ZhiJian Medical: Pioneering Respiratory Therapy with 'Haze' Nebulizers to Empower Home Healthcare

Do you understand breathing?

To healthy individuals, this question may seem particularly absurd. However, for those with compromised cardiopulmonary function or suffering from pulmonary diseases, regaining the correct “way of breathing” to alleviate their suffering has become their most cherished aspiration.

According to public data from the American Association for Respiratory Care, the United States has been developing the respiratory therapy profession since the 1940s and now boasts over 100,000 practitioners working across major healthcare institutions and medical device companies. In contrast, China’s development in the field of respiratory therapy has been relatively lagging. Chinese universities only began offering related majors in the late 1990s, and the number of practitioners currently stands at merely a few hundred. Furthermore, there are few domestic manufacturers specializing in the research and development of devices for this field, with the niche market largely sustained by imported products.

“The market potential for respiratory therapy in China is enormous, yet few companies have turned their attention to this sector,” said Xie Yuebing, CEO of Sichuan Zhijian Medical Technology Co., Ltd. (hereinafter referred to as “Zhijian Medical”). “Respiratory therapy products imported from abroad are not only expensive but also fail to align with the physiological characteristics of the Chinese population. Furthermore, these imported products exhibit poor consistency; we even suspect that they are being sold in China because they have been phased out of European and American markets.”

In this context, Zhijian Medical was established in 2016, dedicated to filling the gap in domestic respiratory therapy and developing high-end, precision Chinese-made medical devices.

Xie Yuebing, a graduate of West China School of Clinical Medicine at Sichuan University, spent 13 years at West China Hospital. He initially worked in the Intensive Care Unit (ICU), specializing in respiratory therapy. After obtaining a master’s degree in neurosurgery, he became a neurosurgeon. During this period, he collaborated with classmates on the research and development of deep brain stimulators, gradually acquiring foundational knowledge in manufacturing.

“Over more than a decade of professional experience, Xie Yuebing has identified a significant disconnect between users and manufacturers of medical devices in China. Most manufacturers rely on imitating foreign devices, lacking insight into their specific clinical applications and failing to adjust or iterate products based on clinical needs. ‘We lack healthcare professionals engaged in the research, development, and production of clinical medical devices,’ he noted.”

Looking back, Xie Yuebing identified an opportunity in the yet-to-be-developed market for respiratory therapy devices and, when the time was right, resolutely embarked on the path of entrepreneurship. However, Xie did not go it alone; he was joined by four of his former college roommates. Among them, one had previously served as a senior executive at a multinational ventilator company, while another had worked as a production supervisor at a large medical device company based in Hangzhou. In this small but highly specialized team, each member brought unique technical expertise and focus areas, yet all moved toward a common goal: transforming laboratory concepts into commercially viable products.

As a company dedicated to the research, development, and manufacturing of devices in the field of respiratory therapy, Zhijian Medical’s current flagship products include respiratory trainers, assisted sputum expectorators, and handheld mesh nebulizers. These products are designed to support patients’ pulmonary rehabilitation, shorten hospital stays, and reduce admission frequency through home-based chronic disease management, thereby preventing cross-infection caused by patient overcrowding in hospitals and improving patients’ quality of life.

It is understood that traditional nebulizers currently available on the market are air-compression nebulizers requiring a power outlet. These devices utilize compressed air to aerosolize liquid medication into a mist; however, the resulting particle size distribution is characterized by large diameters and significant heterogeneity. In contrast, the handheld mesh nebulizer developed by Zhijian Medical employs the principle of aperture-based atomization. By leveraging the high-frequency oscillation of a ceramic plate perforated with thousands of micropores ranging from 1 to 5 μm in diameter, the device selectively generates drug particles within this specific size range.

It is important to note that particles sized 1–5 μm are most prone to deposition in the lungs. Particles that are too large tend to deposit on the pharyngeal wall, failing to reach the lungs and increasing the risk of secondary infections; conversely, particles that are too small are exhaled immediately, rendering them therapeutically ineffective. For instance, PM2.5 is particularly harmful because particles of 2.5 μm can readily deposit in the alveoli and enter the bloodstream. Xie Yuebing described it as follows: “If traditional nebulizers produce ‘fog,’ then ours produces ‘haze.’ The utilization rate of traditional nebulizers is only 4%, whereas our mesh nebulizers can achieve over 20%.”

Furthermore, Zhijian Medical emphasizes localization in product design, tailoring parameters to the physiological characteristics of Asian populations to better suit domestic users. Meanwhile, to facilitate home-based healthcare, the company has enhanced product portability by enabling nebulization therapy powered by dry batteries for home use. It has also launched a mini-program for chronic disease management, which, integrated with IoT modules, allows for remote online guidance and monitoring of medication adherence.

“Just in terms of portability, there is strong market demand,” said Xie Yuebing. “Nowadays, the time cost for patients’ families is very high. Taking nebulization three times a day as an example, traditional nebulization would require nine hospital visits over three days. With our device, nebulization can be performed at home, which improves compliance among pediatric patients and also helps reduce the rate of hospital complaints.”

Currently, Zhijian Medical has established partnerships with West China Hospital of Sichuan University, West China Second University Hospital of Sichuan University, the Second Affiliated Hospital of Chongqing Medical University, the Affiliated Hospital of China Medical University, the Affiliated Hospital of Guangzhou Medical University, and Xiangya Hospital of Central South University, among others. Its pulmonary rehabilitation products have been adopted for clinical use in these hospitals.

From Xie Yuebing’s perspective, the continuous research and development and innovation of medical devices constitute the company’s most critical task and mission. He told VCBeat that in the coming years, the company will primarily promote two innovative products. One is a mesh nebulizer for mechanical ventilation, currently under development for intensive care unit (ICU) use, which is expected to obtain both the Medical Device Registration Certificate and the Production License around March next year, thereby filling a gap in the domestic market. The other is a portable ophthalmic nebulizer developed in collaboration with Sichuan Shenghe Pharmaceutical Co., Ltd. This product aims to enrich the company’s own product portfolio while enabling it to take an early lead in capturing the new, untapped market of ophthalmic nebulization.

In addition, Xie Yuebing revealed that the company may conduct financing activities in the second half of next year to advance the development of two innovative ICU medical devices targeting the respiratory and critical care fields.

“We aim to become a leading respiratory therapy enterprise in China that is closely aligned with clinical practice, focusing on the research and development, iteration, and commercialization of medical devices,” said Xie Yuebing. “In the later stages, sales will be handled by professional and mature distributors, who will manage the ‘last mile’ into hospitals.”