【Tomorrow 10 o'clock】

Medicine, education, and research must be carried out, and academic organization must be guided. Every medical expert is a time management master.

No matter where the Chinese hospital rankings are listed, Peking Union Medical College Hospital has always ranked among the top three, and the rheumatism and immunology department of Union Medical College Hospital is a top-notch domestic and internationally influential golden sign. Professor Zeng Xiaofeng is the leader of this ace department. At the age of 59, he has been working in clinical practice for nearly 40 years, but there is still a young man’s vitality between his eyebrows, and his eyes are full of vitality while talking and laughing.

Professor Zeng Xiaofeng

How did Zeng Xiaofeng grow into a "top" expert in the industry? How did the Union Rheumatology team develop to such a famous place today? Let's listen to his story...

The path to medical treatment is unreplicable

Zeng Xiaofeng was less than 17 years old when he was in the college entrance examination and was admitted to the Shanghai First Medical College at that time (today’s Shanghai Medical College of Fudan University). Surprisingly, he, who has made great achievements in the field of clinical medicine, initially studied basic medicine. "It was different from now on, and basic medicine is more popular than clinical."

There is no special reason for choosing to study medicine. Zeng Xiaofeng's high school is a provincial key, so most of the students in the class have passed the national key college score line. In order to avoid "intra-study", the teacher suggested that everyone should not be crowded in the same school to apply for the application, so he applied for the "medical examination".

Just after working in the laboratory of rheumatology and immunology for nearly two years, Professor Zhang Naizheng told Zeng Xiaofeng that Union tradition is that medicine, teaching and research must be grasped, and it is not enough to do basic research alone; it is necessary to be able to afford medical teaching and research, which requires him to go to clinical rotation. With the support and encouragement of Professor Zhang Naizheng, Zeng Xiaofeng decided to shift his focus from basic research to clinical work, enter the rotation of the clinical system, and start from an intern doctor. However, Zeng Xiaofeng lacks clinical work experience after all, and starting later than those of the same senior year, doing clinical practice may affect promotion. For this reason, he wrote a special guarantee letter, expressing his willingness to be promoted in the future according to his actual work ability.

"I didn't expect that I did a good job. After being an intern doctor for half a year, I was promoted to a resident doctor. In 1989, I competed to be a chief resident doctor. The subsequent promotion was not affected at all, and even became the first person to be promoted to attending physician in this class." In fact, Zeng Xiaofeng was promoted to chief physician when he was only 37 years old in 1999, and was also the first person to be promoted to senior professional title in the same class. This is relatively rare in the industry.

All achievements and recognition are earned by diligence. Zeng Xiaofeng, who is not a professional in the clinical field, has worked harder than others to catch up and surpass. He does not go to any other places every day except the wards, dormitories, laboratories, libraries, and basically has no personal life. The result of his efforts is that in addition to his solid clinical work, he also does a good job in scientific research. He has been publishing papers in the National Core Journal since 1986. He is very good at summarizing and analyzing and publishing quite a few articles. He was the first in the number of articles published in the hospital that year. By 1994, Zeng Xiaofeng's research had won many international awards.

Zeng Xiaofeng said that in fact, he was also deeply influenced by the old professors. There is a saying that "Exclusive Education has three treasures, professors, cases, and libraries." The old professors work hard and have very strict requirements for their younger generations. Now, almost no one in Union Education Hospital knows that he is from basic medicine, and his experience cannot be copied.

There are still many fruits to pick in this tree of rheumatism and immunity

In the early 1990s, Zeng Xiaofeng was the first in China to use intravenous injection of large doses of GC globulin (ivig) to treat systemic lupus erythematosus. This therapy is now routine at home and abroad, but making this attempt at that time was equivalent to being the first to eat crabs.

Zeng Xiaofeng also reported many cases that are very rare internationally and are the first in China, such as Sle combined with arteritis, Sle combined with Nukacer infection, Sjogren's syndrome combined with amyloidosis, etc. He recalled that it was "easy" to come up with results at that time, just like a tree full of fruits, you can pick them with your hand. The fruits of other disciplines were almost picked. Only the tree of rheumatism and immunity still had many fruits not picked. "But you have to climb up on the ladder to pick them. All we need to do is discover these fruits and then try to pick them."

Zeng Xiaofeng always followed Professor Zhang Naizheng's teachings of "doing clinical work steadily", digging into the clinical practice and studying hard. He never gave up on improving himself, and once went abroad to learn how to do clinical research more accurately. At the same time, he was still insisting on basic research.

In 1999, Zeng Xiaofeng "picked" a new "fruit". That year, p) antibody detection methods were a new breakthrough in the international community. Unfortunately, everyone had no business acumen, did not apply for patents, and carried out commercial development, but was first registered by foreigners. Zeng Xiaofeng laughed and said, "If I had a patent back then, I might not have to sit here at all. Now we use this kit and we have to pay foreigners."

In fact, Zeng Xiaofeng has many firsts in the rheumatology community. He was the first to propose that ultrasound examinations can be used for the diagnosis and treatment evaluation of rheumatism, and published an academic paper in 1998; he was the first to establish anti-myeloperoxidase (mpo) and protease 3 (pr3) detection methods and used for the diagnosis of vasculitis, etc.

The growth of Union Rheumatology and Immunology Department,

It is a microcosm of the development of China's rheumatism

This year marks the 100th anniversary of the founding of Peking Union Medical College Hospital. As an emerging discipline, the Department of Rheumatology and Immunology has grown into a brand department and external business card of Union Medical College Hospital. In Zeng Xiaofeng's view, the development history of the Department of Rheumatology and Immunology in Union Medical College Hospital actually reflects the process of the development of the discipline of rheumatology and Immunity in my country.

The talented Union Rheumatology Team

The major of rheumatism and immunity in my country was founded by Professor Zhang Naizheng, who is known as the father of Chinese rheumatology. In the late 1950s, he began to engage in rheumatism and immunity major and promoted the construction and popularization of disciplines. In 1979, he began to establish a rheumatism and immunity specialty in Union Hospital, and the following year it was officially established. Since then, the major of rheumatism and immunity in China has been able to develop steadily.

The rheumatism and immunology department of Union Hospital has developed to this day, with many talents. The team has more than 40 people, 17 senior professional titles, and 15 doctoral supervisors, which is almost impossible to see in other disciplines or other hospitals. For each team member, Zeng Xiaofeng, as the director, has proposed that he should have his own sub-specialty research direction in addition to clinical work, and all three aspects of medical teaching and research must be grasped.

"Our scientific research is very clear, 'Scientific research is the leader, teaching is the foundation, and clinical is the foundation'. After I became the director, I added two more sentences, 'Platforms are the cornerstone, resources are the future'. We must have a platform to do things, and we cannot do our own affairs. We can do many big things through these platforms and data centers, and we can also use the platform to drive the national strength to do it together, such as our Sle multi-center registration research.

Resources are the future, and this resource has many aspects, including patient resources, scientific research project resources, and talent resources. Without these three resources, it is difficult to strengthen the department’s strength.”

In 2008, it was a very important turning point for the development of Union Hospital and my country's rheumatism and immunization. The Union's rheumatism team obtained a major project of the National 11th Five-Year Plan for Science and Technology Support Plan, so it quickly established the China Systemic Lupus Erythematosus Research Collaborative Group (Cstar), included it in more than 100 centers across the country, and started cohort research. This is the first China's own SLE database. More than ten years have passed, it has become an internationally renowned database and published dozens of SCI articles. At present, foreign SLE-related research data will contain Chinese data, and these data are basically from the Cstar database.

Later, cohort research on diseases such as Sjogren's syndrome, rheumatoid arthritis and other diseases was also carried out one after another. From then on, we bid farewell to the problem that there was no national data for Chinese people in the past, and basically found out the "foundation" of common rheumatism, such as the clinical characteristics of these diseases in China, the current diagnosis and treatment status and prognostic factors, filling a large number of gaps, and the research results were also widely adopted internationally.

Zeng Xiaofeng said: "Our 11th Five-Year Plan has rolled to the 12th Five-Year Plan and the 13th Five-Year Plan, and has realized the idea of ​​establishing a sustainable development research model proposed back then. I think this is a very meaningful thing."

He emphasized that Union Hospital has always taken the world as its mission and hopes to drive the development of national rheumatology and immune specialties through its own efforts. In 1985, the Rheumatology Branch of the Chinese Medical Association was also established under the rush and struggle of Professor Zhang Naizheng. Its establishment indicates that the discipline of rheumatology and immune began to become a real discipline.

"Not only that, Professor Zhang Naizheng did a lot of work on the promotion and popularization of majors. He even personally communicated with leaders at all levels of the Ministry of Health at that time, calling for greater support for disciplines. He also went abroad and contacted academic organizations such as the European Union for Anti-Rheumatology (Eular), the Asia-Pacific Alliance for Rheumatology (APL) and other academic organizations to come to China for meetings, invited experts to class, and also led domestic scholars to go out to participate in international conferences and academic exchanges." Zeng Xiaofeng recalled.

After more than 30 years of growth, the Rheumatology Branch of the Chinese Medical Association has given birth to 11th chairman. Except for the 8th chairman from the other hospitals, all of them are from the Rheumatology and Immunology Department of Union Hospital. Zeng Xiaofeng is the 9th and 10th chairman. Because of this, in the promotion and activities of my country's rheumatology and Immunology Department of Peking Union Hospital has always been the main participant and organizer.

In recent years, the society has formulated the "China Rheumatology and Immunology Discipline Development Plan" and put forward the slogan of "one city, one department, one center", that is, every county-level city must establish at least an independent rheumatology and immunology department and establish a testing center that can detect all rheumatology-related antibodies. After the plan was released, hospitals across the country have responded and put into construction.

This plan has also been recognized and supported by the country. Professor Zeng Xiaofeng said, "One thing I feel very proud of is that during my term, I saw the major event of establishing rheumatism and immune departments in tertiary hospitals across the country began to be implemented. On October 31, 2019, the Health Commission specially issued an article "Guidelines for the Construction and Management of Rheumatism and Immunity Department of Comprehensive Hospitals" to emphasize this matter. What is the specific implementation situation? I need to follow up next."

Talking about our comparison with the international community, Zeng Xiaofeng believes that the gap exists objectively, and the domestic level of scientific research and national capital investment are not as good as those in basic research. However, we are not bad in clinical practice. In recent years, we have done a lot of research, and the number of published articles is second only to the United States. Last year, there was a global hospital rheumatism and immunity-related articles published in the list, and Peking Union Medical College Hospital ranked first in the world.

Fortunately, the country attaches great importance to the development of rheumatology and immune specialties. In April 2019, the fourth batch of National Clinical Medical Research Centers was officially announced. "Our department is very honored to be one of the fourth batch of centers. In the past, it was difficult to make multi-center prospective cohort research and interventional research in China, which were all small and retrospective analysis. However, since the establishment of the National Clinical Medical Research Center, there have been more and more of these studies in China. In recent years, the speed of catching up has been very fast, which has completely changed the international status of our rheumatology and immune discipline."

To improve scientific research level, capital investment, equipment and relevant talents are also needed. In Zeng Xiaofeng's view, it is inappropriate to let rheumatology and immunologists be responsible for basic research. More basic research talents should be cultivated, and clinicians should also strengthen cooperation with basic researchers. Basic research and clinical research are now in a state of separation and need to be better combined.

Zeng Xiaofeng has always promoted these work on various platforms in his practice. He has part-time jobs in many societies, including the former chairman and Cstar director of the Rheumatology Branch of the Chinese Medical Association, as well as the president of the Rheumatology Immunology Branch of the Chinese Medical Association, the head of the China Center of the Scleroderma Experimental Research Group (Eustar) of the European Anti-Rheumatology Alliance, the head of the National Rheumatology Data Center (Crdc), the director of the National Clinical Medical Research Center of Skin and Immune Diseases, etc.

The hospital needs to carry out "medical and educational research". There are so many academic work outside the hospital, but there are no three heads and six arms. How can we do it? Zeng Xiaofeng said that in fact, all these work is done to one focus, that is, to promote the development of disciplines, popularize knowledge on rheumatism and immune diseases, and improve the level of diagnosis and treatment. If all resources are concentrated in this direction and the goals are clear, there will be no distractions, and you can do it well if you take more positions.

Of course, this is not an easy task. Although it is hard for those who can do it, Zeng Xiaofeng has to devote almost all his time to work, and to a large extent he sacrifices his family and personal life. He attends various meetings and activities almost every weekend and prepares various matters. As he gets older, he gradually feels a little overwhelmed. It takes a long time to recover after coming back from a business trip. However, out of his love for the subject, he has worked with a sacred sense of mission for decades and has long been used to it.
Chapter completed!