No one had heard of the disease, including Song Zimo and Dr. Kim.

Dr. King looked at him in surprise and thought to himself, this kid has read more books than my old Kim. I thought he was a surgeon, but I didn't expect the theory to be so solid. I don't have any entertainment for a day, basically read books in my spare time, Chinese and English, orthopedic monographs have been read all over, papers are refreshed every day, tracking the international frontier, and I have never heard of this disease.

He pondered Yang Ping's words, and there was indeed some truth. If there are metal plants, more or less metal ions will be released, and these ions are sent to the various joints by the blood circulation, and if the synovium is allergic to them, it is easy to produce an inflammatory reaction, which is theoretically entirely possible.

Song Zimo gently touched Yang Ping next to him with the tip of his elbow: "Senior brother is senior brother, such a desperate illness has been thought of, where did you know about this disease?"

"I forgot, I've heard someone say it." Yang Ping understated.

Director Han nodded: "Well, being able to put forward this diagnosis shows that I usually read books and study in a wide range, so you can talk about it in detail." ”

Yang Ping said: "This patient had a history of surgery for a wrist scaphoid fracture four years ago, and used two metal miniature countersunk screws, which have not been removed. The location of the disease is more consistent with the inference, first the left wrist joint, and then the other joints. The synovitis of the left wrist joint is considered to be caused by the direct release of metal ions, so it occurs earlier, while the other joints are caused by the blood spread of metal ions, which is naturally lagging behind. In addition, in terms of time, it is also inferred that the swelling and pain of many joints occurred after this surgery. I'm just speculating at the moment, and there is not enough evidence. You can try to remove the two screws to see if the symptoms will gradually reduce. ”

"Dr. Yang's opinion, I agree, remove the two screws. Even if it is not, it will not cause any adverse effects to the patient. "The opinion of the pastoral is decent.

"There are so many young men, why didn't any of them speak." Director Han said.

The usual discussion starts with junior doctors, gradually escalates, and finally Director Han concludes. But today, this case is so rare that everyone has been diagnosed with "incurable diseases", which is how disgraced and disgraced it is, so that doctors across the country are dumbfounded.

Just now, everyone was silent, and they couldn't pry their mouths open, and when Yang Ping said this, everyone's thinking was opened, although no one had heard of this disease, but Senior Brother Yang said yes, that is this disease, and the rest depends on how to verify the inference.

"Well, I agree with Senior Brother, no, Doctor Yang's opinion." Fang Yan said.

Xiao Wu also nodded: "I agree with this opinion, it seems that I can't think of anything else." ”

Zhang Lin raised his hand and pretended to be old and heavy when he spoke: "I have an immature idea, these metal ions make it metabolize itself too slowly, is it possible to use the chelating agent of metal ions to speed up the removal of metal ions, so that the symptoms can be quickly relieved." ”

Director Han praised Zhang Lin: "Very thoughtful, everyone has any ideas, put forward any ideas, make bold assumptions, and carefully verify them." ”

Zhang Lin was praised and immediately became energetic, as if he had suddenly grown a few points taller.

Song Zimo said: "You can do joint puncture, draw joint fluid to detect metal ions, see if you can detect metal ions, if you can detect metal ions, to see if it is consistent with the composition of the inner plant screw." ”

Song Zimo is still Song Zimo, although the position of the senior brother was forcibly taken away by Yang Ping, but the position of the second senior brother seems to be shaken.

"Well, this idea is very good, synovial fluid puncture and aspiration to find metal ions, this is not difficult for the laboratory department, it is really not possible, you can find the laboratory of the medical university to do it." Dr. Jin approved, he has always been optimistic about Song Zimo.

"Even if a metal ion is present, it doesn't necessarily prove that it is the cause." Tian Yuan said.

The discussion began to escalate, and Director Ouyang said: "We first solve the practical problem clinically, remove the screws, and observe whether the follow-up symptoms will gradually ease. Diagnostic treatment is clinically permitted, not to mention that it is beneficial to the patient. As for the rest, it can be studied slowly, this is really rare, and it can be studied as a subject. ”

Director Ouyang is actually quite handsome, his back is straight, like the back of a soldier standing in a military posture, and his hair is half black and white, which has become a unique charm. Dr. Jin also belongs to this lean type, and his group is in stark contrast to Director Bai's group.

Director Bai's weight of one hundred and eighty pounds was pressed on the chair, if it weren't for the fact that the quality of Corey's chair was not bad, it might be overwhelmed and fall apart, and the chief officer under him was also a heavyweight, and the two of them sat together, looking weird.

"At present, many people are studying whether metal-to-metal artificial hip joints are harmful to the human body due to the metal ions produced by friction entering the blood circulation. But the ions released by plants within metals are rarely studied, because the ions released are almost negligible. Director Bai spoke with a lot of anger.

A few years ago, one of my classmates was a visiting scholar in Europe, and mentioned that there were European doctors studying this area, but I don't remember the specifics, but I didn't see the relevant papers published. ”

Everyone is very active, you say a word, I say a word, but they are not just talking, but have a certain idea. Clinical rigorous thinking is very important, in fact, logical reasoning ability. A wise doctor diagnoses diseases like a cocoon, with a clear and logical approach.

Everyone's opinions were combined, and the outline of the idea was already relatively clear, Director Han said: "Why did you take out this case for discussion? I just want to say two words, seriously, we should take any problem seriously, don't think of a joint pain? A lot of people can't find out the cause, and after routine examination and treatment, they are discharged. The reason why Union Hospital cannot be shaken in the big brother position in the medical field is because of its rigor, and this biggest tradition has continued to this day.

The first case of AIDS in our country was diagnosed by Xiehe, and this process can be a wonderful book. At that time, everyone had never seen this disease, and they could only learn about it through literature reports, and there were no mature biological reagents for diagnosis, so it was all up to doctors to combine resources and carry out pioneering work. There are countless examples of this.

A patient with hyperthyroidism was diagnosed with advanced bone cancer in several hospitals, causing a loss of bone calcium throughout the body. The professor looked at it for a long time and said: I am inexperienced in this, and I can't draw conclusions, I have to check the information, and you don't need to register in a week, you can come directly to the outpatient clinic to find me.

At that time, the patient was angry, and he waited for a few months to wait for you This sentence: I don't know? I almost didn't get mad on the spot, and the patient dropped a sentence of Concord, and fortunately left. A week later, the patient thought about it and went to the professor anyway.

At that time, international research on hyperthyroidism bone mineral disease was just beginning, and many people did not know about this disease. After work, the professor desperately checked the information and discussed it on the phone with his colleagues at home and abroad. A week later, the diagnosis was made: it was hyperthyroidism, not bone cancer.

No matter what kind of illness this patient has in the future, he will go to Xiehe for treatment, and he would rather wait a few months to see Xiehe.

In the past, the secretary of the World Health Organization (UNICEF) visited our country and mentioned that he was born in the 30s at the Union Hospital, and as a result, the Union Hospital retrieved his birth records, and his footprints at birth were intact, and his mother's breastfeeding time several times a day was clearly recorded. What kind of rigor is this. ”

Director Han spoke earnestly and talked a little too much: "I thought that everyone thought that this case was boring and had no value in discussion, but today everyone is actively speaking, which shows that everyone is seriously thinking." It is true that this case is very rare, and an Austrian doctor has studied and published a paper, but in German, and in a nondescript medical school journal, so it is difficult for everyone to retrieve it. ”

Papers in German, everyone's eyes are generally cast on them, can this guy still read papers in German, isn't it?

"Xiao Yang, where did you see this German paper?" Director Han asked.

"I've just heard a professor talk about it before, so I'll make a note of it." Yang Ping smiled.

"No matter how you get it, it's commendable to be able to remember something so unpopular and apply it when you need it. The patient followed the process just discussed, punctured and extracted the joint fluid to find metal ions, surgically removed the screws, and explained to the patient clearly. Director Han finally concluded.

Two screws caused three years of severe synovitis in the joints of the limbs? Is it or not?

Everyone can't wait.