godfather of surgery

Chapter 594 Strange Renal Bone Disease

In the space laboratory, Yang Ping used the experimental body to observe the pathogenesis of teratoma.

How do these cells develop into various organs in the human body, such as teeth and hair? There are also articles in CELL, a top international journal. The research team at the University of California uses teratoma as an ideal model for studying the process of human development.

Teratomas are tumors that contain various tissues, including bone, brain, hair, and muscle.

Its formation is caused by the uncontrolled differentiation of a large number of stem cells, which can occur in all types of tissues in the body. It is another possibility for the assembly of human tissues and organs by cell division besides the fetus.

Therefore, the out-of-control of stem cells is of great research value.

The laboratory in the system space is very quiet. There is only Yang Ping alone. The assistant is a mechanical arm like the tentacles of a mechanical octopus. Various equipment are arranged in a well-organized manner.

These devices are all top-notch in the world, such as electron microscopes, gene sequencers and so on.

From the experimental body purchased from the mall, Yang Ping took some tissues and observed them with an electron microscope.

Exactly how they differentiate into muscles and how the human body regulates their differentiation involves too much information, which is far beyond the reach of spinal external fixator technology.

Doing scientific research is a difficult and lonely thing. If you don't have a strong interest, it will be difficult to adapt.

Here, the laboratory is isolated from the outside world and cannot access the Internet. The only alternative to the Internet is the system library, where various books and periodicals can be accessed at any time.

Yang Ping is like a prisoner, locked in the space.

He not only observed the changes in various structures of cells, but also sequenced genes, hoping to decipher the mechanism of organ formation and to grow organs in vitro.

It's a pity that if you stay here for a long time, you will be mentally fatigued, and you need to go out for a while before you can continue, otherwise you will stay inside and complete the experiment before going out.

When Yang Ping came out, everyone was off work.

August kept one apple for himself, and distributed the rest to other doctors and nurses.

During this time, he just wanted to study hard with Professor Yang and didn't want to be disturbed.

He likes the current state of learning very much and is improving every day.
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Dormitory for advanced students of Sanbo Hospital.

August locked himself in his room, writing an e-mail to the Duke, and foreigners love e-mail.

"Mr. Duke, hello, I have been in China for nine days, and I have seen the novel effect of Professor Yang's new technology with my own eyes. It is suitable for almost any spinal correction, and it is very safe. The gradual and gentle correction allows the soft tissue to fully adapt. Time, so in today’s world, this kind of technology is the only way to save the little duke. Just yesterday, Professor Yang discussed the little duke’s condition with me, and has agreed to go to Germany to operate on the little duke, but the obstacle now is the new equipment It has not yet obtained legal authorization in Germany, so our Harlaching Orthopedic Hospital must win the clinical trial base, so that the new device can obtain legal authorization as soon as possible—”

After writing the email and revising it several times, August sent the email.

Then I wrote a diary again.

【Today, the professor asked me to talk about the condition of the little duke. I am very happy, because this is the first time that the professor asked me to discuss the case alone. I thought I could drink the cup of tea from the professor, but I didn’t get it. I did Hint, intentionally means that my throat is dry, but the professor didn't see it, or he saw it, so he wouldn't give me a cup of tea for this reason. This cup of tea represents strength and honor. During the training period, I will definitely be able to get this cup of tea. Come on, August, you can do it! 】

August came out of the room, and Robert and Takahashi were watching TV in the living room. TV can not only learn Chinese, but also understand Chinese culture, so they must watch TV for an hour every day.

The three sat down, watched TV, and exchanged learning experiences. August's impression of the Japanese changed somewhat.

In fact, their learning focuses are different. August is a spinal surgery major, so he must study and master the whole technique in depth.

In the future, Takahashi will become an all-rounder in orthopedics in the Affiliated Hospital of Dongdae University. Like August, he needs to master new technologies, but he does not have the urgent need for in-depth research like August.

Robert's main direction is sports medicine. For spinal surgery, he only needs to understand. He hopes that the concept of this technology can be used in sports medicine in the future. At the same time, he came here on behalf of the hospital to strive for a clinical experiment base for new technologies.

"Bang bang bang!" someone knocked on the door.

August happened to be free, so he went to answer the door, and it was the Chinese doctor next door.

The Chinese trainee mysteriously told August the bad news that a girl in the intern’s dormitory lost her panties and she has reported it to the hospital’s security department. I hope everyone who sees suspicious people will contact the dormitory staff.

August frowned and turned to look at Takahashi.

Is it?

It's him!
-
The next afternoon, Yang Ping went to the ICU to see Li Jun, accompanied by Song Zimo.

Because Li Jun is in the ICU ward, Yang Ping has to go to the ICU at least once a day.

Sanbo Hospital has three ICUs, an ordinary ICU, a trauma ICU, and a CCU, which is a cardiac intensive care unit.

Qin Xiaowei has been away for a few days and has not appeared again, but according to the doctor, he will call Dr. An every day to inquire about Li Jun's condition.

"We recently gave him another EEG, and the brain waves are much more active than before."

The director of the ICU went out for consultation, and Dr. An accompanied Yang Ping to report the latest progress of the disease.

Brainwaves are more active, which often means waking up is imminent.

Dr. An asked someone to bring over the EEG and show it to Yang Ping.

Indeed, brain waves are much more active.

Yang Ping carefully analyzed the brainwave images, and Li Jun should be able to wake up soon.

It seems that his luck is good, if he can wake up, then he will pass one of the two hell gates.

The remaining one is to get out of ECMO.

"Renal anemia, we injected Eredro (roxadustat) into the stomach for a period of time, and the red blood cell count and hemoglobin content tended to rise. We are still looking for the best dose of anticoagulant drugs, which is difficult to control. Even if we grasp it now, he will still face this problem in the future.”

Dr. An checks whether the various channels of ECMO are unobstructed and whether the parameter settings are reasonable.

"Director Liu from the Kidney Transplant Center is here!" Dr. An revealed the new news.

Yang Ping was startled. Tan Xiaowei had talked to him before leaving, and revealed that he had left for a few days to prepare for freehand rock climbing, which was very dangerous. Although he was very confident, he had to prepare for the worst.

In case something goes wrong with him, one kidney will be donated to Li Jun, and the other kidney will be given to those in need.

If he can come back safely, as long as Li Jun survives the danger and is able to undergo a kidney transplant operation, he hopes to transplant a kidney to Li Jun as soon as possible.

Director Liu from the Kidney Transplant Center should have come to check on Li Jun's condition. Now that his life and death are pending, it is impossible to perform a kidney transplant operation.

"I heard from the doctor on the side of the kidney transplant that his cousin is a good match for his kidney. It would be a good thing if he can get over this test and get a kidney replacement." Song Zimo said beside him.

Dr. An nodded, feeling a little more confident.

After watching Li Jun, Yang Ping subconsciously glanced at the ward next to him. There has been a new occupant, and now there is a fat man lying there, the kind that is so fat that his body can occupy the entire bed.

This reminded Yang Ping of the patient he met before, Wei Danian.

Yang Ping still remembered the name of this patient, because he suffered from a rare genetic disease and often suffered from lactic acidosis. Later, Yang Ping contacted the genetics laboratory of Southern Metropolis Medical University, and through gene sequencing, he found that this guy had a mutation in the ATP5F1D gene, and this Genes involved in mitochondrial function lead to disturbances in lactate metabolism.

Although there is no solution for the time being, Dr. Jin drew a calendar for him to help him avoid risks.

"What's the name of that patient? What's the condition?"

Yang Ping pointed to the next door and asked Dr. An curiously.

"Wei Danian, lactic acidosis! It seems that you were the one who diagnosed it last time?"

It's him again?Four hundred catties of Wei Danian.

Yang Ping felt that this guy was really lucky, every time he had a 50% chance of surviving, he would always be caught, and every time he tossed a coin, he would always get what he wanted.

"Are people awake?" Yang Ping wanted to chat with him.

"Sober, ready to transfer back to the endocrinology department tomorrow." Dr. An took Yang Ping to the ward.

Wei Danian, Yang Ping must go and have a look. This patient made the names of several doctors appear in the top journal --- "New England Journal of Medicine", and Wei Danian's name was used to name the disease.

"Wei Danian!"

Yang Ping called his name.

The four-hundred-jin boy stared at Yang Ping with squinting eyes, but didn't react for a long time.

Wei Danian couldn't recognize Yang Ping who was wearing a mask and hat.

"Doctor Yang, he operated on your broken thigh!" Yang Ping reminded him.

He squinted his eyes and thought about it for more than ten seconds, then smirked: "You are Dr. Yang, who helped me operate and set bones. Why are you here? What a coincidence!"

Nonsense, I'm a doctor here, is it strange to meet me?

Looking at it like this, Wei Danian gained a little more weight, his eyes could still be opened before, but now he opened them hard, only to reveal a crack.

In the past, the neck and shoulders could be distinguished, but now the neck and shoulders cannot be distinguished.

If you don't do anything about this weight, it will be a big trouble in the future.

"I only remember Dr. Jin, I almost forgot about you, Dr. Yang, sit down! You're welcome!" Wei Da wanted to get out of bed to greet the guests.

Dr. An was so scared that he quickly held him down: "Don't move!"

"You're welcome, we'll just stand."

Seeing him like this, Yang Ping was in a daze, thinking he was at home.

Chat with Wei Danian for a while.

This time he clamored to go on a trip. His father checked the life calendar given to them by Dr. Jin, and several red days were coming soon. Traveling is not courting death, and not every time they will have such good luck.

Under the persuasion of his parents, Wei Danian had no choice but to cancel the trip and was admitted to the endocrinology department to prevent the outbreak of lactic acidosis.

As a result, as soon as he was admitted to the endocrinology department, lactic acid poisoning broke out, Wei Danian passed out and was sent to the ICU for rescue.

Wei Danian's home is in the community opposite the hospital, on the first floor, close to the gate of the community towards the hospital.

Not for anything else, just for the ambulance to arrive in a few minutes.

With this calendar, Wei Danian's parents learned how to be good. When the red day comes, they simply stay in the hospital for a few days. In case of illness, there are doctors and nurses.

Coming out of the ICU, in the family waiting area, I met Wei Danian's parents.

He is also the father of the big fat man. He recognized Yang Ping and was very grateful to Yang Ping. If Yang Ping hadn’t helped with gene sequencing to find out the cause of lactic acidosis, and Dr. Jin had made a life calendar later, his son might have died again this time. Dangerous.

Now that there is a calendar, when encountering high-risk days, you can be directly admitted to the hospital to wait for the disease, or take measures to intervene in advance to avoid being in danger.
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After returning from the ICU, Yang Ping went to participate in a case discussion of the whole hospital. Over there in the internal medicine building, the medical department organized a meeting. Once a week, the whole hospital brought out some difficult cases for everyone to discuss and brainstorm. This is Sanbo Hospital. old tradition.

When Yang Ping arrived, many people had already gathered.

Professor Zhang Zongshun is also there, as well as the chief directors of various subjects, and a lot of doctors and masters.

It was a bit late and there was no place, so Professor Zhang beckoned to let Yang Ping go, and there was a place beside him.

The case of this consultation is a bit interesting.

A patient in the Department of Otolaryngology had dental implants before and had pain in the left sinus area. After taking an X-ray, the screw that fixed the denture was missing in broad daylight. There was an image of a screw in the left sinus. The screw went into the sinus?
How it got there, no one knows.

Results of the final discussion: Open the sinuses and remove the screws.

A patient in the Department of Urology had yinjing persistent erection after a cold, and various drug treatments were ineffective. When he was about to bleed, the anesthesiology department helped with spinal anesthesia, but the patient could not always bring an anesthesia pump.

A six-year-old patient in the Department of Pediatrics had a high fever every Tuesday afternoon for no reason. It has been like this every week for the past three months. No abnormalities were found in all examinations.

Let the experts study and study what is going on.

A patient in the Department of Nephrology is also a patient with uremia. He began to receive hemodialysis 7 years ago due to renal failure. Later, he felt bone pain all over the body, which became more and more serious. Gradually, joint deformities, blurred vision, tooth loss, subcutaneous induration, etc. symptom.

In the past, I had double kidney stones for more than ten years. I had eight stone removals, and finally hemodialysis was performed because of renal failure caused by kidney stones.

There are also several patients with kidney stones in the family, and one of them died of uremia at the age of ten due to kidney stones.

The physical examination revealed that the patient had decreased vision, multiple missing teeth, multiple skin sclerosis with pigmentation on the extremities, deformed fingernails, interphalangeal joints, interphalangeal joints, bilateral ankle joints, knee joints, elbow joints, and shoulder joints. Both appeared enlarged and deformed.Slit-lamp examination revealed calcium deposits around the cornea of ​​the left eye.Abdominal CT showed bilateral nephrocalcinosis.Extensive destruction of the phalanx, dense epiphysis, and calcification of the soft tissue at the end of the fingers and toes were found under X-ray.

Nephrology considers renal bone disease.

But this renal bone disease is a bit interesting, how can there be calcium deposits in the cornea?

This week's case discussions are rich in gold content, and they are all difficult and miscellaneous diseases. When the cases are presented, everyone has a headache.

Yang Ping was very interested in this strange renal bone disease.

This is obviously not renal bone disease. Yang Ping sorted out the patient's medical records in his mind, trying to connect the medical history, physical examination and auxiliary examination with logical clues.

In medicine, monism is the focus of diagnosis, and the coexistence of two diseases is considered only when one disease cannot be explained.

If a disease can explain all symptoms and signs, then try to explain it with a disease.

PS: I finally finished editing. I got off work very late today, and this chapter is more difficult to edit. It took a long time to edit, thank you everyone!

(End of this chapter)