方舟子的Blog

 

美联社记者黄敬龄 2010年10月19日北京

 

（羽矢翻译）

 

就在不久前，肖传国这位中国泌尿科医生还看起来像是登上了职业生涯的顶峰：他发明了帮助病人克服尿失禁的外科手术，并且正在培训美国和各国的医生。随后却手铐加身，坦白他雇凶袭击两位持续批评他、称其欺诈的人。

 

此丑闻令公众震惊，并激起了要求完善中国医疗研究规范的呼吁。虽然科研欺诈及不端行为在中国四处泛滥，肖传国却并非一般的江湖庸医。这位美国受过训的医生上月被捕后，还有30多名美国、加拿大、法国、印度等国家的泌尿科医生发信支持他。

 

中国几位患者控诉手术导致了包括运动功能恶化在内的严重副作用。著名的《南方周末》在一篇分析报道中称，法规不健全导致肖传国“把病人当作了自愿跑来的实验室小白鼠”。

 

上星期，北京一家法院因肖传国在袭击案中的角色判处这位54岁的医生5个半月的拘役。肖传国因被警方监禁而无法采访到。

 

一些美国医生认为，肖的手术是试验性的、但还是有希望的，两家美国医院正在进行有少量志愿者（多为儿童）参加的临床试验。而另一些美国医生则持怀疑态度，特别是针对肖所声称的百分之85的成功率。这项手术意在帮助那些因事故截瘫或先天缺陷脊柱裂而不能控制小便者。

 

“美国大多数小儿泌尿科医生对肖的报告嗤之以鼻，”加州大学戴维斯儿童医院小儿泌尿科主任Eric Kurzrock说，“你知道，从来没有人相信他那85%的成功率。而且你看看他那些报告，非常缺乏详细数据。”【译注：针对美国 Beaumont医院试验结果论文，Eric Kurzrock在美国《泌尿学杂志》发表编辑评论，认为“该手术的临床疗效与（肖传国）此前所报告的截然不同”】

 

据媒体报道，肖传国在中国对数百名患者贸然实施了其手术。目前，一些患者称肖夸大了成功率，而且手术令他们的病情恶化。

 

不管肖是否真的欺诈或违反伦理，此案仍凸显中国医疗研究缺乏规范、患者几无保护的现状。

 

“中国医疗界是狂野西部，这不是什么秘密，”纽约州立大学研究人员曹聪说。他写过两本有关中国科技创新的书。

 

方是民（方舟子）以非官方执法者的身份出现了。他揭露学术欺诈事例，并公布在他的网站上。

 

他揭露了肖，两人最终陷入长期争斗。作调查报道的记者方玄昌（与方是民无亲属关系）则另外撰写了有关肖的批评报道。

 

肖所付出的代价高昂。他曾告诉记者们他的手术能获诺贝尔奖，而且他说成为两“方”目标的代价是使他没能入选享有盛誉的中国科学院院士。

 

6月份，两个人用金属管袭击了方记者，在他头上流下了又深又长的伤口。两个月后，方是民被人用化学喷剂和铁锤袭击后逃脱，留下轻微伤。

 

警方在肖培训完阿根廷医生回国时将其逮捕。审讯录像上，肖说他付给了远房亲戚10万元人民币雇佣了两人，“想把他们打个鼻青脸肿……别给打残了。”

 

肖说：“我没有任何其他的方法来解决，真想打他一顿。”他指的是揭露他的方是民。

 

7名患者或患者家属在审判肖传国的法庭外抗议，声称他们代表了受肖欺骗的200名患者，以为这项需花费3万元的手术的成功率真的是85%。

 

患者璩彬彬说：“我们需要解释，我们要求正义。”坐在轮椅上的29岁的他说，3年前未做手术时他还能不依靠拐杖来回走动。

 

支持肖的患者也露面了。19岁的大学生郭玉岭（Guo Yuling）称，他做肖氏手术前的13年间裤子一直是湿的。【译注：在现场的患者家长发现，此人“排尿外器官和一个正常发育成熟的男人同大（通常情况下，这种病孩儿的外排尿器官是不发育的）”】

 

人权律师彭剑说，两名患者正以虚假宣传起诉肖，更多的诉讼正在计划中。彭剑说，他已经准备好150件案例的材料，这些案例手术没有效果或患者情况恶化。

 

到目前为止，这件丑闻还没有使美国继续进行临床试验的计划脱轨。

 

密歇根州William Beaumont医院的研究者们报告了好坏混杂、有些有副作用的9名脊柱裂患者的初步试验结果。明年年初之前，他们计划开展一项为期5年、由国立卫生院资助230万美元的临床试验，

 

该医院泌尿科主任Kenneth Peters医生说，他保证患者能完全知悉该手术是试验性的，而且具有严重危险。

 

“按我们的经历，肖医生完完全全是一位超乎想象的绅士、科学家和很好的同事，”Peters说。他是支持肖的信件的签署者之一。

 

佛罗里达州St. Petersburg的儿童医院也另外在进行着有8名儿童参加的试验研究。

 

美联社调查员Xi Yue对此文有贡献。

 

【译注：

1. Beaumont医院回复患者问询时多次提供虚假信息，称肖氏手术是中国的“常规手术”、“中国各个医院每天都在做这个手术”，并建议和介绍病人去中国找肖传国做手术。

2. 2006年12月，Kenneth Peters曾对美联社记者说：“有一些风险，包括全身麻醉和伤口感染。对于能行走的脊柱裂儿童来说，腿部神经重建导致一些足无力的小风险。”

3. 2008年4月，该医院在其新闻发布会上声称此手术副作用“包括轻微的术后脊液外漏、下肢无力和头疼，最近的技术发展已戏剧性地降低了这些并发症的发生率”。

详见：

http://webcache.googleusercontent.com/search?q=cache:qlNsld4U63UJ:spinabifidaconnection.com/showthread.php%3Fp%3D3209

http://www.msnbc.msn.com/id/16270675/

https://www.beaumonthospitals.com/news-story-beaumont-results-urinary-nerve-rewiring-surgeries-spina-bifida-patients

】

 

http://news.yahoo.com/s/ap/20101019/ap_on_he_me/as_china_risky_medicine

 

Patients protest Chinese doctor’s risky surgery

 

By GILLIAN WONG, Associated Press Writer – Tue Oct 19, 5:53 am ET

 

BEIJING – At one moment, the Chinese urologist seemed to be at the height of his career: He had invented a surgical procedure to help patients overcome incontinence and was training doctors in America and elsewhere. The next, Dr. Xiao Chuanguo was in handcuffs, confessing that he’d hired thugs to attack two persistent critics who called him a fraud.

 

The scandal has shocked the public and prompted calls for better regulation of Chinese medical research. And while research fraud and misconduct is widespread in China, Xiao is no run-of-the-mill charlatan. More than 30 urologists from the United States, Canada, France, India and other countries issued a letter in support of the U.S.-trained surgeon after his arrest late last month.

 

In China, several former patients have complained about severe side effects, including a worsening of their mobility. The respected Southern Weekly newspaper said in an analysis that poor regulation led to Xiao “treating patients as if they were voluntary lab mice.”

 

Last week, a Beijing court sentenced the 54-year-old doctor to five and a half months in detention for his role in the attacks. Xiao, in police custody, could not be reached for comment.

 

Some American doctors consider his technique experimental but promising, and two U.S. hospitals are carrying out trials on a small number of volunteers, mostly children. Others, though, are skeptical, particularly of his claims of an 85 percent success rate. The surgery is meant to help people who cannot control their bladders because of a paralyzing accident or a birth defect known as spina bifida.

 

“Most of the pediatric urologists in the United States were very cynical about his reports,” said Dr. Eric Kurzrock, chief of pediatric urology at the UC Davis Children’s Hospital in Sacramento, California. “Nobody ever believed there was an 85 percent success rate, you know, and when you looked at his reports they were very short on details.”

 

In China, Xiao forged ahead with the surgery on hundreds of patients, according to media reports. Now, some are saying he exaggerated the chance of success and that the surgery left them worse off.

 

Whether or not he is guilty of fraud or an ethical lapse, his case highlights the unregulated nature of research in China, with few protections for patients.

 

“It’s no secret that the Chinese medical space is the Wild West,” said Cong Cao, a researcher at the State University of New York who has written two books on China’s science and innovation.

 

One man, Fang Shimin, has emerged as an unofficial sheriff, unearthing examples of scientific fraud and posting them on his website.

 

He took on Xiao, and the two ended up in a long-running feud. Separately, investigative journalist Fang Xuanchang, no relation to the other Fang, also started writing critical pieces about Xiao.

 

The stakes are high for Xiao, who once told reporters his procedure should win him a Nobel Prize and has said that becoming a target of the two Fangs cost him a seat in the prestigious Chinese Academy of Sciences.

 

In June, two men attacked the journalist Fang with metal pipes, leaving a deep gash on his head. Two months later, the other Fang was attacked with a chemical spray and a hammer, escaping with minor injuries.

 

Police arrested Xiao after he returned from training doctors in Argentina. In a videotaped interrogation, the doctor said he paid a distant relative 100,000 yuan ($15,000) to hire two men “just to give them black eyes and swollen faces … but not to do any permanent damage.

 

“Nothing else would solve the problem except beating him up,” he said, referring to Fang Shimin, the muckraker.

 

Half a dozen patients and family members protested outside his trial, saying they represented 200 patients who were duped by Xiao into thinking the 30,000 yuan ($4,500) procedure had an 85 percent success rate.

 

“We need an explanation. We need justice,” said Qu Binbin, a 29-year-old man in a wheelchair who said he was able to get around without crutches before having the surgery three years ago.

 

Supporters of the doctor also showed up. Guo Yuling, a 19-year-old college student, said he constantly wet his pants for the first 13 years of his life before Xiao’s surgery.

 

Two former patients are suing Xiao for false advertisement, and more lawsuits are planned, said Peng Jian, a human rights lawyer who said he has documented 150 cases in which the surgery had no benefit or left patients worse off.

 

So far, the scandal has not derailed plans to continue studies in the U.S.

 

Researchers at William Beaumont Hospital in Royal Oak, Michigan, reported mixed results — and some side effects — from a pilot study of nine spina bifida patients. By early next year, they plan to begin a 5-year clinical trial funded by $2.3 million from the National Institutes of Health.

 

Dr. Kenneth Peters, the hospital’s head of urology, said he ensures that patients are fully aware the surgery is experimental and carries serious risks.

 

“Dr. Xiao has been nothing but in our experience an incredible gentleman, scientist and a very good colleague,” said Peters, one of those who signed the letter in Xiao’s support.

 

A separate 3-year study on eight children is under way at All Children’s Hospital in St. Petersburg, Florida.

 

Associated Press researcher Xi Yue contributed to this report.