MTL - Doctor’s Life Simulator-Chapter 354 Surgery demonstration, finale guest!

The 354th chapter of the doctor's life simulator surgery demonstration, the finale guest!

After seeing Qin Lang, the venue suddenly became quiet.

Qin Lang is really too young.

Professor Jiang, the host of the meeting, started to introduce:

"The special guest at the opening of this meeting is Qin Lang, Director Qin from the First Affiliated Hospital of Zijingang University. The report brought by Director Qin is "Organ Transplantation Pathology Clinical Technical Operation Standard - Heart Transplantation""

Hearing this, the pot exploded all of a sudden.

"The standard for heart transplantation? This is too arrogant. Even the top doctors in the industry would not dare to propose a standard for heart transplantation, right?"

"That is, a stinky stinky boy who has done several heart transplants, is it alright?"

"This kind of conference, such an opening report, isn't it funny?"

In fact, the content of the report was very different from Qin Lang's age and qualifications. Except for a few people who had seen Qin Lang's surgery and knew about Qin Lang, these directors and professors couldn't sit still.

For this, Qin Lang was not flustered at all, nor did he care.

Under the accumulation of several lifetimes, Qin Lang did not have any stage fright in the face of these scenes, and did not pay attention to the various noises in the audience. For him, this lecture was completely pushing the heart transplant surgery in Huaguo. Take it to the next level.

He is contributing to the entire Chinese medical community, and naturally he doesn't care about those questioning little people.

Qin Lang's tone is very authoritative, just like the posture of Taishan Beidou in the industry, very arrogant and very model.

"Everyone, in order to further standardize the clinical technical operation of organ transplantation pathology, I have spent nearly a month reviewing the various operations of the heart transplantation operation. This time, I will report from the endocardium of the transplanted heart. The standard of clinical operation of myocardial biopsy, the standard of clinical technical operation of pathological diagnosis of transplanted heart rejection, etc., set an industry standard for heart transplantation."

Hearing Qin Lang's words, everyone in the venue was in an uproar, especially in the field of heart transplant surgery, professors and directors with certain attainments.

"This Qin Lang is too loud."

"No, at such a young age, he dares to boldly introduce industry standards."

During the discussion, Qin Lang's rhythm and tone did not change at all.

"First, I'll make the first point, the purpose and timing of endomyocardial biopsy of transplanted hearts."

"Endomyocardial biopsy (endomyocardial, EMB), especially EMB through the jugular vein, is the main method for the diagnosis of transplant heart rejection, and there is currently no recognized non-invasive examination and biomarker detection that can replace EMB. In addition to rejection In addition to the reaction, a variety of diseases that affect the function of the transplanted heart and even endanger the life of the recipient, such as ischemic injury, infection and malignant tumor, all require biopsy (biopsy) and its pathological diagnosis to be clear and differentiated..."

Hearing Qin Lang's professional explanation, the directors under the stage were all a little surprised.

Although they were a little disgusted with Qin Lang's tone and attitude, the theories and opinions expounded by Qin Lang completely entered their hearts.

"This little doctor really has something."

A chief physician of the 301 People's Liberation Army Hospital in Imperial Capital sighed with emotion. From Qin Lang's report, he could feel the depth and professionalism of this lecture.

"The biopsy of the transplanted heart can be divided into two types: procedural biopsy and indicative biopsy. Procedural biopsy (), also known as planned biopsy, is a biopsy performed at a specified time point, usually 2 weeks and 1 month after transplantation. , 3 months, 6 months and 12 months of continuous multiple biopsies, after 12 months, a biopsy every 4 to 6 months; Indicative biopsy (indi) is at any time after transplantation, when the transplanted heart function appears Abnormalities, especially biopsies performed when clinical suspicion of rejection. In addition, in order to observe the treatment effect, re-biopsy can be performed at intervals of 1 to 2 weeks..."

Qin Lang continued his speech with clear regulations and rigorous logic.

After Qin Lang's first point of view came to fruition, all the doctors in the venue became quiet.

"Director Qin really has some research on heart transplantation. Just the proposal of a procedural biopsy and an indicative biopsy convinced us to take it orally."

"Yes, Director Qin's angle is really professional."

Several doctors kept nodding, taking a tacit attitude towards the quality of the opening report.

"Next, I will introduce the pathological technical process to you."

Qin Lang did not stop and continued to output professionally.

At this time, all the doctors listened to Qin Lang's narration with great respect.

For the profession of doctors, strong ability means strong, no good means no, and there is nothing to hide.

After Qin Lang explained the pathological technical process, he began to introduce the acute T cell-mediated rejection of heart transplantation.

When hearing this, even Professor Liu from the Second Hospital of Harbin Medical University became quiet and was very pleasantly surprised.

After all, rejection has always been a difficult point in heart transplant surgery, and it can be said to be a worldwide problem.

"Acute T cell-mediated rejection (acute T cell mediated reje), also known as acute cellular rejection (acutereje, ACR), is the most common type of rejection in transplanted hearts. The main pathological features are inflammatory infiltration in myocardial biopsy tissue and myocardial infiltration damage..."

Qin Lang started the discussion very professionally, and all the chief physicians and professor-level physicians listened quietly.

Although, in the operation, these professors had their own experience and operation skills for certain content, but this is the first time that someone has such a standardized summary and discussion.

After half an hour, Qin Lang completed his entire report.

In the venue, there was silence, and after a while, crazy applause broke out.

In particular, experts like Professor Liu from the Second Hospital of Harbin Medical University and Academician Zhong from Union Medical College Hospital, who are accomplished experts in the field of heart transplant surgery, have gained a lot after listening to Qin Lang's report.

"amazing!"

Professor Liu from the Second Hospital of Harbin Medical University sighed with emotion. To be honest, he also had the ambition to formulate norms for heart transplantation, but there were too many things to pay attention to. young man finished.

After Qin Lang finished the lecture, he went on quietly, without any intention of chatting with the organizer.

Seeing that Qin Lang is so greedy for reputation, the host, Professor Jiang of Fuwai Hospital of Huaguo Academy of Medical Sciences, is also very emotional.

"Thank you very much Director Qin for bringing us the specially invited lecture. I believe that experts and professors in the industry have felt the value and significance of Director Qin's report this time."

"After this conference is over, the Huaguo Medical Association will organize the rest of the experts and scholars to sort out and deepen Director Qin's report, and launch a standard for surgical procedures in my country - "Heart Transplantation Procedures"."

Hearing Professor Jiang's words, the doctors in the audience were very agreeable and at the same time very envious.

After all, the doctors who can be selected into the norm are the top figures in various fields. It can be said that he is a person who has left great achievements in the medical field of China.

After Qin Lang withdrew, there was a burst of applause in the venue.

"The invited lecture this time is really impressive. The standard of heart transplant surgery really deserves its name."

Looking at Qin Lang's fate, these doctors were full of admiration and envy.

Of course, there were also some doctors who had some doubts. After all, Qin Lang was too young.

Such a comprehensive and complex specification, is it really possible for a physician under thirty years old to come up with it?

Some doctors who had known Qin Lang, looked at Wen Yunqi and Director Huang with some meaning.

Wen Yunqi naturally didn't care about this.

Next, Professor Jiang came on stage again and began to announce the long-established expert report.

It's just that after Qin Lang's specially invited report, these doctors were a little bit lacking in interest. In fact, compared with Qin Lang's report, these lectures are still a little bit worse in terms of layout and content.

Soon, the morning expert lecture was over, but everyone's memory was all about handsome, young Qin Lang.

It was not until the afternoon that everyone was attracted by another project, that is, broadcasting surgery. If the expert lectures in the morning were purely theoretical, then the surgery demonstrations in the afternoon were real.

Operation and technology cannot be faked!

Under the introduction of Professor Jiang, the first operation demonstration began. It was a chief physician of the 301 People's Liberation Army Hospital in the imperial capital.

It is a tricuspid atresia operation.

The so-called tricuspid atresia, also known as tricuspid valve and tricuspid orifice absence, is a deformity in which there is no direct communication between the right atrium and the right ventricle.

Tricuspid atresia is a cyanotic congenital heart disease, the incidence of which accounts for 1-5% of congenital heart disease. It ranks third after cyanotic congenital heart disease relaying tetralogy of Fallot and dislocation of the great arteries.

The main pathological changes are tricuspid atresia, patent foramen ovale or atrial septal defect, mitral valve and left ventricular hypertrophy, and right ventricular dysplasia.

From 1955 to 1958, eshakin and Glenn et al. conducted arterial experiments, and then Meshakin and Glenn successively applied superior vena cava and pulmonary artery shunt for patients with tricuspid atresia, which was later called Glenn shunt.

This time, the demonstration operation is to perform a bidirectional pulmonary artery shunt.

The director of the People's Liberation Army Hospital adopted the surgical plan of the right atrium-pulmonary artery connection.

On the screen, is an operation that has been recorded a long time ago. After the preoperative preparation, the dissociation of the common pulmonary artery and the left and right arteries will begin.

This chief physician is obviously very experienced, especially in the pericardial mesh anastomosis, in order to prevent postoperative traction, a very narrow anastomosis is used in the anastomosis.

"What a great anastomosis."

In the venue, watching the operation of the director of the People's Liberation Army Hospital, they were full of praise.

"Look, when Director Huang placed the extravalvular conduit between the right atrium and the pulmonary artery, he used a patch to close the atrial septal defect through the right atrium incision, which very accurately solved the pressure on the external conduit. It's amazing."

In the venue, the doctors were naturally knowledgeable, and they were amazed at Director Huang's operation.

"The next step is the anastomosis between the right atrium and the right ventricular outflow tract. Director Huang actually used a portal incision. The atrial wall was turned over to the right ventricular outflow tract incision and anastomosis with the lower edge of the incision. The anterior wall was covered with a pericardial patch. The operation is really proficient.”

In the venue, the doctors, especially the young doctors, were really eye-opening.

"As expected of the surgery demonstration at the Huaguo Heart Congress, this technique is really refreshing!"

"The superior vena cava is cut off again, and the distal end of the superior vena cava is anastomosed with the right pulmonary artery. Director Huang's anastomosis technique is really amazing. Look at the evenness of the line and knotting, it's amazing!"

Seeing Director Huang's basic skills, many young doctors are envious.

In the venue, several doctors from the First Affiliated Hospital of Zijingang University were yawning, especially Wen Yunqi and Director Huang, who didn't pay attention at all.

Not far away, several physicians from the Imperial Capital 301 Hospital naturally noticed the reaction of the First Affiliated Hospital of Zijingang University. There were several chief physicians who were somewhat dissatisfied.

However, after all, it was at the venue, so I was embarrassed to say anything, but I was still a little unhappy in my heart.

After all, as far as they know, the First Affiliated Hospital of Zijingang University did not even have the qualifications to be selected for the surgery demonstration this time. Wen Yunqi and Director Huang were too arrogant.

It seems that Director Huang's operation skills are completely ignored.

"Zhejiang Province, how can these Adou from Zhejiang Province, who can't be helped, compare with the chief physician of our Imperial Capital Hospital. I think it may be Director Wen and they are a little ashamed and embarrassed to admit it. Get a batch."

A chief physician of the Imperial Capital 301 Hospital analyzed that, after all, in the eyes of the Imperial Capital Hospital, Hangcheng is just a countryside.

Just like many programmers who went to Ali in the imperial capital, they disliked Hangzhou very much, and complained that Hangcheng was inferior to the magical capital and the imperial capital.

On the screen, Director Huang continued his operation, and soon entered the proximal end of the anastomosis with the common pulmonary artery. Due to the difficulty and length of the operation, at this point, Director Huang took a short rest, waiting for his mental state and physical strength. After entering the best, the final operation begins.

"Reincarnation Paradise"

For this, many doctors are very admirable, after all, controlling the rhythm of surgery is a sign of a mature doctor.

In the auditorium of Zijingang, Harbin Medical University Second Hospital, and Union Hospital, many doctors yawned.

Even a few doctors frowned. This speed is really slow. After all, they have seen doctors who don't need trimming at all.

Three hours later, Director Huang completed his operation.

In the video, it is obvious that Director Huang is very satisfied with his operation.

"Cardiopulmonary function test should be performed after operation, and the right atrial pressure should be maintained at an early stage of >2.0kPa (15mmHg). If it cannot be maintained, blood and plasma should be transfused. In the case of low cardiac output syndrome, dopamine, isoproterenol or sodium nitroprusside should be used. Drugs. Fresh blood, platelets and fibrinogen should be used in a timely manner when there is a lot of bleeding in the early postoperative period. The right atrial pressure is increased after the operation, and the lymphatic fluid return is limited, which can lead to an increase in the drainage volume. Diuretics and/or digitalis can be used. Post anticoagulation for 2-3 months..."

Director Huang was very professional and experienced and went to the dressing room after making the post-operative doctor's order.

In the venue, many doctors applauded to show their respect. I have to say that Director Huang's operation is still very good, and his understanding of the surgery is even more different from ordinary people.

And amid the applause of the doctors, Professor Jiang appeared again and introduced the second demonstration operation, which was a heart stent operation performed by the chief physician from Fuwai Hospital.

Seeing the difficulty of this operation, the Chinese physicians at the venue were all very excited and looking forward to it.

"Heart stent surgery is a new technology that has been carried out in the past 20 years to improve myocardial insufficiency and blockage of cardiac arteries caused by coronary heart disease. There are not many hospitals in the country that can maturely perform this kind of surgery."

"Professor Li's operation is really exciting."

"Yes, in the cardiac stenting procedure, a metal stent is placed in the diseased coronary artery, and the UU reading www.uukanshu.com supports its wall to maintain the blood flow in the lumen. Among them, the operation and technical requirements of the main surgeon are very important. It is very high, especially for the control of the stent, which is very detailed, and its difficulty is a little weaker than that of a heart transplant."

In the venue, various doctors also sighed, and obviously highly respected this operation.

"Although the heart stent operation is not very complicated, the risk of the operation is indeed very high, especially if the patient is a patient with coronary heart disease and the operation site is the blood vessel of the heart, the stent is very likely to block or will block the blood vessel."

In the venue, some senior chief physicians explained to their subordinate physicians.

"Moreover, the stent is put in and held up, it does not mean that the blood vessel or this part will not be narrowed or blocked again..."

Being able to be selected for the operation of the Huaguo Heart Congress naturally has its merits. Director Li's operation has benefited many doctors a lot.

"Speaking of which, these demonstration operations are already so powerful. I don't know how the final operation will be. I'm really looking forward to it."

In the venue, many doctors were looking forward to it. After all, in principle, the mysterious final operation must be more powerful than these ordinary demonstration operations, although these operations are already within the reach of ordinary surgeons. Ceiling up.

The more powerful the first three surgeries were, the more doctors looked forward to the final surgery of this conference.

Finally, four hours later, Professor Jiang announced the progress of the conference again. The last one is also the finale of this conference. The demonstration operation began!

On the screen, the video of the operation began to play. +Bookmark+