After being separated from my family, I became a darling of the military region thanks to my medical
Chapter 249 A Tricky Test, the Surgical Queen Before the Blackboard
1:30 p.m., Operating Room No. 1 at the Beicheng Military Region General Hospital.
Director Ma arrived on time at the outermost edge of the third circle of people in the operating room. He wore a loose sterile gown and carefully stepped onto the creaking wooden bench. When his gaze finally fell upon the slender figure under the operating lights, past the heads of the provincial hospital experts in front of him, his breathing slowed down.
On the operating table, Ye Zhen is performing a heart operation.
Three hours later.
Director Ma shuffled down the stairs from the operating room. His legs trembled uncontrollably, and his surgical gown was soaked with cold sweat, clinging icy to his back. But his eyes shone with a terrifying intensity, his pupils filled with an uncontrollable madness.
Pushing open the wooden door of the dilapidated dormitory, Vice Dean Gao was sitting on a wooden bed propped up with bricks, holding an enamel mug and drinking his own jasmine tea.
"How are you?" When Vice Dean Gao saw Director Ma's distraught appearance, his heart skipped a beat, and his brows furrowed tightly.
Director Ma walked to the table, and without even pouring water, grabbed Vice Dean Gao's teacup and gulped down a mouthful. Water dripped down his chin onto his collar, which he roughly wiped with the back of his hand, his voice trembling.
"Dean... Fuwai Hospital has to admit defeat." Director Ma gasped for breath. "She wasn't performing surgery at all, she was carving! For ventricular septal defect repair, she didn't use traditional interrupted sutures, she used double-ended needles for continuous suturing, with a stitch spacing error of not even one millimeter!"
Vice Dean Gao paused, his hand holding the teacup lid still, and his expression changed.
Director Ma swallowed hard, becoming increasingly agitated as she spoke: "There were also blood vessels that had become detached while the heart was still beating. That mutated coronary venous plexus ruptured, blood gushing out, and she didn't even use clamps. Holding a needle holder with needle and thread, she picked it up with tweezers in her left hand and swiftly stitched it twice with her right! The most terrifying thing was the vascular anastomosis technique she used—no need to flip it, just suture it in situ! I saw her insert the needle without even blinking; it was so fast that I could only see a blur from my seat. The deputy director of the coronary surgery department, who was pulling the hook, almost got into a fight with the person next to him just to get a closer look at her knot-tying technique!"
Vice Dean Gao's hand, which was holding the teacup, froze in mid-air, unaware that a few drops of warm tea had spilled onto the back of his hand.
He had initially thought that the General Hospital of the Military Region's rise to fame was partly due to hype and luck. But Old Ma was the most reliable surgeon at Fuwai Hospital, and even he was so frightened; this was definitely not some kind of smokescreen.
"She'll be giving a lecture in the small conference room at eight o'clock tonight." Vice Dean Gao stood up, slamming his teacup down on the table with a loud "bang," his eyes revealing a stubborn, unyielding determination. "I'm going to meet this Dr. Ye. Performing surgery quickly is one thing, but whether the theoretical foundation, anatomical logic, and complication management are sound is another matter entirely. Academically, Fuwai Hospital has never been afraid of anyone!"
7:50 PM.
The small conference room on the third floor of the old office building was packed with men in white coats. Doctors who couldn't find seats were even squatting against the wall in the corridor, with their laptops propped up on their laps.
Thanks to Director Ma's help in queuing up three hours early to secure a seat, Vice Dean Gao sat comfortably in a chair in the very center of the first row. A black hardcover notebook rested on his lap, and the cap on his expensive Hero brand fountain pen had been removed.
At exactly eight o'clock, the noise in the corridor instantly disappeared.
Ye Zhen pushed open the wooden door and walked in. She was wearing an extremely clean white lab coat, slender, with features as cold and refined as a painting. She carried no lecture notes or lesson plans, only half a piece of white chalk between her fingers. As she walked to the blackboard, her powerful professional aura instantly filled the entire space.
"Today we'll be discussing complex congenital heart disease, specifically the surgical field anatomy logic of double outlet right ventricle and transposition of the great arteries."
Without uttering a single wasted word, Ye Zhen turned around and began drawing complex anatomical diagrams on the blackboard. The chalk scraped against the blackboard, producing a crisp, continuous "thump-thump" sound.
Ten minutes later, a more detailed anatomical diagram of the coronary arteries and ventricles than any textbook appeared on the board.
"Ask any questions now." Ye Zhen turned around, her hand holding a half piece of chalk, and precisely pointed it at the right ventricular outflow tract on the diagram. Her voice was clear and professional, without any unnecessary emotional embellishment.
The vice dean in the front row hadn't touched a pen. He stared intently at the diagram on the blackboard, his mind racing, before finally standing up and posing his first probing question.
"Dr. Ye, during transposition of the great arteries surgery, the common practice in China for perfusion of myocardial protective fluid is to use mild hypothermia. However, these patients have extremely poor myocardial tolerance and are very prone to intraoperative myocardial ischemia. How do you handle this?"
This is a fundamental but extremely difficult pain point to address.
Without even pausing to think, Ye Zhen looked at him calmly: "No need for mild hypothermia. Instead, use moderate hypothermia combined with high-potassium blood-containing cardioplegic solution, alternating between anterograde and retrograde perfusion. This will not only provide more thorough myocardial protection but also give the surgeon an extra thirty minutes for safe procedures."
Clean, concise, and to the point!
Many of the department heads in the back row lit up and quickly lowered their heads to frantically take notes. Vice Dean Gao didn't sit down; his face flushed slightly, and he immediately threw out a second, even more tricky question, trying to disrupt Ye Zhen's rhythm.
"Okay, even if the myocardium is protected, what about whole-line coronary artery transplantation in infants? The blood vessels are as thin as a hair, and the anastomosis is extremely prone to twisting and narrowing. Once a thrombosis occurs after the operation, the patient won't even have a chance to get off the operating table!"
The atmosphere in the meeting room became tense. Everyone could tell that this leading figure from Fuwai Hospital was applying pressure layer by layer, pressing forward relentlessly.
Ye Zhen remained calm. She even turned around, wiped away a section of the lower right corner of the blackboard with the back of her hand, and then the chalk fell again, drawing a cross-section of a pipe opening.
"Therefore, we must abandon the traditional 'end-to-end anastomosis' and adopt the 'button-style' aortic valve sinus resection method that includes the aortic wall. We preserve some tissue around the coronary artery ostium and transplant it as a whole to the root of the new aorta, like sewing a button. This way, the anastomosis tension is zero, and there will be no twisting."
The only sound in the room was a collective gasp. A brilliant idea! They turned blood vessel transplantation into a "patching" procedure, perfectly avoiding the risk of the blood vessel itself becoming too narrow!
Vice Dean Gao's chest heaved violently. In both exchanges, the other party hadn't uttered a single stammer. He gritted his teeth and finally posed that ultimate problem, which was unsolvable even in the international academic community, preparing to deliver the final blow.
"Dr. Ye, you can compensate for the first two issues manually. However, in right ventricular outflow tract reconstruction for tetralogy of Fallot, during the widening of the patch, the traditionally used artificial polyester or Dacromet mesh is extremely prone to calcification due to rejection within three to five years post-surgery! Calcification can trigger pulmonary valve regurgitation, ultimately leading to irreversible right ventricular failure! This problem stems from substandard materials; how do you address it?"
Vice Dean Gao's gaze was fixed on Ye Zhen, sharp and determined.
The air in the conference room froze. This was clearly someone trying to sabotage the meeting! Even top international cardiovascular medicine journals are struggling with this problem; there's simply no standard clinical solution in China.
Ye Zhen put down her water glass, her gaze finally landing squarely on Vice Dean Gao. Her face showed no embarrassment at being challenged; instead, it radiated an air of absolute, superior confidence.
"Artificial patches lack endothelial cells, so calcification is an inevitable result of materials science. The solution is not to replace them with artificial materials, but to abandon artificial materials altogether."
Ye Zhen flipped her wrist and wrote several large characters heavily on the blackboard with chalk: "[Autologous Pericardium Replacement Solution]".
"Take the patient's own intact pericardium. But do not use it directly, as it will deform due to insufficient tension. Prepare a 0.6% glutaraldehyde solution on the operating table." Ye Zhen listed a chemical formula and a graph of soaking time on the blackboard.
"Free autologous pericardium is immersed in a solution for ten minutes for tanning and fixation. The cross-linking effect of glutaraldehyde greatly increases the mechanical strength of the pericardium while completely eliminating its antigenicity!"
Ye Zhen turned around, tapping the chalk on the previously drawn drainage channel with a "smack." "Using it as a patch, it possesses inherent human biological properties, so calcification will absolutely not occur. Furthermore, the hemodynamic pressure differential will be perfectly controlled within 15 mmHg!"
As the last word faded, she casually wrote down the hydrodynamic formula for calculating pressure difference next to her.
The entire room was deathly silent. You could hear a pin drop.
Vice Dean Gao stood there, the expensive Hero brand fountain pen hovering above the notebook, its nib suspended in mid-air, a drop of ink spreading across the page.
He frantically mentally rehearsed the procedure of using autologous pericardium tanned with glutaraldehyde. From physiological anatomy to histochemistry, and finally to the calculation of blood flow pressure gradient. Perfect, rigorous, and flawless! This not only completely solved the rejection problem but also eliminated the dependence on expensive imported patches, reducing the surgical cost to an extremely low level!
This is a revolutionary, bloody, and devastating attack!
Looking at the young woman in her early twenties in front of the blackboard, he felt that his medical knowledge accumulated over the past thirty years had been crushed into nothingness in front of this blackboard and this half piece of chalk.
Vice Dean Gao's lips trembled a few times, and his previous aggressive demeanor vanished completely. He didn't utter a single word of rebuttal, but instead obediently sat back in his chair, opened a brand new page in his notebook, bowed his head deeply, and began to copy the formulas and recipes on the blackboard word for word.
His attitude was extremely devout, like that of an old student who had just started school.
Outside the corridor window, Zhou Hai, with his hands tucked into the sleeves of his military overcoat, watched the Vice Dean Gao, who was sitting in the first row, writing furiously and completely obedient. The deep wrinkles on his face completely smoothed out, and he silently bent over with laughter.
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