medical simulator

Chapter 190 Immortals want to fight! (Please subscribe!)
"Hip joint infection." Zhou Cheng turned his head and said after thinking for a while.

Luo Yun took another look at the video sent by Professor Song, and asked again without directly asking why:

"What about the previous ones? What are your considerations?" Asking the specific reason for a plain film is not in itself the main purpose of Professor Song for taking out this group of plain films.

Zhou Cheng's memory does not have a photographic memory, but the features of the previous flat film are still in his mind, and Zhou Cheng is not completely sure about the answer, so he said:

"The first case should be tuberculosis of the hip joint, and the second one is just like what Professor Liu said, it is DDH with necrosis of the femoral head."

"Third, I would consider bilateral hip synovitis."

"The third plain film, do you want to consider synovitis?" Luo Yun frowned.

The reason why he asked Zhou Cheng was that he had an answer in his heart, but he couldn't be sure, but he also felt that the group of films that Professor Song showed was very interesting, so he wanted to explore it with Zhou Cheng.

It can not only confirm my guess about the diagnosis in my heart, but also teach Zhou Cheng.

However, at the time of the third plain film, Luo Yun considered bilateral hip osteoarthritis!

This seems to be a bit different.

However, according to Zhou Cheng's prompt, Luo Yun thought about it for a while, and suddenly realized it!

With a half-smile at the corner of his mouth, he said: "You kid, everyone else was taken into the pit by Professor Song, and you are still standing outside the pit?"

The cases Professor Song brought were of course joint surgery cases, and all of them were hip joints.

Hip tuberculosis, hip osteoarthritis, hip dysplasia with avascular necrosis of the femoral head, hip infection!

These are four classic cases of differential diagnosis of the hip joint. To complete the diagnosis, many auxiliary examination methods are needed to confirm the diagnosis.

But that is for ordinary doctors, and for top joint surgeons, there are different signs among hip tuberculosis, osteoarthritis, dysplasia and infection, even displayed in the information volume Among the fewest flat sheets.

It is time to be able to diagnose through this.

It's just that, to see synovitis from ordinary plain films, Zhou Cheng's thinking this week is also amazing.

Zhou Cheng pursed his lips and said, "Ms. Luo, you specifically pointed out this kind of hip synovitis when we were in the outpatient clinic together, and we checked the information together later."

It happened on the weekend last week. At that time, Luo Yun hadn't been to the outpatient clinic for a long time, and it was Zhou Cheng's first visit to the clinic at that time, so Luo Yun explained the cases that Zhou Cheng didn't know about.

However, another situation is that Luo Yun was licked to death by Zhou Cheng in the simulated world! ~
He also passively gave an academic gift package, the knowledge points contained in it include the plain film reading of synovitis, but it is possible that Luo Yun himself did not call it out in time, and Zhou Cheng now has a perfect level of skills, as high as 50+ !

It can be said that the knowledge reserve is extremely rich, so there is no problem in completing the mobilization of these knowledge structures, and then I can see something different.

"That's an MRI. The signs of synovitis on the MRI are completely different from the signs on ordinary X-ray films." Luo Yun is very satisfied with Zhou Cheng's talent, but ah, Zhou Cheng's Modesty and stability are what he has never liked.

Obviously I can see it, but I have to find a reason to prevaricate, although this is a consensus among all disciplines at present, everyone has to live with face...

But you must know that in the daily communication, I have given more face, and in the process of flattering each other, I feel that I am very good, so I don't study, and I don't go in-depth.

"Has no one raised their hands yet?"

Professor Song looked around and saw that no one raised their hands anymore, and he was quite satisfied with the effect of this set of flat films he brought.

Of course, Professor Song didn't know if Mr. Xu and Mr. Kong saw it, but they probably did, so they wouldn't tell the truth.

Luo Yun touched Zhou Cheng: "You raised your hand to answer the question?"

Zhou Cheng quickly shrank his body, trembling slightly: "Mr. Luo, me? Now?"

Then Zhou Cheng shuddered violently, shaking his head like a rattle.

Just kidding, on weekdays in the department, when facing Yan Haihan, he felt a feeling of looking at the mountains and was trembling. Although Yan Haihan has stepped down from the position of director now, Zhou Cheng is still a little nervous when he sees Yan Haihan. fear.

And if the director of Yan Haihan is a landowner in the No. [-] Hospital, then when he faces Ding Changle, how should he confess?Ding Changle is currently the head of trauma surgery in Hunan Province.

Ding Changle is just the director and professor of trauma surgery in one of the three affiliated hospitals of Shonan University. Compared with the resume of a great director like Lei Zhong, who is also the dean, he is a little less interesting.

This Professor Song, according to Luo Yun's introduction, is currently the deputy director of the Second Affiliated Hospital of Shonan University and Professor Li's mentor!
Professor Li and Professor Lei Zhong are figures of a generation!

Even Professor Liu Yiping will be respectful to Professor Song, so he will answer this question?
Forget it, the level of difference is too much.

"Ms. Luo, you can answer." Zhou Cheng waved his hands repeatedly and lowered his head.

Luo Yun sighed, and said, "What are you afraid of? Tell me what you know. If you make a mistake, the old professor will naturally correct it for you. You can remember it for a lifetime."

But Zhou Cheng still didn't dare to show off the limelight, mainly because he wasn't used to it yet, he hadn't even attended a class in the department, and he had been in the limelight before, now Zhou Cheng really didn't want to ask him to show off.

Through the mock copy, Zhou Cheng knew more and more how difficult it is to promote the development of a subject.

Although the skills that Zhou Cheng has acquired so far may be the perfect point in this era, but after a few decades, the ceiling of these skills may be redefined.

I had a mock copy, so I was able to take a shortcut, while the others had earned their fame through their hard work and talent.

Zhou Cheng can stand up to answer questions, and maybe attract the attention of everyone, but showing off with skills is not Zhou Cheng's original intention.

Zhou Cheng rubbed his hair and didn't say much.

……

After Professor Song saw that no one raised his hand, he stopped wasting any more time, and took the initiative to end his confusion:
"This plain film is superficially similar to the first plain film I listed. But it is only similar, not the same plain film of a patient."

"It can be seen that these four plain films have a wide range of enhancements, which can also be called whitening phenomenon!"

"This wide-ranging whitening phenomenon basically takes into account the infection of the joint cavity! It is not enough to simply see the infection step."

"At this time, we can use some other special factors to make detailed distinctions one by one."

Professor Song said, and flipped through the plain film to the first plain film: "The last case just now, the medical history only lasted for one year!"

"And there is no tenderness around the hip joint! This shows that the articular surface in our joint cavity has not been eroded particularly severely, and may not even have invaded the pain layer."

"But in the first film, we can also see extensive enhancement, but its medical history has lasted for more than [-] years!"

Professor Song said, holding up two fingers.

"It has not been discovered for 20 years, which means that the patient just does not have the symptoms of high fever and chills that accompany common hip joint infections, otherwise the infection focus may have been discovered."

"If it's not a heat infection, then it can only be a cold infection focus."

Heat infection means that there will be traditional infectious symptoms after infection, but cold infection focus is not necessarily the case. Often patients do not have too many symptoms and are ignored.

"And no matter how the cold infection can last for more than ten years before the onset worsens, we have to consider whether this patient has tuberculosis."

"Tuberculosis in the joint cavity may not be detected by ordinary blood tests for tuberculosis and tuberculosis antibody antigens."

"There won't even be corresponding typical symptoms, and the diagnosis can only be made by biopsy and culture."

"Then, how can we make a diagnosis through this film?"

"It can only be identified by medical history."

Professor Song turned to the fourth picture while talking, and apologized to the person who answered the diagnosis:
"When our doctors read the film, we should not only look at the plain film, but also consider the length of the patient's medical history and age."

"If she had hip osteoarthritis, she'd been in pain for more than 20 years!"

"Will she still have joint space? But when we look at this film, the space is only a little narrow, but we can see some small insect-like cavities, so we have to think in the direction of infection, right?"

"So the first plain film, we can also preliminarily consider hip joint tuberculosis and septic hip arthritis."

In this regard, Professor Song made a point and clarified the distinction between tuberculosis and common joint infections.Professor Song didn't stay any longer, but continued to read the second and third flat films.

"Next, let's look at the second film. This film is the best one in today's group of films. It is congenital hip dysplasia and femoral head necrosis. This should be our joint surgeon. Essential skills."

"We can first see that the CE angle of the hip joint is outside the range of normal people. At the same time, we can also see that the bone quality on the femoral head is uneven, with localized regular reduction, necrosis and collapse. more likely."

"Let's not worry about this film. If you don't know how to watch it, you should go home and study it hard. Don't let us spend our whole life in joint surgery and forget the door to enter joint surgery. That would be ridiculous!"

"The third film! This is a very interesting flat film."

"We should take into account patients with intermittent claudication."

"In addition to neurogenic and vascular, we also need to consider our orthopedic diseases,"

"Hip Synovitis."

"The tenderness in front of the hip joint lasted for 8 years and became worse for two years. We could not see the narrowing of the joint space and the formation of osteophytes. On the contrary, we could see that the local imaging density in the joint space increased."

"In this way, the sciatic nerve inflammation caused by hip joint compression on the sciatic nerve can be temporarily ruled out. Although synovitis is relatively rare, if we also consider..."

Professor Song's in-depth analysis directly won a lot of applause...

When Luo Yun heard Professor Song give the final answer, he couldn't help but give Zhou Cheng another look: "Look, you dare not raise your hand to answer the question. What are you afraid of? What you said is right. .”

"Do you think you will never stand there for the rest of your life? If you don't even have the most basic courage and the courage to admit mistakes, how can you study well?"

When Luo Yun was scolding Zhou Cheng.

Professor Song's lecture on the stage is over.

He is not young at all, so he doesn't need to prepare too much content.

As the beginning of the second half of today's meeting, Professor Song has already laid down the leader, and it is a leader that many people rarely see. Such a case!
At the same time, it can be presented, and it can be explained in detail. It may only be an older generation like Professor Song who has a lifetime of experience as a reserve.

It is possible to unscrew each disease individually and explain the simple theorem of this particularly complicated case in a simple way.

If it is a young professor, he may know the diagnosis himself, but he cannot analyze the differential diagnosis, but relies on various laboratory tests, then the impact of this sharing will not be so strong.

"Mr. Luo, isn't it great to just take a class like this?" Zhou Cheng also felt that Luo Yun's thinking was very strange.

If this is an operating table, Zhou Cheng can go up to complete an operation without hesitation, and this will not hinder him.

But this is Zhou Cheng's first time participating in such an academic conference. He didn't even go through the principles and procedures, so if he asked questions and answered them casually, it would offend people, because Zhou Cheng was afraid that the questions he asked would At that time, no one could answer, and of course the venue was shut down.

How bad is that.

Moreover, the speakers above are all Zhou Cheng's targets, so how could he offend them?It would be great to hear more about their private goods, and it would be great to throw out some seemingly outrageous conjectures.

"Me?" Luo Yun suddenly had an expression of hatred for iron.

Back then, it was his teacher who asked him to give a lecture on the stage, and he rushed up, but he didn't hesitate.

At that time, he couldn't keep up with Zhou Cheng?

Just to force yourself!
It can be said that if Mr. Zeng did not force Luo Yun to give lectures in various venues and force him to prepare too many things as background, he would not be able to learn so quickly!
On Zhou Cheng's side, he is obviously capable and strong, but he just seems dumb.

How timid as a mouse!It doesn't have the same demeanor as he did back then, and it's also a wonderful flower.

Zhou Cheng pursed his lips and continued to listen.

Luo Yun also sighed, and gave up the inner struggle.I didn't think that Zhou Cheng was hopeless, but that Zhou Cheng's edges and corners were almost smoothed out. At his age, he would think about too many things.

At this moment, Zhou Cheng knew very well what to say and what not to say.

Although before, it was common for different professors to fight each other.

But who are those people?
Who are you?Ordinary training, no teacher and no foundation.

He's going to cause trouble, and if someone just stands up here, Cai Dongfan will be crushed. Does he dare to say anything more?

dare not.

Luo Yun is different, his teacher can make him have a kind of unbridled irascibility.

……

Next, Professor Chen from West China called a group of speakers from prefecture-level hospitals in Hunan Province to share the cases they talked about.The first quarter of the second half of the annual meeting is finally over!

After a tea break, Professor Zhuang, the director of the Joint Surgery Department of the Second Affiliated Hospital of Shonan University, finally came to the rostrum!became the chairman of the meeting.

The second half of the meeting is considered to be the beginning.

Professor Zhuang emphasized in an extremely loud voice:
"Welcome all colleagues, experts, professors, and teachers to come to our joint surgery venue again."

"The next thing I want to share with us is the professor of orthopedics at Hunan Provincial People's Hospital and a member of the Hunan Provincial Orthopedics Committee. Dong He, Professor Dong. He is also a top expert in our orthopedics family in Hunan Province. Welcome!"

Zhou Cheng listened to Professor Zhuang's words, carefully read the above resume, and found that Dong He was actually just an associate professor, and the writing was so correct, but what Professor Zhuang read out was still a professor.

I don't know if it's Professor Zhuang's slip of the tongue, or if it's something else.

At this moment, Luo Yun began to knock on the table again to make a point!

"Listen carefully, there is definitely a big melon in this scene!"

"What big melon?" Zhou Cheng was curious.

"You just have to watch." Luo Yun turned out to be tricked!
Zhou Cheng squinted his eyes first. Dong He was only the deputy director of Xiang Provincial People's Hospital, but he was praised so much by Professor Zhuang. Luo Yun also said that there are big melons. It seems that there is something wrong with the doorway here.

Is there any grievance between Professor Zhuang and Professor Dong He?

No time to think about it.

Dong He quickly walked to the stage, bowed to the applause of the crowd, and said:

"Thank you everyone, thank you teachers for your applause."

"But it's a pity." Dong He was extremely talkative, with clear words and a frustrating tone.

"Today, all the experts brought us successful cases, and they came to teach us lessons."

"But I came here today to trouble the teachers. The main reason is that I brought a failure case we encountered today. I really have nothing to do, so I came here to ask you for advice."

"However, I may be lucky. Today, there is Professor Zhuang Zhou from Xinjiang Medical University, who happened to be at the scene. Professor Zhuang Zhou is a master in joint infection. He is a big man. He might be able to make things difficult for us. I brought The case that came here happened to be related to joint infection."

"I hope Professor Zhuang can speak well after listening to it."

Then, Dong He opened the ppt.

Under the stage, Professor Zhuang Zhou sat with his hands behind his back and leaned back his stool, as if he was listening carefully and ready for battle at any time.

Dong He came here with a request. In such a venue, he retreated a hundred steps from the beginning, "humble" into the dust.

At this time, if there is a request that cannot be answered, it will be called not giving face, and naturally it will not work.And Zhuang Zhou is also curious, this Dong He is also interesting, bring the failed cases to the annual meeting?

What is he trying to do?

Medical history: middle-aged female, 58 years old, right knee joint pain for 10 years, aggravated for two years.

X-ray showed: stage 4 right knee osteoarthritis.

Dong Hedao: "Everyone has also seen the case information. It is actually not complicated. The patient was admitted to the hospital for the first time. We conducted a routine preoperative examination on him, and there was nothing special about it."

"So, we did a total knee resurfacing."

"On the third day after the operation, the patient's wound began to ooze clear fluid without bleeding."

"On the day we discovered the exudate, we immediately conducted a general microscope examination and bacterial culture on the exudate, and there were no pus cells and no bacterial growth."

"After the operation, the use of antibiotics was routinely extended to the fifth day after the operation. We took the fluid again for examination and re-examined the inflammatory indicators."

"The results showed that the inflammatory indicators were normal, and there was still no bacterial growth."

"However, at this time, the patient's exudate not only did not decrease, but increased."

Dong He posted a photo here, which recorded a large amount of seepage, and the gauze and cotton pads inside were dyed dark yellow.

"We consider that the patient's BMI = 27.5, which belongs to a slightly obese physique, and may be due to fat liquefaction."

"On the sixth day after the operation, the exudate had not stopped, so the first debridement and suture was performed."

Here, Professor Dong He released another photo with an explanation:

"We can see from the pictures that there is a large amount of clear, non-turbid, colorless liquid in the preoperative field."

"During the operation, we took the joint fluid and sent it for culture of bacteria, fungi and special bacteria. The results were all negative! After debridement, we performed continuous drainage."

"After debridement and suture this time, the patient's exudate disappeared. On the 15th day after debridement, the stitches were removed and he was discharged from the hospital."

"However, in the third month after the operation, the patient's knee joint swelled, and the skin temperature increased, and the floating patella test was positive. The joint fluid was extracted and sent for bacterial culture, which showed that it was Staphylococcus aureus infection,"

"We immediately performed joint cavity debridement and knee joint replacement gasket replacement. After the operation, a catheter was placed, and gentamicin solution was added to flush and drain the drainage until the bacterial culture was negative."

"Patient improved again and was discharged."

When Professor Dong He said this, he reluctantly opened the next picture: "Six months after the first operation, and three months later, the patient had the same symptoms of swelling and elevated skin temperature again. Into the hospital."

"But this time, when we took the joint fluid and sent it for culture, it showed Mycobacterium tuberculosis infection."

"Let's review the results of previous preoperative examinations and cultures. No tuberculosis bacillus growth was seen. Laboratory tests and a full set of tuberculosis tests were all negative."

"At this time, for the sake of insurance, we obtained the consent of the patient himself and performed joint fusion."

Speaking of this, Dong He walked away from the podium and said, "But just last week, the patient said that her skin temperature had risen in the joints of her affected limb."

"There may be suspicion of reinfection."

"So taking this opportunity today, I would like to ask Professor Zhuang Zhou, is there any inappropriateness in our handling of this case? I hope Professor Zhuang can enlighten me."

Dong He talked to such an extent. Although Professor Zhuang Zhou had shrunk his body when Dong He mentioned Mycobacterium tuberculosis, he was extremely unwilling to take this troublesome muddy water, but Dong He named it by name. up.

He also had to stand up and say:

"According to the patient's existing case data, during the first operation, there was exudate, but no bacterial growth. During the second operation, Staphylococcus aureus grew. In the third operation, Mycobacterium tuberculosis was directly cultured."

"It's clinically, fairly uncommon, and I haven't encountered it myself."

"However, there is one point. Ordinary infections will basically not change to special bacterial infections. Special bacterial infections generally persist."

"However, in the first two preoperative examinations of this patient, the culture of Mycobacterium tuberculosis was negative, which is somewhat difficult to explain. Now that the patient has undergone joint fusion, I think there is not much comparison on my side. Great suggestion!"

"I rarely meet patients with joint fusion nowadays."

Although Professor Zhuang Zhou is engaged in joint infection, it is just a simple joint infection. Where have you encountered this kind of Staphylococcus aureus for a while, and Mycobacterium tuberculosis for a while?
Can you be more professional about your infection?Can you be more dedicated and not change back and forth?
Joint fusion is actually the destination of patients with joint infection in the early years, but now it has been abandoned for a long time.But the case that Dong He encountered seemed to be inconsistent, and he didn't know how to deal with it.

You can do the renovation again, and the bacteria will gnaw again, which will hurt the patient's money.You have merged, the patient's joint mobility has disappeared, and the quality of life has been greatly reduced.

It's hard for Zhuang Zhou to say more, he is not a god.

He didn't get any useful answer, but Dong He still nodded gratefully: "Thank you Professor Zhuang for your clarification, perhaps, this patient had occult Mycobacterium tuberculosis infection from the very beginning, it's just something I couldn't understand. "

"Why can't this kind of Mycobacterium tuberculosis be cultured?"

After Dong He finished speaking, he was about to return to the middle of the podium.

Because when he replied to Professor Zhuang Zhou's words before, he walked out of the table of the podium in order to show respect.

But at this time, Professor Zhu from the Second Affiliated Hospital of Shonan University suddenly raised his hand!
He is the referee himself, so after raising his hand, he asked directly:
"Professor Dong, I have two questions, can I ask you for convenience?"

Professor Zhu is quite polite.

Dong He's expression remained unchanged, and he stretched out his hand: "Professor Dong, tell me."

"First, why didn't you choose joint revisions after you first found S. aureus?"

"The second question, after culturing Mycobacterium tuberculosis, why did you do joint fusion directly, instead of choosing to do the first-stage joint cleaning and the second-stage replacement?"

"Joint fusion is equivalent to allowing the patient to lose all mobility to control infection. Compared with the problems that this kind of surgery deals with, the impact on the patient's quality of life seems somewhat inequitable."

Ok.

The purpose of joint fusion is to control infection, but the cost is to lose all mobility, which is not worth the candle!

Zhou Cheng's expression darkened immediately. The question that Professor Zhu asked was indeed a bit sensitive.

Moreover, Zhou Chengcheng found that when these two questions were asked, the eyes of everyone at the scene immediately lit up.Including Luo Yun, who also saw a climax after watching a play, rubbed his hands together, and said to Zhou Cheng:

"here we go!"

This question is more vicious and direct than the questions asked to Zhuang Zhou, Chen Xueliang and others before, it is almost equivalent to going straight to the point.I almost slapped Dong He in the face for why did you do this.

But when you think about it, it makes sense.

In Hunan Province, medical resources and status are dominated by Shonan University, and other hospitals can't get ahead, so they will definitely join forces to break through the 'monopoly position'.

Hunan Provincial People's Hospital is the big brother of the affiliated hospital of Hunan University.If he doesn't take the lead in fighting, how will the others fight?
More than once on various occasions, began to spray.

Although I haven't sprayed it, I sprayed myself between the fourth and third positions!

Shonan University, with its three affiliated hospitals, should reasonably be ranked first, second, and third in Hunan Province, but there are private rumors that the Hunan Provincial People's Hospital is better than the third hospital.It's all about fighting!
You want to hit me, can I not fight back?
The professors of the Affiliated Hospital of Shonan University and the professors of the No. [-] Hospital will not fight each other at this time, and will be consistent with the outside world. After solving the external problems, they will fight over who is the big brother.

In this way, the current Professor Zhu can figure it out when he asks such a question.

……

The discussion below began to boil——

The case brought by Dong He is indeed full of doubts.

The content of the discussion was just as what Professor Zhu said.

Not when you should be doing a joint revision!
Joint fusions were done when they shouldn't be.

And brought it to such an occasion, isn't this asking for trouble?
All eyes were on Dong He.

Dong He didn't feel too uncomfortable, his face was just a little awkward for a while, after tidying up his collar,

Slowly said: "Thank you, Professor Zhu, for your question."

"As for these two issues, I will not explain them first."

"Please also wish the professor to continue listening."

"I'm not done yet."

As soon as Dong He said this, almost everyone in the audience could see Dong He's hidden embarrassment, some didn't quite understand?No, you should answer, what do you mean by continuing to talk?
What's the use of hiding these embarrassments?

Can you hide it?

You want to fight back, why do you continue to give lectures?
Also, how long is your stinky basket, haven't you finished talking yet?

I saw that Dong He just slowly opened the follow-up:
"After we cultured Staphylococcus aureus for the second time, we sent this case to Shanghai."

"And invited Academician Zeng for a consultation."

"At that time, the suggestion given by Academician Zeng was to replace the gasket directly. There is no need for joint revision."

"Furthermore, the patient was admitted to the hospital for the third time. After tuberculosis was detected, Academician Zeng considered that the patient may have multiple infections. Joint fusion is safer than joint revision. In terms of economic benefits, it is more beneficial to the patient."

"We communicated with the patient for a long time, and finally the patient decided to stay in our hospital for joint fusion."

As soon as these words came out, everyone's mouths opened slightly.

Then he directly shifted his gaze, which was originally focused on Dong He, to Professor Zhu Zhu Jinshan.

Now, is he a little embarrassed?

The two sharp questions that Zhu Jinshan asked at the right time directly hit Academician Zeng with one shot, and they hit the bull's-eye...

This Dong He, oh no, a person from Xiang Provincial People's Hospital!

It's like killing a wolf. I didn't explain the situation for so long before, and even asked Professor Zhuang Zhou if there was anything wrong with the handling. Isn't this just to draw Zhu Jinshan out on purpose.

Then?

Where is this asking for advice?This is a big fire pit specially set up, waiting for people to jump!
Perhaps, their original purpose was to wait here for the people affiliated with Shonan University.

Hunan Provincial People's Hospital is not an affiliated hospital of Hunan University, and it is not in the same system. It is a medical institution second only to the Hunan University system in Hunan Province.

It's normal for the two families to have friction with each other.

Even in the No. [-] Hospital of Hunan University and the No. [-] Hospital of Hunan University, it is rare to see people from the two of them sitting in the same venue at the same time and having friendly discussions on the same issue, let alone people outside the system.

Of course, this is internal, if it is external,
You say Hunan University sophomore, don't mention Hunan University, once it is mentioned, Hunan University First Attached will definitely help.

Similarly, outsiders, don't directly upgrade any hospital in Hunan Province to the provincial level.

Inside is contention, if you don't fight, you won't advance.

If you are fighting outside, then progress is slow, and that is regress.

If there is no competition, then it is impossible to outcompete others.

Although I know this, but at this time, digging a hole for the Second Hunan University Hospital is quite unkind, and this hole also involves an academician.

If it is an academician of our school, then it may be fine if you talk about it in private.

They are academicians from other schools. If this is not done well, it will affect the relationship between the two schools.

Academicians, even in the highest institutions of higher education in Huaguo——Huaqing University, Kyoto University, Huaguo Academy of Sciences University, are still treasures, and they cannot be obtained casually.

After seeing this slide, Professor Zhu's expression changed slightly, and he said immediately:
"Professor Dong, I'm just talking about the facts."

"Because no matter according to the guidelines or all the current clinical and statistical evidence, joint replacement is more suitable for patients with joint infection than joint fusion, even for joint tuberculosis."

"The suggestion given by Academician Zeng is Academician Zeng's personal idea!"

"You still haven't answered my question directly."

Professor Zhu's voice was still full of air.

But in fact, the words added later are not enough to alleviate the embarrassment of other people at present.

Dong He can naturally tell from the expressions of other people in the field that they are not very satisfied with Zhu Jinshan's answer.

So naturally, he replied very easily: "I would like to answer Professor Zhu from the following two aspects,"

"First, as I said before, before the joint fusion, we have fully explained the relevant risks and complications with the patient and his family, and the patient's family chose the joint fusion themselves."

"Secondly, we have to take into account that the patient has undergone multiple surgeries, and the economic affordability of the patient's family is limited. Under this premise, I think it is understandable that the patient would choose joint fusion once and for all."

"So, that's what we did."

Dong He didn't say a word about the academician's consultation, but only answered from the side, which seemed to give Professor Zhu Jinshan enough face.

But in fact, he just didn't want to carry the reputation of intentionally bullying others under the banner of academician consultation.

Even though, he has already done so in reality, which is the reason why he put this consultation opinion behind.

At this time, Professor Zhu Jinshan directly suffered a dumb loss.

However, just as he stopped talking, Professor Xu suddenly raised his hand.

Professor Song from the Second Hospital of Hunan University gave a lecture in person today, and Professor Xu is an old teacher at the Affiliated Hospital of Hunan University.

He was not a speaker, and had always been a spectator. At this time, he raised his hand on his own initiative.

Professor Song didn't raise his hand, it's not easy to raise his hand, because Professor Song is Professor Zhu's mentor! ! ~
A hospital, chiming in, everyone can see that there is a commotion within the family. Is this orthopedic annual meeting the words of the family?
Professor Zhu happened to have a chance to change the subject, and immediately said, "Professor Xu, please speak."

Professor Xu stood up, his body was slightly tougher than Professor Song's, and his tone of speech was also thicker:
"First of all, I'm not here to ask questions."

"Second, no matter what kind of expert or academician they are, they must have the most sufficient evidence before they can perform surgery."

"In your case, no matter what the situation is, joint cleaning and revision are the best choices. Even if Academician Zeng is standing in front of me now, that's the reason."

"Of course, this question will come to an end here for the time being! The reason why Academician Zeng made such a suggestion must be because he knows a reason, but we don't."

After Professor Xu finished speaking, he sat down.

These words directly silenced Ya Que on the scene.

If we say that among the older generation, Professor Song is a professional master!

Well, Professor Xu is absolutely second to none in Hunan Province in the academic and professional fields, and is even more important in the whole country.He used to be the closest to the Hall of Academicians.

But, close is close.

Originally, Professor Xu had a good chance of becoming an academician and becoming one of the top people in the country. However, due to other reasons, he was only nominated as an academician.

But to be reasonable, even an academician would be very polite to Mr. Xu, which is a respect for his professional and academic contributions.

Dong He could only smile wryly.

His little tricks are useless in front of Professor Xu, not to mention that Professor Xu just said such a thing, that is, he said that Academician Zeng did something wrong, so what else can Academician Zeng say after hearing it?
After all, according to the most rigorous approach, if economic factors are not considered, then what Professor Xu said is correct.

Moreover, it is still after joint fusion, and it may recur again.

Dong He's helpless expression was also in everyone's mind.

No, I just dug a hole for Professor Zhuang to jump into, and Mr. Xu immediately fished him up, and all the fire was drawn to him. I have to say, with such a treasure, it is really ahead. No matter how you do it, I feel very at ease in my heart.

It seems that there is nothing else, just bullying.

Of course, Dong He would not say these words, as did everyone else.

Professor Zhu Jinshan felt lucky to survive the catastrophe, and quickly took over the conversation: "Thank you, Professor Xu, for clarifying the confusion."

"Next, let's continue the meeting and follow the procedure. If other people have any questions, they can put it aside for a while and wait for Professor Dong to finish introducing the case first."

However, when Zhu Jinshan said this, he suddenly saw the audience, and two people stood up at the same time.

Surprisingly, it was Liu Yiping and Luo Yun, both of whom were ready to reach out for the microphone.

However, he also sat down slowly after hearing Zhu Jinshan say that he wanted Dong He to continue introducing the case!

But even though Liu Yiping and Luo Yun sat down, Zhu Jinshan still felt a little uneasy.

Who are Liu Yiping and Luo Yun?

One is the big disciple of Academician Zeng Diwei, and the other is his core disciple, the thorn you just picked?Will the big talk that old professor Xu said just now bring out something?

Zhu Jinshan looked at Dong He, and his heart began to stir——

Did Dong He know in advance that Professor Liu Yiping would come to Shashi?

Or did he know Luo Yun's true identity in advance?
Today's meeting in the second half of the second quarter, I'm afraid it won't be a good ending!

……

Zhou Cheng saw Luo Yun sitting down, and his body trembled slightly, because he had never seen Luo Yun's expression so formal before.

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(End of this chapter)