I can extract side effects

Chapter 466 NDM-1 Drug Resistance Gene, Combination Drugs

Zhu Jun's account at station B has millions of fans, and he is also considered a very influential Up master in the game area.

Although he doesn't broadcast live every day, it is actually rare for him to disappear for a week like this.

Many fans who missed him came to the space to leave a message, asking about his recent situation.

Until this day, the account @口强王朱俊 suddenly released a new video.

It was not Zhu Jun who appeared on the screen, but a face in his thirties who was somewhat similar to him.

As soon as he came up, he introduced himself, told all about Zhu Jun's condition, and released a video of Zhu Jun unconscious in the ICU.

"Hi everyone, I'm Zhu Ming, Zhu Jun's elder brother. Zhu Jun is seriously ill and unconscious. Let me speak for him."

"Four days ago, Zhu Jun's liver and kidney function was damaged due to a urinary tract infection, his platelet index was very low, and he was in a severe coma. He has been lying in the ICU intensive care unit."

"We don't need donations, and we don't need money. We just hope that a more professional team of doctors can come to Hangzhou Zhejiang Medical First Hospital for offline treatment, because his current physical condition cannot be transferred to other cities."

"We need specialists in infectious diseases, hepatology, nephrology, or intensive care."

"I haven't closed my eyes for several days, and my mother fainted from crying, and everyone is on the verge of collapse."

"I temporarily entrusted Zhu Jun's up owner friend to make this video. I am still accompanying him in the hospital, and I am trying to find a treatment plan everywhere."

"It's urgent, human life is at stake, I hope everyone will forward it more and help spread it."

"I just want to find a better expert and treatment plan, and I am willing to spend any money."

"If you can help, please leave your contact information in the comment area, thank you very much."

When the video "I am in a coma, please help me find an expert" was released, fans were shocked.

They forwarded it one after another, expressing their best wishes.

"I'm crying, I hope he recovers soon."

"A good man will live a long life and get well."

"I have been following the up master for several years. His optimism and bravery have inspired me. I have gone through many troughs in life. Auspicious people have their own fortune. He will be fine."

"Come on, young man! I have a classmate who is a doctor. I'll help you to ask."

After Zhu Ming released the video, he also called many local media for help.

When the media report was also published on the Internet, it immediately caused a sensation.

Netizens were very sympathetic after reading Zhu Jun's deeds, and helped to forward it one after another, and @many well-known medical big V.

The medical big Vs lived up to expectations and gave their own interpretations, saying that they would ask experts in the industry, and by the way, they also conducted a wave of popular science for the public.

Huang Yaoshi: "Paralyzed patients and bedridden elderly, due to perennial catheterization, have low autoimmunity, which will inevitably lead to urinary tract infections and other diseases. In this case, it is mostly caused by opportunistic pathogens, such as E. coli. Lebsiella, Pseudomonas aeruginosa, etc. It is recommended to take cephalosporin antibiotics for anti-infection treatment under the guidance of a doctor."

Dr. Lilac: "Looking at the patient's condition, he has already entered the ICU. It must be very serious. I am not a professional infection doctor, so I can only help forward it. I hope some experts in the industry can stand up and give a professional treatment plan."

There is a trick in mind: "Urinary tract infection belongs to the category of "sprain syndrome" in traditional Chinese medicine. It is mostly caused by infection of damp-heat pathogens. Righteous deficiency and evil love. If the blood collaterals of the kidney and bladder are damaged, the blood does not follow the meridian and become hematuria. The deficiency of spleen and kidney qi for a long time, the defense is not strong, and it is easy to be infected with external evils, which recurs and aggravates the condition. I Here are a few Chinese medicine prescriptions that are symptomatic, and when the patient is rescued, they can recuperate the body."

Although doctors and big Vs are very enthusiastic about giving advice, netizens seem to be ungrateful to some people.

Especially after Xin Youshu issued a few Chinese medicine prescriptions, it immediately attracted a lot of ridicule.

"To be reasonable, for a disease like high paraplegia, Chinese medicine practitioners shouldn't touch porcelain."

"Some people may not know that many liver and kidney injuries are caused by taking traditional Chinese medicine."

"Hehe, Chinese medicine black is really everywhere, come here if you smell it. Western medicine is so powerful, why can't high paraplegia be cured, even a urinary tract infection can't be cured, and you have the face to ask for help from the whole network?"

"At least the patient is still hanging in the ICU, and when he turns back and pours a dose of traditional Chinese medicine, he immediately whines and mourns.

"This question should be looked at dialectically. If you don't try it, how will you know if it will work?"

"Once again, there is no distinction between Western medicine and Chinese medicine. They are all modern medicine. Can you understand the basic common sense before arguing."

Almost instantly, Chinese medicine blacks and Chinese medicine fans came and went, launching a high-intensity battle, which completely misled the topic.

Just when Zhu Ming launched the entire network, looking for experts.

Hangzhou, Zhejiang Medical First Hospital.

In a spacious conference room, the directors of various departments such as infection department, ICU department, hepatology department, nephrology department, and cardiology department are all gathered at this moment and are conducting expert consultation.

After explaining Zhu Jun's case, Dr. Zhao sat down and waited quietly.

The director of the nephrology department pondered and said: "The acidosis caused by the patient's kidney damage has been treated with sodium bicarbonate, and diuretics were also used for the edema. to continue the medication.”

The director of the ICU rubbed his face, and said with a tired face: "I have issued a critical illness notice twice, and I have been rescued each time. I have tried my best."

"If it continues to deteriorate, it is likely that in addition to the kidneys, other organs in the body will fail frequently, and then it will be really powerless."

Hearing this, everyone looked at the director of the infection department in unison.

The director of the infection department smiled wryly, and said: "Basically, except for a few antibiotics that are seriously harmful to the liver and kidneys, all other antibiotics that can be used have been used, but with little effect. It can be seen that the Pseudomonas aeruginosa on the patient's body is very resistant to drugs. .”

"To be honest, I don't have a good idea."

Speaking of this, he showed a hint of hesitation, and said, "How about we try polymyxin? See if it can curb the super bacteria on the patient."

The director of the nephrology department hesitated for a moment, then flatly refused: "No, it's too dangerous. This antibiotic is very toxic to the kidneys."

The director of the Department of Infectious Diseases is still struggling: "What if it is used multiple times in small doses?"

The director of the nephrology department asked with a straight face, "How small is a small dose? Antibiotics are usually given by intravenous drip or intravenous injection. Adults need to inject 100-200 mg every 8 hours. The dose is already very small. Does it work? Don’t forget that the patient I just rescued was sent away by you before he lived for a few hours.”

The director of the infection department fell silent for a moment.

The director of the ICU suddenly interjected and asked, "Have you figured out what is causing the drug resistance?"

The director of the infection department took out his mobile phone and explained: "We are doing genetic testing on the Pseudomonas aeruginosa extracted from the patient's body. It is estimated that the results will come out soon."

The phone was connected quickly, and he asked a few words, his expression became dignified.

After hanging up the phone, he looked around and said slowly: "After PCR sequencing of Pseudomonas aeruginosa in the patient's body, the NDM-1 drug resistance gene was detected on the coding plasmid, which is resistant to all β-lactam antibiotics. Medicinal."

He paused for a moment, then added: "This resistance gene even produces resistance to another last-line antibiotic, the carbapenem antibiotic."

"The only options we have left now are polymyxins, not only that, but also in combination with antimicrobial inhibitors."

The whole audience was suddenly silent, and everyone knew what this meant.

Before, although everyone also speculated that there must be some gene mutation in Pseudomonas aeruginosa, it will be resistant to so many antibiotics.

However, when the truth was finally revealed, everyone still felt a tinge of despair.

There are a wide range of β-lactam antibiotics, including penicillins and their derivatives, cephalosporins, monoamide rings, carbapenems and penem enzyme inhibitors, etc., which are the most widely used antibacterial drugs one type.

NDM-1 is a new super-resistant gene discovered by scientists, which encodes a new drug-resistant enzyme that can break down most antibiotics and make them ineffective.

Not only that, but it spreads rapidly between different bacterial populations.

Pseudomonas aeruginosa itself can change the permeability of the cell membrane and prevent the entry of penicillin drugs. With the drug resistance gene, it can even take the initiative to hydrolyze penicillin and cephalosporins and other drugs with hydrolytic enzymes.

In other words, except for those two or three drugs that are called the last line of defense of antibiotics, there are no drugs available.

The director of the infection department pondered for a moment, as if he had made up his mind, he said resolutely: "In this case, we can only use polymyxin, and it is best to use it together with a bacteriostatic agent such as tigecycline."

The director of the liver department turned dark immediately: "Although tigecycline can overcome the tetracycline resistance caused by bacterial efflux and ribosome protection, it is the last treatment for patients with multidrug-resistant Gram-negative bacteria infection, but it Very toxic to the liver."

The director of the infection department smiled: "So the patient's liver is counting on you."

The director of the liver department and the director of the nephrology department looked at each other at the same time, both wanting to cry.

At this time, the phone of the ICU director rang, and he hurried out for a minute, then rushed back immediately.

With a happy expression on his face, he said loudly to everyone: "An acquaintance contacted me just now and provided a solution. It can not only reduce the dosage of the medicine, reduce the damage to the liver and kidney, but also enhance the efficacy of the medicine."

Everyone looked over in unison, waiting for his answer.

The director of the ICU was overjoyed and said: "The person who called me was the director of the ICU of the First People's Hospital of Kunming City. He has a lot of experience in nosocomial infections caused by super bacteria. called me..."

"Get to the point!"

Everyone roared in unison.

The director of the ICU felt a trace of coldness in the eyes of his colleagues, and immediately shrank his neck and said.

"Sanqing's nano-pill, which is a nano-scale powerful drug delivery tool, can reduce the dose of antibiotics to one-thousandth and deliver them directly to the lesion, reducing the loss in the human body's metabolic process, so it can maintain the same At the same time, it greatly reduces the toxicity to the liver and kidney, as well as other adverse reactions.”

"At present, this pill has just entered the third phase of clinical trials. We need to contact Sanqing Group as soon as possible to apply for participation in clinical trials."

"With the nano-pill, it can be combined with polymyxin and tigecycline. The former is effective against drug-resistant Pseudomonas aeruginosa, and the latter can inhibit the drug resistance of bacteria, which will surely save the patient. "

As soon as the words fell, the director of the nephrology department applauded: "Wonderful, if the dosage is one-thousandth, the dosage will be reduced from 100 mg to 0.1 mg, and the toxicity to patients will be basically negligible. It really serves multiple purposes!"

The director of the liver department also nodded approvingly. Generally, for intravenous drip, the dosage of antibiotics is about a few grams, and within 8 hours, so as to maintain the drug concentration in the body and achieve the bactericidal effect.

At the same time, most of the antibiotics are excreted from the liver and kidneys. A large dose will be very toxic and accompanied by other adverse reactions.

If it can be reduced from the gram level to the milligram level, and the content of the drug in the body can be maintained, then the effect will be self-evident for the patient.

Although the dosage of polymyxin is not so large, only 100 mg, but if it can be reduced to less than 1 mg, then all concerns will disappear.

The director of the infection department immediately stood up and urged: "Since there is such a good thing, what are you waiting for? Hurry up and call the people from Sanqing. I remember that when our hospital bought equipment, there seemed to be a medical representative from Sanqing. Come here."

The director of the ICU got up and walked towards the door: "Yes, I will contact you right away. You can wait for my good news."

*****

Due to the urgency of the situation, Xue Shen rushed to Hangzhou with nano-pills that night.

Dr. Zhao enthusiastically took him to the intensive care unit.

"Sanqing sent someone here so quickly, I am really grateful."

Xue Shen opened the refrigerator in his hand, pointed to the two slightly green syringes inside, and asked, "Do you have polymyxin and tigecycline for injection here?"

Dr. Zhao nodded in surprise: "Yes, why, don't you have these two kinds of antibiotics?"

Xue Shen spread his hands and said: "We have made some improvements to the nano-pill technology. Now we only need to inject the antibiotic injection into the solution of the nano-pill, and the nano-polymer on the green algae can bind the drug molecule within a few minutes. It's attached to the pill."

"In this way, we don't need to prepare in advance in the laboratory, and mount the antibiotics on the nano-pills in advance, and they can be deployed on site.

"Of course, the dosage of different drugs must be properly adjusted to achieve saturation and meet the maximum loading effect."

Dr. Zhao was dumbfounded, and couldn't help admiring the magic of nano-pills.

"There is such a miraculous pill, it is indeed produced by Sanqing."

Soon, the nurse brought two bottles of medicine, one was polymyxin B sulfate for injection, and the other was tigecycline for injection, both in the specification of 50 mg.

Dr. Zhao hesitated for a moment and asked, "What should I do with this? It seems that the dosage is a bit too much."

Xue Shen smiled: "Take a part first, about a few milligrams, and then inject it into the solution. After the nano-pill absorbs drug molecules to saturation, it will not continue."

Doctor Zhao suddenly realized: "It turns out that it is so convenient."

He carefully extracted a small amount of the medicine from the two injections, and injected them into a nano-pill solution respectively.

Xue Shen shook the two syringes vigorously, seeing that the liquid became cloudy, and then quickly returned to clarity, except that there were some precipitates that were barely visible to the naked eye at the bottom.

Dr. Zhao opened his eyes wide, and after looking at it for a while, he asked, "Is that all right?"

"That's right, you lead the way."

Xue Shen put the syringe into the refrigerator again, picked it up, and followed Dr. Zhao to the ICU ward.

Several department directors have gathered around the patient's bed, waiting for treatment.

The expressions on their faces were originally a little anxious, but after seeing Xue Shen, they instantly turned into bright smiles.

Xue Shen took out the nano-pill injection and handed it to the director of the ICU under the signal of everyone.

He could see that the other party was more excited, as if he had been looking forward to this moment for a long time.

The director of the ICU took a careful look at the injection in his hand, and reluctantly looked away.

At this moment, Zhu Jun still had a high fever and was lying unconscious on the hospital bed.

The entire ward was very quiet, save for the beeping of the monitor and the occasional gurgling of the ventilator.

After the nurse disinfected, the ICU director took a deep breath.

Under the nervous eyes of everyone, two nano-pill solutions were injected into the patient's vein in turn.