I can see the status bar

Chapter 1026 D+4 day (1)

Some people regard medical research as a weapon to save the common people, but some people don't think so.

For them, research is just a job.As for what kind of results and great achievements will be achieved after this work, these people don't care much.

The situation of Linus is quite special, his situation is just in between.

When he was still in the United States, his research direction was the mechanism of allergies.The reason for choosing this direction is that Linus traveled to Japan when he was just in college, but he encountered the first and worst allergy in his life - hay fever.

The severe allergies caused by hay fever, and the ensuing painful experience, planted a seed in Linus' heart.A few years later, the seed gradually sprouted - he obtained his doctorate in immunology and entered Dr. Pascal's laboratory to continue working.

During his years working in Dr. Pascale's laboratory, Linus learned a lot.From the methods of scientific research, to the ideas of research problems, and even to the methods of "being a human being".

Dr. Pascal is a very loyal person.This trait is not common among Americans, but it is even more precious among American "scientists".It just so happens that Linus is of Italian descent, and the habit of valuing his family is like an instinct engraved in the bones of Italians.This coincided with Dr. Pascal's personality again, it was strange that the two of them didn't show their temper.

Although Pa was treated unfairly because he came to China, Linus, who already regarded the bald guy as his family, didn't hold grudges against Pa.He understood that his teacher had lofty ideals and a sincere heart.If someone thinks that Pascal's actions are for self-interest, Linus will not hesitate to slap that stupid guy twice.

It is precisely because of such a foundation of trust that Linus did not hesitate to put down all the work in his hands after receiving Dr. Pascal's request for help, and began to search for relevant research clues.

Convalescent plasma therapy was first used in 1891 - 18 years before the concept of blood types was discovered - when a German doctor Emil Adolf von Behring first used it on a patient suffering from diphtheria .Then, the patient's condition improved rapidly.This therapy was widely used in the prevention and treatment of other bacterial infectious diseases before humans discovered antibiotics.

During the Spanish flu pandemic in 1918, the absolute mortality rate of patients who received convalescent plasma was reduced by 21%.During the treatment of Argentine hemorrhagic fever from 1959 to 1983, the mortality rate of patients who did not receive convalescent plasma treatment was as high as 43%, while among patients who received convalescent plasma treatment, the mortality rate was successfully reduced to less than 3%.

The most eye-catching achievement of convalescent plasma therapy was the first Ebola outbreak in 1976.Although the number was small, after the application of the convalescent therapy, the symptoms of both patients were greatly improved, and they survived.In the face of the Ebola epidemic in the Democratic Republic of the Congo (Kinshasa) with a mortality rate as high as 88%, all patients treated with convalescent plasma survived.It's almost a miracle.

Although convalescent plasma therapy has been effective and has a long history, the treatment remains understudied.Since the discovery of the first effective antiviral drug, iodine, in 1962, the research on virus treatment has begun to develop into antiviral chemical drugs.Plasma transfusion therapy for convalescents lacks high-quality randomized controlled trial testing, there is a risk of infection during the process of taking and transfusing plasma, and blood types containing high-titer neutralizing antibodies are poorly accessible—the number of convalescent patients with high-titer antibody serum The large gap between demand and supply of plasma and non-renewability—this series of objective factors make it difficult to promote serum therapy for convalescents and lacks the value of promotion and research.

What's more troublesome is that plasma, as a blood product, has its own risks of anaphylactic shock, blood transfusion-related circulatory compliance, and blood transfusion-related acute lung injury.This has fundamentally hindered the commercialization and widespread clinical application of plasma therapy for convalescents.

Without commercial prospects and profits, pharmaceutical giants have little interest in this therapy.Without the interest of pharmaceutical giants, it is extremely difficult to advance relevant research.

This has led to a near standstill in research on plasma therapy for convalescents.However, this therapy still leads to two new research directions - imitating the IgG effect in the plasma of recovered patients, producing monoclonal antibodies that bind to the virus receptor binding region; and clearing the immune cells in the patient's plasma to treat Plasma exchange therapy in autoimmune diseases.

But now Yunhe's situation is more embarrassing.Monoclonal antibodies are specific drugs against viruses that take time and luck to develop.If you are lucky, this monoclonal antibody may be available within two years, but if you are unlucky, or the virus itself mutates too fast, the monoclonal antibody that has not yet completed research may have failed.

Monoclonal antibodies cannot be counted on, and plasma replacement is not only useless for patients with viral infections, but may even hinder the body's immune system from clearing the virus.The only hope left now is the "new use of old drugs" of convalescent plasma and other existing drugs.

Convalescent plasma therapy, which has not been tested in large, well-designed randomized controlled trials, is often considered an "empirical" treatment.

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After several hours of high-intensity telephone communication, the sky in Ningyuan has turned slightly white.Dr. Pascal yawned enormously. He looked at the huge five words "empirical treatment" on his computer screen, and his brows that were loosened were tightly wrinkled again.

"President Liu, I have something I want to consult with you." The strong execution ability of the doctors in the Fourth Central Hospital was clearly demonstrated by Dr. Pascal. Old Pa called Liu Tangchun at 10:[-]:[-] in the morning The call passed, and Liu Tangchun asked the first moment when he answered the phone, "I remember you told me before that Chinese medicine is an empirical therapy, right?"

"Not exactly." Liu Tangchun, who was preparing for the regular meeting report in the morning, put down the pen in his hand. He was a little surprised why Dr. Pascal suddenly remembered to tell himself this. "My opinion is that in the long-term clinical application of traditional Chinese medicine, a batch of simple materialistic treatment methods have been summed up for patients with certain specific symptoms. But Chinese medicine itself is not sure why this treatment method works, so It is still necessary to carry out scientific and systematic research on traditional Chinese medicine through modern scientific research..."

"I'm not interested in how to improve Chinese medicine at all." Dr. Pascal, who had been tossing for several hours, was a little grumpy, and he interrupted Liu Tangchun, "I just want to make sure, as a doctor, do you think traditional Chinese medicine is a An empirical therapy that has some effect?"

"Yes." Liu Tangchun gave an affirmative answer, "Thousands of years of application accumulation, Chinese medicine must have its own unique features. Humans are animals that are good at learning. Although they lack credible theoretical assistance, thousands of After years of study and accumulation, traditional Chinese medicine is definitely an effective empirical therapy."

"Then, I suggest to carry out an experiment on the treatment of new coronaviruses by traditional Chinese medicine." Dr. Pascale rubbed his face and sighed, "Since the empirical therapy that appeared 100 years ago can be used in Yunhe, there is no reason why Chinese medicine can't .”

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As for the biggest disadvantage of convalescent plasma therapy—the uncontrollable antibody titer in donor plasma, Dr. Pascal had a... not very humane idea.

Since the antibody titer level in the donor body is uncontrollable, it is better to take advantage of the powerful immune memory ability of the human body.As long as a group of recovered volunteers are recruited and exposed to the new coronavirus again, their bodies can produce a large amount of antibodies in a short period of time.Generally speaking, repeated infection will not cause severe symptoms in patients, and it can also allow patients to generate several times the peak of antibody production during the first infection in a short period of time.

In a way, it's like vaccinating people multiple times.

And the plasma antibody titer collected after this will be many times higher than the plasma titer of the recovered patients who recovered naturally.The same 400ml of plasma will double the number of patients that can be saved.

Of course, this idea only stayed in Dr. Pascal's mind for a moment, and then he gave up directly.Perhaps in the United States or other capitalist countries, under the temptation of huge bonuses, there are always a few "braves" who come forward.Volunteer to become this "humanoid self-propelled antibody manufacturing machine".But...it is absolutely impossible in China.

Chinese people value life and respect life.In order to stop the spread of the disease, the Chinese were able to make a city of 1000 million people hit the pause button in an instant.And 14 billion people can control their travel together and stop to prevent the spread of the disease... Dr. Pascal knows that no other country can do this kind of thing.

The respect and love for life makes it impossible for this kind of "paying people to infect" things to happen in this country.

Then, in order to respect and love life, now seems to be a time to let go of prejudice and re-examine past experience and precious wealth.What is the difference between the essence of plasma therapy, which was used before the discovery of blood type, and the traditional Chinese medicine therapy that was studied and concluded by the ancients for thousands of years?

As a doctor, Dr. Pascal has the same moral values ​​as Sun Lien, Xu Yourong, Yuan Ping'an and even the 380 million doctors across the country—as long as he can cure patients, even handstand bungee jumping is not bad.

The plasma treatment plan for convalescents formulated without data support seems to be something like letting doctors bungee jump to treat patients.

　The content about "plasma therapy" mentioned in this article mainly comes from the article "Analysis of the Current Situation and Development of Plasma Therapy Taking Novel Coronavirus Pneumonia as an Example", the authors are Bai Wendi, Cai Wei, Chen Shifeng, and Chen Yaoqing.This article was published in "Acta Virus" in May 2020, Volume 5, Issue 36.

　　
　
(End of this chapter)