Chapter Summaries

Wei Kang learned that Three Purities had won a 400-million-yuan share of a major ultrasonic scalpel procurement tender. At Linyuan County People's Hospital, its new unit completed a successful first surgery, leaving staff eager to use the technology and President Sun Guangrong convinced the hospital needed another one.

• Jian Lianyun cooked free-range chicken for Wei Kang, who praised the meal and proposed selling the farm’s extra meat to hospital employees.
• Lu Tingfeng told Wei Kang that Three Purities had secured one-quarter of the blades and one-third of the units in the 16-Province Alliance tender, worth 400 million yuan.
• Wei Kang instructed Lu Tingfeng to manage production and ensure timely delivery, technical support, and after-sales service for hospitals of every level.
• At Linyuan County People's Hospital, President Sun Guangrong and Director Liu inspected the new Three Purities ultrasonic scalpel and prepared for its first operation.
• The hospital performed a laparoscopic intestinal polyp removal with the ultrasonic scalpel, and the successful, bloodless surgery prompted several department directors to request the equipment.
• President Sun Guangrong concluded that the hospital needed to purchase another ultrasonic scalpel because one unit could not serve so many departments.

Gu Xian and Xue Shen confirmed that Oral Insulin caused the same hypoglycemia symptoms in rats as injected insulin, then discussed the nanoparticle technology and the challenges of developing and selling the medicine. Gu Xian began explaining how pharmaceutical giants maintained their insulin monopolies, but stopped just before revealing their main tactic.

• Gu Xian and Xiao Lan gave Oral Insulin to three rats and injected insulin into three control rats, then observed both groups develop matching hypoglycemia symptoms.
• Xiao Lan injected glucose into the rats, which quickly recovered, and Gu Xian and Xue Shen concluded that Oral Insulin had entered the bloodstream and worked.
• Gu Xian and Xue Shen explained how the nanoparticle layers and cell-penetrating peptides protected insulin and helped it cross the intestinal wall.
• Xue Shen and Gu Xian told Xiao Lan that successful rat trials were only an early step, with further testing and human clinical trials still needed.
• Gu Xian discussed insulin's high prices and asked Xiao Lan why the three pharmaceutical giants had maintained their market dominance; she cited production, sales, supply-chain, and treatment-system barriers.
• Gu Xian said those barriers did not fully explain the century-long monopoly and hinted at the giants' real special tactic, leaving Xiao Lan and Xue Shen waiting for his explanation.

Gu Xian explained how the Big Three kept their insulin advantage through genuine technological upgrades, while Xue Shen and Xiao Lan prepared to create oral insulin. After successful animal tests and further development, the team completed fifth-generation oral insulin, and Wei Kang ordered a Phase I clinical trial to begin.

• Gu Xian described the evolution of insulin from animal-derived first-generation insulin to the later generations, explaining how improvements addressed patients’ needs and sustained the Big Three’s position.
• Xiao Lan concluded that continuous drug innovation—not merely layered patents—was the Big Three’s key advantage, while Xue Shen said their team would make fifth-generation oral insulin.
• Gu Xian assigned Xue Shen the animal experiments and began studying insulin analogs and mass production.
• After further rat tests showed sustained blood sugar reduction of up to 60%, the team planned oral insulin with rapid-acting insulin in the outer nanoparticle layer and long-acting insulin in the inner layer.
• The team developed fifth-generation oral insulin suitable for human clinical trials, and Wei Kang ordered an immediate Phase I trial.

After Phase I testing found no toxic side effects, Sanqing Group began Phase II trials of Oral Insulin, and Cao Fang enrolled her one-year-old daughter, who had been diagnosed with Type I Diabetes and required lifelong insulin treatment. The child’s blood sugar remained stable after taking the oral drug, leaving Cao Fang hopeful that she could avoid daily injections.

• Wei Kang reviewed the Phase I results and approved expanding the Oral Insulin trials to Phase II.
• Cao Fang rushed her critically ill daughter to Kun City First People's Hospital, where doctors diagnosed ketoacidosis and suspected Type I Diabetes.
• Cao Fang learned to manage her daughter’s diet, blood sugar tests, and insulin injections during the child’s hospitalization.
• The attending physician offered Cao Fang a place for her daughter in Sanqing Group’s Phase II Oral Insulin trial, and Cao Fang signed the consent form.
• Cao Fang gave her daughter the lowest dose of Oral Insulin, and the child showed no unusual reactions while her health indicators stayed stable.

After Tang Xiaolong was rushed to the ICU with severe diabetic ketoacidosis, his mother Zheng Jie learned about Sanqing Group’s oral insulin trial and enrolled him. The chapter then followed the growing group of diabetes patients joining the trial and described how oral insulin spared them repeated injections.

• Tang Xiaolong was admitted to the ICU with dangerously high blood sugar and diabetic ketoacidosis after repeatedly neglecting his insulin injections and diet.
• Zheng Jie told the doctor about Xiaolong’s struggles with his illness and despaired over his future complications.
• The doctor told Zheng Jie that Sanqing Group’s oral insulin was entering Phase II trials, and she signed Xiaolong up as a volunteer.
• The hospital admitted more teenage Type I and severe Type II diabetes patients to the trial as the number of participants grew.
• The trial patients combined oral insulin with diet control and weight loss, and they welcomed no longer needing frequent injections.

Gu Xian and Wei Kang planned a patient-management system for Oral Insulin, while Xiang Gaofei proposed expanding Dragon Map into AI diagnosis. Oral Insulin's Phase II trial rapidly filled with eager applicants and reached its final stage as the Diabetes management app launched alongside Phase III recruitment.

• Gu Xian briefed Wei Kang on Oral Insulin's successful Phase I and II results and discussed how difficult diabetes self-management made treatment adherence.
• Wei Kang directed Gu Xian to prepare an integrated Diabetes management plan for Dragon Map, including patient guidance and clinical decision support.
• Xiang Gaofei proposed developing AI diagnosis using Sanqing's medical data, and Wei Kang approved the idea and promised support.
• News of Oral Insulin spread through Type I Diabetes support groups, bringing a surge of applicants that filled the Phase II trial and sped it toward completion.
• Xiang Gaofei's team completed a basic Diabetes management function for Dragon Map and launched it with Phase III trial recruitment notifications to registered patients.

After losing her job, Zhao Juan joined Sanqing Group’s Phase III Oral Insulin trial and found that the medicine kept her blood glucose stable without injections. Meeting Li Xin and other Diabetes patients inspired her to consider taking the civil service exam, while the trial’s growing success sent Sanqing’s new drug trending online.

• Zhao Juan was laid off when her company eliminated her entire department, despite having concealed her Diabetes.
• After seeing an announcement for Sanqing Group’s Oral Insulin trial, Zhao Juan applied, enrolled at a local hospital, and found that the medicine kept her blood glucose stable.
• Zhao Juan met Li Xin, who described how he concealed his Diabetes to pass a government job medical examination.
• Inspired by Li Xin and encouraged by the prospect of Oral Insulin, Zhao Juan decided to consider taking the civil service exam.
• More trial participants experienced Oral Insulin’s benefits, and Sanqing’s new drug gained widespread attention online.

Three Purities' Oral Insulin entered Phase III trials and drew worldwide excitement, while its threat to established insulin makers triggered a chaotic online controversy over fake claims that insulin had become free. After public pressure pushed the FDA to approve trials in Eagle Country, Wei Kang authorized the overseas clinical trials, leaving the three pharmaceutical giants alarmed.

• Tangtang and other trial volunteers shared positive experiences with Three Purities' Oral Insulin, prompting Chinese media and netizens to celebrate the breakthrough.
• Foreign media reported on the drug's clinical progress, and Eagle Country netizens welcomed it as a potential alternative to costly injections from Eli Lilly, Sanofi, and Novo Nordisk.
• A hacked Eli Lilly account falsely announced free insulin, followed by similar posts from Sanofi and Novo Nordisk, causing the companies' stock prices to plunge.
• The three companies denied the announcements, while fake accounts and public criticism fueled further anger over insulin prices.
• Eagle Country netizens petitioned the FDA to begin trials of Three Purities' Oral Insulin, and the FDA agreed under public pressure.
• Wei Kang approved overseas clinical trials, delighting Eagle Country netizens and worrying the three pharmaceutical giants.

Eli Lilly responded to the threat of Three Purities’ Oral Insulin and a lawsuit over insulin prices by announcing steep price cuts and shifting its focus toward Type II Diabetes drugs. As Eli Lilly’s rivals faced mounting pressure, Three Purities began an Oral Insulin Phase III clinical trial in Eagle Country.

• After Three Purities’ Oral Insulin research drew international attention, Eli Lilly CEO Rex learned that California had sued Eli Lilly, Novo Nordisk, and Sanofi over insulin prices.
• Rex and Eli Lilly’s executives agreed to cut insulin prices by 70% and gradually shift company resources toward GLP-1 receptor agonists and other treatments.
• Eli Lilly announced major insulin price cuts and a $35 monthly out-of-pocket cap, prompting public praise and a rise in its stock price.
• Sanofi and Novo Nordisk faced public pressure to lower their own prices as Eli Lilly’s announcement shifted criticism onto its competitors.
• Three Purities entered Eagle Country and began a Phase III clinical trial of Oral Insulin.

Freeman joined a trial of Sanqing Group’s Oral Insulin and found it more convenient and effective than his insulin pump. In China, Wei Kang reflected on Sanqing’s goal of curing Diabetes and launched an Islet Stem Cell Transplant Project, then reviewed the company’s other research programs.

• Freeman learned that Oral Insulin had entered clinical trials in Eagle Country and enrolled in the trial the next day.
• Freeman found that taking Oral Insulin before meals kept his blood sugar stable, while other trial participants also wanted access to the drug after the trial ended.
• Wei Kang discussed the insulin market and Sanqing’s plans, deciding to focus on Type I Diabetes rather than enter the crowded GLP-1 drug field.
• Wei Kang outlined Islet Stem Cell Transplant as a potential way to restore insulin production and completely cure Diabetes.
• Wei Kang created the Islet Stem Cell Transplant Project and assigned personnel to it.
• Wei Kang reviewed Sanqing’s research progress and learned that Artificial Blood Vessel samples had been completed.

Wei Kang visited Xue Shen’s Nano Laboratory and learned how its homemade Protein Synthesizer produced the elastin used in a small-diameter Artificial Blood Vessel. He inspected the sample and heard the plan for animal testing, which was expected to begin the following week.

• Xue Shen showed Wei Kang the lab’s prototype Protein Synthesizer and explained how it chemically assembled proteins, including the 218-amino-acid Elastin Molecules.
• Xue Shen explained the synthesizer’s capabilities and limits, contrasting chemical protein synthesis with Genetic Engineering Technology.
• Xue Shen presented a 4-millimeter Artificial Blood Vessel and demonstrated its elasticity, durability, and ability to return to its original shape after stretching and squeezing.
• Xue Shen outlined plans for mouse and pig Animal Experiments, with the pig tests comparing the new vessel against imported Polyester Artificial Blood Vessels.
• Wei Kang praised the results, expressed anticipation for the experimental report, and left while Xue Shen felt pleased that he had impressed the boss.

Xue Shen discovered that the artificial blood vessels implanted in the lab mice had integrated with their tissues and showed promising compatibility, so the team prepared to move on to pig experiments. Meanwhile, Sanqing Farm’s unusual pork dishes became popular, and Wei Kang learned that Jian Lianyun was pregnant.

• Xue Shen examined the mice after an intern reported that their implanted blood vessels could no longer be felt, then dissected one and found the graft integrated with the mouse’s tissue.
• A medical student reported that the graft showed good tissue compatibility, endothelial growth, and resistance to thrombosis, and Xue Shen planned large-animal experiments.
• Sanqing Farm’s Devil Muscle Pig pork became a popular cafeteria dish and helped boost Sanqing Garden’s tourism business.
• Wei Kang returned home and learned from Jian Lianyun that she was pregnant, then celebrated and began thinking about their child.

At Huaxi Hospital, Dr. Tang treated young patients whose kidney failure was linked to years of harmful folk remedies and excessive supplements, then referred them to a clinical trial for a new chronic kidney disease drug. The trial patients improved after two courses of treatment, while more young people continued to arrive with advanced kidney disease.

• Dr. Tang diagnosed an eighteen-year-old girl with severe kidney failure and learned that she had taken an unknown herbal decoction daily for six years to treat menstrual pain.
• Because the girl’s family could not afford dialysis, Dr. Tang offered her a place in Sanqing Group’s clinical drug trial, which her mother accepted.
• Dr. Tang found that a high school boy’s kidneys were badly damaged and learned that his grandparents had fed him excessive supplements and rich foods for years.
• The boy’s father agreed to follow Dr. Tang’s advice, arrange hospitalization, and enroll his son in Three Purities’s clinical trial.
• Dr. Tang continued seeing increasing numbers of young patients with chronic kidney disease and urged them to join the trial.
• After two courses of treatment, the young patients in the drug trial began to improve.

Dr. Tang reviewed the clinical-trial results showing that Sanqing Group’s new drug had sharply improved kidney function for most patients with early-stage Kidney Failure, then visited the Dialysis Room to tell long-term dialysis patients that medical advances might eventually offer them hope. The chapter ended with the patients listening intently as he repeated his news inside the room.

• Dr. Tang compared trial results and found that two courses of treatment had restored many patients with mild Kidney Failure to near-normal kidney function, while some severely ill patients had also improved enough to stop dialysis.
• Moved by the results, Dr. Tang went to the Dialysis Room, where patients with Uremia greeted him and a distressed middle-aged man broke down over his illness and financial hardships.
• Dr. Tang comforted the man and encouraged him to hold on for his son, then announced that Sanqing Group’s new drug had helped many early-stage patients recover and escape dialysis.
• The dialysis patients crowded around Dr. Tang with questions, and his news stirred laughter and renewed hope among them.
• Dr. Tang entered the Dialysis Room and patiently repeated the news to the patients lying on the beds.

Xiao Jie told Dr. Lin how years of pressure to act outgoing had led to severe social anxiety, and he began weekly psychotherapy alongside a new medication. Two weeks later, he joined a clinical trial for Sanqing Group’s social anxiety drug, and his condition began to improve.

• Dr. Lin explained that Xiao Jie’s symptoms could be Social Anxiety Disorder and recommended psychotherapy after several antidepressants failed to help.
• Xiao Jie described how his parents’ expectations, university social life, and a hostile job had worsened his anxiety until he isolated himself and struggled to leave home.
• Xiao Jie opened up to Dr. Lin, briefly held his gaze, and agreed to continue weekly therapy with a different medication.
• Two weeks later, Dr. Lin offered Xiao Jie a place in the clinical trial for Sanqing Group’s social anxiety medication, and Xiao Jie agreed after learning participation was voluntary.
• Xiao Jie began the trial and followed its medication records, examinations, and follow-up schedule as his condition gradually improved.

Xiao Jie told Dr. Lin how an experimental medication had eased his social anxiety and helped him return to everyday life. He left the appointment with a job offer and a date with the girl he liked.

• Xiao Jie visited Dr. Lin after three months and described how the clinical-trial medication helped him speak to fellow patients and play games with strangers.
• Xiao Jie explained that after two courses of treatment, he could handle crowds, shop at a market, and attend job interviews without fear.
• Xiao Jie told Dr. Lin he had stopped taking the medication during a desensitization period and would accept further treatment if his condition relapsed.
• Dr. Lin asked Xiao Jie about the trial and his current condition, then saw him out of the consultation room.
• Xiao Jie received a call confirming he had passed a job interview and invited the girl he liked to see a movie.
• Dr. Lin watched Xiao Jie leave, then called for his next patient.

Zheng Jiamin learned that a promising Gene Therapy for her daughter Tiantian’s Dravet Syndrome had entered Clinical Trials, giving her hope after years of managing the child’s seizures. At Sanqing headquarters, Wei Kang reviewed the company’s growing drug pipeline and weighed how to develop a promising Antioxidant Drug.

• Zheng Jiamin brought Tiantian to Dr. Liu for another course of Clobazam and learned that Midazolam Nasal Spray would not be introduced domestically because of regulatory and trial costs.
• Zheng Jiamin remembered Tiantian’s first seizures and Dravet Syndrome diagnosis, then reflected on the family’s years of fear and limited treatment options.
• Dr. Liu called Zheng Jiamin with news that Sanqing Group’s Gene Drug for Dravet Syndrome had entered Clinical Trials and had shown encouraging results in other patients.
• Zheng Jiamin turned the taxi around and returned to Huashan Hospital to register Tiantian for the trial.
• Wei Kang reviewed Sanqing’s promising drug projects, including its epilepsy Gene Drug, and considered whether the Antioxidant Drug should be developed as a prescription medicine.

Wei Kang struggled to choose a Phase III indication for the Antioxidant Enzyme Accelerator, then selected Acute Radiation Sickness and Ischemia-Reperfusion Injury because both were closely linked to oxidative damage. He ordered the Phase III trial to advance and planned to pursue anti-aging research after the drug entered the market.

• Wei Kang reviewed the drug's animal and early clinical results, weighing the difficulty of proving antioxidant treatments effective for complex chronic diseases.
• Wei Kang rejected Coronary Heart Disease as an initial target after considering the lengthy trials and Probucol's failure to compete with Statins.
• Wei Kang chose Acute Radiation Sickness as the primary indication because radiation causes Free Radical damage and the condition has high mortality without a targeted treatment.
• Wei Kang selected Ischemia-Reperfusion Injury as a backup indication, citing the role of Free Radicals and SOD in tissue damage after blood flow returns.
• Wei Kang ordered Three Purities to formally advance the Phase III Clinical Trial and planned future foundational research into a preventive anti-aging drug.

Li Qing discovered that years of radiation exposure had caused him and much of the Interventional Department to exceed safe dosage limits, so Director Yao urged the staff to join Sanqing Group’s Phase III trial of an antioxidant drug. The next day, more than twenty department staff arrived to register, startling the doctor in charge.

• Li Qing led a two-hour emergency aortic intervention that saved a critically ill seventy-two-year-old patient, then performed seven more operations during a twelve-hour shift.
• Director Yao noticed a swollen spot on Li Qing’s forehead, and Li Qing checked his Dosimeter Pen and found a reading of 120.
• Director Yao explained that Sanqing Group’s antioxidant drug was in a Phase III clinical trial and ordered staff with readings above fifty to seek treatment and radiation leave.
• More than half the department’s staff found their readings exceeded fifty, so Director Yao volunteered to cover operations while they went for treatment.
• More than twenty Interventional Department staff arrived at the clinical building to register for the trial, and the registration doctor wondered whether the department had been wiped out by a medical accident.

Li Qing joined a clinical trial for Three Purities's Antioxidant Enzyme Accelerator and discovered that his radiation-related blood abnormalities and other health problems improved rapidly. After the first group left the clinical building, Director Yao and doctors from another hospital arrived to join the next round, drawn by reports of the drug's effects.

• Li Qing and his Interventional Department colleagues signed consent forms, passed examinations, and entered the six-day trial.
• During the trial, Li Qing's SOD and White Blood Cell levels rose into the normal range, and he told his colleagues that he believed he had received the drug.
• The subjects who received the medicine showed marked improvements in their health, while those given placebos mainly benefited from rest.
• The Three Purities research team found the dramatic results easier to measure and prepared the subjects for a second testing cycle after a week of routine work.
• Director Yao signed up for the trial, and Director Fang brought doctors from his hospital after hearing about the drug's results; both hoped it might restore their hair.