◇◇新语丝(www.xys.org)(xys.dxiong.com)(xys.3322.org)(xys.dyndns.info)◇◇   所谓“院士候选人肖传国的成果被国外权威教科书采纳”   中科院院士候选人肖传国教授简介声称:“在国际上首先提出并证实了“人 工体神经-内脏神经反射弧”理论。……并为国内外权威教科书采纳:《外科学》 第四、五、六版,《CAMPBELL'S UROLOGY》,8th Ed. 2002。” 其中《外科学》为肖传国的老师裘法祖主编,《CAMPBELL'S UROLOGY》又是 怎么回事呢?   niupi在《揭开院士候选人肖传国所谓“国际公认的肖氏反射弧原理”的神 秘面纱》文中指出:“肖氏提供的最得意的证据‘他的发明被写进了Campell Urology’。不错,在该书第26章由Alan Wein写的‘Neuromuscular dysfunction of the lower urinary tract and its management’中引用过他 在1999年在Journal Of Urology上的一篇用猫做实验的文章,Wein指出这是一个 有趣的实验。该章节共引用600多篇文献,是不是每一篇被引用的文章都被称为 ‘某某氏理论’呢?”   以下是该书与肖传国的研究有关的部分,在介绍了许多人的工作之后,有一 个小段简单介绍了肖和de Groat等人在1999年发表的一篇论文。也就是方舟子在 搜狐访谈中说的“其实这个什么‘肖氏反射弧’也是自吹自擂的,国际学术界没 有人这么说的,最多在某一篇综述文章里提了一下其工作,回国就自称是被国际 公认的‘肖氏反射弧’。”   Walsh Campbell’s Urology 8th edition 2002   Section 5: Voiding Function and Dysfunction   Chapter 26 Neuromuscular dysfunction of the lower urinary tract and its management (Allan Wein MD) pp 933 - 1026   Promotion or Initiation of Reflex Contractions (pp 999 – 1000)   In most types of SCI or disease characterized by detrusor hyperreflexia, manual stimulation of certain areas within sacral and lumbar dermatomes may sometimes provoke a reflex bladder contraction ([633] Wein and Barrett, 1988). Such “trigger voiding” is sometimes induced by pulling the skin or hair of the pubis, scrotum, or thigh; by squeezing the clitoris; or by digital rectal stimulation. According to the classic reference ([224] Glahn, 1974), the most effective method of initiating a reflex contraction is rhythmic suprapubic manual pressure (seven or eight pushes every 3 seconds). Such activity is thought to produce a summation effect on the tension receptors in the bladder wall, resulting in an afferent neural discharge that activates the bladder reflex arc. Ideally, the contractions thus produced will be sustained and of adequate magnitude. Patients potentially able to induce bladder contraction in such a way should be encouraged to find their own optimal “trigger points” and position for urination. To accomplish this, manual dexterity and either the ability to transfer to a commode or the ability to use an external collecting device are required. If this type of patient has significant sphincter dyssynergia, such maneuvers may have to be combined with measures to decrease outlet resistance. This form of inducing bladder contraction is occasionally possible and desirable in patients with supraspinal disease and involuntary bladder contractions. If induced emptying can be carried out frequently enough to keep bladder volume and pressure below the threshold for activation of the micturition reflex and below the level dangerous for upper tract deterioration, incontinence can be “controlled.” This actually amounts to a form of timed voiding.   Some clinicians still believe that the establishment of a rhythmic pattern of bladder filling and emptying by maintaining a copious fluid intake and by periodically clamping and unclamping an indwelling catheter or by CIC can “condition” or “train” the micturition reflex. Such regimens certainly are of benefit by focusing attention on the urinary tract and by ensuring an adequate fluid intake. It is also true that balanced lower urinary tract function can be achieved while a patient is on such a program ([445] Opitz, 1984; [395] Menon et al, 1992), but whether this is a cause-and-effect relationship is unknown and difficult to prove.   One fascinating set of experiments that relates to the concept of establishing or promoting a reflex pathway for micturition are those reported by [650] Xiao and de Groat (1999). These individuals created a skin to CNS to bladder reflex pathway in cats by intradural microanastomosis of the left L7 ventral root to the S1 ventral root, leaving the L7 dorsal root intact to conduct cutaneous afferent signals. A detrusor contraction was able to be initiated by scratching the skin or by percutaneous electrical stimulation in the L7 dermatome. This new reflex pathway could initiate voiding without striated sphincter dyssynergia. This reflex could be elicited after transecting the spinal cord at the L2–L3 or L7–S1 levels. The pathway is mediated by cholinergic transmission at both ganglionic and peripheral levels, as shown by cholinergic blockade experiments. Thus, in this experimental model, somatic motor axons can innervate parasympathetic bladder ganglion cells and thus transfer somatic reflex activity to the lower urinary tract. (XYS20051102) ◇◇新语丝(www.xys.org)(xys.dxiong.com)(xys.3322.org)(xys.dyndns.info)◇◇