Chapter 409 Rare disease, unexpected miracle drug

Debridement, hemostasis, suturing.

For Xu Qiu, covering dentistry, ENT, and ophthalmology is not a problem.

"Facial stitching +1!"

"Medullary cavity debridement +1!"

"..."

Half an hour later, Xu Qiu finished treating the large scar that ran across the left side of his face.

"Thank you. I heard the police beauty in our station told you about you. Are you Dr. Xu?" the policeman with his face bandaged with gauze said excitedly.

"Police beauty?"

"Yu Bingqing, I have been to your hospital several times before. You saved the trafficker Zhang San last time."

"oh."

Only then did Xu Qiu remember.

"What happened next?"

The policeman said with some sadness and anger: "It's exactly what you said, that kid pretended to be unconscious. Later, we called our colleagues who were pre-trial officers to come over, and after a few of them came back, he took action on all of them.

We spent a few days arresting the woman who had interacted with him, her name was Aunt Zhu.

They are all women, who knew she could do such an animal thing.

She sold Zhang San's wife to four old men, and committed suicide that night because she could not bear the humiliation.

Zhang's third son, as well as the victim's second son, traveled to five or six provinces before finding them all.

Fortunately, those who buy them are intended to raise them, so there is no harm to the body.

Fortunately they are boys, if they were girls..."

The processing room was silent.

Wang Fan clenched his fists.

"Should this bastard be sentenced to death?" he asked through gritted teeth.

The policeman nodded: "Two lives, plus two children, and one child has suffered irreversible mental damage. There is no escape from the death penalty. It will take a year and a half to be sentenced."

Punishment is for reform.

For Zhang San, people like him no longer need to be reformed. Let God forgive him.

Xu Qiu is also very satisfied with the result.

It would be too easy to let him die unconsciously.

To be rescued and then wait for a long period of death penalty is the most severe punishment that a society governed by the rule of law can achieve.

…

The next day.

After the morning shift, Xu Qiu called Li Xue and transferred the medical records of the girl yesterday.

Li Xuehui reported: "The pediatrician stopped the medicine as you asked, and checked the epinephrine quantitative measurement and biopsy. It seems that there is something wrong..."

Xu Qiu glanced at the report.

The plasma concentration of epinephrine in a normal person does not exceed 480 units, while the urinary epinephrine ranges from 0 to 80 units.

However, the girl's blood concentration was over a thousand, and her urine concentration reached a high level of 400 units.

Pathological biopsy found some blood-filled vascular spaces and hair follicles.

These two projects left Li Xue a little confused.

Clinically, epinephrine levels are generally used to assist in the judgment of high blood pressure. Why should it be done on a little girl with unexplained bleeding?

Besides, what’s the point of a biopsy showing blood-filled hair follicles, etc.?

"Moreover, Doctor Xu, you figured out the problem at that time, right? Why can't I figure it out?" Li Xue couldn't understand.

She is a very talented doctor and has very solid clinical skills. How could she not be able to do a simple skin palpation well?

Xu Qiu said honestly: "I cheated."

"I know you're cheating. Forget it. What do the adrenaline levels and the biopsy indicate?"

"Hemathidrosis."

Li Xue was stunned by the words in Xu Qiu's mouth.

She quickly used the computer at hand to check the literature library before she found this rare disease.

Xu Qiu continued to explain:

“To be precise, it is hemathidrosis caused by dermal defects.

Patients have a weak skin matrix, so blood easily accumulates abnormally in blood vessels.

When the pressure in the blood vessel cavity continues to increase, the blood vessel cavity will rupture, and then blood will leak out along the sweat gland ducts and even appear on the surface of the skin. "

Li Xue's face was full of confusion: "But I have done a biopsy before, and no dilated blood vessels or lumen fragments were found."

Xu Qiu: “This has to do with the pathogenesis of hemorrhagic syndrome—intermittent bleeding.

The reason for intermittent bleeding is that the fragments of the blood vessel cavity will disappear after leaking out of the skin, and will be rebuilt when the blood flow stops.

Therefore, abnormalities can only be detected during the attack period. "

Li Xue nodded silently.

She thought for a moment and then asked, "What about the adrenaline level?"

"Adrenaline will constrict the blood vessels around the sweat glands, leading to increased dilation. Blood will more easily fill the sweat gland ducts and leak out more easily. The sudden bleeding a few days after hospitalization should be related to this."

Xu Qiu recalled the loose feeling when palpating the girl's skin.

The cause of this area is most likely due to the continuous accumulation and elimination of blood, which rises and falls like a balloon. After the blood is completely drained, fatigue, or even missing matrix, endothelial cells, etc., lead to this area. Soft and sunken.

It is considered a histological defect.

Li Xue still looked surprised.

I just went to see him twice and was he really diagnosed?

Hemathidrosis!

She took advantage of these few minutes to scan it roughly.

This is a disease of unknown origin and pathogenesis, usually associated with plague, hemophilia, menstrual abnormalities, or severe mental illness.

There are less than a hundred cases reported both at home and abroad.

Almost catching up with the rare brain-eating amoeba.

only……

How to treat this disease?

"Resume medication first, and add propranolol after confirming that there are no drug contraindications. Then you can ask the psychiatric department to come for consultation to see if she has any mental illness." Xu Qiu arranged.

Hemophilia, plague, etc. have long been indirectly ruled out through various tests.

Next is her mental problem.

As for the added drug propranolol, that is, propranolol, it is actually a β-receptor inhibitor.

Clinical studies have shown that the sympathetic nervous system is involved in the onset of hemathidrosis.

And propranolol has three effects.

First, anti-vasoconstriction, thereby constricting blood vessels.

Second, blocking angiogenesis-related signaling pathways, such as reducing the synthesis and release of NO, thereby inhibiting vascular smooth muscle relaxation and ultimately constricting blood vessels.

Speaking of which, NO is hailed as the "future molecule" in Linhai's small blood vessels and has played a huge role in the replacement of small blood vessels, but propranolol is a contraindicated drug after surgery.

Otherwise, the NO release technology equipped with Linhai's small blood vessels will be perfectly restrained by propranolol.

As for the third point, propranolol can also inhibit vascular endothelial growth factor, reduce vascular expression, promote the death of capillary endothelial cells, and further reduce the formation of new blood vessels.

Each of the three effects accurately hits the pathogenesis of hemathidrosis.

This is a very beautiful coincidence in clinical practice.

A drug for treating arrhythmia, hypertension, and angina pectoris, but in the end it has a miraculous effect on hemathidrosis, which has nothing to do with the heart and blood pressure.

I am afraid that even the company that developed propranolol could not have thought that it would one day become a "magic drug" for a rare disease.