In 2004, there are only two types of mobile communication: phone and text messages.

At Liu Ming's age, he chose to type slowly in pinyin, which is far less convenient than a two-minute phone call. Moreover, as the factory owner, the phone is the basic communication method for doing business, and there is no situation where he cannot afford to pay high phone calls.

But Liu Ming chose to send a text message like Qi Jing.

When Qi Jing saw the text message at first sight, he felt a little strange. However, the text message was not very good, with only sixty or seventy words in length but full of sincerity, writing about his helplessness and apology:

In addition to a few difficult places, Qi Jing couldn't find any fault when he saw it. Moreover, for this matter, communication between text messages is more worry-free than telephone calls. After all, voice calls cannot be evidence, and text content like text messages is much more convenient.

Since I said that, Qi Jing wouldn't care too much even if he felt that something was weird. He replied to him casually:

After receiving the reply, Qi Jing called to the ophthalmology department and found Jiang Ling who was still worried: "Liu Ming replied to the text message, he was the one who just asked you for treatment."

"real?"

Hearing this news, Jiang Ling breathed a sigh of relief, and his heart hanging high was finally gently relieved: "That's great, thank you."

"Everyone is a colleague, maybe I have to ask you for help in the future. You have his phone number. I will forward the text message sent to me later for you as evidence." Qi Jing thought about it after explaining, and still suggested, "It should be no problem to make these preparations, but I think he should come to the hospital again just in case."

"Well, I understand this."

After learning from one mistake, Jiang Ling was confused and knew very well that this matter was related to her future and could not be lucky. If she didn't call the patient back and actually gave the treatment just now, she would have left a knot in her heart and would never be relieved.

This storm has come to an end, at least there should be no following for Qi Jing.

After hanging up the phone, Qi Jing stroked all the patients who were dealing with today. The morning was dull, but the situation started to be a little irritating in the afternoon. Throughout the day, there were many people in critical condition, but except for the female patient who had difficulty breathing due to severe pneumonia, everyone else was properly handled.

Why hasn't anyone come down from the infectious department yet?

Qi Jing looked at the time. It has been more than 4 hours since he called him. It would be normal to have a busy department, but today it is a double break, so it shouldn't be like this.

Considering the patient's troubles, he still couldn't help but call the infectious department again.

The man who answered the phone was still the hospitalized male doctor in the morning: "Hey, who should I look for?"

"I'm in a hurry. I called for a consultation in the morning." Qi Jing felt a little uncomfortable. "The patient was suffering from severe pneumonia, with a high fever of more than 39 degrees. After five hours, he had just been on the ventilator. Why didn't anyone come down to consult?"

"Hmm?" Unexpectedly, the male doctor also found it strange, "Did Director Cai not go down?"

"I didn't see anyone."

"The director's office has been empty, and I don't know where she went." The other party seemed helpless, "For consultation... I am the only one in the department now, so I can't escape."

Qi Jing couldn't even get the pneumonia, so it was not very meaningful to take the risk of having someone hospitalized for consultation.

Once you sit in this position, you will often slowly leave the clinical practice. Many people start to see the dragon from the secondary high school.

"Then give me Director Cai's Little Lingtong." Qi Jing leaned back and prepared to call himself to ask why.

"I've called twice before, but no one answered."

"Just give it to me."

"Okay." The patient was a big shot, and the male doctor was not worried and handed over the phone number.

As soon as Qi Jing hung up the phone, he dialed the number and called. However, just as the hospital said, the phone kept ringing, but no one answered.

Cai Ping has been in a state of "lost contact" since 11 o'clock. As a doctor, Qi Jing is still a diagnostic doctor who is particularly sensitive to diagnosis, so he has to consider it in some strange directions.

Cai Ping is in her 50s, and he doesn't know whether she has hypertension or not, but judging from her weighty body, even if she doesn't have hypertension, she has a high chance of diabetes. The incidence of the three highs has increased year by year, and it may be the same among the three, otherwise wouldn't you be sorry for her pear-shaped figure.

Hypertension corresponds to stroke.

If high blood sugar control is insufficient, it will turn into ketoacidosis. Too much sugar control means low sugar in stress blood, which are all complications of major problems in high blood sugar.

In the three highs, the high blood lipids look slightly better, but it itself is a high-risk factor that causes hypertension. When the situation reaches a certain level, it will also cause myocardial infarction and deep venous thrombosis. From the perspective of risk, it is only serious.

I started guessing again...

Qi Jing gently patted his forehead with his palm and said to himself: "If your brain is bent in, it is easy to hit a dead end, and the more you think about it, the more outrageous it becomes. At the beginning, this old lady lived to be seventy, she was in good health and was very energetic. Now she is still young, nothing should happen."

After changing his thinking, he focused on this severe pneumonia again.

In fact, he called the infection department to go to the director-level preparatory class. Even if Cai Ping, the chief director, did not do the preparatory class, the two directors in her department had a low level. Even if he could not diagnose the infection caused, he could still help check the diagnostic treatment.

Since Cai Ping is in the preparation class and he is not here, Qi Jing can only rely on himself.

Of course, he had already had a diagnosis, but it would take some verbal treatment to convince Wang Ting.

The patient was a middle-aged woman in her forties. When she came to the hospital, she had low fever, cough and some mild chest pain, and no sputum or other respiratory symptoms. There was no problem with the electrocardiogram in the ordinary emergency. However, the chest X-ray showed a large white pleural effusion in the left lung, so she turned to them.

After Hu Dongsheng took over, he considered that it was pleural effusion caused by pleuritis. Pleuritis will cause pleural irritation and chest pain will occur when coughing or breathing.

At the beginning, we had conservative treatment to see if the anti-infection treatment could be absorbed and eliminated by itself. However, within an hour, the patient's condition worsened, and in addition to coughing and chest pain, there was another difficulty in breathing.

Hu Dongsheng felt that it was the pleural fluid that pressed the left lung, so he didn't hesitate and directly called the respiratory department to get the pleural fluid.

The doctor who did breast wear was quick to get his hands and feet and pulled out a lot of fluid, but after the compression was relieved, the patient's breathing difficulty did not improve. This situation is rare, but Hu Dongsheng's reaction was very fast. He judged that the cause of breathing difficulty was not only pleural effusion, but may even have nothing to do with pleural effusion.

After notifying Wang Ting about the specific situation, the patient was asked to have a CT scan, but the result was that he could only see that there was a very mild diffuse inflammation in the left lung and no obvious lesions were found.

Logically speaking, the patient's condition is very serious, and his body temperature continues to rise after entering the hospital. Now he has difficulty breathing, but in the left lung where the pleural fluid is produced, they can't even detect a lesion. Death played a joke with these emergency doctors, and hid it behind the scenes after a fake shot, leaving only a bag of clear pleural fluid.

At this time, Qi Jing guessed that the cause of the infection might be Toxoplasma gondii.

The guess is very bold, but there are actually not many reasons, only two points.

Toxoplasma gondii usually infects the brain and lungs. There are several forms of lung disease. One of them is severe pleurisitis, which causes a large amount of pleural effusion. Although the lungs are seriously infected, they are not obvious in imaging. The second point is that the patient has raised a cat at home. Although the cat died two years ago, Qi Jing still believes that Toxoplasma gondii was brought by this dead cat.

"What's the reason?" Wang Ting slapped the table and scolded, "At least you can say something useful!"

Qi Jing spread his hands and said with a smile: "What can I do? The laboratory departments in the hospital do not have special dyeing for parasites at all, otherwise it would be fine to use the pleural effusion for a light microscope examination, which is very easy."

"Then let the family notify you and send it to the Centers for Disease Control and Prevention."

"The CDC is not fast, and it takes a lot of time to get the results. Can she survive the results in this situation?" Qi Jing thought about it and came up with a solution that was not a solution. "In fact, Toxoplasma gondii is a parasite that may cause disease. If a patient is infected with Toxoplasma, the number of T cells should be reduced."

"You mean to do a CD4T cell count?"

"Immunofluorescence can still be done in the laboratory." Qi Jing smiled, "Actually, I really want to get rid of HIV testing together."

"Forget HIV, what do you say when the family asks?"

"Speak straight, what else can I say?"

Qi Jing replied seriously and immediately caught a bloody routine check-up from Wang Tingfei: "What a bad idea? You should be more at ease and stay in the clinic honestly. Don't go to the observation room to find trouble for me if I have nothing to do!"

Wang Ting only adopted his previous opinion, and first did a CD4T cell count to check the patient's immunity. Although the reduction of CD4T cell is closely related to HIV itself, the old man was still stable. It would be better to suppress it before the cell count came out.

However, the CD4 count itself also takes time. During this period, the patient's condition further worsened and he was directly carried into the heavy cell.

The severe pneumonia caused by unknown infections, the oxygen saturation dropped below 90 when the respiratory department came down. There is nothing else to do except recommending the ventilator. Now, the infectious department can only use antibiotics selectively and try their luck.

Of course, Qi Jing still felt it was like Toxoplasma gondii, so he wrote down drugs for anti-Toxoplasma infection on the prescription sheet early in the morning.

If sulfadiazine and pyrimethamine are used in combination, azithromycin or clindamycin can be added if the situation allows. If the CD4T cells are reduced, interferon is also required.

After that, I can only leave it to fate.

Qi Jing turned on the computer and kept refreshing the patient's laboratory examination report column...

In fact, in his opinion, even if the CD4T cells are not high, they should be treated directly. After all, Toxoplasma infection is only more common in patients with decreased immunity, and in fact, a small number of patients have normal immunity.

With the sound of the mouse constantly tapping, a check record suddenly appeared in front of him.

"Here's here..."

Qi Jing clicked on the report, and the inspection item in front of him suddenly appeared in front of him. The bright red numbers and the downward arrow were extremely eye-catching: "It's so low!"

After confirming that he read it correctly, he immediately ran to the ICU.

Wang Ting didn't expect that the patient's immunity would be reduced so much: "It's only 93? That's so low?"

"Yes, adults need to have more than 500 per liter per microliter, and the double digits are too low." Qi Jing looked at the patient who was plugged in with a ventilator and took out the prescription form that had been filled in anti-toxoplasma treatment, "Start the treatment."

Wang Ting looked at the four rows of medicines and felt scared: "You use so many medicines?"

"The infection is too severe, you must take a try." Qi Jing explained, "Since CD4 is reduced and the immune system is completely shut down, she will suffer from septic shock at any time. It's really time..."

Wang Ting sighed: "I'll go talk to my family."

When encountering such severe patients in the U-hindrance, Wang Ting usually goes to talk to his family. After working for so many years, the old man is very good at controlling his emotions and will not over-stimulate his family's nerves. He has always been in charge of this aspect.

Qi Jing's mouth is already very owed and knows his shortcomings, so he doesn't even touch such a job.

But this time he rarely stopped the old man: "I'll do it."

"You go talk?"

Qi Jing stepped forward and lifted the patient's sleeve. He could clearly see some small rashes on the skin of his arms. These rashes that appeared at some unknown time, lung infections in her body, and CD4T cells were all pointed to HIV.

Now it is still a question whether the patient can be rescued. The most important thing is to determine the patient's family, that is, her husband's situation.

"Do you want his husband to have an HIV test?" Wang Ting sighed, "It's not that I haven't encountered such a thing, of course I'll let him do it."

"Director, you misunderstood." Qi Jing said, "It's time now, so we can't say it."

"Can't you say it?"
Chapter completed!