Mission blessing!

Text|Liubiggeneral

They were born at a time when the country was in urgent need and shouldered a sacred historical mission
.

Faced with the experimental conditions of one poor and two whites, he did not get discouraged.

After 190 failures, artemisinin was discovered

After 190 failures, artemisinin was discovered

In 1965, the U.
S.
government gave up its small fight against Vietnam and instead sent troops directly to the war.
The number of U.
S.
troops invading Vietnam reached 500,000
.

In 1967, the Vietnamese side asked China for help, saying that the anti-aggression war lacked medicines to deal with malaria, so on May 23, the Chinese government launched the "523 Project" to fight malaria

The research at this time is still like looking for a needle in a haystack.
The researchers tried more than 40,000 Chinese medicinal materials before and after, but none of them achieved satisfactory results
.

So they rearranged the classics and folk prescriptions, visited old Chinese medicine practitioners and Youfang doctors, and conducted serious investigations.

The screening results showed that Artemisia annua is far less effective in inhibiting malaria parasites than pepper, so Tu Youyou took the pepper extract of Yuyagang to Hainan for a test, but because it was too toxic to accept, their research was once again at a deadlock
.

In 1970, the "523" project team (at this time Gu Guoming from the Academy of Military Sciences also joined) could only turn to the ancient wisdom of our country again.
Together they collected traditional Chinese medicine and folk medicine for malaria treatment, including 808 single and compound prescriptions.
Artemisia has the highest frequency, so I decided to keep the focus on Artemisia annua
.

When I read the "Elbow Reserve Emergency Recipe", I found that "grasp the Artemisia annua with two liters of water, squeeze the juice, and take it all.
" These few words aroused their attention.
They are "twisting" rather than " "Boiled", the reason why the desired effect was not achieved in the early stage was probably because the high temperature destroyed the effective components of Artemisia annua.
So they took a different approach and experimented with low-boiling solvents
.

Yu Yagang and Gu Guoming used ethanol instead of traditional Chinese medicine high-temperature water decocting method.

In early 1971, Yu Yagang and Gu Guoming returned to their original positions, and joined the "523" project team with Zhong Yurong and Lang Linfu.
Based on the preliminary research of the research team, after comparing various extraction conditions, they finally adopted ethanol cooling.
The low-temperature extraction of Artemisia annua L Zhong Yurong and her assistant Cui Shulian found that the clinical effect of "Crystal II" of Artemisia annua is remarkable and stable
.

There are many controversies about the discovery of artemisinin, but there is no objection that Tu Youyou proposed to extract with ether, which played a key role in the discovery of the anti-malarial effect of artemisinin and further research.

Later, after further research and experimentation, it was found that although artemisinin can effectively treat malaria, it also has shortcomings.
In particular, the conclusion of the clinical trial of artemisinin by Li Guoqiao Group of Guangzhou College of Traditional Chinese Medicine: "Quick-acting, short-term high-efficiency, low toxic side effects, no drug resistance, but high recurrence rate" conclusion
.

Therefore, in a series of subsequent studies, the researchers focused on the structural modification of artemisinin, that is, entering the optimization stage with artemisinin as the lead compound
.

Based on the structure of artemisinin, through structural modification and derivation at various reaction sites of artemisinin, 25 related compounds were synthesized and tested for antimalarial activity: In 1973, the research group of Tu Youyou confirmed the artemisinin With the presence of carbonyl groups in the structure, artemisinin was reduced with sodium borohydride to obtain a reduced derivative—dihydroartemisinin.

Artemisinin and its analogues

Arsenic trioxide in the treatment of acute promyelocytic leukemia

Arsenic trioxide in the treatment of acute promyelocytic leukemia

An old Chinese medicine doctor in the Lindian County Democracy Commune Health Center in Heilongjiang Province miraculously cured his mother’s skin cancer by using the method of “contamination with poison”.
Since then, the old Chinese medicine doctor has cured many cancers that came here by intramuscular injection.
Patient
.

In 1971, Professor Zhang Tingdong investigated the remedy and found that the remedy was composed of three medicines, namely arsenic, light powder (mercurous chloride) and toad venom.

Professor Zhang Tingdong, who studies blood diseases, is thinking about whether "713" can be used to treat leukemia, so Professor Zhang Tingdong and others have adopted a "world-leading" method that is also a bold method-intravenous injection
.

They divided the patients into several groups and injected medicines of different ingredients to find out who among the arsenic, light powder, and toad venom is at work.

The results showed that the advantages and disadvantages of these three medicines are obvious.
Medicines containing light powder hurt the kidney; medicines containing toad venom have the side effect of raising blood pressure, and the effect of using arsenic alone is still very good
.
Subsequently, the effect of arsenic (arsenic) on the treatment of acute promyelocytic leukemia was further studied
.

By 1979, Zhang Tingdong and his team had come to the conclusion that arsenic can treat leukemia, especially for acute promyelocytic leukemia, which is still in use today
.
The current trade name of arsenic trioxide is Trisenox, which has been certified by the US FDA for the treatment of acute promyelocytic leukemia that is not sensitive to the first-line drug, all-trans retinoic acid
.
In 2003, the University of Hong Kong developed an oral preparation of arsenic trioxide
.
Oral preparations bring great convenience to outpatients and long-term treatment patients
.

All-trans retinoic acid in the treatment of acute promyelocytic leukemia

All-trans retinoic acid in the treatment of acute promyelocytic leukemia

Wang Zhenyi obtained a doctorate degree in medicine at the age of 24.
He was assigned to the Department of Hematology in 1953.
During his clinical work, it was found that some patients were bleeding after tooth extraction, and conventional hemostatic therapy was ineffective.
After consulting a large number of literatures, he found that the disease was named abroad.
For "hemophilia", after hard research, Wang Zhenyi first established the diagnosis and differential diagnosis methods for hemophilia A, hemophilia B and mild hemophilia in China.
In 1959, he was assigned to work on leukemia
.

In 1978, Wang Zhenyi discovered that there are two ways to treat leukemia: one is chemotherapy, and the other is to let leukemia cells "change the evil and return to the right.
" At the same time, foreign countries have achieved certain results in this regard.
For example, in 1983, Koeffler summarized a variety of compounds (including Retinoic acid) in vitro cell culture on the differentiation of human leukemia cells
.

In 1983, Flynn et al.
of the University of Minnesota in the United States reported that 13-cis-retinoic acid was used to treat a case of APL patients, who had remission of leukemia and died due to other reasons.
In 1984, Nilsson of the Department of Internal Medicine of Lund University Hospital in Sweden reported that 13-cis retinoic acid was used.
Retinoic acid was used to treat a case of APL, so Professor Wang Zhenyi determined his research field-all-trans retinoic acid induced differentiation therapy
.

In 1986, a 5-year-old girl suffered from acute promyelocytic leukemia, with high bleeding and fever, and her life was in danger.
The doctor felt hopeless
.
At that time, Wang Zhenyi's all-trans retinoic acid treatment method was still only in the test tube experiment stage.
After obtaining the consent of the girl's family, he decided to give it a try
.
The girl's blood picture continued to improve after the medication, and her body temperature dropped after one week, and basically recovered after 3 weeks, and completely relieved after 1 month
.
It is worth mentioning that at that time, all-trans retinoic acid was approved by the Shanghai Municipal Health Bureau for use in skin diseases
.

Some people laughed at Wang Zhenyi, how can medicine for treating skin diseases be used to treat leukemia? But Wang Zhenyi believes that he has done thousands of experiments, because in vitro culture has proved that this medicine can normalize the leukemia cells without toxic side effects
.
The recovery of the first patient gave Wang Zhenyi great confidence.
In one year, he treated 24 identical cases and cured 23 cases
.
The curative effect of this method is good, but the recurrence rate is high.
Even with chemotherapy, there are still 40% to 50% of patients who will relapse
.

In the mid-1990s, after learning that the Harbin Medical University where Zhang Tingdong was working, the Chinese medicine arsenic could be used to treat APL, Wang Zhenyi's students Chen Zhu and Chen Saijuan and his wife began to cooperate with Zhang Tingdong
.
They found that the combined therapy of all-trans retinoic acid and arsenic trioxide can effectively reduce the recurrence rate and increase the cure rate
.
In the end, this approach, known as the "Shanghai Plan", caused the five-year disease-free survival rate of APL patients to jump from about 25% to about 95%, which caused great international repercussions
.

Replantation of severed limbs

Replantation of severed limbs

On January 2, 1963, Wang Cunbai, a 27-year-old young worker from the Shanghai Machine Tool Steel Mould Factory, was completely cut off by a punch at an inch above his right wrist joint and was sent to the emergency room of Shanghai Sixth People's Hospital half an hour later
.

As a rule, for patients with this type of trauma, doctors can only bandage the injured limbs.
If the hand is broken, they have to break it.
When the wound is healed, the prosthesis can be installed.
As for the broken limb, it can only be treated as medical waste
.
However, Chen Zhongwei, a 34-year-old surgeon, couldn't bear it, so after consulting his family members, they decided to take the risk of replanting with severed hands
.
Although Chen Zhongwei is an orthopedic expert, the replantation of severed fingers involves the reconnection of blood vessels, nerves, tendons, and bone marrow.
The blood vessels are the most difficult, and the thinnest cannula in the hospital was 4 mm.
Her blood vessel was only 2 mm.
At a critical moment, the head nurse asked whether plastic tube sleeves could be used, because when her daughter was braided, she found that the plastic tube would become thinner if it was stretched
.
As a result, such a quick method of generating wisdom was really used on the operating table, and it was also successful
.

It was 1963, and the importance of such a breakthrough was self-evident.
Even in foreign countries, there was no successful replantation of amputated fingers
.
Previously, the most advanced technology was focused on the repair of blood vessels.
For example, Harry Buncke invented the first operating microscope instrument, and Jacobson and Suarez completed the anastomosis of blood vessels under the microscope in 1960
.

Wu's masks and plague prevention

Wu's masks and plague prevention

There have been three major outbreaks of plague in human history
.
The first started in 541 AD and broke out in the Eastern Roman Byzantine Empire under the rule of Justinian the Great
.
The second time began in the 14th century and lasted for hundreds of years.
It was also this pandemic.
The plague was dubbed the terrifying name of "Black Death"
.
The third time I came to China, starting in 1855, the climax period was India, Hong Kong in 1894, and Northeast China in 1910-1911
.

In the winter of 1910, the pneumonic plague was endemic in Siberia and Harbin in northeastern China.
The epidemic spread rapidly.
It went south and reached Gyeonggi.
The daily death toll was in the hundreds.
At that time, Japan and Russia threatened the Qing government on the grounds of protecting the nationals.
If the epidemic cannot be effectively controlled immediately, the Chinese will not be allowed to enter and participate in the prevention of the epidemic, thereby achieving control of the three northeastern provinces
.

In December, Shi Zhaoji from the Ministry of Foreign Affairs of the Qing government urgently called Wu Liande, who was the deputy supervisor of the Tianjin Army Medical College at the time, studied in the UK and obtained a doctorate in medicine from Cambridge University, to go to Harbin to investigate and deal with the plague
.
A British-made medium-sized microscope, and the necessities for the study of bacteria: alcohol, test tubes, scissors, and pliers.
In this war, these are all Wu Liande's tools, and the rest is courage and determination
.

At that time, it was generally believed that the plague was transmitted from rats to humans, and the way to fight the plague was very simple: extermination of rats, but Wu Liande did not think so.
He believed that it was spread from person to person
.
He carefully investigated and researched and found that the source of the severe respiratory infectious disease came from a kind of marmot on the grassland.
Hunters and furriers who hunted marmots were the first to be infected, and the initial infection mortality rate was almost 100%
.

In order to clarify the cause and pathology, Wu Liande personally dissected the body of a Japanese inn owner who was married to a Chinese in the epidemic area, despite the opposition of the government and other doctors.
This was also the first pathological autopsy of an epidemic in Chinese medical history
.
A few days later, Wu Liande found a large number of Yersinia pestis in the specimens through a microscope, which made it more certain that the epidemic was pneumonic plague, and its transmission route was directly through human-to-human respiration and droplets, rather than indirectly from mice.
To fleas and then to people
.

Wu Liande believes that to cut off the route of transmission, it is wise to isolate people infected with pneumonic plague from healthy people to avoid droplet infection caused by patients' coughing and spitting
.
So Wu Liande designed and invented a simple mask made of cotton yarn
.

The method of making this kind of mask is very simple.
It uses general surgical gauze sold in pharmacies.
It is about 9 inches wide and cut into 3 feet long.
Each piece is folded into double layers along the length, and a piece is 4 inches long, 6 inches wide and half thick.
Cut each end of the gauze into two pieces, each 15 inches long, to make it into a two-layer gauze bandage.
Use the cotton in the middle to cover the mouth and nose, and the upper tail at both ends must pass over the ears.
It is tied to the back of the head, and so does the lower tail at both ends, but it must pass under the ears
.

Such self-made masks are simple and easy to wear and low in price.
Each only costs two and a half of the national currency.
Wu Liande has mobilized a lot of manpower and material resources to ensure that the masks are continuously supplied to the citizens and are quickly accepted by the people
.
This thickened mask is called "Wu's mask" by later generations
.

Learning from the demeanor of these masters of traditional Chinese medicine is, on the one hand, a personal love for the national culture-Chinese medicine, on the other hand, it is moved by the noble medical ethics and superb medical skills of these masters of traditional Chinese medicine
.
I hope that more people will understand the demeanor of the masters of traditional Chinese medicine, understand the connotation of their sincerity, and explore the essence of traditional Chinese medicine from the masters
.

Reference materials:

1.
New drug fromancient Chinese remedies: unsung heroes in unusual times

2.
Wang YX, Xiao F.
Top fivemedicalinnovations in China mainland since Xinhai revolution (1911): results of AMEsurvey-002.
Quant Imaging Med Surg 2015.
5:453-66.