Interview topics: 2008 Shen Yang, director
Fan Dongsheng president, Zhang Jun and Shen Yang, director of interviews between the director of guest experts to talk with netizens Good afternoon! Welcome to the Sohu interview between healthy.
gradually freeze people specifically what kind of disease
Moderator: interviews begin, first Professor Zhang Jun brief introduction to getting cold What kind of specific people disease, its incidence and trends of how, many users is the first time I heard of the disease.
Zhang Jun: This disease has been a hundred years of history, neurological diseases in general are crazy in the form of disease, is reasons not clear at present, a total of about sports, including the motor neurons and lower motor neuron damage have occurred. Popular speaking, all about sports, our breathing, our movements, our activities, all with the movement between cells, will be affected. the disease up to now one hundred years of history, in general, this disease is very dangerous disease, mainly caused by rapid increase in motor system malleable malignant process. about this disease, relatively speaking In a relatively rare neurological disease, the patient is the most common cause of onset found in the lock when the patient or when picking up things from the ground that muscle atrophy, along with the progress of the disease, found the legs difficult to walk, eat, and difficult , and finally the gradual emergence of breathing difficulties. The disease is gradually developing process, probably only three to five years survival is 50% of patients will die three years, five years 90% of patients will die, is a very bad disease.
Moderator: our country have the disease, there is no statistical figures?
Zhang Jun: our country has not a detailed epidemiological information on the country, suggesting that groups in the fifty thousand new cases in China between the seventy.
early symptoms of gradually freezing
Moderator: Now the disease have emphasized early detection and early treatment, Director Zhang will explain what the early symptoms of the disease, early detection of disease is not very difficult?
Zhang Jun: Indeed it is, the early onset of the disease is a part of the small muscles of patients with atrophy, the early onset of many diseases are the same clinical manifestations. The age of disease onset 40 to 60 years old, this age is the stage of a high incidence of cervical disease. Many patients with cervical disease can occur early unilateral limb muscle atrophy and weakness, so many patients mistakenly believe that cervical spondylosis, the wrong surgery The first diagnosis of the patient, it is important point directly to delay the patient's condition related to the treatment with him.
Moderator: This disease has not susceptible?
Zhang Jun: It is not clear epidemiological data, epidemiological data from the international point of view, some groups relative to the general population the incidence is slightly higher, such as steel mill workers, a number of marathon runners are relatively higher incidence of , there are some countries a high incidence of a number of football players, not to say that with the general population, these groups were significantly increased, the may be speculated that with the environment, sports injuries related to a certain extent.
Moderator: This violations of human disease is the movement of the system, and ultimately with the sports-related features are lost?
Zhang Jun: all functions associated with the movement are lost.
the purpose of checking serum protein electrophoresis to exclude any disease?
User: Will Fan Yuanzhang, if the suspected motor neuron disease, the purpose of checking serum protein electrophoresis to exclude any disease? my family members of patients in Inner Mongolia, in January 2008 to three homes please Fanyuan Zhang doctor, he suspected that exercise neuron disease, to check the serum protein electrophoresis, we have not figure out, I ask: check what is the meaning of serum protein electrophoresis to exclude or to check what disease? Thank you.
Fan Dongsheng: check serum protein electrophoresis, to exclude a MGUS disease, usually with a monoclonal virus immunization-related disease, usually of bone marrow and blood system are related by serum protein electrophoresis to see if there is a normal serum protein concentration, so we as a screening, with some clinical manifestations. If checked is negative, to rule out the MGUS patients, if you examine the problems, that is positive to be treated.
Fan Dongsheng, Professor
the diagnosis of motor neuron disease: early diagnosis is very important.
Moderator: The diagnosis of motor neuron disease need to exclude a number of factors, make the correct diagnosis is very difficult.
Fan Dongsheng: patients, a late no difficulty. simply to get clinical data can be seen, of motor neuron disease check difficulty is in the early atypical time, there are some performance can be shown, if not experience, it may be difficult to judge in this regard disease. of motor neuron disease early diagnosis is very important to the late diagnosed is meaningless. emphasis on early diagnosis, to the authority of the hospital authority of doctors to find a clear diagnosis, if misdiagnosed, may delay the timing, if a diagnosis of the disease that otherwise would waste a lot of time, it will cost a lot. If not the disease to petrified. Hirayama disease and motor neuron disease manifestations are different. diagnosis of early diagnosis and screening is very important.
treatment, including what
Moderator: go to the hospital for some authorities diagnosis. For the unfortunate people who put this disease, treatment consists of what?
Zhang Jun: We know this disease has a hundred years of history, the first few years are no way these diseases, whether domestic or doctor International doctor. In recent decades, many breakthroughs in the treatment, the first is drugs, the only universally recognized world power, such as too, can delay the development of the disease. Other treatments, including early non-invasive treatment of respiratory computer, but also a gastrostomy. now emphasizes the treatment of multiple factors, since not clear what causes this disease, as long as with the disease-related factors, are targeted for treatment. the international community are doing the screening of a large-scale look at whether the drugs RIS find effective drug. RIS treatment is comprehensive treatment, including medication, therapy and nephrostomy computer treatment, and symptomatic treatment of patients, integrated together. Therefore, patients must have confidence in this regard, for patients, not without any treatment approaches, there are ways to gradually improve the patient's symptoms and delay the development of the disease.
Fan Dongsheng: In fact, the treatment of this disease, that is to be summarized in three aspects, the first treatment is the most basic nutrition, that is, the gastrostomy problems, the present study shows that the development of the disease condition and the nutritional status of the patients very closely, and if poor nutrition, can lead to the rapid development of the disease, the nutritional status of patients and their families to adjust our efforts to do things Because the patient has some features may affect the throat, the patient into the food difficult for patients to have difficulty eating can choose gastrostomy. ostomy feeding difficulties can be improved to enhance nutrition. So the most important nutrient is the most basic treatment. building the first want to make foundation, nutrition is the foundation, if nutrition is not doing a good job, what expensive drugs, is a great waste.
second is drug therapy, drug therapy, there is a disease. Rilutek is the only treatment of this disease drugs, and other drugs are still exploring them.
Third, if there is ventilatory disorder patients, available evidence shows that the breathing machine early on to help slow the disease has meaning, you can play the same and drugs role, the question is when to use breathing machine, the patient to the hospital diagnosis and follow-up, do not forget to check once every three months, lung function, respiratory function to determine whether the patient look downward, if dropped, down to a certain extent , the largest decline in more than 70% ventilation, we recommend the early use of the patient, if the 50% reduction, it must be used, it is 100%, 90% can not temporarily. on the clinical follow-up indicators of this indicator is very important.
stress again three aspects, the most basic nutrition support, and the second is drug therapy, such as too is the power of the center, along with other drugs. the third time in the appropriate use of ventilator treatment.
what aspects of nutritional support, including
Moderator: I just talked about nutrition support, nutritional support, including specially to buy some special food, or some of their daily intake of protein can.
Fan Dongsheng: mainly high-calorie nutrition, such as the United States to do Experimental animal studies have shown that patients with motor neuron model, two groups of animals, other treatment is the same, the only difference between a normal diet with a group of high-calorie feeding, feeding time found that high-calorie animals fed a diet, time of onset and the onset of symptoms were significantly higher than normal feed to late onset of symptoms to light, indicating that nutritional status of the transition of the disease has a very important role in the development, now not only in animal experiments, the patient The study also showed that out of an article published in the United States show a relatively high cholesterol, high blood lipid levels compared the prognosis of patients find that their situation is better. lipids in the elderly is higher than the positive side, but the movement neuron disease, high blood lipids have a protective role. Although this is not very precise results, but the current situation, basic research with animal experiments and the situation in general view now is to enhance the nutritional support in this regard, especially when the patient developed throat problems, be sure to pay attention to early conduct gastrostomy surgery, can eliminate the disease caused by malnutrition aggravating factors.
Zhang Jun: high-calorie diet does not have to require patients to buy health products . patients need high-calorie diet is due to two aspects, on the one hand the disease itself is a high metabolic state, requires high-energy metabolism. Another patient was due to problems with swallowing, can not guarantee enough heat, enough energy, enough nutrition into the body. gastrostomy primary purpose for the patient to establish a channel to ensure that nutrition stuff into the body, absorbed into the body, patients have to buy unnecessary so-called high nutrient, high metabolism thing. gastrostomy at the finish After mainly adds the amount of protein in fat can guarantee the most basic needs of patients.
Professor Zhang Jun
fistula into the food on the preparation of the principle of
users: About fistula into the preparation of food, because just do ostomy, we do not know how to prepare the food into. There are some things that sounds simple, but the specific operation is not easy, such as how food is thin consistency? no medical knowledge and experience is very difficult to grasp from the outset, improper food preparation afraid the tube is blocked. if it is available, then, can be in Sunday's patients at the test range and counseling? explain what food can play in, what kind of mill broke. Thank you. In addition, patients in three hospital colostomy done, whether it can also set up a program for nurses or doctors to do some demonstration and operation of gastric fistula use and food preparation. This may also discuss and Gastroenterology. sorry to mention a lot of requirements, I know you are all busy. Thank you very much.
Zhang Jun: the proportion of foreign to do fistula is very high, with the United States had talked to experts in this field has reached nearly 50% of patients do before. abroad more convenient that they have a ready-made nutrient solution selling, with their own families do not have bags, there are daily, with weekly use, finished, ready-made nutrient solution to the families of the patients reached the herd the. According to China's current situation, the high cost of foreign costs may be reimbursed, and the country is not reimbursed. We need to finish their home after ostomy, to deploy their so-called diet. principle is: they do not block control things can look inside to play, this thing hit enter, do not block the fistula can be. generally need to mill, including the foam fish, juice, fruit juice can fight. just do the fistula early, not well adapted to the gastrointestinal need a few times, while the temperature of the food fight fistula as possible consistent with the temperature, not too cold, easy to diarrhea, overheating caused the patient harm. With increased gradually, gastrointestinal gradually adapt. Now the question is, preparing the next Beiyisanyuan Editorial Board missionary in this area will increase, so that nurses on the topic how to fistula care, if the fistula in the diet, do subject teachers. < br> Fan Dongsheng: The patient's problems are more specific. just started not too familiar with the case number can be a little thin. The tube if the care is good, for once a year, if the tube is blocked, just finished two months for one, increased costs and increase the suffering of patients. slowly, there will be some experience. comes to nutrition, there are not any, and if their economic circumstances permit, you can buy intestinal nutrient solution to the hospital, but the relative prices will be expensive, if your configuration, then broke through the mill, we have a patient, poultry meat have broken, its dilution, can. worry about plugging in every time a gastrostomy feeding principle, each time to ensure that water washing, washed away to solve this problem, do not rinse with water, a little bit longer, dry and completely blocked the tube. In principle, rare bit of good.
gastrostomy fistula infection how to do
Moderator: There is this problem in two patients, because it is not in Beijing, relatively far away from Beijing. they feel to do gastrostomy here in Beijing, what happens in case of infection or other problems to handle them too much trouble. like this happens, it will not happen very often?
Fan Dongsheng: gastrostomy less chance of infection, because it is minimally invasive surgery, the stomach itself is not absolutely sterile, Because the food into the stomach, we see virtually no infections of patients, from the yellow Beiyisanyuan Gastroenterology, Professor Wang, this has been very much to do, has done a very skilled, in general, 15 minutes to 20 minutes done, finished, because to stay in hospital to do the body to adjust. this not particularly worried. If the patient is far away from Beijing, Shanghai there less do I know, probably some of the equipment such as tube reasons, do not do in some places, some patients heavier, went to Beijing to do, not good physical condition, not suitable. gastrostomy can not be done locally, you can do to a surgical operation, so the effect is the same , but not invasive, it is necessary to do into the operating room, surgery can also address nutrition problems, it is able to do surgery general surgery. If the patient activities are easy to do gastrostomy is completely minimally invasive , damage is relatively small, relatively cheap.
Zhang Jun: motor neuron disease to do with an ordinary patient gastrostomy very different, often do gastrostomy patients are injured, the first of these patients prone to asphyxia, respiratory function is often not a good second, if the doctor is not very specialized, relatively speaking gastrostomy do have some risks. Beiyisanyuan very much similar to the patients, mainly China as fistula, and through our endoscopy to do more under the ostomy, colostomy done so Gastroenterology on this type of ALS patients experience relatively more certain. as far as possible want to live near or around Beijing Beiyisanyuan to our side to do the best, If the difficulty, do as Fanyuan Zhang said surgery is a very good solution.
insomnia, pain mm gradually freeze the psychological adjustment
Moderator: This disease is very painful. Patients suffering from this disease, will also be a great psychological pressure, many users mentioned. The patient's mood is irritable, as well as the patient is difficult to fall asleep, this year there will be no New Year slept, sleeping on the couch all the above, how this treatment as ?
Professor Shen Yang Shen Yang: I have two professors, in the course of treatment, in addition to treatment for the disease itself, there is another check against therapy for the symptoms. check against the purpose of treatment to reduce the survival of patients suffering this time, of course, impossible to reduce, pay attention to this problem is to make the best possible conditions to alleviate the suffering of patients and improve his quality of life. patients with motor neuron disease the development of muscle atrophy may be accompanied by very powerful, there joint dislocation, muscle spasms occur, or excessive secretion of saliva. had the disease after a relatively high degree of malignant disease, the patients themselves and their families psychologically a blow, this is the case, the patient may have depression, mood, whether it is breathing, such as breathing machines have been used to the night may be oxygen, can cause insomnia, its easy to get up early, because the status of the middle of hypoxia, then a Pain, pain is severe, it may cause can not sleep, or pain in the future will wake up sleeping. some patients to stop drooling at night, swallowing function is poor, unlike the normal function of a self-protection, which will affect sleep. saliva after too easily obstruct breathing.
the patient presented to sleep well, in the end have to analyze what causes, if it is too much saliva, but there will be restlessness, bad mood, emotion depression, irritability, this situation can be added to the tricyclic anti-coke drugs, this drug has a side effect, can cause dry mouth, constipation, etc. situation. If the patient disease to a certain extent, at the breathing machine, then if have sleep problems, the first judge is not a breathing problem, such as during the day, such patients must regularly check the blood to ventilation, and if found that he has this problem, it should be a ventilator, can reduce oxygen at night situation. and then the data of a current through the foreign including our own findings, if possible, conditions, sleep apnea do to patients early in the monitoring, polysomnography, the role of the examinations can be done at night determined the concentration of blood vessels, we Some affected patients ventilator during the day without any symptoms, ventilatory function in the early investigation is good, but do polysomnography, can be found down stage, and some even reached 65%, and now there is economic conditions to promote Figure patients can sleep early to do monitoring, but also help early detection of respiratory problems, to provide an early use of respiratory support and tips.
Moderator: In general, is to make concrete analysis of the reasons for poor sleep.
Zhang Jun: Indeed it is, the patient bad mood, irritable, there may be two reasons, one reason is that ALS patients to the cortex, the patient developed cerebral cortex damage, there will be psychiatric symptoms, including mood changes. In addition we ALS is a very bad disease, we conducted a survey among patients and family members of patients in which anxiety is high. sleep well because of anxiety caused? or depression caused? or breathing disorder caused by the breathing machine anomaly caused by oxygen? specific situation should be approached. We are now before the disease management model and is very different, both domestic and international, before we concern is the physical condition of patients, to treat diseases where there is where the tumor was obtained, We remove the tumor has now become a psychological, physiological, and even social psychology, physiological model. this is very important thing to pay attention to the patient, now that ALS can not be completely cured, it is necessary to work in many areas, such as drug treatment, ventilator therapy, the treatment of early gastric fistula, there is very important that we promote the overall care of patients or the overall care, which is composed of multi-professional tier model, this model may be for many patients, including patients symptomatic such as headaches, sleep well must be addressed, including swallowing problems, emotional problems and even his life. abroad to do it very small, the patient is sick, but he was still at work, in the case of the disease , how to adapt to the current work is still work training, including how the physical rehabilitation after paralysis, even when the patient got the disease abroad, Christians think that is not what I do a lot of bad things, God punish me. Then the priest to enlighten . or even the patient has died, one year after the death, family members should be concerned about the situation in foreign countries, not simply your sick I simply give you some medicine, but the mental and physical aspects of attention and treatment.
Whatever the cause of sleep disorder, caused by the exclusion of some causes of sleep disorders, the many patients want to eat some of the drugs to promote sleep and promoting sleep drugs are tranquilizers, such as stability, Shu fixed, Gallo determined The drugs inhibit the effect of breathing, can cause damage of thinking. ALS patients in the use of sleeping pills, when a great danger. If by check, do not exclude the involvement of the role of mechanical ventilation, we use the second generation in the class drugs or can, if there is respiratory drugs, non-plate two post-drug, non-North, to BAK farmers, but large, they would have side effects. Atypical Antipsychotic drugs Aodan United States Lin, specifically designed to anxiety, such as Mu Dan Ping, both of the side effects of medicines the patient is likely to cause sleep too much, in clinical practice, use of these drugs to improve the patient does not sleep problems, relatively speaking, to be safer than sedatives.
should How to care?
User: What is holistic nursing? at home, what can families do? Where can I find a good, experienced nanny? your hospital nurse can provide on-site service? example to the house to guide the suction like?
Zhang Jun: foreign model is multi-disciplinary team, including the responsibility of nurses, dieticians, nurse therapists, spiritual comfort, social workers, medical consultants and even some volunteers, is a multi-disciplinary team. how to develop nursing? vast majority of patients at home, and all patients will feel very comfortable, we know that the hospital environment, including life will be greatly affected, in the home will be very good. multi-disciplinary team on a regular basis to give the patient and his family meeting to discuss the patient and the biggest problem, the biggest problem is, what family needs, what the patient needs to discuss with the families and patients, after finalizing a treatment program, according to this treatment at home for multi-directional multi-disciplinary aspects of care and treatment. domestic point of view also can not do this now because of all this foreign stuff is foreign to the burden of health insurance is, currently only in the hospital to carry out domestic multi-disciplinary team for treatment, the patient at home to carry out, is still very difficult, there are practical problems.
Fan Dongsheng: We are now actively push ahead on this matter, the case of domestic and foreign differential, foreign Zhang Jun the situation described is very satisfactory, but at this stage we can not, can not we do not, and now we have a team is actively advancing this matter, including hospitals and related links, in the hope that the relatively fixed, more specialized health care team, we also contacted a number of hospitals, is negotiating process. as site service, medical cost, many large hospitals, can not spare to do these things. now can do some early patients, with the family of late and I hope the early intervention of patients with advanced earlier decision to do the next step, from the professional knowledge to provide some guidance, once the patient breathing on it, to find temporary hospital ventilator, very difficult, and the family to make decisions is also very confused, do or not do it, do after the opportunity to spend a lot of money on the breath, if not, the patient will have problems seeing. These things were discussed and the guidance in advance, this is our things to do at this stage, can be stratified in future management of patients who asked not to be as early, on how patients with advanced guidance. our overall efforts to push ahead now in the care, but in stages, and all of a sudden do so a little difficult to go abroad, the majority of patients and their families hope and consensus, and actively promote this thing.
Zhang Jun: We also want to make the patient live with dignity, while his family home care from the very heavy work of liberation.
at home can use the Machine?
Moderator: Several talked about the breathing machine for the case of patients, such as breathing machine in the family can do?
Fan Dongsheng: Speaking of breathing machines, But listen, wonder, there are two concepts, the early patients using noninvasive ventilator, sometimes called the doctor will simply BiPAP, 20,000 to 30,000 dollars to buy back home, wearing a face mask, nasal mask used in the home . This is the early use of the patient, the effect of delaying the development of the disease. There are significant patient to the late symptoms of shortness of breath, without ventilation support, oxygen patients will be serious and even choked to death, is the so-called invasive tracheotomy in the hospital with a large ventilator, the patient should be hospitalized, living in the ICU ward, non-invasive and invasive a two-stage, non-invasive early, invasive in the end use. Non-invasive ventilation is not up to use, non-invasive how to use the breathing machine, what time to use, this is the regular pulmonary function testing is very important, if lung function is 100% can not, if dropped, to 50% must use, if we do not, the condition will develop significant influence. to 60%, 70% with early use, in general, non-invasive ventilation is not the answer the patient's difficulties, but the treatment of disease and disease prevention play a further increase in the role. has created the solution to the latter part of the patient breathing symptoms, use this to go to the hospital.
Zhang Jun: We advocate the early use of noninvasive ventilation is a treatment, not to say that bad breath, with breathing machines to maintain it. and this breathing machine should use at home, after a hospital doctor and ventilator factory trained, who mastered the non-invasive mechanical ventilation, the so-called non-invasive patient by face mask and nasal mask for ventilation in the treatment, especially early, not 24 hours wear, bed, watching TV , rest time, when the fixed wear, evening wear, when to sleep, ambulation usually do not need to wear, it is very convenient.
on drug treatment
Moderator: experts mentioned drugs Rilutek Treatment of Amyotrophic Lateral Sclerosis are the most commonly used drugs, a lot of outsiders to this drug that can not buy anywhere else, and no access to health care.
Zhang Jun: Rilutek ALS patients, drugs are epoch-making significance, changed from no to a drug treatment drug treatment as the significance of this milestone. If the patient if economic conditions permit, as early use, from all clinical data, only in the early stage of drug Rilutek most significant effect is the most obvious. now Rilutek are all drugs sold in several big cities of Beijing, Shanghai and Guangzhou are all sold, Beijing Beiyisanyuan, Union Hospital, Xuanwu Hospital, Shanghai, Wah Yan Hospital, Zhongshan hospital or some.
friends: My mother had amyotrophic lateral sclerosis, I have seen on some Web sites that East peacekeeping force (L-carnitine) is a force as the only alternative medicine too, and I would like to ask can eat this medicine? What role have you?
Fan Dongsheng: In 2006, Japan has an animal experimental study, found that L-carnitine on the animal model of prolonged survival time. any valid and effective drug treatment to see animals experiment effectively invalid, then use the clinic, a look is not safe, two small-scale experiments in the effective or not effective, if effective access to three large-scale look is not really effective. the drug in animals has good results, the Japanese research results, the article also published in the journal better. Since the animal effective to see a clinical safety unsafe, L-carnitine is commonly used in clinical medicine, the treatment of other disease is the medicine this substance in the body can produce its own material, there is no problem in terms of security. security can be used. to see if he did not work effectively, efficiently animal experiments to clinical not effective if the patient is not clinically use of force, such as economic conditions too, such as too much power over four thousand dollars a month, a considerable portion of patients can not afford the medicine, he will have the treatment, no treatment, the patient may also have no hope. levocarnitine the drug from the animal experimental point of view there are good results, said earlier that security is better, so those who do not like too much hard drugs in patients with no economic conditions, you can use the drug L-carnitine. but in fact not a substitute for, since not replace the role of the ultimate clinical efficacy has not been confirmed. just because it is safe, so we recommend that in the absence of conditions, you can use one with a look, but not recommended as a standard. If the patient conditions, such as force too, do not propose to use the L-carnitine. Because Rilutek is the result of thousands of patients proved to be effective, and L-carnitine was confirmed without extensive, but effective in animal experiments. It can not serve as an alternative This is not a concept.
User: Can lithium carbonate in ALS patients and its application prospect? When will the trial of the drug?
Fan Dongsheng: This is the antipsychotic, is effective in the clinical use of drugs , he himself is anti-psychotic drug, a clinical but also safe. in Italy showed a certain secondary clinical efficacy, now entering Phase III clinical, multi-center Phase II clinical studies to confirm the effect of how to our nation. is promoting this thing, the use of any drug use can not think of it to use, must have the approval by the SFDA, we are doing this, other users have mentioned, why did you say delayed treatment, because there are many areas not that we can grasp, you must get the national documents of approval to do this thing, next Monday there on the further progress of this matter. In this respect the patient's own unauthorized use is not recommended, there are many drugs that are effective, as the most typical Last year, the year before last, there is an international drug is minocycline tetracycline drug effective in animal experiments, after a clinical, Phase II clinical use is valid, then some ranging Phase II clinical valid and effective, Phase III clinical is proven to use, if the patient their own use, there may be harmful results. We must Phase III clinical trial results through the standard use until after publication. If we start to do the drug test, will be recruiting patients, will strict indications and contraindications as well as observation indicators, to ensure patient safety, do not own the unauthorized use of the patient.
Moderator: recruiting the patient's condition, will come out through a number of ways to publish?
Fan Dongsheng : Yes, if started, there will be ways to recruit.
friends: We all know that this disease is very painful, very painful father feel alive, has been trying to persuade him, and now more and more serious diseases, will have several experts some experience, how to motivate the patient, how to convince some of his father's firm.
Zhang Jun: ALS is a very personal indeed, the disease progressed very quickly, then got the disease, regardless of the patients themselves and their families have to endure psychological and economic pressure is very large, the incidence population is 40 years old to 60 years of age is high, and it is young and healthy, family, contributing to society ages, this problem occurs, we say that ALS is not the worst case , said dementia, although can live for many years, but do not have good quality of life. motor neuron characteristics of patients with the greatest feeling there is no problem, thinking no problem. the one hand, the progress of our medical and scientific research in progress, we strive to treat the disease, alleviate its symptoms, reduce the suffering of the patients, on the other hand the survival of the patient for a long time, we recommend that patients can read a book called II
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