Doctor's Life Simulator

Chapter 357 Surgery Demonstration, Finale Guest!
After seeing Qin Lang, the venue suddenly fell silent.

Qin Lang is really too young.

Professor Jiang, the host of the meeting, began to introduce:
"The special guest at the opening of this conference is Qin Lang, Director Qin from the First Affiliated Hospital of Zijingang University. Director Qin's report is "Clinical Technical Operation Specifications for Organ Transplantation Pathology-Heart Transplantation""

Hearing this, the pot below suddenly exploded.

"Standards for heart transplantation? This is too arrogant. Even the top doctors in the industry dare not propose the norms for heart transplantation, do they?"

"That's right, a young brat who has done a few heart transplants, is that okay?"

"Isn't it funny for such a conference and such an opening report?"

In fact, the content of the report was too 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.

Regarding this, Qin Lang did not panic at all, nor did he care.

After several generations of accumulation, Qin Lang was not stage fright at all in the face of these scenes, completely ignoring all kinds of noisy voices from the audience. For him, this lecture is completely pushing Huaguo's heart transplant surgery Take to a new level.

He is making a contribution to the entire Huaguo medical community, so he naturally doesn't care about those little people who question him.

Qin Lang's tone was very authoritative, as if he was a big dipper in the industry, very arrogant and very stylish.

"Everyone, in order to further standardize the clinical and technical operations of organ transplant pathology, I have spent nearly a month reorganizing the various operations of the heart transplant operation. This time, I will start from the endocardium of the transplanted heart. From the perspectives of the clinical operation specification for myocardial biopsy and the clinical technical operation specification for pathological diagnosis of transplanted heart rejection, it sets an industry standard for heart transplantation.”

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

"This Qin Lang, such a tone is too loud."

"That's right, such a young man dares to launch industry standards without shame."

Amidst the discussions among the crowd, Qin Lang's rhythm and tone did not change at all.

"First, I will address the first point, the purpose and timing of endomyocardial biopsy in transplanted hearts."

"Endomyocardial biopsy (endomyocardial biopsy, EMB), especially transjugular EMB, is the main method for diagnosing rejection of transplanted hearts. At present, there is no recognized non-invasive examination and biomarker detection that can replace EMB. Except In addition to rejection, a variety of lesions that affect the function of the transplanted heart and even endanger the life of the recipient, such as ischemic injury, infection, and malignant tumors, require biopsy (biopsy) and pathological diagnosis to be clear and differentiated.”

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

Although they were a little disgusted with Qin Lang's tone and posture from the bottom of their hearts, the theory and viewpoints expounded by Qin Lang completely entered their hearts.

"This little doctor really has something."

A chief physician at the 301 People's Liberation Army Hospital in Imperial City expressed 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. Protocol biopsy, also known as planned biopsy, is a biopsy performed at a specified time point, usually 2 weeks, 1 week after transplantation. Multiple consecutive biopsies at 3 month, 6 months, 12 months, and 12 months, and 4 biopsy every 6 to 1 months after 1 months; indication biopsy (indication biopsy) is at any time after transplantation. Abnormal cardiac function, especially biopsy when rejection is suspected clinically. In addition, in order to observe the effect of treatment, re-biopsy can be performed at intervals of 2 to [-] weeks”

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

After Qin Lang's first point of view landed, all the doctors in the venue fell silent.

"Director Qin really has a certain amount of research on heart transplantation. Just the proposal of procedural biopsy and indicative biopsy convinced us."

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

Several doctors kept nodding their heads, and had already adopted 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, if you are capable, you are strong, if you are not good, you are not good, and there is nothing to hide.

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

When he heard this content, 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 cellmediated rejection), also known as acute cellular rejection (acute cellular rejection, ACR), is the most common type of rejection of transplanted hearts. The main pathological feature is myocardial biopsy tissue Inflammatory infiltration and myocardial injury”

Qin Lang began to discuss very professionally, and all the chief physicians and professor-level physicians listened quietly.

Although, these professors had their own experience and operation skills in the operation before, it was the first time that someone had such a standardized summary and discussion.

Half an hour later, Qin Lang finished his entire report.

There was silence in the venue, 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 quite accomplished 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 said with emotion. To be honest, he also had the ambition to formulate heart transplant surgery standards, but there are too many things to pay attention to. Unexpectedly, on this day, a man under 30 The young man is done.

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

Seeing that Qin Lang is so not greedy for fame, the host, Professor Jiang from Fuwai Hospital of Huaguo Academy of Medical Sciences, was also very moved.

"I am very grateful to Director Qin for the specially invited lecture. I believe that experts and professors in the industry have felt the value and significance of Director Qin's report."

"After this conference is over, the Huaguo Medical Association will organize other experts and scholars to reorganize and deepen Director Qin's report, and introduce a standard for surgery in our country-"Heart Transplant Surgery Standards."

Hearing Professor Jiang's words, the doctors in the audience agreed very much, but at the same time they were very envious.

After all, the doctors who can be selected into the standard are all top figures in various fields.It can be said that he is a figure who has made great achievements in the medical field of Huaguo.

After Qin Lang retreated, applause broke out in the venue.

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

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

Of course, there are some doctors who have doubts, after all, Qin Lang's age is too young.

Such a comprehensive and complicated standard, can a doctor under 30 really come up with it?
Some physicians who had known Qin Lang looked at Wen Yunqi and Director Huang with some meaning.

Wen Yunqi naturally didn't care about this at all.

Next, Professor Jiang came on stage again and began to announce the expert report that had been scheduled long ago.

It's just that after Qin Lang's special lecture, these doctors were a little bit less interested. In fact, compared with Qin Lang's report, these lectures were still a bit lacking in structure and content.

Soon, the expert lectures in the morning ended, but everyone remembered the handsome and young Qin Lang.

It wasn't until the afternoon that everyone was attracted to another project, which was broadcast surgery. If the expert lecture in the morning was purely theoretical, then the surgery demonstration in the afternoon would be real.

Operation and technology cannot be faked!
Under the introduction of Professor Jiang, the first surgical demonstration began, and it was a chief physician of the 301 People's Liberation Army Hospital in Imperial Capital.

It is a tricuspid atresia surgery.

The so-called tricuspid atresia, also known as the tricuspid valve and the absence of the tricuspid valve orifice, 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, accounting for 1-5% of congenital heart diseases.It ranks third in cyanotic congenital heart disease after tetralogy of Fallot and dislocation of great arteries.

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

From 1955 to 1958, Carlon, Meshakin 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.

And this demonstration operation is to perform a two-way 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, there is an operation that has been recorded long ago. After the preoperative preparations, the dissociation of the common pulmonary artery and the left and right arteries began.

The chief physician is obviously very experienced, especially in the pericardial patch anastomosis, in order to prevent postoperative traction, a very narrow anastomosis was used during the anastomosis.

"Amazing anastomosis."

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

"Look, when director Huang placed the extravalvular catheter between the right atrium and the pulmonary artery, he applied a patch to close the atrial septal defect through the incision of the right atrium, which solved the compression of the outer catheter very accurately. It's amazing."

In the venue, all the doctors are naturally knowledgeable people, and they are full of admiration for Director Huang's operation.

"The next step is the right atrium-right ventricular outflow tract anastomosis. Director Huang actually adopted a gate-shaped incision. The atrial wall was turned to the right ventricular outflow tract incision, which coincided with the lower edge of the incision. The anterior wall was covered with a pericardial patch. This The operation is really skilled.”

In the venue, all the doctors, especially those young doctors, really opened their eyes.

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

"The superior vena cava was severed again, and the distal end of the superior vena cava was anastomosed with the right pulmonary artery. Director Huang's anastomotic technique is really amazing. Look at the evenness of the wiring 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 yawned, especially Wen Yunqi and Director Huang, who did not watch seriously at all.

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

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

After all, as far as they knew, the First Affiliated Hospital of Zijingang University didn't even have the qualifications to be selected for the surgical demonstration at this conference. Wen Yunqi and Director Huang were too arrogant.

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

"Zhe Province, these people from Zhejiang Province who can't afford it, how can they compare with the chief physicians of our Imperial Hospital? I think it may be that Dean Wen and the others are a little ashamed and embarrassed to admit it. They can only pretend that nothing happened, but they are actually panicked. Get a batch."

A chief physician at the 301 Hospital of the Imperial City analyzed, after all, in the eyes of the hospital in the Imperial City, Hangzhou is just a countryside.

Just like many programmers who went to Ali from the imperial capital, they don't like Hangzhou very much, and complain that Hangzhou is not as good as the devil's capital and the imperial capital.

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

For this, many doctors admire it very much. After all, controlling the rhythm of surgery is a sign of a mature doctor.

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

Even a few doctors frowned, this speed is really a little slow, after all, they have seen doctors who don't need to be trimmed at all.

Another three hours later, Director Huang completed his operation.

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

"Postoperative cardiopulmonary function testing, early maintenance of right atrial pressure > 2.0kPa (15mmHg), blood and plasma should be maintained if not maintained. Low cardiac output syndrome, application of dopamine, isoproterenol or sodium nitroprusside, etc. Drugs. Fresh blood, platelets, and fibrinogen should be applied in a timely manner when there is a lot of bleeding in the early postoperative period. Postoperative right atrial pressure increases, and lymphatic fluid flow restriction can cause increased drainage. Diuretics and/or digitalis can be used. After anticoagulation for 2~3 months"

Director Huang is very professional and experienced. After the postoperative doctor's order, he walked to the changing room.

In the venue, many doctors applauded to express their respect. It has to be said that Director Huang's operation is still very good, and his understanding of the operation is even different from ordinary people.

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

Seeing the difficulty of this operation, the doctors in the venue were very excited and looking forward to it.

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

"Professor Li's operation is really exciting."

"That's right, heart stent surgery, a metal stent is placed into the diseased coronary artery to support its wall to keep the blood flow in the lumen unblocked. Among them, the operation and technical requirements for the main surgeon are very high, especially for stents. The control is very detailed, and its difficulty is a little weaker than that of a heart transplant.”

In the venue, all the doctors were also emotional, obviously highly respecting this operation.

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

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

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

The operation that can be selected for the Huaguo Heart Conference naturally has its merits. Director Li's operation has benefited many doctors a lot.

"Speaking of which, these few demonstration surgeries are already so powerful, I don't know how the final finale surgeries 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 finale operation must be more powerful than these ordinary demonstration operations, although these operations are already within the reach of ordinary surgeons. The ceiling is up.

The more powerful the first three operations were, the more the doctors looked forward to the finale operation of this conference.

Finally, after four hours, Professor Jiang announced the progress of the meeting again, and the last one, which is also the finale demonstration surgery of this meeting, began!
On the screen, the video of the operation began to play.

(End of this chapter)