godfather of surgery

Chapter 1290 Different Meanings

Upon arriving at Sanbo Hospital, Rikoyang was quickly transferred to the institute's intensive care unit because his life was in imminent danger.

"Professor Yang, may I observe the entire treatment process? Not as an official event, but as a personal learning experience?" Johannesson requested. He had long considered himself Yang Ping's student, and was one of the founding members of Yang Ping's online academic forum and WeChat group.

“Of course!” Yang Ping nodded.

Johannesson was thrilled: "Thank you." He was grateful that Yang Ping hadn't treated him differently because of American arrogance.

Yang Ping said, "Now we need to perform external ventricular drainage on Li Gaoyang. You can go in and take a look together."

The surgery began half an hour later, with Song Ziming as the surgeon. The puncture needle was precisely inserted into the lateral ventricle, and dark red cerebrospinal fluid flowed out, causing the intracranial pressure monitor readings to drop rapidly.

The entire surgery took only ten minutes.

“God…” Johannesson murmured, “Dr. Song is so skilled at surgery now.”

Although external ventricular drainage is a minor surgery, it can still demonstrate the doctor's professional competence.

Having not seen him for some time, Johannesson was amazed at how much progress Song Ziming had made. While admiring him, he couldn't help but feel a little ashamed.

Twenty-four hours after the drainage procedure, Li Gaoyang's symptoms were relieved.

Rolf, dressed in isolation gown, sat on the edge of the bed, holding Li Gaoyang's hand. "Professor Yang said that the first phase of treatment will begin tomorrow, using the world's most advanced K therapy. You were almost turned away by this new method, and it was all your own doing. But fortunately, you woke up at the critical moment and made the right choice."

Li Gaoyang nodded, indicating that he understood.

“And…” Rolf lowered his voice, “the White House and the FDA have been pressing for data, and fortunately, Professor Yang doesn’t mind sharing your treatment data with them…”

Rigaoyang gripped Rolf's hand slightly tighter: "Only by living... can everything else exist..."

The treatment officially began at nine o'clock the next morning.

The principle of K therapy is actually not complicated. It involves injecting an adeno-associated virus vector carrying the therapeutic gene into the bloodstream via intravenous injection. The blood circulation carries it to various parts of the body, including crossing the blood-brain barrier, and then infecting tumor cells. It initiates the tumor cell apoptosis program within the tumor cells, causing them to die. This infection and initiation process is highly selective.

The atmosphere in the treatment room was relaxed.

Yang Ping stood to the side as the nurse administered the medication, Song Ziming monitored the vital signs, Xu Zhiliang recorded the data, Johannesson observed from the side, and a large group of graduate students surrounded them.

Johannesson was very surprised that the world's top cancer treatment method was so simple, no different from a regular IV drip. It did not require an expensive special treatment room, complicated operating techniques, or even sterile isolation gowns.

"Initiate administration." The nurse turned on the IV drip.

"You don't need to be so nervous, it's just an IV drip." Yang Ping comforted the trembling Li Gaoyang, whose family had gone to great lengths to secure this opportunity.

"The patient's vital signs are stable," Song Ziming said.

The infusion lasted for forty minutes. Afterwards, Li Gaoyang was transferred to the intensive care unit to begin 48 hours of intensive monitoring to observe the immune response and early efficacy.

Nothing happened on the first day.

The following afternoon, Rigoyan's temperature began to rise, reaching 38.5 degrees Celsius.

“Immune activation response.” Yang Ping looked at the data. “This is a normal phenomenon, indicating that the viral vector is working.”

But by evening, her body temperature had risen to 39.8 degrees Celsius, her heart rate had increased, and her blood pressure had fluctuated.

"Isn't it too intense?" Song Ziming asked. "Does it need to be treated?"

Johannesson waited anxiously for Yang Ping's reply.

"We will continue to observe," Yang Ping said. "Unless organ dysfunction occurs, we will not intervene in the immune process. Multiple clinical trials have shown us that it is safe and controllable, although we cannot rule out unexpected events."

A strong immune response is the most dangerous part of first-generation K therapy—the activated immune system is so strong that it can damage normal tissues.

Sisi almost died from this strong immune response, but after several iterations, the reaction was completely under control. However, due to racial differences, Li Gaoyang's reaction was still a bit stronger.

At 2 a.m., Li Gaoyang's body temperature exceeded 40 degrees Celsius and he began to have convulsions. For safety reasons, the doctor gave him sedation and put him on a ventilator to assist his breathing.

"The cerebral edema has worsened." Song Ziming stared at the monitoring image. "There is a clear inflammatory response in the tumor area."

Everyone held their breath. Rolf paced anxiously in the observation room, while Johannesson took notes rapidly. This was a treatment response pattern he had never seen before.

Yang Ping appeared very relaxed and ordered: "Administer methylprednisolone to control cerebral edema, and begin cooling treatment at the same time."

"Don't be too nervous, we just need to treat the symptoms," Yang Ping reassured Johannesson beside him.

Medication was administered, and physical cooling was initiated. The next six hours were a long wait. Li Gaoyang struggled on the brink of life and death, while the medical team recorded data and adjusted the treatment plan every ten minutes.

Li Gaoyang's treatment was not timely, as he had already developed significant cerebral edema. In addition, due to racial differences, the side effects were somewhat stronger.

As the morning sunlight streamed through the blinds into the intensive care unit, Rigland's fever finally began to drop. 39 degrees…38.5 degrees…38 degrees. The convulsions stopped, and his vital signs improved.

"He pulled through." Johannesson breathed a sigh of relief.

Yang Ping nodded, but his face showed no joy, only calm. "The immune storm may have aftershocks, and this is just the beginning." According to the agreement, all treatment data is transmitted in real-time to the NIH server in the United States. However, before transmission, the data undergoes a layer of "de-identification"—removing patients' personal information while retaining complete treatment parameters and efficacy data.

"They requested the genetic sequence of the viral vector," Song Ziming reported to Yang Ping, "citing the need for a safety assessment."

“Give them the truncated version.” Yang Ping said without looking up, “Show the vector backbone and target portion, but hide the core gene-editing components and promoter design.”

Yang Ping explained, "The agreement only mentions sharing 'treatment-related data,' not 'core technical details.'" Yang Ping raised his head, his eyes sharp. "We treat patients, and they learn the technology. It's an unspoken exchange, but we can't give away all our cards. Controlling the core technology is the bottom line. Don't trust them."

Song Ziming nodded and began preparing the data package.

Meanwhile, at the headquarters of Nandu Ruixing, Huang Jiacai was holding a new round of talks with representatives of the six industry giants. This time, the atmosphere was completely different.

"You've all seen the live updates on Li Gaoyang's treatment progress," Huang Jiacai said, getting straight to the point. "The patient survived the most dangerous immune storm, which means that K therapy is also effective for these most critically ill patients."

In the conference room, representatives from multinational corporations exchanged glances. Over the past few days, they had obtained fragmented information about the treatment process through their own channels, but the briefing provided by Huang Jiacai was the most complete.

“The efficacy data are impressive,” Schneider acknowledged. “But we also noticed serious adverse reactions during the treatment. Could this affect regulatory approval?”

“Any innovative therapy carries risks,” Huang Jiacai responded. “The key is to look at the risk-benefit ratio. For late-stage patients with only a few months of expected survival, the risk is negligible compared to the benefits.”

He pulled up a chart: "This is a predictive model updated based on rikoyan treatment data. If we launch a formal multicenter clinical trial within three months, we expect K therapy to receive conditional approval in major global markets by the end of next year. At that time, the annual treatment capacity can reach 50,000 cases, and exceed 500,000 cases in three years."

Numbers flashed across the screen, and the representatives began to calculate—500,000 cases, even with tiered pricing under the universal healthcare framework, would result in an annual market size exceeding ten billion US dollars. More importantly, this would completely transform the market landscape for brain tumor treatment.

"So," Huang Jiacai looked around, "the question now is: do you all want to be participants in this future, or bystanders?"

This time, there was no united front, no unified message. Sato from Japan took the lead in stating: "We are willing to be among the first partners to take charge of production in Japan. We have prepared a detailed plan that can reduce production costs by more than 25%."

Germany's Schneider Electric followed suit: "We have the most comprehensive network of doctors in Europe and can train more than a thousand doctors to master the patient screening and management process for K therapy within six months."

Thompson from the US hesitated for a moment, but ultimately said, "If the FDA initiates formal approval following the Ligoyan case, we are willing to work with BG to undertake the organization of clinical trials in North America."

One after another, the six giants made their statements.

The inclusive framework, a plan they collectively resisted just a month ago, has now become an unavoidable reality. Li Gaoyang's treatment serves as a touchstone and a living advertisement, proving the effectiveness of the technology and demonstrating China's technological control—they don't rely on anyone and can therefore set their own rules.

At the conclusion of the meeting, Huang Jiacai announced: "Next week, Ruixing will officially launch its global partner recruitment. All applicants will be evaluated according to unified standards, and the first batch of partners will be announced within three months. At the same time, we will announce the detailed implementation rules of the inclusive framework, including the pricing formula, data sharing mechanism, and quality management system."

The delegates left with complex expressions. They knew they were witnessing the beginning of a new era—an era where technology leaders were no longer merely suppliers, but rule-makers; and where traditional giants had to learn to compete under these new rules.

A week later, Rikoyan began the second phase of K therapy.

This time, the process was much smoother. His immune system had undergone its first "training," and the response was more controllable. Forty-eight hours after treatment, imaging showed that the tumor had shrunk by 15%.

Rolf stood in the observation room, looking at Rigoyang in the intensive care unit. His face was no longer ashen when he first arrived, and his eyes had regained their sparkle. Yesterday, he had even expressed a desire to see the scenery outside the window.

"Professor Yang," Rolf approached Yang Ping after the meeting, "if the treatment is successful... can he go back to how he was before?"

Yang Ping thought for a moment and answered honestly: "The nerve damage caused by the tumor is irreversible. Even if the tumor disappears completely, there may still be some functional impairment, which is unavoidable. So this treatment also has its own golden window, but based on the current volunteer treatment, the probability of leaving sequelae is not high, and even if there are, they will be relatively mild."

Rolf was silent for a moment, then said, "That's enough. As long as you're alive, there's hope."

That evening, Huang Jiacai arrived at the hospital. He didn't go into the ward, but just glanced at Gao Yang through the glass, and then chatted with Yang Ping.

“There is a lot of pressure from the United States,” Huang Jiacai said. “The White House wants us to start formal multi-center clinical trials as soon as possible. They want to accumulate more data domestically before Europe and Japan.”

“The technical preparation is fine,” Yang Ping said. “But we must control the pace. If we move too fast, quality control may be problematic. K therapy is not mass-produced; each case is a customized treatment.”

“I understand.” Huang Jiacai nodded. “So the conditions I discussed with them were: we can speed things up, but they must accept our training system and quality control standards. Moreover, the first one hundred cases must be completed under our supervision.”

"That's right, we must stick to our principles."

“Li Gaoyang’s success left them with few options. That’s the nature of technological advantage: when you have something that others don’t, you have the power to set the rules.”

“Professor Yang,” Huang Jiacai suddenly said, “sometimes I wonder if we’re moving too fast? Using a single technology to challenge the vested interests of the entire global pharmaceutical system.”

Yang Ping turned to Huang Jiacai and said, "Have you ever seen patients with advanced cancer? I've seen too many. Some of them are only teenagers, some have just become parents, and some are top scientists, artists, and entrepreneurs. In the face of disease, they are all equal, equally desperate, and equally waiting for death."

He paused for a moment: "If we have the technology to save them, but delay because of commercial interests, political calculations, or so-called 'industry rules,' then what's the difference between us and those we once criticized?"

Huang Jiacai did not answer immediately. After a long while, he said, "You're right. So we must continue down this path, no matter how difficult it may be."

Downstairs, in the intensive care unit, Li Gaoyang stared at the ceiling with his eyes wide open. The monitor beeped rhythmically—the sound of life. He recalled many things: his studies in his youth, the struggles with competitors after starting work, the ecstasy of becoming the president of BG for the first time, and the doctor's calm yet cruel pronouncement on the day of his diagnosis.

Then he remembered what Yang Ping had told him before the treatment: "This treatment will be a bit difficult, but if you can get through it, you will find that life has a different meaning."

What are the different meanings...?

He doesn't know the answer yet. But at least, he still has the chance to find it.

(End of this chapter)