top student at medical school

Chapter 567: When Young and Prolific!
"Dean Chen is a bit unpredictable; perhaps I haven't fully won him over yet." Fang Ziye confidently labeled his relationship with Chen Song as such!
If I were in Wu Xuanqi's shoes at Tongji Hospital, my experience would definitely be completely different.

“But that’s normal. If Dean Chen Song had been completely open and trusting from the start, it would have been something to be wary of,” Fang Ziye asserted.

After the research direction was decided, Fang Ziye rushed to the demonstration room in the surgical treatment area to participate in the surgical discussion.

Today, my foothold in the sanatorium is based on my clinical skills, not on being a senior 'researcher'!
Naturally, it was only after meeting those top experts with Dean Chen Song that Fang Ziye realized that there were indeed top-notch figures in the domestic scientific research community.

Just like those elderly people, many of them improved the current drug formulas, reducing side effects or enhancing the therapeutic efficacy of the drugs.

Some classic drugs have been revitalized by adjusting their dosage.

Different drug dosages can produce vastly different therapeutic effects; this is a fundamental principle recognized in pharmacology.

Therefore, the development of pharmacology will continue.

In the scientific community, the emergence of new drugs is certainly the most dazzling achievement, but if some classic drugs, those that have undergone clinical trials, can be given a new lease on life in another form, their clinical significance will be even greater.

Because these classic drugs can be directly applied in clinical practice and begin clinical trials without the need for multiple rounds of animal testing!
The surgical treatment area and the second demonstration classroom were empty.

Fang Ziye pushed the door open and then closed it again: "Have you seen a ghost?"

Looking at the message again, the location Gu Yi sent was indeed Demonstration Room 2.
Fang Ziye made a phone call and asked a question. Gu Yi quickly hung up and typed a WeChat message back: "Damn? I stayed up too late. I sent the wrong message. It was for Conference Room Two."

It looks like I received a harassing phone call.

Fang Ziye: "..."

The demonstration room is definitely the one in the surgical treatment area, and the conference room is the one inside the main building.

"I'm sorry I'm late, Professor Gong."

"I was just about to leave when Dean Chen Song called to criticize me. I went over and listened to his lecture," Fang Ziye explained briefly.

"It's alright, Professor Fang. You're the team leader; our work will continue even if you don't come!"

"Today we will mainly continue the discussion from last time."

"This patient's deformity spans across the knee joint, so in addition to functional reconstruction, this surgery will also require joint reconstruction and correction."

"Neither our trauma group nor our hand surgery group has experts who specialize in joint surgery. However, Professor Qiao Yongjian from the spinal surgery department had been a joint surgeon for ten years before switching to spinal surgery."

"I've already consulted Professor Qiao, and he's willing to come and help tomorrow!" Gong Jiahe reported on their preparations.

Upon hearing this, Fang Ziye scratched his ear and said, "Professor Gong, didn't I say before that I would find a way? You did call someone, didn't you?"

Previously, the surgical plan for this patient had been discussed about twice. Fang Ziye was a little modest, saying that his joint surgery correction skills were average, and Gong Jiahe actually believed him.

I sought advice through my personal connections.

Fang Ziye has already demonstrated his expertise in trauma surgery and hand surgery. Presumably, in everyone's perception, these two subspecialties have already consumed all of Fang Ziye's mind and energy.

Therefore, it is understandable that he is not very good at joint surgery.

"Team Leader Fang, I definitely remember what you said, but I asked several professors in hand surgery, and it seems you haven't invited anyone?"

"I'm so anxious!" Gong Jiahe said.

Fang Ziye's abilities are unquestionable; his strength is definitely the strongest in the group. However, when it comes to interpersonal relationships, Fang Ziye is, after all, a newcomer.

If Fang Ziye hadn't been honest and hardworking since his arrival, but instead focused on cultivating interpersonal relationships, Chen Song would probably have kicked him out immediately.

Once you're recognized, of course you should share what you have!
We are in a cooperative relationship, not a competitive one. As long as you do a good job, you will be credited, and it has nothing to do with you if others do well.

It is essentially a pass/fail assessment, rather than a competitive one.

Therefore, everyone hopes to do more, focusing on one key area for breakthrough, with others lending a helping hand.

The reason why rare and difficult diseases are difficult is that they may span multiple, even seven or eight, specialties.

For example, spinal cord hemisection or complete resection injuries that are currently completely untreatable in clinical practice require the combined efforts of at least a dozen departments to treat.

Spinal surgery, hand surgery, vascular surgery, gastrointestinal surgery, urology, joint surgery, anesthesiology, cardiology, etc...

"Thank you for your concern, Professor Gong!"

Fang Ziye pursed his lips, glanced at his knowledge points which he had accumulated to eighty or ninety thousand, and said, "Professor Gong, actually I have some knowledge of orthopedics."

"When I was a general resident before, I encountered quite a few patients with joint dislocations. We also encountered pelvic fractures and hip joint injuries. When treating them, we have to understand these things to some extent."

"In addition, our team's main research focus is bone tumors, so we have some understanding of the theory and some procedures of bone tumors, but sports medicine is a relatively unfamiliar area."

Fang Ziye only revealed a little bit of the information.

I'm already an associate professor, so it's not a big deal if I'm a little more versatile, right?

As for why I am like this, don't ask. The answer is talent. Otherwise, how did I become an associate professor?

Gong Jiahe opened his mouth.

Fang Zhikuan also turned his backside to make his gaze fall more directly on Fang Ziye.

Professor Du Donglin's eyes darted around, and he asked cautiously, "Professor Fang, the diseases covered here are not the common ones outside. If you only have a slight understanding of them, it's not enough."

“Showing off your strength is not a good thing in a sanatorium!” Du Donglin’s tone was not sarcastic, but rather like that of an elder.

Fang Ziye nodded upon hearing this: "I know, Professor Du."

"Let's take it slow and see what happens."

Fang Ziye raised his right hand and pressed it down slightly before saying, "Actually, I had some ideas when I was at Zhongnan Hospital, but I didn't have the opportunity to put them into practice."

"There are many factors at play. One is our own experiences and encounters, and the other is that the focus of our work arrangements is still controlled by the teachers."

"When I came to the sanatorium this time and heard Professor Gong say that you would give me the position of group leader, I was both apprehensive and somewhat happy."

"I am apprehensive about not doing a good job in this position, but excited that I can truly plan things according to my own intentions and ideas."

Some people put down their pens when they heard Fang Ziye say this in such a sincere tone.

These words couldn't be written down in a notebook; instead, he looked at Fang Ziye thoughtfully.

After Fang Ziye arrived, he served as the team leader for a month and never made any grand pronouncements or empty promises.

Now that he has been the team leader for almost ten days, he has never said anything about his thoughts. Everyone thinks that Fang Ziye is just not good at speaking, or has nothing to say.

But now Fang Ziye is still using the old trick of "a new broom sweeps clean"!
Whether out of personal courtesy or their duty, they all wanted to finish what Fang Ziye had to say!

Fang Ziye's hands were slightly sweaty, which definitely showed that he was nervous!
He was just an associate professor, at least in terms of his title, but sitting in front of him were six professors and five associate senior professors!
He had higher titles and more seniority than his colleagues, yet he still had to stand up and take charge of these seniors with a clear conscience. This required him to overcome his own inner obstacles.

At the same time, you also need to give a sufficient reason to persuade them!

Fang Ziye had been preparing for this for a long time.

After their fingers were intertwined and pressed together nearly four or five times, Fang Ziye said again, "Professor Gong had previously suggested that I gradually develop functional reconstruction surgery in the sanatorium and make it a routine procedure. It is a very popular, in-demand, and easy procedure on the market right now."

"However, I've never been particularly enthusiastic about this. It's not that I'm particularly aloof or unwilling to take on more patients or do more work."

"On the contrary, it's very simple for me."

Fang Ziye took a deep breath, gradually calming his inner tension, and began to open up: "No matter how the professors think of me, I still want to say what I want to say."

"Firstly, I have experience leading the research and development of two clinical projects, so I am very clear about the process and difficulty involved."

"However, I feel that this process is very enjoyable, and it is also something that contributes more and more to the development of the medical field!"

"So, I still want to continue doing this kind of thing."

"Secondly, simply repeating the surgeries you've already performed to bring patients recovery and health is indeed something to be happy about, after all, it's the result of your own hard work."

"However, doing the same thing day after day, year after year, even if it's a hobby, will lead to burnout once it becomes a profession!"

"To put it simply, there's no passion; it's just mechanical repetition."

"So, I also want to create something new, because I've done it before."

"Thirdly, our team spent less than half a year developing limb-sparing surgery and functional reconstruction surgery for previous injuries, going from nothing to something, and from something to mastery."

"Regardless of the length of this period, or whether it fuels my arrogance, I am confident that I can do something new again."

"Although it will take longer, it's worth it."

"If we can't succeed in one year, we can try two years; if we can't succeed in two years, we can try three years. We're still young, and let me be honest."

"Although my mentor was in my previous team, the overall strength of our current team is several times that of the previous team."

"I believe that developing new treatment plans for diseases will only be faster, not slower; it's a waste of time."

Fang Ziye's words silenced everyone present.

It must be said that Fang Ziye's thinking logic is very meticulous. His words are somewhat inflammatory, but more importantly, they are credible.

Fang Ziye completed his two previous clinical research projects in just six months!
Such ability and talent are currently unparalleled in the country. Such talent surpasses even the most outstanding geniuses in clinical medicine in China, rather than being comparable to them!

With past facts laid out before them, even if Fang Ziye hadn't said those things, they would have naturally started to think in those directions!

Fang Ziye is capable of doing such a thing.

Instead of boasting or bragging, even if it carries a hint of arrogance, it's not overly exaggerated.

Fang Ziye scanned the crowd, taking in all their different expressions, before saying, "My current plan is this: our sanatorium uses a two-way appointment system for medical treatment, so we basically don't lack patients."

"Based on the experience accumulated by our trauma surgery and hand surgery departments in the sanatorium, the treatment of bone defects in trauma surgery is relatively mature."

"The standardized treatment plan for bone defects is not perfect at present. We can refine it a little in this direction!"

"If we can correct and improve the standardized treatment plans and guidelines for bone defects to some extent, then it will be worthwhile even if it takes us six months to do this."

"Professor Gong, Professor Fang, what do you two think?" After explaining his arrangements, Fang Ziye directly asked Gong Jiahe for his opinion.

Promises made in theory must first be put into practice!

For something to be implemented, thorough preliminary preparations are essential. This includes preliminary research on basic research topics, presenting all possibilities to the public.

When Gong Jiahe heard Fang Ziye ask this question, he remembered that what he had said to Fang Ziye was not that Fang Ziye hadn't understood, but rather that it had perfectly aligned with Fang Ziye's heart and beliefs.

In fact, it wasn't that he misled Fang Ziye, but rather that his thoughts coincided perfectly with Fang Ziye's.

"If we can really revise the guidelines and expert consensus, then it will definitely not have been a wasted effort!" Gong Jiahe nodded.

What are the results of revising the guidelines and expert consensus?
Those sitting here will become experts and authorities!

If things go well, we could establish a Chinese Medical Association, an Orthopedics Branch, and a Bone Defects Group, where everyone present would be considered a veteran.

After listening, Fang Ziye said, "There are different types of bone defects at present."

"In clinical practice, small bone defects are more common, and the main treatments are autologous bone grafting, calcium carbonate, bone cement, and bone transport."

"Including the bone defects we treated in the early stages, we mainly used bone prosthesis materials for repair."

"The reason there are so many treatment options is that each treatment is equally effective."

"The other meaning of 'the treatment effect is similar' is that the patient is not satisfied, which is why many experts seek treatment elsewhere."

"Our team has a natural advantage, which is the individualized design of prosthetic materials for bone defects."

"We can treat bone defects in hemipelvic fractures with prostheses, so other bone defects can certainly be treated well as well."

"However, personalized prosthetic treatment is actually one of the alternatives to basic procedures such as bone transport, except that bone cement and other prostheses are replaced with metal prostheses!"

"This is not the final destination of our research. Currently, there is a relatively advanced bone defect replacement solution using nanomaterials for bone defect treatment."

"My idea is that if we can combine osteoinductive materials with nanotechnology, bone defects can be repaired and regenerated on nanomaterials after surgery, achieving the standard of fracture healing."

"This can effectively complement the treatment options for bone defects."

"Based on current research trends, the bone-inducing material, CC composite material, is a non-metallic in-vivo consumable." "It produces no metal debris and has been successfully applied in surgeries such as heart valve replacement. If we introduce a design module for this material and improve it, we could potentially design personalized prostheses based on the specific bone defect segments of patients..."

“Carbon composite materials are elements that are closer to the human body than silicon, and are highly compatible with it…” Fang Ziye slowly unveiled his research plan.

Every step was logical and based on prior research.

Some were independently developed, while others were based on existing technologies.

We should learn from what we should learn!

"Professor Fang, this must be difficult to advance. There are many bone-inducing drugs and materials on the market, but how to combine them with C materials and nanotechnology is also a challenge in basic scientific research."

“Even if it is developed, preliminary research on animal models is still needed to ensure that it is non-toxic, and that various indicators such as the brittleness of the prosthesis material and internal fixation meet the national standards.” Gong Jiahe frowned.

This is a massive project!
"Yes, Professor Gong, but if we don't move in this direction, we'll never be able to move forward. Taking the first step is even more important than the result."

"Moreover, this topic has both a very strong core and great potential for expansion!"

"Therefore, this is both a short-term scientific research plan and a long-term plan."

"We'll start with a model of individualized bone defect prostheses, which will yield results soon."

"The next step is basic scientific research."

"Improvements in surgery, instruments, and materials used to manufacture instruments can be advanced and integrated step by step!"

"If this is successful, it could potentially replace more than 50% of the orthopedic treatment consumables currently on the market!"

"This topic is very meaningful, but progress is difficult."

"We don't need to look too far ahead. The first step is to standardize the procedures for individualized prosthesis design. The second step is to supplement the current standard procedures for treating bone defects!"

"As for the third step and beyond, we can proceed slowly. Even if we return to our original institutions, it will still be a large-scale project that requires collaboration among multiple centers and laboratories."

"It's fate that we met!" Fang Ziye analyzed.

Short-term plans have their own arrangements, and long-term plans have their own strategies. No one can find any flaws in Fang Ziye's solutions.

Everyone has something to do and something to earn, and it's just a matter of taking one step forward, and it's within easy reach.

Gong Jiahe nodded.

Professor Fang Zhikuan seemed a little uncomfortable: "Professor Fang, your bait is a bit too tempting."

Professor Yan Huanan, on the other hand, had his head down, seemingly deep in thought.

If Fang Ziye's plan is followed, then the prospects for his early research are far greater than those for limb salvage surgery and functional reconstruction surgery.

Its impact is even greater than that of the microcirculator!
What the hell?!

Gentlemen love fortune, in a proper way.

A gentleman cherishes his reputation, but he acquires it through proper means.

Throughout history, countless scholars have dreamed of receiving the posthumous title of Wenzheng Gong!
"Professor Fang, it depends on how you interpret it. How can this be considered fishing and bait?"

"This is just a practical analysis based on the real-world situation, and we've come up with a path that's closest to reality and worth exploring."

"Let's get started! Let's start with bone defects, and bone defects of all kinds of difficult and complicated diseases!" After saying this, Fang Ziye looked at Professor Du Donglin.

"Professor Du, the subspecialties of bone defects and hand surgery are not very compatible."

"But there is one interstitial disease that I believe is a good area for hand surgery to explore!"

"It refers to diabetic foot, diabetic dysfunction, and diabetic-related nerve necrosis caused by diabetes."

"There is currently no particularly good treatment option for skin and soft tissue defects caused by diabetes."

"The amputation rate for diabetic foot is over 15%!"

"Peripheral nerve dysfunction caused by diabetic foot is outside the scope of functional reconstruction surgery at Zhongnan Hospital."

"In addition, functional reconstruction surgery for neurodegenerative diseases was not previously among the functional reconstruction surgeries we performed."

"Diabetic foot is very smelly, the surgery is very complex and requires precise operation. This is a disease that many medical staff are unwilling to take on and treat in detail, but in reality, the number of patients is very large."

"Therefore, I believe that in hand surgery, we don't need to focus solely on functional reconstruction. Instead, we can gradually bring in some patients with diabetic foot."

"This is a comprehensive disease combining foot and ankle surgery and hand surgery, which is a promising area for further development!"

"In this regard, the main treatment options for diabetic foot are as follows."

"Inferior vena cava interventional therapy, vascular bypass surgery, skin grafting."

"The main pathological mechanism of diabetic foot is ischemic necrosis of local soft tissues, which is also the mechanism of peripheral nerve degeneration."

"There aren't many people researching this area right now, but just because it's not popular or widespread doesn't mean it's unimportant or meaningless!"

"If we can reduce the amputation rate of diabetes to less than five percent, or even one percent, that would be something to be very proud of."

"The treatment for this is mainly based on the following points."

"Nerve damage caused by trauma or infection is essentially due to obstruction of local blood circulation, caused by trauma or infection leading to embolism of local blood vessels."

"This is similar to the pathogenesis of diabetic foot."

"Neural transplantation is a core skill of our hand surgery department. We must understand the essence of nerve transplantation!"

"I wonder if Professor Du has any ideas or approaches regarding in vitro nutrition of nerves, or abdominal nutritional support, similar to skin flap transplantation?" Fang Ziye asked.

Fang Ziye only gave a slight hint, but Professor Du Donglin immediately said, "That's impossible!"

"Abdominal flap transplantation for skin defects relies on the sufficient blood supply to the abdomen, allowing the flap to be grown there, and nerve transplantation?"

"Neural transplant, neural transplant," Du Donglin repeated several times, but ultimately could not continue.

Fang Ziye said, "I think the preoperative nourishment technique for nerve transplantation is feasible! Although it is limited to the upper limb, the nourishment of the lower limb is not necessarily limited to uninterrupted nourishment!"

"If we could supply the peripheral nerves to the abdomen, and then replant them in the previously severed segment when surgery is needed again, wouldn't that be feasible?"

"In principle, it is feasible!"

The reason why diabetic foot causes peripheral nerve damage is because of poor blood circulation, which often occurs in the anterior tibial region.

The nerves and soft tissues in this location are prone to necrosis due to local anatomical features.

However, the blood supply to the abdomen is relatively rich!
The fundamental principle of farming is to first bury a nerve that is about to die in fertile soil, and then replant it in its original place.

The process of planting rice seedlings does not take place in paddy fields.

"But? But?" Du Donglin felt it was a bit crazy; this idea was indeed crazy.

Yet it makes perfect sense.

Many skin flaps used in hand surgery are grown in front of the abdomen through an open incision, allowing the patient's hand to adhere to the abdomen. After the flap has healed, it is dissected and sutured before flap transplantation.

Do they treat neurology like this too?

Maybe someone is really crazy to do something like that!
The two nerves are different.

Upon hearing this, Fang Ziye finally said, "Professor Du, Professor Gong, these are some of my thoughts. We don't need to keep chasing after the increasingly mature functional reconstruction technique and jumping on the bandwagon."

"Even if we can't catch the trending topics, we can create them ourselves."

"For example, the replantation of severed limbs in hand surgery was first proposed and completed by the Sixth Affiliated Hospital of Shanghai. Before it was completed, everyone thought it was unbelievable!"

"The world's first nerve transplant was performed by a surgeon in Canada. Before he did it, no one thought it was possible."

"But actually, once you grasp the basic principles, all that's left is to do it."

"That's all I wanted to say. Let's get back to the surgery we're going to be doing tomorrow!"

Fang Ziye then changed the subject and began to analyze the case step by step with everyone.

The Gong family and professors are all professionals; it's impossible that they would lose interest in discussing the cases just because Fang Ziye made some empty promises.

On the contrary, they all have their own ideas and concepts, and will propose some solutions, such as osteotomy and reshaping surgery!

Once a plan is proposed, either approve it or find supporting evidence for its feasibility.

Either oppose it, or find unfeasible evidence and theoretical support.

Ultimately, the agreed-upon plan was: knee joint reconstructive surgery + tendon transfer, tendon transplantation, and skin and soft tissue repositioning (with the option of flap transplantation)!
After the discussion, it was already 9:53 PM.

It was indeed getting late, and Fang Ziye still needed to send the surgical plan to the surgical department so that they could prepare the instruments and anesthesia in advance for tomorrow.

So everyone dispersed.

However, after the discussion ended in the conference room, Fang Ziye rode his electric scooter to the villa and had only been video chatting with Luo Tingzhu for a few seconds when he arrived.

The doorbell rang outside the villa area.

Through surveillance, Fang Ziye discovered that the visitor was Professor Fang Zhikuan.

"Tingzhu, Professor Fang is here. I'll go open the door. We'll chat later." After receiving a nod from Luo Tingzhu, Fang Ziye walked out of the villa area to personally greet her.

When Fang Ziye arrived at the door, Professor Fang Zhikuan and Professor Du Donglin were together. The two looked at each other with a hint of affection in their eyes.

Then, from a distance, another sound rang out.

"Professor Fang, Professor Du, you two are really quick. I just went back and took a shower, and I didn't expect to be the last one to arrive." The visitor was Professor Gong Jiahe.

In the darkness, his figure was enormous; his already slightly overweight frame was stretched into a large, dark shadow by the streetlights.

As Professor Yan Huanan strolled "just happened" to arrive at Fang Ziye's door, he hummed a tune and jumped up and down, then chuckled, "Professor Fang, it's quite lively at your door..."

……

All six professors from the trauma surgery and hand surgery departments came to him without exception.

In Fang Ziye's living room, the kettle was bubbling and steaming, as if it were strapped to a leash.

Inside the room, the six people looked at each other, none of them daring to speak first.

In the end, Professor Fang Zhikuan broke the ice: "Team Leader Fang, if we are to conduct basic research on bone defects, where should we begin?"

What basic cell lines are needed?

Professor Gong Jiahe hurriedly replied, "Our team has all the basic cell lines for bone tumors, normal bone, normal cartilage, and osteoarthritis."

"As for other basic cells!"

Gong Jiahe still couldn't keep it all to himself: "We can also think of a solution together."

Fang Ziye's bait was too strong; it could even turn a person into a mandarin fish, let alone a fish.
Fang Ziye said, "In terms of bone induction materials, the substrate is one thing, but there are two other more important things: structural construction and auxiliary materials."

"CC material is the substrate. If we want to design the substrate structure, we need to consult with a materials science expert."

"More importantly, we need to consider the auxiliary materials or medications. The key is to incorporate the most effective drugs currently available into the substrate and spatial structure to stimulate the migration and landing of osteoblasts."

"If we break it down further, it can be divided into many tasks."

"I wonder which steps the professors are willing to take?" Fang Ziye asked.

There is strength in numbers. These professors all have teams. As long as they give instructions, someone will naturally be able to get the results.

Professor Miyagawa gave an irrelevant answer: "Being young is good; you have strong physical fitness and plenty of energy, so you produce a lot of children."

Gong Jiahe and the upper and lower levels of Fang Ziye are suspected of driving.

(End of this chapter)