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Medicalpractice版 - Dr.Xiao's procedure.
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相关话题的讨论汇总
话题: procedure话题: dr话题: xiao话题: md话题: he
进入Medicalpractice版参与讨论
1 (共1页)
A*******s
发帖数: 9638
1
Just saw a patient who is 20 yrs old. He has a spinal bifida but has to do
cath since age 16 after he had a surgery for a tethered spinal cord. He came
to see me for other medical problems. Since I saw his PMH, I mentioned Dr.
Xiao's procedure.
We watched the youtube togather and he got very excited. He is pretty
healthy otherwise.
C*****D
发帖数: 1299
2
He has to go to detroit or Denmark for the clinical trial.
Any other sites open for clinical trials?

do
came
Dr.

【在 A*******s 的大作中提到】
: Just saw a patient who is 20 yrs old. He has a spinal bifida but has to do
: cath since age 16 after he had a surgery for a tethered spinal cord. He came
: to see me for other medical problems. Since I saw his PMH, I mentioned Dr.
: Xiao's procedure.
: We watched the youtube togather and he got very excited. He is pretty
: healthy otherwise.

A*******s
发帖数: 9638
3
Don't know. I hope he sets a criteria for the procedure and carefully screen
the candidates. Why the clinical trial not done in China? Language
barrior could be a significant variant for the screening.

【在 C*****D 的大作中提到】
: He has to go to detroit or Denmark for the clinical trial.
: Any other sites open for clinical trials?
:
: do
: came
: Dr.

a********n
发帖数: 182
4
很为肖传国教授自豪啊。强化训练一下英语,回美国行医吧。
A*******s
发帖数: 9638
5
我一直纳闷, 当年肖有时间跟方舟子耗,为什么不考个board? 现在肯定做外科
attending,相信他的手术就可以更加科学化了, 还避免了牢狱之灾。

【在 a********n 的大作中提到】
: 很为肖传国教授自豪啊。强化训练一下英语,回美国行医吧。
c****l
发帖数: 1086
6
你相信如果真的像你说的这么聪明,这么有前途,他会傻到回
中国去干这个? 这不是明摆着这中间有猫腻,你们这些人为
啥宁可相信他是无辜的,而不是去相信更靠谱的解释,“肖就
是个骗子”。
对于医学,科学的评价,peer-review才是比较客观的,用
几个媒体的报道说明不了啥问题。
BTW,你给病人的建议,你还是谨慎为妙,要是哪天病人真做
了这个手术出了问题,你可是逃脱不了干系啊。


board? 现在肯定做外科
了牢狱之灾。

【在 A*******s 的大作中提到】
: 我一直纳闷, 当年肖有时间跟方舟子耗,为什么不考个board? 现在肯定做外科
: attending,相信他的手术就可以更加科学化了, 还避免了牢狱之灾。

A*******s
发帖数: 9638
7
我老是厦大毕业的。

【在 c****l 的大作中提到】
: 你相信如果真的像你说的这么聪明,这么有前途,他会傻到回
: 中国去干这个? 这不是明摆着这中间有猫腻,你们这些人为
: 啥宁可相信他是无辜的,而不是去相信更靠谱的解释,“肖就
: 是个骗子”。
: 对于医学,科学的评价,peer-review才是比较客观的,用
: 几个媒体的报道说明不了啥问题。
: BTW,你给病人的建议,你还是谨慎为妙,要是哪天病人真做
: 了这个手术出了问题,你可是逃脱不了干系啊。
:
: 】

c****l
发帖数: 1086
8
吓唬长大的?:)

【在 A*******s 的大作中提到】
: 我老是厦大毕业的。
S**********e
发帖数: 1325
9
lol

★ 发自iPhone App: ChineseWeb - 中文网站浏览器

【在 A*******s 的大作中提到】
: 我老是厦大毕业的。
C*****D
发帖数: 1299
10
有空能否学些基本知识再来胡乱指控。 方粉尽可上水版胡编。除了中国所谓专家和几
篇letter to editors, 从来没有peer revie w paper 说肖有问题。
肖和peters倒是分别发文,还写书。还有cme course。
再去上网看许多美国病人的评价,有许多spina bifida patient supporting groups
支持clinical trials。去那些美国人网站去看手术后病人怎么评价方粪spam他们网站。
许多方粪拿着这篇2009的综述,断章取义或英文太差,或别有用心。把一篇比较中性的
文章说成停用肖手术。
贴下文,是为the silenced majority,没有对方粪教育的义务。
Editor: Alan R. Cohen, MD Spring 2009
Xiao Procedure
Jeffrey P. Blount, MD, and Gerald Tuite, MD
At the conclusion of the recent First World Congress on Spina Bifida
Research and Care in Orlando, Fla., the Spina Bifida Association hosted a
two-day postgraduate course on the promising but controversial new surgical
procedure known as the lower urinary tract refunctionalization by somatic/
autonomic nerve root transposition. This procedure was pioneered by Chuan-
Guo Xiao, MD, from the Union Hospital of Tongji Medical College in China. Dr
. Xiao is a urologist who has dedicated the last two decades of his career
to the development of these techniques.
The procedure, commonly called the Xiao procedure, involves the surgical
transposition of functional lumbar ventral roots to sacral roots. Typically
the L5 ventral root is partially or completely divided and rerouted/
anastamosed to the S3 root or complex of sacral roots containing S3 and S4.
The rationale for the procedure centers on the spinal reflex-arc and on the
capability of somatic motor axons to regenerate into and replace
preganglionic axons. Clinically vigorous stimulation within the dermatome of
the transposed lumbar root initiates a spinal reflex that results in
bladder contraction. Experimental work done by Xiao and colleagues in the
late 1980s and early 1990s in rat, cat and dog models demonstrated
histological evidence of bladder reinnervation. Between 1995 and 2002, 86
patients with spinal cord injuries were treated, and the reported success
rate was 80 percent. The National Institutes of Health sponsored a trial for
40 spinal-cord-injured patients at New York University in 2003. An 80
percent response rate was reported. Between 2000 and 2003, 40 patients with
spina bifida were treated and an 85 percent effectiveness rate was observed.
Between 2003 and the time of the meeting presentation, approximately 1,300
children had undergone the Xiao procedure in China. Only 400 patients were
available for follow-up due to cultural and geographic issues, but Dr. Xiao
and his team observed an 87 percent rate of effectiveness.
As a result of these reported outcomes there has been great excitement among
spina bifida patients and their families about the procedure. Other
urologists and neurosurgeons throughout the world have become sufficiently
interested in learning the procedure, and Dr. Xiao has lectured and operated
extensively. The Orlando meeting was the first time that he taught the
surgical technique in a postgraduate course in North America. More than 75
attendees were present and were evenly divided between urologists and
neurosurgeons.
The Xiao procedure has been performed in the United States by a group from
William Beaumont Hospital in Royal Oak, Mich., led by urologist Ken Peters.
Dr. Peters traveled to China to learn the procedure and invited Dr. Xiao to
be present at the initial surgeries in Michigan. Financing was achieved
through philanthropic benefactors, and follow-up has been comprehensive and
essentially uniform. Dr. Peters also presented at the Orlando postgraduate
course. A total of nine patients were operated upon and their outcomes were
reviewed with up to a three-year follow-up. Dr. Peters reported that two
patients are no longer requiring catheterization and that seven of nine
patients have some measureable return of reflex. Bowel function improved
more quickly and more extensively than bladder function. Eight-to-nine
patients had bilateral leg weakness initially, yet their weakness improved
back to baseline such that only one patient has residual weakness. One
patient has foot drop.
In addition to the Beaumont group, several groups in North America have
learned the procedure and prepared a protocol for treatment. These include
groups in Tampa, Fla., led by Gerald Tuite, MD, and in Atlanta, Ga., led by
urologist Edwin Smith. Dr. Tuite also traveled to China to learn the
surgical technique directly from Dr. Xiao. Immediately before the meeting Dr
. Tuite invited Dr. Xiao to Tampa, and eight children were treated under the
direction of both surgeons. Dr. Tuite’s partners and Tae Sung Park, MD,
from Washington University/St. Louis Children’s Hospital also observed or
participated in the surgeries. The Atlanta group has approved a protocol and
has institutional review board approval, but it has not yet operated upon
any patients.
Extensive discussion and rigorous debate ensued and closed out the first day
of the postgraduate course. The second day was dedicated to discussions
regarding how best to initiate trials in the U.S. and elsewhere. The
Beaumont, Atlanta and Tampa groups all presented proposed protocols. The
Tampa protocol is unique in that it proposes performing the procedure only
in the context of detethering a tethered spinal cord. Significant debate
about protocols ensued. There was a strong consensus of opinion that the
procedure should only be done in the setting of a cooperative, properly
constructed (good design, sufficient power, etc.), organized multicenter
clinical trial. There was uniformity of opinion across disciplines that
children with spina bifida and society at large are poorly served when
multiple centers undertake small, independent studies, and that such studies
are counterproductive to proper assessment of the technique. The Beaumont,
Atlanta and Tampa groups all agreed to halt further surgery until a unified
neurosurgery/urology research design could be developed.
A task force headed by Jeffrey Blount, MD, and Dr. Tuite was formed that
will coordinate the development of an organized approach in neurosurgery.
There will be a meeting of all interested groups at the upcoming AANS Annual
Meeting to further these discussions and move forward with the development
of protocols. The meeting time and location will be forthcoming.
Jeffrey P. Blount, MD, University of Alabama at Birmingham, and Gerald Tuite
, MD, University of South Florida, Tampa.
©1998-2009; American Association of Neurological Surgeons / Congress

【在 c****l 的大作中提到】
: 你相信如果真的像你说的这么聪明,这么有前途,他会傻到回
: 中国去干这个? 这不是明摆着这中间有猫腻,你们这些人为
: 啥宁可相信他是无辜的,而不是去相信更靠谱的解释,“肖就
: 是个骗子”。
: 对于医学,科学的评价,peer-review才是比较客观的,用
: 几个媒体的报道说明不了啥问题。
: BTW,你给病人的建议,你还是谨慎为妙,要是哪天病人真做
: 了这个手术出了问题,你可是逃脱不了干系啊。
:
: 】

相关主题
[合集] 你有生以来做出的最佳临床诊断是什么? (转载)Case #2 Fever in Traveler
A recent case【Case discussion】 Vision loss
一个失败的CASE(Not a presenation)Don't jump, please
进入Medicalpractice版参与讨论
C*****D
发帖数: 1299
11
要讨论肖手术,请用美国数据和出版文章,中国的那些污七八糟非医学有关的请移到其
他版面探讨。
c********n
发帖数: 651
12
我能小声说下我们是校友么?

【在 A*******s 的大作中提到】
: 我老是厦大毕业的。
A*******s
发帖数: 9638
13
Nice read.
I wasted my time in 水版, 呵呵

站。

【在 C*****D 的大作中提到】
: 有空能否学些基本知识再来胡乱指控。 方粉尽可上水版胡编。除了中国所谓专家和几
: 篇letter to editors, 从来没有peer revie w paper 说肖有问题。
: 肖和peters倒是分别发文,还写书。还有cme course。
: 再去上网看许多美国病人的评价,有许多spina bifida patient supporting groups
: 支持clinical trials。去那些美国人网站去看手术后病人怎么评价方粪spam他们网站。
: 许多方粪拿着这篇2009的综述,断章取义或英文太差,或别有用心。把一篇比较中性的
: 文章说成停用肖手术。
: 贴下文,是为the silenced majority,没有对方粪教育的义务。
: Editor: Alan R. Cohen, MD Spring 2009
: Xiao Procedure

A*******s
发帖数: 9638
14
你也是被吓大的? lol

【在 c********n 的大作中提到】
: 我能小声说下我们是校友么?
h*******l
发帖数: 1542
15
智商曝露贴啊!

【在 A*******s 的大作中提到】
: 我老是厦大毕业的。
1 (共1页)
进入Medicalpractice版参与讨论
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话题: procedure话题: dr话题: xiao话题: md话题: he