MTL - Doctor’s Life Simulator-Chapter 368 Selected for the list and awarded the Nobel Prize in Medicine
"Director Zhu, what's your situation? I need to explain!"
Under the observation of Deputy Director Qian, he asked for Director Huang. He couldn't believe it. Although Qin Lang was talented, this was the plan they spent a lot of time negotiating together, the first plan.
This Qin Lang listened to it once, and even if he started the operation, he dared to directly modify the plan that the expert has demonstrated during the operation. This is too reckless.
They didn't think about the function of the HTK liquid that was suddenly used. What if there was an accident?
They are not doing animal experiments, but a real patient. If Director Zhu cannot give a reasonable explanation, Deputy Director Qian and Director Huang are going to stop the operation.
The remote equipment in the operating room was still very smooth. Director Zhu immediately raised his head and looked at the remote display:
"Director Huang, Deputy Director Qian, it's my fault for making an oolong in this matter. In fact, this technique was not actually invented by me. I accidentally got a hint from Director Qin, and then proposed the use of dual The concept of polar radio frequency clamp. In fact, before us, Director Qin has developed a more complete and optimized plan."
"As for why HTK fluid..."
Director Zhu wanted to explain, but there was an exclamation from the other side of the screen.
"Qin Lang, you said that this plan was actually created by Qin Lang?"
Wen Yunqi also suddenly became interested, this stinky boy really gave him a huge surprise every time.
Dean Wen asked into the microphone, "Qin Lang, why do you use HTK fluid instead of cold blood cardioplegia?"
In the operating room, Qin Lang and others immediately issued an order when the temperature of the nasopharynx dropped to 32°C:
"Block the aorta and the superior and inferior vena cava, and perfuse the aortic root with HTK solution to protect the myocardium."
As soon as I helped Director Zhu, he immediately started to cooperate. At the same time, the nurse was also providing perfusion fluid. The entire operation was arranged in an orderly manner.
Qin Lang continued to clarify the details of the operation:
"Perfuse HTK solution at 4°C with a single perfusion dose of 30ml/kg. During the perfusion process, the HTK solution is sucked away from the coronary sinus with a suction tube. The initial perfusion pressure is about 100mmHg, and the perfusion pressure is reduced to about 50mmHg after cardiac arrest. , the total perfusion time is 6 min.”
"Okay, Director Qin."
Under Qin Lang's clear instructions, the rest of the medical staff began to follow the operation. In the observation room, several doctors were envious of their ability to control the field.
And then Qin Lang looked up at the monitor. Facing the old acquaintance on the other side of the screen, Dean Wen Yunqi explained:
"Conventional cold-blood cardioplegia is of course not impossible, but because it requires multiple infusions, it has certain risks and makes the operation more difficult. So I used a more optimized HTK solution."
"HTK solution was invented by Professor Bretseider and his colleagues in Germany in 1975. In 1979, it was improved by adding histidine/histidine buffer system and α-α-ketoglutaric acid on the basis of low sodium and microcalcium. ,"
"
"Balancing effect" is a significant feature of HTK solution, it can make the lacunae of blood vessels and tissue lacuna to be completely perfused, which will eventually lead to the balance of temperature, ion and oxygen metabolism inside and outside the cell, so as to achieve a better perfusion effect. It takes 3-5 minutes for ion balance, 2-4 minutes for temperature balance inside and outside cells, and 5-7 minutes for oxygen metabolism balance. Therefore, when HTK fluid perfusion time is maintained for 6-8 minutes, it can achieve the best myocardial protection effect.
Moreover, the biggest advantage of HTK solution is that it only needs to be perfused once, and the myocardial protection effect of 2~3 hours can be achieved. It is convenient, durable and does not affect the operation of the operator. The only disadvantage is that the cost is relatively high. "
After listening to Qin Lang's analysis, Director Huang was silent for a while. He didn't know the shortcomings of cold-blooded cardioplegia, but since he learned this technique, he has been operating according to the industry's gold standard. It seems that as long as he improves his proficiency, it can be avoided as much as possible for a veteran like him, and he is even proud of making up for the shortcomings of the spell with his own skills.
He never thought that he could directly replace it with HTK fluid like this. Based on his clinical experience, of course, he knew that this small step directly lowered the difficulty of the operation by an order of magnitude.
Under one perfusion of HTK solution, there is a myocardial protective effect of 2-3H, which makes it possible for many attending physicians to operate this operation.
For the hospital, the ability to carry out this procedure several times at once is undoubtedly a great boon for the patients who were originally hard to find.
"Director Qin, you did a very good job."
Director Huang gave a sincere compliment.
In the remote observation room, there are those who understand the deep meaning of Qin Lang's operation, some who seem to understand but not understanding, and some who are not aware of it.
In short, Director Qin is as sharp as ever!
In the operating room, Qin Lang went into the next operation again, and began to cut the left atrium longitudinally along the inter-atrial sulcus, and started the ablation route of the left atrium.
Looking at Qin Lang's operation on the screen, the doctors in the observation room were amazed.
Especially Qin Lang's switching and connection before the bipolar ablation forceps and the single-stage pen.
For the ablation of the left atrium isthmus, the bipolar ablation forceps could not reach the mitral valve annulus. Qin Lang switched the monopolar radiofrequency pen to perform "supplemental ablation" so that the ablation line reached the mitral valve annulus.
Afterwards, the heart is turned up and a monopolar pen is applied to the epicardium to extend the mitral isthmus ablation line and fully ablate the coronary sinus.
"sutures..scalpels..."
After completing the ablation of the main body, Qin Lang began to process the left atrial appendage again.
Soon Qin Lang completed the excision, suture, suture, ligation, and inner suture.
Twenty minutes later, Qin Lang completed all the ablation lines.
Next, is valve molding.
Twenty minutes later, the entire operation was officially completed.
"Clap clap clap!"
In the observation room, Dean Wen took the lead in applauding, and Director Huang was still unfinished, and some wanted to say something.
Deputy Director Qian understood immediately, licked his face and said to Director Zhu, "Director Zhu, after the video of this operation, can you send it to me, so that the young doctors in our department can study hard."
Director Zhu was a little flattered when he heard that the director of the Cardiovascular Department of Zijingang Hospital asked for a video of the operation. This time, he was in Qin Lang again.
Sure enough, a top surgeon can support a department!
"Of course, of course."
Director Zhu nodded immediately, and I have to say that Qin Lang really alone has only one operation to improve the status of the Cardiovascular Medicine Department of Hecheng First Hospital.
While Director Huang and Deputy Director Qian were playing Qin Lang's surgery video, President Wen was going to ask Qin Lang to share his experience with the young doctors in his hospital.
"Director Zhu, like this, after the operation is over, I want to hold another video conference. I want to invite Qin Lang to share his experience with the doctors in our hospital. This surgical improvement is too shocking. already."
"certainly!"
Director Zhu's face is dignified, and his heart has already blossomed with joy.
"Okay, then we'll connect via video later."
Before the meeting, Dean Wen made another phone call to Qin Lang in private:
"Qin Lang, your surgery today is very good. You can write a paper for a week. I will recommend it for you, and send it directly to the "China Journal of Cardiovascular Diseases", plus your previous paper on heart transplantation. You can directly publish a special issue.”
Hearing what Dean Wen said, Qin Lang was also very happy. Of course, he knew the weight of the "China Journal of Cardiovascular Diseases", which can be said to be the first core journal in the domestic cardiovascular field, with an impact factor of more than 5.0 all year round.
Not to mention its special issue.
Of course, in addition to letting Qin Lang publish papers, Dean Wen also has a little selfishness.
"Qin Lang, this time, for your dissertation, I will introduce you to a senior sister who is also my doctoral student. If you have any dissertation that you cannot write, I will ask your senior sister Liu Qiqi to help you sort it out."
Dean Wen transitioned here very naturally, saying that he asked Liu Qiqi to assist Qin Lang in writing the thesis, but in essence he asked Qin Lang to bring Liu Qiqi around to help her complete her doctoral thesis.
Liu Qiqi has been studying for a long time, but she has not been able to graduate. It is not that she has not worked hard. It is purely a matter of talent.
Dean Wen has too many things to do herself, so she doesn't have the energy to spend too much time on Liu Qiqi, and the field of her research is very difficult and ordinary people can't take it.
And Qin Lang is the best choice. Dean Wen continued to introduce his student's situation to Qin Lang:
"Liu Qiqi is two years older than you and is my doctoral student, but her research topic "CHA2DS2-VASc scoring system for identifying high-risk patients with atrial fibrillation after cardiac surgery: Meta analysis", the workload of this scoring system is very high It’s big and cumbersome, so I haven’t graduated with a Ph.D.”
Qin Lang sighed with some sympathy in his heart. It is too difficult to be a female doctor, especially a female doctor of medicine. Fortunately, I have a simulator. Otherwise, I am under the guidance of Professor Shen Xi, and I don't have to think about graduating at all.
With Qin Lang's current ability, it is only because of his qualifications and procedures, otherwise, with his current achievements, any thesis is more than enough to graduate with a doctorate.
For example, the modified maze operation this time, as long as it can be published in the "Chinese Journal of Cardiovascular Diseases", it is more than enough to graduate with a doctorate.
However, Qin Lang was not in a hurry at all and took his time.
This time, Dean Wen gave him an olive branch, and of course, he further established an intricate relationship with Qin Lang, and everyone provided convenience to each other.
The medical field is like this, it needs contacts and resources to form a strong circle.
Undoubtedly, the current Qin Lang can already build a huge relationship network with him as the core.
The faction of Zijingang First Hospital, the relationship between Shen Xi and Wu Jizong, can represent many, many behind.
When Qin Lang and Liu Qiqi started to write related papers together.
There is also good news from Wang Rou's team.
After taking over the production line and R&D line related to smoking cessation drugs from Ming's Pharmaceutical Group, the entire smoking cessation drug project was officially launched under the high-rise building of Qin Lang!
Qin Lang's new drug is a smoking cessation drug obtained by simulation in the research and development laboratory. Of course, it is not comparable to a defective product such as Pfizer. With detailed and complete phase III clinical trial data, bupropion has successfully passed the approval of the Drug and Food Supervision Bureau. Also approved by the US FDA.
For Qin Lang's new drug, Pfizer is of course watching closely, but they have invested tens of millions of dollars in the team, and they can't find any problems with bupropion. They can only envy and envy Qin's pharmaceutical. the company's research and development capabilities.
Before, Huaguo's illegal construction committee had specially praised Qin's Pharmaceutical Company. This time, Qinlang's new drug has withstood the supervision and inspection of the industry in all aspects. Therefore, these government departments also gave a boost.
In addition to the domestic market, Qin's Pharmaceutical Group's new smoking cessation drugs have also been successfully launched in the country.
In addition to the United States, in Europe, America, Southeast Asia and other countries, the smoking cessation drug has achieved great success as soon as it is launched.
With this smoking cessation medicine, Qin Lang's worth has also risen.
And Ming's Pharmaceutical Group also relied on the investment in Qin's Pharmaceutical Company, and the stock price rose further, and Qin Lang, as the chief scientist of Ming's Pharmaceutical Group's drug research and development trials, also gained fame and fortune.
A few months later, Qin Lang's name finally appeared in this year's Forbes 30-under 30 list. Although it was only at the bottom of the list, it was already very difficult.
The list covers entrepreneurs, managers and people in show business, sports, technology and culture. In addition to wealth, it is a list that examines from the multi-dimensional dimensions of influence, performance and innovation, which can be said to be very valuable.
Not only a role model for young people, but also an idol for the new generation, Qin Lang can be selected as a scientist in the medical field, which is also admirable and admirable.
[Ding, congratulations to the host for completing the long-term mission: completely defeat Pfizer's conspiracy, launch his own smoking cessation drug, save Ming's Pharmaceutical Group, and at the same time be included in the Forbes 30-year-old elite list. Get the mission reward: 1. Get the research project: Cancer therapy that suppresses negative immune regulation. (Note: The research results have the potential to win the Nobel Prize in Medicine)]
Qin Lang was also very excited to see this high-end project.
This is completely two-dimensional from ordinary surgery. It requires talent and opportunity. There is basically no way forward for this kind of cutting-edge theoretical research, and it completely requires one's own exploration and research. It is necessary to invest a lot of time ~www.novelbuddy.com~ energy into it.
This research direction obtained by Qin Lang is to provide a new principle for cancer treatment, that is, to attack tumor cells by stimulating the inherent ability of the human immune system.
Qin Lang has a general understanding of the idea of this topic, but it is still in its embryonic stage and needs to invest a lot of time to promote it.
This research requires Qin Lang to find a special protein. If the human immune system is compared to a car, then this protein is like the brakes of a car. By releasing the brakes, immune cells will be released to attack tumors. This will be a whole new direction of treating patients.
This topic is also a very suitable breakthrough direction for Qin Lang. After all, Academician Wu Jizong and Professor Shen Xi are the top leaders in the field of immunology, and they are their disciples. Naturally, they can borrow their resources to the greatest extent. .
[Ding, new mission: A long-term mission to win the Nobel Prize in Physiology or Medicine through brand new research in the field of immunology. Mission reward: 1.1 life simulation points, 2. get new permissions, the future of medicine. 】
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