BACKGROUND: To discuss the basic theory of traditional Chinese medicine (TCM) related to stem cell for a try to offer a new combining site +for the modernization research of the basic theory of TCM.METHODS: Comparatively analyzing the characteristic of stem cells and the essence theory in TCM.RESULTS: Stem cells have the capacity for both self-renewal and differentiation and can produce the daughter cells with the same phenotype and genotype as themselves. Stem cells have the plasticity that a stem cell may differentiate into cells other than the lineages to which it is committed, and therefore, is also termed transdifferentiation. So it is of great value for stem cell application in tissue engineering, curing tissue-damaged diseases and as the vector for transgene therapy. We compared the character of stem cells with essence theory, an elementary and important part of the basic theory of TCM, and found that stem cells are related greatly to essence,according to its two origin, congenital essence and acquired essence, and four kinds of functions of essence, which are controlling reproduction,controlling growth and development, manufacturing marrow and transforming blood; nourishing and moistening the zangfu-organs. Furthermore, stem cells especially have direct connected with the congenital essence which is stored in the kidneys. Congenital essence is the reproductive essence accepted from parents. Sperm and ovum merge to be oosperm, that is just the totipotent stem cell. The connotative meanings of congenital essence include all germ plasm and the special developing message of a genus in the oosperm. Genital stem cells are in charge of the function of controlling reproduction of congenital essence. Growth and development function is related to the proliferation and differentiation of adult stem cells controlled by gene. Manufacturing marrow function has relation with bone marrow stem cells and neural stem cells (NSC) in medullary cavity in which contains bone marrow, spinal cord and brain. Dominating bones function of the kidneys is related to mesenchymal stem cells (MSC), and hematopoietic stem cells (HSC) execute the function of producing blood completely.CONCLUSION: We consider that stem cells have a close relation with the congenital essence, and we put forward a new viewpoint in this research that stem cells have the same properties of congenital essence, and they are existence formation of congenital essence in cell level.

OBJECTIVE: To explore application value and efficacy of personalized osteotomy in primary total knee arthroplasty (TKA) for severe varus knee osteoarthritis. METHODS: From June 2018 to January 2020, 36 patients (49 knees) with severe varus knee osteoarthritis were treated, including 15 males (21 knees) and 21 females (28 knees), aged from 59 to 82 years old with an average of (67.6 ± 6.5) years old;the course of disease ranged from 9.5 to 20.5 years with an average of (15.0 ± 5.0) years;11 patients (15 knees) with Kellgren-Lawrence grade Ⅲ and 25 patients (34 knees) with grade Ⅳ according to Kellgren-Lawrence grading. According to AORI clsssification of tibial bone defects, 8 patients (15 knees) were typeⅠTa and 16 patients (18 knees) were typeⅡ T2a. All patients' femor-tibial angle (FTA) was above 15°, and received primary TKA with personalized osteotomy. Thirty-three patients (45 knees) were treated with posterior-stabilized (PS) prostheses, 13 patients (15 knees) with PS prostheses combined with a metal pad and extension rod on the tibial side, and 3 patients (4 knees) with legacy constrained condylar knee (LCCK) prostheses. FTA, posterior condylar angle (PCA), medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA) before and after operation at 1 month were measured and compared by using picture archiving and communication systems (PACS). Recovery of lower limbs before and after operation at 12 months was evaluated by American Knee Society Score(KSS), and complications were observed and recorded. RESULTS: All 36 patients (49 knees) were followed up from 15 to 40 months with an average of (23.46±7.65) months. FTA, MPTA were corrected from preoperative (18.65±4.28)° and (83.75±3.65)° to postoperative (2.35±1.46)° and (88.85±2.25)° at 1 month, respectively (P<0.001). PCA was decreased from (2.42±2.16)° before operation to (1.65±1.35)° at 1 month after operation, LDFA improved from (89.56 ± 3.55)° before operation to (91.63±3.38)° at 1 month after operation (P<0.05). KSS increased from (67.58±24.16) before opertion to(171.31±15.24) at 12 months after operation, 14 patients (19 knees) got excellent result, 19 (26 knees) good, and 3 (4 knees) fair. CONCLUSION Personalized osteotomy is helpful for recovery of axial alignment of lower limbs and correct placement of prosthesis, could effectively relieve pain of knee joint, recover knee joint function.
Male ; Female ; Humans ; Child ; Adolescent ; Young Adult ; Adult ; Arthroplasty, Replacement, Knee ; Osteoarthritis, Knee/surgery* ; Retrospective Studies ; Knee Joint/surgery* ; Osteotomy ; Tibia/surgery*

Objective To compare the effects of intravenous thrombolysis with tenecteplase com-bined with endovascular treatment versus alteplase combined with endovascular treatment in patients with acute ischemic stroke(AIS).Methods A total of 98 patients with AIS in the hospital from Jan-uary 2021 to October 2022 were randomly divided into alteplase group and tenecteplase group,with 49 cases in each group.The alteplase group received alteplase thrombolysis combined with endovascular treatment,while the tenecteplase group received tenecteplase combined with endovascular treatment.General clinical materials were compared between the two groups;the National Institutes of Health Stroke Scale(NIHSS)scores at baseline(T0),1 hour after thrombolysis(T1),24 hours after endo-vascular treatment(T2),7 days after endovascular treatment(T3),and at discharge(T4)were com-pared between two groups;the modified Rankin Scale(mRS)scores and Barthel index(BI)scores at T0,30 days after endovascular treatment(T5),and 90 days after endovascular treatment(T6)were also compared between two groups;the length of hospital stay,occurrence of complications,and clini-cal efficacy were compared between the two groups.Results There were no significant differences in age,gender distribution,body mass index(BMI),hypertension,diabetes,coronary heart disease,smoking,alcoholism,cerebral infarction volume,infarction location,and clinical classification be-tween the two groups(P＞0.05).Compared with the alteplase group,the NIHSS scores at T,,T2,T3 and T4 were significantly lower in the tenecteplase group(P＜0.05).Similarly,the mRS scores at T5 and T6 were significantly lower while the BI scores at T5 and T6 were significantly higher in the tenecteplase group than the alteplase group(P＜0.05).The length of hospital stay was significantly shorter in the tenecteplase group than the alteplase group(P＜0.05).The incidence rates of post-treatment complications such as cerebral hemorrhage,gastrointestinal bleeding,skin and oral muco-sa bleeding,atrial fibrillation,and hypotension in the alteplase group were 10.20％,2.04％,8.16％,0％,and 8.16％respectively,while those in the tenecteplase group were 2.04％,4.08％,6.12％,2.04％,and 4.08％respectively;the incidence rate of cerebral hemorrhage in the tenecteplase group was significantly lower than the alteplase group(P＜0.05).The total effec-tive rate was 85.71％in the alteplase group,which was significantly lower than the 91.84％in the tenecteplase group(P＜0.05).Conclusion Compared with alteplase bridging therapy,tenecte-plase bridging therapy shows better clinical outcomes,which can improve the quality of life and prognosis of patients with AIS to a certain extent,reduce the probability of cerebral hemorrhage,and enhance clinical efficacy.

Objective To compare the effects of intravenous thrombolysis with tenecteplase com-bined with endovascular treatment versus alteplase combined with endovascular treatment in patients with acute ischemic stroke(AIS).Methods A total of 98 patients with AIS in the hospital from Jan-uary 2021 to October 2022 were randomly divided into alteplase group and tenecteplase group,with 49 cases in each group.The alteplase group received alteplase thrombolysis combined with endovascular treatment,while the tenecteplase group received tenecteplase combined with endovascular treatment.General clinical materials were compared between the two groups;the National Institutes of Health Stroke Scale(NIHSS)scores at baseline(T0),1 hour after thrombolysis(T1),24 hours after endo-vascular treatment(T2),7 days after endovascular treatment(T3),and at discharge(T4)were com-pared between two groups;the modified Rankin Scale(mRS)scores and Barthel index(BI)scores at T0,30 days after endovascular treatment(T5),and 90 days after endovascular treatment(T6)were also compared between two groups;the length of hospital stay,occurrence of complications,and clini-cal efficacy were compared between the two groups.Results There were no significant differences in age,gender distribution,body mass index(BMI),hypertension,diabetes,coronary heart disease,smoking,alcoholism,cerebral infarction volume,infarction location,and clinical classification be-tween the two groups(P＞0.05).Compared with the alteplase group,the NIHSS scores at T,,T2,T3 and T4 were significantly lower in the tenecteplase group(P＜0.05).Similarly,the mRS scores at T5 and T6 were significantly lower while the BI scores at T5 and T6 were significantly higher in the tenecteplase group than the alteplase group(P＜0.05).The length of hospital stay was significantly shorter in the tenecteplase group than the alteplase group(P＜0.05).The incidence rates of post-treatment complications such as cerebral hemorrhage,gastrointestinal bleeding,skin and oral muco-sa bleeding,atrial fibrillation,and hypotension in the alteplase group were 10.20％,2.04％,8.16％,0％,and 8.16％respectively,while those in the tenecteplase group were 2.04％,4.08％,6.12％,2.04％,and 4.08％respectively;the incidence rate of cerebral hemorrhage in the tenecteplase group was significantly lower than the alteplase group(P＜0.05).The total effec-tive rate was 85.71％in the alteplase group,which was significantly lower than the 91.84％in the tenecteplase group(P＜0.05).Conclusion Compared with alteplase bridging therapy,tenecte-plase bridging therapy shows better clinical outcomes,which can improve the quality of life and prognosis of patients with AIS to a certain extent,reduce the probability of cerebral hemorrhage,and enhance clinical efficacy.