Back in 2002 as a doctor

"Professor Zhou, is there any example?" Xiao Kai asked cautiously.

Wang Xueteng's ears perked up unknowingly.

She didn't really believe what Zhou Congwen said, because Wang Xueteng knew that Zhou Congwen didn't have much contact with Mr. Huang, so why would he say so much.

This ascetic man is talking nonsense again, let's see how he can justify himself this time.The textbook is wrong?Zhou Congwen can really talk nonsense.

"For example, ATP's high-energy phosphate bonds are broken to supply energy. Dean Xiao, you know about this."

"I know." Xiao Kai tried hard to recall the biochemistry he learned when he was in school, but he had only a few memories.

In clinical practice, biochemical knowledge is rarely used, and people with the best memory seem to be unable to do so. After all, it was a long, long time ago to learn about high-energy phosphate bonds.

"Then let me ask you one thing, how much ATP can be generated by a glucose molecule being completely oxidized?"

"..."

Xiao Kai was stunned.

This kind of question is simply too unpopular. It has something to do with medicine, but it is not used in clinical practice.

He immediately thought of the Huang Lao that Zhou Congwen had just described. Shouldn't there be standard answers to such objective questions?

Xiao Kai frowned in thought.

"In the cell, after 1mol of glucose is completely oxidized and decomposed, about 1161kJ of energy can be stored in ATP, and the formation of ATP's high-energy phosphate bond requires 30.54kJ/mol of energy, so the amount of ATP formed is: 1161/30.54=38. "

"This is the answer used in high school textbooks, which is 38."

"And then? Professor Zhou." Xiao Kai asked.

“大学的生化课有自己的算法。”周从文道，“糖酵解：1G→2ATP+2NADH+2H++2丙酮酸=2+2×2.5=7ATP。

三羧酸循环：2丙酮酸→25ATP+6CO2+4H2O如进行苹果酸穿梭则不会减少能量，还是32ATP，在脑等部位会进行3磷酸甘油穿梭，减少2分子ATP，最终净产生30ATP。”

"That is to say, the university's biochemistry textbook overturned the statement in the high school textbook."

"But is it 38 ATP pairs, or 30 or 32 ATP pairs?"

Xiao Kai was dumbfounded, he didn't have the slightest impression of all these words, but he remembered something Zhou Congwen said about the shuttle of malic acid and the shuttle of glycerol-3-phosphate.

When I was in school, I didn't notice the difference between the third-year biochemistry class and the high school textbook.

Professor Zhou is really, why does he remember this kind of thing so clearly.

"Don't say I'm messing around. The normal ranges of blood pressure and central venous pressure that we often use in clinical practice have been adjusted many times in just ten years. The same is true for isotonic dehydration. I have read at least three versions." Zhou Congwen Shaking his head, "Let's talk about it and listen to it. Be nice to the interns. Many children are not enlightened."

Zhou Congwen paused for a moment, then continued, "The data in the textbooks are constantly being adjusted, so why make things difficult for the children."

"Professor Zhou, when did you open your orifices?" Xiao Kai asked.

"In the Third Hospital of Jianghai City, it was opened when Wang Chengfa smashed it with the medical records." Zhou Congwen said with a smile.

In the last life, it should be the postoperative system possession; in this life, it should be the moment of rebirth.

There is nothing wrong with saying that Wang Chengfa smashed it open with a medical record clip.

But this kind of thing can't be said, Zhou Congwen said immediately, "About how much ATP is produced by glucose, the boss I asked some time ago was scolded by the boss."

"Oh?" Xiao Kai suddenly became interested.

"What did Huang Lao say?"

"The boss drew a picture to explain it to me." Zhou Congwen recalled that when he was a green young man in his previous life, he met his boss and asked this question.

And the boss's answer made me realize that the system is not a panacea.

"How to say?"

"The boss said that when the mitochondria were oxidized in the end, there were two shuttle pathways, one was to produce 2.5 ATP and the other was to produce 1.5 ATP, resulting in a difference in the amount of ATP produced.

During anaerobic glycolysis, 2 ATPs are consumed, but during one anaerobic glycolysis, there are two substrate-level phosphorylations, 4 ATPs are generated, and 2 ATPs are generated in net.

Therefore, any steps of sugar in the body, including pyruvate cycle, pyruvate to acetyl coenzyme A, tricarboxylic acid cycle, etc., all generate ATP, although they are all stored in the form of NADH and FADH. "

"..." Xiao Kai was speechless.

Do this weird pair of masters and apprentices usually talk about these things?

Who cares about how much ATP can be generated after a glucose is completely oxidized? This has no guiding significance for clinical treatment, but it seems to be engaged in scientific research.

However, Xiao Kai immediately thought of how Mr. Huang and Zhou Congwen were tirelessly researching new techniques every day. Perhaps, this is what a clinician should look like.

"The literature is not all right. In the world's top journal literature, at least 10-20% of the articles are nonsense, which is at least." Zhou Congwen said, "It is better to have no books than to believe in books, and the teachers are not good. Why? You have the face to blame the students."

Xiao Kaipin sucked at Zhou Congwen's words.

The words in this passage seem very messy and fragmented, but after careful consideration, they said a lot, and it wasn't just about Director Lei of the Department of Gynecology.

Wang Xueteng fell silent and drove the car speechlessly.

Except for Zhou Congwen and the medical team brought by Zhou Congwen, among the doctors she has contacted, it is the limit to publish an article beginning with Chinese, SCI?No one would think about it except the doctors in the imperial capital and the magical capital.

And what about Zhou Congwen?

I have already begun to have an "objective" understanding of the world's top journals, and 10-20% of the literature content is wrong!

Logically speaking, Wang Xueteng believes that what Zhou Congwen said is right. Medicine is a science that always overthrows the cognition of the predecessors to make progress.

However, on the expressway to Jianghai City, listening to Zhou Congwen talking about similar things, this gave Wang Xueteng an illusion—the big boys playing basketball on the school playground were sweating, and the best one among them was against him. NBA stars pointing fingers.

……

……

In the Third Hospital of Jianghai City, Li Qinghua sat in the waiting area for the patient's family members, accompanying Li Ran.

Zhou Congwen made a phone call. Although the dinner and chat with Zhou Congwen was a bit unpleasant at the end, he could see through it without telling the truth. Li Qinghua must do his best to complete what Zhou Congwen told him.

Moreover, Li Ran also went out from the Third Hospital of Jianghai City, and Li Qinghua had to take good care of his own soldiers, both emotionally and rationally.

Li Ran waited for the CT results blankly, he didn't even dare to go to the operating room.

Li Qinghua understood this feeling. When he found a small nodule in the physical examination last year, he was the same as Li Ran every day.

Chapter 1451 Zhou Congwen's dog leg

The examination results of Li Ran's mother were rather strange. The directors of the relevant departments of the Third Hospital gave various diagnoses, but there was one thing in common—there was definitely a problem with the blood vessels.

Because he has been engaged in cardiothoracic surgery for a long time, Li Qinghua has seen more about aortic dissection, which is much better than doctors in other departments.

What happens if the carotid artery is dissected?Li Qinghua's mind was blank, he had never seen a similar patient.

But there is a problem with the blood vessel, it is definitely not a plaque of arteriosclerosis, what else could it be?Li Qinghua was more inclined towards the diagnosis of carotid dissection aneurysm.

Li Ran stared blankly at the ground without expression. Li Qinghua comforted him, "Li Ran, Cong Wen has already rushed over, you have to trust him."

"En." Li Ran nodded.

"It's just a problem with the carotid artery. Didn't you see Congwen have a similar operation when you were in medical university?" Li Qinghua asked.

"No." Li Ran shook his head, "The last time I heard that Congwen had an arterial dissection, it was on our side."

Li Qinghua scratched his head a little.

The operation of aortic dissection is actually quite easy to do. The diameter of the aorta is there, as long as the hands are not too raw, it can be performed.

However, the carotid artery is relatively thin and still controls the blood supply to the brain. Once something goes wrong, the consequences will be disastrous.

Zhou Congwen should be able to do it, but he doesn't know the success rate.

Just as he was thinking, a voice came, "Li Ran, how is the situation?"

Li Ran and Li Qinghua were startled at the same time.

This voice is very familiar, quite familiar, but why does it appear here?

Zhang You bared his big teeth, and walked in hurriedly.

Li Qinghua stood up immediately, pulled Li Ran, and then strode forward to meet him.

"Director Zhang, why did you come here?" Li Qinghua asked with a smile.

Li Qinghua was surprised that Zhang You appeared here.

He knew very well that it was definitely not Li Ran's face, but Zhang You's love for the house and Wu in order to please Zhou Congwen. Zhang You and Director Zhang arrived before Zhou Congwen arrived.

It seemed that Zhou Congwen had been doing well in the Second Hospital of Medical University, and Li Qinghua figured out the cause and effect the moment he went up to him.

"Qinghua, look at what you said." Zhang You bared his big teeth, his mouse-like eyes were a bit annoying, he shook hands with Li Qinghua, "No matter what, Li Ran is working at my place, such a big thing happened , I always have to care about it."

care?

Li Qinghua didn't think so.

Zhou Congwen was still halfway, but Zhang You rushed over as if "teleporting", there must be something strange about it.

But he didn't talk about it, just smiled without saying a word.

"How's the situation?" Zhang You asked.

"I think it's carotid artery dissection." Li Qinghua whispered, "Although I haven't seen it before, the carotid artery is narrow and there are abnormal signal shadows. Director Zhang, have you ever had a similar operation?"

"No." Zhang You curled his lips, "The vascular department will be a fart."

Li Qinghua didn't quite agree with Zhang You's behavior of belittling other departments by opening his mouth, but he couldn't refute it directly, so he smiled and shut his mouth.

"I'll watch the film."

"Li Ran." Li Qinghua greeted him.

Li Ran's actions were as stiff as his expression.

Li Qinghua felt that Li Ran was a bit too much. After all, Zhang You is also the director of the Thoracic Surgery Department of the Second Hospital of Medical University, so Li Ran should be more enthusiastic when he came all the way to visit.

Even if you are not enthusiastic, you should feel a little more at ease in your heart.

But looking at Li Ran's actions, it seemed that he didn't want to show Zhang You the film at all.

But Zhang You didn't seem to understand Li Ran's meaning at all. He took a few steps forward, patted Li Ran on the shoulder, and took the film bag in Li Ran's hand while talking.

"Don't worry, Li Ran." Zhang You said, "Just make sure you have a good blood pressure. Professor Xiao Zhou waited a little longer for the stent, otherwise he would have arrived long ago."

"There are not many operations for carotid artery dissection in the three provinces in the Northeast. I have only done a few cases tentatively. I am a little surprised that Olida has consumables in his hand."

"Oh?" Li Qinghua's mind was moved, and he moved to Zhang You's side.

"I guess Olida's manager Wang is caring. As long as Professor Xiao Zhou can perform the operation, she will prepare all kinds of consumables in advance, so as not to make Professor Zhou angry if he can't get them out when needed."

Li Qinghua was shocked.

What did Zhou Congwen do to Olida's Manager Wang to make her rush so hard.

Moreover, she acted submissively like a little maid, fearing that Zhou Congwen would be unhappy with the consumables she took for nothing.

Zhang You's thinking is different from others, and the idea he thought of at the first time was rather crooked.But Zhang You didn't reveal what he was thinking, but walked to the window formally, took out the film and took a look.

"The machines in Jianghai City are good." Zhang You praised, "There are not many hospitals that can do vascular CTA."

"The group company is still very rich, and the affiliated hospitals must meet the hardware requirements." Li Qinghua explained.

"Now patients who come to the provincial capital to see a doctor, many people in other cities have to be re-examined, but Jianghai City doesn't need it." Zhang You said while watching the film, "It's like a film with enhanced blood vessels, even in the provincial capital. As long as we are in the second year of medical school, we can do it in the first year of medical school.”

Li Qinghua smiled apologetically.

Zhang You babbled on and on, without stopping for a moment.

In fact, he didn't care about what he was talking about. It was certain that there was something wrong with the film, but Zhang You didn't find out what the problem was after looking at it.

Zhang You is indeed the director, but not the director of the vascular department. After all, it is a disease such as carotid artery dissection that has never been seen before, and it is normal if he has never seen it.

"Consider it is likely to be mezzanine."

A few minutes later, Zhang You put the film back.

"Wait for Xiao Zhou to come, I will go with him."

Li Qinghua was surprised, "Director Zhang, have you also undergone interventional surgery?"

Zhang You was a little proud, and his big die showed a bright smile.

"Xiao Zhou will participate in the World Cardiothoracic Surgery Competition next year."

Li Qinghua was taken aback. Does the interventional surgery have anything to do with the World Cardiothoracic Surgery Competition?

"Surgery is the treatment of valvular disease under intervention."