On Tuesday afternoon the next day, Yu Zhiming received the diagnosis result from the middle-aged Taoist priest, which was mainly heavy metal poisoning such as nickel.
The possible source of the poisoning is that the Taoist priest himself said that he once camped in an uninhabited place with clear water and practiced cultivation for two or three months.
At that time, I drank mountain spring water from a small spring every day.
Yu Zhiming was also told that the hospital had notified the local geological exploration department to take samples and test them, and they might be able to find a nickel mine.
Yu Zhiming also learned from Teacher Qi Yue that searching for mineral deposits through endemic diseases was an effective method of prospecting in the early years.
At nearly 6:30 in the evening, Yu Zhiming completed the rapid screening of fifty volunteers for stomach and liver cancer in the very early stage cancer project, and then hurried to the general surgery department.
He accepted Dr. Wang Jiangyue's invitation to assist her in completing a kidney transplant.
Yu Zhiming knew that this was an opportunity for learning and practice specially given to him by Dr. Wang, and he understood it very well.
This is the first time he has participated in a human organ transplant since he started practicing medicine, and he is very excited and looking forward to it.
Therefore, after Yu Zhiming finished his scheduled work for the day, he rushed to the general surgery department as soon as possible.
However, Yu Zhiming failed to see Dr. Wang in the office. When he asked about it, he went to the ward.
He rushed to the ward again and saw Dr. Wang Jiangyue who was explaining the operation situation to the patient. He also saw the patient and kidney donor who were to be operated on tonight.
The patient is a 35-year-old man with advanced uremia, which has caused the loss of basic functions of both kidneys. In recent years, he has relied entirely on dialysis for support.
The donor of the kidney was the patient's 60-year-old father, who was emaciated and had only completed the retirement procedures for a month.
Yu Zhiming knew that under normal circumstances, during kidney transplant surgery, the patient's original kidney does not need to be removed. The patient is equivalent to having an extra kidney in the body through transplantation.
Most of the transplanted kidneys are placed in the patient's right iliac fossa, in parallel with the original kidney, to assume the renal function.
The reason why the original kidney is not removed is because there is a small chance that the function of the original kidney will slowly recover through a long period of recuperation.
Another possibility is that with the advancement of medicine, methods to restore kidney function have been developed.
Of course, not all kidney transplant surgeries do not require removal of the original kidney.
About 10% of kidney transplant surgeries require removal because the original kidney suffers from inflammation, tumors and other factors.
While Yu Zhiming was thinking about the knowledge about kidney transplant surgery and the operation process, he walked into the ward and stood quietly aside.
Wang Jiangyue caught Yu Zhiming out of the corner of his eye.
She nodded slightly to Yu Zhiming as a greeting, and turned her eyes to the patient and his father again.
"The operation time, unless there are any unexpected circumstances, is expected to take about two and a half hours."
"Do you have any more questions?"
The patient, the patient's father, and the family members and friends who accompanied them all shook their heads.
"Okay, let's start preparing for the surgery."
Following Wang Jiangyue's words, the attending physician, resident physician, and intern physician standing behind her came forward to the patient and the patient's father, and began to prepare them for entering the operating room.
Yu Zhiming came to Wang Jiangyue's side and said, "Dr. Wang, thank you for giving me this opportunity to learn and practice."
Wang Jiangyue chuckled and said, "Dr. Yu, you're welcome."
"I also have to thank you for coming all the way to be my surgical assistant despite a hard day's work."
"Director Cui specifically told me that Dr. Yu, your surgical skills are quite skilled, no worse than those outstanding surgical surgeons in our department."
Wang Jiangyue praised again: "Dr. Yu, you are a double major in internal medicine and surgery, and you are so outstanding. It really surprises me."
Yu Zhiming said modestly: "That's just Director Cui flattering me. My surgical skills were all learned at the county hospital. I'm just relatively skilled in performing first- and second-level minor surgeries."
"I haven't experienced anything as big as a kidney transplant."
Wang Jiangyue laughed and said: "Kidney transplantation is not a big event. Among organ transplant surgeries, it is the most common operation..."
"Hey, please wait a moment!"
Wang Jiangyue suddenly called to the assistants who were taking the patient and his family out of the ward, and then looked at Yu Zhiming.
"Doctor Yu, please give the patient's father a physical examination. He is a bit old, and his physical indicators barely meet the criteria for donation."
Yu Zhiming hummed, asked the patient's father to lie on the hospital bed, and gave him a full body examination.
His inspection revealed a problem.
Wang Jiangyue felt a thump in her heart when she saw Yu Zhiming's face full of important discoveries.
It seems that the operation cannot be performed tonight.
With the worried eyes of people in the room, she called Yu Zhiming out to the corridor and asked in a low voice.
"cancer?"
Yu Zhiming nodded and replied: "Doctor Wang, his stomach doesn't feel very good. It is necessary to do a biopsy to confirm."
Wang Jiangyue sighed softly and said, "If you say you don't feel well, then it's definitely gastric cancer."
"Alas, we can only find another donor..."
Human organ donation includes kidneys, liver, heart, lungs, pancreas, small intestine and other large organs, as well as heart valves, skin, bone, cornea and other tissues.
The medical standards for donation of different human organs and tissues are different.
According to my country's medical regulations, kidneys, liver and other large organs must be excluded from systemic or infectious diseases that pose a fatal threat to the recipient, including malignant tumors (except intracranial tumors), infectious diseases, severe hypertension, etc.
If a cancer patient donates a large organ, there are considerable risks to the recipient.
Such profound organ donation cases have occurred more than once in the history of medicine.
Yu Zhiming saw a similar case analysis with tragic consequences in a medical journal.
Four patients who had received lung, left kidney, liver, and right kidney transplants all developed breast cancer with similar histological types within 16 to 6 years after surgery.
This chapter is not over, please click on the next page to continue reading! The organs of these four recipients all came from the same donor, and no breast cancer was found in the donor at the time of donation.
Unfortunately, three of the four recipients died of metastatic breast cancer.
Only one right kidney transplant recipient survived after the transplanted kidney was removed and underwent immunization, chemotherapy and other methods.
Later research revealed that the donor should have been in a very early stage of breast cancer at the time, but it had not yet been detected.
However, through organ transplantation, cancer cells in the body were passed on to the four recipients.
More than one case has shown that this cancer cell is too cunning, good at hiding, and can cause trouble without warning and endanger human health.
In view of this, organs from cancer patients must be carefully evaluated before determining whether they can be used.
In the case of the patient's father, if he is diagnosed with gastric cancer, his kidney will definitely not be transplanted to his son...
Yu Zhiming followed Wang Jiangyue back to the ward and heard her announce that tonight's surgery was canceled and the patient's father would undergo a comprehensive gastric examination tomorrow.
Yu Zhiming saw the undisguised expression of disappointment on the patient's face, as well as the complex look directed at him...
Wang Jiangyue personally sent Yu Zhiming off to the General Surgery Department.
The two of them stopped outside the building. Wang Jiangyue said with a happy face: "Dr. Yu, thank you for inviting me here. If the transplant operation is completed, the father will be diagnosed with gastric cancer."
"This is a big problem."
Yu Zhiming sighed softly and said: "With this discovery of mine, if the transplant operation is canceled, the patients and their families may not think this is a good thing."
"After all, contracting his father's metastatic gastric cancer through kidney transplantation is only a possibility, not a certainty."
"Today, it is not easy to find a suitable donor kidney source."
Speaking of this, Yu Zhiming was not sure whether he had done a good thing.
Given the patient's physical condition, if a kidney donor cannot be found in the next few months, he may not be able to survive.
After transplanting his father's kidney, even if he is unlucky enough to get metastatic gastric cancer, with proper treatment, it is not a luxury to live for another three to five years.
There is still a small chance that you will not get metastatic gastric cancer.
Wang Jiangyue seemed to see what Yu Zhiming was thinking, and said in a deep voice: "Dr. Yu, the patients and their families only think about the immediate needs, not the future."
"This is drinking poison to quench thirst."
"That person also has several immediate relatives. Besides, it may not be possible to find other sources of donated kidneys in the next few months."
After a pause, Wang Jiangyue spoke again: "If in a year or two, this father and son, one with gastric cancer and the other with metastatic gastric cancer, might come back and cause trouble for our hospital."
"From the perspective of our hospital and doctors, just follow the rules and regulations and don't take risks..."
Yu Zhiming hummed, then asked: "Doctor Wang, how many young doctors do you have in charge now?"
"Three attending physicians and three resident physicians!"
Wang Jiangyue replied and asked with a smile: "Doctor Yu, do you want to recommend someone to me?"
Yu Zhiming smiled coquettishly and said, "I have an ordinary friend named Bao Wan, who graduated from Peking University School of Medicine. Like me, he just joined the job this year."
"She is very interested in general surgery."
"if……"
Wang Jiangyue interrupted cheerfully: "A friend who can be recognized by you, Dr. Yu, must be good in all aspects."
"Just ask her to come directly to me."
Yu Zhiming quickly explained: "Dr. Wang, she and I are just ordinary friends. Don't think too much about it."
"My idea is, Dr. Wang, if it's convenient for you, take some time to give her some advice and observe her."
"If her abilities and other aspects come to your attention, that would be the best thing."
"If you don't like it, there's no need to force it."
Yu Zhiming said slowly: "I just want to ask Dr. Wang to give her a fair competition and a chance to show herself."
"If she is not strong enough, forget it."
Wang Jiangyue said seriously: "Dr. Yu, I understand what you mean."
