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1. Consideration of Scientific Paradigms and Research Reason

编辑:Xu Rongxiang 出版社:CHINA SOCIAL SCIENCES PRESS 发行日期:2009 September

Medical historians today are fortunate to be able to scan, across thousands of years, the extensive research focusing on human health problems and related therapies which have evolved today into the modern disciplines of life science and medicine.

During the development of these modern disciplines, certain questions have consistently arisen in the minds of generations of researchers including: “What are the advantages and disadvantages of a current medical system?” “What medical practice will be adopted in the future that is most advantageous for human physiology and health?” and “Is it possible for the average human being to attain one hundred years of age and still be in good health?” The question as to what the future of medicine will reveal has always teased men and women in the health sciences. As early as 2,000 years ago, both eastern and western medicine originally arose from an apprenticeship with nature and natural phenomena. Everyone attempted to harness nature’s secrets to solve the health problems of their time.  The first written documentation on traditional Chinese medicine is the Huang-Di Nei-Jing or Yellow Emperor's Cannon of Internal Medicine (http://www.hungkuen.net/tcm-history.htm) that was finished during the Spring and Autumn Warring States Period (between 800 B.C. and 200 B.C.).  This documentation represents the development of medicine away from sorcery and en route to being used as the foundation of Chinese medicine. Shen Nong (3493B.C.) hailed as the "Divine Cultivator" tested myriad herbs, and in so doing gave birth to the art of medicine.  Hua Tuo (110-207 A.D) was the most famous doctor in ancient China who developed the use of Mafei San (surgical anaesthesia) a good 1,600-1,700 years before western doctors learned about ether and other chemical or pharmacological anesthetic agents. These and other great achievements supported the foundation of Chinese medicine with its comprehensive and systematic gifts which include modern day’s internal medicine and surgery.

Ancient Greece and Rome dominated the empiricism of the ancient west. At around 6 B.C., Alcaemon (http://emuseum.mankato.msus.edu/prehistory/aegean/culture/greekmedicine.html), from ancient Greece, performed human autopsies and concluded that the brain was the organ of thought and sense. By the 5th century BC, Hippocrates, father of modern western medicine, after studying the conditions of dying patients, (http://www.cpus.gov.cn/kxrw/index.asp?rw=419&jiang=0), articulated the elaborate general doctrine that all of the Four Humors,  phlegm, blood, yellow bile and black bile, had to be in correct proportion to one another for health to result.  (http://www.med.virginia.edu/hs-library/historical/antiqua/textn.htm).  Almost the same time, Aristotle (http://www-groups.dcs.st-and.ac.uk/~history/Mathematicians/ Aristotle.html) the student of Plato, pushed back the frontiers of knowledge and superceded his teacher by proposing that the earth was composed of the four elements: earth, water, air and fire.  (http://galileo.imss.firenze.it/museo/b/earisto.html). With about 2500 years of development, there came into being two academic systems: eastern medicine and western medicine.  Eastern medicine, which originated from ancient Chinese medicine, has brought tons of benefits and contributions to human health by providing treatments based on the plain philosophy and holism, while western medicine experienced two periods: one during the warring period of ancient Egypt and ancient Rome when the massive wounded were treated, which brought morphologic research from anatomy to applied surgery, and the other during the Renaissance when medicinal chemistry was developed based on the alchemy, thereby resulting in the rudiments of modern western medicine and surgery.

Historically, both eastern and western medicine have continuously integrated modern scientific discoveries into their medical treatments and thus continued to develop. However, historians might also question what kind of significant benefits, whether in Chinese or western medicine, these discoveries have played in promoting human health and in effectively treating diseases. Let me share with you an image that concerns me. Imagine a modern, well-educated medical doctor holding a knife in his left hand and a pharmaceutical drug, a cellular poison, in his right. Now he suggests to the patient: “I will use the knife to excise your injured organ to cure disease and save your life and then I will use the ‘poison’ to cure the disease. Is that OK?” You see, combating poison with poison, is the paradigm which we were taught by the older generations of doctors. And because no one offered a more reasonable option, western drugs today are made primarily of chemical toxins which are incompatible with life and which, not surprisingly, when applied to diseased human beings, inevitably have deleterious side effects on health. Therefore, it is not an unjust comparison to liken western drugs to poison when seen in the context of the rule of life or vitality.

For many centuries, medical professionals the world over have sought to reduce drug toxicity as much as possible while many governments have set up national drug control administrations to ensure drug safety for humans. However, no substantial and meaningful changes have been made to traditional medical system due to the inflexible concept of “poison” and, until now, due to the lack of effective nontoxic options for the treatment of disease. Where is the new medical system that conforms to the principles of human vitality? In which direction should the practice of human medicine go? Herein, I would like to share with devoted readers the exciting story of the establishment of regenerative medicine and therapy as well as our compelling research which supports this new paradigm shift towards a medicine which is in accordance with the laws of human health and wellness.

We inaugurated the research into the secrets of regenerative medicine and therapy in early 1980.  Although many difficult challenges fell before us since 1987 (the year we established ourt Research Center), our published research results demonstrate that we are presently amongst the leaders in this field. Back in 1989, I published research demonstrating the heretofore unthinkable result of scar-free healing of burns through the application of regenerative cells. The clinical results were impressive and the pictures demonstrating irrefutable clinical effects (no scars) are available for the interested reader in The Chinese Journal of Burns, Wounds and Surface Ulcers.

Subsequently, the work done by Dr. James A. Thomson and his colleagues from Wisconsin University in 199889 revealed that when cells were isolated directly from the inner cell mass of human embryos at the blastocyst stage and then cultured in vitro to produce a pluripotent stem cell line, they would then transform into many types of cells.  Thomson’s group believe that any cell from a fertilized egg, termed as “totipotent stem cells”, if placed into a woman's uterus, has the potential to develop into a fetus and then to form an entire viable organism. Meanwhile, Dr. John Gearhart and his colleagues isolated pluripotent stem cells from fetal tissue of terminated pregnancies and confirmed Dr. Thomson’s results. Their work was published in Science and saluted as “the first breakthrough out of the ten big achievements in 1999”.

This technological achievement triggered a burst of stem cell research and a whirlwind of ethical debate followed immediately by a drive for commercialization, some of which was quite unscrupulous. For example, a certain laboratory announced that they had created a human ear on the dorsum of rats. More stir! Not surprisingly though, on closer inspection, we learned that their statement was not actually true. In fact, the scientists in that laboratory did something different though not entirely insignificant. They managed to first make a human ear model scaffold using polyglycolic acid (macromolecule chemical material) and then, after placing this structure beneath the rat subcutis, cartilage cells cultured and proliferated within the said scaffold creating something that looked like an ear but was not one at all. Like a shadow perpetually attached to its master, commercialization is never far from the frontiers of science.

Imagination, while an important component of science, is only a distraction unless the rigor of the scientific method is also employed. No trickery is allowed. Unfortunately, such tricky performances -such as human ears on the back of mice- disturb the current field of stem cell research. Traditionally, Chinese scientists and doctors prefer to investigate principles from experimental results and holistic concepts in order to discover tri-dimensional development modes en route to comprehensive conclusions. In contrast, westerners are adept at imaging from scantling phenomenon, then designing several research directions for further exploration before finally attaining an answer. The Western mode of research necessarily requires adequate funding which seems to not be in short supply.  For example, a result that might require ten thousand dollars in China might require, in the West, a price of ten million dollars. Nonetheless, despite funding discrepancies, we are pleased to reveal that, though relatively underfunded, Chinese researchers have accomplished the clinical application of regenerative medicine while Western researches are still formulating strategies. This difference in degree of clinical success validates the eastern way of thinking about research, which produces empirically superior clinical results in an expeditious manner.

Our focus in this book will be to reveal that the clinical results springing from the research on burns wherein data suggest that most dry wounds heal with scar formation whereas most moist wounds heal with less scarring. While probing the mechanism of this superior healing over many years, we discovered one type of unknown cell that has a regenerative capacity which may play a significant role in this process. After years of basic research and clinical study, we found that the cells with regenerative potential turned out to be keratin 19 positive expressed epidermis stem cells which appear to be the primitive cells at the start of human embryonal development. Coincidently, this understanding shed a great light on the mystery of optimal physiological healing of deep burns by regeneration. Using wound repair as a model, we dynamically demonstrated that the process of skin regeneration and development can resemble embryonic tissue development. Based on the discovered skin regenerative law, we conducted experimental studies on the regeneration and repair of tissues and organs of mammals by creating a vital environment. I am now pleased to report that up to the present, we have had consistent success in repairing and regenerating 55 types of tissues and organs.

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