Dialogue With The First Henan Aid Medical Team Captain Zheng Daer Attached Hospital Zhou Zheng: Patients Need "One Person, One Strategy, One Person, One Case" Precise Treatment.

In January 25th, at ten o'clock on the first day of the lunar new year, Zhou Zheng, director of the Department of respiratory and critical care medicine of Second Affiliated Hospital of Zhengzhou University, who had been waiting for the new year's vacation in recent years, received a special message: "lead the team to Wuhan to support the treatment of the new crown pneumonia in Wuhan."

Without hesitation, at half past nine pm the next night, after intense personnel and supplies, Zhou Zheng led the first batch of 137 Henan medical teams to Wuhan and opened their new crown pneumonia epidemic.

"We have been fighting for nearly 1 months so far," Zhou Zheng, a reporter for the February 24th economic report, and his team building system took over the Fourth People's Hospital of Wuhan (hereinafter referred to as the "four hospitals in Wuhan"). "At the earliest stage, we took over 2 beds, with 30 beds on each floor. Now we have added 3 wards to 111 beds in the beds, and the cure rate is increasing in the ward now." the report is based on the report of twenty-first Century.

Henan medical team captain Zhou Zheng. Data map

Urgent acceptance of suspected patients

Twenty-first Century: what is the situation of the Fourth People's Hospital of Wuhan after your team arrived in Wuhan?

Zhou Zheng: we arrived at the guesthouse and took 20 minutes to have a quick meal. We began to have a meeting with the Fourth People's Hospital of Wuhan.

We learned that at the time, the Wuhan four hospitals had opened 10 beds, and 300 beds were all occupied, but there were still many patients waiting in the outpatient hall. About 700 people were waiting to be hospitalized. On the afternoon of January 28th, we took a field trip. The ward we took over was changed from the temporary surgical ward to the isolation ward. Because the preparation was too hasty, many infectious ward needed measures could not be put in place. We are stepping up to explore how to prepare for the layout, from cleaning, medical waste, staff corridors, patient passages, fire corridors and other details.

We were asked to receive patients for third days. Two beds, 60 beds, we first open a ward, and then open second wards, so that we can sum up our experience. In fact, the two wards were all closed on the day of opening.

Twenty-first Century: what are the main tasks after entering the four hospitals in Wuhan?

Zhou Zheng: at that time, our task was to treat suspected patients, which had not yet been tested by nucleic acid, but had suspected fever, cough, chest tightness, and lung problems. If the nucleic acid is detected more than two times after admission, it can be discharged. If positive, it will be transferred to other hospitals. This is somewhat like a triage ward.

But at that time, we saw from CT that many of the patients were suspected, but by testing blood routine and observing their physical symptoms, they were basically diagnosed by clinical diagnostic criteria.

Twenty-first Century: is there a negative nucleic acid test, but is it ultimately confirmed as a new crown?

Zhou Zheng: this has happened. Some patients with negative nucleic acid test also appeared to be angry, and even the first day was very good. After two days, respiratory failure occurred quickly.

A more than 30 year old boy was admitted to hospital with fever, chest tightness and coughing. His blood routine was lymphocytic reduction, chest CT, two lung multiple spots, and frosted glass shadow. The others were in Wuhan, but the nucleic acid test was negative for two times. According to the standards, he should be discharged. But at the end of our discussion, we decided to treat it according to the new crown pneumonia, and his treatment plan was Leigh Bhave Lin. 500 mg, two times a day; gamma globulin 10 grams a day, once a day; moxifloxacin, after treatment, the patient's condition immediately improved, second days had fever, he is also one of the first batch of patients discharged from our hospital 5 people.

Timely adjustment of treatment plan

Twenty-first Century: how effective is your ward treatment?

Zhou Zheng: we have received more than 120 patients in two wards, which have been cured and discharged 28. The discharge criteria of patients were: first, the body temperature was normal for at least three days; second, the symptoms of respiratory tract improved significantly; third, second times the nucleic acid was negative. In addition, CT should be discharged from hospital. If a patient has double nucleic acid but aggravated, he can not be discharged from hospital.

Twenty-first Century: what discoveries and adjustments have you made in the actual clinical treatment?

Zhou Zheng: the clinical treatment of new crown pneumonia is also about "one person, one policy, one person, one case". All kinds of guidelines are general guidelines, but individualized treatment should be considered in actual treatment, because there is no specific remedy for this disease, for example, Leigh Bhave Lin may not be effective for some people.

In fact, so far, the new crown pneumonia critical and critical patients are still concentrated in the elderly population. And most of the death patients have underlying diseases, such as diabetes patients themselves, the immune system is poor, and the characteristics of diabetes new crown pneumonia patients are: many people do not have fever, just sulk, poor appetite, and even appear hyperglycemia. We treated a patient with diabetes and a new crown pneumonia. After that, the patient's blood sugar was lowered and the whole situation was improving. In view of this kind of patient, treats the foundation sickness, then carries on the antiviral treatment, through "one person one case" precise treatment, the effect will be better.

Twenty-first Century: do you have any impressive cases in your treatment?

Zhou Zheng: I am very impressed by the rapid progress of two elderly patients. One of them was 43 years old and the other was 48 years old. They were very mild when they came, but they were a little sulk. Their body temperature was about 38 degrees low, and their mental state was very good. However, one of the patients was rapidly aggravated after hospitalization. First of all, it was suffocating. We hurried up the hormone therapy, but the patient's suffocation continued to increase until he died. The whole process lasted only two hours.

Another patient had a stable condition on the first three days after admission, but on the fourth day the patient said sulk. We hurried to take oxygen therapy, but the patient was hard to breathe and his lips became cyanotic. We gave him high flow oxygen and hormones, and still did not alleviate. The patient increased from sulking to death.

Twenty-first Century: why do some patients develop very quickly?

Zhou Zheng: some patients with mild diseases who did not have underlying diseases suddenly became worse after two or three days. They did not die of complications or pulmonary infection, but acute respiratory failure, called acute respiratory syndrome (ARDS). I call this situation "inflammatory storm".

Immune cells have protective effects on the human body, but excessive release of some cytokines will cause damage to normal cells, such as heart, liver and kidney cells. This is why I especially emphasized that hormone therapy is not too late, because once the patient's condition is serious, once the inflammatory storm starts, it can not stop, like floods.

Since these two clinical phenomena, we have adjusted the plan in a timely manner, using gamma globulin technology to prevent the inflammatory storm. The effect is really good. Now the patient's condition rarely progresses so fast.

Know what you know.

Twenty-first Century: early health care workers have been infected. How do you protect your team?

Zhou Zheng: "safety is the sky" - we repeatedly emphasize safety. We have six steps to wear isolation clothing, washing hands, wearing masks, wearing hats, wearing isolation clothes, wearing shoes covers, and checking in a mirror. Looking at the mirror is a very important part, just like makeup, not looking at the mirror, sometimes do not know whether they have been changed. So when we wear protective equipment, we should look at the mirror and supervise each other.

In fact, in the early days, we also had psychological pressure. But once in a ward, fear will disappear. Our understanding of the virus is also deepening, such as how long the virus can survive in vitro, how far the virus spreads in the air during the dialogue, and which secretions of patients are prone to viruses, so that we can have a clear idea of what we can do at work.

Twenty-first Century: how do you predict the trend of the next epidemic?

Zhou Zheng: I am very concerned about the number of suspected patients. Personally, I think there will be a platform stage, into the stalemate stage, and then usher in the turning point. This judgment is based on two points. First, the number of patients in the early stage is too large, and the number of diseases is relatively high. Second, the initial source control is not good enough, and there are a lot of mobile infection sources. But before the diagnosis of more than 10000 reached a small climax, I feel that I can see hope and become better and better.

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