After Yang Ping's operation, he came to see the old dean, the old dean was already able to walk on the ground, Yang Ping gave him a physical examination, and there was no problem with the sensory muscle strength of both lower limbs, indicating that there was no rebound edema after the nerve root was released from compression.

There are many causes of sciatic nerve pain, lumbar disc herniation is only one of the most common causes, other causes are tumors in the spinal canal or sciatic nerve itself, sciatic nerve entrapment in the piriformis muscle, sciatic neuritis, herpes virus infection, etc.

The old dean is a schwannoma of the 5th nerve root, most of which are benign tumors, and the tumors cut out during the operation have a complete capsule from the appearance, which also conforms to the characteristics of benign tumors, but the final diagnosis depends on pathology.

It is precisely because the most common cause of sciatica is lumbar disc herniation that the old dean did not care and did not go to a better hospital for examination, which caused a misdiagnosis.

"Where do you think my lumbar disc is herniating?"

The old dean held the MRI film in his hand, but he couldn't read it, so he had to ask Li Min.

Li Min pointed out: "Look here, the intervertebral disc of L4/5 and L5/Sacrium 1 does have herniation, but it is very light and will not cause symptoms, you see, now after the schwannoma is removed, the symptoms are all gone, so this lumbar intervertebral disc herniation has no symptoms at all." ”

''That means I also have a herniated disc?'' Just a schwannoma? The old dean thought to himself.

"You have a herniated disc but you don't have a herniated disc, those are two different things."

Li Min now has a solid knowledge of these common diseases.

Lumbar intervertebral disc herniation and lumbar intervertebral disc herniation are two concepts, lumbar intervertebral disc herniation is only an imaging manifestation, not a disease, patients can see lumbar intervertebral disc herniation by magnetic resonance or CT, but there are no related symptoms.

If there is a herniated lumbar disc on imaging, and the patient also has symptoms of low back pain or leg pain, then it is called lumbar disc herniation, which is considered a disease.

Lumbar disc herniation does not need to be treated, but lumbar disc herniation needs to be treated, the manifestations of lumbar disc herniation, some manifest as low back pain, some manifest as leg pain, leg pain is generally manifested as radiating pain, radiating from the buttocks to the lower limbs, and the distance of radiation varies according to the severity of the disease.

Low back pain is pain caused by the disc itself, and the cause of the pain is irritation of the sinus nerve inside the lumbar disc.

After lumbar disc herniation, the annular fibrous disc ruptures and the nucleus pulposus herniates, and this pathological change leads to local stress changes and inflammatory responses, and mechanical pressure and inflammatory mediators can stimulate the sinus nerve nerves and cause low back pain.

Leg pain is caused by compression or irritation of the spinal nerve roots, causing pain and numbness in the nerves that make up the nerve that continues to make up it.

These are the symptoms of low back and leg pain.

At present, there are a small number of reports in the world that the herniated lumbar disc nucleus pulposus can be naturally absorbed by the human body, which is also completely possible from a medical point of view, because once the nucleus pulposus of the intervertebral disc is out of its original normal position, the human body will treat it as an illegal substance and send phagocytes to eliminate it.

But this is only a single-digit report, not a routine, so lumbar disc herniation, once diagnosed, definitely needs treatment.

Try to treat conservatively first, because in most cases it is alternating between seizures and remission, not continuous seizures, especially in the early stage, but also a very long remission period, even once in a few years, this situation does not require any surgery, during the attack period, oral oral treatment of some non-steroidal anti-inflammatory drugs and neurotrophic drugs can be done, and the remission period strengthens the lumbar back muscle exercise, so that the lumbar spine becomes more stable.

It should be clear that the target of treatment is the symptoms, not the herniated disc, and after the symptoms disappear, the intervertebral disc is still herniated, and the herniation is herniated, and it doesn't matter. It is not possible to get the disc back to its original shape.

If the symptoms are severe and persistent, after regular conservative treatment for more than 3 months, the pain symptoms affect life and work, then surgery can be considered, the surgery can be small and not big, if there is no spinal segment instability, try to only do lumbar disc nucleus pulposus extraction, do not do nail segment fixation.

Young and middle-aged people, if there is no congenital spinal instability, spinal instability will generally not occur, so generally only a simple nucleus pulposus extraction is done, no nailing, no fixation.

This kind of surgery can be minimally invasive as much as possible, it really can't be minimally invasive, open surgery is also good, if the condition allows for minimally invasive surgery, whether to choose open surgery or minimally invasive, the standard of choice is to see the doctor's level, skilled open surgery is much better than the minimally invasive foot holding.

If low back pain is not caused by a common disease, it is easy to miss the diagnosis, because low back pain is not to see the orthopedic spine clinic, or to see the urology, the doctors who sit on both sides of the clinic, whether they are experts or ordinary doctors, are surgeons who are good at surgery, the vast majority of surgeons are very weak in knowledge other than surgery, especially in the face of complex diseases, the ability to think is very weak, and they are used to operating quickly.

Hearing Li Min say this, the old dean was very happy, it seems that this kid is really learning.

Yang Ping persuaded him to wait until the stitches were removed before being discharged, and he was not in a hurry for the next few days, anyway, there were already people in the hospital to help them go to work.

Li Guodong is currently working happily in Guandu Hospital, and with Li Guodong's current level, he can now fully support the business of Guandu Hospital, not to mention Guandu Hospital, even if it is Beiqiao County People's Hospital, he has no pressure to be a department director.

There are only a dozen doctors in Guandu Hospital, and the conditions are very poor, but in the process of poverty alleviation several times, some old equipment has been obtained, such as high-end X-ray machines, color ultrasound, and so on.

There is even an old C-arm machine, which is the time of poverty alleviation, the superior hospital eliminated things, this machine is just not new, the machine is eighty percent new, and it can be used directly without maintenance, for the doctors of Guandu Hospital, this machine is usually only used when the fracture is repaired.

In fact, what Guandu Town lacks now is not basic equipment, but talents, and without good talents, these equipment cannot be used to the fullest.

In the process of poverty alleviation, some hospitals in remote mountainous areas can obtain a lot of good equipment, but many of them are thrown in the warehouse and useless, because there are no relevant talents, there are no people who can use them, and the machine is just a pile of scrap metal.

In addition to routine surgeries, he also learned X-rays, magnetic resonance and CT readings, analysis of various examination results, fracture manual reduction, local sealing, various hemostasis techniques, etc., which are very beneficial to his business in primary hospitals.

The old dean listened to Li Min's introduction, and couldn't help but smack his tongue, this kid's level has improved so quickly, if there is no bragging, this is properly beyond the level of the department director of the county hospital, no, even higher.

Hearing that Li Min's old dean was hospitalized in Sanbo Hospital, Dean Xia specially took the time to see the old dean and gave him a fruit basket to show his respect for his predecessors.

The old dean was smiling, he knew that he was stained with the light of Xiao Lizi, who was the best rural doctor in the country and a good doctor in China, so everyone paid special attention to it.

When the dean saw the dean, it was very cordial.

For the seniors, Dean Xia is shh

Dean Xia said, "Old Dean, your body is really tough, we have to learn from you." ”

The old dean looked disapproving: "For 50 years, I have carried weights every day for cross-country marathons, can I not be in good health?" ”

When everyone thought about it, it seemed that this was the case, and the village doctor often had to carry the medicine box over the mountains and mountains, and after understanding this meaning, everyone couldn't help but laugh.

After a conversation, the old dean burst golden sentences one after another.

The point is that no matter what the old dean says, others laugh so much that his stomach hurts, but he doesn't laugh himself, and he is still serious.

Song Zimo and Xu Zhiliang's investigation in Europe has also ended, Europe is very fragmented, there are many large and small countries, going abroad in Europe is similar to our county and province, plus their air transport is more developed, so they can also go to many countries in half a month.

Their expedition has almost all the famous medical universities, hospitals and laboratories in Europe, and the recorded inspection reports can be compiled into a thick book.

Huang Jiacai and Gan Fengyi both led their teams to participate in the European Spine Surgery Conference, after the meeting, Huang Jiacai stayed in Europe to inspect several well-known European pharmaceutical and medical device companies, Gan Fengyi received a notice from the company to return to China, and heard that the company has major personnel changes.

——

Yang Ping's clinical research was not delayed at all, except for the normal operation time every day, some fragmentary rest time, Yang Ping used it to enter the system space laboratory to do experiments.

In the Systems Space Laboratory, three of Yang Ping's experiments are being carried out at the same time.

The study of apoptosis of tumor cells, the study of the mechanism of skin amplification, and the further study of organ spatially directed genes have not been left behind.

There has been a new progress in the study of apoptosis of tumor cells, and Yang Ping found that this unexpected protein molecule K factor is actually a dimer small molecule after structural analysis.

From the study of the mechanism of apoptosis of osteosarcoma tumor cells in Sisi, it can be seen that these dimer small molecules can activate the silent gene expression inside tumor cells, and this molecule can actually be functionally regarded as a reverse transcription epigenetic chemical proximity inducer.

When it initiates apoptosis, it can mobilize the expression of hundreds of genes, and first remove the shield of the original tumor cells from apoptosis, and then start the apoptosis program, which means that the tumor cells are re-exposed to the shroud of "apoptosis", so a large number of deaths begin to occur.

It seems that the apoptosis of tumor cells is an extremely complex process, and Yang Ping needs further research.

If this dimer molecule can be replicated, then the process of tumor cells being "killed" can be repeated, and for current biotechnology, it is completely achievable to replicate a dimer small molecule.

The convenience of the system laboratory is incomparable to that of the real laboratory, and Yang Ping immediately began to purchase various equipment with points on the system panel, preparing to use manual methods to manufacture the K factor for the next step of research.

In the next study, it is necessary to collect images at a more microscopic level, not only to take pictures, but also to shoot videos at the molecular level, so as to understand the mechanism of action of the entire K-factor.

In order to cooperate with the experiment, Yang Ping began to upgrade the electron microscope in the laboratory, upgrading the new electron microscope 4D camera, which can shoot atomic-level video.

Electron microscopy is a major advance in the field of human research, which uses electron imaging tools to break through the limits of optical microscopy and provide a pair of eyes for people's observation of the nano world, without which human observation of the microscopic world would stop at 200 nanometers and cannot move forward half a step.

The electron microscope of the Yangping System Space Laboratory is the world's top and is equipped with a special electron detector, which can only collect a part of the information when the electron interacts with the observation target, while this microscope equipped with a special electron detector can collect all the information in the interaction process and obtain more comprehensive information.

If we take pictures of the whole process of K factor participating in initiating apoptosis of tumor cells, and then Yang Ping analyzes this process, we will definitely be able to thoroughly understand the mechanism, how it relieves the apoptosis program, and how it initiates the apoptosis program.

Whether it is the purchase of experimental equipment or the upgrading of equipment, it is completed in an instant, and only a part of the points is deducted.

Director Fang of the Department of General Surgery hurried to the Institute of Surgery with two cherries, he came to find Yang Ping, this morning he went out of the outpatient clinic and received a hepatic echinococcosis, which required extracorporeal liver resection and autologous liver transplantation, which was originally very difficult.

However, Director Fang has already undergone in vitro resection and autologous transplantation of abdominal organ clusters, and he is also under the traction of Yang Ping, so he is not afraid of this kind of operation at all, but he knows that his level has not yet reached home, so he must ask Yang Ping to escort him.

The last abdominal organ cluster transplant, he took it to an academic conference to speak, which attracted a lot of admiration, and abdominal cluster organ transplantation is much more difficult than autologous liver transplantation alone.

Director Fang put a box of cherries at the nurse's station, ready to carry another box of cherries to the doctor's office, at this time, the office nurse at the nurse's station took out her mobile phone to answer the phone, as if it was a call from her home.

Director Fang finally seized the opportunity to stand up, and he saddled up before and after the horse, at least two boxes of cherries at a time, and Gao Yuan was often empty-handed, and he was actually more popular with these nurses than himself.

Not long ago, Lao Fang finally got a glimpse of the reason, Gao Yuan knew how to stand up, and seized an opportunity to reprimand the nurse, and this time he finally let himself seize the opportunity.

"What's going on, work hours, what calls are you answering, don't you see that you're busy now? If you can't get off work to say something, let the head nurse educate it well. ”

Director Fang took out the momentum of the head of the department in his own department and reprimanded the nurse very seriously.

The nurse put down her phone, her face confused, as if she was saying, "Are you talking about me?" ”

"Look at what you see, it's you."

Director Fang didn't give any face, Gao Yuan was so powerful last time, these little girls from the Institute of Surgery can still be controlled by Gao Yuan.

"Who are you looking for? Is there any registration at the door? The office nurse called Director Fang.

''I'm looking for Professor Yang. ”

''Did you make an appointment in advance?'' ”

"There is an advance reservation!"

"You go to the security guard at the door to register, I will ask Professor Yang, and you can only go in after Professor Yang's confirmation, this is the rule of our department."

"Is there a rule?" Director Fang returned to the door and asked the security guard at the door to register.

The security guard said, "That's true. ”

At this time, Director Gao also came in, and he swaggered into the ward.

He doesn't register, tell me to register?

These little girls, this is the opposite, Liwei didn't stand up.