Han Guangyun quickly set up a group, pulled Mr. Wu in, and then video group chat.


    Matthew trimmed his hair to make himself look more energetic.


    Director Tang''s room is a little dark and the background is familiar. It looks like her office.


    "Director Tang, Mr. Wu wants to ask the patient about the video and prepare the patient information on your side." Matthew cleared his throat and said.


    "Horse yard, you haven''t rested yet? How can I look like a medical dispute in the medical department?"


    "I''m afraid I have to toss about something. I''ve been sleeping in my unit recently." Matthew said faintly.


    In fact, there are other reasons why he doesn''t go home.


    "I''ll see. By the way, the sputum culture results are back. There may be more evidence that the patient is not infected by the new pneumonia." director Tang sat at his desk with his mobile phone.


    Soon, Wu Mian added.


    The streets are cold,


    no one,


    No car.


    Wu Mian sat on the steps, next to a small head, and his eyebrows should be Chu Zhixi.


    "Oh? The horse yard didn''t come home." Wu Mian said with a smile. "Are you worried that the family will be infected? Can you carry it if you sleep in the medical office every day?"


    "..." Matthew sighed.


    "Or the people in the community won''t let you in?"


    This sentence is more heartbreaking.


    Matthew felt that Mr. Wu picked up something bad to say. There was a big wedding today. He said it so heartbreaking.


    "Director Tang, you are also in the office."


    "Well, when I went home, the community said that the people in the hospital had better not go back. They were afraid of carrying the virus. I thought about it, and it seems so." director Tang said faintly, "the hospital is particularly unpopular now, and the despised chain transmits very fast."


    "Well, it''s normal." Wu Mian didn''t complain. He held a cigarette in his mouth, touched the lighter and lit it. After taking a sip, he said, "it''s not easy for the community. My mother became a volunteer and controlled the community with the streets and neighborhood committees. She braved the wind and snow every day."


    Matthew looked at Wu Mian and Chu Zhixi in the video. He didn''t see them for more than ten days. He felt as if he were separated from the world.


    Professor Chu with long hair has a small flat head, deep Le marks on his forehead and bridge of his nose, and faint blood can be seen in some places.


    Mr. Wu is the same. Coupled with the back of director Tang''s office, Matthew felt sad all his life.


    It''s been a long time, and I don''t know what day it will be.


    "Director Tang, tell me about the patient."


    Director Tang began to report the medical history.


    It''s quite simple to report to Matthew. It''s very detailed to report to Wu Mian.


    "Physical examination: the patient was conscious, his body temperature was 36.7 ℃, he breathed 26 times, his blood pressure was 13175mmhg, spo293%, noninvasive ventilator, fio270%.


    The superficial lymph nodes of the whole body are not enlarged, the jugular vein is not dilated, the respiratory movement of both lungs is slightly enhanced, and scattered wet rales can be heard in both lower lungs. There is no special physical examination in the rest of the heart, lung and abdomen, and there is no edema in both lower limbs. "


    "Laboratory tests showed elevated leukocytes and inflammatory indicators - leukocyte count 13.05 × 109l, neutrophil percentage 88.3%, ESR 64mmh, procalcitonin 0.21ngml] "


    "CD4 absolute count 48cell, CD8 absolute count 59cell.


    Etiological examination: sputum culture: more Aspergillus fumigatus complex (3 +), positive serum GM test (0.12). "


    "The result of sputum culture is Aspergillus fumigatus?" asked Wu Mian.


    "Yes, Mr. Wu. The results of sputum culture have not come back during the consultation in the afternoon, so we are more inclined to new pneumonia. After all, the patient is strong labor, suddenly has fever, blood oxygen saturation decreases, and needs ventilator to assist breathing. These are the diagnostic criteria of new pneumonia. Plus lung CT..."


    "Did the results of alveolar lavage come out?"


    "Not yet, but tomorrow morning," said Director Tang. "According to the sputum culture results, the preliminary diagnosis of" pulmonary aspergillosis "was given voriconazole + moxifloxacin anti infection, methylprednisolone anti-inflammatory treatment, and non-invasive ventilator assisted ventilation was continued."


    "Mr. Wu, the problem now is that the cause of diffuse interstitial changes in both lungs is unknown, and Aspergillus infection can not explain the disease."


    "I''m going to have a biopsy of my right lower lung."


    "No," Wu Mian said with a cigarette in his mouth. "According to the current situation of the patient, there is a high possibility of pleural reaction in puncture biopsy, and emergency rescue may be needed."


    "..." director Tang was stunned.


    Without explaining why, Wu Mian continued, "I suggest adjusting the medication and changing moxifloxacin + voriconazole to Dafukang + piperacillin tazobactam."


    "Miss Wu, what disease do you think?"


    "There are some judgments, but I''m not sure. I heard the medical history. When the patient had the attack four years ago, he worked in a foreign place, and all the data were missing at that time?"


    "Yes, Miss Wu."


    "Ask where to work. I''ll see if I can ask the people in the local hospital for information." Wu Mian said faintly.


    He said, spitting out a rim of his eye leisurely. Matthew saw his eyes and was quiet. Miss Wu looks in a good mood. That''s the best news.


    Director Tang was very happy. Having previous data is of great significance to the diagnosis of patients.


    Matthew de sighed in his heart that teacher Wu had to spend a lot of time looking for past materials for such a small matter. He was a little too serious.


    Soon, director Tang asked that the patient worked in Jiangnan Province four years ago. He only knew the city and did not know which hospital he went to.


    "I''ll find out the patient''s ID number to me."


    "Miss Wu, it''s very troublesome."


    "It''s OK," said Wu Mian. "In recent years, the big data health system has been built, and some cities in the South upload the data from the image database. After all, CT machines can save data for up to half a year, so they have to be cleaned up once, otherwise the old cow can''t pull the broken car at all."


    In the video, Wu Mian''s mask was pulled on his jaw, smoking silently with a cigarette in his mouth, and he didn''t see any action.


    After smoking a cigarette, Chu Zhixi''s voice came, "brother, I found it."


    "Let me have a look."


    "When the patient suffered from pulmonary tuberculosis 4 years ago, chest CT showed multiple small nodules and mass shadows involving both lungs." Wu Mian said, "this patient is a little interesting."


    Han Guangyun was stunned and didn''t know what Wu Mian was talking about.


    Director Tang knew that she asked for the first time, "tuberculosis should not have obvious infection lesions, and the patient is a young male without other basic diseases. He has been engaged in physical activities for a long time. Why does such a serious infection occur repeatedly?"


    "Do a genetic test... Has the second hospital carried out this test?" Wu Mian said. "If not, I''ll leave you a phone call. It''s one of my patients."


    "Huh?"


    "Leso gene''s boss still lives at the foot of laogua mountain." Wu Mian smiled and said, "director Tang contacted him to see if there were ciliary movement related genetic defects."


    "Primary ciliary dyskinesia?" director Tang was stunned.