”Gangrene is the name of a disease in Chinese medicine, which is equivalent to lower limb ischemic disorders such as thrombo-occlusive vasculitis, atherosclerotic occlusive disease and diabetic foot gangrene in Western medicine. From November 2003 to April 2005, our department applied autologous stem cell transplantation to treat 9 patients with gangrene and achieved good results, which are reported as follows: General information There were 9 patients in this group. The minimum age was 41 years old and the maximum age was 76 years old. Gender: male 6 cases; female 3 cases. The duration of the disease ranged from 6 months to 3 years. There were 3 cases of thrombo-occlusive vasculitis, 3 cases of atherosclerotic occlusive disease, and 3 cases of diabetic foot. One case of thrombo-occlusive vasculitis (Chen X X) was done twice (both lower extremities). 7 patients had reached the stage of amputation when they came to our department. All patients underwent preoperative color Doppler ultrasound examination of the lower extremities, lower extremity vascular magnetic resonance (MRA) examination and brachial-ankle index (ABI) test, which showed arterial stenosis and occlusion of the affected extremities, consistent with the manifestation of vasculitis. Seven of them had undergone various conservative treatments for several months in external hospitals and our TCM vascular department, and all of them were referred to our department for treatment due to poor results. The treatment method For the 9 patients, 1 had autologous peripheral blood stem cell transplantation and 8 had autologous bone marrow blood stem cell transplantation. The stem cells were first collected and extracted by our department in cooperation with the external hematology department, and then injected into the patient’s ischemic limb by drawing a 3×3M mesh grid on the skin of the affected limb in the operating room, and then injecting 1 ml of stem cell suspension (each ml of suspension contains 1×108 single nucleated cells) into the center of each grid after routine disinfection and spreading of towels, at a depth of about 1.5M, so that the stem cells The suspension was injected into the ischemic muscle of the affected limb, and a total of 50 spots were injected. The efficacy of the treatment was evaluated according to the “Diagnostic and efficacy criteria for Chinese medicine” implemented in 1995. 9 patients were cured in 2 cases, showed efficacy in 3 cases, improved in 2 cases, invalid in 1 case, and died in 1 case six months after surgery, with an overall efficiency of 77.8%. Among them, 3 patients with significant effect did not have amputation after surgery, and only the necrotic stump toe was amputated. 2 patients with improvement had their amputation planes changed from thigh to calf after surgery. The brachial-ankle index (ABI) of the patients was monitored postoperatively and increased from a mean of 0.68 before surgery to a mean of 0.75 at one month after surgery, showing an improvement in lower extremity blood flow compared with that before surgery. Discussion In China, thrombo-occlusive vasculitis (TAO) and atherosclerotic occlusive disease (ASO) are the two most common ischemic diseases of the limb arteries. In recent years, the incidence of TAO has decreased significantly, while ASO is gradually increasing. Diabetic foot is a refractory secondary disease of diabetes mellitus. Microangiopathy caused by diabetes mellitus leads to severe limb ischemia, and patients often face the tragic end of toe amputation, foot amputation, and limb amputation in the late stage. According to Chinese medicine, the disease develops due to congenital deficiency and weakness of positive qi, resulting in stasis of blood vessels and veins, poor flow of qi and blood, and paralysis and obstruction. The symptoms include cold and numbness in the initial stage, necrosis and decomposition of the toe joints in the later stage, black rot and ulceration, and long-lasting sores. There is no good treatment yet. Autologous bone marrow stem cell transplantation is one of the latest international treatments for arterial ischemia of the lower extremities. It has been reported that this method provides significant pain relief after one week of treatment, and about one month later, neovascularization is formed and the blood supply to the limb improves. Autologous cell transplantation has no significant adverse effects and is highly effective, eliminating the need for amputation to the greatest extent possible. Stem cells are cells with unlimited or longer-term self-renewal capacity and capable of producing at least one highly differentiated daughter cell, which has multi-differentiation potential and self-replicating function. Under specific conditions, they can differentiate into different functional cells and form a variety of tissues and organs. The medical community expects that stem cells can be used to repair those damaged tissues or organs, hence the term “universal cells”. Research has shown that vascular endothelial cells and hematopoietic stem cells are derived from a common progenitor cell, and that bone marrow also contains such cells. Human bone marrow contains a large number of hematopoietic stem cells, which can be induced to differentiate, migrate and form blood vessels under certain conditions. It has been experimentally and clinically proven that endothelial progenitor cells derived from bone marrow or peripheral blood can differentiate and form new blood vessels at the site of vascular injury, thereby improving the blood supply to the limb. Because the stem cells were obtained from the patients themselves, there was no immune rejection or ethical issues associated with embryonic stem cells. 87% of the ischemic limbs showed improved blood supply, increased ankle-brachial index, and significant collateral angiogenesis on imaging, which reduced amputation rates and contributed to healing of most ulcers. More importantly, there were no complications, and clinical safety and efficacy were initially confirmed. The successful implementation of autologous bone marrow stem cell transplantation has opened a new avenue for the treatment of lower extremity ischemic diseases, significantly reducing the amputation rate of such patients and improving their quality of life. We found that the first signs of improvement after stem cell transplantation were a significant reduction in pain in the affected limb, a decrease in dependence on pain medication, and a change in skin temperature from cool to warm. The wound secretion decreased gradually 2-3 weeks after the operation, the granulation grew rapidly, the wound shrank rapidly, and the redness and swelling disappeared. The younger the patient and the higher the number of stem cells isolated, the faster the postoperative recovery. However, the long-term efficacy is still unclear and is to be observed at a later stage of follow-up.