She wanted to study infectious diseases, but she mistakenly entered the endocrinology department, a road she has been walking for 35 years
Written by | Wang Hang
Source | "Medical Endocrinology Channel" public number
Every Tuesday and Thursday morning is director Zhang Qiu's expert outpatient time, if there is no special situation, she will appear half an hour in advance in the First Affiliated Hospital of Anhui Medical University Changjiang Road outpatient 11th floor of the national standardized metabolic disease management center clinic.
Outside the door of the clinic, many of them are old patients who have followed Director Zhang Qiu for many years and loyal "fans".
Zhang Qiu is the director of the Department of Endocrinology, and she also has many academic titles and achievements: Jianghuai Famous Doctor, Director of the Endocrine Quality Control Center of the Anhui Provincial Health Commission, Chairman of the Endocrinology Branch of the Anhui Medical Association, Standing Committee Member of the Diabetes Branch of the Chinese Medical Association (9th) and Leader of the Diabetes Education and Management Group, Vice President of the Chinese Sports Rehabilitation Education College of the Chinese Medical Association, and the first batch of experts of the National Health Science Popularization Expert Database...
This year is the 35th year of Zhang Qiu's work in the field of endocrinology. From the initial little knowledge of endocrinology, bent on learning the department of infectious diseases but mistakenly assigned to endocrinology, to the construction of dozens of people in the national endocrinology research center Anhui Branch Center, becoming the leader of the discipline, Zhang Qiu witnessed the development and leap of endocrinology disciplines in the mainland, and also added a strong ink to the field of diagnosis and treatment of chronic diseases such as diabetes.
Endocrine association
Zhang Qiu's endocrine medical career began with a "sexism".
In 1987, after graduating from Anhui Medical University (formerly Anhui Medical College), Zhang Qiu entered the First Affiliated Hospital of Anhui Medical University (hereinafter referred to as "Anhui Medical Affiliated Hospital") to rotate the departments, and when determining the professional direction, her first choice was the department of infection, in her words, "There are many patients in the department of infection, and the condition is serious, and the treatment is very challenging." ”
When running for the same position as another boy, the old director of the infection department had the idea of "son preference", and she regrettably passed by the infection department.
She did not give up, and successfully obtained the master's degree of Professor Sun Guihua, director of the Department of Internal Medicine, which was also a chance to open Zhang Qiu's fate with the department of endocrinology for more than thirty years.
At that time, zhang qiu was also less valued, and there was also the early endocrinology discipline in the mainland.
In the 1970s and 1980s, the prevalence of endocrine diseases such as diabetes was low, there were fewer doctors engaged in endocrinology, and many provincial and municipal hospitals did not even set up endocrinology specialties.
In the case of an annuology Hospital, the endocrine ward established at the end of the 1970s was in the same ward as the Department of Nephrology, and the patients admitted and treated were all acute and serious patients of internal medicine, such as suicide by taking poison, drunkenness, fever to be investigated, etc. Many complex diseases such as unknown etiology and difficult diseases are also admitted to the endocrinology department.
In the past three decades, with the continuous improvement of clinical laboratory and molecular biology technology, the department of endocrinology has ushered in a period of rapid development. Zhang Qiu told the "medical community" that although she was assigned to a relatively unpopular department at that time, the Anyi Affiliated Hospital where she worked had always attached importance to the development of endocrinology.
Laboratory of "Two-place Disease (Dihythoxylum)"
As early as 1964, the Anyi Affiliated Hospital established an endocrinology professional group, which marked the establishment of the Department of Endocrinology in Anhui Province. In 1978, the endocrinology professional group had an independent bed, and formed a cooperative group for endemic disease investigation to conduct a survey of "two-place disease (dijia disease)" in the Dabie Mountains.
In 1984, he opened an endocrinology specialty laboratory in the internal medicine laboratory to independently undertake the detection of endocrine hormones and metabolites; in 1988, Professor Sun Guihua led the establishment of the Endocrinology Branch of the Anhui Medical Association and served as the first chairman.
In 1989, the Department of Endocrinology of Anyi Affiliated Hospital became officially independent, with 27 beds, and the following year it became the first batch of professional master's degree awarding points in Anhui Province, cultivating a large number of outstanding endocrine professionals.
In 1997, it was approved as the endocrine drug clinical trial base of the National Drug Clinical Trial and Evaluation Center, and in 2005, it became an independent ward and established the Institute of Endocrine Metabolic Diseases, with the number of beds increasing to 37; in 2010, a new ward was established, and the number of beds increased to 74.
In 2014, Zhang Qiu, who was also the deputy director of the Department of Endocrinology, also served as the director of the Department of Internal Medicine, and in the same year became the first chairman of the Diabetes Branch of the Anhui Medical Association. Under the leadership of the Provincial Health Commission and the Medical Association, he wrote the "Guidelines for graded diagnosis and treatment of diabetes in Anhui Province" (2015 edition), and participated in the preparation of the "Interpretation of the Guidelines for the Prevention and Treatment of Common Diseases in Anhui Province" and the "Integrated Management Plan for Diabetes in Anhui Province". Since then, she has successively won the honorary titles of the second Jianghuai Famous Doctor and the Chinese Medical Doctor Association as "Good Teacher in the Mind of Resident Doctors".
Old picture of Professor Zhang Qiu and tutor Professor Sun Guihua's free consultation
After serving as the director of the department in 2016, she focused on promoting interdisciplinary translational medicine scientific research and talent training, adopted the talent training mode of "sending out" and "bringing in", and cultivated a large number of outstanding young and middle-aged backbones, with 3 doctoral supervisors, 11 master's supervisors, 80% of doctors obtained doctoral degrees, and 7 people had overseas study experience, forming a talent echelon structure that combines old, middle-aged and young people.
As one of the first batch of clinical key specialties of Anhui Provincial Health Commission, Anhui Medical Affiliated Hospital has been leading and promoting the development of endocrinology in Anhui Province. In 2020, it was awarded the Anhui Branch Center of the National Metabolic Disease Research Center (the only one in the province), and in 2021, it was awarded the priority development key specialty of the Provincial Health Commission. The specialty ranking has always ranked first in Anhui Province, with strong medical service, teaching and research and technical radiation capabilities.
From "cold bench" to "fragrant food", Zhang Qiu witnessed and promoted the start and development of endocrinology in mainland China, and in her view, achieving these achievements is a good era for her to catch up with the development of the specialty.
Changes in the spectrum of endocrine diseases
In addition to the hospital's attention, the change of the disease spectrum has also brought opportunities for the development of endocrine and metabolic diseases.
Zhang Qiu recalled that thirty years ago, the spectrum of endocrine diseases was narrow, and the incidence of diabetes was not as high as it is now, but there were more "big neck diseases" (goiter) caused by "iodine deficiency".
Surveys in the 1970s showed that iodine deficiency diseases were endemic to varying degrees in many parts of the mainland, with about 720 million people under threat, 35 million people with large neck disease and 250,000 people with small disease. In 1979, the main wards of the country began to promote the implementation of the prevention and control strategy based on iodine oil pills, but the epidemic situation of the disease has not been fundamentally improved.
In the 1970s and 1980s, Professor Sun Guihua, Zhang Qiu's supervisor, led the Department of Endocrinology to carry out research on the prevention and treatment of iodine deficiency diseases in Anhui Province, and the team he led left valuable data on the investigation of the iodine nutrition status of Anhui Province before and one year after iodization of salt, and published the precious "Atlas of Iodine Deficiency Diseases".
After becoming an endocrinologist, the first scientific research work Zhang Qiu participated in was to go to the remote Dabie Mountains to conduct an epidemiological investigation of iodine deficiency diseases.
In 1994, the participants of the Iodine Deficiency Disease Expert Group of the Ministry of Health took a group photo
"Although the state has been preventing and controlling, many remote mountainous areas in Anhui have inconvenient transportation and lagging information, so we organized a lot of human, material and financial resources to do research and science popularization in various cities in the province, especially in the remote Dabie Mountainous Area."
When Zhang Qiu and other doctors went to Dabie Mountain to do flow tuning, they found that "some fifteen or sixteen-year-old teenagers look like two- or three-year-old children, young, deaf and dumb, and the iodine deficiency in the fetal period affects the development of the entire nervous system, but this kind of Cretin disease is completely preventable." ”
Through measures such as salt iodization for the whole people, macroneck disease has also become a typical disease jointly eliminated by the Department of Endocrinology and the CDC, providing a lot of valuable data and rationalization suggestions for the national formulation of policies for the prevention and treatment of iodine deficiency diseases, and also making outstanding contributions to the prevention and treatment of iodine deficiency diseases in the mainland.
In the past, the diagnosis and treatment conditions were limited, there were not so many advanced machines to assist in diagnosis, there were no conditions to detect various hormones and other indicators, and there were often symptoms in endocrinology clinics that could not find the cause, and even if the cause was found, there were not so many drugs to deal with, "basically relying on clinical experience, just like the Sherlock Holmes judgment." ”
Zhang Qiu said that thanks to the strong support of the hospital, the department closely follows the cutting-edge new technologies at home and abroad in diagnosis and treatment, and has its own endocrine specialty clinical laboratory, molecular biology laboratory, outpatient rapid detection and functional laboratory, bone density examination room, clinical drug experiment and evaluation center, etc., as a key specialized laboratory in Anhui Province, the diagnostic level has reached the level of hypothalamic-pituitary gland and molecular biology.
As the level of laboratory testing increases, the spectrum of endocrinology is also expanding.
Zhang Qiu introduced that in addition to common diseases such as diabetes and thyroid disease, the diagnosis level of difficult diseases such as osteoporosis, pituitary adrenal gonad disease and rare diseases has been significantly improved.
Assist grassroots chronic disease management
"The clinical strength of our department is very solid, because we have our own specialized laboratories, and there are so many experts and teams with excellent medical technology, but there is still a gap in basic research compared with Beijing, Shanghai and Guangzhou."
In 2016, Zhang Qiu succeeded as the director of endocrinology at the First Affiliated Hospital of Anhui Medical University, and she proposed to increase the capacity building of department research, combine clinical ideas with basic research, and improve the ability of medical translation.
Group photo of the old, middle and young people in the department
The Department of Endocrinology of the Hospital has also cooperated with heidelberg University School of Medicine, Hefei Institute of Materials and Materials of the Chinese Academy of Sciences, The Basic Medical College of Anyi University, the Department of Burns of the First Affiliated Hospital of Anyi University, Vascular Surgery, Orthopedics and Nephrology, etc., and has carried out more basic and clinical research on chronic complications of diabetes such as foot wound injury repair, vascular lesions and diabetic nephropathy.
The department has successively received 8 national projects such as the Sino-German cooperation project of the State Fund, the national fund and the youth project, dozens of provincial scientific research projects, and published a number of high-level academic papers.
Since then, Director Zhang Qiu has led the Provincial Diabetes Branch to lead the formulation of the "Anhui Provincial Diabetes Graded Diagnosis and Treatment Guidelines", written the integrated prevention and treatment plan for diabetes in Anhui Province, participated in the formulation of a number of domestic specialty guidelines and expert consensus, and regularly carried out new guidelines and endocrine diagnosis and treatment norms in various parts of the province every year, radiating advanced diagnosis and treatment and management concepts to the grass-roots level.
The data shows that the incidence of diabetes in the 1980s was only 0.9%, and the adult prevalence rate has climbed rapidly to 12.8% in the past 40 years. In the Department of Endocrinology of the First Affiliated Hospital of Anhui Medical University, the number of outpatient visits exceeds 180,000 every year, and diabetics account for the majority, and many patients are queuing up all year round to wait for admission.
The reason for the high prevalence of diabetes, Director Zhang Qiu believes that one is the urbanization of rural areas, the economic status of residents has improved year by year, they do not completely rely on manual labor to maintain their lives, and their living standards have improved significantly; second, residents have not yet formed a healthy lifestyle, and the concept of health has not adapted to economic and social development.
"The difficulty of diabetes management is at the grassroots level." Although the treatment methods of diabetes are changing with each passing day, Director Zhang Qiu said that in addition to attaching importance to individualized treatment, comprehensive chronic disease management is also crucial, and the biggest challenge at the grassroots level is how to do a good job in health education, early screening and early prevention of diabetes and early standardized treatment.
There are about 350 million people with pre-diabetes in the mainland, according to the natural law of development, 10 million to 35 million cases of pre-diabetes cases progress to diabetes every year, early detection and early prevention will greatly reduce the probability of prediabetes progressing to diabetes and reduce the number of diabetes patients.
In recent years, Director Zhang Qiu and his team have focused on improving the ability of grass-roots diabetes prevention and treatment and chronic disease management, and the department has signed contracts with most communities in Hefei and a number of medical hospitals in the province, and established a diabetes prevention and control alliance to send talents and the latest diagnosis and treatment and chronic disease management mode for grass-roots communities and hospitals.
In 2017, with the strong support of the hospital leaders, the hospital built the first national standardized metabolic disease management center in Anhui Province with a scale of 1300 square meters on the 11th floor of the Changjiang Road Outpatient Clinic, carried out diabetes health education and diabetes management work, combined with the characteristic services of the diabetes common care clinic, improved the standard management rate of diabetes and patient satisfaction, and won the national diabetes health education management demonstration unit and the national diabetes educator training base.
Every year, they undertake 1-2 national academic conferences, host national and provincial-level follow-up classes, and carry out diabetes prevention and treatment guidelines and standardized diagnosis and treatment training for common endocrine diseases at the grass-roots level in various cities and cities in Anhui Province.
From laboratory basic research to clinical, to talent training and empowerment for the grassroots, the Endocrinology of the First Affiliated Hospital of Anhui Medical University has established a mature system of medical services, teaching research and technology radiation.
In this regard, Director Zhang Qiu has a more vivid analogy: "In a flood fight, if you focus on the far downstream of the dam, you may save some people, but you can't prevent the disaster from happening again, if you know where the pass is, go upstream, fundamentally solve the problem, the pass forward is the key." ”
Under the impetus of Zhang Qiu and the director of the department, the endocrinology specialty ranking of the First Affiliated Hospital of Anhui Medical University has always ranked first in Anhui Province, and has gradually moved out of the province, radiating Henan, Jiangsu and other regions.
In the future, Director Zhang Qiu and his team will continue to do a good job in the education and management of chronic diseases such as diabetes, and contribute to the basic and clinical research of endocrine metabolic diseases in mainland China.
Expert Profiles
Professor Zhang Qiu
Chief physician, doctoral supervisor
The second Jianghuai famous doctor of Anhui Provincial Health Commission
The first batch of national health science experts
He is a member of the 9th Standing Committee of the Diabetes Branch of the Chinese Medical Association and the leader of the Diabetes Education and Management Group
He is a member of the First Standing Committee of the Thyroid Disease Prevention and Control Committee of the Chinese Preventive Medicine Association
Vice Chairman of Diabetes Education and Management Branch of China Health Promotion and Education Association
Vice Chairman of the Endocrinology and Diabetes Committee of the Western Psychiatric Association
Member of the Second Standing Committee of the Diabetes Committee of the Chinese Association of Women Physicians
Director of the Endocrine Quality Control Center of the Anhui Provincial Health Commission
Head of the Department of Endocrinology and Metabolic Diseases, Anhui Medical University
Director of the Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University
General Secretary of the Party Branch of the Department of Internal Medicine of the First Affiliated Hospital of Anhui Medical University
Vice Chairman of the Ethics Committee of the First Affiliated Hospital of Anhui Medical University
Source: Endocrine Channel of the Medical Community
Review: Zhang Qiu, First Affiliated Hospital of Anhui Medical University
Editor-in-charge: Wan Shunshun
Proofreader: Zang Hengjia
Plate making: Xue Jiao