The neural regulation of sailing -- Interview of the Second Affiliated Hospital of Tsinghua University doctor Ma Yu

(from "Fourth" Tsinghua Xinglin magazine in 2014 06 Author: Tang Yuan Yuan)Personal fileMa Yu, female, physician, worked in the Second Affil


(from "Fourth" Tsinghua Xinglin magazine in 2014 06 Author: Tang Yuan Yuan)

Personal file

Ma Yu, female, physician, worked in the Second Affiliated Hospital of Tsinghua University (Jade Spring Hospital Department of Neurosurgery). 2005 graduated from the China Medical University, Ph.D., Institute Professor Wang Zhongcheng, then under the tutelage of academician, China Academy of Engineering in Beijing City Department of Neurosurgery, Beijing Tiantan Hospital, Department of neurosurgery and function of Professor Zhang Jianguo postdoctoral research. Surgical treatment in deep brain stimulation motion for Parkinson's disease, dystonia, Tourette syndrome and other disorders in recent 10 years. In the DBS assessment, precise preoperative localization and target postoperative combined with medical treatment and other aspects of adjustment program has very abundant clinical experience, has been in operation for nearly a thousand DBS cases, controlled postoperative patients of nearly million.

The Second Affiliated Hospital of Tsinghua University, 2013 (Jade Spring hospital) led by Vice President Zhang Yuqi, began preparations for neural regulation and stereotactic surgical treatment group". This is a need for Department of Neurosurgery, nerve electrophysiology, neural regulation, neurology, neuropsychology and rehabilitation of a number of professional and close collaboration with the team, as a whole set of surgery, electric physiology and scientific research, which is very important to the electrophysiological and neural regulation "part of the lack of a rich experience of the person in charge. Dr. Ma Yu chose to join the Second Affiliated Hospital of Tsinghua University of the family, in support of President Zuo Huancong and vice president Zhang Yuqi to set up clinical electrophysiological and neural control center". At present, the center has carried out a comprehensive and multi department cooperation, including: the improvement of the original detection of EMG changes in the treatment of hemifacial spasm microvascular decompression in the commonly used technology, in order to improve the detection rate; monitoring spinal cord function in the treatment of lumbar disc herniation surgery; nerve electrophysiology monitoring protection with Department of Neurosurgery surgery.

For Ma Yu doctors, the most proud of her is to participate in research and development of domestic pacemaker Wang Zhongcheng academician. Dr. Ma Yu worked from our neurophysiological expert Professor Gao Dongming, and Gao Dongming worked for the founder of the French professor Benabid brain pacemaker, helped invent the electrophysiological monitoring device of the famous "BenGan" operation. She then enrolled in the doctoral student of China Medical University professor Wang Yunjie Department of Neurosurgery experts. In 2005-2009, under the joint guidance of academician Wang Zhongcheng and Professor Zhang Jianguo, doctoral and postdoctoral research work in Beijing Institute of Department of neurosurgery. At that time coincided with the Tsinghua University professor Wang Zhongcheng and academician of the joint development of domestic Tsinghua brain pacemaker, Dr. Ma, who undertook a large number of clinical and scientific research in the work of the. Animal experiments during the period from 2006 to 2009 mainly Tsinghua brain pacemaker, December 2009 clinical trial of domestic brain pacemaker, and the development of rechargeable brain pacemaker, until the end of the clinical trial.

Also called a brain pacemaker implanted deep brain stimulator (DBS), is currently the surgical treatment of Parkinson's disease (PD) is the preferred method, can also be used for essential tremor, dystonia and epilepsy disease. With the rapid aging of the population in China, Parkinson's disease has become a major disease affecting the health and quality of life of the elderly, but also a heavy mental and economic burden on the family. At present, China's total number of patients with Parkinson's disease more than 2 million, accounting for about half of the world's number of such patients, the number of patients is still increasing at an annual rate of 100 thousand. The DBS operation first implanted the microelectrode into the specific region of the patient's brain by stereotactic surgery, and then generated the chronic electrical stimulation of the brain nucleus through the neural control device to achieve the purpose of treatment. This method is reversible, adjustable, slight trauma, significant efficacy, adverse reactions and fewer complications. DBS surgery is a systematic process of treatment, deep brain stimulator implantation is part of the treatment, postoperative open pacemaker stimulation given high-frequency begin treatment, so after only reasonable controlled operation combined with drug adjustment to correct the DBS operation to really show its therapeutic effect is. Maintain the DBS effect and improve the vital part of the symptoms and quality of life. "The treatment program" individual postoperative mainly consists of four parts, parameters are set correctly according to the situation of the pacemaker of each patient, with medication, reasonable correct treatment and appropriate psychological counseling and rehabilitation training, in order to make every Parkinson patients can get the best effect after operation. This is a relatively high level of program control experience and the requirements of each department." Dr. Ma Yu said.

Since 2005, Ma Yu began to be responsible for preoperative evaluation, intraoperative electrophysiological monitoring and postoperative patient controlled procedures in patients with functional DBS in Department of neurosurgery. So far, Ma Yu physicians in the surgical treatment of DBS patients with more than 1000 times, has programmed patients nearly ten thousand people. Dr. Ma Yu began to study the treatment mechanism of DBS from the master during entering this field, after the doctor and postdoctoral research for DBS clinical and research of long-term in-depth exploration, she is currently engaged in the DBS program for the longest time, the number of patients with the most professional doctor program program. Compared to similar products in China and foreign countries, Ma Yu found that China's own R & D and manufacture of brain pacemakers and foreign products can achieve the same program-controlled effect, but the price is only half of the former. The original appearance of the product looks a little bit worse, but it is now in the

Under the premise of lowering costs, reducing the economic burden of patients under the premise of the maximum degree of optimization, and from the practical and functional point of view, China's products and even in some areas a slight advantage. Now, Tsinghua brain pacemaker exchange group (QQ 147184371) has nearly a thousand people, Dr. Ma Yu DBS consulting QQ group (QQ No. 204150045) is also growing. "This is the word of mouth with the results, we have not done any publicity." Dr. Ma Yu paused for a moment and said, "in fact, the patient's word of mouth is more effective than any publicity." In the promotion and application of domestic pacemaker made giant

Great progress, and now Ma Yu doctors will focus on her vision and focus on the recent hot spots at home and abroad - telemedicine. Due to suffering from neurological diseases are often inconvenient (Parkinson, dystonia, epilepsy, etc.) the hospital visit month after month and year after year not only time-consuming, but also brought heavy mental and economic burden to patients and their families, some people even had to give up the follow-up treatment. Dr. Ma Yu calculations to reporters: "a lot of people with Parkinson are not local people, some live far away, usually need to go through to the hospital because life can not take care of themselves fatigued by a long journey, so, need at least one family accompany. The families are usually young, is the age of work, to accompany the need to leave. Travel, accommodation, meals, loss of money

Fees, as well as registration fees, inspection fees and other costs together, a time about 5 thousand dollars. The patients with DBS after surgery to achieve the best results, usually need to go through a number of times, we will observe and analyze the symptoms of patients, and a number of program-controlled parameter adjustment. So and so, go back and forth several times, tens of thousands of blocks will not. Is it possible for us to try to build a DBS remote control system to minimize the physical and economic burden of patients?"

DBS remote medical monitoring system can break down barriers of distance in the hospital, patients and experts, to improve the postoperative patients with DBS program management level, reduce the cost of health care, improve the quality of life of patients, but also greatly overcome the distance of obstacles on the return of medical treatment, the mobility of the program with Parkinson at home you can easily accept the professional and individual DBS after operation. This means that the implementation of remote monitoring and program control can reduce the time delay in medical treatment, and reduce the physical and mental pain caused by the change of patient's symptoms due to the improper parameter settings after DBS. I am in the hospital, the patient at home, through the collection of symptoms, physiological data reception, you can program, without the patient to run back and forth." This is not just an idea, more exciting is that this will soon be implemented! Ma Yu physician and Tsinghua University Institute of Aeronautics and Astronautics research and development team, has been successful at home and abroad to fill the blank field of the remote monitoring and control. Domestic DBS remote monitoring system development has made significant progress, in the experimental stage, there is a huge market prospects, the future is expected to promote the establishment of DBS remote monitoring and control system for the benefit of the majority of medical, after DBS group.

Doctor Ma Yu has clinical experience very much for the program for each field, she programmed patients will conduct in-depth understanding and careful pondering again, so she felt a lot of harvest days and months multiplying down. "When we become a doctor, is to always make a summary of the patient's condition, if you can not do this, then it can not be called a good doctor." She often tells her students. Dr. Ma Yu observed in a large number of clinical work, the majority of patients with DBS have a certain degree of psychological disorders, depression, anxiety, obsessive-compulsive disorder, and some even before the onset of the whole night can not sleep. Even if these patients underwent DBS surgery, the heart can not open the knot, the degree of improvement of symptoms after surgery will be significantly limited, the quality of life can not be expected to improve. According to the literature, nearly 1/3 of patients with Parkinson DBS may have depression symptoms. Dr. Ma Yu is trying to give patients psychological rehabilitation guidance. She found that sometimes a simple targeted psychological counseling for patients, you can get unexpected good results. One patient was impressed by Dr. ma. He was a senior intellectual who had to undergo surgery because of severe Parkinson's disease. But some things occurred during treatment that old man always can't let go, always think "why I got Parkinson", "what do not do so well, unpleasant things always go like wandering in my mind. Because the problem is programmed after operation, the son of the elderly are attracted to the Second Affiliated Hospital of Tsinghua University found Ma Yu physician. After careful treatment and medication adjustment, the overall symptoms of the elderly were significantly improved, but Ma Yu was still depressed. See the old man in this state, the horse from the son of the physician Yu know some reasons, she decided to talk about and the old man: "you see, although you have experienced some setbacks, but your operation or the success of the program is not a problem, the development of everything in the right direction. You can try to put down the burden before, to continue their life at home raising grass flowers ah ah, not only the physical symptoms will be getting better and better, life will be better and more comfortable than before, the main purpose is to improve the operation of the DBS symptoms, improve the quality of life. Parkinson's disease is not as terrible as we thought, we can do a lot of things we are interested in under the correct treatment. The road of life is long, we have to look forward......" She said, the old man had been hanging head gradually lifted, finally gave the horse a feather doctor smile. In order to get more theoretical basis in the postoperative mental state of patients improved, 2012 horse feather physician into Institute of clinical psychology, psychological Chinese system learning professional theory, which makes her ability in understanding and treatment of postoperative patients after psychological control has been further improved. Dr. Ma Yu is more and more welcomed by patients after surgery, and even some patients to find her not for other, just to see her, the heart is more practical. Although Ma Yu physician came to the Second Affiliated Hospital of Tsinghua University, just a few months time, diagnosis and treatment of 4 to 5 patients per week, but the reporter noted that the simple room hung with several dated fresh banners, patients and their families gratitude shows between the lines. In this regard, Ma Yu physician very modest: "here just started to understand the situation of the patients, the treatment of people is still relatively small, it also gave me enough time to carefully treat every patient, and I am also more willing to each patient and to maintain close contact, timely question and the problem with solution treatment, whether through QQ group or directly to our hospital."

China was the first DBS operation in Beijing in 1998. Now do more and more patients with DBS surgery, but the establishment of a program to improve the program is very small, follow-up treatment can not keep up. Since DBS patients need to be followed up regularly in order to track the condition of the patient, the doctor regularly adjust the parameters of the program, so that the pacemaker can play the best therapeutic effect. In other hospital, from the preoperative to postoperative program usually only by the same physician admissions, it is too busy, no time to take into account the result to all aspects, even about the patient, most only half an hour's time, it is difficult to completely solve the problem of patients. In view of this, we have now established a complete DBS surgical treatment process, which includes the "perfect preoperative examination, diagnosis and determine the treatment plan, to evaluate the postoperative effect, precise and meticulous surgical treatment, postoperative nerve regulation and neurology, neuropsychology and rehabilitation work closely with comprehensive treatment" and a series of complete medical intervention. Here, we as a professional team, can provide patients with a full set of individual medical services, including preoperative diagnosis, surgery, postoperative control and regulating drugs, transfer machines, regulating psychology, and rehabilitation guidance each link has operation and communication of professional physicians, which not only can be very good the quality control of the whole process of surgical treatment, patients can also feel the genuineness of the doctor from the hospital care. We have the confidence to do our best, "said dr.. There are a large number of basic medical research as the accumulation of clinical experience. As a responsible person, Ma Yu physician has undertaken and completed a deep brain surgery and the application of electrical stimulation related China Postdoctoral Science Foundation "of deep brain stimulation in rat nucleus accumbens" Experimental Study on the treatment of opioid dependence and Beijing Nova project "deep brain stimulation effect and research" the mechanism of dystonia, special fund of the National Natural Science Foundation of deep brain stimulation on Alzheimer's disease rat hippocampal neuron protective effect and mechanism of "talent training plan in Beijing city; participate in the completion of the" part of the basic and clinical study of domestic brain pacemaker "development of national science and technology project in 11th Five-Year; and won the two prize of the 2010 higher school scientific research outstanding achievement award (ranked second) and 2009 Chinese medical science and Technology Award third-prize (No. fourth). "The business of the Second Affiliated Hospital of Tsinghua University clinical electrophysiological and neural control center" is now flourishing, each member of the center on one, from the medical perspective of different patient efforts together for Parkinson. Dr. Ma Yu finally said firmly: "I will have a good rehabilitation in patients with DBS as my career, and I will continue with the patient side by side against Parkinson's disease in this way! Do not abandon, do not give up!" (end)

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