godfather of surgery

Chapter 1124 Good fortune and misfortune depend on each other
The number of volunteers for the Phase I clinical trial is currently insufficient, but Sisi’s treatment is not restricted by the Phase I clinical trial and can start early.

Ruixing's biopharmaceutical factory is responsible for the production of biological agents. Their preparation technology is very mature, and both talents and equipment are very complete. The prepared K biological agent was delivered by cold chain vehicle and is very convenient to use. It is directly injected into Sisi's body through intravenous injection.

After many improvements, this virus-like microorganism is now very safe. There is no discomfort after injection, just like taking ordinary antibiotics. In rare cases, a low fever will occur, but this time Sisi did not even have a low fever, just as easy as injecting saline. This is because the K virus has been improved many times to have the current low reactivity.

During the improvement process, the experimental team also discovered many rules, which made the subsequent improvement work more and more handy. As the data accumulated, the technical threshold became higher and higher, making it difficult for subsequent followers to catch up.

Sisi did not have any problems this time and was very comfortable during the whole process. I'm afraid this was the best treatment she had experienced since she became ill.

The absence of pain does not mean that there is no treatment effect. Subsequent dynamic detection shows that this treatment effect is better than any previous treatment effect. The original tumor image on imaging shows signal changes, and some diffuse edema signal changes have appeared, which means that tumor cells are currently dying in large numbers.

But the problem also comes with it, the large-scale death of tumor cells, the collapse of cell membranes, the outflow of cell fluid, and the tumor edema. This kind of edema is not a big problem in other parts, but if it is in the skull, especially the brain stem, it will be fatal.

If this continues, Sisi is likely to develop brain hernia!
Everyone was on high alert. Yang Ping narrowed his eyes and stared at the dedicated electronic imaging screen, studying Sisi's head MRI image, and fell into deep thought. He had thought of this problem before the experiment, but reality always differs from predictions. First, the therapeutic effect of the new K biological agent was underestimated, so it was used in excessive doses, resulting in the death rate of tumor cells far exceeding the estimate before the experiment, which was the source of the danger.

Judging from the current situation, controlling the death rate of tumor cells will also be a technical key in the future. Once it gets out of control and exceeds the speed, it may cause fatal brain herniation for intracranial tumors. In order to cope with the danger, Sisi was transferred to the dedicated ICU upstairs.

"The edema is growing very fast. You see, it is much more obvious today than yesterday. We don't know where the peak and trough of the edema are, and we can't predict it. We also have no experience to refer to, so there is no way to know when it will start to subside and whether surgical intervention is needed. Professor Deng has also seen Sisi's MRI images and said that the edema is developing very quickly, but he has no experience in this area. He has never seen edema caused by the rapid death of intracranial tumor cells and the lack of time to absorb the cell debris, so he has no way to predict the curve of the edema." Song Zimo said from the side.

Professor Deng is the current professor of neurosurgery in the institute's outpatient department. He used to work in Tiantan Hospital and was later introduced to Sanbo Hospital. As a neurosurgeon in the expert group of Sanbo Hospital, he is experienced, but he is helpless in the face of this new situation.

The institute's combination of clinical and scientific research is very good. If there is no strong clinical support, the volunteers participating in the experiment will have no choice but to risk their lives if they encounter such dangerous situations.

"I've been thinking about this too. If surgery is performed in advance, it will be very destructive and life-threatening. But if surgery is not performed, once the edema continues to worsen and causes brain herniation in the medulla oblongata, the success rate of surgery will be very slim." Yang Ping touched his nose. This decision was very difficult to make.

No matter what you do, the risk is very high. One is to intervene actively, and the risk lies in the surgery, which means that the risk is in Yang Ping's own hands; the other is to wait passively, and you can only take your chances. There are uncontrollable factors, and the risk is on the so-called luck side. Maybe now is the peak of the edema, and it will start to subside later, but it is also possible that now is not the peak period, and the edema is still progressing rapidly. Once it progresses rapidly, it is almost impossible to save the patient.

One is to exert subjective initiative, and the other is passive opportunism. The current treatment is out of control. Yang Ping repeatedly studies the imaging pictures: "Starting from the first MRI picture, one by one, a little slowly."

The doctor controlling the computer immediately did as he was told and brought up the first head MRI image of Sisi that she had done at Sanbo Hospital. Then, starting from there, he played all of her head MRI images in the Sanbo Hospital database one by one in chronological order.

Yang Ping stared at these pictures, studying them one by one. He wanted to make a longitudinal comparison and summarize the current level of Sisi's tumor edema through these pictures.

Many of the other laboratory researchers standing around were not doctors, and they had no right to speak at this time because it was beyond their knowledge. This was the advantage of the composite army. No matter what problems arose, there were corresponding members to deal with them.

Tang Shun and Lu Xiaolu kept staring at Yang Ping, waiting for his answer. At this time, Professor Yang was the most qualified person to make the decision.

Sisi's biggest risk is the foramen magnum hernia, which is also called cerebellar tonsillar herniation. At this time, the cerebellar tonsils and medulla oblongata are pushed into the spinal canal through the foramen magnum due to the pressure difference caused by edema. The medulla oblongata is the center of life, and this squeezing of the medulla oblongata is fatal.

"Call Sisi's parents over, I'll talk to them. We'll have surgery right away and perform a craniotomy!" Yang Ping finally made a decision. It's better to leave your life to yourself than to uncertain luck. He doesn't believe in luck. Luck is only something you have to rely on when there is no other way.

A graduate student immediately ran to call Sisi's parents, who were already waiting for Sisi in the ward. Sisi's intracranial neurological symptoms were not very serious, but once the edema exceeded the critical line, the mortality rate would be extremely high.

"Sisi's edema is far from reaching its peak now, and it will worsen faster in the future. If no intervention is taken, she may develop a severe and fatal foramen magnum hernia tonight," Yang Ping predicted.

"How is the surgery performed? Should the bone craniotomy be performed in advance to relieve the pressure?" Song Zimo asked.

"Yes, that's right. This is the only way. We need to use the bone flap to enlarge the foramen magnum and reserve sufficient space for the medulla oblongata. Now let Ruixing use 3D printing technology to print a set of brackets and shells from the cervical vertebrae to the occipital bone. They will be used for temporary support and protection after the operation. This bracket is very important."

"I will send the imaging data to Ruixing immediately." Dr. Li, the attending physician, responded immediately.

Ruixing now has a flexible assembly line that can customize orthopedic internal fixation at any time. Using the most advanced 3D printing technology, it can complete a set of internal fixation from design, production, sterilization and packaging in two hours, and it can be sent to the operating table for use in two hours.