【 Evan Kass, MD Chief of Pediatric Urology Beaumont Children's Hospital ( 博蒙特儿童医院泌尿外科主任 ) 在Science网站上肖传国被拘的消息 后两次留言,支持肖传国。下面是第一次留言的中译和原文。译者为星湖网友 】 【第一次留言】 我认识肖医生很多年了,在 我看来,他是一个好人,一个充满爱心的医生,天才 的外科专家,诚实的研究者。他的外科手术(反射弧手术)的科学基理首先是通 过动物实验研究得来的,其成果发表在专业学术期刊上。经过多年的研究,这个 成果才被用于人类。我们参与了一项前瞻性研究来评价这个手术,而且已经为这 项研究建立了一套切实可行的操作规则。肖医生从一开始就参与了这项操作规则 的建立,与我们进行了充分合作,并清楚该研究结果将被公布。他没有试图掩盖 他的任何研究结果或者任何相关信息。他被美国的医生和科学家们认作是一个值 得尊敬的同事。另一方面,方先生(方舟子)是一个曾经被揭发剽窃他人成果的 人,而肖医生就是那个揭发者。方先生因此不顾一切地寻求报复,利用各种机会 试图诋毁肖医生。这种攻击是令人难以想象和置信的。说肖医生这样的人会去雇 佣几个傻瓜去打方先生、不久回国去让人逮捕,这样的事是没有道理的。如果他 真的雇人做这种事,难道他不会知道这些人在他自阿根廷回国前就会被逮捕,而 避免回国吗?肖医生是个聪明的人,而制造这个袭击企图的人是某个傻瓜,不会 是肖医生。【张清翻译】 Evan Kass MD Chief of Pediatric Urology Beaumont Children's Hospital I have known Dr Xiao for years and in my opinion, he is a good man, a caring physician, gifted surgeon, and an honest investigator. The scientific basis for his surgical procedure was initially developed in the animal laboratory and the results published in peer reviewed journals. Only after years of research was it applied to humans. We have been involved in a prospective study to evaluate this procedure and have constructed a valid research protocol for this project. Dr Xiao, has been involved with the deveopment of the research protocol and has cooperated fully with us and understands that the results of this study will be published. He has not tried to hide any of his research results or any other information. He is considered by the physicians and scientists in the United States as a respected colleague. Mr Fang, on the other hand, is an individual who is reported to have published research that was not his, and was reportedly called on it by Dr Xiao. He has conducted himself as a man seeking revenge at all costs and has tried to discredit Dr Xiao at every turn. One has to wonder if these claims of assault are real or imaginary. It makes no sense for a man of Dr Xiao's stature to hire some fools to punch Mr Fang and then return to China sometime later to be arrested. If he had hired someone for this task, wouldn't he have known that they were arrested prior to his return to China from Argentina and avoided arrest?? Dr Xiao is a brilliant man, and this reported assault attempt seems to be the work of a fool, not Dr Xiao. I have known Dr Xiao for years and in my opinion, he is a good man, a caring physician, gifted surgeon, and an honest investigator. The scientific basis for his surgical procedure was initially developed in the animal laboratory and the results published in peer reviewed journals. Only after years of research was it applied to humans. We have been involved in a prospective study to evaluate this procedure and have constructed a valid research protocol for this project. Dr Xiao, has been involved with the deveopment of the research protocol and has cooperated fully with us and understands that the results of this study will be published. He has not tried to hide any of his research results or any other information. He is considered by the physicians and scientists in the United States as a respected colleague. Mr Fang, on the other hand, is an individual who is reported to have published research that was not his, and was reportedly called on it by Dr Xiao. He has conducted himself as a man seeking revenge at all costs and has tried to discredit Dr Xiao at every turn. One has to wonder if these claims of assault are real or imaginary. It makes no sense for a man of Dr Xiao's stature to hire some fools to punch Mr Fang and then return to China sometime later to be arrested. If he had hired someone for this task, wouldn't he have known that they were arrested prior to his return to China from Argentina and avoided arrest?? Dr Xiao is a brilliant man, and this reported assault attempt seems to be the work of a fool, not Dr Xiao. 2 天前, 22:43:49
【很多媒体,很多知名人士,一评论肖方事件,动辄把肖传国说成是骗子,柴静女士也有拿不出事实,才拿出锤子的高论。这些评论都是基于对方舟子的相信,基于他们质朴的正义感。只不过,他们无法想象,人可以无耻到什么地步。肖传国没有拿出事实吗?和鸣的信里有基本的陈述,亦明的文章也有精确的考证,肖传国自己,也早就拿出了事实。但是,这些事实在所谓追求真相的记者所撰写的文章那里,完全消失了。现在,肖传国暂时不能发言,就把 肖传国五月份答亦明问 ,转到这里。从科学网转到科学网,有点儿怪异。大家最好去看原帖,不仅因为原帖里有图。地址:http://www.sciencenet.cn/m/user_content.aspx?id=322885】 学者肖传国 发表于2010-5-11 19:24:32 查看评论 :10 │ 浏览:1864 打印 推荐给朋友 您的姓名: * 必填 您的邮件: 朋友邮件: * 必填 推荐理由: 未分类 左脚,还是右脚?鹿,还是马?这是个问题肖氏答问 【这是回答美国学者亦明有关肖氏反射弧手术的提问。文中介绍了科学新闻杂志、中国新闻周刊、南方周末等是如何污蔑诬陷,指鹿为马,蓄意造谣,误导大众和病人的】 请肖传国先生回答以下十个问题(注:您的答复有可能被全部或者部分公开): 一、我注意到您对外界很少使用治愈、治愈率这样的术语,但偶尔也会使用。比如,您在2005年发表的《肖传国:对病人总是应该负责的》中说: 关于治愈率。这类病人,10个能治疗好一个也是重要突破了-证明了人工反射弧的理论。 我很高兴是80%左右。但是,我这几年一直对20%左右因各种原因无效的病人深感愧疚:这些病人来开刀不容易,经济上更是一大打击。我一直在寻找新的治愈 途径。现已成功。我现在借此机会宣布一下:我们已有把握让所有(100%)脊髓损伤病人不再需要导尿管,不再需要造篓管,不再需要尿袋子,不会再有泌尿系 感染,不会再有肾积水,尿毒症。( http://www.rainbowplan.org/bbs/topic.php?topic=11197select=forum=1 )。 请问:您这里所说的治疗好、治愈率,其确切含义是什么? ANWSER TO Q 1: 这类情况一般不用治愈率,而是用有效率。这个帖子当时好像是回答网友的提问:治愈率是多少?对这类病人,所谓治疗好的标准是:不再需要导尿管,不 再需要造篓管,不再需要尿袋子,不会再有泌尿系感染,不会再有肾积水,尿毒症。同时不再有大便解不出或失禁。 二、神源医院出具的证明说, 术后随访8个月以上60例,85%的患者大小便已恢复正常,(http://www.xys.org/xys/netters/Fang- Zhouzi/blog/xiaochuanguo4.txt),您是如何理解这句话的?恢复正常的具体含义是什么? ANWSER to Q2: 这是一个被歪曲的证明:当时中国新闻周刊的蔡如鹏欺骗基金委叶鑫生给我和医学院科研处打电话,假冒国家自然基金委的名义采访,所以才接待他(我以前从不接 受采访),也毫无戒心,也的确没啥可戒备的,要啥给啥。其中有两份卫生部的鉴定资料是整合在院士申报的原始材料中,那天是周六没法复印,我念他老远来,就 同意他把那本原始申报资料带回北京复印后寄回来。神源的所谓证明也在原始资料中,其内容是正确的,但时间则有错,在4月30号正式交由大学直接送交科学院 的最后正式申报院士材料中早就通知神源医院纠正过来了。但这蔡如鹏把所有资料都交给了方舟子,他如获至宝,但一大本资料里,却也只能找到神源医院这个我们 已经发现并纠正了的小问题:-) 术后随访8个月以上60例,85%的患 者大小便已恢复正常:这句话的确不专业,正确的说法应该是术后随访8个月以上60例,85%的患者已能自主大小便(Voluntary voiding and defecation)。这些病人术前无一能自己解大便或小便,术后8月,80%以上基本能自己解,这就解决了主要问题,但这85%的病人中,肯定有部 分病人可能解不净,或偶有管不住,这都与再生的神经、膀胱、括约肌、大脑之间的协调需要更多时间有关。 三、您是怎么定义手术成功率的?假定手术前的患者等级为0,正常人的等级为10, 85%左右手术成功的患者,大致来说,一年后的平均等级为几? ANWSER TO Q3: 7-8级 四、根据我的理解,肖氏手术的意义不仅仅是使患者具有了自主控制大小便的能力,而且由于减轻了肾脏的负担(如减少了积水),还延长了患者的寿命。我的这个理解正确吗?如果是正确的,您是否有相应的数据来证明这一点? ANWSER TO Q4: 理解正确。你可从我在J.Urol的论文中查到这组数据。同时给你两个直观的证据:1)我可给你两个1995年在平顶山做肖氏手术的病人的电话:其中一个 病人当时已经是肾功能衰竭,依靠每天透析勉强保命,术后8个月,就能自己解小便,透析也不需要了,肾功能也恢复了。现在他手上的透析动静脉造瘘管仍在。当 时,平顶山医院2个病区的截瘫病人没做肖氏手术的现在早死光了。2)著名的小善善:小善善术前肾脏已是重度积水,肾功能受损,尿毒症。如果不做手术,挺不 过一年。 五、根据我的理解,患者在经过肖氏手术之后,必须要经过物理治疗或持续的锻炼才能够恢复腿部的力量。并且,恢复控制排泄的功能本身也需要一定的训练。请问,不论是神源,还是协和,有多少患者(百分比)在术后接受这样的治疗或者专业指导?术后训练包括在治疗合同之中吗? ANWSER TO Q5: 脊髓膨出的病人不需要,一般一年内均可自行恢复腿部肌肉力量到术前水平。至于排尿训练,对脊髓膨出病人不需要,但对截瘫病人非常需要。我们对所有病人都要求每6个月来免费尿动力学复查和训练。 六、请您说明一下,《南方周末》所说的那个广西孩子脚溃烂,现面临截肢的危险,与肖氏手术是否有关系?如果没有关系,怎么才能够证明? ANWSER TO Q 6: 与肖氏手术半点关系都没有。给你三个证明够不够?:-) 1,请你看看这个链接的所有内容,包括其中给出的美国权威医学教学网站,你就会知道为什么这种病人会有下肢溃疡甚至完全烂掉而与肖氏发射弧手术无关。 http://www.starlakeporch.net/bbs/read.php?1,57275,57287#msg-57287 . 【增补一个更直观的例子 http://blog.sina.com.cn/s/blog_4c5150170100ha9n.html 】 2, 你可以在网上搜索一下爬行女孩小艳丽, 这个13岁的女孩被驴友们在深山发现时,双腿严重溃烂,一条腿已完全烂掉,大小便失禁完全不能穿裤子。媒体报道后神源医院用肖氏手术解决了她的大小便问 题,同时为她装了假肢。我很详细的给南周那记者解释了为什么这类病人腿会有问题,他却蓄意用这照片。 3, 你再到新语丝看看这到处骂我的病人的告状信。 http://www.starlakeporch.net/bbs/read.php?1,53703,53706#msg-53706 还好,他在手术前已经双脚趾都烂掉了,只能爬。否则他一定会把双脚趾烂掉算在肖氏反射弧头上。 4, 再给你一个最简单的证明,最足以说明方舟子和南方周末记者的阴毒和无耻:你看看这照片是左脚还是右脚?:-)))))为了同时恢复膀胱排尿功能和直肠/乙 状结肠(在左边)的大便功能,肖氏反射弧手术基本只用左侧的神经(见我的论文),除非左腿完全烂掉了。显然,这个病人的左腿是好的:-)))) 【注:已经查实:共有4个广西病人(2个成人,2个小孩)在神源医院手术,均是用的左侧腿神经】 七、《北京科技报》的《调查神源医院》中,有下面这段话: 2006 年8月,善善妈妈带他在河南神源医院接受了肖氏反射弧手术。手术以后,善善觉得排尿时不痛了。但是医生要借助电刺激来辅助善善排尿。当时,有很多媒 体报道善善的手术,而一遇到媒体来采访,医生就会给善善喝很多水。医生嘱咐我,由于神经是刚接好的,善善像刚出生的婴儿一样,排尿时需要别人教。回到海 南后,善善总是在妈妈的指导下,尝试用力排尿。但即使让他坐得再久,他也不能排完。同年,小善善回到河南神源医院接受复查。当时,善善的情况仍然没有好 转。医院给我们的回复就是慢慢来。 如果上述所说属实,您仍旧认为小善善是成功的例子吗?如果上述所说有假,请指出。 ANWSER TO Q7: 小善善是一个非常成功的例子。这是一个完全没有医学知识,没有记者基本职业道德,但充满敌意和偏见的报道,一一指出实在太累,我把小善善的情况写一遍吧, 凡与我所写不符合的地方均为假的。2006年8月,小善善父母和海南几位记者带他在河南神源医院接受了肖氏反射弧手术。同时,由于重度肾积水,为了 阻止在神经再生完成前肾功能继续恶化,同时还做了膀胱造瘘手术。手术以后6月,善善能自己排尿了,排尿时也不痛了。术后8月来神源医院复查,医生通过尿 流动力学和神经电生理检查(通过刺激左脚皮肤即可引起排尿)证实新的神经反射弧已经建立,已能自主排尿,不再需要造瘘管保护肾脏,当即拔除造瘘管。当时, 有很多媒体来报道善善的手术,医生就让善善喝几杯可乐饮料,待膀胱有尿后自己拉尿给记者们看。医生嘱咐病人家长:神经已经长好啦,但善善得膀胱像刚出生 的婴儿一样,需要时间成熟,而且由于术前膀胱发炎太厉害导致膀胱疤痕挛缩容量小(100毫升),要看随年龄增长能否慢慢增大,回去要教善善锻炼憋尿。若 10岁后任然只能装100毫升尿就马上要解小便,则做个扩大膀胱的手术就行了。术前善善大便靠父母手抠,小便根本解不出,尿路总是发炎,严重肾积水,肾 功能受损,每周至少打针吃药消炎几天。现在大小便完全自解,泌尿系完全不再发炎,肾积水消失,肾功能正常。唯一一点是膀胱增大不明显,仍然只能装100毫 升左右尿,所以上课要戴纸尿裤,以免万一膀胱满了憋不住(就像奥运会开幕式迎宾女学生和国庆大阅兵的官兵都要穿纸尿裤一个道理。)我可以随时给善善作的膀 胱扩大手术解决上课要穿纸尿裤问题,但还想再等等看他能否自己发育增大而免除手术。 八、您为什么要依赖郑州大学建立神源医院,而不是在您自己工作的学校建立,或者在自己工作的医院推广肖氏手术? ANWSER TO Q 8:我所在的协和医院一直床位紧张,病人要排队等候很长时间。我们泌尿外科是全国重点学科,全国疑难病人都来求医,入院更难。泌尿外科多年只有46张床, 仅仅应付那些必须优先手术的肿瘤和急诊病人都不够,(去年增加到92张,仍然不够),而截瘫和脊髓膨出不是急诊,只能排队,当时有400多这种病人登记等 床。我也多次和医院商量,但根本不可能解决:增加床位设置要部里批准,而且每个专科都差床位,都重要。你不能说尿拉不出来比心脏病更要紧吧?在这种情况 下,郑州大学两位教授(一位是我的博士,一位是我的973分课题负责人)向我要求了近3年在郑州主办专科医院,最后,考虑到1)病人实在太多,而河南病人 更多,2)肖氏反射弧是从河南起步的,我理应感恩反哺,3)在国家医院收费太高且没法控制,想减免费用帮助一些穷人根本不可能,而在郑州他们答应有自主权 (后来的确为近百位穷人减免了费用),就最后同意了。另外,不存在不在自己的医院推广肖氏手术的问题:10多年从没停过,每周基本都有肖氏手术,但因床位 有限,主要只能照顾国外病人,特别疑难的病人以及关系病人。 九、方舟子说: 先天性脊柱裂脊膜膨出的患儿发生尿失禁后12%能恢复正常 , 脊髓膜膨出患者经常规治疗后其寿命与健康人无大区别 。这些话有科学根据吗?请解释(最好有文献为证)。 ANWSER TOQ9: 均纯属胡说八道。的确非常讽刺:一个对医学完全无知的网上流氓竟可以任意编造医学数据和结论达到诋毁我的目的,而我却必须用文献来应对其编造。好在你我都知道如何找文献,而且这类文献也实在太多。可惜99.9%的大众却不会。 Arch Dis Child. 1980 Nov;55(11):845-50. Survival and handicap of infants with spina bifida. Althouse R , Wald N . Abstract A follow-up study was carried out on 213 infants born with spina bifida cystica (including encephalocele and occipital meningocele) from 1965 to 1972 to women resident in Oxfordshire and the western part of Berkshire. The 5-year survival rate was 36% (39/107) for those with open lesions, 60% (30/50) for those with closed ones, and 18% (10/56) for those with lesions which could not be classified (not known) but which were probably nearly all open. The extent of handicap among these survivors was assessed by means of criteria described by Lorber; among those with open lesions (including 'not known') 84% (41/49) were severely handicapped, 10% (4/49) were moderately handicapped, and only 6% (3/49) had no handicap; among those with closed lesions, 37% (11/30) were severely handicapped, 33% (10/30) were moderately handicapped, and the remaining 30% (9/30) were not handicapped. Closed head lesions (encephalocele or occipital meningocele) were more often associated with severe handicap (6/8; 75%) than were closed spinal lesions (5/22; 23%). The children with open lesions who survived for at least 5 years spent, on average, at least 6 months in hospital during the first 5 years of their life and had, on average, at least 6 major surgical operations. In comparison, those with closed lesions spent one-third less time in hospital, and had fewer than half as many operations. During the period of the study a selective treatment policy was adopted typical of that commonly practised now, and all the infants were born before antenatal screening had been introduced. Our results therefore may be helpful in assessing the benefits to be expected from antenatal screening for open spina bifida. PMID: 7436454 PMCID: PMC1626957Free PMC Article 十、假设病人或者病人家属同意,并且不存在任何法律问题,您能够公布100成功的病例供大家查证吗? ANWSER TO Q10: 完全可以,甚至更多。总共有近1600病人作了肖氏手术,按有效率至少80%计算,成功的有1280人,无效的320人。在得到病人同意后,我曾给那南方 周末的记者武汉市、郑州市等愿意接受采访的30多个成功病例的联系方式,包括我在郑州神源医院做的唯一两个病人(小善善、黄XX)。他也的确做过采访,但 却故意造谣说假话,隐瞒真相 你要不要那几十个同意采访的病人名单和联 系方式?但要求是不能对社会公开:否则,全国无数病人都去电询问,这些病人就没法应付,没法过日子了。实际上大多数成功病人家属都不愿公开。我以前从不给 任何媒体病人信息,这次给南方周末以为它会是个比较客观的公器,可以通过他们的采访而代表所有人去查证,谁知道这姓柴的记者甘当方舟子帮凶公器私用,南方 周末自毁名声。污蔑我的确无所谓,但他误导病人,会耽误、害死无数病人及其家庭,实在是罪恶滔天。。 【注:应亦明要求并答应保守病人隐私,我今天已将给南方周末记者的Email(附有几十个病人联系方式)直接转发给亦明了】 谢谢您花费时间回答我的问题。
2009年的圣诞节是在印度孟买度过的。印度医学会准备了10个截瘫或先天脊柱裂病人,请我去教他们的泌尿外科医生和神经外科医生做肖氏反射弧手术。一周下来,几个印象最为深刻:1, 印度的社会、经济、环境等比我想象的差太远,比中国至少落后10-15年。2,印度的医学水平、医护水平却很高,在亚洲算一流。我们合作非常默契愉快。这与印度的医学院都属英联邦医学体系有关,教学和医院日常工作全部是英语。我在美国英国都认识许多优秀的印度裔医生,他们的英语和专业和美英的医学院毕业的医生比基本没有区别。 但是最有趣的一件事却是在孟买最后一天发生的。头5天每天2台手术,把我累得够呛。专程从美国来帮我做术中监护的神经电生理主任Bill也没空游玩。最后一天,东道主驱车陪我们游览孟买景点,由于交通太糟糕,几小时没法下车。后来我和BIll尿憋的不行,只好让主人在博物馆门口将我和Bill放下车去上厕所,约好15分钟再来接。 可是博物馆(West India Prince Wells Musium)守门的不让进去拉尿,说必须要买门票。我们急忙憋着尿跑到售票口一看票价:靠!印度人:10卢比,印度学生:5卢比,外国人:300卢比! 我还在气愤,Bill已经迫不及待的掏出600卢比买了两张票,拉着我就往里冲!谁都不看一眼那些袒胸露腹的女神而直奔厕所。完事之后,无限轻松,BIll开始骂这泡尿真贵!我哈哈大笑说买票时你可是跑的那快。BIll苦笑:3000一张也得买呀,这俩大教授总不能拉在大街上不是? 回美国后,Bill sent me a poem,以纪念孟买一泡尿: Hello Dr. Xiao It was really great to see you and work with you again. Each time is a real privilege for me. I'm sending a nice pic of you with the X-mass carol band at diner. Just remember. Dr Xiao to India to see How to help make children pee With heavy work load complete As a tourist loaded in back seat The view of Mumbai is complete Now full bladder requires relief Museum bathroom we can see Cost the good Doctor 300 Rupee Warm regards, Bill
NIH 年底批准了230万美元,由Beaumont医院(美国最大的私立医院之一))牵头,在美国几个主要医学院多中心推广研究肖氏反射弧(somatic-autonomic reflex arc)肖氏手术。NIH已决定由哈佛大学医学院建立DATA Base,收集处理多中心肖氏反射弧手术资料。 向NIH要求参加该计划的大学太多,在平衡协调上伤透脑筋。我当然希望多多益善,但经费有限。目前基本选定东海岸哥伦比亚大学医学院,哈佛大学医学院,华盛顿大学(WUSTL)/南佛罗里达大学, Emery大学医学院。有些大学已自筹经费开展肖氏手术,但仍要求加入该项目(for academic reputation and credit) 该项目的组织、申请、协调、很像国内的973计划项目,但不像973计划那样在经费预算上花费无穷无尽的精力和时间。 相关NIH链接 http://projectreporter.nih.gov/project_info_description.cfm?aid=7696321 Project Number: 1R01DK084034-01 Principal Investigator(s): PETERS, KENNETH M Title: SAFETY AND EFFICACY OF NERVE REROUTING FOR TREATING NEUROGENIC BLADDER IN SPINA B Awardee Organization: WILLIAM BEAUMONT HOSPITAL RESEARCH INST Abstract Text: DESCRIPTION (provided by applicant): Spina Bifida, a congenital defect of the spinal cord, causes nerve damage and a loss of sensation and muscle function below the waist resulting in bowel, bladder and sexual dysfunction. Patients cannot urinate or are constantly wet, and this continues throughout life causing major quality of life and health problems. Clean intermittent catheterization is usually needed to empty the bladder properly. Antimuscarinic medications are commonly required to alleviate high urinary tract pressures that can cause irreversible kidney damage, where dialysis or kidney transplant is the only way to sustain life. Dr. Xiao developed and is performing a novel procedure in China that connects a functioning, healthy lumbar spinal nerve root to the sacral nerve that controls the bladder. The end result is the creation of a new reflex where the bladder can be emptied by scratching or stimulating the skin supplied by that spinal nerve root. He has reported that in 92 SCI patients, 88% regained bladder control within one year after the nerve rerouting surgery and in 110 children with spina bifida, reported success in 87% at one year. However, in China rigorous follow up is challenging, therefore much is still unknown about the neurorecovery post surgery, complications and results occurring in the first year in particular, and the potential role that central nervous system remodeling may play in achieving successful outcomes. At Beaumont, a pilot study is underway on 9 spina bifida subjects, however no other center in the US is currently studying this technique. Our preliminary data are very promising, and with 9 subjects now 12 months post procedure, 7/9 subjects are voiding either voluntarily or by stimulating the new reflex mechanism. This project aims to expand upon our pilot experience to conduct a larger and more rigorous study to establish the safety and effectiveness of the proposed somatic-autonomic reflex pathway procedure in gaining bladder and bowel control in patients with spina bifida. Additionally, we will systemically evaluate and optimize frequency and location for excitation of the new somatic-autonomic reflex arc to a) gain more insight into the neurorecovery associated with nerve rerouting, and b) scientifically and systematically determine the ideal stimulation parameters to achieve best voiding results and make the somatic-autonomic reflex pathway rerouting most useful for the patients. Achieving the aims outlined in this proposal will help firmly establish the procedure as safe and effective, and revolutionize the treatment of bladder and bowel dysfunction in patients with spina bifida. PUBLIC HEALTH RELEVANCE: Spina Bifida, a congenital defect of the spinal cord, causes nerve damage resulting in bowel, bladder and sexual dysfunction. Dr. Xiao, in China, developed a new procedure to rewire the nerves affecting the bladder, and this project aims to scientifically establish the safety and effectiveness of the surgical procedure. Public Health Relevance Statement: Principal Investigator/Program Director (Last, First, Middle): Peters, Kenneth M. Project Narative: Spina Bifida, a congenital defect of the spinal cord, causes nerve damage resulting in bowel, bladder and sexual dysfunction. Dr. Xiao, in China, developed a new procedure to rewire the nerves affecting the bladder, and this project aims to scientifically establish the safety and effectiveness of the surgical procedure.