4hw.com.cn: "I'm not the God of medicine". Since its release, Douban has exceeded 9 points and had no bad comment. Everyone swipes the screen crazily. The movie shows the original "Lenin" with 40000 yuan for leukaemia patients. The hero of India's generics, who is kind enough to buy 500 yuan for one box, is arrested and checked by the police. So what medical knowledge is involved in this movie? Let's get to know.
Why do masks appear frequently
Mask, presumably, is the most impressive feature of vulnerable patients in the film. When the audience saw the optimistic benefit of LV at first sight, they were amused by the close-up shot of him taking off his mask layer by layer. Then, the mask seems to be a clue of the film, whether it is the shouting of patients protesting against the company of 'Lenin' or the voice and cough of the protagonist asking the patients to take off the mask; At the end of the day, hundreds of patients stood by the street and slowly took off their masks to watch the police car. The white or blue masks gave people visual impact again and again.
Just a pair of masks, is it really so important? For leukemia patients, yes.
The so-called leukemia is the malignant transformation of human bone marrow hematopoietic stem cells. Normal blood is composed of three major components: red blood cells, white blood cells and platelets. Among them, red blood cells are responsible for transporting oxygen and carbon dioxide, white blood cells are responsible for resisting invaders, and platelets are responsible for repairing damaged blood vessels to prevent bleeding.
The hematopoietic stem cells in the bone marrow of leukemia patients can no longer produce normal blood components, but produce a large number of immature and non functional blood cells, thus causing anemia, infection and bleeding. Because of the lack of mature white blood cells, the resistance of leukemia patients is very low, and they are easy to be invaded by pathogens. Once an infection occurs, they will not recover through their own immunity like normal people. Therefore, people with leukemia often need to take disinfection measures in their living places, and they need to wear two or three layers of masks when they are outdoors in a 'bacterial environment'.
When the protagonist "brother Yong" scolds the patients' owners for being rude and wearing masks, the patients' taking off the masks is like exposing themselves to the air full of bacteria and putting their lives in danger. But they did so, so that they could get 'Indian medicine' to save their lives. When the hero was tried by the court and escorted to the prison by the police car, hundreds of patients did the same thing again, in order to pay homage to brother Yong, which is more important than their own safety.
Is there such a magic medicine as' Lenin '
Yes. In fact, the film's' Lenin 'is called' greavey 'in real life, and its composition is' imatini'. Since it was approved and published, it has made remarkable achievements in the treatment of chronic myeloid leukemia, known as a breakthrough in the history of human anti-cancer.
100 years ago, scientists knew little about cancer, and the mainstream academic circles simply attributed leukemia and other malignant diseases to virus infection or environmental factors. In the 1950s, people realized that chromosome 22 in cancer cells of patients with chronic myeloid leukemia was significantly shorter, and this abnormal chromosome was also named 'Philadelphia chromosome'. In 1973, the University of Chicago found that Philadelphia chromosome was partially exchanged with chromosome 22 due to chromosome 9, which made chromosome 22 short.
In 1983, the National Cancer Research Institute of the United States found that due to the staggered translocation between two chromosomes, the abl gene on chromosome 9, just connected with the BCR gene on chromosome 22, fused into a BCR abl gene, which encodes a unique tyrosine kinase, which is not controlled by other molecules and has been in an active state. It's as if the locked accelerator has been opened, which makes the hematopoietic stem cells divide endlessly, causing cancer.
By the end of 1980s, researchers found that a derivative of 2-phenylaminopyrimidine can inhibit tyrosine kinase, but its specificity is poor, so it can not be directly used for treatment. On this basis, the researchers continue to optimize its properties, greatly improving the solubility of the molecule, and improving its specific ability to inhibit the target enzyme. The molecular code is cgp57148b - imatinib. But a chemical molecule to a drug that can work in an organism has to go through numerous failures. After 20 years of repeated animal experiments, imatinib, a relatively safe drug, has finally been brought to the door of human trials.
In western medicine, drugs from animal research to clinical application usually go through four phases of clinical trials. In short, phase I is to explore the maximum consumption of drugs and find out the specific process of drugs in the human body from absorption to discharge; phase II is to determine the best consumption of drugs, compare the efficacy of similar drugs and the effects of drugs on different stages of the disease; Stage III is to clarify the relationship between risk and benefit, and explore the possible complications and side effects of drugs through more patients participating in the study. The phase IV trial is conducted after the approval of listing. The study needs to collect a wider range of data, further determine the efficacy, and identify rare risk events. Generally speaking, this process will take several years or even decades.
Imatinib has achieved amazing results in clinical trials. Of the 54 patients who received 300 mg initially, 53 had complete remission. After one and a half years of treatment, their disease progression free survival rate reached 89.2%. Before the birth of Gleevec, only 30% of patients with chronic myeloid leukemia could live for 5 years after diagnosis. Gleevec raised it to 89%, and five years later, 98% of the patients still had complete hematologic remission.
So it seems that Gleevec is indeed the 'magic drug' and 'life sustaining pill' for patients with chronic myeloid leukemia.
Why can't we copy it legally in China
In the movie, the ingredients of "authentic medicine" and "Indian medicine" are exactly the same, one is priced at 40000 yuan, the other is priced at 500 yuan. Although there is no such exaggeration in reality, it is also about 25000 yuan and 1000 yuan. Since India legalizes generic drugs, why can't we do the same?
It only costs 500 yuan to make a drug according to its composition list, but it has cost tens of billions of dollars to write this composition list. During this period, it has achieved five top medical prize winners in the world. In the film, the defense lawyer's opinion in court is irrefutable: it's our scientists who saved the patients with chronic myeloid leukemia, not the imitators. In addition to Greaves, there are dozens of similar human achievements. If we open up imitation, the benign competition of science will turn into vicious competition. Everyone is competing for low-cost imitation. No one is willing to develop better new drugs at a high price, and human technology will stagnate, and there will be no next 'magic drug' Gleevec. Fortunately, every patent has a fixed period of protection, which is not unlimited. The setting of the protection period not only embodies the respect for the patent, but also contains the meaning of inclusive.
In addition, although the components of generic drugs are the same, the production process is indeed unreliable. Although India's generic drugs do not have any adverse reactions in the film, the risk of generic drugs is indeed higher. Therefore, it is not a long-term strategy to eat generic drugs.