Respiratory Examination Department

The Department of Respiratory Examination of the First Affiliated Hospital of Dalian Medical University consists of three sections: the Bronchoscopy Room, the Pulmonary Function Laboratory, and the Desensitization Treatment Room.

The Bronchoscopy Room was established in 1980. It was one of the earliest hospitals in China to perform fiberoptic bronchoscopy examinations and has trained many physicians in fiberoptic bronchoscopy for numerous large hospitals in the province. It currently has one professor (chief physician), one attending physician, one resident physician, and two supervising nurses. It is equipped with two internationally advanced electronic fiberoptic bronchoscopy systems, five diagnostic and therapeutic fiberoptic bronchoscopes, two main units, and one imaging workstation. Transbronchoscopic bronchial mucosal biopsy has been performed; its positive pathological diagnosis rate and the number of people undergoing fiberoptic bronchoscopy examinations rank first in the city. It is the only institution in Dalian to perform transbronchial lung biopsy through fiberoptic bronchoscopy. Combined with bronchoalveolar lavage, this greatly increases the etiological confirmation rate for diffuse lung disease (DPLD). It was the first institution in China to implement the lower-respiratory-tract double-plug protected culture method, improving the positive rate of etiological testing for refractory bronchopulmonary infections. It has received provincial and municipal Science and Technology Progress Awards and is particularly renowned for removing foreign bodies from the lower respiratory tract. On many occasions, it has successfully removed various difficult-to-extract foreign bodies using highly skilled techniques, thereby avoiding open-chest lung resection. It will soon introduce medical thoracoscopy and new endobronchial interventional treatment techniques using fiberoptic bronchoscopy, in order to better meet patients’ medical needs.

The Pulmonary Function Laboratory introduced pulmonary function testing technology in 1980 and officially began examination work in April 1981. It was the earliest pulmonary function laboratory established in the Dalian area. The subjects examined include patients from internal medicine, surgery, gynecology, pediatrics, otolaryngology, and other departments, as well as people undergoing physical examinations. It also frequently undertakes research work for nationwide pulmonary function testing of related diseases and projects involving the diagnosis and assessment of asthma. As the medical, teaching, and research needs of our hospital have grown and its overall capabilities have continued to improve, the pulmonary function testing equipment has also been continuously upgraded. The first equipment upgrade was the transition from a float-type spirometer to a digital lung-volume scanner manufactured in Shanghai. This greatly reduced the workload of medical staff, reduced the time and effort required for manual calculations and charting, and enabled the laboratory to provide more examination appointments. The second equipment upgrade was the introduction in 1996 of a body-plethysmography pulmonary function instrument manufactured by the American Maijiafei Company (SYNEMED). This added many new examination items and met the needs of clinical medical, teaching, and research work. The third equipment upgrade was the introduction in 2014 of the Master Screen pulmonary function instrument manufactured by German Jaeger, reputed to be the world’s leading brand of pulmonary function equipment. This will certainly improve the level of pulmonary function testing at our hospital. At present, our Pulmonary Function Laboratory performs the vast majority of pulmonary function tests available in China, including pulmonary ventilation function, diffusion function, airway resistance, bronchodilation testing, bronchial provocation testing, exhaled nitric oxide, and impulse oscillometry.

Desensitization therapy is a treatment specifically targeting Type I hypersensitivity reactions. It is mainly used to treat Type I allergic diseases caused by inhaled sensitizing allergens, such as hay fever, perennial allergic rhinitis, and allergic asthma. It involves injecting allergic patients with gradually increasing doses of allergen extracts so that, when they are exposed to the sensitizing allergens again, they no longer develop allergic symptoms or experience reduced symptoms.

Bronchial asthma is currently considered to be a chronic inflammatory disease triggered by multiple factors and characterized mainly by the involvement of eosinophils, mast cells, and T lymphocytes. Approximately 60% of cases are related to exposure to specific allergens and belong to the category of Type I allergic diseases. In recent years, many new asthma medications have been developed, including airway anti-inflammatory drugs, bronchial antispasmodics, and H1-receptor blockers. However, to date, there is still no treatment that can cure asthma, and there are relatively few treatments targeting its causes. Desensitization therapy is an etiological treatment that uses extracts of allergens to which the patient has shown a positive skin-test reaction. Through repeated injections in small doses, it ultimately enables the patient to develop tolerance to that allergen.

The Desensitization Treatment Room of our hospital began operating in October 2005. It uses the internationally standardized house-dust-mite desensitization vaccine manufactured by the Danish company ALK-Abelló and recommended by the World Health Organization (WHO) to provide desensitization treatment for patients allergic to house dust mites. The Alutard house-dust-mite allergen preparation is a safe and effective medication, characterized by reliable efficacy and good tolerability. Some patients begin to show a therapeutic response after 2–3 injections; at the latest, efficacy begins to appear after approximately 1 year of treatment. Such patients are mostly children or patients with a relatively short disease course, and the longer the treatment continues, the more obvious the effect becomes. After continued treatment for 3–5 years, satisfactory long-term results can be achieved. Our department has so far provided desensitization treatment to 108 patients allergic to house dust mites. The patients have responded well, producing good social benefits. In addition to desensitization treatment, our department also performs allergen screening, providing a good method for obtaining a definitive diagnosis for the many patients with allergies. The allergens include house dust mites, dust mites, tropical clawless mites, mugwort, ragweed, dog hair, cat hair, molds, German cockroaches, American cockroaches, peaches, crabs, fish, and others. More than 3,800 patients have undergone this examination, producing good social and economic benefits.