Siheyuan: Rebirth in a prosperous era, great doctors are sincere

Chapter 618 Father Retired

Li Pingan believes that the reason why meningitis became prevalent two or three years later was mainly due to the specific environment at that time.

It is common to see large-scale connections across the country, from the capital to the provincial level and from the provincial level to the capital, and many of them are primary and secondary school students. This is one of the main reasons why the disease can spread.

Li Ping'an has no way of predicting or controlling what will happen in the future. All he can do is to take precautions as much as possible to reduce the losses in two or three years.

There is no shortage of penicillin in the country now, and what Li Pingan can do is to develop a meningococcal vaccine.

The epidemic meningitis vaccine is a group A meningococcal polysaccharide vaccine. It is made by culturing group A meningococci in liquid culture, sterilizing them with formaldehyde, extracting the capsular polysaccharide antigen from the supernatant, and then freeze-drying it for use in preventing meningococcal meningitis caused by group A meningococci.

There are 13 different serogroups of meningococci, classified according to the antigenic structure of their polysaccharide capsule. Five serogroups: A, B, C, Y and W135 are responsible for almost all human cases.

In the mid-1960s, the main bacteria prevalent in my country were group A meningococci, and this was also the bacteria isolated from Han Xiulan.

The Health Bureau did not find any sick patients at the steel factory, the tailor shop, or the primary school where Han Xiulan attended, so the bacteria intercepted by the laboratory of the Sixth Hospital were the only pathogens.

It was not difficult to produce this vaccine. Li Ping'an handed the bacteria to the Ministry of Health and Beijing Pharmaceutical Factory, explained the situation and asked them to start production.

Since there was no outbreak of the disease, the Ministry of Health gave the task of researching a vaccine to Jingcheng Pharmaceutical Factory.

After developing the vaccine, Beijing Pharmaceutical Factory conducted clinical trials in accordance with regulations.

Vaccine clinical trials are an important part of the vaccine development process, and their purpose is to evaluate the safety and effectiveness of vaccines.

Clinical trials of vaccines are generally divided into four phases.

Phase I clinical trials mainly evaluate the safety and tolerability of the vaccine in healthy people and determine the appropriate vaccination dosage.

The Phase II clinical trial will expand the scope of subjects to further evaluate the safety and initial effectiveness of the vaccine.

Phase III clinical trials are conducted on a larger number of subjects to fully evaluate the effectiveness and safety of the vaccine and provide key evidence for its marketing.

Phase IV clinical trials are mainly conducted after the vaccine is launched on the market to monitor the long-term safety and effectiveness of the vaccine during large-scale use.

A vaccine was developed quickly.

The Sixth Hospital is also one of the hospitals conducting clinical trials.

The subjects are mainly children aged 6 months to 15 years old.

The first vaccination starts at 6 months old. Children under 3 years old are given 2 doses with an interval of 3 months. Children over 3 years old are given 1 dose. The vaccination should be completed before the epidemic season of meningococcal meningitis. In the event of an epidemic, the age group can be expanded for emergency vaccination.

This immunization plan is a rule copied by Li Ping'an for later generations. Whether it is suitable for the current stage still needs further testing and research.

The body's immunity to Neisseria meningitidis infection mainly depends on humoral immunity.

Two weeks after overt infection, latent infection or vaccination, the levels of group-specific IgG, IgM and IgA antibodies in the serum increased significantly.

Secretory IgA antibodies can prevent Neisseria meningitidis from invading respiratory mucosal epithelial cells;

Serum IgG and IgM antibodies have the function of killing pathogens with the participation of complement;

Serum antibodies, with the participation of complement, can enhance the phagocytosis and killing of pathogens by phagocytes.

Antibodies, also known as immunoglobulins, are very specific molecules that bind to their target antigen and, most commonly, neutralize it.

They do this by promoting structural changes, blocking binding sites required for function, or marking cells to which they bind for phagocytosis.

They can also help antigens or cells aggregate.

When detected, the body typically produces them in response to toxins or other pathogens.

They are part of a specific immune response, produced to fight a known threat.

Antibodies can also play a therapeutic role and be used to affect specific metabolic pathways.

Immunoglobulin (Ig) molecules are "Y"-shaped glycoproteins composed of two heavy chains and two light chains.

The light chain consists of two domains and the heavy chain consists of four domains.

These domains all have constant and variable regions, which explains the wide variation in structure between the molecules.

The arms of the "Y" are composed of light chains, with the N-termini of the heavy chains tightly bound together.

The main body of the "Y" is made up of the other end of the heavy chain, the C-terminus.

They are divided into classes A, D, E, G, and M, with IgG being the most common.

This form is commonly found in the blood and tissues, easily crosses the placenta and provides the fetus with its first immunity.

There are four subclasses of the IgG class, which have slightly different structures but each have two identical antigen-binding sites at the end of the "Y" arm.

IgM and IgG are immunoglobulin M and immunoglobulin G respectively, and are important antibody molecules in the human body.

When the human body is infected with pathogenic microorganisms, IgM antibodies will appear first in the body after one week, followed by IgG antibodies.

When performing immunoglobulin testing, an increase in IgM usually indicates primary biliary inflammation, macroglobulinemia, etc. If IgG is found to be significantly elevated, it may indicate an autoimmune disease.

Checking the level of IgM is helpful for the early diagnosis of infectious diseases. IgM can also bind to complement to dissolve bacteria and blood cells, neutralize viruses, etc. IgG can also bind to complement, neutralize bacteria and viruses, help immune cells enhance their phagocytic ability, and play an anti-infection effect.

Infants under 6 months old can obtain IgG antibodies from their mothers and develop natural passive immunity, so they rarely get infected.

After 6 months, the antibody level from the mother gradually decreases and the infant's susceptibility to the disease gradually increases. Therefore, infants in the 6-month to 2-year-old age group have the lowest immunity and are a susceptible group to Neisseria meningitidis.

Since this vaccine is a purified vaccine, the residual protein and nucleic acid content is extremely small. The reaction after injection is generally mild. A few people have a short-term low fever, which usually occurs 6-8 hours after vaccination. Local redness and tenderness usually gradually disappear 24 hours after vaccination.

Li Ping'an took the lead in arranging for the three children of Li Ye, Chen Nan and Chu Kang to get vaccinated and participate in the clinical trial. All the children of the medical staff of the Sixth Hospital in their families participated, and even the children in the courtyard participated.

Even Han Xiulan was re-vaccinated, and Li Pingan also paid special attention and research to her.

Several hospitals and laboratories exchanged research results with each other, and after a long period of research, they came to a number of experimental conclusions.

3岁以上被接种者于接种后7-10天血清中即可测出杀菌抗体和凝集抗体，2-4周达高峰，血清抗体阳转率达90%以上，保护水平可维持3年左右。对2岁以下婴幼儿能维持1年，2岁以下婴幼儿年龄越小抗体形成越差。

实验证明，6个月-2周岁儿童约30%-50%缺乏对多糖抗原的免疫应答，有抗体者也只能维持1年。

This is because the immune system of infants and young children is not fully developed, and polyantigen is a T-cell-independent antigen. After vaccination, infants only produce IgM antibodies, not IgG antibodies, no recall reaction, and no enhanced immune response. Therefore, increasing the number of injections for infants and young children has no obvious effect.

This type of vaccine has been the most thoroughly researched because it poses no threat of disease and takes two to three years or even longer to research. During the clinical trials, children and teenagers of appropriate age in Beijing and Shanghai were vaccinated.

Two or three years later.

The disease was immediately eradicated as soon as it showed signs of becoming an epidemic.

When the locust flowers were in full bloom that year, no one competed with the Li family for them, and even Jia Zhang didn't go to pick them.

The Li family couldn’t finish it.

Li Ping'an and Qin Huairu gave them to relatives and friends, and Xu also asked the third aunt and Han's mother to pick some at the hospital's family quarters.

early summer.

Li Lin retired.

Although he is retired, he and Jiang Shan still go to the steel factory's medical room to help every day.

In fact.

Now there are only three doctors on duty in the Zha Steel Factory's medical room: Wang Fengnian, Lin Wen and his wife, and Su Jin.

Su Jin is also an obstetrician and gynecologist, mainly diagnosing and treating gynecological diseases.

Wang Fengnian thought that he was the leader of the medical office, and he didn't have much idea of ​​respecting the elderly and loving the young. Even though he knew that Li Lin was Li Ping'an's father, and Jiang Shan and Li Ping'an had a close relationship, he still ordered the two of them around.

In his opinion, both of them were non-staff members and he was the one in charge of the infirmary.

but.

The medical skills of Wang Fengnian and his wife were indeed not that good. Li Lin and Jiang Shan were suppressed too harshly by this guy. They both backed off and went to the infirmary less often.

This made Wang Fengnian panic.

Although they didn't commit any serious mistakes, they were unable to cure the workers' family members' minor illnesses such as headaches, fever, diarrhea, and stomachaches.

The workers frequently reported this matter to their leaders.

After learning about this, Director Yang comforted the workers' families and asked them to go to the Sixth Hospital for treatment first, while he went to find Li Pingan.

The Sixth Hospital is developing very well now.

Li Ping'an would be reluctant to transfer doctors directly from the hospital, so he suggested that Director Yang go to the Health Bureau and other superiors. If the superiors could transfer a group of highly skilled doctors to the Zhagang Steel Plant's medical room, it would be much better than finding doctors from the Sixth Hospital.

The Sixth Hospital could only allocate two or three doctors to the medical room at most, and they were reluctant to do so because Li Pingan’s medical skills were too advanced.

Director Yang followed the advice and went to the Health Bureau to explain the matter. He did not say that Wang Fengnian and his wife were not good doctors, he only said that they were too young.

The steel mill is a large enterprise, and even the Health Bureau and other superiors take it very seriously.

They mobilized five or six doctors to the infirmary, none of them were young. There were old Chinese medicine practitioners who had been practicing for 20 to 30 years, as well as Western medicine practitioners, and many who could perform surgery.

The level of doctors in the Zhagang Steel Plant's medical room has improved, and is no weaker than when the Soviet expert Andrei was there.

As a result, Wang Fengnian and Lin Wen seemed a little redundant, and he was soon ostracized by other doctors. Strictly speaking, it was not ostracism, because his medical skills were not good, so naturally there were fewer patients who came to see him. As for surgery, other doctors were even more reluctant to let him do it.

Wang Fengnian was very unconvinced and told his parents about the incident when he returned home for dinner.

No one is better than his mother. As soon as he sticks his butt out, Aunt Mei knows what kind of shit he is going to do.

Before he could continue, Aunt Mei stopped him and said, "Do you still want to change your workplace? Do you want to go to the Sixth Hospital or the Capital University Hospital this time? I tell you, don't even think about it. Just stay in the infirmary of the steel factory. People like you, with poor medical skills, will not be respected by anyone in any unit. Don't embarrass me and your sister at the Capital University Hospital. As for the Sixth Hospital, your father can't help you. Li Ping'an knows that you are not worthy of him!"

Wang Fengnian and his wife looked at each other. Since they couldn't change their jobs, they could only spend their days in the steel factory's medical room.

Wang Fengnian became obedient, but when Li Lin and Jiang Shan went to the steel factory's medical room to help again, they found that they had become redundant.

and.

Even if two people went to help, the other doctors would not let them prescribe medicine.

Although it was not stated explicitly, there was some caution. The two men had already retired and they were just there to help. They had no agreement with the steel plant or the Sixth Hospital. What should they do if there was something wrong with the diagnosis or the prescription?