Chapter 367 - 249: Kill Shot

As his words fell, a wave of low murmurs of agreement spread through the auditorium.

To be fair, this type of case was extremely rare.

It combined pregnancy, a severe lipid metabolism disorder, and a delayed expression of inflammatory markers.

To use it as a counterexample did seem like a deliberate attempt at nitpicking.

But from the standpoint of academic rigor, it was impossible to refute.

On the Chinese delegation's side, a panicked Wen Xuyang turned to Guo Fengwan. "Elder Guo, this case… SIRS has erupted, but the CRP isn't keeping pace. How do we explain that?"

Guo Fengwan's brow furrowed. For a moment, he couldn't deduce the pathological logic either.

Miller and his group had clearly come prepared.

All eyes once again focused on Jiang He, waiting for his response.

However, Jiang He just stood there and let out a sigh.

'I gave you all this time to prepare, and this is the best question you could come up with? Pathetic.'

He looked at Carter and spoke bluntly, "Dr. Carter, do you really understand modern medicine? Your lack of basic clinical insight is pathetic."

Carter was stunned. "What did you say?"

He never would have imagined that before answering the question, Jiang He would first launch a personal, academic insult at him.

The verbal assault nearly shattered his composure.

"I'm only going to say this once, so I hope you can understand."

Jiang He radiated an overwhelming presence as he spoke:

"In pancreatitis induced by hypertriglyceridemia during pregnancy, the core driving force in the early stages is not the traditional autolysis and necrosis of pancreatic acinar cells. Rather, it is the microvascular toxic reaction caused by a massive accumulation of free fatty acids (FFAs) in the pancreatic microcirculation!"

"You question why CRP isn't high in the first six hours? Because CRP is an acute-phase protein synthesized by the liver. In the very early stages, the massive release of free fatty acids causes microcirculatory embolism and local ischemia. During this time, the systemic cytokine storm has not yet fully activated the liver's transcriptional pathways."

"Do you understand? If you don't, get a notebook and write it down. You can study it slowly when you get back."

The entire hall erupted in an uproar.

Good heavens, how could this young Chinese man be so arrogant!

Carter's face flushed red as he tried to rebut, "What about the transcriptomics data? Why didn't the miRNA in your model change?"

"Because the patient was in the third trimester. Under the blanketing effect of extremely high levels of progesterone and placental lactogen, the mother is in a state of relative immune tolerance. In the first few hours of the disease's onset, this tolerant state creates what is called a 'transcriptional suppression effect'."

"Look closely at the third page of my paper. My model, which is specifically for women of childbearing age, incorporates a dynamic endocrine covariate adjustment coefficient. If you input the data Dr. Carter provided into my model in its entirety, it would have triggered the highest-level red alert at the three-hour mark and recommended immediate initiation of intensive insulin lipid-lowering therapy!"

"Dr. Carter, is it that you can't understand the logic of my model, or do you simply lack the most basic academic knowledge? Hmm?"

The vast, century-old auditorium instantly became as quiet as a community library.

Carter opened his mouth, but the words caught in his throat. He had absolutely no idea how to respond.

Jiang He's argument had just delved into the deep, intersecting waters of immunology, metabolic diseases, and obstetrics.

Carter's specialty, however, was surgery. Not only could he find no fault in the argument, but he was even struggling to fully comprehend it.

The despair of being so thoroughly and publicly intellectually crushed made him want to die of shame and indignation.

'It's so hopeless… like an impotent husband…'

Seeing the situation turning sour, Dr. Hayes immediately stood up, attempting to launch an attack from a different angle:

"Mr. Jiang, you introduced a so-called covariate adjustment coefficient into your algorithm. Where did you get the sample size for that? No hospital in the world could collect a sufficient number of cases of severe pancreatitis in hyperlipidemic pregnant patients in such a short time!"

"Sample size?"

Jiang He laughed. This question was even more laughable than the last.

"As one of the largest critical care centers in the South China Region, Affiliated Hospital No. 1 has archived the complete data for 87 cases of pregnancy with complications over the past five years. Dr. Hayes, Johns Hopkins University might have the world's most luxurious labs, but your annual emergency admissions don't even measure up to a single quarter at one provincial Class A tertiary hospital in China. Are you really using your pitifully small experience with rare diseases to question the breadth of a Chinese database? Don't you think that's a bit like a frog judging the size of the sky from the bottom of a well?"

Hayes's face shifted between pale and ashen from the rebuke, but he was smart enough to keep his mouth shut.

He desperately wanted to say that the United States also has plenty of homeless people and addicts to provide samples, but saying that in this setting would be tantamount to shooting himself in the foot.

The expressions of the foreign scholars in the audience grew serious.

Several of the true academic titans had already quietly taken out their notebooks and begun to jot down the cross-disciplinary pathological logic Jiang He had just mentioned.

In the Chinese delegation's seats,

Wen Xuyang felt a tingling sensation spread across his scalp, a thrilling chill that ran from the crown of his head to the soles of his feet! He was trembling all over!

This was more than just the pleasure of seeing a personal score settled; it was the exhilarating feeling of a Chinese doctor finally holding his head high in the face of Western academic barriers!

Zhou Deming and Guo Fengwan glanced at each other, and both elderly professors felt their eyes grow hot.

Here in Baltimore, on Hopkins's century-old home turf.

A twenty-one-year-old Chinese doctor was using the most hardcore science to wipe the floor with this group of arrogant Western elites!

Shen Yu watched the radiant man on the stage, the corners of her mouth rising in an irrepressible smile.

'That's my Dr. Jiang.'

They say you should never meet someone too stunning in your youth. But in that year of apricot blossoms and gentle rain, Jiang He had stormed into her world with just such an unstoppable force.