Zhong Nanshan: Guardian of Life

Chapter 26 Based on Facts

On February [-], [-], Zhong Nanshan pointed out in his speech that the etiology of atypical pneumonia is unknown, but considering comprehensive clinical conditions, viral infection is more likely.But what are pathogens?Only by finding the pathogen can we really choke the throat of the disease.

On February [-], experts from the Center for Disease Control and Prevention in a certain place said that the pathogen that caused "SARS" was basically determined to be chlamydia.The medical community in Guangdong was shocked—if the pathogen is chlamydia, then the treatment plan is much simpler, but if the judgment of "the pathogen is chlamydia" is wrong, then the wrong treatment plan will cost more lives!
"There is insufficient scientific basis to draw conclusions from the results of electron microscope observations of two lung tissue specimens. The chlamydia pathogen found in the autopsy of the patients can only be used as one of the causes of death of the two autopsies, and it cannot prove that chlamydia is the cause of the two cases. The only cause of death of the deceased, let alone chlamydia is the only cause." At the emergency meeting organized by the Guangdong Provincial Department of Health, Zhong Nanshan bravely voiced his doubts.

The expert group of Guangdong Province supports Zhong Nanshan. They believe that from a clinical point of view, the pathogen of "SARS" is more like a new type of virus.In order to be responsible for the patients, they also referred to the conclusions of the local CDC, adjusted the treatment plan, and adopted various drugs and symptomatic treatments against bacteria, viruses, and chlamydia.

At critical moments, Zhong Nanshan stood up again and again without fear.He clarified the reason for his bluntness in public: "Science can only seek truth from facts, and cannot protect oneself wisely. Otherwise, patients will be the victims." His eyes are firm and his expression is solemn and open, so similar to his respected father Zhong Shifan.He believed that his father must also be firmly on his side.

While under pressure, Zhong Nanshan questioned the statement that "the pathogen is chlamydia", while slowly groping for symptomatic treatment measures in practice.What is not in the book can only be explored in practice.Zhong Nanshan personally inspected the mouth of each patient, and concluded that the symptoms of "SARS" patients are different from those of ordinary pneumonia patients: "SARS" patients have no symptoms in the throat; fever, low white blood cells, and inflammation in the lungs, but no lung symptoms. rales; and the most prominent feature is dyspnea.Through personal observation of the patient's mouth, Zhong Nanshan came to the conclusion that all cases had no upper respiratory tract infection.These practical experiences of personally diagnosing and treating patients and closely observing and contacting patients made him more sure of the judgment that the pathogen was not Chlamydia.

Zhong Nanshan later said in an interview with CCTV's "Face to Face" program: "There are two big differences in our clinical feelings, which are difficult to explain with pneumonia caused by chlamydia: first, pneumonia caused by chlamydia is rarely so severe; , We used sufficient doses of anti-chlamydia and mycoplasma drugs, but they had no effect at all. At that time, I thought, unless this chlamydia is a special variant, it is difficult to explain it with chlamydia."

Under the auspices of Zhong Nanshan, the "Clinical Diagnostic Criteria for SARS Cases in Guangdong Province" was promulgated, which provided clear clinical diagnostic criteria for hospitals to treat "SARS" patients and solved practical problems.Before figuring out what the pathogen was, under the command of Zhong Nanshan, the Guangzhou Institute of Respiratory Diseases worked out a set of "symptomatic treatment" in practice.This program has effectively improved the success rate of critically ill patients and has been learned and adopted by other hospitals.They summed up the experience of "three early and three reasonable": early diagnosis, early isolation, early treatment; rational use of corticosteroids, rational use of ventilators, and reasonable treatment of complications.They created the "non-invasive ventilation" method, that is, ventilation with a non-invasive nasal mask instead of intubation or tracheotomy ventilation usually used for critically ill patients, in order to reduce the patient's pain and avoid more serious secondary infections.They used corticosteroids to patients in a timely and appropriate amount according to their conditions, which greatly reduced the mortality rate of patients.

The above measures are quite different from traditional clinical treatment measures, which has caused many controversies.However, Guangdong medical staff represented by Zhong Nanshan, based on practice, resisted all opinions and won the support of the Guangdong Provincial Department of Health.On March [-]th, the Guangdong Provincial Department of Health issued the "Guidelines for the Treatment of Patients with SARS in Guangdong Provincial Hospitals", which formulated the work guidelines of Guangdong medical staff represented by Zhong Nanshan in fighting against "SARS", and distributed them to cities and provinces. Direct and affiliated medical units.

(End of this chapter)