Surgery Godfather

Chapter 2235: Chapter 1456: Room Temperature_2

Weber said, "In the afternoon I went to Neurosurgery for a post-operative review with Teacher Gong, he said he’d come home for dinner, and tomorrow morning we’ll discuss the unknown protein."

Tang Shun patted Weber on the shoulder, "If this experiment can identify the hidden variables, your experience will greatly help them."

Weber smiled, revealing a set of white teeth, "Thanks, I’ll head back first, see you tomorrow."

When Yang Ping arrived at the Neurosurgery ICU, Xu Zhiliang was doing rounds.

Teacher Gong lay in the hospital bed, his head wrapped in gauze, with various monitoring lines connected to his body. His eyes were open, and upon seeing Yang Ping enter, the corners of his mouth moved, seemingly trying to smile but not having enough strength, only managing a small expression.

"Teacher Gong, how are you feeling?" Yang Ping walked to the bedside, bending down to ask.

"I’m okay..." Teacher Gong’s voice was soft yet clear, "Just... dizzy... want to sleep..."

"Dizziness is normal, there’s still edema in the brain tissue post-surgery." Yang Ping checked his pupils, equal and reactive to light on both sides. He then asked him to stick out his tongue, which was centered with no deviation. "How about swallowing? Do you choke when drinking water?"

"No choking... I just... drank... a small sip..."

Yang Ping nodded and turned to Xu Zhiliang, "I saw the post-operative CT; it’s good. But the peak edema period post-medulla surgery is 48 to 72 hours; it’s only the first day now, so we can’t take it lightly. The dehydration, steroid, and neuro-nutrition protocols must be strictly followed, and any abnormalities must be immediately addressed."

Xu Zhiliang nodded, "I’ve arranged for dedicated monitoring, with vital signs recorded every hour, and the respiratory rhythm is being watched as well, with the system set to automatically alert if abnormalities occur."

"Good." Yang Ping looked at Teacher Gong again, "Teacher Gong, rest well and cooperate with the treatment. Your surgery was very successful, with the lesion completely resected. Once the edema subsides, you’ll feel better and better."

Teacher Gong blinked to indicate he understood.

Yang Ping stepped out of the ICU, standing in the hallway for a moment.

"Professor!" Xu Zhiliang caught up, "There’s something... I want to discuss with you..."

"Go ahead."

Xu Zhiliang paused and said, "Our Neurosurgery department... recently took in a complicated case and would like to request your consultation..."

"What case?"

"A... twelve-year-old... girl, with a diffuse intrinsic pontine glioma, considering DIPG." Xu Zhiliang’s voice lowered, "The family... doesn’t... want to give up, they’ve been to hospitals all over the country, and finally came to us... here."

"What’s the family’s attitude?" Yang Ping asked.

Xu Zhiliang said, "Shall we chat via WhatsApp?"

"Alright." Yang Ping nodded, then returned to the Institute.

Xu Zhiliang composed a WhatsApp message.

"The family’s attitude is very determined! They said, even if there’s only a one percent chance, they want to try. I’ve checked the literature; there is a new experimental therapy called ONC201, a small molecule drug targeting the dopamine receptor D2, which has shown certain effects in some DIPG patients. But it’s not yet approved in China, and would require going through the compassionate use program."

Yang Ping pondered for a moment. He knew about ONC201, an experimental drug still in clinical trials with an unclear mechanism of action, but it had some promising early data. However, the compassionate use process is complex, with strict ethical review, and the drug’s efficacy is far from confirmed.

"Send me the case file, and I’ll take a look. Also, inform the family that we’ll have a discussion tomorrow afternoon to assess it together," Yang Ping replied.

"Okay, I’ll arrange it."

Yang Ping checked the time; it was already six-thirty, so he quickly went home.

Xiao Su’s braised pork ribs were already served.

When Yang Ping opened the door, the kitchen was filled with a rich aroma of sauce, mixed with the sweet fragrance of star anise, cinnamon, and rock sugar. Xiao Su, wearing an apron, was stir-frying the last vegetable dish, the spatula flipping with a rhythmic sound as the vegetables sizzled in the pan.

"You’re back?" Xiao Su didn’t even turn around, "Wash your hands, dinner’s ready soon."

Yang Ping changed his shoes and went to the kitchen entrance, gently wrapping his arms around her waist from behind. Xiao Su’s belly was already quite prominent, and even through the apron, he could sense the smooth curve. Placing his palm on it, he indeed felt a gentle thump, like a little fish swimming inside.

"Active today," Yang Ping commented with a smile.

"Yes indeed, while I was cooking, he was tumbling inside," Xiao Su nudged him with her elbow.

Yang Ping let go and went to the bathroom to wash his hands. The reflection in the mirror showed stubble growing out, hard and prickly.

"I’ll shave it tomorrow, a few days without shaving doesn’t matter," he muttered to himself.

The table was already set with food.

"There was a post-operative patient in Neurosurgery, I went to check. Also encountered another DIPG case and discussed it with Xu Zhiliang for a while." Yang Ping picked a piece of rib, the meat tender and flavorful, "Delicious."

Xiao Su watched him devour his meal with a smile but her brows slightly furrowed, "DIPG? The same childhood brain cancer we saw on the news?"

"Yes." Yang Ping nodded, "That disease is troublesome, but the family doesn’t give up. All we can do is give it our best."

Xiao Su was silent for a moment and then said, "You also need to take care of yourself, with so much going on lately, make sure you don’t overwork."

"Of course," Yang Ping smiled.

After dinner, Yang Ping helped with the house chores, then sat on the couch, watching TV and chatting with Xiao Su. A medical news segment was on, announcing the approval of a new gene therapy for rare disease treatment in a certain country. Yang Ping watched for a while, found it uninteresting, and then turned off the TV to go to his study.

He turned on the computer and logged into his email. Professor Green’s reply was already there, saying he completely understood his caution, agreeing to start with a video meeting, with further discussions on the co-corresponding author issue later. The meeting was scheduled for next Thursday at 9 PM, accounting for the time difference, which was 9 AM Boston time.

Yang Ping replied with an "OK," then opened the DIPG case file sent by Xu Zhiliang.

The girl’s name was Lin Xiaoyu, twelve years old, a second-year student at a key middle school in Beijing. Three months ago, she started experiencing walking instability and facial asymmetry symptoms. An MRI at the local hospital found a pontine lesion. She was transferred to a Tertiary Hospital, underwent a biopsy, and pathology confirmed DIPG. After receiving standard radiotherapy, the tumor continued to progress. The family refused to give up, going through various paths to finally arrive at Sanbo Hospital.

Yang Ping looked through the imaging data one by one. The latest MRI showed a significantly enlarged pons, with the tumor diffusely infiltrating, no clear boundaries, almost occupying the entire transverse section of the pons. The fourth ventricle was compressed and deformed, obstructing cerebrospinal fluid circulation, leading to mild hydrocephalus.

"Typical DIPG," Yang Ping concluded internally. This imaging pattern was one he had seen many times before.

He examined every detail meticulously: the tumor’s signal characteristics, enhancement pattern, diffusion restriction status, and spectral analysis...

Suddenly, his attention focused on a spectral analysis image. There was a significantly elevated choline (Cho) peak and a reduced N-acetylaspartate (NAA) peak, typical of a malignant tumor. However, the lactate (Lac) peak was also significantly elevated, usually indicating hypoxia and necrosis within the tumor.

"Hypoxia..." Yang Ping muttered. A hypoxic tumor microenvironment triggers a series of adaptive signaling pathways, including the HIF-1α pathway. The activation of HIF-1α influences the tumor’s metabolism, angiogenesis, invasiveness, and treatment resistance.

K Therapy might actually be worth a try; theoretically, K Therapy should be well-suited for this kind of tumor.

Yang Ping picked up the phone to call Lu Xiaolu, who was currently overseeing one of the K Therapy labs.

It would be a pity not to use K Therapy for this case. K Therapy has accumulated many cases, including those of diffuse intrinsic pontine glioma. Although there aren’t many of these cases yet, all are clinical trial cases, but it has already been proven effective for this type of tumor.

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