I'm just a veterinarian! You've unlocked the Great Physician System!

From an academic perspective, Liu Xinxin is far from qualified.

Almost all scholars know that it mainly publishes major breakthroughs in basic science, discoveries that are enough to change the theoretical framework of a discipline, as well as mechanistic research that can be generalized and repeated, and results that have universal significance for the global scientific community.

Even though Liu Xinxin's case is rare and represents an extreme development.

She can't even get on.

This is a rare but known phenomenon, not a revolutionary new ethical discovery.

"But what if we discover a new pathogenic mechanism?"

Ilotti smiled.

A simple case study is definitely not enough to publish in Nature.

Although I haven't been in academia for very long, I'm fairly familiar with this journal.

To reach the level of Nature, one must either demonstrate a completely new treatment method, such as discovering a novel molecule that can reverse necrotizing fasciitis, which is Vibrio vulnificus infection, and then have complete animal models, molecular mechanisms, and clinical data before it can be published.

It's simply impossible to complete this in a short period of time.

At least a year and a half.

Once discovered, it could even be a Nobel Prize-level achievement.

After all, it can reverse marine Vibrio vulnificus infection to some extent!
So not only did she know, but Dr. Cameron certainly knew they couldn't do it.

Another approach is to propose new theories that change global perceptions.

However, it is impossible for a single case to accomplish all of this.

So there is another viable path.

That is, a new pathogenesis mechanism has been discovered.

While this is far from reaching the level of a Nobel Prize, it should be hopeful of getting published in Nature, although the field is also very narrow.

At the same time, this is also the most difficult compared to the previous two.

"What new pathogenic mechanism is it? Does it suggest that the bacterium contains unknown toxins, or has a new immune escape pathway been discovered? Or have you found the cause of the gene mutation leading to 'ultra-rapid progression'?"

Cameron's eyes remained filled with astonishment.

He suddenly felt that the latter possibility was very likely!
Because he learned that Ilotti and Zhang Lingchuan had undergone whole-genome sequencing, virulence factor analysis, immunological mechanism analysis, and so on.

8 month 19 number.

Stanford University School of Medicine Presentation Room.

At this moment, there was an additional young Chinese man who was giving a report above. He was not from this school and did not even have a doctoral degree.

Facing the academic luminaries and Nobel laureates in the audience, he remained composed and confident.

"In traditional understanding, the virulence of Vibrio vulnificus mainly comes from RTX toxin, hemolytic toxin, and endotoxin. However, we have found a specific activating toxin in the body of Ms. Liu, an infected patient we found at West Bay Hospital in South Africa."

The PPT above simultaneously displays Zhang Lingchuan's content.

"That is, the toxin has limited toxicity in ordinary people, but in a certain type of special host, it is activated to produce a 'hidden toxicity mode'."

At this point, Ilotti nodded.

Zhang Chuqi was indeed not very able to adapt to the pace of scientific research.

But after getting to know him for a while, she discovered that Zhang really had a lot of potential.

It's something you grasp almost instantly.

Working with someone like that is incredibly easy.

“We did some research and found that the patient carried a rare variant of matrix metalloproteinase overactivation, which is the gene test report: ‘Rare high expression variant in the MMP-9 promoter region’.”

The large screen displays the genetic testing report.

Reviewing Liu Xinxin's medical history, there was no liver disease, no diabetes, and no immunodeficiency, but the genetic report indicated problems.

This is one of the reasons why her condition progressed so rapidly.

……

"In simple terms, this is a rare host metalloproteinase variant that is abnormally activated in an inflammatory environment, cleaving the surface structure of Vibrio vulnificus, exposing the silent toxin domain, and triggering a hyperacute necrotizing cascade reaction."

Because Zhang Lingchuan and Ilotti collaborated on the research.

After Zhang Lingchuan finished speaking, Ilotti also spoke.

She mainly talked about the main structure of the paper that would be published next.

【Host-Specific Protease–Mediated Activation of a Cryptic Toxin Drives Hyperacute Necrotizing Progression in Vibrio vulnificus Infection】

"Host-specific protease-mediated cryptic toxin activation drives the hyperacute necrotizing progression of Vibrio vulnificus infection, which is the title of our prepared paper."

[Background: V. vulnificus typically progresses rapidly, but the hyperacute 1-hour necrosis has not been explained.]

[Case Study: A rare patient with extremely rapid disease progression.]

[Discovery: The host carries a mutant metalloproteinase.]

[Mechanism: This enzyme cleaves bacterial outer membrane proteins → activates the silencing toxin.]

[Result: Hyperacute necrosis was reproduced in the in vitro model.]

[Significance: This proposes a new paradigm of 'host-determined virulence expression'.]

In addition to the title, there is also the structure of their paper abstract.

Of course, core experimental designs were also conducted.

Humanities papers all emphasize field research methods, so how could a paper aiming for top journals not have a specific experimental design?

Zhang Lingchuan is missing in this regard.

Because his previous work as a veterinarian was not as standardized. His work in human medicine was mostly about improving his skills and supplementing his basic theories, with very little involvement in experiments.

It's no wonder that his teacher's wife hoped he would cooperate more with Ilotti here. Even if the subsequent results did not meet the goal, it would be good to get involved in more experiments.

First, they confirmed the clinical phenotype.

The case timeline, lactate curve, histopathological evidence of extensive endothelial damage, and the absence of conventional high-virulence mutations in the strain sequencing led to the conclusion that the strain itself was not an abnormally high-virulence type.

At the same time, host whole-exome sequencing was performed.

A rare mutant metalloproteinase was discovered and named the hMMP-Xv variant. Its characteristics include enhanced expression under inflammatory conditions, abnormally increased affinity for the catalytic site, and the ability to cleave Vibrio outer membrane proteins.

In vitro validation is, of course, also essential.

Three sets were done respectively.

The results showed that bacteria released large amounts of toxin fragments in the serum of ordinary people, patients, and recombinant mutants, and that endothelial cells lysed within 24 minutes.

Finally, the toxic mechanism was confirmed.

In short, it's quite complicated.

Fortunately, he went inside.

"What is the breakthrough significance of your research? Could you give a brief summary of the overall research?"

Dr. Tina Rowland, Associate Dean of Stanford Medical School, then posed a question.

"Zhang, come here."

Ilotti looked at Zhang Lingchuan, who was standing to the side.

"In short, this is a case of hyperacute necrotizing progression caused by Vibrio vulnificus infection, with extensive hemorrhagic blisters and tissue necrosis appearing within 1 hour, significantly faster than previously known clinical progression. Whole-genome sequencing of the pathogen did not reveal any virulence-enhancing mutations, ruling out the 'highly virulent strain' hypothesis. Instead, whole-exome sequencing of the host revealed that the patient carried a rare metalloproteinase variant (hMMP-Xv)."

……

"Our in vitro experiments show that this mutant enzyme is abnormally highly expressed under inflammatory conditions, and can cleave bacterial outer membrane proteins, exposing previously masked 'silent toxin domains' and activating membrane pores to form toxic activity."

"After activation, the toxin causes rapid lysis of endothelial cells, overactivation of the complement cascade, and loss of control of the coagulation system, leading to hyperacute necrosis and septic shock."

All eyes were once again focused on the young man from China.

It must be said that the other party's overall expression was very fluent.

They don't even have an accent when speaking foreign languages.

"Therefore, our research is the first to demonstrate that the virulence of some pathogens is not entirely determined by their own genes, but may depend on specific host molecules to trigger it."

"The breakthrough has four aspects: 1. It proposes a new paradigm of 'host-determined virulence expression'; 2. It reveals the inducible activation mechanism of hidden toxins; 3. It provides a theoretical basis for individualized infection risk prediction; 4. It reshapes the understanding of the differences in the progression rate of necrotizing soft tissue infections."

……

The entire niche academic conference, which started at 8:30 AM, lasted until noon. "Clap clap clap—"

After Zhang Lingchuan finished speaking, a round of applause broke out in the audience.

This includes Roland, the vice dean of the medical school, and Nobel laureates, among others.

Although there were relatively few people, Zhang Lingchuan felt a strange sense of pride for some reason.

Perhaps this time I've really made a lot of progress.

After all, it has been recognized by so many industry leaders.

"First of all, we think this research is of great significance, even changing the logic of infectious diseases from 'strong strains cause severe illness' to 'specific host-pathogen interactions can activate hidden virulence'. However, the paper is still a bit immature if you want to publish it in Nature. But we can help you, and I hope you will become the youngest publisher in that journal."

Vice Dean Roland looked at Ilotti and Zhang Lingchuan.

Both of them were in their twenties.

Being able to publish a paper in Nature, especially an independent study, is already a remarkable achievement.

They came here today for only two reasons.

If things are too bad, the first thing to criticize and correct is the young person.

If it is truly original, we should give it our full support, because the author's institution is undoubtedly Stanford Medical School.

Everyone's interests are intertwined.

If young people have the potential to rise to prominence, why not give them our full support?
"Thank you, Dr. Roland!"

Ilotti excitedly pulled Zhang Lingchuan aside to express her gratitude.

So, for the next few days...

Zhang Lingchuan and Ilotti were with these experts.

23 number.

Because the medical licensing exam starts on the 24th, Zhang Lingchuan flew back in the early morning of the 23rd.

Publishing in top journals is certainly important.

However, obtaining a medical practitioner's license is also crucial.

Ilotti didn't say anything about it, but expressed her support and said she would communicate with Zhang Lingchuan online.

The exam is on the 24th.

Zhang Lingchuan was very nervous before the theory exam.

But at this moment, he felt that things had become much simpler.

On the 25th, I continued my journey to Stanford Medical School in the United States.

September 1st marks the start of the new school year.

The enormous campus welcomed many new students.

The admissions office statistics show that many high-scoring students have come to their university, and the overall quality of the student body has doubled.

But at this moment, they also encountered a troublesome problem!

"Principal, the new students all want Xiaochuan to speak!"

"That's right! We already said before that Xiaochuan would be the spokesperson for the new students, but now he's nowhere to be found! This is putting us in a very difficult position!"

Many people come to Jilin University because Zhang Lingchuan is studying here.

His cover was also printed on their admissions brochure.

They even chose him as their spokesperson!
Now Zhang Lingchuan has disappeared!
"It's not like I didn't want to invite this kid. He was supposed to speak, but he went to Stanford in California. What can I do?! If you have any complaints, take them to Dean Shen!"

Principal Feng Xicai said in an annoyed tone.

He's under a lot of pressure too!
"???"

Old Shen looked up blankly.

No?

Looking for me?
"Forget it, let's wait until military training is over before letting this kid come. Old Shen, you're sure he'll be back by the end of September, right? If he can't come back by then, you'd better figure something out! I don't care about you! Also, our Great Wall must be the first stop! You must complete the mission!!"

Feng Xicai waved his hand.

He said something to ease the tension.

"!!!"

But in Lao Shen's view...

It would have been better not to ease the tension at all!

What if this kid doesn't come back by the end of September?
Is the first stop here?
Ms. Huang made a reservation first!

Being a "sandwich man" (a man caught in the middle) is so hard these days!!

end of September.

Zhang Lingchuan boarded a plane back to China at Stanford, California.

His phone was flooded with urgent inquiries from the First Affiliated Hospital of Peking University, Peking University, the Provincial People's Hospital, and the Capital University of Traditional Chinese Medicine. Old Shen, in particular, was asking almost every day!

It was like he entered AK Media and someone had a gun to his head—it was perfectly on time!
Speaking of his time abroad, besides being exposed to systematic academic research, what made him happiest was the mission.

On the plane, with a thought, Zhang Lingchuan saw the attending physician task assessment panel appear in front of him.

[Sunday, September 27th.]

I. Professional Reputation.

[Currently needed reputation: 192000/20 "8000"]

II. Timely Tasks.

[Current total followers: 6700 million / 8000 million [2010 million]]

[Surgery Live Stream Video: 0/50 "No Data Available"]

International visits: 5/5 "Completed"

Number of international conferences: 5/5 "Completed"

[Number of patients seen this week: 50/50]

III. Mock Assessment.

[Level 1 "Sequence of Life" is complete. Level 2 "Silent Killer" and Level 3 "Triple Delivery Room of Hell" are also complete.]

……

He has now completed all his international visits and international conferences.

Dean Roland and Nobel laureate in Physiology or Medicine Bryan Berg took him to Canada and the British Empire to attend two academic seminars.

They are all relatively niche.

Therefore, he met the requirement for the number of international visits.

The happiest thing is...

Before returning, I received a reply from Nature saying that the initial review had been passed.

The editor highly praised their research, even saying that if it were successfully published, it would likely cause a sensation in the global academic community.

Ms. Liu Xinxin probably never dreamed that her death would be so valuable, uncovering a new pathogenic sequence.

Of course, actually publishing a paper is not that easy.

Normally, it takes about six months for a Nature paper to be published.

It can take as long as two years.

Because there are still second, third and final trials to come.

However, he will not pay attention to these things for the time being.

Because, aside from the relentless pressure from Lao Shen and his team, he still had over ten million fans to reach and 50 surgical video recording tasks to complete.

There's still a little over a month left.

We need to hurry!
...(End of this chapter)