Surgery Godfather
Chapter 1129 - 905 Blind Spot_2

Chapter 1129: Chapter 905 Blind Spot_2

"Everyone should read more books. Dean Xia has proposed establishing a library for our hospital. We will create the largest on-site library in the nation and the entire world, subscribing to all medical journals and purchasing memberships to various medical electronic reading platforms to create excellent reading conditions for everyone,"

"This expense will be sponsored by societal forces and will not cost our hospital a penny."

"This matter will soon be brought to the staff meeting for a vote, and I hope everyone will actively support it. Doctors who do not actively learn will lag behind, and hospitals that do not actively learn will also lag behind."

Director Zhao’s words immediately sparked enthusiastic applause from all the doctors present. Everyone had already heard rumors that the hospital was going to build a large library combining traditional and online resources, and now it turned out to be true, which would make searching literature for writing papers much easier.

The so-called "not costing a penny" actually refers to funding provided by the hospital’s Overseas Chinese Fund. Since Guo Jingyao underwent two surgeries, not only had he injected funds into Yang Ping’s research fund, but he also paid great attention to the hospital’s Overseas Chinese Fund, becoming its leading figure and revitalizing it, soon amassing a substantial amount of capital.

Having money makes things easier, and Dean Xia didn’t hesitate to spend. Known for his resolve, he began to boldly make improvements, enhancing the hospital’s facilities, increasing welfare for the medical staff, and arranging for doctors to receive training abroad.

With the help of Robert, Takahashi, and August, the hospital now has a large number of doctors undergoing formal and systematic training in Europe, America, and Japan.

"In any case, as long as everyone strives to learn and work hard, the hospital will create the best conditions for you," Director Zhao said with an encouraging tone.

"Director Zhao, the hospital should also take care of our marriages and help create the best conditions for that, right?" Doctor Wen from the Pathology Department called out.

Always stirring up trouble!

Director Zhao, from several rows away at the podium, glared at Wen Ruzheng.

Your damn love letter reads like a terrorist threat, and you’re talking about marriage.

Director Zhao recalled Wen Ruzheng’s love letter, which had stirred up the hospital: "I will cut your heart into pieces and study it under a microscope for a lifetime."

It was a downright threatening letter, enough to scare anyone off from dating you.

"We have considered that issue as well and have decided to change the hospital’s annual external matchmaking event to biannual. Channel the courage you had for streaking into this, and I guarantee you’ll be holding a son next year," Director Zhao replied irritably.

"We’ve gone off-topic, let’s get back to the discussion!" Director Zhao redirected the topic and set down the microphone.

Director Ouyang of Orthopedics stood up and straightened his salt-and-pepper center-parted hair, saying, "I’ve also watched ’House M.D.’ Regarding the cobalt poisoning case in the show, I remember the patient had undergone two hip replacement surgeries. The first surgery used a ceramic-on-ceramic prosthesis, and during the second hip replacement, the doctor used a metal-on-metal prosthesis, but he failed to remove all the ceramic fragments from the joint cavity when taking out the ceramic prosthesis. Those residual ceramic fragments became a hidden danger, constantly wearing down the surface of the metal joint, eventually leading to the release of heavy metal ions from the cobalt-chromium-molybdenum alloy, causing cobalt poisoning."

"In fact, there were two mistakes made by the doctor in the second surgery; he should have removed the ceramic fragments from the joint cavity, and he should not have used metal-on-metal."

"We have an experience-based rule in hip replacement surgery—once ceramic, always ceramic, which means if a ceramic head is used in the first hip replacement surgery, then a ceramic head must also be used in the second surgery. That way, we might avoid the fine ceramic debris left over after the first surgery from wearing down a metal head in the second surgery, causing heavy metal ion poisoning. Director Tan, is that correct?"

Director Tan took over the conversation: "That’s right, metal-on-metal prostheses are rarely used now. Doctors used to favor them, especially in large metal-on-metal femoral head prostheses, and Peking Union Medical College Hospital also favored them for a time."

"If we knew there was a risk of heavy metal poisoning, why did we still use these metal-on-metal prostheses?" asked a Neurosurgeon.

Each field has its own challenges; Director Fang of the General Surgery Department raised his hand to ask a question.

"This involves the pros and cons of artificial joints. The artificial hip joint prostheses we currently use include ceramic-on-ceramic, ceramic-on-polyethylene, metal-on-polyethylene, and metal-on-metal. Metal-on-metal is used the least,"

Director Guan of the Cardiology Department said, "Old Tan, we are internal doctors and don’t understand your surgical aspects very well. Take this opportunity to explain to us in detail, which type of hip joint prosthesis is the best?"

Director Tan replied, "Each type of hip joint prosthesis has its advantages and disadvantages. However, considering all aspects, ceramic-on-ceramic is currently the best, and metal-on-metal is the least recommended."

"What exactly do you mean by what you said ’this against that’?" a doctor who had just started working in pediatrics asked.

"Oh, our artificial joints are divided into two major parts, the far and the near. For example, with the hip joint, the far end is the femoral head, and the near end is the acetabular socket. The two combine to form a joint."

Ceramic-on-ceramic, the ball is made of ceramic, and so is the socket; ceramic-on-polyethylene, the ball is ceramic, and the socket is polyethylene; metal-on-polyethylene, the ball is metal, and the socket is polyethylene; metal-on-metal, both the ball and the socket are metal."

Director Tan said this while using his hands to make shapes of the ball and the socket to help explain.

"Ceramic-on-ceramic, its greatest advantage is that it has a low coefficient of friction, so it’s especially wear-resistant, and it can last twenty to thirty years unless it’s accidentally smashed or loosens."

"Secondly, compared to metal heads, there’s no negative impact from the release of heavy metal ions."

"Its drawback is that it’s relatively brittle, and compared to metal, it’s more likely to shatter when subjected to a violent impact."

"Metal-on-metal is now rarely used; its greatest disadvantage is that the heavy metal ions released after wear are harmful to the human body. Its advantage is that it’s not easily shattered. With current medical conditions, its advantages cannot cover its greatest drawbacks, so the use of metal-on-metal is becoming less and less common."

"Metal-on-polyethylene is in between the two types of prostheses mentioned above. Compared to ceramic-on-ceramic, it is cheaper, reducing the economic burden on patients. Compared to metal-on-metal, it wears out much less and is not as likely to release a large number of metal ions."

Director Guan from the Cardiovascular Department said, "So what you’re saying is that except for the high risk of breaking, ceramic-on-ceramic artificial joints otherwise have mainly advantages."

"You could understand it that way, but it also has another significant disadvantage; that is, it’s quite expensive, the priciest among these types," Director Tan laughed and said.

"Mainly because medical ceramic materials are expensive and not easy to process, so ceramic hip prostheses are naturally pricey."

Director Han also joined in to add a few words.

"However, our country already has companies that have developed a very good ceramic called soft ceramic, which overcomes the drawback of ceramics being prone to breaking. If used for medical purposes, it not only has a low coefficient of friction but also is not easily broken; this would be the best artificial hip joint."

The benefits of these hospital-wide case discussions are numerous, allowing doctors to engage in interdisciplinary learning and fill the gaps in their knowledge.

Take, for instance, this patient with cobalt poisoning. If a doctor in the cardiology department had basic orthopedic knowledge, he would pay attention to the patient’s past history of left hip joint replacement and would arrange for the patient to have an x-ray examination of the hip joint in both anteroposterior and lateral views.

If the attending physician had a basic knowledge of reading films, he would be able to see from the x-rays that the hip prosthesis showed obvious wear.

If he lacks basic film-reading knowledge, no problem—he could ask someone from orthopedics to take a look, avoiding wasting too much time on the diagnosis.

Yang Ping felt that by attending such meetings, even just by listening, participants would increase their knowledge and improve their basic understanding.

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