Great doctor starts with adding points

"Brother Crab." Guan Yun and Cao Zhiyuan understood each other and called out politely.

Fu Jinjin is not only the director of the trauma surgery department, but also the chief director of the Department of Orthopedics at Minda Hospital. The new employees he hand-picked have no problem with their academic qualifications and skills, so they will definitely be admitted to this hospital.

Guan Yun still has more than a year to study for a professional master's degree, and Cao Zhiyuan still has more than a year to complete his social residency training. There must be times when he gets along with Wu Xie. express directly.

Wu Xie didn't take the initiative to ask for words, but after following Guan Yun and the two to the dressing room of the operating room and seeing no one around, he asked again: "How are Director Fu and that Teacher Zhou's temper? Swearing?"

Wu Xie was also a member of the resident physicians, belonging to the lowest level, and it was Tongji Hospital, so Wu Xie could quickly find the same empathy with the two.

Of course, Guan Yun, as a student of Fu Jinjin, cannot have a shallow conversation with Wu Xie.

Cao Zhiyuan replied: "Are there any directors who don't scold others? But they only scold when they do something wrong."

"That's good. That's good." Wu Xie nodded when he heard the words, and after putting on the mask, his eyes narrowed, as if the stone in his heart had been put down.

Wu Xie's words made Guan Yun and Cao Zhiyuan look at Wu Xie more.

The recruitment announcement of Minda Hospital states that the principle of recruitment is the minimum requirement for a master's degree or a doctor's degree. Generally speaking, only a small number of postgraduate students in this hospital have the opportunity to stay in the hospital.

Wu Xie is a master from Tongji Hospital Affiliated to Huazhong University of Science and Technology, and is welcome to Minda Hospital.

But in fact, Wu Xie does not have eight legs and four mouths, and is more independent than ordinary people. On the contrary, he is alone in the process of finding a job. Even if he has a good relationship, he is still nervous.

So Guan Yun said: "Brother Crab, today is the weekend, and the operation is arranged for Mr. Zhou, and Professor Zhou rarely swears."

Then Cao Zhiyuan and Guan Yun didn't say much. After entering the operating room, they started the pre-operative preparations.

Wu Xie only took the opportunity to help lift his upper arm during disinfection.

Then, during the disinfection, Wu Xie also asked about the full name of the real surgical procedure: "Double nerve bundle transposition from the ulnar nerve and median nerve to the brachial muscle."

The patient's current diagnosis is a brachial plexus injury.

Brachial plexus injuries are a common type of peripheral nerve injury.

This was the only information Wu Xie could get during the disinfection process. After the disinfection and draping was completed, Associate Professor Zhou Xiaoning, Director Fu Jinjin, and Deputy Director Huang Yaolong came down from the operating room and took over the operation.

In addition to Guan Yun and Cao Zhiyuan, there are already five people on stage, so there is basically no place for Wu Xie to stand, and there is no chance to go on stage.

Under such circumstances, if Director Fu Jinjin didn't take the initiative to invite, Wu Xie couldn't go on stage to squeeze people.

But Wu Xie is not in a hurry. He is not familiar with the patient's condition now, and he only has a general understanding of the diagnosis. After seeing that Associate Professor Zhou Xiaoning has begun to expose the nerve, Wu Xie went to the side first and started Review the patient's medical record.

The patient has been engaged in physical labor for a long time, and he stated that "the right biceps muscle was weak after repeated labor 2-3 years ago, and the shoulder muscles gradually atrophied in the past year, and the activity limitation increased."

After coming to the doctor, the skin sensation in the biceps area decreased, the muscles were atrophied, and the muscle strength was only grade 2. The electromyogram showed damage to the musculocutaneous nerve innervating the biceps brachii, no obvious abnormalities were found in the ulnar nerve and the median, and no obvious compression of the axillary nerve was found in ultrasound...

The patient also went to many hospitals when he was working abroad, but his condition did not improve, and his muscle atrophy gradually worsened...

This belongs to the patient's medical history, and then Wu Xie looked at his nerve EMG, and indeed found abnormal potentials of the musculocutaneous nerve, suggesting possible damage.

However, nerve electromyography can only identify which nerve has been damaged, but it cannot really locate which segment of the nerve has what kind of damage.

Wu Xie, who has specialized in nerve transposition surgery, knows that nerve electromyography is a qualitative functional test to determine whether there is or is not. If there is no nerve damage, then there is no need to consider related diseases.

And if there is, more precise positioning is needed.

Without being able to go to the hospital to observe patients and medical history in advance, and without having the opportunity to undergo surgery, Wu Xie is still looking for learning opportunities for himself.

Only by studying the medical records thoroughly and making the operation process more transparent, then in the process of learning, will you be able to grasp the whole process of the operation, and then discover some key points that you need to pay attention to.

Wu Xie is good at learning.

The learning mode of teaching without teaching is completely different and should not be confused.

When coordinating with Long Yuan and Duan Hong, one is a senior brother and the other is a master. Even if Wu Xie doesn't understand the overall principles of surgery and can't grasp the entire process of the operation, they will still twist out the details and key points. for your attention.

It is equivalent to actively telling you where the key points and difficulties of the operation are, and you only need to pay attention to the corresponding operation at that time.

But when learning surgery with other people, no one will tell you the difficulties and key points. Even when someone else has a specific teaching object, he only pays attention to the difficulties of his teaching object, not for you. instructional design.

So under such circumstances, some of the more important details, but Zhou Xiaoning's younger brother, Deputy Director Huang Yaolong, is in control, and the two of them may slip past without you noticing.

Both can, so it's not particularly important, but if you don't, you will be confused.

This kind of learning is no longer the principle that the so-called height difference of the connected device determines the learning efficiency.

This is called chicken grabbing rice. You can catch it, eat a few grains, but you can’t catch it, and it won’t wait until it’s out of date. Even the food that is sprinkled on you later is definitely not as fine as it was during the operation.

Therefore, Wu Xie continued to take a closer look at the patient's MRI.

For nerve injury, you only need to look at the anatomy. Find the anatomical shape of the musculocutaneous nerve and biceps brachii on the MRI, and then look at the biceps brachii branch of the musculocutaneous nerve to see if you can find any defects.

This is conducive to self-diagnosis of musculocutaneous nerve injury and to determine the specific nature of the injury.

No one taught me, this step is very difficult, Wu Xie can't even start from the beginning without reading the medical records at his current level of film reading! Associate Professor Zhou Xiaoning and the others will definitely not teach you how to diagnose from the beginning.

But no one taught it, and it is necessary to repeat the path that others have already diagnosed and find out the location of the injury, so that we can better find the location of the injury in the process of reading the operation.

Correspond the nature of the injury with the nature of the injury that you have prepared in your heart in advance.

This is the wild apprentice, you have to work harder.

No one is right or wrong, everyone's identity corresponds to different.

Although the professional-level MRI reading technology can not clearly clarify the layers of each layer and achieve the layered sense that the senior brother always talks about, it is not difficult to look at the anatomical structure.

At the same time, it also relies on the knowledge of basic anatomy——

The musculocutaneous nerve originates from the lateral bundle of the brachial plexus, passes through the coracobrachialis muscle, descends between the biceps brachii and brachialis, and branches to the coracobrachialis, biceps brachii and brachialis muscles, at the end of the biceps brachii tendon Outer edge, pierces near the cubital fossa, and becomes the lateral cutaneous nerve of the forearm.

This is the general anatomy, the inherent deformation of the musculocutaneous nerve, and the basic homework that I need to do in advance.

Only in this way can the musculocutaneous nerve be found on MRI.

Three key, one is the lateral bundle of the brachial plexus, and the other is the coracobrachialis muscle, passing through.

Wu Xie carefully found the corresponding structure on the MRI, and as expected, she found the very thin nerve direction of the musculocutaneous nerve between the biceps and brachialis.

Wu Xie is a little happy, this is the sense of accomplishment.

Possessing a professional level of MRI reading skills and a professional level of basic anatomy only means that you have the ability to diagnose nerve injuries, but it does not mean that you are proficient and can start from scratch on the spot.

In hand surgery, the diagnosis and treatment of peripheral nerves has always been a super difficult point, otherwise most prefecture-level city hospitals would not be able to perform such operations.

step by step.

Continue to deepen the knowledge of anatomy——

Branches of the musculocutaneous nerve: coracobrachialis branch, biceps brachii branch, brachialis branch.

Three branches, but only the biceps branch to focus on.

Biceps brachii branch, of which 2 to 3 branches are more common, and the musculocutaneous nerve sends to the biceps brachii branch?

Don't rush, slowly extract memories.

Oh yes.

The first branch is about 10-15cm below the midpoint of the clavicle.

Wu Xie continued to use his fingers to make gestures on the MRI, and then he found out that the patient had two biceps branches, not a single branch, and some patients could have up to five branches.

sure?

Wu Xie asked himself questions from the perspective of Senior Brother Longyuan to improve the participation and communication in the learning process.

Deformation of the musculocutaneous nerve——

Sure, there are only two, and the two are in the shape of double bird claws.

Collinear segments have bifurcations at both the proximal and distal ends. resembling an X shape.

The site of injury is at the proximal end of the collinear segment! The nature of the injury so far determined is chronic, with a small capsule.

inflammation? Stuck? Or schwannomas?

Not necessarily, it may be that the previous stretching process caused the rupture of the nerve bundle, and when the scar healed, a Ф structure was formed.

In this way, Wu Xie could safely and boldly bring the key diagnostic elements to the operating table.

Chronic injury of the biceps brachii branch of the musculocutaneous nerve can be seen as two branch injuries at the proximal end of the collinear segment. There are bumps at the injury site, and infection or other signs cannot be completely ruled out.

These are all honed out bit by bit by relying on my own basic skills, so Wu Xie's memory is very deep.

However, at the bedside, the above-mentioned running-in process is completely unimportant, because the next operation process has almost nothing to do with the previous running-in.

This is where the difficulty and charm of medicine lies. Every step you take needs huge, intertwined, and complex basic medical skills to support it, otherwise, it will be rootless duckweed.

During the operation, you have to be clear about it yourself, so that you can better capture and understand what Professor Zhou Xiaoning may give you during the operation, and gain knowledge points.

Bifascicular Transposition of Ulnar and Median Nerves to Brachialis!

This surgical procedure not only requires you to open up and find the biceps brachii branch of the musculocutaneous nerve, which is the translocated receptor.

And you have to first determine the donors for the transposition, that is, the ulnar nerve and the median nerve.

Moreover, before the operation begins, it is necessary to find out the shape of the blood vessels of the upper arm, so as to prevent the blood vessels from being accidentally injured during the operation.

Nerves are the source of life in sports, and blood vessels are the source of life. If the blood vessels are damaged, everything will be for nothing!

Wu Xie rereads the operation, reading, is a very good word——

The patient is now in the supine position with the upper extremities abducted. This is the body position, which is convenient to operate.

At present, Associate Professor Zhou Xiaoning is taking the skin incision in the central part of the biceps groove, which is being stripped to the gap between the triceps and biceps.

Then, based on basic anatomy, Wu Xie roughly thought about Associate Professor Zhou Xiaoning's surgical thinking. Now Associate Professor Zhou Xiaoning should be doing "nerve and artery incision and exploration".

Identify the ulnar nerve medial to the brachial artery and simultaneously identify the median nerve lateral to the artery. In this way, not only the blood vessels can be separated, but also the two nerves of the donor can be found and separated separately.

After this, the musculocutaneous nerve deep on the side of the biceps can be found by palpation.

With sufficient skill, it is also possible to electrically stimulate the brachialis and biceps nerve bundles to determine which is missing motor function.

The biceps and brachialis branches are dissected and separated from the proximal musculocutaneous nerve, leading them to the ulnar and median nerves. …

In it, there will be a lot of knowledge for myself to extract, and it may be that Associate Professor Zhou Xiaoning will explain the critical moments and grasp some principles.

Donor nerve selection is based on the principle of proximity to the recipient nerve.

This is one of the principles, and you need to listen to Associate Professor Zhou Xiaoning carefully, or maybe not.

Usually the biceps branch is close to the median nerve and the brachialis branch is close to the ulnar nerve, but this is not always the case. Tension-free suturing to the recipient nerve is the principle for planning the site of release.

This is the second principle, and it is probably necessary to talk about it, but unfortunately there is no notebook, otherwise, you can draw a key symbol.

▲

Then there is the double-bundle transposition to repair the musculocutaneous nerve!

The principle that should be grasped is that the transposition of the flexor carpi ulnaris muscle branch from the ulnar nerve anastomoses with the biceps brachii muscle branch, and the transposition of the flexor carpi radialis muscle branch of the median nerve anastomoses with the brachial muscle branch of the musculocutaneous nerve.

During this process, Associate Professor Zhou Xiaoning should also explain in detail.

(Note: The above is my way of learning and grasping in the process of studying and observing the operation. I don’t know how other people learn. If there are other learning methods, you can explain them and guide them to learn from each other.)

The operation has not progressed to this stage. This is just Wu Xie's design and speculation of a general operation process based on his basic skills, and the final steps may not be completely consistent.

Wu Xie is still a spectator, but he has already read it with gusto. He has disassembled the overall operation process, so he can find some more details during the operation.

Even if no one paid attention, and no one would specifically interact with him, Wu Xie still extracted some sensitive points.

For example, as the surgery continues to progress.

“One experience is to release the distal side of the donor nerve and the proximal side of the recipient nerve. Stimulation with the nerve can help to distinguish the excess nerve bundles of flexor carpi radialis and flexor carpi ulnaris. The other donor nerves are from the median A bundle of nerves that innervate the flexor digitorum superficialis and palmar longus muscles. The motor branch of the median nerve is on the medial side of the nerve, while the motor branch of the ulnar nerve is on the side or center of the nerve."

"Really?" Zhou Xiaoning asked Huang Yaolong.

Both Huang Yaolong and Fu Qianjin nodded.

"Knowledge point +1!"

"Knowledge point +1!"

"..."

About five or six hours later, the patient placed a drainage tube and analgesic pump!

And the patient's upper limbs are immobilized with a shoulder joint immobilizer, allowing a slight range of elbow and shoulder joint movement.

Professor Zhou Xiaoning said: "The shoulder joint fixator was removed 7 days after the operation, and the shoulder joint functional exercise began 2 weeks after the operation. After the function of the biceps and brachialis muscles recovered, strength training and follow-up functional exercise guidance began..."

"Okay, senior brother." Huang Yaolong frowned at this moment, maybe he was recalling which part he didn't learn well, and where he swallowed the jujube a little bit.

Professor Fu Jinjin praised and said: "Professor Zhou is still amazing. This operation is perfect, even comparable to a textbook-level operation."

Zhou Xiaoning smiled and shook her head slightly: "Nerve transposition is not a basic surgical procedure. At present, there is no particularly unified surgical principle, including the selection of nerve bundles after dissection of the ulnar nerve and median nerve."

"At present, there is no unique conclusion. If there is no conclusion, it cannot be a textbook. Compared with the extremely classic spells in textbooks, it is still far behind."

Zhou Xiaoning is still self-aware.

The more he knows, the more cautious he becomes. Although he also feels that his nerve transposition technique is remarkable, it is not enough to become a classic and be written into textbooks. Even more powerful professors have a great understanding of the nerve transposition technique. The understanding of position art is more transparent.

It's just that Fu Jinjin may not have seen it.

Huang Yaolong also said after hearing the words: "Director Fu, although my brother's current technology has no chance to become a textbook, there is already a precedent for it to become a reference book."

"Brother, you are the deputy editor-in-chief of the previous book Introduction and Extension of Hand Surgery Basics?"

Textbooks are different from professional tools and auxiliary books. Textbooks must be both basic and classic, and must stand the test of time.

As for the tool aid book, you can share your own experience and summarize your own surgical experience.

Wu Xie could hear this sentence, Senior Brother Long Yuan was not lying, Associate Professor Zhou Xiaoning's level is really high, otherwise it would not be possible to write a book, and he is the editor-in-chief.

Zhou Xiaoning blinked her eyes and scolded: "Master gave me the opportunity, otherwise I wouldn't have the face to become the editor-in-chief? You don't think too much about your words, you make others laugh at you."

Zhou Xiaoning's cursing voice was followed by Baibai's ears, and then she looked at Wu Xie: "Right, Xiao Wu, don't laugh at me."

Tongji Hospital's trauma surgery is still the top trauma surgery in China. Although Huazhong Concord's watch is the same, you still have to keep a low profile in front of knowledgeable people. After all, you are not crushing others in all directions.

Pretending to be too much is easy to be laughed at.

Moreover, Wu Xie was a transparent person during the whole operation, so Zhou Xiaoning decided to bring the topic to Wu Xie.

But how dare Wu Xie make a joke, and bowed slightly: "Teacher Zhou, don't make fun of me. I will always be just a student in front of you, so I dare not tell jokes."

"Mr. Zhou, no one dares to laugh at your skills!" Wu Xie was determined, and directly pulled a group of people to stand beside him.

Let Zhou Xiaoning have no room to take advantage of, unless Zhou Xiaoning can find such a person, then she will be there.

"Haha!" Zhou Xiaoning smiled upon hearing this.

"Director Fu, you little Wu can still talk."

Fu Jinjin said, "Professor Zhou, people who can read will actually be able to learn to speak relatively well after entering the society."

"Well, it's getting late now, let's go to eat, this operation spanned the noon meal."

As Fu Jinjin spoke, he gave Huang Yaolong a wink.

As Zhou Xiaoning's younger brother, Huang Yaolong said: "Brother, let me ask where the restaurant is still open. At this point, it may not be easy to find a place to eat."

Zhou Xiaoning was indeed hungry, so she nodded, "Okay, go find it, call all the people in the department, and have surgery on weekends, and they have worked hard to help."

Hearing that Huang Yaolong went to make arrangements first, Wu Xie reckoned that Huang Yaolong had to prepare something in private before leaving early.

The attending physician Wu Longshan and the two resident physicians continued to wait in the operating room to treat the patient and send them back to the ward. Wu Xie followed Fu Qianjin and Zhou Xiaoning's buttocks and walked slowly towards the locker room.

Not far from the operating room, Fu Jinjin might also feel that Wu Xie's presence was not very strong in this operation, so he said: "Xiao Wu, Professor Zhou's surgical skills are very strong teachers in the whole country, and he can follow him." Opportunities to learn are hard-won, and you young people have strong learning abilities, so you must cherish such opportunities."

"In any case, the follow-up development direction of our department is the peripheral nerve and peripheral vascular injury in hand surgery."

Wu Xie hurriedly nodded upon hearing the words: "Okay Director Fu!"

"Mr. Zhou's surgery skills are so good, I will definitely not let this opportunity go easily."

"I'm afraid that Mr. Zhou will dislike me because I didn't have much contact with hand surgery during the master's degree."

The operating room on the weekend was dark and quiet.

Zhou Xiaoning glanced at Wu Xie slightly when she heard the words, and asked jokingly, "You don't have much contact with our hand surgery, and you still say that my technique is good? What's so good about it?"

At this moment, the three of them happened to walk to the passage to the dressing room, so all three of them took off their hats and masks at the same time.

Then Fu Jinjin turned his head to look at Zhou Xiaoning slightly in a daze, and wondered in his heart if Wu Xie had offended Zhou Xiaoning somewhere, why should he be so embarrassing with a graduate student from Tongji Hospital.

Isn't it too difficult for a person who just graduated with a master's degree to comment on the advantages of your operation?

However, Zhou Xiaoning's expression was not serious at the moment, it seemed that she was just joking.

Fu Jinjin felt relieved, and said something for Wu Xie: "Of course it's good everywhere."

Wu Xie nodded, smiled, swallowed back what he had planned in his heart: "Yes, Director Fu!"

"Director Fu, Xiao Wu deserves to be your man. He always likes to put a high hat on me with you." Zhou Xiaoning was slightly disappointed.

It's just hard to explain, Wu Xie is the teacher who was entrusted by Professor Meng Tang of the Hand Surgery Department of Tongji Hospital. Looking at the person who took him a little bit, he wanted to comment on the basic skills of this young man, but now he has no chance.

The three of them continued to walk down to the locker room.

Zhou Xiaoning was in a very good mood because she had just successfully completed an operation. While changing clothes, she said, "Director Fu, I will drive Xiao Wu to a place to eat later. I have eaten and I want to go play around .It is convenient to drive.”

Fu Jinjin was also changing clothes, and his head was stuck, and he got out of his shirt after shaking it: "Professor Zhou, let Huang Yaolong go with you later?"

"Isn't Yaolong going to pick up the teacher, I just drive around by myself."

"Xiao Wu, take a taxi and come back later." Zhou Xiaoning simply handed the conversation over to Wu Xie, striving for a chance to get along with Wu Xie.

Fu Qianjin is still not particularly relieved that Zhou Xiaoning is traveling alone: ​​"Xiao Wu, are you familiar with Enshi? If you are familiar with it, why don't you take Professor Zhou around?"

"I'm from Shazhen, and I didn't come to Enshi a lot before." Wu Xie was a little embarrassed.

It's not that Wu Xie is unwilling, but that Zhou Xiaoning is not Longyuan, and with Longyuan, Wu Xie can be very casual. And Zhou Xiaoning is not Tang Yuewei either, with Tang Yuewei, or being taken by Tang Yuewei, she can go around anywhere.

"Then I'll let Guan Yun follow you later, Mr. Zhou, it just so happens that Guan Yun can still drive." Fu Qianjin arranged it like this.

"Success!" Zhou Xiaoning's original intention was to be alone with Wu Xie for a while.

...

When they arrived at the underground garage, Wu Xie was slightly taken aback when he saw that Associate Professor Zhou Xiaoning was driving a Geely Emgrand, but he barely moved. I just think Zhou Xiaoning is too low-key.

After Zhou Xiaoning rejected Wu Xie's suggestion to drive, she said, "Xiao Wu, do you have any opinions on the operation just now, or is there anything you don't understand?"

Now that Fu Jinjin is not around, Zhou Xiaoning can be more direct.

Ask in conjunction with the case.

Wu Xie blinked slightly when she heard the words, then turned her head and asked: "Mr. Zhou, in fact, I haven't figured out what caused the damage to this patient's diagnosis, and it doesn't look like the sheath of the biceps branch. Tumor, but it looks like a local chronic injury caused by compression."

"Then, due to an accidental traumatic factor, it caused a break in the nerve bundle, and there is no problem with the epineurium and endoneurium. It is relatively unclear here."

"Then, after Mr. Zhou, you stripped the epineurium of the median nerve, the selected nerve bundles were transferred to the biceps brachii branch of the musculocutaneous nerve, and bridged across the brachial artery and brachial vein. Wouldn't such a straddle affect the blood supply at the far end?"

Zhou Xiaoning asked specific questions, and Wu Xie asked specific questions back.

This is the opportunity that Zhou Xiaoning gave him. Wu Xie naturally wanted to catch this problem, but how to catch and deal with it had to be carefully grasped.

If you are too proud, giving pointers and appearing to be professional, then you are extremely unprofessional.

Starting with specific questions, you can not only ask what you want, but also cover your basic skills, so that Zhou Xiaoning can know what level she is.

When Zhou Xiaoning heard Wu Xie's question, her steering wheel trembled slightly.

Wu Xie's question is quite professional, even better than the doctors in the department. He is not a practitioner of hand surgery, so he would not ask such a question at all.

Without answering, Zhou Xiaoning asked back with a serious tone: "Have you ever been in contact with hand surgery before?"

"I went to hand surgery a long time ago, and I have a little contact with it. But?" Wu Xie hesitated to speak.

He didn't tell what happened to him.

Everyone's pity is something that everyone concerned will care about. Talking about this with strangers is just a shallow exchange of words.

"After work, I seldom contacted, but before I came, in order to avoid making me laugh, I did a little bit of infrastructure construction." Wu Xie replied very straightforwardly.

Zhou Xiaoning's heart was tumbling, you have done more than a little bit of infrastructure construction.

In fact, Zhou Xiaoning saw Wu Xie in the operating room. Wu Xie's temperament was very stable, and she was not pretending to be so stable.

He didn't panic because he was 'in the cold', nor was he confused because he was ignored, forced to laugh.

Zhou Xiaoning noticed that Wu Xie was thinking during the whole process.

And this kind of thinking is either pretended by Wu Xie, or Wu Xie really understands, he is reading, reading from his own perspective.

This is actually analogous to the fact that someone who has a poetic spirit in his belly, who really understands surgery and surgery, will find it very interesting even in the process of watching the operation, because he can think about it.

One cut and one grind are similar to the process of tasting tea, which is a kind of enjoyment.

But this is hard to pretend.

However, Zhou Xiaoning didn't know exactly what level this Wu Xie was. She just said, "Professor Qi will come tonight and perform the surgery we discussed today."

"Come over when you're eating."

"It is estimated that Director Fu will call you too!"

Wu Xie bowed slightly when he heard the words, he understood Zhou Xiaoning's meaning: "Thank you, Teacher Zhou!"

During the unconscious teaching process of Associate Professor Zhou Xiaoning, he got 8 knowledge points for this operation. If Professor Qi taught him consciously again tomorrow, he might get even more things.

"After work, regardless of major, but do what you encounter and do."

"The opportunity is the same." Zhou Xiaoning did not continue to communicate with Wu Xie in depth, and did not answer the above questions.

Because there is no need to answer, since Wu Xie doesn't understand now, after he answers, maybe Wu Xie won't be able to understand it in a while.

But it is enough to understand Wu Xie's basic skills.

This Wu Xie was far beyond his expectations. At least, without saying a word, he was a little better than Huang Yaolong, who hadn't had hand surgery for a long time, and Fu Jinjin, who was new to hand surgery.

At least a little bit.

Then combined with Wu Xie's current age.

In terms of plasticity, Zhou Xiaoning already has a bottom line.

But I don't know if Wu Xie has the intention to go deep into hand surgery, and even enter the real gate of hand surgery.

I don't like to judge this matter, so I might as well leave it to my teacher.