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

“Dr. Chen, please continue.” Smith’s voice was exceptionally clear in the quiet conference room.

"The traditional principle, based on the premise that the lesions are relatively independent, prioritizes treatment of the heart in order to restore the function of the heart organ as quickly as possible and buy time and opportunities for subsequent treatment. I completely agree with this point."

Chen Yang's voice was steady and powerful. He deliberately affirmed some of the opponent's points first, which was his consistent debating strategy—to establish before refuting.

He Yonghua nodded slightly in his seat. Director Chen had always had a strong talent in this area.

"but......"

Chen Yang spoke again, and in that instant, the laser pointer in his hand suddenly lit up. The red light, like a precise scalpel, drew several key adhesion points on the image. The atmosphere in the conference room suddenly tensed, and everyone held their breath.

"Look closely, everyone, look here, here, and here..."

The red dot of the laser pointer moved across the image, each point seeming to gently tap on everyone's hearts: "The lymphangioma tissue is not just 'next to' the heart, but like tree roots, it deeply infiltrates, wraps, and adheres to the adventitia of the aorta, the main trunk of the pulmonary artery, and even part of the atrial wall."

Chen Yang continued, "If we follow the standard procedure and establish extracorporeal circulation first, the insertion site is very likely to tear these fragile tumors."

His gaze swept over everyone present, finally settling on Smith's face. At that moment, Smith felt a strange unease, as if the other man had seen through his deepest doubts.

"So......"

Chen Yang's voice suddenly lowered, but became even more penetrating: "Even if we are lucky enough to establish extracorporeal circulation, when the heart stops beating and the correction of intracardiac malformations begins, the traction of surgical instruments and slight changes in the position of the heart are very likely to cause uncontrollable tearing and bleeding in these wrapped and adhered areas."

Chen Yang paused deliberately as he spoke, allowing the horrific image to fully resonate in everyone's minds.

The conference room was so quiet that the faint sound of the air conditioner running could be heard, and everyone was engrossed in Chen Yang's description.

"At that time, we will be facing a massive hemorrhage rescue operation targeting a diffuse, fragile tumor in a child who has already undergone heparinization and needs extracorporeal circulation to maintain life. Professor Smith, you know better than I do what the success rate will be."

Smith opened his mouth, wanting to refute, but found himself speechless.

The scene Chen Yang described was one of the most terrifying nightmare scenarios their Mayo team had ever imagined. His brow furrowed, his fingers tapped unconsciously on the table, and a storm raged within him.

"Therefore, my logic is not 'putting the cart before the horse'."

Chen Yang's voice rang out again, and the red dot of the laser pointer moved gracefully, this time landing on several relatively thick nourishing blood vessels.

"My logic is to 'clear out the external obstacles first, and then attack the core stronghold.'"

He Yonghua felt a surge of relief, and his gaze toward Chen Yang was filled with uncontrollable admiration.

Qu Haoran clenched his fists tightly, his nails digging deep into his palms, and shouted in his heart: "Director Chen's superiority is not only technical, but also an absolute lead in thinking!"

“Our priority in treating lymphangiomas is not to ignore the heart, but precisely to create a relatively ‘clean’ and ‘safe’ battlefield for heart surgery.”

Chen Yang's explanation is like a precise surgical operation, peeling away the layers to reveal the essence of the problem: "By reducing its blood supply through interventional embolization, by precisely hardening it to make it partially shrink and the boundaries relatively clear, and then by ultra-microscopic 'sculpting' dissection, the heart and major blood vessels are 'liberated' little by little."

“This process is indeed like clearing mines in a minefield, requiring extreme patience and precision. But as long as we successfully remove the tumor in the key area, the subsequent heart malformation correction surgery can be performed in a risk-controlled environment.”

"This does not increase unnecessary risks, but rather significantly reduces the ultimate risks of the surgery overall!"

"To use a perhaps imperfect analogy, it's like repairing a precision instrument that's tightly entangled with vines. Would you choose to risk severing the wiring and forcefully repair the core of the instrument, or carefully remove those deadly vines first?"

A hush fell over the conference room, as if even the air itself had frozen. This vivid metaphor acted like a key, unlocking the locks in everyone's hearts. Several experts who had initially been skeptical nodded unconsciously, their eyes gleaming with thoughtful consideration.

Stevenson broke the silence first, clapping softly, his voice filled with undisguised admiration: "Brilliant!"

"Chen, your anatomical knowledge and three-dimensional spatial imagination are amazing. This idea, though bold, does provide us with a completely new direction that is worth exploring in depth."

Smith remained silent for a moment, his furrowed brows still not fully relaxed, but the doubt and sharpness in his eyes had been clearly replaced by a deep contemplation.

He spoke slowly, his tone still serious, but no longer as aggressive as before: "Director Chen, your analogy is very interesting. However, how can we ensure that the process of clearing away the 'vines' does not damage the 'precision instruments' themselves? The adhesion between those tumors and blood vessel walls may not even have a clear boundary under a microscope."

At this moment, everyone could feel that the nature of the dialogue had undergone a fundamental change—from questioning to discussion, from confrontation to cooperation.

"This requires real-time intraoperative assessment and ultramicroscopic techniques."

Chen Yang stated frankly, without any hesitation: "We don't have a 100% guarantee; medical exploration always involves risks. But we are confident that, with the team's experience and cooperation, we can minimize those risks. And..."

Chen Yang looked at Wen Haodong and Xun Jiahong, his eyes conveying trust and expectation: "We also have traditional Chinese medicine as an important support during the surgical period. It can improve the child's physical condition before the operation, enhance their tolerance and healing ability, and prevent infection and promote recovery after the operation. This is also a key link in improving the success rate."

Wen Haodong added, "Based on the information we have and traditional Chinese medicine theory, this child suffers from a condition of deficiency in the root and excess in the branch, with extreme deficiency of vital energy."

"We can use herbal formulas that invigorate qi and blood, strengthen the spleen and resolve phlegm, and promote blood circulation, combined with moxibustion on acupoints such as Zusanli and Qihai, to try to adjust his physical condition to a relatively ideal plateau before the surgery."

Smith looked at the group of young and confident Chinese doctors in front of him. They each performed their duties and complemented each other, forming a close-knit whole.

He had to admit that the team's professionalism, innovation, and teamwork far exceeded his expectations. After all, it was this team that had created miracle after miracle in Country R.