I can see health

Chapter 409 Rejection
Lu Chen didn't care too much about the unexpected person's opinion.

In the electrophysiology training class in Kyoto, he paid more attention to the teaching of the old professor.

These are top electrophysiology experts all over the country.

For example, Yang Feng, an electrophysiology expert from the Department of Cardiology, Kyoto University School of Medicine, is teaching you today.

Yang Feng, he is currently one of the authoritative experts in the field of electrophysiology in China.

It was Yang Feng who was Lu Chen's tutor in the Department of Cardiology when he applied for the Kyoto University School of Medicine.

Lu Chen vaguely remembered the scene when Professor Yang Feng gave him an interview.

And Professor Jia Bo, who is a judge at the Electrophysiological Society, is only a student of Professor Yang Feng.

At this moment, Yang Feng stood on the rostrum with a stern expression, looked around at the people below, and then slowly said: "When the pacemaker is buried in the subcutaneous tissue in front of the pectoralis major muscle, because the prototype of the single-electrode pacemaker is close to the chest The front of the large muscle, so it is easy to be affected by the myoelectric potential, and there will be three manifestations. Do you know which three are them?"

Among the professors, there was complete silence.

Everyone frowned, and some of them had thoughts in their hearts, but they were not sure.

At this time, Min Xiaobo suddenly raised his hand.

"You answer." Yang Feng pointed to Min Xiaobo.

Min Xiaobo immediately stood up and said: "The first one should inhibit the pacemaker from sending out pacing pulses, which is quite common. The second one is to trigger ventricular pacing, and its ventricular tracking frequency is less than the programmed upper limit frequency. Three... I haven't thought of it yet."

The expression on Yang Feng's face remained unchanged, still cold, "Okay, sit down, does anyone know the third one?"

Min Xiaobo touched the back of his head and sat down helplessly.

Among the teachers, there were whispers. Everyone had some ideas, but they were still not sure.

half an hour.

Seeing no response from the crowd, Yang Feng began to actively look for "prey".

"Fang Ruzhang, you answer."

Fang Ruzhang sat in the last row with an awkward smile on his face.

"Professor Yang, this, I, I don't quite understand..."

Yang Feng frowned, and spoke mercilessly, "Fang Ruzhang, how did you get into the third week? You don't even know this question?"

Fang Ruzhang looked embarrassed and felt a little annoyed, but he didn't dare to attack.

Although he borrowed time from Lu Chen's simulated operating room, he passed the second weekly exam on his own strength!
However, Fang Ruzhang's current results ranked last on the promotion list.

In the third week of the weekly exam, it was almost impossible for him to pass when there were still five people to be eliminated.

"Duan Jiufang, do you know?" Yang Feng began to roll the roll again, looking directly at Duan Jiufang who was sitting in the front row, "I see that you are usually active in class, do you know the answer to this question?"

With a confident smile on her face, Duan Jiufang stood up and said loudly, "After the atrial electrodes of the double-gun pacemaker sense the myoelectric potential, it may trigger cardiac arrest."

Yang Feng frowned, "What's the reason?"

"Uh..." Duan Jiufang paused, and said: "It may be because the pacemaker inhibits the pacing pulse, and the electrocardiogram showed its own heart rhythm, causing a short-term global cardiac arrest!"

After speaking, Duan Jiufang looked at Yang Feng expectantly.

Yang Feng shook his head slightly, "Not very accurate."

"Ah?" Duan Jiufang looked disappointed. She thought about this answer for a long time, and it was well-founded, but she was rejected.

Yang Feng was a little disappointed, he looked at Yu Hewei in front of him.

I wanted to call Yu Hewei by name, but in a blink of an eye I felt that it was unnecessary, because he must have known it.

Yang Feng continued to look for the next target, and finally settled on a person.

"Lu Chen, come and answer."

Lu Chen sat in the first row, directly meeting Yang Feng's gaze.

In the training class at this time, everyone's attention was also focused on this.

Lu Chen's name has already been revealed during the training.

Many people have known this somewhat monstrous little genius.

Lu Chen smiled. He had the answer in his mind, so he stood up and said, "If you pace in an asynchronous way, that is, when the myoelectric frequency is high, the pacemaker will initiate a pulse at the interference frequency or the lower limit frequency. The incidence rate is related to the quality of the pacemaker, the sensitivity of the setting and the swinging degree of the patient's upper limbs!"

After a pause, Lu Chen continued: "As Teacher Duan said just now, it may cause short-term global cardiac arrest. Of course, it may also cause other malignant arrhythmias."

As soon as Lu Chen's words came out, the classroom was so quiet that a needle could be heard.

Everyone secretly pondered Lu Chen's words in their hearts.

"Okay!" Yang Feng finally showed a smile. He walked up to Lu Chen, patted him on the shoulder, then turned his head and said to Duan Jiufang, "Xiao Duan, although your answer is correct, but it is not comprehensive. I still have to answer it today." Lu Chen's answer is the most accurate!"

"Professor Yang deserves the award, but you still teach well." Lu Chen smiled.

Yang Feng smiled, the flattering words are useful, "Then tell me, how to identify the influence of myoelectric waves on the pacemaker?"

Lu Chen thought for a while and then said, "Sometimes obvious myoelectric waves can be seen on the body surface electrocardiogram, but it does not affect the pacemaker function. Sometimes even though the myoelectric waves are not obvious, the pacemaker function is inhibited instead."

"Myoelectric interference mostly occurs when young people and manual laborers are engaged in physical activities. In order to identify the influence of myoelectric waves on the pacemaker, patients can be allowed to use the limb on the side of the pacemaker to do vigorous resistance exercises under ECG monitoring. , observe the functional status of the pacemaker and test the perception threshold of myoelectric waves, and then adjust the pacemaker perception sensitivity appropriately through program control to eliminate the influence of myoelectric waves."

Yang Feng smiled, "Well said!"

Then he waved his hands and motioned Lu Chen to sit down, "The influence of myoelectricity on pacemakers is very common in clinical practice, but it is easy to be ignored. We are doing electrophysiological interventional surgery history, once we ignore the influence of this little detail , may lead to serious consequences, such as the points we just mentioned, malignant arrhythmia, and even cardiac arrest."

……

Yang Feng is worthy of being an expert professor in the field of cardiac electrophysiology.

A lecture, which is explained in a simple way, so that everyone has endless aftertaste.

Although Professor Yang Feng is now more inclined to administration and has fewer opportunities to practice clinical operations, his experience here is unmatched by the group of young, middle-aged and young doctors in front of him.

Lu Chen learned a lot from this lesson.

He now has an advanced skill card for electrophysiological intervention, and he has a high ability to accept those obscure knowledge.

In a blink of an eye, the third weekly exam ended.

No.1, Yu Hewei!
No one can shake his position at present.

No.2, still Lu Chen!
Lu Chen, like Yu Hewei, won the No.2 throne again.

……

Returning to the training class from the hospital where he was assessed, Lu Chen ran into Yang Feng on the way.

I thought it was just passing by by chance, but Yang Feng took the initiative to come forward and talk to Lu Chen.

"Lu Chen, are you interested in following me in the next second stage?"

Yang Feng had a pleasant smile, which was different from his usual indifferent expression in class.

The first phase is coming to an end.

Yang Feng basically acquiesced that Lu Chen could pass the first stage of assessment.

The first stage is one-to-many training.

In the second stage, it is one-on-one training.Everyone else has to choose a mentor.

Lu Chen looked at Yang Feng in front of him with a slightly dazed expression.

He thought of sitting in front of Professor Yang Feng for an interview a year ago.

Back then, Lu Chen wished Yang Feng could hire him.

However, it backfired.

One year later, Professor Yang Feng finally said this sentence.

However, Lu Chen smiled and shook his head: "Professor Yang, I'm sorry, I already have a tutor I like."

　You can take a day off at noon tomorrow, 5 more!
　　
　
(End of this chapter)