godfather of surgery

After Yang Ping performed the operation, he came to see the old director again. The old director could already walk. Yang Ping examined him and found that there was no problem with the sensory strength of both lower limbs, indicating that there was no rebound after the nerve root compression was released. Edema.

There are many causes of sciatic nerve pain, and lumbar disc herniation is only the most common cause. Other causes include tumors in the spinal canal or the sciatic nerve itself, compression of the sciatic nerve in the piriformis muscle, sciatic neuritis, herpes virus infection, etc.

The old director had a schwannoma of the fifth lumbar nerve root. Most of them are benign tumors. The tumors removed during the operation had a complete capsule in appearance and were consistent with the characteristics of benign tumors. However, in the end, pathological diagnosis was required.

Precisely because the most common cause of sciatica is lumbar disc herniation, the old director did not pay attention and did not go to a better hospital for examination, which resulted in misdiagnosis.

"Where do you think my lumbar disc herniated?"

The old dean had an MRI film in his hand, but he couldn't read it himself, so he had to ask Li Min.

Li Min pointed out: "Look here, there is indeed a herniation of the lumbar 4/5 and lumbar 5/sacral 1 intervertebral discs, but it is very mild and will not cause symptoms. You see, now after the schwannoma is removed, the symptoms have all disappeared, so this Lumbar disc herniation has no symptoms at all.”

''Does that mean I also have lumbar disc herniation? Just combined with schwannoma? "The old dean thought so himself.

"You have a lumbar disc herniation, but you don't have a lumbar disc herniation. These are two different things."

Li Min now has a very solid knowledge of these common diseases.

Lumbar disc herniation and lumbar disc herniation are two different concepts. Lumbar disc herniation is just an imaging manifestation, not a disease. Patients can see lumbar disc herniation through magnetic resonance imaging or CT, but there are no related symptoms.

If there is a lumbar disc herniation on imaging and the patient also has symptoms of low back pain or leg pain, then it is called lumbar disc herniation and is considered a disease.

Lumbar disc herniation does not require treatment, but lumbar disc herniation requires treatment. Lumbar disc herniation may manifest itself as low back pain or leg pain. Leg pain generally manifests as radiating pain, which radiates from the buttocks to the lower limbs. The distance varies depending on the severity of the condition.

Low back pain is pain caused by the intervertebral disc itself. The cause of the pain is stimulation of the sinus vertebrae nerves in the lumbar intervertebral disc.

After lumbar disc herniation, the annulus fibrosus of the intervertebral disc ruptures and the nucleus pulposus herniates. This pathological change leads to local stress changes and inflammatory reactions. Mechanical pressure and inflammatory mediators can stimulate the sinus vertebrae nerves and cause low back pain.

Leg pain is caused by compression or irritation of the spinal nerve roots, causing pain and numbness in the nerves that constitute the continuation.

Commonly referred to as low back and leg pain are these symptoms.

There are currently a few reports in the world that the herniated lumbar disc nucleus pulposus can be naturally absorbed by the human body. This is completely possible from a medical point of view, because once the intervertebral disc nucleus pulposus deviates from its original normal position, the human body will treat it as an illegal substance. Send phagocytes to clear and eliminate them.

However, this is only a single-digit report and cannot be regarded as a routine. Therefore, once a lumbar disc herniation is diagnosed, it will definitely require treatment.

Try to treat conservatively first, because in most cases it is an alternating attack and remission, not a continuous attack, especially if it occurs early, the remission period is extremely long, or even occurs once every few years. In this case, no surgery is needed. Orally taking some non-steroidal anti-inflammatory drugs and neurotrophic drugs can provide symptomatic treatment. During the remission period, strengthen the lumbar and back muscle exercises to make the lumbar spine more stable.

What needs to be made clear is that the target of treatment is the symptoms, not the herniated disc. After the symptoms disappear, the disc is still herniated, and it does not matter if it is herniated. It is impossible to restore the disc to its original shape.

If the symptoms are severe and persistent, and regular conservative treatment is ineffective for more than 3 months, and the pain affects life and work, then surgical treatment can be considered. Surgery can be small and never major. If there are no spinal segments In cases of instability, try to only perform lumbar disc nucleus pulposus removal without nailing segmental fixation.

Young and middle-aged people, if there is no congenital spinal instability factor, generally will not have spinal instability, so generally only simple nucleus pulposus removal is required, without nailing or fixation.

This kind of surgery can be as minimally invasive as possible, but it cannot be minimally invasive. Open surgery is also good. If the condition allows for minimally invasive surgery, the choice of open surgery or minimally invasive surgery depends on the doctor's level. A skilled open surgery is better than a minimally invasive surgery. The minimally invasive method of holding the foot full is much better.

If low back pain is not caused by a common disease, it is easy to miss the diagnosis, because low back pain is either seen in the spine clinic of the orthopedics department or in the urology department. The doctors in these clinics, whether they are experts or ordinary doctors, are all surgeons who are good at operating. Most surgeons have very little knowledge other than surgery. Especially when faced with complex diseases, their critical thinking ability is very weak. They have become accustomed to operating easily. Who has nothing to do to make a diagnosis in an analytical manner like a physician?

Hearing what Li Min said so eloquently, the old dean felt very happy. It seemed that this boy had really learned something.

When the old director saw that he was recovering so well after the operation, he began to make arrangements to be discharged from the hospital. Yang Ping persuaded him to wait until the sutures were removed before leaving the hospital, and not to rush for the next few days. Anyway, there were already people in the hospital helping them to work.

Li Guodong is currently doing a great job at Guandu Hospital. With Li Guodong's current level, he can now fully support the business of Guandu Hospital. Not to mention Guandu Hospital, even Beiqiao County People's Hospital, he has no pressure as a department director.

There are only a dozen doctors in Guandu Hospital, and the conditions are very poor. However, during several poverty alleviation projects, some old equipment was obtained, such as high-end X-ray machines, color ultrasound, etc.

There is even an old C-arm machine, which was eliminated by higher-level hospitals during the poverty alleviation period. This machine is just not a new model. The machine is 80% new and can be used without maintenance. For the doctors of Guandu Hospital , this machine is usually only used when manipulating fractures.

In fact, what Guandu Town lacks now is not basic equipment, but talents. Without good talents, these equipment cannot be put to full use.

Some hospitals in remote mountainous areas can obtain a lot of good equipment in the process of poverty alleviation, but many of them are left in warehouses and are useless because there are no relevant talents and people who can use them, and the machines are just a pile of scrap metal.

Li Min learned very comprehensive skills here. In addition to conventional surgeries, he also learned X-ray, magnetic resonance and CT reading, analysis of various examination results, manual reduction of fractures, partial closure, various hemostatic techniques, etc. , these technologies are very beneficial to his business in primary hospitals.

The old dean couldn't help but click his tongue after listening to Li Min's introduction. This kid's level has improved so quickly. If he didn't brag, he would have surpassed the level of the department director of the county hospital. No, even higher.

Hearing that Li Min's old director was undergoing surgery at Sanbo Hospital, Director Xia took the time to visit the old director and even gave him a fruit basket to show his respect for his senior.

The old dean was smiling. He knew that he had benefited from Xiao Lizi. Xiao Lizi was the best rural doctor in the country and a good doctor in China, so everyone paid special attention to him.

When the dean meets the dean, it is extremely cordial.

For the seniors, Dean Xia was always polite and friendly, while the old dean was calm and unhurried in front of everyone.

Dean Xia said: "Old Dean, you are really tough. We must learn from you."

The old dean looked disapproving: "For fifty years, I have been carrying heavy loads for cross-country marathons every day. How can I not be in good health?"

When everyone thought about it, it seemed like that was the case. Rural doctors often had to carry medicine boxes over mountains and ridges. After understanding this meaning, everyone couldn't help laughing. After a conversation, the old dean made a lot of wise words.

The key point is that no matter what the old dean said, others would laugh until their stomachs hurt, but he himself would not laugh and still act serious.

Song Zimo and Xu Zhiliang’s inspection in Europe has also ended. Europe is very fragmented, with many countries, large and small. Going abroad in Europe is similar to our traveling out of counties and provinces. In addition, their air transportation is relatively developed, so they can travel a lot in half a month. nation.

Their inspections visited almost all the famous medical universities, hospitals and laboratories in Europe, and the recorded inspection reports can be compiled into a thick book.

Huang Jiacai and Gan Fengyi both led their teams to attend the European Spine Surgery Conference. After the meeting, Huang Jiacai stayed in Europe to inspect several well-known European pharmaceutical and medical device companies. Gan Fengyi received a notice from the company to return to China and heard that the company had major personnel changes.
-
Yang Ping's clinical research was not delayed at all. In addition to the normal daily operation time and some fragmented rest time, Yang Ping used it to enter the system space laboratory to conduct experiments.

In the System Space Laboratory, Yang Ping's three experiments are being carried out simultaneously.

The study of tumor cell apoptosis, the study of skin amplification mechanism, and the further study of organ spatial guidance genes have not been left behind.

There has been new progress in the study of tumor cell apoptosis. Yang Ping conducted structural analysis of this unexpected protein molecule K factor and found that this molecule is actually a small dimer molecule.

From the study on the mechanism of apoptosis in Sisi's osteosarcoma tumor cells, it can be seen that these dimer small molecules can activate the expression of silent genes inside tumor cells. This molecule can actually be regarded as a reverse transcription epigenetic function. Genetic chemical proximity inducer.

When it initiates cell apoptosis, it can mobilize the expression of hundreds of genes, and first removes the original tumor cell's shield against apoptosis, and then initiates the apoptosis program, which is equivalent to the tumor cell being re-exposed to the shroud of "apoptosis". So a large number of deaths began to occur.

It seems that tumor cell apoptosis is an extremely complex process, and Yang Ping needs further research.

If this small dimer molecule can be copied, the process of "killing" tumor cells can be repeated. With current biotechnology, copying a small dimer molecule is completely achievable.

The convenience of the system laboratory is unmatched by the real laboratory. Yang Ping immediately used points on the system panel to purchase various equipment, preparing to use artificial methods to create K factors for further research.

Next research must collect images at a more microscopic level, not only taking photos, but also taking videos at the molecular level, so that the mechanism of the entire K factor can be clarified.

In order to cooperate with the experiment, Yang Ping began to upgrade the laboratory's electron microscope and upgrade a new electron microscope 4D camera, which can shoot atomic-level videos.

Electron microscopy is a major advancement in the field of human research. It uses electrons as imaging tools to break through the limits of optical microscopes and provides a pair of eyes for people to observe the nanometer world. Without electron microscopes, human observation of the microscopic world would have stopped. At 200 nanometers, there is no way to advance even half a step further.

The electron microscope of the Yangpyeong System Space Laboratory is the world's top, equipped with a special electron detector. Traditional electron microscopes can only collect part of the information when electrons interact with the observation target, but this microscope equipped with a special electron detector, All information during the interaction can be collected to obtain more comprehensive information.

If K factor is photographed to participate in the entire process of initiating tumor cell apoptosis, and then Yang Ping analyzes this process, he will be able to thoroughly understand the mechanism, how it releases the apoptosis program, and how it initiates apoptosis. procedural.

Whether it is purchasing experimental equipment or upgrading the equipment, it can be completed in an instant, and only a part of the points will be deducted.

Director Fang of the general surgery department hurried to the surgical institute with two cherries. He came to see Yang Ping. This morning he went to the outpatient clinic and admitted a patient with hepatic echinococcosis who required extracorporeal hepatectomy and autologous liver resection. Liver transplantation is a very difficult operation.

However, Director Fang has already undergone extracorporeal abdominal organ cluster resection and autologous transplantation, and he also performed the surgery under Yang Ping's guidance, so he is not afraid of this kind of surgery at all. However, he knows that his level is not yet at home, so he must ask Yang Ping to protect him. convoy.

He lectured on the last abdominal organ cluster transplantation at an academic conference, which attracted a lot of admiration. Abdominal cluster organ transplantation is much more difficult than autologous liver transplantation alone.

Director Fang put a box of cherries at the nurse's station and was about to take another box of cherries to the doctor's office. At this time, the office nurse at the nurse's station took out her mobile phone to answer the call, which seemed to be a call from her home.

Director Fang finally seized the opportunity to establish his authority and took at least two boxes of cherries at a time. However, Gao Yuan was often empty-handed and was actually more popular with these nurses than himself.

Lao Fang finally figured out the reason not long ago. Gao Yuan knew how to establish his power and took an opportunity to reprimand the nurse. This time he finally allowed himself to seize the opportunity.

"What are you doing? It's working time. What kind of phone calls should you answer? Don't you see that you are busy now? If you have something to do, you can't talk about it after get off work. Let the head nurse educate you."

Director Fang showed off the momentum of a department director in his own department and reprimanded the nurse very seriously.

The nurse put down the phone with a confused look on her face, as if she was saying, "Are you talking about me?"

"Whatever you're looking at, it's you."

Director Fang didn't give him any face. This was how Gao Yuan established his authority last time. Gao Yuan could still handle these little girls from the surgical institute.

"Who are you looking for? Have you registered at the door?" The office nurse called to Director Fang.

''I'm looking for Professor Yang. "

''Have you made a reservation in advance? "

“Advance reservation is required!”

"You go to the security guard at the door to register. I will ask Professor Yang. Only after Professor Yang confirms can you enter. This is the rule of our department."

"Is there such a rule?" Director Fang returned to the door and checked in with the security guard at the door.

The security guard said, "That's true."

At this time, Director Gao also came in, and he walked into the ward swaggeringly.

He didn't register, so he asked me to register?
These little girls are rebelling and have not established their power.