I run a clinic in the United States

Chapter 229 Halloween Role Playing and the First Battle with Surgical Robots
Lizsharte Meyer was very efficient. Not long after Zhou Qiao and the others came out of Academician Domitri's office, he sent them three high-performance laptops.

It is also equipped with a large monitor, mechanical keyboard, mouse, mouse pad, screen privacy film, cooling base, speakers and the brand’s matching notebook docking station.

That kind of docking station is a small box that integrates a power supply and various interfaces. It can very simply connect a laptop and various peripherals together without the need for frequent plugging and unplugging. There is only one connection between the laptop and the docking station. A small type-C interface or wireless connection function makes it easy to carry the computer away for meetings at any time.

This is not a special treatment for Zhou Qiao and the others, but a standard treatment for the staff of the institute.

Lizzy Chardy is actually the "little housekeeper" of the institute and an assistant to the academician. She usually takes care of some daily work.

With the computer in hand and no rush to go back, Zhou Qiao and the other three began to work hard.

Although the academician did not rush them, he asked them to take it home and write it slowly, and they could submit it within two weeks.But the three of them still wanted to finish it as soon as possible. They were idle, so why not do some work?
In addition, after it is completed, it will definitely be a first draft, and the academician will also point out various areas that need modification.

The review article Zhou Qiao was assigned was from the "CA-A CANCER JOURNAL FOR CLINICIANS" sponsored by the American Cancer Society. Last year, it topped the list with a score of 286.13.

Zhou Qiao had never heard of such a high impact factor when he was studying. After all, he went to a relatively poor medical school. The article with the highest impact factor published by a professor in the school had an impact factor of more than ten?He didn't pay attention.

Because he was not qualified to pay attention at that time.

It was only during a class outing that a classmate named so-and-so who was born in the school mentioned that Professor so-and-so had published a high-level article and treated him to a treat. This classmate’s parents even attended the event. Dinner.

After graduation, that classmate stayed in school as a counselor with a bachelor's degree.Where can I reason from this?Although it is a relatively poor medical school, if there is an open recruitment, you will not be able to get in with a master's degree, and you will have to start with a doctorate!

Then the other person is working and studying at the same time.It is equivalent to occupying a position in advance.That classmate's usual grades were far inferior to Zhou Qiao's.

Before Zhou Qiao graduated, he was a bit hesitant to enter a township hospital.

……

The topic given to him by Academician Domitri was the latest research progress in cytokines and tumor treatment.

Mainly reflected in the treatment of cancer with cytokines and chemokines.

In the past few decades, cytokines and cytokine receptors have attracted the attention of many big names and been studied extensively as cancer targets or cancer treatments, for example, to enhance interferon and interleukin IL. -2. The growth inhibitory and immune stimulating effects of IL-7, IL-12 and IL-15, or the inflammatory and tumor-promoting effects of cytokines such as tumor necrosis factor, IL-1β and IL-6.

These discoveries gave rise to several cytokines or cytokine antagonists, and then there were many clinical trials, but the therapeutic effects were limited.

Now, the emergence of more effective immunotherapies and a deeper understanding of the tumor microenvironment are enabling new approaches to utilizing cytokines in cancer treatment, including the use of cytokine-based therapies to enhance activity or mitigate the effects of other therapies. associated toxicity as well as targeting early-stage cancers, but many challenges remain in terms of delivery methods, context dependence, and the pleiotropic, redundant, and often conflicting effects of many cytokines.

What Zhou Qiao wants to do is mainly to summarize some previous research results, make some prospects for future research directions, and provide some ideas.

The first part is easy to write, just read a lot of literature and extract the core, but the later "dry part" requires Academician Domitri to put forward some revision opinions and directions.

Zhou Qiao did not rely on the system, but wanted to rely on his own abilities to study hard and write a high-level review.This is a pretty good experience opportunity.

Ability to integrate one's own medical knowledge to give one a broader perspective and insight.

The review manuscript that Murphy received came from the famous "The Lancet". Last year, its impact factor was as high as 202.731, making it one of the top journals.Even for her former mentor, Professor Eric Parsant, it would be difficult for her to publish such an article.

The topic given to her by Academician Domitri was the causal impact of microbiota and cancer.

The human microbial community constitutes a very complex kingdom of microorganisms in the human body, symbiotically symbiotic with the host across multiple body parts, and most of them have good effects.

Interactions between the host and the microbiome naturally influence a variety of physiological processes and various multifactorial disease conditions.It’s not just intestinal laxatives and the like, it can also affect cancer.

Over the past decade, microbial communities have been recognized to influence development, progression, metastasis formation, and treatment response in multiple cancer types.

Strengthening the regulatory interactions of microbial communities on cancer and the molecular mechanisms that influence cancer treatment are of great scientific and clinical significance.

The idea given to her by Academician Domitri was to describe the molecular pathogenic mechanisms that coexist in the entire microbial niche and contribute to the occurrence and development of cancer.Focuses on understanding the causal impact of microbial communities on cancer and its treatment response, and how microorganisms, or their secreted bioactive metabolites, might be exploited as potential targets for precision cancer therapeutics, as well as advances, limitations, and challenges and prospects.

The review manuscript Stephanie received was also from a very good journal, the New England Journal of Medicine, with an impact factor as high as 176.079 last year.

Stephanie's topic is: Research progress on the cross-talk between cell death programs when the host defends against malignant tumors.

(Due to space limitations, I will not introduce it in detail)
In fact, there are very few with an impact factor over [-], less than ten in the world. Only academic leaders and Nobel Prize winners like Academician Domitri can get manuscript invitations from so many top journals.

Will Zhou Qiao submit the article himself?Haha, even if the system helps him create a top-quality article, there is still no such opportunity.Will be thrown directly into the trash.It's just so cruel.

Academician Domitri also had some other resources for inviting manuscripts, but the impact factor was relatively poor. The academician selected the three best opportunities and gave them to these three new disciples.It's hard to say that we don't take them seriously.

It can be said that Academician Domitri usually declines invitations from journals ranked below 100 on the grounds that he is busy with work and has no time to write articles.

Now Zhou Qiao and the others have not started research on their respective topics, and they have not produced any results. Writing a review is the fastest way to get a paper.

Although it is just a review, Zhou Qiao and the others do not know how many years it will take them to write an article with such a high impact factor without the opportunity given by academicians.

The monopoly of various resources by academic circles is really not something that can be said casually.

Academician Domitri Cobb himself comes from a wealthy family, because in the United States, class solidification is even more serious, and it is difficult for "children from poor families" to break out of the circle.Which one of those who can become an academician does not come from an extraordinary family?The excellent education you received since childhood?
Although Harvard University also recruits a small number of very outstanding poor students, these are just "obligations" and "superficial efforts". Entering does not mean integrating.

In the United States, some universities provide "work-study" opportunities for poor students to earn money. What is this opportunity?

The most common one is... asking them to clean the bathrooms of their rich classmates.

For another example, some universities carry out some activities to promote "inclusivity", allowing poor students to also have the opportunity to participate in some paid social gatherings. It seems good, but, damn, the queue for poor students to buy discount tickets is a separate one. Team, very eye-catching.

In order to take care of poor students, some universities let them eat in the cafeteria when it is about to close, because they can buy reduced-price meals at this time, but the price is that they have to endure hunger first. In addition, the attitude of the staff may not be good after entering. .Snobbery exists in every country.

These are just small details, and they will be over after a while, but the resources, situations, and opportunities you get in the end are completely different from the other worlds.

China is much better. At least the college entrance examination is fair and does not require so-called "recommendation letters" or all kinds of fancy "resumes." However, the reason why poor students and the rich second generation can live in the same dormitory is just because they Admitted to the same university.

It is just the intersection of "seemingly equal" in these four years.

After graduation, everyone goes their separate ways and gets jobs easily. Students with "extraordinary backgrounds" enter the government or the military, and there are even a series of "customized" positions. What about the children from poor families?Finding a job is a problem.

As for buying a house and taking root in first-tier cities, the difficulty is vastly different.

Ordinary people struggle for many years to make a down payment, buy a small house, and become an ordinary resident of a big city. They may have bought several houses before they even go to college.

As an ordinary person with no foundation, Zhou Qiao is still of Chinese descent. If he wants to break out of the circle in the United States, or pave the way for his many unborn descendants to break out of the circle, even if he has a small amount of money now, it will be as difficult as reaching heaven.

Luo Ya is very powerful, a natural leader, with good genetics, and can do all kinds of things, but Luo Ya's resources will only be given to her biological son or daughter.

Moreover, Luo Ya’s achievements today were only possible because she risked her life!Zhou Qiao had helped her treat her injuries before, and the scars on her body were proof of this.How can you conquer people's hearts if you don't come from a bad background and don't take the lead?

The only people she could rely on were the black people at the bottom.

If Murphy and Stephanie didn't know Zhou Qiao, the normal path would be to be a mid-level doctor or an ordinary professor at the university.

Stephanie may have a chance to participate in this surgery competition, but at most she will only be able to enter the national finals and will not be able to compete for the top twenty, let alone get third place.

Murphy may have a more difficult time. He comes from an ordinary family and has autism. He is a 19-year-old genius doctor of medicine who has just graduated and can't even find a job.Instructor recommendations are useless.

If her family background was better and she had more significant letters of recommendation, she might not even need an interview.Went directly to work.

As for the twin girls, they have no relatives and a small clinic like Iris is their home. They don’t have education from prestigious schools, so their upper limit is even more limited.

Murphy and Stephanie have doctorates in medicine, which actually exceeds that of more than 90% of young people in the United States.

Zhou Qiao's status, wealth, and academic theoretical research are far inferior to those of Academician Domitri Cobb. He has the opportunity to study with the Nobel Prize winner, become a "true disciple", and be called "teacher". No shame.

There are so many white scientists in Academician Domitri's research institute, and there are also many from well-off families and from famous universities. However, they have not had the opportunity to become apprentices because Academician Domitri has a very high vision and looks down on them.

What's more, Academician Domitri paid such a high salary to the three of them. They don't have to clock in or stay in the institute all the time. It's equivalent to "working from home". In China, you can find such a good "boss" ?

After Zhou Qiao and the others stayed for two days, they took a flight back to San Francisco.

This time, I still didn’t go to New York, Chicago, the Great Lakes and other places.Because the clinic is too busy.

Then, Halloween arrived.

Halloween (November 11st) is a very important holiday in the West.Also known as the Ghost Festival, it is equivalent to the Chinese Ghost Festival (Taoism) or the Bon Festival (Buddhism).

On the eve of Halloween, also called "Holy Night", people will hold various celebrations. In ancient times, in Gaul, Britain and Ireland, priests would praise autumn, starting at midnight on Halloween and continuing until the next day, for a whole day.

On Holy Night, the great God of Death will summon all the ghosts of those who died that year. If there are evil ghosts, they will be punished by being reborn as animals.

The mere thought of a large number of ghosts or witches would terrify the faint of heart.So people lit huge bonfires and closely monitored these evil spirits.

Of course, fewer people believe in ghosts now. Most people regard Halloween as a good opportunity to have fun, tell ghost stories and scare each other.

Make-up, jack-o'-lanterns, trick-or-treating, apple biting, and worship are all traditional Halloween programs.

The Iris Clinic, under the management of Elena and Ava, was also full of atmosphere. Jack-o-lanterns and many candies were prepared and distributed to some of the little ghosts who came to beg for candies.

Cathy pushed little Danielle to join in the fun and ask for candy.

Yoona and her mother also came.

Stephanie had nowhere to go, so she stayed at the Iris Clinic and was busy with Elena.

Stephanie is dressed as a Medusa, while Elena and Ava are a corpse bride and a centaur girl respectively.

Zhou Qiao was carefully dressed up by three girls and became a Behemoth. This is a giant beast recorded in the Old Testament. Some people think that it is the incarnation of Satan, which is quite powerful and terrifying.

Little Danielle has learned to walk and can speak simple syllables. Cathy helped her dress up as a little witch with a toy broom. Little Yoona was dressed up as a cute elf by Park Soo-joo. Kim Hee-jin and Park Soo-joo were one One is Frankenstein and one is a vampire.

Little Danielle is naturally courageous and is not afraid of these "scary" guys at all. She giggles and reaches out for candy.But she was still too young, so Elena gave her a large lollipop, holding it in her hand and sucking it without worrying about choking.

Murphy stayed at home with her family, but in the fall and winter, her grandparents began to have various ailments again.She planned to take her grandparents to Iris Clinic for a comprehensive physical examination after Halloween.

I also plan to follow Zhou Qiao’s advice and go to a traditional Chinese medicine clinic in Chinatown to buy some medicated meals and use dietary therapy to help my grandparents recuperate their bodies.

There are Chinese medicine practitioners sitting there who can take your pulse and provide different dietary formulas according to your physical condition.

Her grandparents and mother don't know yet about her buying a new house.Because it was difficult to explain before, I didn’t have that much money, but now, the prize money for the surgery competition is very generous. There are 80 US dollars in the California division, and 30 US dollars in the finals. And now I have a temporary job in Academician Domitri’s research institute. , the annual income is more than [-] US dollars, plus the income from the Iris Clinic, it makes sense to buy a house.

Murphy planned to wait for some time before telling his family that he would buy it with a loan.

Everyone in the family also knows that she is now a "little rich woman" and will not doubt her.

Rachel and Vivica also stayed at home to spend time with their families and distributed candies and other small gifts to the neighborhood kids.

Happy time is always short-lived. At night, in the dead of night, Zhou Qiao wanted to take off his clothes, but Elena and Ava stopped him.

Zhou Qiao: "..."

Elena and Ava, a zombie bride, and a centaur girl, gathered around from left to right, laughing.

"Oh my God, I really don't have such strong tastes!" Zhou Qiao looked at the dim light of the ghost-headed jack-o-lantern in the room and begged for mercy with some trepidation.

Although he does not believe that there are ghosts in the world, he still feels a bit scary because he has been influenced by ghost stories since he was a child.

"No! You have to do this!"

The zombie bride and centaur girl knocked him down. Fortunately, Zhou Qiao, as the brave and evil incarnation of Satan, was not afraid of them.

The ancient behemoth Behemoth fought one against two, fighting the zombie bride and the centaur girl. Each used different ultimate moves, and the battle was very fierce.

……

Since Iris Clinic ranks among the top three in minimally invasive cardiac surgeries in the United States, although there are three people tied for No. 3 with two others, this achievement is already quite remarkable.After the Iris Clinic’s own publicity and the publicity of some media in San Francisco, the Iris Clinic has become famous.

No, there are many patients scheduled for heart surgery who come here because of its reputation.

During the previous competition, there was no charge, but now that the competition is over, normal charges will naturally apply.

In the community of the Westins, a poor three-year-old boy was diagnosed with congenital heart disease.

After the diagnosis, the family was wondering which doctor to find for surgery.

When Americans go to see a doctor, they always go to the doctor, not the hospital.Because the conditions of the hospital are "public".

UCSF Medical Center, such a good hospital, so what?Doctors at many clinics can borrow equipment there.

Most of the doctors there also have their own private clinics outside.

If it was before, I would still hesitate, but now, the three talented doctors from Iris Clinic are my natural first choice!

Especially Zhou Qiao is a dazzling champion, defeating so many doctors from top hospitals.

Moreover, many neighbors in the community recommended Zhou Qiao.For example, Mr. Westin is a die-hard fan of Zhou Qiao, and he has always been full of praise for Zhou Qiao, a Chinese doctor.

So, the couple took their three-year-old baby to Iris Clinic.

Ava received them warmly.

It is naturally difficult to perform surgery on such a young child.

After Zhou Qiao's consultation, he admitted the little guy to the hospital, arranged preoperative examination and evaluation, and finally issued a plan and told them that it would not be a problem!
If you do it here, the effect will be great. You are in the right place!
The child's parents were very surprised. Although Zhou Qiao's "voice" was a bit loud, it was not surprising when they thought that this young and handsome doctor was the national champion.

So the parents signed the consent form for the surgery.

Of course, the approximate cost was also informed in advance, which the parents said was acceptable.

The surgery will be performed at the University of California Medical Center, and Zhou Qiao plans to use his "Prometheus-3000" surgical robot.

When he received the award before, after he had negotiated the donation with the University of California, San Francisco Medical Center, he left the address of the University of California, San Francisco Medical Center. After so many days, the surgical robot had already been sent.

And it has been installed, debugged and put into use.An old expert has tried it before and thinks this new robot is quite awesome!
The day before the operation, Zhou Qiao took Murphy and Stephanie to get familiar with the instrument. They have strong learning abilities and were proficient in all operations in basically half a day.You can even put forward some suggestions for improvements.

However, there is no doubt about the convenience of this surgical robot.

The little boy's congenital heart disease is "patented ductus arteriosus (PDA)". For this situation, the best way is to "repair the heart."

There are many types of "PDA heart filling surgery", such as thoracotomy, minimally invasive surgery assisted by thoracoscopic surgery, PDA occlusion, etc. They are all very mature surgeries. In the past, Zhou Qiao would have definitely chosen to use his hands. Thoracoscopy-assisted minimally invasive surgery or PDA closure, rather than a surgical robot.

It’s not that the University of California Medical Center didn’t have surgical robots before, but that the cost of using surgical robots was too high and not cost-effective.

First, patients or family members may not accept it, and second, the clinic will earn less.

But now, he uses the latest "Prometheus-3000" surgical robot for free. It allows him to earn more, and the results are faster and better. Why not?

In addition to the "Prometheus-3000" surgical robot donated by Zhou Qiao, the University of California, San Francisco Medical Center actually has more than 30 surgical robots, including ten Prometheus-1000 and -2000. There are other brands of surgical robots.

I didn’t use it before because I had to pay and the fees were expensive.Moreover, ordinary young doctors at the University of California Medical Center are not eligible to use it.

The emergence of surgical robots can be said to be of great significance in the history of modern surgery. It has subverted traditional surgical methods.

Especially for children's surgery, pediatric surgical robot surgery should be the future development trend.

Because children's organs and tissues are smaller than those of adults, and their blood vessels and tubes are thinner, they have higher requirements for surgical accuracy. This Prometheus-3000 surgical robot has more than 360 degrees, but continuous Several 360-degree rotatable robotic arms and super tremor filtering function can ensure very stable and precise operations. It has the characteristics of small trauma, fast recovery, complete resection and few complications. It is especially suitable for minimally invasive children's surgery. Surgery to relieve children’s pain during and after surgery.

At nine o'clock in the morning, Zhou Qiao brought Murphy, Stephanie, Elena, Ava, and their children to the University of California Medical Center.

The children's parents waited anxiously outside.

"Oh, I don't know how long this operation will take?" the child's mother said worriedly.

The child's father said: "I heard that Dr. Zhou's surgery is very fast. However, this kind of radical surgery for congenital heart disease is a very complicated surgery. Even for a champion like Dr. Zhou, it probably takes two or three hours, right?" Don’t worry too much, just watch a soap opera first to relieve your tension.”

"Then why don't you play games?"

"I'm not in the mood to fight!"

"Then me too!" The child's mother shrugged.

The couple was restless outside the operating room. Not long after, the child's grandparents also arrived.

In the operating room, Ava plays a song, and the opening song is Ban Sheng Snow.

A very beautiful song: "The frosty moon sets in front of the court and shines on someone who has been sleepless all night. It is difficult to write down memories when I pick up a pen and disturb the candlelight. I can't escape parting even when I read human stories. Countless clouds and sunny days change..."

After playing less than six songs, Zhou Qiao was done!

Ava was surprised: "So fast this time?"

Elena chuckled: "Men can't speak fast."

Murphy pursed his lips and said: "The bleeding during this operation did not exceed 1 ml! It is simply amazing!"

"Well, yes, this surgical robot really saves time and effort." Stephanie was also full of praise. With such sharp equipment, future surgeries will be even more efficient.

Of course, since this equipment is donated to the University of California Medical Center, an appointment is required for each use, and sometimes it may not be available.

But it doesn’t matter, use it if you have it, if not, they can do it with their hands.In fact, Zhou Qiao also suggested that if there is no special need, it is better to use your hands to hone your surgical skills.

You can use robots later when you are old and your hands and feet are no longer so flexible.

The reason for the donation is that the Iris Clinic does not meet the conditions. The daily maintenance and annual maintenance of this kind of surgical robot are quite troublesome and costly.Zhou Qiao can save a lot of energy by leaving this kind of work to the University of California Medical Center.

Moreover, after the donation, his clinic's status in the medical center has risen to another level. Correspondingly, the various prices in the affiliation agreement have further discounts and the authority is higher.

The University of California Medical Center has approached him to sign a supplemental agreement.

Even Ava was surprised at how long the surgery took, let alone the child's relatives.They all couldn't believe it.

After waking up from anesthesia, the child felt almost no pain. The child's mother carried him back to Iris Clinic.To their family's surprise and surprise again, they had surgery in the morning, and oh my god, they got out of bed and started running in the afternoon!
He can run and jump, and the little guy doesn't feel any discomfort at all. His condition is much better than before the surgery.

Before the operation, if the child ran like this, he would immediately have shortness of breath, palpitations, and even hoarseness and cyanosis.But now, running and jumping, I am full of energy and look rosy.

The effect of the surgery can be said to be immediate.

Of course, since I just had surgery, it is still not advisable to move too much.So when Stephanie heard the commotion and came to check the ward, she suggested that the parents should restrict the child's movements a little and not let him have his temper.

The child's parents understand.

Early the next morning, Zhou Qiao brought Murphy, Stephanie, Park Xiuzhu and others to check the ward. After checking the little guy, he felt that the little guy was in good condition and all vital signs were stable and normal, so he directly The little guy was discharged from the hospital.

The little guy later came for a review under the leadership of his parents and recovered quite well. The imaging report showed that the congenital heart disease had been completely cured.

When Mr. Westin heard about it, he gave his neighbor a thumbs up: "Let me just say, Dr. Zhou is pretty awesome!"

(End of this chapter)