The Godfather of Surgery

New drugs, especially specific drugs that are effective in treating tumors, are generally extremely expensive. This is something that cannot be helped because the cost of research and development of new drugs is extremely high. Pharmaceutical companies invest heavily in the research and development of new drugs, and the risks are also extremely high.

In the pharmaceutical industry, there is a Thirty Rule for the research and development of new drugs: the research and development of new drugs takes an average of 10 years, costs 1 billion US dollars, and the success rate is less than 10%.

Take the R\u0026D investment in the most popular oncology and immunology drugs as an example. According to statistics, among 20 new drug samples, the average investment amount is as high as 4.46 billion US dollars.

Since there is such a large investment, such high risks, such a long R\u0026D cycle, and there is not enough profit stimulation, no one is willing to do such a thing. Once a new drug is launched, the price will inevitably be extremely high, and pharmaceutical companies need to recover it as quickly as possible. costs instead of slowly making money.

For example, when new anti-tumor drugs were launched, pharmaceutical companies did not even think about poor people using them at first. They just wanted to make money from the rich as soon as possible.

Although some pharmaceutical giants in Europe and the United States have been reviled by the world, it is undeniable that without them taking the lead, other companies would not even have targets for imitation. Without original drugs, there would be no cheap generic drugs.

Although the current market competition mechanism for new drugs and new medical devices has many shortcomings, it is relatively reasonable and there is currently no alternative mechanism.

This 1.2 million one-shot medicine, Akilenza Injection, belongs to CAR-T cell therapy. It is a cell therapy product produced in China by my country's Fosun Kate Company using American technology. Therefore, the price is relatively cheap. It is also the first in my country. Cell therapy products.

There are currently five CAR-T cell therapy products on the market worldwide, namely Kymriah, Yescarta, Tecartus, Breyanzi and Abecma. Among these drugs, the most expensive is Kymriah, which is priced at US$4.75 million in the United States and US$313,000 in Japan. Dollar.

CAR-T is not a standardized assembly line preparation, but a personalized cell therapy method that requires each patient to generate CAR-T cells individually.

Its preparation process is highly demanding, and the preparation process requires strict quality control and quality testing. The entire preparation process takes one month.

General immune T cells are extracted from the patient's body and transported to the preparation laboratory using cold chain throughout the process. The laboratory uses genetic engineering technology to modify the patient's T cells to form CAR-T cells and massively expand these CAR-T cells. , after strict quality control and quality inspection, the CAR-T cells are returned to the hospital through cold chain transportation and injected into the patient through injection.

Once CAR-T cells encounter tumor cells expressing corresponding antigens in the patient's body, the CAR-T cells will be activated and amplified, exerting their huge specific killing power and eliminating tumor cells.

The cost of training workers for manufacturing CAR-T cells is also expensive. The average training cost per worker is 300,000 yuan, which shows the high cost.

Yang Ping has his own ideas. He has strong personal research and development capabilities and can single-handedly drive the entire pharmaceutical industry forward. However, he must not destroy the healthy competition mechanism of the entire industry. Once this mechanism is destroyed, he will have to wait until he is old. On that day, the entire pharmaceutical market will be chaotic and disabled, and it will take a long time to rebuild this dynamic mechanism.

——

In the system space laboratory, Yang Ping's three experiments were carried out at the same time. Thanks to the rewards given by 13 CNS articles and the establishment of the Medicine journal system, the huge points allowed Yang Ping to carry out three operations at the same time.

The huge space laboratory is divided into three areas by Yang Ping. The K factor research in the tumor laboratory is progressing smoothly. According to Yang Ping's experimental steps: find K factor - analyze K factor - synthesize K factor - use K factor. Now the third step has been completed and the fourth step has been completed. K factor can be synthesized artificially. Now the experiment has entered the fourth step, which is also the most difficult step. Only after completing this step can K factor enter clinical practice.

This method of killing tumors was named K therapy by Yang Ping, which is also called apoptosis therapy.

CAR-T therapy is a cell therapy that uses immune principles. It uses T cells in the human body to modify T cells.

Yang Ping's K therapy uses the apoptosis mechanism of human cells to control the apoptosis mechanism of tumor cells, initiate the apoptosis program of tumor cells, and kill tumor cells.

If all previous targeted tumor treatments were to start from the outside, the tumor cells would be accurately identified and then killed using various methods.

Yang Ping's K therapy starts from inside the tumor cells. It allows the tumor cells to awaken themselves, start the self-destruction process, and commit collective suicide. This is a natural way of the human body to eliminate rebellious cells.

Yang Ping made various modifications to K factors so that they can pass through the blood circulation smoothly and safely, and finally combine with tumor cells in some way to initiate the apoptosis program of tumor cells.

The cost of trial and error is huge. Yang Ping makes a modification once and then tries it again. This is repeated over and over again. No matter how much system space time is consumed, it is already insignificant when converted into real time.

In a real laboratory, this kind of trial and error is extremely labor-intensive and time-consuming. For example, in the initial molecular discovery of monoclonal antibody drugs, finding an antibody requires a step-by-step method in an antibody library of 1 billion or even 10 billion. Screening, and finally selecting an antibody to make a monoclonal antibody drug, this process has at least 1,000 steps, and no mistakes can be made in each of these 1,000 steps.

A pharmaceutical company in my country developed a monoclonal antibody drug. It took 7 years and more than 3,000 days and nights to successfully develop it. Many times it encountered difficulties and had to start over.

Different from the real laboratory, in the system space laboratory, Yang Ping's trial and error cost is extremely low, because the system space has a huge time advantage and has countless robotic arms to assist work, so Yang Ping only needs to set up the experimental program, Everything is left to the system panel. He only needs to enter the system space regularly to check. Once a problem is found, readjust it. And if it is just a trial and error operation, Yang Ping does not even have to look at it. This way is blocked. The system panel will command the robotic arm to enter automatically. Next route.

For example, when screening antibodies from an antibody library, the experimental steps are directly set up, and the system panel directs the robotic arm to screen continuously. Yang Ping only needs to lie down in the laboratory to rest.

The huge system laboratory has expanded to the size of several football fields. With various instruments spread out on the flat surface and a high dome, Yang Ping felt for the first time how grand his space laboratory was. Those dexterous and delicate octopuses The hands work tirelessly and bear all the physical labor in the laboratory.

The machines here will never break down, never need to take a break, and can always work smoothly.

The system panel is like a loyal servant, managing a huge laboratory and processing massive data every moment. The data from each instrument in the laboratory is sent back to the panel for various calculations.

The walls of the laboratory are made of transparent glass, surrounded by magnificent natural scenery, including mountain waterfalls, huge waves of the sea, boundless wilderness, and mysterious forests. Now Yang Ping likes this laboratory more and more.

Yang Ping's Medicine journal is actually an online paper publishing platform. It has no concept of time. You can upload your own paper at any time, day or night. After being reviewed by the editor, it can be published publicly. The editorial board will publish the weekly papers. The collection of papers has been turned into a paper publication. The paper publication is only used for archiving and does not need to be disseminated.

Since publishing 13 CNS articles, Yang Ping has never published a paper in other journals. All his subsequent papers were published in Medicine, such as the later research on tumor apoptosis and skin amplification. These research stages All sexual papers are published in Medicine, so that you can make your scientific research results public as quickly as possible, declare your intellectual property rights, and spread them to the world at the same time.

——

Li Ruizhong showed up at Professor Zhang's door at eight o'clock the next morning. He only believed in Professor Zhang and was unwilling to go to any other department to continue diagnosis and treatment.

Anyway, the Institute of Surgery can accept any patient. It is a clinical department with a research nature, an entity that combines scientific research and clinical practice.

Li Ruizhong is the breadwinner of the family. Now that he finds out that he has this kind of disease, he will definitely not be able to bear the shock.

Professor Zhang patiently and layman explained to him the details of the disease, telling him not to worry and that his condition had not yet reached its most serious stage.

To this end, Professor Zhang also contacted the Department of Hematology and Oncology to help contact the contact information of several cured patients, hoping that Li Ruizhong could chat with these patients and strengthen his determination to defeat the disease.

After this brainwashing, Li Ruizhong became more open-minded and gained confidence. He was very grateful to Professor Zhang.

Professor Zhang, thank you very much. When you say this, this disease is really not a problem.

Treat me well. You are the backbone of the family. Why do you faint when you faint? You have to stand still, you know?

''I can't accept this right now, oh, I have to pay you back yesterday's room fee and lunch money.

''No, no, we are friends now, treat me as a treat, and the Sanbo Hotel belongs to our hospital, and the lunch boxes are from the hospital cafeteria. I am an expert. These can be reimbursed and cost nothing. It's okay.

real?

real.

''Professor Zhang, I live in your building. You can help me issue a hospitalization certificate and help me with treatment.

Okay, we will try our best to help you save money, but you still have to spend it. Money is earned by people. Once the disease is cured, you can make more money in the future, so that you can keep the green hills and don't have to worry about running out of firewood.

Once this person's concept changes, his energy and spirit will be different. Yesterday, Li Ruizhong's eyes were still dull, but today he is full of confidence.

Xiao Li, let me tell you, this person only lives for one breath. You can't let go of your breath. Everything is easy to handle. Is there anything about the expenses?

Professor Zhang, I called the factory director and asked for an advance payment of part of my salary. The factory director said he would help me raise part of the money in the factory. With the addition of medical insurance, I should be able to survive, right?

You still have some status in the factory.

''I'm an electric welder. I started doing this when I was 16 years old. I've been doing this for more than 20 years, and my skills are still somewhat good. The boss really hasn't hired anyone better than me.

You are a skilled worker!

Just a welder, some kind of technical worker.

You can't say that. You are a skilled worker now. The country is in urgent need of talents. Are you a high school graduate?

Junior high school, after graduating from junior high school, you come out and do this with others.

Xiaoli, I speak more directly. Don't mind. You are now an experienced technical worker, but your theoretical knowledge is a bit lacking. You will have to strengthen your study in this area in the future and find ways to conduct on-the-job learning to improve your culture and academic qualifications. , In a situation like yours, if your theory and culture improve, your salary will increase several times. Nowadays, large enterprises such as shipyards are recruiting powerful welders everywhere. If your theory improves, your understanding of welding technology will be different, and the technology will also change with it. You need to improve, otherwise you will always stand still.”

Professor Zhang, when you say this, I really think it is like this. When I first came out, a coworker worked with me as an electric welder. He was studying in some on-the-job college while working. Now he is working in some shipyard. Welders, I heard they earn tens of thousands a month.”

''That's the truth, you need to improve, learn to improve yourself, and plan things well. In fact, you spend money on smoking and drinking, and it doesn't cost much to enroll in an on-the-job college.

''I'm already 38, is it too late?

It's too late. If you start now, won't you be in your 40s in three years? If you retire, you can still work for twenty years. If you are in good health after retirement, you can continue to work. Look at me, I won't continue to work in my eighties. Make money while living, don’t be afraid if you have skills.”

After I was cured, I saved up money to study. Professor Zhang, I worked until I was over eighty.

In Professor Zhang's clinic, through this kind of chat, Li Ruizhong not only built up confidence in the disease, but also had a completely different view on his life. He felt like he had been injected with chicken blood. Now he felt energetic all over his body. He decided to cure it. After getting sick, I studied while working and studied my welding skills.

He felt that in the past twenty years, he had been living in a haphazard manner, completely drifting with the trend. It would have been better if he had had someone like Professor Zhang to guide him when he was young, so that he would not have been stuck in the same place.

''Thank you Professor Zhang!

When the hospitalization certificate was issued, Li Ruizhong raised his hand and bowed, packed his things and prepared to go to the hospital.

''Come down and chat when you have time.

Okay!

Xiao Lin, a graduate student who had been sitting next to him and following the doctor, was stunned. Yesterday, Li Ruizhong was dumbfounded and even had thoughts of committing suicide. Why was he so energetic today? Professor Zhang was so powerful that he could change the patient's mind. This is a great doctor.

After Li Ruizhong left, Professor Zhang said to Xiao Lin: We as doctors can not only treat diseases, but also help patients build confidence. That is, we can not only treat physical diseases, but also help them change their ideas in their minds, such as this If patients cannot build up confidence in treatment, even if they give up treatment, some may even commit suicide.

Dr. Xiao Lin admired Professor Zhang's brainwashing skills very much. If it hadn't been for Professor Zhang's brainwashing, Li Ruizhong would not have been so happy to be hospitalized for treatment.

——

Li Ruizhong happily came to the ward of the Institute of Surgery for hospitalization. Sometimes people need to be brainwashed so that they have faith, goals, and motivation.

Patients hospitalized at the Institute of Surgery are mainly surgical, and it is very rare for patients to receive only medical treatment without surgery.

Diffuse large B-cell lymphoma is a type of non-Hodgkin lymphoma and the most common type. It is one of the few tumors that can be completely cured.

Non-Hodgkin's lymphoma is the most common malignant tumor of lymphatic hematopoietic tissue. It can be caused by factors such as infection, genetics, immunity, and environment. The main symptom is severe lymph node distension throughout the body. Chemotherapy is the main treatment, but the most effective treatment method is It is 1.2 million shots of CAR-T cell therapy.

Originally, the main symptoms of this disease are painless progressive lymphadenopathy and local masses, but some people have atypical symptoms.

Li Ruizhong's symptoms are atypical. His lymphadenopathy is not very obvious. The most prominent symptom is wandering joint pain in his limbs. Doctors rarely perform systemic examinations during physical examinations, such as not palpating the whole body. lymph nodes, and the migratory pain in multiple joints throughout the body is so obvious, so the doctor must seize this prominent symptom for examination.

When Li Ruizhong found Professor Zhang, Professor Zhang's consultation was very detailed, and then he almost performed systematic palpation of the whole body. He found that the lymph nodes in the groin were still swollen, because the slightly swollen lymph nodes were not painful. , Li Ruizhong didn't care, Professor Zhang did a color ultrasound of his lymph nodes, which showed that they were still swollen.

So Professor Zhang performed a lymph node puncture on him. After the puncture examination, it turned out to be diffuse large B-cell lymphoma. After comparing the pathological diagnosis with all the symptoms, it was basically consistent, and it was this disease.

Li Ruizhong's supervising doctor is Dr. Zhao Wenbo, a rotating master's student with excellent academic performance and work performance. He and Li Guodong often argue about academic issues, but their personal relationship is still fine, and academic disputes have not affected their personal friendship as colleagues.

Under the guidance of Professor Zhang, Li Ruizhong did not eat breakfast when he was hospitalized so that he could complete some routine blood tests during hospitalization as soon as possible.

After the operation in the afternoon, Yang Ping conducted a separate ward check on newly admitted patients and key patients with complex conditions. Because Li Ruizhong needed medical treatment, Yang Ping paid special attention to it.

The conventional treatment for diffuse large B-cell lymphoma is chemotherapy. Because CAR-T cell therapy is expensive, it is generally used for relapsed or refractory diffuse large B-cell lymphoma.

In fact, there are some diseases that ordinary people think are terminal illnesses, but they can be cured. However, these cure methods are too expensive, not popular, and inaccessible to ordinary people.

When heart transplant surgery first appeared, ordinary people had no way to treat end-stage heart disease. But American billionaire David Rockefeller has begun using heart transplants to save his life. He had six heart transplants in his life and lived to be 101 years old.

At that time, the technology of heart transplantation had just come out, and because the cost was too high, this cutting-edge treatment method would not be available to general hospitals.

Yang Ping's ideal is to use his own system to reduce research and development costs, so that ordinary people can enjoy the latest and most cutting-edge medical treatments and avoid suffering as much as possible.

He decided to treat the patient with cell therapy, using his own cheap method.

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