Surgery Godfather

Chapter 2171: Chapter 1427: Unified Theory

When Manstein left Yang Ping’s office, it was already dark.

He stood in the corridor for a while, still clutching that notebook. The last few words that Yang Ping had said pierced his mind like nails: stem cell theory and three-dimensional gene orientation theory should be unified at the fundamental level, with the mechanisms for guiding cell differentiation and positioning as a single system. The idea was so vast that he didn’t know where to start thinking. At this moment, he also felt that he was far behind Professor Yang in terms of insight.

He returned to the laboratory and sat in front of the microscope. The tissue sections of M21 were still on the stage; those red and green fluorescent cells were quietly glowing in the dark field. He stared at those cells for a long time, repeatedly turning Yang Ping’s words over in his mind. The desired cells appear in the desired location. From the fertilized egg onward, the human body repeats this action. Differentiation and migration, division and positioning—what cells become and where they go happen simultaneously in embryonic development, never separated. A neural progenitor cell is born in the subventricular zone of the lateral ventricles, migrates along the fibers of radial glial cells to a specific layer of the cerebral cortex, where it differentiates into a specific type of neuron. Where it goes determines what it becomes; what it becomes determines where it goes. Differentiation and migration are two sides of the same coin, not two separate processes.

After adulthood, this system is shut down; cells no longer migrate on a large scale, and tissues aren’t massively remodeled. When injury happens, the body’s first response isn’t repair, but scarring. Evolution has opted for a conservative strategy, preferring functional loss over uncontrolled growth. Tumors are the result of such uncontrolled growth. Over billions of years of evolution, the body learned that the risk of repair is sometimes greater than the risk of not repairing. Thus, the repair mechanism was sealed, like an instruction manual locked away in a cabinet—you know it’s there, but can’t access it.

Now, Yang Ping says that manual can be opened. The way to open it is to reactivate the guiding signals from embryonic development, to tell the body "there’s a need for repair here," to tell precursor cells "you should go there, you should become this." Precise gene editing, nonspecific microenvironment adjustment, maybe even a certain chemical small molecule. Different keys, same lock.

Manstein wrote in the notebook: "Unified regulatory mechanism of differentiation and migration—reactivation of embryonic development?"

He looked at this line, felt it wasn’t accurate enough, crossed it out, and wrote another line below: "Repair is re-enactment of development."

He kept this line without crossing it out.

The next morning, Manstein went to see Yang Ping. Yang Ping was already in the office, the draft of the review spread out on the desk, with a teacup steaming beside it.

"Professor, didn’t you sleep?"

"How could that be? Resting well leads to better work." Yang Ping raised his head, "You came at the right time; I’ve figured some things out. Take a look too."

Manstein sat down, opened his notebook, ready to take notes.

"Let’s start from embryonic development," Yang Ping stood up, walked to the whiteboard, and picked up a black whiteboard marker, "The fertilized egg divides, forming a cell mass. Cells begin to differentiate, begin to migrate, begin to form tissues, organs, systems. What rules does this process follow? There’s only one rule—cells appear at the right time in the right place and do the right thing."

He drew a circle on the whiteboard, representing the fertilized egg, then drew numerous branches, representing the paths of cell differentiation and migration.

"What determines ’right’? It’s position. Cells receive signals from a location to understand what they should become. Positional awareness precedes differentiation; it’s not differentiation that determines position, but position that determines differentiation."

Manstein nodded; he knew this was the core of three-dimensional gene orientation theory.

"Look at stem cell therapy again," Yang Ping drew another branch on the other side of the circle, "We extract stem cells, amplify them in vitro, then inject them into the injury site, hoping they’ll differentiate into the cell types we want. The success rate is very low. Why? Because we only give them the instruction of ’what to become,’ without guidance of ’where to go.’ Stem cells, once injected, don’t know where they are, don’t know what they should become. They randomly differentiate, with most becoming useless cells, only a very few turning into correct cells, but with incorrect location, incorrect connections, incorrect function."

Manstein’s pen began to move faster.

"Embryonic development isn’t like this," Yang Ping connected the two branches on the whiteboard with a line, "In embryos, differentiation and migration are simultaneously regulated. A cell continuously receives positional signals during migration, and its differentiation program gets updated at each new location. By the time it reaches its destination, it has completed differentiation. It’s a perfect, integrated system."

Manstein stopped his pen and looked up at Yang Ping.

"Professor, you’re suggesting that what we observe in stem cell activation during spinal cord injury repair is essentially a restart of this system?"

"Not just a restart!" Yang Ping wrote two big words on the whiteboard—"Unification," "What we’re observing is the underlying logic of this system at work. Whether we’re doing precise gene editing or nonspecific microenvironment adjustments, what we’re essentially doing is the same—we’re giving the body a signal saying ’this is the embryonic period, need to build tissue.’ The body receives this signal and activates that sealed mechanism. Precursor cells understand where they should migrate, what type they should differentiate into, and what kind of connections they should establish."

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