DIVISIONS/UNITS/CENTRES

Introduction



The Division of Respiratory and Critical Care Medicine has played an instrumental role in providing tertiary clinical respiratory service, medical education and respiratory research in Hong Kong since 1960s. Over the years, the Division has gained significant representation and reputation among respiratory circles locally, nationally and internationally. There has been close working relationship with the local and regional chest societies. Leaders of the Division have also served as Presidents of the Asian Pacific Society of Respirology.

A wide spectrum of clinical respiratory service is mainly provided in the respiratory subspecialty ward, ventilator unit, respiratory high-dependency unit and sleep laboratory at the Queen Mary Hospital. During the unprecedented epidemic of Severe Acute Respiratory Syndrome (SARS) in 2003, the Division had made pivotal contributions to the combat of the epidemic in Hong Kong, while community-acquired and opportunistic pneumonias is a constant challenge interposed by surges of viral respiratory tract infections every year. The Division was one of the pioneers in promulgating the significance of sleep-related breathing disorders in Hong Kong, and the multidisciplinary sleep center at Queen Mary Hospital provides comprehensive in-laboratory and home sleep study services for patients with various sleep disorders. The Division has also been actively introducing cutting-edge technologies to Hong Kong, including autofluorescence bronchoscopy, endobronchial ultrasound and pleuroscopy. Our development of interventional pulmonology since 2006 has significantly enhanced the diagnostic workup of pulmonary conditions especially lung cancer. In addition, the Division has strong clinical interests in managing advanced lung cancer since 1990s, with vast experience in delivering systemic chemotherapy and targeted therapy.

Apart from providing medical education on respiratory medicine for undergraduates, the Division receives overseas elective students or subspecialty trainees and postgraduate research students. We also serve as one of the key subspecialty training centres for respiratory medicine in Hong Kong. The Division has always been keen to provide continuous medical education for local health care professionals, including our contributions to the respiratory module in the departmental diploma course.

The research conducted by members of the Division is multi-faceted, and embraces the spectrum of basic, translational and clinical platforms. We have established animal and cell models for interrogation of smoking, intermittent hypoxia and pleuropulmonary carcinogenesis. Diseases of interest include obstructive sleep apnoea, lung cancer, chronic obstructive pulmonary disease, asthma and bronchiectasis. We have also taken a key role in the establishment of updated lung function reference values for both children and adults in Hong Kong which are now in clinical use territory-wide.

Sleep apnoea had been an obscure disease in Hong Kong until the turn of this millennium. Our community-based study showed that this disease was common even among our local Chinese population with lower body mass index compared to Caucasians, that eventually led to an increased awareness of sleep apnoea in Hong Kong. Our research now focuses on delineating the adverse cardio-metabolic impact of sleep apnea and intermittent hypoxemia in both clinical and animal studies.

Lung cancer remains the top cancer killer in Hong Kong, with high prevalence of epidermal growth factor receptor mutations that predict good but unsustained response to targeted therapy. We have been working on the molecular mechanisms of drug resistance, genetic risks associated with lung cancer among never-smokers, novel lung cancer therapeutics and multi-center clinical trials. The Division was first accredited as a designated clinical trial centre for respiratory medicine and oncology under State Food and Drug Administration (SFDA) of China in 2006.