There is no need to be too normal to be a doctor

After Chen Gong left the laboratory, he was not angry, but was very calm.

If you think about it carefully, Liu Zhi's making things difficult was actually not an accident.

It can even be said to be inevitable!

When he came to the laboratory, as a student, he was destined to do many things.

Those team leaders, professors or experimenters did not have enough respect for him. They only cared about Professor Xu behind them.

To put it bluntly, this is a personality that Yang Guangye has set for himself!

Although Yang Guangye and Qi Huan showed respect for themselves.

but……

This is not enough!

For ordinary students, they join the laboratory because their abilities are insufficient and they need to learn from the teacher. In this way, this status is indeed enough.

But for Chen Gong, it is not enough!

What Chen Gong hopes to get is not only respect, but also certain authority.

This is also the reason why Chen Gong has always been dissatisfied with Yang Guangye. He has not arranged a substantial identity and independent laboratory for himself.

And these are what Chen Gong really needs.

To put it bluntly, Chen Gong was very curious.

That's what Yang Guangye's attitude is towards himself!

Is it the attitude of an equal, a collaborator who puts himself in the top three responsible persons for the project?

He is still a student who needs comforting and hopes that a little sweetness will satisfy him.

Chen Gong had to think about this question. Did Yang Guangye think that he conceived the idea of ​​​​the tricarboxylic cycle on atherosclerosis just because of coincidence and certain strength and talent.

But it does not have the role to further develop in the laboratory, and it does not have enough application roles for experimental advancement or even the experiment itself.

It was Liu Zhi who came out today, and it was because of trivial matters like Tao Shengnan, a student.

This happens.

What next?

After the experiment begins, there will be a lot of discussions and disputes due to concepts, experimental directions, etc. during the initiation and development stages, and there will also be a lot of competition.

If there is a real dispute or competition between their own ideas and the other party's, what will they choose to do?

Liu Zhishang can embarrass himself!

What about the team leaders?

What about those experts and professors?

Or even... what about Yang Guangye or Qi Huan?

What status and height will they place their opinions on?

How respectful and supportive can they be? !

Chen Gong had to think about this.

To be honest, the study of the tricarboxylic cycle on atherosclerosis is not just the work of Yang Guangye.

It is also Chen Gong’s efforts and dreams.

This is the first project in his life, it is of great significance, and he also wants to complete it.

And Yang Guangye is the best partner he can find currently!

In fact, a few days ago, when Chen Gong saw that Professor Xu Tong and the National Natural Science Foundation of China review committee were coming, he already had this idea in mind.

Xu Tong is definitely a person who has the right to speak and make decisions, and is even respected by Yang Guangye and everyone in the biochemistry teaching and research department of the entire school.

He has certain rights!

And Chen Gong happened to need his presence.

To put it bluntly, Chen Gong has discovered that Yang Guangye seems to have no intention of straightening himself out, at least not yet.

The reason is unknown, and Chen Gong doesn’t want to wait any longer.

Chen Gong decided to take the initiative on his own.

It's just... Chen Gong hasn't figured out how to do it at that time to attract Xu Tong's attention and let the entire research team see his contribution?

In other words...how can I get the right to speak that I deserve in the research group!

This is more difficult, after all, we have to not offend Yang Guangye...

After thinking about it, Chen Gong didn't think of a good way, but he didn't expect...Liu Zhi would give him such an opportunity now.

This surprised Chen Gong.

He decided...not to come tomorrow!

childish? Immature?

hehe!

Isn't he just a child?

Chen Gong smiled faintly and left the laboratory with Shou Weixiang and Tao Shengnan.

Looking at Chen Gong's leaving figure, Song Hongwen stood there without reacting.

He really doesn't want to leave!

This opportunity is really important to him.

If I leave, all my previous efforts will be... wasted!

But...seeing Chen Gong and others being bullied, Song Hongwen also wanted to stand up in his heart.

But he didn't have the courage...

In other words, this is not actually a matter of courage. It is his courage that is not enough to resist his losses. In his heart, loyalty is a kind of blind lack of rational thinking and an impulsive behavior. He cannot Do!

Even Song Hongwen didn't have the courage to stand up and help the three of them speak.

Because he is afraid, afraid that he will be targeted, afraid that he will become a thorn in Liu Zhi's side!

Liu Zhi, he couldn't afford to offend him.

Therefore, Song Hongwen stayed where he was, with his head lowered and motionless.

On the contrary, it was Wu Tianjie. Although he was jealous of Chen Gong, he also respected Chen Gong's behavior very much.

Why doesn't he hope that when he is being made things difficult, targeted, criticized, or treated unfairly, there is someone who can stand up for him like Chen Gong?

Why wouldn't he wish he had a friend like this?

Can we share joys and sorrows and adversity?

After thinking about it, Wu Tianjie stood up quickly and said, "Teacher Liu, please calm down, Chen Gong is too impulsive."

"I'll help you persuade him."

"Don't be angry, it's just...a small thing."

"Maybe there's some misunderstanding!"

After saying that, Wu Tianjie hurriedly stood up and chased Chen Gong. However, after taking two steps, he suddenly realized something. He turned around and took a look and found Song Hongwen sitting in the corner with his head lowered and silent.

…

…

After leaving the laboratory.

Shou Weixiang followed Chen Gong, feeling panicked.

His character is not the kind to follow Chen Gong and scold Liu Zhi for not being a human being.

After something happened, he hoped that he could make up for it, that he would not drag Chen Gong down, that...

But no matter how much we hope, what can we do!

In this school, he, Shou Weixiang, is just an insignificant figure, although he seems to have a certain degree of popularity or fame among the students.

But in the end, it's just smoke and mirrors.

Even Liu Zhi, Sun Zhi, Wang Zhi, and Li Zhi can control themselves casually.

When Tao Shengnan faced unfair treatment, slander, and bullying, he had no choice!

But Chen Gong stood up and made them feel bad.

But in the end... he was implicated.

So, what are the words of comfort now?

The key is that Chen Gong is now targeted by the laboratory teacher because of them, and... may also be reported to the school leaders.

This made Shou Weixiang feel a sense of guilt.

As they walked, Shou Weixiang couldn't help but push Chen Gong with his shoulder, and said vaguely: "It's really stupid, I'm sorry."

Chen Gong heard this and pushed Shou Weixiang away with his shoulder: "Go away, don't be gay!"

Hearing this, Shou Weixiang grinned and hugged Chen Gong with a hahahahaha laugh:

"Fuck, it doesn't matter what you say, I'll use force!"

Shou Weixiang was tall and powerful, so he hugged Chen Gong and ran out.

It made everyone laugh.

There were a lot of people on campus at six o'clock at this time. Seeing this scene, they couldn't help but burst into laughter.

Tao Shengnan followed behind, actually feeling the most guilty in his heart.

She really felt a little uncomfortable for Chen Gong to be like this because of what happened to her.

At this time, Wu Tianjie stood there and saw the actions of Chen Gong and Shou Weixiang. For a moment, he felt a little envious in his eyes.

The education he has been taught since childhood is to study hard, work hard, be progressive, be positive and enterprising.

Don't play with bad boys.

In fact, Wu Tianjie knew that those children were not bad children, they just didn't like to study.

They are very loyal to their friends, very generous, and very good friends. They are even much better than some "good children" in the eyes of their parents.

Wu Tianjie wanted to join them when he was a child, but was beaten up by his parents and taught him a long time.

What does it mean that different positions conspire against each other...

He had heard this too many times.

I gradually got used to it.

Over the years, he suppressed that urge.

It stands to reason that with many years of experience and education, it is impossible for him to behave like Chen Gong at this moment.

He may even feel immature and childish.

But Wu Tianjie was really envious of this kind of behavior at this moment.

Maybe this is what youth should taste like?

Who is young and not frivolous?

Sometimes, he envied Chen Gong, even jealous.

Study well and have caring friends around you.

But now he suddenly discovered that friends require hard work.

For example, when Shou Weixiang was in the classroom that day, when Chen Gong was called on by He Mingliang, he dared to stand up and pick up the bag.

Chen Gong was able to confront Liu Zhi today because of the other party.

Perhaps, in the eyes of these teachers, they are just little students.

But youth never talks about gains and losses. Only the cluster of flames is the most heart-warming beauty.

The relationship between Chen Gong and Tao Shengnan can only be said to be above average.

But Shou Weixiang and Tao Shengnan were like a couple.

Therefore, Wu Tianjie is not stupid. He naturally knows very well that Chen Gong is helping Shou Weixiang, not Tao Shengnan.

Wu Tianjie took a few steps quickly and chased after him.

"Chen Gong, Shou Weixiang."

"Wait a moment."

Chen Gong turned around and saw Wu Tianjie actually coming out. He was stunned for a moment: "Ah? Wu Tianjie? Why did you come out?"

"The meeting summary isn't over yet, is it?"

Wu Tianjie smiled: "No."

"However, I came out under the guise of helping Teacher Liu criticize you."

"you are awesome!"

While speaking, Wu Tianjie gave a thumbs up.

Shou Weixiang turned around and took a look at this time, but there was no figure he wanted to see in the crowd, and he felt a little disappointed.

However, everyone has his own ambitions. Although Shou Weixiang didn't want Song Hongwen to follow him and run away, causing him to suffer injustice.

But……

Even so, he still felt a little lost.

Chen Gong naturally saw what the other party was thinking. He patted Shou Weixiang on the back, smiled and said to Wu Tianjie, "Let's go to dinner together?"

Wu Tianjie felt happy when he heard the sound.

He really wanted to integrate into Chen Gong's group.

Be friends with Chen Gong and the others.

If that happens, Wu Tianjie believes that this may become one of the most memorable things in his college youth.

"No, just eat."

"I have something wrong."

"You guys eat well."

"I still have to go back and talk to Liu Zhi."

After some hesitation, Wu Tianjie smiled, waved goodbye, got up and left.

He felt that rather than being friends with Chen Gong, he would rather think of Chen Gong as a competitor.

This will give him more motivation.

However, Wu Tianjie returned to the laboratory.

After coming in, Wu Tianjie said to Liu Zhi: "Teacher Liu, Chen Gong also knows that he is impulsive."

"Don't be angry."

Liu Zhi snorted coldly and remained silent.

…

Chen Gong and the others went to a small restaurant outside the school and ordered a few dishes.

Shou Weixiang specially brought a few bottles of beer.

He smiled and said, "I'm treating you today. Everyone is open to eating and drinking."

Chen Gong smiled: "Well, okay, last time you two joined the laboratory, I didn't go there. Today is just the right day."

Tao Shengnan still felt that he had caused Chen Gong trouble and was a little sorry.

He poured himself a glass of beer and said, "Chen Gong, thank you!"

"I caused trouble for you today."

"I respect you."

Chen Gong waved his hand: "What the hell!"

"My daughter-in-law is being bullied. If I don't take action, my son will have to sever ties with his father!"

As soon as these words came out, Shou Weixiang's old face turned red: "You idiot, what kind of daughter-in-law are you? You're talking nonsense!"

"You have to call me godmother."

Tao Shengnan couldn't help but laugh, covered his mouth and chuckled.

Before the food was even served, Shou Weixiang and Chen Gong had already finished two bottles.

This posture is heading in the direction of getting drunk tonight.

"Hey, Lao Chen, I'm going to say something, but don't interrupt."

"Thank you so much for today. You don't know, I feel so aggrieved when I see men being wronged."

"Thank you for venting your anger on my brother."

"I don't know if you will be punished for this."

"I don't care so much anymore."

"Don't worry, it's all here."

Shou Weixiang pointed to his heart and swore: "I, Shou Weixiang, swear that if you, Chen Gong, need my help in the future, I will shirk you once. You are not a human being!"

Chen Gong knew that Shou Weixiang was not telling lies.

Tao Shengnan nodded and took a drink.

"Hey... it's a pity. We still want to prepare well in the laboratory and strive to write a good thesis before graduation."

"When I graduate, I can successfully take the postgraduate entrance examination and the Ph.D. examination!"

"Then I can have my own world."

"I didn't expect that the enemy was not successful at the beginning, and the middle road collapsed."

"I guess I won't be able to go to the laboratory."

Chen Gong smiled when he heard this: "Who said you can't go?"

"hehe……"

"Going!"

Shou Weixiang was speechless: "Brother, stop bragging."

"I know you are more respectable than me in the laboratory."

"But Liu Zhi dares to take advantage of me. To put it bluntly... we are just students in the eyes of those teachers."

"You have some talent, but just appreciation is not enough for them to punish a teacher."

Chen Gong shook his head: "Just wait."

As he spoke, there was a twinkle in his eyes, and he knew that he had to do something.

About this topic!

From the preparatory work before the start to all the later matters, Chen Gong was involved.

However, no subject is perfect.

This one is no exception.

There is something lacking in his theoretical basis.

The experiments Chen Gong did during this period were all to complete this idea.

He originally planned to wait until the proposal report was over and talk to Yang Guangye and Qi Huan.

but now……

Chen Gong felt that he needed to put on airs.

It's not that he did it on purpose, or that he had much panache.

It was because Chen Gong discovered that if he didn't show himself, sooner or later what happened today would happen again.

To put it bluntly, he wants to show off his wrist.

Tomorrow is the final stage of the project preparation process, with a pre-project report on the work process and detailed arrangements.

Under normal circumstances, this link is still the last level of the review.

However, over the years, it has basically passed the expert group review, proposal report, and final review... After passing, this last step is a ceremony.

Xu Tong will naturally not be alone when he comes tomorrow.

Instead, we need to bring some review experts with us.

Therefore, when the time comes, there will naturally be some reports.

In this case...

Chen Gong smiled: "Come, drink!"

"Don't worry, I'll be fine."

"No one can punish me."

"Unless... I don't want to start this subject."

"Besides, you will go back too."

Shou Weixiang smiled: "I just appreciate your shameless bragging."

"Very charming!"

Chen Gong said with a dark face: "Get out!"

…

…

It’s nearly eight o’clock after we’ve had enough wine and food.

We ate and drank for two hours.

Shou Weixiang seemed a little unhappy and insisted on going to KTV to sing.

But Chen Gong was worried about something and didn't go.

Tao Shengnan suddenly asked: "By the way, Chen Gong, let me ask you something."

"Do you think I'm going to the lab tomorrow?"

"Professor Wang asked me to take Professor Xu and the others to Shanhe Tower tomorrow afternoon."

Chen Gong smiled: "It depends on yourself."

Tao Shengnan thought for a moment and then said: "I want to go."

"After all, Professor Wang asked me to go, not Liu Zhi."

"The more they don't want me to be in the limelight, the more I'm going to piss them off."

"snort!"

Hearing this, Chen Gong smiled slightly and gave a thumbs up: "Well done!"

Shou Weixiang obviously drank too much, mainly because he had something on his mind. At this time, it is especially easy to get drunk when drinking.

Chen Gong was fine, half drunk.

In this case, he didn't want to sleep at all.

There are a lot of thoughts in my mind, and I want to quickly write down my previous ideas and experimental results.

Tao Shengnan and Chen Gong carried Shou Weixiang back to the dormitory.

Song Hongwen was reading there and was stunned for a moment when he saw Shou Weixiang and the others coming back.

Yang Pengwei was still looking at the love apartment. After hearing the noise, he stood up quickly:

"Hey, Cao, why did I drink so much?"

"The key is...don't call me when you're drinking."

"It's changed!"

"Come on, help, put him on the chair."

Ji Chao nodded quickly when he heard the sound and came to help.

"I'm not drunk!"

"Really not!"

"hehe……"

"Hehehehe..."

Chen Gong was speechless and waved his hand to Tao Shengnan: "You go back first, we will just take care of him."

Shou Weixiang also smiled and said: "You go back first, man, I... I won't send you off."

Hearing this, Tao Shengnan rolled his eyes: "Then... you take care of him, I'll leave first."

After Tao Shengnan left, Shou Weixiang suddenly started crying.

"Uuuuuuuuuuuuuuuuuuuuuuuuuuu...Am I so useless!"

"Chen Gong, I can't even protect the girl I love."

"I...I'm really useless."

Shou Weixiang was very sleepy and sad.

Friend Yang on the side was stunned for a moment and looked at Chen Gong: "What's wrong?"

Chen Gong smiled: "It's okay, he drank too much."

Outside the door, Tao Shengnan had not gone far at all.

Listening to Shou Weixiang's cry, tears suddenly flowed down.

She wiped her tears, took a deep breath, got up and left.

She doesn't need protection, she even needs to protect her man.

…

…

Shou Weixiang cried for a while and then went to bed.

Song Hongwen said nothing and took notes silently.

After Chen Gong hesitated, he stood up and left with his notebook: "Don't wait for me tonight, I won't come back."

He's going to have some quiet time tonight to write this article.

Chen Gong did not go to the biochemical laboratory building, but went to the anatomy laboratory.

Yang Guangye and Qin Xuehai are two types of people.

Qin Xuehai was more courageous and gave Chen Gong enough autonomy and respect.

He even directly announced Chen Gong as the third person in charge in front of everyone in the laboratory.

Maybe people who are surgeons have a more forthright and forthright personality.

In contrast, Yang Guangye, as the deputy dean, has an academic background, but he is in a management position.

Don’t think that academic pursuits are simple.

Quite the opposite!

In the medical field, it is always easier to do clinical work than to do academic work.

The academic circle is a complex circle.

The expert doctors in surgery and orthopedics have a bold and outgoing personality and often drink with the students.

The shelf is not big!

For example, Zeng Hui, although he joked with Chen Gong, he never treated Chen Gong as an outsider when something happened.

After Chen Gong came to the laboratory, he went directly to Qin Xuehai's office.

There is a bed, a desk, and a laboratory next to it, making it very convenient to stay up late and work overtime.

Chen Gong has been here several times and is familiar with the roads.

As he spoke, he opened his notebook.

Afterwards, Chen Gong imported the data from his mobile phone.

This is the result of his experiments during this period.

The tricarboxyl cycle is a ubiquitous metabolic pathway in aerobic organisms.

The Calvin cycle, as the retrograde operation of the tricarboxylic cycle, is actually a metabolic pathway for anaerobic organisms.

The tricarboxylic acid cycle is the final metabolic pathway of the three major nutrients (carbohydrates, lipids, and amino acids), and it is also the hub of the metabolic connection between carbohydrates, lipids, and amino acids.

Lipid metabolism plays a crucial role in atherosclerosis.

Atherosclerosis is a disease involving the intima of the systemic arteries ranging from large elastic types (such as the aorta) to medium elastic types (such as the epicardial coronary arteries).

It is characterized by the formation of intimal plaque in arteries.

(Although there are severe cases where plaques can fuse).

Each plaque has a different composition.

Lipids are the basic components of atherosclerotic plaques. Strictly speaking, intimal thickening is not atherosclerotic plaques, but an adaptive response of the vascular intima to mechanical damage.

Therefore, when Chen Gong originally proposed to study atherosclerosis based on the tricarboxylic cycle, he actually mainly started from the perspective of lipid metabolism.

This idea is mainly divided into four steps.

And these four steps have gradually been extended and become one of the basis for establishing this topic.

First, the first step is low-density lipoprotein LDL, which is called "bad fat" and will increase the risk factors of cardiovascular and cerebrovascular diseases.

It penetrates into the endothelial cell gap and monocytes migrate into the intima, which is the earliest stage.

Secondly, Ox-LDL binds to the scavenger receptors of macrophages and is taken up, forming macrophage-derived foam cells, which correspond to the fat streaks in pathological changes.

Next is the third step. Vascular smooth muscle cells (SMC) in the arterial media migrate into the intima, engulf lipids to form myogenic foam cells, proliferate and migrate to form a fibrous cap, corresponding to the fibrous plaques in pathological changes.

In the fourth step, Ox-LDL causes necrosis and disintegration of the above two types of foam cells, forming atheroma-like necrosis and atherosclerotic plaques.

Corresponds to atheromatous plaques in pathological changes.

In summary, atherosclerosis can be understood based on the formation mechanism of the tricarboxylic cycle:

The key link lies in Ox-LDL. How to prevent LDL from being oxidized into Ox-LDL has become the core of treating and preventing atherosclerosis.

But……

However, Chen Gong found that studying according to this idea was incomplete, and there was even a problem!

According to the results of the latest "World Biochemical Yearbook" report, the formation of foam cells in the third step is not the main clue and reason.

Therefore, Chen Gong began to explore the order and ideas of foam cell formation and began to study.

Therefore, Chen Gong’s main work during this period was here.

Fortunately, his experiment went well!

Chen Gong discovered that the formation of foam cells cannot be studied simply based on this idea.

He needs to explore it at the level of small molecule RNA.

then……

Chen Gong began to study small molecule RNA.

MicroRNA (miRNA) is a type of non-coding RNA with a length of about 21 to 23 nucleotides that exists in eukaryotes. It can bind to mRNA to inhibit the expression of post-transcriptional genes and affect biosynthesis.

In the tricarboxyl cycle, the presence of small RNA molecules will affect the formation of foam cells.

This process... Chen Gong found it very magical.

In fact, Chen Gong is also very lucky!

He discovered that there are indeed some small molecules that affect the process of atherosclerosis!

These small molecules conduct more direct research on atherosclerosis through mechanisms such as foam cell formation, lipid deposition, and inflammatory response.

That is to say...

The study of the tricarboxylic cycle on atherosclerosis cannot simply start from the tricarboxylic cycle.

Just because the tricarboxylic cycle is a very attractive topic, we cannot blindly magnify the role of the tricarboxylic cycle.

Therefore, this topic requires additional research on small molecules.

This can make it more perfect.

Chen Gong feels that this is a holistic and comprehensive study.

If we ignore the intervention of small molecule RNA and only use the tricarboxylic cycle perspective, deviations will occur and unpredictable consequences will be caused to the experiment.

Of course, Chen Gong was not innocent.

It is based on experiments.

During this time, Chen Gong discovered that small molecule RNA: microRNA-21 was positively correlated with the stability of plaques in coronary artery disease.

This point is the result obtained by Chen Gong based on historical data collection and analysis.

As a result, Chen Gong later conducted data searches and experiments.

He found that overexpression of the protein kinase (MKK3) gene in macrophages lacking small molecule No. 21 promoted the p38-CHOP and JNK signaling pathways, causing the transporter ATP-binding cassette transporter G1 (ATP-binding cassette transporter G1) that regulates cholesterol efflux in macrophages ( ATP-bindingcassette sub-family G member 1, ABCG1) is degraded and affects the formation of foam cells [12].

This discovery is the best argumentative basis.

It can even be said to be the core of all Chen Gong’s arguments today.

Small RNA No. 21 can promote the efflux of tricarboxyl cyclic ATP through gene expression, thereby indirectly affecting the formation of foam cells, thus forming a basis for atherosclerosis!

At the same time, he recently conducted animal experiments and found that the expression of small molecule RNA No. 21 can significantly inhibit the secretion of the inflammatory cytokine IL-6, and can also preclude TLR4 antibodies and NF-κB inhibitor pyrrolidine dithiocarbamate. treatment, negatively regulates lipopolysaccharide-induced lipid deposition and inflammatory response in macrophages, and plays a certain protective role against atherosclerotic plaques.

Here, Chen Gong even came up with an idea!

Is it possible to perform a negative regulation in a disguised form through the reverse circulation of the tricarboxylic cycle, and then realize the idea of ​​protecting atherosclerosis?

…

Chen Gong's idea is so advanced that it can even be said that no one has ever done it!

This is the result of ingenious in-depth research on the tricarboxylic cycle.

Naturally, Chen Gong would not spend the funds in vain.

He is indeed studying something...

As he spoke, his hands jumped and flew on the keyboard like an elf playing the piano.

After typing each byte, new ideas were formed...

This will become a key node in changing this issue.

Time passes minute by minute.

finally!

At two thirty-five, Chen Gong completed his thoughts and ideas.

After finishing writing, Chen Gong felt extremely excited.

The drunkenness had just dissipated, but Chen Gong's excitement had not passed.

This gave him some insomnia.

Can't sleep...

But now, what can I do in the middle of the night?

Success hesitated for a while, then suddenly a plan came to mind.

or……

Do you want to do anatomy experiments for a while to rest and change your mind?

After this idea came to mind, all Chen Gong's sleepiness disappeared and was replaced by a kind of happiness.

It's like feeling tired of doing homework or writing papers, and suddenly playing games or watching movies.

Refreshing!

So, Chen Gong stood up and opened the door of the laboratory next door.

After turning on the light, Chen Gong discovered that there was a model of the neuroskeletal and muscular structure of the tail vertebra on the table.

Moreover, there is a notebook and a medical record next to it.

At this time, Chen Gong's eyes lit up and he was as excited as if he had discovered a fun game.

what exactly is it?

Chen Gong picked up the medical record and started reading it.

"Patient Zhao Qiaoxian, 48 years old, has had hip pain for more than a month, which has worsened for a week..."

Hip pain?

Chen Gong is thoughtful...

There are many causes of hip pain.

Of course, he has a professional term.

Buttock pain, also called "posterior lumbar spinal nerve pain", has many causes, such as intervertebral facet joint disease, bone hyperplasia, posterior spinal nerve entrapment, chronic aseptic inflammation of the posterior branch, etc.

Because the gluteal epithelial nerve comes from the lateral cutaneous branch of the posterior branch of the lumbar 1 to 3 spinal nerves and is distributed on the upper and outer skin of the buttocks, pain often occurs in the waist, buttocks, and thighs, and rarely exceeds the knee joint.

Chen Gong looked at the cases and was gradually attracted to them.

Every case diagnosis is an interesting reasoning process, making full use of the anatomy and pathology knowledge to conduct an exploration.

This process is very happy.

Just like a delicious late-night snack, after eating it, you can sleep soundly.

Generally speaking, the causes of hip pain are multi-faceted, such as intervertebral facet joint disease, bone hyperplasia, posterior spinal nerve entrapment, posterior branch chronic aseptic inflammation, etc.

This requires further exploration of the causes and symptoms.

"Patients' pain often occurs in the waist, buttocks, and thighs, and rarely exceeds the knee joint. Pain in the buttocks is the main complaint, which often occurs continuously and rarely intermittent..."

Chen Gong frowned slightly.

Not lightning pain?

Lightning pain in the buttocks is a very common symptom, common among office workers.

The symptom is a sudden sharp pain on one side of the buttock, accompanied by numbness in the leg and foot on the same side, and then the pain slowly disappears.

In this case, the pain is most likely due to damage to the sciatic nerve. (Eye insertion is recommended).

Then there is the soreness of the buttocks. Buttocks soreness is also one of the common complaints in outpatient clinics. Because of its very special location, it is often confused with lower back pain and sciatica.

For hip pain, in addition to considering the pathological changes of the joint itself, it is also necessary to exclude the pathological changes around the joint and the referred pain from distant lesions.

Other than that, it’s just radiating pain!

This situation is more common in dense sacroiliitis, which is a non-specific inflammation characterized by bone sclerosis, with highly dense bone sclerosis, especially in the lower 2/3 of the ilium, but the joints The gap remains unchanged.

There is recurrent low back pain, sometimes radiating down to both sides of the buttocks and thighs.

But……

The patient’s condition is none of these, right?

The patient's symptoms were low back pain and buttock pain on the affected side, accompanied by inductive sciatica. Moreover, the main pain sensation was soreness and swelling. The pain suddenly worsened after bending, squatting, standing up, or twisting the sacroiliac area or waist. Turning over, Activities such as getting up are restricted.

Uh-huh?

The patient weighs 210 pounds?

Good guy...

Chen Gong looked at the other person's age, height and weight and couldn't help but exclaimed that he was an expert.

48 years old, 147 centimeters, 210 pounds...

Isn't this sciatica pain?

Chen Gong hurriedly looked through the subsequent examination results.

X-rays and CT scans were all done, with no positive findings.

but……

The lack of results does not mean that the examination is meaningless.

In modern medicine, the biggest role of examinations is to eliminate problems.

At least, this film can rule out degenerative diseases in the spinal canal, such as spinal stenosis, spondylolisthesis, and lumbar disc prolapse.

Isn't this the case?

Chen Gong frowned and continued to examine the body.

The straight leg raising test and strengthening test were negative, there was no sensory disturbance in the sciatic nerve distribution area, the tendon reflexes were normal, and there were no symptoms of other nerve roots.

This is interesting!

It was also the first time for Chen Gong to see such a case.

Obviously there are these signs, but there is no imaging support from the film.

What could happen?

Chen Gong hesitated and suddenly saw an information point.

"Swelled lymph nodes can be palpated deep in the subcutaneous tissue of the patient's sacroiliac region..."

This thing seems clueless.

But Chen Gong's mind was spinning very quickly.

He believes that no symptom is useless in the diagnostic process.

Just like when a disease occurs, no one is innocent!

Just like the relationship between toothache and hemorrhoids, can you believe that some scholars have actually studied the relationship?

After Chen Gong saw it, he also said it was wonderful.

At this moment!

Chen Gong looked back and forth through the medical records many times.

A large number of descriptive signs and various indicators...

A human figure has even formed in Chen Gong's mind.

Image of a 48-year-old woman who is 14cm tall and weighs 210 pounds.

The bones, muscles, nerves, and organs also clearly appeared in Chen Gong's mind.

gradually……

Chen Gong fell into deep thought.

What exactly happened?

In this way, as time passed by, Chen Gong continued to open the medical records, and the various symptoms in his mind gradually became fuller.

suddenly……

Chen Gong saw something.

The patient reported “swelling and pain behind the knee”.

What's going on?

In Chen Gong's mind, the patient's pain area increased by one, and there was swelling in the popliteal fossa!

This is a special signal!

Could it be... at the blood vessel level?

Chen Gong closed his eyes and started thinking crazily.

suddenly……

He related that the patient had palpable lymph node enlargement in the subcutaneous tissue above the sacroiliac joint...

perhaps……

Isn't this a lymph node? !

This idea made Chen Gong's eyes light up.

He quickly opened the book and looked at it.

Half an hour later...

Chen Gong finally thought of something.

right!

This may not be a tumor, a nodule, or hyperplasia and calcification.

But...a hernia!

What is a hernia?

It means that the tissue has prolapsed and there is an extra piece.

The hernia in women is even worse, it is a fat hernia.

It’s called…sacroiliac joint fat hernia!

His most typical signs are that single or multiple nodular masses can be palpable in the subcutaneous tissue above and outside the sacroiliac joints on the medial side of the upper edge of the iliac crest, ranging from 1 to 3 cm in diameter. Pain when pressed.

After this happens, it will be accompanied by swelling of the popliteal fossa, which causes vascular obstruction in the lower limbs.

Some patients may experience pain in the sciatic nerve distribution area, but the straight leg raising test and strengthening test are negative, and there is no lower limb sensory impairment or abnormal reflexes.

Following this line of thinking, Chen Gong continued to analyze the cases back and forth.

The more I look at it, the more Chen Gong feels like it, or even that it should be him!

Sacroiliac fascia fat hernia is actually a hernia formed by the protrusion of buttock fat through the sacroiliac fascia.

To put it bluntly, there is too much fat in the buttocks, which pierces the sacroiliac fascia and bulges out, causing pain.

After Chen Gong thought it through...

So on the blank paper behind the medical record, I drew the model diagram in my mind.

Then the area and location of the sacroiliac fascial fat herniation were also drawn.

As for treatment techniques...

Chen Gong did not paint.

Not just because I can’t, the main reason is because it’s not necessary.

Hernia surgery is actually very simple. It is nothing more than stuffing the fat back and repairing the fascia.

Um……

Although Chen Gong doesn't know how to do it, it doesn't affect him that this operation is simple.

Then, Chen Gong gave some answers, closed the medical record, and yawned.

Go back to sleep...

This late night snack is really good.

…

ps: Answer two questions.

First: I spoke about increasing the number of fans because I was too anxious and my habitual thinking was adjusted to 500. I’m sorry about this...it has been modified. Don’t worry.

Second: Someone said yesterday that the quality was not good. In fact... although the veteran was anxious, he... was really attentive. This may be because the plot design was not very good at the beginning. I will correct this.

Third: just thank you!

Thanks to the brother of "There is a Trap in the Sky" for the generous reward of 100,000. This is a brother who has followed the veteran for several books. I really appreciate the support!

Thanks to "lyglian" for the 9000 reward, thank you boss!

Finally, thank you to every reader who supports the genuine version, thank you.