Doctor's Life Simulator

Chapter 352 What else do you want to ask?
"Okay, Professor Liu, after I tidy up, I will go directly to the Second Hospital of Harbin Medical University."

Qin Lang's expression remained unchanged, and he agreed to Professor Liu's invitation very calmly:
"Professor Liu, let's see you tomorrow. I don't care about money or not, and I don't care about reputation. The main thing is that I can participate in such a meaningful second heart transplant and have the opportunity to meet with a leader in the field of heart transplant, Professor Liu. It is an honor for me to cooperate.”

Hearing Qin Lang's words, the corners of Director Dong's mouth twitched. Director Qin's face was as top-notch as his skills.

"That's really great, Director Qin, we'll see you tomorrow. I'll arrange a doctor to take care of the reception right away."

Professor Liu communicated with Director Dong for a while, then cut off the video communication.

"Director Chen, Director Qin's airport pick-up and subsequent accommodation and living matters will be left to you. Be sure to entertain him."

Professor Liu looked at Chen Minjie and said something.

"Guaranteed to complete the mission."

Director Chen forced a smile, but his heart was bleeding. It was originally his chance to help.

And Qin Lang communicated with Director Dong again in Xiehe Hospital, and rushed back to the hotel directly.

As soon as he walked into the aisle, he saw a girl squatting furtively at the door of her room, holding a small card in her hand and stuffing it.

"Hey you!"

Qin Lang yelled, and the girl turned her head immediately, and when she saw the tall and big Qin Lang, her face turned red.

Immediately got up, thought for a while, covered his face with one hand, and was about to run.

"Stop, what are you doing?"

Qin Lang couldn't help asking.

The girl stuffed the small card into her pocket, swallowed her saliva, looked at the handsome Qin Lang, and struggled: "A lot of money for a child, yes, a lot of money for a child, my sister has been paying attention to you for a long time because you are so handsome. I'm not that kind of card."

The girl emphasized again, lest Qin Lang misunderstand, she ran away on errands.

Qin Lang touched his face, feeling very helpless, as expected, boys should learn to protect themselves outside.

Qin Lang opened the door of the room, just about to go in, the phone vibrated, took it out and looked at it, it was Director Dong who gave him the surgery fee, and it turned out to be a full 20!
Then came a text message from Director Dong: "Director Qin, the total cost of this operation is 30 yuan. Since you have participated in many operations, you account for the majority. I will be the chief surgeon in name and receive [-] yuan. Happy cooperation, looking forward to the next time cooperate."

For this, Qin Lang is also very satisfied. Director Dong is still very particular. Under normal circumstances, even if the chief surgeon is named, at least half of it will be given away.

Qin Lang thought for a while, but he didn't seem to know what to say. Following the principle of saying less and making less mistakes, he replied directly: "Okay."

Director Dong who received the text message also chuckled, this Director Qin is really a master.

Just as Qin Lang was about to pack his luggage and rush to the Second Hospital of Harbin Medical University, the phone rang again.

"What's the situation?"

Qin Lang took out his mobile phone. It was Wang Rou, a former doctoral student of Professor Shen Xi, who is now the head of the pharmaceutical research and development laboratory of his new company.

This time, Qin Lang entrusted her with the research and development of smoking cessation medicine, so when she saw Wang Rou's call, Qin Lang was also full of expectations.

I only heard the excited voice of Dr. Wang Rou on the phone:

"Director Qin, good news. According to your previous arrangements, after completing the synthesis of the first phase of the compound, our second phase of the experiment is also on the right track. But now there is a key problem, and I urgently need you to come back and fix it. Check. If it goes well, we will be able to enter Phase III clinical trials in a few months, and we will be able to undergo regulatory approval soon.”

Hearing Wang Rou's news, Qin Lang was also quite satisfied. Sure enough, after having the simulation of the new drug research and development simulation laboratory, and then projecting it into reality, the experiment went very smoothly.

Qin Lang is also very convinced that as long as the next clinical trials follow his guidance, there will be no problems with the new drug.

Qin Lang thought for a while, he could wait until he went to Harbin Medical University to complete the operation before returning to Hangzhou, and arranged in a flat tone:

"Okay, I got to know Dr. Wang. You have all worked hard recently. I have a very important consultation and an operation in the past two days. I will rush back when it is completed."

Hearing Qin Lang's indifference, Wang Rou felt a little anxious. Why is the operation so important?
"Director Qin, do you know what it means to pass the Phase III clinical trial? That's a domestic market worth billions a year, and there are billions overseas. If the new drug is successful and passed regulatory approval, we will It's done!"

Wang Rou really couldn't understand, Director Qin would be so indifferent, he shouldn't rush back immediately at such a time, and still do some surgery.

"Director Qin, our current experiment has reached a critical stage. If you don't come back to check it out, our previous efforts during this period will be wasted."

Regarding Wang Rou's plea, Qin Lang thought about it, anyway, he was in control of everything, so he would go back and give guidance, it wouldn't take too much time.

As for the Second Hospital of Harbin Medical University, there is still a final general consultation before the operation, and there is still some time for the formal operation.After that, I can conduct consultations remotely.

After making a plan, Qin Lang took out his mobile phone and booked a ticket back to Hangzhou to see what problems Wang Rou's team encountered.

Under normal circumstances, drug development is very difficult, and the process of drug development is extremely complicated.

Take the drug research and development of Ming's Pharmaceutical Group as an example. From early research and development to drug launch, the steps and processes to go through are so long that the letters A to H can be arranged.

A, the first is basic research.This process is to start with patients, clinical pathology, and statistical data to find and verify potential targets.

Under normal circumstances, this step would take several years of hard work by the developers, but here in Qin Lang, it is done directly.

B, Pharmacology and biomarker development.Including pharmacology and druggability studies of targets, biomarker studies related to targets and prognosis.

Qin Lang also directly skipped this step. Under normal circumstances, at least tens of millions of dollars would be invested in the laboratory of Ming's Pharmaceutical Group, and it would even take several years to complete it.

C, Lead compound discovery.Lead compounds are compounds with certain biological activity obtained through various ways and means, and are usually obtained by in vitro screening for further structural modification and optimization.

This step would cost tens of millions of dollars in the laboratory of Mingshi Pharmaceutical Group, and the R&D personnel would need some luck to discover it.And this step, Qin Lang also completed it instantly.

D, lead compound optimization, preclinical candidate compound confirmation, preclinical research to support declaration, production and quality control (CMC).In this link, potential drug candidate molecules are screened out, systematic pharmacodynamic studies and toxicology studies are carried out, and samples used to support clinical research need to be produced under the conditions of quality management (GMP).

This step, for Ming's Pharmaceutical Group, it is very lucky that two or three of dozens of drug research and development projects can enter this step.

Often, at this point, hundreds of millions of research and development expenses have been spent, and it has taken several years.

Therefore, for the researchers in the drug laboratory, Qin Lang's smoking cessation drug project completed the compound synthesis of bupropion in a short time, and the samples of the small reagents surprised them.

The more you understand the difficulty of new drug research and development, the more you understand the hardships of Qin Lang to get to this point.

Wang Rou welcomed Qin Lang with great admiration.

"Director Qin, you really only spent a few months designing this sample of bupropion?"

Dr. Wang still asked in disbelief. At first, she felt that this project was far away. When she actually saw the sample, she was completely dumbfounded.

She didn't even rely on the team strength of Ming's Pharmaceutical Group, but only relied on her own team to successfully synthesize the lead compound. Such a smooth and bizarre research and development process was unheard of even among all the new drug research and development projects she knew. .

Hearing Qin Lang's confirmation, Wang Rou looked at Qin Lang as if she was looking at a god.

"He is truly a man favored by the God of Medicine."

Wang Rou led Qin Lang: "Director Qin, after you provided the lead compound, we officially entered the clinical research."

Namely: E, clinical research.It mainly conducts clinical trials, including Phase I, Phase II, and Phase III clinical trials.Each phase has a different goal and a different scale.

Wang Rou took Qin Lang to see the Phase I clinical trial they had completed.

"Director Qin, look, the Phase I clinical trial is mainly for preliminary clinical pharmacology and human safety evaluation experiments. The laboratory has completed the human body's tolerance to the new drug and pharmacokinetics, and it is necessary to formulate the drug regimen. Provide evidence."

"Under your guidance in the early stage, we greatly reduced the range of drug doses, and quickly obtained the relationship between drug doses and drug side effects. At the same time, we also clarified the drug's kinetic properties and The determination of metabolites and the metabolic pathway of drugs in the human body."

"The end result is exactly what you predicted earlier."

Wang Rou looked at Qin Lang in disbelief, as if the man in front of him had traveled back from the future and had the ability to predict.

"After that, we went straight to phase II clinical trials."

Wang Rou, continue to show Qin Lang the data and various materials of the team's clinical trials during this period.

Since the simulation was carried out in the system's laboratory, Qin Lang is very clear about this information and knows the correct data.

Therefore, there is no need for Wang Rou's detailed explanation at all, and Qin Lang is even clearer than Dr. Wang in terms of some summary statistical results.

After all, Wang Rou relies entirely on the laboratory staff to sort out and count the experimental data, and finally get the results.

And Qin Lang is the standard answer to look directly at, and there will always be some deviations in the artificial statistics of the laboratory.

"Director Qin, the phase II clinical trial is the preliminary evaluation stage of the therapeutic effect, and its purpose is to preliminarily evaluate the therapeutic effect and safety of the drug on patients with target indications. In this step, it is also necessary to determine the research design and administration of the Phase III clinical trial Dosage plan. This time, I invite you here because I want to formulate a plan for this Phase III experiment together."

"Here is my preliminary plan and data support, you can read it first."

Wang Rou himself is very knowledgeable about statistics and data processing. After all, his second major is mathematics, especially for statistics.

Seeing Wang Rou's data and plan, Qin Lang was also very impressed. Wang Rou's plan was very close to the standard answer.

Qin Lang looked at it, and said admiringly: "Dr. Wang's skills are indeed profound, and this plan is basically feasible. In this way, give me a day tomorrow, and I will give you my suggestion."

"of course."

Wang Rou replied with great anticipation, and brought Qin Lang to his general manager's office.

In the laboratory, the rest of the members are also very curious and looking forward to how amazing this Director Qin is!
Retreat for a day, study the experimental data, and propose a plan for the third phase. Just listening to it will make the blood of the laboratory staff boil. If they can really draw a conclusion, then this Director Qin will really make them worship.

The next day, Qin Lang was in the office, of course it was just to deceive others, after all, it would be too scary to give an answer at a glance.

Moreover, Qin Lang just took advantage of this time to participate in the consultation of the Second Hospital of Harbin Medical University through the remote system, as long as he rushed to the scene for surgery afterward.

The general consultation of the department is the exchange of thoughts and ideas, and there is no need to be present in person.

Qin Lang's general manager's office has various supporting facilities, and naturally there is no shortage of remote systems.

This new company, Ming's Pharmaceutical Group has invested a lot of money, so it is naturally very advanced, especially the office of Qin Lang, which is spacious and grand.

Qin Lang put away a bunch of materials, and wrote out the dosage plan for the third phase and the clinical trial plan for the third phase.

First of all, several sets of data of Wang Rou were corrected, and then random blind selection method was used to control clinical trials, and placebo and marketed drugs were added as controls.

Soon, a rigorous scientific and detailed plan was completed.

After doing all this, Qin Lang looked at the time, and it was time for the consultation at the Second Hospital of Harbin Medical University.

However, in the consultation room of the Second Hospital of Harbin Medical University at this moment, the expert group also broke out.

"This director Qin, is he reliable or not? Didn't he agree to come for a consultation today, who?"

"Director Qin, I didn't get on that plane at all. I waited at the pick-up gate for a long time and didn't arrive, and I didn't get through on the phone."

Dr. Chen's face was full of grievances, but he was a little happy in his heart. If Qin Lang really didn't come, he would be the one to help.

Professor Liu also didn't expect that Director Qin would run away.

When he was depressed, his cell phone rang. It was Qin Lang's number, and Professor Liu connected it immediately.

"Professor Liu, I'm sorry, I'm in the same situation as you in Union Medical College Hospital. I also have an emergency here. I was supposed to go to the Second Hospital of Harbin Medical University this morning, but there are some problems with my new drug research and development project. I am in the guidance laboratory. The plan for conducting Phase III clinical trials. Therefore, today I can only participate in the consultation through remote video."

Professor Liu didn't expect Director Qin to be so difficult to deal with.

Moreover, he even led the research and development of a new drug, and even went to the third phase of clinical trials?

What kind of fairy operation is this.

Professor Liu smiled bitterly: "Okay, then I will arrange a remote video."

After Professor Liu hung up the phone and said that Qin Lang wanted to participate in the consultation via remote video, the expert team exploded one by one.

"This is too arrogant, no one comes, and direct video consultation?"

"That's right, they don't take us seriously."

"I believe that a young doctor like him can lead the research and development of new drugs, and even enter the third phase of clinical trials."

"Could it be that you are not confident about participating in the second heart transplant, so you simply dare not come here, and find a reason in the consultation to shirk it."

"It's very possible. After all, the difficulty and complexity of ordinary heart transplantation and second heart transplantation are worlds apart."

"Hey, he lost the chain at a critical moment. I really looked up to him before."

All of a sudden, the expert group had a lot of discussions about the remote video consultation of Qinlang, and they were very unfavorable.

"Okay, everything is quiet. Director Qin was invited by me, and I will be responsible for all his actions. After a normal consultation, I will connect Director Qin's video connection, and everyone will treat it as a regular collaboration of experts from other hospitals." consultation."

Professor Liu, as the person in charge of this operation, since he spoke, the doctors in the expert group stopped talking.

However, there is always some resistance in my heart. After all, Qin Lang is too young. Such a young doctor doesn't even come to the scene. Video consultation is a little contemptuous to them.

Before the consultation started, Professor Liu pondered for a while, and told Chen Minjie: "In a moment, you will be in charge of Director Qin's video connection. If Director Qin really can't come over in time after the consultation, this operation will be done." It's up to you to cooperate with me."

"Hey, okay."

A gleam of joy flashed in Chen Minjie's eyes, but his face was still very calm: "Professor Liu, don't worry, I will cooperate with Director Qin well, and at the same time, I am ready to stand on top at any time."

"Well, let's go."

Professor Liu looked at Chen Minjie, slightly relieved, but he also hoped in his heart that Qin Lang could come to the Second Hospital of Harbin Medical University. After all, Chen Minjie's level was still far behind Qin Lang's, and it was his choice when there was no one else. .

Commonly known as the jack, the kind that is not even as good as the spare tire.

In the independent office of the new company, Qin Lang turned on the remote video on time and joined the Second Hospital of Harbin Medical University. The third conference about Ye Jian's second heart transplant was also the last consultation before the operation.

Qin Lang saw the situation in the consultation room very clearly through the screen.

The entire consultation was hosted by Professor Liu. Before the meeting, Professor Liu first introduced to the expert group Qin Lang who participated in the remote consultation.

Regarding the greeting on Qin Lang's screen, the expert team politely smiled but did not look at him.

Under the control of Professor Liu, the consultation began.

For the content of the meeting, first, Professor Liu summarized the contents of the previous two consultations, and then Director Chen reported the progress of the latest equipment, equipment and special medicines.

"Professor Liu, with the cooperation of various departments in our hospital, all the equipment and medicines needed for Ye Jian's surgery have been prepared."

After that, each department reported their latest progress one by one. Generally speaking, everything was ready.

Ten minutes later, Professor Liu began to enter the second part of the consultation, which is the most critical research on the surgical technique before the operation, the allocation of personnel during the operation and the role each person needs to play.

As a candidate who is valued by Professor Liu, Qin Lang needs to bear a huge responsibility.

Although I had seen Qin Lang's surgery before, it was a routine heart transplant after all. In addition, this time Qin Lang opted for a video consultation, some doctors in the expert group were a little upset.

One of the chief physicians asked bluntly:
"Director Qin, as an assistant in this operation, the responsibility is very heavy. We just want to take advantage of this consultation, and we also want to know Director Qin's understanding of Ye Jian's second heart transplant operation."

On the screen, Qin Lang didn't care about the aggressiveness of the expert group at all. After all, in the simulated world, his master heart transplant surgery could calmly deal with any tricky questions.

Qin Lang smiled slightly, if he could help these doctors, he would be very happy.

He said very honestly: "Experts, I am very confident about this technique."

In the consultation room, Professor Liu also looked at Qin Lang in surprise. This young doctor is really not low-key at all.

"Then let's start with the preparation of the recipient first. How does Director Qin think about the preparation of the recipient?"

A chief physician looked up at the screen and said coldly.

Without even thinking about it, Qin Lang responded very easily:

"In addition to a comprehensive medical history before the operation, a detailed physical examination is also required, including blood, urine, and stool routine; blood biochemistry, liver and kidney function, lung function, gastrointestinal barium X-ray, throat swab, sputum, and urine. Bacterial culture. Tuberculin test, serum E-cell inclusion body virus, toxoplasma, HIV, Epstein-Barr virus and hepatitis virus inspection are performed. Blood type identification, lymphocyte toxicity cross test and HLA typing are also carried out, especially those like Ye Jian. For patients with severe heart failure that cannot be controlled by drugs, intra-aortic balloon counterpulsation should be performed, or mechanical assist devices should be considered to temporarily improve organ function and create conditions for heart transplantation.”

Hearing Qin Lang's eloquent talk, the director nodded, feeling horrified in his heart.

Qin Lang wasn't prepared for these questions at all, and he answered them all impromptu, that is to say, he really has a deep knowledge of heart transplantation.

In the consultation room, Chen Minjie was also a little unbelievable. Of course, he could tell a lot about these questions, but for Qin Lang's comprehensiveness and rigor, he still needs to do his homework in advance.

"So solid basic skills."

The members of the expert group who originally wanted to wait for Qin Lang to get stuck, and then educate him on the need to be humble in doing things, all breathed out.

What a tough little guy.

Another director of the Department of Urology next to him couldn't sit still. He was just watching a show, but now he had to save some face for the doctors of the Second Hospital of Harbin Medical University, and asked another question:
"Director Qin really has a lot of research on heart transplantation, and the preparation of this recipient is very comprehensive. Then, how does Director Qin view the adoption of a donor heart?"

Since heart donation requires the cooperation of multiple organ physicians and the cooperation of urologists on the same stage, it is a very comprehensive process. Asking this question is to suppress Qin Lang's momentum and let him know that, This is a very comprehensive operation, and the individual's ability is very limited.

Regarding this question, Qin Lang frowned slightly, no matter how stupid he was, he could feel the targeting of these expert team members thousands of miles away.

Qin Lang chuckled, but he wasn't afraid at all. Since he wanted to test himself, he took this opportunity to show it off and convince all these experts.

This will also help with subsequent surgery.

After straightening his sleeves, Qin Lang looked at the director of the Department of Urology with sharp eyes, and replied lightly:
"I'm really familiar with donor heart harvesting. Doctors, you can ask any questions you have about donor heart harvesting. I'll answer your questions."

"What a big breath."

This is the case with medical consultations. It is easy to get angry in the communication.

Of course, more academic tit-for-tat.

"Excuse me, how does Director Qin deal with the thrombosis in the small vessels of the donor heart?"

A chief physician first raised a question, he really couldn't stand it anymore, Qin Lang seemed like an old expert.

"It's very simple, take the supine position, disinfect the skin of the chest and abdomen with routine iodine tincture, and heparinize the whole body with 3mg/kg"

Another chief physician flipped through the information and asked, "Then how did Director Qin ensure that the cardiac arrest is in a diastolic state, the perfusion volume and perfusion pressure, and how to design it?"

"Ensure that the donor heart is in a diastolic state, the perfusion volume is generally 1 000ml, and the perfusion pressure is maintained at 40-80mmHg."

Qin Lang's expression remained unchanged, his expression remained unchanged, and he returned very calmly.

"Then Director Qin, how to prevent the heart from expanding when infusing cardioplegia?"

A chief physician asked about a very detailed operation. If you are not familiar with this operation, you will definitely get stuck.

Qin Lang didn't pause at all, and said smoothly:

"When infusing cardioplegia, the right superior pulmonary vein and inferior vena cava should be cut immediately to prevent the heart from expanding. At the same time, ice saline is placed in the pericardial cavity for local cooling..."

Twenty minutes later, Qin Lang looked at the panel of experts whose foreheads were dripping with sweat, and asked calmly:

"Is there anything else you want to ask?"

(End of this chapter)