Back in 2002 as a doctor

Page 704

"Eggs hurt, there is something wrong with what you said." Zhou Congwen smiled slightly, and turned to look at the itinerant nurse, "Men's eggs are one high and the other low, and most... let's say less, at least 85% are left and right. Height. Only humans walk upright, and two eggs of the same height will rub against each other."

"So, in the process of evolution, human beings have already avoided the painful situation you mentioned, and the evolution is quite complete."

"Your statement is not rigorous enough, or it is fundamentally wrong."

"!!!"

Driving in the operating room and having a yellow cavity are normal.

But it is rare to drive like Zhou Congwen.

The moment after Zhou Congwen finished speaking, Xiao Kai subconsciously stretched out his hand to see if it was what Zhou Congwen said.

Not only him, but even Lu Tiancheng who was being disinfected, Liu Wei in front of the anesthesia table, and even the itinerant nurse wanted to touch it.

"Bah!" The itinerant nurse abruptly stopped her movements at the critical moment, and she spat, "Professor Zhou, you are such a stinky hooligan. It is said that the better your surgical operations are, the faster you drive." Hurry up. Originally I didn’t believe it, but today I believe it.”

"It's not driving, I'm just talking about a fact." Zhou Congwen said with a smile, "The tailors in old London must take this into consideration when measuring their body shape.

They will also explain in advance in a standard Cockney accent that they need to be measured separately so that the trousers will not fit properly. "

"Cut." The itinerant nurse sneered, "Professor Zhou, you make it sound like the clothes you are wearing are custom-made in London."

Zhou Congwen smiled and didn't explain the matter.

The clothes I wore in the last life were really made by those old tailors in London.

Although he didn't think there was anything good about it, Zhou Congwen remembered one of the details.

Emmm, in order to avoid egg pain and fit, they will measure the height.

"The key is that we learned it when we were in school, tissue culture class, remember." Zhou Congwen said, "The reason why this happens is that when the embryo is 30 weeks old, the egg settles from the abdominal cavity into the YN, and the right side descends. Later than the left side, resulting in a higher right side.

As for why the left side fell first, there is currently no explanation in basic science. "

The itinerant nurse was speechless.

Driving in the operating room and having a yellow accent are so common that it is already a rule.

Everyone is concentrating on the operation, and when they are tired, they will subconsciously say the easiest thing.

And besides this, what could be easier than this?

Driving is driving, and everyone drives. Itinerant nurses have experienced many battles, and they will not fall behind no matter who they face.

But Zhou Congwen was different.

He said something casually, and then started to academically prove that what he just said was correct.

What the hell, I've never seen anyone like him.

Everyone else has a yellow accent, only Zhou Congwen is serious about being his old hooligan.

"Similarly, the two hands of human beings are not exactly the same size. Most people have a larger right hand and a smaller left hand. Women... cough cough cough. The most typical is our chest surgery. You see, the lungs are the two left lung lobes , with three lobes on the right side."

"So what..."

"Surgery!" The itinerant nurse yelled angrily because she really couldn't stand Zhou Congwen.

Zhou Congwen shrugged, seeing that Lu Tiancheng had almost finished the list, he went to brush his hands.

After returning, disinfect and put on clothes.

Xiao Kai gave the tape of the sterile gown to Zhou Congwen's department. The itinerant nurse had counted the number of instruments with the instrument nurse, and said, "Professor Zhou, I will have to give you some rat poison to make you dumb. You are too good at saying Now, my mind is full of tissue culture. Let's go to school..."

"Rat poison, it's still sold clinically." Zhou Congwen put on sterile gloves and stood beside Lu Tiancheng, chatting with the itinerant nurse while assembling the connecting wires of the thoracoscope.

"Do you still prescribe rat poison in the outpatient clinic? If there is, I will eat all the rat poison in the pharmacy!" The roving nurse seized a flaw in Zhou Congwen, and was going to pursue it fiercely. She would never give Zhou Congwen, an old rascal, any chance to come back.

Zhou Congwen suddenly raised his head, glanced at the itinerant nurse, and narrowed his eyes, "It's okay to eat everything, and you have to rescue it. Why bother?"

"Cut, get scared!" The roving nurse said triumphantly, "Professor Zhou, do you speak with your heels? How can our hospital sell rat poison?"

"Yes." Zhou Congwen said earnestly while doing the work of the first assistant, "There is a medicine in clinical practice. We have to take it after bypass surgery, heart valve replacement, and interventional surgery in the chest pain center. Don't you know?"

Xiao Kai smiled slightly when he heard that Zhou Congwen subconsciously stripped the interventional surgery out of the Department of Circulatory Internal Medicine and turned it into a surgery performed by the Chest Pain Center.

The equipment nurse smiled, "Professor Zhou, I dare not say that. I know you are joking, but there are people coming and going in the operating room, and it is not good for people to hear that you are giving rat poison to patients."

"No, what I said is true and very serious. If you don't believe me, look into my eyes." Knowing that the equipment nurse was speaking for him, Zhou Congwen gave her a kind smile.

The itinerant nurse asked contemptuously, "What medicine? Tell me."

"Warfarin, you know this drug."

"I know, I have to take it after heart surgery, it's for anticoagulation." The roving nurse said, "What does it have to do with rat poison?"

"When Warfarin first applied for a trademark, its name was Warfarin." Zhou Congwen said lightly.

"!!!"

Everyone in the operating room fell silent after hearing what Zhou Congwen said.

"Historical records show that in 1921, a strange phenomenon gradually spread on many ranches in Canada and the northern United States.

The local cattle and sheep suddenly became very fragile. After the wound bleeds, the blood cannot coagulate normally. Some operations that do not seem to be life-threatening, such as dehorning, are usually normal operations, but they can make the cattle and sheep bleed. and die. "

"Frank Schofield, a Canadian veterinary pathologist, investigated the matter. He found that during the year, the weather was so warm that the pasture stored on the farm was moldy and putrefied, and he speculated that the moldy pasture caused the blood clotting in the livestock. disfunction."

"Isn't it haunted?" The itinerant nurse asked with a smile.

"Of course not, we are materialists." Zhou Congwen prepared the equipment and said to Lu Tiancheng, "Let's drive."

Then, he reached out and asked the equipment nurse for a piece of dry gauze.

Chapter 1201 Card Screen

"The veterinarian Schofield fed fresh and moldy pasture to the rabbits separately. As a result, the rabbit that ate the moldy pasture had abnormal bleeding, while the rabbit that ate fresh pasture was safe, which confirmed his conjecture about this strange incident."

"Finding the problem and solving the problem should have been this process. However, the veterinarian Kelfield did not continue to study it due to some reasons, but this matter is not over yet."

"Until 1940, the chemist Karl Paul Link finally isolated the anticoagulant substance from these moldy pastures and determined its structure. This is a dicoumarin-like substance, It is composed of two molecules of coumarin-like substances."

"What is warfarin? It is a kind of coumarin anticoagulant, which has an anti-vitamin K effect in the body. Look, let's make a connection here."

The itinerant nurse was completely speechless.

Zhou Congwen babbled and babbled, the key is to have reasons and evidence, and in the end he even described the commonly used clinical medicine as rat poison, making it impossible for him to refute.

What a nasty guy.

The point is that he drives too fast, a typical old rogue surgeon.

But... the equipment nurse glanced at Zhou Congwen.This kind of hooligan is no better than Zhang You.

"The monomeric coumarin molecule itself does not cause coagulation disorders, but this effect occurs when two molecules combine to form a dicoumarin structure. In the following years, several molecules have been discovered Structurally similar substances."

"The pharmacist Link modified the structure of dicoumarin, obtained a more potent anticoagulant substance in 1948, and named it warfarin."

"For many years since then, warfarin has been used as rat poison, specially given to rats. Because rats are naturally vigilant, once they find that their kind have eaten something and die immediately, other rats will not touch this kind of food again."

"But warfarin is different. It takes a long time for rats to get sick and die after eating it. Emm, there are many rat poisons with various names on the market, but the internal ingredients are actually the same as warfarin."

When Zhou Congwen said this, he suddenly paused, "That's right!"

"Ah?" The equipment nurse and the itinerant nurse listened intently, and were taken aback by Zhou Congwen's "That's right".

"Don't be greedy for cheap and buy rat poison as warfarin! Although the ingredients of the medicine may be the same, there are still some differences." Zhou Congwen said cautiously and solemnly.

"I'll go, Professor Zhou, your imagination is too rich." The itinerant nurse said contemptuously, "There are so many kinds of rat poison, who knows what ingredients are in it. Send it for identification? It will cost more money."

"Well, that's the reason." Zhou Congwen helped Lu Tiancheng stop the bleeding, and said, "There was a patient who was bleeding profusely for no reason, and couldn't stop it no matter what he said, and he still couldn't find out the reason."

"Huh?" The equipment nurse was taken aback when Zhou Congwen talked about the case naturally and smoothly.

"Don't be in a daze, chat to avoid boredom." Zhou Congwen said with a smile, "The long tongs are ready, and the warm salt water can also be prepared."

"Professor Zhou, have you always been so fast?" the itinerant nurse asked.

"Hehe." Zhou Congwen didn't care about her level of provocation and teasing, and used long pliers to help Lu Tiancheng expose the surgical field, while saying, "Later, after investigation, my boss found that the patient's illness was caused by eating barbecue. Visceral bleeding."

"Rat meat?! Meat from rats that died after eating rat poison?"

"Well, and it was the kind that was poisoned to death after eating rat poison containing warfarin... containing coumarin-like anticoagulant substances." Zhou Congwen said, "So after finding the cause and prescribing the right medicine, the patient will recover soon. "

"Fortunately, my boss has rich clinical experience. If I change someone else, I don't think all patients may be able to get out of the ICU."

"Really or not? Rat poison is given to people, isn't this a joke." The itinerant nurse was still a little confused and dubious.

"In 1951, an American soldier who attempted suicide by eating rat poison made a full recovery after being treated with vitamin K.

This accident led to a new discovery in the medical community - this kind of rat poison is surprisingly safe when used on humans.

And clinically, many patients do need anticoagulant substances to prevent thrombosis.As a result, people began to develop warfarin into an anticoagulant drug. "

"Khan, this is okay?"

"Of course, as long as it's not rat poison, it's fine. It's all chemicals anyway, so it's nothing." Zhou Congwen said casually.

"Then the rat poison becomes an anticoagulant?"

"Of course, US President Eisenhower took the first generation of warfarin in 1954." Zhou Congwen said.

"Tsk tsk." The itinerant nurse sighed, not knowing whether it was because of Zhou Congwen's erudition, or because the President of the United States took rat poison.

While chatting happily, Zhou Congwen suddenly frowned, "Tian Cheng, continue."

"Zhou...Professor Zhou, freeing...I've never done it before." Lu Tiancheng said nervously.

"Hehe." Zhou Congwen said with a smile, "everyone has a first time, it's okay, I'm here. I'm watching your operation very seriously, and I didn't get distracted, don't worry."

"I……"

"Do it." Zhou Congwen said firmly.

After Zhou Congwen's observation for a period of time, he still has a lot of trust in Lu Tiancheng's surgical skills.

In the medical team, apart from Chen Houkun and Yuan Qingyao, Lu Tiancheng performed the best surgery.Of course, Xiao Kai has gradually faded out of the clinic, not counting him.

If the level is okay, then use a lot of surgeries. Zhou Congwen is going to gradually let Lu Tiancheng undergo surgeries.

If one does not work, then ten, and if ten does not work, then there will be a hundred. There will always be a day when it will be fed.

It is not the first time that Zhou Congwen has led a student, nor is it the first time to lead a doctor in training, so he knows it well.

But the people Lu Tiancheng and Zhou Congwen had met were different.

He was very proficient at performing surgery until he reached the position of sleeve cutting. Before that, he showed the qualities that a surgeon should have.

The basic operation of thoracoscopic surgery is not a problem for Lu Tiancheng, and he has a good grasp of details such as mirror image and fine detail.

But when it came time to separate the trachea and blood vessels, Lu Tiancheng started to freeze the screen as if the network speed was not good.

The meal after meal made Zhou Congwen feel extremely uncomfortable.

"Wait!" Zhou Congwen couldn't stand it anymore, so he had no choice but to stop.

Looking at Lu Tiancheng from the side, his tense sterile cap was completely wet, and the skin between the cap and the mask turned white. Even Zhou Congwen could see that Lu Tiancheng's brow relaxed as soon as he stopped the operation.

Alas, they are all old doctors, how could there be such a problem?

"Tiancheng, break up boldly, as long as you don't force it." Zhou Congwen said, "Be gentle with your hands. I will tell you in advance what to be careful about."

Chapter 1202

"Take a break for one minute." Seeing that Lu Tiancheng was really nervous, Zhou Congwen said simply.

"Old Lu, you can't do this." The patrol nurse smiled, "Do you want to dry the gauze? It depends on your physical strength, what you have done, you are sweating profusely."

"Yes." Lu Tiancheng was not polite, turned sideways, bent over, and stretched his head out of the sterile field.

The itinerant nurse chatted for chatting, but when she was doing her job, she was quick with her hands and feet. She tied two pieces of dry gauze to Lu Tiancheng's sterile cap to absorb sweat.

After finishing the business, the itinerant nurse smiled, "Lao Lu, you are not in good health, do you usually sweat profusely after exercising for two or three minutes?"

Lu Tiancheng was silent.

It's not that he can't joke, nor does he have to keep a straight face during the operation, like a disciplinary committee member.

It's just that Lu Tiancheng has been looking forward to today's operation for a long time. He has only one thought in his mind - it can only succeed, not fail.

The more this happened, the more nervous Lu Tiancheng became. The more nervous he was, the more he couldn't do it.

Usually very proficient, clear in the chest, all kinds of movements that have formed muscle memory feel deformed as soon as they are shot.