Chapter 645 What is the level of the Golden Knife Award?
Professor Liang was indeed suffering from heart disease. 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 a roast duck at noon.
Everyone present was familiar with the juniors, so it was no secret that he 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 Professor Liang might not have been able to eat enough when he entertained him before.
Doesn’t it 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 the cultivation of cartilage.
If stem cells are used to grow real articular hyaline cartilage and transplanted, 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 with 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 in the field of stem cells. It is difficult for anyone to match the breadth and depth of his knowledge.
No wonder he can conduct a thorough analysis of other people's research and finally come up with his own plan.
What if the Union Stem Cell Laboratory cooperates with 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 the Peking Union Medical College Laboratory to give up its leadership and join Yang Ping's project.
From the medical school to the hospital, Union Medical College has more than 20 academicians, and they are leaders in many national-level projects. How could they arbitrarily give up their leadership and join young people's new projects?
If we cooperate, many conflicts seem difficult to reconcile.
However, it doesn't matter whether we cooperate or not. As long as Yang Ping is in the country and the project is in the country, Professor Liang will feel at ease.
Maybe 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, 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 rest 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, 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 vertebrae resection of three vertebrae, tumor resection, and 3D printing
Titanium alloy artificial vertebra implantation, posterior pedicle screw system fixation, the operation is too big and the risk is too high. It is estimated to 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."
The number of cases was relatively small. It was done in Xiehe University and Huaxi University. At that time, both vertebrae were done, 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 the operation after being fully prepared.
As soon as he heard about the surgery, Yang Ping immediately became excited. This kind of surgery 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 surgery is a very big project.
"Come on, let's go to the ward and have a look." When Professor Liang heard about this kind of case, he seemed to be on stimulants. He didn't even need to rest after meals.
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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. Didn't he say he was sick? He didn't look like he was 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 are gathered together, and everyone is very busy.
When they saw 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.
This chapter is not over yet, please click on the next page to continue reading! These Ph.D.s 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.
Seeing that Professor Liang was going to see this case now, everyone put down their work and prepared to listen carefully to the lecture. All the young people had 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.
Xiehe Orthopedics has more than 60 doctors, including those who are studying for doctorates and masters, so 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 orthopedic field, 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 and Yang Ping, as well as the director of the team, all sat in the first row. The other doctors started from the second row and were automatically sorted.
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. Unexpectedly, so many people gathered 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 obvious tension in the psoas muscles on both sides.
The skin sensation was reduced, the anal reflex was weakened, and the skin sensation on the lateral side of the right thigh was reduced. Auxiliary examination: the anteroposterior and lateral levels of the lumbar spine and lumbar spine MRI showed: space-occupying lesions in 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 invasion of lumbar 4 vertebrae tumors 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. We treat it 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 very much with Director Hu's approach.
Twin Cities Spine Center is a world-class spine center that has made great contributions to the development 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 not sensitive to traditional radiotherapy and chemotherapy. Of the three options for treating tumors—surgery, radiotherapy, and chemotherapy—surgery is the only remaining option. Therefore, 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, causing the patient to have incontinence of urine and feces, 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 anatomical structure of the lumbar spine is very complex. There are spinal nerves inside, the abdominal aorta and vena cava in front, and a large number of blood vessels around it. The vertebrae are deeply located and have irregular and complex shapes.
To completely remove the 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 spinal surgery.
The requirements for surgeons' anatomical knowledge and anatomical practice are very high.
Jing Yunsong's tumor involves a long and wide range of lumbar spine segments. The tumor grows aggressively in all directions and forms 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 axis of the human body, is missing three sections. It is like a building without load-bearing walls and columns, so it cannot be done after removal. 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 performed a similar operation not long ago. I don’t know if you remember it. It took twelve hours for two vertebrae. West China Hospital also performed one case, 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 it be possible? How long would it take?
