Chapter 167 The sudden increase in ground glass nodules! (Please subscribe)
What is ground glass nodule.
To put it simply, when performing a CT examination, a cloud-like thin shadow appears on the CT image.
Under normal circumstances, human lungs are smooth and uniform in texture. Each alveoli is closely arranged, and blood vessels are arranged in it like a fine network.
Once images similar to ground glass nodules appear, it means that there are some pathological changes in the lung tissue.
It can even be directly understood that some unknown tumors have grown in the lungs that were originally uniform in texture.
Of course,
Like tumors elsewhere in the human body, nodules on the lungs can be benign or malignant.
Benign nodules are generally inert nodules and will not undergo major changes even for many years;
Malignant nodules develop very quickly and may occur without attention in one or two years. It expands to invade blood vessels and even causes cancer cell metastasis.
If you get to this point, it will be a bit troublesome.
So,
Once a pulmonary nodule is discovered in a CT examination, an experienced radiologist or respiratory medicine doctor will use the CT image to determine whether the nodule is likely to be benign or malignant. Should we continue to observe or perform surgery directly?
In addition, there is another type of nodule on the lungs called "solid nodules".
Solid nodules are denser and more malignant than "ground glass nodules", but one advantage of solid nodules is that they may be like "scabs" exist.
For example, after tuberculosis treatment, the "tuberculosis virus" affects the lungs, eventually leading to the formation of solid nodules in the lung tissue.
This nodule is similar to a scar and does not have much impact.
Another example is the fibrosis of some lung tissues caused by smoking and quitting smoking, which may also form pulmonary nodules.
In short,
Solid nodules may also be "scars" on the lungs, but ground-glass nodules are almost certainly pathological changes in the lung tissue.
To put it more simply, the discovery of ground glass nodules means there is a risk of lung cancer.
If it doesn’t develop, it will be fine. Once it develops, surgery is almost necessary, just like a time bomb.
But fortunately, as long as pulmonary nodules are discovered early and removed in time, they will behave like normal people.
Thinking of this, Zhang Yang stood up, patted Feng Gang gently, and said comfortingly:
"Director Feng, it's okay. I also know something about pulmonary nodules. Now it's OK to have them removed at an early stage." It’s okay, don’t worry.”
"Well, that's true."
Feng Gang exhaled slightly, and his face relaxed a little when he heard Zhang Yang's comforting words.
“However, it would be great if you could develop a medicine that can eliminate lung nodules by taking medicine, so that I don’t have to get a knife.”
“Haha!”< br>
Zhang Yang couldn't help but laugh. He knew that Feng Gang was only half-joking.
Of course, he could also understand Feng Gang's mood at this time. After all, anyone who encounters such a thing hopes to have a drug to treat it.
After chatting for a few more words, Zhang Yang returned to the Qingshan Pharmaceutical office half an hour later.
Of course he would not suddenly plan to develop a drug to treat pulmonary nodules just because of Feng Gang's words. However, Feng Gang's incident also touched him a little.
To be precise, it was a reminder.
Although Feng Gang is not a clinician, he can still be regarded as a medical staff. He can detect pulmonary nodules in time and pays attention to it. But what about people with little relevant medical knowledge or people who do not pay attention to it?
Will it delay the condition?
He thought of the employees of Qingshan Pharmaceutical.
You must know that although the company arranges physical examinations for all employees every year, the physical examination reports are given to employees individually. The company does not know about it, so it does not know whether some of them have found pulmonary nodules but Employees who don’t take it seriously?
After thinking for a moment, Zhang Yang personally called Ren Xiaomin. Ren Xiaomin was in charge of internal affairs.
After a while, Ren Xiaomin appeared in the office.
"Zhang Yang, what's wrong? What's wrong with me?"
"Yes."
Zhang Yang stood up from his chair and poured a cup of tea for Ren Xiaomin, and then told Feng Gang that he was found guilty. Pulmonary nodules may be early stage lung cancer.
Ren Xiaomin naturally knew Feng Gang, and the relationship was even pretty good. After hearing this, he couldn't help but be stunned.
"Director Feng Gang and Feng were diagnosed with early-stage lung cancer? My God, there are too many cancers now, right?"
Zhang Yang shrugged helplessly and said:
"Yes, that's why I called you here because I want you to take a look at everyone's CT reports during our company's physical examination this year."
" Go and see how many employees have been diagnosed with pulmonary nodules, then find their CT images and find a professional doctor to take a look. If there are any high-risk ones, they need to be examined immediately. Those who undergo surgery must intervene immediately. ”
“And those employees who are at medium risk must also be solemnly informed and draw their attention. An early operation can solve the problem. If it is delayed to the mid-term and late stage, it will be troublesome. ”
“You can let the chairman of the labor union take care of this matter. This is also a reflection of our company’s humanistic care.”
Ren Xiaomin immediately understood Zhang Yang's thoughts, and I have to say that Zhang Yang was indeed thoughtful.
"Oh, by the way, show me the detailed data after the statistics."
"Okay!"
After a few words, Ren Xiaomin immediately took action. .
This matter is not difficult for him. Qingshan Pharmaceutical arranges its annual physical examination at the Third People's Hospital of Chengdu. He only needs to go to the hospital to extract the results of the CT report and get accurate data quickly. .
Two days later, Ren Xiaomin appeared in Zhang Yang's office again, only this time he had an extra piece of organized information in his hand.
“Zhang Yang, this is the statistics I collected from the hospital these two days, and the results are a bit shocking!”
“This year, a total of 2,142 of our employees participated in physical examinations, and 340 of them were actually examined. Pulmonary nodules were found, accounting for 15.8%! "
Walking into the office, Ren Xiaomin's face was solemn, and he put the results directly on Zhang Yang's desk without any unnecessary words.
Zhang Yang was also surprised, with a hint of disbelief in his eyes!
"15.8%! Is this proportion too high?"
"How can it be so much!"
Ren Xiaomin shook his head and continued:
"I think so too Strange!”
“And I also calculated the data from four years ago and this year. Four years ago, although we had only a few hundred employees, the proportion was only 7%.”
“I really don’t know why the proportion has increased by nearly 10% in just a few years!”
“I searched online in the past two days and asked several experts and professors in respiratory medicine. They all said It is possible that the CT machines are more advanced now, so there are more nodules in the report!”
“But I don’t think this is the reason. We used the same CT machine for physical examination a few years ago. Why is it suddenly so advanced? I think there may be another reason.”
As he spoke, Ren Xiaomin quickly opened the report statistics from four years ago and this year's report statistics.
Zhang Yang took a closer look and found that it was exactly what Ren Xiaomin said, the ratio had obviously increased a lot!
"It's really weird!"
Zhang Yang was even more surprised, and he obviously saw the clues, but after thinking for a long time, he shook his head:
"That's all, this kind of thing We are not professionals, and it is not our turn to delve into the specific reasons.”
< br>"Brother Ren, how are the conditions of the 340 employees who were found to have pulmonary nodules? Have all the CT images been seen by a doctor? Are there any confirmed lung cancers that require surgery?"
Ren Xiaomin also returned to the topic, Then he turned to the last page of the information on his desk:
"I saw all the CT images from Director Liu and Deputy Director Zhang of the Department of Respiratory Medicine. Among the 340 pulmonary nodule reports, 286 were tiny nodules less than 5mm. According to the current National Health Commission's pulmonary nodule treatment guidelines Standard, if it is less than 5mm, it is recommended to follow up and check once a year until it grows to 5mm. "
"And 46 of the remaining 54 reports are medium risk, and the two professors gave the same advice. It's a need Pay close attention and follow up once every six months or a year. If necessary, perform surgery immediately. ""Only in the last eight reports, the two professors had certain differences. In some reports, Director Liu recommended immediate surgery, while Deputy Director Zhang felt that surgery should be carried out immediately! You can observe and wait!”
“Oh? There is a disagreement between the two professors?”
Zhang Yang looked startled, and upon seeing this, Ren Xiaomin continued to explain:< br>
"I have also read those eight reports. It is really difficult to judge whether it is malignant or benign from imaging!"
"And the current CT, MRI, or other examination equipment There is no way to determine 100% the nature of the nodule,
This can only be judged based on the experience of doctors, so there will inevitably be some disagreements.”
“Of course, there will naturally be some misdiagnoses.”
"So..."
As he said that, Ren Xiaomin couldn't help but show a bitter look on his face:
"In the past two days, I personally found these eight colleagues and told them the views of the two professors."
" Now they are under a lot of pressure and are confused about who to listen to. Whether to perform surgery or continue to observe, several colleagues even asked for leave to go to other hospitals to see other doctors. "
Zhang Yang also felt a headache after hearing this. If this kind of thing happens between doctors. If there are differences, the patient will naturally find it difficult to decide.
After all, surgery to remove a lung is no small matter no matter how you think about it.
At this moment, Ren Xiaomin couldn't help but sigh:
"Zhang Yang, it would be great if there was a drug that could determine whether a nodule is benign or malignant. In this way, the patient would not be entangled and the operation should be performed! ”
“And doctors are also under pressure when making judgments. It won’t be so big, and it won’t be misdiagnosed. This will also reduce a lot of doctor-patient disputes!”
”If you think about it if the nodule is benign after an operation, how can the patient blame the doctor? "
Zhang Yang nodded, Ren Xiaomin was telling the truth.
This idea is even more reliable than the drugs for treating pulmonary nodules that Feng Gang mentioned before.
After all, although lung cancer is terrible, only about 20% of lung nodules actually transform into lung cancer.
Once you can know whether a pulmonary nodule is benign or malignant when it is first discovered, not only can you perform surgery in a timely manner, but the psychological pressure on those patients who have detected pulmonary nodules will not be so great.
But...
Zhang Yang has no intention of developing such a drug, and Qingshan Pharmaceutical currently has no relevant pulmonary researchers.
Thinking of this, his mind suddenly thought of Zhou Xiaomei.
"By the way, Brother Ren, what are the results of Zhou Xiaomei's CT?"
Hearing Zhang Yang mention Zhou Xiaomei, Ren Xiaomin's tense expression relaxed.
In the past six months, Zhang Yang and Zhou Xiaomei have communicated more and more. The two of them usually have dinner together after get off work, and Ren Xiaomin is quite happy to see this.
“There is nothing wrong with my little sister’s examination report, and no pulmonary nodules were found.”
"Oh."
Zhang Yang breathed a sigh of relief:
"That's good, and how about her blood test?"
"She had severe aplastic anemia before. 'Patient, there is no recurrence, right?"
"There is no recurrence, it's normal!"
"But Zhang Yang, if you care about my little sister, just ask her directly. Why are you asking me?"
The conversation between the two gradually became relaxed. After a while, this time it was due to Feng Gang's discovery of early-stage lung cancer. The discussion about letting Zhang Yang screen the company's lung nodules on a whim was considered over.
As for the eight employees with pulmonary nodules who had some differences, Zhang Yang also asked the union chairman to follow up throughout the process. Regardless of whether the final choice was surgery or continued observation, the company fully supported them.
A few days later, Zhang Yang remembered the news that Director Feng Gang and Feng were about to undergo surgery. However, when he called to show concern, he learned that Feng Gang's surgery had been delayed.
Zhang Yang did not ask for specific reasons. Since the operation was postponed, his attention gradually shifted from the ground glass nodule to the "Qiangjing Oral Liquid" currently undergoing clinical trials.
However, "Qiangjing Oral Liquid" is an "effective compound" automatically screened by a simulation laboratory. It has undergone "animal experiments" and "preclinical preparations", and there is nothing to modify at this stage.
After the successful completion of the second and third phase clinical trials, it will almost be confirmed to be put on the market, and there is almost no need for him to worry about it.
Zhang Yang then set his sights on another drug to treat "zoospermia" and "azoospermia".
After discovering that the target of this drug is sperm morphology regulatory protein, also known as SMRP, Zhang Yang moved from the simulation laboratory to reality.
First of all, the search for "lead compounds" after discovering the SMRP target has at least a specific direction, and it can be handed over to the scientific researchers of the project team to try it one by one.
Secondly, Zhang Yang found that he could not afford to conduct a long-term simulation experiment. In just over a month, the original 950 energy points were reduced to only 400 points.
The most important thing is that the "Qiangjing Oral Liquid" for treating "asthenozoospermia" is already in clinical trials. This drug that also treats infertility is not in such a hurry and is slowly being passed by the scientific research team. Find a suitable "lead compound" and develop it slowly!
No rush.
……
The orderly progress of various tasks allowed Zhang Yang to enjoy a rare relaxing time.
In a blink of an eye, half a month passed.
Not only has he been more relaxed recently, but the subjects participating in the clinical trial of "Qiangjing Guben Oral Liquid" are also enjoying a rare relaxing time.
Rongcheng Third People's Hospital, Clinical Trial Center.
Today, Monday, is the time to collect medicines, draw blood, and test sperm once a week.
Liu Qiang arrived at the trial center on time early in the morning. After taking the medicine for more than half a month, not to mention whether it had any effect, at least he was thinking about it a little bit.
After a while, members of the first group of the second phase of the clinical trial he was in began to arrive one after another. Everyone had known each other for more than half a month, and they all looked familiar and greeted each other.
The time soon came to nine o'clock in the morning. Seeing that the blood test was about to begin, Liu Qiang took a brief look at the members of his team and suddenly realized that something was wrong.
"Hey, why hasn't Xiao Wang come today? He is usually very active!"
"Yes! And Xiao Li, Xiao Li is always the first one, today Why haven’t they come yet?”
Not only did Liu Qiang notice that the team members were not uniform, but another member of the same team also noticed the abnormality.
Soon, someone suggested:
"Send a message in the group to ask! Don't forget."
"Okay."
Liu Qiang then took out his mobile phone I opened the patient group, but just when I was @ Xiao Li and Xiao Wang, a message suddenly appeared in front of me.
“@李强,@老王, haha, I’m pregnant, I won’t continue to participate in clinical trials!”
Pregnant? !
Liu Qiang was stunned for a moment, and an indescribable feeling suddenly welled up in his heart.
Envy, jealousy, and a hint of expectation and excitement.
The news spread quickly in the first group, and several patients present expressed their emotion that Xiao Wang was so lucky!
“It’s only been three weeks since the clinical trial, right? She’s already pregnant?!”
"Hey! I'm so envious!"
However, someone soon realized, is there any problem with withdrawing from the clinical trial halfway? !
(End of this chapter)