medical simulator

"What about the indications for surgery?" Zhou Cheng was obviously not surprised that Fang Yun could answer these questions.

Fang Yun frowned suddenly. Zhou Cheng was asking about the indications for surgery. In fact, there should be surgical contraindications, so he replied: "Manipulative reduction failed, unstable fractures, fractures that cannot be stabilized by plaster external fixation, All require surgery.”

"The type of this fracture belongs to B2.21 type, which is an unstable fracture type, or a femoral fracture. Even after manual reduction and plaster external fixation, it is difficult to achieve the fixation effect. Therefore, surgical treatment is required."

"If there is no concurrent shock and no serious medical diseases, surgical treatment can be performed."

Fang Yun didn't make a long speech, but picked the key points.

He knew that simply memorizing simple concepts in front of people like Zhou Cheng would definitely not be able to please him.Besides, he hasn't memorized anything conceptual for a long time.

The answer is concise.

And it also has a sense of hierarchy, one is for surgery, the other is for surgery, and the answers are different. He thinks that Zhou Cheng will definitely be able to hear the difference and the details he noticed.

"Fracture treatment?" Zhou Cheng was quite satisfied with Fang Yun's answer, so he continued to ask.

"The principles of fracture treatment are reduction, fixation, and rehabilitation exercises."

"Reduction includes manual reduction and surgical reduction. Fixation is divided into external fixation and internal fixation. Rehabilitation treatment is a follow-up rehabilitation training plan for patients after reduction and fixation." Fang Yun's answer was still decisive and capable.

"Are manipulative reduction and surgical reduction completely separate? How do you define reduction?" What Zhou Cheng asked at this moment has gone beyond the content of textbooks, and even beyond the scope of general specialist content.

Fang Yun has a good foundation, and he wants to teach.

Now these questions should be the questions that the attending and deputy chief physicians need to think about.

Fang Yun turned his head and glanced at Zhou Cheng, still hesitating in his heart. Teacher Zhou, your question is a bit out of line, but he still replied: "Surgical reduction is actually a combination of manual reduction and internal fixation device-assisted reduction. The purpose is to Achieve anatomical reduction and restore normal bone structure."

"There is no distinction between high and low. They are all for the purpose of reset. They should be viewed in an integrated way. Fixation is just to maintain reset."

"How to distinguish the method of fracture reduction?" Zhou Cheng's eyes lit up suddenly, this Fang Yun is very good, this is no longer a basic skill, it is already a skill.

Fang Yun looked at Zhou Cheng's words again, his eyes flickered, as if hesitating, should this question not be answered.After all, if we meet for the first time, if Teacher Zhou Cheng is really unable to get off the stage, how inappropriate would that be?

"You answer." Zhou Cheng signaled Fang Yun to continue.

Fang Yun lowered his head slightly, and glanced at Zhou Cheng's expression out of the corner of his eye: "Mr. Zhou, reset is the purpose. When doing reset, the principle of attention is to fully pull the fracture and separate the broken ends before performing reset. In the process, Only the force borrowed can distinguish and differ.”

"Blind strength can be used to antagonize the contraction of the muscles with the pure physical strength of the operator, so that the affected limb can be fully pulled, and the fractured ends can be separated before performing the reset operation."

"Using ingenuity, experienced and skilled surgeons will cleverly use part of the muscle strength of the patient's affected limb and analyze the shape of the muscles. Through ingenuity, they can make the reset easier."

"Then you can use your original strength. In the non-anesthesia state, the patient's own pain stimulates many muscle contractions. With this force, you can achieve the reduction without much effort. If it is during the operation and under anesthesia, the operator must find a suitable position to stimulate the natural strength of the muscle."

"I also heard that what kind of energy can be used, I don't know..." Fang Yun looked at Zhou Cheng, his tone became lower and lower.

When the skill has reached this level, according to Professor Chen Xueliang, it has reached a new level, and it is a world-class technique reset operation, which is perfect in the world.

Zhou Cheng frowned upon hearing this.

According to Fang Yun, getting started is brute force, proficiency is ingenuity, and proficiency is basic strength, then the perfect level should be what he called Huajin.

However, this strength transformation is actually not completely accurate. The perfect level of technique reset should be borrowed, but it can be borrowed from different positions, not simply relying on the strength of muscles and ligaments.

On the contrary, my current redefined fracture reduction technique has a little bit of strength.This force comes from the anatomy of the bone. Depending on the location of the fracture, it is different from the anatomy of the surrounding muscles. Through the bone itself, it can transmit force and reset itself.

This is our body's self-protection mechanism.

Zhou Chengcheng nodded, and said, "I agree with the previous points you said, but I think you can change the strength you said."

"Further up, it is heterotopic borrowing. For example, if we want to reset the fracture of the tibia, the location of the tibial fracture is very strange. If there is no muscle anatomical borrowing nearby, then we may have to use the femur and above the femur. Other positions, such as the muscles at the origin of the iliac crest and pubic bone, are used to borrow force."

"This is also a kind of leverage."

"Further up, there is bone repositioning force. Our physical body, after being hit, will have a self-protection mechanism to a greater or lesser extent, and it will still be the same after a fracture."

"This is also related to the precise anatomy of our human body. When we are injured, our existing anatomical structures will tend to restore our body to its original structure. If this force is used well, some Complicated, short bones and even fractures that cannot be reduced, which are understood in the conventional field, can also be reset manually.”

"Take the femur as an example. In our tradition, we believe that the femur cannot be reduced by manual reduction or external fixation with plaster, because even after reduction, the fracture is still unstable. Simple external fixation with plaster cannot achieve fixation. maintain the reset effect."

"However, I have done it myself. After the femur fracture is reset, it can achieve the effect of reduction and achieve the effect of continuous reduction." Zhou Cheng laughed as he spoke.

His last sentence is a bit annoying. It became what he liked to use when he was a junior doctor and when the superior doctor was bragging. What have I done.

"You can ignore the last sentence." Zhou Cheng himself didn't like this, so he hoped that Fang Yun could filter it out.

Fang Yun shrank his eyes suddenly when Zhou Cheng was speaking, and then he was very surprised, and his tone was extremely excited: "Thank you, Teacher Zhou!"

You know, Fang Yun is also a person who has seen the world. He was an undergraduate at Seoul University before. Good hospital for postgraduate study.

However, during the internship rotation, the professor showed him a lot of things, such as the complicated way of medicine that is not understood by ordinary people. Chen Xueliang introduced this medicine The different realms and levels of the book are classified in an easy-to-understand method, but it is not yet perfect.

Even during the postgraduate re-examination, my teacher Bu Haoran and the teachers there did not completely classify them. Unexpectedly, Zhou Cheng found a follow-up.

Zhou Guo is indeed unusual.

What the teacher said before is correct, in Changshi, there is indeed a great opportunity.

"It seems that you understood and didn't think I was talking nonsense."

"Okay, let's call the next patient first. This kind of discussion and learning will be done one by one in the future. You learn slowly, and I will teach slowly." Zhou Cheng also felt a sense of accomplishment.

MD, if all medical students had Fang Yun's qualifications and understanding, it would be great, and it would be so easy to teach. I just need to list the scoring standards for skills with different proficiencies, and they will automatically move closer. .

However, Zhou Cheng also knew that this was almost impossible.

Every subject requires talent.

Pure hard work can only reach the height of proficiency, it is absolutely impossible to be perfect!

Fang Yun was not in a hurry, but was more enthusiastic. He hurried out and called the next old lady in. After that, Fang Yun became more diligent...

In the afternoon, the outpatient clinic ended.

Zhou Chengcheng asked: "Xiao Fang, where are we going to eat tonight?"

"Mr. Zhou, I brought some fermented bean curd from home. It would be great to order a takeaway and eat it together. I will discuss the article with Brother Li later." Fang Yun followed Zhou Cheng out, and hurriedly Said that at this moment, the eyes are full of strange colors.

"You can just call him Xiaoyue. Li Chongyue has a good talent for scientific research, but he is a mess in clinical practice. You are enough to be his teacher." Zhou Cheng confessed to Fang Yun, hoping that Fang Yun would not put his attitude too low, which is not suitable for him. The fit within the group atmosphere.

Li Chongyue was called to Changshi by Zhou Cheng for two reasons. To facilitate discipline, he was afraid that Cai Dongfan would not be able to discipline him. Moreover, Li Chongyue belonged to the kind who was good in theory but poor in operation. His current level was too high. High, and the entry threshold for teaching.

Maybe it would be better for Fang Yun to teach him, but Zhou Cheng didn't know what Fang Yun's basic skills were like now.

However, according to Yang Yifeng, Fang Yun's surgery reproduction skills are a bit against the sky, so it shouldn't be bad!It's just that he can't touch the level of the ceiling of skills, so the height is not high enough now...

He taught Li Chongyue, raised his technical height by himself, and took what he needed.

"Ms. Zhou, Brother Li's theory is still very good. We keep our own in private. It doesn't matter. Mr. Zhou, I brought a lot of fermented bean curd this time. Do you want Mr. Zhou?" Fang Yun hurriedly started Bribed Zhou Cheng and hugged his thigh tightly.

After all, Zhou Cheng not only gave him his dormitory, but also taught him so many things.Gotta give a gift.

It's just this gift, a little bit shabby.

"It's okay, you can keep it for yourself first, and I will live right across the door from you. If you want to eat, you can come over at any time. I'll see if I cook at home later. If I do, you and Chong Yue will also come over together." Zhou Cheng It also means a little pampering.

Although Fang Yun is the same age as him, at this moment, in his eyes, Fang Yun is like a very talented child, who has a huge water tank with no water in it, waiting for his own irrigation, with excellent talent!

"Thank you, Mr. Zhou, then I'll go back first?" Fang Yun said quickly, impatiently, wanting to go back and read.

"Okay!" Zhou Cheng smiled, didn't say much, and then just walked straight back to the department, and then got out of the operating room, waiting at the door for An Ruo who got off work.

After a while, An Ruo came out and said, "Zhou Cheng, my parents found out that we live together, what should we do?"

Hearing this, Zhou Cheng stiffened his feet and asked, "Why don't we go to Shashi? Confess?"

"I'm not going." An Ruo's face instantly turned red.

How inappropriate is it to confess this kind of thing?

Zhou Cheng was also making a joke, of course, he could only follow his heart, instead, he and An Ruo had already exercised extreme restraint, and it was already a matter of course.

……

After Fang Yun came out of the outpatient clinic, he couldn't help calling his teacher, Bu Haoran: "Master, what kind of freak is that little Zhou teacher you mentioned? You said he was similar to me big?"

Today, when Zhou Cheng was testing Fang Yun, Fang Yun was also testing Zhou Cheng.

Unfathomable, this is Fang Yun's understanding of Zhou Cheng.

Bu Haoran was on the other end of the phone, laughing loudly, with a hearty voice: "Did you get educated today? Did you get hit? Or did you just gain knowledge?"

"Master, to be honest, there are both." Fang Yun's tone was a little unconvinced.

"That's right, with your talent, if you come to graduate school, you may not be much worse than Xiao Zhou now, but don't be too arrogant and complacent. People like Xiao Zhou are very rare even among similar people. of."

"That Yang Yifeng you called me before, you know, can you compare his talent? He has said that he is far behind Zhou Cheng." Bu Haoran said to Fang Yun Looking at the facts, I hope he can recognize the gap.

Fang Yun smiled and said, "Master, I have no intention of arguing with Teacher Xiao Zhou about who is smarter."

"Master, you also know that after fighting and fighting, the last thing to look at is your own realm and position. Talent is something that is useless if you don't use it. I am very happy that there are people like Teacher Xiao Zhou."

"As long as the teachers can make me improve, I am happy. Thank you, Master." Fang Yun's tone was humble.

When Bu Haoran heard this, he said, "Xiao Fang, don't underestimate yourself. Your talent is no worse than Xiao Zhou's, it's just that you are lacking for a few years. Study hard."

"Don't compare, and don't compare. If there is no competition, there will be no motivation to move forward. I just want to lie flat. It depends on your last gaze and where you want to go."

"If you only want to spend your time in the county hospital, then your current level is enough in the prefecture-level city hospital. Even if you are bold enough, it is not a big problem to go to an ordinary teaching hospital."

"But if you want to go further, you have to look at the path that can push medicine forward. That is scientific research."

"You can't promote the development of the subject, and the final destination is a senior technician!"

"Xiao Zhou's technology is certainly good, but what is even more powerful is that he dares to forge ahead to the forefront when dealing with unknown affairs. This is what you want to see."

"It's not what you get now, who owns it. If you don't have this thought, you'll just be mediocre after all. As far as the discipline is concerned, it's just such a high-level talent who is engaged in this discipline, not the top talent who develops this discipline!" Bu Haoran saw it quite clearly.

"I see, Master. However, if I want to go to a higher place, I must first have a platform for me to stand on. Otherwise, I haven't even seen the highest place, so there is no need to talk about going to a higher place." Yes. I think, Teacher Zhou is my best chance to go to the highest platform." Fang Yun's tone was humble, but what he said was not humble at all.

"Be cautious at all times, be humble at all times, and jump at the right time!" Bu Haoran said.

"Okay, Master, I will remember." Fang Yun nodded solemnly.

The opportunity for him to learn is hard-won, and he will cherish it very much. As for where he will end up in the end, he doesn't know. Anyway, he has nothing to worry about at the moment, so he rushes forward recklessly.

In the county hospital, he has already surpassed his parents' generation. He went to the prefecture-level city hospital and made a fortune. The teaching hospital is the achievement Fang Yun envisioned in his heart.

If you can push the discipline one step forward, it is the sublimation of the individual.

In life, people always have to do something by themselves.

Fang Yun hung up the phone and disappeared into the crowd. He was the most inconspicuous person in the crowd. No matter what he did, he was just a part of the crowd when he reached the crowd, but his heart was quite peaceful.

Chapter 349 Show your sharpness!

Time passed like water, and two more months passed in a flash.

One day, when Zhou Cheng just walked out of the large classroom of the clinical medicine department of Changshi Vocational and Technical College, several students surrounded Zhou Cheng.

One of the girls wearing glasses adjusted her eye sockets: "Mr. Zhou, is every skill in this clinic really as mysterious as what Mr. Zhou said?"

A young man beside him said, "Ms. Zhou, we also asked the teacher of internal medicine, and she said that what you said, Mr. Zhou, is false. There is no such thing at all."

Looking at this group of 'scholars' in their early 20s, Zhou Cheng felt very embarrassed.

They are junior college students. They are only in their sophomore year, so they have to finish the study of internal and external women and children, and then go to practice in their third year.

Such a foundation made Zhou Cheng doubt life when he was teaching.

The content of Lu Cheng's lectures is the whole of surgery. He tried to combine the theory of skill levels he planned to do in the teaching, and then it became what it is now.

This group of students not only didn't believe it, but they didn't understand it by themselves. Instead, they asked the teacher of internal medicine. Naturally, the teacher of internal medicine severely criticized themselves. They all talked to Zhou Cheng.

It probably means, Dr. Zhou, why don't we go back to being clinicians.

So, after that, Zhou Chengcheng stopped trying on them, but started to teach them basic knowledge, and chose to become a pure tool person.

However, these curious children were still very curious. While they didn't believe it, they secretly inquired about their own fame, so they approached him a little too far, thinking that they had hidden some martial arts secrets.

Of course, Zhou Cheng was not sure whether any of these people were recording. Zhou Cheng really couldn't handle this group of professional fart kids.

"If you think you have it, you have it. If you don't think it, you don't have it. First lay the foundation and clarify the knowledge in the textbook. If you have any doubts about the chapter on debridement I taught today, read the book first, and then try it out." If you can’t find any information, then come to ask me.”

"Instead of blindly getting something for nothing." Zhou Cheng also started to play Tai Chi with them.

Then, Zhou Cheng immediately took the opportunity to sneak away, and quickly took a taxi back to the dormitory.

An Ruo hasn't come back yet, but today, because Fang Yun is not on the operation day and has nothing else to do, he has been helping An Ruo organize the materials at An Ruo's home.

Hearing the sound of Zhou Cheng opening the door with a key, Fang Yun quickly stood up and asked, "Mr. Zhou, have you finished class?"

After seeing Fang Yun, Zhou Chengcai finally found a sliver of confidence in his teaching. Fang Yun had been with him for two months, and the growth rate and room for growth were exceptionally large. Now he is able to be clinically independent.

This is what he has seen, the qualifications and talents are second only to Yang Yifeng, the clinical talent may be stronger than Luo Yun and Chu Hanbo, but they are a little weaker in scientific research, and now they are being carried out by An Ruo subject data.