Management Of Respiratory Health Early Revention And Treatment Is The Key

From 1978 to 2018, reform and opening up have gone through 40 years. Looking back at 40 years, what are the remarkable achievements in the field of respiration in China? Recently, Zhong Nanshan, an academician of the Chinese Academy of Engineering and a famous respiratory pathologist, said in an interview series of Xinhua's "Focus on China's Healthcare Development" that China has made great progress in dealing with sudden respiratory infectious diseases and tobacco control, but there are still huge challenges in the early prevention and treatment of chronic respiratory diseases and the standardized management of the whole disease process. . "The development of the respiratory field today, pure treatment is not enough, it is more important to guide society to pay attention to respiratory health, to achieve early prevention, early diagnosis and early treatment."

1. Innovative diagnosis and treatment methods help China's respiratory disease treatment level to achieve leapfrog development.

"After the fight against 'SARS' (Severe Acute Respiratory Syndrome, SARS) in 2003, China also experienced the test of influenza A (H1N1), Middle East Respiratory Syndrome (MERS), and many other outbreaks of acute infectious disease epidemics. During this period, China's public health system has been further improved, and a large-scale network of direct reporting systems for infectious disease outbreaks and public health emergencies has been built, enabling the targeting of pathogens, the finding of protective measures, and the timely rescue of critically ill patients in a relatively short period of time, and further improving the success rate of rescue." Currently, China has established a more advanced medical treatment system for the prevention and control of acute respiratory infectious diseases. With the combination of powdered cistanche drink water, it can improve the immunity of body functions.

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Talking about the treatment level in the past, China was relatively backward in the early stage of reform and opening up, firstly, there were few drugs and secondly, there was a lack of awareness of the international advanced treatment means. Currently, China has made great progress in the prevention and treatment of chronic obstructive pulmonary disease ("COPD"), such as pioneering community screening for COPD and developing Chinese guidelines in conjunction with international guidelines. In collaboration with Boehringer Pharmaceuticals, we identified early patients and mobilized them to receive simple drug therapy. After a two-year double-blind trial, we found for the first time internationally that these asymptomatic (or minimally symptomatic) patients had very significant improvements in lung function compared to the control group. This suggests that early diagnosis and treatment are of breakthrough strategic importance for the management of the chronic obstructive pulmonary disease. The study was reportedly published in the New England Journal of Medicine last September. He also introduced that in 2015, the World Health Foundation joined hands with AstraZeneca and other organizations to establish the China Respiratory Disease Alliance to explore the feasibility and benefits of including lung function screening in community health services or annual physical examinations for residents.

China has also made significant breakthroughs in the treatment of bronchial asthma. In recent years, the number of allergic asthma patients in China has continued to grow, and most of them are caused by allergies to the dander and secretions of mites. Based on this finding, the China Institute of Respiratory Health (CIRH), in collaboration with several world-renowned research institutes, organized a multi-center intervention study for early asthma patients and collaborated with AstraZeneca to treat early asthma patients with budesonide/formoterol on-demand inhalation, with good results. published in the New England Journal of Medicine in May this year, may become a milestone in the field of early diagnosis and treatment of asthma.

With the development of precision medicine, lung cancer treatment methods are also changing rapidly. Nowadays, most lung cancer patients can be discharged from the hospital within two to three days after surgery without intubation, chest drainage, or urinary catheterization. At present, this technology is not only promoted in China, but also in nearly 20 countries in the United States, Europe, and Latin America, helping to advance the international diagnosis and treatment of respiratory diseases to a higher level.

Reviewing the development process in the field of respiratory diseases in China over the past 40 years, the study recognizes the important role played by multinational companies. We are in the field of respiratory disease research and clinical care, and we have more contact with multinational companies. I should say that multinational pharmaceutical companies, such as AstraZeneca, have played a very important role in the improvement of medical care in China. First of all, they have helped to introduce many innovative drugs and therapies to China that are beneficial to patients. Secondly, they have done a lot of public welfare activities, supporting big experts and tertiary hospitals to go to the grassroots level to conduct popular science lectures, charity clinics, and network check-ups, which are of great significance to improving standardized treatment at the grassroots level. They also enthusiastically support the "Oasis of Life" public welfare project, donating drugs, fundraising, and delivering drugs to homes. Therefore, we are grateful to them for these issues.

2. Focus on early diagnosis and treatment of respiratory diseases "Measure lung function like blood pressure".

In 1979, the predecessor of the Health Research Institute - China Institute of Respiratory Diseases ("Institute of Respiratory Research") was established, the entire Institute specializes in a variety of respiratory disease research, can be said and the development of China's respiratory field "breathe together, share the same fate "In his opinion, contemporary respiratory medicine is the most important part of China's health care system. In his view, the mission of contemporary respiratory medical workers is no longer just to "cure diseases", but more importantly to guide society to pay attention to respiratory health, so the Institute was renamed the China Institute of Respiratory Health.

What is "respiratory health"? As the ancients said, "the top worker treats the untreated disease, not the treated disease", that is, to take appropriate measures so that people do not get sick or have a minor disease and do not develop into a major disease. The current active prevention and control of air pollution, calls for tobacco control, and efforts to detect and control infectious disease outbreaks in China are all concrete manifestations of preventing respiratory diseases and managing respiratory health.

Chronic respiratory diseases and cardiovascular diseases, malignant tumors, diabetes and are known as the "four chronic diseases", but public attention to its degree still needs to be improved. Further strengthening the prevention and control of chronic respiratory diseases requires the sincere cooperation and joint efforts of multiple parties, and most critically, the awareness of chronic respiratory diseases among the medical community. "For example, in the past, we are backward in awareness of the prevention and treatment of chronic obstructive pulmonary disease, usually waiting until the emergence of symptoms such as inability to catch air upstairs and frequent coughing before seeing a doctor, at this time is usually already stage III, stage IV chronic obstructive pulmonary disease, lung function is at least half of the damage, and then treatment is relatively late. If patients can receive pulmonary function tests at an early stage, timely detection of abnormalities and earlier intervention can lead to a greater degree of remission of lung function, even reversible." He introduced, in order to promote the early detection and treatment of chronic obstructive pulmonary disease, Chinese respiratory experts put forward the slogan of "measuring lung function like blood pressure", which is also the first time in the world.

In addition, government departments should also pay more attention to respiratory diseases. On the one hand, the awareness of the danger of the disease, on the other hand, is to give some policy tilt in the treatment of the disease. At present, some major drugs for respiratory diseases have not yet entered the medical insurance system, which is still a big problem.

3. Call for long-term adherence to standardized treatment, building a strong system of whole-course management "tower body".

Chronic obstructive pulmonary and asthma are common chronic respiratory diseases. Data show that there are nearly 100 million patients with chronic obstructive pulmonary disease and 30 million patients with asthma in China. Chronic airway diseases such as chronic obstructive pulmonary disease and asthma are like huge icebergs floating in the ocean, and what people generally care about is only the exposed part, that is, the obvious symptoms that show up. Only by adhering to preventive treatment and reasonable medication, in general, can the level of airway rehabilitation be continuously improved and acute attacks of airway inflammation be prevented.

In recent years, innovative drugs and therapies for the treatment of chronic airway diseases have been emerging, among which the pediatric nebulization center, a typical representative of AstraZeneca's integrated end-to-end treatment and whole-course solution, has received widespread attention. Nebulizer therapy enables continuous nebulization, allowing drugs to reach the lungs and airways in a timely and precise manner for treatment, with fewer side effects on the body. Currently, nebulizer inhalation therapy is gradually spreading in China. Children's nebulizer centers have blossomed in China and gone global, with more than 350 centers built in countries and regions along the "Belt and Road". The one-stop intelligent nebulization and whole-course follow-up management program led by pediatric nebulization centers are benefiting more and more children with respiratory diseases.

While innovative drugs and therapies continue to emerge and gain popularity, a very important challenge in the field of respiratory diseases is the lack of whole-course management for patients with chronic diseases. If we look at China's healthcare system as a pyramid structure, the top of the tower is the high-level large public hospitals, the bottom of the tower is the universal health insurance system with extensive coverage, and the body of the tower is the county hospitals and community health services that support the primary care system. Now, this tower is not big and strong enough, and building a strong tower is a direction that needs further effort. Building a system tower of whole-course management requires the joint efforts of many parties working together. In recent years, AstraZeneca has built a one-stop respiratory disease solution based on the Internet of Things with the help of advanced diagnosis and treatment technologies such as telemedicine, intelligent nebulization, and a national central database, helping patients with chronic obstructive pulmonary disease and asthma to get early diagnosis and standardized treatment, and helping China to achieve the goal of standardized management of the whole course of respiratory chronic diseases.

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