Yu Jianshui was startled for a moment, and then he was overjoyed.
At this time, as long as someone said it was not cancer metastasis, he was willing to believe it. But when Boss Zheng said it, he seemed to be more forceful.
"Boss Zheng, Boss Zheng, what do you suspect?" Yu Jianshui asked eagerly.
"Promise." Su Yun looked at him contemptuously and said.
"I think it's heterotopic ossification." Zheng Ren said.
"Isn't heterotopic ossification often found near large joints?" Su Yun asked with a frown.
Yu Jianshui knew the term heterotopic ossification, but that was something to review before the exam. Since the beginning of clinical practice, a urological surgeon has rarely been exposed to the disease of heterotopic ossification.
He tried to remember what ectopic ossification was.
"Didn't you tell me that it often appears near large joints, such as the hip and elbow joints. But there is also a small probability of occurrence in other locations, such as the patient in front of me." Zheng Ren shook the CT in his hand Pianzi smiled and said: "Don't worry, Mr. Yu, it's okay."
Seeing that Zheng Ren was sure, Yu Jianshui smiled relaxedly.
Heterotopic ossification refers to the occurrence of osteoblasts in soft tissue and the formation of bone tissue. Yu Jianshui recalled the definition of this word. If it was called heterotopic ossification, many difficulties could be explained. For example, CT scan showed local calcifications.
But... incision, heterotopic ossification, it sounds unreliable.
"Boss Zheng, how is this heterotopic ossification formed?" Yu Jianshui asked in a low voice.
"The precipitating factors may be neurological and bioelectrical factors, but so far, there is no definite statement." Zheng Rendao: "Most of these changes will appear near large joints, starting with redness, swelling, heat and pain, and finally after bone formation , leading to joint mobility impairment."
"In fibrous connective tissue, primitive cells proliferate actively with a rich capillary network, calcium salt deposition, and bone formation. Mature heterotopic ossification has the structure of bone, with the outer layer wrapped in fibrous connective tissue and the osteoblasts inside. Trabecular nodes and bone-like tissue have active primitive cells in the center." Zheng Ren pointed to the film and said, "The image in the film is exactly the same as the definition of heterotopic ossification."
"Boss, it's useless for you to talk so much." Su Yun blew a breath, his black hair flowing, "Can't we just cut it off for pathology?"
"No." Zheng Ren said firmly.
“…”
“…”
Su Yun and Yu Jianshui were startled.
Generally speaking, the gold standard for judging whether an abnormal growth is a malignant tumor is pathological diagnosis. If there is any suspicion, a needle biopsy will be performed and sent for pathological diagnosis.
This is already a fixed clinical mindset.
Why did Zheng Ren say no
"Heterotopic ossification was first recognized after it appeared in large numbers during World War I. Blast injuries and spinal cord injuries were considered to be the causes of ectopic ossification. But subsequent research showed that this was just Part of the reason."
"Urinary tract infection is also one of the causes." Zheng Rendao: "The specific mechanism is not clear yet, it is just speculation."
Su Yun sighed. According to the current medical science, there is no final conclusion for many diseases. In other words, everywhere is a huge minefield, and you may not know which one will step on it, but it will be shattered to pieces.
Heterotopic ossification is relatively good. Although incisional ossification is extremely rare, it does not cause death of the patient.
If it was really that kind of menacing disease, such as the malignant fever that the boss encountered...
The more he thought about it, the more he felt bored. Su Yun sighed and said, "Boss, why do you no longer want to do this?"
"Because you know more and are exposed to more, the unknown is..."
"Stop it, don't give me chicken soup." Su Yun raised his hand and said, "You haven't said why you can't cut it yet."
"It is still in the osteogenesis stage. If it is cut off, it will grow again. It can only be carried out after 9-12 months or when the ossification is mature and the ossification has stopped. Use etidronate disodium after surgery and take it orally for one year. That’s it.”
"At the cellular level?" Su Yun asked
"Guess so."
"Can you be more reliable?"
"The research institute has no conclusion. I haven't seen any information that is recognized as useful." Zheng Ren was also helpless and packed up the film.
"Mr. Yu, please talk to Director Miao." Zheng Ren said, "If nothing happens, I'll leave."
"That..." Yu Jianshui hesitated, wanting to say something, but was embarrassed.
"The film has made it very clear, don't worry." Zheng Ren knew what he was thinking about, smiled and patted Yu Jianshui's shoulder, comforting him.
"It won't delay the condition." Yu Jianshui whispered.
"You can't understand what I'm saying." Su Yun was unhappy and said directly, "It's okay, what's the point of delaying? Are you expecting it to be a tumor?"
"Brother Yun..." Yu Jianshui said quickly: "Isn't this very scary?"
"No." Zheng Ren said with a smile: "You are concerned and confused. If you are a patient in other departments or see me in the outpatient clinic, I believe you can give a correct diagnosis."
After saying that, Zheng Ren opened the door of the duty room and walked out.
Mr. Yu didn't leave. He was silent for a moment, then picked up his cell phone and called Director Miao.
"Director, I just met Boss Zheng and asked him to take a look at the film."
"Yeah, I met you by chance."
"Boss Zheng said it was ectopic ossification."
"Oh, Director Chu thinks so too? That's good, that's good."
"Okay, let's wait until you come back." Yu Jianshui hung up the phone and looked at the film bag in a daze.
Boss Zheng and Director Chu have the same opinion, that’s good, that’s good.
The patient's condition recovered very well, there was no metastasis to other organs, and the urea nitrogen and creatinine were both low.
If incision transplantation is excluded, then there is hope for survival of more than 5 years, and it can even be said that there is great hope.
No problem, that’s good.
Mr. Yu let out a sigh of relief. On this day, he had frightened himself quite a lot. Yesterday, the patient came for a review and received local films. Director Miao was worried about the resolution issue and asked the patient to do one on this side.
Ever since the surgery, when Director Miao took the patient for examination, he had been very nervous, but now he was finally relieved.
It's okay, that's fine.
But find time to treat Boss Zheng to a meal and connect with each other, Yu Jianshui thought in his mind. Looking up but not looking down, if there is anything I can't do, I even point to Boss Zheng to help me next time.
Not counting this time, Yu Jianshui inquired about the incident of malignant hyperthermia in the operating room. According to Director Xu of the Anesthesiology Department, if Boss Zheng was not there, he would not be so perfect in presiding over the rescue.
It was as if Boss Zheng had personally experienced the successful rescue of malignant hyperthermia. Later, when everyone recalled, they discovered that Boss Zheng was indeed able to be busy and not messy. Every order is extremely targeted.
It's better to have a better relationship with this kind of person.
Yu Jianshui secretly made up his mind.