"Research on the most needed things that the country urgently needs" approached Zhong Nanshan's respiratory disease prevention and control innovation team
Central Commission for Discipline Inspection and State Supervision Commission website Huang Qiuxia Hou Ke
On November 3, Zhong Nanshan's respiratory disease prevention and control innovation team won the first prize of the 2020 National Science and Technology Progress Award.
From SARS to COVID-19, from lung cancer to COPD, this innovative team not only saved countless lives with its scientific research results, but also played a pivotal role in the global prevention and treatment of respiratory diseases.
After winning the award, Zhong Nanshan said: "This award confirms the direction of the team's research, which is to study what the country urgently needs and what is most needed." "The motto of our team is to stand upright for the people. The problem to be solved, theory, laboratory research, diagnosis, and treatment must be advanced to the international front; the "site" is to develop "simple, inexpensive, effective, and safe" drugs or treatment methods suitable for national conditions. The result of the "site" is for the people."
In the prevention and control of the new crown pneumonia epidemic, what experience has the team accumulated and what new thinking does it have?
What important scientific research achievements have they made in making breakthroughs in difficult and severe respiratory diseases?
Since its inception, how do they fulfill their solemn promise of "stand up to the people"?
The reporter interviewed the team a few days ago.
Confronting the new crown virus and promoting the establishment of a cycle management system for public health emergencies
At the beginning of 2020, the new crown pneumonia epidemic came suddenly.
"Now it can be said that there must be some transmission from person to person." As the leader of the high-level expert group of the National Health Commission, Zhong Nanshan made a keen judgment at the first time, and soon put forward the strategy of "early attention, early deployment, early activation, and early implementation". .
In order to curb the spread of the new crown pneumonia epidemic and buy precious time, the internal medicine, emergency department, intensive care department and other relevant departments of the First Affiliated Hospital of Guangzhou Medical University worked together for seven days and nights to extract and analyze the clinical characteristics of 1,099 confirmed patients with new coronary pneumonia in 31 provinces, regions and municipalities in China data.
On February 28, 2020, a paper written by the team based on clinical diagnosis and treatment experience was published in the New England Journal of Medicine, which attracted attention.
The thesis reports the epidemiology, clinical characteristics, laboratory test data and final clinical outcome of the new virus. It involves a wide range of data points and has made a significant contribution to virus research, prevention and control in China and the world.
During the critical period when the virus was raging, Zhong Nanshan presided over the writing and revision of multiple editions of the "New Coronavirus Pneumonia Diagnosis and Treatment Plan" to provide reference for treatment in various places.
The team used the remote network conference system to take the lead in conducting 24 remote consultations of critically ill and critically ill cases in Wuhan, Jingzhou, Hubei and other places for more than 55 cases, guiding clinical diagnosis and treatment, and increasing the success rate of critically ill cases.
At the same time, the team built and promoted the application of a predictive and early warning system and health code based on big data and artificial intelligence, which improved the accuracy of prevention and control.
Combining artificial intelligence technology to develop diagnostic models based on clinically simple and practical data and imaging features to guide clinical triage quickly and accurately.
At present, the number of mutations of the new coronavirus is increasing, and the mutant strains are circulating in many countries.
In May of this year, there was a case of local transmission of the delta variant of the new crown virus in Guangzhou. The team quickly launched an emergency response to the epidemic, and soon established the "Falcon" air film laboratory to support large-scale nucleic acid screening. The characteristics of infection, transmission laws, and clinical characteristics are summarized to provide reference for the prevention and control of the virus and policy formulation.
In addition, the concept of "close connection" and the "yellow code" system have been updated in our community prevention and control strategy to better carry out accurate tracking, which provides a reference for other cities in my country and even the global screening.
"Faced with the high degree of uncertainty of virus mutations, it will be more challenging to accurately predict the changing trend of the epidemic." He Jianxing, one of the team leaders, director of the National Respiratory Medicine Center and dean of the Guangzhou Institute of Respiratory Health, told reporters, Under the enlightenment of the anti-epidemic experience, the team has strengthened the prevention, early warning, and prevention and control of major respiratory infectious diseases and the sudden public health events caused by them, and promoted the establishment of a chain cycle of "prevention, supervision, treatment, and control" Management system, participated in the formulation of many national policies and regulations.
SARS, H1N1, H7N9, Middle East Respiratory Syndrome... For the past 20 years, the team has been confronting the new virus head-on.
During the fight against the SARS epidemic in 2003, Zhong Nanshan led the team to clarify the pathogenic mechanism of the SARS virus, and summarized the "three early and three reasonable" treatment methods, namely "early diagnosis, early isolation, and early treatment", "reasonable use of corticosteroids, and reasonable use of corticosteroids." Ventilators and reasonable treatment of complications" protect the lives and health of patients.
Why do research and construction of anti-virus infections?
He Jianxing told reporters that after SARS, Academician Zhong Nanshan led the entire team to put forward the law of virus changes: Generally speaking, the virus will mutate significantly every six years, and there will be relatively large mutations in more than ten years, and each time the virus changes significantly. Variations will cause epidemics for a period of time.
Therefore, it is very important to establish a corresponding scientific research system and medical center, and prepare for it in advance.
He Jianxing introduced that at present, the team is using the national laboratory as a platform to coordinate research on the prevention and treatment of new coronary pneumonia virus. The key research directions are protein structure, high-titer monoclonal antibodies and even cocktail antibody therapy, small molecule drugs, etc., and follow-up research on existing Continuous development and improvement of vaccines, evaluation of use effects, etc.
In terms of treatment, strengthen the research and development of life support technologies such as new ventilators and extracorporeal membrane lungs to increase the treatment rate as much as possible.
"Constant pondering" promotes continuous innovation and solves the "stuck neck" problem in the treatment of respiratory diseases
In addition to the research on the prevention, early warning, and prevention and control of major respiratory infectious diseases and sudden public health events caused by them, the minimally invasive treatment system, molecular pathogenesis and early prevention and control of lung cancer, the epidemiological characteristics and early stage of chronic obstructive pulmonary disease , Comprehensive prevention and control, and molecular epidemiological characteristics, early diagnosis and intervention of allergic diseases are also the main research directions of the team.
"These are also the most urgent scientific problems in the treatment of respiratory diseases." He Jianxing said.
In 1971, the First Affiliated Hospital of Guangzhou Medical University established the "Chronic Bronchitis Prevention Team".
Eight years later, the "Guangzhou Institute of Respiratory Diseases" was established on this basis, and the team was formally established, becoming one of the earliest respiratory disease research teams in China.
From the first national key laboratory of respiratory diseases, the first national clinical research center of respiratory diseases, to national laboratories, national respiratory medicine center, etc., the team has successively established 11 national platforms to focus on the "epidemic development of respiratory diseases". Research on the key scientific issues of “scientific characteristics, molecular mechanisms and early intervention”, and put forward innovative concepts such as “occult asthma”, “tubeless surgery”, “early intervention and comprehensive prevention and control of chronic obstructive pulmonary disease”, and established an international Leading molecular marker prediction model for evaluating lung cancer recurrence and a community model for early intervention and comprehensive prevention and control of COPD.
In 2015, He Jianxing and his team proposed the "tubeless" concept for lung cancer surgery. Its academic name is full tubeless single port thoracoscopic surgery. As a minimally invasive technique, patients with lung cancer do not need tracheal intubation or Deep venous catheters are needed, urinary catheters are not needed, and chest drainage catheters are not needed after surgery. The degree of trauma is greatly reduced. Young patients can even walk directly back to the ward from the resuscitation room after surgery. Some patients with very early lung cancer can visit Discharged within 24 hours.
In December of the same year, he led the team to successfully hold the first International Tubular Minimally Invasive Thoracic Surgery Workshop, which attracted more than 100 thoracic surgery experts from Europe and the United States to observe and study.
In He Jianxing's view, the driving force of innovation is "better curative effect and the needs of patients"; the realization of innovation depends on "continuous thinking"; the evaluation of innovation mainly depends on "whether it has application value".
It is precisely under the guidance of this concept that the team has continuously developed new technologies, new diagnosis and treatment, new methods, and new drugs for difficult and severe respiratory diseases.
In order to overcome the chronic obstructive pulmonary disease, which has a high prevalence rate in my country and relatively backward diagnosis and prevention and control technology, the team has developed a suitable technology for early screening and diagnosis of COPD suitable for national conditions, and for the first time confirmed that biofuel smoke is COPD It is the first time that the long-term application of the antioxidant carbocysteine can effectively prevent the acute attack of COPD, which is an important factor of the disease.
For asthma that often recurs and does not heal for a long time, the team was the first to prove a new method of vaccine combined with hormones to treat asthma; innovatively proposed the concepts of "occult asthma" and "chest tightness variant asthma", and proposed early prevention methods for asthma based on this; The new technology of simple bronchial provocation test for the diagnosis of asthma can enable about 35% of patients with atypical asthma to be detected early and get timely intervention.
"Solving difficult problems in the field of medical science and developing disease prevention, diagnosis and treatment methods and drugs suitable for national conditions. The ultimate goal is to make medical research benefit the general public." He Jianxing said that he will continue to strengthen the introduction, training and output of high-level respiratory medicine talents. Actively prepare for the establishment of the National Respiratory Health Industry Innovation Center, strive to achieve industrial development in the fields of pharmaceutical equipment, vaccines, medical data, etc., take the lead in the prevention and treatment of chronic respiratory diseases in Guangdong, and radiate the country, and further build a major respiratory infectious disease prevention, control, early warning and prediction network , And continue to promote the solution of the "stuck neck" problem in the field of medical science.
Develop diagnosis and treatment methods suitable for national conditions to promote early detection, early diagnosis and early treatment of respiratory diseases
November 17 this year is the 20th "World COPD Day" with the theme "Healthy Breathing, Unparalleled".
"Come out a path that can be used for early intervention and treatment of COPD like hypertension and diabetes, so as to minimize the impact of COPD on society." Zhong Nanshan proposes to establish a nationwide community of respiratory diseases. Coordinate the prevention and treatment system to jointly promote the "early screening, early diagnosis and early treatment" of respiratory diseases.
Oriented by clinical needs, the team currently has 8 national-level research platforms, using big data, artificial intelligence, multi-center clinical research, biological resource libraries, etc. to carry out research, and actively promote the implementation of research results.
"On the one hand, we will transform advanced technologies into products, and develop medicines, technologies, and devices that are suitable for national conditions with high efficiency, simplicity, low price, and safety. On the other hand, we will use advanced experience to form clinical diagnosis and treatment norms, consensus, and guidelines. Grassroots promotion, through the'application-feedback-correction' mechanism, to achieve better coverage and application." He Jianxing told reporters.
From “disease treatment as the center” to “health as the center”, various big tests have made this team more and more aware that in order to better protect the health of the people, in addition to clinical treatment of “pre-sickness”, More important is prevention.
"Building a'healthy China' should pay more attention to prevention instead of treatment, and promote early detection, early diagnosis and early treatment of respiratory diseases." He Jianxing said.
Taking COPD as an example, data shows that there are more than 90 million COPD patients in my country, of which more than 95% are in the early stage of the disease, and the early patients generally have no obvious symptoms.
Zhong Nanshan said that chronic obstructive pulmonary disease has become the third leading cause of death for Chinese residents after cardiovascular and cerebrovascular diseases and cancer. (Going up the stairs) I feel unable to breathe. At this time, I go to the doctor again. It is too late, and the lungs have undergone irreversible changes."
In 2017, domestic prospective studies have proved that early diagnosis in the community, as long as a few drugs are given early intervention, the lung function of patients can be significantly improved, and a considerable number of patients can return to normal.
"We are now also preparing to carry out large-scale early intervention in the community, and after finding the patient, we will actively intervene and treat it early." Zhong Nanshan said.
Recently, with the joint efforts of Guangdong Zhongnanshan Medical Foundation and Shanxin Physical Examination and other social forces, the "Good-hearted Breathing Health Screening for Ten Thousand People" was officially launched, allowing more people to learn about lung cancer, chronic obstructive pulmonary disease, allergic diseases, and sleep breathing. Early screening for lung cancer, chronic obstructive pulmonary disease, and allergic diseases.