Doctor's Life Simulator

Chapter 349 New drug simulation again, smoking cessation drug bupropion: Zyban SR
After the operation was successful, all the directors naturally looked at Qin Lang differently and were amazed.

In the next few days, Qin Lang continued to cooperate and assist Academician Zhong to perform several operations, involving a dozen cases in the experimental group and the control group.

The next stage of the whole subject research was led by academician Zhong, with the participation of other directors and experts, and Qin Lang completed the first assistant work of this stage.

After the last operation, Academician Zhong and the Chief Physician of Cardiac Surgery of Union Medical College Hospital called Qin Lang to the office.

"Qin Lang, your recent operation is very perfect. Academician Zhong and I are very satisfied. If you are interested, you can directly exchange and study in our hospital for a month. I also have several operations here. I would like to invite you. You participate together."

For those at the chief physician level of Union Medical College Hospital, the research procedures and topics are naturally very difficult, and the requirements for the level of participants are even more stringent.

Therefore, for the chief physician to offer such an invitation, Qin Lang already valued it very much.

Of course, in addition to helping him with research projects, the most important thing is that the director of Union Medical College Cardiac Surgery wants to let Qin Lang feel the atmosphere of Union Medical College Hospital through this month's exchange and study. The academic atmosphere, as well as the top talent pool, also accept and treat patients with the most research value in the country and have the most cutting-edge research directions!
The director of the Heart Surgery Department of Xiehe Heart Surgery is very confident. After a month, even if he doesn't take the initiative to invite him, Qin Lang will have the idea that he can't do without it.

Academician Zhong also said to Qin Lang with a pleasant face, "Qin Lang, think about it."

To be honest, Qin Lang really wanted to stay with the invitation of the two big men. After all, no doctor could refuse Xiehe's invitation.

However, Qin Lang still has more important things to do now, and needs to win the business war with Pfizer for Ming's Pharmaceutical Group.

Seeing Qin Lang's hesitation, Academician Zhong thought he was worried about the opinions of his original unit, so he directly dispelled Qin Lang's worries:

"Qin Lang, don't worry, as long as you are willing. I will personally explain the situation to you at the First Hospital of Hecheng City."

"Academician Zhong, director, I actually want to stay, but I can't. Recently, I need to go back to Hangzhou to develop a new drug, which concerns the future of many people. I can only say sorry."

Academician Zhong and the director didn't expect Qin Lang to have such a reason. That being the case, we can only wait for Qin Lang to finish his work.

"Qin Lang, if this is the case, then we will not force others to do anything difficult, but I hope that you will come to our department to study and exchange after you have completed your own new drug research and development. The door of Xiehe Hospital is always open for you!"

Academician Zhong expressed unprecedented sincerity. He really appreciates and likes Qin Lang.

"Thank you Academician Zhong and the director for your appreciation, I will definitely. When I complete my mission, I will definitely come to Union Medical College Hospital, the top medical school in Huaguo, for further study!"

After the three chatted happily for a while, Qin Lang left Xiehe Hospital.

After returning to Zijingang No. [-] Hospital, Qin Lang directly started the simulation of new drug research and development. During this period of time, he has obtained enough simulation points.

[Ding, do you want to consume 3 life simulation points to start the smoking cessation drug bupropion: Zyban SR, the first stage of research and development simulation? 】

Qin Lang directly clicked on the simulated drug and watched the description of the drug research and development laboratory:

【Drug name: Bupropion.Psychiatric drugs, central nervous system drugs, raw materials, organic chemical raw materials.]

【Use: It is a safe and effective antidepressant drug that can be used clinically. It has a very good smoking cessation effect and can greatly increase the success rate of active smoking cessation. 】

After a general understanding, Qin Lang chose to start!
[Ding, consume 3 life simulation points to start the first phase of research and development of bupropion! 】

【New drug research and development in progress】

【安非他酮：1-(3-氯苯基)-2-[(1，1-二甲基乙基)氨基]-1-丙酮盐酸盐;1-(3-氯苯基)-2-[(1，1-甲基乙基)氨基]-1-丙酮】

[Chemical structural formula: C13H18ClNO]

【Molecular Weight: 239.74】

【Melting point: 233-234°C】

【Boiling point: bp.005 52°】

【Acidity coefficient: pKa 7.0 (Uncertain)】

【color: White】

[Entering the first stage, the compound is being simulated and synthesized.]

【Stirring】

【Cooling】

【reflux, heating, hydrolysis, filtration, crystallization.】

[Ding, congratulations to the host, the first stage of compound synthesis is completed.Have you obtained the synthetic route of the compound and mastered the best synthetic route? 】

Of course, Qin Lang chose to obtain it at the first time. Countless information entered his mind, and Qin Lang directly grasped the synthetic route of this compound.

Moreover, the main physical parameters of bupropion can be checked directly through the drug laboratory.

[Do you want to consume 1 life simulation point to synthesize the first tube of reagents in the drug laboratory?Remarks: This reagent can be brought back to the real world]

Qin Lang naturally consumed another life simulation point. It has to be said that the research and development of new drugs is really a high-consuming investment.

In the virtual laboratory, under the brand-new top-notch equipment, Qin Lang started the preparation operation and tried to synthesize it by himself.

[Ding, consume 1 point of life simulation point to start preparing the compound of bupropion for the first time. 】

In the virtual laboratory, Qin Lang quickly started to operate, trying to synthesize it by himself.

Various instruments and reagents kept appearing in Qin Lang's hands. After concentrating on it, a small tube of bupropion appeared in Qin Lang's hands in its entirety.

[Ding, do you want to consume 6 life simulation points to start the second phase of research and development of bupropion? 】

Looking at the consumption, Qin Lang smiled wryly, and was really reluctant. It seems that after completing several stages of research and development of the smoking cessation drug this time, it is necessary to accumulate more life simulation points.

Next, after Qin Lang completed the two-stage simulation, he simultaneously went to the new company to carry out the first-stage experiment.According to the timeline in the simulated world, time waits for no one.

Qin Lang is the first person in charge of the new company. Naturally, no one dares to object to his arrangement. The R&D team with Qin Lang as the core operates in an orderly manner.

This time, in addition to exposing Pfizer's ugliness, Qin Lang plans to launch the bupropion: Zyban SR as soon as possible!

While Qin Lang was silently preparing the new drug bupropion, the R&D laboratory of Pfizer Pharmaceuticals in the United States was also intensively researching and developing the new drug. It was an improved smoking cessation drug based on the thinking and direction of Mingshi Pharmaceutical Group. : Chantix!

According to Pfizer's plan, this brand new drug will be launched on the market within three months.

Although there are some side effects, as long as the first-mover advantage is taken, there are ways to make up for it later.Moreover, these drugs with hidden side effects will be pushed to China in the future, and Pfizer doesn't care at all.

After all, the Huaguo market is an emerging market with low requirements and blind faith in Pfizer.

Pfizer and FDA are the top standards in the industry, and they will not and dare not question them at all.

After the first batch of drugs are released, it won't be long before an improved version can be produced.Unknowingly!
When Qin Lang and Pfizer were competing for drug development.

The Second Hospital of Harbin Medical University, Vice President's Office.

Dean Zhang sat at his desk, looking at a document, sometimes frowning, sometimes clenching his fists.

After a while, a middle-aged doctor in his forties walked in. Professor Liu Bin, a top expert in the Department of Cardiac Surgery of the Second Hospital of Harbin Medical University, is also a giant in the field of heart transplantation in China.

When Dean Zhang saw Professor Liu, he spoke with great respect and asked politely:

"Professor Liu, I heard that you are going to the Imperial Union Hospital for a heart transplant recently?"

"Yes, Dean Zhang also knows about it." Professor Liu did not hide it. After all, flying knives are very popular among senior doctors in China, and no hospital would bother to find a doctor because of this.

Hearing Professor Liu's affirmative answer, Dean Zhang frowned. If it was normal, he really didn't care. Professor Liu went to the imperial capital to throw knives.

However, it happened to be a more important matter now. He needed Professor Liu to stay and guard to organize a surgery that would leave a mark in the history of heart transplantation.

However, the cost of a heart transplant is basically around 20 to 50 yuan, especially for a top domestic expert like Professor Liu, the cost of one appearance is at least 40 yuan.

Therefore, to directly ask Professor Liu to give up the flying knife and stay to prepare for the operation in the hospital is to cut off his fortune. Naturally, Dean Zhang can't make a strong request, so he can only persuade Professor Liu to give up voluntarily.

After all, Dean Zhang is an old fox who has been in charge for many years, and he is very handy in playing the emotional card, so he got up and started making tea, chatting seemingly aimlessly.

"Professor Liu, what do you think of the Cardiac Surgery Department of the Second Hospital of Harbin Medical University?"

Dean Zhang made tea, poured a cup for Professor Liu, filled it himself, took a sip, and said calmly.

"The Second Hospital of Harbin Medical University is naturally the pioneer of heart transplantation in China. The history of heart transplantation in the Department of Cardiothoracic Surgery of the Second Hospital of Harbin Medical University can also be regarded as the history of the development of heart transplantation in Huaguo."

For heart transplantation, Professor Liu is of course full of confidence. In his opinion, the heart transplantation in the Second Hospital of Harbin Medical University is the top in the country, and he is the top heart transplant in the Cardiac Surgery Department of the Second Hospital of Harbin Medical University. .

Taking another sip of tea calmly, Dean Zhang continued to sigh with emotion: "Yes, the heart transplant surgery in our hospital has really gone through a process from scratch, from obscurity to fame in China."

Putting down the teacup, Dean Zhang looked at Professor Liu meaningfully, and said in a long voice, "It's not easy~"

Professor Liu also nodded: "Yes, it is really not easy for the heart transplantation in the Second Hospital of Harbin Medical University to come to this day. From the exploration stage to the development stage, and then to the current mature stage, it took several generations of hard work. .”

Professor Liu began to recall carefully, and he knew everything about the entire development history:
Exploration stage: In 1956, Professor Zhao Shijie, the pioneer of cardiothoracic surgery in the Second Hospital of Harbin Medical University and a famous surgical expert, successfully carried out the research on the dog head transplantation experiment, and obtained the best domestic record of survival of 5 days and 4 hours after transplantation. Pioneer in the field of organ transplantation.

In the early 80s, Professor Xia Qiuming, a well-known cardiothoracic surgeon in my country from the Second Hospital of Harbin Medical University, resolutely aimed at this risky high-tech project. He led the staff to search for literature, understand the history and current situation of foreign heart transplantation, and took the lead in starting a challenging project in China. Exploration in the field of heart and heart-lung transplantation, successively determined the basic operation method of heart transplantation, and explored effective treatment methods for anti-rejection after heart transplantation; at the same time, done a lot of clinical and basic research on the monitoring of acute rejection after transplantation , which laid a solid foundation for my country's heart transplant work.

On April 1992, 4, Xia Qiuming performed the surgery, hundreds of experts from the Second Hospital of Harbin Medical University, and more than 26 departments worked together to treat a patient with dilated myocarditis for many years——Yang Yumin, a farmer from Dongfeng Town, Taiping District, Harbin City, performed the first case in Northeast China One year after the allogeneic heart transplantation, Yang Yumin returned to society, supported himself, and won a "daughter" in the second year.

Yang Yumin lived a healthy life for 18 and a half years after the operation, becoming the person with the longest healthy survival time after heart transplantation in mainland China.Yang Yumin passed away on November 2011, 11 due to chronic rejection.
However, the development stage of the Second Hospital of Harbin Medical University: With this as a starting point, the heart transplantation work in my country has entered a new clinical stage from a low state.

In the second year after the first heart transplant, in February 1994, the Second Hospital of Harbin Medical University successfully performed an allogeneic heart transplant for Yu Wenfeng, an outstanding teacher at Maoershan Town Middle School in Shangzhi City, Longzhou Province.

In 2000, the Second Hospital of Harbin Medical University successfully performed a heart transplant for 57-year-old writer Yang Mengyong, completing the oldest heart transplant case in my country.

After the operation, Yang Mengyong's silver hair turned into black hair, and his face was radiant.

In Yang Mengyong's book "Let's live and talk again", he fully expresses his gratitude to the Second Hospital of Harbin Medical University for giving him a second life.It is the biggest wish of several heart-changers to "repay the society" with their own practical actions.

And the third stage is the mature stage: While vigorously developing the clinical operation of cardiac surgery, experts in the cardiac surgery department of the Second Hospital of Harbin Medical University realized that extracorporeal circulation and myocardial protection are the basis for the development of cardiac surgery, and repeatedly conducted a large number of animal experiments. , a series of studies on myocardial protection methods such as ischemic cardiac arrest, potassium-containing cold crystal myocardial arrest, cold blood potassium arrest, and warm blood potassium arrest have made breakthroughs. The National Science and Technology Commission has positioned it as the most advanced in China It is advanced and has further established the leading position of the Cardiac Surgery Department of the Second Hospital of Harbin Medical University in China.

Today, aortic sinus aneurysm repair, complete pulmonary venous drainage correction, coronary artery bypass grafting, mitral valve replacement, aortic valve replacement, etc. have become routine cardiac surgery in the Second Hospital of Medical University.

Hearing Dean Zhang's detailed description of the department's heart transplant surgery, Professor Liu was naturally overwhelmed and emotional.

"Professor Liu, now you are the flag bearer in our hospital's mature stage. With the joint efforts of you and the departments, the success of Rastalli operation, Fantan operation and Bantall operation marks the progress of the Cardiac Surgery Department of the Second Hospital of Medical University in complex congenital heart disease and complex congenital heart disease. The field of surgical treatment of macrovascular diseases has reached a new level."

"This year, we have completed thousands of heart surgeries, including all common heart diseases and complex heart diseases in infants and young children, minimally invasive surgery for small body weight, valve replacement and plastic surgery, on-pump and off-pump bypass surgery, great vessel surgery, organ transplantation etc., with a success rate of 96%. Cardiac surgery has become the first in the three provinces in Northeast China. It is a key discipline with national and foreign influence. It is the only one in the country that can simultaneously perform heart transplantation, lung transplantation, aortic arch replacement, It is a heart surgery center with many high-tech technologies such as complex congenital heart disease treatment, coronary heart disease bypass, biological valve mechanical valve replacement, and thoracoscopic minimally invasive cardiac surgery.”

Hearing Dean Zhang's praise, Professor Liu also puffed up his chest, which is what he is most proud of.

Seeing that the atmosphere was almost rendered, Dean Zhang sighed faintly:

"Originally, this time, our hospital had an opportunity to once again leave a strong mark in the history of heart transplantation in the country and even in the world. It's just that Professor Liu happened to be going to perform a throwing knife. Alas, what a pity."

"What does Dean Zhang mean? What kind of opportunity can make our department go further domestically and internationally? In front of the honor of the department, I can completely let go of this flying knife."

Professor Liu's mind was agitated at the moment, and his mind was full of collective honor. He put aside the matter of the flying knife and gave up a full 40 yuan in surgery fees.

"Does Professor Liu still have any impression of Ye Jian?"

"Ye Jian?" Professor Liu pondered in his mind, "You mean, that Ye Jian who was "replaced" by the then director of the Cardiac Surgery Department ten years ago."

"Yes, this time, I would like to invite you to organize more than [-] relevant departments and hundreds of medical workers to challenge another limit in the history of Chinese medicine, the "second heart transplant", which means to replace Ye Jian with his third heart transplant. A heart, a wonderful life for the third time!"

Hearing Dean Zhang's idea, even Professor Liu, who is an authority in the field of heart transplantation, was a little shocked.

Ye Jian needed a second heart transplant. The main reason was that after the heart transplant, there were two problems that could not be solved in the world: one was chronic rejection, and the other was vascular disease of the graft.

But now Ye Jian has two factors at the same time, especially a heart transplant recipient like him who has survived for a long time.

Dean Zhang handed Ye Jian's latest medical examination information to Professor Liu.

Looking through the information, Professor Liu's entire face also became very serious:
"Ye Jian, the main problem in the heart at present is the coronary arteries. The arteries supplying blood to the heart are severely diseased, narrowed, and even blocked, causing severe blood supply to the myocardium. At the same time, there are fatal arrhythmias, that is, frequent ventricular tachycardia. A severe tachyarrhythmia that can develop into ventricular fibrillation and cause sudden cardiac death. Ye Jian has induced ventricular fibrillation twice."

"Dean Zhang, the situation is very dangerous. Ventricular fibrillation can lead to death if the rescue is not timely."

Dean Zhang nodded: "Ye Jian had ventricular fibrillation twice in Chengdu, Sichuan Province two months ago and one month ago. He suffered a sudden cardiac arrest and lost consciousness. After timely rescue, he was saved from death. He has been sent to the In our hospital, during his heart test, he had 24 ventricular tachycardias within 100 hours, and each ventricular tachycardia may develop into ventricular fibrillation. In other words, he is in danger of cardiac arrest every second. Without a heart transplant, he could die at any moment."

Professor Liu looked at the information again: "Ye Jian's chronic rejection caused severe coronary artery disease. In the past three years, he has been combined with diabetes to aggravate the coronary artery changes, and because he has been taking anti-rejection drugs for many years, the blood vessels will also be damaged. , the combination of these factors makes the lesion reaction of coronary artery extremely serious and develops rapidly."

"With the current level of medical development in the world, there is no other way to solve this arrhythmia and myocardial ischemia. The only way to save Ye Jianhua's life is another heart transplant."

After reading it, Professor Liu made the same judgment as Dean Zhang. The only way for Ye Jian to survive now is a second heart transplant.

"So Professor Liu, this second heart transplant operation, only you in our hospital can complete this extreme task."

Dean Zhang poured another cup of tea for Professor Liu, and continued, "Professor Liu, my idea is that starting today, you will immediately organize cardiac surgery, cardiology, nephrology, urology, ultrasound medicine, rheumatology and immunology. Experts from more than ten disciplines, including the Department of Medicine, consulted to formulate a comprehensive plan.”

"After all, Ye Jian's heart attack was sudden and complicated. Ye Jian's chronic rejection caused serious coronary artery disease. In the past three years, he has been complicated with diabetes and aggravated the coronary artery changes. Taking anti-rejection drugs all year round will also affect blood vessels. There are damages. These factors lead to the extremely serious and rapid development of the coronary artery disease reaction. At the same time, Ye Jian is accompanied by the inevitable severe renal function damage and liver function damage to varying degrees after heart transplantation, and the success rate of the operation is seriously reduced. .”

"Dean Zhang, you really gave me a huge problem, but it's also a huge opportunity."

After all, Professor Liu is one of the top three performers in heart transplantation in China. Although he knows the difficulty is extremely high, he still has the spirit to challenge it.

"Yes, so Professor Liu, this time I will mobilize the resources and manpower of the whole hospital to cooperate with you. If necessary, I can also invite experts from other schools you know to cooperate and assist."

Dean Zhang also understands the difficulty of a second heart transplant. In the past 30 years, there have been less than ten second heart transplants in the world that have been documented, and there are no literature records. As for the country, it is still blank, and there is no precedent. learn from.

That is to say, the operation plan this time needs to rely entirely on Professor Liu to take the lead, and the elite forces of all departments to create a plan for the first time, which has not been verified and is not mature. Even Professor Liu is very disturbed.

After all, compared with the first heart transplant, the difficulty of the second heart transplant is much higher than that of the first transplant. First of all, the physical condition of the second transplant patients is far worse than that of the first transplant patients.

Ye Jian has suffered from ventricular fibrillation twice, leading to loss of consciousness, severe kidney damage, liver damage, and poor blood condition in his body... Multiple factors have led to a continuous decline in the success rate of surgery.

Secondly, the heart that has been transplanted has become very adherent after more than ten years, and the heart environment in the patient's body is almost completely unknown.Thirdly, the pericardium has been stripped during the first transplant, and the risk of heart damage during the second thoracotomy is several times higher than that of ordinary people.

"According to preliminary judgment, Ye Jian's time is running out, and you only have four days left for surgery. Therefore, within three days, you must make all preparations for the second heart transplant."

Seeing that the time was ripe, Dean Zhang broke the last layer of window paper.

Of course, Professor Liu was completely attracted by this task, not only for the honor of the department, but also for his own pursuit.

"Dean Zhang, then I will arrange and design Ye Jian's surgery plan now."

After thinking about it for a while, Professor Liu immediately came up with a preliminary plan. He planned to call together more than a dozen departments of the Second Hospital of Harbin Medical University, hundreds of experts, staff members, and eight medical groups including the preoperative preparation group and the surgery group. Conduct surgical research, as well as preparations for facilities, medicines, and material support.

Soon, top experts from more than a dozen medical departments, including cardiac surgery, cardiology, anesthesiology, ICU, nursing, ultrasound medicine, radiology, laboratory, hematology, nephrology, urology, and rheumatology, were working in Liuzhou. Mobilized by the professor, he came to the consultation room.

Regarding Ye Jian's second heart transplant operation, the first hospital-wide general consultation was held.

At the same time, Professor Liu took advantage of the gap to make a phone call to Director Dong of Union Medical College Hospital.

"Director Dong, I'm sorry, I have an important project here. I can't come to the original heart transplant. You can find another expert to throw the knife."

Director Dong, one of the Chief Physicians of the Cardiac Surgery Department of Union Medical College Hospital, was dumbfounded after hearing what Professor Liu said:

"Professor Liu, are you kidding me? This has already been discussed. You will come to our hospital to perform surgery tomorrow. I will prepare everything. You also know that the patient is older and the heart transplant is difficult. Very high. That’s why I invite you to be the chief surgeon. If you don’t come, where can I find a doctor who is as good as you.”

Director Dong himself has also undergone heart transplantation, but they were all relatively young patients. This time, the patient is a big man in the imperial capital. He is already very old and has underlying diseases. Top Professor Liu.

"It's only one day, Professor Liu, it's hard for me to do this."

Director Dong's tone was almost crying.

"Director Dong, I can't help it either. The patients I have now are more dangerous and important than those on your side. I'm sorry. Besides, I believe you have many experts in Xiehexinwai. No, you can go Take a look at Fuwai Hospital. Alright, I won’t talk to you anymore, I’m going to have a consultation here.”

Professor Liu hung up the phone directly.

Listening to the busy tone on the other end of the phone, Director Dong almost collapsed. If he had been able to find someone a few days earlier, but the time is too urgent now. As far as he knows, the Heart Surgery Department of Xiehe can perform such difficult heart transplants. The chief physicians are all full.

"It's really not possible, I will do it myself?" Director Dong struggled, "No, I am still close, unless there is a powerful assistant to help me."

(End of this chapter)