madnovel Chapter 112 National-Level Skills, Unraveling the Mystery!
Chapter 112 National-Level Skills, Unraveling the Mystery!
Chapter 112 National-Level Skills, Unraveling the Mystery!
The teacup held only a sliver of steam, rising gently and slowly.
The light from the suspended round lamp is soft.
The computer screen displayed densely packed test results data and text —
Guo Ziyuan leaned forward slightly, and after reading the long explanatory message sent by An Yue, asked, "So—can you now confirm that it's too late for you to apply for similar research projects?"
"Is the data we collected before useless?"
An Yue replied, "That's right, Dr. Guo."
"This result is due to my own reasons and will not affect you, Dr. Guo."
"Our previous agreement remains valid."
An Yue was somewhat wary of Guo Ziyuan saying anything more extreme, so he quickly clarified the matter.
"Then why did you come back?"
"What I mean is, what's the point of sending me these messages again?" Guo Ziyuan asked.
As previously agreed, the transaction would be essentially completed when Anyue returned from Yishi.
Guo Ziyuan was only helping Anyue collect data and assisting with the operations to speed up the data collection process.
Whether your chosen research direction is problematic or whether you can secure funding is none of Guo Ziyuan's concern.
Guo Ziyuan doesn't run a project-based company that guarantees funding; he doesn't say things like, "You pay a certain amount, and I guarantee you'll get the project; otherwise, the transaction is invalid or you'll get a refund."
"If I want to reapply for a research topic, I need to collect data more quickly. So, I hope Dr. Guo can still help me."
"Of course, I will collect data while writing the paper, and it won't delay our previous transactions."
"But we must make one point clear again: if I am the corresponding author, the research rewards for publishing the paper will belong to me!" An Yue's attitude was clear.
Publishing papers can earn money, and that's what Anyue is after.
Guo Ziyuan: "That's no problem—I only want the paper, not the rewards from the hospital and the school for publishing papers."
"What direction should we take for data collection next? If we have to come up with that on the fly, it'll take a lot of time, won't it?"
"You didn't tell me what kind of data you need to collect, how can I help you?"
"I suggest we discuss this issue again later!"
An Yue: "No, Dr. Guo, I've already chosen my research direction. Besides the previous research on debridement of diabetic foot, I have three other alternative directions."
"The reason I want to collect data on the current direction is simply because I don't want all my previous efforts to go to waste."
"So, if you'd like, Dr. Guo, I can send you the document right away, and we can start collecting data in three days at the latest."
After reading An Yue's words, Guo Ziyuan felt like he was just a nobody on the side of the road.
Ding Xianqi once explained to Guo Ziyuan the project planning and paper planning of scientific research leaders.
For example, with academic papers, people usually submit a few, work on a few more, and have a few more in reserve.
The same applies to research projects; you can lead one, apply for one, and register several or even a dozen.
The main problem is a lack of time and energy, not a lack of ideas for research topics.
Guo Ziyuan extracted the key information and asked, "So can I understand it this way: what you're doing now is just to prevent your previous efforts and hard work from being in vain?"
"You weren't without a choice, you just wanted to reclaim the project you'd worked hard on?"
"Or are you just trying to make others feel uncomfortable?"
Guo Ziyuan didn't know what Anyue had gone through, but he could make a rough guess.
An Yue: "There's nothing wrong with that, is there? I'm taking back what I did myself, not someone else's project."
""
Guo Ziyuan quickly said, "You misunderstood, I didn't mean that."
This Anyue man is a bit stingy, which is normal, but that's to be expected.
Why should I leave the research I've done to others?
Even if there are unavoidable reasons, I can still take it back.
"But what about the next part of the research? How long do you expect to spend collecting information?"
"I don't want to waste time if it takes too long," Guo Ziyuan added.
"It won't be long, and it will be roughly in the same direction as now."
"It just requires a few more procedures. I need to report to the hospital to see if I can use the research start-up funds I have there."
"Oh—that's fine." Guo Ziyuan thought for a moment and then agreed.
Nobody can ever have too many academic papers.
An Yue quickly replied, "But Dr. Guo, this time the number of papers isn't as many as last time."
"I don't have much data, but I can guarantee that the quality of this paper will be even higher than the last one."
"Then, I'll send you the document, and you can take a quick look at it first," An Yue said.
Kuo Tzu-yuan: "I can't be bothered to watch!"
"I've already said, I'm just an executor. I'm too lazy to use my brain. You're the brain of this project. I'll only listen to you."
This isn't my own project; we're just collaborators. I can't be bothered to look at your proposal.
Guo Ziyuan did not choose to download it.
"I have something else to do, let's talk later!" Guo Ziyuan ended their conversation.
An Yue: "Thank you, Dr. Guo. I will compile and print out the data collection forms as soon as possible, and complete all the procedures."
Guo Ziyuan saw the message, but pretended not to.
When Guo Ziyuan focused his attention on the video on the computer again, he found that his field of vision had changed once more.
-
If expert-level film reading skills are the ability to discover details that others cannot, and to break down the field of view of a flat film.
Therefore, the film reading skills of a national-level expert can be further subdivided based on this level.
It was a mysterious and profound feeling.
This kind of disassembly allows Guo Ziyuan to use his brain to separate different tissues such as the vascular system and nervous system from the CT scan and then reassemble them into a virtual field of view.
Moreover, after completing this reorganization, Guo Ziyuan's field of vision can be expanded infinitely, allowing him to see very clearly which blood vessel's diameter has decreased and which blood vessel's diameter has increased at a certain location.
This reconstruction is more three-dimensional and clearer than the three-dimensional vascular reconstruction by CTA.
Is this the skill of a national-level expert in film analysis?
As Guo Ziyuan looked at the imaging data on the computer, a broad smile spread across his face, and he almost started dancing with joy.
This level of film reading is virtually foolproof when used for film diagnosis!
As Guo Ziyuan continued to slide the mouse, Chi Huanlin's foot CT and 3D reconstruction imaging data were extracted into different systems in Guo Ziyuan's field of vision.
Muscles, blood vessels, nerves, bones —
Those lower limbs are truly well-proportioned.
Pooh!
After cursing himself, Guo Ziyuan began to clear his mind of all the random thoughts and then meticulously examined every detail.
Osteomyelitis is confirmed.
No sinus tract has appeared yet.
Chi Huanlin's osteomyelitis hasn't progressed to the point of bone resorption and necrosis yet; it appears to be the simplest form of osteomyelitis.
She just got a soft tissue injury while hiking, which later developed into an infection.
This is a primary wound that can be cleaned and sutured very well at a county hospital.
The diagnosis of osteomyelitis is definitely correct.
Therefore, there is no reason to recommend amputation for this level of osteomyelitis.
The nerves are fine, and the soft tissues are currently fine as well.
It's osteomyelitis!
Why is the treatment ineffective?
Is the medication wrong?
Is the bacterial culture inaccurate?
None of these are correct.
As a top-tier tertiary hospital, Yilan Central Hospital has qualified laboratory testing techniques, and the results of bacterial and drug sensitivity cultures are reliable.
It's 15 years now, and it's not yet the kind of "centralized procurement drug" whose efficacy might be discounted in future generations!
If the medication and diagnosis are correct, why is the treatment so ineffective?
Osteomyelitis, if there is no necrotic bone, can be treated with medication.
Severe osteomyelitis can be cured through thorough debridement, topical medication, and intravenous medication.
Necrotic osteomyelitis can also be treated with deprivation and antibiotic carrier therapy.
Osteomyelitis is an inflammation of the bone marrow, cortical bone, and periosteum caused by infection with pathogenic bacteria.
Most cases are hematogenous, often caused by trauma or surgical infection. They are frequently caused by purulent bacteria or toxins from boils or other lesions entering the bloodstream and reaching the bone tissue. The ends of the bones in the limbs are most susceptible. Recurrent attacks are common clinically.
As Guo Ziyuan looked at the basic definition of osteomyelitis, he began to unravel the mystery.
Since the diagnosis and medication are all correct, we need to look at the most basic principles of osteomyelitis to find the possible reasons for the poor treatment effect.
In summary, it boils down to these points.
Pathogenic bacterial infection and inflammation.
This is crap.
Caused by blood!
This is the cause of the illness. Now that osteomyelitis has developed, the origin of the pathogen is no longer so important.
In the early stages of osteomyelitis treatment, antibiotics are generally used for the full course of treatment and in sufficient quantities. Using sensitive antibiotics can control the inflammation.
Osteomyelitis, there aren't any specific types for now, are there?
What is that problem?
Guo Ziyuan began rubbing his temples.
After an unknown amount of time, when Guo Ziyuan was reconstructing and carefully examining Chi Huanlin's CT scans again, he suddenly discovered a rather peculiar point.
Chi Huanlin's intraosseous nutrient vessels appear flat on CT scans!
This flatness indicates that there is not enough blood flow to penetrate.
Upon seeing this sign, Guo Ziyuan's eyes lit up: "So, the diagnosis is correct, the treatment is correct, and the problem lies in her anatomy?!"
"Normally, external injuries to ordinary people do not cause osteomyelitis. However, her bone marrow was blocked, leading to a decrease in local resistance and a near-deficient immune function. Therefore, bacteria settled here."
"In other words, there is no problem with the medication, but conventional medication is administered intravenously, returns to the heart through blood circulation, and is then delivered to various parts of the body."
This is actually a broad-spectrum treatment, with very little antibiotic reaching the affected area.
After the already limited supply of antibiotics is evenly distributed, the amount of antibiotics that can actually reach the infected area is even less.
There's something wrong with the blood vessels here!
No matter how much medicine you use, it's essentially useless.
Debridement treatment is also ineffective; no matter how thoroughly you debride, you can't remove all the bacteria.
Pathogenic bacteria multiply very quickly.
Even a small amount of residue, without drug control, could potentially reignite.
What is the root cause of the ineffective treatment?
Okay, let's assume that's true.
So, what should we do now?
Topical medication?
Even with topical medication, the drug only remains in the medullary cavity or outside the bone cortex; it does not penetrate into the cortical bone.
How can we deliver the medication evenly and accurately?
Small blood vessels are distributed throughout the body, facilitating the even distribution of medication. Now that these small blood vessels are malfunctioning, how to deliver the medication effectively becomes a problem on a completely different level.
It's a bit of a brain teaser.
Perhaps this is the fundamental reason why Chi Huanlin in his previous life, even after going to Tongji and Xiehe Hospitals, still succumbed to sepsis and died?
It seems—for the time being—that this situation is unsolvable!
The diagnosis was clear, but Guo Ziyuan was still at a loss.
Treatment for osteomyelitis has long been thoroughly researched in clinical practice. Countless orthopedic surgeons have studied it for nearly a century, and every conceivable aspect has been thoroughly explored.
In such cases, there are still some who slip through the net. These are extremely rare events, and even if you know the outcome, it's very difficult to reverse!
Unless there is a fundamental technological breakthrough.
That's even more impossible!
Is knowing the reason the last act of defiance?
Guo Ziyuan thought for several hours but couldn't come up with a particularly good solution.
However, it's not that we haven't thought of solutions, but some are too extreme and tend to involve "over-medicalization".
For example, since the blood supply to this section of your bone is problematic, and since I can't change the direction of the blood vessels, I'll just dissect this section of bone.
Artificially creating bone defects, and then treating them as such —
This treatment plan might be effective, but it won't be accepted by peers.
-
Most importantly, Guo Ziyuan currently does not have the authority to preside over the diagnosis; he cannot absolutely control or decide on Chi Huanlin's treatment plan.
"Never mind, I'll go to sleep first—" It was already 2:40 a.m.
Guo Ziyuan felt sleepy, so he quickly stretched and went to the bedroom to lie down.
Guo Ziyuan was woken up by his alarm clock at 7:30.
Guo Ziyuan did not have any morning grumpiness and woke up as scheduled.
In both his past and present lives, Guo Ziyuan has always been quite self-disciplined, thanks to his long experience working on the front lines of clinical practice.
Being able to sleep at 3 AM and wake up at 7:30 AM might not necessarily be a bad thing.
Guo Ziyuan's rented apartment was not far from the hospital, and he arrived at the emergency department at 7:47 a.m.
He was carrying breakfast in his hand and walked straight toward the control room he was in charge of.
Having pushed open the door to the doctors' rest room diagonally opposite the operating room and squeezed halfway inside, Guo Ziyuan discovered that An Yue, wearing a white coat, was standing at the door of operating room 3.
She stood with her back to the wall, hands in her pockets, eyes half-closed as if resting.
After a slight hesitation, Guo Ziyuan put down his breakfast and asked, "Dr. An, what are you doing here?"
An Yue's eyelids lifted at the sound, her lower eyelids returning to their original position. She pulled her hands away and said, "Dr. Guo, I wanted to come to the control room to assist you and prepare for collecting data for us."
Guo Ziyuan's eyes flashed: "I didn't see the tender document you sent!"
An Yue remained calm, knowing that Guo Ziyuan was unwilling to cause trouble.
The two only had a relationship of mutual benefit, not any real connection. Guo Ziyuan's sense of boundaries was even stronger than he had imagined.
"I know, but I wrote it, so I got it—"
"My idea is this—" An Yue wanted to explain his reasoning.
Guo Ziyuan pushed the door open again: "Let's talk in the lounge. You making it seem like I'm forcing you to memorize something when you're here—"