标题: Open letter in support of Chuan-Guo Xiao [打印本页] 作者: admin 时间: 2010-9-30 22:42 标题: Open letter in support of Chuan-Guo Xiao 本帖最后由 admin 于 2010-9-30 22:44 编辑
Open letter in support of Chuan-Guo Xiao, M.D. from the International Academic Community
September 29, 2010
To all,
We have all had the pleasure of knowing Dr. Chuan-Guo Xiao for many years. He is an
internationally respected surgeon-scientist who has made major advances in the
development of neuroregeneration to restore voiding and bowel function. Dr. Xiao
performed groundbreaking animal research in the United States, demonstrating that a
motor nerve that innervates the leg can be used to reinnervate the bladder and
bowel. This reinnervation allows for development of a reflex to initiate bladder
function. The results of his studies were published in peer-reviewed journals and
other scientists have replicated Xiao’s findings confirming these results.
Dr. Xiao eventually took the courageous step of moving from animal research to
human studies and began performing the rerouting procedure on patients with spinal
cord injury and spina bifida in China. Neurogenic bladder is life threatening in China
due to a lack of both antimuscarinics and intermittent catheterization, and lessening
the complications of neurogenic bladder would be considered a lifesaving success.
Patients with neurogenic bladder and bowel suffer greatly and endure a host of issues
such as urinary retention, incontinence, recurrent infections, renal insufficiency,
fecal incontinence, constipation, and poor quality of life. For a procedure as
complicated as nerve rerouting requiring nerve regeneration, one cannot expect
normalization of bladder and bowel function to be the definition of success. What is
important is that the benefits outweigh the risks of the procedure.
Dr. Xiao published his clinical results in peer-reviewed journals and was twice
honored by the Jack Lapides Essay Contest, one of the most respected international
awards given to scientists who make major contributions to the field of neurourology.
In 2008, he was named the Kelm Hjalmas Memorial Lecturer from the International
Children’s Continence Society for his scientific achievements. Many of us have
traveled to China to examine patients treated by Dr. Xiao and/or have been trained
by him in the nerve rerouting surgery he invented. Dr. Xiao is a very skilled surgeon
who is passionate about patient care and works tirelessly to train physicians around
the world in performing his nerve rerouting procedure.
In the United States, an independent and very rigorous pilot research trial was
performed to test the safety and efficacy of this procedure. The one-year results
were recently published in the Journal of Urology. At the 12-month follow-up visit, a
cutaneous to bladder reflex was found in 7 of 9 spina bifida patients, confirming that
rerouting does occur. This finding by itself is remarkable and Dr. Xiao should be
commended. In addition, a number of patients demonstrated improvement in bladder
and bowel function, which has continued to improve with longer patient follow-up.
The 36-month results are currently being analyzed and will be reported in the near
future. The pilot data was supportive of Dr. Xiao’s procedure, and now an NIH
sponsored clinical trial is being conducted to further study lumbar to sacral nerve
rerouting in spina bifida patients. In addition, similar procedures have been done
worldwide, with Dr. Xiao helping to mentor the surgeons at each site.
The Chinese people and government should be proud of Dr. Xiao for his dedication to
his patients, his scientific achievements, and his willingness to train doctors around
the world how to perform his surgery. The International scientific community was
shocked to hear of Dr. Xiao’s arrest. Those of us who know Dr. Xiao well find it
difficult to believe that he is involved in these attacks.
Dr. Xiao is a compassionate man who is respected worldwide for his integrity and his
innovative scientific contributions to society. We implore the Chinese government
and authorities to treat Dr. Xiao fairly and to protect his human rights as these
charges are investigated. Please strongly consider Dr. Xiao’s scientific and
humanitarian contributions to the world as facts are gathered in this case.
Sincerely,
Kenneth M. Peters, MD
Professor and Chairman of Urology
Beaumont Hospital
Royal Oak, Michigan USA
Jack S. Elder, M.D.
Chief of Urology, Henry Ford Health System
Associate Director, Vattikuti Urology Institute
Department of Urology,
Children's Hospital of Michigan
Detroit, MI USA
Edwin A. Smith M.D.
Assistant Clinical Professor of Urology
Emory University School of Medicine
Atlanta, Georgia USA
Kevin M. Feber, MD, FAAP
Beaumont Children's Hospital
Royal Oak, MI USA
Ananias C. Diokno, M.D., F.A.C.S.
Executive Vice President & CMO
Beaumont Hospital
Royal Oak, Michigan 48073 USA
Juan José de Benito
Urologist
Hospital Nacional de Clínicas
Córdoba, Argentina.
William E. Nantau B.Sc., CNIM
Clinical Manager
Clinical Neurophysiology Department
Beaumont Hospital Royal Oak, MI USA
Evan J Kass MD,FACS,FAAP
Chief, Division of Pediatric Urology
Beaumont Childrens Hospital
Professor of Urology, Oakland University-William
Beaumont School of Medicine
USA
Jacques Corcos MD.
Professor of Urology, McGill University
General Secretary of the International Continence
Society
Jewish General hospital
3755 Cote Ste-Catherine
Montreal, Quebec, Canada H3T 1E2
Jose Gonzalez, M.D.
Department of Urology
Beaumont Hospital
Royal Oak, Michigan USA
Christopher Payne, MD
Associate Professor of Urology
Stanford University Medical School
Stanford, CA 94305-5118 USA
Kenneth I. Glassberg, MD
Director, Division of Pediatric Urology
Morgan Stanley Children's Hospital of New York-
Presbyterian
Professor of Urology, Columbia University
College of Physicians and Surgeons
3959 Broadway, CHN 1118 NY USA
Earl Y. Cheng, MD
Associate Professor of Urology
Children’s Memorial Hospital
Chicago, Illinois USA
Darius J. Bagli, MDCM
Professor of Surgery
Senior Associate Scientist
Director of Urology Research
Divisions of Urology and
Developmental & Stem Cell Biology
The Hospital For Sick Children
Institute of Medical Science
University of Toronto
Henri B. LOTTMANN, MD, FEBU, FEBPS,
FRCS(england) FEBPU
Paediatric urology unit
Hopital Necker-Enfants-Malades
149, rue de Sèvres
75015 Paris, France
Dr. Amrish Vaidya MS. MCh.
Consultant Paediatric Surgeon,
Kokilaben Dhirubhai Ambani Hospital,
4 Bungalows, Andheri W, Mumbai, India
Marc Cendron, MD
Associate Professor in Urology
Harvard Medical School
Children’s Hospital Boston
Boston, MA USA
Stuart B. Bauer, MD
Associate Director, Neurourology
Professor of Urology
Harvard Medical School
Children’s Hospital Boston
Boston, MA USA
Edmond T. Gonzales, Jr., MD
Professor of Urology
Baylor College of Medicine
Houston TX USA
Richard Macchia, MD FACS
SUNY Distinguished Teaching Professor
Cleveland Clinic, Florida
Benjamin Girdler, MD
Urology Center of the Rockies
Fort Collins, Colorado USA
William C. de Groat, Ph.D.
Professor of Pharmacology
University of Pittsburgh
Pittsburgh, PA USA
Michael R. Ruggieri, Sr., Ph.D.
Director of Urologic Research
Temple University School of Medicine
Philadelphia, PA USA
Stanley J Kogan MD
Chief, Pediatric Urology
Children's Hospital at Montefiore
Bronx NY USA
Anthony Caldamone, MD
University Urologic Associates, Inc.
2 Dudley St Ste 185
Providence, RI 02905 USA
Yves Homsy MD, FRCSC, FAAP
Clinical Professor of Urological Surgery and
Pediatrics
University of South Florida
Children's Urology Group
5507 E. Longboat Blvd
Tampa FL 33615 USA
Dr. Enrique Turina
Professor of urology of the National University of
Buenos Aires
Chief of section Urology of Instituto de
Rehabilitación
Government of Buenos Aires, Argentina.
Dr. Angel Ozón
Urologist of the Instituto de Rehabilitación of Buenos
Aires
Dr. Daniel Ekizian
Urologist of Instituto de Rehabilitación.
Professor Dr. med. Karl-Dietrich Sievert
Vice Chair
Prof. of Urology, Director - Uro-oncology,
Neurourology, Incontinence, & Reconstructive
Urology
Department of Urology University of Tuebingen
D72076 Tuebingen, Germany
Holly Gilmer, MD
Chief of Pediatric Neurosurgery
Beaumont Hospital
Royal Oak, Michigan USA
Yegappan Lakshmanan, MD
Chief, Pediatric Urology
Children’s Hospital of Michigan
Detroit, MI USA 作者: admin 时间: 2010-9-30 22:45
Dr. Xiao Arrested – sad and dubious
Many of you may have heard of Xiao’s procedure and some of you may have had that surgery. The inventor of the procedure Dr. Chuanguo Xiao was arrested for plotting personal attacks against other people on September 21, 2010 in Shanghai.
He had allegedly paid a mafia member in China to organize the attacks. This man was allegedly his relative, but not so legally or by any definition of relatives. The man was a cousin to his sister’s husband. According to Beijing police, this man organized two attacks, firstly against Xuanchang Fang, a journalist in Beijing and then Shimin Fang, the archenemy of Dr. Xiao.
Shimin Fang had gained himself the title of Fraud Buster No. 1 of China and he has been leading a multi-year campaign against Dr. Xiao in China. Many of you on this forum may have personal experience of the campaign because Fang did send his gang members (they like to call themselves “volunteers”) to this forum to post anti-Xiao materials. I learned of this forum because of reading material describing how Fang organized his anti-Xiao campaign and I felt obliged to inform you of the event.
Firstly I need to introduce myself. I had been in Fang’s camp for quite a while. He had an influential website which many Chinese visit regularly. I had contributed hundreds, if not over a thousand, of articles to his cause, including some attacking Dr. Xiao. Fang had once considered me as a candidate for directorship on the board of his anti-fraud organization. Due to a series of events I realized that he was a fraud himself and I started to expose his fraud. Misguided by Fang, I had a biased view of Dr. Xiao for a long time. Breaking up with Fang does not make me a friend of Dr. Xiao. I just want to share with you the news and offer my views.
I see that Fang’s gang’s IDs on this forum are still active. To forestall potential attacks on me, I would like to point out that Fang’s gang always hide behind IDs even though they like to discover and expose the private information of their “enemies”—unfortunately I am now one of them. At any point of time, I can tell you who I am and what I do. But they cannot. I was a surgeon back in China and I had a master degree in surgery. Currently I work for a university doing research and finance (an odd combination).
Back to Xiao’s arrest, both Fangs are the ones he hates the most in China. It would not surprise me that he did pay someone to “fix” them. He did vow to revenge them. Dr. Xiao is successful as an internationally recognized figure for the innovative procedure bearing his name. But his success has been somewhat blocked in China and Fang has had tarnished his name in China. He does have the motivation to do such an uncivilized deed.
The challenge is the lack of credibility on the part of Fang and Beijing police. Fang gave conflicting accounts of his being attacked. As Chinese, we always cast dubious eyes to the police. There have been reports where murdered individuals reappeared many years after when the police had caught the murderers and the murderers were convicted. The police can get what they want once they jail the suspects and beat them to admit to whatever they want the suspects to admit.
While I do believe that Dr. Xiao may have committed the crime, I see irregularities. In other words, Dr. Xiao might as well be framed.
1. Dr. Xiao is always straightforward. He never hides his anti-Fang attitude, not before the police. The Beijing police made it sounds like he had admitted to the crime. The police is essentially making false statements.
2. According to Fang’s accounts of his being attacked, one man sprayed him and the other man held a hammer trying to hurt him. According to the police, one of the men admitted that he did both.
3. According to Fang, he had opportunity to observe the men who had attacked him. It was his description of the men leading subsequent police investigations. But Fang was surprised that the police finally captured the suspects. He did not know! As a key witness he was not invited to recognize if those men caught were indeed his assailants!
4. Fang was not invited to the news conference of the police announcing the result of their investigation and arrest of the gang of fours. Why the police would not notify the victims that their assailants were caught?
5. The other three men were detained in early September of 2010. Dr. Xiao started his trip to South America on September 7, 2010. If the police had the evidence then, they should arrest Dr. Xiao at the airport: Dr. Xiao may try to escape! But they did not because probably they had not enough time to beat the men into admitting to what they want yet.
6. Dr. Xiao returned to China September 21, 2010, at least dozen days after the other men were detained. If Dr. Xiao indeed paid the others to commit the crime, shouldn’t he be concerned and checking on them regularly? Dr. Xiao has places to go and why would he return to China after knowing the others were caught?
7. Unsuspecting Xiao returned and disappeared with Beijing police. Hence we are left with a one-side story. No media has been allowed to interview him, even under police supervision.
8. Dr. Xiao has a much more successful career than those of both Fangs. Even though his name tarnished, he still holds prominent positions in China and people who know him respect him. Among widespread media attack, he still has audiences in esteemed universities and academic institutions in China. He frequently flies to other countries to teach other surgeons of the Xiao’s procedure and he is international renown. Why would he risk all those to seek out an ineffective means for revenge? He should have long realized that his every success is the best revenge to those who try to tarnish his name.
Fang had successfully lead media campaign against Dr. Xiao to seriously bias the public opinion. There is no free media in China. What gives him the power to orchestrate such a national level campaign? He had been increasingly speaking on Party lines in terms of public policy. Therefore, I do believe that Fang may be able to frame Dr. Xiao if he truly wants to. He truly wants to.
I hope my post does not offend anyone other than Fang’s anonymous gangs. I just want to keep people informed. You may potentially benefit from Xiao’s procedure and his fate is a concern to you and the scientific community. This is what I can do for all the erroneous writings I had contributed in the past of Dr. Xiao, a brilliant surgeon.
Let the North American reporters sort it out. 60 Minutes or W-5 anyone??? 作者: admin 时间: 2010-9-30 22:45
Has the entire world gone crazy or is it just me? 作者: admin 时间: 2010-9-30 22:46
Correction: Xiao was arrested Sept 19, 2010 and the police announced it Sept 21, 2010. 作者: admin 时间: 2010-9-30 22:46
That is so so sad! I hope is not true. If it is, it might be because he believes in his procedure, and saw he helps people. When somebody did threaten his work, he reacted in a very bad way. Again, he might have done nothing wrong. I hope so! 作者: admin 时间: 2010-9-30 22:46
you be posting new clues each week?
Oh yes, do we have to be over 18 play? 作者: admin 时间: 2010-9-30 22:47
To be honest I don't really care about his personal beef. Page me when his procedure is refined and curing SCI patients. I've got my own drama to deal with.
Late.
__________________
Quote:
Originally Posted by Wise Young
The first surgery has been tentatively scheduled for October 11. The cells are ready to go and we have completed validation of cell viability and quality. Five patients have been qualified.
在美国，已经开展过一项独立而且严格的先期试验来检验这项手术的安全性和效益。术后一年的治疗结果最近发表在《泌尿科学杂志》（ Journal of Urology）上。在12个月的随访期间，在9位脊髓裂患者中，有7位患者，观察到皮下至膀胱的神经反射弧的构建成立，证明神经通路重建手术的确起了作用。这个成绩是了不起的，肖医生应该得到嘉奖。并且，一部分患者已经展现出大小便排便功能的改善，并将随时间推移而变得更好。术后36个月的成果正在分析中，不久就会发表。该先期试验的数据是支持“肖氏手术”的，现在受NIH（美国国立卫生研究院）资助的临床试验正在开展，以进一步在脊髓裂患者中研究腰椎至骶神经通路重建。还有，在肖医生的帮助和指导下，类似的临床试验也在世界范围内开展。
Kenneth M. Peters, MD
Professor and Chairman of Urology
Beaumont Hospital
Royal Oak, Michigan
（美国Beaumont医院泌尿科主任）
Jack S. Elder, M.D.
Chief of Urology, Henry Ford Health System
Associate Director, Vattikuti Urology Institute
Department of Urology, Children's Hospital of Michigan
Clinical Professor of Urology, Case School of Medicine
(美国密西根儿童医院泌尿科主任)
Edwin A. Smith M.D.
Assistant Clinical Professor of Urology
Emory University School of Medicine
Atlanta, Georgia
（美国艾默里大学医学院临床助理教授）
Kevin M. Feber, MD, FAAP
Board Certified in Pediatric Urology
Comprehensive Urology
William Beaumont Children's Hospital
（美国William Beaumont儿童医院医生）
Ananias C. Diokno, M.D., F.A.C.S.Executive Vice President & CMOBeaumont HospitalRoyal Oak, Michigan 48073 USA
（美国Beaumont医院执行副总裁）
Juan José de Benito
Urologist
Hospital Nacional de Clínicas
Córdoba, Argentina.
（阿根廷国立医院）
William E. Nantau B.Sc., CNIMClinical ManagerClinical Neurophysiology DepartmentBeaumont Hospital Royal Oak
（美国Beaumont医院临床神经生理科临床主管）
Evan J Kass MD,FACS,FAAPChief, Division of Pediatric UrologyBeaumont Childrens HospitalProfessor of Urology, Oakland University-William Beaumont School of Medicine
（美国Beaumont儿童医院泌尿科主任，奥克兰大学医学院教授）
Jacques Corcos MD.Professor of Urology, McGill UniversityGeneral Secretary of the International Continence SocietyJewish General hospital3755 Cote Ste-CatherineMontreal, Quebec, Canada H3T 1E2
（加拿大麦基尔大学泌尿学教授，国际儿童排尿节制学会秘书长）
Jose Gonzalez, M.D.
Department of Urology
Beaumont Hospital
Royal Oak, Michigan
（美国Beaumont医院泌尿科医生）
Christopher Payne, MD
Associate Professor of Urology
Stanford University Medical School
Stanford, CA 94305-5118
（美国斯坦福大学医学院泌尿学副教授）
Kenneth I. Glassberg, MD
Director, Division of Pediatric Urology
Morgan Stanley Children's Hospital of New York-Presbyterian
Professor of Urology, Columbia University
College of Physicians and Surgeons
3959 Broadway, CHN 1118
（美国哥伦比亚大学医学院泌尿学教授，儿童泌尿学分科主任）
Earl Y. Cheng, MD
Associate Professor of Urology
Children’s Memorial Hospital
Chicago, Illinois
（美国芝加哥儿童医院泌尿学副教授）
Darius J. Bagli, MDCM
Professor of Surgery
Senior Associate Scientist
Director of Urology Research
Divisions of Urology and
Developmental & Stem Cell Biology
The Hospital For Sick Children
Institute of Medical Science
University of Toronto
（加拿大多伦多大学外科学教授，泌尿学研究主任）
Henri B. LOTTMANN, MD, FEBU, FEBPS, FRCS(england) FEBPU
Paediatric urology unit
Hopital Necker-Enfants-Malades
149, rue de Sèvres
75015 Paris
France
（法国Necker-Enfants-Malades医院儿童泌尿科医生）
Dr. Amrish Vaidya MS. MCh.Consultant Paediatric Surgeon,Kokilaben Dhirubhai Ambani Hospital,4 Bungalows, Andheri W, Mumbai, India
（印度Kokilaben Dhirubhai Ambani医院医生）
Marc Cendron, MD
Associate Professor in Urology
Harvard Medical School
Children’s Hospital Boston
Boston, MA
（美国哈佛大学医学院泌尿学副教授）
Stuart B. Bauer, MD
Associate Director, Neurourology
Professor of Urology
Harvard Medical School
Children’s Hospital Boston
Boston, MA
（美国哈佛大学医学院泌尿学教授，波士顿儿童医院神经泌尿科副主任）
Edmond T. Gonzales, Jr., MD
Professor of Urology
Baylor College of Medicine
（美国贝勒医学院泌尿学教授）
Richard Macchia, MD FACS
SUNY Distinguished Teaching Professor
Cleveland Clinic, Florida
（美国Cleveland临床中心教授）
Benjamin Girdler, MD
Urology Center of the Rockies
Fort Collins, Colorado
（美国科罗拉多洛基泌尿中心医生）
William C. de Groat, Ph.D.
Professor of Pharmacology
University of Pittsburgh
（美国匹兹堡大学药理学教授）
Michael R. Ruggieri, Sr., Ph.D.
Director of Urologic Research
Temple University School of Medicine
（美国坦普大学医学院泌尿学研究主任）
Stanley J Kogan MDChief, Pediatric UrologyChildren's Hospital at MontefioreBronx NY USA
（美国Montefiore儿童医院儿童泌尿科主任）
Anthony Caldamone, MD
University Urologic Associates, Inc.2 Dudley St Ste 185Providence, RI 02905
（美国布朗大学泌尿学中心医生）
Yves Homsy MD, FRCSC, FAAP Clinical Professor of Urological Surgery and Pediatrics University of South Florida Children's Urology Group 5507 E. Longboat Blvd Tampa FL 33615
（美国南弗罗里达大学临床泌尿学教授）
Dr. Enrique Turina
Professor of urology of the National University of Buenos Aires
Chief of section Urology of Instituto de Rehabilitación
Government of Buenos Aires, Argentina.
（阿根廷国立Buenos Aires大学泌尿学教授）
Dr. Angel Ozón
Urologist of the Instituto de Rehabilitación of Buenos Aires
（阿根廷国立Buenos Aires大学泌尿学医生）
Dr. Daniel Ekizian
Urologist of Instituto de Rehabilitación.
（阿根廷国立Buenos Aires大学泌尿学医生）
Professor Dr. med. Karl-Dietrich Sievert
Vice Chair Prof. of Urology, Director - Uro-oncology, Neurourology, Incontinence, & Reconstructive Urology Department of Urology University of Tuebingen D72076 Tuebingen, Germany
（德国Tuebingen大学泌尿学教授、主任）
Holly Gilmer, MD
Chief of Pediatric Neurosurgery
Beaumont Hospital
Royal Oak, Michigan
（美国Beaumont医院儿童神经外科主任）
The results from this study and previous animal and clinical studies by Xiao
clearly demonstrate that nerve rerouting produces a somatic-autonomic or cutaneous/bladder reflex with stimulation of the lower extremity dermatome.1 What is also clear is that the clinical benefit of the procedure is not at all similar to previous reports.（本次及以前肖的动物和临床研究的结果清楚表明，神经重建术可建立下肢经皮刺激的体神经－自主神经或皮肤－膀胱反射。同样，也清楚表明，该手术的临床效果与前面的报告截然不同。）
这个评论，首先肯定了反射弧理论得到证实，但临床效果却出乎意料地差。
密执根大学医学院泌尿科John Park在Editorial comment中说：
Xiao reported that more than 87% of 110 patients gained sensation and continence within 1 year (reference 7 in article). In comparison, the current patients undergoing the identical procedure with the help of Xiao himself only showed a modest improvement in objective urodynamic studies and subjective reporting. （肖报告110名患者1年内有超过87% 的患者获得了尿感和控尿。相比之下，在肖亲自帮助下做同样手术的患者，却只在客观尿动力学研究和主观报告中略有改善。）
这个评论，对美国进行的预试验结果与肖的报告结果相差太大，提出疑问。
最后，来看看比利时根特大学泌尿科Piet Hoebeke在Editorial是怎么总结的：
Although promising, this study cautions us that further controlled studies are needed before this nerve rerouting procedure can be used more routinely.（该研究虽然有希望，但我们得注意，在神经重建术成为更常规的手术前，需要进一步的对照组研究。）
我查阅了美国肖氏反射弧手术临床试验的资料，临床试验的正式名称是：Nerve Rerouting Treatment for Neurogenic Bladder in Spina Bifida （对脊柱裂神经原性膀胱的神经重建治疗）。该项目于2009年9月得到NIH的正式批准，每年资助大约四十七万美元，共五年。申请书虽然说明是建立在肖传国的研究基础上，但提供的数据是美国自己做的九例患者的资料，也就是今年8月份泌尿科杂志发表的受到争议的研究报告。申请时，已经注意到治疗效果和肖传国的报告相差很大，用了这样的句子However, in China rigorous follow up is challenging,说明在中国进行严格的随访很难，结论不可靠。因此，必须在美国进行严格的临床试验，以确定治疗效果和安全性。可以说，早在一年多前，在申请项目时，就知道以后会引起争议，而这种争议，特别是负面的，恰好支持在美国进行临床试验的必要性。项目的主持人是William Beaumont医院的Kenneth Peters医生，他主持过很多项临床科研项目，经验丰富，几乎所有的情况，都事先仔细考虑过。老手毕竟是老手，现在回过头看这些资料，让我拍案叫绝，不得不佩服Peters的眼光以及事先设下的应对策略。申请资料中的关键点是，美国自己做的九例患者中，七例产生反射，证实了理论的成立。而今年报告公开发表后，再严厉的批评，都承认理论是成立的。因此，这项试验的学术价值不可否定，那么就看看临床治疗效果和安全性怎么样了，值不值得在临床上推广应用。
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