"Why haven't Director Hu Huan and Director Sun Jun come yet? You can't be packing your things, right?" Zhou Yewu sighed.

Chen Riyuan also sighed.

The two of them stared at each other, waiting here.

"Continue to see the patient?" Chen Riyuan pointed to the patient's medical record on the computer.

Zhou Yewu's face, which was already a little sad, instantly became even more uncomfortable.

Seeing a patient is also a boring thing.

And the key is to follow Chen Riyuan to read it again. After that, I got together and read it again.

When will this be seen?

Zhou Yewu blew the bangs on his forehead, feeling that studying medicine was really a boring project.

Facing these indicators and test tests every day is boring.

"Look at the patient again, don't forget the purpose of our visit to Wuhan this time." Chen Riyuan said.

These words were like a wake-up call, which woke Zhou Yewu up.

He almost forgot his purpose to come to Wuhan!

He is coming to fight the epidemic! He is here to fight against the new G virus!

What are you doing now? If you see a few patients, you will lose your attitude?

Zhou Yewu realized the wrong attitude and felt a little guilty.

Then he followed Chen Riyuan to continue seeing the patient.

The patients in the entire critical isolation ward are actually not as bad as they imagined.

Although the name is severe, it is still different from the ICU in a normal hospital!

In wards six, only some patients with confirmed infection with new G were diverted to wards six, and their vital signs were stable.

"There are so many patients who have merged the system problems of other departments." Zhou Yewu looked at the dazzling diagnosis on the electronic medical record.

Nowadays, severe illness is more like a general practitioner, with diseases in multiple departments.

Chen Riyuan was a little surprised when he heard Zhou Yewu's tone and explained: "Well, the new G virus can not only erode the immune system, but now there are damage to various organ systems. As you can see, it is not uncommon for bleeding from the upper small digestive tract."

Zhou Yewu has also read this new G guide, and he still knows it.

"Uncle Chen, why can the new G virus, a respiratory virus, affect other digestive tract and cardiovascular system?" He said curiously.

This question is really hard to explain.

Chen Riyuan frowned.

In fact, for Chen Riyuan, the difficulty of explaining this problem is that there are too many knowledge points covered. He sorted out his ideas a little and was thinking about the most perfect explanation method.

Have it!

He had a sudden inspiration and said, "ACE2 knows?"

Zhou Yewu nodded.

Isn’t ACE2 the human angiotensin converting enzyme 2?

Zhou Yewu still has this basic knowledge.

Chen Riyuan continued with relief: "Existing studies show that the key to the novel coronavirus infecting human cells is the binding of the S protein of the coronavirus and the human angiotensin converting enzyme 2 protein."

"I understand, then ACE2 is a protein in the human body that participates in blood pressure regulation, so the damage to multiple organs caused by New G may be related to the expression of ACE2 receptors in the human body?" Zhou Yewu said happily.

His brain circuit is indeed fast. He is worthy of being an excellent regular training doctor at Tianfeng Hospital. He praised himself happily.

No, it's really...

He suddenly blushed after thinking about it.

Fortunately, this protective isolation suit is thick enough! Otherwise, Zhou Yewu would be even more embarrassed when facing Chen Riyuan.

Chen Riyuan was also very satisfied with Zhou Yewu's answer: "The relevant reasons for the damage to multiple organs are indeed related to this aspect."

To put it bluntly, this new G causes angiotensin converting enzyme 2 to be expressed in blood vessel cells, renal tubular cells, gastrointestinal tract, and even **.

Like in the intestine, the new G virus can infect intestinal cells in the large and small intestines, resulting in diarrhea, nausea and abdominal pain.

But why not all patients have gastrointestinal symptoms?

Zhou Yewu thinks this may be for patients with mild to moderate COVID-19, and the gastrointestinal infection burden may not be enough to cause symptoms.

Then when we reach the kidney, the cells in the renal tubules are filled with ACE2 receptors, and most patients with intensive care will experience acute renal injury.

For example, some patients will lose their sense of taste or smell, or have neither, so if they are analyzed using the ACE2 receptor, it is not surprising that everything is expressed in nasal epithelial cells.

The loss of smell is not caused by inflammation, swelling or congestion in the nasal cavity, but the "direct damage" to these epithelial cells. Loss of smell will also affect the sense of taste, but the virus may also have a direct impact on the sense of taste.

Zhou Yewu once saw a paper summarizing that the ACE2 level in olfactory epithelial cells in the upper respiratory tract is 200 to 700 times higher than that in the lower respiratory tract, which may explain the high transmission of the virus.

Other effects of new G viruses on the lungs, pancreas and heart are likely to be the same.

With Chen Riyuan's random guidance, Zhou Yewu immediately admired this teacher even more.

In a few words, he successfully explained the question in his heart.

"Since I talked about the impact of the New G virus on the body's organs, do you know what the main impact is? That is why I'm so difficult to fight the epidemic this time, and severe patients across the country used ECMO for treatment." Chen Riyuan asked.

When asked this question, his brow bones were obviously frowning deeper!

This problem is really the most difficult part in fighting the epidemic. Why do so many people die?

In addition to the onset of basic problems, the focus is actually the attack on the human lungs by this new G virus!

Zhou Yewu really thanks to Xu Lu for asking him to read this latest new G guide at Xingqiao Community Service Center. Now what Chen Riyuan asked, he actually had corresponding knowledge points in his mind.

I think everything seems to be what just happened.

He was still standing on the podium, and below were Xu Lu, Zhou Ling and the doctors there.

Zhou Yewu suddenly realized that he actually missed these friends a little.

"Old man, I haven't sent me a message yet to condolences." He thought to himself.

It has been almost half a day since I came to Wuhan. Xu Lu and Zhou Ling didn't know if they fell asleep, but they didn't even have any kind greetings.

Especially Xu Lu!

Fortunately, he helped him write medical records for so long, and consulting.

Ugly!

While Zhou Yewu cursed Xu Lu in his heart, he accidentally looked at Chen Riyuan, remembering that he had not answered Chen Riyuan's question yet.

There was a chill behind me.

This tragic problem really needs to be changed.

He immediately said: "The lungs are the organ that respiratory toxicities are the most common attacks on. The two-type alveolar cells in the lungs are covered with ACE2 receptors. Once infected by G-catavirus, the cells will be dysfunctional or die, and will be gathered in large quantities by immune cells, so that this inflammatory response will break out into acute respiratory distress syndrome, which is ARDS!"

While he answered, the clothes in the protective suits were a little sweating due to nervousness and then wet.

"Uncle Chen, you shouldn't be angry, I'm always confused." He said a little embarrassedly.

Chen Riyuan smiled and shook his head: "Young people, I have a lot of worries, I understand."
Chapter completed!