top student at medical school

It is obvious that Fang Ziye's team's research on spinal cord injury treatment is not common knowledge. Even Tang Xiaoping, as the director of vascular surgery, had no one to disclose the information to him.

Fang Ziye's team already has members from the vascular surgery department, so there is no need to seek help from this hospital.

"Currently, there is no damage to the patient's medulla oblongata or intracranial cavity. The heavy object did not hit the head; it fell sideways, resulting in damage to the right shoulder, pelvis, and spine as the main sites of injury!"

"Currently, after more than three hours of emergency treatment, the patient's vital signs are stable, but the burst fractures of the lumbar and thoracic vertebrae have not yet been treated..."

"The bleeding points in the chest and abdomen have been treated, and there is no obvious damage to any organs..." Professor Wang Ou reported the situation to Fang Ziye after finishing the phone call.

Fang Ziye nodded, then looked at the anesthesiologist Lin Hua and asked, "Professor Lin, shouldn't Director Liao be at the hospital now?"

Lin Hua nodded upon hearing this, his tone slightly displeased: "What's wrong? Do you want to change the anesthesiologist halfway through?"

Lin Hua guessed Wang Ou and Fang Ziye's intentions, but he didn't know how determined they were.

Ignoring Lin Hua's politeness, Wang Ou replied, "If it's convenient, Professor Lin, could you please call Director Liao Pei? If it's not convenient, I'll make the call myself."

Lin Hua's expression shifted between light and dark for a while. After hesitating for a moment, Lin Hua still gave face to some of the people Wang Ou had called.

Professor Liao Pei entered the operating room about ten minutes later. After entering, he stood on tiptoe to look at the patient lying flat on the operating table.

He asked, "Professor Wang, are you planning to drive right in?"

"Should this kind of acute injury really be treated with spinal cordotomy during the emergency room?"

“After the spinal cord is cut open, the internal pressure drops, which may make it more difficult to control the area below the point of operation.”

Liao Pei knew what Wang Ou wanted to do, so he turned to Lin Hua and said, "Lin Hua, go to operating room 2 first."

Lin Hua was speechless. He really wanted to say that he called Professor Liao to support him, not to ask her to drive him away.

Since Liao Pei had already stated his decision, Lin Hua could only nod dejectedly: "Okay, Director Liao."

Liao Pei then patted his student: "What are you still standing there for? Everyone else has already cleared the area..."

Liao Pei was about to chat with Fang Ziye and the others when she suddenly heard Lin Hua from her department throwing a tantrum. Her expression shifted between anger and uncertainty: "Hey... Lin Hua, what you said is a bit..."

Lin Hua had already left, quite dissatisfied with what had happened today.

Liao Pei chased after them for almost half a minute, then quickly returned, rubbing his forehead and saying, "This team is really hard to manage. Any little thing can make them explode."

"Ugh……"

Wang Ou and Fang Ziye exchanged a glance, sharing the same sentiment. Even in Fang Ziye's situation, things were actually quite chaotic, not as harmonious as they appeared on the surface.

Professor Liao Pei was also a shrewd person. He knew that he had seen through Wang Ou and Fang Ziye's thoughts, but he did not delve into it: "Professor Wang, Professor Fang, didn't we agree last time that the next step of clinical treatment would not begin until May?"

"Why was it suddenly moved up to today?"

"That's a difference of almost two months!"

Wang Ou said, "There's no time like the present. Professor Fang and I originally planned to continue the next phase of clinical trials in May, but we just happened to encounter this case in the emergency room today."

"This case is quite classic, and it is a spinal cord injury caused by double vertebral fractures, which has a near 100% paralysis rate in clinical practice."

"Based on data from our basic research, it can be confirmed that after spinal cord injury, the potential channels are in a closed state. Through continuous microcurrent stimulation by acupuncture electrodes, the channels can be reactivated."

"But we haven't proven what state the potential channels are in at the time of spinal cord injury, or whether we can reduce the number of closed channels by using microcurrent stimulation through acupuncture electrodes."

"In animal experiments, we are unable to quantify the extent of functional loss in any particular rabbit; we can only look at the cure rate."

"So, I had some ideas before, which was to first treat a few emergency spinal cord injury patients, and then replicate a relatively new rabbit model of spinal cord injury, in order to find an effective treatment method in the emergency injury period."

"Isn't this exactly what we've been waiting for?"

Wang Ou's words were long, but Liao Pei listened attentively. After listening, he nodded repeatedly: "It sounds complicated, and it must be even more difficult to do. I'm afraid that none of the projects that Professor Fang has done can be done without racking your brains."

Fang Ziye said, "Yes, there are some research projects where I'm just a figurehead. I don't even know how the projects were done, but the articles are published anyway."

"I've only glanced at the tender documents..."

Upon hearing this, Liao Pei and Wang Ou were momentarily unsure whether Fang Ziye was implying something about them or simply stating his own thoughts.

Because that's what most professors do right now.

They've only gained a reputation; their own students or their favorite "research experts" are responsible for applying for research grants, while most professors are primarily clinical.

Once these 'research experts' have matured, they will rise to a higher social status than professors who only focus on clinical work...

In this day and age, scientific research is king.

This is a fact, and it is the best virtuous cycle, but in fact, many people's "bitterness" is hidden in such a virtuous cycle!
"Professor Fang, everyone else is on their way. Shall we review the film again more carefully? Or is it unnecessary to review it?" Wang Ou decided to focus on the specific steps involved.

Fang Ziye shook his head: "After an emergency injury occurs, plain X-rays and CT scans for conditions like burst fractures of the spine are mainly used to assess whether there is a fracture and to what extent it is."

"For more precise cases, you have to explore them yourself; CT scans and MRIs offer too limited information."

"Even seeing nerve compression is not enough, nor is seeing spinal cord deformation!"

“I think that before the equipment and other doctors arrive, we can open up the patient’s spinal cord injury area and record the data and indicators of the patient’s spinal cord injury in an emergency at a closer distance.”

"Oh, right, we also need to contact the neurology department and have them come over to do a bedside electromyography (EMG) to assess the patient's electromyographic response in the emergency situation following spinal cord injury," Fang Ziye said.

Liao Pei volunteered, "Then I'll make the call. Professor Fang and Professor Wang, you two keep at it. I'll call Mei Bin from the neurology department over..."

Liao Pei knew that this was a major project, and that the project could not be undertaken by just one person, and that the final team involved would not be limited to just one hospital.

However, even if it's just a small part, such a big topic is worth Liao Pei's hard work.

This matter is very meaningful, and Fang Ziye does indeed need his help.

……

After Fang Ziye and Wang Ou washed and disinfected their hands again before getting onto the operating table, Professor Tang Xiaoping from the Department of Vascular Surgery had already left.

Having completed his emergency hemostasis and rescue mission, he naturally would not continue to participate in spinal cord injury and fracture internal fixation surgeries.

However, after Wang Ou saw that Fang Ziye had confirmed that Tang Xiaoping had left, he took over to stop the bleeding and clean the wound for a second time. Wang Ou then raised her head and hummed in response.

Fang Ziye said, "Professor Wang, to do something well, you must first have the right tools."

"No matter how perfect our initial preparations are, it's never too much. Personally, I feel that if I make some further adjustments, it would be the icing on the cake, and it might help the patient recover better after surgery."

"Actually, what I did wasn't that crucial; I was just making trouble out of nothing..."

Fang Ziye spoke politely, but he did it very seriously.

After watching for a while, Wang Ou could intuitively feel the gap between Fang Ziye and Tang Xiaoping, and even the huge gap between Wang Ou herself and Fang Ziye.

With a sigh, Wang Ou said, "Professor Fang, you could actually put it more bluntly."

"Even if you say that Dean Wang's basic skills are just so-so, Dean Wang wouldn't dare to confront you directly..."

"After all, you said it, so it's a fact to you."

"So, Dean Wang's basic skills are just so-so?" Zhang Ziqian from the Department of Urology walked in and asked as Wang Ou was speaking.

Zhang Ziqian is stationed in the animal laboratory. Every day, he leaves the animal laboratory very early in the morning to start his day of clinical work at the hospital. After completing his clinical tasks, Zhang Ziqian returns to the vicinity of the animal laboratory.

It wasn't anyone who forced Zhang Ziqian to do this, and Zhang Ziqian didn't feel that anyone was exploiting him. On the contrary, Zhang Ziqian felt that it was wonderful to be able to reach a stage where effort would be rewarded.

After all, given his current position, even Wang Xinghuan could hardly offer much help anymore; he would have to rely on himself for everything.

Those who dream of rising from associate professor to professor are no ordinary people.

Wang Ou casually said, "Professor Fang Ziye said it, what? You dare to have a problem with it?"

Wang Ou thought she had Zhang Ziqian under control, but Fang Ziye shook his head and said, "Brother Qian, these are all things Professor Wang said himself. Professor Wang has a lot of ideas."

Zhang Ziqian looked at Wang Ou, cupped his hands slightly, and suddenly realized: "Oh, okay, Teacher Wang, I'll tell Director Wang next time to ask him to vote for you in the next dean election."

"Or I could recommend you."

Fang Ziye glanced at Zhang Ziqian: "Brother Qian is really smart, he figured out the truth so quickly."

Zhang Ziqian said, "Right? Professor Fang, you heard it too, you can be my witness..."

Wang Ou was completely manipulated by Fang Ziye and Zhang Ziqian's back-and-forth, and he didn't even know when he had said he wanted to be the dean.

……

About twenty minutes later, Fang Ziye clapped his hands: "Alright, alright, teachers and professors, jokes aside, surgery is surgery."

"Professor Wang Ou and I made a last-minute call to all the teachers at this time, mainly for two reasons. First, we have encountered an emergency patient who is most suitable for spinal cord resection."

"This is the girl. She currently has two spinal cord injuries and is assessed to have a 99.9% chance of postoperative paralysis."

"Secondly, our research group currently needs to collect emergency observations from patients with spinal cord injuries. Using this data as a prototype, we will establish a new animal model to study the treatment of the primary diseases that cause spinal cord injuries."

"After all, spinal cord injury is a classified disease, and due to different causes, it is divided into many etiologies. Trauma is just one of the classifications..."

"Associate Professor Liao Jia lives quite far from here. He just texted me that he will arrive in ten minutes."

"Since Professor Liao Jia is the person in charge of our team's animal model creation, we will have to wait until Professor Liao Jia comes and collects the first-hand data before we can start exploring treatments."

Professor Mei Bin said, "Okay, Professor Fang, we have now solidified the electromyography data of the patient's lower limbs and abdomen."

"Because spinal cord injury leads to spinal cord concussion, the muscles below the thoracic vertebrae lose their superior central control. However, the electrical conductivity of each muscle itself is good, and as long as a signal can reach the local area, its mobility can be restored..."

"These data are basically consistent with the data we collected from patients with chronic spinal cord injury, which proves that after a spinal cord injury, whether it is a transient or permanent injury, the local potential channels will change!"

Zhang Ziqian said, "Professor Wang Xinghuan can't come today. I will temporarily take full charge of the urology department."

Even if Wang Ou makes the call herself, Wang Xinghuan cannot be on call 24/7.

Upon hearing this, Luo Songyuan from the Department of Gastrointestinal Surgery immediately replied, "Professor Yang Guoliang from the Department of Gastrointestinal Surgery is on his way."

"Professor Xiong Bin said he can't come today."

Luo Songyuan, an attending physician in the Department of Gastrointestinal Surgery and a student of Professor Yang Guoliang, looked at Li Mengchao, Professor Xiong Bin's student, with a wary expression.

He never expected that Professor Xiong Bin's doctor, Li Mengchao, would directly turn against their team at this critical moment, and in such a direct way!
After Li Mengchao drew his sword, Luo Songyuan couldn't just sit and wait to die. He thought, "Since Li Mengchao has made his move, let's just give up." Everyone changed their previous dejected attitude and did everything they could to the best of their ability.

He wanted to see how Li Mengchao would "catch up"!
Li Mengchao stood in the crowd, inconspicuous, obediently holding his position.

This is a fairly normal reaction, and also a reaction that shows confidence.

If Li Mengchao had just suggested competing with Professor Yang Guoliang's team led by Luo Songyuan, Li Mengchao would immediately offer a better solution, or he would publicly criticize Luo Songyuan and his team.

Even if what such a person says is true, one should still be wary of them. They must have discovered the loophole long ago, but chose not to report it, deliberately trying to harm others.

The more Li Mengchao didn't do that, the more confident he seemed to be in ignoring the "fierce resistance" of the group led by Luo Songyuan!
"The orthopedics department is here too!" Hu Qingyuan was on duty today, so it was Feng Junfeng, another student of Fang Ziye, who came here.

Compared to Tian Yao, Feng Junfeng's qualifications might be slightly inferior, but Feng Junfeng is relatively more low-key and honest, and he comes from Zhongnan Hospital, so Fang Ziye treats him relatively better. "Now that everyone is almost here, let's begin. First, according to the previous plan, we need to take the first step, which is to open the spinal cord and observe the internal morphology of the spinal cord at the time of injury..."

"The time is now 1:05:13 AM. We are prepared to cut open the epidural space precisely at 1:06 AM..."

As Fang Ziye spoke, the voices of the others grew softer and softer, and then all eyes turned toward Fang Ziye.

Fang Ziye was able to lead the team and preside over all of this because he had experience in managing two major clinical projects, an experience that allowed him to outperform everyone else.

People who participated more often than Fang Ziye did not work on projects as large as Fang Ziye, and people who worked on projects even larger than Fang Ziye did not feel as involved as Fang Ziye.

"At 1:07, we'll officially begin the incision. Monitor intracranial pressure and changes in cerebrospinal fluid," Fang Ziye said.

“Currently, intracranial pressure is normal, 120 mmH2O (millimeters of water column)!” someone responded.

"it is good!"

Fang Ziye and Wang Ou continued their investigation. Fang Ziye meticulously dissected the dura mater of the spinal cord and then said, "Professor Wang, even in this severe case of a burst fracture of the lumbar vertebrae, the spinal cord segments are not completely tangled up; they are still protected."

"It is only during high-energy violence that the spinal cord experiences tremors."

"This is completely different from what I expected, where the spinal cord would be ejected directly from the ends of the lumbar vertebrae after such a high-energy injury, resulting in a complete transection of the spinal cord."

Upon hearing this, Wang Ou said, "This patient was just the one who was hit. If it were the person who jumped off the building, you would be able to see this situation."

"Although he hit someone and got some cushioning, I don't think he could save them."

"Currently, spinal cord concussions resulting from such extreme violence will cause a portion of the electrical pathways within the spinal cord to remain closed, the specific reasons for which are unknown..."

"Could it be that there are actually different one-to-one connection channels within the spinal cord region, and after the oscillation occurs, the alignment between the channels becomes inaccurate, leading to the obstruction of electrical signal transmission?"

"After rest and recuperation, some recovery is possible; is it a newly reconnected channel?"

Wang Ou's intended interpretation is that the electrical signal pathways within the spinal cord are like tunnels or passageways.

The tunnels were originally connected, but due to the earthquake, some tunnels may have changed direction, so the tunnels that transmit data down were blocked, and the tunnels that receive data were also blocked.

In relation to real geology, it's like a real earthquake; for the patient, a spinal concussion is like an 'earthquake'!
"We cannot rule out Professor Wang's guess, but we also do not know. At present, we are not able to obtain electrical signal information in the spinal cord conduction process like an electrocardiogram."

“After all, the electrical conduction within the spinal cord is different from cardiac activity; it’s not continuous!” Fang Ziye shook his head.

Fang Ziye suddenly paused, saying, "That's enough, Professor Wang, stop pulling!"

Wang Ou's hand was a beat too slow, but the outcome was not serious; it only caused some small blood vessels in the spinal cord to deform.

Fang Ziye took a deep breath: "We've opened it up long enough. Now we're going to dissect it from the inside."

“This way we can have the opportunity to understand things layer by layer…” Fang Ziye’s words encouraged everyone’s confidence.

In truth, Fang Ziye still felt some regret.

An assistant is just an assistant, not one's own hand. Professor Wang Ou's skills are already strong enough, far surpassing those of the rest of his team. Even Nie Mingxian and his colleagues don't have Professor Wang Ou's level of expertise in spinal surgery.

Therefore, what Fang Ziye needs to do is not to complain that Wang Ou and others are not good enough, but to think about how to lead these people, whom he thinks are not good enough but who are actually at a relatively high level in the country, to do a good job and complete the project.

After Fang Ziye finished speaking, the onlookers whispered, "You don't need to write down what Professor Fang said. Don't take notes randomly."

"Don't memorize anything that's not related to your major; you're not doing live text commentary..."

Fang Ziye was taken aback when he heard this, but he wasn't surprised.

The team takes notes to facilitate subsequent organization. The orthopedics department also assigns people to take notes during surgeries, procedures, and discussions.

"Professor Fang, because the time is still too short, we can't design the acupuncture electrodes in advance. We can only use some of your preliminary assumptions to get a batch that is most suitable for the patients."

"At this hour, even working overtime wouldn't be enough time."

"But for emergency surgery, there's no way to design an individualized plan on the spot," Li Nanlong from Smith & Nephew said politely, trying to sound calm.

Fang Ziye never imagined that personalized acupuncture electrodes could serve emergency patients!
Unless technology reaches an extremely advanced level, those who provide timely services to emergency patients are sacrificing other people's rest time to work overtime.

"It's okay, just make do with it. We only decided on this spur of the moment."

"Professor Wang, we have confirmed that these two injuries have not caused any deformities such as rupture, tearing, or torsion of the spinal cord at the vertical level, right?"

"Therefore, most patients with spinal cord injuries currently suffer from functional loss due to collisions and shocks within the spinal cord, rather than a loss of anatomical structure!" Fang Ziye and Wang Ou defined the injury very rigorously.

Yes, this definition must be rigorous.

Burst fractures of the lumbar and thoracic vertebrae are different in nature from burst fractures accompanied by spinal cord rupture.

Generally speaking, if a patient's spinal cord is protruding from their body, there's no point in trying to save them; the King of Hell has already reserved their place.

"Yes, because the spinal cord is very important, it has been protected by multiple layers of protection, and the level of protection is no less than that of the brain tissue, and may even be better than that of the brain tissue."

"Currently, there are only very few, and extremely rare, cases of anatomical rupture of the spinal cord, such as crush injuries to the chest and abdomen caused by large vehicles, or thoracolumbar injuries caused by sudden high-speed violent collisions."

"Most of these patients died directly, so they have no clinical research significance."

"Our focus is on patients with spinal cord injuries that are not due to spinal cord anatomical deformities or ruptures, and these are living patients," Professor Wang Ou cautiously added another framework to the definition.

Fang Ziye said, "Professor Wang, this is actually a very good vegetarian dish. It is an injury to the thoracic and lumbar vertebrae. So, if we can prove that these two injuries are connected in series like an electrical circuit, then we can better prove that the signal transmission process in the spinal cord is an electrical signal."

"Come on, give me the needle electrode!" Fang Ziye said.

"No, that's not right. I corrected the terminology last time. From now on, it should be called a needle bridging device, not a needle electrode."

"Yes! Professor Fang, you said last time that it was going to be renamed and named after its function. Although it originated from acupuncture electrodes, it has already undergone its own evolution."

"Professor Fang, you're a genius!" Li Nanlong from Smith & Nephew said in an overly ingratiating tone.

Fang Ziye didn't want to dwell too much on whether the qualifications were good or not: "The acupuncture bridging device has been placed, and now we will begin microcurrent stimulation with acupuncture electrodes."

"And test it!~"

"First time! Thoracic spine needle bridge connected, lumbar spine needle bridge disconnected." After Fang Ziye gave the order, someone immediately turned on the needle current.

"Electrical release!" the circulating nurse said immediately after opening it.

"Frequency 110, duration two seconds, release complete!" The circulating nurse precisely timed it.

Two seconds passed in the blink of an eye.

No one can read all the data status at this time except machines, and multiple machines working together.

Professor Mei Bin immediately began to examine the electrical signals from different locations over the past two seconds.

"I could feel movement in the thoracolumbar region, but no movement below the lumbar spine! No electrical signals were detected in the muscles of both lower limbs and the pelvic muscles!"

“It might be in a series connection,” Mei Bin said happily.

The term "series connection" means that the electrical circuits of the thoracic and lumbar spine are integrated; if there is a problem in one part, other parts will also have problems.

Fang Ziye looked calmly at everyone and continued, "Let's begin the second set of tests. The needle bridging device for the thoracic spine is disconnected, and the needle bridging device for the lumbar spine is connected. The needle electrode points are below the site of injury in the thoracic spine..."

"Starting the third set of tests, the needle bridging devices for the thoracic and lumbar spine segments are all connected, and the needle electrode points are located between the injury sites in the thoracic and lumbar spine segments..."

Fang Ziye issued various commands one after another, as if he were playing a word game.

In fact, these seemingly minor wordplays constitute a significant step forward in human understanding of spinal cord injury, a step that humanity has never taken before.

……

Twenty minutes later, Mei Bin, who was in charge of data collection, said with an almost unnaturally excited tone: "Professor Fang, the data we've collected so far is extremely significant. We've completely confirmed that electrical signals within the spinal cord can be conducted bidirectionally and are in series!"

"This corresponds to our previous guesses."

Upon hearing this, Fang Ziye said, "No, no, Professor Mei, actually, the electrical signal conduction in our lumbar spine is in series in a single path, but between multiple paths, it is still in a state of parallel and series intertwining."

"Why do I say that? Because some of the functions worked after we corrected the entry point of the needle current. Other functions did not."

"This means that the transmission between the same set of electrical signals is meaningful."

"Moreover, the fact that different electrical signals are in parallel does not mean that the signals are different, but that they are in different positions. It is the position that determines the function, not the local path."

"If that's the case, I think the routers we use on our network would be a good reference..."

Although Fang Ziye rejected Mei Bin's suggestion, he didn't completely reject it, so Mei Bin was still happy.

Mei Bin asked, "Professor Fang, in that case, how confident are you about the extent to which spinal cord injury patients in this acute injury state can recover their function through microcurrent stimulation?"

Fang Ziye shook his head: "It's hard to say!"

"I just hope my guess is wrong, otherwise, this research might disrupt our research plan."

"If the points and pathways within the spinal cord are truly not fixed, then that's troublesome. On the contrary, if they are fixed, we can find ways to replace them."

Fang Ziye said this because similar phenomena exist in the human body.

For example, nerve damage, as long as it is confirmed, can be treated.

However, if the damage is to the cerebral cortex, there is no way to replace it.

The more one-to-one the correspondence, the more rigid the rules become, but even though the rules are rigid, they are also simpler to deal with.

Professor Mei Bin's understanding of the topic was more thorough than many others. He understood Fang Ziye's meaning and said, "Really? Professor Fang, didn't we eliminate these messy possibilities during our previous discussions?"

"If the signal transmission in our bodies were so chaotic and changed so easily, then even normal people like us could experience sensory or functional disorders."

"I am more looking forward to the possibility that we can discover that the potential of our internal spinal cord pathways is far greater than the potential of the pathways we need to use. If that is the case, the treatment outcomes for spinal cord injury patients will be even better in the future."

Upon hearing this, Fang Ziye said, "Professor Wang, Professor Mei Bin, let's call it a day. We've already confirmed two things."

"Let's stop speculating; that's against the rules."

In fact, there are many more research topics that can be carried out in clinical practice, but further speculation is based on the assumption that all of today's speculations are true!
No project can be tackled by skipping two steps at once, because if one step is impossible, the choice for the next step will change.

Throughout human history, we have suffered too many losses from trying to take two steps at once. Therefore, very rigorous researchers would rather proceed at a slower pace than rush their research.

Mei Bin nodded and said, "I think it's okay, Professor Fang. The patient we treated last time received continuous treatment with acupuncture electrodes. This time, we're just adding a needle-shaped connector."

"This is a very normal inch-by-inch progress. Each time there is only one small variable factor, which can form a good before and after comparison."

"However, we still lack basic data from animal experiments."

Upon hearing this, Liao Jia said, "We don't even have any animal models related to emergency medicine, so where would we get animal experimental data related to emergency medicine?"

"The state of spinal cord injury is completely different from the state of acute spinal cord injury caused by spinal cord fracture!"

"The human body is really interesting!" Liao Jia said, then carefully lowered his head to look at the inside of the spinal cord that Fang Ziye had opened.

He closed his eyes, as if recalling this scene, or perhaps savoring the moment… (End of Chapter)