The Godfather of Surgery

After returning from the Imperial Capital, Yang Ping brought Xiao Su some special snacks from the Imperial Capital, as well as some handicraft gadgets that girls like, such as hairpins, bracelets, etc. They are all beautiful and cheap tricks, but Xiao Su likes them very much. .

Every time Yang Ping goes out, he will definitely bring a small gift to Xiao Su. He can forget about other things, but he will never forget this.

After coming back, Yang Ping would also share with Xiao Su the surgeries he had performed outside. Xiao Su would listen with interest, her eyes filled with admiration and admiration for Yang Ping.

It was already noon when he came back, so Yang Ping went to the department after lunch.

The current state of the department is very good. Xia Shu has been fully integrated into the new team. Soon, Dr. Wen and Dr. Jin from the Department of Orthopedics will be transferred to the Institute of Surgery. This will add two more doctors to the Institute of Surgery, and the manpower will be larger than before. adequate.

Yang Ping went to the surgery in the afternoon and performed a few operations. After get off work, he went to the general surgery department to visit Pan Doudou. She was not discharged from the hospital yet. Fortunately, this little girl took advantage of the live broadcast and made some money, otherwise she would not have so much money. He has been hospitalized waiting for an organ transplant.

The skinny Pan Doudou was lying on the hospital bed, with an infusion tube connected to the subclavian area on her left side. In order to use intravenous nutrition for a long time, the nurse had punctured and inserted the subclavian vein for her.

Now she relies entirely on intravenous nutrition to maintain her life. Even if she doesn't eat, the air accumulation caused by the loss of peristalsis in the intestines is enough to cause her great pain.

Pan Doudou's condition became more and more serious, and Pan Doudou's entire body took on a more serious skinny appearance. His frontal bones, cheekbones, and mandibles had all protruded, and the outlines of his bilateral eye sockets were vaguely visible, which made people look scary. It's not the so-called skinny beauty.

Even in this state, Pan Doudou did not forget to live broadcast. Her state aroused sympathy from fans. Everyone spontaneously donated money to her, cheered her up, and hoped that she could get through it. People with fans are different.

After watching Pan Doudou, Yang Ping sat for a while in the doctor's office of the General Surgery Department and chatted with Director Fang about Pan Doudou's condition.

A few days ago, there was a patient who died in a car accident. The family had agreed to donate his organs, but later regretted it.

Because of the influence of traditional concepts, Chinese people generally have a repulsive attitude towards organ donation, which is understandable.

Director Fang couldn't help but feel a little regretful. At the same time, he also apologized for calling Yang Ping in the middle of the night. He was really excited that day and didn't understand the situation for a while, so he called Yang Ping directly.

As a doctor, who cares about answering the phone in the middle of the night? Sometimes on vacation, the phone is very quiet and I am not used to it.

When Yang Ping was the chief resident in the past, the mobile phone assigned to the chief resident by the department was a Nokia senior phone. The ringtone is still engraved in Yang Ping's mind. If he hears this ringtone now, Yang Ping will immediately become nervous instinctively. This is an emergency.

This kind of thing can only wait. Contact me if you need it. Yang Ping had no choice but to wait for the organ.

Her CA199 was very high, almost 10 times higher, Dr. Chen, who was in charge of the bed, reported.

Yes, we are investigating the cause. Director Fang showed a slightly worried look on his face.

I remember she had CA199 before. Is it normal? Yang Ping asked.

Dr. Chen nodded: Yes, I have had CA199 done before and it has always been normal.

CA199 is a tumor marker. It is so high that it is 10 times higher. If tumors are considered, the previous diagnosis may be overturned. Before organ transplantation, it is not okay to have problems with the diagnosis.

Tumor markers are just an indicator. It does not mean that an increase is a tumor. Other factors need to be considered.

Pan Doudou's current diagnosis is autoimmune intestinal smooth myositis. Yang Ping has personally seen the pathological slides. There is definitely no problem with this. Could there be tumors in other parts? Yang Ping began to check in his mind.

Bring the medical records over and let me take a look. Yang Ping felt that he should take a good look at the medical records again.

Dr. Chen immediately brought the medical records over, but the recent examination sheets were not included and were still placed in the cabinet at the nurse's station. Director Fang was very unhappy: What happened? Go get it quickly.

A trainee immediately ran to get the examination sheets, sweating on his forehead in such anxiety. These examination sheets were all tests that were added because of the elevated CA199.

Taking out all the examinations before her admission was like squeezing out toothpaste. Director Fang scolded his graduate students and trainees.

Yang Ping turned to this checklist and found that CA199 was actually 255U/ml. The normal value is 0-25U/ml, which is more than 10 times the normal high value. Generally speaking, increases in this indicator are more common in pancreatic cancer, liver cancer, and colon cancer. Some benign tumors of the digestive system may also increase.

However, this indicator is not specific enough. All clinical examinations have two important evaluation parameters: sensitivity and specificity.

Sensitivity detects the presence of disease; specificity reduces the chance of error.

The so-called high sensitivity means a strong ability to detect diseases. If we use anti-virus software to detect viruses as an analogy, there are 100 viruses mixed in 10,000 files. It can detect all 100 of them, but unfortunately, it detects them as viruses. There are more than 100 files, there are hundreds of them, and 100 viruses are included in these hundreds of files.

What is the specificity? The specificity is that it can only detect 50 viruses, but these 50 are all viruses and are not mixed with other files.

The specificity of CA199 is not high. Even if it is elevated, it is not necessarily pancreatic cancer.

For example, CA199 will rise during a woman's menstrual period. Yang Ping thought about it and found that there were no signs of tumors in other examinations. It should be other reasons.

How is the patient's menstrual period? Is it your period now?

Well, Dr. Chen doesn't pay much attention to the patient's menstrual pattern. Dr. Li couldn't answer for a while, so he looked through the medical records. There was a column in the hospitalization record specifically for recording menstrual history, but many doctors might not pay too much attention to it.

Seeing the menstrual history recorded at that time, Dr. Chen began to calculate the date of the next menstruation.

You'll know if you ask, what are you talking about with your fingers here? Director Fang is a sharp-tongued person with a straightforward personality, so he likes to train people.

However, the doctors under him are used to it. He trains others, but he does not have any evil intentions. On the contrary, he is very protective of the doctors under him.

Dr. Chen immediately ran to the ward to ask about Pan Doudou's menstrual history. After asking, he came back and said, It is indeed the second day, but the amount is very small.

''With her current nutritional status, her menstrual flow must be sparse, and some patients may experience amenorrhea in this nutritional status. Yang Ping judged.

If this is the case, then the increase in CA199 should be a response to menstruation, not an increase caused by tumors, and it will have no impact on future surgeries, so Yang Ping can rest assured.

Coming out of the surgical building, just at the gate of the surgical institute, Yang Ping met head nurse Cai. The head nurse sprained her foot and had a plaster on her foot. However, she was a workaholic and did not want to take a vacation, so she used crutches to go to work, but she lived in a plaster cast. Wearing crutches makes commuting inconvenient, and the doctors and nurses in the department are very busy. No one is willing to help except Xia Shu. He is new here and doesn't have that many things to do.

The head nurse lived in a community near the hospital, so Xia Shu used a wheelchair to push her to commute every day.

Song Zimo and Xu Zhiliang from the department have seen the head nurse's injury. They said that the injury is indeed serious, but the plaster will only take a few days. The key is to use crutches for a month, and it will take almost three months to fully recover.

If the head nurse hadn't been in good physical condition, the ankle joint would have been severely swollen, but now the swelling is not very obvious.

The head nurse is very anxious, what should we do? The department is so busy now, it is impossible to take a vacation.

At that time, Yang Ping went to the imperial capital. Song Zimo, who was guarding the house, was the acting department director. He said that it was not appropriate to take a vacation at this time. He hoped that the head nurse could put the overall situation first and insist on going to work despite being sick. However, a person must be sent to take the head nurse to and from work.

Song Zimo asked around, hoping to find a nurse to perform such an arduous task, but the nurses shook their heads and couldn't spare the time. These heartless guys would all fall apart at the critical moment.

There was no other way, Song Zimo had no choice but to tell Xia Shu: Dr. Xia, this matter can only trouble you. Don't worry, the department will remember your contribution.

Xia Shu said that it was an easy matter, regardless of contribution or contribution, it was just a matter of hands. The head nurse lived across the street, but driving was inconvenient. As long as he had a wheelchair, he would push the head nurse to and from get off work every day.

Song Zimo patted Xia Shu on the shoulder: Dr. Xia, you are more enlightened. I would like to thank you on behalf of the department.

In this way, Xia Shu began to use a wheelchair to push the head nurse to and from get off work every day. The wheelchair just rolled out from the ward had a bad track. Xia Shu wanted to change to a new wheelchair, so he asked the outpatient nurse to get a newer wheelchair.

Yang Ping chatted with the head nurse for a few words. Xia Shu had already rolled out the wheelchair from the outpatient clinic on the first floor. When he saw Yang Ping, he immediately said hello: Professor hasn't gotten off work yet?

''I just went to the general surgery department to see a patient, and now I'm back to the department to put away my clothes before get off work. Yang Ping said.

Xia Shu was quite attentive and carefully helped the head nurse to sit in the wheelchair. Then he said goodbye to Yang Ping and pushed the wheelchair very hard to the head nurse's house across the street.

Sometimes it's really strange that the head nurse is usually the kind of lady with a professional temperament, but now she just sprained her ankle, and she looks like a little girl.

——

Back in the department's office, Yang Ping took a break and entered the system space laboratory to take a look.

The experiment in the system space is still going on, and it is different since the system rules were upgraded.

According to the previous rules, when Yang Ping comes out of the system space, everything in the system space stops at that moment. After Yang Ping enters the space again, the system space will restart from the moment it stops.

But it's different now. Even if Yang Ping leaves the system space, the experiment will continue to be carried out, and the time progress inside will be advanced proportionally, much faster than the real time.

In this way, the experiments in the system space and Yang Ping's real-life activities can be carried out in parallel. This has advantages and disadvantages. The advantage is that neither is delayed. The disadvantage is that once Yang Ping leaves, the experiments inside will continue to go wrong if they go wrong. In short, each has its own advantages and disadvantages. .

This time Yang Ping entered the system space and found that there was a cell bank that used tumor cells as culture objects, but the vast majority of the cells were dead.

This cell bank was established by Yang Ping with great efforts. It has been used to observe the performance of tumor cells during their division. However, he did not expect that so many cells would die without paying attention. At present, it seems that the rate of cell death is still accelerating. This cell bank Basically it can't be used, so we have to start from scratch.

This is like a farmer who worked hard to make a fortune from two pigs and increase the number of pigs in the farm to hundreds or thousands. But suddenly one day, a swine fever caused a large number of dead pigs to lie on the pig farm. At this time No matter how the farmer feels, Yang Ping's mood is similar at this time.

Fortunately, just in case, Yang Ping also kept some seed cells. These cells were taken from Sisi's body at that time. All the tumor cells used in the laboratory were derived from the tumor cells in Sisi's body.

This was just an accident. Yang Ping was lost in thought about the cells, and suddenly an idea flashed in his mind.

These are all tumor cells. Most of them die suddenly, which is a blow to your stem cell experiments. But isn’t it a good thing for tumor research?

Isn’t the ultimate goal of any tumor research to kill tumor cells? Thinking of this, Yang Ping immediately had a new idea in his mind.

These dead tumor cells are not discarded garbage, but treasures. It is just right to establish a new subject to study the reasons for the death of these cells, and maybe find some new methods to treat tumors.

In fact, in the medical field, it is very difficult to clearly study a certain mechanism. As long as you can really study one, it is enough to win the Nobel Prize.

One of the winners of the Nobel Prize in Physiology or Medicine studied why peppers are spicy. Why are peppers spicy? This is something that everyone understands, but it is difficult to figure out the mechanism and why this happens from a scientific perspective.

Two American scientists won the Nobel Prize for their study of how spicy chili peppers taste. Wouldn’t the Nobel Prize podium be crowded by foodies who taste all kinds of flavors every day?

In fact, it is easier said than done.

These two scientists revealed from a deep level, a very deep level, from a molecular level deeper than cells, why eating chili peppers irritates the mouth and chrysanthemums. This is not only a matter of spiciness, but also a matter of pain. From the molecular level, these two scientists Only by clearly explaining why people feel pain and thus revealing the mechanism of human pain transmission at the molecular level can we win the Nobel Prize.

The death of cells originally seems to be a very simple matter, but when it rises to the level of serious science, it is by no means as simple as imagined.

First of all, cell death can be divided into two categories, regulated death and accidental death, which are similar to natural death and accidental death in humans. There are 11 types of death in total. Some of these 11 ways of death have Chinese characters. Translations, such as apoptosis, ferroptosis, and oxygen death, some do not even have Chinese translations and can only use English nouns.

To study the cause of death of these tumor cells, we must first figure out what kind of death they are, and then we must figure out the cause and process of their death at the molecular level. This is not enough. You have to explain these in scientific language. clear and direct.

Yang Ping thought of waste utilization and established a new topic in the system space to study the death mechanism of these cells.