novelMigli Chapter 1457 Unknown Factors
Chapter 1457 Unknown Factors
Chapter 1457 Unknown Factors
As night deepened, the light in the study cast a soft glow on Yang Ping's face.
Lu Xiaolu answered the phone after it rang twice. In the background, he could hear the beeping of instruments, so he must still be in the lab.
"Professor, you haven't rested yet?" Lu Xiaolu's voice carried a hint of surprise.
“You haven’t rested either.” Yang Ping leaned back in his chair, his gaze still fixed on the spectral image on the screen. “I have a case I’d like to discuss with you. It’s a twelve-year-old girl with a diffuse brainstem glioma, diagnosed as DIPG by biopsy. The tumor progressed after radiotherapy, but the family is unwilling to give up and wants to try a new treatment plan.”
There was a few seconds of silence on the other end of the phone.
Lu Xiaolu was probably processing this information. Everyone involved in cancer research knows what DIPG means in the field of neuro-oncology. The median survival after diagnosis is less than a year, the five-year survival rate is less than one percent, and no treatment has significantly improved prognosis in the past thirty years.
“Typical DIPG imaging findings include pontine enlargement, diffuse infiltration, and compression of the fourth ventricle,” Yang Ping continued. “But I noticed a significant increase in lactate peaks on the spectrum, indicating a clear hypoxic microenvironment within the tumor.”
Lu Xiaolu raised her voice slightly, "K therapy is being extended to gliomas. There are not many cases at present, and there are strict indications, but it is more suitable in environments with significant hypoxia."
“That’s what I think too,” Yang Ping said. “How many similar cases have you accumulated over your area with K-therapy?”
“Eight cases of brainstem gliomas, only two of which were DIPG.” Lu Xiaolu seemed to be flipping through the data, pausing for a few seconds. “The two cases had relatively good results. One case showed a 40% reduction in tumor size on imaging six months after treatment, and the clinical symptoms improved significantly. The other case did not have such a good result, but it still shrank by 10% after six months.”
"What about the specific treatment plan? Please compile the administration method, dosage, and combination therapy regimen for K therapy and send it to me. We need to discuss it with the family tomorrow afternoon, and I want to give them the clearest possible expectation."
"Okay, I'll organize it and send it to your email tonight."
After hanging up the phone, Yang Ping flipped through Lin Xiaoyu's medical records again, and before he knew it, it was already eleven o'clock.
At 6:30 a.m. sharp, the alarm clock rang.
Yang Ping opened his eyes and found that Xiao Su was no longer beside him. Soft sounds came from the kitchen: the clinking of pot lids, the sound of running water, and Xiao Su softly humming a song.
He sat up, rubbed his eyes, and then got out of bed.
"Why are you up so early?" Yang Ping walked into the kitchen, where Xiao Su was cooking porridge.
"I can't sleep, the baby's practicing boxing in my belly." Xiao Su turned to look at him. "Why didn't you sleep a little longer? You went to bed so late last night."
“I’m used to it, I wake up on time.” Yang Ping walked to her side and looked at the porridge in the pot. It was millet porridge with red dates, cooked until thick, the aroma of rice mixed with the fragrance of dates, which smelled comforting.
"What are the plans for today?" Xiao Su asked.
"I went to the research institute this morning to discuss a new discovery by Einstein. This afternoon, there's a case discussion in neurosurgery about a child with DIPG; the family wants to try K therapy."
Xiao Su paused for a moment while stirring the porridge.
"DIPG? The kind that grows on the brainstem?" She was a nurse by training, and although she was no longer on the front lines of clinical practice, she still knew the basics of these diseases.
"Correct!"
Xiao Su was silent for a moment, then said, "Isn't it true that those kinds of illnesses don't respond very well to treatment? You told me that before."
“Conventional treatments are indeed not very effective,” Yang Ping said. “But K therapy can, and Lu Xiaolu has accumulated some case data. Although it’s not a trial specifically for DIPG, the results of a few cases have given us some confidence.”
Xiao Su didn't respond; she understood what Yang Ping meant. When faced with a terminal illness, a doctor can't tell the family "there's absolutely no hope," nor can they say "it can definitely be cured." They must find a balance between hope and reality, neither giving false promises nor extinguishing the last glimmer of hope.
"The porridge is ready. Let it cool down a bit before you eat." Xiao Su ladled a bowl of porridge and placed it in front of Yang Ping. "Eat before you go to work."
Yang Ping sat down, picked up the bowl, blew on it to cool it down, and took a sip. The porridge was cooked perfectly; the rice grains had split open, and the sweetness of the red dates had completely infused into it. It was warm and comforting, warming him from his throat all the way to his stomach.
“It’s delicious,” he said.
Xiao Su smiled, sat down opposite him, turned a small fan towards the porridge, and then helped stir it: "Let it cool down."
As doctors and nurses, they understand this principle of healthy eating: you shouldn't eat food that's too hot too often.
Soon, the porridge cooled down. After finishing breakfast, Yang Ping shaved, changed into a clean shirt, and went out.
Inside the research institute building, a busy day has begun.
When the elevator doors opened, Yang Ping saw Tang Shun standing in the hallway, making a phone call. His expression was serious, and his brows were furrowed. Upon seeing Yang Ping, he raised his hand in a gesture of acknowledgment, then quickly said a few words and hung up.
"What's wrong?" Yang Ping walked over and asked.
Tang Shun said, "Weber stayed in the lab until 2 a.m. last night. He said the temperature exposure time verification experiment had to be done immediately and he couldn't wait until the next day. When I came in this morning, I saw him asleep in the break room next to the culture room, covered with a white lab coat."
Yang Ping frowned.
“He’s in such a state that he’s prone to making mistakes in experiments. Let him go home and rest. The experiment won’t be affected by one more day, but this can’t happen again.”
“I told him, but he wouldn’t listen.” Tang Shun shrugged helplessly. “He said that hypothesis had been swirling in his head all night, and he couldn’t sleep without testing it. Now he’s started the experiment, and I can’t stop him.”
Yang Ping didn't say anything more and walked towards Weber's laboratory.
Weber was indeed inside. He was wearing a white lab coat and gloves, operating in the clean bench. His movements were steady, showing no signs of fatigue, but Yang Ping noticed obvious dark circles under his eyes and bloodshot eyes.
“Weber,” Yang Ping called out.
Weber turned his head, saw Yang Ping, and smiled: "Professor, you've come at the right time. I just finished inoculating the cells. This time I set up four temperature conditions: room temperature exposure for five minutes, ten minutes, fifteen minutes, and a control group that was kept at 37 degrees Celsius throughout."
"Didn't you sleep well last night?" Yang Ping asked.
“I slept for a while,” Weber said casually. “I lay in the lounge for two hours, that’s enough. Back in Germany, I once worked for 48 hours straight. I was younger then, and although I can’t do it as well now, I’m not far off.” Yang Ping looked at him and frowned.
"After you finish this batch of experiments, you must go home and rest. This is not a suggestion, it is a requirement. I cannot believe the results of experiments conducted under fatigue."
Weber opened his mouth as if to say something, but seeing Yang Ping's expression, he swallowed his words.
“Okay, I’ll go back when I’m done,” Weber said.
Yang Ping nodded, turned, and left the lab. He went to Mainstein's office; the door was open, but he wasn't there. He asked a student nearby, who said that Mainstein had gone to the proteomics platform because the mass spectrometer there had a minor problem, and he had gone to fix it.
Yang Ping then went to the proteomics platform.
Einstein was squatting next to the mass spectrometer, holding a wrench and tightening something. His white lab coat was stained with oil, and his hair was messy, making it seem like he had been there for a long time.
“Professor, please wait a little longer, it will only take three minutes,” Mainstein said without looking up.
Yang Ping didn't say anything, just stood there watching.
Mannstein moved with practiced ease, turning the screw a few times, then adjusting something with the screwdriver before finally standing up and pressing the start button. The mass spectrometer emitted a low hum, and a line of green text appeared on the screen: System self-test passed.
“Alright.” Mainstein clapped his hands. “This is the mass spectrometry verification data for the unknown factor I mentioned. We just ran it yesterday, and haven’t had time to analyze it carefully yet.”
He opened a software program on the computer next to him and retrieved a set of data. A dense graph of peaks appeared on the screen, each peak representing a peptide segment, and each peptide segment corresponding to a part of a protein.
“Look here,” Mainstein said, pointing to one of the peaks. “This peptide appeared in three independently prepared conditioned media, but not in the control medium. I searched the database, and this peptide only matches that unknown protein; no other known protein produces the same peptide.”
Yang Ping looked at the peak, then at the mass spectrum next to it, and asked, "What's the degree of matching?"
“Ninety-nine point seven percent,” Mainstein said. “This means it’s almost certain that the protein is indeed present in the conditioned medium. It’s not contamination, it’s not a false positive, it’s real.”
Yang Ping nodded; the verification result was solid. Mass spectrometry is the gold standard for protein identification, and a 99.7% match rate leaves virtually no room for dispute.
"What about the functional experiments?" Yang Ping asked.
Mainstein twitched his chin slightly. "Weber's working on it. He designed a new scheme yesterday to verify the effect of temperature exposure time. I just heard he didn't go home last night and stayed in the lab all night?"
"Yes, I just came from over there. Tell him to finish this batch and then go back to rest."
Mainstein shook his head: "That Weber, he was like that when he was young, he wouldn't sleep until he got the experiment right. But that's not good. Scientific research is a marathon, not a sprint. If you run too fast, you'll collapse halfway through."
Yang Ping smiled and said, "I'll have someone keep an eye on him. Once he's done, I'll let him go back. If that doesn't work, I'll have two PhDs escort him back to bed."
“I thought so too. By the way, about that discovery you mentioned in your email yesterday.” Mainstein turned around, his eyes lighting up. “What information about this unknown factor did you say you found in the protein database?”
Yang Ping walked to the computer, logged into the protein database, and entered the number.
Once the page loaded, he turned the screen toward Mainstein.
Mannstein leaned closer and read line by line. His expression changed from calm to surprise, from surprise to excitement, and finally to deep thought.
“This domain…” Mainstein pointed to a line of text, “is a key domain for intercellular communication. If this protein does contain this domain, it may not function alone, but rather as a signaling molecule that transmits information between cells.”
“And look here,” Yang Ping pointed to another line, “this protein is expressed at the highest levels in the nervous system, especially in the spinal cord and brainstem. This is directly related to your spinal cord injury repair experiments.”
Mannstein remained silent for a good ten seconds, then slowly said, "Professor, have you ever thought about a question?"
"What's the problem?"
"This protein is naturally present in the human body."
Yang Ping nodded. He had thought about this idea as well. The fact that Einstein brought it up meant that their thinking was consistent.
"If that's the case, then we need to adjust our research direction. We need to shift from finding new molecules to finding ways to activate endogenous molecules. The former is substitution, while the latter is regulation. Regulation is more elegant, safer, and more in line with our equilibrium theory than substitution."
“Yes!” Einstein nodded vigorously. “Moreover, the cost of regulation is lower and it is easier to promote. The production cost of a small molecule drug that activates endogenous molecules may only be one percent of that of cell therapy, and it is also much more convenient to store and transport. Professor, how come I find that several of your important theories are surprisingly connected?”
Yang Ping said slowly, "This is exactly the question I've been thinking about. Perhaps there is an unseen hand controlling all of this, and these theories are just different manifestations of that hand."
The two stood in front of the computer for a while, neither speaking. The page with the unknown factor hung silently on the screen, like a door that had just been cracked open. What lay behind that door, no one knew, but the light shining through that crack was enough to excite.
Yang Ping broke the silence, "I'm going back to my office now. You organize the mass spectrometry data and write a complete report. At next week's group meeting, you can specifically talk about the discovery of this unknown factor."
“Okay!” Mainstein nodded.
Yang Ping stepped out of the proteomics platform and checked his phone. Xu Zhiliang sent him a WeChat message: "Professor, the family will arrive at 2 PM. I've booked a small conference room in the neurosurgery department."
He replied with a "okay" and then walked towards his office.
At noon, he had a simple meal in the institute's cafeteria, then returned to his office and looked through the K-therapy case files that Lu Xiaolu had sent in the early hours of the morning.
Eight cases of brainstem gliomas and two cases of disseminated intravascular coagulation (DIPG) were included. The best outcome was observed in a nine-year-old boy who, after being diagnosed with DIPG, received radiotherapy and temozolomide chemotherapy, but the tumor continued to progress. After enrollment in the ketamine therapy program, he received intravenous infusions every four weeks, combined with oral temozolomide. Six months after treatment, MRI showed a 40% reduction in tumor size, significant improvement in clinical symptoms, and he no longer needed assistance walking; facial asymmetry had also largely recovered. Twelve months after treatment, the tumor continued to shrink, although the rate of shrinkage slowed, the trend remained positive.
Yang Ping compiled the efficacy data of these eight cases into a table, and summarized the mechanism of action and theoretical basis of K therapy in layman's terms, which he planned to use to explain to the family members in the afternoon.
At 1:30, he packed his things and walked towards the small conference room in the neurosurgery department.