I Can See Health

   Chapter 783 Beriberi

   "beriberi? Foot moss?"

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

   "Do you know the principle of beriberi?" Lu Chen asked back.

  Jin Miao paused and said slowly: "Beriberi is a thiamine, which is vitamin B1 deficiency, a beriberi foot fungal infection."

   "Well, yes, I know this." Lu Chen nodded slightly.

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

  It is found mostly in beans, meats (except cured meats), brown rice, and grains made from whole grains, but in very low levels in milled rice, dairy, fruits and vegetables.

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

  Jin Miao looked puzzled.

   Beriberi, heart failure, can't be contacted at all!

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

   "I remembered, I learned it when I was in school, long-term use of rice noodles can lead to thiamine deficiency, that's what I said!"

   However, Jin Miao was still very puzzled.

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

  Lu Chen said sternly: "You only know one, but you don't know the other."

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

   Jin Miao suddenly realized.

   "That is, thiamine deficiency, will it 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 is beriberi.

   On the heart, it is heart failure.

   On the nervous system, it is Wernicke's encephalopathy.

   Wernicke’s encephalopathy is a common metabolic disease of the central nervous system caused by chronic alcoholism due to thiamine deficiency. The symptoms include ophthalmoplegia, mental disorders, and ataxia.

"But this is just my inference!" Lu Chen said, "This cardiac change is manifested by a decrease in ejection fraction, which is indistinguishable from dilated cardiomyopathy. Although the myocardial edema seen by cardiac magnetic resonance T2 signal enhancement has a certain value, it is difficult to distinguish from dilated cardiomyopathy. That kind of change doesn’t happen very often.”

  Although a prompt has popped up in the system and the completion of the system upgrade has risen, indicating that Lu Chen’s diagnosis is correct, clinically, evidence is still needed.

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

  Lu Chen shook his head slightly: "The test can be tested, but the blood test has limitations in diagnosing thiamine deficiency."

   "Firstly, thiamine levels are greatly affected by recent caloric intake; secondly, whole blood thiamine content is less than 1% of the total body weight, even if plasma thiamine levels are reduced, it cannot truly reflect thiamine deficiency."

   "Although it can be tested by measuring erythrocyte transketulase activity, this test is not widespread."

   "Simply put, our hospital is temporarily unable to do this test."

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

  Lu Chen smiled, "We can make a therapeutic diagnosis. Vitamin B1 is a dime a piece, and it's not expensive. Take ten tablets (100mg) a day. Anyway, it's water-soluble, so you're not afraid of overdose."

   "Okay." Jin Miao nodded immediately and began to issue a doctor's order.

   "However, the treatment of heart failure still needs to continue." Lu Chen said, "While treating the symptoms, we will cure the cause."

"Um."

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

   After working under Lu Chen for so long, he knew too much about Director Lu Chen's clinical abilities.

   Outsiders only know that Lu Chen's TAVR surgery ability is strong, but only Jin Miao knows that the most terrifying thing about Lu Chen is his clinical decision-making ability.

   No matter how complicated or difficult the medical record is, when Lu Chen has it, all kinds of clues will immediately become clear!

   "Director Lu, you are really amazing!"

  Jin Miao couldn't help but flattered.

   However, he is flattering from the 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.

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

   Jin Miao's eyes lit up, isn't this a good research topic?

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

  Lu Chen smiled, "There are a lot of good topics, and I don't have time to cover everything. Time has to be spent on the most valuable things."

   "Hmmmm." Jin Miao nodded.

  Since Director Lu Chen doesn't like this topic, he is very interested in it!

  TAVR surgery has to be done, but promotion still depends on papers!

   He can't wait to go back to the dormitory now and start researching this "cardiovascular beriberi".

  …

  Lu Chen got off work, but received an unexpected call.

  Caller ID is a name that has not been 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.

   "That's right." Lu Chen nodded and joked with a smile, "What's wrong? Do you want to join me?"

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

   "What?" Lu Chen was a little stunned.

  Gu Xinyue stayed in a tertiary hospital in Kyoto after graduating. I heard that she was doing well, why did she suddenly want to come to Guanghai?

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

  Lu Chen didn't ask for the specific reason. He knew that Gu Xinyue might have something to hide, so he replied: "This year, we have a place in our department. I can contact you, but the procedures such as the entry interview and examination need to be carried out normally."

   "No problem, I'll pack my things right away."

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

   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 a call from Lu Chen.

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

   "Oh, that's a long story..."

  Lu Chen frowned, "Let's make a long story short."

   Wang Zihao sighed and said, "Lao Gu was tricked by the director of their department. An operation patient who was in charge of the bed had an accident. The director was in charge of the operation and he was the second assistant. In the end, the director put all the main responsibility on Lao Gu!"

   Lu Chen was a little silent when he heard the words.

   This kind of thing, Lao Gu has no back and can only swallow his voice.

   But this happened, it is definitely impossible to continue to stay in the department!

   I took the time to do physiotherapy today, and my neck pain is much better.

   Thank you for your concern.

   (end of this chapter)