medical simulator

Chapter 187 So Cool! (seeking subscription)

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 As long as surgery exists, the topic of postoperative infection will never be outdated, because in reality, bacteria and other microsomes are everywhere, throughout the treatment process, at any step , may lead to infection.

This is an established complication of all surgeries.

As far as a surgeon is concerned, it is inevitable that all his surgical patients will be infected, and it has not been encountered because the number of patients is not enough.

At present, the definition of the gold standard for the treatment of joint infection in joint surgery is one-stage debridement and two-stage surgery.

If it is a natural joint infection, it is the first stage of debridement, and the second stage depends on the situation to perform joint replacement, joint replacement, arthrodesis or other operations.

And if the infection after joint replacement is caused by surgery, then it is also the first stage of debridement, the bone cement and antibiotics are excluded during the operation, and the joint revision is performed in the second stage.

This is a relatively safe measure.

However, what Professor Zhuang Zhou said is that whether it is a joint infection that occurs naturally or a joint infection caused by postoperative infection, it can be thoroughly debrided in the first stage, and then the joint can be repaired in the first 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 type of surgery is an absolute taboo! ~
One who treats conventionally understood contraindications as routine surgery, and even dares to talk about it.

First of all, I can only say that I am very courageous——

Because in the current guidelines, the gold standard for all infection management is the second-stage surgical treatment.

Surgery and treatment in violation of the guidelines are the right of senior officials only, and if there is a mistake, the person who leads the group or performs the operation must bear the responsibility!
Is primary surgery okay?

Of course, it not only saves the time of operation, but also allows patients to recover as soon as possible, and reduces their hospitalization expenses and medical treatment time.

But the risk is extremely high in the traditional perspective.

The standard treatment method written in the guidelines is to do two surgeries, one-stage surgery, which is time-consuming and costly. Once anything happens, the doctor will be held responsible.

Under such circumstances, the ability of the professor who dared to take such a risk and perform the operation against the guideline is naturally needless to mention.

This is a relatively new understanding and field, and 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 to reach a consensus.

However, Zhou Cheng listened to Professor Zhuang Zhou's summary——

Professor Zhuang Zhou used a very formal summary——

take home messege (main points and summary):
This usually appears in more formal literature submissions, but Professor Zhuang Zhou wrote it in the ppt, which proves that he has already spent a lot of thought when making this ppt.

"Joint infection can be done in one phase, but there are a few key points that must be paid attention to."

"First, before the operation begins, we must find out the infection bacteria, and it is best to do a drug sensitivity test. If conditions permit, we can form a joint cooperation team with the laboratory department!"

"Second, there must be a time limit for sensitive antibiotics of sufficient length before surgery begins."

"Based on our experience, it is recommended that the premedication of sensitive antibiotics is generally 24 hours, and for limited conditions, more than 12 hours is enough."

"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 re-infection."

"Third, during the operation, thoroughly debride the wound, remove all infected tissues, clean the hidden spaces of infection, including muscle spaces, and intra-articular blind spaces. During this process, new spaces must not be opened!"

"Fourth, antibiotic carriers can be used appropriately during surgery."

"Fifth, continuous drainage after surgery. Those who have the conditions and are amazing can perform continuous irrigation and drainage."

"Sixth, sufficient amount of postoperative course, timely culture of drainage fluid and exudate, and timely adjustment of the dosage and duration of antibiotics. The routine recommended postoperative antibiotic use time is 96-120 hours!"

"Seventh, proper postoperative rehabilitation training..."

"These are the photos before, during and after the operation of some of the cases we did. Please supervise me..." Zhuang Zhou was calm and relaxed, as if I came here to study, but in fact, he was full of emotions. It's all about showing off and pretending.

Hearing this, Luo Yun smiled a little, shook his head, then turned around and saw Zhou Cheng, holding a notebook, and carefully copied out all the words Zhuang Zhou said.

Then he asked with a flash of expression: "What are you doing?"

"I think what Professor Zhuang said is quite good, so I wrote down the notes so that I can think about it in the future." Zhou Cheng told Du Yanjun's remarks.

But in fact, Zhou Cheng felt that the new direction of joint infection treatment that Zhuang Zhou just talked about was tailor-made for him.

Isn't this a new breakthrough and perfection in the treatment of joint infection - a redefined realm?
Zhou Cheng even forgot the idea of ​​simulation, and directly took the idea that Zhuang Zhou just explained, and went to the simulation world once or twice, and he might be able to get the perfect—redefined skills, isn't that a good thing?

So Zhou Cheng naturally had to write it down quickly. As for the specific effect of what Professor Zhuang Zhou said, it still takes time to verify this sentence. Zhou Cheng didn't need to consider this factor at all.

The existence of the simulator is to give him a lot of opportunities for trial and error, as well as more trial and error time costs.

If it doesn't work once, I'll come twice, if it doesn't work twice, I'll come ten times, it's okay, that's three to five days.

Luo Yun's expression continued to be strange, he tapped Zhou Cheng's notebook, and said, "Didn't you see that everyone else just pretended to be Professor Zhuang Zhou, so let's listen to it?"

"Have you seen anyone taking notes like you?"

Zhou Cheng followed what Luo Yun pointed out, and he didn't see anyone taking notes, and even many people had their arms crossed, their posture was not listening to the class, but watching the excitement.

After Zhou Cheng finished recording, he was listening to Zhuang Zhou's concluding remarks, and replied with a little distraction: "Mr. Luo, I'm also a stupid bird flying first."

Zhou Cheng feels that learning is personal, not common, and he is not someone else. Others are either associate professors, directors, or graduate students.

Associate professors or directors of other places do not need to study at all, and graduate students have their own better learning platforms!

Zhou Cheng himself did not have this opportunity, so naturally he could take more notes.

The opportunity to learn is precious and hard-won.

Seeing Zhou Cheng's seriousness, Luo Yun rolled his eyes and said, "You really take Professor Zhuang's pretentious words seriously?"

"Do you know, this Professor Zhuang, the reason why he dared to carry out the first-stage treatment of joint infection in his unit is that there are certain background factors in it."

"First of all, his affiliated hospital is Xinjiang Medical University, which is located in Xinjiang Province. Do you know that Xinjiang Province's medical insurance policy is excellent. Basically, such large-scale operations are completely covered by medical insurance. "

"That is to say, on their side, ordinary people's joint replacements are all paid by the medical insurance, and the patients themselves don't have to pay anything."

"So, neither the patient nor the doctor is afraid of having the joint prosthesis revised for the second time. The worst thing is to install another one. The patient does not pay for it himself, but suffers a little. He can bear it."

"But besides here, can you repeat this in any other place?"

"It can't be repeated, and this unique geographical advantage is the root of Professor Zhuang's daring to do these things. It's useless for you to take his notes."

"As long as Professor Zhuang has not changed his ability to change the guideline, and before he has received widespread worldwide recognition, what he said, in fact, is quite flashy fundamentally."

Luo Yun spoke so thoroughly that Zhou Cheng's eyes widened slightly.

And this thing?

Co-author, others just quietly let Zhuang Zhou pretend and force him to go through the motions, so 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 mentioned by Zhuang Zhou are very substantial. He just tried a simulation according to Professor Zhuang Zhou's train of thought.

I followed the train of thought taught by Professor Zhuang Zhou completely, and I didn't need to design anything myself.

And the third dungeon that Zhou Cheng got at the emergency scene a while ago was the bone and joint dungeon, which fits perfectly with the joint surgery conference exhibition hall that he came to today.

Then--

Zhou Cheng gained joint infection (initial/postoperative) treatment experience (perfect-world-defining level) at one time.

As soon as he got into the soul, although he couldn't directly break the rules like what Professor Zhuang Zhou said, he reached the perfect level in one go!

"But I think what Professor Zhuang said is quite reasonable?" Zhou Chengcheng patted his head slightly and asked Luo Yun.

What Professor Zhuang Zhou said is definitely not false, but it has not been recognized!
"Principles are principles, and implementation is implementation. Keep listening, and you will feel that everything the professors say makes sense."

"Let me tell you this. In fact, an academic exchange conference like this is a large-scale pretentious scene. It is to see who will brag. Anyway, as long as you don't blow yourself up and can justify yourself, you are amazing .” Luo Yun continued to roll his eyes, feeling that Zhou Cheng’s notes were superfluous.

Even if it is right, can it be done?
No.

Why do you pay attention to something that can’t be done, or even something that can be promoted after an unknown number of years?

You can't replicate this model anywhere else without health insurance coverage, you just have to play by the existing guidelines!
"Professor Zhuang is the kind who can boast." Luo Yun explained to Zhou Cheng again.

So he is forcing Wang Zhuangzhou?
Zhou Cheng blinked his eyes, and was unwilling to continue entangled in front of Luo Yun. Anyway, he had already confirmed that what Zhuang Zhou said was correct, and he got benefits.

There is no need to confront Luo Yun, saying that what Luo Yun said is not the truth, making Luo Yun unhappy.

……

After Professor Zhuang Zhou finished his lecture, there was a burst of applause from below, and even Luo Yun gave him warm applause, with slaps and slaps.

If Luo Yun hadn't been applauding and talking to Zhou Cheng at the same time, Zhou would have thought that Luo Yun was Zhuang Zhou's devout follower, after all, his applause was very loud.

"Like this kind of academic conference, listen to [-]% doubts and [-]% doubts, and keep [-]% of the remaining [-] points to keep [-] points. Only by carefully analyzing and reflecting the pros and cons can we be rewarded."

"Studying medicine is definitely not just how others teach it, but how you learn it."

"Before you come into contact with genres, all medical knowledge is the foundation. You can learn it first and believe it is true. But after you really start to come into contact with different genres, you have to start to question what you hear and see. Smell and even see the truth.”

"Talk about right and wrong, but not just about right and wrong."

"In terms of experience and medical experience, everyone in this venue will have their own experience. Whether you can tell it is a state. Whether you can convince the majority of people is a state. Can you emulate what others say? , Keeping enough sobriety is another realm.”

After Luo Yun finished speaking, the applause almost stopped.

Luo Yun's words were a little esoteric, Zhou Cheng frowned tightly, but he didn't seem to have much idea, so he just memorized these words.

And maybe Luo Yun didn't think 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 Huaxi Orthopedics was invited to the podium by Lei Zhong, the chairman of the conference.

The order of speakers in this kind of academic conference is generally arranged with the boss first, occupying a good time node.

For big brothers of the same level, the guests are given priority, and then the distance is given priority. Generally, those who come from afar are given priority to show respect for the speaker.It also gives more free time to experts and professors who have a long way to go.

For example, if Professor Zhuang Zhou has other arrangements, he can yo-yo go home after finishing his lecture now, and not participate in the follow-up meeting schedule...

Professor Chen Jiwu is of medium stature, slightly shorter than Zhuang Zhou, but he is also 1.7 meters tall, thin and thin, not as burly as Professor Zhuang Zhou, but more of that kind of gentle and refined.

No one will despise Chen Jiwu just because he is not tall or big.

After all, he is a professor from West China Hospital Affiliated to Sichuan University. The weight of this name is now more important than that of the Affiliated Hospital of Shonan University.

Professor Chen Jiwu is also a professor of joint surgery.

However, his major direction, unlike other professors, is the correction of joint deformities.

Orthopedics, there are four sub-specialties, trauma, joints, bone disease, sports medicine, and joint surgery, there are too many branches of details——

Different directions lead to different avenues, and there are many trails, which are not known to all.

In the eyes of outsiders, joint surgeons and orthopedic doctors may represent a person's identity, but in fact, the profession can be more professional!

A wise man will feel more ignorant!

Although the correction of joint deformity is also a kind of joint replacement, it is an extremely complicated one. It requires a very deep foundation to be able to correct the deformed joints to a normal level...

This is also what Chen Jiwu is sharing now without haste.

For this project, currently in Hunan Province, there is only one professor from Attachment [-] who has such skill, and the orthopedic professors in Attachment [-] are not deeply involved in this field.

This is not a question of level, but a different direction of special research, so it is not easy to compare directly.

For example, compared with Attachment [-] and Attachment [-] of Shonan University, in terms of complicated hip and knee replacement and revision, Attachment [-] is slightly inferior to Attachment [-]!
The Second Affiliated Hospital is slightly inferior in terms of deformed bones and joints.

Each has its own advantages.

The comprehension taught by Chen Jiwu is also a new field, which is another feast for Zhou Cheng...

However, when Zhou Cheng was listening to the class, Luo Yun next to him kept muttering.

"Is this okay? Wouldn't there be... problems?"

"Isn't that a little unreasonable?"

"Wouldn't it be better if the angle was increased here?"

If he hadn't known that Luo Yun was awesome, if it hadn't been for Professor Zuo Hu from the Joint Surgery Department of the Affiliated Hospital of Shonan University who had appeared in Guoba Hospital, Zhou Cheng would probably have wondered if Luo Yun was crazy or bewitched. I started to teach Professor Chen Jiwu's sharing, and he was still giving advice there.

However, Zhou Cheng still doesn't know that Luo Yun's teacher, the field of research is the complex joint revision!
Deformity correction is also one of the complex joint replacements.

Professor Chen Jiwu's lecture style is quite different from that of Professor Zhuang Zhou.

While Zhou Cheng was listening, he was still taking notes.

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 discussion, but most of them were extremely exciting.

He was a little bit taller than him, and he didn't dare to correct and discuss it. He could only ask Professor Chen Jiwu for advice on some doubts.

Therefore, Luo Yun stopped pointing fingers at Zhou Cheng's learning style.

What Zhou Cheng recorded the most is mainly what Professor Chen Jiwu said, data problems, because these problems are the key to his simulation process, which saves him a lot of time to search documents, and even some data are Chen Ji Wu's own private goods can't be found in the literature...

After Chen Jiwu and Zhuang Zhou gave their lectures, the follow-up speakers were not other experts who came from afar, but to ensure that each session had a certain amount of gold, so they were arranged in the morning. At the beginning of the second quarter of the field, avoid people who really want to attend the class, and slip away after listening to the important class.

……

When the time was approaching the coffee break, Professor Chen Xueliang from the Affiliated Hospital of Seoul University finally came on stage.

The direction of his main attack is nonunion.

Bone nonunion belongs to the department of orthopedics, originally Luo Yun just listened casually.

The Department of Medicine of Seoul National University, formerly known as Huzhou Medical University, is a small specialty. It was not on the table at first, but since it was merged into Seoul University, it has made rapid progress in recent years. In just a dozen years, it has been published made a name for himself.

Currently in the comprehensive ranking of medical schools, it used to be within [-]!

This is no joke.

For more than ten years, I don't know from which position, they broke into the top [-], which proved their strength.

Luo Yundu was feeling emotional: "Professor Chen really has his own unique insights on the bone fracture."

"I didn't know much about nonunions before."

"But after getting in touch with our field of orthopedics, I realized that Professor Chen really has too many things in his hands."

Luo Yun's emotion is also Zhou Cheng's emotion.

In the field of nonunion, in the whole world, almost few people touch it.

There are mainly several reasons!
Patients with nonunions are almost all done by others. If you pick it up, it is equivalent to wiping their ass, and others don't even know that you are doing good things for them.

It's a thankless job, who wants to do it?
And most importantly, the main reason for nonunion is that the blood vessels in the fracture area are damaged or the blood supply itself is not rich after the fracture!
A fracture can heal because of its own healing process. It cannot grow back on its own, and you can't beat or scold it. You can only rely on your hands to make it grow back. This ability is really amazing.

Just like, dry land is not suitable for growing rice, but you just want it to grow rice, and it must grow well and beautifully.

Isn't this what you are looking for?
But in such a seemingly impossible field, Professor Chen Xueliang can do quite well.

Luo Yun said with emotion: "In the past, I didn't have a deep relationship with the orthopedics department of the Affiliated Hospital of Huhan University, so I don't know much about this aspect."

"It seems that in the future, you can still walk around more."

Zhou Cheng didn't reply, he naturally knew that what Luo Yun said about us was Shanghai Jiaotong University.

The reason why Shanghai Jiaotong University School of Medicine and the Affiliated Hospital of Seoul University do not have a deep relationship is because of the comprehensive strength of Seoul University, which was lower by more than one gear in the past, and they were not willing to play with them at all.

After Chen Xueliang finished talking about the nonunion, finally, the meeting came to a break, also called tea break.

One lecture lasted more than two hours.

The lecturers also listened to the lecture for more than two hours. During the coffee break, they should drink water!

Those who should go to the bathroom have to go to the bathroom.

Old smokers must have a cigarette or two to refresh themselves.

Among the surgeons, there are not a few who smoke. At first, they do it to refresh themselves, and later, they just want to smoke to refresh themselves.

Immediately after the tea break, Luo Yun got up immediately, and seemed to be walking towards someone. Zhou Cheng saw that the direction Luo Yun was heading was Professor Chen Xueliang from Seoul University, and he probably wanted to communicate with him a little bit.

Zhou Chengcheng didn't interrupt, he was spending time sorting out all the professor's lectures in the morning.

Whether it is a professor in the province or outside the province, I have gained a lot.

The most important thing is that some of these people's ideas are likely to become the perfect idea for Zhou Cheng to use the mock copy, which will save him a lot of time!
They are all good things, Zhou Cheng is looking forward to them, and then Zhang Zhengquan will record the lecture records of all the venues in the video!

This is definitely a bumper harvest, so Zhou Cheng had to take the time to fill in the details a little bit, so as not to forget that it would take time to re-watch the video.

Time is precious, time is pressing, and saving a little bit is a little bit!
……

After the tea break, came the second session of the morning.

However, according to the conference schedule, before the opening lecture of the second session, there will be a 10-minute discussion meeting, which is mainly to review the main problems of many speakers in the first session.

That is the question section.

Of course, this kind of question is randomly drawn on the spot and is symbolic.

Otherwise, if you really have to finish the questions and answers one by one, you will be exhausted.

The host of the second meeting has changed. Zhou Cheng doesn’t know him, and Luo Yun hasn’t come back yet. Therefore, Zhou Cheng can only sit quietly, guarding Luo Yun’s position, and then Looking at the stage again, waiting for the Q&A session to begin.

After the host took the chair seat, he said without nonsense: "Next is the discussion session of the first session of the agenda. I don't talk nonsense here. I will give more time to colleagues and seniors."

"First of all, I would like to thank the previous professors for their kind words. They brought us a big feast, which can be regarded as a feast for our ears."

"However, I believe that you, including me, after the lectures of several professors, still have some things that are not clear, and now is just the time to learn from the scriptures."

"Comrades, if you have any questions in your mind, you can just ask the professors directly."

"If you don't take the initiative to participate, then I just use the power of the host to take care of my own problems." The chairman, who is also a rather cheerful person, joked.

It can be seen that he is very talkative, not the kind of rigid opening remarks.

The people off the field, of course, would not let this opportunity go, and it was not the teacher who was taking the roll call, fearing that something they didn't know would be known.

It is precisely because I don't know, I don't understand, that I have to ask.

So, the first person stood up.

It was none other than Professor Chen Xueliang from the Affiliated Hospital of Seoul University.

He raised his hand and stood up.

"Hi, Professor. I would like to ask Professor Zhuang Zhou such a question. It may be rather sharp." He knew the professor who hosted it.

Only then did Zhou Cheng know that this professor was called Professor Zhu.

"That is, after the first-stage operation for joint infection, I also saw that there is still a chance of recurrence. So, in this case, what is the procedure for the patient to follow up?"

"When you perform joint infection surgery again, do you choose the first stage or the second stage?"

Chen Xueliang himself said that this question is more acute!

It's really more sharp!

Zhou Cheng's head was a little bit down.

This is an academic exchange meeting, can you still ask such a question?Are you not afraid of offending others?
You said that the chance of infection is low, but if this small number of patients with recurrent infection chances come to see a doctor again, should you do it in the second phase or according to the guidelines?
If it’s still the first issue, then post it again. Are you going to keep moving forward and never regress?
As for the procedure for the follow-up visit after the patient relapses, it is actually asking in disguise,

Did they make a medical fuss?

Is this problem acute?

This is a very real problem, but it is also a common problem. If it is someone else, they may still consider the other party's face and would not ask this question.

But Chen Xueliang asked, and he had his own reasons.

That is, after the first-stage replacement of your joint infection, if it is re-infected and the patient makes a fuss, what should you do?
Do you have any countermeasures? After all, this is not in line with the current diagnosis and treatment guidelines, and the lawsuit cannot be won.

You said, if there is no way for us to learn, then today we will just listen to it for fun.

This was the first sharp question Zhuang Zhou heard. He stood up, picked up the microphone, and said to Chen Xueliang:

"Thank you Professor Chen for your question. To be honest, I have been speaking outside for so many years, and this is the first time I have answered this question."

"I'm also very glad that Professor Chen can ask this question, because I myself have sometimes asked myself this question!"

"I just said that this kind of one-stage replacement surgery is not recommended for inexperienced surgeons. It is necessary to accumulate a certain amount of experience to minimize the chance of recurrence. This is one of the reasons."

"Secondly, our preoperative communication is relatively complete."

"Because the patient itself may be a re-infection or a first-time infection, and the infected patient, with such advanced communication, is also aware of the complexity of his condition. After full communication and without coercion, the patient himself, There will be no big opinions."

"After all, our department also does the second-stage replacement, and compared with the first-stage replacement, the ratio is half and half."

"Moreover, I can answer one more question for you, and that is the question of the cost."

"Actually, if a second-stage operation is really needed, it will definitely cost more than the first-stage operation."

"Also, compared to a one-stage operation or one revision, it's not much less money."

"Then, on the premise of explaining this premise to the patient in advance, the patient can fully consider various possibilities when making a choice on his own. It also maximizes the patient's right to choose with informed consent."

"It's a display of humanitarianism."

"Thank you."

After Zhuang Zhou finished speaking, he politely ended his answer.

Chen Xueliang nodded and didn't ask any more questions, just smiled and sat down casually.

Obviously this answer is different from the answer in his heart, but killing people is nothing more than a nod.

At this time, Professor Zhu took over the words naturally: "Thank you, Professor Chen for asking questions, and also thank Professor Zhuang for your answers and clarifications. I believe that our understanding of joint infections will become more and more in-depth in the future!"

"It has benefited a lot more and more. Of course, just now Professor Chen also provided us with a very good idea of ​​communicating with patients."

Professor Zhu didn't know whether he was complaining or for other reasons, so he was entangled in such a sentence.

Then quickly changed the subject.

"Next, we still have to move on to the next question. I don't know which comrade has any questions. Do you want to ask the previous professors?"

Brush brush.

Many people raised their hands.

Professor Zhu could only call someone casually, a middle-aged man in a plaid shirt in the fourth row in front of his left.

The staff handed him the microphone.

He also asked without nonsense: "I also have a question, just ask Chen Xueliang, Professor Chen."

"Actually, the question I want to ask is the same as the one that Professor Chen asked Professor Zhuang just now."

"We all know that once a nonunion occurs, it is extremely difficult to grow back. If it doesn't grow back, what will Professor Chen do?"

As soon as this question came out, the scene was quiet again for a moment!

This question is exactly the same as Chen Xueliang asked Zhuang Zhou before, but his way of asking is more relaxed.

Zhou Cheng's eyes widened.

Then at this time, Luo Yun finally came back, sat next to Zhou Cheng, turned to him, and said, "This is all a small scene, academic exchange, academic exchange, how can you call it an academic exchange if you don't fight?"

"That's a large-scale pretentious scene! It's just a business promotion."

Zhou Cheng nodded, feeling that Luo Yun's words made sense.

However, it is not the first time that Professor Chen Xueliang answered this question, he just said:

"So far, I have only received two cases of nonunion that still did not grow well after surgery. One of them was because of a car accident during a trip after surgery, which caused the fracture site to re-fracture."

"The other, because he did not follow the doctor's advice, performed heavy physical labor within a year, resulting in chronic repetitive injuries to the fracture site and continued bone nonunion."

"However, if I encounter a case where the nonunion still exists after surgery, I think I will deal with it from the following aspects."

"First, reflect on your own preoperative evaluation."

"Second, reflect on whether your operation is imprecise."

"Third, after reflection, perform surgery on this patient."

"As for the other issues, I believe that patients with nonunion usually go to many hospitals. Even if they are not medical practitioners, they have already known about the disease of nonunion. Once it occurs, it is very difficult to avoid it. recurring."

"My current understanding is this, thank you!"

Chen Xueliang sat down confidently.

This answer made it difficult for everyone to understand, because they didn't know whether what Chen Xueliang said was true or not.

However, in the course of Chen Xueliang's narration, only two cases of poor prognosis were indeed mentioned.

Compared with what Zhuang Zhou said about the chance of recurrence of joint infection, it was much lower.

So, I can only say that this question is not very well asked——

Naturally, Professor Zhu would not give any more chances to ask questions, otherwise today would be a question-and-answer session, which will be the next part.

Therefore, Professor Zhu directly asked the next one.

One person stood up, feeling very lucky, and said, "Thank you very much for the host for giving me a third chance to ask a question. I would like to ask Professor Chen Jiwu from West China Hospital."

"When you were undergoing extreme joint deformity, did you ever experience fractures after bone grafting? If you encountered such a situation, how would you deal with it?"

Chen Jiwu also stood up and replied: "..."

When it came to the third question in a row, Zhou Cheng finally understood that the truth of 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!

These questions are more tricky than the other, and they are simply fighting each other.

In the past, if Chen Xueliang deliberately asked Zhuang Zhou similar questions, there may have been a festival in the past.

Then someone asked back, it was revenge.

Then the third question is definitely not accidental. Everyone can't have enemies, right?
The lecturer is the lecturer, and the lectures he lectures are lectures. No matter how fancy the lectures are, the audience is a group of intelligent people. They will not think that what you say is what you say. Questions you can't even think of,
'打' kill you.

Perhaps, it is precisely because of this that it is one of the sources of medical technology and discipline development.

This touched and benefited Zhou Cheng a lot!

It also made him truly understand that in medicine, every step he takes, he has to cross countless thorns and troubles before he can truly and steadily take every step well.

There is no shortcut, only those with great wisdom and perseverance can pass and reach the distance...

Although he currently has a lot of perfect level skills, he still doesn't have enough reserves, and his knowledge is not mastered enough, so he can't show them out now, otherwise, he won't be able to pass this academic conference!

If Zhou Cheng was asked to answer such a question, Zhou Cheng would probably choose to give up on the spot and reply to the defense link in the Internet jokes, only answering but not defending. At this time, if you don't argue, you will have no way to get along.

To mix in the circle, you have to make all kinds of preparations.

Academic, not so unpredictable, of course, not so down-to-earth, at least, there will not be many people joking with you...

If you can get on the stage, then you can come up on your own. If you accidentally poke your nest and you can't handle it yourself, 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 can continue to stay here and listen to the lecture carefully, I'll go see an acquaintance."

"Is it Professor Liu?" Zhou Cheng said a little more, mainly because this is not a particularly formal occasion.

Zhou Cheng had heard the introduction of today's foreign guests before, and one of them was Professor Liu from the Ninth People's Hospital Affiliated to Jiaotong University in Shanghai.

It seems that it is the same unit as Luo Yun's graduate school, but ah, after all, there are different departments in the big hospital, and Luo Yun didn't take the initiative to bring it up. Zhou Cheng didn't know whether Luo Yun and Professor Liu were familiar with each other.

"En!" Luo Yun nodded, because he had already seen Professor Liu walk out.

And he planned to attend Huaguo's orthopedic annual meeting in a while, and go to Shanghai, so naturally he had to ask Professor Liu to bring an official message when he returned in advance.

Because Professor Liu is a big brother of his teacher, and he came to Hunan Province, Luo Yun, as the host, also wanted to entertain him.

Originally, Luo Yun planned to ask Zhou Cheng to come with him, but Zhou Cheng was such an asshole, he seemed to be obsessed with listening to the lecture, a speaker who was bragging, he took notes for several pages!
This made Luo Yun feel ashamed to interrupt Zhou Cheng's study, so he simply let Zhou Cheng continue to attend classes here.

Luo Yun left without further explanation, while Zhou Cheng just glanced at the direction in which Luo Yun left, and then continued to concentrate on listening to the class.

The content shared by these speakers is [-]% true and [-]% false, but this falsehood is also the inference they have made after a long time of research, something for communication, and some extended thinking.

Bragging also requires homework, and it is these homework that is a good material for Zhou Cheng to imitate his ideas and gather the strengths of everyone.

Squeeze the simulator and other people's wool, get something for nothing, this is something that everyone feels very cool about!

Now that he was so happy, he decided to have a blast all at once, Zhou Cheng decided to stick his ass here and not move!
　Staying up all night is cool for a while, but staying up all night is a waste.

　　
　
(End of this chapter)