要再次声明一下：我对医学和法律都是外行，里面的术语都是从google和字典查的，要请专家把关。其他方面也请多指教。
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“肖氏手术”治愈率：85%，还是0%？
The cure rate of "Xiao procedure": 85% or 0%?
记者：邸利会
2009年11月23日《科学新闻》杂志第22期
Di Li-hui, Science News (Chinese) Vol. 22, Nov. 23, 2009
编者按：在10月28日第20期，本刊以《谁来评定肖传国》为题报道了“肖氏反射
弧”这一受争议的手术。文章刊出后，本刊记者又获悉了这一手术的更多信息。
Editor: In Volume 20, Oct. 20th, this magazine reported "Xiao reflex arc", the controversial operation procedure, in an article "Who will evaluate Xiao Chun-guo?". After the article was published, our reporters have learned more information about this procedure.
公益诉讼律师彭剑继续忙于搜集整理各方证据。此前的10月16日，两名脊柱
裂患儿的母亲将河南神源泌尿外科医院告上法庭，目前法院将庭审的时间初步定
在12月28日。彭剑透露，在年底之前，预计还会有20个左右的患者（家属）提起
诉讼。
Commonweal lawsuit lawyer Peng Jian is busy in collating evidence from different sources. Previously on Oct. 16th, the mothers of two children with spina bifida filed lawsuits against Henan Shen Yuan urinary surgery hospital. At present, the court has set the date for hearing on Oct. 28th. Peng Jian revealed that, before the end of the year, it was expected that about twenty more patients (or their relatives) would bring their cases to the court.
调查重新启动
Investigation restarted
“我意识到，对这个案子，只能是众多的病友，最好是同期的病友一起揭发
才有效。”彭剑告诉《科学新闻》，他从2006年开始试图搜集患者名单——那一
年，方舟子因为对“肖氏反射弧”这一理论及其提出者肖传国在学术界的地位提
出严厉质疑，而遭到肖传国的起诉并败诉。
"I realized, for this case, the only effective way was for many patients to make the disclosure together,
especially those who took the operation at about the same time." Peng Jian told Science News that he started the effort to collect the names of the patients since 2006 - in this year, Fang Zhou Zi lost his case against Xiao Chuan Guo. Fang was sued by Xiao, because he harshly questioned the theory of "Xiao reflex arc" as well as the academic standing of Xiao Chuan Guo, who was its inventor.
2007年暑期，当手中的名单已经积累到几十个时，彭剑便安排实习生，开始
做电话寻访。“当时，我们打通了40多个人的电话，了解到他们术后的结果很不
好，绝大多数根本没有什么效果，甚至有造成残疾的。”曾参与电话寻访的刘琳
告诉《科学新闻》。
In the summer of 2007, when the names on his list had totaled a few dozens, Peng Jian arranged interns to start interviewing the patients over the phone. "At that time, we successfully got through to more than forty people, and learned that the outcomes of their operations were very bad. In most cases there was virtually no improvement. Some even caused disability." Liu Lin, who took part in the phone interviews, told Science News.
但进一步的调查取证却遇到了困难，主要的问题是缺乏资金支持。期间，虽
然有一些公益组织有提供资助的意愿，但终究没有实现。而此时不断有患者来到
彭剑所在的律师事务所，希望“加快法律援助的进程”。
But further investigation was hindered by difficulties. The main one was the lack of financial support. Although several non-profit organizations expressed the intention to provide supports, none materialized.
Yet in the meantime, patients continuously visited the law firm where Peng Jian works, hoping to "accelerate the process of legal aid".
2009年9月，当资金较为充裕之时，调查取证的工作再次启动。这一次，据
患者彼此通信获得的150多人中，打通电话的有80多人，现场寻访人数15人。彭
剑说，“目前‘数字’还在不断增加，每天至少有2个，多至三四个电话打过来
为案件提供佐证。”
September 2009, when financial resource became less of a constraint, the investigation was started again. This time, among the 150 plus contacts obtained through the exchanges between the patients, more than eighty successful phone interviews were made, and fifteen were interviewed in person. Peng Jian said, "Now the 'number' is still increasing; we receive at least two, up to three or four calls each day, that provide evidence for the case."
在迄今为止所接触过的接受了“肖氏”手术的病友中，调查结果显示没有一
例完全成功，手术有明显效果的比率也很低——这与医院方面所宣传的“治愈率
85%”形成鲜明对照。
Among the patients who had received the "Xiao procedure" and been contacted so far, the research finds no example of complete success. The ratio of cases with evident improvements is also low - This is a sheer contrast to the "85% cure rate" advertised by the hospital.
更多的矛盾
More contradictions
彭剑律师还发现了另一处让人觉得难以理解的矛盾。
Lawyer Peng Jian also found another inexplicable contradiction.
郑州大学神经泌尿外科研究中心在2007年2月28日为肖传国2007年申报院士
出了一张证明，称：郑州大学神经泌尿外科研究中心自2006年 1月开始应用肖传
国教授发明的“人工体神经－内脏神经反射弧”技术，治疗脊柱裂、脊髓脊膜膨
出所致的神经原性膀胱患者117例，术后随访8个月以上60 例，85％的患者大小
便已恢复正常。
The Neural Urinary Surgery Research Center at Zheng Zhou University issued a certificate to Xiao Chuan Guo on Feb. 28th, 2007, for his application to academian. In the certificate, it was claimed: Starting from Jan. of 2006, the Neural Urinary Surgery Research Center at Zheng Zhou University had applied the "人工体神经－内脏神经反射弧" technique invented by Professor Xiao Chuan Guo on 117 patients with neurogenic bladder caused by spina bifida or meningomyelocele. Sixty cases were followed up for more than eight months. 85% of the patients have obtained bowel movement and urination completely continent.
但彭剑查到，2006年8月14日的《大河报》曾经报道：“昨天，小善善在郑
州神源泌尿外科医院接受手术……小善善的手术是河南首例……郑州大学及基础
医学院院长董子明说：善善的手术创下了河南第一——河南首例‘人工反射弧’
手术。而郑州神源医院也创下全国第一——这是国内首家跨学科的‘神经泌尿外
科’医院，是郑州大学科研、临床相结合的一个创举。”
But Peng Jian found out, it was reported on Aug. 14th of 2006 by Da He Bao:"Yesterday, little Shan Shan
received the operation at Zheng Zhou Shen Yuan Urinary Surgery Hospital ...... the operation for
little Shan Shan was the first case in Henan ...... Dong Zi-ming, from Zheng Zhou University and
the dean of Fundamental Medical School, said: Shan Shan's operation made a Henan record -
the first 'Artificial reflex arc' in Henan. And Zheng Zhou Shen Yuan hospital made a national record -
this was the first, in our nation, interdisciplinary, neural urinary surgery, hospital. It is a creation
of Zhengzhou University by binding together research and clinical practice."
也就是说，该中心迟至2006年8月13日才做了第一例“肖氏反射弧”手术。
此时距离该中心为肖传国出具治愈率证明仅有6个半月，与其证明称“术后随访8
个月以上60例”明显矛盾。
In other words, the center conducted the first "Xiao reflex arc" operation as late as Aug. 13th of 2006.
It was merely six and a half months apart from the time when the center provided the certificate of cure rate for Xiao Chuan-guo, which evidently contradicts with its claim "Sixty cases were followed up for more than eight months".
彭剑等人寻访了在2006年8月到2007年上半年在郑州神源泌尿外科医院做过
“肖氏反射弧”手术的100多名患者，未发现有一例大小便恢复正常，许多患者
术后反而病情恶化。从手术时间看，这些患者至少应该占了该中心证明所说的
“117例”的相当一部分。这对声称“85％的患者大小便已恢复正常”的院方提
出了强烈质疑。
Peng Jian and others sought out and visited more than a hundred patients who took the "Xiao reflex arc" operation at Zheng Zhou Shen Yuan Urinary Surgery Hospital between Aug. 2006 and the first six months of 2007. They found no case of bowel movement and urination completely continent. Instead, the conditions of many patients deteriorated after the operation. Judging from the time to take the operation, these patients should at least count for a considerable portion of the "117 cases" mentioned in the certificate issued by the center. This calls into serious question the hospital's claim "85% of the patients have obtained bowel movement and urination completely continent".
“让病人来说，是最客观的”
"Let the patients say, it is the most objective way"
由于调查取证获得的治愈率接近于0%的结论，让人太过震惊——这是否与非
医学专业人士的询问，如彭剑等人的调查会造成一定的偏差有关。
It is perhaps too shocking to believe the conclusion of the investigation that the cure rate is close to 0% - Is it related to the bias caused by the questions designed by people who are not medical professional, such as Peng Jian?
“民间的统计方法和结果，虽然正式发表可能还需通过评审，但也能说明一
些问题。”北京博爱医院教授廖利民如此评价，“目前，只有病人说话才可以说
明问题。要想伸张正义，还得走病人这条路。如果手术成功，病人是最大的受益
者；手术失败，病人是最大的受害者。让病人来说，是最客观的。”
"The statistical results obtained through amateur methods, though review is needed before being published officially, can already shed light on some questions." Professor Liao Li-min at Beijing Bo Ai hospital commented in this way, "At present, only when the patients speak out can we expose the problems. Justice can be served only through the patients. If the operation succeeds, patients are the biggest beneficiary; if it fails, patients are the hardest-hit victim. Let the patients say, it is the most objective way."
对于花费财力、人力进行患者的逐个问询，对于彭剑来说，是条最直接也可
能是唯一可以依赖的取证路径。“找同行专家评议，理论上讲是可以的，但现实
当中是不可能的。已有的、对这项手术的评估鉴定都是‘权威们’做的，包括一
些科学技术成果的鉴定。现在再找专家，作出不同的鉴定结论，岂不是很难？况
且，我发现，现在同行专家都有意回避。”彭剑说。
To Peng Jian, spending money and man-power to interview the patients one by one is the most direct and, possibly, the only viable way to collect evidence. "Peer review, while theoretically feasible, is impossible in reality. The current evaluation of the procedure was all made by the 'authoraties', including the evaluation on some scientific achievements. Isn't it too difficult to find other experts to draw a different conclusion? Moreover, I find that, the experts in the field are trying to stay away," Peng Jian said.
彭剑的这一说法得到了同行的认可。“专家都不想卷入，尽管我们也不愿意
看到病人成这个样子。”一位知名泌尿外科专家告诉《科学新闻》，“不是我们
不愿意，而是我们说的可能不起任何作用。他可以说我们什么都不懂。所谓专家
同行，在他眼里，任何人都可以说成什么都不是。”
What Peng Jian said was acknowledged by experts in the field. " We experts don't want to get involved, although we do not like to see what has happened to the patients." A well-known expert in urinary surgery told Science News, "It is not that we are not willing to (speak out), but that what we say probably won't have any effects. He can say we know nothing. So-called experts and colleagues, or anybody, in his eyes, can be dismissed as worthless."
同行评议
Comments from peers
但毕竟还是有专家敢于说话。
Nevetheless, there are experts who, after all, are brave enough to speak out.
“我用两句话来描述：第一，这个手术绝对不是像他描述的，解决了神经膀
胱的问题；第二，这个手术可能对部分病人是有效的，因为毕竟有一定的适应症，
有一些病人可以用这个治疗，但绝对不是说所有的病人都可以。”重庆第三军医
大学的宋波教授如此认为。
"I use two sentences to describe it: first, this procedure is absolutely not like what he described, that it has solved the problem of neurogenic bladder; second, the procedure may be effective for some patients, because there are some 适应症. Some patients can be treated with this (procedure), but absolutely not all."
Professor Song Bo at the Chong Qing The Third Military Medical University held this opinion.
宋波表示，他对这类手术不赞成盲目的吹捧或者宣传，因为这毕竟不是商业
活动。“如果说解决了神经膀胱的问题，我极力反对；以此报科技进步奖，我也
是不太赞同的。”他同时认为现在也没有充分证据说这些手术完全无效。“但他
的研究并没有完成，适应症到底是什么都还不能确信，就说解决了什么重大问题，
这是不成立的。”宋波说。
Song Bo indicated that he did not agree to blindly gloss over or promote this type of procedures, because,
after all, this was not a business activity. "I am all against the statement that it has solved the problem of neurogenic bladder; I did not agree with applying to the National Prize for Progress in Science and Technology based on this (procedure) either." In the meantime, he believe, there has not enough evidence so far to assert that the procedure is completely useless. "But his research is not finished yet. It is not even sure what is the 适应症. It is unfounded at this stage to say things like a grand problem has been solved." Song Bo said.
“他是把（神经外科）技术用到泌尿外科上。我们在临床上也看不到几个病
人，实际的手术操作我们也没见过，根本就发表不出什么意见。是人家领来的病
人，我也没看手术，他那时候文章也没有。国际上对他的评价，我们更不了解，
都是他自己说的，看不到国际上对他的评论。他说我们开展不了这个手术，但他
们自己为什么也推广不开，我们也有疑问。”北京医科大学第一医院教授、中国
工程院院士郭应禄告诉《科学新闻》。
"He applied (neuro-surgery) techniques to urinary surgery. We could see only few clinical patients. We did not see actual operations either. We simply were not able to make any comments. Somebody brought the patients. I did not watch the operation. He had no papers at that time. We knew even less about his international reputation. All was from his own mouth. Couldn't see international comments. He said we would not be able to conduct the operation, but why they were not able to make people accept it themselves either, we are also wondering." Guo Ying-lu, a professer of Beijing Medical University and an academian of China engineering academy, told Science News.
“做科学，我们要允许出错，允许探索，做各种各样的努力。但不能允许在
没有完整的科学证据的条件下，在没有大量循证医学的证据下，就说解决了什么，
创造了什么，这是不科学的提法，我反对这样的提法。”宋波最后如此总结。
"When doing science, we should allow mistakes, exploration, and all kinds of efforts. But we should not allow claims such as what has been solved and what has been created, when there is no complete scientific evidence, nor a large amount of evidence-based medical data. They are not scientific. I am against them." Song Bo summed up.