Joint infection is an eternal topic in joint surgery.
This situation is like infection after surgery. As long as surgery exists, the topic of postoperative infection will never go out of style, because in reality, bacteria and other microparticles are everywhere, throughout every step of the treatment process.
, may lead to infection.
This is an established complication of all surgeries.
For a surgeon, it is inevitable that infections will occur in all of his surgical patients. The reason why he has never encountered them is because the number of patients is not enough.
Currently, the gold standard definition of joint surgery for the treatment of joint infection is one-stage debridement and two-stage surgery.
If it is a natural joint infection, the first stage is debridement, and the second stage is joint replacement or joint fusion or other surgeries depending on the situation.
If infection occurs after joint replacement due to surgery, the first stage of postoperative debridement will be performed, bone cement and antibiotics will be placed during the operation, and the joint revision surgery will be performed in the second stage.
This is a safer measure.
However, Professor Zhuang Zhou said that whether it is a joint infection that occurs naturally or a joint infection caused by postoperative infection, thorough debridement can be performed in one stage, and then the joint can be treated in the next stage of surgery.
Therapeutic treatment such as replacement or revision.
This is equivalent to merging the second-stage surgery into the first-stage surgery. In the past, this surgical method was an absolute contraindication!~
A person who treats commonly understood taboo surgeries as routine surgeries and even dares to talk about them.
First of all, I can only say that I am very courageous——
Because according to the current guidelines, the gold standard for all infection treatments is two-stage surgical treatment.
Only senior officers have the right to perform surgeries and treatments that violate the guidelines, and if something goes wrong, the person who led the team or performed the surgery will have to take responsibility!
Is one-stage surgery good?
Of course, it is good. It not only saves the time of surgery, but also allows patients to recover as soon as possible, and also reduces their hospitalization expenses and medical time.
But the risks are extremely high from a traditional perspective.
The standard treatment method written in the guideline is to perform two surgeries, one-stage surgery, which consumes time and money. Once anything happens, the doctor will be held responsible.
Under such circumstances, the ability of a professor who dares to take such a risk and perform surgery against the guidelines goes without saying.
This is a relatively new understanding and field, it can also be said to be a new vision and concept, but it has not yet become a consensus...
There is still a long way to go before consensus can be reached.
However, Zhou Cheng listened to Professor Zhuang Zhou’s summary——
Professor Zhuang Zhou used a very formal summary——
take home message (key points and summary):
This usually appears in more formal literature submissions, but Professor Zhuang Zhou wrote it in the ppt, which proves that he put a lot of thought into making this ppt.
"Joint infection can be treated in one stage, but there are a few key points that you must pay attention to."
"First, before the operation begins, the infecting bacteria must be identified. It is best to conduct a drug sensitivity test. Units that have the conditions can form a joint collaboration group with the laboratory department!"
"Second, there must be a sufficient time limit for the use of sensitive antibiotics before the operation begins."
"Based on our experience, it is recommended that sensitive antibiotics should be premedicated for 24 hours before surgery. For those with limited conditions, more than 12 hours can be used."
"If sensitive antibiotics are not used before surgery, the duration of antibiotic use after surgery can be appropriately increased by 3-5 days, which can also reduce the chance of postoperative reinfection."
"Third, during the operation, complete debridement, remove all infected tissue, and clean the hidden spaces of infection, including muscle spaces and intra-articular blind spaces. During this process, do not open new spaces!"
"Fourth, antibiotic carriers can be appropriately utilized during surgery."
"Fifth, continuous drainage after surgery. If conditions permit and the patient is satisfied, continuous flushing and drainage can be performed."
"Sixth, adequate postoperative treatment, timely drainage of fluid, culture of exudate, and timely adjustment of the dosage and duration of antibiotic use. The recommended postoperative antibiotic use time is 96-120 hours!"
"Seventh, proper rehabilitation training after surgery..."
"These are the pre-operative, intra-operative and post-operative photos of some of the cases we did. Please supervise me..." Zhuang Zhou was calm and composed, as if I came here to study, but in fact, he was full of
It's all about showing off and showing off.
When Luo Yun heard this, he smiled slightly, shook his head, and then turned around to see Zhou Cheng. He actually took a notebook and carefully copied out everything Zhuang Zhou said.
Then he asked with a flash of his face: "What are you doing?"
"I think what Professor Zhuang said is quite good, so I took notes so that I can think about it in the future." Zhou Cheng recounted Du Yanjun's remarks.
But in fact, Zhou Cheng felt that the new direction in the treatment of joint infections that Zhuang Zhou just talked about was tailor-made for him.
Isn't this a new breakthrough point and perfection in the treatment of joint infections - a redefined realm?
Zhou Cheng even skipped the idea of simulation. He just took the idea that Zhuang Zhou just explained and practiced it once or twice in the simulation world. I'm afraid he would be able to get perfect-redefined skills. Isn't this a good thing?
So Zhou Cheng naturally had to write it down quickly. As for what Professor Zhuang Zhou said, it would take time to verify the specific effect. Zhou Cheng did not need to consider this factor at all.
The existence of the simulator allows him to have many trial and error opportunities and more trial and error time costs.
If it doesn't work once, I'll do it twice. If it doesn't work twice, I'll do it ten times. It'll finally work, which is three to five days' work.
Luo Yun's expression continued to be weird, he knocked on Zhou Cheng's notebook and said, "Don't you see that these other people only think that Professor Zhuang Zhou said that, and we listen to it like this?"
"Have you ever seen anyone taking notes like you?"
Zhou Cheng followed what Luo Yun pointed and saw that no one was taking notes. Many people even had their hands folded on their chests, as if they were not listening to the lecture but watching the fun.
After Zhou Cheng finished recording, he was listening to Zhuang Zhou's concluding remarks, and while being slightly distracted, he replied: "Teacher Luo, I am the stupid bird who flew first."
Zhou Cheng feels that learning is personal, not shared. He is not someone else. Others are either associate professors, directors somewhere, or graduate students.
There is no need to study for an associate professor or a director somewhere. Graduate students each have a better learning platform!
Zhou Cheng himself didn't have this opportunity, so naturally he could take more notes.
Opportunities to learn are precious and hard-won.
Seeing that Zhou Cheng was serious, Luo Yun rolled his eyes and said, "Do you really take Professor Zhuang's pretentious words seriously?"
"Do you know that Professor Zhuang, the reason why he dares to carry out the first-stage treatment of joint infection in his unit has certain background factors?"
"First of all, his affiliated hospital is Xinjiang Medical University, which is located in Xinjiang Province. Did you know that Xinjiang Province has an excellent medical insurance policy? Basically, major surgeries like this are completely covered by medical insurance.
"
"In other words, over there, ordinary people's joint replacements are all paid for by medical insurance, and the patients themselves don't have to pay anything."
"So, neither the patient nor the doctor are afraid of having the joint prosthesis repaired for the second time. The worst that can happen is to install another one. The patient doesn't have to pay for it himself, but he just has to suffer a little bit, and he can tolerate it."
"But anywhere else but here, could you repeat that?"
"It cannot be repeated, and this unique geographical advantage is the fundamental reason why Professor Zhuang dares to do this. It is useless for you to take his notes."
"As long as Professor Zhuang does not have the ability to change the guidelines and obtain widespread recognition around the world, what he says is actually quite superficial."
Luo Yun spoke very thoroughly, making Zhou Cheng's eyes widen slightly.
Is there still such a thing?
Co-authored, others just quietly let Zhuang Zhou finish his pretense and go through the motions, and then he took it seriously?
Zhou Cheng has never had the opportunity to participate in such an academic exchange before!
However, Zhou Cheng just discovered that this kind of academic exchange is simply tailor-made for his simulator——
The details Zhuang Zhou said were very substantial. He had just tried a simulation according to Professor Zhuang Zhou's ideas.
It is completely based on the ideas taught by Professor Zhuang Zhou, and you don’t have to design anything yourself.
The third copy that Zhou Cheng got at the emergency scene some time ago was the bone and joint copy, which is consistent with the joint surgery conference and exhibition hall he came to today.
Then--
Zhou Cheng gained experience in treating joint infections (initial/post-operative) in one go (perfect - world-defining level).
Once it entered the soul, although it failed to directly break the rules as Professor Zhuang Zhou said, it still reached the perfect level in one go!
"But I think what Professor Zhuang said is quite reasonable?" Zhou Chengcheng touched his head and asked Luo Yun.
What Professor Zhuang Zhou said was definitely not false, but it was not recognized!
"Principles are principles and implementation is implementation. Just keep listening. You will feel that everything the professor says makes sense."
"Let me tell you this. In fact, academic exchange conferences like this are just large-scale show-off events. What you want to see is who can brag. Anyway, if you brag, as long as you don't brag yourself and can justify yourself, you will be great.
." Luo Yun continued to roll his eyes, feeling that the notes made by Zhou Cheng were really unnecessary.
Even if it is right, can it be done right?
cannot.
Why should you pay attention to something that cannot be made, or even something that will take an unknown number of years to be promoted?
Without medical insurance, you can’t replicate this model anywhere else, you just have to follow the existing guidelines!
"Professor Zhuang is the kind who is particularly good at boasting." Luo Yun explained to Zhou Cheng again.
So he just forced Wang Zhuangzhou?
Zhou Cheng blinked, unwilling to continue to struggle in front of Luo Yun. Anyway, he had already confirmed that what Zhuang Zhou said was correct and he had benefited from it.
There is no need to confront Luo Yun and say that what Luo Yun said is not true and make Luo Yun unhappy.
…
After Professor Zhuang Zhou finished his lecture, there was a burst of applause from below. Even Luo Yun gave him warm applause and slaps.
If Luo Yun hadn't been talking to Zhou Cheng while applauding, Zhou Cheng would have thought that Luo Yun was a devout follower of Zhuang Zhou, after all, his applause was very loud.
"In an academic conference like this, if you listen 100% and doubt 90%, and listen 10% and reserve 90%, you must carefully analyze and reflect the pros and cons in order to gain anything."
"Studying medicine is definitely not just about how others teach you, but also how you learn."
"Before you come into contact with a school, all medical knowledge is the basis. You can learn it first and believe it as truth. But after you really start to come into contact with different schools, you have to start to question what you hear and see.
Smell and even see the reality.”
"We have to talk about right and wrong, but we can't just talk about right and wrong."
"When it comes to experience and medical experience, everyone in this venue will have their own experience. Whether you can express it is a state of mind. Whether you can convince more people is a state of mind. Whether you can follow what others say is a state of mind.
, staying awake enough is another level."
After Luo Yun finished speaking, the applause almost stopped.
Luo Yun's words were a bit profound. After Zhou Cheng frowned tightly, he didn't seem to have much clue, so he just remembered these words.
And maybe Luo Yun never thought that Zhou Cheng would immediately ascend to enlightenment after hearing his words, so he didn't say anything more.
…
After Zhuang Zhou got off the podium, Professor Chen Jiwu from West China Orthopedics was invited up to the podium by Lei Zhong, the chairman of the conference.
The order of speakers at academic conferences like this is generally arranged with senior speakers first to occupy a good time node.
For bosses of the same level, guests are given priority, then distance is given first, and generally those who come from afar are given priority to show respect for the speaker. Experts and professors who are further away are also given more free time.
Just like, if Professor Zhuang Zhou has other arrangements, he can just go home after finishing his lecture and not participate in the subsequent meeting schedule...
Professor Chen Jiwu is of medium height, slightly shorter than Zhuang Zhou, but he is also 1.75 meters tall. He is thin and not as burly as Professor Zhuang Zhou, but more of a gentle and elegant person.
No one will look down upon Chen Jiwu just because he is not tall or big.
After all, he is a professor from the West China Hospital Affiliated to Sichuan University. The weight of this name is now more important than that of the Affiliated Hospital of Hunan University.
Professor Chen Jiwu is also a professor of joint surgery.
However, his major direction is different from other professors, which is the correction of joint deformities.
Orthopedics has four subspecialties, trauma, joints, bone disease, and sports medicine, and joint surgery has too many detailed branches——
Different directions lead to different avenues, and there are many byways, not all of which are known to people.
In the eyes of outsiders, joint surgeons and orthopedic surgeons may represent a person's identity, but in fact, professionalism can be even more professional!
A wise man will feel even more ignorant!
Although the correction of joint deformities is also a type of joint replacement, it is an extremely complicated one and requires a very deep foundation to correct deformed joints to normal levels...
This is what Chen Jiwu is now sharing unhurriedly.
For this project, currently in Hunan Province, only one professor from the first appendix has such skill, and none of the orthopedic professors from the second appendix are involved in this aspect.
This is not a matter of level, but rather a matter of different research directions, making it difficult to directly compare.
For example, when comparing the Appendix 1 and Appendix 2 of Shonan University, in terms of complex hip and knee joint replacement and revision, the Appendix 1 is slightly inferior to Appendix 2!
The Second Affiliated Hospital is slightly inferior to the First Affiliated Hospital in terms of deformed bones and joints.
Each has its own advantages.
The insights taught by Chen Jiwu are also in new fields. This is another feast for Zhou Cheng...
However, while Zhou Cheng was listening to the class, Luo Yun next to him kept mumbling.
"Is this okay? Isn't there any... problem?"
"Isn't this a little unreasonable?"
"Would it be better if the angle here was increased?"
If he hadn't known that Luo Yun was very good, and if Professor Zuo Hu from the Department of Joint Surgery at Shonan University Affiliated Hospital hadn't appeared in Guoba Hospital, Zhou Cheng might have thought that Luo Yun was crazy or deranged, because he actually
I started to give advice based on what Professor Chen Jiwu shared, and continued to give advice there.
However, Zhou Cheng still doesn't know that Luo Yun's teacher's research field is complex joint repair!
Deformity correction is also a type of complex joint replacement.
Professor Chen Jiwu's teaching style is also quite different from Professor Zhuang Zhou's.
Zhou Cheng was still taking notes while listening.
Luo Yun saw Zhou Cheng writing and drawing again. Although there was something strange in his eyes, he didn't say much. Everyone has their own study habits.
Although he felt that some of what Professor Chen Jiwu said was too one-sided and some of the content was still open to question, most of it was extremely exciting.
He was a little taller than him, but he didn't dare to ask for correction or discussion. He could only ask Professor Chen Jiwu for advice on some doubts.
Therefore, Luo Yun stopped criticizing Zhou Cheng's learning methods.
What Zhou Cheng recorded the most was mainly the data problems mentioned by Professor Chen Jiwu, because these problems were the key to his simulation process and saved him a lot of time in searching the literature. Even some data were attributed to Chen Jiwu.
Jiwu's own private goods cannot be found in the literature...
After Chen Jiwu and Zhuang Zhou gave their lectures, the subsequent speakers were not the other experts who came from afar. Instead, in order to ensure that each session had a certain gold content, they were arranged in the morning.
At the beginning of the second period, avoid people who really want to listen to the lecture and then leave after listening to the important lecture.
…
When the time was approaching the coffee break, Professor Chen Xueliang from Seoul National University Hospital finally came on stage.
His main attack direction is bone nonunion.
Nonunion belongs to the Department of Orthopedics. Luo Yun originally just heard about it casually.
Seoul National University School of Medicine, formerly known as Hu Province Medical University, is a small specialty that was originally unqualified. However, since it was merged into Seoul National University, it has made rapid progress in recent years. In just a dozen years, it has become a major
gained his own reputation.
The current comprehensive ranking of medical schools was within fifty before!
This is no joke.
For more than ten years, they have rushed into the top 50 from nowhere, proving their strength.
Luo Yundu sighed: "Professor Chen really has his own unique insights on the issue of non-union."
"I didn't know much about nonunions before."
"But when I really came into contact with our field of orthopedics, I realized that Professor Chen really contains too many things."
Luo Yun's emotion was also Zhou Cheng's emotion.
In the field of non-union, almost no one touches it in the whole world.
There are several main reasons!
Patients with nonunions are almost always the ones who have done something bad by others. If you take it, it is equivalent to wiping someone else's butt. Others don't even know that you are doing good things for them.
It is a thankless job, who is willing to do it?
The most important thing is that the main reason for nonunion is that the blood vessels in the fracture area are damaged after the fracture or the blood supply itself is not rich!
The ability of a broken bone to heal is due to its own healing process. It cannot grow on its own, and you cannot beat or scold it, so you can only rely on your hands to make it grow. This ability is really amazing.
It's like, dry land is not suitable for growing rice, but you just want it to grow rice, and it needs to grow well and beautifully.
Aren't you just looking for boredom?
But in such a seemingly impossible field, Professor Chen Xueliang was able to do quite well.
Luo Yun lamented: “In the past, I didn’t have much contact with the Department of Orthopedics of Huhan University Affiliated Hospital, so I didn’t know much about this aspect.”
"It seems that I can still move around more in the future."
Zhou Cheng didn't reply, so he naturally knew that the us Luo Yun was talking about were Shanghai Jiaotong University.
The reason why Jiaotong University School of Medicine and Seoul National University Affiliated Hospital do not have a close relationship is that the comprehensive strength of Seoul University was more than one level lower than that of Seoul National University, and I was not willing to play with them at all.
After Chen Xueliang finished talking about nonunion, the meeting finally came to a break, also called tea break.
One lecture lasted more than two hours.
Those who attended the lecture also listened for more than two hours. During the coffee break, it was time to drink water!
Those who need to go to the restroom must go to the restroom.
Old smokers must have one or two cigarettes to refresh themselves.
Among surgical doctors, there are not a few who smoke. At first, they smoke to refresh themselves, and later just because they want to smoke to refresh themselves.
Immediately after the tea break, Luo Yun stood up and seemed to be walking towards someone. Zhou Cheng saw that the direction Luo Yun was walking in was Professor Chen Xueliang of Seoul University, and he probably wanted to have a little communication with him.
Zhou Chengcheng did not interrupt. He was currently spending time sorting out the lectures of all the professors in the morning.
Whether they are professors from within the province or from outside the province, they have gained a lot.
The most important thing is that some of these people's suggestions may become Zhou Cheng's perfect ideas for using the simulation copy, which will save him too much time!
They were all good stuff, and Zhou Cheng was looking forward to it. Later, Zhang Zhengquan recorded all the lectures at the venue and made videos!
This is definitely a great harvest, so Zhou Cheng has to take some time to fill in the details a little bit, so as not to forget that it will take time to watch the video again.
Time is precious and urgent, so any little you can save is worth it!
…
After the tea break, it was time for the second session of the morning.
However, according to the conference schedule, before the opening lecture of the second session, there was a twenty-minute discussion session, mainly to review the main issues raised by many speakers in the first session.
That is the question and answer session.
Of course, this kind of question is randomly chosen on the spot and is symbolic.
Otherwise, I would be exhausted if I had to finish the questions and answers one by one.
The host of the second meeting has been changed. Zhou Cheng doesn't know him, and Luo Yun hasn't come back yet. Therefore, Zhou Cheng can only sit quietly where he is, guarding Luo Yun's position, and then
Then he looked towards the stage, waiting for the question-and-answer period to begin.
After the host sat on the chair, he said without nonsense: "The next is the discussion session of the first agenda. I will not nonsense here and give more time to all my colleagues and seniors."
"First of all, I would like to thank the previous professors for their kind words and bringing us a feast, which is really a blessing."
"But, I believe that after the lectures of several professors, you, including me, still have some unclear points, and now is the time to learn from them."
"Comrades, if you still have any questions in your mind, you can just ask the professors directly."
"If you don't take the initiative to participate, then I will just use my power as the host to seek my own personal problems." The chairman, who is also a quite cheerful person, joked.
It can be seen that he is very talkative and does not start with a rigid opening statement.
Of course, people off the court would not miss this opportunity, and they were not called by the teacher in class, as they were afraid that things they did not know would be known.
It is precisely because you don’t know or understand that you ask.
So, the first person stood up.
It was none other than Professor Chen Xueliang from Seoul National University Hospital.
He raised his hands and stood up.
"Hello, Professor. I would like to ask Professor Zhuang Zhou this question. It may be more pointed." He knew the professor who was presiding.
Only then did Zhou Cheng know that this professor was called Professor Zhu.
"That is, after your first-stage surgery for joint infection, I have also seen that there is still a chance of recurrence. So, in this case, what is the procedure for patients to come for follow-up consultation?"
"When you perform surgery again after a joint infection, should you choose the first stage or the second stage?"
Chen Xueliang himself said that this issue is quite acute!
It's really quite sharp!
Zhou Cheng's head was a little down.
This is an academic exchange meeting, can you still ask this? Aren't you afraid of offending people?
You said that the chance of infection is small, but if this small group of patients with a chance of recurrent infection come back for treatment, should you do it in the second phase or follow the second phase of the guideline?
If you still do it in the first issue, then if you issue it again, will you continue to move forward unyieldingly and never back down?
When a patient relapses and then comes back for a follow-up visit, what kind of procedure will he follow? In fact, he is asking in disguise:
Did they have any medical trouble?
Is this a serious question?
This is a very real problem, but it is also a common problem. If it were other people, they might still consider the other person's face and not ask this question.
But Chen Xueliang asked, and he had his own reasons.
That is, if your joint becomes infected after primary replacement and the patient becomes re-infected, what should you do?
Do you have any countermeasures? After all, this is not in compliance with the current diagnosis and treatment guidelines. The lawsuit cannot be won.
You said, if we can't learn it at all, then today we will just listen to it for fun.
This was the first such pointed question Zhuang Zhou had heard. He stood up, picked up the microphone, and said directly to Chen Xueliang:
"Thank you very much, Professor Chen, for your question. To be honest, this is the first time I have answered this question after speaking outside for so many years."
"I am also very happy that Professor Chen can ask this question, because I myself have asked myself this question sometimes!"
"I just said that this kind of primary replacement surgery is not recommended for inexperienced surgeons. You must accumulate a certain amount of experience to minimize the chance of recurrence. This is one of them."
"Secondly, our preoperative communication is relatively complete."
"Because the patient himself may have a reinfection or a first-time infection, and infected patients, with such advanced communication now, are aware of the complexity of their condition. After full communication and without force, the patient himself,
I won’t have much of an opinion.”
"After all, our department also does second-stage replacement, and compared with first-stage replacement, the ratio is half and half."
"Furthermore, I can answer one more question for you, and that is about the cost."
"Actually, if a second-stage surgery is really required, it will definitely cost more than a first-stage surgery."
"And compared with one stage of surgery and one revision, it doesn't cost much money."
"Then, if this premise is clearly explained to the patient in advance, the patient can fully consider various possibilities when making independent choices. This also maximizes the patient's right to informed consent to choose."
"This is the embodiment of humanitarianism."
"Thanks."
After Zhuang Zhou finished speaking, he ended his answer politely.
Chen Xueliang nodded after hearing this and didn't ask any more questions. He just smiled and sat down casually.
Obviously this answer is different from the answer in his heart, but killing people is just a nod.
Professor Zhu took over the words naturally at this time: "Thank you Professor Chen for your golden question, and thank you Professor Zhuang for his answers and questions. I believe that our understanding of joint infection will become more and more profound in the future!"
"I have benefited more and more. Of course, Professor Chen just provided us with a very good idea for communicating with patients."
Professor Zhu didn't know whether he was complaining or for some other reason, so he hesitated over this sentence.
Then he quickly changed the topic.
"Next, we have to move on to the next question. I wonder if any of my colleagues have any questions. Can I ask the professors in front of me?"
Brush brush brush.
Many people raised their hands.
Professor Zhu could only call out one person, a middle-aged man wearing a plaid shirt in the fourth row in front of his left hand.
The staff handed him the microphone.
He asked without any nonsense: "I also have a question for Chen Xueliang, Professor Chen."
"Actually, the question I want to ask is the same as the question Professor Chen asked Professor Zhuang just now."
"We all know that once a nonunion occurs, it is extremely difficult to grow it back. If it doesn't grow back, what will Professor Chen do?"
As soon as this question came up, the scene was quiet for a moment again!
This question is exactly the same as the question Chen Xueliang asked Zhuang Zhou before, except that his way of asking it was more gentle.
Zhou Cheng's eyes widened.
Then at this time, Luo Yun finally came back, sat next to Zhou Cheng, turned to him, and said: "These are all small scenes, academic exchanges, academic academics, how can we call academic exchanges if we don't fight?"
"It was a big show-off scene! It was just business promotion."
Zhou Cheng nodded, feeling that Luo Yun's words made sense.
However, this is not the first time that Professor Chen Xueliang has answered this question. He just said:
"So far, I have only received two cases of non-union that still did not heal well after surgery. One of them was because he was involved in a car accident during a trip after surgery, which caused the fracture site to be re-fractured."
"The other one did not follow medical advice and performed heavy physical labor within a year, which resulted in chronic repeated injuries to the fracture site and continued nonunion."
"However, if I encounter a case where the nonunion still exists after nonunion surgery, I think I will deal with it from the following aspects."
"First, reflect on your preoperative assessment."
"Second, reflect on whether your operations are not precise."
"Third, after reflection, perform surgery on this patient."
"As for other issues, I believe that patients with nonunion usually go to multiple hospitals. Even those who are not medical practitioners have long known about the disease of nonunion. Once it occurs, it is difficult to avoid it.
Relapsed.”
"This is my current understanding, thank you!"
Chen Xueliang sat down with confidence.
This answer was difficult for everyone to understand, because they had no idea whether what Chen Xueliang said was true or not. There were only two special cases with recurrence of nonunion.
However, in Chen Xueliang's narration, he did mention only two cases of patients with poor prognosis.
Compared with the chance of recurrence of joint infection mentioned by Zhuang Zhou, it is much lower.
Therefore, I can only say that this question was not raised very well——
Professor Zhu will naturally not give you another chance to ask questions, otherwise today will become a Q&A session, and this will be the next part.
Therefore, Professor Zhu asked directly the next question.
One person stood up, feeling very lucky and said: "Thank you very much to the host for giving me the third opportunity to ask questions. I would like to ask Professor Chen Jiwu from West China Hospital,"
"When you were suffering from extreme joint deformity, have you ever experienced fractures after bone grafting? If you encountered this situation, how would you deal with it?"
Chen Jiwu also stood up and replied: "..."
It was only after reaching the third question that Zhou Cheng finally understood that the truth behind the so-called academic conference was actually like this.
How difficult it is to give a good lecture in front of so many experts and professors!
Each of these questions is more tricky than the last, and they are simply fighting each other.
Before, if Chen Xueliang deliberately asked Zhuang Zhou similar questions, he might have had some trouble before.
Then someone asked back if it was revenge.
Then this third question is definitely not accidental. Everyone can't have enemies, right?
The lecturer is a lecturer, and the class he teaches is the class he teaches. No matter how colorful the lecture is, the audience is a group of people with brains. They will not think that what you say is what it is, but it will use a lot of words.
Questions you haven't even thought about,
‘Fight’ you to death.
Perhaps, it is precisely because of this that it is one of the sources of the development of medical skills and disciplines.
This deeply touched and benefited Zhou Cheng!
It also made him truly understand that in medicine, every step you take requires you to cross countless thorns and overcome countless troubles before you can truly take every step in a down-to-earth manner.
There are no shortcuts, only those with great wisdom and perseverance can pass and reach the distance...
Although he currently has many perfect-level skills, he still has not enough reserves, and his knowledge is not comprehensive enough, so he cannot show it yet. Otherwise, he will not be able to pass this academic conference!
If Zhou Cheng were asked to answer such a question, Zhou Cheng would probably give up on the spot and go back to the answer part of the Internet joke, where he only answers but does not defend. At this time, if you don't defend, you won't be able to get away with it.
To mix in the circle, you have to make various preparations.
Academics are not that mysterious, and of course, they are not that down-to-earth. At least, there won’t be many people joking with you...
If you can get on the table, then you can get up on your own. If you accidentally poke your hole and you can't get it out, you will have to bear the consequences.
Zhou Cheng continued to listen carefully, but Luo Yun walked out again and said to Zhou Cheng: "Zhou Cheng, you continue to stay here and listen carefully to the lecture. I'm going to meet an acquaintance."
"Is it Professor Liu?" Zhou Cheng said more, mainly because this was not a particularly formal occasion.
Zhou Cheng had heard the introduction of today's foreign guests before, one of whom was Professor Liu, from the Ninth People's Hospital Affiliated to Shanghai Jiaotong University.
It seems that they are studying in the same institution as Luo Yun, but after all, there are different departments in large hospitals. Zhou Cheng would not know if Luo Yun and Professor Liu were familiar with each other unless Luo Yun took the initiative to bring it up.
"Yes!" Luo Yun nodded, because he had already seen Professor Liu walking out.
And he planned to attend the Orthopedics Annual Meeting in China and go to the magic city in the near future. Naturally, he had to ask Professor Liu to bring official news in advance when he returned.
Because Professor Liu is his senior disciple, and when he comes to Hunan Province, Luo Yun, as the host, also has to entertain him.
Originally Luo Yun planned to ask Zhou Cheng to join him, but Zhou Cheng seemed to be obsessed with the lecture. He was such a braggart of the speaker that he took several pages of notes!
This makes Luo Yun so embarrassed to disturb Zhou Cheng's study, so he simply lets Zhou Cheng continue to listen to the class here.
Luo Yun left without explaining much, while Zhou Cheng just glanced at the direction Luo Yun was leaving and continued to concentrate on the lecture.
The content shared by these speakers is 70% true and 30% false, but this falsehood is also the inference they have made after long-term research, something they use to communicate, and some extended thinking.
Bragging also requires homework, and these homework are good materials for Zhou Cheng to simulate his ideas and gather everyone's strengths.
Collecting the simulator and other people's wool, getting something for nothing, this is something that everyone feels very happy!
Now that I feel so good, I just want to feel good all at once. Zhou Cheng decided to stick his ass here and not move it!
Staying up late feels good for a while, but staying up all night will make you useless.