salary can be paid at the end of the month? Can the housing subsidy be in place? Even basic survival is a problem, where are the scientific research funds and support?"

  Professor An Yongchun saw the heavy atmosphere and made a joke:

   "There is still money. If the leaders can reduce business reception and save the reception funds for going out to treat guests and welcome leaders at all levels to inspect and visit, it will be enough for us to carry out scientific research."

  Professor Wang Qizheng is a local expert in Haidong Province. He knows more about the situation of Yuezhong Hospital, so he also joked:

"Look, the Yuezhong Hospital is still rich. I heard that this year, foreign sponsorship alone has reached more than 20 million U.S. dollars. Now the Yuezhong Hospital is building buildings, introducing advanced equipment, and doing research. , are you envious?

And you don't know that Comrade Chen Qi opened an international class of endoscopy, with 20 places, each of which charges 300,000 US dollars, and can earn 6 million US dollars in foreign exchange in this way. The most wealthy hospital in China is not the Yuezhong Hospital No. "

   These foreign professors were stunned again.

  Vietnam Hospital of Traditional Chinese Medicine earns almost 30 million US dollars a year just for extra money. Which hospital in China is so arrogant?

  Professor Peng smiled wryly:

   "No wonder the number of international papers published. A local hospital like Yuezhong Hospital has become the first in the country, and it is far ahead. It seems that Comrade Chen Qi is not willing to spend money on scientific research, he really has money to do scientific research."

  Wang Qizheng also laughed and said:

"Our Haidong Medical University has also gained a lot of glory. There are still several projects in cooperation between the university and the hospital, and there are many international papers when it is done. How about it, envy, or you old guys will come here Working in Vietnam, Comrade Chen Qi wants to vigorously develop the burn department, and he will definitely not be stingy with scientific research funding and your personal treatment."

   "I was moved by what you said."

   "Haha, you can think about it!"

   Several old professors were joking, but Chen Qi knew that this possibility was very small. For example, Professor Peng Yongyan is not only the director of Southwest Hospital, but also a member of the military system.

  Professor Ni was thinking about the workers of the Yue Steel Factory next door, so he asked:

   "Comrade Chen Qi, since you have the most advanced equipment, do you have more advanced medicines for the infections that occur?"

  Chen Qi nodded and said, yes!

   "We do have the most advanced antibacterial drugs in our hands, but we don't use any antibacterial drugs casually, but choose antibacterial drugs according to the patient's drug sensitivity test and bacterial culture results."

  Drug susceptibility tests were rarely done in China in the 1980s. why?

  Because the common people in China in this era have almost never been exposed to antibiotics, and they take very few "anti-inflammatory drugs", and they have no money to buy them.

   As for the purchased poultry such as chickens, ducks, fish, pigs, etc., firstly, I don't have the money to buy them often, and secondly, antibiotics are not used to prevent diseases in poultry these days.

  So the food these days is also absolutely safe, green and pollution-free food, so that there is one less contact with antibiotics.

   One advantage of this is that the human body is effective to any antibiotics, and can play a bactericidal effect, and the curative effect is remarkable.

(Recently, "mycoplasma" is very prevalent in the author's area, the infection rate is high, and the mycoplasma pneumonia caused by it is also clinically common. The author's hospital has done an experiment, which is to use alveolar lavage to directly obtain pathogenic microorganisms and make drug-resistant ones experiment.

  Among the 100 mycoplasma specimens obtained, 96 were resistant to macrolide drugs such as azithromycin and erythromycin, and the drug resistance rate reached 96%. This is very exaggerated and very scary.

  Because if you have mycoplasma pneumonia, cough and high fever, macrolide drugs are almost ineffective, so there are no other drugs that can be used, and then our doctors have to use large doses of hormones...)

  Professor Ni asked again, "Then what is the result of your bacterial culture? What medicine did you use?"

"Just for these two patients in our hands, because the burn time is too long, Pseudomonas aeruginosa is the main bacteria. We use ceftriaxone from Roche Pharmaceuticals in Switzerland and levodex from Hearst in Germany. Star Needle."

   Several professors were shocked when they heard this:

   "It's a huge investment. The ceftriaxone needle alone costs 50 US dollars. How much do you spend? Can patients afford so much medical expenses?"

  It is so hard to be a doctor in China, because you must first consider whether the patient can bear it, rather than prescribing medicine blindly.

  Some people often accuse doctors of prescribing medicines indiscriminately and indiscriminately, resulting in sky-high medical expenses, making patients and their families feel worse than death, and returning to poverty due to illness.

  In fact, this is an unlikely possibility, the result of bad media hype.

  Because after the sky-high medical expenses, say 500,000 yuan, the patient cannot afford it, or can only afford 50,000 yuan, then the remaining medical expenses must be borne by the hospital, departments and doctors themselves.

  For example, 500,000 yuan, minus 50,000 yuan paid by the patient, and 450,000 yuan is bad debt. What about the money?

   It is useless to go to court. The patient's family is so poor that there is only one thatched cottage. What can your hospital do?

  Even if the patient has a house at home, have you heard of any hospital that would file a lawsuit and auction off the house in order to ask for medical expenses?

  Bad debts are generally flat. For example, the hospital pays 150,000, the department pays 150,000, and your doctor personally pays 150,000.

  How much does a doctor earn a year? How many patients can be compensated?

  So no doctor dares to prescribe sky-high prices indiscriminately, because this is burying himself.

  As for doctors abroad, they are much happier. The amount of medical expenses is not within their consideration. Either the national medical insurance pays for it or the insurance company pays for it.

  What is the doctor's role? The duty of a doctor is to take good care of the disease, and to use whatever treatment measures are beneficial. This is true humanitarianism.

  Chen Qi didn't feel bad about these medical expenses, because these medicines came from the UCLA Medical Center in the United States that was burned by him in a big fire, and the medicine storehouse is still in his space.

  Of course, Chen Qi also wanted to find an opportunity to put the bill of Ding Xinjuan's mother and daughter on Yue Steel Factory.

  Professor Ni continued to ask: "What is the therapeutic effect of these imported drugs?"

  Chen Qi shrugged: "How is the effect, you can see for yourself. Now the vital signs of the two patients are very stable, and I am still waiting for the skin grafting operation."

  Professor Ni gritted his teeth, blushed and said:

"Comrade Chen Qi, um, um, Dongshan Hospital won't be able to produce this kind of imported medicine for a while. Now the systemic infection of the two worker masters next door is very serious, and ordinary antibacterial medicines are ineffective. I wonder if you can provide some imported antibacterial medicines. Give us the medicine..."

   Provide bullets to the "enemy"?

  Chen Qi's eyeballs twitched, even though the medicine was sold to the workers of the Yue Steel Factory, Chen Qi could take the opportunity to "earn a fortune", after all, the medicine was provided by him personally.

   But helping Dongshan Hospital, he still felt uncomfortable.

  So Chen Qi boldly proposed:

"Professor Ni, it's actually a joke whether you want to fight in the ring or not, so I have a proposal. The two master workers in your hands should be handed over to our Yuezhong Hospital for treatment. It just so happens that you can also get away, and it just so happens that we also need more patients. It is difficult to test whether the formula is successful or not."

  Professor Ni's eyes are like a twitch when he hears it...

Chapter end