Chapter 300 Anti-tuberculosis Four-in-One Drug
Among the drugs used in the "quadruple therapy", isoniazid, rifampicin and pyrazinamide are all bactericidal drugs.
Ethambutol has an antibacterial effect on tuberculosis bacteria. When used in combination with other anti-tuberculosis drugs, it can delay the bacteria from developing resistance to other drugs.
However, three of the drug ingredients, isoniazid, rifampicin and pyrazinamide, may damage liver function.
There are also gastrointestinal reactions such as nausea, vomiting, abdominal discomfort, and may also cause joint pain, blurred vision, allergic reactions, etc.
Therefore, young people like Zhao Yanxia can receive outpatient treatment and regular checkups, while old men like Ma Lianliang can only be hospitalized for observation and adjust the dosage and quantity of drugs at any time according to examination indicators.
Dean Shen was worried when he heard that he had to be hospitalized, and he reminded him in a low voice:
"Xiao Qi, our Chinese medicine hospital, whether it's the main hospital or the branch hospital, doesn't have an inpatient department. Look..."
Traditional Chinese medicine hospitals all adopt the outpatient model, so neither Kuanjie nor Changping has an inpatient department and no relevant staff are assigned.
If Ma Lianliang needed to be hospitalized for treatment, there would be no place to put him.
When Director Su of the Peking Opera Theater heard this, his mind started working quickly. He just wanted Master Ma to recover and return to the stage, and he didn't care how you treated him.
"Old Shen, I see a lot of your dormitories are empty. Why don't you clear one out for us to use as a ward?"
When the Changping branch was being built, they feared a second or third wave of staff reductions, so they built extra dormitories from the outset to avoid a shortage of housing later. (This was also the idea behind the Third Front construction back then.)
This time, the National Peking Opera Company came to Changping for a three-day performance, and these empty dormitories became temporary accommodation for the actors.
Dean Shen thought about it after hearing it and shook his head:
"No, that's not possible. The five dormitory buildings are all connected. Our hospital has 600 staff and family members, including many elderly and children. It's inappropriate to put tuberculosis patients in the dormitory area as a ward."
After all, tuberculosis is an infectious disease, so Dean Shen is still vigilant. He doesn't want to infect people in his unit, and the employees will not agree.
Ma Lianliang was a little anxious when he heard this. His senior disciple Zhang Xuejin was very perceptive. Seeing his master's anxiety, he immediately suggested:
"President Shen, Doctor Lin, can we go to Union Hospital for treatment? The inpatient department there is more fully equipped. I heard that they just imported a lot of equipment from abroad, which will make it easier to monitor the condition of my master and Teacher Chen, right?"
The speaker may not intend it, but the listener may take it seriously.
Dean Shen was immediately unhappy: "What's the matter? Our Chinese Medicine Hospital's patients still need to be admitted to Union Hospital for treatment? Doesn't our Chinese Medicine Hospital have any face?"
Zhang Xuejin was also a smart man. He knew that he might have accidentally violated other people's taboos, so he quickly shrank his neck and stepped aside.
Lin Sanqi looked at the handsome 19-year-old Zhang Xuejin and thought that the Peking Opera circle was also a circle where people competed with their fathers.
Ma Lianliang is Zhang Junqiu's adoptive father, and Zhang Xuejin is Zhang Junqiu's biological son. But Zhang Xuejin also worships Ma Lianliang as his master. Look how messed up the generations are.
However, Zhang Xuejin was a man with a conscience. Ma Lianliang was persecuted to death. So many of his disciples and relatives and friends did not dare to see him off, and were afraid to avoid him. Only Zhang Xuejin went to see him off.
True friendship is revealed in times of crisis, which shows that Ma Lianliang did not accept him as his apprentice in vain, and also shows that Zhang Junqiu's family education is really good.
Oh, by the way, Zhang Xuejin later married the movie star Song Jia, so he was quite lucky.
Lin Sanqi thought about it again and remembered that Zhang Xuejin's health did not seem to be very good. He had hepatitis B, which is also an infectious disease. He later died young from this disease.
Although hepatitis B cannot be completely cured like tuberculosis, it is not difficult to control.
Lin Sanqi thought that when he had free time, he would do something about hepatitis B. After all, China is a country with a high incidence of hepatitis B, with one in ten people being hepatitis B patients. This figure is more exaggerated than that of tuberculosis, and the consequences are more serious.
Everyone in the small conference room had no idea that Lin Sanqi was having so much trouble. They were all still racking their brains to find a way to set up an inpatient department.
Dean Su looked out the window at this time, then pointed to a pile of rocks at the foot of the mountain in the distance and said:
"Old Shen, look over there. The ground is all rocky, so you can't grow crops. It's empty anyway, so you can build a ward. This way, you can meet the needs of inpatients while keeping them away from your dormitories. Killing two birds with one stone, right?"
The Chinese medicine hospital has 1,000 acres of mountain land, with some fruit trees planted on the mountain, but they are abandoned because they cannot produce crops.
Dean Shen thought about it, and the light above his head suddenly lit up, thinking that this seemed to be a good idea.
Tuberculosis is an incurable disease in China today. If Lin Sanqi has a secret recipe that can cure tuberculosis, it will greatly enhance the reputation of the Chinese medicine hospital.
If a Chinese medicine hospital sets up a special "tuberculosis ward" to treat tuberculosis patients, it will not only create huge economic benefits, but more importantly, it will have huge social benefits.
Even if Chinese medicine hospitals can cure most tuberculosis cases, it will not only be able to suppress its old rival, Peking Union Medical College Hospital, domestically, but will also make a sensation around the world, becoming a major satellite of my country's medical and health care industry and bringing glory to the country.
Thinking of this, Dean Shen quietly pulled Lin Sanqi aside and asked seriously:
"Xiao Qi, how confident are you in treating tuberculosis?"
Lin Sanqi thought that Dean Shen was talking about the two patients in front of him, so he replied without thinking:
"I'm 100% confident in Zhao Yanxia's recovery. Ma Lianliang's case is a bit more problematic. He's too weak. While undergoing anti-tuberculosis treatment, he'll need Traditional Chinese Medicine to regulate his liver and protect it. The cure rate should be... over 99%."
Dean Shen thought that Ma Lianliang's cure rate was 50%, half and half, but he didn't expect it to be 99%. What's the difference between that and a cure?
The old man glared at Lin Sanqi without concealing anything and continued to ask:
"Xiao Qi, you see, there are a lot of tuberculosis patients right now. For example, eight employees at our Traditional Chinese Medicine Hospital have tuberculosis. If we set up a tuberculosis department specifically to treat tuberculosis patients and prepare 50 beds, are you confident in the treatment? Or are there any problems with the drug supply?"
Lin Sanqi instantly became alert.
He traveled to this era to make a fortune by monetizing traffic, not to be a doctor.
If he spends every day in the hospital treating patients, even if he becomes the best doctor in the country, what good is that? What can he do with a salary of one or two hundred yuan a month?
Even if he works 12 hours a day, he can only see more than 100 patients a day at most. How many patients can he see in a year?
Therefore, he was absolutely unwilling to tie himself down to a clinical position, and he wanted to travel all over the country for procurement.
"Uncle Shen, please don't harm me. You know my role is to get supplies that others can't, exchanging Chinese medicinal herbs for food and so on. I don't want to sit in the outpatient clinic every day. You let me be the department director, isn't that harming me?"
Dean Shen was furious when he heard this and slapped Lin Sanqi on the head:
"Get lost! How could I possibly harm you? There are so many tuberculosis patients across the country suffering from the disease right now. You're a descendant of a distinguished family of traditional Chinese medicine practitioners, and you clearly have a prescription, but you don't even think about curing the disease and saving lives? Are you so obsessed with money?"
Lin Sanqi cried out in injustice: "Uncle Shen, I don't love money, I only love Chinese medicinal herbs. Please don't wrongly accuse me, a child of an aristocratic family, okay?"
Dean Shen was furious when he heard this, and slapped Lin Sanqi on the head:
"We'll let you treat patients without delaying your ability to earn money from traditional Chinese medicine. Think about it, when our tuberculosis ward opens, all the secret recipes will depend on you alone. Whatever traditional Chinese medicine you want, our hospital will purchase it from all over the world for you.
The hospital will provide you with whatever quantity and types of herbs you need, and you can take them secretly. It won't show up in our hospital's accounts anyway. What do you think of my suggestion?"
Lin Sanqi was a little surprised, thinking that Shen Guoming, the old revolutionary with thick eyebrows and big eyes, actually taught him how to embezzle the company's Chinese medicinal materials? The sun rose from the west?
Dean Shen asked impatiently, "Boy, do you think this is feasible?"
Lin Sanqi thought that it was possible and there would be no problem in actual operation.
Anyway, he can have wild ginseng, musk, or officinal maple. The hospital can purchase them and he can take them away secretly. He just needs to give the secret recipe and declare to the public that all the herbs have been used up.
But in theory, this is fleecing socialism. If someone finds out and reports it, both Shen Guoming and Lin Sanqi will be in big trouble and will be killed at the drop of a hat.
"Uncle Shen, is this feasible?"
"Why not? If you can break through the treatment of tuberculosis, it will definitely be a world medical miracle and a great thing that will bring glory to our country. Who would dare to question you? As long as you can cure tuberculosis, everyone will only praise you.
Besides, you're the only one who knows the secret recipe for the medicine you're going to make, and you're the only one who knows how many herbs you need. Anyway, you're a powerful guy, so as long as you can transport the herbs without anyone noticing, no one will be able to catch you in the act, so what are you afraid of?"
With the collusion between Dean Shen, Purchasing Section Chief Kong Shuihu, Pharmacy Section Chief Zhou Mingzhe, and Finance Section Chief Zheng Meimei, it was very easy for him to "embezzle" these medicinal materials. It would be impossible to find out by just checking the accounts.
As long as he didn't do something stupid by secretly carrying bags of herbs out of the hospital and getting caught in the act, then those herbs would only be considered to have been consumed in the making of the secret medicine, rather than being embezzled.
Lin Sanqi planned to open a pharmaceutical factory in 2013. In addition to precious natural musk, natural bezoar, and rhino horn, he also needed a large amount of pearls, cinnabar, realgar, coptis chinensis, scutellaria baicalensis, gardenia, turmeric, borneol, snake gall, Panax notoginseng, etc.
If all these medicinal materials were also obtained from 1960, it would be far more advantageous than purchasing them in 2013, and the efficacy would be more reliable.
Thinking of this, Lin Sanqi nodded firmly:
"Okay, Uncle Shen, let's do as you say. You'll be in charge of getting the herbs, and I'll be in charge of making the secret medicine. Let's strive to build the most advanced tuberculosis treatment center in the world and open the eyes of those people at Union Hospital."
"Hey, you finally figured it out, haha."
Dean Shen immediately took action and took the people from the General Affairs Department of the Chinese Medicine Hospital to the foot of the farm mountain to survey the terrain, contact the construction team, and prepare to build the "Tuberculosis Department" ward.
These days, many rules and regulations are not perfect. There is no need for approval from this department or that department, so there are fewer mothers-in-law, which can greatly improve work efficiency.
Finally, a relatively flat piece of land was selected at the foot of "White Tiger Mountain" to start building the ward immediately.
It is called a ward, but in fact it is just a row of bungalows.
Unlike later generations, we have to distinguish between clean areas, isolation areas, contaminated areas, buffer areas, etc., and we also have to set up independent medical vacuum systems, isolated operating rooms, intensive care units, etc.
Keep everything simple and quick.
The ward was being built in full swing, and Lin Sanqi was also starting to prepare anti-tuberculosis drugs and related inspection equipment.
His personality is that if he does something, he either doesn't do it at all or does it perfectly.
In fact, the main reason why Lin Sanqi was unwilling to be a clinical doctor in 1960 was that being a doctor would affect his ability to make money, which cannot be denied.
But there is another question: how many patients can a doctor see in a day? It's a drop in the bucket. To be honest, one doctor with polymorphisms of Panax notoginseng is not much, and one doctor with less polymorphisms of Panax notoginseng is not much.
But in the end he agreed to serve as the "Director of the Tuberculosis Department", the main reason being.
As long as his appearance can cure tuberculosis, and then he formulates standards for the diagnosis and treatment of tuberculosis, a system can be formed and promoted nationwide, and the people who will benefit will be millions of tuberculosis patients.
As for tuberculosis drugs, Lin Sanqi also has a plan.
If it really doesn't work, why not just buy equipment in 2013 and then build a pharmaceutical factory in 1960 to mass-produce tuberculosis drugs?
Anti-tuberculosis drugs are generally divided into first-line drugs: isoniazid, rifampicin, pyrazinamide, ethambutol and streptomycin.
Second-line drugs: sodium para-aminosalicylate, prothionamide, amikacin, kanamycin, capreomycin, levofloxacin, moxifloxacin, etc.
Second-line drugs are basically not used because their efficacy is average and their side effects are huge. They are usually only used when there is an allergic reaction to first-line drugs.
Among the five first-line drugs, streptomycin was once used as a miracle drug. Selman Abraham, who invented streptomycin, also won the Nobel Prize in Physiology or Medicine in 1952.
However, this drug was later proven to be highly ototoxic and nephrotoxic, and could easily cause vestibular damage and lead to deafness in patients.
Decades ago, a generation of children became deaf after receiving injections due to illness. The drug used was streptomycin, so it later became a backup drug and was no longer used easily.
Lin Sanqi is not planning to use streptomycin this time. Knowing that this drug is poisonous, but still using it, isn't that irresponsible to his compatriots?
The remaining four drugs are isoniazid, rifampicin, pyrazinamide, and ethambutol.
Lin Sanqi checked the information and found that in the 1950s and 1960s, the most advanced treatment for tuberculosis abroad was: streptomycin + para-aminosalicylic acid + isoniazid.
This treatment plan can indeed cure tuberculosis, but the side effects of these three drugs are very serious, such as damage to the liver and peripheral nerves, strong gastrointestinal reactions, and allergic reactions that are difficult to prevent.
The key is that the combined treatment course of these three drugs is as long as 12-24 months, which means that long-term medication is required for 1 to 2 years, which creates a medical cost problem.
Streptomycin, para-aminosalicylic acid, and isoniazid are all drugs that were invented not long ago. They have very low production and are very expensive. Even in Europe and the United States, only a few wealthy people can afford them.
This is also why tuberculosis is still an incurable disease in China because anti-tuberculosis drugs have not yet been introduced into the country.
Lin Sanqi should not be used to treat tuberculosis. To treat tuberculosis, the most advanced quadruple therapy must be used:
Isoniazid + rifampicin + ethambutol + pyrazinamide pattern.
Isoniazid and pyrazinamide have already been invented, so Lin Sanqi can no longer get this piece of fat.
So how to intercept the patents of rifampicin and ethambutol has become a top priority.
European and American countries are very rogue, and registering patents is their favorite thing to do.
If Lin Sanqi took out the most advanced drugs of later generations and used them to treat tuberculosis in China, these advanced drugs would be secretly taken out of the country by "spies" and obtained by foreign pharmaceutical companies.
Then it is entirely possible that foreign pharmaceutical companies will be the first to crack the drug ingredients and then apply for a patent.
By then, if China wants to use anti-tuberculosis treatment, it will have to pay patent fees to European and American pharmaceutical companies. Wouldn’t that be a waste of his work?
There are many painful lessons to be learned from drug patents.
Taking ginkgo as an example, there are currently 68 patents related to ginkgo applied for in China. Although there are only 4 patents applied for by foreigners, they almost cover the entire extraction process of ginkgo.
Although my country has the largest number of applications, most of them only cover details such as dosage changes and quality differences, and lack key innovative technologies. This means that the lifeblood of ginkgo leaves has been seized by foreign pharmaceutical companies, and China has to pay patent fees to foreign countries.
Take artemisinin as an example. It is a special anti-malaria drug that was successfully researched by several generations of Chinese doctors, such as Tu Youyou. However, it was eventually patented by a German company.
The patent for artemisinin is not in our country's hands, and we have to pay German pharmaceutical companies to use this drug. For this item alone, China loses at least US$200 million to US$300 million every year.
In addition, the Jiuxin Pills produced in Japan were developed based on the famous Chinese medicine Liushen Pills. Because Chinese companies do not have registered patents and trademarks, more than US$100 million flows into the pockets of Japanese companies every year.
According to data from the World Patent Database, more than 70% of Chinese medicine patents were applied for by Japan, followed by North Korea, while my country only had a pitiful 0.3%.
China, the birthplace of Chinese herbal medicine, accounts for only 3% of the global trade in Chinese herbal medicine, which is approximately US$30 billion annually.
It is very infuriating that a lot of money is being made by foreign companies.
Some idiots even shouted that "the methods passed down by our ancestors cannot be changed" and that Chinese medicine must adhere to tradition and cannot follow the methods of modern medicine.
These people are either stupid or bad, extremely stupid and extremely bad!
Just wait for foreign countries to register all the patents of our traditional Chinese medicine, and it will be difficult to regret later.
As a time traveler, Lin Sanqi attaches great importance to patents. Patents are like a hen that lays eggs. With patents in hand, even if he does not produce them himself, the licensing fees can be a large sum of money.
Even if I don't want the money, it would be nice to hand over the patent to the country in exchange for a lot of Chinese medicinal materials.
Wait, Lin Sanqi is criticizing others for preemptively registering Chinese patents, but then it seems that rifampicin and ethambutol weren't invented in China? They were both invented by foreign pharmaceutical companies.
Lin Sanqi, a time traveler, registered their patent. Isn't that just as robbery and despicable as foreign pharmaceutical companies?
Do not do to others what you do not want others to do to you.
Humph! Those who say this are pedantic. If others can rob us, why can't we rob them?
Lu Shuren once said: We should be nobler than the noble and more despicable than the despicable.
The temperature in the capital has begun to warm up on May nights.
After watching the Peking Opera, Jin Caifeng and her grandchildren fell asleep in the house, and Pan Ye also returned to his dormitory.
The bright moonlight shines on the earth, illuminating the surroundings. At the edge of the cornfield, a pot of boiling water is bubbling on a small table.
Lin Sanqi used a lot of effort to make tea, and finally poured out three cups of water, holding them with both hands and giving them to his father.
Lin Kucan took the teacup and smelled it, then chuckled:
"Great tea! I haven't had this Phoenix Dancong tea in years."
Lin Sanqi picked up the cup himself and replied with a smile:
"Dad, I've prepared five pounds of Phoenix Dancong tea and five pounds of Huazhou Tangerine Peel for you. I'll send them to you when you finish them."
Lin Kucan drank the tea in three gulps and then leaned back on the bamboo chair:
"Xiao Qi, I feel like our Lingnan School's abilities are getting better and better. Being able to reduce fever is one thing, but can you also cure plague? And now you've come up with a cure for tuberculosis. Is this another one of our Lin family's ancestral treasures?"
Lin Sanqi was a little embarrassed: "It must be inherited from my ancestors."
Lin Kucan nodded slightly, obviously having his own thoughts:
"You can say it's inherited, but I have to know how you plan to treat tuberculosis. This time is different from before. Before, reducing a fever was no big deal, but this time it's tuberculosis, a major problem that even foreign countries haven't conquered.
If you can truly cure tuberculosis, even if you can achieve an 80% or 90% cure rate, not a 100% cure, you'll have created a medical miracle. Higher authorities will undoubtedly investigate and perhaps even demand our secret formula."
Lin Sanqi thought that this was a high probability event.
Previously, some individuals asked for the secret recipe for treating influenza to be contributed free of charge, but in the end, Dean Shen and Dean Tu of Union Hospital helped to resist.
This secret recipe for tuberculosis is related to the safety of more than 10 million tuberculosis patients across the country, and the country cannot attach too much importance to it.
Since Lin Sanqi's secret formula works in China, can it also be used abroad? Could it be made into pills and exported to earn foreign exchange?
In 1960, the mainstream view was that everything on this land belonged to the country, individuals had no rights, everything had to obey the overall situation, and once a private secret recipe was exposed, it would belong to the country.
Is this wrong? Actually, it is not wrong.
The country is still so poor and ordinary people can't afford it. Does Lin Sanqi insist on holding on to the secret recipe and want to make a lot of money from it?
If we want to eradicate tuberculosis, one or two doctors are definitely not enough; we must rely on the power of the country.
Then the country needs to get the secret recipe, mass-produce it, and then promote it nationwide for free to eliminate tuberculosis. There is nothing wrong with this principle.
"Dad, I wouldn't admit it to anyone else, but you're my father, so I'm telling you the truth. I do have a secret recipe for treating tuberculosis. Look, it's this medicine."
Lin Sanqi took out a tablet from his pocket with the name of the medicine written on it: "Ethylamine, Pyrazine, and Rifampicin Tablets".
This was a commonly used medicine for the treatment of pulmonary tuberculosis in 2013. In order to make it easier for patients to take it, the four drugs, isoniazid, rifampicin, ethambutol and pyrazinamide, were directly combined together to make a tablet.
The advantage is that the patient only needs to take one pill a day.
The original treatment plan required patients to take four kinds of pills orally, some once a day, some three times a day, and the quantity varied. It was very troublesome and prone to accidental or missed doses, affecting the efficacy.
(End of this chapter)
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