MTL - Doctor Chen, Don’t Be a Coward!-Chapter 301 System Upgrade

  Chapter 301 System Upgrade

   For surgery, there is a situation called "perfect operation state".

  What is the perfect surgical state?

  For example, cholecystectomy, in general, cholecystectomy is not a big problem, but because of recurrent cholecystitis and the existence of special circumstances, there will be a large area of ​​adhesion in the gallbladder triangle area.

  This will make the entire triangular area a mass of paste, how to separate the gallbladder triangle, how to take out the gallbladder, how to separate the adhesion relationship between the gallbladder and other tissues...

wait!

  These are the key factors that increase the risk of surgery, change the operation process, and even increase the difficulty of surgery proportionally!

   Likewise...

  Orthopedic surgery is no exception, especially surgery related to fractures in the joint area.

Ankle joint fractures will lead to chaos in the joint cavity, such as tense tendons, limiting the surgical area, first incision and then repair, such as large-scale entanglement of ligaments, falling into bone cracks, such as damage to blood vessels and nerves or changes in anatomy structure etc...

  Any accident will make the operation more difficult. The operation itself is a process of destruction and correction.

  Any damaged soft tissue needs to face a repair process after surgery.

  So the speed of recovery, the degree of recovery, and whether the recovery level reaches the expected value all have a lot to do with the degree of damage to the patient's fracture area!

  The so-called perfect state means that during the operation, for the tissues and blood vessels and nerves that do not need to be treated, there is no need to perform too much intervention, and the damaged tissue is simply repaired and removed. This is the perfect state!

Performing surgery in a perfect state, several articles have been reported in the foreign journal "The Lancet", which is about good perioperative management, allowing patients to perform surgical repairs in a perfect state, and in a perfect state of surgery, the patient's prognosis, There will be a significant improvement in recovery and later stages!

  So, in recent years, the further research on surgery is often a discussion on how to make patients perform perfect surgery in the perioperative period.

  For example, why are you not allowed to eat during gastroscopy surgery? After eating, you can’t see the condition of the gastric mucosa clearly, so you are not allowed to wash it? Will the difficulty of surgery increase?

  One truth!

   And at this very moment!

  Luo Qiping, Meng Si, Li Ke and others looked at Zhang Xiao's damaged joint area, and were silent for a while.

   Everyone stared at the scene in front of them dumbfounded, a little unbelievable!

   "This...is this...perfect surgery state?"

   "But...how is it possible?!"

   Li Ke couldn't help saying something excitedly!

  Accompanied by his words, several people around, no matter what master's or doctoral tutor or expert professor, all became excited.

   You know, everyone knows what Zhang Xiao's situation was like before.

  How could it be possible to present the situation of perfect operation? !

  However, the facts are right in front of you, what can you question?

  Perfect operation status is directly related to the postoperative recovery of the patient and the recovery of the patient!

   Meng Si also nodded excitedly: "Yes!"

   "This is the state of perfect surgery!"

   "Director Chen, you... you are really amazing!"

  Luo Qiping's face turned red, his eyes were fixed on the patient's ankle joint capsule, and there was also some excitement in his eyes.

  He, Luo Qiping, as a leader in the field of orthopedics, naturally quickly thought of the relationship between Chen Nan's previous manipulation reset and the perfect operation state at this time!

   What an amazing young man!

  I still underestimated this young man... really amazing.

   Manual reset is manual reset.

  Perfect state of surgery is perfect state of surgery.

  However, Chen Nan used manipulative reset techniques to properly combine the perfect surgical state in modern surgical theory with an ingenious combination of traditional Chinese medicine bone setting techniques to achieve such an amazing picture!

   This is just... amazing!

  He, Luo Qiping, feels that he has lived with dogs for so many years. He has been engaged in orthopedic research and clinical work for decades, and he has a deep understanding of bone marrow.

  But... why didn't I have such an idea?

  By combining bone setting techniques with reduction techniques, patients can achieve perfect surgical conditions before surgery. Isn’t this what I pursue? !

  One time!

  Luo Qiping was very excited.

  Because he seems to have found the secret to success.

   This is a feasible and promising road!

  Western medicine can also set bones, but... how can their three-legged cat kung fu understand the essence of our rubbing, pinching, touching, kneading, pinching and pressing?

  Let’s not talk about it too far, just using this kind of energy can stump a group of people!

  The more Luo Qiping thought about it, the more excited he became!

but…

  When he saw the patient's condition, he suddenly frowned.

  Because he found that when the joint capsule was exposed, the posterior tibial blood vessels and nerve bundles were well preserved, and the anatomical distance was good.

this…

  He suddenly recalled Chen Nan's previous method of reset...

   Immediately!

   He finally understood.

I see.

   You must know that in ankle joint surgery, there are two very important and difficult points to pay attention to.

  First: When exposing the joint capsule, do not damage the posterior tibial blood vessels and nerve bundles!

  Second: It is accompanied by damage to the anterior tibial talar ligament and the anterior and posterior tibiofibular ligaments, requiring primary repair.

  But there is no such picture in Zhang Xiao's joint capsule area at this time.

  This is a bit powerful!

  Luo Qiping finally realized at this time that this perfect surgical state was not because he couldn't think of it...

   But can't do it!

  If you want to maintain such tension and position of the posterior tibial blood vessels and nerve bundles in the joint capsule area, the technique...is not easy.

   What is needed is no longer pure smoothness and softness, but a combined strength.

   Only in this way can the positions of the posterior tibial blood vessels and nerve bundles be adjusted at the same time without the anterior and posterior ligaments being damaged!

  This is strength!

  For so many years, I have never been able to achieve such a perfect surgical state for patients through manual reduction.

   Amazing!

  Luo Qiping nodded and said, "Director Chen, it's really...remarkable!"

   "It's the first time we met, you really gave us all a big blow!"

   "Long experience!"

   "Luo has really learned a lot!"

   "Everyone should take a look, this is the real way to reset the fuck."

   "No, to be precise, this is a modern traditional Chinese medicine reset that combines modern anatomy and surgery!"

   "Everyone, take a good look and study hard!"

   "The opportunity is too difficult!"

   "Director Chen, you have to forgive my negligence for not greeting you properly!"

   "Don't worry, I don't know what to do with the other departments. In the orthopedics department, I absolutely support you to become the deputy director of the ward!"

  Chen Nan heard the sound and smiled: "Director Luo is serious!"

   "Don't worry about it, everyone."

  Meng Si smiled: "Director Chen, you are too modest, but you are proud!"

   "Your strength, we recognize!"

   "In our hospital, or in our ward, nothing else is easy to use. Nothing can compare to real kung fu!"

   "For you, we are all convinced!"

   Li Ke and others nodded in agreement: "Yes!"

   "Director Chen, you are really skilled! Let me... increase my knowledge!"

  Chen Nan smiled: "Nothing!"

"real!"

   "It's just a little trick!"

   "Didn't I teach you? You can learn it too!"

   "Really trivial."

  As soon as these words came out, a group of experts and professors in the operating room were all speechless.

this…

   Just finished saying that your excessive modesty is pride.

   You just said this is a trick! ?

  Luo Qiping blushed, you are playing tricks, what am I?

  But... Thinking about it carefully, Chen Nan really taught everyone everything without reservation.

  You can't refute yet!

  This kid... is interesting...

  Listening to everyone talking and laughing, Zhang Xiao on the operating table was a little confused.

   Or panic!

  He even regrets it now, is it too late to say general anesthesia?

  I'm **** lying on the hospital bed, you... respect me a little, please?

It is said that... those doctors like to chat during the operation. One of his seniors had an operation last year. He said that when the group of doctors operated on him, they discussed which restaurant to eat hot pot at night, and they also talked about... what kind of hind legs to eat, and they also talked about lamb bones. Something... He shuddered when he heard it.

  At this moment, Zhang Xiao really felt the slightest empathy.

  He couldn't help but said, "This... Excuse me!"

   "Am I… serious?"

   "Director Luo, Director Chen."

  Luo Qiping suddenly laughed: "Seriously?"

   "Zhang Xiao, if you ask me, you have to thank Director Chen very much."

   "I can tell you responsibly, you can resume training in less than two months!"

   "And, your physical fitness, your athletic ability, will never be compromised!"

   "Director Chen's method just now solved many problems!"

  Zhang Xiao couldn't understand the techniques and joint capsules, but he understood the previous sentence, which means...he can recover better?

  Won't affect training, let alone cause damage to your athletic ability?

  Is this...real or not?

  Zhang Xiao couldn't help getting excited: "Really?"

  Hearing Zhang Xiao's question, everyone couldn't help laughing.

  Luo Qiping even smiled and said, "Can I still joke with you?"

"hehe!"

"real!"

"believe us!"

   After speaking, Luo Qiping said to Meng Si and Li Ke beside him: "Okay, you two, get ready to start!"

   Meng Si quickly nodded and smiled: "To be honest...I can't wait!"

   "It's like seeing a plate of braised pig's trotters when someone has been hungry for days!"

  Zhang Xiao: "???"

  I'm still awake, brother!

   Can you consider how I feel?

   Is it a little... a little bit too much? !

   While speaking, everyone was preparing for the operation.

   At the side, Sha Guangzhong finally had time to observe the patient's reaction to anesthesia.

  He wanted to see how the acupuncture anesthesia works.

  If this...can relieve pain while not having so many side effects of anesthetics, if it is stable and long-lasting, this...is not ordinary!

  After surgery begins.

   Along with incision of the joint capsule, observation and inspection of the soft tissue and fractured ankle.

  Zhang Xiao didn't show the pain he should have. On the contrary, the patient's reaction was comparable to that of spinal anesthesia.

  Sha Guangzhong couldn't help looking at Chen Nan who was observing the operation, and asked with a smile:

   "This... Director Chen, hello, I am Sha Guangzhong, the director of the anesthesiology department in our ward."

  Chen Nan turned around and looked at Director Sha who was wrinkled when he smiled, and smiled: "Director Sha, hello."

  Sha Guangzhong smiled slightly: "This...Director Chen, I have also studied acupuncture anesthesia."

   "However, it really can't achieve your effect!"

   "How do you do different levels of anesthesia and pain relief?"

  Chen Nan said with a smile: "Different acupuncture points have different effects, and for the anesthesia of the lower extremity joint area, there are actually not many acupuncture points."

   "After the operation is over, I will sort it out and send it to you."

   "Let's go back and think about it together."

   "After all, I am from Yeluzi, and many things are not very systematic."

  When Sha Guangzhong heard this, he quickly waved his hands: "Director Chen, you don't need to be modest!"

   "You are a dragon crossing the river, and a tiger descending the mountain. You are so tight!"

   "To be honest, Director Luo rarely gives such a high evaluation."

   "Don't be modest."

   "I have a lot of questions here, and I want to consult."

   "I just noticed that you adjust the waveform, wave width, frequency, intensity, and combination of electroacupuncture, which seem to be different from ours."

   "Is this different for the effect of anesthesia?"

  Chen Nan took a good look at Sha Guangzhong, and the other party observed him quite carefully.

  He nodded and agreed: "That's right, for acupuncture anesthesia, I usually use high frequency (40-200HZ) at the incision point and low frequency (2-8HZ) at distant point."

  Sha Guangzhong heard the sound and nodded thoughtfully: "This should be the reason why the muscles are completely loosened!"

   "The high-frequency waveform, frequency, and intensity will strengthen the stimulation of acupuncture points, and at the same time help the secretion of neurotransmitters to speed up, making the suppression of the central nervous system more obvious."

   "The remote assistance is to help the surrounding organs and tissues not be involved!"

   "This is a good way!"

   "However... I have a question, Director Chen, how did you manage to stimulate the organization's multi-layered and multi-directional damage?"

   "This is something I have never understood!"

   "I am an anesthesiologist. In order to learn this acupuncture, I also worshiped a teacher and studied it for more than ten years."

   "Since the establishment of our integrated traditional Chinese and Western medicine ward, I came here and started to learn acupuncture."

   "Hey... It's been a long time since I can't get the practice, I'm a little anxious!"

   "When I have time, I have to ask for advice."

   Chen Nan smiled and nodded: "Yes!"

   "Mutual communication and learning."

  The operation process was very fast, and there was not much to deal with. After repairing the patient's talofibular ligament and deltoid ligament, the fracture was fixed with intramedullary ankle screws.

  The materials selected are also excellent, in order to avoid secondary damage in the later stage.

  This is good news for athletes.

   The operation didn't last long, it was over!

  At this time, Zhang Xiao really wanted to ask several directors how the operation effect was.

  He looked at Meng Si with unsatisfactory eyes, somewhat uneasy.

  He was about to speak.

  Luo Qiping spoke suddenly. He looked at Chen Nan and asked, "Director Chen, how long will this anesthesia effect last?"

   "I don't know if it hurts after taking the needle?"

   "This patient has just had surgery, so it will take some time to get used to it."

  Chen Nan smiled slightly: "No."

   "The acupuncture anesthesia I used just now is actually not a simple anesthesia."

   "It's the method of acupuncture anesthesia combined with acupuncture analgesia during surgery."

   "The purpose is to avoid the occurrence of intolerance to wound pain after surgery."

   "Take the needle, it will be done right away."

   "After the needle is removed, the patient's pain will not be obvious."

   "Of course, the feeling of the lower limbs exists, but it only limits the intensity of the pain."

   "I'm taking the needle now, everyone can see the patient's condition."

   Meng Si glanced at Li Ke, and both of them saw each other's thoughts from each other's eyes.

   I can't stop thinking about it!

  They want to do a few more surgeries of this kind.

After all, the allure of a perfect surgical condition to a surgeon is like a gourmet’s appetite for gourmet food. .

   At this time, when they heard the news that Chen Nan had taken the needle, they were stunned for a moment!

   Meng Si said in disbelief: "To be honest, I am not a patient who has never tried acupuncture anesthesia."

   "But... I'm telling the truth, during the operation just now, I forgot that it was acupuncture anesthesia!"

   "The patient's response is not at all, the anesthesia effect is very good, and the response to all organizational levels is very good!"

   "If Director Chen hadn't mentioned acupuncture anesthesia just now, I almost forgot about it!"

"Hey…"

   "This acupuncture anesthesia, the effect is really good!"

   Li Ke nodded in agreement: "That's right, the effect of anesthesia is not inferior to spinal anesthesia at all."

   "Director Chen, it really opened our eyes!"

  Sha Guangzhong said with a smile: "Yes, I will definitely give this anesthesia effect a thumbs up!"

  Luo Qiping originally admired and admired Chen Nan very much, but... now seeing the faces of the people around him who had never seen the world, he felt a little more embarrassed.

   These bastards!

   Do you want to act like a country bumpkin?

   You are the pillars of the China-Japan Friendship Hospital, okay?

  You are the future of the integrated traditional Chinese and Western medicine ward, understand? !

   Look at yourselves now?

  Luo Qiping wished he could **** and show these people what he looked like at this moment!

  Shame!

   Phew!

  At this time, Zhang Xiao saw that everyone was silent, and was plucking up the courage to ask questions.

  Luo Qiping interrupted again.

   "Get the needle."

   Zhang Xiao was held back again when the words came to his lips.

  Chen Nan nodded with a smile, and said, "You are welcome, let's see the effect."

   "Actually, my understanding of acupuncture and moxibustion anesthesia for surgical anesthesia is divided into long-acting analgesia and short-acting analgesia."

   "Short-acting analgesia is to strengthen acupoint stimulation, so that patients will not have too much pain response during surgery."

   "The long-term mechanism is to choose an analgesic method to reduce the pain."

   While speaking, Chen Nan turned off the power of the electroacupuncture, and then began to take the needles one by one.

  When all acupuncture needles are taken out.

  Chen Nan nodded to Meng Si: "Director Meng, try it."

   Meng Si heard the sound, eager to try, nodded quickly, and gently touched the patient's ankle area with his fingers.

  Zhang Xiao closed his eyes.

  He understood now.

  Myself...is superfluous!

  Happiness belongs to them, excitement belongs to you, and I am just a tool for your happiness...

  At this moment, he wished he could pick up an iron block and smash his other ankle, making them worry about him.

  You...you don't see me as a patient at all, okay?

indeed!

  When the operation goes well and there are no twists and turns, the doctor is very happy in the operating room.

  If the doctor becomes serious and the atmosphere is serious, it can only explain one problem, this operation may be... dangerous.

  Zhang Xiao closed his eyes and ignored the group of people.

   Meng Si gently touched Zhang Xiao's wound with tweezers: "Does it hurt?"

  Zhang Xiao closed his eyes and remained silent.

  He didn't realize that the other party was talking to himself.

  When Meng Si saw this, he was stunned. Several people around him also looked at Zhang Xiao curiously, and then looked at Meng Si.

   "Are you touching?"

  Meng Si was helpless: "I touched it!"

  Luo Qiping rolled his eyes when he saw this, "Give it to me!"

   While speaking, I touched myself.

  Zhang Xiao: Close your eyes, don't disturb.

   Meng Si looked at Zhang Xiao at this moment, and asked, "Zhang Xiao, do you hurt?"

  Zhang Xiao quickly opened his eyes and looked at the people excitedly. Did you finally think of me?

   "I... hurt? Where does it hurt?"

   Mengs: "…"

  People around: "..."

  Meng Si: "I said, does your ankle hurt?"

  Zhang Xiao froze for a moment: "It doesn't hurt, why does it hurt?"

  Luo Qiping's eyes widened suddenly. It's over. Could it be...Acupuncture anesthesia also has an expiration date?

  Need to wait for the anesthetic to wear off?

  Chen Nan said at this time: "Use some strength!"

  Luo Qiping nodded and tried a little harder.

   "Oh, I feel it!" Zhang Xiao said quickly, "But...it's not very painful, it's just...the feeling of numbness."

  Luo Qiping breathed a sigh of relief: "Oh!"

"it is good!"

   "Okay, let's send the patient away."

   "Go back and have a good rest."

"Nurse."

  The nurse nodded quickly, and everyone moved Zhang Xiao to the hospital bed, about to be transferred.

   And Zhang Xiao quickly said: "Wait!"

   "Did my operation go well?!"

  If he doesn't ask any more questions now, he will go back to the ward soon.

  This damn... a surgery, I have no right to speak.

  When everyone heard the sound, they were stunned for a moment, then looked at each other, and then laughed hahaha.

   Zhang Xiao was at a loss!

  I...I asked this question, is it very 2?

  What are you laughing at?

  Meng Si said with a smile at this time: "Okay, don't worry, it's a success!"

   "The operation went well!"

   "Take good care of yourself."

   "Nurse, push away."

  Zhang Xiao was numb, just watching himself being pushed away.

That's it?

  The joys and sorrows of human beings are not interlinked...

  …

  …

  After returning to the ward, Chen Nan suddenly became a favorite.

  Luo Qiping asked Li Ke to prepare the patient's VAS score and test the patient's recovery in three days.

   Then he said to Chen Nan: "Director Chen, I really trouble you today!"

  Chen Nan smiled: "Director Luo, you already call me Director Chen, isn't this my job?"

  Luo Qiping smiled slightly: "Hehe, yes!"

   "It makes sense."

   "By the way... It's still the same thing, do you have a department you want to go to, let's discuss it in the afternoon."

   Chen Nan listened to Luo Qiping's words, thought for a while and said, "Forget it, let's talk about it tomorrow."

  Luo Qiping immediately became curious when he heard the sound.

   After all, now that I have offered to help Chen Nanlai settle the situation, is he not in a hurry?

   You can’t really have a title without actual work, can you?

  Could it be...Chen Nan wants to work in orthopedics?

  Thinking of this, Luo Qiping's eyes lit up, it should be like this...

   After all, the work that Chen Nan has carried out since he arrived today has already been approved by everyone.

  Here is undoubtedly the best place to work.

But…

  Luo Qiping actually has his own scruples. If Chen Nan goes to the orthopedics department, the work in this ward will still have a lot of internal medicine and massage and acupuncture, which is a bit inappropriate.

   "Director Chen, I am straightforward, and you are also quick to talk, so let's stop playing around. What do you think, tell me?"

   "Or, which department do you prefer to go to and which department are you good at?"

  Chen Nan smiled: "Director Luo, I appreciate your kindness."

   "I know what you mean."

   "However... as you said before, the three generations of old, middle-aged and young people in each department are very stable, and the structure of the department is also good."

   "After I went there, I undoubtedly destroyed this chemical reaction."

   "Of course I didn't come here to cause trouble."

  When Luo Qiping heard this, he immediately shook his head: "Director Chen, what you're talking about..."

  Chen Nan waved his hand and continued:

   "I was thinking, since the internal medicine department has a lot of opinions on my arrival, I will not please after I go now."

   "Everyone's work, after all, should be on business, not on intrigue."

   "So, my idea is, don't schedule work for now."

   "Just be the deputy director of this special ward."

   "I also looked at the nine departments. There are five internal medicine departments in total, including pulmonary disease, cardiology, spleen and stomach, gynecology, and medical oncology."

   "I don't know the situation of each department, so I went there rashly, it's inappropriate!"

   "What I think is, I will be the deputy director of this ward, and then participate in the big rounds of each department."

   "In this process, I think it is more appropriate."

   "I can not only participate in the department, but also understand the department."

   "Slowly, blend in again."

   "To tell you the truth, when I was down below, I was always in charge of the work of the Department of Traditional Chinese Medicine, and I rarely looked at problems from an outside perspective."

   "It's just right. When I come here, I will stand in the position of deputy director of the integrated traditional Chinese and Western medicine ward and look at each department."

   "Of course, surgery, I naturally want to learn about it, but... for now, I still want to focus on internal medicine."

   "Let me relieve some stress!"

  Luo Qiping stared at Chen Nan, knowing that the other party was telling the truth, but... because of this, his evaluation of Chen Nan suddenly increased a lot.

   This is a young man who understands the overall situation.

  You can't use age to speculate on his ability.

  And... just as Chen Nan said, from different perspectives, the way of looking at and thinking about the problem and the starting point are different.

   It's just... he has a doubt.

   That means Chen Nan can solve these problems well?

   You know, these departments all have something they are good at. Chen Nan is like this... It is undoubtedly a test!

   "Director Chen...do you want to come one by one?"

   "Otherwise, this... involves so many departments, doesn't it..."

  Chen Nan smiled: "Director Luo, don't worry about this."

   "Since I dare to come, I am ready."

   "Don't worry!"

  Luo Qiping nodded and laughed, this is really...not that the Raptors can't cross the river!

"it is good!"

   "Spine!"

   "I like you!"

   "Well, since you just came here, I'll call a few friends in the evening, and we'll sit down together. After all, we'll all be colleagues from now on."

  Chen Nan smiled: "Then I will go with my mouth and stomach!"

  Luo Qiping was immediately happy: "Good!"

   "Just bring your stomach and mouth!"

  …

   On the same day, the news reported by Chen Nanlai spread to all departments in the integrated traditional Chinese and Western medicine ward.

  The major directors also know that the deputy director of the ward is here.

  For a while, everyone's minds were very complicated.

   But that night, Chen Nan received a system notification tone.

【Ding! Trigger the system upgrade task! 】

  【You successfully took office as the deputy director of the integrated traditional Chinese and Western medicine ward of the China-Japan Friendship Hospital, triggering the system upgrade task: a blockbuster! 】

  【Task Requirement: Newcomer, starting today, use your strength to prove yourself, within three days, complete the blockbuster. 】

  【After the task is completed, the system will be officially upgraded and a new section will be opened. 】

  Chen Nan was stunned!

  Is the system upgraded? !

  This...is a bit sudden.

  A blockbuster...how amazing?

  Chen Nan couldn't help thinking.

  …

  ps: Thanks to the leader of the leader for "regardless of it and ignore it" for the heroic reward of 15,000, thank you brother.

  Thanks to the old friend "Junren" for the heroic reward of 1500, thank you.

  Thank you for your support. The new map will be written well. In fact... the protagonist in the source city is already tied up. This map will be more exciting and written more thoroughly.

  (end of this chapter)