As the first endocrinology specialty established in China, the Department of Endocrinology of PUMCH has been leading the development of the discipline. With the first provincial/ministerial-level key laboratory in endocrinology in China, the Department of Endocrinology has been the birthplace of many innovative research outcomes, which have been translated for clinical applications. In the diagnosis and treatment of intractable endocrine and metabolic diseases, the Department of Endocrinology has continuously improved its clinical skills and taken the lead in formulating and publishing several treatment guidelines. It has become the last hope for patients.

Specialty Clinics and Multidisciplinary Cluster

Last Hope for Patients with Intractable and Rare Endocrine Diseases

The Department of Endocrinology is a typical department with a large outpatient clinic and a small ward. Although there are only 80 medical and nursing staff at present, the average annual number of outpatient visits over the past five years is nearly 200,000. The Department of Endocrinology was the first to establish specialized groups for diabetes, bone metabolism, thyroid, pituitary, adrenal and gonadal diseases, and it set up corresponding specialized outpatient clinics to facilitate long-term follow-ups and observation of various endocrine diseases, which enables doctors to better summarize clinical experience, and understand the treatment effect, progression and outcome of diseases. Such an arrangement serves as the PUMCH template for development of endocrinology departments.

For patients with intractable diseases and patients requiring long-term effective management, the Department of Endocrinology has put in place a mechanism of long-term follow-ups by the corresponding specialized group, which has become a department feature. Over 40 years, about 50,000 patients a year have received whole-life-cycle care through the long-term follow-ups. The electronic database, clinical observation forms and clinical biobank derived from the follow-up patients in the specialty clinics have become a “treasure trove” for any PUMCHer conducting clinical studies related to endocrinology.

“We admitted an 80-year-old patient; when we accessed his past medical records, we found 5 thick medical records, showing the first consultation dating back to around 1960,” said a doctor who had been trained in the Department of Endocrinology. He sees such medical records as a treasure, “better than any reference books”. As a matter of fact, writing good medical records is the first step in the training of clinicians at PUMCH. This is particularly true in the Department of Endocrinology which holds trainees to a higher bar. The chief physician on duty randomly checks the medical records every week, not only for format but also for content. Thanks to such rigorous training, the Department of Endocrinology is among departments that produce the most “excellent medical records” in PUMCH.

“Rare and intractable diseases that you read about in books, such as acromegaly, hypophosphatemic rickets and Cushing’s syndrome, have become ‘common diseases’ here!” said another impressed doctor who had been trained at the Department of Endocrinology. The department has formed a multidisciplinary cluster with the Department of General Surgery, Neurosurgery, Urology, Ophthalmology, Cardiology, Nephrology, Clinical Nutrition, Pediatrics, Obstetrics and Gynecology, Diagnostic Ultrasound, Nuclear Medicine and Radiology, etc. It admits more than 10,000 patients with endocrine and metabolic diseases every year, including more than 1,500 patients with difficult, critical and rare endocrine and metabolic diseases, standing as the last beacon of hope for the diagnosis and treatment of endocrine and metabolic diseases in China.

Bent on improving medical service quality in recent years, the Department of Endocrinology has conducted clinical pathway explorations for multiple diseases, aiming at “improving medical quality, increasing diagnosis and treatment efficiency and safeguarding patients’ safety”. Such explorations put patients first and seek to tap and boost interactions between doctors and patients, doctors and nurses, and patients and nurses. As a result, they have significantly enhanced patients’ sense of satisfaction, diagnosis and treatment efficiency and medical safety, as evidenced by the reduction of average hospitalization days from 14 to 10. The Department of Endocrinology, a long-standing and strong presence in the field, is constantly integrating and optimizing clinical resources in pursuit of higher quality and efficiency and more vigorous development.

Hard Work That Pays off

Striving to Be an Innovation Base in Constant Pursuit of Higher Heights

In the course of medical exploration, the Department of Endocrinology has created numerous “firsts” or breakthroughs: reported the first case of insulinoma diagnosed in China; named a disease renal osteodystrophy, the first disease named by Chinese worldwide; established the “Chinese model” of community-based diabetes prevention and treatment; continuously improved the diagnosis and treatment of pituitary tumors via leveraging the combination of clinical and basic studies; led the formulation of the first “International Consensus on Clinical Management of Tumor-induced Osteomalacia” and conducted internationally leading researches on hypophosphatemic osteomalacia; established the precision diagnosis and treatment system of hereditary endocrine diseases and won the first prize of the China Medical Science and Technology Award with the research outcomes. And the list goes on. For more than 100 years, endocrinologists generation after generation have practiced the philosophy of translational medicine - from the clinic to the laboratory, and then from the laboratory back to the clinic.

In 1988, the endocrine laboratory became the “Key Laboratory of Endocrinology under the Ministry of Health”, which is also the first provincial/ministerial-level key laboratory in endocrinology in China and was awarded “Excellent Laboratory” during the 2016 key research base evaluation by the National Health Commission during the 12th Five-Year Plan period. The lab went as far back as the PUMCH metabolic lab established in the autumn of 1924 which back then mainly took on basal metabolic measurements and metabolic function-related tests and research. After establishing the earliest radioimmunoassay and the normal pituitary hormone levels of Chinese, the endocrine laboratory successively created a variety of endocrine hormone testing methods, which have been recognized by domestic colleagues and adopted by other laboratories.

The Department of Endocrinology has been diving into clinical issues-oriented translational medicine research in the laboratory, which has been very fruitful: in 1991, “clinical research on idiopathic growth hormone deficiency” won the third prize of the National Award for Science and Technology Progress; in 1992, “clinical and basic research on hormone-secreting pituitary tumor” won the first prize of the National Award for Science and Technology Progress, the first time in the field of endocrinology in China; “basic and clinical research on endothelin and myocardial ischemia and hypertension”, “clinical and experimental research on primary osteoporosis” and “establishment and clinical application of insulinoma diagnosis and treatment system” won the second prize of the National Award for Science and Technology Progress in 1998, 2002 and 2016 respectively.

Having developed and built itself for nearly 100 years, the endocrine laboratory has expanded into a multifunctional translational medicine platform touching on novel antibody preparation, novel endocrine factor detection, multi-omics assessment of metabolic diseases, genetic testing and functional analysis of rare endocrine diseases, model animal phenotypes and endocrine genetic diseases, etc.

The strong academic vibe inspires endocrinologists to constantly dive deeper. Over the past 20 years, the papers they published on SCI-indexed journals have increased by 30-odd times, and many of them were published on top journals. Of the ten most important papers published globally on tumor-induced osteomalacia (TIO), three were contributed by PUMCHers. Big data analysis shows that in 2020 and 2021, papers published by PUMCH endocrinologists on SCI-indexed journals rank second globally in the field of endocrinology, highlighting the strong presence of PUMCH on the international stage. The Department of Endocrinology has also published many monographs, including “Basic and Clinical Endocrinology”, “PUMCH Metabolic Osteopathic Studies, PUMCH Diagnosis and Treatment Norms for Endocrine Diseases”, “Grand Rounds of Endocrinology, PUMCH”, “Hereditary Endocrine and Metabolic Diseases”, “Diabetology”, “Thyroid Diseases - Basic and Clinical”, and “Modern Treatment of Diabetes”. Among them, the “PUMCH Endocrinology and Metabolism” is a particularly well-known and valuable book.

Value Talent Cultivation

Strive to Be the Top Talent Training Base in Endocrinology

A multidisciplinary team (MDT) denotes not only the combination of multiple disciplines, but also the interconnectivity of multiple systems in the patient’s body. In recent years, the Department of Endocrinology has taken the lead to build a strong cluster of disciplines with other departments and platforms of PUMCH. They conduct close and complementary cooperation in medicine, teaching and research for joint progresses. On its journey of self-betterment, the Department of Endocrinology highly values talent cultivation and trains doctors from all over the country, which earns it the reputation of Huangpu Military Academy, once the best military training school in China, in endocrinology. In 1962, the Department of Endocrinology launched the first class of advanced further education in endocrinology, which kicked off training of endocrinologists in China. Starting from 1999, the Department of Endocrinology has held a national clinical endocrinology class every year to provide further training and education to doctors from all over the country, many of whom subsequently became founders, leaders and academic backbone talents of local endocrinology departments, disseminating the PUMCH experience and expertise acquired during the training to all over the country.

“The Department of Endocrinology is a treasure for PUMCH”. In the next 100 years, the Department of Endocrinology will shift from a medical model to a medical science model, and strive to build a national collaborative network for endocrine and metabolic diseases and further improve the major endocrine and metabolic disease center, the neuroendocrine tumor center, and the genetically rare endocrine disease center. The department will also establish large-scale research cohorts and explore the precision diagnosis and treatment model of various endocrine and metabolic diseases, all in a bid to make greater contributions to improving the prevention and treatment of endocrine and metabolic diseases in China.

Group picture of the Department of Endocrinology

Written by: Wang Jingxia

Picture courtesy: Xu Zhen

Translator: Liu Haiyan

Editor: Yang Hongbo and Wang Yao