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质疑肖传国,甄别方骗子
作者:nile
发表时间:2010-09-29
更新时间:2010-09-29
浏览:1814次
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地址:65.
::: 栏目 :::
朱令铊毒案
薄熙来黑帮覆灭
转基因阻击战
云心水心
健康净土
网战风云
网络文痞方是民
天理人性

实事求是是科学的基本精神。这四个字可以分成两部分,实事,指通过观察测量和实验取得现象,数据或证据。求是,指用逻辑或数理方法对对所发现的客观事实进行分析处理以揭示事物的本质或规律。这四个字不仅可以用来指导科学,同样可以用来甄别骗子。现成的例子就有一个。

有一个帖子题为“同济医学院外科医生常士民对肖传国手术的明确质疑”。方舟子集团用来作为肖传国造假的证据到处撒布。不小心被Nile看到了。作者在帖子里说,外科医生常士民和肖传国都是同济的医生。常大夫根本不信肖的牛皮。并附有常医生的全文,常士民医生给编辑的一封信,发表在美国泌尿学杂志上(J Urol. 2004 Jun;171:2387-8.)。nile就在“实事”的层面上,检查一下常医生这封信的具体内容,看看帖子的作者说的是不是事实。

首先要指出,根据信尾常士民医生的落款,常和肖不在同一个医院工作。常士民在上海同济大学医学院同济医院整形外科,肖传国在武汉华中科技大学同济医学院附属协和医院泌尿外科。两个人的医院所在地,医院名称,工作专业都不同。常医生原信的标题如下:

Re: an artificial somatic-central nervous system-autonomic reflex pathway for controllable micturition after spinal cord injury: preliminary results in 15 patients.

文章的第一段交代了文章的目的:基于我们的认识和治疗经验,我们要对人工“体—中枢神经—膀胱”反射通路作一个评论。第二段进入正文,开始谈第一个问题。作者认为,人工反射的作用与脊髓损伤病人自然形成的反射作用有相似之处。第三段讨论应该用哪根神经做供体哪根作受体。肖用左侧腰5作供体,骶2和3作受体。常认为可以用腰5或骶1作供体,骶3或骶4作受体,效果会更好。第四段,讨论手术如何促进副交感神经轴突再生而减少体运动神经的轴突再生,以更好地排空膀胱。第五段,讨论用什么方法作为传入信号激发反射更好。如果用“肌腱—中枢神经—膀胱”反射,会不会比“皮肤—中枢神经—膀胱”反射更好?进一步讨论指出“皮肤—中枢神经—膀胱”可以解决膀胱的排空,但是还没有解决膀胱的顺应性和存储量,是否可以通过“去神经传入(deafferentation)”来解决这个问题,deafferentation在这里指干扰或去除膀胱的牵张感觉从骶髓后角根传入骶髓。最后一段全文照贴如下。请大家作个阅读理解,自己判断一下常医生是否认为肖传国的“体—中枢神经—膀胱”反射弧手术是学术造假。

Finally, establishing an artificial “somatic-CNS-bladder” reflex arc to trigger voiding in patients with spinal cord injury is a new and promising approach. Congratulations to Xiao et al, who present interesting and inxxxxative research work. However, more experimental and clinical studies and long-term followup are needed before a definite conclusion is drawn.

根据本人对方舟子集团捏造事实手法的了解,基本可以断定发出这个帖子的xyzt是方舟子集团的人。方舟子集团诬陷别人学术造假所使用的方法大概可以简化如下:肖传国是骗子,因为他说太阳是从西边升起的。大家现在看到了吧,和他一个医院工作的常医生都不相信,常医生认为太阳是东边升起的。方舟子集团在这里一口气撒了三个谎。其实,肖传国说的是太阳从东偏南N度升起,常医生认为可以是东偏南N±5度。而且肖和常不在一个医院工作。

很明显,常医生的评论是对肖氏手术的补充建议。按nile的理解,常医生在评论中提出了三个建设性的意见。第一,常认为不经过肖氏手术建立人工反射弧,病人也可能自然产生替代的排尿反射。因此,手术一定要有非手术对照才能证明疗效。第二,肖用腰5后根与骶2,3吻合,而常认为可以用腰5和骶1的后根与骶3,4吻合。第三,肖没有切断膀胱感觉神经的传入枝而常认为可以试试。这样学术评论到了方舟子们的手里就变成了常医生怀疑肖传国学术造假。方舟子要揭发肖氏手术是伪科学,就应该和常医生一样,把文章发给泌尿学杂志,经过同行专家评议后发表。而不可以在自己的“新语丝”上想怎么编就怎么编,想怎么骂就怎么骂。

方舟子们的这种手法使Nile想起方舟子早年打击基督教时理直气壮批神创论。神创论的支持者们有一说就是很多生物专家们发表文章质疑进化论。事实上,没有一个人在学术平台发表论文说进化论是伪科学,专业人员们讨论的是在生物进化的具体机制。比如进化的速度是匀速的,加速的,减速的还是跳跃式的。不知道如今的方舟子把昔日对手的手法借为己用,有没有事先得到人家的同意。不管是方舟子,还是其他的什么骗子,nile相信,他们之所以敢于公然撒谎就是有很多人不了解事实也懒得去查证事实。 “实事求是”是科学的精神,而甄别骗子不要“求是”。取其前一半“实事”就够了。Nile把方舟子们的帖子附在文后,有兴趣的可以查证一下。


附件:

同济医学院外科医生常士民对肖传国手术的明确质疑

xyzt 贴于2005/09/21 07:43 (华中科技大学校友论坛)

baih 于 [教育与学术]

已经白纸黑字发表过
因为是都是同济的医生,常大夫在严重质疑肖传国吹牛以后,客客气气地加了一句方法还要更多实践验证,其实常大夫根本不信肖的牛皮

RE: AN ARTIFICIAL SOMATIC-CENTRAL NERVOUS SYSTEMAUTONOMIC REFLEX PATHWAY FOR CONTROLLABLE MICTURITION AFTER SPINAL CORD INJURY: PRELIMINARY RESULTS IN 15 PATIENTS
C. G. Xiao, M.-X. Du, C. Dai, B. Li, V. W. Nitti and
W. C. de Groat
J Urol, 170: 1237–1241, 2003
To the Editor. Reconstruction of controlled voiding in spinal cord injury still remains a major challenge in medicine. Xiao et al perxxxxed an interesting investigation first in animals (rat1 and cat2) and then in clinical patients, by establishing the “skin-central nervous system (CNS)-bladder” artificial reflex pathway to trigger bladder contraction. Based on our understanding and clinical experience in bladder treatment of patients with spinal cord injury, we would like to comment on some points regarding the artificial “somatic-CNS-bladder” reflex pathway.

First is the relationship between naturally triggered voiding and artificially triggered voiding. In patients with suprasacral spinal cord injury one or more nature triggering points usually develops to initiate voiding, for example tapping the lower abdomen, pulling the pubis or scratching the skin below the spinal cord injury level. Does the patient who underwent the operation still retain naturally triggered voiding? Furthermore, we do not think the artificial reflex arc can “control” voiding. It may have the same role of trigger point in spastic bladders of spinal cord injury.

In addition, which root should be selected as the recipient? For the donor root in clinic it can be L3, L4, L5 or S1. Considering spine stability, L5 or S1 is preferential. For the recipient root one must consider its normal innervative frequency and efficacy to bladder detrusors. Generally speaking, S2 roots in patients seldom have innervative contribution to bladder detrusor because there is no bladder pressure increase when S2 is stimulated (20 V, 30 Hz). S3 and S4 are the dominant contributors of bladder innervation, with the right side more efficacious.3 Furthermore, the proximal lumbar somatic motor ventral roots innervating the hindlimb muscle are much larger than the distal sacral ventral roots innervating the pelvic organ and floor. Therefore, it is technically possible to anastomose 1 proximal donor root with 2 or 3 distal recipient roots. So in our opinion the recipient root for neurorhaphy should be S3 or S4, bilaterally or unilaterally.

Another point centers on how to promote axonal regeneration to pelvic nerves rather than to pudendual nerves. As we know, the ventral root of L6 in rat, S1 in cat, S2 in dog or S3 in man contains somatic motor fibers as well as parasympathetic preganglionic fibers. The xxxxer xxxxs pudendal nerve to innervate pelvic striated muscles and sphincters, and the latter xxxxs pelvic nerve to pelvic ganglion and then innervate pelvic organs. Theoretically, the proximal somatic motor fibers are more inclined to regenerate into distal somatic nerves because they can release the same neural trophic and growth factors to attract and induce axonal sprouting and regenerating. However, the aim of this operation is to get more reinnervation to bladder and less reinnervation to sphincter. What can we do to inhibit axonal regeneration to distal somatic nerves and enhance to autonomic nerves?

Another question is which is a more efficacious trigger, skin or tendon afferent? Scratching skin induces a superficial spinal reflex, while knocking tendon induces a profundal reflex. The impulse produced by tendon reflex seems more robust than that by skin. However, in animal experiments and clinical sacral anterior root stimulation (Brindley electrode) the intensity of electrical stimulus is hundreds to thousands of times higher than the biological current. Is there any difference between the “skin-CNS-bladder” and “tendon-CNS-bladder” reflex pathway? Which one can give a better result? Another issue regards whether to do deafferentation. It has been proved clinically that sacrificing 4 or even 5 sacral roots has no effect on voluntary voiding or defecation.4 Selective sacral root rhizotomy in patients with supraconal spinal cord injury, whether efferent or afferent, usually gives encouraging initial results but is disappointing in long-term followup.5 Because the plasticity of autonomic nerve and bladder smooth muscle is so strong, only complete denervation could achieve permanent spasm relief.6, 7 In our opinion the “somatic-CNS-bladder” reflex arc only sets up a new somatic trigger point to initiate voiding. It seldom affects bladder compliance and reservoir function. Thus, establishing a “somatic-CNS-bladder” reflex arc without supplementation of appropriate deafferentation will ultimately lead to a hyperreflexic and spastic bladder. What is the role of deafferentation? Does it diminish the efficacy of the somatically triggered voiding?

Finally, establishing an artificial “somatic-CNS-bladder” reflex arc to trigger voiding in patients with spinal cord injury is a new and promising approach. Congratulations to Xiao et al, who present interesting and inxxxxative research work. However, more experimental and clinical studies and long-term followup are needed before a definite conclusion is drawn.

Respectfully,
Shi-Min Chang
Department of Orthopedic Surgery
Tongji Hospital Tongji University
389 Xincun Road
Shanghai 200065
People’s Republic of China
1. Xiao, C. G. and Godec, C. J.: A possible new reflex pathway for micturition after SCI. Paraplegia, 32: 300, 1994
2. Xiao, C.-G., De Groat, W. C., Godec, C. J., Dai, C. and Xiao, Q.: “Skin-CNS-bladder” reflex pathway for micturition after spinal cord injury and its underlying mechanisms. J Urol, 162:936, 1999
3. Chang, S. M. and Hou, C. L.: The frequency and efficacy of differential sacral roots innervation to bladder detrusor in Asian people. Spinal Cord, 38: 773, 2000
4. Anson, K. M., Byrne, P. O., Robertson, I. D., Gullan, R. W. and Montgomery, A. C.: Radical excision of sacrococcygeal tumours. Br J Surg, 81: 460, 1994
5. Torrens, M. and Hald, T.: Bladder denervation procedures. Urol Clin North Am, 6: 283, 1979
6. Brindley, G. S.: The first 500 patients with sacral anterior root stimulator implants: general dexxxxion. Paraplegia, 32: 795, 1994
7. Madersbacher, H.: Denervative techniques. BJU Int, suppl., 85:1, 2000

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