Chapter 570

"Dean Chen is a bit moody; perhaps I haven't fully entered his sight yet." Fang Ziye very firmly pinned this label on his relationship with Chen Song!

If I swapped places with Wu Xuanqi from Tongji Hospital, the encounter would definitely be completely different.

"But this is normal; if Dean Chen Song had poured his heart out to me from the start, holding nothing back, that would be worth guarding against." Fang Ziye affirmed this again.

Once the research direction planning was settled, Fang Ziye hurried to the Demonstration Classroom in the Surgical Outpatient Area to attend the surgical discussion.

Now, my foothold in the Yangyuan still lies in clinical ability, not in being a Premium 'Researcher'!

Naturally, it was only after meeting those top experts with Dean Chen Song that Fang Ziye realized the domestic research circle also has Big Shot-level figures.

For instance, one of those elders improved current drug formulas, reducing side effects or enhancing therapeutic efficacy.

Some gave classic drugs a new lease on life by adjusting dosages.

Different drug dosages can have vastly different efficacy; this is a basic principle acknowledged by pharmacology.

Therefore, the development of pharmacology will continue on.

In the research circle, new drugs emerging is naturally the most dazzling achievement, but if some classic drugs, clinically proven drugs, can be given new life through another form, their clinical significance will be even greater.

Because these classic drugs can be directly applied clinically, starting clinical trials without needing multiple rounds of animal experiments!

In the Surgical Outpatient Area, the Second Demonstration Classroom was empty.

Fang Ziye pushed open the door, then closed it again: "Am I seeing things?"

He checked the message again; the location Gu Yi sent was indeed Demonstration Classroom Two?

Fang Ziye dialed a number, asked a sentence, and Gu Yi hurriedly hung up and typed back on WeChat: "What the hell? Stayed up too late, I sent the wrong message, it's Conference Room Two."

It looked just like he had received a harassing call.

Fang Ziye: "..."

The Demonstration Classroom is definitely the Surgical Outpatient Area's Demonstration Classroom; the Conference Room is the one in the Comprehensive Building.

"Sorry I'm late, Professor Gong."

"I was just about to set off when Dean Chen Song's scolding call came in; I went over to listen to the dressing-down." Fang Ziye explained briefly.

"It's fine, Professor Fang; you're the Group Leader, if you don't come, our work still has to continue! ~"

"Today we mainly continue the discussion from last time."

"This patient's deformity spans the knee joint, so this surgery, besides functional reconstruction, also requires joint reconstruction correction surgery."

"Our Trauma Group and Hand Surgery Group don't have cross-joint experts, but Professor Qiao Yongjian from Spine Surgery did Joint Surgery for ten years before transferring to Spine Surgery."

"I've already consulted him; Professor Qiao is willing to come help tomorrow!" Gong Jiahe reported their preparations one by one.

Hearing this, Fang Ziye scratched his ear and said: "Professor Gong, didn't I say before I'd find a way? You still went and called someone?"

Previously, this patient's surgical plan had been discussed about twice; Fang Ziye was slightly modest, saying his joint surgery correction technique was average, and Gong Jiahe actually believed it.

He went to ask through his own connections.

The capabilities Fang Ziye has shown so far are expertise in Trauma Surgery and Hand Surgery; presumably in everyone's perception, these two sub-specialties have already consumed all of Fang Ziye's heart and energy.

So not being very proficient in Joint Surgery is only natural.

"Group Leader Fang, I definitely remember your words, but I asked several Hand Surgery professors, and it seems you didn't ask anyone either?"

"I was anxious!" Gong Jiahe said.

Fang Ziye's capability is fine, his strength is absolutely the strongest in the group, but in terms of interpersonal relationships, Fang Ziye has just arrived after all.

If he had just arrived and didn't do things honestly and steadily, only thinking about managing relationships, Chen Song would probably have kicked Fang Ziye out directly.

After being recognized, naturally there should be mutual exchange!

Everyone is in a cooperative relationship, not a competitive one; as long as you do well, you can have credit, others doing well has nothing to do with you.

Equivalent to a pass/fail 'assessment', not a competitive assessment.

Therefore, everyone hopes to do more things, taking one point as a core breakthrough, with others helping out one after another.

Difficult and complex cases are difficult precisely because they may span multiple, even seven or eight specialties is not impossible.

For example, current clinical complete helplessness against spinal cord hemisection or complete transection injuries; to tackle such disease types, at least a dozen departments' comprehensive joint effort is needed.

Spine Surgery, Hand Surgery, Vascular Surgery, Gastrointestinal Surgery, Urology, Joint Surgery, Anesthesiology, Cardiology, etc...

"Thank you for your trouble, Professor Gong!"

Fang Ziye pursed his lips, saw his Knowledge Points had accumulated to eighty or ninety thousand, and said: "Professor Gong, actually regarding Orthopedics, I understand a fair amount."

"When I was Chief Resident, I encountered quite a few joint dislocation patients, and also pelvic fractures, hip joint injuries, mangled extremities; during treatment, one must understand them to some extent."

"Plus our team's main research direction is Bone Tumors, so I have some understanding of bone tumor theory and operations, but Sports Medicine is a relatively unfamiliar module."

Fang Ziye just revealed a little bit of his hand.

I'm already an Associate Professor; me being a bit omnipotent is nothing, right?

As for why I know them, don't ask; ask and it's talent, otherwise how did I get this Associate Professor title?

Gong Jiahe opened his mouth.

Fang Zhikuan also shifted his buttocks, letting his gaze better land on Fang Ziye.

Professor Du Donglin's eyes rolled around, asking cautiously: "Professor Fang, the disease types here aren't common outside; just a little exposure is still not enough."

"In the Yangyuan, showing off is not a good thing!" Du Donglin's tone wasn't sarcastic, but explained in an elder's tone.

Fang Ziye nodded hearing this: "I know, Professor Du."

"Take it slow, walk slowly, look slowly."

Fang Ziye spoke to here, raised his right hand and pressed down slightly, then said: "Actually when I was at Zhongnan Hospital, I had some ideas of my own, but no chance to implement them."

"Many comprehensive factors: one is my own experience and encounters, two is our work arrangement's focus, still controlled by the teachers."

"This time coming to the Yangyuan, hearing Professor Gong say you'd give me the Group Leader position, I was both apprehensive and a bit happy."

"Apprehensive about doing poorly in this position, happy that I can truly plan things according to my own intentions and ideas."

Hearing Fang Ziye say this, some people's tones became sincere, and they put down their pens.

These words could not be written in the notebook; instead, he observed Fang Ziye thoughtfully.

After Fang Ziye arrived, he served as Acting Group Leader for a month, never once speaking in grand terms, never once painting a rosy picture.

Now he has been Group Leader for nearly ten days, and still has never spoken of his ideas; everyone assumed Fang Ziye simply found it hard to say, or had nothing to say.

But now Fang Ziye still pulled the old trick of "a new official's three fires"!

Whether out of personal feeling or duty, they all wanted to let Fang Ziye finish his words!

Fang Ziye's hands were slightly sweaty; nervousness definitely existed!

He was merely an Associate Professor, at least in title, yet sitting before him were six Professors, five Deputy Chief Physicians!

In title and seniority they all surpassed him, yet he had to stand up and arrange these seniors with a clear conscience, which meant he first had to overcome the barrier in his own heart.

At the same time he had to give a sufficient reason to persuade them!

For this, Fang Ziye had prepared for a long time.

Fingers tightly interlocked, after clenching and unclenching nearly four or five times, Fang Ziye spoke again: "Earlier Professor Gong also suggested that I gradually carry out functional reconstruction surgery in the sanatorium, making it a routine procedure; this is currently a very popular, sought-after, and relatively easy technique on the market."

"However, I have never had much enthusiasm for this aspect. It is not that I am particularly arrogant, unwilling to take in more patients, do a bit more."

"On the contrary, for me, this is very simple."

When Fang Ziye spoke here, he took a deep breath, the nervousness in his heart gradually soothed, and at the same time he began to reveal his innermost thoughts: "Regardless of how the various professors view me in their hearts, I still want to say everything I want to say."

"First, I previously had experience as the lead researcher on two clinical projects, so I am very clear on the process and difficulty involved."

"But I feel that this process is very enjoyable, and it is something that benefits the development of the medical cause more greatly and more highly!"

"So I still want to continue doing such things."

"Second, simply repeating surgeries I have already done, bringing rehabilitation and health to patients, this is indeed worth being happy about; after all, this is the fruit of my own two hands' labor."

"However, doing the same thing day after day, year after year, even if it is one's hobby, once it becomes a profession, burnout will appear!"

"To put it plainly, there is no passion, it has merely become mechanical repetition."

"So I also want to create something new, because I have done it before."

"Third, our team previously spent less than half a year on the research and development of mangled extremity limb salvage surgery and functional reconstruction surgery, going from nothing to something, from something to mastery."

"Regardless of whether this length of time fostered arrogance in my heart, I have confidence that we can create some new things again."

"Although it will consume more time, it is also worth it."

"If not in one year then two years, if not in two years then three years; we are all still young, and I will speak a truth."

"Although my previous team had my Person of Gratitude, comprehensively calculated, our current team's comprehensive strength is several times that of the previous team."

"I believe that if we undertake new disease-type treatment plan research and development, it will only be relatively faster, not slower, not a waste of time."

Fang Ziye's words made everyone present fall silent.

One must admit, Fang Ziye's thinking logic is extremely meticulous; his words have a certain incitement, but even more credibility.

Fang Ziye's previous two clinical projects were completed in half a year!

This kind of capability and talent is currently absolutely unique nationwide; such talent, even compared to the most top-tier geniuses among domestic clinical medicine seniors, slightly surpasses them, rather than being merely comparable!

With past facts placed before everyone, even if Fang Ziye had not spoken like this, they would have spontaneously thought in these directions!

Fang Ziye has the capability to do such things.

Not empty talk or boasting; even if there is a hint of relying on talent to be arrogant, it is not that exaggerated.

Fang Ziye scanned the crowd, and after taking in all their different expressions, Fang Ziye said: "My current planning is like this: our sanatorium operates a two-way appointment diagnosis and treatment system; patient sources are basically not lacking."

"Based on the experience accumulated in the early stage by our sanatorium's Trauma Surgery and Hand Surgery, bone defect treatment in Trauma Surgery is relatively mature."

"But the standardized treatment plan for bone defects is currently not perfect enough; we can advance a bit in this direction!"

"If we can correct and improve the standardized treatment plans and guidelines for bone defects to a certain degree, then even if we spend half a year doing such a thing, it is worth it."

"Professor Gong, Professor Fang, what do you two think?" After Fang Ziye finished his arrangements, he directly asked Gong Jiahe's opinion.

Painting a rosy picture must first be grounded!

For things to be grounded, all kinds of preliminary preparations must be done well. That is the preliminary research of basic research projects, laying out all possibilities before everyone.

Hearing Fang Ziye ask like this, Gong Jiahe recalled the words he had once said to Fang Ziye; Fang Ziye had not failed to understand, but rather they fit perfectly into Fang Ziye's heart and philosophy.

Even, it was not he who guided Fang Ziye, but rather it coincided exactly with Fang Ziye's ideas.

"If the guidelines and expert consensus can really be corrected, it absolutely does not count as a wasted trip!" Gong Jiahe nodded.

What is the result of correcting guidelines and expert consensus?

The fucking people sitting here will become the experts, become the authorities!

If it is done well, and a Chinese Medical Association, Orthopedics Branch, Bone Defect Study Group are established, everyone present will be Elders.

Fang Ziye listened and said: "Current bone defects have different classifications."

"Clinically, small bone defects are more common, mainly treated with autologous bone grafting, calcium carbonate, bone cement, bone transport surgery, etc."

"Including the bone defects we treated in the early stage, they were also mainly treated with bone prosthesis material bridging."

"The reason there are relatively many treatment methods is because the effect of each treatment is quite equivalent."

"Another layer of meaning of similar treatment effects is that they are not too satisfactory, so there are many experts seeking elsewhere."

"And our team has a relatively natural advantage: individualized prosthesis design for bone defect prosthesis materials."

"We can treat half pelvic fracture bone defects with prostheses; then other bone defects certainly can also achieve relatively good efficacy."

"However, individualized prosthesis treatment is actually also one of the alternative options for basic techniques like bone transport surgery; it merely replaces bone cement and other prostheses with metal prostheses!"

"This is not the final destination of our project; currently, regarding bone defect treatment, there is a nanomaterial bone defect replacement option that is relatively advanced."

"My idea is: if osteoinductive materials can be combined with nanotechnology, allowing bone defects to form native bone on the nanomaterial after surgery, reaching the standard of standard fracture healing."

"Then this can well supplement the bone defect treatment plan."

"Osteoinductive materials, according to current research frontier directions, cc composite material, is a non-metallic in vivo consumable."

"It has no metal debris, has already been relatively successfully applied in heart valve and other surgeries; if we introduce this material's design module and improve it, there is a chance to design individualized prostheses according to the bone defect patient's defect segments..."

"Carbon composite material is a substance closer to the elements of the human body than silicon, with extremely good biocompatibility..." Fang Ziye slowly pushed out his research plan in this manner.

Every step is well-reasoned, and all have preliminary research as their foundation.

Some are independently developed, some are borrowed from others.

What should be borrowed must be borrowed!

"Professor Fang, pushing this forward won't be easy, right? There are already quite a few bone-inducing drugs and materials on the market currently; how to combine them with C-material and nanotechnology is also a basic research difficulty."

"Even if developed, it would still need animal model preliminary research to guarantee no toxicity, and that the prosthesis material and the brittleness of internal fixation surgery meet various indicators reaching nationally recognized standards." Gong Jiahe frowned.

This is a super huge project!

"Yes, Professor Gong, but if we don't lean in this direction, it will be forever impossible to move forward; taking the first step is even more important than the result."

"Moreover, this research project has extremely strong core and extensibility!"

"So this is both a near-term research plan and a long-term plan."

"Let's start from the individualized bone defect prosthesis model first; this can yield results in the near term."

"Going a step further, that is the basic research direction."

"Surgical improvement, instrument improvement, and instrument manufacturing material improvement can be advanced and integrated step by step!"

"In this way, if it can truly succeed, the farthest reach could even replace over fifty percent of current orthopedic consumables on the market!"

"This project is very meaningful, just difficult to advance."

"We don't need to look too far; we only need to standardize the procedural plan for individualized prosthesis design — that is the first step; the second step is to supplement the current standard treatment plan for bone defects!"

"As for the third step and beyond, we can advance slowly; even if everyone returns to their original units later, it will still be a major project requiring multi-center, multi-laboratory collaboration."

"Meeting is fate!" Fang Ziye analyzed.

Short-term has short-term arrangements, long-term has long-term planning; no one can find any loopholes in Fang Ziye's plan.

Everyone has things to do, credit to claim, and taking one light step forward is easily within reach.

Gong Jiahe nodded.

Professor Fang Zhikuan, however, seemed slightly uncomfortable: "Professor Fang, your bait is a bit too tempting, isn't it?"

Professor Yan Huanan, on the other hand, kept his head down, unknown what he was pondering.

If things really proceed according to Fang Ziye's plan, then the prospects of its preliminary research far exceed those of mangled extremity limb salvage surgery and functional reconstruction surgery.

Its significance of influence is even greater than that of the microcirculation instrument!

This f*ck?

A gentleman loves wealth, but obtains it by proper means.

A gentleman loves fame, but also obtains it by proper means.

Throughout history, unknown how many scholars have dreamed of obtaining the posthumous title of Wenzheng Gong!

"Professor Fang, that depends on how you understand it? How is this fishing and bait?"

"This is just solidly, based on the reality encountered, analyzing a path closest to reality that can be explored."

"Let's get started first! Taking bone defects, various difficult and complex bone defects as the foundation!" Fang Ziye finished saying this, then looked toward Professor Du Donglin.

"Professor Du, bone defects and hand surgery sub-specialties don't have strong compatibility."

"But there is an intersex disease type — wait, 'intersex' is likely a typo for 'key' or 'specific' — I believe is currently a good project for hand surgery to extend into!"

"That is diabetic foot caused by diabetes, diabetic dysfunction, diabetic-related nerve necrosis."

"Skin and soft tissue defects caused by diabetic foot currently have no particularly good treatment plan."

"The amputation rate caused by diabetic foot is over fifteen percent!"

"Peripheral nerve dysfunction caused by diabetic foot is outside the scope of functional reconstruction surgery at Zhongnan Hospital."

"Additionally, functional reconstruction surgery for neurodegenerative lesions was not previously in our developed functional reconstruction surgeries either."

"Diabetic foot smells bad, surgery is very complex, and requires fine operation; this is a disease type many medical staff are unwilling to accept for consultation and detailed treatment, yet the patient volume is actually enormous."

"So I believe our hand surgery department doesn't need to stare solely at pure functional reconstruction surgery, but can progressively bring in some diabetic foot patients."

"This is a comprehensive disease type of foot and ankle surgery and hand surgery, a good pioneering direction!"

"In this aspect, currently, the main treatment plans for diabetic foot are as follows."

"Inferior vena cava endovascular intervention, vascular bypass surgery, skin graft surgery."

"The main pathological mechanism of diabetic foot is local soft tissue ischemic necrosis; the mechanism of peripheral nerve degeneration is also this."

"Currently not many people research this direction, but few and unpopular doesn't mean it's unimportant or meaningless!"

"If we can lower the diabetic amputation rate to below five percent, or even one percent, that would also be a very proud achievement."

"For treatment in this aspect, it is mainly based on the following points."

"Nerve damage caused by trauma and infection; its essence still boils down to local blood supply circulation obstruction, where trauma or infection leads to local blood supply embolism."

"This converges with the pathogenesis of diabetic foot."

"Nerve grafting surgery is our hand surgery's specialty; we must understand the essence of nerve grafting surgery!"

"I wonder, does Professor Du have any ideas or thoughts on in vitro nerve nutrition or abdominal nutritional support, analogous to flap transplantation?" Fang Ziye asked.

Fang Ziye merely gave a slight reminder, and Professor Du Donglin said: "Impossible!"

"Abdominal flap transplantation for skin defects relies on the abdomen's ample blood supply, so the flap can be nurtured in the abdomen; nerve grafting?"

"Nerve grafting, nerve grafting." Du Donglin repeated several times, but ultimately didn't continue saying impossible.

Fang Ziye then said: "I think nerve grafting preoperative nutrition technology is feasible! Although it's limited to the upper limb, lower limb nutrition isn't necessarily limited to pedicled nutrition only!"

"If we can nurture peripheral nerves in the abdomen, and when surgery is needed again, re-implant them at the previous severed segments, isn't that also feasible?"

"In principle, it is feasible!"

Why does diabetic foot present peripheral nerve damage? Because of poor blood supply, mostly occurring in the anterior tibial region.

The nerves and soft tissue at this location are prone to necrosis, caused by local anatomical characteristics.

However, the blood supply in the abdomen is relatively rich!

Burying the nearly necrotic nerves first in fertile soil, then transplanting them back to their original location — this is the fundamental nature of a farmer planting fields!

Growing rice, the process of raising seedlings, is not carried out in the paddy fields.

"Possible? But?" Du Donglin felt a bit crazy; this idea was simply crazy.

Yet it also made perfect sense.

Many flaps in hand surgery are cultivated on the anterior abdomen, and they are open wounds, letting the patient's hand and abdomen adhere together; after they heal well, they are separated and sutured, performing flap transfer surgery.

Do nerves work that way too?

It might really be that only nerves work this way!

Two nerves are not the same.

Fang Ziye listened up to this point and finally said: "Professor Du, Professor Gong, these are some of my thoughts; we have absolutely no need to chase after functional reconstruction surgery that is already gradually maturing, just to chase trends."

"Even if we can't catch the trend, we can create our own trend."

"For example, limb replantation surgery in hand surgery was first proposed and completed by the Sixth Hospital of Magic Capital; before its completion, everyone thought it was incredible!"

"The world's first nerve transplantation surgery was done by a surgeon from Country A; before it was done, everyone also thought it was impossible."

"But in fact, as long as the basic principles are mastered, the rest is just doing it."

"That's what I have to say; let's talk about the surgery we're doing tomorrow!"

Fang Ziye then changed the subject and began to analyze the case step by step together with everyone.

Professor Gong Jiahe and the others are all professionals; it's impossible for them to lose focus on the case discussion just because Fang Ziye painted a slightly rosy picture.

On the contrary, they all have their own ideas and concepts, and would propose some plans, such as performing osteotomy correction surgery, etc.!

Once a plan was proposed, they would either support it, finding evidence for its feasibility.

Or oppose it, finding evidence and theoretical support for its infeasibility.

In the end, the plan everyone finalized was: knee joint correction reconstruction surgery + tendon displacement surgery, tendon transplantation surgery, skin and soft tissue defect surgery (standby flap transfer surgery)!

After the discussion, the time had already reached 9:53 PM.

The time was indeed not early; Fang Ziye still had to send the surgical plan to the surgical department so they could prepare instruments and anesthesia in advance tomorrow.

So everyone dispersed.

However, after the discussion ended in the conference room, Fang Ziye rode his electric scooter and arrived at the villa, then video-called Luo Tingzhu for only a few seconds.

The doorbell outside the villa area rang.

Through surveillance, Fang Ziye discovered the visitor was Professor Fang Zhikuan.

"Tingzhu, Professor Fang is here; I'll go open the door, we'll chat again in a bit." After Fang Ziye finished speaking and got Luo Tingzhu's nod, he walked out of the villa area to personally welcome him.

When Fang Ziye reached the doorway, Professor Fang Zhikuan and Professor Du Donglin had gathered together, the two people facing each other, with a slight air of 'deep affection'.

Then, from the distance, another sound rang out.

"Professor Fang, Professor Du, you two are really fast; I just went back and took a shower, didn't expect to be the last to arrive." The visitor was Professor Gong Jiahe.

In the darkness, his figure was huge; his already slightly plump build was stretched by the streetlights into a large dark blob.

Professor Yan Huanan, who "happened" to be strolling to Fang Ziye's doorway, humming a tune, jumped in place, then laughed heartily: "Professor Fang, your doorway is really lively……"

……

All six professors from Trauma Surgery and Hand Surgery, without exception, came knocking.

In Fang Ziye's living room, the kettle boiled like it was strapped with leather strips, gurgling and continuously steaming.

In the room, six people looked at each other, not a single one daring to speak first.

In the end, it was still Professor Fang Zhikuan who opened the topic: "Group Leader Fang, if we want to do basic research on bone defects, what point should we start from?"

"What basic cell lines are needed?"

Professor Gong Jiahe hurriedly said: "Whether it's bone tumors, or normal bone, normal cartilage, or basic cell lines for osteoarthritis, our team has them all."

"As for basic cells in other aspects!"

Professor Gong Jiahe still didn't want to monopolize: "We can also think of ways together."

The bait Fang Ziye offered was too strong; people would be hooked into bigmouth bass, let alone fish?

Fang Ziye said: "Bone induction material, the base material is one aspect; additionally, there are two more important matters: structural construction and auxiliary materials."

"CC material is the base material; for designing the base material structure, we need to invite material science experts to discuss."

"The more important part is auxiliary materials or drugs: how to wrap the currently relatively easy-to-use drugs into the base material and spatial structure to stimulate osteoblast migration and attachment — that is the relatively crucial point."

"If subdivided, it can be divided into quite a few tasks."

"Don't know which steps the several professors are willing to handle?" Fang Ziye asked.

Many hands make light work; these professors all have teams; as long as the tasks are assigned down, there will naturally be people to produce results.

Professor Gong Jiahe answered irrelevantly: "Youth is good, strong physical quality, abundant energy, so prolific."

Professor Gong Jiahe scanned Fang Ziye up and down, with the suspicion of flirting.

(Chapter End)