medical simulator

Looking at Luo Yun with a smile: "It's good if you come, it's good if you come!"

He also patted Luo Yun on the shoulder.

"Mr. Zhu, I bought two pieces of bacon and a fish, which was fresh and just caught. I passed by and bought one." The old man told Teacher Zhu.

Then Professor Liu Yiping came out again, and after another cold announcement with the old man and Luo Yun, they finally got some leisure time. Luo Yun and Liu Yiping were also driven out of the kitchen by the teacher's wife, Teacher Zhu, who also smiled in the kitchen. The kitchen is busy!

Mr. Zeng took out his precious tea leaves. Liu Yiping and Luo Yun had already found out the tea sets as if they were at their own home. Young man, it's Zhou Cheng, the little Zhou that Junior Brother Luo recommended to you vigorously."

After Liu Yiping said this, Zhou Chengcheng quickly stood up, like an outsider, very cautious: "Mr. Zeng, I am Zhou Cheng."

From the beginning to the present, Mr. Zeng has spent several minutes, and found him in less than half a minute, which shows how little sense of existence he has in his heart.

Then Luo Yun hurriedly pushed the teacup in front of Mr. Zeng, and said, "Teacher, this is Xiao Zhou, who is also a student I brought up before. He is very talented, so I dared to bring him here to see you."

Then Luo Yun looked at Zhou Cheng again, and after serious thinking for a while, he said, "Better than me!"

Professor Liu Yiping smiled and said nothing, but Mr. Zeng didn't take it seriously, and hurriedly greeted him: "Xiao Zhou, sit down, sit down, sit down and talk."

Only then did a few people shift their focus of attention to Zhou Cheng, and then three pairs of six eyes stared at Zhou Cheng and kept scanning up and down, obviously they didn't take what they said seriously.

Seeing that Liu Yiping and Zeng Diwei didn't have much interest in Zhou Cheng, Luo Yun said again: "Xiao Zhou, this is Professor Liu Yiping, who is also the teacher's first student, and our senior brother."

"This is Mr. Zeng that you have been thinking about. In terms of joints, Mr. Zeng is a very tall person in China at present. You will know this in the future. It is not comparable to a half-assed person like me." Luo Yunkai joking.

Zeng Diwei glanced at Luo Yun, and said: "Xiao Luo, your mouth is not as honest as before. You are deliberately causing trouble for me."

"How dare you, teacher, I'm telling the truth. Do you think my temperament is like a flattering person?" Luo Yun said with a smile.

Old Zeng thought for a while, then shook his head: "It didn't seem to be the case before, but it's not necessarily the case now."

After finishing speaking, Mr. Zeng took a sip of his tea, with an expression of endless enjoyment, and then he said, "Oh, by the way, there are fruits in the refrigerator. I just bought them this afternoon. Take them out and eat them first."

Professor Liu Yiping said: "Teacher, didn't you say that eating fruit before meals is bad for your health? Why did you break the precept once Junior Brother Luo came?"

Even so, he stood up and went to the refrigerator to get some fruit.

Then the fruit was brought, and after everyone ate a little, Luo Yun officially started talking: "Teacher, I am here this time mainly for three things, and the first thing is to attend the annual meeting."

"The other thing is to hand in the materials for the entrance exam, and the third thing is to introduce Zhou Cheng to you, the teacher."

"I watched Xiao Zhou grow up with my own eyes. He did a very good job of manipulative reduction for joint dislocations and very good manipulative reduction for fractures. Not only that, he is now, even though he is in my unit."

"I also obtained the authorization of Class III surgery in advance, which was jointly performed by Professor Lei from the Affiliated Hospital of Shonan University at the annual meeting of orthopedics, leading the members of the Trauma Branch of the Hunan Medical Association."

"Of course, these are secondary. The most important thing is that his talent is really good. If I hadn't been delayed by something, I must have shown it to the teacher on the first day!"

"Teacher, if you don't believe me, you can test the school, but it may be limited to clinical practice for the time being."

Hearing what Luo Yun said, Mr. Zeng looked Zhou Cheng up and down seriously.

Putting down the teacup slowly, he suddenly asked, "Do you know the type of the femoral neck bone marrow cavity?"

Zhou Cheng frowned immediately when he heard the words. Zeng Lao's temper is also a straightforward person. As soon as he came on stage, he asked such a difficult question?

The classification of the bone marrow cavity in the femoral neck is difficult for most people to understand, but it is not difficult for Zhou Cheng.

"Ordinary type, chimney type, and champagne glass type." Zhou Cheng accurately named three special types.

"Based on what classification?" Mr. Zeng asked again!

If it is said that the names of the three classifications are very professional knowledge, then the question of what to base the classification on is an extremely tricky question.

This does not bother Zhou Cheng, who has perfect skills in total hip replacement: "The classification based on CFI can also be called fractal."

"The canal flare index (CFI) is used to describe the internal shape of the proximal femur, which refers to the ratio of the width of the medullary canal at the midpoint of the lesser trochanter 2 cm proximal to the femoral isthmus."

"A CFI > 3.0 is called a chimney-shaped medullary cavity, and a CFI between 4.7 and 6.5 is called a champagne-shaped medullary cavity."

Zhou Cheng first used CFI to replace himself knowing the name, and then explained it, with reasons and sources!

Professor Liu Yiping's eyes lit up slightly when he heard this. Only those who really want to start hip replacement surgery will understand this kind of in-depth knowledge.

How difficult is it for Zhou Cheng to know so much?

"Why is it so divided?" Mr. Zeng was still asking trickyly.

This is a more tricky question, and it does not belong to the category of clinical application!

Hearing such a question, both Luo Yun and Liu Yiping's eyelids began to twitch, because even if they were to answer this question, they would need a special god-level skill——

impromptu.

That is - now compiled!

"The poor correlation between proximal and distal femoral canal diameters in prosthesis selection necessitates decisions based on how well they fit the proximal rather than the distal femur in favor of optimal metaphyseal load transfer .”

"Previous studies have found that the relationship between the inner and outer diameters of the femoral medullary cavity 20 mm below the lesser trochanter and the outer diameter of the femur is the most constant, with an accuracy of ±12%. Anatomical basis for metaphyseal fixation of cemented prostheses."

"Later, some scholars confirmed the high variability of the femoral medullary canal through CT studies, and also showed a poor correlation between the femoral medullary canal at 20 mm above and below the lesser trochanter."

"The use of CFI or Dorr classification is to facilitate the selection of prosthetic stems in clinic, or to provide a structural basis in the process of prosthetic stem design."

Having said that, Zhou Chengcheng began to enter the state:

"According to Wollf's law, the implanted stem will change the load distribution of the proximal femur and significantly affect the continuous process of bone remodeling."

"Whether it is a cemented stem or a non-cemented stem, and regardless of the shape of the femoral stem, it will inevitably reduce the compressive stress, tensile stress and shear force on the proximal femur after being inserted into the femoral medullary cavity."

"If the non-cemented stem can obtain a firm proximal matching fixation, it can form a normal stress distribution, while a firm distal fixation will significantly reduce the stress distribution pattern of the proximal femur."

“The closer the distal femoral stem contacts the medullary canal, the more pronounced the proximal femoral stress shielding. The lack of contact between the distal femoral stem and the cortical bone may reduce stress shielding, bone resorption, and thigh pain. The above evidence suggests that Stem length plays an important role in the transfer of stress to the femoral bone."

"Theoretically, shortening the femoral stem length can reduce the stress shielding of the proximal femur, but at the expense of reducing the contact area for fixation and stress transfer."

"Some scholars have found that shortening the length of the femoral stem can effectively reduce the stress shielding of the proximal femur without affecting the initial stability of the prosthesis fixation. They also believe that the femoral stem prosthesis designed for metaphyseal fixation can provide the best It is close to the matching of the biomechanical characteristics of the femur itself."

"but……"

Eloquently, Zhou Cheng didn't even need any references, he directly wrote an article and discussed it!This is the foundation, at least I have read many articles and have a deeper understanding of many knowledge points, so I can have such effort!

Zeng Lao's eyes became more and more energetic, and he waited patiently for Zhou Cheng to finish speaking.

Elder Zeng narrowed his eyes, pondered seriously for a moment, then turned his head to look at Professor Liu Yiping, and said with a smile: "How, I said, there are geniuses in this world, right?"

Professor Liu Yiping laughed and said, "Yes, yes!"

"Xiao Zhou, very good!"

Then, for some reason, the corners of his mouth twitched, which made Luo Yun and Zhou Cheng wonder if they had asked Professor Liu Yiping similar questions before, and when Professor Liu Yiping asked the third question, there was no reason why he made it up now. Compiled.

However, just after Professor Liu Yiping finished speaking, Professor Zeng Diwei, sitting in the middle, suddenly said a little coldly: "You have memorized a lot of articles, right?"

"However, it's not bad. Being able to flexibly apply the memorized articles to answer questions proves that your resilience and organizational skills are very good. At least, in terms of organizing language, you are better than your two senior brothers! "

"However, being a doctor is ultimately in your hands. It is really good only if you are good at your hands."

Although Zeng Diwei's words were harsh, Zhou Cheng was overjoyed to hear one of the key words. He quickly stood up and said, "Thank you, teacher!"

Teacher Zeng Diwei just said, your two senior brothers.

This proves that he agreed to Zhou Cheng's status as his student, but whether he can become a student or not depends on his skill.

This is at least half the agreement.

Although, Mr. Zeng still has a little suspicion that beating Zhou Cheng will only endorse, but this is also for Zhou Cheng's good.

However, what puzzled Zhou Cheng was that after that, Mr. Zeng stopped talking to Zhou Cheng, but only took the initiative to talk to Luo Yun and Liu Yiping, deliberately keeping Zhou Cheng cold.

……

Until the end of the dinner, Mr. Zeng even said bluntly: "Xiao Zhou, if you still have something to do, you can go back first. You two brothers and I, let's talk more and catch up on the old days!"

It was an order to evict the guest directly.

When Luo Yun saw this and wanted to say something, Professor Liu Yiping stood up and said, "Xiao Zhou, you should go back first, and study hard with Ding Dian first. Don't worry!"

"Okay!~" Zhou Cheng felt a little confused, but after saying goodbye to everyone honestly, he walked out of the house.

There was no one to see her off, and after walking out of the villa complex, she took a taxi and headed back to the rented house!

What Zhou Cheng didn't know was that right after Zhou Cheng left, Mr. Zeng hurriedly asked, "What's the specific situation of this young man, let me tell you first? This foundation is quite solid, so I don't know how his heart is?"

"But the performance at home just now is still very good, neither arrogant nor impetuous."

Luo Yun said: "Teacher, then you have misunderstood Xiao Zhou, he is definitely not the kind of person who can't sit still..."

Then, Luo Yun told about Zhou Cheng's past events, including the fact that Zhou Cheng failed the postgraduate entrance examination several times, and then he was as stable as an old dog in clinical practice.

Finally, Luo Yun concluded: "Teacher, don't say that you drove Zhou Cheng away. If you don't believe me, try it. If you don't authorize him or ask him to do something in the clinic, he will probably be able to do it." Wait until the patient is half dead before taking action!"

"There is definitely no problem with his character. As for the clinical operation ability, this is actually his strong point."

"En!~" Mr. Zeng nodded in satisfaction.

"That's not bad, it will be of great use in the future!"

"Instead, I ignored him. Since he came to Shanghai, I have been ignoring him, just to see his character. After all, what if things are done in a hurry?!" Elder Zeng looked at Liu Yiping next to him.

Professor Liu Yiping laughed along with Han.

And the old lady who was called Teacher Zhu by Mr. Zeng said after washing her hands, "Dr. Zeng, you are a doctor like a Taoist priest, and you are still taking a test for your character. You have to change your temper. "

"Moody, weird, I think Xiao Zhou is a good kid. He is tall and handsome, with an easy-going temper, neither arrogant nor irritable. Hey, by the way, does he have a girlfriend?"

"Well, then I don't know, Shifu, you can ask yourself when the time comes." Luo Yun said.

"Then I'll ask when the time comes." Teacher Zhu seemed very enthusiastic, and then went upstairs, as if deliberately giving up the space to Zeng Diwei and the other three.

Elder Zeng continued to ask: "Luo Yun, what Xiao Zhou said is really as good as you said in clinical practice? Why do I feel that you are a magic stick? It seems a little more unreliable than your senior brother. "

Professor Liu Yiping started to pretend to be dead again. With Mr. Zeng, he didn't dare to go too far.

Luo Yun then said, "Teacher, you have to take the test yourself, don't you? What Xiao Zhou did in the test is his own test, and it's not something I can say to increase his score."

"Well, being able to answer my first question proves that he has read the book."

"Being able to answer the second question proves that he has read the article!"

"The answer to my third question is to prove that he read the documents with his brain, not endorsed them. I said he memorized the articles, but he didn't have any special reaction, which proved that he is not a competitive person. people."

"At least not to win or lose, that's good." Mr. Zeng finally gave Zhou Cheng a high degree of affirmation.

"What do you think?" Elder Zeng looked at Liu Yiping.

Liu Yiping said respectfully, "The teacher is right!"

2 Ten chapters of thunder and strange flowers!

After Zhou Cheng hurried back to his rented house rather helplessly, he still smiled wryly for a while, with a kind of self-indulgent rush.

When he was in No.[-] Hospital, Zhou Cheng felt that Cai Dongfan still valued him a little bit.

But after coming to Shanghai, even with Professor Liu Yiping's recommendation and Luo Yun's costly support, he is still wandering on the edge.

It seems that he is a student of Academician Zeng Diwei, but it doesn’t matter if he can’t even enter the clinical team. Even for studying scientific research, he has to follow Ding Dian first. Zhou Chengcheng got the qualification to enter the laboratory of Ding Dian’s scientific research group laboratory .

In fact, speaking of it, it’s still not enough.

The foundation of the Eighth Hospital is not enough. If Zhou Cheng came out of the Affiliated Hospital of Shonan University, then he would definitely not be treated as he is now, at least he would pay more attention to it.

If Zhou Cheng himself had a higher professional title, or had a few SCI papers that could accumulate enough to qualify him to beat Liu Yiping, then the result would definitely be completely different.

From the No. [-] Hospital to the No. [-] Hospital in Shanghai, the span is indeed large, but unfortunately, the steps are too big, and it is almost torn apart.

Although Zhou Cheng was not in a hurry, when he saw Mr. Zeng, Professor Liu Yiping, and Luo Yun being so close today, he actually felt a little sour in his heart.

But it's still early to come to Shanghai, and there is plenty of time to slowly enter the eyes of others, and then go out of the eyes of others.And now such a change, on the contrary, has more time to learn.

Zhou Cheng has a lot to learn...

"Ding dong!"

At some point, Zhou Cheng's cell phone rang a notification tone.

I picked it up and saw that it was An Ruo who sent me a message from VX: "Brother, I asked a friend to read the article you sent me. She specializes in editing SCI articles, but after reading it, she said It’s because there aren’t too many vocabulary that need to be specially revised, so I won’t send out revised drafts.”

"As for the structure of the article, brother, you need to modify it slightly according to the target format of the journal you are submitting to."

"As for the content of the article, she said she didn't particularly understand it."

Whether the article is good or not, the content is the most important!The content is the core part, but the structure of the article is the skeleton of an article and the venue. The same content, some people write it is very high-level, and some people write it, just like water journals and hydrology.

The expression of the number of words in the article is a stepping stone. If the editors of the journal can read without dyslexia, it will be easier to pass the manuscript!

This was when Zhou Cheng accidentally chatted with An Ruo before, and they talked about writing a net-meta analysis, and then An Ruo asked if he could send it to her to read and study.