Respiratory

In the Department of Respiratory Medicine of Tianjin First Central Hospital, Director Zhang Jiushan serves as the director of internal medicine and leader of the respiratory team. In the early 1980s, under the leadership of Director Zhang Jiushan, the Department of Respiratory Medicine first established a pulmonary function room and an allergy laboratory. We took the lead in carrying out lung function tests and a national hay fever epidemiological survey in Tianjin. In 1992, the new site of Tianjin First Central Hospital was completed. The Respiratory Department also experienced careful construction by senior directors Xu Lianqing, Hu Qizhen, and Tao Jiaju. Under the leadership of the current subject leader, Professor Jiang Ping, it has become a key supporting discipline of the hospital integrating scientific research, teaching, and clinical practice. It occupies an important position in the field of respiratory medicine in Tianjin.In 2000, the Respiratory Department established a bronchoscopy room and began to perform routine bronchoscopy and bronchoalveolar lavage. Over the past two decades, the bronchoscopy room has developed rapidly and can now perform bronchoalveolar lavage (BAL), transbronchial mucosal biopsy (TBB), and transbronchial lavage. Endoscopic third- and fourth-level interventional surgical treatments include endoscopic lung biopsy (TBLB), transbronchial needle aspiration (TBNA), transbronchial ultrasound-guided needle aspiration (EBUS-TBNA), airway foreign body forceps, airway balloon dilatation, airway stent implantation, etc. In 2010, the Department of Respiratory Medicine was awarded the title of "GINA-ARIA Chinese Physician Training Program Education Center" and is the only base in Tianjin authorized by the Global Asthma and Allergic Rhinitis Prevention and Control Organization and the Global Asthma Alliance GINA-ARIA program to train Chinese physicians. In 2017, the Department of Respiratory Medicine won the title of "China's Standardized Specific Immunotherapy Demonstration Outpatient Unit" and is the only unit in Tianjin that carries out standardized subcutaneous immunotherapy for adults. In 2018, it was awarded the only "Chronic Airway (Asthma) Standardized Diagnosis and Treatment and Provincial Asthma Specialty Clinic" project demonstration base in Tianjin.On December 18, 2018, the PCCM expert review team composed of well-known experts across the country came to our hospital to conduct an on-site review of the standardized construction project of the Department of Respiratory Medicine in our hospital. On January 19, 2019, at the China Respiratory Medicine Development Conference, the Department of Respiratory Medicine obtained the National Respiratory and Critical Care Medicine Standardization Construction Project (PCCM) Level 3 Hospital Standard Unit Certificate, marking that the Respiratory and Critical Care Medicine Department of our hospital has reached national standards and is developing in the direction of standardization and homogeneity. The medical staff of the Department of Respiratory Medicine has a complete structure, a reasonable talent echelon, and strong academic strength. There are currently 17 doctors and 17 nurses. Among them, there are 2 chief physicians, 5 deputy chief physicians, 7 attending physicians and 3 resident physicians. Among them, there are 5 doctors, 12 masters, and 2 master supervisors. There is 1 deputy chief nurse, 7 supervisory nurses, 7 nurse practitioners and 2 nurses. 15 people have a bachelor's degree and 2 people have a college degree. There are currently 35 fixed beds and 45 open beds. It now has 4 functional examination rooms including endoscopy room (including bronchoscopy and thoracoscopy), pulmonary function examination room, sleep breathing monitoring room and allergy research room; it has first-class equipment that can meet the examination and treatment needs of a variety of respiratory diseases.The Department of Respiratory Medicine is dedicated to the diagnosis and treatment of chronic obstructive pulmonary disease, pulmonary hypertension, cor pulmonale, asthma, lung cancer, interstitial pulmonary fibrosis, pulmonary embolism, various refractory pneumonias, pleural effusion of various causes, bronchiectasis, lung abscess, apnea syndrome, respiratory failure, sarcoidosis, and immune-related lung diseases. It is currently responsible for the theoretical teaching and clinical teaching tasks of Tianjin Medical University, Nankai University School of Medicine, and Tianjin University of Traditional Chinese Medicine; it is a standardized training base for resident doctors; a clinical pharmacist training base for the Ministry of Health, and has trained more than 20 clinical pharmacists; it is a training base for master's students of Tianjin Medical University, Nankai University School of Medicine, and Tianjin University of Traditional Chinese Medicine, and has mentored 14 master's students since 2017. The Department of Respiratory Medicine attaches great importance to standardized teaching rounds, and has accepted teaching reviews from the Medical University System on behalf of the hospital several times. In 2010, the Department of Respiratory Medicine established a collaborative relationship with Johns Hopkins University in the United States. In 2011, the Department of Respiratory Medicine and Haihe Hospital jointly invited famous experts from Hopkins Hospital in the United States and China to hold the first "New Progress in Diagnosis and Treatment of Airway Diseases" study class in Tianjin.During the 11th Five-Year Plan period, it obtained 6 scientific research results, filled 2 gaps in Tianjin, participated in 1 National Ministry of Health Industry Fund Project, 1 Chinese Medical Association project, 4 bureau-level projects, published more than 40 papers, and 9 in the Chinese Series. The Department of Respiratory Medicine won the second prize in the 2007-2009 Tianjin Respiratory Society Paper Publication Competition. Since 2016, he has completed more than 10 scientific and technological achievements, published more than 40 papers in core journals, including 16 SCI papers, participated in many academic conference paper exchanges, completed 7 patents, participated in the compilation of 2 textbooks, and 1 expert consensus article. The Department of Respiratory Medicine will expand the number of beds to more than 80, expand the bronchoscopy room into a respiratory endoscopy diagnosis and treatment center, build a chronic respiratory disease diagnosis and treatment center and the first rock salt aerosol chronic airway disease treatment center in Tianjin, etc. It will adhere to the synchronous development of clinical, scientific research and teaching, create a good academic atmosphere, promote the standardization of daily work and the advancement of diagnosis and treatment technology. Strengthen exchanges and collaboration with foreign hospitals to improve the overall strength of the department; maintain the advanced position of the Respiratory Department in Tianjin, and strive to occupy the leading position in Tianjin in the scientific research and clinical aspects of asthma, bronchoscopy interventional diagnosis and treatment, and pulmonary fibrosis. The Department of Respiratory and Critical Care Medicine has 5 auxiliary function examination rooms:1. Allergy laboratory: This examination room is mainly divided into two parts, allergen detection and desensitization treatment; and exhaled nitric oxide measurement and analysis. The former uses Phaidia allergen quantitative detection technology, which is not affected by factors such as patient age, skin condition, medication, disease, and pregnancy status. It has the advantages of high sensitivity, strong specificity, and traceable results. Both the positive predicted value and the negative predicted value can reach more than 90%. Compared with similar methods, the lowest quantification limit can reach 0.1KUA/L. Currently, the projects that can be carried out cover 28 types of common indoor allergens (house dust mites, dust mites, cat dander, mold, etc.), outdoor allergens (various weed pollen), and food allergens (egg albumen, milk, wheat, peanuts, soybeans, sesame, nuts, etc.). Exhaled nitric oxide detection is simple, fast, safe, can accurately reflect the severity of airway inflammation, and is easily accepted by patients. It has broad application prospects. 2. Pulmonary function examination room: This examination room can carry out all pulmonary function tests (including tests on diffusing function, ventilation function, small airway function, airway resistance, etc.) and bronchodilation test.3. Sleep apnea monitoring room: Adopts the American Bonded NOXT3 all-digital wireless sleep recording system. This instrument adopts new chest and abdominal strapping technology and wireless connection to maximize the liberation of patients. RIP technology accurately measures respiratory motion and collects high-quality signals. Including oronasal airflow + snoring + blood oxygen saturation + chest and abdominal movements, etc., it can be used for preliminary screening of OSAHS patients, and can also be used to evaluate efficacy and follow-up. 4. Bronchoscopy room: It can carry out interventional techniques such as ultrasound-guided transbronchial lymph node biopsy (TBNA), airway balloon dilatation, intra-airway stent implantation, narrow-wavelength imaging to identify benign and malignant lesions, transbronchial lung biopsy, painless bronchoscopy and traditional bronchoscopy items - bronchoscopy mucosal biopsy, alveolar cleaning, brushing, etc. Among them, painless bronchoscopy uses intravenous anesthesia combined with local anesthesia, allowing patients to successfully complete the examination without pain. Rapid on-site evaluation, referred to as ROSE, has been carried out, including rapid on-site cytology evaluation (C-ROSE) and rapid on-site microbiology evaluation (M-ROSE).This technology uses modified Wright's staining (WF staining), which takes only 30 seconds. In most cases, it can be observed under a microscope in 1 minute. By observing the cytological morphology of exfoliated tissue, the disease can be quickly evaluated, such as the pathological classification of lung malignant tumors; identification of fungi, some parasites, tuberculosis, etc., and provides better and faster auxiliary examination methods for the diagnosis of clinical diseases. 5. Internal medicine thoracoscopy room: This technology is widely used in the field of respiratory and critical care medicine, mainly including diagnosis and treatment of pleural tumors; diagnosis and treatment of pneumothorax; diagnosis and staging of lung cancer; identification of causes of pleural effusion; treatment of refractory benign pleural effusion; thoracoscopy biopsy can provide multiple and selective specimens, and the diagnosis rate can be significantly improved. The tuberculosis culture rate of its specimens can reach 78%, which is double the culture positive rate (39%) of the combined application of pleural effusion and needle biopsy.