Zhang Zhe's child is actually chronic osteomyelitis, chronic osteomyelitis does not need pathological examination to confirm the diagnosis, and the diagnosis can be confirmed based on medical history, physical examination and imaging examination.

It's just that any organ and tissue that is cut out during surgery should be examined for pathology, which is a medical practice.

Song Zimo just took this opportunity to study the pathological manifestations of this rare focal chronic osteomyelitis, and also to see if the surgery really completely removed the lesion.

To this end, Song Zimo asked the pathology department to help and made dozens of pathological sections from the entire bone plug removed, so that the entire bone plug could be carefully observed.

Pathological sections are presented under the microscope and in a sandwich of concentric circles under low magnification, with necrotic bone in the center, infected bone tissue around necrotic bone, and normal bone tissue in the outermost circle.

Under high magnification, the field of view is like an abstract picture, and a small number of infiltrated lymphocytes can be seen in the necrotic and infected bone tissue, while normal bone tissue has no lymphocytes.

Judging from these dozens of pathological sections, each one is similar to a sandwich structure, that is, Yang Ping made an accurate judgment from the patient's image pictures, planned the diameter of the ring drill used in the operation, and put it in place at one time during the operation, and removed all the problematic bone tissue.

Even if a surgical robot is used to do it, it cannot be so accurate, because the surgical robot cannot replace the clinical judgment of the preoperative surgeon, it is only a passive tool.

Song Zimo finished reading the slice, indeed, his eyes were uncomfortable after looking at it for a long time, so he asked Xu Zhiliang to come over and take a look, and Gao Qiao was ready.

This kind of pathological section, Yang Ping's auxiliary examination training in the system space, has received devilish training, not to mention looking at pathological sections, the production of the entire pathological section, he has personally done every process, very proficient.

Now he just wants to pass on some experience to Song Zimo and Xu Zhiliang, so that they can also master how to read pathological slides, and he hopes that one day, they can be more powerful than pathology experts.

Xu Zhiliang did not have as much contact with pathological sections as Song Zimo, when he was a doctoral student, he did experiments and watched some, but there was almost no contact after clinical practice.

Xu Zhiliang sat down at the workstation and began to look at the pathological sections, Takahashi sat next to him, and it was Takahashi's turn next.

Song Zimo received a call from Tang Fei, she had already taken Fujiwara Miyuki to the door of the pathology department, and they also wanted to come in and have a look.

Fujiwara Miyuki got along well with Tang Fei during this time, and she also wanted to follow Yang Ping and be able to get in touch with more cutting-edge technology.

Song Zimo went out to pick up the two of them, they sat quietly next to them, Fujiwara Miyuki greeted Yang Ping, and Yang Ping smiled in response.

The microscopic examination room was quiet, and the doctors at the workstation were all seriously looking at the pathological sections, and occasionally someone went out to the bathroom, almost trotted out, trotted in, and did not rest after coming in, and continued to sit at the workstation to read the pathological sections.

If the daily task cannot be completed, it will be piled up to the next day, and a lot of specimens will be received the next day, so that the accumulation will only increase, and pathologists are more difficult to recruit.

Therefore, the pathology department of a large hospital is not as competitive as the clinical department, and even a master's degree student in the pathology department has the opportunity to enter.

A young doctor suddenly got up: "Did you see Director Guan and Director Shi?" ”

"I should be looking at the frozen sections next door, and I just sent several specimens to be frozen." Another doctor replied.

"This kid, please help me take a look, there should be no problem." The younger doctor asked for help from another, more senior doctor.

The senior doctor went over to help look at it for a while: "This doesn't seem to be anything, I can't see it, let's wait for the two directors to come over." ”

Yang Ping rested beside him, heard the doctor's confusion, and purely gave technical help: "I'll help you take a look?" ”

The senior doctor raised his head, looked at Yang Ping, and was suspicious: "Or, can you help take a look?" ”

It's just curious, does this orthopedic doctor really look at pathology slides? Or a pathological section of the gastrointestinal tract, I don't have any hope for him to really look at it.

The senior doctor gave up his position, Yang Ping sat down and looked at it for a while: "Lymphocyte infiltration can be seen in the squamous epithelium of the esophagus, it is likely to be Crohn's disease, are there sections from other parts?" If similar changes are made on gastroscopy and colonoscopy biopsies, Crohn's disease can be diagnosed. ”

The pathologists who were concentrating on their work all looked up, and Song Zimo, Xu Zhiliang, Takahashi, Tang Fei and Fujiwara Miyuki also looked at Yang Ping.

"Look at what I'm doing, that's what it's about, esophageal squamous intraepithelial lymphocyte infiltration, is a slight manifestation of Crohn's disease in the esophageal mucosa, and is there a section of other parts of the digestive tract? Why don't I take a look at it for you? Yang Ping didn't expect that he would open his mouth and attract so many eyes.

A doctor of orthopedics, sitting in the microscopy room of the pathology department, instructing other pathologists to look at the sections, the senior doctor just now, should have ten years of experience, people are not strange.

The senior doctor was stunned for a while, picked out two slides from a large slide box, and handed them to Yang Ping.

Yang Ping put the slides under the microscope one by one, looked at them and said: "Focal enhanced gastritis of the gastric mucosa, there is focal active inflammation of the mucosa at the end of the ileum, there is no doubt, and the diagnosis is Kronen disease." ”

At this time, Director Guan and Director Shi came in, and the young doctor told the two directors in confusion that Director Shi was experienced after all, and every time he encountered something difficult, he still wanted him to help him.

"Why don't you take a break, Mr. Shi." Director Guan couldn't bear it, Director Shi had just looked at several frozen slices, and his eyes were red.

"It's okay, I'll take a look." Director Shi is very persistent.

Yang Ping gave up his position, the old director sat down, and read the three slides carefully before speaking: "Lymphocyte infiltration can be seen in the esophageal squamous epithelium, focal enhanced gastritis of the gastric mucosa, focal active inflammation of the mucosa at the end of the ileum, and Kronen's disease!" ”

The old director raised his head, took out his sunglasses and put them on: "The pathological changes in this case are very slight, and ordinary people can't see it, this is what the teacher taught me when I was a visiting scholar in the United States. ”

The pathologist immediately turned his gaze to Yang Ping again, this time it was a look of adoration, he only looked at one slide, deduced the pathological manifestations of the other two slides, said the most likely diagnosis, and after reading the other two slides, he directly made a definitive diagnosis, and it took only two minutes.

As a pathologist, I was not convinced by this ability to capture microscopic images.

An orthopedic surgeon looks at pathological sections, and he is actually more powerful than a pathologist, and he looks at slices from the department of gastroenterology, and he still doesn't let people live.

Song Zimo was also amazed, if he hadn't dragged him down to look at the pathology slides together today, how would he know that the level of pathology slides in this thing is so high, it's too versatile!

"Just now, Dr. Yang from the Department of Orthopedics saw it, and he also said that it was Crohn's disease, but I still don't believe it." Said the senior doctor.

"Oh?"

Director Shi was surprised, he stood up, picked two more slides from the box, and put one under the microscope: "Dr. Yang, help me take a look?" ”

See? Or don't look?

Yang Ping is not polite, whether he really wants to ask himself to help see it, or test himself, it is not easy to refuse, Yang Ping sat on the microscope: "Intestinal serrated adenoma (SSP)!" ”

Director Shi immediately showed it to Yang Ping, and Yang Ping quickly said the diagnosis: "Pan's cell metaplasia." ”

"The quality of the slide is not good, you can only see a cross-section, if only you could see the flattened full-thickness structure of the mucosa." Yang Ping added.

Director Shi took off his sunglasses: "Young man, it's a waste not to engage in pathology, from a cross-section, we can see intestinal serrated adenoma (SSP) and Paneth cell metaplasia, the national pathology expert wrench index, indeed, the quality of this slide is not good, if it is a high-quality endoscopic biopsy specimen, you can see the whole mucosal full thickness of the tiling, but we often can't do it, intestinal serrated adenoma and Paneth cell metaplasia are determined by observing the crypt base, and only the full-thickness tiled mucosa can show the crypt base, Changes in the basal crypt cannot be observed, and doctors are unable to diagnose the diagnosis. ”

Director Shi turned to all pathologists and said, "The quality of pathological slides has a very important impact on pathological diagnosis. To make a satisfactory section, there are very high requirements for each step of the extraction, embedding, sectioning, staining, and covering. ”

"When I was a visiting scholar in the Department of Pathology at MIT, their endoscopic biopsy specimens were able to see flattened full-thickness mucosal structures, compared to the cross-sectional sections of endoscopic biopsies in China."

"This made me suddenly understand why we rarely diagnose serrated adenoma (SSP) of the colon, and rarely see Paneth cell metaplasia, which is important in the diagnosis of inflammatory bowel disease, not because of the disease spectrum, but because of the quality of the slide."

Of course, there is a question of machinery and equipment, but it is more a question of professionalism and professional attitude.

A perfect section is very important, not only pleasing to the eye, but also pathological changes at a glance, to ensure the quality of pathological diagnosis to the greatest extent.

"Young man, what do you think is wrong with this slide, and what are the improvements?" Director Shi asked Yang Ping if he wanted to see how well this young man understood.

Yang Ping could only objectively point out: "During the production process of this specimen, there was curling during dehydration, the tissue was not erected during embedding, the color matching of HE staining was not very coordinated, and there were cavities and glue overflow in the cover, if these steps were improved, it should be better." ”

Director Shi almost applauded: "Very well said, for example, the collocation of all colors of HE staining is perfectly coordinated, and the infiltration of intraepithelial lymphocytes can be accurately detected under low magnification, and it does not need to be seen under high magnification; The tissue is erected during embedding, and all the tissues are neatly arranged like soldiers in a row, which can ensure that the full-thickness structure of the mucosa is cut out during sectioning. ”

"Young man, have you done pathology before?" Director Shi wondered how he knew so much knowledge.

Yang Ping didn't mean to show off, he just wanted to share the knowledge he had mastered with everyone, so that everyone could improve and do better next time, and the biggest headache was to explain: "When I was studying, I was more interested in pathology, so I studied very seriously." ”

Not only can I look at the pathological section, but I am also familiar with the process of making pathological slides, where are the shortcomings of a slide, and where is the problem, at a glance, it is not so simple to be interested.

If IQ is calculated on a 200-point scale, Takahashihara estimates that Dr. Yang's IQ starts at 160. Now I think that Dr. Yang's IQ is about to break through the rhythm of 200 points. He received professional and systematic training in pathology, and Yang Ping's occasional interest was not resisted.

Seeing Yang Ping sitting there, quiet and calm, Fujiwara Miyuki didn't know why, and suddenly had an inexplicable intuition that Yang Ping was lonely.

Perhaps, it was the height of genius.