Chinese medicine: from rural hospitals to top three hospitals in Kyoto

On Monday, Chen Yang arrived at Kyoto International Medical Center early.

Good morning, Director Chen!

Good morning, Director Chen.

Throughout the journey, staff from the medical center greeted Chen Yang.

At Kyoto International Medical Center, the surgical department is now divided into three medical teams, each with about ten people. The number of people in the traditional Chinese medicine department has not increased. Including nurses and some staff, the total number is approaching one hundred.

"Good morning." Chen Yang smiled and nodded as he walked towards his office.

Along the way, all the medical staff he encountered were in high spirits, and their eyes were filled with respect and enthusiasm as they looked at him.

Chen Yang could sense that this trip to Country R had not only made a name for itself internationally, but also greatly strengthened the cohesion and sense of pride within the center.

On the desk, files were piled up like a mountain.

Chen Yang had just arrived at the office when Gao Anliang arrived, his face bearing his usual gentle smile, but his eyes revealing a hint of seriousness.

"Good morning, Director Chen."

Gao Anliang greeted Chen Yang with a smile: "During your absence, the center has been operating smoothly overall, and we have also accumulated some matters that require your personal decision-making."

"Thank you for your hard work, Director Gao."

Chen Yang sat down behind his desk, his gaze sweeping over the stack of documents: "Let's talk about the important ones first."

"First, let's talk about the progress of the 'Yangshen Cup' Medical Competition."

Gao Anliang picked up the top folder: "National registration closed last week. Preliminary statistics show that the number of valid registrations exceeded 38,000, far exceeding expectations. The preliminary screening and preliminary rounds in various provinces and cities are about to begin. The organizing committee hopes that you can give a final review."

Chen Yang nodded: "This is a big deal and cannot be taken lightly. Leave the plan here, I'll review it carefully and then we'll discuss it further. Is there anything else?"

"Have."

Gao Anliang's expression turned serious: "In the past week, we've received three requests for help regarding complex cases from overseas, one each from Europe and North America. The descriptions of the symptoms are all very complicated, one of which..."

As Gao Anliang spoke, he pulled out a medical record summary and handed it to Chen Yang, saying, "It's a joint treatment request from the Mayo Clinic."

"Oh?" Chen Yang raised an eyebrow and took the document.

The fact that Mayo was willing to lower himself and ask for help indicates that this case is far from simple.

As Chen Yang quickly skimmed through the medical record summary, his brows gradually furrowed.

The patient was a twelve-year-old boy diagnosed with "congenital heart malformation with systemic lymphangioma".

The heart malformation itself is an extremely complex tetralogy of Fallot combined with pulmonary atresia. What is even more challenging is that the child also has diffuse lymphangioma, which invades the mediastinum, pericardium, neck and even oral cavity, causing difficulty in breathing and swallowing, and is closely related to the heart and major blood vessels.

After evaluation, the Mayo Clinic's cardiac surgery team believed that surgically removing the heart malformation would almost inevitably lead to fatal bleeding or lymphorrhea from the lymphangioma, posing an extremely high risk. Therefore, they hoped to conduct a remote consultation with Kyoto International Medical Center, which has demonstrated remarkable expertise in tackling complex vascular diseases, to explore the possibility of surgery.

"Director Chen is a tough nut to crack."

Gao Anliang looked at Chen Yang and tentatively asked, "Is Mayo trying to probe our capabilities again?"

Chen Yang smiled and shook his head: "It shouldn't be that bad, it's just a joint exchange."

Chen Yang's skill level is beyond question at Mayo Clinic; after all, the several high-difficulty surgeries he performed in R country speak for themselves.

"This disease is indeed very difficult to treat, and Mayo probably doesn't have much confidence either."

Chen Yang pondered for a moment and said, "Of course, it cannot be ruled out that some people on Mayo's side do have other ideas in mind."

Mayo Clinic is a top international medical organization, very large, with many factions within it, unlike Kyoto International Medical Center, which is still in its infancy.

"Are the medical records complete?" Chen Yang asked.

"The imaging and examination reports from Mayo Clinic are very detailed, but we need to communicate further to get more specific information."

“Contact Mayo Clinic. We need all of the patient’s original data, including all DICOM format image files.”

Chen Yang pondered for a moment and said, "At the same time, notify Director He, Director Zhong, and Director Qu to hold an emergency multidisciplinary consultation at 2 p.m. Oh, and also have Director Wen and Dr. Xun participate."

"Understood!" Gao Anliang immediately agreed and turned to make the arrangements.

Chen Yang leaned back in his chair, his gaze falling once again on the medical record summary.

Although this case may not necessarily be a test by Mayo, it is the first official case of collaboration between Mayo and the medical center, and it can be considered a new challenge.

Afterwards, Chen Yang took out the registration form for the Medical Competition and looked at it carefully.

This year's "Yangshen Cup" Medical Competition is divided into three stages: preliminary round, semi-final, and final. The preliminary and semi-final rounds are held in various provinces and cities, while the final is held in Kyoto.

Due to the large number of applicants, the Kyoto International Medical Center did not arrange for staff to participate in the semi-finals. Instead, the local Chinese medicine association and Chinese medicine colleges organized the event. Judges would only be sent to the Kyoto International Medical Center for the semi-finals.

Chen Yang was just casually glancing around, since there were so many people that he couldn't possibly look at everyone one by one. But as he glanced at the crowd, he spotted a familiar name.

........

At 2 p.m., Zhong Dongyang, He Yonghua, Qu Haoran and others were already seated in the center's largest conference room.

A huge electronic screen displayed three-dimensional reconstruction images of the child's heart and images of lymphangioma throughout the body, sent by Mayo Clinic.

The tiny heart was twisted, its blood vessels had an unusual orientation, and the crisscrossing lymphangioma tissue, like gray vines, wrapped around the heart, major blood vessels, and mediastinum, making one's scalp crawl.

He Yonghua gasped: "Heart malformation is already extremely difficult, but to add this deadly lymphangioma... this surgery is like defusing a minefield, no, like digging for treasure in quicksand!"

Zhong Dongyang's expression was grave: "Lymphangiomas have a rich blood supply, fragile tissue, no capsule, and unclear boundaries with normal tissue. Once they rupture during surgery, bleeding and lymphatic leakage are extremely difficult to control, and the patient may not survive the operation."

Qu Haoran stared at the images of the brain and neck, and added: "The tumor has compressed the airway and esophagus. The child is now having great difficulty breathing and maintaining nutrition. His physical condition may not be able to support a long and complicated surgery."

Wen Haodong and Xun Jiahong also frowned.

From the perspective of traditional Chinese medicine, this child has congenital deficiency, depletion of vital energy, phlegm and blood stasis, and deep-seated pathogenic toxins. He falls into the extremely critical category of "consumptive disease" and "abdominal masses," and his body's vital energy is already unable to resist the pathogenic factors.

"Does Mayo have any preliminary plans?" Chen Yang asked Gao Anliang.

Gao Anliang shook his head: "They tried local sclerotherapy and partial interventional embolization, but the results were poor, and the tumor is still slowly progressing. Surgery is what they believe is the only possible way to cure it, but the risk assessment is 'extremely dangerous'."

Silence fell over the meeting room; it truly was a nearly unsolvable problem.