On Tuesday afternoon the next day, Yu Zhiming received a diagnosis from a middle-aged Taoist priest, mainly nickel and other heavy metal poisoning.

The possibility of the source of the poisoning, according to the Taoist priest himself, once camped in a no-man's land with beautiful water and clear water, and practiced for two or three months.

At that time, I drank mountain spring water from a small spring every day.

Yu Zhiming was also told that the hospital had notified the local geological exploration department to go for sampling and testing, and maybe a nickel mine could be found.

Yu Zhiming also learned from Mr. Qi Yue that finding mineral deposits through endemic diseases was an effective way to prospect for minerals in the early years.

At nearly half past six in the evening, Yu Zhiming hurried to the Department of General Surgery after completing the rapid screening of stomach and liver cancer among 50 volunteers of the Very Early Cancer Project.

He accepted Dr. Wang's invitation to assist her with a kidney transplant.

Yu Zhiming knew that this was a learning and practice opportunity specially given to him by Dr. Wang, and he was very understanding.

This is the first time he has participated in a human organ transplant since he started medicine, and he is very excited and looking forward to it.

Therefore, Yu Zhiming finished today's scheduled work and rushed to the general surgery department as soon as possible.

It's just that Yu Zhiming couldn't see Dr. Wang in the office, and when he asked, he went to the ward.

He rushed to the ward again and met Dr. Wang Jiangyue, who was talking to the patient about the operation, and also saw the patient who was going to operate tonight and the kidney donor.

The patient, a 35-year-old man, had advanced uremia that caused both kidneys to lose their basic function and had been on dialysis for the last few years.

The donor of the kidney was the patient's 60-year-old father, who was emaciated and had only completed the retirement procedures for less than a month.

Yu Zhiming knows that under normal circumstances, after kidney transplantation, the patient's original kidney does not need to be removed, and the patient is equivalent to having an extra kidney in the body through transplantation.

Most of the transplanted kidneys are placed in the patient's right iliac fossa, which is connected in parallel to the original kidney and takes on kidney function.

The reason why the original kidney is not removed in this way is because there is a small chance that the function of the original kidney will slowly recover through a long period of recuperation.

Another possibility is that with the advancement of medicine, a way to restore kidney function has been developed.

Of course, not all kidney transplants require removal of the original kidney.

About 10% of kidney transplants are performed because the original kidney has inflammation, tumors, and other factors, and needs to be removed.

Yu Zhiming was thinking about the knowledge and process of kidney transplantation, walked into the ward, and stood quietly aside.

Wang Jiangyue's corner of her eyes caught Yu Zhiming.

She nodded lightly at Yu Zhiming, said hello, and looked at the patient and his father again.

"The operation time, if there are no accidents, is expected to take about two and a half hours."

"Do you have any questions?"

The patient, the patient's father, and the family and friends who accompanied them shook their heads.

"Alright, I'm getting ready for surgery."

With Wang Jiangyue's words, several attending physicians, resident physicians, interns, and other people standing behind her stepped forward to the patient and the patient's father, and began to make some preparations for them before entering the operating room.

Yu Zhiming came to Wang Jiangyue's side, "Doctor Wang, thank you for giving me this opportunity to learn and practice. ”

Wang Jiangyue chuckled and said, "Doctor Yu, you're welcome." ”

"I also have to thank you for coming over to me as a surgical assistant despite a hard day's work."

"Director Cui specially told me that Dr. Yu's surgical skills are quite skilled, no worse than those excellent surgical attending physicians in our department."

Wang Jiangyue praised again: "Doctor Yu, you have double cultivation in internal medicine and surgery, and you are so good, I am really surprised." ”

Yu Zhiming said modestly: "That's Director Cui praising me, my surgical skills were all learned in the county hospital, but I am more proficient in operating first- and second-level minor surgeries." ”

"It's not a big scene like a kidney transplant."

Wang Jiangyue said with a smile: "Kidney transplantation is not a big scene, and it is the most common operation in organ transplantation......

"Hey, wait a minute!"

Wang Jiangyue suddenly shouted to the assistants who wanted to take the patient and the patient's family out of the ward, and looked at Yu Zhiming again.

"Doctor Yu, please give the patient's father a physical examination. He is a little old, and his physical indicators are barely in line with the donation standards. ”

Yu Zhiming hummed, let the patient's father lie on the hospital bed, and gave him a full body examination.

He really checked that something was wrong.

Wang Jiangyue saw Yu Zhiming's face full of important discoveries, and her heart was full of sighs.

It seems that this operation will not be done tonight.

In the worried eyes of a room full of people, she called Yu Zhiming out of the corridor and asked in a low voice.

"Cancer?"

Yu Zhiming nodded and replied, "Doctor Wang, his stomach doesn't feel very good, so it is necessary to do a biopsy to confirm." ”

Wang Jiangyue sighed lightly and said, "You said that you don't feel good, then there is no doubt that there is a stomach cancer lesion." ”

"Well, I have to look for another donor......"

Human organ donation includes large organs such as kidneys, liver, heart, lungs, pancreas, and small intestine, as well as tissues such as heart valves, skin, bones, and corneas.

The medical standards for donation of different human organs and tissues are different.

According to China's medical regulations, the kidneys, livers and other large organs should be excluded from the existence of systemic or infectious diseases that pose a fatal threat to the recipient, including malignant tumors (except intracranial tumors), infectious diseases, severe hypertension, etc.

If a cancer patient is donating a large organ, there is a considerable risk to the recipient.

There have been more than one case in the history of medicine that has taught people such a lesson in organ donation.

Yu Zhiming saw a similar case study with tragic consequences in a medical journal.

Four patients who had undergone lung, left kidney, liver, and right kidney transplants developed breast cancer with similar histologic types within 16 months to 6 years after surgery.

The organs of the four recipients were all from the same donor, and the donor was not found to have breast cancer at the time of donation.

Unfortunately, three of the four grantees died of metastatic breast cancer.

Only one right kidney transplant patient survived immunotherapy, chemotherapy and other means after the transplanted kidney was removed.

Later studies revealed that the donor was supposed to be in a very early stage of breast cancer, but it had not yet been detected.

However, through an organ transplant, the cancer cells in the body were passed on to the four recipients.

More than one case has shown that this cancer cell is too cunning, good at hiding, and inadvertently stirs up trouble and endangers human health.

In view of this, the organs of cancer patients must be carefully evaluated before judging whether they are available.

In the case of the patient's father, if he is diagnosed with stomach cancer, the kidney will definitely not be transplanted to his son......

Yu Zhiming returned to the ward with Wang Jiangyue, and heard her announce that tonight's surgery was cancelled, and the patient's father would undergo a comprehensive stomach examination tomorrow.

Yu Zhiming saw the undisguised expression of disappointment on the patient's face, as well as the complicated gaze cast at him......

Wang Jiangyue personally sent Yu Zhiming out of the Department of General Surgery.

The two stopped outside the building, and Wang Jiangyue said with a happy face: "Doctor Yu, fortunately, I invited you over, if the transplant is done, that father will be diagnosed with stomach cancer." ”

"That's a big problem."

Yu Zhiming sighed lightly and said, "This discovery of mine, let the transplant surgery be canceled, patients and their families may not think that this is a good thing." ”

"After all, his father's metastatic stomach cancer through a kidney transplant is only a possibility, not a certainty."

"Nowadays, it is not easy to find the right type of donor kidney source."

Speaking of which, Yu Zhiming is not sure if he has done a good thing.

With the patient's physical condition, if he can't find a donor kidney source in the next few months, he may not be able to persevere.

And transplanting his father's kidney, even if he is very unlucky enough to have metastatic stomach cancer, with proper treatment, it is not a luxury to live for another three or five years.

There is also a high probability that you will not get metastatic gastric cancer.

Wang Jiangyue seemed to see what Yu Zhiming was thinking, and said in a deep voice: "Doctor Yu, patients and their families just thought of what they were anxious about in the present, but how could they think of the future. ”

"This belongs to drinking water to quench thirst."

"That person also has several immediate family members, and besides, it may not be impossible to find other ways to donate a kidney in the next few months."

After a pause, Wang Jiangyue spoke again: "If a year or two later, this father and son, one with stomach cancer and the other with metastatic stomach cancer, may come back to our hospital for trouble." ”

"From the perspective of our hospital and doctors, just follow the rules and regulations, and don't take risks......"

Yu Zhiming snorted, and then asked, "Doctor Wang, how many young doctors are you bringing with you now?" ”

"Three Attending Physicians, Three Residents!"

Wang Jiangyue replied, and asked with a smile: "Doctor Yu, do you have someone to recommend to me?" ”

Yu Zhiming smiled and said, "There is an ordinary friend named Bao Guan, who graduated from the medical school of Beijing University, and like me, he just joined this year. ”

"She is very interested in general surgery."

"If ......"

Wang Jiangyue interrupted very heartily: "Friends who can be recognized by Dr. Yu are definitely not bad in all aspects." ”

"Just let her come to me directly."

Yu Zhiming hurriedly explained: "Doctor Wang, she and I are just ordinary friends, don't think about it." ”

"My idea is that if it's convenient for you, Dr. Wang, you can take a little time to guide her and observe."

"If her abilities and other aspects are in your eyes, it will be even better."

"If you don't like it, don't force it."

Yu Zhiming said slowly: "I just want to ask Dr. Wang to give her a fair competition and a chance to show herself." ”

"If she's not strong herself, forget it."

Wang Jiangyue said with a serious tone: "Doctor Yu, I understand what you mean. ”

"I'll give her a chance to investigate......"

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(End of chapter)