She wanted to study infectious diseases, but she entered the endocrinology department by accident. She has been on this road for 35 years
Writing | Wang Hang
Source | Public Account of “Medical Endocrinology Channel”
Every Tuesday and Thursday morning is Director Zhang Qiu’s expert clinic hours. If there are no special circumstances, she will show up at Changjiang Road Clinic 11 of the First Affiliated Hospital of Anhui Medical University half an hour earlier The National Standardized Metabolic Disease Management Center clinic.
Outside the clinic, patients have long been surrounded by admiring patients. Many of them are old patients and loyal “fans” who have followed Director Zhang Qiu for many years.
Zhang Qiu is the director of the Department of Endocrinology. She also has many academic titles and achievements: a famous doctor of Jianghuai, director of the Endocrine Quality Control Center of Anhui Provincial Health and Health Commission, and chairman of the Endocrine Branch of Anhui Medical Association. , Member of the Standing Committee of the Diabetes Branch of the Chinese Medical Association (9th session) and the leader of the Diabetes Education and Management Group, Vice President of the Chinese Academy of Sports Rehabilitation Education of the Chinese Medical Association, and the first batch of experts in the National Health Science Expert Database…
This year marks Qiu Zhang’s 35th year working in the field of endocrinology. Zhang Qiu witnessed from the beginning when he knew little about endocrinology and wanted to study infectious diseases, but was classified into endocrinology by accident, to building an Anhui branch of the National Endocrinology Research Center with dozens of people and becoming the leader of the discipline. It has contributed to the development and leap of endocrinology in my country, and it has also made a great contribution to the field of diagnosis and treatment of chronic diseases such as diabetes.
Connect with endocrine
Zhang Qiu’s endocrinology career began with a “sex discrimination”.
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 in various departments. When deciding on a professional direction, her first choice was the infectious disease department. In her words, “the infectious disease department has many patients, and the condition is serious, so it is very challenging to treat.”
When running for the same position with another boy, the old director of the infectious disease department had a “patriarchal” mentality, and she regretfully passed by the infectious disease department.
She did not give up, and she successfully obtained the master’s degree from Professor Sun Guihua, director of the Department of Internal Medicine of the University.
At that time, like Zhang Qiu, there was also the early endocrinology discipline in my country.
In the 1970s and 1980s, the prevalence of endocrine diseases such as diabetes was low, and there were fewer doctors engaged in endocrinology. Many provincial and municipal hospitals did not even set up endocrinology.
Take the Affiliated Hospital of Anhui Medical University as an example, the endocrine ward established in the late 1970s is in the same ward as the nephrology department, and it treats patients with acute and severe internal medicine, such as suicide by poisoning, drunkenness, etc. , fever to be investigated, etc… Many complex diseases such as unknown etiology and intractable diseases are also admitted to the endocrinology department.
In the past three decades, with the continuous improvement of clinical testing and molecular biology techniques, 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 the time, the Affiliated Hospital of Anhui Medical College where she works has always attached great importance to the development of endocrinology.
Laboratory of “Two-Site Diseases (Diocytic Dike Disease)”
As early as 1964, the Affiliated Hospital of Anhui Medical College established an endocrinology professional group, which marked the establishment of the endocrinology department in Anhui Province. In 1978, the endocrinology professional group had an independent bed, and formed an endemic disease investigation cooperation group to carry out the investigation of “two endemic diseases (earth disease and gram disease)” in Dabie Mountains.
In 1984, a specialist endocrinology laboratory was set up 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 Anhui Provincial Medical Association Endocrinology Branch and served as the first Chairman of the session.
In 1989, the Department of Endocrinology of the Affiliated Hospital of Anhui Medical College officially became independent and opened 27 beds. In the following year, it became the first batch of professional master’s degree conferring points in Anhui Province, and cultivated a large number of outstanding endocrinology professionals.
In 1997, it was approved as an endocrine drug clinical trial base of the National Center for Drug Clinical Trials and Evaluation. In 2005, it became an independent ward, and the Institute of Endocrinology and Metabolism was established. The number of beds increased 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. In the same year, he became the first chairman of the Diabetes Branch of the Anhui Medical Association. Under the leadership of the Provincial Health and Medical Commission and the Medical Association, he wrote the “Guidelines for Graded Diabetes Diagnosis and Treatment in Anhui Province” (2015 Edition), and participated in the “Interpretation of the Guidelines for the Prevention and Control of Common Diseases in Anhui Province” and the “Integrated Management Plan for Diabetes in Anhui Province”. write. Since then, she has successively won honorary titles such as the 2nd Jianghuai Famous Doctor and the “Good Teacher in the Heart of Resident Physicians” by the Chinese Medical Association.
Old picture of Professor Zhang Qiu and his tutor Professor Sun Guihua’s free clinic
After serving as the director of the department in 2016, she has focused on promoting interdisciplinary translational medical research and talent training. There are a large number of outstanding young and middle-aged backbones. There are 3 doctoral supervisors, 11 master supervisors, 80% of the doctors have obtained doctorate degrees, and 7 people have overseas study experience, forming a talent echelon structure combining the old, the middle and the young.
As the first batch of key clinical specialties of Anhui Provincial Health and Health Commission, Anhui Hospital has been leading and promoting the development of endocrinology in Anhui Province. In 2020, it was awarded the National Metabolic Disease Research Center Anhui Branch Center(the only one in the province), and in 2021, it was awarded the priority development key specialty of the Provincial Health and Health Commission. The junior college ranking has always ranked first in Anhui Province, with strong medical services, teaching research and technical radiation capabilities.
From “cold bench” to “sweet pastry”, Zhang Qiu witnessed and promoted the start and development of endocrinology in my country. In her opinion, to achieve these achievements, she has caught up with herself A good time for professional development.
Changes in the spectrum of endocrine diseases
In addition to the hospital’s attention, changes in the disease spectrum have also brought opportunities for the development of endocrine and metabolic diseases.
Zhang Qiu recalled that 30 years ago, the spectrum of endocrine diseases was relatively narrow, and the incidence of diabetes was not as high as it is now. It was just a “big neck disease” (goiter) caused by “iodine deficiency”. ) more.
In the 1970s, surveys showed that iodine deficiency disorders were prevalent in many areas of our country to varying degrees, and the threatened population was about 720 million, 35 million people with big neck disease, and 250,000 people with cretinism. In 1979, major wards across the country began to promote and implement the prevention and control strategy based on lipiodol, but the epidemic situation did not fundamentally improve.
In the 1970s and 1980s, Professor Sun Guihua, Zhang Qiu’s mentor, led the Department of Endocrinology to carry out research on the prevention and treatment of iodine deficiency disorders in Anhui Province. A year later, the valuable information from the survey of iodine nutrition status in Anhui Province was published, and the precious Atlas of Iodine Deficiency Disorders was published.
After becoming an endocrinologist, Zhang Qiu’s first scientific research work was to go to the remote Dabie Mountains to conduct epidemiological investigations on iodine deficiency disorders.
In 1994, a group photo of the participants of the iodine deficiency disease expert group of the Ministry of Health
“Although the country has been preventing and controlling, many remote mountainous areas in Anhui have inconvenient transportation and lagging information. Therefore, our department organized a lot of human, material and financial resources to all parts of the province, especially It is the remote Dabie Mountains for research and popular science.”
When doctors such as Zhang Qiu went to Dabie Mountain to conduct an epidemiological survey, they found that “some fifteen- or sixteen-year-old teenagers look like two or three-year-old children, they are deaf and dumb, and they have iodine in their fetuses. Deficiency affects the development of the entire nervous system, but this cretinism is completely preventable.”
Through the national salt iodization and other measures, big neck disease has also become a typical disease jointly eliminated by the endocrinology department and the CDC, providing a lot of valuable information for the country to formulate iodine deficiency disease prevention and control policies. The data and rationalization suggestions have also made outstanding contributions to the prevention and treatment of iodine deficiency disorders in my country.
In the past, the conditions for diagnosis and treatment were limited. There were not so many advanced machines to assist diagnosis, and there was no condition to detect various hormones and other indicators. In endocrinology outpatient clinics, symptoms were often found and the cause could not be found. Even if the cause is found, there are not so many drugs to deal with it, “basically relying on clinical experience, just like the Sherlock Holmes case.”
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 clinical laboratory for endocrinology, molecular biology laboratory, and outpatient clinic. Rapid detection and function laboratory, bone mineral density examination room, clinical drug experiment and evaluation center, etc., as key specialized laboratories in Anhui Province, the diagnostic level has reached the level of hypothalamus-pituitary and molecular biology.
As the level of testing in specialist laboratories has increased, the spectrum of diseases in endocrinology has also expanded.
Zhang Qiu introduced,In addition to common and frequently-occurring diseases such as diabetes and thyroid disease, the department is specialized in the diagnosis of intractable diseases such as osteoporosis, pituitary adrenal gland diseases and rare diseases. level has been significantly improved.
Helping grassroots chronic disease management
“The clinical strength of our department is very solid, because we have our own specialized laboratory, there are so many experts and teams with excellent medical technology, but, compared with Beijing, Shanghai and Guangzhou, basic research There are still gaps.”
In 2016, Zhang Qiu took over as the director of endocrinology at the First Affiliated Hospital of Anhui Medical University. She proposed to increase the scientific research capacity of the department, combine clinical ideas with basic research, and improve the ability of medical transformation .
Group photo of senior, middle and young students in the department
The Department of Endocrinology of the Hospital has also successively cooperated with the Medical School of Heidelberg University in Germany, the Hefei Institute of Materials and Materials of the Chinese Academy of Sciences, the Basic Medical College of Anhui Medical University, the Department of Burns, Vascular Surgery, and Orthopedics of the First Affiliated Hospital of Anhui Medical University. Long-term cooperation with the Department of Nephrology, etc., has carried out a lot of basic and clinical research on chronic complications of diabetes such as wound repair of foot disease, vascular disease and diabetic nephropathy.
The department has successively received funding from 8 national-level projects including the China-Germany Cooperation Project of the National Foundation, General Project of the National Foundation and Youth Project, dozens of provincial-level scientific research projects, and published many A high-level academic paper.
Since then, Director Zhang Qiu led the Provincial Diabetes Branch to formulate the “Guidelines for Graded Diabetes Diagnosis and Treatment in Anhui Province”, wrote the Anhui Provincial Diabetes Integrated Prevention and Treatment Plan, and participated in several domestic specialist guidelines and expert consensus It is formulated, and the promotion and training of new guidelines and endocrine diagnosis and treatment norms are regularly carried out in all parts of the province every year, and advanced diagnosis and treatment and management concepts are radiated to the grassroots.
Data shows that the incidence of diabetes was only 0.9% in the 1980s, and the adult prevalence rate has risen rapidly to 12.8% in the past 40 years. In the Department of Endocrinology of the First Affiliated Hospital of Anhui Medical University, the annual outpatient consultation volume exceeds 180,000, and diabetes patients account for the majority, and many patients wait in line for admission all year round.
The reason for the high prevalence of diabetes, Director Zhang Qiu believes, is that the first is the urbanization of the countryside, the economic situation of residents is improving year by year, and the living standards are significantly improved because they do not rely entirely on manual labor to maintain their lives; It is because the residents have not yet formed a healthy lifestyle, and the concept of health has not been able to adapt to the development of the economy and society.
“The difficulty of diabetes management lies at the grassroots level.” Although diabetes treatment methods are changing with each passing day, Director Qiu Zhang said, In addition to attaching importance to individualized treatment, comprehensive and slow Disease management is also very important, and the challenge at the grassroots level is the greatest, such as how to do a good job in health education, early screening, early prevention and early standardized treatment of diabetes.
There are about 350 million people with prediabetes in my country. According to the natural law, 10 million to 35 million cases of prediabetes develop into diabetes every year. Early detection and early prevention will greatly reduce the incidence of prediabetes. Probability of progression to diabetes, reduce the number of people with diabetes.
In recent years, Director Zhang Qiu and his team have focused on improving the ability of grassroots diabetes prevention and chronic disease management. Established the Diabetes Prevention and Control Alliance to deliver talents and the latest diagnosis and treatment and chronic disease management models to grassroots communities and hospitals.
In 2017, with the strong support of hospital leaders, the hospital built the first national standardized metabolic disease management center in Anhui Province with a scale of 13000 on the 11th floor of Changjiang Road Outpatient Clinic to carry out diabetes health education and diabetes management throughout the process. Work, combined with the characteristic services of the diabetes joint care clinic, improve 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 host 1-2 national-level academic conferences, host national and provincial-level follow-up classes, and promote diabetes prevention and control guidelines and endocrinology for grassroots units in various cities in Anhui Province. Standardized diagnosis and treatment training for common diseases.
From laboratory basic research to clinical practice, to talent training and empowerment for the grassroots, the First Affiliated Hospital of Anhui Medical University has established medical services, teaching research and technical radiation mature system.
In this regard, Director Zhang Qiu has a more vivid metaphor: “In a flood fight, if you focus on the most downstream of the dam, it may save some people, but it cannot prevent the disaster from happening again. , if you know where the pass is, go upstream and fundamentally solve the problem, moving the pass forward is the key.”
Under the promotion of Zhang Qiuhe’s successive department directors, the endocrinology department of the First Affiliated Hospital of Anhui Medical University has always ranked first in Anhui Province, and 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 and metabolic diseases in my country.
Professional Profile
Professor Zhang Qiu
Chief physician, doctoral supervisor
The 2nd Jianghuai Famous Doctor of Anhui Provincial Health Commission
The first batch of national health science experts
Chairman of the 9th Standing Committee of the Diabetes Branch of the Chinese Medical Association and Leader of the Diabetes Education and Management Group
The first standing committee of the Chinese Preventive Medicine Association Thyroid Disease Prevention Committee
Vice-Chairman of Diabetes Education and Management Branch of China Association for Health Promotion and Education
Vice Chairman of the Western Psychiatric Association Endocrinology and Diabetes Committee
The Second Standing Committee of the Diabetes Committee of the Chinese Women’s Physician Association
Director, Endocrine Quality Control Center, Anhui Provincial Health Commission
Head of the Department of Endocrinology and Metabolism, Anhui Medical University
Director, Department of Endocrinology, First Affiliated Hospital of Anhui Medical University
Secretary of the Party Branch 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: Medical Endocrinology FrequencyRoad
Review: Zhang Qiu, First Affiliated Hospital of Anhui Medical University
Editor in charge: Wan Shunshun
Proofreading: Zang Hengjia
Plate making: Xue Jiao