COPD is a common chronic respiratory disease,and is one of the diseases with distinctive influence on the living quality and pulmonary functions of patients and with the highest mortality rate among different diseases in China. Academician Zhong Nanshan, Professor Ran Pixin and Professor Zhou Yumin have always been engaged in the prevention and control of COPD. They have taken the lead to organize a large-scale epidemiological survey nationwide and discovered that the prevalence rate of COPD in China reached 8.2% (data of 2007) and 35.1% of the patients had no distinctive respiratory symptoms. In China, the prevalence rate of COPD among non-smokers is 5.2%. Most patients are female and with a long history of contact with bio-fuel. Later epidemiological survey proved for the first time that burning bio-fuel is an important cause of COPD. Based on these important discoveries, the research team conducted a 4-year tracking and interview with the residents in the community and adopted comprehensive intervening measures. They had discovered that these measures could slow the decline of pulmonary functions of citizens and lower the incidence rate of COPD. Later, the research team upgraded the ovens of community residents, canceled the use of bio-fuel and improved the ventilation conditions of their kitchens. After a 9-years of tracking and visiting, the team discovered that among the residents subject to these intervening measures, the decline of their pulmonary function has slowed down and the incidence rate of COPD has declined. Among those who only upgraded their ovens or improved the ventilation of kitchens, or even without any intervening measures, the decline speed of their pulmonary function and incidence rate of COPD showed no distinctive difference from their level nine years ago. The research is a great breakthrough in epidemiology. Therefore, it was awarded as the “best paper of environmental epidemiology” in 2014. It was the first time for Chinese scholar to win the award since it was established in 2008.

The research was named as “the world’s best paper of 2008” by the journal Lancet, which was an honor won by Chinese scholars in respiratory medicine and has been written into the global guide to the prevention and control of chronic obstructive pulmonary disease. Inspired by the curative effect of carbocisteine, the team further discovered that the high-dosage N-acetylcysteine could also effectively reduce the acute exacerbation risk of COPD. Their research fruit was published on the journal Lancet--Respiratory Medicine, which further proved the great values of expectorant drugs to COPD.

For the aforesaid major discovery, the research team won a second prize in the national award for scientific progress. Professor Ran Pixin was met by President Xi Jinping.

Index of the review:

Guan WJ, Ran PX, Zhong NS. Prevention and management of COPD in China: successes and major challenges. Lancet Respir Med. 2016. DOI: http://dx.doi.org/10.1016/S2213-2600(16)30092-3