This doctor has a system

Chapter 448 513. Maybe men can’t have children
"Just a guess." Gao Feng said.

"Then your guess is probably wrong." The technician in the radiology department said with a smile. He clicked a few times with the mouse skillfully, and at the same time, a nurse went in with a tray to insert the indwelling needle into the patient.

When performing pulmonary artery CTA, contrast agent needs to be injected into the body. Sometimes some patients may have allergies, and the nurse will ask in advance.

By the time everything was ready, 10 minutes had passed.

As the CT machine started running, clear images were displayed on the computer.

Gao Feng sometimes wonders, how did doctors treat patients before there was such a good thing?

Then you can only fumble around. If you really don't understand anything, you can ask the surgeon to cut it open and take a look.

Don’t think this is a joke. In fact, even now, sometimes the basis for diagnosis is still incision.

"It's really a pulmonary embolism!" Ye Xianyong, who was in charge of the bed, was shocked.

"It looks fine." Gao Feng carefully checked the computer and said, "Anticoagulation, it doesn't require any special treatment."

"How's it going? How's it going lately?"

"Buy a gift," Li Youliang suggested. "It's better than empty-handed."

"Said he was grounded by his wife."

"Only they know the specific situation." Fan Yulong said with a smile, "But now there are rumors flying all over the sky."

"I heard that both of them were beaten with panda eyes. Several people tried to pull them apart, but they couldn't pull them away."

"Oh, he's very lucky." Gao Feng looked at the experiment records and was not too disappointed. This was much better than he expected.

"It might end badly if we go back, but it might be even worse if we don't go back." Wu Bufan struggled, "My wife has such a bad temper!"

"There are a few directions you should pay attention to." He handed Xiong Huaxin a small note before leaving. "Some of the targets were discovered by me before, but they have not been verified yet."

Taking action directly in public, it seems that the contradiction cannot be reconciled.

2 years? The day lily was already cold. Gao Feng didn't want to spend too much energy on it.

Several teams that work with him only let him be responsible for financial matters, and other times they treat him as if he does not exist.

The patient was relatively lucky, as the embolism was not serious, which may also be the reason for his atypical clinical manifestations.

Gao Feng expressed shock at this. Director Qiao should be Qiao Kaiqing. Both of them are chief physicians. They are somewhat famous not only in Xiehe but also in the country.

Gao Feng came to the laboratory early the next morning, and Xiong Huaxin sat at the door waiting for him.

But the final results made him a little disappointed, and he felt that they were not worthy of his hard work, so he simply gave up.

wife
"You guys eat first, I have to go home." Wu Bufan wiped the sweat from his head, "I think I said the wrong thing just now."

As we all know, orthopedics is a large department that uses a lot of consumables. Their consumables have one outstanding feature: they are expensive.

"Just say you were joking with her when you get back. Don't admit it even to death."

"Hubby, your little lover is here to see you." The wife said on the phone. Wu Bufan hadn't been home for a few days, and his daughter was crying out to find him, so his wife called him.

"What?!" Wu Bufan was stunned for a moment, "How did she find our home?"

Wu Bufan came over again, and Gao Feng felt that he was really interesting.

"Why?" Li Youliang asked.

The three of them were eating when Wu Bufan's phone rang.

"It's okay, it feels like it's going step by step." Xiong Huaxin reported the progress of the past two weeks to him, "There are difficulties in finding the target, and we can't rush this."

"However, that Wang Liang is very capable. He found two."

In fact, it was not like this before. He had undertaken some experimental tasks and completed them well.

Immune checkpoint inhibitors eliminate the inhibition of T cell activity by blocking the binding of immune checkpoints such as PD-1 to ligands, thereby improving the ability of T cells to kill tumors.

"Do you usually wander around?" Li Youliang asked.

Wu Bufan did not appear in front of Gao Feng for the next few days, and finally Li Youliang called him.

As long as the mechanism and most of the targets of PD-1 immunotherapy can be found, the next step will be easy. After the results are verified, related drugs can be developed. This should be a good market.

"There's something going on in the Orthopedics Department." Fan Yulong looked like he was just watching the excitement, "Director Shi, the director of their department, and Director Qiao got into a fight, right in front of the administrative building."

"At this rate, enough targets should be found within two years, and ligands can be formed by then."

"Stop shouting, you look very angry." An old man in the next bed said angrily, "Your wife just went out to buy you food, wait until she comes back and then scream!"

"The directors of the Department of Orthopedics are fierce, and they will never push if they can."

"Absolutely. Sometimes I go to the laboratory to have a look." Wu Bufan said, "My hands-on ability is okay, but I can't endure too much hardship."

When he returned to the ward, Gao Feng found that the office was very lively, and everyone was gathered together to discuss something.

"What's going on?" Li Youliang asked Fan Yulong, "What are you gossiping about?"

"Are you sure you want to go back?" Li Youliang asked.

In fact, Gao Feng far underestimated the value of PD-1 immunotherapy. Fortunately, he gradually realized this in subsequent work.

However, when he learned that he had pulmonary embolism, the patient himself was frightened.

"It's over, it's over!" He panicked after searching Baidu on his mobile phone, "I'm going to die!"

During the use of consumables, you will always encounter problems of one kind or another.

For example, during surgery, patients need to use an expensive consumable, which costs 12000 yuan per pack. However, this pack of consumables cannot be used by one patient, and it is more than enough for two patients.

In a series of surgeries, it is very likely that five patients will use three packs of consumables, but the cost of each pack of consumables will be recorded in each patient's account.

Obviously, there are two more packs of consumables at this time.

What to do with excess consumables?

In most cases, the surgeon who performs the surgery must have the final say.

Retreat to the hospital? That was obviously impossible, and the hospital was unwilling to get involved in such a thing.

Most of the time, the manufacturer is contacted directly and asked to send someone to take it away. Of course, it is definitely not free. This has been a common practice in the past.

Because there are many people in a surgical team, especially those with relatively high standards, it is embarrassing that the surgery fees are often not enough.

For example, a patient underwent a 4-hour operation and the total cost was 36000 yuan, of which 30000 yuan was consumables, 3000 yuan was miscellaneous things such as anesthesia, and the remaining 3000 yuan was the income created by the entire team. That is the cost of surgery.

医院拿1000元，主刀拿500，剩下的1500元6-7个人分.
Would you do it if it were you?

I definitely won’t do it, I’m not a fool. So how can we maintain such a mature and highly technical team?

That will test the level of the leader. Most people are thinking of ways to deal with consumables.

This is what Director Shi Gaolang of the Orthopedics Department did. He felt that he was doing pretty well. At least the Department of Orthopedics was flourishing under his leadership.

But some people think this is not possible.

Qiao Kaiqing is a doctor who returned from studying abroad and has outstanding abilities. He had been working at the University of London Medical School before.

Although he was doing well abroad, his parents were old and unwilling to leave China. In recent years, he had the idea of ​​returning to China.

After communicating with the leadership of Union Hospital, the two sides hit it off and he was introduced to the hospital as a high-end talent.

Director Shi Gaolang is a relatively generous person. He has a cheerful personality and always looks high on people with strong abilities.

After Qiao Kaiqing got his approval, he quickly assigned a surgical team to him, but this was also the beginning of the conflict between the two.

Not long after, someone came to Director Shi and said that he was unwilling to follow Director Qiao.

"I'm different from others. He has made enough money abroad." This man didn't hide it, "I still have to support my family."

Director Shi soon learned the cause of the matter. Qiao Kaiqing never dealt with the equipment dealer when performing surgeries, and also prohibited the people below from contacting the latter.

He believes the previous approach undermined professional ethics.

Director Shi felt that he had just come back and was still a little aloof, so he wanted to persuade him.

"Kaiqing, you don't know, the national conditions are different." Director Shi pulled him aside and said, "The average basic salary of orthopedic surgeons abroad can reach 50 US dollars a year, but we can't do this."

"If you don't think of a way, the people below may not be able to pay their mortgages."

Director Shi felt that Qiao Kaiqing would listen to the advice. After all, no matter how good a person is, he can't perform the surgery on his own. He must have a team under him.

But what he didn't expect was that instead of listening to his good advice, the latter went directly to the dean.

Originally, this was something that was agreed upon and could not be seen in the light.

Would the dean not know? He knew, but facing Qiao Kaiqing, he could only say that he didn't know.

Director Shi angrily stopped Qiao Kaiqing's surgical authority, but the latter said he would report to the Discipline Inspection Commission.
Qiao Kaiqing's current request is that Director Shi must assign him a surgical team, but the problem now is that no one is willing to follow him.

"Then everyone is not stupid. I used to earn 3 yuan a month, but now I earn 1 yuan a month." Fan Yulong said with a smile, "So Director Qiao is now a loner."

The leaders of the hospital called the two people to the administrative building again today, but it obviously had no effect.

Director Shi had a hot temper when he was young. Although he has calmed down a lot now, when he was so provoked, he couldn't help it anymore. He grabbed Qiao Kaiqing and beat him up with a hammer.

The latter was not to be outdone. The two of them went back and forth, and even the union chairman who was quarreling was punched.

"They have all been suspended, and everyone is waiting to see how to deal with it."

Gao Feng was silent, it was really hard to say who was right and who was wrong in this matter.

Director Shi's behavior is obviously illegal. If the consumables are used, they are used, and if they are not used, they are useless. As long as they are recorded, this pack of consumables must be consumed.

Although the behavior of several patients sharing consumables does not directly harm the rights of the patients, there is still a huge risk, which is both moral and legal.

But Qiao Kaiqing's behavior also made people feel uncomfortable.

He is unwilling to take the money. This behavior is worthy of encouragement. But you can't force Director Shi to configure a surgical team for him. You can rely on your own charisma or pay for it yourself.

This kind of kidnapping of the department is extremely disgraceful.

To be honest, given the national conditions, it is difficult for individuals to change some established rules. Even if the country takes action, it must proceed slowly.

Even if the overall moral level of medical staff is higher than that of most other industries, in the final analysis, they are still human beings and they also hope for a better life. If they only mention selfless dedication, it will be fine in the short term, but it will definitely not work in the long term.

It's hard to fool people nowadays.

"Youliang, please pay attention to this matter and see how it ends." Gao Feng said.

"Okay." Li Youliang responded quickly.

Provincial People's Hospital

Yue Penghui was accompanying his wife to her prenatal check-up, and he was very nervous.

"How come all the people doing color ultrasound are women?"

"I don't know, maybe men can't have children," said his wife Ni Shuang.

"When was the file established?" the triage nurse asked.

"1927." Yue Penghui hesitated for a moment, "Did you ask this during the prenatal checkup?"

"Comrade, don't ask him, he doesn't know anything." Ni Shuang said, "He was with us 6 months ago."

After entering the consulting room, the doctor checked the fetal heart rate monitor and thought it was okay.

"Was it natural conception?"

"It should be." Yue Penghui said, "Who dares to force this?"

Is this man a fool? The doctor attending the consultation looked at him speechlessly.

"Next time you better not come." Ni Shuang said disgustedly, "Just wait to hold your son."

"Don't worry, I will definitely stay with you more in the future." Yue Penghui said ashamedly.

But he soon broke his promise, because Wang Liang called him and said that there was a shortage of manpower in the capital, and he would probably ask him to bring a group of people over.

Gao Feng decided to write an article first, and the title was called the mechanism of immune checkpoint inhibitors blocking PD-1.

The editor of the British Medical Journal, Iacobair Marchionne, had made several appointments with him.

"PD-1 (CD279) is a type I transmembrane protein composed of 288 amino acid residues and belongs to the CD28 family. It is widely expressed on a variety of immune cells, such as activated T cells, B cells, NK cells and DC cells.”

"In many cancer types, PD-1 is expressed on a large proportion of tumor-infiltrating lymphocytes (TILs). Its structure includes an extracellular IgV domain, a hydrophobic transmembrane."

After all, he was really involved in the entire experiment. When Gao Feng wrote this article, he felt as if he had it at his fingertips. He only briefly talked about the mechanism of immune checkpoint inhibitors blocking PD-1, and the length met the requirement. .

Icobar Marchionne soon received this article. He read it carefully and found that many parts were incomprehensible.

This made him feel happy, and after thinking about it, he quickly forwarded the article to several independent reviewers.

"The Chinese have made another breakthrough in their research." Professor Joel Toth of Oxford University School of Medicine frowned.

The overwhelming feeling made him anxious.

(End of this chapter)