Surgery Godfather

Chapter 2222: Chapter 1450: Six Extremely Critical Cases_2

At three thirty, the meeting room was packed.

Tang Shun, Lu Xiaolu, Manstein, Weber, Jiang Jitong, among others, along with some newly appointed project leaders, their students, and postdocs, filled the meeting room to capacity.

Yang Ping sat at the head of the table, his gaze sweeping over everyone.

"Let’s begin," he said.

The first to report was Tang Shun. He reported on the progress in the cell laboratory, noting that the optimization of various original cell cultivation processes had achieved breakthroughs, with batch output increasing by thirty percent compared to last month and purity exceeding ninety-five percent. This advancement marked a crucial step towards the large-scale production of original cells. These original cells are those generated by the body’s self-repair mechanism, forming cells identical to those in the original tissue.

Having heard this, Yang Ping nodded, "Very good, but ninety-five percent purity is still not enough; clinical conversion requires over ninety-nine percent. Continue to optimize the process and strive to achieve the target within three months."

Next was Lu Xiaolu. He reported on the progress of the tumor laboratory, stating that the application research of three-dimensional guided gene theory in lung cancer treatment had yielded some preliminary results, but they were not ideal. They designed several different gene editing strategies; some were effective, some were ineffective, and some even had adverse effects.

Yang Ping listened and pondered for a moment, "This shows our understanding of the three-dimensional guided gene theory is still insufficient. Don’t rush to find applications; first, clarify the mechanisms. Once the mechanisms are understood, applications will naturally follow."

Jiang Jitong was also a key player now; he reported on the progress of vaccine initiator research. They designed several new initiator sequences, verified their activity on a cellular level, two of which performed better than existing reports.

Yang Ping listened and said, "Quickly conduct animal experiments to see the effect in vivo. If the animal experiments also outperform existing reports, then apply for a patent."

Next was Manstein, who reported on the progress of original cell repair of spinal cord injury, focusing on the data and papers Yang Ping had reviewed in the morning. He spoke very clearly, from experimental design to data results, statistical analysis to conclusion deduction, every step was explained thoroughly.

Yang Ping listened and added, "Manstein’s experiment still needs to supplement some mechanism experiments. If anyone has good suggestions, feel free to communicate with him."

Manstein smiled and nodded towards everyone.

Lastly was Weber. He reported on the study of the promotion effect of stem cells in original cell repair of spinal cord injuries. His data and conclusions were clear; original cells could promote the nerve-directed differentiation of stem cells, and the combined application was more effective than the application alone. As for the underlying mechanism, he was still researching.

Yang Ping listened and said, "Weber’s discovery is very valuable. The next step is to conduct dosage gradient experiments to find the best combined application plan. Also, start writing the paper."

Weber couldn’t hold back his smile.

The regular meeting lasted over an hour and ended close to five o’clock.

Yang Ping returned to his office and called Dean Xia to confirm the renovation modification plan for the new institute. Dean Xia said the blueprints had already been sent to the design institute, and construction drawings could be produced next week, with work expected to start next month.

After hanging up the phone, Yang Ping leaned back against the chair and let out a long exhale.

The day’s tasks were finally concluded.

Early the next morning, as Yang Ping arrived at the office, the phone on the desk rang.

"Professor Yang, this is Xia Shu." The voice on the other end was somewhat urgent, "The patient’s coagulation function re-test results are out."

Yang Ping’s heart tightened, "How is it?"

"PT and APTT have basically returned to normal, but platelet function is still somewhat deficient. The thromboelastogram shows the platelet inhibition rate is still over sixty percent. At this rate, it will take at least another two or three days to reach an acceptable range for surgery."

Yang Ping was silent for a moment. Two or three days might sound brief, but for a patient with ninety percent left main coronary artery stenosis and multiple daily angina attacks, two or three days could mean countless near-death experiences or even a fatal myocardial infarction.

"What’s the patient’s angina situation?" Yang Ping asked.

"It flared up again last night, lasted nearly ten minutes, and was relieved only after taking nitroglycerin. This morning during rounds, the patient told me he doesn’t dare to sleep, fearing he won’t wake up once asleep." Xia Shu’s voice carried evident fatigue, having evidently not slept well last night either.

Yang Ping quickly weighed his options in his mind.

The risk in waiting was the potential for acute myocardial infarction or sudden cardiac death at any time. Not waiting entailed the risk of fatal bleeding during and after surgery, and acute thrombosis at anastomosis sites due to platelet dysfunction.

Choose the lesser of two evils.

"Here’s the plan." Yang Ping made a decision, "Make sure all preparations for blood, platelets, and coagulation factors are in place this morning. Then organize a multidisciplinary consultation involving anesthesia, intensive care, and the blood transfusion department to formulate a detailed perioperative management plan. If everything goes smoothly, perform the surgery tomorrow morning."

"Tomorrow morning?" Xia Shu’s voice carried a hint of uncertainty, "Given the patient’s current coagulation status, is the surgery really feasible tomorrow?"

"It’s feasible!" Yang Ping said, "But not in the conventional sense; special strategies are required. First, reverse the effects of anti-platelet medication during surgery, which though increases bleeding risk, ensures the safety of anastomosis sites. Second, infuse platelets and cryoprecipitate continuously during and after surgery to maintain coagulation function. Third, ensure complete hemostasis before closing the chest, leaving no potential bleeding points. Fourth, delay anticoagulation post-surgery, apply anti-platelet medication only after endothelialization of anastomosis sites. These four steps are indispensable."

The sound of Xia Shu flipping through his notebook was heard from the other end of the line, as he meticulously recorded each word.

"Professor, what should be used to reverse anti-platelet drugs? Traditionally, platelet infusion is used, but its effect is unstable."

"Use gene-recombinant activating factors alongside platelet infusion, employing a dual approach," Yang Ping said, "I came across some literature earlier suggesting this method has the best reversal effect, though it’s pricier, but it’s justified for this patient."

"Alright! I’ll contact the pharmacy department immediately to see if the medication is available."

"If it’s unavailable, instruct the pharmacy department to urgently procure it, stating that it’s on my behalf, and this patient must have it tomorrow."

"Understood!"

Xia Shu hung up the phone, and Yang Ping also put down the receiver. He sat in the chair for a while, mentally reviewing the surgical plan for the next day.

This surgery’s difficulty lay not in complex maneuvers but because every action was akin to walking a tightrope. Anesthesia induction could lead to cardiac arrest, sternal division might rupture the aorta, harvesting bridge vessels might cause coagulation dysfunction, performing anastomosis might result in vascular tearing, post-closure there might be massive hemorrhage, returning to the ICU there might be blocked bridge vessels... Every step could have problems, and each problem could be fatal.

He had to personally scrub in, just in case.

Yang Ping stood up, left the office, and headed towards Tang Shun’s laboratory.

Tang Shun was observing cells under a microscope. Seeing Yang Ping enter, he lifted his head, "Professor, what’s up?"

"I have a surgery tomorrow, possibly lasting four to five hours."

Tang Shun put down the pipette and wiped his hands, "What kind of surgery requires you to operate personally?"

"The patient under Xia Shu, porcelain aorta combined with diffuse small vessel disease and coagulation dysfunction—’six extremely severe’ case."

Tang Shun whistled, "Six extremely severe? That patient is really going to be operated on? I thought Xia Shu was merely talking. What’s this with him and Li Zehui, planning to break another world record?"

"Maybe, they might be trying to prove to the world they are top-tier, beyond Cleveland, because they recently handled a ’three extremely severe’ case there. Furthermore, this patient really can’t wait any longer, and delaying further could lead to myocardial infarction at any time," Yang Ping said, "This patient has no chance of survival without surgery. With surgery, there’s at least a sliver of hope."

"Alright then, tomorrow you can focus on the surgery, and I’ll take care of things here." Tang Shun said, "By the way, regarding the Deputy Director matter you mentioned yesterday, I spoke with Lu Xiaolu about it, and he agreed."

Yang Ping nodded, "That’s good, you two coordinating gives me peace of mind."

"One more thing," Tang Shun handed a document to Yang Ping from the table, "Weber’s paper sent off yesterday was directly accepted by Nature without requiring experimental supplements, only requiring a language edit."

Yang Ping took the document and glanced at it; it was Weber’s paper on the co-culture of original cells and stem cells. He had read the draft before; the data was solid and conclusions innovative, truly top-tier journal material.

"That’s good news," Yang Ping handed the document back to Tang Shun, "Congratulate Weber for me, then have him send me the final version of the paper to review."

"Alright!"

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