Chapter 779 Beriberi

"Beriberi? Athlete's foot?"

Jin Miao stared at Lu Chen in surprise, making sure that Director Lu was not joking.

"Do you know what the cause of beriberi is?" Lu Chen asked back.

Jin Miao paused and said slowly: "Beriberi is a thiamine, vitamin B1 deficiency, a fungal infection of the feet."

"Well, not bad, I still know this." Lu Chen nodded slightly.

Thiamine, or vitamin B1, is an essential cofactor for carbohydrate metabolism and energy production.

It is found mainly in legumes, meats (except cured meats), brown rice and cereals made from whole grains, but is present in very low levels in polished rice, dairy products, fruits and vegetables.

"But, Director Lu, what does this have to do with the heart failure patient just now?"

Jin Miao looked confused.

Beriberi, heart failure, there is no connection at all!

Lu Chen smiled and continued: "Long-term drinking and reliance on high-calorie, low-nutrient convenience foods will increase the risk of thiamine deficiency. Thiamine deficiency will affect the production of adenosine triphosphate and cause adenosine accumulation in the body."

"I remembered that I learned in school that long-term consumption of rice flour can lead to thiamine deficiency. That's what I'm talking about!"

However, Jin Miao was still very confused.

"Director, even if he has thiamine deficiency, how can it be related to heart failure?"

Lu Chen said seriously: "You only know one, but not the other."

"Thiamine deficiency can manifest as cognitive impairment (eg, Wernicke's encephalopathy), peripheral neuropathy (dry beriberi), heart failure (cardiovascular beriberi or wet beriberi)."

Jin Miao suddenly realized.

"In other words, thiamine deficiency will have various effects on different organs or systems?"

"That's the truth." Lu Chen nodded, "The patient's nervous system and heart failure are all caused by this!"

On the feet, that's beriberi.

In the heart, it’s heart failure.

Neurologically, it's Wernicke's encephalopathy.

Wernicke's encephalopathy is a common metabolic disease of the central nervous system caused by thiamine deficiency in chronic alcoholism. Symptoms include external ophthalmoplegia, psychosis, and ataxia.

"But this is just my inference!" Lu Chen said, "This cardiac change is manifested by a reduced ejection fraction, which is difficult to distinguish from dilated cardiomyopathy. Although the myocardial edema seen with enhanced T2 signal on cardiac magnetic resonance has certain value, this Such changes do not always occur.”

Although the system has popped up a prompt and the system upgrade completion degree has increased, which indicates that Lu Chen's diagnosis is correct, clinical evidence still needs to be produced.

Jin Miao wondered: "Can't we identify it by testing the thiamine level in the blood?"

Lu Chen shook his head slightly: "It can be tested, but blood tests have limitations in diagnosing thiamine deficiency."

"First of all, thiamine levels are greatly affected by recent caloric intake; secondly, the thiamine content in whole blood is less than 1% of the total body volume. Even if the plasma thiamine level is reduced, it cannot truly reflect thiamine deficiency."

"Although it can be tested by measuring red blood cell transglutase activity, this test is not widely available."

"To put it simply, our hospital is temporarily unable to perform this examination."

Jin Miao frowned: "Can't it be diagnosed?"

Lu Chen smiled and said, "We can perform therapeutic diagnosis. Vitamin b1 is only a dime a piece and is not expensive. You can take ten tablets (100mg) a day. It is water-soluble anyway, so you don't have to worry about overdose."

"Okay." Jin Miao nodded immediately and began to issue medical instructions.

"However, the treatment of heart failure must continue." Lu Chen said, "While treating the symptoms, we should also cure the cause."

"Um."

Although there is no diagnosis yet, Jin Miao already believes in this diagnosis.

Having worked under Lu Chen for so long, he knew Director Lu Chen's clinical abilities very well.

Outsiders only know that Lu Chen has strong surgical skills, but only Jin Miao knows that the most terrifying thing about Lu Chen is his clinical case-solving ability.

No matter how complex or difficult the medical record is, once it is in Lu Chen's hands, all the clues will become clear immediately!

"Director Lu, you are so amazing!"

Jin Miao couldn't help but flatter him.

However, he was flattering from the bottom of his heart.

"Pay more attention to the details." Lu Chen smiled, "Don't ignore it. Many clinical diagnoses are hidden in it."

"Yeah." Jin Miao nodded quickly.

"Digging deeper, some studies have found that heart failure may lead to thiamine deficiency, and supplementing thiamine may help improve left ventricular function and quality of life." Lu Chen said with a smile, "It's just possible, there is still debate. You can further research and publish papers.”

Jin Miao's eyes lit up. Isn't this a good research topic?

"Director Lu, if you have this idea, why don't you research it yourself?"

Lu Chen smiled, "There are so many good topics, and I don't have time to cover them all. My time must be spent on the most valuable things."

"Yeah." Jin Miao nodded.

Since Director Lu Chen doesn’t like this subject, he does like it very much!

You need to have TAVR surgery, but promotion still depends on your thesis!

He wished he could go back to his dormitory right now and start studying this "cardiovascular beriberi".

…

Lu Chen got off work and received an unexpected phone call.

The caller ID showed a name I hadn't seen for a long time, Gu Xinyue.

"Old Gu?" Lu Chen answered the phone and asked.

"Lu Chen, are you in Guanghai?" Gu Xinyue's voice came, still a little cold.

"Yes." Lu Chen nodded, smiled and joked, "What's the matter? Want to come to me?"

Unexpectedly, Gu Xinyue answered without hesitation: "Yes, I want to come to you."

"What?" Lu Chen was a little confused.

After graduation, Gu Xinyue stayed in a tertiary hospital in Kyoto. I heard that he was doing well. Why did he suddenly want to come to Guanghai?

"I want to come to you." Gu Xinyue repeated again.

Lu Chen did not ask for the specific reason. He knew that Gu Xinyue might have something to hide, so he replied: "There is a quota in our department this year. I can help you contact, but the procedures such as the job interview and examination need to proceed normally."

"No problem, I will pack up and come over right away."

After saying this, Gu Xinyue hung up the phone, leaving Lu Chen with a confused face.

He rushed to Guanghai in such a hurry, something must have happened!

Lu Chen thought about it and called Wang Zihao who was also in Kyoto.

Wang Zihao returned from studying abroad and also stayed in Kyoto to work.

"Lu Chen, didn't Lao Gu tell you about this?" Wang Zihao was surprised when he received Lu Chen's call.

"We haven't been in touch recently, he didn't say it!" Lu Chen said, "What happened, why did Lao Gu come to me?"

"Well, it's a long story..."

Lu Chen frowned, "Let's make it short."

Wang Zihao sighed and said, "Lao Gu was cheated by their department director. A surgical patient in his bed had an accident. The director was the main surgeon and he was the second assistant. In the end, the director pushed all the main responsibilities to Lao Gu!"

Lu Chen was silent after hearing this.

For such things, Lao Gu had no back and could only swallow his anger.

But if this happened, it would definitely be impossible to continue staying in the department!

－－－－－－－Off topic－－－－－－

I took some time to do physical therapy today, and my neck pain is much better.

Thank you for your concern. 　　16377/10526257