Tài liệu Burns Regenerative Medicine and Therapy pdf

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Contents
VII
Preface
1
Brief Introduction to the History of Burns Medical Science
5
Introduction
5 Consideration of Scientific Paradigms and Research Reasoning from the Viewpoint of
Foundation and Development of Medical Science Systems
7 Research Status of Stem Cell and Regenerative Medicine and Therapy from a Holistic
Philosophy
8 Discussion of the Future of Regenerative Medicine and Therapy Based on the Results of
Multi-Organ Regeneration Research
13
Rationale Foci of Local Treatment of Burns Medicine and Therapy
13 Pathogenesis Focus of Burns Wounds
14 Pathological Focus of Burns Wounds
16 Therapeutics Focus
19
Evaluation and Classification of Burn Severity
19 Clinical Assessment of Burn Area
20 Clinical Evaluation on Depth of the Burns Wound
23 Clinical Classification of Burns Severity
27
Clinical Principles of Burns Regenerative Medicine and Therapy
27 Standardized Local Treatment of the Burns Wound
27 Background Information of Standardized Local Treatment and Sources
28 Standardized Local Treatment of Burns Wounds
34 Indications and Diagnostic Principles of Burns Regenerative Medicine and Therapy
34 Diagnostic Principles of Burns Medical Therapy
34 Burns Regenerative Medicine and Therapy (BRT with MEBT/MEBO)
35 Burns Surgical Therapy with Excision Followed by Skin Grafting or Cultured Composite
Autografting Technique
36 Intensive Description of Burns Regenerative Therapy with MEBT/MEBO
36 Concept and Principle of BRT with MEBT/MEBO
37 Therapeutic Effects of Moist-Exposed Burns Ointment (MEBO)
37 Clinical Application of BRT with MEBT/MEBO
37 Clinical Treatment
40 Systemic Comprehensive Treatment with BRT with MEBT/MEBO
V
45
Experimental and Clinical Study on Burns Regenerative Medicine
and Therapy with MEBT/MEBO
47 Systemic Antishock Effect of Local Treatment with BRT with MEBT/MEBO
47 A Comparative Study on the Antishock Effect between BRT with MEBT/MEBO and
Conventional, Dry-Exposed Burn Therapy Using a Rabbit Model
50 Experimental Study on Maintaining Physiological Moist Effect of BRT with
MEBT/MEBO on Treating Burns Wounds
53 Clinical Study on Invisible Water Loss of Burns Wounds Treated with BRT with
MEBT/MEBO
55 Experimental Study of Moist-Exposed Burn Ointment on Improving Wound
Microcirculation of the Zone of Stasis in the Early Stages after Burns
57 Clinical Study of Moist-Exposed Burns Ointment on Improving Microcirculation of
Burns Wounds
60 Experimental Study of the Effect of BRT with MEBT/MEBO on Hematological
Parameters in the Treatment of Burned Rabbits
63 Studies on the Anti-Infection Effect of BRT with MEBT/MEBO
63 Effect of BRT with MEBT/MEBO on the Immunity of Burns Patients
68 Study on the Bacterial Count of Viable Tissue of Burns Wounds Treated with BRT with
MEBT/MEBO
70 Comparative Study of the Effects of Moist-Exposed Burn Ointment, Silver Sulfadiazine
and Hot Dry-Exposed Therapy on Controlling Burn Wound Infection with
Pseudomonas aeruginosa
74 Experimental Research on the Mechanism of the Anti-Infection Effect of BRT with
MEBT/MEBO
77 Primary Exploration on the Mechanism of the Anti-Infection Effect of BRT with
MEBT/MEBO
82 Experimental Research on the Anti-Anaerobic and Anti-Fungal Effect of MEBO
88 Studies on the Effects of BRT with MEBT/MEBO on Regeneration and Healing of Burns Wounds
88 A Comparative Study of Fibronectin and Moist-Exposed Burns Ointment (MEBO) in
the Treatment of Experimental Corneal Alkali Burns in Rabbits
89 A Comparative Study of the Effects of Moist-Exposed Burns Ointment (MEBO) and
Other Drugs on the Healing Rate of Corneal Epithelial Defect in Rabbits
92 Exploration of Pathological Changes and Mechanism of Experimentally Burned Rabbits
after Treatment with Moist-Exposed Burns Ointment
96 Electron-Microscopic Observation of One Case of Skin Burns Wounds Treated with MEBO
99 Pathomorphological Changes of Deep Burns Wounds Treated with MEBO
104 Observation of Microcirculation in Nail Folds at the Recovery Stage of Burns Wounds
Treated with BRT with MEBT/MEBO
106 Physiological Healing Procedure and Histological Observation on Deep Second-Degree
Burns Treated with BRT with MEBT/MEBO
111 Clinical Procedure and Histological Observation of Full-Thickness Burns Treated with
BRT with MEBT/MEBO: A Case Report
114 Effect of BRT with MEBT/MEBO on the Expression and Regeneration of Epidermal
Regenerative Stem Cells
119 Clinical Reports of Burns Regenerative Medicine and Therapy (MEBT/MEBO)
119 Clinical Trial Report of Burns Regenerative Medicine and Therapy (MEBT/MEBO):
Multicenter Study
129
Clinical Demonstrations of Burns Regenerative Medicine and
Therapy (MEBT/MEBO) on Successful Treatment of Extensive Burns
130 Extensive Burns Cases with Most Wounds of Superficial Partial-Thickness
131 Extensive Burns Cases with Most Wounds of Deep Partial-Thickness
134 Extensive Burns Cases with Most Wounds of Full-Thickness
141
Clinical Results of Surgical Excision and Skin Grafting Therapy in
the Treatment of Extensive Burns Patients
145
A Commentary on Burns Medical and Regenerative Therapy
149
Conclusion
VI Contents
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Preface
This book, which you now hold in your hands, will
change how medicine is practiced around the world. It is
an extraordinary book written by an extraordinary medi-
cal doctor who is also a pioneering scientist in the best
sense of the word. Prof. Rong Xiang Xu has a very rare
spirit, for he is a man with a compassionate heart who
observed the terrible suffering of his burns patients and
rather than simply accepting conventional treatments
(which do little to correct the burns trauma), this doctor
created, with much diligence and hard work, the new stan-
dard of care for burns treatment.
I first learned of Dr. Xu’s work through reading the
burns literature and learning of his research efforts in Chi-
na. After analyzing his published research in the late
1980s, I determined to meet and question this man whose
research was so daring and innovative. In 1991, I brought
a group of American doctors to China to study Dr. Xu’s
MEBT/MEBO protocols. What I saw in Dr. Xu’s burns
clinics astounded me.
I trained at major American teaching hospitals such as
Harvard’s Massachusetts General Hospital, University of
Vermont Medical Center and Dartmouth Hitchcock
Medical Center, each of which offered what we believed
to be the best burns treatments in the world. We were con-
fident in the 1980s that no one took better care of burns
patients than we did. Our burns patients were treated in
technologically endowed surgical suites, given potent dou-
ble antibiotic intravenous protocols along with topical
silver-impregnated cold cream, all this administered un-
der utterly sterile conditions in isolation suites and, of
course, costing enormous sums of money. Our goals were,
in retrospect, quite humble: keep the patients alive,
reduce their pain, control their infection, and perform any
surgery necessary to maximize their cosmetic and func-
tional recovery. Typically, the majority of our patients left
our burns units horribly scarred yet appreciative of our
efforts.
Today, I know that the burns treatment protocols
offered in the best American hospitals are obsolete and
despite our best intentions, scientifically irresponsible.
We must not be satisfied with clinical results which leave
our patients so disabled and in such pain. That is a provo-
cative statement and I offer it with the earnest hope that
you, dear reader, will determine for yourself whether it is
a valid statement. The book you hold in your hand with
its many references describes a new way of treating burns
patients and, while you may question its scientific ratio-
nale, you must, at the end of the day, behold its superior
clinical results. Dr. Xu offers intriguing opinions about
regenerative medicine and therapy which may or may not
be validated in the future. He raises, once again, the
ancient dichotomy between Vitalism and Materialism
which we, in our infatuation with quantitative scientific
methodology, have turned away from as we split atoms
into leptons, quarks and neutrinos. Today as we wade into
genetic analysis, we are not inclined to step back and see
the vital context within which the genetic process oper-
ates. We see the trees but not the forest. But again, as clini-
cians who have taken the oath to serve our patients, I sug-
gest that once you have done your due diligence and
investigated Dr. Xu’s clinical results, then you will no lon-
ger be able to practice conventional dry burns therapy
again. Therefore, like all revolutionary books, this one is
somewhat disconcerting. My sympathies are with you!
It is my honor to add a few preface words and I see my
challenge as helping introduce the reader to these innova-
tive ideas in a manner most conducive to enhancing colle-
gial and collaborative discussion. Therefore, I want to
address our human need for certainty and our aversion to
new ideas in general. Without intending to evoke defen-
siveness in the reader, I am reminded of a story of a wom-
an who traveled far and wide to find the right doctor for
her problem. Finally, she selected a very famous and tal-
ented doctor and during their first consultation, she
exclaimed, ‘Oh doctor, I am so pleased that you will care
for me. I do hope that you can treat what is wrong with
me!’ whereupon the doctor responded: ‘My dear lady, it is
my hope that you have what I treat!’ We doctors tend to be
better practitioners than students of science and we are all
guilty at times of being slow to learn new approaches to
familiar problems. Innovation is not an easy path for a
doctor to follow as lives are at stake and somehow we are
encouraged to ‘let someone else do the research.’ In the
old days, the doctor always observed his patient and con-
sidered various factors that impacted the progress of the
treatment. The doctor was always an innovator and al-
ways felt responsible for doing his part in pushing back
the frontiers of knowledge. Today, however, things have
changed for most doctors and very few of us continue
scientific work after beginning to practice. That does not
have to be so, but to innovate as a doctor is not without
peril.
VII
There is a saying in America that you can determine
which is the pioneer in a crowd of men by looking at their
backs, for the pioneer is the one with the most knives in
his back. All people, scientists and doctors included, are
uncomfortable with change and the innovator is often
unfairly criticized as he tends to ‘rock the boat’. It is part
of human nature to be wary of change, especially if some-
one tries to improve what we ourselves are offering to our
patients. In medicine, where unscientific practices can kill
people, we all should be cautious before embracing new
ideas. I know from experience that most of the medical
practitioners are well-intended and we do our heart-felt
best to advance science for the benefit of our trusting and
long-suffering patients. So why do we resist change? Why
are innovations met with distrust and resistance? Consid-
er what a professor might feel if he were to learn that what
he taught other doctors and what he published as recom-
mended treatment protocols now no longer were the opti-
mum protocol. That would feel very uncomfortable. That
might be, depending upon the character of the professor,
almost unbearable, for to the degree we offer out-dated
treatments, to that same degree we are exacerbating rather
than ameliorate the suffering of our patients.
Therefore, despite ourselves, doctors are slow to study
innoative ideas, choosing instead to focus our effort on im-
proving only that which we currently practice, not learning
something new and different. The scientists among us know
that economics and politics interfere too often in the scien-
tific world and so I urge you, dear reader, to put aside pre-
judices and comfortable paradigms and to remember the
last time you listened to a dressing being changed for a
burns patient. Listen in your mind’s memory to the screams
of pain as the dried scabs are pulled away from living tissue
beneath in order to cleanse the burns wound. Remember
the look of anguish on the faces of both patient and nurse as
the blood flows anew before a new layer of Silvadene
©
is
applied. In my clinical experience, no nursing task is more
heart-breaking than the dressing change of a burns patient.
Now, remember if you will, the last time you shook hands
with a ‘successfully treated’ burns patient upon discharge
from the hospital as she returned home, scarred almost
beyond recognition and still suffering from restricted
movement due surgical procedures and consequent deep-
tissue scarring. You know you did your best as her doctor,
but what a horrible outcome. She remains scarred for life.
Now, comes the ‘what if’? What if, dear reader, a burns
treatment protocol exists that takes away severe pain, that
requires no horrendous dressing changes, that features a
self-cleaning circulation within the wound that removes
dead cells and bacterial debris and delivers regenerative
nutrients to the living tissue at the base of the burns
wound? What if this burns treatment protocol works in
accordance with the natural laws of tissue regeneration so
that minimal antibiotic use is required and so that burns
wounds heal faster and with practically no scarring com-
pared to the burns treatments offered today in the finest
hospitals around the world? ‘What if’ indeed!
As you read ahead, please remember two things:
First, please remember that Dr. Xu is offering his
scientific experience to anyone interested in learning
about his innovative burns treatment protocol. He has
founded research institutions, sponsored international
symposia, published scientific journals and been recog-
nized by his government as the inventor of one of the
most significant technologies in China today. Dr. Xu is
seeking colleagues to continue this research and writes
this book now as an invitation for other dedicated scien-
tist to investigate this new paradigm. Dr. Xu has done his
research and has published his findings on burns regener-
ative therapy. Now it is our turn. As his medical col-
leagues worldwide, it is up to us now to accept the respon-
sibility to determine for ourselves whether there is merit
in his claims. He now welcomes medical colleagues from
around the world to come and learn what he has to teach.
The world can no longer ignore his gift. These medical
claims, though they sound fantastic to western ears, are
indeed supported by rigorous and controlled scientific
studies – both in vitro and in vivo.
Secondly, remember if you will, that I myself took time
off from my practice and went to China on my own
expense to determine whether Dr. Xu really was able to
treat burns patients with MEBO/MEBT so that his pa-
tients were in minimal pain and upon discharge, walked
away happy to look in a mirror – not scarred in any signif-
icant way. What I saw in Dr. Xu’s burns hospital beds and
through his microscopes at his research centers has in-
spired me to treat my burns patients with MEBO/MEBT.
He has also inspired me to renew my commitment to
practice, first and foremost, scientific medicine so as to
always be open to learning innovative ways of offering the
best care possible for my patients. He himself is an excel-
lent example of this work ethic.
Burns regenerative therapy with moist-exposed burns
ointment is the new standard of care for burns treatment.
In the pages ahead, you will learn how Dr. Xu, in coopera-
tion with natural laws inherent in living tissue, founded
the new science of regenerative medicine for the benefit of
burns patients in particular, and all mankind in general.
Let us work together to silence forever the screams of pain
during burns dressing changes which haunt too many of
us in the field of burns treatment. Great suffering can
serve to inspire heroic efforts. Today we can begin a his-
toric collaboration together in the field of regenerative
medicine and therapy, thanks to the pioneering effort of
Prof. Rong Xiang Xu.
Bradford S. Weeks, MD
The Weeks Clinic Recipient:
International Orthomolecular Physician of the Year, 2003
VIII Preface
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Brief Introduction to the History of
Burns Medical Science
1
Fire was, perhaps, man’s first double-edged sword, for,
throughout history, it has both served and destroyed man-
kind. While fire served to keep wild animals at bay in the
night and warm people chilled by the winter air, it also
turned on its master. From time to unfortunate time, fire
leapt out at man and caused what remains today one of
the most painful of human experiences, the burn.
Burns injuries were first described in the Ebers papy-
rus (1500 B.C.) which tells the reader that a delicate mix-
ture of cattle dung and black mud was ‘just what the doc-
tor ordered’ for a burn. Through centuries that followed
any physician worthy of note had a favorite remedy for
the relief of burns pain and suffering. Dupuytren, the
famous 19th century French surgeon who first described
the contracture that bears his name wrote: ‘Burns had
been the object of one of the most bizarre treatment meth-
ods’. Fabricius Hildanus, a 15th century German physi-
cian, was the first to classify burns into three degrees and
debates raged well into the 20th century about how best to
treat the burns – to cool or to not cool, to moisten and
drain or to dry and seal for sterility. Finally, consensus
was reached after the First World War that the best treat-
ment for burns was surgical skin transplantation with sub-
sequent scar reduction and pain control medications as
needed. In the early 1950s, spurred on by thermal injuries
during the Korean War, the US government established
the original Surgical Research Unit (The US Army Burn
Center) at Brooke Army Hospital in San Antonio, Tex.,
USA where skin grafting became the preferred treatment
for 30% total body surface area (TBSA) burns. Survival
was now the expected prognosis and one counted oneself
lucky to survive.
Since the 1950s and 1960s, many medical experts from
other countries threw themselves into the research work
of burns medical science and contributed a great amount
of experimental data which advanced the field of burns
treatment. By now, patients with more than 90% TBSA
burns can expect a fighting chance for survival when of-
fered treatment from a protocol involving surgical burns
therapy consisting of localized treatment and systemic
medical management. Once established in academic
teaching centers, this two-pronged approach was quickly
practiced around the world. The localized treatment of
the 1960s was typified by a drying of the burned skin
which enabled a crust (deep, partial-thickness) or eschar
(full-thickness) to develop over the burned tissue. This
crusting was accompanied by surgical excision of necrotic
skin tissues and of viable dermis (tangential excision of
crust). In addition, whole subcutaneous tissue (fascial
debridement of eschar) was also an all too frequent aspect
of the treatment. After this debridement was achieved,
autografts or cultured epithelial autografts were placed on
top of the lesion to close the wound from exogenous infec-
tious agents. In the case of small, deep burns, initial exci-
sion and immediate autografts were recommended in the
early stage after an injury. The systemic treatment, based
upon what was then known about burns pathophysiology,
was practiced in accordance with conventional surgical
wounds management. This combined therapy consisted
of medical management to avoid shock syndrome as well
as to avoid infection while at the same time offering local
and systemic nutrition support for tissue and whole body
physiology, respectively. A great many protocol formulas
were championed by leading scientists and doctors and
these were offered with qualified success worldwide. This
treatment became the ‘standard of care’ and became
known collectively as ‘conventional surgical burns thera-
py’ or ‘surgical excision and skin grafting burns therapy’.
Its theories and treatment measures were compiled in
medical textbooks worldwide prior to being introduced
into China in the late 1950s. A recent improvement of this
conventional surgical therapy was the innovation by
American doctors who successfully treated patients with
extensive, deep burns by using cultured composite auto-
grafts. This represented an important advance in the auto-
graft technique.
2 Burns Regenerative Medicine and Therapy
In the 1980s, burns specialists began to look deep-
er into the physiology of traumatic burns wounds re-
sponding to conventional therapies. To their chagrin,
these burns specialists discovered that these ‘state-of-the-
art’ clinical treatment protocols, while representing a life-
saving improvement compared to the primitive pre-
1940s protocols, nonetheless remained a merely destruc-
tive therapy as far as the localized tissue was concerned.
These burns specialists noted that conventional therapies
neither rehabilitate the burned tissue itself, nor do they
cooperate with the natural physiological repair mecha-
nisms of burned tissue. Therefore, the feasibility and rea-
sonableness of conventional surgical therapy, character-
ized as it is by dryness, excision and grafting, was evaluat-
ed and found lacking both in theory and methodology.
Although Western researchers conducted massive experi-
mental studies that addressed concerns of desiccation,
excision and skin grafting, little progress was attained and
ultimately the clinician was left with a suboptimal medi-
cal result – the disfiguring scar. This arena of painful
dressing changes, rampant infection, devitalized tissue
and residual scarring was the frustrating stage upon which
the burns therapist pleaded for innovation but upon
which no champions advanced until recently.
During World War II, an alert and observant Army
surgeon, Joseph E. Murray (born April 1, 1919), had
noted that skin grafts were only compatible between iden-
tical twins. From this observation, Murray then postu-
lated that transplantation of internal organs might also be
fraught with rejection and he began the experimentation,
initially with canine and later with human kidneys, which
ultimately resulted in his sharing the 1990 Nobel Prize for
Physiology or Medicine with E. Donnall Thomas. Mur-
ray’s work in organ- and tissue-transplant techniques set
the tone for burns therapies for the rest of the 20th centu-
ry. Consistent with the reductionistic genius of the Ameri-
can mind, an ill patient was seen as a collection of parts –
some functioning better than others. In the case of the
burns patient, the therapeutic goal became to surgically
remove the burned parts before transplanting thereupon
some unburned parts. It was no surprise that, prior to
Murray and Thomas, the host system rejected the graft
tissue since a living being is far more than the sum of its
parts. Today, potent immunosuppressive pharmaceutical
agents are required for successful transplantation proto-
cols in burns. Though life-saving, these drugs, true to their
name, hobble the native host immune system of the sur-
viving burns patient. Frequently, the doctor is chagrined
at the trade-off whereby his patient survives – but at the
expense of his immune system. As in most areas of medi-
cine and surgery, burns specialists suffered along with
their patients for they knew that there must be a better
way to help those burned patients.
Nonetheless, despite the frustrating situation where
the best the burns specialist could offer would be a life
hobbled by chronic pain and disfiguring and motion-
restriction scarring topped by systemic immunosuppres-
sion, no one was ‘thinking outside of the box’. Beneath
this consensus that transplantation surgery was the treat-
ment of choice, we can now discover another unspoken
consensus, i.e. that burns are a disease of the skin and
therefore ought to be treated dermatologically rather than
systemically or holistically. Everyone saw that the burned
part was the problem and that it should be replaced.
In the 1970s, in China, Professor Xu Rong Xiang alone
was thinking outside of the box where he boldly estab-
lished an entirely new theory of burns physiology upon
which he then built a dramatically effective burns treat-
ment which he called ‘Burns Regenerative Therapy’
(BRT). This innovation, which integrates moist-exposed
burns treatment (MEBT) and moist-exposed burns oint-
ment (MEBO), was a balm to the struggling burns therapy
industry. The therapeutic essence of MEBT/MEBO is to
maintain the burns wound in an optimum physiologically
moist environment through the use of a specially designed
ointment – MEBO. Rather than surgically excising the
burned tissue and its underlying dermis, the goal became
to heal the burned tissue and stack the cards in favor of
tissue regeneration – an unimagined goal. MEBO, the pat-
ented topical remedy, is composed of natural plant ex-
tracts dissolved in a sterile and refined sesame-oil base
with beeswax as a preservative. When applied topically,
MEBO promotes burns tissue repair in an astonishingly
effective manner. Initially, MEBO cleans the burned tis-
sue by stimulating the discharge and removal of debris
(liquefaction of necrotic tissues). As a complementary
healing benefit, MEBO also enhances the regeneration
and repair of the residual viable tissue at the base and
periphery of the burn in order to anchor vitality within
the wound-healing process. Coincident with the applica-
tion of MEBO, a systemic comprehensive treatment is ini-
tiated based on the natural pathophysiology of burned tis-
sue. Accordingly, BRT and MEBT/MEBO is distin-
guished from conventional surgical therapy in that dry-
ness, excision, skin grafting and scarring as well as the
excruciating pain associated with dressing changes is no
longer a necessary component of burns care.
The history of MEBT/MEBO is quite auspicious and
parallels the ascendancy of China in the marketplace of
modern times. Today, the West embraces China as one of
the three countries in the history of mankind which were
able to safely send a man into space. Equally so, Western
doctors who have observed the miracle regenerative cures
of MEBT/MEBO embrace Dr. Xu and his team as pio-
neers in burns therapies. The West first learned about
MEBT/MEBO on August 16, 1988 via a Chinese press
release that declared the clinical success of this newly dis-
Brief Introduction to the History of Burns Medical Science 3
covered burns treatment theory and its uniquely effica-
cious therapy. Bolstered not only by clinical success (both
in China and abroad) but also supported by copious scien-
tific research, MEBT/MEBO immediately altered the di-
rection of academic research in burns treatment world-
wide.
Dr. Xu is one of the bright lights in the firmament of
scientists alive today. Yet he too stands above the shoul-
ders of scientists who came before him. The treatment
philosophies of traditional Chinese medicine urge the
pursuit of regeneration as opposed to replacement of
burned or diseased tissues as have a precious few Western
doctors who sought to apply agents to improve and accel-
erate the wound-healing process. Ambroise Pare (1510–
1590) postulated that a surgeon’s goal in wound manage-
ment was to create an environment where the healing pro-
cess could proceed in an optimal fashion. Pare demon-
strated the beneficial effect of the application of hot oil to
fresh open wounds. Since then and over the centuries
many publications have pointed out that a moist environ-
ment enhances epithelialization in the wound-healing
process. Controlled experimental and clinical data have
in recent times supported the suggestion that a moist envi-
ronment enhances wound healing in the form of an occlu-
sive dressing compared with a dry environment. Xu has
developed MEBT – a therapeutic procedure based on the
moist environment of the wound, using an ointment that
enhances epithelial repair, and in particular that of par-
tial-thickness burns wounds. MEBO consists only of natu-
ral ingredients including – apart from honey and sesame
oil –17 amino acids, 14 fatty acids, and 4 polysaccharides.
The ointment’s main active substance is considered to be
ß-sitosterol at a concentration of 0.25%. Clinical and
experimental investigations by Chuanji, Yunying and Xu
have indicated that MEBO has the following therapeutic
effects:
1 Analgesic: MEBO reduces pain in partial-thickness
burns wounds.
2 Anti-shock: MEBO reduces evaporation of water from
the burns wound surface and improves microcircula-
tion by decreasing peripheral and systemic capillary
exudation.
3 Anti-bacterial: MEBO changes the biological behavior
of bacteria, inducing a decrease in bacterial toxicity
and invasive capacity, as well as sensitivity to antibiot-
ics; it also increases the wound’s local and systemic
immunity.
4 MEBO promotes epithelial repair; it also reduces heal-
ing time in partial-thickness burns.
5 MEBO improves and reduces scar formation and con-
tributes to the formation of a smooth, thin, and aes-
thetically acceptable scar, thus preventing the forma-
tion of hypertrophic scars.
In 1989, Americans finally learned that the paradigm
had shifted in burn care when Newsweek published a
report subtitled: ‘Could a new medication from China
change the world’s approach to treating burn injuries?’
This caught many US doctors unawares and even today,
14 years later, 90% of US burns specialists are unaware
that this BRT and MEBT/MEBO has been validated in
hundreds of experimental studies and clinical practices
around the world. These results substantiate the claim
that the theory and practice of BRT and MEBT/MEBO
comprise a successful revolution in burns care by offering
a patently superior methodology of burns treatment when
compared to the desiccation, excision and grafting re-
quired by conventional therapy. In addition, BRT and
MEBT/MEBO also offered the first sophisticated and
accurate characterization of natural burns pathogenesis,
allowing scientists around the world to finally understand
the principles of effective therapeutic burns treatment.
MEBT/MEBO therefore attained the rarified status of a
truly revolutionary and beneficial clinical success story.
With this new therapy, which heralds an advancement
into a new field of burns medical science, patients sustain-
ing partial-thickness or full-thickness dermis burns can-
not only survive what once were life-threatening burns
injuries, but can now do so without inordinate pain,
immune-depleting surgical excision or the disfiguring
scars from the now obsolete surgical technique of skin
grafting. Today, the history of burns therapy has ad-
vanced into a bright and promising future. Professor Xu is
teaching the world to work with the regenerative forces of
nature. In the pages that follow, Professor Xu welcomes
collaboration as we surge forward together committed to
reducing the pain, disfigurement and suffering of burns
patients the world over. Let us strive together for this
noble and finally attainable goal.
Bradford S. Weeks, MD

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Introduction
5
Regenerative medicine and therapy is an innovative
concept described through a new research field and repre-
sents a unique approach towards the goal of regenerating
functional tissues and organs. On the occasion of the pub-
lishing of Burns Regenerative Medicine and Therapy, I
would like to share with readers the insights into the gene-
sis, current research status and exciting advances in this
critically important realm of health sciences – regenera-
tive medicine.
Consideration of Scientific Paradigms and
Research Reasoning from the Viewpoint of
Foundation and Development of Medical
Science Systems
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 advan-
tages 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 medi-
cine 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 and 200
BC). This documentation represents the development of
medicine away from sorcery and en route to being used as
the foundation of Chinese medicine. Shen Nong (3493
BC), hailed as the ‘Divine Cultivator’, tested myriad
herbs and in so doing gave birth to the art of medicine.
Hua Tuo (110–207 AD) was the most famous doctor in
ancient China who developed the use of Mafei San (surgi-
cal anesthesia) a good 1,600–1,700 years before western
doctors learned about ether and other chemical or phar-
macological anesthetic agents. These and other great
achievements supported the foundation of Chinese medi-
cine 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 BC, 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, Hip-
pocrates, father of modern western medicine, after
studying the conditions of dying patients (http://www.
cpus.gov.cn/kxrw/index.asp?rw=419&jiang=0), articulat-
ed the elaborate general doctrine that all of the Four Hu-
mors, phlegm, blood, yellow bile and black bile, had to
be in correct proportion to one another for good health to
result (http://www.med.virginia.edu/hs-library/historical/
antiqua/textn.htm). At almost the same time, Aristotle
(http://www-groups.dcs.st-and.ac.uk/Fhistory/Mathema-
ticians/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 2,500 years
of development, there came into being two academic sys-
tems: eastern and western medicine. Eastern medicine,
6 Burns Regenerative Medicine and Therapy
which originated from ancient Chinese medicine, has
brought tons of benefits and contributions to human
health by providing treatments based on plain philosophy
and holism, while western medicine experienced two peri-
ods: 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 alche-
my, 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 sig-
nificant 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-edu-
cated 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 possi-
ble 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 the 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 dis-
ease. 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 accor-
dance with the laws of human health and wellness.
We inaugurated the research into the secrets of regen-
erative medicine and therapy in early 1980. Although
many difficult challenges fell before us since 1987 (the
year we established out Research Center), our pub-
lished research results demonstrate that we are presently
amongst the leaders in this field. Back in 1989, I pub-
lished 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. Thom-
son and his colleagues from Wisconsin University in 1989
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 fertil-
ized 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 pub-
lished 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 fol-
lowed 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 surpris-
ingly 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 entire-
ly 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 pro-
liferated 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 sci-
ence, is only a distraction unless the rigor of the scientific
method is also employed. No trickery is allowed. Unfortu-
nately, such tricky performances – such as human ears on
the backs 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 conclu-
sions. 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 thou-