Takahashi's three-month training period is coming to an end, and he hopes to extend his training time and continue to stay at Sanbo.

There are still many cases that he needs to learn, and during this time he followed Yang Ping, he not only learned advanced surgical methods, but also learned a new way of thinking, both for anatomy and surgery, and it has reached a new height.

Takahashi felt that three months was far from enough, and if he could stay, he would be willing to --- for a year or three years.

Unfortunately, it is impossible for him to stay in China with so much time, and there is still a lot of work for him to do at the University of Tokyo Hospital.

Takahashi's visa has a maximum stay of 180 days, and he hopes not to waste a day.

So he applied to Fujiwara Masao for a three-month extension, and Fujiwara Masao replied: Takahashi continued to stay in China to study, and Miyuki must return to Japan as scheduled after the expiration of the term.

Miyuki's arthroscopic technology has advanced so quickly that it is possible to carve a crooked letter into the olive pit.

She didn't care about Fujiwara Masao's words, although he was the director of the Department of Orthopedics at the University of Tokyo, he still had an identity, his brother.

In fact, Miyuki has more time to stay than Takahashi, she is just a middle-level young doctor and does not have any position.

"You should listen to Fujiwara-sensei and go back as soon as possible." Takahashi didn't want her to go against Fujiwara-sensei's words.

Miyuki didn't care: "Why should I listen to him, I have my own life!" ”

In fact, Miyuki knew in her heart that her brother asked her to go back, just to let her meet with Mitsui Yusuke, and the two families wanted to talk about their marriage arrangements, which was a marriage between the Fujiwara family and the Mitsui family, which was a major event.

Although Yusuke Mitsui is also a top student of Todai, she is outstanding in both talent and appearance, but she doesn't like that guy and doesn't feel anything about him.

"I also have a visa for one hundred and eighty days, and I don't want to call him anymore, you tell Mr. Fujiwara that I have decided to stay in China and continue my studies." Miyuki Fujiwara is very determined.

Takahashi sighed helplessly, this is already a matter for the Fujiwara brothers and sisters, and he can't intervene himself.

---

After the fifth round of surgery, the final round of surgery in the regional competition: anterior surgery for thoracolumbar fractures, which is as risky as pelvic acetabular fracture surgery.

The surgical approach is an important part of the operation, and the risk of the approach is destined to be very risky.

In a large hospital, because a patient with anterior thoracic spine surgery died on the operating table, like a frightened bird, it was forbidden to do anterior spine surgery for a long time, which was a bit extreme.

After the sixth round of surgery, Song Zimo still maintained a perfect score, and his strong combat effectiveness attracted a lot of attention to this Yisuke.

With the end of the sixth round of surgery, the regional competition is over, and the emblems of the hospitals in each competition area are arranged on the homepage of the website.

The photos of the main knives of each team are also played on the website in a loop, and everyone is familiar with the other main knives, only Yang Ping, who is not familiar to everyone, because he did not appear in the regional competition at all.

In the Western Division, Li Ling from West China and students from Professor Fu Shancheng were promoted with full scores, and the team from Xijing Hospital missed the full score by one point, and advanced as the second place, and the third team was also from West China.

In the northern division, Ouyang Siming, Xiao Yi, Lu Qing, and Song Yuncheng were respectively from the Third Hospital of the Imperial Hospital, Jishuitan, 301, and Xiehe, all of whom were promoted with full scores.

In the Eastern Division, Wen Rentao and Yue Zhengming advanced with full scores, and Wang Kaisheng from Changzheng Hospital advanced as the second place.

In the central division, there is only one team with a perfect score in Xiangya, Tongji is two points behind, and Xiangya's brother hospital is four points behind.

In the southern division, Song Zimo and Su Nanchen advanced with full scores, and Lin Hao was too sloppy in the anterior operation of thoracolumbar vertebra fracture, and one point was deducted.

The number of promotion places in each division is three, and the full score is unlimited, and the tied ones will be promoted with the excess places.

For example, if there are more than three perfect scores, all of them will be promoted, and other non-perfect score teams will not have a chance.

Two teams with full scores, there is still one place left to fill in the second place, and no matter how many the second places are tied, they will be promoted with this place.

If there is a perfect score team, the other two places, the second and third places are filled, if the second place is tied for the occupancy, the third place has no chance, and so on.

A total of 16 teams qualify for the national competition, and after a two-week break, the national competition will be randomly matched by computer.

The competition implements a knockout system, within the specified period, the specified type of surgery is completed, and the points are scored, and those who lag behind in the total score are eliminated, the leader is promoted, and those with the same score are added.

Those who advance advance to the second round of elimination, the third round of elimination, and finally the championship round.

According to the current situation, there are exactly 16 teams in the competition, and the first round will determine the top eight, the second round will determine the top four, the third round will determine the champion and runner-up, and the fourth round will be the championship.

In the duel of masters, if you are a little weak in that link, you will fall behind your opponent.

The young generation of rising stars in the medical field are all gearing up and eager to try.

In the national competition, the first round of orthopedic surgery is arthroscopy and intervertebral foraminoscopy, and it is difficult for doctors who do not have comprehensive skills to go far.

Some hospitals are not large, and they can't even find the cases, let alone participate in the competition.

So in the end, those who can participate in the competition are the well-known top hospitals.

Knowing oneself and knowing one's opponent, a hundred battles are invincible, the regional competition is over, everyone begins to sweep the list, most people are familiar with it, only Sanbo Hospital, everyone is not very familiar.

Many doctors who participated in that trauma orthopedic academic meeting have memories, including Fu Shancheng and Professor Meng Heng.

Lin Hao was extremely depressed, and originally wanted to get rid of Sanbo Hospital, but he was almost thrown off by Song Zimo.

He decided to play steadily in the national competition, even if he didn't meet Sanbo, he would go further than Sanbo.

If you can meet Sanbo in the first round, it would be best if arthroscopic shoulder and knee multi-ligament reconstruction is the most valuable surgery in this round.

Lin Hao can rely on the world's most advanced surgery taught by his mentor Robert to raise the score and eliminate Sanbo Hospital in one fell swoop.

During the two-week break, the results of the computer random party will be announced on the website by 6 p.m. on the Friday of the following week.

---

In Director Han's office, a USB flash drive containing Professor Feng's images and pictures was plugged into the computer.

X-rays, CT and MRI of the cervical spine, as well as enhanced images, appear on an electronic screen.

Chordoma, malignant, occurs less frequently in the upper cervical spine and penetrates into the skull from the upper cervical spine to the skull.

The tumour originates from the remnants of the notochord tissue of the embryo and generally grows slowly.

Therefore, if the surgery can be successfully removed, a certain survival period can be obtained.

However, the upper cervical medulla and the medulla oblongata are connected, which is the center of the respiratory circulation, which manages the heartbeat and breathing of the person.

Professor Feng's chordoma invades the respiratory and circulatory centers, and the prognosis is very poor, and his life is in danger at any time.

In this case, the tumor and the respiratory and circulatory centers are mixed together, and there is no way to operate at all.

"I have done radiotherapy, but it is ineffective, and I have been treated with targeted therapy drugs PDGFR inhibitor imatinib and MTOR inhibitor sirolimus, but the effect is not satisfactory, and then combined with rapamycin, it still does not work." Director Han called Yang Ping to the office, but he did not say that the patient was his mentor, Professor Feng, for the time being.

Yang Ping carefully analyzed the images and then analyzed the 3D printed models.

Director Han poured the image data into the 3D printer to print out the models of the upper cervical vertebrae, skull base and tumors, and the tumors grew staggered, showing dumbbells, antlers, and winding complex growth.

Yang Ping observed for a long time, this case is indeed difficult, involving three departments: neurosurgery, orthopedics and oncological surgery.

It is no exaggeration to say that this tumor should be a forbidden area for surgery.

If you want to do this surgery, there are four difficulties, and the first one is the difficulty.

Conventional exposure is not enough, the posterior side of the upper cervical spine and the posterior side of the skull should be completely opened from the back path, and it should be able to be installed after opening.

In this way, the upper cervical medulla and medulla oblongata can be exposed, and then the medulla oblongata and upper cervical medulla should be cut to completely remove the tumor while protecting the vital functional area.

The other three difficulties are that the surgical operation should be very precise, which is the biggest test of surgical accuracy.

Robotic surgery will be precise, but it is not suitable for this high-risk surgery, the most reliable is the machine, and the least reliable is also the machine.

Robots don't have the touch of people, and once they make a mistake, even a little, is fatal.

The accuracy of this surgery should be controlled at about 0.1mm, ordinary metal scalpel, no matter how sharp it is, can not do this kind of accuracy, and the scalpel can not cause extrusion to the tissue, as long as the ordinary scalpel cuts, it must be extruded.

Therefore, it is necessary to use an advanced laser knife for surgery.

Thirdly, the boundary of the tumor is determined, and the tumor is mixed with the medulla oblongata and the upper cervical medulla, and no matter what method is used, there is no way to identify the tumor and the vital functional areas that need to be protected during the operation, and can only rely on the experience of the surgeon.

There are few cases in the first place, and there are even fewer surgeries, and most of the surgical cases are failures.

Finally, hemostasis, this tumor is still very abundant, a little hemostasis is not complete, the hematoma compresses the respiratory circulation center, and the patient is breathing and heartbeat.

Yang Ping was looking at the image pictures and the 3D model, and Director Han was touching the cup on the side, feeling uneasy.

It took a long time for Yang Ping to speak.

"With a state-of-the-art laser knife, the upper cervical vertebrae and skull base are opened posteriorly, completely exposing the upper cervical spinal cord and medulla oblongata, and then the surgical operation with a precision of 0.1 mm is performed."

Is surgery feasible? Director Han finally waited for Yang Ping's reply, and immediately asked, "What is the success rate of the operation?" ”

"Not high!" Yang Ping replied with insufficient confidence.

This is the first time that Yang Ping has not been confident enough to answer, even if it is Lu Gang's case, he is full of confidence and does not hesitate to say: Admitted to the hospital.

"How high is the estimate?" Lao Han still asked.

"Eighty percent."

Yang Ping made an approximate estimate, there is no way, the operation is too difficult, this kind of forbidden area surgery, where can the success rate be high.

"Eighty?"

Lao Han thought that he had misheard, and the success rate of this operation, as currently reported, did not exceed one percent.

"Yes, no way, it's too difficult, at most eighty percent!" Yang Ping was very embarrassed.

It was confirmed that it was eighty percent, and Lao Han calmed down.

"Where's the patient?" Yang Ping is very concerned, this case is very special.

Which case in his hands is not special or difficult?

"The patient is in the Sixth Courtyard of the Demon Capital, and I don't know the arrangements over there yet."

Lao Han has a bottom in his heart.