Knee synovial chondromatosis has seen a lot, so many rare.

Xiao Wu took off the film, so as not to make the fearful person feel uncomfortable again, and he admitted the patient to the hospital to improve the preoperative examination and surgical arrangements.

Yang Ping continued to study the puncture of patients in Huaqiaolou, and repeatedly simulated the puncture with the help of the images constructed in his mind to adjust the angle of the puncture in order to hit it with one blow.

Song Zimo didn't rest at noon, stayed in the laboratory to practice arthroscopy, lunch was given to him by Tang Fei from the cafeteria, he ate in the dining room of the department, and continued to practice in the afternoon.

It is said that in the past at the trauma and orthopedic department, as long as there was nothing special, he practiced until after 10 o'clock, and sometimes until 12 o'clock.

The CT and MRI three-dimensional reconstruction of the patients in Huaqiao Building has been completed, and the thin-slice scan, the reconstruction effect is very clear, Director Han compared Yang Ping's painting with the reconstructed image on the electronic reader, the spatial structure is almost not much different, and Yang Ping's picture is more expressive.

Director Han looked at the time, it was already half past four, put down the matter at hand, and took Yang Ping to the Overseas Chinese Building to attend the conference consultation.

In the conference room of the Department of Internal Medicine of the Overseas Chinese Building, several directors had already arrived, and Director Zhao of the Medical Department had also arrived, and everyone gathered around the oval table to discuss Mr. Ning's condition privately in advance.

Director Kong beckoned Director Han and Yang Ping to sit down, and each seat on the table was placed with a high-definition tablet, which is the terminal of the mobile medical record system, on which the patient's medical records and auxiliary examination results can be accessed, and the screen resolution of the tablet is much higher than that of the ordinary one, just to be able to see the details of the image clearly.

Director Kong's phone did not stop, and people came in one after another, the major directors of the hospital, several professors from outside the hospital, and Director Zhuang of the Department of Internal Medicine also came to help accompany the experts from the outer hospital.

"This is the Second Attached Hospital--"

"This is the attached courtyard--"

"This is the cancer hospital's--"

Several directors came over and took their seats one by one, Director Kong and Director Zhuang were at ease, properly arranged, without a trace of neglect and omission, the brothers of the Overseas Chinese Building can be regarded as characters on the scene.

Naturally, the consultation has to see the patient, and some people have proposed to see the patient first, Director Kong took someone to the ward to see the patient, and Director Zhuang helped to accompany the guest.

Everyone uses this time to catch up, these experts are usually familiar with the relevant specialist directors of Sanbo Hospital, and often get together for meetings, and some of them are brothers.

Usually busy, it is rare to meet, except for the academic meeting, it is this kind of general consultation meeting, chat a few words, and talk about their recent situation.

Only Professor Su Qingyun has not yet arrived, he is the main expert of this meeting, although the patient is liver cancer, but the problem to be solved now is caused by spinal metastases, Su Qingyun is the chairman of the orthopedic department of Nandu Province, and he is a popular candidate for academicians, so he is naturally the most heavyweight expert in this consultation, and the meeting was postponed from three to five o'clock to wait for him.

Su Qingyun is still the dean of the first annex, he is busy with affairs, he can take the time to come, he is already very face-saving, everyone privately discusses where this patient is sacred, and invited Professor Su to come forward in person, usually some consultations in other hospitals, even if he is invited, students are sent to participate.

There are still a few minutes left, and Professor Su has not yet appeared. Yang Ping had seen Professor Su before, and the Municipal People's Hospital had an academic meeting, and Professor Su had been there, but it was seen from a distance, not as close as it is now.

Professor Su has published more than a dozen articles in top international orthopedic journals such as AJAM and **JS, with a very high impact factor, so it is at the peak level in China and has a place in the world.

Some people raised their wrists to look at their watches, others looked at the door, and some people exchanged heads and ears, but they all waited patiently.

"Wait and speak boldly, you don't have to be stage frightened, academic things, one is one, two is two, there is nothing to be humble." Director Han explained to Yang Ping in a low voice.

At five o'clock, Professor Su, under the guidance of Director Kong, came in, followed by a young doctor, who looked very similar to Professor Su.

As soon as Professor Su came in, he greeted everyone with a smile: "Sorry! You've been waiting for a long time! ”

Actually, he wasn't late, he just came in on the hour, but the others came early.

Professor Su is in his fifties, not old at all, wearing glasses, wearing a Mao suit, with a white shirt inside, elegant temperament, everyone's demeanor, strong aura comes from the precipitation of long-term academic positions.

Everyone stepped forward to shake hands with him, and when he shook hands with Director Han, Professor Su stayed longer: "Brother Han, I haven't seen you for a long time. ”

Seeing Yang Ping beside Director Han, Professor Su asked, "Who is this?" ”

"Dr. Yang, my student!" Director Han introduced.

Yang Ping shook hands with Professor Su.

"Young people have an extraordinary temperament, Professor Han's vision is famously poisonous, and he has not recruited doctors for many years, but he would rather lack than abuse, and it seems that he has picked good seedlings." Professor Su said with a smile.

"This is Dr. Sue!" Director Han introduced the young man next to Professor Su.

"Su Nanchen!" The young man next to Professor Su shook hands with Yang Ping.

"Yang Ping!" Yang Ping could feel his confidence and calmness.

When Director Han was in the magic capital before, he and Professor Su were both outstanding figures of the young generation of orthopedics, but Director Han went from the magic capital to Sanbo in the southern capital, and he wanted to start a new business, so naturally he could not be compared with Professor Su academically, but the foundation was still there.

The two sympathized with each other, exchanged a few words, and then sat down.

"That's Professor Su's son, a graduate of the eight-year program of Concord, with a young talent in orthopedics, who studied at the Minnesota Twin Cities Spine Center and the New York Special Surgery Hospital after graduation. Golden Knife Award Southern Division, he will be your strong opponent; In the national division, he is a rare super strong opponent, and he is also an all-rounder. Director Han attached himself to Yang Ping's ear and said.

Tiger father has no dog, this Dr. Su is not only a talent, but also graduated from the eight-year system of Concord, the difficulty of the eight-year examination of Concord is no worse than that of Tsinghua University, and those who can be admitted are basically academic overlords, the top few in the provincial college entrance examination.

Professor Su must have high hopes for his son, otherwise he would have taken this kind of meeting with him, and to bring him with him would be to let him see the world, participate in more exchanges, and even help him build his reputation and network.

Everyone sat down, the consultation began, Director Zhao presided, and the doctor in charge of the bed reported the medical records.

After the medical record was reported, Director Kong added: "Dear experts, Dear Professor Su, today I would like to take time out of your busy schedule for consultation, the problem that this patient needs to solve is severe pain in the chest, thank you!" ”

"Let's take a look at the patient first? Isn't it convenient? Professor Su proposed.

Director Kong took everyone to the ward to see the patient, Professor Su personally asked about the medical history and physical examination, and other professors also selectively asked about the medical history and physical examination according to their own needs.

After seeing the patients, everyone washed their hands and returned to the conference room.

Director Xu of Sanbo Pain Department spoke first: "This patient, admitted to the hospital the day before yesterday, from admission to the present, the pain treatment has been followed up by us, according to the ladder principle of tumor analgesia, this patient has been using morphine for three months, this hospitalization, morphine used to the extreme, 30 mg times, two days, but can only solve the pain in the liver area, the pain in the chest is still intense, after admission to the hospital did a comprehensive examination, ruled out the chest pain caused by the heart, lungs and aorta, etc., according to the nerve positioning, According to CT and magnetic resonance images, the thoracic 2 nerve root was violated and compressed, so we thought it was caused by the thoracic 2 nerve root, but unfortunately, neuraxial anesthesia and analgesia could not be performed here, and once respiratory depression was caused, the consequences were serious, so we encountered difficulties and needed your help. ”

"Have you considered the use of an implantable analgesic pump, implanted into the spinal canal, with morphine as the main drug of the analgesic pump formulation, and released regularly, so that it can not only analgesia, but also will not cause anesthesia in the plane and will not affect breathing." The director of the pain department of the second attached pair said.

After the director of the second attachment finished speaking, the director of the pain department of the attached one said: "Neuraxial implantable analgesic pump is also unrealistic, the suppression of pain in the liver area has been used to the extreme amount of morphine, this kind of radicular pain, according to our experience, morphine is almost ineffective, in the lower plane before, we have used, if the nerve root is healthy, there is no tumor invasion, there is an effect, this kind of tumor tissue has invaded and stretched, morphine is ineffective, and anesthetic drugs must be used for nerve block." ”

The director of the pain department attached to the second has a different opinion: "The difficulty of nerve block is too high, there is almost no feasibility, usually our nerve block is around the sheath, even if it is punctured into the sheath, there will be anesthetic leakage, this kind of block, we must ensure that all the anesthetic is in the nerve sheath and cannot leak out, otherwise it will cause anesthesia in the plane and inhibit breathing, and we can only use a ventilator to assist breathing." ”

After a short silence, the professor from the cancer hospital spoke: "Do you consider limited surgery, do not move other places, enter from the back route, and only remove the tumor tissue that compresses and invades the nerve root, release the compression, liberate the nerve root, and the pain will be eliminated naturally." ”

"The family refuses surgery, even if it is limited!" Director Kong explained.

"We don't want to have surgery, but we have to solve the problem, and this is a problem for us." The director of the orthopedic department of the second attached said.

The orthopedics department of the second attached is the second in Nandu Province, and the orthopedics of the attached one and the second are on the same table a long time ago, since Professor Su Qingyun became the director of the orthopedic department, the orthopedics department of the attached one has begun to take the lead, from pressing to throwing away.

Symbolizing the highest risk surgery in orthopedics, scoliosis orthopedics, the annual volume of surgery in Appendix 1 is more than 300, which is in the first echelon in the country, while Appendix 2 is only close to 100 units, which is in the second echelon.

For bone tumors, Appendix 1 has an independent large-scale bone tumor ward, while Appendix 2 does not have an independent large-scale bone tumor ward temporarily.

So naturally, the second orthopedic department is willing to bow down and regard the attached one as the big brother.

Neuraxial analgesia is not available, nerve block is not feasible, and the family refuses to operate.

Can't go on with this discussion?

The discussion fell silent again.