"More than 10,000 a year?" The father of the child hesitated slightly.

Gritted his teeth and nodded: "That's okay, Doctor Zhou, can you give me this number?" ”

After leaving with the child, Fang Xian didn't ask Zhou Xiyin why he knew.

Now that I'm seeing an outpatient clinic, I still have doubts and ask after work.

In the next period of time, Fang Xian found that in fact, there are not many cases of incurable diseases in Cixian County, most of them are chronic diseases, and there is no particularly good way to deal with chronic diseases in one step.

For example, fasciitis and bursitis can only be cultivated slowly.

Such a disease is a critical disease that is overtreated by surgery and relatively under-treated, and it is difficult to find a real and appropriate solution once and for all.

If you really want to make an analogy,It can be regarded as,A new book bought is tattered.,It's too wasteful to lose it directly.,It's good to keep it for continued use.。

……

"Shein, you seem to know a lot, huh?" After ordering at noon, Fang Xian asked Zhou Xiyin.

Zhou Xiyin said to the waiter: "Boss, send us an extra bowl of shredded potatoes, the kind fried with sour chili peppers." It's okay to count more money. ”

Zhou Xiyin's attention was not here.

The potatoes in Cixian County are all grown by farmers, and some of them are alpine potatoes, which are very crispy and fragrant when fried, which is the taste of potatoes bought in Shashi supermarkets, and there are many methods.

There are also potato chips boiled with wild shallots, which are also delicious, soft and glutinous.

"Good beauty." The waiter nodded.

Zhou Xiyin turned her head at this time, as if she had exposed her foodie nature, and her face was slightly red: "Senior Brother Fang, what did you just ask me?" ”

"What I'm asking is, Senior Sister Zhou seems to know a lot of things that are not in literature and books." Fang Xian said.

Fang Xian's theory is not bad, theory is a kind of cognition.

The blind spot that can't be reached by level 5 theories, this is not simple.

"Oh." Zhou Xiyin immediately realized: "Senior brother, many of the devices I mentioned today are supporting devices for rare diseases, because there are too few cases, and they have not accumulated a sufficient number of cases for more than ten years. ”

Fang Xian instantly realized: "Are these many instruments made by Professor Zhou?" ”

If it has not been seen in the article, then it will not appear in the textbook, let alone in the field of vision of most doctors.

For the clinical application of medical devices, the management is becoming more and more strict, and the principle of strict control of access is the lowest place to ensure the rights and interests of patients.

It's not that you can use it if you say it's easy to use, and it's not that a small number of people say it's good, but it must stand the test of data and years, and there are no problems, so that it can be truly applied to clinical practice.

In clinical practice, it is very common for some devices to be put on hold for one or two decades or even longer before they are put into clinical practice.

It is not uncommon for some doctors, in order to study some rare diseases, to wait for their students to complete their manuscripts.

The direct contact object of medicine is people, so no matter how complicated the procedures are, no matter how cautious the medical research is, it is not too much.

Otherwise, what is the damage area caused by Sanlu milk powder?

"Hmmm! ~" Zhou Xiyin nodded, not going too deep into this topic.

Because every time she mentions her father, the topic will be completely changed, either the other party will directly break down psychologically and become directly enthusiastic, or he will collapse so much that he has nothing to say.

"Professor Zhou is really a strange person." Fang Xian sighed with emotion.

"Senior brother, do you know a saying? It is the high-level embodiment of medical technology, which is the theoretical draft, and the more advanced embodiment is carried on objective objects. This is called applying what we have learned, and linking theory with practice. Zhou Xiyin said this at the right time.

"yes!"

"The high-level embodiment of medical technology is the theory, and the more advanced is the carrier."

"But ordinary people, where can they achieve the step of theory and carrier?" Fang Xian shook his head slightly.

If he wants to become a theory, it is extremely difficult, that is, he is now following Professor Xu Fengnian, and under the indoctrination of his uncle, he has reluctantly contributed to the growth of some theories.

This is a new theory and cognition, but to have a carrier of knowledge, it needs to go further.

As far as the most critical scalpel in surgery is concerned, what can be done in China is the low and mid-end. For example, ordinary electric knives, lancets, sharp knives, etc.

For example, plasma electrosurgical unit, ultrasonic bone knife.

It cannot be produced because the technology is monopolized.

The reason why some developed countries are developed is not that they are only developed at present, but that they have always been developed.

It is not that one or two aspects are developed, but that all aspects, the technical level is higher than that of China, even if the comprehensive strength of China is already very strong, but we cannot help but realize this.

"Senior Brother Fang, you also have a chance."

"Maybe you can't create, but you can advance, use your technology, to advance." Zhou Xiyin said this again, as if she was comforting, but her tone and expression were serious, and it didn't look like comfort.

"Push?" Fang Xian had some doubts.

"Yes, it's pushing."

"Actually, there are some things, it's not that it's not good enough, it's that there's no more suitable way to prove it's better."

"And to have such proof, there must be objective data. To get such data, the number of level 5 skills is a very critical part of medical technology. ”

"If you use different devices at the same level, which has a better prognosis, that's better."

"In other words, it is better to not need very sophisticated medical technology to still achieve the prognosis that can be achieved by superb medical technology, but how to control such bias is the most fatal problem."

Bias in medical research refers to the systematic errors in all aspects of study design, implementation, data processing and analysis, as well as one-sidedness in the interpretation and inference of results, resulting in biased discrepancies between research results and the real situation, thus incorrectly describing the link between exposure and disease.

It is almost impossible to completely avoid errors in research work, but for all kinds of errors that may exist in research, we should try to control and prevent them in all aspects of clinical research work, so as to make the research conclusions more in line with the actual situation.

In a sense, bias is an unavoidable error in a sample survey. That is, as long as it is sampling, bias will occur.

Correspondingly, to control bias to the greatest extent, it can only be judged by means of multiple sampling, pre-experiments, etc. Since many investigations or experiments cannot be replicated or pre-experimented, experience is also very important in managing bias.

Naturally, human bias is a difficult factor to control.

For a theory to be recognized, reproducibility is key.

And this kind of reproducibility should not be chosen by special groups of people, but must be repeated by everyone, and it can be done, which is an objective fact, which is difficult.

Fang Xian heard the words and thought thoughtfully.

For a long time before, Fang Xian was just trying to gain skill points, and he didn't think in this direction at all.

When Zhou Xiyin mentioned this, Fang Xian said: "Xiyin, you mean, in fact, we already have a lot of good products, but we can't launch them?" ”

Zhou Xiyin shook his head: "Senior brother, it's not that there is no way to push it out, but there is no way to correct it." ”

"The correction here refers to the correction up or down."

"The instrument is actually a tool, the use of tools, is our human instinct, if the manufactured tools, in the use, also need a certain basic foundation or strong basic skills, then this tool, is not a particularly mature tool."

"It's just reaching convenience, not complete convenience."

"But level 5 skills can correct the threshold for using tools, which is something that many professors can't do."

"But Senior Brother Fang, the number of your level 5 skills is not a few, you can do such a thing." Zhou Xiyin once again meant something.

"Huh?" Fang Xian looked left and right, and he didn't feel that he had more noses and eyes than others.

Why is it so special?

If from the technical level, Fang Xian's basic skills are ridiculously solid, and the real high-precision technology, except in terms of functional reconstruction, in other aspects, there is no way to be better at all, then how can he do what others can't do?

"Anyway, you can, brother."

"But right now, we're looking for these longer-term things, and we're a little bit out of reality. I think the most suitable thing for us to promote at present is to find some more common diseases and then simplify their surgical operations. ”

"Medical technology is a service, not the more complex and unfathomable, the better, on the contrary, the more down-to-earth some operations can be served, the more they can serve more people."

"Simplifying complex surgical methods and achieving better treatment results through more streamlined operation procedures is a big problem and problem we are facing."

"Lowering the professional barriers within the profession, this is what many professors are doing in the teaching hospital!" Zhou Xiyin suddenly raised the topic a few degrees.

"Oh." Fang Xian nodded.

……

In the afternoon, the outpatient clinic continues.

Zhou Xiyin and Fang Xian admitted two patients who needed to be hospitalized, but these two patients, in fact, the type of disease is not complicated, one is stiff calf, and what needs to be done is a release operation.

Calf stiffness is actually the adhesion of the calf muscles, and the loss of ankle joints and toes of motion can be relieved.

But this kind of operation is only simple in principle, and it is really difficult to loosen all the adhesion muscles, which is really not small, at present, according to Zhou Xiyin, such a technical difficulty is no less than directly curing cancer.

It's impossible to undo all adhesions and return all mobility.

This disease is just not very dangerous.

However, Fang Xian's current level 5 debridement and level 5 hemostasis can be applied to such a difficult disease, and a professor in Australia has done a similar topic, and the treatment suggestions for complete adhesion of such calf muscles are positioned in level 5 debridement and level 4 hemostasis, which can meet relatively high requirements.

The second patient is a femoral deformity that requires osteotomy and orthopedics.

The difficulty of this operation is even less high, but in the prefecture-level city hospital, basically no one dares to do it, and in the Affiliated Hospital of Shonan University, some professors feel that the difficulty of operation of such diseases and the sense of gain are not strong, so they only do it occasionally.

The patient's family background is average, and he is unwilling to go to provincial and municipal hospitals for osteotomy and orthopedics, so he has been dragging it out.

But it is inconvenient to drag and walk, and the walking, sitting and lying with the arched legs outside the femur can be the same as a normal person?

The corresponding procedures of these two diseases are relatively simple. It just so happens that Fang Xian can operate it through basic medical skills and basic skills of specialists, and it is not considered a skipping operation.

However, after Fang Xian sent the two patients to the ward, the doctor on duty gave the information back to Huang Bohang.

Huang Bohang immediately called Fang Xian.

"Doctor Fang, you took in the two patients in the department today? The prognosis of these two patients will not be very good, right? ”

"Doctor Fang, if you want to have surgery, why don't I help you find the source of the disease?" Huang Bohang was a little scared.

In the county hospital, if the prognosis is not good, the surgery should never be performed.

If high-quality surgery is not done, the prognosis of the patient is not good, and it is extremely easy to rip off.

Although I know that Fang Xian's ability is a bit good, you don't want to hurt anyone.

"Director Huang, these two patients are actually fine, they are not critically ill, and the patient's willingness to seek treatment is quite good." Fang Xian explained.

"Doctor Fang, it's not a matter of willingness to seek treatment, it's such an operation, which is not easy for our hospital to carry out."

"Speaking of release surgery and osteotomy orthopedics, it is not particularly difficult, but the prognosis of these two surgeries?" Huang Bohang felt that he had made it clear enough.

"Personally, I still think that we can do minor surgeries such as fracture and debridement routinely. There's no need to fuss. ”

"Otherwise, you will have all the surgeries done when you arrive now, and when you leave, there will be another patient coming, and we will not be able to explain it?" Are you right? Huang Bohang spoke very politely.

Fang Xian can pat his ass and leave after a few months, but if there are similar patients in the future, Huang Bohang and others said that they can't do it again, so they will have to talk more at that time, and the patient may also greet people with foul language.

Fang Xian pondered for a moment, and then said: "Director Huang, the release technique is a kind of debridement surgery, and the bone speciality osteotomy and orthopedic surgery is actually a variant of fracture internal fixation, and this operation is not difficult?" ”

"I think Director Huang, you and Director Qin can be taken down quickly."

"Doctor Fang, that's what I said, but our basic skills?"

"The proficiency of debridement and fracture fixation does not need to be very high, Director Huang, why don't we try to do a few first? If you think it's still difficult to carry out routine work in the future, let's stop it? ”

"Is that okay?" Fang Xian regressed.

After coming around, I knew the difficulty of the county hospital, and Fang Xian could understand.

But Fang Xian has already said it to such an extent, if Huang Bohang still wants to push back and block, Fang Xian has to suspect that Huang Bohang is in the county hospital, and his positioning is to grind foreign workers and make a living.

"Doctor Fang, you're not kidding, are you? How could we possibly perform such a difficult surgery? Huang Bohang's voice still felt very difficult.

(End of chapter)