godfather of surgery

Chapter 1407 Everyone Has Fantastic Ideas



Chapter 1407 Everyone Has Fantastic Ideas

Chapter 1407 Everyone Has Fantastic Ideas

When the news from Berlin arrived, Yang Ping was in the institute's laboratory looking at a cell staining slide.

It was Mannstein, a voice message, his tone very excited.

"Professor, I did it!"

The voice was not loud, and even a little hoarse, as if he had stayed up for several nights.

"It's cellular repair, not scarring; it's genuine, functional neural tissue with normal electrical signal transmission. I'm using your three-dimensional guided gene theory, and now cellular repair has increased to 14%—my God, 14%! That's a huge leap forward, meaning my approach is absolutely correct."

“When I told you the good news last time, I only found a few spinal cord progenitor cells at the site of the injury. Even though it was just a few, I was certain that your theory was successful. I didn’t give up and continued to improve the method. Now it’s 14%, and I firmly believe that one day I can achieve 100%.”

"If we can achieve 100%, the repair of spinal cord injuries will become a breeze."

"If it reaches 50%, I will try to conduct a head transplant experiment using monkeys."

End of audio.

Yang Ping placed his phone on the lab table. He hadn't finished looking at the cell staining slide yet. He continued, and under the microscope, the cell nuclei marked with the staining agent, tiny blue dots, filled the field of vision like a silent starry sky.

Yang Ping's three-dimensional guided gene theory is based on an extremely simple idea: the human body is made up of cells. Why are cells not laid flat, but able to build the human body in three-dimensional space? In fact, the genetic information contains a special three-dimensional spatial positioning ability. This ability allows cells to grow in the direction they need to form the human body, rather than a cube or sphere.

Theories have previously suggested that cellular migration in three-dimensional space is determined by the spatial gradient of gene expression. This idea is not new in developmental biology; similar hypotheses about "morphogen gradients" have been proposed by scientists before. However, Yang Ping's contribution lies in transforming this hypothesis into a true theory, not a crude conjecture, but a systematic scientific theory.

Einstein's application of Yang Ping's theory to spinal cord injury also faced numerous setbacks and missteps. At one point, Einstein attempted to make a breakthrough by focusing on the precise crawling of nerve axons. Einstein's original words were: "Gene A's expression increases X hours after injury, causing protein B to form a gradient within the Y space. This gradient guides the axons of type C cells to grow in direction D. If you suppress gene A with drugs X hours later, the axonal growth direction will change, and the new direction will be E."

Scientific theories can not only explain, but also predict. Prediction is the core of science; it's not about explaining what has already happened, but about predicting what hasn't. A theory that can only explain the past is nothing. A theory that can predict the future is a candidate for truth.

Einstein's spinal cord theory, developed using Yang Ping's method, predicted a specific time window: 48 to 72 hours after spinal cord injury is the optimal time for intervention. Within this window, if the expression level of a specific gene can be precisely controlled, the microenvironment around the injured area can be altered, creating an opening in the "wall" that inhibits regeneration, allowing the original cells to repair the nerve.

The exchanges between Mainstein and Yang Ping were very frequent and in-depth. Not every day, but anytime. Whenever Mainstein thought of a problem, no matter the time—it could be 3 a.m. in Berlin, or noon in Nanjing—he would message Yang Ping. Sometimes it was a voice message, sometimes a casually taken photo of an experimental record, sometimes just a few keywords and a question mark. Yang Ping might not reply immediately, but he would always reply that same day. His replies were never roundabout, never filled with jargon, and never deliberately mysterious. He could give the core answer to a question within three sentences. If he didn't know the answer, he would say, "I don't know," and then, "But we can think about it together."

Mannstein later told August, "Professor Yang was a genius, but he remained honest with himself, honest about the questions, and honest about what he didn't know. In academia, this kind of honesty is extremely valuable."

Breakthroughs in protocellular repair did not happen overnight.

Mannstein was fifty-seven years old. He had won the Nobel Prize, which was the pinnacle of his academic career. But after the peak came a long decline, not a decline in reputation, but a decline in research direction. He turned to the "hard-to-crack" field of spinal cord injury repair, carrying the halo of the Nobel Prize and the best resources of Charité Medical School, yet he was stuck on this problem for a full fifteen years.

Fifteen years is more than five thousand days and nights of wheelchair life for a spinal cord injury patient. For Mannstein, it was countless failed experiments, countless overturned hypotheses, and countless silent nights alone in the laboratory facing the microscope. He tried chemogenetics, optogenetics, cell transplantation, and biomaterial scaffolds—all the cutting-edge technologies were used, but all could only achieve "scar repair." Axons grew, but their orientation was disordered; synapses formed, but electrical signal transmission was abnormal; the animal's motor function improved at best, but it was far from a "cure."

Once, after a failure, Mainstein called Yang Ping. Yang Ping barely spoke on the other end of the line, only occasionally humming in agreement to show he was listening. After Mainstein finished speaking, Yang Ping was silent for a moment, then said something that Mainstein would remember for a long time:

"You're using your own logic to think about its path; you should use its own logic to walk its path."

Mannstein was stunned: "What do you mean?"

"Neurons have evolved over hundreds of millions of years, and their navigation systems are more precise than any navigation system we can design. Don't decide where they go for them; ask them, 'Where do you want to go?' Then create the conditions for them to go there. You're not guiding them; they're finding their way. You're just removing the obstacles in their path. Similarly, why can't nerve cells repair themselves, while bones can? Have you considered this from a more fundamental logical perspective?"

This statement changed the direction of Mainstein's research for the next few years.

He shifted from "active guidance" to "passive permission," no longer attempting to "direct" axon growth with exogenous signaling molecules. Instead, he used gene editing technology to "turn off" endogenous factors that inhibit axon growth one by one, allowing the axon to explore, choose, and find its own direction. It's like a child learning to walk; you don't take the steps for them, but simply clear away the obstacles on the ground, and they will walk on their own.

The effects of this transformation were quickly reflected in the experimental data. They achieved, for the first time, the rudimentary form of "functional regeneration," with axonal growth changing from "random" to "directional," extending along the white matter tracts after traversing the damaged area. It was a glimmer of hope, but not enough. The animals' motor function improved slightly, but it was still far from "normal." Mainstein knew they were still on the threshold, one foot inside and one foot outside.

However, the experiment stopped at a slight improvement and made no further progress. After having an in-depth discussion with Yang Ping, he decisively abandoned the original approach.

Even though he had already achieved some success, he had to reluctantly give it up because Yang Ping told him that his approach was wrong and that he had to start with the original cell repair approach in order to have any chance of success.

He realized he should try protocellular repair instead of axonal growth and crawling, although the latter also applies the three-dimensional spatial guidance gene theory.

This time he succeeded. The repair of spinal cord injury is not about the growth and crossing of axons, but about repair itself. This is not scarring, but the repair of protocellular tissue. This is the closest the entire field has come to a "cure" in fifteen years.

He sat before the microscope, watching the fluorescently labeled nerve fibers that had traversed the damaged area, like luminous shooting stars in the darkness. He stared for a long time, then picked up his phone and sent Yang Ping a message: "Your theory is amazing! I've achieved 14% of the original cells in spinal cord injuries."

Last time, it only existed sporadically.

Yang Ping replied: "Congratulations!"

Mannstein looked at those two words and smiled broadly.

Mannstein sent the report he had written about the entire experiment to Yang Ping, who read it in one morning.

He sat in his research institute office, the text scrolling across the screen line by line. He read each data point, each chart, each conclusion slowly. It wasn't that he couldn't understand it, but that he couldn't bear to read it quickly. Mannstein had poured fifteen years of his life, more than five thousand days and nights, and countless struggles of coming close to success only to fall back to rock bottom into this paper. He didn't want to consume it all in thirty minutes.

Yang Ping stopped reading after reaching the last conclusion.

He pushed his chair back and leaned against the back to rest, his mind preoccupied with someone.

The person on his mind wasn't Mainstein, but someone he'd never met—a patient. A future, potentially existing person who would one day lie on an operating table. That person might be a young man injured in a car accident, a worker who had fallen from a height, or an ordinary person sentenced to lifelong paralysis due to a spinal cord injury. If Mainstein's research continued to advance, if "protocellular repair" moved from animal experiments to clinical applications, that person would be saved. That person would stand up, walk, run, and do everything he couldn't do now.

Yang Ping picked up his phone and sent a message to Mainstein.

"I've finished reading it. This is the most important achievement in clinical medicine this year, bar none."

Einstein's reply came quickly, not in text, but in voice. Yang Ping opened it, and Einstein's voice came through the phone.

"Professor, do you know what I regret most in the past fifteen years?"

Yang Ping did not reply; he knew that Mainstein was not really asking him a question.

"It was arrogance! The arrogance that followed the Nobel Prize. I thought that with my fame and resources, there was no fortress I couldn't conquer. I tried every path I thought was 'correct,' but forgot the more fundamental questions. When you called me before, you said, 'You're using your own logic to think about its path; you should use its logic to walk its path.' Those forty minutes were more useful than all the literature I'd read in the past fifteen years. In the end, science isn't about experimental techniques, it's about how you think. The way you think about problems is the most unique I've ever seen, and the only one that led me out of that dead end."

"Later I thought, why not try your theory?"

Yang Ping did not reply immediately after listening to the voice message.

He recalled that when he first started thinking about these issues, many of them didn't arise later; it was just that the conditions became available to address them.

He was working on three-dimensional guided gene sequencing when he was a newly graduated resident physician, shuttling between wards and operating rooms every day, with almost no time for himself. He could only read during breaks from night shifts, take notes during surgical intervals, and think about problems on the subway home. His notebooks were filled with all sorts of random things: diagrams of cell signaling pathways, sketches of gene regulatory networks, hand-drawn anatomical structures, and data copied from literature. What seemed like a jumbled mess to others was, to him, a map that was slowly becoming clearer.

However, later, the pressures of life forced him to temporarily abandon these whimsical ideas. He had to complete his daily work, deal with promotions, and keep an eye on his monthly salary...

If it weren't for the later development of the system, his ideas might have remained buried forever. Of course, they might have been realized, but the likelihood of them being realized was certainly slim.

In fact, the system never gave him any "ideas" later on, but it gave him a huge amount of time and opportunities to try and fail.

It was precisely these numerous opportunities for trial and error that allowed him to experiment with every idea, thus increasing the probability of success to an unprecedented level.

Now he understands why one must be focused and consistently dedicated to succeed in a particular field, because time is limited and opportunities for trial and error are also limited. If these opportunities are spread across different areas, the success rate will naturally decrease.

Sometimes he thinks that everyone has had some brilliant ideas, but in the end these ideas are stifled and worn away, while he is fortunate enough to be able to try them at low cost.

That night, Yang Ping didn't stay at the research institute. He turned off the lights, locked the door, and went down the stairs. One by one, the motion-activated lights in the stairwell turned on, then turned off behind him. His footsteps echoed in the empty stairwell, like an ancient rhythm that only he could understand.

As he stepped out of the research institute, the night breeze of Nandu hit him. He stood at the entrance, took a deep breath, and then looked up at the sky. There were no stars in the night sky, only thin, greyish-white clouds, drifting slowly in the city lights. But behind the clouds, he knew that the stars were still there; they had always been there, just unseen.

He recalled what Mainstein had said in the voice message: "The only thing that got me out of that dead end."

Scientific research is sometimes like this: a flash of inspiration can lead to a breakthrough in an instant. Without that moment of inspiration, you might never get through it in your entire life.

(End of this chapter)


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