Surgery Godfather
Chapter 1061 - 870 How Did We Go Off Topic?

Chapter 1061: Chapter 870 How Did We Go Off Topic?

After Lan Xueping’s preoperative examinations were complete, all the results came out quickly.

The discussion of her case took place in the Meeting Room, with Professor Deng from the Outpatient services also invited to participate in the discussion.

This was not an informal discussion but a highly confirmed one, with someone specially assigned to record it, and the proceedings were to be filed in the medical record in the end.

Since that afternoon was the scheduled time for routine case discussions,

"Let’s discuss this case, since we are going to use a new surgical technique that we’ve never used before to relieve the patient’s symptoms," Yang Ping got straight to the point.

Penguin disease isn’t considered a rare disease. According to statistics from the United States, there are 3-5 penguin disease patients per 100,000 people. Our country does not have such statistics, so we can only refer to the data from the US to speculate that we have approximately 40,000 to 70,000 penguin disease patients. It’s a terminal illness, more terrifying than amyotrophic lateral sclerosis.

The Physician in Charge was Dr. Zhou, a Standardized Training Student, and he reported the case.

A formal case discussion is usually initiated by the younger doctors, that is, by professional titles from low to high, with the Department Director concluding at the end.

"Hereditary cerebellar ataxia, this disease is truly a death sentence. There are no precedents in the world for surgically treating this disease, and as for medication, the only known effective medication to date is the Japanese drug He Tianrailing. Other methods, such as acupuncture, massage, and traditional Chinese medicine, have shown no evidence of effectiveness to date."

Li Guodong stands out among the young people, and he is now very eager to apply for Yang Ping’s doctoral program, so he studies very hard, and always takes the initiative to speak during case discussions.

Indeed, to date, the only confirmed medication that can effectively alleviate the symptoms of Penguin disease is He Tianrailing, a pituitary hormone-releasing excitatory drug, the first orally administered drug approved to promote the release of thyrotropin, which has endocrine effects as well as certain effects on the central nervous system, including increasing motor activity, antagonizing the temperature decrease induced by risperidone, and antagonizing the sleep induced by pentobarbital, among others.

The thyrotropin-releasing hormone located in the brain is co-localized with other neurotransmitters or neuromodulators, functioning as a neurotransmitter or neuromodulator to achieve neuroprotective effects.

One of the main symptoms of hereditary cerebellar and spinal ataxia is progressive deterioration of motor coordination function. Dopamine in the brain is involved in the regulation of the motor system,

and thyrotropin-releasing hormone and its analogs have been proven to change the metabolism of acetylcholinesterase and dopamine, thus activating the dopamine system, strengthening the regulation of the motor system, and improving symptoms of ataxia.

He Tianrailing is a synthetic analog of thyrotropin-releasing hormone, but its excitatory effect on the central nervous system is 100 times that of the body’s own thyrotropin-releasing hormone, and the duration of its effect is 8 times.

It is precisely this formidable efficacy that makes it the only effective medication for Penguin disease.

The Physician in Charge, Dr. Zhou, spoke up, "The patient’s family had someone buy it in Japan. She has taken this medication, tried three brands---Jg, Sawai, and Tanabe Mitsubishi, and in the end, found Tanabe Mitsubishi to be the most effective. She has been taking it since, perhaps because it’s the original research pharmaceutical. But this drug can only alleviate symptoms; the patient herself said that without this drug, she probably wouldn’t be able to speak or type by now. However, the heavier the illness, the worse the effect of the drug becomes, because it cannot stop the progression of the disease, only dilute some of the symptoms."

The Physician in Charge showed the empty medication boxes while speaking, which were provided by Fang Liu for the doctors to record the medication.

"Dr. Li, you just mentioned she had acupuncture and massage, and used traditional Chinese medicine? Ineffective?"

Dr. Zhao asked. Doctor Zhao Wenbo, a rotation Graduate Student at the Surgical Research Institute, was also eager to apply for Yang Ping’s Ph.D. program, and he had a strong passion for traditional culture, especially traditional Chinese medicine. The fact that Li Guodong had just boldly stated that traditional Chinese medicine was ineffective deeply bothered him.

"That’s right, the patient’s family personally said this. Dr. Zhou should be aware of it—it wasn’t me who said it. Indeed, acupuncture, massage, traditional Chinese medicine, and herbal treatments had no effect," Li Guodong insisted on his opinion.

Dr. Zhou nodded slightly, "That is indeed what the patient’s family said."

"She just hasn’t found a true practitioner of Chinese medicine. There are many masters among the general populace, and the academics of today merely have empty reputations," Dr. Zhao defended.

"What masters among the populace? Martial arts have been shouting about hidden masters among the people for so many years, and in the end, we got the people’s masters like Teacher Lei and Teacher Ma," Li Guodong casually remarked.

Unexpectedly, this comment angered Dr. Zhao, "The way you put it, it’s as if traditional Chinese medicine is pseudoscience, just like the naysayers of Chinese medicine out there."

Li Guodong was somewhat puzzled, "Are you saying I can only mention that Chinese medicine is effective and not that it’s ineffective? If I say it’s effective, I’m right, but if I say it’s ineffective, I’m denigrating Chinese medicine? I was simply stating the patient and family’s feedback on this specific case realistically. How does that make me a denigrator of Chinese medicine?"

"Since you claim it is effective, you need to present evidence. You can’t just say she found the wrong doctor, as in martial arts, where talking big is easy. Why not settle it in the ring and see who actually prevails?" Li Guodong never really agreed with Dr. Zhao’s academic perspectives.

This fellow would readily label someone for being even slightly critical of Chinese medicine.

"Many martial arts techniques are lethal. How can one perform with gloves on?"

"Do you think, if both Teacher Ma and Tyson removed their gloves and were not limited in techniques, who would die first?"

What exactly were they discussing? How did the topic drift so much? Song Zimo rapped on the table, "Attention! This is a case discussion. Please refrain from discussing irrelevant matters. You can talk about Chinese medicine and martial arts after the meeting."

Dr. Zhao was just getting riled up, but Li Guodong didn’t seem as eager. He only wanted to defend his viewpoint.

"Professor, are you considering surgery as treatment?"

Song Zimo asked, sensing the odd atmosphere among the interns today, wondering why they started off on such a confrontational note. Song Zimo decided to steer the discussion in the opposite direction.

Yang Ping nodded, "My idea is simple. Since the cerebellum is atrophying, regardless of the mechanism of onset, there is compression and blood flow is compromised. If we perform a resection of the cerebellomedullary cistern arachnoid membran*e, loosen the cerebellar and brainstem arachnoid membranes, decompress the hard meninges, and decompress the posterior cranial fossa with a bone flap, coupled with bilateral occipital artery muscle flap application on the surface of the cerebellum, we can achieve a dual effect of cerebellar decompression and increased blood supply. Theoretically, it should improve cerebellar blood flow."

"Because whatever the cause, the cerebellar atrophy is definitely linked to reduced blood flow. Relieving compression helps to preserve existing blood flow, allowing the ones on the brink of death to recover, and vascular pedicle muscle flap transplants can increase new blood flow to the cerebellum. Over time, the blood vessels of the muscle flap would gradually integrate into the cerebellum."

"We don’t know on which link our intervention falls in the physiological chain of this illness, but it’s bound to be helpful."

Professor Deng slightly nodded, "Changing our approach, what else can we do if not this method? However, the key to the application of this new method is the cooperation of the patient and their family. Otherwise, it would be hard to explain if it fails. The patient and their family in this case are very cooperative and have complete trust in us. Under such circumstances, we should take a chance."

Indeed, without the earnest cooperation of the patient and family, how could a doctor take a chance?