Medical science and technology innovation is an important engine to promote the development of new quality productivity in health. At the main venue of the 2024 China Health Science and Technology Innovation and Discipline Construction Conference and the High-quality Development Conference of Chinese-style Modern Hospitals, the participating academicians and scholars gave keynote speeches on topics such as technological innovation and discipline development and construction in medicine and related fields, and jointly discussed the cutting-edge trends and future trends of high-quality development in the medical field.
Bard Year
He is an academician of the Chinese Academy of Engineering and an honorary dean of Zhejiang University School of Medicine
What is a "first-class university" and a "first-class discipline"?
A first-class university is not only a platform for providing high-quality education, but also an important base for scientific research and innovation and social services. Through their educational, research, and social service activities, leading universities have a profound impact on the development of the country and the progress of society. Since the middle of the 20th century, the mainland has continued to strive to build a world-class university. Through the merger of institutions, policy support and key construction, the mainland's higher education system has made remarkable achievements in the pursuit of academic excellence and the enhancement of international competitiveness.
The most important thing in running a first-class university is to have first-class scholars and cultivate first-class talents. Looking back at history, China has produced many outstanding talents in the field of medical education and scientific research, who have played an important role in medical research, clinical practice, education reform, policy formulation, etc., and promoted the development of medical science and the progress of medical education.
In my opinion, the criteria for a first-class university can be summed up in three words: "have, produce and educate", that is, have high-quality faculty, rich academic resources, advanced scientific research facilities, etc.; Able to produce high-level scientific research results and cultivate outstanding talents; Able to produce graduates with an innovative spirit and a sense of social responsibility.
First-class universities play multiple important roles in society, which can be described as "talent pool", "resource pool" and "think tank". Specifically, first-class universities should cultivate and attract top talents and provide high-quality professionals to society; Provide new ideas and theories to lead social and cultural progress; To promote the development of science and technology as a center for the creation and dissemination of knowledge.
The mission of a first-class university can also be elaborated from three aspects: first, to run first-class disciplines, that is, to establish and develop internationally competitive disciplines; second, to produce first-class talents, that is, to cultivate outstanding talents who can play a leading role in their respective fields; Third, we need to produce first-class results, that is, to produce results that have a significant impact on social development through scientific research and innovation.
It should not be ignored that there are also some problems to be solved in the field of medical education in mainland China, such as the over-construction of medical schools, the quality of clinical medicine and the ability of medical graduates need to be improved.
I believe that it is necessary to give full play to the leading role of the national medical unit in national medical education, scientific research, clinical services, policy consultation and international cooperation.
First, the national medical unit is the cradle of national medical talents and outstanding talents, and provides human resources support for the country's medical development.
Second, the state-based medical unit bears the responsibility of solving the medical problems faced by the country, improving the national medical level through scientific research and technological innovation, and acting as a tractor and booster for medical development.
Thirdly, the state-based medical unit serves as a model for providing medical services to the public, and demonstrates how to effectively solve the country's difficult and critical medical problems through high-standard medical services.
Fourth, the national medical unit provides professional advice and suggestions in the process of formulating national medical and health policies, and becomes a think tank for policy and planning.
Fifth, when the country is faced with an emergency medical task or a public health emergency, the state-based medical unit can respond quickly and become the main force and mobile team to complete the task.
In summary, the national standard medical unit not only promotes the progress of medical science, but also makes important contributions to the protection and promotion of public health.
As a typical example, Peking Union Medical College has fulfilled its mission and responsibility as a national-based medical unit. As the core base of the Chinese Academy of Medical Sciences, Peking Union Medical College undertakes a number of national research tasks and shoulders the responsibility of an educational institution. It plays an important role in cultivating national medical talents, solving national medical problems, providing public services, participating in national policy formulation, completing national tasks, and international exchanges. It plays a key role in the development of medicine in the country.
The development and achievements of Zhejiang University School of Medicine have given it the potential to become the "Concord of the South". Through the development of educational innovation, discipline construction, talent training and scientific research platform, Zhejiang University School of Medicine is steadily moving towards the goal of becoming a first-class medical education institution in China and even in the world. Be a man, do things, do knowledge, and do your best to be responsible. I hope that colleagues will work together to make unremitting efforts to build a first-class university and first-class disciplines.
Du Jiangfeng
Academician of the Chinese Academy of Sciences, President of Zhejiang University
When microscopic magnetic resonance technology meets biomedicine
Since the middle of the 20th century, magnetic resonance technology (MRI) has achieved great success in the field of medical imaging and has won the Nobel Prize many times. With the continuous progress of science and technology, microscopic magnetic resonance technology is bringing revolutionary changes to the biomedical field with its unique advantages.
Conventional magnetic resonance (MRI), despite its great success in the field of medical imaging, is limited by its ability to probe at the microscopic scale. Because traditional magnetic resonance imaging usually relies on a large number of water molecules inside the human body, imaging individual cells or molecules is powerless.
Microscopic magnetic resonance technology can enable the detection and imaging of smaller signals, weaker signals, and finer resolution, so that biomedical samples can be studied at the microscopic scale. This is because microscopic magnetic resonance technology uses diamond sensors and quantum technology to achieve high sensitivity and resolution detection of individual molecules, even single spins. The core of this technology is to use the nitrogen-vacancy defect in the diamond as a sensor to convert the magnetic signal into a change in fluorescence intensity through the detection of a single spin quantum phase, so as to achieve accurate measurement at the microscopic scale.
At the same time, compared with traditional magnetic resonance, microscopic magnetic resonance technology can be operated under room temperature and atmospheric conditions, with high spatial resolution and long coherence time at the atomic scale, which provides a more relaxed and suitable working environment for biomedical research.
In view of these advantages, the application of microscopic magnetic resonance technology in the biomedical field is promising. Our team has achieved a number of breakthroughs.
First, the world's first paramagnetic resonance spectroscopy of a single protein molecule was obtained. Compared with the traditional electron paramagnetic resonance, the resolution and sensitivity of the new technology are greatly improved. Compared with ultra-high-resolution fluorescence microscopy, it can not only provide nanometer resolution spatial positioning information, but also further resolve the structural information and conformational changes of individual molecules.
Second, paramagnetic resonance detection of a single DNA molecule in aqueous solution revealed the motility characteristics and local environmental characteristics of the molecule.
Thirdly, single-cell magnetic resonance imaging with a resolution of 10 nanometers was realized, which provided the possibility for nano-resolution imaging of proteins in situ cells.
Fourthly, the immunomagnetic microscopy method has been established, which has formed a micron-resolution magnetic imaging of lung cancer tissues, which provides a new way for accurate diagnosis of tumors.
Self-developed scientific instruments are crucial to promoting the progress of relevant technologies in the mainland. On the basis of these research progresses, the research team has successfully developed a number of instruments, including high-power X-band pulsed electron paramagnetic resonance spectrometer, and has realized the transformation of results, which have been adopted by scientific research institutions at home and abroad.
Looking forward to the future, microscopic magnetic resonance technology based on diamond quantum sensing is expected to play a greater role in the cross-scale detection and research of single molecules, single cells and even pathological tissues. The review article of the research team will be published soon, which will provide more solid theoretical support for the development of this field.
With the continuous maturity of technology and the continuous expansion of applications, microscopic magnetic resonance technology will undoubtedly play an increasingly important role in the biomedical field. We have reason to believe that it will lead to more precise and effective solutions for the diagnosis and treatment of diseases.
Fan Jia
He is an academician of the Chinese Academy of Sciences and the president of Zhongshan Hospital affiliated to Fudan University
Technology + innovation Explore the path of high-quality development of hospitals
The new quality productivity is a contemporary advanced productive force born from revolutionary breakthroughs in technology, innovative allocation of production factors, and in-depth industrial transformation and upgrading. The strategic positioning of the National Medical Center is to carry out core technology research on the prevention and treatment of major diseases related to the disease spectrum of the mainland population, so as to promote the development of the medical industry.
Promoting the construction of the national medical center is an important focus for the development of new quality productivity in the field of health care, and "science and technology + innovation" is not only the essence of the development of new quality productivity, but also the mission of the national medical center, which requires us to continue to think about what kind of innovation should be done, and how to implement innovation, which requires us to effectively practice and manage.
In 2022, the country's first comprehensive national medical center construction project was officially launched in Zhongshan Hospital affiliated to Fudan University (hereinafter referred to as "Fudan Zhongshan Hospital"). In December 2023, two capital construction projects of the National Medical Center undertaken by Fudan Zhongshan Hospital officially started: the Shanghai International Medical Science and Technology Innovation Center and the first phase of the Qingpu New Town Campus of Fudan Zhongshan Hospital.
In the exploration of building a national medical center, Fudan Zhongshan Hospital adheres to the following four focus points.
First, take the discipline as the basic unit and continue to promote original innovation. The hospital has undertaken 29 national clinical specialty construction projects, has 43 key disciplines and specialties in Shanghai, established 33 disease-centered multidisciplinary clinical diagnosis and treatment centers in the hospital, and has 156 subspecialties, leading the development of the hospital's discipline groups with two "leaders" of pan-vascular discipline group and oncology discipline group. At the same time, the hospital has a series of scientific and technological innovation platforms, including the State Key Laboratory, the Basic Science Center of the National Natural Science Foundation of China, and the National Engineering Research Center under construction, which continue to inject momentum into the development of medical disciplines.
Second, improve the construction of systems and mechanisms to support the development of high-tech technologies. The hospital transforms products and application technologies through new technology cultivation management system, clinical research system, achievement transformation system, medical-engineering integration system, and industry-medicine integration system. The hospital promotes the construction of a clinical research center system, with relatively independent institutions and shared functions. We have a medical ethics committee, a clinical research center, and various departments have been established to enable scientific and technological innovation to be transformed and incubated as soon as possible, and to form usable technical products as soon as possible. The hospital has been approved as the Shanghai Innovation Base for the Integration of Industry and Medicine, and the Pilot Unit for the Transformation and Innovation of Scientific and Technological Achievements in Shanghai, and has made a series of innovative achievements in medical equipment and instruments, surgical interventional technology, artificial intelligence, and diagnostic technology.
Third, we need to deeply apply digital intelligence technology and explore new paradigms in scientific research. The hospital has built a bioinformatics data analysis platform base to form bioinformatics data standards; A multi-modal and multi-omics molecular diagnosis, treatment and prognosis prediction model has been constructed, and an integrated clinical trial platform with the characteristics of Fudan Zhongshan Hospital has been built by using 5G new infrastructure technology, a new paradigm of future medical care has been built, a big science platform has been built, and a big data platform integrating multidisciplinary data has been established.
Fourth, strengthen the integration of high-quality resources and unite the innovative power of science and technology. The seven functional platforms of the hospital integrate scientific and technological resources and form a close linkage, promote exchanges and cooperation within and outside the hospital, strengthen collaborative innovation and research capabilities, and form a "five forces linkage" between the government, hospitals, enterprises, universities and scientific research institutes. In addition, the hospital has opened up a new situation of win-win cooperation through high-level foreign exchanges.
Song Erwei
He is an academician of the Chinese Academy of Sciences and director of the Medical Department of Sun Yat-sen University
Research has led four revolutions in cancer treatment
The treatment of tumors has undergone four revolutions. In the case of breast cancer, since the 16th century, surgeons have advocated total mastectomy for breast cancer patients. The first total mastectomy for breast cancer in mainland China was performed in 1837 by Dr. Bo Jia, the predecessor of Sun Yat-sen Memorial Hospital of Sun Yat-sen University.
However, many cancer patients develop local recurrence and distant metastases within a short period of time after surgery. At the time, medical opinion was that it was impossible to cure the tumor by simply removing it. With further research, many pathologists and surgeons have proposed that malignant tumors, including breast cancer, spread through the lymphatic system. Guided by this philosophy, Dr. Halstead proposed the first surgical method of "radical mastectomy". The scope of removal in this procedure includes all breast tissue, lymph nodes in the area where the breast is drained, and pectoral tissue under the breast. This led to the first revolution in cancer treatment, starting with breast cancer, which is considered a localized disease by the medical community.
Although radical mastectomy reduces the risk of local recurrence, a significant number of breast cancer patients develop distant metastases after surgery, resulting in death. In order to further solve this problem, the Fisher brothers have carried out a series of experimental studies on the biology of tumor metastasis since 1957, using ⁵¹Cr as the tracer material, and observed that tumor cells can enter the lymphatic or blood system, leading to tumor spread. As a result, they proposed that "tumor dissemination is disorderly", and for the first time proposed the theory that "breast cancer is a systemic disease", as well as the strategy of "breast-conserving sequential systemic therapy for breast cancer". During the same period, some large-scale clinical studies have confirmed the efficacy and safety of breast conservation therapy for breast cancer, marking that breast cancer has entered the era of "breast conservation and radical cure". In mainland China, Professor Su Fengxi began to advocate the concept of "breast conservation first" in China. Therefore, we propose the second revolution in tumor treatment, believing that solid tumors such as breast cancer are systemic diseases, and more attention should be paid to systemic or systemic treatment.
At the beginning of the 21st century, American scientist Charles Peruux distinguished breast cancer into different molecular types for the first time through gene chip testing, confirming the theory that "breast cancer is a heterogeneous disease" at the molecular level. Since then, a large number of studies on precision typing and targeted therapy for breast cancer have emerged, and a new era of "precision and individualized diagnosis and treatment of tumors" has begun. In the field of lung cancer treatment, the research and development of targeted drugs for "EGFR (epidermal growth factor receptor) mutant lung cancer" has greatly improved the clinical diagnosis and treatment of patients with this subtype of lung cancer. By guiding individualized precision treatment through molecular typing, we believe that this is the third revolution in cancer treatment.
Returning to breast cancer treatment, a review of real-world data and long-term follow-up data from our team found that breast-conserving patients had a better survival benefit. Why is this happening? Our team started with tumor immunity and carried out basic research exploration. After the tumor is removed by breast-conserving surgery, the "soil" that gave birth to the tumor is still preserved, and the tumor antigen remains in it. Further chemoradiotherapy can help present the preserved tumor antigens to the immune system to further activate anti-tumor immune cells, which can be maintained for a long time. Therefore, tumor antigen-specific immune cells can be detected in the peripheral blood of patients for a long time after breast-conserving surgery, which can prevent tumor recurrence and metastasis in the future.
The game between the immune system and the tumor runs through the whole process of tumor development. In terms of optimizing immunotherapy strategies, many domestic teams have given some good plans. We put forward the concept of how to improve the control of effector immune cells (EICD), and deeply explored the mechanism affecting EICD in breast cancer and other solid tumors, and put forward the "tumor ecology theory", which expanded the focus of tumor treatment from the "local view" that only focuses on tumors to the "global view" that focuses on the entire internal environment of the body.
The four revolutions in cancer treatment and breast cancer are closely related, and China's breast cancer research is leading a new round of cancer treatment revolution, and Chinese scientists will take on a new historical mission.
George Pascal
Chairman of Mayo Clinic and Executive Medical Director for the Americas
Mayo's experience in creating a highland for medical innovation
Mayo Clinic is one of the world's largest and first integrated team care practices. Founded in 1864, Mayo has evolved to create an integrated care model that focuses on patients, integrates resources, values and respects, and puts the value of patients as human beings first, and is committed to innovation and integrating clinical practice, education and research. In this service model, doctors are not only practitioners of medicine, but also artists who care for patients. The team of doctors will conduct a comprehensive assessment and consultation with the patient, gain the trust of the patient, and provide better service to the patient.
Mayo's service model is based on a collaborative team of experts who listen to patients' needs, conduct interdisciplinary consultations, evaluate patients, and develop diagnosis and treatment plans to ensure that patients receive high-quality care.
Mayo has grown with clinical integration as a foundational strategy that integrates physician networks within the hospital to improve the quality and efficiency of care through incentive programs and performance management. The hospital also focuses on the development of the healthcare system, with a focus on the integration of medical practice, education, and research.
Mayo is also exploring a hierarchical system of care. When primary community care fails to meet the needs of patients, patients will be referred to medical centers for specialist care, and subsequent care will be returned to the primary community to ensure the maximum efficiency of medical resources.
Mayo focuses on three key elements: management approach, infrastructure and organizational culture. First, doctors and hospitals have the same goals and establish a coordinated and unified medical service model; the second is a powerful information and knowledge management system to transform and share information; The third is to unify the payment mode of finance.
Physicians are an important foundation for integration, and hospitals select the right mix of specialists to provide quality services to patients, allowing physicians to be widely involved in treatment and management, and the hospital and physicians to make decisions together. This requires physicians not only to have medical technology, but also to have leadership to achieve sustainable and healthy development of the entire system.
To improve the quality of hospital management, Mayo Clinic optimizes its information technology infrastructure, establishes a seamless data exchange platform, and applies disease registries and other clinical tools. Carry out performance monitoring, develop a system to track the performance of doctors, and evaluate doctors; Establish a performance-based bonus pool and establish a bonus structure that is linked to project objectives and physician performance.
In addition, Mayo continues to promote multidisciplinary collaboration within the hospital. At Mayo, it's not just one physician who serves patients, it's "the entire organization." This multispecialty collaboration is designed to bring Mayo care to the best of each patient.
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