Chapter 645 What is the level of the Golden Knife Award
Professor Liang was indeed mentally ill. After reading the information Yang Ping brought, his face was rosy, energetic, and he no longer coughed. He ate five bowls of rice and almost half of the roast duck at noon.
The people present were all familiar juniors, so it was no secret that they could eat, and there was no need to be polite at home.
Professor Liang's appetite should be among the best among the elderly. Yang Ping suspected that he might not have been able to eat enough when he entertained Professor Liang before.
Don't you mean viral acute upper respiratory tract infection? Could it be that the virus was killed so quickly?
Hu Guolin and Song Yun couldn't understand it at all. Professor Liang's wife knew her husband's temperament, so she didn't find it strange.
After lunch, Professor Liang and Yang Ping discussed the application of stem cell technology in orthopedics, especially in cartilage cultivation.
If stem cells are used to grow real articular hyaline cartilage and transplant it, the post-transplantation process will be like fracture healing, which is much simpler than other organ transplants.
Yang Ping chose stem cells to cultivate muscles because muscles have the basic characteristics of other organs. For example, after transplantation, they must rely on anastomosed blood vessels for blood supply and to exert their own contraction function. The quality of the function cannot be compromised. There is another important point. After muscle transplantation, the nerves must be anastomosed to allow nerve function to recover, otherwise it is meaningless.
Therefore, if all the problems of cultivating muscles from stem cells are solved, it will be equivalent to solving all the basic problems of cloning organs.
Through communication with Yang Ping, I found that Yang Ping has read almost all papers and monographs on the field of stem cells. It is difficult for anyone to match the breadth and depth of his knowledge.
No wonder you can conduct a thorough analysis of other people's research and finally come up with your own plan.
How about cooperation between Xiehe Stem Cell Laboratory and Yang Ping? Professor Liang came up with this idea.
Concordia's stem cell research has been going on for thirty years, while Yang Ping's stem cell research has just begun. It may take some time to convince the professors in the laboratory to cooperate with Yang Ping.
Moreover, it is difficult to coordinate the issue of leadership in the cooperation between the two. Yang Ping's project is so big that it must take the lead, and it is impossible for Xiehe Laboratory to give up its leadership and join Yang Ping's project.
Union Medical College has more than 20 academicians from medical schools to hospitals, and they are leaders in many national-level projects. How could they arbitrarily give up their leadership and join young people's new projects?
Many conflicts seem difficult to reconcile if we cooperate.
However, it doesn't matter whether they cooperate or not. As long as Yang Ping is in the country and the subject is in the country, Professor Liang will feel at ease.
Perhaps the older generation has a deep understanding of the chokehold on key technologies, so the research on these major technologies is always viewed from a national strategic level, and they attach great importance to "independence and self-renewal".
"Xiao Yang, if you have any difficulties with the project, please feel free to tell me, such as funding, manpower, etc." Professor Liang felt that he could still be of some help. After all, he has a high status in the medical circle and has a lot of scientific research resources. transfer.
"Okay, I will tell you if I have any difficulties." Yang Ping was very grateful for Professor Liang's concern.
After talking to Yang Ping for a long time, Professor Liang said to his wife: "I will take my temperature later. If there is no problem, I will go to the hospital to work."
"It's Saturday, why don't you take a break and recuperate?"
Teacher Luo is still a little worried.
Professor Liang said unconvinced: "Five bowls of rice and half a side of roast duck. Have you ever seen a patient who can eat like this?"
"Okay, go ahead, Guolin, and keep an eye on him." Teacher Luo had no choice but to agree, but he was still worried and told Hu Guolin to pay attention to his body, after all, he had been lying down for three days.
"Are there any special patients these days?"
I have been bedridden for the past few days, and I have just recovered my strength today, so I naturally care about the patients in the department.
"There is a rather special patient with chordoma that invades the 2, 3, and 4 lumbar vertebrae. During the case discussion, it was decided to undergo surgery: posterior-anterior-posterior approach, total spondylectomy of three vertebrae, tumor resection, and 3D printing Titanium alloy artificial vertebrae are implanted, and the posterior pedicle screw system is fixed. The operation is too big and the risk is too high. It is estimated that it will take more than 20 hours. We have not arranged the operation for the time being, waiting for your help.
Professor Liang has now handed over the position of department director to Professor Hu Guolin, but he still insists on doing rounds and operations.
Professor Liang knew as soon as he heard it: "This is a world-class surgery. Currently, only a handful of hospitals in the country can perform total vertebra resection. In addition to tumor removal and vertebra reconstruction, there are probably only three or four hospitals in the country that can perform this kind of surgery." There are relatively few cases. Xiehe Hospital and Huaxi Hospital both performed surgery on two vertebrae, which took about fifteen hours.”
"Yes, so we have to be fully prepared before we dare to do it. Patients also come here for our ceiling position." Professor Hu is also very rigorous and can only arrange surgery after being fully prepared.
As soon as he heard about the operation, Yang Ping immediately became excited. This kind of operation is interesting to perform.
The anatomy of the vertebrae is extremely complex, and the invasion of the tumor makes the anatomy even more complicated. There are spinal nerves inside, various criss-crossing blood vessels outside, and the aorta and vena cava in front. Three whole vertebrae and the tumor can be removed at one time , and then rebuild.
This operation is a very big project.
"Come on, let's go to the ward and have a look." When Professor Liang heard about this case, he seemed to be on stimulants. He didn't even need to rest after meals.
——
Professor Liang, Professor Hu, Song Yun and Yang Ping walked to Union Hospital.
Professor Liang’s home is not far from Xiehe, and the walk is a walk after dinner.
Any acute upper respiratory tract infection is just a cloud.
Everyone came to the orthopedic ward of Union Hospital and saw Professor Liang who was in high spirits. Everyone was very confused. Wasn't he sick? Doesn't it look like you are sick?
The doctors in the department have just completed their professional studies, and there are many people in the office. A large number of doctors gather together, and everyone is very busy.
Seeing Professor Liang and Director Hu, everyone greeted them respectfully.
Several doctors knew Yang Ping. After recognizing Yang Ping, they were very excited and ran over to talk to Yang Ping.
These PhDs have all participated in animal experiments in Guilin, and their names are all signed on Yang Ping's papers. They are all Yang Ping's admirers.
They knew that Yang Ping was coming to Union Medical College, and Union Medical College had prepared ten beds for clinical trials of scoliosis patients, but they did not expect that Yang Ping would arrive so soon.
"Director Hu, take a look at the medical records of the patient you mentioned, and let's discuss it in a small group." Professor Liang sat down and ordered Professor Hu Guolin. Song Yun immediately went to get the medical records, then turned on the computer and put the medical records on the screen.
When everyone saw that Professor Liang was going to see this case, they all put down their work and prepared to listen carefully to the lecture. All the young people held notebooks in their hands. The learning atmosphere of Xiehe University was great.
Doctors arrived one after another, including some chief doctors and deputy chief doctors.
There are more than 60 doctors in Xiehe Orthopedics, including those who are studying for doctorates and masters, and the number of doctors is very large.
Many young doctors heard that Yang Ping was coming and came to see him as much as possible. The winner of the Golden Knife Award is still very famous in the orthopedics world, especially among young doctors, he is an idol figure.
Seeing that the office could no longer be crowded, Director Hu suggested that it would be better to go to the conference room.
Everyone moved to the conference room, ready to discuss this case.
Professor Liang, Director Hu, Yang Ping, and the director leading the team are all sitting in the first row, and other doctors are automatically sorted starting from the second row.
Song Yun also has to sit in the back, because he is not yet qualified enough to sit in the front row, but now he and several other doctors are responsible for multimedia control.
Originally, Professor Liang only wanted to have a small discussion with a few people, but he did not expect so many people to gather spontaneously, so he had to expand the scale of the discussion.
Professor Liang finished flipping through the paper medical records and handed them to Yang Ping: "Look at this medical record."
Yang Ping took the medical records and quickly flipped through them to grasp the key information of the medical records.
Jing Yunsong, male, 48 years old, was admitted to the hospital with lower back pain and numbness and pain in the anterolateral aspect of his right thigh for 7 months. Physical examination showed percussion pain in the spinous processes of waist 2, 3, and 4, and the psoas muscles on both sides were obviously tense. There was hypoesthesia in the skin, weakened anal reflex, and hypoesthesia in the lateral skin of the right thigh. Auxiliary examination: Anteroposterior and lateral lumbar spine and lumbar spine MRI showed space-occupying lesions on the 2nd, 3rd, and 4th lumbar vertebrae, which was considered to be chordoma.
Tumors at the 2nd lumbar vertebrae grow into the spinal canal and have significantly compressed the spinal cord and nerve roots in the spinal canal, causing damage to the conus equina; tumors at the 3rd lumbar vertebrae grow into the abdominal cavity, forming a huge soft tissue mass that adheres to the aorta and vena cava ahead. ; The range of lumbar 4-vertebral tumor invasion is much smaller.
"This case has been discussed by everyone. We are just interested in it, so we took it out for study. It is not considered a formal discussion, but is treated as a study." Professor Liang expressed his attitude to avoid causing confusion in the procedure.
"The delegation from the Twin Cities Spine Surgery Center in Twin Cities, Minnesota, USA, will arrive tomorrow. I will temporarily join this case in the academic exchange case." Director Hu reported to Professor Liang.
Teaching hospitals with a strong academic atmosphere like Union Medical College have academic activities almost every Saturday and Sunday. Some are limited to domestic exchanges, and some are international exchanges. This is almost normal.
"Yes, this is relatively rare. The surgery is huge and the risks are high. Talk to them." Professor Liang agreed with Director Hu's approach.
Twin Cities Spine Center is a world-class spine center that has contributed greatly to the advancement of spine surgery.
Song Yun began to report the medical records, and everyone listened and thought.
Chordoma is a rare malignant tumor that occurs in the skull base, vertebrae and sacrum. The incidence is very low, about 0.8 people/1 million per year. Without effective treatment, the 5-year survival rate is only about 30%. This The survival rate is also very low.
The 5-year survival rate is a statistical concept and is generally used clinically to evaluate the treatment effect or prognosis of malignant tumors.
It is not the outcome of a specific patient, it does not mean that they can only survive for 5 years, but it refers to the survival rate of patients with malignant tumors 5 years after diagnosis.
That is, out of 100 diagnosed patients, how many are still alive after five years.
The higher the 5-year survival rate, the better the treatment effect of this tumor and the better the prognosis. On the contrary, the treatment effect is poor and the prognosis is poor.
Chordoma is insensitive to traditional radiotherapy and chemotherapy. There are three options for treating tumors - surgery, radiotherapy, and chemotherapy. Surgery is the only option left, so surgical treatment is the main treatment for chordoma.
Chordoma is very easy to relapse after surgery. Once it recurs, it will often damage the spinal nerves, leading to incontinence, paralysis of the lower limbs, and even death.
Therefore, whether the tumor can be completely removed during the first surgery is the key to chordoma treatment.
For Jing Yunsong, 3 of the 5 lumbar vertebrae are affected by the tumor, which is equivalent to the tumor having invaded three-fifths of the entire lumbar spine. To completely remove the tumor, these 3 vertebrae must be removed, and there is no other option. .
The anatomy of the lumbar spine is very complex, with spinal nerves inside, the abdominal aorta and vena cava in front, and a large number of blood vessels around it. The vertebrae are deep and have irregular and complex shapes.
To completely remove a vertebrae, all normal structures around the vertebrae must be protected and then safely separated from the vertebrae so that the vertebrae can be removed.
Therefore, total vertebra en bloc resection is also the most difficult and technically demanding operation in the field of spine surgery.
The requirements for surgeons' anatomical knowledge and anatomical practice are very high.
Jing Yunsong’s tumor affected a long and wide range of lumbar spine segments. The tumor grew aggressively in all directions and formed a mixed state of interpenetration and interweaving with the surrounding tissues. In this mixed state of enemy and friend, the tumor must be cut out and protected. The poor spinal nerve makes the operation even more difficult.
After the vertebrae and tumors are removed, the spine, which is the central axial bone of the human body, is missing three sections. Just like a building does not have load-bearing walls and columns, it cannot be removed and left alone. The removed vertebrae must be reconstructed to rebuild the central bearing of the human body. Heavy pillar.
Traditional titanium mesh and other supports cannot replace the three-vertebral complex for load-bearing. 3D printing technology must be used to create a personalized three-vertebral complex in order to reconstruct the "load-bearing column" of the human body.
Jing Yunsong has visited top hospitals across the country and came to Xiehe this time, hoping to get the best treatment.
"Surgery is the only treatment method. Everyone agrees on this, and there is no doubt about the surgical method. All three vertebrae along with the tumor are removed, and then a 3D printed artificial vertebrae is implanted. Finally, pedicle screws are used to connect the upper and lower normal vertebrae. Fixing them together is a very difficult operation. We did a similar operation not long ago. I don’t know if you remember it. It took 12 hours for two vertebrae. West China Hospital also did one, and the time was about the same. " Professor Hu clarified the medical records and recounted the results of everyone's discussion.
Xiehe is the ceiling of Chinese hospitals. When patients come here, they have no thought of transferring or going to other hospitals.
This is the last stop for medical treatment.
Many patients think that Xiehe is not good, so they can only go back to eat and drink well.
Those doctors who were familiar with Yang Ping came up with an idea: If Yang Ping performed this surgery, would they be able to win it? How long will it take?
What is the level of the Golden Knife Award?
What are the top surgeons in the country?
(End of chapter)