Friday, October 22, 2010

OHRP Responds to Open Letter on Xiao's Procedure

Back in March, we sent an open letter on Xiao's Procedure, with supporting material, to several government offices and related hospitals. Of them, the Office of Research Integrity of Department of Health and Human Services, had previously responded to decline an investigation.

Today, an email arrived from a different office, the Office for Human Research Protections, indicating that they are taking actions on this issue:

From: Borror, Kristina C (HHS/OASH)
To: Eddie Cheng
CC: Menikoff, Jerry (HHS/OASH)
Subject: "Xiao Procedure"

Dear Mr. Cheng:

The Office for Human Research Protections (OHRP) has received your letter concerning research conducted at William Beaumont Hospital. I apologize for the delay in responding to you.

OHRP has responsibility for oversight of compliance with the U.S. Department of Health and Human Services (HHS) regulations for the protection of human research subjects (see 45 CFR Part 46 at http://www.dhhs.gov/ohrp/humansubjects/guidance/45cfr46.htm). In carrying out this responsibility, OHRP evaluates, at OHRP's discretion, substantive allegations of noncompliance involving human subject research projects conducted or supported by HHS or that are otherwise subject to the regulations (see OHRP memorandum dated October 14, 2009 at http://www.hhs.gov/ohrp/compliance/ohrpcomp.pdf for an explanation of OHRP's jurisdiction).

OHRP has initiated an evaluation of the matter referenced in your letter. We notified the funding agency of your allegations and they have stopped enrollment into the study. We will advise you when the evaluation has been completed.

OHRP appreciates your concern about the protection of human research subjects. Please do not hesitate to contact me at any time should you have any questions or wish to provide additional information.

Sincerely

Kristina C. Borror, Ph.D.
Director
Division of Compliance Oversight
Office for Human Research Protections
1101 Wooton Parkway, Suite 200
The Tower Building
Rockville, MD 20852

(Note: email address and phone number are also included in the above email. Although they are public records, they are omitted here to limit spam.)

Wednesday, October 20, 2010

Nature Editorial: A Hammer Blow to National Ethics

Nature joins the fray with an editorial of its own today:

A hammer blow to national ethics

Nature 467 , 884 (21 October 2010)
Published online 20 October 2010

China needs to act on broader science failures, not simply condemn an isolated case.

The trial of Chinese urologist Xiao Chuanguo for organizing beatings of two of his critics started on a Sunday. By Monday, the Beijing district judge had handed him a five-and-a-half- month sentence, and lesser or equal terms to other men involved. One of the victims, Fang Shimin, a self-styled science watchdog who investigates misconduct claims under the name Fang Zhouzi on his New Threads website, says the penalty is too light. But the judgment has already made Xiao persona non grata in China.

The attacks involved a hammer, steel rods and pepper spray (see Nature 467, 511; 2010). Xiao's supporters argue that the incident involving Fang Shimin followed a long-standing feud between the two men. The Chinese scientific establishment is right to condemn Xiao for his crime, but the authorities should not use this case to divert attention from wider failings in the research community.

The science ministry issued an online statement after the verdict, saying that Xiao “should be condemned for his vicious misconduct and lack of integrity”. The ministry wants nothing to do with Xiao, taking pains to disavow claims that he was chief scientist on a ministry-sponsored science project. The China Association for Science and Technology (CAST), the country's largest non-governmental organization of scientists and engineers, likewise welcomed the judgment. Meanwhile, the widespread and debilitating failures in China's scientific community go on largely uncontested, even though they have created fertile ground for this ugly episode.

Lack of monitoring and regulation in China means false CVs and scientific misconduct are rife there. The laxity can lead to a blurring of the lines between what is considered acceptable and unacceptable scientific behaviour, especially among young researchers. Channels of complaint about misconduct exist, but fear of identification and doubts over effectiveness drive many to launch unofficial, often anonymous attacks. Reasoned examination of facts and allegations gives way to vitriol and fear.

The impacts can be widespread. More than 250 patients in China are now threatening to sue hospitals, or Xiao directly, because they claim a surgical procedure he pioneered — which aims to restore bladder and bowel function in patients with spina bifida or spinal-cord injuries — doesn't work. The procedure has its critics, who say it should be considered experimental (K. M. Peters et al. J. Urol. 184, 702–708; 2010). But others back it, and last month 31 scientists (including 22 from the United States) posted a letter of support on the CareCure Community website, which is largely devoted to discussions of cutting-edge spinal therapies. The letter, signed by many who use Xiao's method, asks that his “scientific and humanitarian contributions to the world” are considered. With Xiao's conviction, will his technique get a fair trial?

Chinese government officials often promise to deal with scientific misconduct. This time they should do more than just punish hammer-wielding thugs and take steps to create a system that properly monitors fraud and plagiarism, checks reasonable allegations, prosecutes libellous ones and protects whistleblowers. The careers of scientists, the health of patients and the scientific future of the nation are at stake.

Tuesday, October 19, 2010

AP: Patients Protest Chinese Doctor's Risky Surgery

The following is an Associate Press report:

Patients protest Chinese doctor's risky surgery

By GILLIAN WONG, Associated Press Writer – Tue Oct 19, 5:53 am ET

BEIJING – At one moment, the Chinese urologist seemed to be at the height of his career: He had invented a surgical procedure to help patients overcome incontinence and was training doctors in America and elsewhere. The next, Dr. Xiao Chuanguo was in handcuffs, confessing that he'd hired thugs to attack two persistent critics who called him a fraud.

The scandal has shocked the public and prompted calls for better regulation of Chinese medical research. And while research fraud and misconduct is widespread in China, Xiao is no run-of-the-mill charlatan. More than 30 urologists from the United States, Canada, France, India and other countries issued a letter in support of the U.S.-trained surgeon after his arrest late last month.

In China, several former patients have complained about severe side effects, including a worsening of their mobility. The respected Southern Weekly newspaper said in an analysis that poor regulation led to Xiao "treating patients as if they were voluntary lab mice."

Last week, a Beijing court sentenced the 54-year-old doctor to five and a half months in detention for his role in the attacks. Xiao, in police custody, could not be reached for comment.

Some American doctors consider his technique experimental but promising, and two U.S. hospitals are carrying out trials on a small number of volunteers, mostly children. Others, though, are skeptical, particularly of his claims of an 85 percent success rate. The surgery is meant to help people who cannot control their bladders because of a paralyzing accident or a birth defect known as spina bifida.

"Most of the pediatric urologists in the United States were very cynical about his reports," said Dr. Eric Kurzrock, chief of pediatric urology at the UC Davis Children's Hospital in Sacramento, California. "Nobody ever believed there was an 85 percent success rate, you know, and when you looked at his reports they were very short on details."

In China, Xiao forged ahead with the surgery on hundreds of patients, according to media reports. Now, some are saying he exaggerated the chance of success and that the surgery left them worse off.

Whether or not he is guilty of fraud or an ethical lapse, his case highlights the unregulated nature of research in China, with few protections for patients.

"It's no secret that the Chinese medical space is the Wild West," said Cong Cao, a researcher at the State University of New York who has written two books on China's science and innovation.

One man, Fang Shimin, has emerged as an unofficial sheriff, unearthing examples of scientific fraud and posting them on his website.

He took on Xiao, and the two ended up in a long-running feud. Separately, investigative journalist Fang Xuanchang, no relation to the other Fang, also started writing critical pieces about Xiao.

The stakes are high for Xiao, who once told reporters his procedure should win him a Nobel Prize and has said that becoming a target of the two Fangs cost him a seat in the prestigious Chinese Academy of Sciences.

In June, two men attacked the journalist Fang with metal pipes, leaving a deep gash on his head. Two months later, the other Fang was attacked with a chemical spray and a hammer, escaping with minor injuries.

Police arrested Xiao after he returned from training doctors in Argentina. In a videotaped interrogation, the doctor said he paid a distant relative 100,000 yuan ($15,000) to hire two men "just to give them black eyes and swollen faces ... but not to do any permanent damage.

"Nothing else would solve the problem except beating him up," he said, referring to Fang Shimin, the muckraker.

Half a dozen patients and family members protested outside his trial, saying they represented 200 patients who were duped by Xiao into thinking the 30,000 yuan ($4,500) procedure had an 85 percent success rate.

"We need an explanation. We need justice," said Qu Binbin, a 29-year-old man in a wheelchair who said he was able to get around without crutches before having the surgery three years ago.

Supporters of the doctor also showed up. Guo Yuling, a 19-year-old college student, said he constantly wet his pants for the first 13 years of his life before Xiao's surgery.

Two former patients are suing Xiao for false advertisement, and more lawsuits are planned, said Peng Jian, a human rights lawyer who said he has documented 150 cases in which the surgery had no benefit or left patients worse off.

So far, the scandal has not derailed plans to continue studies in the U.S.

Researchers at William Beaumont Hospital in Royal Oak, Michigan, reported mixed results — and some side effects — from a pilot study of nine spina bifida patients.

By early next year, they plan to begin a 5-year clinical trial funded by $2.3 million from the National Institutes of Health.

Dr. Kenneth Peters, the hospital's head of urology, said he ensures that patients are fully aware the surgery is experimental and carries serious risks.

"Dr. Xiao has been nothing but in our experience an incredible gentleman, scientist and a very good colleague," said Peters, one of those who signed the letter in Xiao's support.

A separate 3-year study on eight children is under way at All Children's Hospital in St. Petersburg, Florida.

___
Associated Press researcher Xi Yue contributed to this report.

Thursday, October 14, 2010

Fang Zhouzi's Wife: Living Indignantly

The following is a translation of an essay written by Fang Zhouzi's wife, expressing her anger and frustration on how the Xiao Chuanguo case was handled. Fang Zhouzi posted the original in Chinese here.

Living Indignantly
by Fang Zhouzi's wife

Today I plan to take an act of rebellion forced by high officials.

I am a very good citizen. I live a normal life. In the subway, I offer my seat to those who are old, preganant, or very young. I am optimistic, always hoping for and pursuing a beautiful future. I live cleanly myself, and think about charity whenever I am able. I have never caused any trouble to society, never wanted to harm anyone. I am one of those who form the foundation of social stability, I am one of those for whom the ruling class is most at ease, never a need to worry or concern about.

However, Xiao Chuanguo spent 100,000 RMB to purchase an attack [on my family] -- considering that the perpetrators lived in a hotel across the street from my family for months and spent all day doing nothing but sitting on a stone bench or sidewalk in front of our building waiting for Fang Zhouzi, that was an expensive undertaking. Unless they are volunteers, this 100,000 sum is most likely only a down payment -- and planned [the attack] for half a year. When they took the action, Fang Zhouzi was lucky enough to be able to run away without serious harm only because of his quick reflexes, a result that led to the conspirator to claim as "impossible" on the Internet. Yet this very conspirator was only sentenced to 5.5 month of detention. This dramatic event became the last straw for me to live a silly and indignant life in this society.

I no longer want to use words like crazy, absurd, or emptiness. This rotten society does not deserve such emotion from me. I want to say it's buffoonery, for the ordinary people are slipping around in a giant, black and messy sauce jar, and splash, they are tripped and fell, and immediately submerged into the bottom. There is only a sound and everything will appear the same normal again. Life goes on. Only that too many people had drawned this way, the stench is unbearable.

"Social phenomena" much worse than this case of attacking Fang Zhouzi are happening every day. In the past, I have always hoped and believed that their exposure will lead to change. A net-friend had described me as "a woman desperately struggling in a sauce jar while her husband is making a great effort to smash it." Because of its symbolic importance, the attack has become national and even international news. But in the end, it is still able to be massaged and smoked into such a ball of mess without any true color. I congratulate the Political and Legal Committee of the city of Beijing.

You have successfully threatened a chivalrous fighter, encouraged criminals, and made obedient people desperate. You did a marvelous job.

Ever since that day of September 21, when Xiao Chuanguo was captured, a strong and mysterious power started to assert its force -- if this power had known it was Xiao Chuanguo's deed ahead of time, he would never have been arrested. So here I want to sincerely express my respect and gratitude to the Beijing police. Given the will and resource, you are able to recover all truth.

Guided by that mysterious power, in the short span of a dozen or so days, the investigation and questioning screeched to a halt. The case was sent to the prosecutors with a baffling charge. The prosecutors did not even take a break during the National Day holiday and forwarded it to the court with high efficiency. The court announced its verdict with lightning speed, without the presence of any "irrelvant" media. Xiao Chuanguo coorperated accordingly. Report shows that Xiao Chuanguo, who had been acting up "like a professional lawyer in questioning witnesses in court," behaved much unlike himself in the beginning, claiming that he did not understand the "causing disturbance" charge but if the court designates this charge to him, he would have no objections. Perhaps because all this had been planned too carefully and executed too smoothly, it actually led to a close call among themselves. When the defendant's side realized that the victim's side is helpless with the cover provided by the court, they wanted to enter a not-guilty plea instead. This sudden change must have not been planned ahead of time. At noon, the hungry judge had no choice but announced that he had to change the simplified proceeding back into a normal procedure. He announced an adjournment, the verdict would have to wait for another day.

The mysterious power realized that they could not afford to wait any longer and quickly took action to guide the events back into a preset track. So, the court was back to action in the same afternoon.

The defendants were then no longer making any troubles and an "intelligent" verdict was reached on time -- never mind that the victims' lawyer was not even present. Xiao Chuanguo said he would appeal. Yes, please continue your act, please continue to act diligently. The whole nation is watching with taste and excitement. They know what's at stake now. When the ruling class embraces sin, deception, and lies, the powerless has no choice but lowering their heads and accepting exploitation, cheating, and insults.

I can no longer trust the laws and courts of my motherland. I can not imagine what would be the result of the petition by more than a hundred victims of the surgical operation called "Xiao's Procedure". I can no longer believe that the Ministry of Science and Technology, Ministry of Education, Ministry of Health, or any other "relevant" power institutes could take their responsibilities. They always pretend to see nothing and hear nothing. Reports say that "the Minsitry of Health may publish its opinion on Xiao Chuanguo within a week." Is it so difficult to say that we need to launch an investigation on the "Xiao's Procedure"?

On the day after the verdict, an abusive and threatening message showed up on my cell phone. I couldn't help but laugh. Look how desperate you guys were, did you want the Beijing Policial and Legal Committee to take another action and arrest the entire family of Fang Zhouzi and kill them? Would that help to ease the hatred of Xiao Chuanguo and the like?

My little baby often makes up stories with me. Lately she has been naming her hero "Little Tear Drop". She also calls her most faviorate toy Little Tear Drop... Why are there so many tear drops in your little heart? I recall the confession from one of the attackers. He had followed Fang Zhouzi all the way as he was carrying our baby to supermarket. I tremble with fear. I have also been unknowingly taken pictures by the spies hired by Xiao Chuanguo. I have not seen those pictures myself. They were most likely taken around my neighborhood. For a Mom who dedicated all her spare time to her baby, the pictures must have been clandestinely taken when I was playing with her. I had even smiled at Xu Lichun, one of the would-be attackers. He was sitting on a stone bench with a funny expression and stared at me. I thought he was a relative of one of my neighbors. Then I turned away to chase my baby. She was calling for me.

China could not tolerate Fang Zhouzi. I open my eyes waiting for the time when the burning lava could break through the ground. There is no need for Fang Zhouzi to change himself. Let the time distill his sincerity and his value.

So, Ah Min, shall we run away?

Sunday, October 10, 2010

Xiao Chuanguo Sentenced to Five and Half Month Detention

In an unusual move, a local court in Beijing took on the case of attacks on Fang Zhouzi and Fang Xuanchang on a Sunday. The proceedings was supposed to be open but few were able to obtain tickets. Fang Zhouzi did not attend it himself. His lawyer Peng Jian represented him. Fang Xuanchang was present.

Previously, the prosecutor of this case had adopted a lower charge against the accused, citing them only for "causing disturbance" (寻衅滋事). The court then used a "simplified procedure" (简易程序) to reach a speedy verdict without a jury.

In court, Xiao Chuanguo did not contest the prosecutor's charge of beating other people and causing disturbance. He said that he did not quite understand the term but "if the court thinks what I did fit this crime, I have no objections." But he denied that he had offered money to his relative Dai Jianxiang for the attacks, while Dai Jianxiang, a co-defendant in the case, insisted as true.

The court spent almost 5 hours cross-examining the evidences and then announced to take a break. However, after Fang Xuanchang, Peng Jian, and others had left the building, the court suddenly issued a callback and announced its decision.

The court found Xiao Chuanguo and his co-defendants guilty and sentenced Xiao Chuanguo and Dai Jianxiang for 5.5 month of detention (拘役), a lessor punishment than normal jail terms. Other co-defendants who participated in the attacks receives detention terms of 4, 3, and 1.5 months.

Even before the trial, Fang Zhouzi and Fang Xuanchang had already voiced their objection of the lessor charges. They believe the accused should be trialled for attempted murder. After the sentencing, Fang Zhouzi expressed his shock, claiming that the decision was even below his already lowered expectations.

Xiao Chuanguo indicated that he might appeal. Fang Zhouzi and Fang Xuanchang are also seeking other possible legal procedures.

Wednesday, October 6, 2010

NYT: Rampant Fraud Threat to China's Brisk Ascent

Today, New York Times pays attention to China's credibility problems and Fang Zhuozi's efforts in exposing them:

Rampant Fraud Threat to China's Brisk Ascent
Andrew Jacobs

BEIJING — No one disputes Zhang Wuben’s talents as a salesman. Through television shows, DVDs and a best-selling book, he convinced millions of people that raw eggplant and immense quantities of mung beans could cure lupus, diabetes, depression and cancer.

For $450, seriously ill patients could buy a 10-minute consultation and a prescription — except Mr. Zhang, one of the most popular practitioners of traditional Chinese medicine, was booked through 2012.

But when the price of mung beans skyrocketed this spring, Chinese journalists began digging deeper. They learned that contrary to his claims, Mr. Zhang, 47, was not from a long line of doctors (his father was a weaver). Nor did he earn a degree from Beijing Medical University (his only formal education, it turned out, was the brief correspondence course he took after losing his job at a textile mill).

The exposure of Mr. Zheng’s faked credentials provoked a fresh round of hand-wringing over what many scholars and Chinese complain are the dishonest practices that permeate society, including students who cheat on college entrance exams, scholars who promote fake or unoriginal research, and dairy companies that sell poisoned milk to infants.

The most recent string of revelations has been bracing. After a plane crash in August killed 42 people in northeast China, officials discovered that 100 pilots who worked for the airline’s parent company had falsified their flying histories. Then there was the padded resume of Tang Jun, the millionaire former head of Microsoft China and something of a national hero, who falsely claimed to have received a doctorate from the California Institute of Technology.

Few countries are immune to high profile frauds. Illegal doping in sports and malfeasance on Wall Street are running scandals in the United States. But in China, fakery in one area in particular — education and scientific research — is pervasive enough that many here worry it could make it harder for the country to climb the next rung on the economic ladder.

A Lack of Integrity

China devotes significant resources to building a world-class education system and pioneering research in competitive industries and sciences, and has had notable successes in network computing, clean energy, and military technology. But a lack of integrity among researchers is hindering China’s potential and harming collaboration between Chinese scholars and their international counterparts, scholars in China and abroad say.

“If we don’t change our ways, we will be excluded from the global academic community,” said Zhang Ming, a professor of International Relations at Renmin University in Beijing. “We need to focus on seeking truth, not serving the agenda of some bureaucrat or satisfying the desire for personal profit.”

Pressure on scholars by administrators of state-run universities to earn journal citations — a measure of innovation — has produced a deluge of plagiarized or fabricated research. Last December, a British journal that specializes in crystal formations announced that it was withdrawing more than 70 papers by Chinese authors whose research was of questionable originality or rigor.

In an editorial published earlier this year, The Lancet, the British medical journal, warned that faked or plagiarized research posed a threat to President Hu Jintao’s vow to make China a “research superpower” by 2020.

“Clearly, China’s government needs to take this episode as a cue to reinvigorate standards for teaching research ethics and for the conduct of the research itself,” the editorial said. Last month a collection of scientific journals published by Zhejiang University in Hangzhou reignited the firestorm by publicizing results from a 20-month experiment with software that detects plagiarism. The software, called CrossCheck, rejected nearly a third of all submissions on suspicion that the content was pirated from previously published research. In some cases, more than 80 percent of a paper’s content was deemed unoriginal.

The journals’ editor, Zhang Yuehong, emphasized that not all the flawed papers originated in China, although she declined to reveal the breakdown of submissions. “Some were from South Korea, India and Iran,” she said.

The journals, which specialize in medicine, physics, engineering and computer science, were the first in China to use the software. For the moment they are the only ones to do so, Ms. Zhang said.

Plagiarism and Fakery

Her findings are not surprising if one considers the results of a recent government study in which a third of the 6,000 scientists at six of the nation’s top institutions admitted they had engaged in plagiarism or the outright fabrication of research data. In another study of 32,000 scientists last summer by the China Association for Science and Technology, over 55 percent said they knew someone guilty of academic fraud.

Fang Shimin, a muckraking writer who has become a well-known advocate for academic integrity, said the problem started with the state-run university system, where politically appointed bureaucrats have little expertise in the fields they oversee. Because competition for grants, housing perks and career advancement is so intense, officials base their decisions on the number of papers published.

“Even fake papers count because nobody actually reads them,” said Mr. Fang, who is more widely known by his pen name, Fang Zhouzi, and whose Web site, New Threads, has exposed more than 900 instances of fakery, some involving university presidents and nationally lionized researchers.

When plagiarism is exposed, colleagues and school leaders often close ranks around the accused. Mr. Fang said this was partly because preserving relationships trumped protecting the reputation of the institution. But the other reason, he said, is more sobering: few academics are clean enough to point a finger at others. The result is that plagiarizers often go unpunished, which only encourages more of it, said Zeng Guoping, director of the Institute of Science Technology and Society at Tsinghua University in Beijing, which helped run the survey of 6,000 academics.

He cited the case of Chen Jin, a computer scientist who was once celebrated for having invented a sophisticated microprocessor but who, it turned out, had taken a chip made by Motorola, scratched out its name, and claimed it as his own. Showered with government largesse and accolades, the exposure in 2006 was an embarrassment for the scientific establishment that backed him.

But even though Mr. Chen lost his university post, he was never prosecuted. “When people see the accused still driving their flashy cars, it sends the wrong message,” Mr. Zeng said.

The problem is not confined to the realm of science. In fact many educators say the culture of cheating takes root in high school, where the competition for slots in the country’s best colleges is unrelenting and high marks on standardized tests are the most important criterion for admission. Ghost-written essays and test questions can be bought. So, too, can a “hired gun” test taker who will assume the student’s identity for the grueling two-day college entrance exam.

Then there are the gadgets — wristwatches and pens embedded with tiny cameras — that transmit signals to collaborators on the outside who then relay back the correct answers. Even if such products are illegal, students spent $150 million last year on Internet essays and high-tech subterfuge, a five-fold increase over 2007, according to a Wuhan University study, which identified 800 Web sites offering such illicit services.

Academic deceit is not limited to high school students. In July, Centenary College, a New Jersey institution with satellite branches in China and Taiwan, shuttered its business schools in Shanghai, Beijing and Taipei after finding rampant cheating among students. Although school administrators declined to discuss the nature of the misconduct, it was serious enough to withhold degrees from each of the programs’ 400 students. Given a chance to receive their M.B.A.’s by taking another exam, all but two declined, school officials said.

Nonchalant Cheating

Ask any Chinese student about academic skullduggery and the response is startlingly nonchalant. Lu Xiaoda, an engineering student who last spring graduated from Tsinghua University, considered a plum of the country’s college system, said it was common for students to swap test answers or plagiarize essays from one another. “Perhaps it’s a cultural difference but there is nothing bad or embarrassing about it,” said Mr. Lu, who this semester started on a master’s degree at Stanford University. “It’s not that students can’t do the work. They just see it as a way of saving time.”

The Chinese government has vowed to address the problem. Editorials in the state-run press frequently condemn plagiarism and last month, Liu Dongdong, a powerful Politburo member who oversees Chinese publications, vowed to close some of the 5,000 academic journals whose sole existence, many scholars say, is to provide an outlet for doctoral students and professors eager to inflate their publishing credentials.

Fang Shimin and another crusading journalist, Fang Xuanchang, have heard the vows and threats before. In 2004 and again in 2006, the Ministry of Education announced antifraud campaigns but the two bodies they established to tackle the problem have yet to mete out any punishments.

In recent years, both journalists have taken on Xiao Chuanguo, a urologist who invented a surgical procedure aimed at restoring bladder function in children with spina bifida, a congenital deformation of the spinal column that can lead to incontinence, and when untreated, kidney failure and death.

In a series of investigative articles and blog postings, the two men uncovered discrepancies in Dr. Xiao’s Web site, including claims that he had published 26 articles in English-language journals (they could only find four) and that he had won an achievement award from the American Urological Association (the award was for an essay he wrote).

But even more troubling, they said, were assertions that his surgery had an 85 percent success rate. Of more than 100 patients interviewed, they said none reported having been cured of incontinence, with nearly 40 percent saying their health had worsened after the procedure, which involved rerouting a leg nerve to the bladder. Wherever the truth may have been, Dr. Xiao was incensed. He filed a string of libel suits against Fang Shimin and told anyone who would listen that revenge would be his.

This summer both men were brutally attacked on the street in Beijing — Fang Xuanchang by thugs with an iron bar and Fang Shimin by two men wielding pepper spray and a hammer.

When the police arrested Dr. Xiao on Sept. 21, he quickly confessed to hiring the men to carry out the attack, according to the police report. His reason, he said, was vengeance for the revelations he blames for blocking his appointment to the prestigious Chinese Academy of Social Sciences.

Despite his confession, Dr. Xiao’s employer, Huazhong University of Science and Technology, appeared unwilling to take any action against him. In the statement they released, administrators said they were shocked by news of his arrest but said they would await the outcome of judicial procedures before severing their ties to him.