The Godfather of Surgery

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

Many doctors theoretically infer that lumbar disc herniation is the sacrifice of human evolution 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 the lumbar spine, especially the lumbar 3/4, lumbar 4/5, lumbar 5/sacral 1, where stress is concentrated, is overwhelmed. decline.

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

If it is anatomically found that the lumbar intervertebral disc rarely degenerates and herniates in humans during the lifetime of monkeys, 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, selecting a certain number of monkeys in different age groups, and then using age as a clue to make MRI images of the intervertebral discs of monkeys from infancy to old age.

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

If you really study this problem thoroughly, explain the principle clearly, and make it clear from the levels of biochemistry, anatomy, physiology, genetics, etc., it is at the level of the Nobel Prize. Why does eating pepper cause chrysanthemum pain? This A simple question gave birth to two Nobel Prizes in medicine, who discovered channels such as TRPV1 (the reason why peppers are hot and sore), TRPM8 (the reason why peppermint is cool) and PIEZO1 (the reason why hugs feel pressure).” Xu Zhiliang did not know Encouragement or pouring cold water.

Anyway, Zhang Lin felt that what he said was ridiculing himself. He could win the Nobel Prize for researching why eating chili and chrysanthemum hurts. If he analyzed the mechanism of fart formation, he could also win the award. Of course, he did not dare to talk back.

Lao Xu is really complimenting you. Why do chrysanthemums hurt when you eat chili peppers? Really, this problem has spawned two Nobel Prizes. Song Zimo was unhurried.

Yang Ping expressed his support for the idea of ​​the two brothers being amused, not afraid that they would be amusing, but that they would be confused and not thinking about making progress.

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

Yang Ping hopes that the state of colleagues in the department is relaxed, optimistic, positive, and free, rather than depressed and rigid.

——

The schedule is very tight. With Xu Zhiliang, Corey has a lot of manpower. At least he can do shifts. If he had led a team to fly knives in the past, there would definitely be insufficient left-behind manpower.

At that time, he went to the Gleneagles Hospital in Malaysia to fly a knife across the country, and Yang Ping's team rushed out.

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

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

The high-speed rail extending in all directions makes the transportation in China very convenient. It leaves at 8:00 pm on Friday and arrives in Guilin at 11:00 pm.

After a night of rest in the Guilin laboratory, the operation was started at 8:00 the next day.

Maybe Director He still remembers Yang Ping's first visit to Guilin, and he was full of praise for the pig offal. The main course for dinner this time was pork offal, and the porridge in the morning was raw pork offal.

Under the guidance of the new concept of a balanced diet, Liang Fatzi has been burping pig offal, but the gout has not recurred.

Director He led everyone to get busy and fully supported Yang Ping's scientific research. They tethered all 40 monkeys at night and mixed the food with sedative and sleeping drugs to keep the monkeys in a drowsiness.

Fasting for eight hours before surgery and no water for four hours before surgery.

Doctors from Concord are very dedicated. All 40 monkeys shave their backs and clean their skin in advance. When shaving, they strictly follow the latest perioperative guidelines and use 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, for preoperative skin preparation, have banned the use of manual razors for shaving, and designated the use of scissors or electric razors. hair to reduce the possibility of skin damage.

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

In the supine position, Liang Fatzi was intubated under general anesthesia. The monkey's tracheal intubation is actually not much different from that of a human being, just like a baby's tracheal intubation.

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

These monkeys, each with a number, each have a medical record belonging to them, which records 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 was changed to a prone position, which was still fixed by a special fixing frame.

In the operating room, there were many people surrounding them one after another. These doctors who were rotating in the laboratory were all medical students.

The youngest winner of the Golden Knife Award, who is so highly regarded by Professor Liang, can this whimsical spinal external fixator succeed?

Song Zimo took Xiaowu to sterilize and spread the sheets. Since it was an animal experiment, it was necessary to simulate the most realistic human surgery as much as possible.

Even the pre-operative verification was carried out carefully to prevent the monkeys and medical records from appearing unreliable, resulting in untrue data.

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

The operation is completed by using more than a dozen symmetrically distributed small incisions without destroying any stable structure of the spine. Each of these small incisions is about two or three millimeters.

It is almost an assembly line operation. One operation only takes ten minutes. The two operating rooms alternate in turn. One side performs the operation, and the other side begins to anesthetize the monkeys. , the efficiency is very high.

After the monkeys recovered from anesthesia, they were sent to the closed garden on the back mountain for observation. In order to rotate the coils regularly, they were all tied up with long ropes, allowing them to move under the restriction of the ropes.

The doctor in charge of the perioperative management of experimental monkeys has rich experience. He has participated in many animal experiments. He taught himself veterinary knowledge, learned to read the monkey's laboratory test sheet, do the monkey's electrocardiogram, and analyze the monkey's image pictures.

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 was going to open a pet hospital, and he would definitely be the best veterinarian.

Because he has participated in heart transplantation, liver transplantation, lung transplantation and kidney transplantation in monkeys, cut open the brain of dogs, removed tumors from it, treated large-scale burns in cats, and treated some minor illnesses with medicine.

The doctor did not say anything casually. He analyzed the matter with a scientific attitude, and finally came to the conclusion that it is completely feasible to switch to a veterinary profession, and the future is bright.

This baby-faced doctor is obviously familiar with Yang Ping, and he said with admiration: Dr. Yang, since the Golden Knife Awards started, you are the only one who has won the championship as an attending physician. I have seen your surgery many times. , It's amazing, why can you be so skilled in surgery, and some new surgery methods are also very skilled, you can't see them as new surgery at all.

It is impossible for Yang Ping to tell him that he has a plug-in. In the plug-in space, there are thousands of surgeries that can be performed. If they fail, they can start again without any worries.

The more operations you do, the more skilled you will naturally be.

As the old saying goes: Only the hands are familiar with you!

That's why.

Even the spinal external fixator, which is undergoing animal experiments, has undergone numerous experiments in the system space, and it has been quite successful.

The operation was too simple. The operation originally planned for two days was successfully completed in one day.

On the monkey mountain in the laboratory, there are forty monkeys tied with long ropes and carrying external spinal fixation frames on their backs. They are very novel.

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 minors' scoliosis may be corrected without surgery.

Continuing to upgrade this technology, adult orthopedics can also be minimally invasively completed with external fixators, and ultimately obtain a spine with normal morphology and function. Traditional surgical orthopedics sacrifices a lot of spinal mobility.

Of course, there are many people who doubt this. Even Professor Liang, who is far away in the imperial capital, has doubts about how to control the force and direction of orthopedics, how to maintain the durability of the force, and whether it can cause traction tissue under such 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 Research Institute of Johnson \u0026 Johnson does not believe that external fixators can be used in spinal orthopaedics. They believe that the complexity of the technology is difficult to achieve. Therefore, their partner in external spinal orthopedic devices chose Dr. Mitsui from Japan.

Yang Ping is confident, this is just repeating his successful experiment.

Song Zimo is also convinced that this Dr. Yang, from the first day he met, has achieved all the bullshit he has bragged 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 Guilin’s landscapes. I came here twice, both directly from the high-speed rail station to the laboratory. I didn’t see what Guilin was like.

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

Xiao Wu reported: Takahashi will be in charge of receiving us when he arrives, and he and his student union will accompany us all the way.

And—— Xiao Wu hesitated for a moment.

What else? Song Zimo saw him hesitating.

Takahashi said that Fujiwara Miyuki insisted on participating in the reception. Xiao Wu knew that Miyuki had a deep love for Yang Ping, and was embarrassed to say.

Yang Ping didn't have time to think about these things. He was thinking that this forum must not allow Masao Fujiwara to prevail.

This forum is regarded as the prelude and weather vane of the next Asia-Pacific Orthopaedic Conference. Whoever has the upper hand in China and Japan will directly decide 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 ass, and you can only follow the standards set by others.

This is also the reason why Professor Su, Professor Liang and others gathered their strength and competed for the chairman of the conference.