top student at medical school

Chapter 402 It hurts to be slapped in the face, so be careful what you say (Please subscribe)

The muscles in the thighs are very thick, whether it is the quadriceps in the front or the hamstrings in the back, the muscles are quite large.

This is an anatomical structure that everyone possesses.

That's why Fang Ziye felt right at home when performing local debridement.

The more complex the location, the more difficult the debridement procedure becomes. In areas with large muscle strips, there are actually fewer details to pay attention to.

Furthermore, Fang Ziye even had the mood to give a coaching session: "What kind of muscles are these?"

Jie Han thought for a moment: "Thin thigh muscle."

“Yes, this is the gracilis muscle. This muscle has a very interesting trigger point. You try it.” Fang Ziye has already completed the suturing of the femoral artery, and with the help of Fang Ziye’s level 4 vascular suturing technique, the blood supply to the treated lower limb is now unobstructed.

Good blood circulation is the foundation for lower limb survival!

Subsequent nerve suturing can only be performed after the debridement is completed.

Yes, this time, through the experience gained from the previous major surgeries, Fang Ziye has once again accumulated more than 9000 knowledge points.

The functional reconstruction surgery performed on Yan Chu alone, which was an original procedure, brought Fang Ziye nearly 8,000 knowledge points.

If he were to save some money, Fang Ziye could upgrade both Vascular Suturing and Nerve Suturing to level 5.

However, there is currently no need to apply vascular suturing; Fang Ziye only plans to add nerve suturing later.

I don't have enough knowledge, so I have to be careful with my resources.

Upon hearing this, Jie Han immediately began reciting: "Origin: pubic ramus and ischial ramus. Insertion: medial aspect of the upper end of the tibia. 3. Trigger point location: middle section of the belly of the gracilis muscle."

While doing this, I started looking for the middle section of the gracilis muscle. After stretching the middle section of the gracilis muscle, I could indeed see the muscle contract.

Furthermore, the patient's current state is no longer just weak and boneless, but truly without bone support. Therefore, after the muscles contract, the thigh area becomes limp and deformed.

This startled Jie Han, who quickly let go of his hand.

"It's okay. This patient's semitendinosus muscle was going to be removed anyway. He had a tendon injury in his calf. The semitendinosus muscle is a natural autologous tendon graft material. Removing it won't have much impact on the patient's function."

"It is one of the best autologous consumables for reconstructing the anterior cruciate ligament in sports medicine." After explaining, Fang Ziye asked Li Yuanpei to broaden his perspective.

"The semimembranosus and semitendinosus muscles have roughly the same course, but because the tendon of the semimembranosus muscle is too small, it is generally not used as a material for autologous tendon transplantation."

"Let's take a look at the tensor fasciae latae muscle..." Fang Ziye treated the patient's muscles as a living anatomical textbook, and began to supplement Jie Han and Li Yuanpei's on-site anatomical knowledge.

Of course, Fang Ziye can also review on his own.

After recognizing almost all the muscles and removing the hematoma and bone fragments through debridement, Fang Ziye saw the femoral nerve severed by the bone fragments and the sciatic nerve that was partially cut off behind it.

After seeing Fang Ziye expose both nerves, Deng Yong looked up and asked, "Ziye, should we change positions?"

Deng Yong was worried that Fang Ziye didn't have enough experience in nerve suturing and treatment.

"Master, let me try stitching it first. I watched Teacher Liu stitch nerves before, and I feel like I've almost mastered the technique myself," Fang Ziye pleaded in a low voice for another chance.

Deng Yong nodded upon hearing this and continued working with Yuan Weihong: "That works too."

-

The professional development of all junior doctors is built upon learning and accumulating surgical experience.

Fang Ziye has excellent basic skills in suturing. Even if he doesn't have mastered many tricks of nerve suturing, the quality of his suturing will not be too bad.

Everyone else can practice nerve suturing in emergency surgery, so why can't his beloved student, Fang Ziye?

Therefore, even if Fang Ziye's suturing wasn't perfect, it's understandable. At least, Fang Ziye can guarantee a level of nerve suturing that surpasses 95% of orthopedic surgeons, or even more.

Upon hearing this, Jie Han's spirits lifted: "Senior brother, are you planning to suture only the outer membrane, or suture the outer membrane and peritunic together?"

Nerves are divided into the epineurium and the perineurium.

The epineurium, as the name suggests, is the outermost membranous structure that surrounds the entire nerve, serving as the first barrier separating the nerve from the outside world.

The most traditional nerve suturing technique is epineurial anastomosis.

However, due to the limitations of epineurial suture, it is currently only applicable to the anastomosis of nerve ends without perineurial branches.

In the femoral segment, where the adventitia covers the area, the femoral nerve divides into perivascular branches. In such cases, in addition to suturing the adventitia, the perivascular branch also needs to be sutured.

However, the suturing method is different now.

There are simple peritunic + simple outer membrane sutures, as well as integrated peritunic and outer membrane sutures.

The anatomical structure of a large nerve is similar to that of an electrical wire. Some of these wires are divided into many strands, which are intertwined within a large wire. When bridging, each strand must be connected separately to avoid transmission disorder.

Because Jie Han is not a professional master's student in hand surgery, he does not have a particularly clear understanding of the subclassifications of nerve sutures.

Fang Ziye replied: "If there is a peritunic, the peritunic and the outer membrane are usually sutured separately. Although the integrated suture of the peritunic and outer membrane sounds impressive, its applicability is not very strong. It is an improved suture method to simplify the suture operation and it is applicable to some nerve segments."

Hearing this, Li Yuanpei nodded slightly: "That's right. I've also heard others say that after the epineurium and perineurium are integrated and sutured, the local scar may be too large, eventually leading to scar hyperplasia within the epineurium, which compresses the nerve and causes symptoms."

"It would be better to suture them separately."

"But Ziye, the femoral nerve stump of this patient is now quite swollen. Should we cut it off and suture it again?" Li Yuanpei's knowledge was ultimately a little bit broader than Jie Han's.

When there is localized edema in the nerve, suturing is difficult and it is hard to identify the internal structures.

Normally, this should be removed.

Fang Ziye shook his head slightly: "Yuanpei, what Professor Liu Huanglong said last time about removing the scar to a scar-free position during nerve transplantation is for elective surgery."

"If the nerve stump has not healed with scar tissue during emergency surgery, then this is unnecessary."

"In addition, because this patient has local nerve edema and will need a second limb-sparing surgery for repair, the most suitable surgical procedure for him is decompression of the epineurium and nerve sheath, followed by suture of the nerve perineurium."

“In this situation, even suturing the outer membrane is not suitable. If the outer membrane and peritunic are then integrated and sutured together, it will undoubtedly put more pressure on the edematous nerves, and may even lead to local necrosis.”

Upon hearing this, Li Yuanpei was slightly surprised: "Ziye, you're still reading?"

This falls under the theoretical scope of hand surgery. It's clear that Fang Ziye's ability to understand these concepts comes from reading professional books on hand surgery.

“We should definitely take a look when we have time. Although Professor Liu used to be a hand surgeon and now nerve suturing is all his responsibility, we still need to have some knowledge of it.”

“I have a very precise focus now. My mentor only lets me perform emergency surgeries and surgeries for diseases related to trauma. So I don’t delve into the details of surgeries such as bone transport and large bone defects, as well as the related theoretical issues.”

"Learning by doing, and applying what you learn, is the best way to learn."

After saying that, Fang Ziye began performing an epineurotomy decompression procedure while adding, "This learning method has actually been followed throughout our school years."

“During our master’s and doctoral studies, we don’t get to work on most fracture surgeries. All we can do is use our basic skills, so of course we have to work on those first.”

"Once you have a solid foundation, Yuanpei and Jiehan, you will find that debridement and suturing, as well as external and internal fixation of fractures, are all based on the flexible application of basic skills."

"Adapting basic skills to local conditions is the foundation of professional techniques."

As Fang Ziye spoke, the sharp knife in his hand had already ripped open the outer membrane, making way for the swollen nerves.

Deng Yong laughed when he heard Fang Ziye's heartfelt words: "Ziye, some things don't need to be said directly. If you say them, it will be even harder for them to understand."

"On the contrary, it will have a 'forced growth' effect."

Deng Yong knew that Fang Ziye's mentorship period was short and he had not yet gained any insights.

Having talent and being a good teacher are completely different concepts. Then he quickly tried to salvage the situation by saying, "You two had better forget about that sentence and stop thinking about it. Just do your job properly and don't be too ambitious."

"If you really want to understand something profound and unfathomable, then you should carefully read the treatment principles in the textbook."

"The treatment principles are the essence summarized by experts from various specialties after much thought. Every word and every sentence is worth careful consideration."

"For example, in the treatment principles of fractures, what is the most important?"

"Repositioning, immobilization, and rehabilitation!~"

"The order and focus of the treatment have been marked out for you."

"The beginning and the end are the key points, while the fixation in the middle is the most important. Once the repositioning is done well, it is just a procedure. Both repositioning and fixation serve the purpose of rehabilitation."

"For example, in surgical emergencies, saving lives always comes first, then treating the illness!"

"Think about the damage again. Yan Chu before, and the young man we're planning to operate on later, their two-stage treatment plans, don't they also conform to the principle of saving lives first?"

“Legs are life too…” Deng Yong said before bowing his head.

Because of Deng Yong's commotion, both Jie Han and Li Yuanpei became thoughtful.

Jie Han's eyes darted around, and another question burst forth, but Fang Ziye quickly silenced him: "Come here, hook your fingers together, watch me suture the peritoneum..."

At the same time, Fang Ziye quietly spent about 4500 points to upgrade his nerve suturing technique to level 5!
After adding the points, Fang Ziye felt a slight warmth seeping into his palm once again.

Immediately afterwards, in order to avoid depleting his knowledge points in future emergency situations and thus missing the opportunity to add more theoretical points, Fang Ziye simply added all the remaining knowledge points to trauma surgery theory in one go.

Furthermore, Fang Ziye gave himself a death order.

The next batch of knowledge points must be used to upgrade the basic theories of orthopedics, hand surgery, and general surgery, instead of wasting time on random skills.

Unless someone is dying in front of you, and you can save them by adding points.

Besides, no one can shake his resolve.

The main problem is that Fang Ziye still can't stand seeing that he has the ability to handle some problems, or that he has the ability to handle some problems after adding some things, so he turns a blind eye to them.

However, Fang Ziye's addition of points did not resonate with anyone.

In the eyes of Deng Yong and others, Fang Ziye's nerve suturing technique was no different from that of Liu Huanglong and others; both were very impressive.

Specialization is key.

Just as laypeople think surgeons are incredibly skilled, daring to operate on human bodies, so too do surgeons think programmers are amazing, able to perform incredible logical and programmatic calculations simply by typing code on a keyboard.

When something is beyond your own capabilities, whether it's extremely impressive or incredibly impressive becomes beyond your comprehension.

Therefore, Deng Yong and the others simply stopped looking at it!
Soon, Fang Ziye finished suturing the perivascular membranes of the femoral and sciatic nerves. After carefully examining the area, Fang Ziye also looked at the fracture fragments that had been extracted from the soft tissue earlier.

He sighed and looked at his master, Deng Yong: "Master, even if we use titanium mesh to rebuild these bone fragments in Phase One, we still can't rebuild them, right?"

Deng Yong rolled his eyes: "Ziye, what are you thinking? The total length of his bone loss is almost a meter!"

"Where did you tear him apart to fill such a big hole? Even if you were to do limb reconstruction, you could only do the tibia."

"From now on, the femoral area will be treated with total femoral replacement for tumors." Deng Yong already had a plan in mind.

The bone defect was too large, so bone grafting was completely useless in this case.

In the past, Fang Ziye would definitely have stopped speaking altogether.

But now, Fang Ziye's trauma surgery theory has only reached level 5, and since he still has some options, it's impossible for him not to speak up.

His tone was very kind and gentle: "Master, in order to facilitate the reconstruction of soft tissue, let's directly perform a lower limb support for this patient in the form of joint fusion."

"Otherwise, even if the debridement and suturing are all done, once the patient returns to the ward, all that's left are two long strips of soft flesh."

"What?" Deng Yong was a little confused.

For a moment, I didn't quite understand what Fang Ziye was trying to say.

In Deng Yong's view, the only option for this patient is to wait for the second-stage surgery to find a way to treat the bone defect. Until then, he can only wait with his rotten legs.

However, Deng Yong was not ignorant, nor was he without any knowledge.

Fang Ziye's words were like peeling away a thin film that was holding him back, making him realize that he might have overlooked something.

I was familiar with these things, but because they weren't good enough or outstanding enough, I forgot about them and left them in a corner.

“Master, what I mean is to connect these existing bones in a way similar to an external fixator, so that the patient at least has support for their lower limb.”

“Bone is the foundation of life.” Deng Yong thought of this and understood: “For someone like him, at most, all that’s left are some bone spurs. External fixation with a brace can only deal with the bone spurs at the fracture ends. How are you going to fix it?”

"How are you going to fix such a long bone defect?"

The intricate structure of the human body's anatomy far surpasses any of nature's wonders.

While it's possible to repair a partial bone loss, now that only a portion remains, repairing it is virtually impossible, exceeding the scope of modern medical understanding.

“Joint fusion surgery,” Fang Ziye said.

Joint fusion surgery is a procedure that modern medicine has abandoned for many, many years.

For example, hip fusion was originally a surgical procedure for treatment purposes, but it was only commonly used in the 1940s and 1950s.

Hip arthroplasty is a surgical procedure used to treat severe damage or deformity of the hip joint. This surgery removes lesions, fuses the joint bones, thereby relieving pain, correcting deformities, and resulting in a strong joint.

After fusion, although the hip joint loses its mobility, such as squatting and running will be somewhat limited, through compensatory activities of the lower back, the contralateral hip joint and the ipsilateral knee joint, the affected limb can not only restore stability and weight-bearing walking, but can often achieve a near-normal gait, without pain, and can perform general physical labor.

Hip fusion is particularly advantageous for manual laborers, and thus it was once a very important treatment method in orthopedic surgery.

However, with the advent of total hip replacement surgery, this procedure has been almost completely phased out.

Things that are eliminated are naturally no longer suitable for the present era.

but?

Fang Ziye seemed to have given it a new lease on life, and Deng Yong's thinking was also quite sharp, after all, he was one of the best in his generation: "You mean, by using the supporting structures of the hip joint, ischium and ilium, the femoral stump can be fused with the bone graft."

"We'll fuse bone grafts at the proximal and distal ends of the knee joint as intermediate support points, and then fuse the ankle and foot joints together as three support points to create a super-long external fixator?"

Fang Ziye's suggestion was really ruthless.

The young man would lose the motor function of all the joints in his lower limbs, but the supporting function of his lower limbs would be preserved as a compensatory measure!

However, this procedure, which would be a catastrophic blow to other patients, was a salvation for the young man at this moment!

Wild vegetables with no flavor are certainly unpalatable, but they taste much better than shit!

The entire lower limb bone is gone, what more do you want?
Even if they manage to save their legs, being able to walk normally is already a luxury.

Still dreaming of being alive and kicking?

This is akin to a child with terminal cancer wanting to grow up, get married, and have children—it's a pipe dream.

"Perfect, these bone fragments are also suitable for recycling."

"Otherwise, these things will have to be thrown away!"

“It’s better than the suggested amputation.” Fang Ziye nodded and continued to ask his master for his opinion.

With his master Deng Yong on stage, Fang Ziye only exercised his right to make suggestions.

Respecting teachers and valuing their teachings is one aspect, giving Deng Yong face is another, but more importantly, in special emergency situations, all actions must be taken under command, with a common goal and everyone working together, rather than fighting alone.

Without the combined efforts of Liu Huanglong, Fang Ziye, and Deng Yong, Yan Chu's surgery would not have been successful.

While Deng Yong was still hesitating.

Fang Ziye added, "If possible in the future, with the fixation still in good condition, we can add intramedullary nailing, local fixation, or use hinged knee joints and tumor-bearing hip joints to reconstruct the lower limbs. At least then, the patient can regain some joint function."

Fang Ziye's words finally convinced Deng Yong.

"You handle it. First, make sure he survives. His lower limbs still have some support. We'll talk about the rest later." Deng Yong's tone had already given in.

All I could think about was this paper title.

Clinical Application of Joint Fusion in Multi-Segmental, Large-Segmental, and Discontinuous Bone Defects

This is another popular topic.

Treatment of bone defects is currently very popular and is a procedure that all top-tier hospitals must perform. However, not all bone defects can be treated effectively.

For example, this patient's type of bone defect, which involves multiple, large, and discontinuous segments, is currently almost unsolvable in the field of modern medicine.

Few people can afford such expenses, and such injuries are an absolute indication for amputation, not limb-sparing surgery.

Even if you have insurance, the insurance company will not acknowledge that you used millions or even tens of millions of yuan worth of bone graft material to save your legs!
"Okay, Master, I'll give it a try first." Fang Ziye wasn't sure if this plan would work.

But it is a viable alternative.

Even if it doesn't work, it's just a brave attempt to learn from a mistake.

But if it succeeds, it would be a different kind of salvation for the patient.

"Joint incision..." Deng Yong wanted to ask Fang Ziye if he knew how to perform joint incision, but he didn't expect that Fang Ziye had already made the incision.

Deng Yong then stopped talking.

It makes sense. Fang Ziye's arthroplasty skills have reached that level. Joint laceration is just a flexible application of anatomy. How could Fang Ziye not know it?
This is a well-established procedure. As long as you've read the textbook and know which anatomical structures can be moved and which cannot, you can leave it to Fang Ziye without any problems.

About half an hour later, Deng Yong and Yuan Weihong completed the cleaning and local nerve suturing of his leg.

Deng Yong sewed it himself, regardless of how well it was sewn or how high the quality was.

I, Deng Yong, personally performed the surgery, so what else could happen?

Does this mean that every surgery for every patient in the world needs to gather the world's top medical resources? Does that mean other doctors won't perform surgeries?
On the other side, Fang Ziye had already fused his hip and knee joints together using Kirschner wires and pressure grafts.

It seems quite cruel.

The young man will definitely lose his joint mobility in the future. Even if the joints are fused and then pried open again, much of the function will be lost.

But it's still better than amputation.

Deng Yong examined the function of the hip and knee joints, sighed softly, and then nodded: "It's alright, this proposed plan is not bad."

"Perfect timing. Continue cleaning the wound and finish the rest, then come over and help me out..."

When Deng Yong got to this point, Professor Zhang from the spinal surgery department finally couldn't help but speak up: "Deng Yong, are you putting pressure on me?"

"If you've completed the bone support for the lower limbs, and the patient can't walk afterward, then it's a problem with my surgical skills, right?"

Professor Zhang's name is very simple, Zhang Quan, which has a distinctly old-fashioned feel.

But in fact, Professor Zhang is quite famous at Zhongnan Hospital, and is one of the most well-known senior professors.

Deng Yong laughed and said, "Teacher Zhang, it's not what you think at all. You're the one wearing this hat, so you're responsible for carrying it. You can't be angry."

Deng Yong's tone was very gentle, with a slight hint of ingratiation.

Upon hearing this, Fang Ziye glanced at Deng Yong and noticed that his teacher had indeed become much more restrained. He figured it was because of Professor Dong Yaohui's impending departure that Deng Yong had no choice but to curb his temper.

Fang Ziye then looked at Yuan Weihong, who was deep in thought.

Yuan Weihong and Deng Yong seem to be two extremes going in opposite directions...

Look at Yuan Weihong. His mentor, Professor Chu, has passed away, and Yuan Weihong doesn't have a real mentor to rely on. So why is he still so arrogant?

Oh, he's toned it down a lot now, but Yuan Weihong was already quite famous.

Professor Zhang was performing anterior approach spinal canal decompression surgery. After looking up, he tilted his neck slightly, making a cracking sound as his joints twisted.

Professor Zhang is now approaching sixty years old, and his physical strength and energy are no longer at their peak.

But they persisted in having the surgery.

"The younger generation is truly formidable. I've heard people discuss the field of orthopedics since I was performing spinal surgery. First it was students, then chief residents, and now even some attending physicians are talking about it."

"He sounds like a talented person, and he looks like a handsome young man. He'll be a master surgeon when we work together," Professor Zhang said calmly and steadily.

There was no particularly high-pitched tone, nor was there any praise or criticism; it was as if he was simply stating a fact.

The patient's current diagnosis is relatively simple, involving only two teams: spinal surgery and trauma surgery.

Upon hearing this, Huang Xiaoming said, "Professor Zhang, in our inpatient group, Director Fang is currently far ahead of everyone else. Many brothers speak highly of Director Fang."

"Me, Zhu Hui from hand surgery, and even the chief resident from joint surgery and orthopedics, are practically matchmakers."

"I heard that even some doctors with doctorates in internal medicine, chief residents, and even some attending physicians, were all beaming with joy and had a deep impression of Dr. Fang after seeing him, and they couldn't eat or drink."

Upon hearing this, Zhang Quan paused slightly: "Then why don't you give Mr. Fang's WeChat to someone else? We have plenty of big, strong men in our orthopedics department. Do you think it looks respectable?"

Huang Xiaoming immediately said, "Teacher Zhang, it's not that I'm unwilling to give you my WeChat, but it's just that I'm only interested in you, and Mr. Fang is already taken."

"That's what's really tough on us brothers. Last time I heard that Cao Runyuan, the chief resident of sports medicine, went on a blind date, even the teachers at Shuiguohu Middle School were asking, 'Who's better at medicine, you or Dr. Fang Ziye?'"

"Brother Cao's defenses were broken on the spot..."

When Zhang Quan heard that Fang Ziye had a girlfriend, he shook his head, but he was also a little curious: "Xiao Huang, you have quite the information network. You don't miss any of this kind of gossip, but you don't know any of the key technologies?"

"What relationship do the doctors at our hospital have with high school teachers?"

Huang Xiaoming said, as if showing off a treasure, "Teacher Zhang, you don't know this, do you?"

"Fang's master's supervisor, who is also Yuan Weihong's wife, works in the Shuiguohu Primary School system. They are all near Shuiguohu, and the primary and secondary schools are in the same system."

"I know them all, it's a pity that Mr. Fang is already taken..."

Fang Ziye remained silent the entire way, waiting for Huang Xiaoming and Zhang Quan to tease and joke about him.

Surgeons need to find some form of stress relief.

The fact that Zhang Quan and Huang Xiaoming were still chatting proves that their surgery was progressing smoothly and that they may have some confidence in the postoperative function.

Under such circumstances, it takes skill to become a topic of conversation for relieving stress.

Fang Ziye comforted himself in this way, thinking that after the joints were fused and the external fixation braces were nailed on, the length of the lower limbs, as well as the force line and weight-bearing line of the lower limbs, were finally restored to their original state.

"Master, could you take another look? I've fixed part of the external fixation brace to the iliac bone. This kind of external fixation should be usable, right?" Fang Ziye asked Deng Yong, his voice emphasizing the point.

Deng Yong immediately understood that Fang Ziye was joking with Professor Zhang Quan, who had suggested amputation as soon as he entered the room.

Although Deng Yong had made the same suggestion, it was ultimately Deng Yong and Fang Ziye who together sought a way to temporarily avoid amputation.

As the saying goes, it is a great virtue to admit one's mistakes and correct them. It is quite normal to change the surgical procedure during the operation.

Zhang Quan's side of the conversation was completely pointless and unnecessary.

"Focus on the surgery and speak properly. Professor Zhang is pleased to say that you think highly of yourself. Don't bring up your teacher Xiao Yuan's sarcastic and unpleasant manner here," Deng Yong said with a laugh.

Upon hearing this, Yuan Weihong immediately looked up, his face full of innocence, his eyes looking completely innocent as he gazed at Deng Yong.

My mind is in turmoil: What the hell does this have to do with me?
Professor Deng, if Professor Zhang Quan really puts his skills to use, I can't keep up. You're selling me out for your son's sake?

Zhang Quan immediately asked the person next to him, "Who is Yuan Weihong?"

Yuan Weihong immediately lowered his head and ostrich-like figure, taking small, quick steps to hide himself next to Deng Yong, hoping that Deng Yong's fat belly could block him out.

Someone immediately filed a complaint.

"That's the one next to Professor Deng. He's Ziye's master's supervisor, and he's also Beihai Yiye!" A chief physician in the spinal surgery department gloated.

"Oh! ~ Good, good, good... I understand, I understand, it's a name I've heard of." Professor Zhang Quan nodded repeatedly, then continued his surgery.

Surprisingly, there weren't many other significant actions!
Even Deng Yong was quite surprised by this scene.

Professor Zhang is currently the most senior non-re-rehired professor in orthopedics and spinal surgery. His temperament shouldn't be like this.

However, after recovering from his surgery, Zhang Quan still reflected on himself and said to those around him, "I should be more careful with my words in the future. If I don't understand an industry, I shouldn't talk about it. Otherwise, to use a more fashionable term, it will be a slap in the face."

"It hurts to get slapped in the face!" Professor Zhang Quan said with a straight face.

(End of this chapter)