In medicine, whether it is internal medicine or surgery, there are two categories: theory and practical operation. However, the actual operation in internal medicine is relatively less.

Among surgeries, some physicians call surgeons "surgeons." This means that after learning the operation, they can't do anything else.

This is actually very consistent with Lu Cheng's current state. All his skills were learned through the pages of books. He knows what to do, and he also knows how to do it better. But! It is too easy to get it this way.

In the process of continuously acquiring book pages, in fact, just speaking of the fineness and complexity of the operation, the top level has reached a critical point, which means that you can only achieve this by just relying on the operation of your hands to change or improve it.

At this point, there is not much room for improvement.

This kind of top-level operation is actually different from the top-level operations that other people have. Most doctors generally have extremely rich theories before they obtain advanced skills.

Combine theory with hands-on operation, and then reach the top level.

Lu Cheng's theoretical foundation is actually very poor. He only relied on his pure skills to reach the top level, which is the ceiling of surgical operations!

No matter how simply you refine your skills, you will never be able to improve them.

Lu Cheng didn't know how Min Hong could tell that he was in this state, but the top level had actually troubled Lu Cheng for a long time. And he didn't get the first expert-level skill page by playing

The strange thing happened, but Professor Hu Lei triggered a random event while Lu Cheng was listening carefully during the class. He got this page, but Lu Cheng didn't have top-notch elbow arthroscopy treatment yet, so he couldn't use it.

.

The skills of arthroscopy and palmaroscopy are actually similar, but why does Lu Cheng have advanced skills in shoulder joints and knee joints, but does not even have intermediate skills in wrist arthroscopy?

This is because the elbow joint and the knee joint, the shoulder joint and the hip joint are not the same thing. Even if you know more about other joints, the most basic anatomy of the elbow joint is different.

Therefore, theory is Lu Cheng's current shortcoming. Before this is made up, it is basically impossible to take another step forward.

Lu Cheng has been thinking about what Min Hong just said.

Disease is actually a life that accompanies us. It has cause and effect, birth and death.

All struggles have their roots.

All diseases will eventually lead to death!

Min Hong is a professor in the Orthopedics Department of the Second Xiangya Hospital. His qualifications and knowledge level are unfathomable. What he says naturally has his own truth.

Lu Chengcheng felt as if he was slightly sublimated by these words. His whole person fell into a hole, as if he could catch something, but he seemed not to catch it. However, this sentence was definitely Min Hong's words for many years.

To summarize the accumulated experience in practicing medicine.

If medicine can be compared to a period of spiritual practice, then what Min Hong is saying now may become the secrets and general outline of Lu Cheng's practice for a long time to come.

Such a scene seemed to appear in front of Lu Cheng's eyes.

This is a world that belongs entirely to bone cells. In bone cells, there are birth, old age, illness and death, and the replacement of old and new, but they are still thriving.

When the line of sight is widened, all the bone cells form the bone tissue and structure we usually see.

But suddenly one day, a kind of external violence invaded, and then the bone cell mass was divided into two. The distal bone cells lost the supply of food channels, constantly accelerating the death of old cells, but again, in order to

They are self-preserving, but they are constantly supplying nutritional tissue to mature or young bone cells.

More and more cells are dying of old age!

Normal activities are like rules and regulations. When a fracture occurs, the constraints of these rules and regulations are lost. Bone cells just want to live and cannot be restrained, so a series of changes occur...

Lu Cheng was listening intently at the moment, and Ji Mo was only listening to Min Hong's speech and thinking about the instructions Min Hong gave him, so he didn't pay special attention to Lu Cheng.

However, Lin Hui and Min Hong's eyes widened when they saw Lu Cheng's current state!

In fact, in every period, when reading, many people have experienced it. As they read, they reach a certain knowledge point, and then they have enough knowledge and make connections with other books they have read, and suddenly they have a sudden enlightenment.

That’s how it feels.

This is called enlightenment.

And when you have this kind of enlightenment, it is called reading the book thoroughly.

It's just that ordinary people, mostly because of a certain knowledge point, or because they have figured out a certain theory, or because they understand a certain knowledge cycle, have such a moment, and at this time, they are completely focused.

, but I don’t have time to pay attention to other people’s reactions.

This is called a state of immersion, a state where you are really fascinated by the book.

Knowledge Min Hong just said that if Lu Cheng can understand this sentence, then Lu Cheng can break the existing shackles.

Then Lu Chengcheng fell into a state similar to an epiphany. How speechless could Min Hong and Lin Hui be?

Lin Hui looked at Min Hong and said softly: "Professor Min, Xiao Lu seems to be thinking about something. Please show him and sort out his thoughts!"

In this state, if someone can guide you in the direction, the gains you will get will be huge.

In fact, there was no need for Lin Hui to remind him. Lu Cheng was also a student of Min Hong. Of course, Min Hong was happy for Lu Cheng to learn more. So after finishing the above sentence, he paused for less than ten seconds before continuing.

"I usually like to tell you that you need to read the book thoroughly. So what does it mean to read the book thoroughly? Let me give you this example."

"Fracture, you know. Fracture is the most basic introductory subject for our orthopedics department, and even for all medical students when they come into contact with orthopedics. So, why should it be placed at the introductory level?"

"Because, if one department is broken, it is half of the orthopedics department!"

"First, we need to understand what a fracture is."

"Let's straighten out our thinking. The definition of fracture in our textbooks and in the whole world is: interruption of the integrity and continuity of the bone."

"This is very simple! However, if you only read a definition here, it is not enough. It is not called reading the book thoroughly."

"Continuing to understand, the first level: the integrity and continuity of the bone is interrupted, that is, when a trauma occurs, we usually talk about broken bones, fractures, and broken legs, that's what it means. But,

This means that ordinary people know that as a professional orthopedic surgeon, do you have the nerve to say that you only know this? Of course not."

"Continuing to understand more deeply, what is the nature of the interruption of bone integrity and continuity other than the kind of fracture that we can see?"

"This is the second layer, an avulsion fracture! An avulsion fracture, will it cause mobility impairment? Not necessarily, it may not affect your activities, but it will cause you severe pain. An avulsion is

There are fracture fragments that are torn off from the intact bone ends, thereby affecting the integrity and continuity of the original bone tissue. However, it may not affect the stress structure of the bone."

"Why, because this kind of patient may come to see you."

"Is this enough? This is a knowledge structure that a doctor, even a physician with a little contact with orthopedics, can know. This is still not enough for an orthopedic surgeon."

"We're still going to level three. Stress fracture!"

"What is a stress fracture? It means that long-term chronic force and continuous stimulation may cause the rearrangement of bone cells in the bone tissue or the accumulation of chronic damage, leading to bone fractures. In this case, it may not necessarily occur violently.

Pain may not affect your activities. However, by definition, there is still a huge change in the continuity and integrity of the entire bone, and it is still called a fracture."

"In such a patient, you won't be able to detect the existence of a fracture. The patient may not have any symptoms or manifestations at first. It even happens to each of us every moment! It's just that it hasn't accumulated enough to see a doctor.

!”

"Is this enough? Not yet."

"We continue to go deeper. The fourth level! When our knees or other joints are hit, there may be fractures, or there may not be fractures. And we don't have much pain at the time, or the pain lasts for a few days, and the pain is severe.

The symptoms were completely relieved and activities resumed. According to the traditional fracture theory, this is definitely not a fracture."

"However, if we stick to the definition, when we have trauma, the cartilage in the joints will be stimulated or damaged to a certain extent, but it will not cause damage to our movements, only during subsequent movements.

, local damage to the cartilage will stimulate our joint surfaces again, leading to the rearrangement of bone tissue, leading to wear and tear of the cartilage and bone planes."

"Over a longer period of time, the rearrangement of our bone tissue will lead to cartilage destruction, narrowing of the bone joints, and deformation of the hip joint surface."

"What this is, this is osteoarthritis. Essentially, the integrity of the bone is still damaged, because its bone cells have been rearranged and are no longer the original normal bone tissue distribution, and the stress structure is no longer the same.

It belongs to the normal stress line from before.”

"The patients you see are all middle-aged and elderly people. Why are the elderly prone to arthritis? Because they live longer and use more. As the saying goes, they have crossed more bridges than you have walked. What happened to them

The number of microfractures may last longer than your lifetime!"

"Traumatic arthritis and osteoarthritis are actually the accumulation of stress microfractures. Is this a fracture? Yes!"

"But, this is still not enough."

"Level 5. Under normal circumstances in our bone tissue, osteoblasts and osteoclasts will continuously produce new bone cells and engulf old bone cells, thus completing the renewal of our entire bone cells.

Replacement."

"Suppose a bone cell has a 1 in 10 billion chance of mutating during the growth process. During the peak period of our growth, we grow rapidly and require a large amount of bone tissue to accumulate to make us grow taller.

Some bone cells will develop into cells that reproduce indefinitely and have abnormal differentiation. They will continue to reproduce and develop, forming vegetations."

"This kind of growth pushes away our normal bone tissue and cells, and even replaces them. In this case, does it destroy the integrity of our normal bone tissue? Same!"

"Then we compare the formation of this neoplasm to a fracture, then the entire process of tumor growth and metastasis is the continuous formation and accumulation of fractures, and it is a process that cannot be interrupted."

"Metastasis occurs when these abnormal fracture-causing bone cells aren't content with just causing us to break bones and go to live elsewhere!"

"The growth process of tumors is actually a cumulative process of fractures. It is a cumulative process that cannot be interrupted on its own. Even if there is even a slight residue, it will still relapse and the process of intractable fractures will be repeated again."

"You don't even know when a patient like this will develop a fracture. By the time he comes to you, he may be hopeless."

"Of course, let's not talk about the issue of treatment or not."

"Okay, in this case, let's go back a little bit."

"So what is a fracture? A fracture is an interruption of the integrity and continuity of the bone."

"If we expand this concept, a normal fracture is a process of normal bone cell rearrangement. An abnormal fracture is a process of abnormal normal or abnormal bone cell proliferation and arrangement."

"Just from a fracture, we can get started, such as osteoarthritis, which is joint surgery, right? Acromial impingement syndrome, which is sports medicine, right? Bone tumor, which is bone disease, right?
To be continued...