I can see the status bar

Chapter 1070
The so-called abnormality must have a demon, a patient whose immune system is much weaker than ordinary people, how can the progress of infection be slowed down like this?Sun Li'en didn't figure it out, and neither did the doctors who came to support the ICU.

"Make a list of all the drugs she has used during this period." Since you can't figure it out, then add additional information for analysis.Sun Lien decided to conduct a systematic research and analysis on this patient in order to find the root cause of her infection progressing so slowly.

If the slow progress of the infection is only caused by physical factors, it means that they may have found a clue that can slow the virus's invasion of the body.This clue may play a huge role in the fight against the new coronavirus - if the cause can be analyzed clearly, it may be possible to have a more detailed understanding of the proliferation and invasion mechanism of the new coronavirus in the human body.

And if, if her infection progressed slowly because some drugs that she had used before had an inhibitory effect on the reproduction of the new coronavirus, then this discovery is even more significant-this may be the first human to discover so far. Drugs that have an inhibitory effect on the new coronavirus.

It is not easy to find a drug that can effectively suppress the virus.Humans have invented countless compounds, and it is simply impossible to conduct an experiment on all of these compounds to determine which ones have an inhibitory effect on the virus.To evaluate the ability of drugs to inhibit virus reproduction at an early stage, the current preferred solution is to use supercomputers to study the combination of compounds and cell receptors, thereby excluding combinations that are unlikely to be effective in large quantities.

The clinical application value of supercomputer is not too great, but it plays a pivotal role in the field of medical research.By performing matching calculations on the models, computers can help researchers narrow down the screening range from tens of millions to hundreds.The time saved by this technology is so long that it can be measured in decades.

However, it will take a long time for such research to be done.To confirm whether a brand new drug is effective against viruses, it first needs to be tested in an in vitro environment, and then progress to biological experiments.After the effectiveness is confirmed in biological experiments, the first, second and third phases of clinical trials will be further carried out.After several years or even more than ten years of research, people can confirm whether this drug is safe for humans and whether it is effective against viruses.

From the news in recent days, some medical research institutes have occasionally announced that drugs have shown antiviral properties in the human body, which is of course good news.But in the eyes of Sun Lien and others, it is probably because everyone pays too much attention to the research on virus control, and at the same time, relevant news organizations lack a systematic understanding of drug research and development, so they prematurely and overly optimistically estimated the status quo.

In vitro experiments are the first step in all drug experiments.Success in in vitro experiments is certainly exciting.But... in vitro experiments do not mean that the drug will definitely have a positive effect in the human environment.

Not to mention that other complex mechanisms involved in physiological and chemical reactions in the human body have not yet been studied clearly, only from the analysis of the known conditions of the human body, we can understand that the external environment and the internal environment are completely different. environment.

Drugs enter the body through oral administration or injection.Oral administration needs to be absorbed through the digestive tract, and injection needs to enter the organs through the blood circulation system.In this process, the first problem will arise - the problem of pharmacokinetics and effective drug concentration.

It is assumed that in an in vitro experiment, a certain drug has the effect of inhibiting the new coronavirus after the concentration reaches 500 micromolar.Does it mean that we can administer this drug to patients and expect the virus to be killed?

In practice, it is very difficult to reproduce such results in humans.The bioavailability of some drugs is inherently low, and it takes several hours after oral administration of 500 mg to detect a drug concentration of about 0.4 micromolar in the blood.In order to increase the concentration of such a drug in the blood to 500 micromolar, it is necessary to increase the dose by 1250 times—patients need to take 625 grams of the drug orally at a time to increase the concentration of the drug in the body enough to suppress the virus. degree.

Taking more than a catty of pills at a time, but no one has the brains to do so.

What's more, the drugs themselves will also cause burdens to the body and even toxic side effects. Some drugs are drugs when the concentration is in the single digit micromolar, but when the concentration rises, they will become deadly poisons.

at the same time.Not all chemical agents that can inhibit and kill the new coronavirus can be applied to the human body.

In more popular terms, spraying some sodium hypochlorite disinfectant on the petri dish can kill all the new coronaviruses in the petri dish.But this does not mean that we can treat diseases by oral or injection of sodium hypochlorite disinfectant.Sodium hypochlorite is a strong oxidant. Once this agent enters the human body, it will cause extremely serious damage to the body—from digestive tract burns to severe scurvy...Under the protection of the human cuticle, we can safely use sodium hypochlorite to treat pathogens. kill.But once this chemical enters the human body, it can kill a living person even faster than it can kill the new coronavirus.

Sprinkle a handful of salt on a cancer cell culture dish, and these cancer cells will die quickly.Does this prove that table salt is an excellent anti-cancer drug?Of course not, unless the patient is determined to give up his life and pickle himself into a mummy, the human body cannot withstand such a high concentration of sodium chloride.

And some drugs that inhibit virus reproduction in other environments with an effective concentration of 10-20 micromolar can prove that they can also exert the same effect in the human body?

Not necessarily.

After the drug enters the human body, a considerable part of the drug needs to be metabolized by human organs to form biologically active chemical products that can be utilized by cells.However, in which organ this metabolic process is carried out, how long the metabolic time takes, and whether the metabolic process will produce toxic products to humans cannot be known through computational simulation.

Biological experiments are used to study these issues.

After several years of biological experimental research, killing countless mice, beagle dogs, cynomolgus monkeys and macaques, and dissecting and grinding their organs for examination, people can roughly understand the basic toxic and side effects of a drug, and its biological effects. The distribution concentration in the body and so on.

After confirming that there are no problems with these key points, the first phase of human trials can be carried out after approval.During this process, the research institutions mainly need to understand the human body's tolerance to the experimental drug and the adverse reaction rate.The second phase of clinical human trials mainly studies whether the comparison drug is effective on the target.After two phases of clinical human trials, the third phase of clinical trials will be carried out after it is determined that the drug has a good prospect. The main purpose of this experiment is to compare new drugs with traditional drugs.As long as the new drug achieves the effect of the traditional drug, or surpasses the traditional drug, it can be declared that the experiment and research and development are successful.

In the experimental process of "in vitro experiment - biological experiment - first phase clinical - second phase clinical - third phase clinical", all steps may go wrong.Once there is a huge flaw in any of the experimental steps, it may mean that the drug has no therapeutic prospect at all.

Drug research and development and experimentation is to use time and money to pile up a future, and every experiment is a big gamble.

This is why Sun Li'en paid special attention to Zhang Min's case.Unlike those who participated in drug experiments, the drugs used by Zhang Min are all very mature drugs for clinical use.If it is effective against the new coronavirus, it means that these drugs have the possibility of "new use of old drugs".

As a mature clinical drug, expanding the scope of use can avoid in vitro experiments, biological experiments and phase I clinical trials.This can greatly speed up the approval process for drug use.

"Current statistics show that the drugs she has used in the recent period are moxifloxacin, ganciclovir, doxofylline, as well as methylprednisolone, hydroxychloroquine phosphate and total glucosides of paeony used to control systemic lupus erythematosus. "Zhou Ce quickly read the approximate records, and selected the most "suspect" drugs from it.

"Moxifloxacin and ganciclovir are now routinely used by us, and doxofylline has never been used in the North Five District, but there is a record of use in the ICU." Yuan Pingan is very familiar with these drugs, and he said after a moment of pondering, "Hydroxychloroquine phosphate and total glucosides of paeony are two drugs that have not been used in the ward. These two seem more likely."

(End of this chapter)