The patient doesn't have coronary heart disease! "Su Yun said out of habit.
However, he moved slightly and sat down steadily. He did not get out of the car. Instead, he stared at Zheng Ren's back thoughtfully.
"Brother Yun, what is Boss Zheng trying to do?" Luan Yingjie asked anxiously.
"I'm going to buy medicine. Do you think I'm going to the pharmacy to buy groceries? You don't say, there are people who go to the hospital to buy Job's Tears. Maybe the pharmacy also sells vegetables. "Su Yun's answer was not serious at all.
"…" Luan Yingjie was at a loss for words.
"Brother Yun, do you think my father's illness will worsen if I don't send him to the mental hospital? Should I move to another courtyard house? I'm really afraid that one day he'll take things too hard and jump off a building, "Luan Yingjie said in distress.
"Oh, Old Luan, you've earned quite a lot over the years. You even have a siheyuan." Su Yun began to chat with Luan Yingjie when he saw Zheng Ren enter the pharmacy.
"Isn't my old house just waiting to be demolished? But they said that they want to protect cultural relics. Tell me, what's the point of protecting an old house? "Luan Yingjie said," After a while, they will have to sort the garbage again, I … "
"Why are you talking about garbage sorting again?" Su Yun said: "It's fine. From the boss's expression, it should be nothing major. Don't worry."
"Brother Yun, there's a rumor in Pengcheng that Boss Zheng cured a Geomaster's Heavenly Wrath. Is that true?" Although Luan Yingjie was anxious, he could not leave now, so he could only talk nonsense with Su Yun.
"What Earth Master? It's just a bath." Su Yun laughed: "Don't spout such superstitious words."
"Uh …" Luan Yingjie was stunned for a moment. He thought to himself, Brother Yun is still young and bold. Geomasters are nothing more than scrubbers in his mouth.
Soon, Zheng Ren came out of the checkpoint and returned to the car.
"The price of nitroglycerin has gone up." This was the first thing Zheng Ren said after getting into the car.
Su Yun was surprised.
Why would a doctor go to a pharmacy to buy medicine? Nowadays, the hospital had zero markup on the medicine, and the medicine was cheaper than the pharmacy. Other than having to queue up and register, there were no other disadvantages.
The price of nitroglycerin didn't affect his boss at all.
"How much did it increase?"
"10 times? 20 times? "Zheng Ren asked.
"…" Su Yun did not know much about this and was shocked.
"In the past, nitroglycerin was all in a big bottle. I don't know how many pills were in it. Sometimes, I asked the patients to go to the pharmacy to buy it themselves," Zheng Ren said. "Now, the cheap big bottles are gone, and only this kind of packaging is left. The packaging takes up 95% of the retail price. What do you think … "
"Stop talking nonsense and get down to business." Su Yun said. "Why did you buy nitroglycerin?"
"Do a tilt test," Zheng Ren said.
"Tilt test? Are you trying to see if my dad's brain is working? Or is your body flexible? "Luan Yingjie asked." Boss Zheng, the mental type that you just mentioned … "
"It's the autonomic nervous system, not the mind," Zheng Ren corrected. "I'm not considering a mental illness. Don't spout nonsense."
Why did Boss Zheng speak as if he was his own son and he was the bystander?
Luan Yingjie was a little surprised.
"The patient's upright reaction is similar to the clinical manifestations of syncope, so it is used to assist in the diagnosis of vasovagal syncope. Is this it? "Su Yun asked.
"Yes."
"Then why are we following him?" Su Yun was puzzled.
"To take a look. In order to increase the effect of the tilt test, the nitroglycerin is more obvious," Zheng Ren said. "I'm worried that the old man will have a temporary discomfort and the family won't be able to deal with it."
"You don't have anything," Su Yun said.
"Call the ambulance," Zheng Ren said. "Let Zhou Litao come directly with the first-aid kit. If anything really happens, he can deal with it immediately."
"Is this considered private use of public resources?" Su Yun spat.
"It's not considered private use of the patient as long as the resources are used on the patient," Zheng Ren said. "If I drive the ambulance out to play, it's considered private use of public resources."
"You don't say. I heard from my teacher that when he went for freelance surgery twenty years ago, the local hospital drove the ambulance out to play," Su Yun said with a smile.
"Now it's gone. The ambulance can't even come here," Zheng Ren said.
Luan Yingjie heard the two of them chatting and felt a little anxious. He took the time to interrupt their conversation and asked, "Boss Zheng, what is the tilt test?"
"Uh …" Zheng Ren thought about it. It would be troublesome to explain, but he could not stay silent when the patient's family asked.
Moreover, there would be some turbulence in the tilt test after taking nitroglycerin. He needed the patient's family's cooperation.
"Let's put it this way, Boss Luan," Zheng Ren said. "When the human body is upright, due to the effect of gravity, 300 to 800 ml of blood accumulates in the lower limbs, causing the central venous pressure, the output of each stroke, and arterial blood pressure to decrease. Reflexively, it causes the sympathetic nervous system to increase, manifesting as an increase in heart rate, a slight decrease in systolic blood pressure, and a slight increase in diastolic blood pressure."
Su Yun saw Luan Yingjie's dumbfounded expression and interrupted him. "Do you have a friend with high blood pressure?"
"Yes."
"The first thing he does every morning is to measure his blood pressure. He lies on his back on the bed because his blood pressure is unstable when he stands up. That's what the boss meant just now. "
Luan Yingjie immediately understood if he explained it in human terms.
Su Yun was helpless. The boss must be looking forward to doing the experiment immediately. The explanation was too professional.
"Well, that's basically it. I think your father has autonomic dysfunction, "Zheng Ren continued. "When a patient with vasovagal syncope stands upright, the blood accumulation in the lower limbs is more severe than that of a normal person. The central venous pressure is significantly reduced, the volume of blood flow is reduced, and the sympathetic nervous system continues to increase."
Luan Yingjie did not quite understand.
"This leads to a significant increase in ventricular contractility, which over-stimulates the baroreceptors in the posterior inferior wall of the left ventricle. As a result, the sympathetic nervous system reflexively decreases, blood vessels dilate, and blood pressure drops. Sudden brain ischemia leads to syncope, sometimes accompanied by increased vagal nerve tension and bradycardia."
"Boss, have you studied the unmyelinated C-nerve fibers?" Su Yun suddenly asked.
"You've studied them before? Using white mice in the lab? "
"Yes, that's interesting." Su Yun smiled proudly. "I cut them …"
Following that, Luan Yingjie listened to Su Yun's story of cutting off the unmyelinated C nerve fibers in the lab as if he was listening to a book from heaven.
Twenty minutes later, he arrived home and made a phone call as soon as he got out.
He called Zhou Litao first and asked if he was busy. Then, he told him about the situation on his side.
Zhou Litao was very interested. He thought that Boss Zheng was a loyal friend. When he met a patient who fainted after eating, he did not forget to ask him to come out and take a look.
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