After Chen Gong left the laboratory, he did not get angry, but was very calm.

Thinking about it carefully, Liu Zhi's difficulties are actually not accidental.

It can even be said that it is inevitable!

He came to the laboratory, as a student, and was destined for many things in itself.

Those team leaders, professors, or experimenters don't have enough respect for him, they just care about Professor Xu behind him.

To put it bluntly, this is a character that Yang Guangye set up for himself!

Although Yang Guangye and Qi Huan showed their respect for themselves.

But......

That's not enough!

For ordinary students, they join the laboratory because their ability itself is insufficient, and they need to learn from the teacher, so this identity is indeed enough.

But for Chen Gong, it's not enough!

Chen Gong wants to get more than just respect, but also a certain amount of authority.

This is also the reason why Chen Gong has always been dissatisfied with Yang Guangye, he did not arrange a substantive identity and an independent laboratory for himself.

And these are what Chen Gong really needs.

To put it bluntly, Chen Gong was very curious.

That is Yang Guangye's attitude towards himself!

Is it an equal attitude that puts oneself in the top three of the project and is a collaborator?

Or a student who needs to be appeased and given a little sweetness to hope.

Chen Gong had to think about this question, did Yang Guangye feel that he had just conceived the idea of the three-carboxyl cycle on atherosclerosis because of coincidence and a certain strength and talent.

However, it does not have the role of in-depth development in the laboratory, and there is no sufficient application for the promotion of the experiment, or even the experiment itself.

It was Liu Zhi who came out today, and it was because of students like Tao Shengnan, who had dispensable little things.

It's going to happen.

What about later?

After the start of the experiment, there will be a lot of discussion and controversy due to the concept, the direction of the experiment, etc., and there will also be a lot of competition.

If they really have a dispute or competition with the other person, what will they choose?

Liu Zhishang can embarrass himself!

What about the team leaders?

What about the experts and professors?

Or even ...... What about Yang Guangye or Qi Huan?

What kind of status and height will they put their opinions on.

How far can they go with respect and support?!

Chen Gong had to think about it.

To be honest, the study of atherosclerosis by the tricarboxyl cycle is not just the brainchild of Yang Guangye.

It is also Chen Gong's efforts and dreams.

This is the first project in his life, which is of great significance, and he also wants to complete it.

And Yang Guangye is the best partner he can find at present!

In fact, a few days ago, when Chen Gong saw that Professor Xu Tong and the review committee of the National Natural Science Foundation of China were coming, he already had this idea in his heart.

Xu Tong is definitely a person who has the right to speak, has the right to decide, and is even extremely respected by Yang Guangye and all the people in the biochemistry teaching and research department of the entire school.

He has certain rights!

And Chen Gong happened to need his appearance.

To put it bluntly, Chen Gong has already discovered that Yang Guangye doesn't seem to have any intention of straightening himself up, at least not at present.

The reason is unknown, and Chen Gong doesn't want to wait.

Chen Gong decided to take the initiative himself.

It's just that...... Chen Gong hasn't thought about it yet, how to operate it at that time, so as to attract Xu Tong's attention and let the entire research group see his contribution?

Or rather...... How can I get my due voice in the research group?

This is more difficult, after all, it is necessary not to offend Yang Guangye......

After thinking about it, Chen Gong didn't think of a good way, but he didn't expect it...... Now Liu Zhi actually gave him such an opportunity.

This made Chen Gong very pleasantly surprised.

He decided...... Tomorrow is not coming!

Childish? Immature?

Hehe!

Isn't he just a child?

Chen Gong smiled faintly, and left the laboratory with Shou Weixiang and Tao Shengnan.

Looking at the back of Chen Gong leaving, Song Hongwen stood there and did not react.

He really didn't want to go!

This opportunity is so important to him.

If you leave, all your previous efforts will be ...... Wasted!

But...... Seeing Chen Gong and them being bullied, Song Hongwen also wanted to stand up in his heart.

But he didn't have the courage to ......

In other words, it's not a matter of courage, it's his courage that isn't enough to fight his loss, and in his heart, such a thing as righteousness is a blind lack of rational thinking, an impulsive behavior, and he can't do it!

Even, Song Hongwen didn't have the courage to stand up and help the three of them speak.

Because he was afraid, afraid that he would be targeted, afraid that he would become a thorn in Liu Zhi's side!

Liu Zhi, he can't afford to mess with him.

Therefore, Song Hongwen stayed where he was, with his head down, motionless.

On the contrary, it was Wu Tianjie, although he was jealous of Chen Gong, he was very respectful of Chen Gong's behavior.

He doesn't want to be embarrassed, targeted, blamed by yin and yang, and suffer injustice, someone can stand up for himself like Chen Gong!

Why wouldn't he want to have a friend like that?

Can we share joys and sorrows?

After thinking about it, Wu Tianjie hurriedly stood up and said, "Teacher Liu, you are angry, Chen Gong is too impulsive." ”

"I'll help you persuade him."

"Don't be angry, it's just...... It's a trifle. ”

"Maybe there's some misunderstanding!"

After speaking, Wu Tianjie hurriedly got up and chased after Chen Gong, but after taking two steps, he suddenly realized something, turned around and took a look, and found Song Hongwen sitting in the corner, with his head down, without saying a word.

……

……

After leaving the lab.

Shou Weixiang followed behind Chen Gong, panicked in his heart.

His character is not the kind of person who follows Chen Gong to scold Liu Zhi for not being a human being.

After something happened, he hoped that he could make amends, hoped that Chen Gong would not be dragged down, and hoped that he would ......

But no matter how much hope can be made!

In this school, he Shou Weixiang is just an insignificant little person, although it seems that among the students, there is a certain popularity or scenery.

But in the end, it's just an ethereal thing.

Even Liu Zhi, or Sun Zhi, Wang Zhi, and Li Zhi can handle themselves casually.

When Tao Shengnan faced injustice, was slandered, and was bullied, he had no choice!

But Chen Gong stood up and let them breathe a bad breath.

But in the end...... But he was implicated.

So, what is it like to say comforting words now?

The key is that now Chen Gong has been targeted by the laboratory teacher because of them, and ...... They may also be reported to school leaders.

This made Shou Weixiang feel a sense of guilt.

As he walked, Shou Weixiang couldn't help but push Chen Gong with his shoulder, and said vaguely: "Harm...... It's really grassy, sorry ha. ”

Chen Gong heard the sound and pushed Shou Weixiang with his shoulder: "Get out, don't do it!" ”

When Shou Weixiang heard this, he grinned, and hugged Chen Gong directly with a hahahaha smile:

"Grass, don't forget what you said, Lao Tzu uses a strong one!"

Shou Weixiang was tall and big, and ran out with Chen Gong in his arms.

It made everyone laugh.

On campus, at six o'clock at this time, there were many people, and when they saw this scene, they couldn't help but laugh.

Tao Shengnan followed behind, in fact, he was the most self-reproachful in his heart.

Because of her affairs, let Chen Gong be like this, she is really a little uncomfortable.

At this time, Wu Tianjie stood in place, and when he saw Chen Gong and Shou Weixiang's actions, for a while, there was a little more envy in his eyes.

The education he was instilled in since he was a child was to study hard, work hard, be upward, be positive, and enterprising.

Don't play with bad kids.

In fact, Wu Tianjie knows that those children are not bad children, they just don't like to study.

They are very righteous to their friends, very bold, and very friends, even much better than some "good children" in the eyes of those parents.

Wu Tianjie wanted to join them when he was a child, but he was beaten by his parents and educated for a long time.

What do you say that the Tao is not in the same position......

He listened to this a lot.

I'm getting used to it.

Over the years, he had suppressed that impulse.

It stands to reason that with years of experience and education, it is impossible for him to act and act like Chen Gong at this moment.

He may even feel immature and childish.

But this kind of behavior, at this moment, Wu Tianjie is really envious.

Maybe this is the taste of youth, right?

Who is young and not frivolous?

Sometimes, he was very envious of Chen Gong, even jealous.

Study well and have intimate friends by your side.

But now he suddenly discovered that friends need to be paid with heart.

For example, Shou Weixiang was in the classroom that day, when Chen Gong was named by He Ming, he dared to stand up and take the bag.

Chen Gong can also confront Liu Zhi today because of the other party.

Perhaps, in the eyes of these teachers, they are just a small student.

But youth never speaks of victory or defeat, only that cluster of flames is the most heart-warming magnificence.

The relationship between Chen Gong and Tao Shengnan can only be said to be above average.

But Shou Weixiang and Tao Shengnan, that is like the rhythm of a pair of dog men and women.

Therefore, Wu Tianjie is not stupid, he naturally knows very well that Chen Gong is helping Shou Weixiang, not Tao Shengnan.

Wu Tianjie walked a few steps quickly at this time and chased after him.

"Chen Gong, Shou Weixiang."

"Wait a minute."

Chen Gong turned around and saw that Wu Tianjie had come out, and was stunned for a moment: "Huh? Wu Tianjie? How did you get out? ”

"The meeting is not over yet, is it?"

Wu Tianjie smiled: "No." ”

"However, I came out in the name of helping Teacher Liu criticize you."

"You're awesome!"

As he spoke, Wu Tianjie gave a thumbs up.

Shou Weixiang turned around and took a look at it at this time, but there was no figure in the crowd that he wanted to see, and he felt a little more lost in his heart.

However, everyone has their own aspirations, although Shou Weixiang didn't want Song Hongwen to run out with him, and then let him suffer injustice because of this.

But......

Even so, he still felt a little lost.

Chen Gong naturally saw the other party's thoughts, he patted Shou Weixiang's back, and said to Wu Tianjie with a smile: "Let's go to dinner together?" ”

When Wu Tianjie heard this, he was overjoyed.

He really wants to integrate into Chen Gong's collective.

Be friends with Chen Gong.

If that's the case, Wu Tianjie believes, this may become one of the most memorable things in his college youth.

"No, you can eat."

"I've got something going on."

"Eat well."

"I have to go back to Liu Zhi to talk back."

After hesitating, Wu Tianjie still smiled, waved goodbye, got up and left.

He felt that he was more willing to imagine Chen Gong as a competitor than being friends with him.

In this way, it will make him more motivated.

However, Wu Tianjie still returned to the laboratory.

After coming in, Wu Tianjie said to Liu Zhi: "Teacher Liu, Chen Gong also knows that he is impulsive. ”

"Don't be angry."

Liu Zhi snorted coldly and didn't make a sound.

……

Chen Gong and the three of them went to a small restaurant outside the school and ordered a few dishes.

Shou Weixiang deliberately took a few bottles of beer.

said with a smile: "Today I have a treat, and everyone is open to eat and drink." ”

Chen Gong smiled: "Well, okay, last time you two joined the laboratory, I didn't go over, today is just right." ”

Tao Shengnan still felt that he had burdened Chen Gong and was a little sorry.

He poured himself a full glass of beer and said, "Chen Gong, thank you!" ”

"I'm giving you trouble today."

"I respect you."

Chen Gong waved his hand: "What is this!" ”

"My daughter-in-law was bullied, if I don't get out of the horse, my son has to cut off the relationship with his father!"

As soon as these words came out, Shou Weixiang's old face turned red: "You are rolling, what kind of daughter-in-law, nonsense!" ”

"You have to call your godmother."

Tao Shengnan couldn't help laughing, covered his mouth, and giggled.

Before the meal was ready, Shou Weixiang and Chen Gong had already eaten two bottles.

This posture is going in the direction of getting drunk tonight.

"Hey, Lao Chen, let me say something, don't interject."

"Thank you so much today, you don't know, I saw a man being wronged, and he was really aggrieved."

"Thank you for taking a bad breath for your brother."

"I don't know if you're going to be disciplined for that."

"I don't care so much anymore."

"Don't worry, here, all here."

Shou Weixiang pointed to his heart and swore: "I, Shou Weixiang, swear, if you Chen Gong need my help in the future, I will shirk it once, not a person!" ”

Chen Gong knew that Shou Weixiang was not lying.

Tao Shengnan nodded and took a drink.

"Hey...... It's a pity, we still want to prepare well in the lab and strive to write a good paper before graduation. ”

"When I graduate, I will successfully take the postgraduate entrance examination and take the doctoral examination!"

"Then you can have a world of your own."

"I didn't expect that the middle way collapsed."

"I guess I won't be able to go to the lab."

Chen Gong smiled when he heard this: "Who said you can't go?" ”

"Hehe......"

"I'm going!"

Shou Weixiang was speechless: "Brother, don't brag either." ”

"I know, you have more face than me in the lab."

"However, then Liu Zhi dares to pinch us, to put it bluntly...... We are students in the eyes of those teachers. ”

"You have a bit of talent, just appreciation, not enough for them to discipline a teacher."

Chen Gong shook his head: "You wait." ”

As he spoke, his eyes flickered a little more, and he knew that he had to do something.

About this topic!

From the preparation before the start to various things in the later stage, Chen Gong has been involved.

However, no subject is perfect.

This one is no exception.

There is nothing lacking in his theory.

Chen Gong's experiments during this time were all to complement this idea.

He originally planned to wait until the end of the opening report to talk to Yang Guangye and Qi Huan.

But now......

Chen Gong felt that he needed to hold the shelf.

It's not that he did it on purpose, or how big a deal he was.

It's because Chen Gong found that if he didn't show himself, what happened today would happen sooner or later.

To put it bluntly, he's going to show off his wrists.

Tomorrow is the final stage of the proposal, and the pre-proposal report workflow and detailed arrangements.

In general, this part is still the last level of review.

However, over the years, it has basically passed the expert group review, the proposal report, and the final review...... After passing, this last link is a ritual.

Xu Tong will come tomorrow, naturally not alone.

Instead, you have to bring some review experts.

Therefore, when the time comes, some reports are naturally indispensable.

Case......

Chen Gong smiled: "Come, drink!" ”

"Don't worry, I'll be fine."

"No one can discipline me."

"Unless...... I don't want to open this topic. ”

"Other than that, you'll go back."

Shou Weixiang smiled: "I appreciate your shameless bragging." ”

"Fascinating!"

Chen Gong's face darkened: "Get out!" ”

……

……

It was nearly eight o'clock.

I ate and drank for two hours.

Shou Weixiang seemed to be a little unhappy, and he had to go to KTV to sing.

But Chen Gong was worried about something, so he didn't go.

Tao Shengnan suddenly asked: "By the way, Chen Gong, let me ask you something." ”

"Do you think I'm going to the lab tomorrow?"

"Professor Wang asked me to take Professor Xu and them to Shanhe Tower tomorrow afternoon."

Chen Gong smiled: "It's up to you." ”

Tao Shengnan pondered for a moment and said, "I'm going." ”

"After all, Professor Wang asked me to go, and it wasn't Liu Zhi."

"The more they don't want me to be in the limelight, the more I'm going to be angry with them."

"Humph!"

Hearing this, Chen Gong smiled slightly and gave a thumbs up: "Good job!" ”

Shou Weixiang obviously drank too much, the main reason was that he had something in his heart, and at this time, it was especially easy to get drunk when drinking.

Chen Gong is okay, five points drunk.

In this case, he didn't want to sleep at all.

I had thoughts in my head, and I wanted to write down my previous thoughts and experimental results as soon as possible.

Tao Shengnan and Chen Gong carried Shou Weixiang back to the dormitory.

Song Hongwen was reading there and was stunned for a moment when he saw Shou Weixiang and them coming back.

And Yang Pengwei was still looking at the love apartment, and after hearing the movement, he hurriedly got up:

"Oh, I'm Cao, why did you drink so much?"

"The point is...... Don't call me when he fucks drinking. ”

"It's changed!"

"Come, come and help, put him in the chair."

Ji Chao nodded hurriedly when he heard this, and came over to help.

"I'm not drunk!"

"Not really!"

"Hehe......"

"Hehehehehe......"

Chen Gong was speechless and waved his hand at Tao Shengnan: "You go back first, we will take care of him." ”

Shou Weixiang also said with a smile: "You go back first, man, I'll ...... I won't send you. ”

Tao Shengnan heard the sound and rolled his eyes: "That's ...... You take care of him, I'll go first. ”

After Tao Shengnan left, Shou Weixiang suddenly cried.

"Woooooooooo......oo Am I so useless! ”

"Chen Gong, I can't even protect my beloved girl."

"I'm Cao...... I'm really useless. ”

Shou Weixiang was very sad.

Friend Yang on the side was stunned for a moment and looked at Chen Gong: "What's wrong?" ”

Chen Gong smiled: "It's okay, he drank too much." ”

Outside the door, Tao Shengnan didn't go far at all.

Listening to Shou Weixiang's cry, tears also flowed down all of a sudden.

She wiped away her tears, took a deep breath, and got up to leave.

She doesn't need protection, she even has to protect her man.

……

……

Shou Weixiang cried for a while and went to bed.

Song Hongwen didn't say a word, silently taking notes there.

After Chen Gong hesitated, he got up and left with his notebook: "Don't wait for me at night, I won't come back." ”

He's going to be quiet tonight and write this.

Chen Gong did not go to the biochemical laboratory building, but to the anatomy laboratory.

Yang Guangye and Qin Xuehai are two types of people.

Qin Xuehai was even more courageous and gave Chen Gong enough autonomy and respect.

Even, in front of everyone in the laboratory, Chen Gong was directly announced as the third person in charge.

Maybe the surgical person is more bold and straightforward.

In contrast, Yang Guangye, as the vice president, although he has an academic background, is a management post.

Don't feel that doing academic work is simple.

Contrary!

In the medical field, it is always easier to engage in clinical practice than to engage in academics.

The academic circle is a complex circle.

Specialists in surgery and orthopedics have a bold and outgoing personality and often drink with students.

The shelves are not big!

is like Zeng Hui, although he joked with Chen Gong, but after encountering things, he never treated Chen Gong as an outsider.

After Chen Gong came to the laboratory, he came directly to Qin Xuehai's office.

There are beds, desks, and laboratories next to it, which is convenient for staying up late and working overtime.

Chen Gong has been here a few times, but he is also familiar with the road.

As he spoke, he opened his notebook.

Subsequently, Chen Gong imported the data from the mobile phone.

This is the result of his experiments during this time.

The tricarboxyl cycle is a ubiquitous metabolic pathway in aerobic organisms.

The Calvin cycle, as the retrograde operation of the tricarboxyl cycle, is actually a metabolic pathway for anaerobic organisms.

The tricarboxylic acid cycle is the final metabolic pathway of the three major nutrients (sugars, lipids, and amino acids), and is the hub of the metabolic links of sugars, lipids, and amino acids.

Lipid metabolism plays a vital role in atherosclerosis.

Atherosclerosis is a disease that affects the lining of the arteries of the systemic circulatory system, from large elastic (eg, aorta) to mesoelastic (eg, epicardial coronary artery).

And it is characterized by the formation of plaques in the arterial intima.

(Although in severe cases plaques can fuse).

Each plaque has a different composition.

Lipids are the basic components of atherosclerotic plaques, and intimal thickening is not strictly a atherosclerotic plaque, but an adaptive response of the vascular intima to mechanical damage.

Therefore, Chen Gong originally proposed to study atherosclerosis according to the tricarboxyl cycle, but in fact, it was mainly from the idea of lipid metabolism.

This idea is mainly divided into four steps.

And these four steps have gradually been extended and have become one of the bases for the establishment of this project.

First of all, the first step is low-density lipoprotein (LDL), which is a type of thing called "bad fat" that increases the risk factors for cardiovascular and cerebrovascular diseases.

It penetrates through endothelial cells deep into the interspace of endothelial cells, and monocytes migrate into the inner membrane, which is the earliest stage.

The second is that Ox-LDL binds to the scavenger receptors of macrophages and is taken up, forming macrophage-derived foam cells, corresponding to the lipid streaks in pathological changes.

This is followed by the third step, where vascular smooth muscle cells (SMCs) from arterial medial migrate into the intima and phagocytose lipids to form myogenic foam cells, which proliferate and migrate to form fibrous caps, corresponding to the fibrous plaques in pathological changes.

In the fourth step, Ox-LDL causes the above two foamy cells to disintegrate and form chyme atheronecrosis, and atheroma plaques are formed.

Corresponding to atheroma in pathological changes.

In general, atherosclerosis can be known according to the mechanism of the formation of the tricarboxyl cycle:

The key link lies in Ox-LDL, and how to prevent LDL from being oxidized to Ox-LDL has become the core of the treatment and prevention of atherosclerosis.

But......

Chen Gong found that the study according to this idea is incomplete, and there is even a problem!

According to the results of the latest World Biochemical Annals report, the formation of foam cells in the third step is not the main clue and cause.

As a result, Chen Gong began to explore the sequence and ideas of foam cell formation and began to study.

So, Chen Gong's main work during this time is here.

And fortunately, his experiment did a good job!

Chen Gong found that the formation of foam cells cannot be studied simply according to this idea.

He needs to explore it at the level of small RNA molecules.

Thereupon......

Chen Gong began to study small molecule RNA.

Small molecule RNA (miRNA) is a class of non-coding RNA with a length of about 21~23 nucleotides in eukaryotes, which can bind to mRNA and inhibit the expression of post-transcriptional genes and affect biosynthesis.

In the tricarboxyl cycle, the presence of small RNA affects the formation of foam cells.

This process...... Chen Gong thought it was amazing.

In fact, Chen Gong was also lucky!

He found that there are indeed some small molecules that affect the process of atherosclerosis!

These small molecules, through the formation of foam cells, lipid deposition and inflammatory responses, have been studied at a more direct level in atherosclerosis.

Other words......

The study of the three carboxyl cycle on atherosclerosis cannot be started from the three carboxyl cycle alone.

The role of the tricarboxyl cycle cannot be blindly amplified simply because it is a very attractive topic.

Therefore, this topic needs to increase small molecule research.

This can be further improved.

Chen Gong feels that this is a holistic, comprehensive study.

If the intervention of small RNA is abandoned, only the perspective of the three-carboxyl cycle will be biased, and it will also cause unpredictable consequences to the experiment.

Of course, Chen Gong is naturally not untargeted.

It has an experimental basis.

During this time, Chen found that small molecule RNA:microRNA-21 was positively correlated with the stability of plaques in coronary artery disease.

This point is the result of Chen Gong's collection and analysis based on historical data.

As a result, Chen Gong later conducted data inquiries and experiments.

He found that macrophages lacking small molecule 21 overexpressed their protein kinase (MKK3) gene, which promoted the p38-CHOP and JNK signaling pathways, resulting in the degradation of the transporter ATP-binding cassette transporter G1 (ABCG1), which regulates cholesterol efflux in macrophages, affecting the formation of foam cells [12].

This finding is the best basis for argumentation.

It can even be said that it is the core of all Chen Gong's arguments today.

No. 21 small molecule RNA can promote the efflux of tricarboxyl circulating ATP through gene expression, thereby indirectly affecting the formation of foam cells, thus forming a basis for atherosclerosis!

At the same time, he recently conducted animal experiments and found that the expression of small molecule RNA No. 21 can significantly inhibit the secretion of the inflammatory cytokine IL-6, and can also pretreat the antibody to TLR4 and pyrrolidine dithiocarbamate, an inhibitor of NF-κB, to negatively regulate the lipid deposition and inflammatory response induced by lipopolysaccharides in macrophages, and play a certain protective role in atheroma.

Here, Chen Gong even came up with an idea!

Is it possible to carry out a negative adjustment in disguise through the reverse circulation of the three carboxyl cycles, and then realize the idea of protecting atherosclerosis?

……

Chen Gong's thinking is very leading, and it can even be said that no one has ever carried it out!

This is the result of an ingenious in-depth study of the tricarboxyl cycle.

Funds, Chen Gong naturally will not be spent in vain.

He's really researching things......

As he spoke, his hands jumped and flew on the keyboard like piano elves.

After tapping bytes one by one, new ideas are formed......

This will be a key point in changing the subject.

Time passes minute by minute.

Finally!

At 2:35, Chen Gong completed his thoughts and ideas.

After writing it, Chen Gong felt extremely excited.

Half of the wine was gone, but Chen Gong's excitement did not pass.

It gave him some insomnia.

Can't sleep......

But now, what can you do in the middle of the night?

Success hesitated, and suddenly came to mind.

Or......

Do your own dissection experiments for a while, rest, rest, change your brain?

After this idea was born, all of Chen Gong's sleepiness disappeared, and in its place was a kind of happiness.

It's like the feeling of being tired of writing homework, tired of writing papers, and suddenly playing a game and watching a movie.

Comfortable!

So, Chen Gong stood up and opened the door of the laboratory next door.

After turning on the light, Chen Gong found that there was a model of caudal vertebral neuroskeletal muscular structure on the table.

Moreover, there is also a notebook next to it, as well as a medical record.

At this time, Chen Gong's eyes lit up, as if he had discovered a fun game.

What is it?

Chen Gong picked up the medical record and read it.

"Patient Zhao Qiaoxian, 48 years old, had hip pain for more than a month, and it worsened for a ...... week"

Hip pain?

Chen Gong thoughtfully......

There are many causes of hip pain.

Of course, he has a professional term.

Hip pain, also known as "lumbar spinal nerve posterior branch pain", has many causes, such as intervertebral facet joint lesions, bone hyperplasia, posterior spinal nerve entrapment, and chronic aseptic inflammation of the posterior branch.

Because the gluteal epithelial nerve comes from the lateral cutaneous branch of the posterior branch of the lumbar 1~lumbar 3 spinal nerve, and is distributed in the upper lateral skin of the gluteal joint, pain often appears in the waist, hips, and thighs, and rarely exceeds the knee joint.

Chen Gong looked at the case and was gradually attracted to it.

Every case diagnosis is an interesting reasoning process, making full use of the knowledge of anatomy and pathology to carry out an exploration.

This process is very enjoyable.

It's like a delicious late-night snack, after eating, you can get a good night's sleep.

Generally speaking, the causes of this hip pain are multifaceted, such as intervertebral facet joint lesions, bone hyperplasia, posterior spinal nerve entrapment, and chronic aseptic inflammation of the posterior branch.

This requires further exploration of the cause and symptoms.

"The pain often occurs in the lower back, hips, and thighs, and rarely extends beyond the knee. Particularly buttocks pain, the main complaint, often persistent, rarely intermittent......"

Chen Gong frowned slightly.

Not lightning pain?

Lightning pain in the buttocks is a very common symptom that is common in office workers.

The symptom is a sudden sharp pain in one buttock, and numbness in the same leg and foot, and then the pain slowly disappears.

In this case, it is likely that the pain is due to sciatic nerve damage. (Eye insertion is recommended).

Then there is the soreness of the buttocks, which is also one of the common complaints in the outpatient clinic, and because of the very special location, it is often confused with lower back pain and sciatica.

In addition to considering the lesions of the joints themselves, it is also necessary to exclude the lesions around the joints and the pulling pain of distant lesions.

On top of that, it's radiating pain!

This condition is more common in dense sacroiliitis, a non-specific inflammation characterized by osteosclerosis with a high degree of dense osteosclerosis, especially in the lower two-thirds of the ilium, but there is no change in the joint space.

There is recurrent low back pain that sometimes radiates down to both buttocks and thighs.

But......

Isn't that the case of the patient?

The patient's symptoms are low back pain and hip pain on the affected side, with inductive sciatica, and the main pain is soreness, which suddenly worsens after bending, squatting, getting up, or squirming in the sacroiliac region or lower back, and is limited in activities such as turning over and getting up.

Well...... Well?

The patient weighs 210 pounds?

Boy......

Chen Gong looked at the other party's age, height and weight, and couldn't help but exclaim as an expert.

48 years old, 147 cm, 210 pounds......

Isn't this sciatica?

Chen Gong hurriedly looked at the results of the later examination for a while.

X-rays and CT scans were all done, and there were no positive findings.

But......

Just because you can't find a result doesn't mean that the test isn't meaningless.

In modern medicine, the biggest role of examination and testing is to do elimination.

At the very least, this film can rule out degenerative diseases in the spinal canal, such as spinal stenosis, lumbar spondylolisthesis, and lumbar disc herniation.

Aren't these cases?

Chen Gong frowned and continued to look at the physical examination.

The straight-leg raise test and booster test were negative, and there was no sensory impairment in the sciatic nerve distribution, normal tendon reflexes, and no symptoms of other nerve roots.

That's interesting!

Chen Gong is also the first time he has seen such a case.

These signs were clearly present, but there was no imaging support from the film.

What could this be all about?

Chen Gong hesitated, and suddenly saw an information point.

"Palpable enlarged lymph nodes deep in the subcutaneous tissue of the sacroiliac region of the patient......"

This thing, it doesn't seem to have any clues.

But Chen Gong's mind turned very fast.

He believes that in the process of diagnosis, there is not a single symptom that is useless.

It's like when a disease occurs, no one is innocent!

Just like the relationship between toothache and hemorrhoids, do you believe that there are really scholars who have studied the correlation?

After Chen Gong saw it, he also called it wonderful.

At this moment!

Chen Gong went back and forth through the medical records many times.

A large number of descriptive signs and indicators......

In Chen Gong's mind, a human figure had even been formed.

The image of a 48-year-old woman with a height of 147 and a weight of 210 pounds.

And the bones, muscles, nerves, and organs also clearly appeared in Chen Gong's mind.

Gradually......

Chen Gong fell into deep thought.

What's going on?

In this way, time passed minute by minute, Chen Gong continued to open the medical record to check, and the various symptoms in his mind gradually plumped up.

Suddenly......

Chen Gong saw a sentence.

The patient feels that "swelling and pain behind the knee"

What's going on?

In Chen Gong's mind, the patient's painful part increased by one, and in the popliteal fossa, there was swelling!

This is a special sign!

Could it be...... Vascular level?

Chen Gong closed his eyes and thought wildly.

Suddenly......

He contacted the patient with palpable lymphadenopathy in the subcutaneous tissue above the lateral sacroiliac joint......

Maybe......

Isn't this a lymph node?!

This thought made Chen Gong's eyes light up.

He hurriedly opened the book and looked at it.

Half an hour later......

Chen Gong finally thought of something.

Right!

This may not be a tumor, a nodule, or a hyperplastic calcification.

But...... Hernia!

What is a hernia?

It's just that the tissue is prolapsed out, and there is one more piece.

And this hernia for women is more bullish than that, it is a kind of fat hernia.

Called...... Sacroiliac joint fat hernia!

His most typical signs are that the upper edge of the iliac crest is medial, and a single or multiple nodular masses can be palpated in the subcutaneous tissue above the outside of the sacroiliac joint, with a diameter of 1~3cm, and the nodule texture is hard and tough, and pain occurs when plucking or pressing.

When this happens, it is accompanied by swelling of the popliteal fossa, which causes a disorder of blood vessels in the lower limbs.

Some patients may have pain in the sciatic nerve distribution, but the straight leg raise test and enhancement test are negative, and there is no lower extremity sensory deficit or abnormal reflexes.

Following this line of thought, Chen Gong continued to analyze the case back and forth.

The more I looked, the more Chen Gong felt that it was like, and even should be!

Sacroiliac fascia fat hernia is actually a hernia formed by the protrusion of buttock fat through the sacroiliac fascia.

To put it bluntly, there is too much fat in the buttocks, which punctures the sacroiliac fascia and bulges, causing pain.

After Chen Gong thought it through......

So on the blank paper at the back of the medical record, I drew the model diagram in my mind.

Then the area and location of the sacroiliac fascial fatty hernia were also drawn.

As for the treatment technique......

Chen Gong did not paint.

Not just because it won't, the main reason is that it's not necessary.

Hernia surgery, in fact, is very simple, it is nothing more than filling the fat back and repairing the fascia.

Well......

Although Chen Gong can't, it doesn't affect his ability to think this operation is simple.

Then, Chen Gong gave some answers, closed the medical record, and yawned.

Go back to bed......

This late-night snack is really good.

……

PS: Answer two questions.

First: I spoke about increasing the value of fans, because I was in too much of a hurry, and my habitual thinking was adjusted to 500, so I'm sorry about that...... It has been revised, everyone can rest assured.

Second: Yesterday someone said that the quality is not good, but in fact, it ...... Although the veteran is in a hurry, he ...... Really careful, probably because the plot design was not very good at the beginning, and I will revise this.

Thirdly, it is grateful!

Thanks to the "pit in the sky" brother's arrogant 100,000 reward, this is the old brother who has followed the veteran for several books, really thank you for your support!

Thanks to "lyglian" for 9000 tips, thank you boss!

Finally, thank you to every reader who supports the genuine version, thank you.

(End of chapter)