godfather of surgery

Chapter 1159 Mystery
"Continue, let's continue studying Sisi's condition." Yang Ping pointed to the images on the electronic screen.

After several treatments, Sisi's condition has improved significantly. Compared with previous examinations, all the tumors in her body are shrinking, and some scattered tumor images have disappeared.

It is evident that the K virus has a very good therapeutic effect on tumors like Sisi. However, the K biological agent (K virus) is obtained through gene recombination and is not very stable at present. After a certain number of iterations, it will mutate, and this mutation will eventually make the K virus mediocre and lose its ability to kill tumors.

"The lab reports that all the seed K biological agents have become ineffective; their iterations have all mutated and lost their therapeutic capabilities."

Song Ziming said regretfully.

Yang Ping thought for a moment: "Let's recreate the K biological agent using gene recombination technology, regardless of cost."

Currently, all of the seed K biological agents stored in the laboratory have become ineffective. It has evolved into a new virus-like structure, which loses its genetic material for fighting tumors during the genetic process, and thus naturally loses its ability to fight tumors.

These gene fragments are artificially added using gene recombination techniques, so they are extremely unstable and easily lost during inheritance, especially since viruses iterate very quickly and are even more prone to loss.

A major problem now exists: no K-biologic agents are available for subsequent clinical trials. If continued treatment is desired, the only option is to use genetic recombination to recreate usable K-biologic agents.

This one-off manufacturing method makes it difficult to apply on a large scale and can only be used on a small scale.

The current bottleneck in this research is how to ensure that the K-biologic agent maintains its efficacy over a long period of time, guarantees its structural and functional stability, prevents the loss of genetic material during iteration, and stably transmits the gene fragments that can fight tumors.

This brings us back to the problem Yang Ping initially considered: using the Y chromosome's gene-blocking mechanism to solve this issue.

However, there is a problem here—even if the Y chromosome gene blocking mechanism is cracked, the goal may not be achieved.

The world's organisms are divided into prokaryotes, eukaryotes, and viruses, and some are not included in the category of organisms.

Humans are eukaryotes, while viruses are simply protein shells containing some genetic material, such as DNA or RNA; their entire structure is completely different from that of eukaryotes.

Can the gene blocking mechanism of the human Y chromosome be transplanted into viruses? This is a very big question.

If transplantation is not possible, what methods can be used to solve this problem?

These are all problems that Yang Ping needs to solve.

Yang Ping, Song Ziming, and a group of graduate students were studying Sisi's condition when they heard Dean Xia's voice. He wanted to greet the nurses at the nurses' station again.

Soon after, the head nurse led Dean Xia and Director Zhao from the medical affairs department in.

Dean Xia and Director Zhao were chatting and laughing, with two other people behind them. One of them was carrying a briefcase and looked like a government clerk. Yang Ping immediately stood up.

Dean Xia saw Yang Ping and said, "Professor Yang, please have a seat. This is Dr. Yuan, a forensic doctor from the Provincial Public Security Bureau. The Provincial Public Security Bureau has encountered a difficult case, and Dr. Yuan from the Provincial Bureau would like to consult on some medical issues. Because it involves a wide range of knowledge, and I heard that this case has a great impact and is being taken very seriously by the higher-ups, we can only trouble you to see if you can help. When would be a convenient time for you? I will have Dr. Yuan schedule a time."

“I’m free right now,” Yang Ping said readily, shaking hands with Dr. Yuan from the provincial department.

Yang Ping simply didn't know what questions the forensic doctor would have to ask him, a clinical doctor, because forensic medicine and clinical medicine are two different fields and they rarely interact. However, sometimes when it comes to death caused by disease, they will consult relevant experts.

Dr. Yuan was quite surprised to meet the young Professor Yang. He had seen Yang Ping's achievements in the news and had long admired him. He had won the Nobel Prize at a young age, which was considered a great honor at the time.

Seeing him in person, I was surprised to find him so young, like a recent graduate. Perhaps those who spend all their time in the lab have less contact with society and age more slowly, Dr. Yuan thought. This was just a subjective feeling, without any medical evidence, because several of his research classmates, even with thinning hair, still looked younger than their peers and had much more innocent eyes.

"Please sit down, Dr. Yuan!" Yang Ping invited Dr. Yuan.

In his previous workplace, Dr. Yuan felt very proud to be addressed as "Doctor," because there were relatively few true PhDs in his unit. Being called "Doctor" represented high knowledge and academic qualifications, which was an intangible honor.

But now that he's at Sanbo Hospital and people are calling him "Doctor," he feels a little embarrassed. After all, hospitals, universities, and research institutes in big cities should have the highest percentage of PhDs in the entire city, so having a PhD is nothing special.

Now, addressing Professor Yang of Sanbo Hospital as Dr. Yuan makes me even more ashamed.

Overwhelmed with excitement, Dr. Yuan momentarily flustered: "Just call me Xiao Yuan."

However, he immediately realized that Professor Yang was much younger than him, and calling him "Little Yuan" seemed inappropriate. He blushed instantly, feeling extremely embarrassed by the inappropriate words he had blurted out in his panic.

"Shall we go to the meeting room to talk?" Yang Ping suggested.

After all, we were discussing a case, and I don't know if it needs to be kept confidential. It's not appropriate to talk about these official matters in the office.

So Yang Ping, Dean Xia, Director Zhao and Dr. Yuan came to the meeting room. Dean Xia personally pushed open the door and turned on the lights in the room.

"Is it alright for us to sit here and listen?" Dean Xia said.

Dr. Yuan immediately nodded: "It's alright, it's alright."

Dean Xia was worried that Yang Ping, having no experience dealing with outsiders, might suffer losses, so he and Director Zhao stayed by his side for peace of mind. These were matters outside Professor Yang's expertise; matters within the medical field were not a concern. Dr. Yuan brought an assistant, a slightly chubby young man, who opened his briefcase, took out a document, and handed it to Yang Ping.

"Professor Yang, here's the situation. We're investigating a complex case. The cause of death is very strange. The autopsy determined it to be a pulmonary embolism caused by deep vein thrombosis. We found the thrombus in the lungs, and after dissection, the cross-section showed a tangled, thread-like structure. I've never seen a thrombus like this before, so I wanted to consult Professor Yang. I've also consulted other experts, such as cardiologists, but they couldn't give a definitive answer. They said it was possible, but whether they'd actually seen it before is another matter. They don't usually dissect patients' blood vessels, and the thrombi removed during surgery are generally quite large, so they don't conduct morphological studies on the cross-section. As for the possibility of forming tangled threads, their answer was that if a thrombus forms in a very thin vein and then breaks off entirely, it can circulate back to the heart, then enter the pulmonary circulation and the pulmonary artery. These vessels might become entangled during this process due to the blood flow, eventually forming a clump."

"This is also a theoretical explanation; in reality, they have no relevant experience."

Dr. Yuan realized that it was impolite to talk so much without giving Professor Yang a chance to speak, so he stopped.

"Go on!" Yang Ping gestured for Dr. Yuan to continue. He had been listening the whole time and couldn't speak until he understood the situation.

Besides, this is the field of forensic medicine. I've read many medical books, but those are mostly basic and clinical medicine. I've hardly read any books or papers on forensic medicine. In this area, I wouldn't call myself an expert; I'm practically a novice. But since Dr. Yuan has come to me, whether I can help or not is another matter. At least I can get him to speak.

“We can’t determine where this blood clot came from right now, because we haven’t found the primary site in the common calf. Of course, we can’t find the primary site in some people either, but I’m still not entirely at ease and dare not draw any conclusions for the time being.” Dr. Yuan briefly recounted what had happened.

Yang Ping flipped through their files. He wasn't particularly concerned about the details of the case, but he needed to understand the basic process. Just like asking about a patient's medical history is necessary when seeing a doctor, the case process is the background of the illness, so a basic understanding is essential.

Yang Ping read the forensic autopsy report very carefully, and the report was written very clearly.

"Director Zhao, could you please call Wen Ruzheng over?" Yang Ping turned to Director Zhao after reading the document.

Director Zhao picked up the phone and called Wen Ruzheng, saying that the institute had a difficult case. As soon as Wen Ruzheng heard that it was a difficult case and that the institute had asked him for help, he put down his work and rushed to the institute.

After arriving at the meeting room, Yang Ping asked him to sit down. He looked at Dean Xia and Dean Zhao, who were staring at him menacingly, as well as two strangers. He had countless questions in his mind. What was going on? He didn't think he had done anything out of line recently.
He sat down carefully, and Yang Ping introduced to Dr. Yuan: "This is Dr. Wen from our pathology department. If we have a thrombus removal surgery, the thrombus will definitely be sent to the pathology department for pathological examination. This is a necessary routine procedure. So Dr. Wen has seen many microscopic manifestations of thrombi. We asked him to help us see if this kind of thrombus has ever existed clinically."

Then Yang Ping briefly introduced the background of the "difficult and complicated disease" to Wen Ruzheng. Wen Ruzheng was very disappointed. He thought that the research institute could not see the pathological slides and needed to ask him, Wen Ruzheng, to take action. He had been waiting for this day for a long time. It turned out that it was not this matter, but that he was invited to be "Sherlock Holmes" and to see the blood clot.

Yang Ping showed Wen Ruzheng the microscopic images of the thrombus in the forensic report. Wen Ruzheng took the opened folder, glanced at it a few times, and said, "Who did this slide? This quality is unacceptable for microscopic examination? Who did this? They should go back to school for further training."

"These aren't pathology images from our hospital; they're from the forensic team," Yang Ping gently tapped the table to remind him.

Dr. Yuan's face turned red and hot: "Our pathology slides are not as high quality as you require, so they look a bit rough to you."

"Oh! I thought someone in our department had done the pathology slides." Wen Ru was engrossed in looking at the pathology slides.

"I have seen tangled blood clots before, but they are very rare because blood clots in small or extremely small veins are generally difficult to dislodge, and even if they do, they are rarely fatal. If such tiny venous blood clots could dislodge, every bruise would be life-threatening, as each bruise would cause some superficial tiny veins to form blood clots. If these blood clots dislodge and cause fatal pulmonary embolism, it would be equivalent to every slightly serious bruise being fatal, which is impossible in reality."

"You can clearly see from these pictures that these cross-sections are formed by many fragmented, thin, strip-shaped blood clots piled together. Moreover, the center and the periphery are roughly the same. When we remove blood clots, the center may be entangled, but the periphery is usually smooth."

"So in clinical practice, I've never seen this kind of thrombus before," Wen Ruzheng said truthfully. He had seen countless pathological slides, but he had never seen such a bizarre thrombus.

Given this, can we conclude that the death was caused by the disease? Because the pulmonary embolism was very typical, and there were no other suspicious signs.

However, there is one point of doubt: this kind of thrombus has never been seen before, and even doctors have never seen it before. Pathologists have seen far more thrombi than forensic doctors, by an order of magnitude, and he also said he had never seen one before.

"So, based on your experience, if this pathology slide belongs to a patient in your hospital, how would you draw a conclusion?" Dr. Yuan was eager to know.

Now, what should a doctor do if they encounter a completely new and morphologically rare thrombus?

"Let's just describe it as fact and diagnose it as a thrombosis. We don't need to consider any other legal matters," Wen Ruzheng replied casually.

He's absolutely right. The issues he considers are completely different from those of a forensic doctor, and he doesn't need to consider any other reasons.

"What are your doubts now? Why is this pulmonary embolism being treated as a suspected homicide and subjected to a forensic autopsy?" Yang Ping asked.

Dr. Yuan said, "The deceased was a well-known and influential private entrepreneur in our city. He died at his lover's house. Now the deceased's family suspects that the cause of death is unclear and there is a possibility of homicide, so they have requested our public security organs to intervene."

"Are there any other suspicious causes of death?" Yang Ping continued to ask.

Dr. Yuan shook his head: "No, the body has not been harmed in any way. The stomach contents were tested and no toxins were found, and the whole blood test also did not find any toxins. However, the test showed residual insulin. According to our tests and calculations, the insulin dosage is within the normal range."

"This patient had diabetes and needed to inject insulin regularly every day. The family believed that his lover had given him an overdose of insulin, which led to his death. However, we have conducted tests and the cause of death was not hypoglycemia. Moreover, the tests showed that the insulin dosage at the time was within the normal range."

"The deceased had diabetes?" Yang Ping was very interested in the medical history.

Dr. Yuan said, "That's right!"

"Are there any other illnesses? Is insulin the only medication you usually use? Have you used any other medications, such as sex aids?" Yang Ping didn't overlook any detail.

Dr. Yuan shook his head: "The deceased was very attentive to his health and never used this type of medication."