From small clinic to medical empire

Chapter 191 We succeeded!
For the human body, the most effective filtering organ is the kidney.

The kidney contains about 300 million glomeruli.

The glomerulus is like a filter, and then the blood is filtered through the glomerulus. Larger molecules, such as protein or nutrients, cannot pass through the filter and remain in the body.

And relatively small toxic substances, such as urea nitrogen, creatinine and guanidine substances, can be filtered into the renal tubules through the screen, and water can also enter the renal tubules through the filter.

Zhang Zifan is not a professional urological surgeon. Even if he is a urological surgeon, if he does not engage in basic research, he may not be able to deconstruct the renal tubule membrane clearly.

Therefore, Zhang Zifan must have a physical object for reference.

Old knives are fast.

Soon, the patient's abdominal cavity was opened.

Due to the prolonged squeeze and the effect of the toxin, what Zhang Zifan saw was an extremely bad scene.

The patient's kidneys are already on the verge of failure, and except for a small number of nephrons that are still dying, other parts have begun to necrosis and degeneration.

[Deconstruction! 】

Zhang Zifan carefully avoided the still functional nephrons, and began to deconstruct the necrotic tissue at the cellular level.

Although the kidney tissue begins to die within a short period of time, it does not mean that all the cells and structures in it have lost their biological vitality.

Zhang Zifan deconstructed some active renal tubules for observation and collection.

The filtration membrane of the renal tubule is deconstructed in three layers.

The inner layer is endothelial cells rich in capillaries, which can basically only block the passage of huge objects such as blood cells, and are less important.

The outer layer is epithelial cells, which mainly play a protective role, and the slit membrane on them also has a certain ultrafiltration effect.

What is really important is the middle layer of the filtration membrane, which is a layer of acellular basement membrane and is the main barrier of the filtration membrane.

The basement membrane is a microfiber mesh structure composed of hydrated gel, and water and some solutes can pass through the mesh of the microfiber mesh.

What Zhang Zifan wanted to learn was the arrangement and structure of these fibrin proteins.

This structure is a complex structure evolved by organisms for hundreds of millions of years. The artificial semipermeable membrane imitates it, but it has never been able to surpass it in terms of certain biological properties.

Next, the problem becomes very simple.

Zhang Zifan needs to find materials to thicken the peritoneum and increase such a membrane structure.

Where do the materials come from?

The patient's kidneys have largely failed, with less than 1/10 of the remaining active membranes.

If all the glomerular mesangium of the kidneys on both sides of the human body are fully expanded, the total area is estimated to be more than 1.5 square meters. Such a large filtration area is conducive to the filtration of plasma.

Zhang Zifan needs to find at least 1/3 of the size, that is, 0.5 square meters of fiber membrane material to initially compensate for the loss of kidney function.

……

From Zhu Jiannan's perspective, Zhang Zifan stared at the patient's kidneys for a while, and then fell into deep thought.

Zhu Jiannan sighed.

Even an optimist like myself can see that there is no solution to the problem at this time.

Does Dean Zhang want to rely on peritoneum for dialysis?
Still too young.

If peritoneum works, who needs hemodialysis!
Zhu Jiannan shook his head, just about to speak to persuade Zhang Zifan, but was held down by Yuan Qiang.

At this time, Yuan Qiang didn't care about the aseptic principle of surgery, or the risk of abdominal infection.

He held Zhu Jiannan firmly with his blood-stained gloves, and then made a silent gesture.

Yuan Qiang understands Zhang Zifan's habits. When he is meditating on the operating table, he does not want to be disturbed.

Even he and Shi Xiaoya secretly nicknamed Dean Zhang "Sleeping Famous Doctor".

……

Zhu Jiannan was stunned.

Does this young man still have confidence in his Dean Zhang?

Does he trust each other so much?
Zhu Jiannan is a little hard to understand, excessive blind faith is not a good quality of a medical worker.

At this moment, Zhang Zifan suddenly raised his head and said, "Get ready for the blood centrifuge!"

"Centrifuge?"

Zhu Jiannan was getting more and more confused. What is the relationship between the centrifuge and the dialysis blood?
Could it be that Director Zhang wanted to use a centrifuge to centrifuge the patient's blood to remove impurities?
This is too outrageous!
Anyone with medical knowledge knows that this is impossible.

Although the centrifuge can separate blood cells and small molecule toxins, the powerful destructive force will cause a large number of blood cells to die.

However, Shi Xiaoya took out the centrifuge from the on-board blood component analysis equipment without hesitation.

Under the command of Zhang Zifan, 100ml of patient's venous blood was centrifuged at variable speed.

"Dean, do you want to prepare a CGF membrane?"

Yuan Qiang was the first to react, a little unsure.

As for Zhu Jiannan, he has practiced medicine for more than ten years, and he has never heard of any CGF membranes!
"clever!"

Zhang Zifan praised without turning his head, he didn't know whether he was praising Yuan Qiang or himself.

However, Zhang Zifan is still very proud of being able to diverge his thinking and think of CGF technology at such a critical moment.

CGF (Condensed Growth Factor, concentrated growth factor film) is an emerging niche technology, only a small number of top dental implant doctors have heard of it.

CGF membrane is mainly used in the partition of alveolar bone and soft tissue.

It has the advantages of simple preparation, good biocompatibility, and convenient material acquisition. However, compared with traditional exogenous biofilms, CGF has poor mechanical properties, which limits its application.

To obtain CGF membrane, it is necessary to centrifuge the patient's own venous blood by low-speed centrifugation and prepare it.

CGF membrane contains a high concentration of growth factors and fibrinogen to form a fibrous network scaffold, which has a good effect on inducing alveolar bone regeneration.

Through variable speed centrifugation, platelets are activated, and the platelet granules release various growth factors, mainly including platelet-derived growth factor, transferred growth factor-[-], insulin-like growth factor, vascular endothelial growth factor, epidermal growth factor and fibroblast growth factor , bone morphogenetic protein, etc., can promote cell proliferation, matrix synthesis and angiogenesis.

The CGF fibrin mesh scaffold can provide space for the new tissue induced by growth factors, and ultimately promote tissue healing and regeneration by guiding the revascularization of the tissue.

The main problem of CGF is that its fibrous network structure is unstable, its toughness is poor, and it cannot bear too much pressure.

This can be solved by compounding with the peritoneum.

The toughness of the peritoneum is quite good, but its fiber mesh is too large, and the filtration efficiency of small and medium molecules is low.

After the two are combined, they can make up for their respective shortcomings and form a very good biological semipermeable membrane.

Even on this basis, Zhang Zifan also used [Deconstruction/Reconstruction Eye] to further improve the fiber arrangement of the composite membrane.

It makes them closer to the deconstruction of the glomerular filtration membrane, and the efficiency of filtering toxic substances is higher!

At this time, Kong Xiang also arrived.

This guy with A+ skills and good at suturing the sclera is Zhang Zifan's great help at this time!
Zhang Zifan didn't bother to explain the principles, and asked Kong Xiang to follow suit.

Soon, pieces of CGF membranes were attached to the peritoneum and closed with ophthalmic sutures.

At the same time, Zhang Zifan spared no effort to use pupil technique to transform and deconstruct as many composite membranes as possible.

After all, Chen Jian's condition was extremely serious, and although the unmodified composite membrane had high efficacy, Zhang Zifan knew that if he wanted to achieve a miracle, he had to do his best.

Finally, when Zhang Zifan felt that there was really no grain of rice in his stomach, Shi Xiaoya cried out in surprise:

"Dean! The patient's indicators have dropped! We... succeeded!"

(End of this chapter)