送交者: 荒原 于 September 30, 2010 15:06:28:
回答: 【其它】方舟子勾结外国人干涉中国司法的铁证 由 十里洋场 于 September 30, 2010 09:50:56:
肖氏反射弧在美国clinic trial的结果发表在今年八月份的Journal of Urology (USA)杂志上。本人刚刚下载并粗略地浏览了一下。注意到几点，列举如下：
1。这篇文章共有11名作者，其中7位也是公开信中的签名者；
2。结论措词非常审慎，与公开信中对这项工作的高度赞扬似乎不太相应；
Purpose: ......
Material and Methods: ......
Results: ......
Conclusions: At 1 year a novel reflex arc with stimulation of the appropriate
dermatome was seen in the majority of subjects. Improvements in voiding and
bowel function were noted. Lower extremity weakness was mostly self-limited,
except in 1 subject with a persistent foot drop. More patients and longer followup
are needed to assess the risk/benefit ratio of this novel procedure.
注意：“was seen”，“were noted”等，还有最后一句：“More patients and longer followup are needed to assess the risk/benefit ratio of this novel procedure.”
3。很奇怪的是，这篇文章后面有一个EDITORIAL COMMENTS，不知为何争论双方无人提起，估计要么就没读，要么就是有意或无意地忽略了。
EDITORIAL COMMENTS
The authors present the first North American experience with lumbar to sacral nerve rerouting for patients with spina bifida. 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.
Although the authors did an excellent job of following the patients and characterizing their changes, the results are hard to validate without a control population going through the same rigorous surveillance regimen. In particular the improved bowel continence and minimal changes in bladder compliance may not be statistically significant. The fact that most patients were still on clean intermittent catheterization and none achieved complete urinary continence is troubling in light of the report of 87% success with 110 children with spina bifida presented by Xiao.［1］ One has to wonder if most of these children are not voiding volitionally or using the newly developed cutaneous reflex, and how
much reinnervation has a role in this surgery. Is it possible that unilateral denervation of the S3 ventral motor nerve produced improved compliance and continence, as previously reported in numerous clinical series?［2,3］
I congratulate the authors for taking on this challenge. I hope this study leads to a rebirth or refocus regarding neurosurgical treatments of neuropathic bowel and bladder. I strongly agree with the authors that this procedure should remain on a research protocol only.
Eric A. Kurzrock
Pediatric Urology
U. C. Davis Children’s Hospital
Sacramento, California
注：文中方括号中的数字是所引的文献，方括号是我加的（原文是上角标）
下面是这篇文章的有关信息：
Outcomes of Lumbar to Sacral Nerve Rerouting for Spina Bifida
Kenneth M. Peters, Benjamin Girdler, Cindy Turzewski, Gary Trock, Kevin Feber,
William Nantau, Brian Bush, Jose Gonzalez, Evan Kass, Juan de Benito and
Ananias Diokno
From the Ministrelli Program for Urology Research and Education (MPURE), and Department of Urology (KMP, BG, CT, KF, JG, EK, JdeB, AD), Department of Clinical Neurophysiology (WN, BB) and Department of Neurology (GT), William Beaumont Hospital, Royal Oak, Michigan
0022-5347/10/1842-0702/0 Vol. 184, 702-708, August 2010
THE JOURNAL OF UROLOGY® Printed in U.S.A.
© 2010 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION AND RESEARCH, INC. DOI:10.1016/j.juro.2010.03.058
所有英文部分都是copy/paste来的，没有个人的有意取舍。