Chapter 716: A Frustrating Lecture

"There's such a disease?" Lu Gang muttered.

Because Lin Jiuze spoke with such formality and the medical record he produced even had a name and surname, it didn't seem like he was lying, so Lu Gang believed him immediately.

"Doctor Chen Pengsheng is the editor-in-chief of the *International Journal of Cardiology*; the article was published in that journal. If Lu Zhuren is interested, you can look it up."

"There are many diseases characterized by 'Orthostatic Intolerance'; besides Postural Orthostatic Tachycardia Syndrome, there are also Vasovagal Syncope, Orthostatic Hypotension, and others."

"What is the impact factor of the *International Journal of Cardiology*?" Xu Leyu suddenly asked.

"Around 5, a small journal," Lin Jiuze said.

"..."

"..."

Xu Leyu and Lu Gang were both rendered speechless by Lin Jiuze's humblebrag.

An SCI journal with an impact factor over 5 is considered a small journal?!

"According to a 2019 review in the *American Journal of Cardiology*, Postural Orthostatic Tachycardia Syndrome is the most common form of 'Orthostatic Intolerance' among young people, most frequently seen in women aged 15-50.

Typical symptoms include dizziness, fainting, problems with thinking, memory, and attention, heart palpitations, tremors and sweating, feelings of weakness and fatigue, tiredness, headaches, poor sleep, chest pain, nausea, and shortness of breath."

"It is exactly the 'lazy disease' that Lu Zhuren just mentioned."

For some reason, Lin Jiuze had abandoned his usual gentleness; as he spoke, he didn't forget to mock Lu Gang.

Lu Gang seemed not to have heard; he was deep in thought.

"Data shows that for every 500 people in the United Kingdom, 1 suffers from some degree of Postural Orthostatic Tachycardia Syndrome. It is perhaps more prevalent in the United States, with 1 in every 100 people suffering from it. I feel that whether or not a correct diagnosis is made depends on the level of the local doctors."

"The medical standard in the United States is very high, so one in a hundred is diagnosed."

Today's Lin Jiuze was different from usual; he was sharp and biting, as if possessed by Lu Gang, with every sentence carrying a sting.

"Does this disease really exist?!" Zhao Zhe said to himself.

"This disease has a long history; records date back to 1871. Initially, it was called 'irritable heart' or 'soldier's heart.' Later, in 1944, it was formally named Postural Orthostatic Tachycardia Syndrome."

"But why? Gravity allergy—feeling uncomfortable all over as soon as you stand up, this..." Zhao Zhe didn't care at all about Lin Jiuze's sarcasm; he asked when he didn't understand, "Doctor Lin, I know at least several thousand people, and up until now, I haven't discovered a single patient with a similar condition."

"Patients' conditions vary in severity," Lin Jiuze smiled slightly. "Many patients feel uncomfortable after getting out of bed, but they don't even realize there is a problem with their body; they move around a bit and feel better."

"What about the pathogenesis?" Lu Gang asked.

"The disease explanation from the United Kingdom's National Health Service (NHS) points out that this disease is the result of multiple mechanisms working together.

When in a supine position, about 1/4 of the body's blood is concentrated in the chest.

If one quickly changes to an upright posture, gravity causes the blood to shift downward; about 500-1000mL of blood will flow to the abdomen, pelvis, and lower limbs within a few seconds of standing.

This instantaneous change can lead to a decrease in venous return, a drop in stroke volume, and a reflex increase in sympathetic nerve activity.

The autonomic nervous system begins to function, compensating by slightly increasing the heartbeat to maintain normal blood flow.

For a normal person, the above process is unconscious; usually, the body handles it on its own within 1 minute.

But for patients with Postural Orthostatic Tachycardia Syndrome, this reaction cannot be triggered correctly. The heart will even 'race' to compensate for the change in blood flow.

Clinically encountered patients with Postural Orthostatic Tachycardia Syndrome all..."

Lin Jiuze began to lecture on the issue of Postural Orthostatic Tachycardia Syndrome; he walked to the blackboard naturally and began writing notes with a marker, as if he were teaching a class.

Zhao Zhe looked for a few moments, but could only see the marker moving around "by itself," as if it were haunted.

Damn it!

Zhao Zhe was also helpless.

However, although what Lin Jiuze was saying might be a bit abstruse and purely theoretical, "gravity allergy" was too strange, so Zhao Zhe, Xu Leyu, and Lu Gang listened with great interest.

"The article *New Progress in the Treatment of Postural Orthostatic Tachycardia Syndrome* has a similar description—exercise can activate the skeletal muscle pump, increase blood pressure, and also has a very good therapeutic effect on severe cases.

Aerobic exercise 3 times a week for 20-30 minutes each time, plus lower limb and abdominal resistance training, and semi-recumbent exercises like swimming or rowing are all worth recommending.

For teenagers, standing against a wall for 30 minutes every day, once in the morning and once in the evening, also has good results. If pre-syncope symptoms occur during training, such as dizziness, blurred vision, paleness, nausea, vomiting, or sweating, one should immediately take a supine or sitting position, or elevate the thighs to alleviate the symptoms."

"After a period of exercise, the symptoms will be alleviated."

"Isn't that just solved by a belt whipping," Zhao Zhe whispered.

The marker in Lin Jiuze's hand "swished" and flew toward Zhao Zhe; Ji Xiang reached out and caught it.

"Doctor Lin, don't mess around."

"..." Lin Jiuze was dazed for a moment, then finally sighed.

This wasn't Massachusetts, and he wasn't facing students from Harvard Medical School, nor was there a monster like Ji Xiang.

Facing Ji Xiang, Lin Jiuze knew he was at a disadvantage.

"That's about it; a belt whipping could also solve the problem, forcing the child to get up and move, which is used to combat the disease. But there is still a certain risk; I suggest being systematic and theoretical..."

Lin Jiuze started a long-winded speech again.

He spoke like the Dean giving a report, where a "let me just say a few simple words" could end up lasting an hour or two.

His chatterbox nature was completely different from Zhao Zhe's.

Lu Gang was a bit reluctant at first, but by the time Lin Jiuze finished, he had already started taking notes.

Half an hour later.

Lin Jiuze capped the marker.

"That's all for today."

Zhao Zhe looked quietly at the blackboard, watching the pile of things written on it; he felt as if he had returned to school.

Lin Jiuze glanced at Ji Xiang; Ji Xiang nodded slightly, and only then was Lin Jiuze relieved.

He was truly worried that Ji Xiang would voice an opposing opinion.

Lin Jiuze's research on Postural Orthostatic Tachycardia Syndrome was already very thorough; after all, being at Massachusetts General Hospital, he had conducted related theoretical research for who knows how many years.

Facing a hospital at the level of the Second Affiliated Hospital, he was almost performing a dimensionality reduction strike.

But facing Ji Xiang, the target of the dimensionality reduction strike was reversed.

Lin Jiuze was always apprehensive, terrified that Ji Xiang would smile and then stand up to say some cutting-edge knowledge, directly overturning all the theories he had mastered.

After finishing the recording, Lu Gang suddenly slapped his thigh, "Oh shit, I forgot, I have to hurry to the Patient! They are still waiting for me for a consultation over there!"

(End of this chapter)