godfather of surgery

Chapter 464 The right to speak

As for whether monkeys will develop lumbar disc herniation, this is indeed a valuable question.

Many doctors have theorized that lumbar disc herniation is a sacrifice made by humans to evolve from crawling on all fours to walking upright.

As an organ, the intervertebral disc has not had time to adapt to the upright human body, so it is rushed to the shelf, so the lumbar vertebrae where the stress is concentrated, especially the intervertebral discs of lumbar 3/4, lumbar 4/5, and lumbar 5/sacral 1, are overwhelmed. decline.

The spine of monkeys is similar to that of the human body, but there are differences. Monkeys crawl on all fours, while humans walk upright. The intervertebral discs of monkeys do not need to bear the vertical load from humans. In theory, the degeneration will be much lighter than that of humans.

If it is found anatomically that the lumbar intervertebral discs in monkeys seldom show human degeneration and protrusion, then this inference can be supported by experimental data.

Xiao Wu and Zhang Lin decided to carry forward Newton's apple spirit, and the topic gradually took shape during the discussion—comparing the differences between monkeys and human intervertebral discs, and finding out the influence of human evolutionary factors on lumbar disc herniation.

This requires observing monkeys of different age groups, and selecting a certain number of monkeys in different age groups, and then using age as a clue to make MRI images of the monkeys' intervertebral discs from infancy to old age.

In the same way, MRI image spectra of intervertebral discs of humans of different ages were made, the two image spectra were compared, and a series of statistical comparisons were performed.

"If you really study this issue thoroughly, explain it clearly in principle, and make it clear from the aspects of biochemistry, anatomy, physiology, genetics, etc., it will be at the Nobel Prize level. Why does eating chili cause chrysanthemum pain? This A simple question gave birth to two Nobel Prizes in Medicine, they discovered channels such as TRPV1 (principle of hot pepper pain), TRPM8 (principle of cool mint) and PIEZO1 (principle of embracing and feeling stress) and other channels.” Xu Zhiliang didn’t know Is to encourage or pour cold water.

Anyway, Zhang Lin felt that what he said was ridiculing himself. If he researched why eating chili and chrysanthemum hurts, he could win the Nobel Prize, but if he analyzed the mechanism of fart formation, he could also win the award. Of course, he didn't dare to talk back.

"Old Xu, this is really a compliment to you. Why does eating chili hurt the chrysanthemum? Really, this question has given rise to two Nobel Prizes." Song Zimo took it easy.

Yang Ping expressed his support for the idea of ​​the two brothers' funny comparison, not afraid of their funny comparison, but afraid that they are muddled and do not want to make progress.

Whether they study peppers and chrysanthemums, or monkeys and intervertebral discs, being curious is always a good thing.

Yang Ping hopes that the state of his colleagues in the department is relaxed, optimistic, active, and free, rather than depressed and dull.
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The schedule is very tight. With Xu Zhiliang, Corey has a lot of manpower. At least he can work in shifts. If you lead a team to throw knives in the past, there must be insufficient manpower left behind.

At that time, when I went to Gleneagles Hospital in Malaysia to throw knives across the country, Yang Ping's team came out in full force. In desperation, Director Han led a group of Gui Peisheng to be on duty in person.

This embarrassing situation will not reappear now, Xu Zhiliang and Song Zimo, whoever stays behind in the department, Yang Ping can rest assured.

So, no matter where you go now, you just leave.

The high-speed rail that extends in all directions makes China's transportation very convenient. It departs at [-] o'clock on Friday night and arrives in Guilin at [-] o'clock.

I rested in the Guilin laboratory for one night, and started the operation on time at eight o'clock the next day.

Maybe Director He still remembered that Yang Ping came to Guilin for the first time, and he was full of praise for pig offal. This time, the main course of dinner was pig offal, and the porridge in the morning was also pork offal.

Under the guidance of the new concept of balanced diet, Fatty Liang has been hiccupping, but the gout has not recurred.

Director He led everyone to get busy and fully supported Yang Ping's scientific research. They tied up all forty monkeys at night, and mixed sedative and hypnotic drugs into the food to keep the monkeys in a coma.

Fasting for eight hours before surgery and water for four hours before surgery.

The doctors of Xiehe are very dedicated. All the body hair on the backs of the [-] monkeys was shaved, and the skin was cleaned in advance. When shaving, they strictly followed the latest perioperative guidelines, using a combination of scissors and electric razors to reduce skin damage.

Every tiny skin injury is a colonization point for bacteria, which increases the probability of postoperative infection. The latest perioperative guidelines prohibit the use of manual razors for preoperative skin preparation, and specify the use of scissors or electric razors to remove hair. hair to reduce the possibility of skin damage.

At eight o'clock the next day, the first monkey was fixed on the special operating bed on time.

In the supine position, Fatty Liang performed general anesthesia with intubation. In fact, the endotracheal intubation of monkeys is not much different from that of humans, just like the endotracheal intubation of babies.

The amount of anesthetic used is calculated per kilogram of body weight, and the weight of each monkey has been recorded in detail in the medical records.

Each of these monkeys has a number, and each has its own medical records, which record their various data in detail, including the results of preoperative examinations, the type and degree of scoliosis.

After the anesthesia was completed, the monkey's position changed to the prone position, still fixed by a special fixation frame.

In the operating room, many people surrounded one after another. These doctors who rotate in the laboratory are all medical students.

The youngest winner of the Golden Knife Award, a person whom Professor Liang regards so highly, can this whimsical spinal external fixator be successful?
Song Zimo took Xiao Wu to disinfect the sheets. Since it was an animal experiment, it was necessary to simulate the most realistic human surgery as possible.

Even the pre-operative checks are carefully carried out to prevent the monkeys and medical records from being misleading, resulting in untrue data.

Yang Ping was the chief surgeon, Song Zimo was the first assistant, and Xiao Wu was the second assistant. Pedicle screws were implanted percutaneously in the lower back, and then an external fixator was installed.

The operation is completed through a dozen symmetrically distributed small incisions without damaging any stable structures of the spine. Each of these small incisions is about two to three millimeters in length.

It is almost an assembly line operation, one operation takes only ten minutes, and the two operating rooms take turns alternately. One side performs the operation, and the other side begins to anesthetize the monkey. , the efficiency is very high.

After waking up from anesthesia, these monkeys were sent to a closed garden in the back mountain for observation. In order to rotate the coil regularly, they were all tied up with a long rope and allowed to move under the restriction of the rope.

The doctor in charge of the perioperative management of the experimental monkeys has rich experience. He has participated in many animal experiments. He taught himself veterinary knowledge, learned to read the test sheets of the monkeys, did the ECG of the monkeys, and analyzed the images of the monkeys.

These medical data of monkeys are different from those of humans, they have their own set of data.

The doctor joked that after he graduated, he would open a pet hospital, and he would be the best veterinarian.

Because he has participated in heart transplants, liver transplants, lung transplants and kidney transplants in monkeys, cut open the brains of dogs, removed tumors from them, treated extensive burns in cats, and cured some minor diseases with medicine.

This doctor is not just talking casually, he has analyzed this matter with a scientific research attitude, and finally concluded that it is completely feasible to switch to a veterinary profession, and the future is bright.

This doctor with a baby face is obviously very familiar with Yang Ping, and he said with admiration: "Dr. Yang, since the start of the Golden Knife Awards, you are the only one who has won the championship as an attending doctor. I have seen your surgery many times." , It’s simply amazing, why can you do the surgery so proficiently, and some new surgical techniques are also very proficient, and you can’t tell that they are new surgical techniques at all.”

It is impossible for Yang Ping to tell him that he has a cheat, and in the cheat space, there are thousands of operations that can be performed, and he can do it all over again if he fails, without any worries.

"The more operations you do, the more proficient you will be."

As the old saying goes: Only hands-on familiarity!

That's why.

Even the spinal external fixator that is undergoing animal experiments has undergone countless experiments in the system space and has been quite successful.

The operation was too simple. The planned two-day operation was successfully completed in one day.

On the monkey mountain in the laboratory, there are forty monkeys tied with long ropes and with external spinal fixation frames on their backs. They are very novel. They each look at the metal frames on other people's backs, and some even stretch out their paws to touch them.

If the deformed spines of these monkeys can be slowly corrected with the help of external fixators, this will be a major innovation, which means that minor scoliosis may be corrected without surgery.

By continuing to upgrade this technology, adult orthopedics can also be done minimally invasively with external fixators, and finally a spine with normal shape and function can be obtained. Traditional surgical orthopedics sacrificed a lot of spinal mobility.

Of course, there are many people who question this. Even Professor Liang, who is far away in the imperial capital, has doubts about how to control the power and direction of orthopedics, how to maintain the durability of the power, and whether it can cause tractive tissue under this kind of tension-stress. Regeneration, whether the percutaneously inserted pedicle screw will loosen and fail, and whether the screw hole will be infected, a series of questions remain unresolved.

The Swiss Institute of Johnson & Johnson does not even believe that external fixators can be applied to spinal orthopedics. They believe that the complexity of the technology is difficult to achieve. Therefore, they chose Dr. Mitsui from Japan as their partner in the field of spinal external orthopedic devices.

Yang Ping himself has a well-thought-out plan, and this is just repeating his own successful experiment.

Song Zimo is also convinced that this Dr. Yang, from the first day he met, has realized all the bullshit he has boasted about.

After a busy day, I can only catch my breath at night. It is impossible to go back at night, so there is no need to be so nervous.

Rest in the laboratory at night, and return to Sanbo Hospital early the next morning.

I didn't have time to appreciate the scenery of Guilin. I came here twice, both from the high-speed rail station to the laboratory. I didn't see what Guilin looked like.

"The Asia-Pacific Orthopedics Forum held in Japan this time must be very intense. Professor Liang, Professor Qin, Professor Su, Professor Meng, and Professor Fu will all be there. It is said that Masao Fujiwara is determined to win this time." On the car back , Song Zimo talked about this topic.

Xiao Wu reported: "Gao Qiao will be in charge of receiving us, and he and his students will accompany us throughout the journey."

"And——" Xiao Wu hesitated to speak.

"What else?" Song Zimo saw him hesitating.

"Takahashi said that Fujiwara Miyuki insisted on participating in the reception." Xiaowu knew that Miyuki had a deep love for Yang Ping, so he was embarrassed to say.

Yang Ping didn't have time to think about these things. He was thinking that Fujiwara Masao must not have the upper hand in this forum.

This forum is regarded as the prelude and weathervane of the next Asia-Pacific Orthopedic Conference. Whoever has the upper hand between China and Japan will directly determine who gets more support.

In international academic organizations, the right to speak is very important.

Without the right to speak, you can only follow other people's buttocks, and you can only follow the standards set by others.

This is also the reason why Professor Su, Professor Liang and others gathered their forces to compete for the chairman of the conference.

(End of this chapter)