Chapter 1821: with translation of chapter title

Su Yun, Coronary Heart Disease.

But he made a slight movement, yet sat down steadily. He didn't get off the carriage with them, but instead looked at Zheng Ren's back, deep in thought.

Yun Ge'er, what is Zheng Lao Ban up to? Luan Yingjie was already flustered, he asked anxiously.

Buying medicine, you can't buy vegetables at the pharmacy? Don't say that—some people even buy coix seed at the hospital, maybe the pharmacy sells vegetables too. Su Yun's reply was completely unserious.

Luan Yingjie was at a loss for words for a moment, not knowing how to respond.

Yun Ge'er, you say if I don't send my dad to a mental hospital, will his condition get worse? Or should I move to a different courtyard house? I'm really afraid he might one day lose hope and jump from a building. Luan Yingjie said anxiously.

Yo, Old Luan, you've made quite a bit these years, and you still have a courtyard house. Seeing Zheng Ren walk into the pharmacy, Su Yun started joking with Luan Yingjie.

My family's old house—isn't it just waiting for demolition? Yet they say we need to protect cultural relics; what's there to protect in an old house? Luan Yingjie said, "In a while we'll also have garbage sorting, I..."

Why are you bringing up garbage sorting again? Su Yun said: "It's fine, I see Boss's expression suggests nothing serious, you can relax."

Yun Ge'er, I heard in Pengcheng that Zheng Lao Ban cured a geomancer's heavenly punishment—is that really true? Although Luan Yingjie was anxious inside, he couldn't leave at the moment, so he just chatted idly with Su Yun.

What geomancer? Just a bathhouse attendant who scrubs backs. Su Yun laughed: "Don't spout feudal superstition."

Er... Luan Yingjie paused, thinking that Yun Ge'er, being young and bold, had turned the geomancer into a bathhouse scrubber in his mouth.

Soon, Zheng Ren emerged from the main point and returned to the car.

Nitroglycerin has gone up in price. Zheng Ren said this as his first sentence after getting into the car.

Su Yun was surprised.

Doctors aside, who goes to the pharmacy to buy medicine when they're not sick? Now hospital medicines have zero markup, making them cheaper than pharmacy drugs, aside from queuing and registration, there are no other drawbacks.

The nitroglycerin price hike basically has no impact on our boss, right?

How much did it go up by?

Tenfold? Twentyfold? Zheng Ren said.

Su Yun, who knew little about this, was startled.

Before, nitroglycerin came in a big bottle; I don't know how many pills were inside, sometimes patients were told to buy it themselves at the pharmacy. Zheng Ren said, "Now the big cheap bottles are gone; only this finely packaged version remains. The packaging accounts for 95% of the retail price—you tell me..."

Cut the nonsense, get to the point. Su Yun said, "What are you buying nitroglycerin for?"

To do a tilt test. Zheng Ren said.

Tilt test? Are you checking if my dad's brain works well or if his body is nimble? Luan Yingjie asked, "Zheng Lao Ban, you just said something about mental..."

It's the autonomic nervous system, not mental. Zheng Ren corrected, "We're currently considering it not a mental disorder, so don't talk nonsense."

How come Zheng Lao Ban's attitude sounds like he's the biological son, while I'm just an outsider?

Luan Yingjie was somewhat surprised.

The patient's upright response resembles the actual fainting seen clinically, so it's used to help diagnose vasovagal syncope. Is that right? Su Yun asked.

Yeah.

Then why are we following along? Su Yun didn't understand.

Just take a look, and to enhance the tilt test's effect, we'll administer nitroglycerin sublingually so the reaction is more pronounced. Zheng Ren said, "I'm worried the old man might experience a transient discomfort that we couldn't handle at home."

You don't have anything either. Su Yun said.

Call 120 emergency? Zheng Ren said, "Have Zhou Litao bring the emergency kit over directly; if anything really happens, we can handle it right away."

Isn't that using public resources for private gain? Su Yun retorted.

As long as resources are used for the patient, it's not. Zheng Ren said, "If I were to take the 120 emergency vehicle out for fun, that would be using public resources for private gain."

You shouldn't say that—I heard Teacher say that twenty years ago he went to practice flying knives, and the local hospital would just take out the 120 emergency vehicle to go play. Su Yun laughed.

Now there aren't any; even the 120 emergency service can't make it here. Zheng Ren said.

Luan Yingjie, hearing the two chat idly here, felt a bit anxious, seized a moment to interrupt their conversation and asked: "Zheng Lao Ban, what is a tilt test?"

Er... Zheng Ren thought, explaining would be troublesome, but since the patient's family asked, he couldn't say nothing.

Furthermore, even a brief period of sublingual nitroglycerin for the tilt test still causes some disturbance, and the patient's family needs to cooperate.

Let's put it this way, Old Luan. Zheng Ren said: "When the body stands upright, due to gravity, 300–800 ml of blood pools in the lower limbs, causing central venous pressure, stroke output, and arterial blood pressure to drop, reflexively increasing sympathetic tension, which manifests as a faster heart rate, a slight drop in systolic pressure, and a slight rise in diastolic pressure."

Seeing Luan Yingjie's bewildered face, Su Yun interrupted Zheng Ren's words and said, "Friends with hypertension, do you have it?"

I do.

The first thing I do every morning after waking up is measure my blood pressure. Lying in bed, lying flat, is because blood pressure is unstable when standing. What the boss just said means exactly that.

Um, after explaining it in plain language, Luan Yingjie understood right away.

Su Yun also felt somewhat helpless; the boss must be eager to do the test right away, but the explanation was too technical.

Yeah, basically that's it. I'm considering that your father has an autonomic nervous function problem. Zheng Ren continued: "In patients with vasovagal syncope, upon standing, blood pools in the lower limbs more severely than in normal people, central venous pressure drops markedly, venous return decreases, and sympathetic tension remains heightened."

Luan Yingjie half-understood, half didn't.

Then it leads to a marked increase in ventricular contractility, overstimulating the pressure receptors of the left ventricular posterior wall, which reflexively causes sympathetic tension to drop, vessels to dilate, blood pressure to fall, the brain to suddenly become ischemic, resulting in fainting, sometimes accompanied by increased vagal tone and bradycardia.

Boss, do you have any research on unmyelinated C nerve fibers? Su Yun suddenly asked.

You've researched it? Using white mice in the lab?

Yeah, it's pretty interesting. Su Yun proudly laughed: "I cut..."

Afterwards, Luan Yingjie listened as if hearing heavenly scripture, to Su Yun's account of the lab story where they severed the unmyelinated C nerve fibers of white mice.

Twenty minutes later, the car arrived home, and Zheng Ren got out and made a phone call.

He first called Zhou Litao, asked whether that side was busy, then told him about his own situation.

Zhou Litao was extremely interested; he felt Zheng Lao Ban was truly righteous, and whenever he encountered a patient who fainted at mealtime, he never forgot to call himself out to have a look.