Gou in the operating room to add some upgrades

Chapter 234 Cognition and Knowledge Carrier

"More than 1 a year?" The child's father hesitated.

Gritting his teeth and nodding: "That's okay, Doctor Zhou, can you give me this phone number?"

After taking the child away, Fang Xian didn't ask Zhou Xiyin why he knew.

Now that I'm in the outpatient clinic, I'd better ask if I have any questions after get off work.

In the next period of time, Fang Xian discovered that there were actually not many cases of difficult and complicated diseases in Cixian County. Most of them were chronic diseases that currently had no particularly good way to deal with them in one step.

For example, fasciitis and bursitis can only be cultivated slowly.

This kind of disease is a critical disease where surgery is considered over-treatment and medication is relatively insufficient. It is difficult to find a truly appropriate solution once and for all.

If we really want to make an analogy, it can be said that a new notebook bought is in tatters. It would be too wasteful to just throw it away, and it would be embarrassing to keep it and continue to use it.

……

"Xiyin, you seem to know a lot, don't you?" Fang Xian asked Zhou Xiyin after ordering at noon.

Zhou Xiyin said to the waiter: "Boss, give us another bowl of shredded potatoes, the kind fried with sour chili. It doesn't matter if you pay more."

Zhou Xiyin's attention was not on Fang Xian.

The potatoes in Cixian County are all grown by farmers, and some are alpine potatoes. They are crispy and fragrant when fried. They have a taste that the potatoes bought in Shashi supermarkets do not have, and there are many ways to prepare them.

There are also potato slices boiled with wild shallots, which are also delicious, soft and glutinous.

"Okay beauty." The waiter nodded.

Zhou Xiyin then turned around, as if her foodie nature had been exposed, her face turned slightly red: "Senior Brother Fang, what did you just ask me?"

"What I'm asking is, Junior Sister Zhou seems to know a lot of things that are not found in documents and books." Fang Xian said.

Fang Xian's theory is not bad. Theory is a kind of cognition.

There is a blind spot that even Level 5 theory cannot reach. This is not simple.

"Oh." Zhou Xiyin suddenly realized: "Senior brother, many of the equipment I mentioned today are supporting equipment for rare diseases. The reason is that there are too few cases and there has not been a sufficient number of cases in more than ten years."

Fang Xian suddenly understood: "Are these many instruments made by Professor Zhou?"

If it has not been seen in articles, it is unlikely to appear in textbooks, let alone in the field of vision of most doctors.

For the clinical application of medical devices, management is becoming more and more stringent nowadays. It is better to avoid indiscriminate use than indiscriminate use. Strict control of access principles is the lowest level to ensure the rights and interests of patients.

It doesn't mean you can use it just because you say it is good, nor does it mean it is good just because a small number of people say it is good. It must withstand the test of data and time, and there are no problems before it can be truly used in clinical applications.

In clinical practice, it is very common for some devices to be put on hold for 20 to [-] years or even longer before being put into clinical use.

It is not uncommon for some doctors to even wait their entire lives for their students to complete a manuscript in order to study some rare diseases.

The direct contact object of medicine is human beings. Therefore, no matter how complicated the procedures or how cautious medical research is, it cannot be overstated.

Otherwise, what is the area of ​​damage caused by Sanlu milk powder?
"Hmm!~" Zhou Xiyin nodded without going too deep into the topic.

Because every time she mentioned her father, the topic would completely change. Either the other party would collapse psychologically and become passionate, or he would collapse and have nothing to say.

"Professor Zhou is really a strange person." Fang Xian said with emotion.

"Brother, do you know a saying? It is the advanced embodiment of medical technology, which is the theoretical draft. The more advanced embodiment is carried on objective objects. This is called applying what you have learned, integrating theory with practice." Zhou Xiyin said in a timely manner. Say this.

"Yes!"

"The advanced manifestation of medical technology is theory, and the higher level is carrier."

"But how can ordinary people achieve this step of theory and carrier?" Fang Xian shook his head slightly.

It is extremely difficult to develop a theory. That is to say, he is now following Professor Xu Fengnian. Under the indoctrination of his uncle, he has barely made some theoretical progress.

This is new theory and cognition, but to have a carrier of knowledge, we need to go further.

As for the most critical scalpel in surgery, what China can produce is low- to mid-range.For example, ordinary electric knife, lancet, sharp knife, etc.

For example, plasma electric knife and ultrasonic bone knife.

It cannot be produced because the technology is monopolized.

The reason why some developed countries are developed is not that they are developed now, but that they have always been developed.

It is not that one or two aspects are developed, but in all aspects, the technical level is higher than that of China. Even though China's overall strength is already very strong, we have to realize this.

"Senior Brother Fang, you also have a chance."

"Maybe you can't create, but you can push forward, use your technology to push forward." Zhou Xiyin said again, as if to comfort, but her tone and expression were serious, not like comfort.

"Advance?" Fang Xian had some questions.

"Yes, just push forward."

"Actually, for some things, it's not that it's not good enough, but that there is currently no more appropriate method to prove that it is better."

"To have such proof, there must be objective data. To obtain such data, in terms of medical technology, the number of level 5 skills is a very critical link."

"If you use different devices at the same level, which one has a better prognosis, that is better."

"In other words, if you don't need very sophisticated medical technology, you can still achieve the prognosis that sophisticated medical technology can achieve, which is better. But how to control such bias is the most fatal problem."

Bias in medical research refers to systematic errors in all aspects of research design, implementation, data processing and analysis, as well as one-sidedness in result interpretation and inference, leading to biased differences between research results and the real situation. , thereby mischaracterizing the link between exposure and disease.

It is almost impossible to completely avoid errors in research work, but for various errors that may exist in research, we must try to control and prevent them in all aspects of clinical research work to make the research conclusions more consistent with the actual situation.

In a sense, bias is an unavoidable error in sampling surveys.In other words, as long as it is sampling, bias will occur.

Accordingly, to control bias to the maximum extent, it can only be judged through multiple sampling, pre-experiments and other means.Since many surveys or experiments cannot be repeated or piloted, experience is also very important in dealing with bias.

Naturally, human bias is a factor that is difficult to control.

For a theory to be accepted, repeatability is key.Such repeatability should not be chosen by special groups, but must be repeated by everyone. It is an objective fact, which is difficult.

Fang Xian was thoughtful when he heard the words.

For a long time, Fang Xian was just trying to collect skill points and didn't think in this direction at all.

When Zhou Xiyin mentioned this, Fang Xian said: "Xiyin, what do you mean is that we already have many good products, but we can't launch them?"

Zhou Xiyin shook his head: "Senior brother, it's not that there's no way to deduce it, it's that there's no way to correct it."

"The correction here refers to upward or downward correction."

"An instrument is actually a tool, and the use of tools is our human instinct. If the use of the manufactured tool requires certain basic skills or strong basic skills, then this tool is not particularly mature. tool."

"It's just convenience, not complete convenience."

"But level 5 skills can correct the threshold for using tools, which is something that many professors cannot do."

"But Senior Brother Fang, you have a lot of level 5 skills, so you can do such a thing." Zhou Xiyin pointed out again.

"Ah?" Fang Xian looked around and didn't feel that he had an extra pair of noses and eyes than others.

Why can it be so special?

If from a technical perspective, Fang Xian's basic skills are ridiculously solid, and there is no way to outperform him in other aspects except functional reconstruction, then how can he do what others can't do? matter?
"Anyway, it's okay, senior brother."

"But now, we are coveting these longer-term things, which is a little bit out of touch with reality. I think the most suitable thing for us to promote at the moment is to find some common diseases and then simplify their surgical procedures."

"Medical technology is a kind of service. The more complex and unpredictable the better, the better. On the contrary, the more down-to-earth some operations are, the more it can serve more people."

"Simplifying complex surgical methods and achieving better therapeutic effects through simpler operating procedures is a big problem and problem we face."

"Lowering professional barriers within the profession is what many professors are doing in teaching hospitals!" Zhou Xiyin suddenly raised the topic a few degrees.

"Oh." Fang Xian nodded.

……

In the afternoon, continue the outpatient clinic.

Zhou Xiyin and Fang Xian admitted two patients who needed to be hospitalized. However, the diseases of these two patients were not complicated. One had a stiff calf and all he needed was a release surgery.

Calf stiffness is actually caused by adhesions in the muscles of the calf, resulting in loss of mobility of the ankle joint and toes, and the adhesions can be removed.

But such an operation is simple in principle. It is really difficult to loosen all the adhesion muscles. At present, according to Zhou Xiyin, such technical difficulty is no less than that of directly curing cancer. .

It is impossible to remove all adhesions and return all mobility.

This disease is not very dangerous.

But Fang Xian's current level 5 debridement and level 5 hemostasis can be applied to such difficult diseases. A professor in Australia once did a similar project to completely treat such calf muscles. The treatment recommendations for adhesions are level 5 debridement and level 4 hemostasis, which can meet relatively high requirements.

The second patient had a femoral deformity and required osteotomy and correction.

This operation is even less difficult, but in prefecture-level hospitals, basically no one dares to do it. At the Shonan University Affiliated Hospital, some professors feel that such a disease operation is not difficult and the sense of gain is not strong, so they just Do it occasionally.

The patient's family background was average and he was unwilling to go to a large provincial or municipal hospital for osteotomy or orthopedics, so he kept putting it off.

But it is inconvenient to drag and walk, and the legs with bowed femurs can walk, sit and lie the same as normal people?

The corresponding surgical procedures for these two types of diseases are relatively simple.It just so happened that Fang Xian could perform the operation through basic medical skills and basic professional skills, and it was not considered a leapfrog operation.

However, after Fang Xian sent the two patients to the ward, the doctor on duty fed the information back to Huang Bohang.

Huang Bohang immediately called Fang Xian.

"Doctor Fang, are you admitting the two patients in the department today? The prognosis of these two patients is not very good, right?"

"Doctor Fang, if you want to have surgery, how about I help you find the source of the disease?" Huang Bohang was a little scared.

In county hospitals, if the prognosis is not good, you should never undergo surgery.

If high-quality surgery is not performed, the patient's prognosis will be poor, and it is extremely easy to argue.

Although I know that Fang Xian's abilities are quite impressive, don't do harm to others.

"Director Huang, these two patients are actually fine. They are not critical diseases, and the patients' willingness to seek treatment is quite good." Fang Xian explained.

"Dr. Fang, it's not a matter of willingness to seek treatment, it's a matter of our hospital not being able to perform such an operation."

"It's not particularly difficult to talk about release surgery and osteotomy and orthopedics, but what are the prognosis of these two surgeries?" Huang Bohang felt that he had made it clear enough.

"Personally, I still think that we can just perform minor surgeries such as fractures and debridement routinely. There is no need to spend a lot of time."

"Otherwise, you have already performed all the surgeries when you arrived. Once you leave, it will be difficult for us to explain to patients again. Don't you think so?" Huang Bohang still spoke very politely.

Fang Xian worked for a few months and was able to leave with a pat on the back. But if a similar patient comes in the future, Huang Bohang and others will say that they can't do it anymore. Then they will have to waste more words, and the patient may even greet him with foul language. people.

Fang Xian pondered for a moment, and then said: "Director Huang, release surgery is a type of debridement, and bone deformity osteotomy and correction are actually a variant of internal fixation of fractures. Isn't this operation difficult?"

"I think Director Huang and Director Qin can get it quickly."

"Doctor Fang, that's what you said, but what are our basic skills?"

"You don't need to be very proficient in debridement and fracture internal fixation. Director Huang, how about we try to do a few first? If you feel that it is still difficult to do it regularly in the future, we will stop it."

"Is this okay?" Fang Xian retreated.

After visiting the county hospital for a while, Fang Xian understood how difficult it was.

But Fang Xian had already spoken to such an extent. If Huang Bohang still tried to push back, Fang Xian had to suspect that Huang Bohang positioned himself in the county hospital as a dawdling worker.

"Dr. Fang, are you kidding me? How could we perform such a difficult operation?" Huang Bohang's expression still made him feel very embarrassed.

(End of this chapter)