Beaumont Hospital's Result of Xiao Procedure Questioned in Journal of Urology

The Beaumont Hospital in Michigan is one of the first American institutes that took up clinical trials of the controversial Xiao Procedure. We have previously reported on their misleading propaganda. More recently, the hospital has also become the first institute to publish clinical results of Xiao Procedure in an established scientific journal. Dr. Ken Peters and his coauthors wrote in Journal of Urology of their results:

At 1 year 7 patients (78%) had a reproducible increase in bladder pressure with stimulation of the dermatome. Two patients were able to stop catheterization and all safely stopped antimuscarinics. No patient achieved complete urinary continence. The majority of subjects reported improved bowel function. One patient was continent of stool at baseline and 4 were continent at 1 year. Of the patients 89% had variable weakness of lower extremity muscle group at 1 month. One child had persistent foot drop and the remainder returned to baseline by 12 months.

In their conclusion, they noted that "more patients and longer followup are needed to assess the risk/benefit ratio of this novel procedure."

The Journal, however, appears to be less than impressed. It published two pieces of editorial comments to accompany the paper, both are quite negative. In one, Dr. Eric Kurzrock of UC Davis Children's Hospital wrote:

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. 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. 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?

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.

In another, Dr. John Park of University of Michigan was even more blunt:

One of the most curious findings is the discrepancy between urodynamic data and subjective voiding. One patient exhibited a decrease in capacity and an absence of reflex arc, and yet he subjectively reported improved bladder and bowel function! I could not help but speculate that his voiding after the procedure could simply be the bladder emptying via intra-abdominal pressure generation against an open bladder neck, given his preoperative stress incontinence. Xiao reported that more than 87% of 110 patients gained sensation and continence within 1 year (reference 7 in article). In comparison, the current patients undergoing the identical procedure with the help of Xiao himself only showed a modest improvement in objective urodynamic studies and subjective reporting. Unless the innovators provide a sound argument and data for the validity of the procedure, there is a great danger of its improper and rapid adaptation by patients and the medical community at large.

USA Today: Plagiarism Shuts Down US School in China

USA Today reported today that a "plagiarism epidemic" has forced Centenary College to discontinue an MBA program in China. According to the paper:

"The college is extremely concerned with the welfare of the Chinese students involved in the program, but must note that its review revealed evidence of widespread plagiarism among other issues, at a level that ordinarily would have resulted in students' immediate dismissal from the college," Debra Albanese, Centenary's vice president for strategic advancement, said in a statement. "Despite that, in an effort to afford students every fair possibility, the college has opted to attempt to reach an amicable solution, in lieu of any such dismissal. The students were offered a choice to receive a tuition refund in exchange for a standard release in higher education or take a comprehensive exam in order to earn a degree."

It went on to say that all but two of about 400 students have accepted a refund.

A "Success" that Could be Easily Replicated

Followers of this blog are well aware that Fang Zhouzi has been a lonely crusader in exposing scientific fraud and misconduct for over a decade. Although there had been a few cases that gained wide publicity, much of his efforts remain unknown to the general public. It is therefore somewhat ironic that it was when he occasionally wandered out of the ivory tower settings that he achieved an usually fame.

It all started with an innocent comment on the Chinese-version of twitters. When answering a question from a follower, Fang Zhouzi casually mentioned that he had been aware that the diplomatic credentials of a famous individual are most likely faked. All of a sudden, the Chinese twitter world exploded and the "news" flooded into traditional news media. In a matter of days, it became the top news in China.

The famous individual in question is Tang Jun (唐骏), a purported self-motivator who had achieved huge success in business world through his own unrelenting efforts. Tang Jun boasts an enviable resume, including the chief executive in China for Microsoft and several successful startups. Several books about his story, including a couple of his autobiography, are best sellers and he is a well-sort motivational speaker in universities and colleges. Indeed, Tang Jun is an idol for China's youth. One of his autobiographies is titled as My Success Can Be Replicated.

In various versions of his books and speeches, Tang Jun describes his experience as having earned a bachelor degree in China, a master in Japan, and a Ph.D. in USA, all while producing several inventions and starting up a few companies.

It was that Ph.D. degree in USA that caught Fang Zhouzi's eyes first. More than a year ago, in fact, Fang Zhouzi had already pointed out that Tang Jun's story could not be consistent with facts. In his online resume, Tang Jun claimed that he left Japan to pursue research in the famed California Institute of Technology (Cal Tech) and then "earned a Ph.D. degree." Fang Zhouzi searched the Cal Tech database and could not find any record of Tang Jun, either as a degree recipient or an author of any published research work. Fang Zhouzi concluded that Tang Jun had lied about his degree.

After the Chinese twitter storm, Tang Jun went through several phases in his defense. He first accused Fang Zhouzi as having ulterior motives and unworthy of responding. Then he claimed that he has been misquoted in his own autobiography and that he had never implied that his Ph.D. was from Cal Tech. Finally, as most who had been exposed by Fang Zhouzi, Tang Jun threatened to sue in courts.

The story quickly takes another turn. After "clarifying" that his degree was not from CalTech, Tang Jun produced a certificate indicating that he indeed has a Ph.D. degree and it was from Pacific Western University in California.

Pacific Western University, Fang Zhouzi quickly pointed out, is a well-known "diploma mill" in the US that has been the target of various governmental and consumer complains. Such a degree certificate could be readily obtained for a fee of over $2,000 USD. Furthermore, Fang Zhouzi and his supporters provided evidence that Tang Jun's claim on his inventions and other achievements are likely to be baseless. "80% of his autobiography could be made-up," Fang Zhouzi told a newspaper.

Tang Jun insists that his degree is genuine. But he has since toned down his public defense and threats. Meanwhile, the story continues to spread, with more and more Pacific Western University degree holders are discovered, some of them occupy prominent positions in business as well as academic worlds in China. There appears to be already a flurry of activities in revising online resumes and pages to remove such degrees, while others argue that their PWU degree was earned through studying programs.

The media circus caught Fang Zhouzi himself by surprise. He hopes that he could soon return to his beloved work of writing scientific essays and paying attention more in academia rather than business world.

Foreign Policy: Who Tried to Kill Fang Xuanchang?

The following is a dispatch by Foreign Policy on July 6, 2010:

Who Tried to Kill Fang Xuanchang?
A chilling attack on a controversial science journalist in Beijing bodes poorly for scientific progress.

BY SAM GEALL | JULY 6, 2010

On the evening of June 24, Fang Xuanchang, a 37-year-old science and technology editor at China's Caijing magazine, finished work around 10 p.m. and began his walk home. Half an hour later he was nearing his apartment by Beijing's third ring road when he felt a sudden blow to his back. Fang turned to see two large men behind him brandishing steel bars.

Fang tried to run away and then shield himself as the men, ignoring his attempts to communicate with them, struck him repeatedly across his back and head. Brawny and adept in martial arts, Fang not only remained conscious, but also managed to fight back. Finally, as Fang stumbled toward a taxi, his clothes soaked in blood, the attackers left the scene.

Later that night at Beijing's Navy General Hospital, doctors sutured a 2-inch gash on the back of his head. His assailants behaved like professionals, carrying out the brutal ambush in about four minutes and showing little concern about passersby witnessing the attack. "Their goal was clear," Fang told me in a June 30 email. "It was to kill me on the spot, or stop me from reaching the hospital in time so that I would bleed to death."

Why would someone try to kill Fang Xuanchang? No one knows, or even seems to care. The attackers remain at large, despite an ongoing police investigation and Caijing's best efforts to cooperate with the police and involve the All-China Journalists Association. The attack was covered in brief in Beijing-based newspapers, including a brief editorial in a state-run newspaper arguing that journalists shouldn't be attacked. But no one in the Chinese media has gotten into the question of who would attack Fang -- and more importantly, why exactly Fang might have been attacked.

For Fang's colleagues, however, the message is clear: Reporting on controversial topics, as Fang has done, is unsafe. Journalists who are abused don't necessarily find out who has attacked them or why, but the message sent to their friends and colleagues is clear: Don't go there, or you could be next. It has a chilling effect on a wide circle of people. In the case of science journalism, the financial and political stakes are increasingly high, and the personal risks might be increasingly high as well.

Fang is one of the leading figures among China's scientific muckrakers -- a scourge of academic and government-sponsored pseudoscience and a critic of public and private quackery. For more than 10 years as a journalist, editor, and blogger on the influential (although frequently blocked) Chinese watchdog website New Threads, Fang has taken on academics listing faked awards and publishing plagiarized papers; hawkers of herbal cancer "cures," such as Wang Zhenguo, peddler of the Tian Xian herbal cancer treatment; and Chinese scientists who claim to predict earthquakes, among other targets. But paranoia and anger, even violence, mark some recent responses to Fang's work.

Several weeks ago Fang, previously science editor at China Newsweek (unrelated to the U.S. magazine Newsweek), appeared alongside a fellow rationalist, the biochemist-turned-columnist Fang Shimin (no relation, better known by his pen name Fang Zhouzi), on a Shenzhen TV debate about earthquake forecasting -- a largely discredited practice that remains an article of faith for many Chinese scientists and officials. One speaker, an official from China's national earthquake administration, a significant bureau under the State Council, spoke positively about parrots that can predict temblors and the paranormal abilities of a man who claimed he heard ringing in his ears before the quake in Yushu, in northwest China, in April. One guest on the show, Ren Zhenqiu of the Chinese Academy of Meteorological Sciences, accused the science activists of accepting U.S. money to stifle Chinese innovation. Fang Shimin claimed on his blog that after the recording, Ren Zhenqiu called him a "big Chinese traitor" and threw a punch at him.

And this is not the full extent of the threats against Fang Shimin. On July 2, Fang said on his Sina microblog that he had received a threatening phone call. "Be careful in the next few days," the voice said. "Someone is going to fix you."

Scientific ideas have a complex life in China. Today an important government slogan is the "scientific view of development," yet academic fraud is widespread. In January, the scientific journal Acta Crystallographica Section E, a peer-reviewed international journal based in Britain, announced the wholesale retraction of more than 70 papers by Chinese scientists who had falsified data. Three months later, the same publication announced the removal of another 39 articles "as a result of problems with the data sets or incorrect atom assignments." According to New Threads, 37 of these were entirely produced at Chinese universities. One Chinese-government study cited by Nature found that about one-third of more than 6,000 scientists surveyed at six top Chinese institutions said they had practiced "plagiarism, falsification or fabrication."

Critics have blamed the pressure to produce fraudulent papers on unrealistic publication targets set by bureaucrats. But for Fang Xuanchang, the problem goes deeper still, as he told me when we met in May. It represents a slide backward from the scientific spirit of the anti-imperialist May 4th Movement -- the early 20th-century uprising that championed democracy, critical thought, and innovation. Speaking after the attack, Fang described himself and his colleagues as "quixotic." "Not many people understand the work we are doing," he said. "Most Chinese people's attitudes to science are superstitious and fearful." Things might be even worse at the elite level, he said, where science is encouraged in the abstract, without a grasp of the scientific method. Regarding scientific and critical thinking, Fang added, "Chinese people need a new enlightenment."

Such issues are not only of parochial concern: Renewing China's oft-cited historical reputation for scientific innovation is a matter of urgency for the world. Last month a report from Britain's National Endowment for Science, Technology and the Arts suggested that as China enters a new phase of economic and geopolitical might, the country's potential to roll out new, low-carbon technologies becomes an increasingly important factor in global efforts to address climate change.

Harnessing scientific prowess requires promoting good academic practice, scientific education, critical thinking -- and science journalism.

Science Journalist Attacked in Beijing

Fang Xuanchang (方玄昌), editor and science reporter of the Chinese magazine Caijing, was brutally attacked on the night of June 24. On his way home close to midnight, two men with steel rods hit him on the back and head and continued to beat him up with a clear intention to murder. Fang Xuanchang fought back and managed to escape. He was later treated in hospital and released with serious, but not life-threatening injuries.

Fang Xuanchang has recently worked in newspapers China News Weekly and Science News, where he had authored many reports criticizing corruption and forgery in China's academia and society. He has also been very active in the efforts exposing scientific fraud, collaborating with Fang Zhouzi (no relation).

Police in Beijing has launched an investigation. Fang Xuanchang thinks that the attack is likely motivated as a revenge to his work as a reporter, although he also does not rule out the possibility of an attack due to mistaken identity.

University World News: Universities Fail to Tackle Plagiarism

In a news item titled "China, Universities fail to tackle plagiarism," University World News summarizes a few recent fraud cases and the lack of proper resolution. It highlights the work of Fang Zhouzi and his New Threads as:

China's universities are failing to crack down on plagiarism despite an unprecedented education ministry circular sent to them a year ago making them responsible for investigating and dealing with rampant cheating.

A number of high-profile cases have only come to light thanks to outspoken campaigners such as Fang Shimin with his popular literary New Threads website written under his pseudonym Fang Zhouzi and used to highlight academic fraud.

Rather than being rooted out by the universities themselves, individuals report cases of plagiarism to online forums or the New Threads blog, which are then rigorously followed up and checked by Fang, a US-educated biochemist.

But of more than 900 cases of academic corruption highlighted by Fang in recent years, just 20 have resulted in punishment by universities. Most involve students rather than academics, Fang said.

AP: Rampant Cheating Hurts China's Research Ambitions

The following is a story from Associated Press published on April 11. It cited Fang Zhouzi and New Threads as well as Professor Rao Yi:

Rampant Cheating Hurts China's Research Ambitions

By Gillian Wong

LIUZHOU, China – When professors in China need to author research papers to get promoted, many turn to people like Lu Keqian.

Working on his laptop in a cramped spare bedroom, the former schoolteacher ghostwrites for professors, students, government offices — anyone willing to pay his fee, typically about 300 yuan ($45).

"My opinion is that writing papers for someone else is not wrong," he said. "There will always be a time when one needs help from others. Even our great leaders Mao Zedong and Deng Xiaoping needed help writing."

Ghostwriting, plagiarizing or faking results is so rampant in Chinese academia that some experts worry it could hinder China's efforts to become a leader in science.

The communist government views science as critical to China's modernization, and the latest calls for government spending on science and technology to grow by 8 percent to 163 billion yuan ($24 billion) this year.

State-run media recently exulted over reports that China publishes more papers in international journals than any except the U.S. But not all the research stands up to scrutiny. In December, a British journal retracted 70 papers from a Chinese university, all by the same two lead scientists, saying the work had been fabricated.

"Academic fraud, misconduct and ethical violations are very common in China," said professor Rao Yi, dean of the life sciences school at Peking University in the capital. "It is a big problem."

Critics blame weak penalties and a system that bases faculty promotions and bonuses on number, rather than quality, of papers published.

Dan Ben-Canaan is familiar with plagiarism.

The Israeli professor has been teaching for nine years at Heilongjiang University in the northeastern city of Harbin. A colleague approached him in 2008 for a paper he wrote about the kidnapping and murder of a Jewish musician in Harbin in 1933 during the Japanese occupation.

"He had the audacity to present it as his own paper at a conference that I organized," Ben-Canaan said. "Without any shame!"

In a separate case, he gave material he had written to a researcher at the prestigious Chinese Academy of Social Sciences. He said he was shocked to receive a book by the academic that was mostly a copy and translation of the material Ben-Canaan had provided — without any attribution.

The pressure to publish has created a ghostwriting boom. Nearly 1 billion yuan (more than $145 million) was spent on academic papers in China last year, up fivefold from 2007, a study by Wuhan University professor Shen Yang showed.

One company providing such a service is Lu's, in Liuzhou, a southern industrial city. His Lu Ke Academic Center boasts a network of 20 to 30 graduate students and professors whose specialties range from computer technology to military affairs.

Lu, a 58-year-old Communist Party member, is approached by clients through Internet chat programs. Most are college professors seeking promotions and students seeking help on theses. Once, 10 students from the same college class put in a collective request for him to write their papers, he said.

"Doing everything on your own, independently, should be possible in theory, but in reality it is quite difficult and one will always need some help," Lu said. "This is how I see it. I don't know if it is right."

Even in the business of selling research papers, there are cheats. Among the papers bought and sold in 2007, more than 70 percent were plagiarized, the Wuhan study found.

Early last year, Internet users found that the deputy principal of Anhui Agricultural University had committed plagiarism in as many as 20 papers. The university removed him from his post but allowed him to continue teaching.

In June, the principal of a traditional Chinese medicine university in the city of Guangzhou was accused of plagiarizing at least 40 percent of his doctoral thesis from another paper.

And in March, the state-run China Youth Daily reported a 1997 medical paper had been plagiarized repeatedly over the past decade. At least 25 people from 16 organizations copied from the work, and more doctors are expected to be named as the investigation by two students using plagiarism-detecting software continues, the report said.

Fang Shimin, an independent investigator of fraud, said he and his volunteers expose about a hundred cases every year, publicizing them on a Web site titled "New Threads."

"The most common ones are plagiarism and exaggerating academic achievement," Fang said.

The papers retracted by the British journal came from researchers at Jinggangshan University in southeastern China. The editors are checking other papers from the same institution, and say more retractions are expected. Calls and e-mails sent to Zhong Hua and Liu Tao, the two researchers named as lead authors of the papers, were unanswered. Other researchers contacted at the university too did not respond.

The journal, Acta Crystallographica Section E, publishes discoveries of new crystal structures, much of it from legitimate Chinese research.

"Chinese authors have submitted thousands of high quality structures to Acta E, which represent an important contribution to science," wrote Peter Strickland, managing editor of Journals of the International Union of Crystallography, which owns Acta E, in an e-mail. He said it was the first time fraudulent papers had been found in any of the journals.

Richard P. Suttmeier, an expert in Chinese science policy at the University of Oregon, said the problems can be traced to China's efforts to modernize its science system in the 1980s and early 1990s when research accountability and evaluation were still weak.

In trying to find ready measures of achievement, China emulated Western practices and began to focus on high-quality publications, but with mixed results, he said.

The problems could hurt the country's ambition of becoming a global leader in research, Suttmeier said.

"I suspect there will be less appetite for non-Chinese scientists to collaborate with Chinese colleagues who are operating in a culture of misconduct," he said.

Last month the Education Ministry released guidelines for forming a 35-member watchdog committee. Also, in a faxed reply to questions, it said it has asked universities to get tough.

Rao, the Peking University dean, remains skeptical.

Government ministries are happy to fund research but not to police it, he said. "The authorities don't want to be the bad guy."

___

Associated Press researcher Xi Yue contributed to this report.