Small intestine transplantation 5 stitches for 0.2 mm vessels

  The operating room at Johns Hopkins Hospital, USA, 1944. Vivian Thomas, a former black carpenter, is in the operating room. Thomas stood behind the white chief of surgery, Blaylock, and instructed him to perform the operation. The subject of the operation was a 16-month-old baby born with a heart that was cyanotic from tetralogy of Fallot. Heart surgery, until then, was considered off-limits. But the two joined forces to perform the first successful heart surgery in human history. Hopkins Hospital, too, became recognized worldwide as a medical shrine. Because he didn’t go to college, Vivian was a lifelong lab technician who couldn’t get on the operating table and had to do experiments on animals.  Today, at Hopkins, doctors of all colors have long gotten along well, and there are more and more yellow faces from China. Due to policy restrictions, Chinese doctors have not been able to get on the operating table for some time. They are more often in the lab, exploring human disease in animals, like Vivian. The Curious Lab of the Jinling Evening News is launching a series called “Chinese Doctors at Hopkins”, which focuses on the world’s most cutting-edge experiments they perform and what they see, hear and feel outside the lab.  Dr. Mao Qi, a doctor of surgery sent abroad by Nanjing University, looks at the portrait of Vivian Thomas hanging in the hallway of Hopkins Hospital every day when he passes by. Thomas portrait hanging in the hall, think about their next surgery to mice, sometimes can not help but feel that some surgical procedures, really like a miracle.  Using mice to simulate human small intestine transplants.  In the past two years, Mao Qi had to suture the arterial vessels of mice almost every day in the lab. The mouse was so small, its blood vessels can be imagined how thin. They are 0.2 to 0.4 mm in diameter and can only be operated under a microscope.  Mao Qi studied small intestine transplantation. Small intestine transplant rejection and infection rate is more than 90%, which is more difficult than kidney, heart and liver, and it is the most difficult organ transplantation surgery.  Why should mice be used for human small intestine transplantation? This is because mice are by far the most common laboratory animal, with many genotypes, and the experiment requires which type of mice can be found immediately. Of course, compared to animals such as rats, rabbits, and pigs, it is much more difficult to perform surgery on mice. Even suturing blood vessels under a special microscope is very difficult. If your hand shakes a little during surgery, you may not be able to find the next stitch.  Mao Qi said that a skilled surgeon, at least 3 to 6 months of training, it is possible to sew the five stitches within half an hour, which is half an hour, the hand can not shake. This alone, someone may not be able to do in a lifetime. It takes a mouse 4 to 6 hours to do the whole experiment, and when it is done, the hands are basically incompetent.  The blood vessels are attached in a non-sutured way.  One hundred years ago, the French doctor Carrère invented the technique of surgical suturing, for which he won the Nobel Prize in 1912. It should be said that both Carrel and Vivian belong to the category of geniuses who perform miracles in the history of medicine. However, in Carrel’s view, surgical suturing was far from the most perfect method, and the needle and thread would always destroy the integrity of the blood vessel wall. Carrel’s lifelong quest to anastomose the two ends of the vessel in a non-sutured way was never realized because the technology and materials of the time were not up to date.  One hundred years later, at Hopkins Hospital, Carrell’s dream has been realized, and various non-suture methods are being performed in the operating room and laboratory. What Qi Mao is doing is exploring a new non-suture method on mouse blood vessels.  Simply put, the two ends of the blood vessels are placed on a circular tube made of special material, the tube is fixed and the two ends of the blood vessels are partially fitted together, so that the two vessels are perfectly anastomosed. Using this method, the two blood vessels were joined together in just 15 minutes. Moreover, the experiment cost much less.  Observation of cells with a two-photon microscope.  Not only that, Qi Mao is also working on a new type of two-photon scanning microscope. Most of the microscopes currently in use are single photon, using a very high energy single photon, but, because of the high energy, it will cause damage to human tissue, and the imaging speed is also slow.  In 1931, the German female physicist Maria Meyer proposed the two-photon excitation theory. Meyer proposed the two-photon excitation theory, she believed that a molecule or atom can also absorb two lower-energy photons and assume an excited state. It is worth mentioning that Maria Meyer came to the United States with her husband from Germany. After coming to the United States with her husband from Germany, Maria Meyer had to volunteer for a while at Hopkins University, where she is also known as the greatest volunteer in the history of the university. Today, the two-photon microscope has better tissue penetration capabilities, while minimizing the damage to living tissue what Qi Mao has done is to use the two-photon microscope to observe changes in small intestine cells, can get better results than ever before.