[Editor’s Note]
2019 is the 70th anniversary of the founding of the People’s Republic of China, as well as a crucial year for building a moderately prosperous society in all respects and for achieving the goals of "Healthy China 2030". For the staff of Xiangya Hospital, this year is bound to be a significant one in the history. The dynamic 113-year-old Xiangya Hospital has witnessed the Fourth Congress of Xiangya Hospital, Central South University (CSU).
The staff of Xiangya Hospital are keen for innovation and have always believed in the power of change. In the past four years, Xiangya Hospital has maintained a stable and democratic atmosphere, as well as coordinated development. Focusing on the goal of building a high-level research-based hospital with international influence, the staff of Xiangya worked hard and its mission of providing public services was fully demonstrated. Its service capability was also significantly improved, and obvious progress was made in talent training. Besides, scientific research was greatly advanced, and the internal reform and the exploration of the development model went hand in hand. All these have laid a solid foundation for building a Xiangya-style first-class hospital that will satisfy the people.
At this moment, the loud rally call has already been heard, and the road map for a new round of reform that connects the far future is unfolding in front of the staff of Xiangya Hospital. The Fourth Congress of Xiangya Hospital, CSU is a gathering for the deepened reform under the background of the new era.
Standing on the new starting line, what kind of spirit should the 100-year-old Xiangya take in order to grow in leaps and bounds in the next 100 years? A series of reports is now launched to help you get a glimpse into everything behind the scene...
Chen Xiang, Vice President of Central South University (CSU) and Professor
of the Department of Dermatology of Xiangya Hospital
In 2017, the Skin Tumor Working Group of Chinese Dermatologist Association of
Chinese Medical Doctor Association was set up and Professor Chen Xiang was elected as the first group leader.
There are “snowflakes” that have nothing to do with romance, that is, the endless dandruff-like flakes on patients with psoriasis.
As one of the top ten stubborn diseases humans suffer from, psoriasis is also known as “psora” and is a common chronic inflammatory skin disease. In China, more than 7.5 million people have been suffering from the disease for years due to excessive proliferation of keratinocytes. Those people are inclined to feeling inferior and wrapping themselves up tightly like men in shells.
In order to remove the “shells” of the group, Hunan Key Laboratory of Skin Cancer and Psoriasis was set up by Xiangya Hospital, CSU, and the Laboratory is led by Cheng Xiang, Vice President of CSU and first-class chief physician. Chen Xiang has worked on CD147 for 20 years since he first proved that CD147 played an important role in the incidence of cutaneous malignant melanoma in 2001. He has been striving to conquer scientific problems and lead his team to overcome psoriasis, melanoma and other “stubborn” skin diseases by studies of pathogenesis and genetic pharmacology to clinical studies of human umbilical cord mesenchymal stem cells. In more than 20 years of dermatology research, Chen Xiang has received many awards and titles, including the first “Changjiang Scholar” distinguished professor of the Ministry of Education in dermatology field in China and the winner of the National Science Fund for Distinguished Young Scholars .
In March 2019, a special therapy was carried out at Xiangya Hospital. A clinical study named “Treatment of Psoriasis with Human Umbilical Cord Mesenchymal Stem Cells” led by Chen Xiang and mainly undertaken by Professor Zhu Wu and Associate Professor Kuang Yehong completed the first cell infusion therapy, which means that the Department of Dermatology of Xiangya Hospital has developed a new medical technique for the treatment of psoriasis. Recently, our reporter interviewed Chen Xiang to learn about the story behind him and his team.
Studying medicine is my dream but pursuing it is not easy.
Q: Medicine study is a tough journey featured in longer schooling, more courses, thicker books, less playtime and less sleeps. Why did you choose to study medicine? Was it your childhood dream?
Chen Xiang: Both my parents were doctors and my mother served as a medical worker in communities and factories for years. They were very busy, but in my mind, they were rather cool in white coats. Coincidently, the place where I lived in my childhood was an alley called Yaowang Street in Changsha. According to the legend, Sun Simiao settled there in his later years, and afterwards, people built a Yaowang Temple to commemorate him. Now, think about it, I grew up with the story of “Yaowang” (King of Chinese Medicine) and lived with two doctors; naturally, I dreamed of studying medicine. As a result, after graduating from the high school, I applied for Clinical Medicine major of Hunan Medical University.
“Chen Xiang, you have to be down-to-earth, careful and rigorous since you choose to be a doctor.” This is what my mother always tells me and I bear in mind. Medicine study is arduous. But once you are interested, learning will not be a burden, but a pleasure. Later, I was admitted to study dermatology at the graduate school of the Second Xiangya Hospital and learned from Professor Wen Haiquan. In 2001, I became a doctor in the Department of Dermatology of Xiangya Hospital.
Xiangya is a cradle of famous medical professors and doctors in China for nearly one hundred years. Inspired by Xiangya’s motto of “Fairness, Bravery, Diligence, Prudence, Honesty, Love, Humbleness, Integrity, Truth, Precision, Profoundness and Professionalism”, I am more determined than ever to become a doctor here.
“Going abroad” is for learning and returning home is for responsibilities.
Q: Being a doctor at Xiangya was actually an enviable job at that time. Why did you decide to leave to study in Japan? And I heard that your Japanese doctoral tutor had invited you repeatedly to stay there.
Chen Xiang: The idea of going to Japan for a PhD was inspired by the gap I saw at a Sino-Japanese dermatologist conference where I learned the scientific research and clinical situation of Japanese dermatology. Therefore, when Professor Tamotsu Kanzaki of Department of Dermatology of Kagoshima University, a world-renowned skin disease and skin pathologist, sent me a PhD admission offer, I decided to learn from other’s strong points. That was a rare opportunity as well as a difficult choice.
I could barely read Japanese before I went to there. I learned to speak Japanese completely by virtue of the natural language environment and my strong desire to be a good student. Afterwards, I am very happy to serve as a volunteer translator in Changsha-Kagoshima sister cities exchange activities.
In Japan, there is a rigorous and layered medical and scientific research system for clinical disciplines. I learned step by step from the most basic laboratory techniques including pathological sections, immunohistochemistry and immune electron microscopy to the fields of cell biology, biochemistry, genetics and molecular biology. In 2001, I was qualified for early graduation and won the Foreign Dermatologist Award of the Japanese Society for Investigative Dermatology. My tutor indeed asked me to stay in Japan to continue scientific research or recommended me to carry out postdoctoral research at NIH of the United States. However, I did not hesitate in this matter, because I was quite certain of my goal before departure, that is, going abroad is aimed to broaden my horizons and returning home is intended to fulfill my duty. When I walked out of Huanghua Airport, my mother looked at me and cried as my hair was rather long and I lost a lot of weight. She thought that I had gone through a tough life in Japan. But I knew that the three and a half years was worth its every minutes. It was because of this period that I began to understand the function of CD147, a member of the immunoglobulin superfamily. Therefore, the first thing I did when I came back was to build a team to launch a comprehensive study on the mechanism of action and inhabitation pathways of CD147 in a variety of skin diseases.
Doctors and patients should join hands in their fight against diseases.
Q: In The Chinese Hippocratic Oath, Sun Simiao wrote that “A doctor dedicated to medicine should keep calm and set the mind to eliminate unnecessary desire and competition. He or she should be compassionate and volunteer to save patients from the tortures of their illness.” How can we explain it? How should we handle the relation between patients and doctors today?
Chen Xiang: In my 20-year research on skin diseases, whether in scientific or clinical research, I always share my patients’ weal and woe. There are countless patients with psoriasis or their families seeking healing in the Department of Dermatology on the 3rd floor of our hospital every day. They are rushing to get help for rehabilitation. These patients generally feel inferior for their flying dander due to hyperproliferation of epidermal keratinocyte cells for many years. They wrapped themselves up like people in shells. The number of people in China suffering from such diseases exceeds 7 million.
They are my friends and comrades in our fight against the skin diseases. In fact, psoriasis is misunderstood as an infectious disease by many people. To release patients from their shells and bravely embrace a brilliant way of life, I always try to encourage them to beat the disease by receiving scientific and effective therapy and keeping a positive and optimistic attitude. Meanwhile, I hope that they can acquire more compassion and support from the society.
To meet the patients’ expectations, we need to make constant innovation.
During the infusion therapy of the “Treatment of Psoriasis with Human Umbilical Cord Mesenchymal Stem Cells” in early March this year, we obtained the cooperation from several patients. They desire to be healed under the immunomodulatory effect of the human umbilical cord mesenchymal stem cells. At present, the human umbilical cord-derived mesenchymal stem cells can be prepared maturely, and the preclinical safety research is basically clarified. We are waiting for the therapeutic outcomes, with the aspirations of overcoming the problem together with our comrades.
Doctors should develop the habit of scientific research in addition to curing sickness and saving patients.
Q: Many young doctors are in a common difficulty that they cannot maintain a balance between helping patients and scientific research. However, you have been leading research teams and treating patients for many years. What do you think about the relationship between clinical treatment and scientific research? How can you keep the balance?
Chen Xiang: The lab experiments related to molecular biology and cell biology would take considerable time and efforts because an experiment may last for several days or weeks, and we have to experience many failures or repetitions before success in most cases. However, without the scientific validation, the individual medical experiences and clinical skills cannot be guaranteed in practice or widely accepted by others.
When I returned to China in 2001 and started on my work, we lacked financial, personnel and location support for research. Fortunately, our team, including Li Ji, Su Juan, Kuang Yehong, Lin Jing and other young doctors and graduate students, studied intensively and soon obtained the first fund related to CD147 molecules sponsored by the National Natural Science Foundation of China. Our team further overcame difficulties, and identified specific functional mechanisms and possible inhibitory approaches in tumor progression under the domestic experimental conditions, including angiogenesis, glycolysis and multidrug resistance of different skin tumors. These students have grown and been recognized as outstanding talents in different fields of domestic dermatology. They have obtained supports from various talent programs, such as Changjiang Scholars Program, Hu Xiang Youth Talents Program and Sublimation Talents Introduction Program.
The clinical study “Treatment of Psoriasis with Human Umbilical Cord Mesenchymal Stem Cells” we declared in March this year is one of the best interpretations of application of scientific research to clinical practice. As the first stem cell clinical research of Hunan Province registered by China and one of the three clinical researches in the field of stem cell-based treatment for psoriasis in China, the infusion therapy of the “Treatment of Psoriasis with Human Umbilical Cord Mesenchymal Stem Cells” completed in early 2019 represents a new breakthrough in the stem cell clinical research for psoriasis in China.
Therefore, I think that the medical practitioners in the new era, whatever their professional levels and the grades of hospitals they come from, can practice their ability of scientific research thinking and develop related habits by utilizing easily available data and materials and solving slight clinical problems. Scientific research does not necessarily depend on the papers published, but on having an ambitious aim and making achievements for the health of the broad masses.
The significance of “Internet Plus” lies in mentoring and assistance.
Q: Xiangya Hospital has been exploring the application of the “Internet Plus” and medical big data in dermatology since 2013. What is the original intention? Have it made any difference?
Chen Xiang: Compared with the orthopedics department, cardiovascular department, neurology & neurosurgery department and other departments, our dermatology department lacks primary medical workers. There are only over 1,000 registered dermatologists in Hunan Province. Further, with the unbalanced distribution of quality medical resources, there are almost no dermatologists in primary medical institutions. There is a long way to go for developing the dermatology, and people like us should take heavy responsibilities. Therefore, Xiangya Hospital began to explore the “Internet Plus medical care” mode to break the ice.
Since 2013, Xiangya Hospital has explored the application of “Internet Plus” and medical big data in dermatology. The “Xiangya Smart Medical Treatment Alliance Platform for Skin Health and Diseases” has been established, which is the first comprehensive dermatological treatment alliance platform integrating clinical research, education and popularization of science. The Xiangya Hospital (Dermatology) Internet Hospital was officially built on the platform, and the Hunan Provincial Targeted Poverty Alleviation Promotion Plan for Skin Health was also initiated at the same time. The province-wide dermatological diagnosis and treatment level was improved by providing primary physician training and telemedicine, and 618 hospitals join the remote medical cooperation.
These creative thoughts are affecting more and more young people. Huang Kai, a master degree candidate enrolled in 2017, has established the “Yafu-Smart Diagnosis and Treatment Medical Treatment Alliance Platform for Skin Health and Diseases” with his team. The platform showed excellent performance in the “Internet Plus” college students innovation and entrepreneurship competition, and has attracted more than 500 dermatologists to join them and established cooperation with 9 top international dermatology institutions. We must praise these young people for their achievements.
As a talents developing strategy of CSU, the Sublimation Scholar Program has attracted a galaxy of outstanding young and middle-aged talents. Peng Cong, as one of the specially-appointed professors of the program, has become the deputy director of the Hunan Provincial Key Laboratory. He is mainly responsible for fundamental research on melanin. It is encouraging that a large number of young talents we trained and brought in, such as Li Jie, Jian Dan, Yin Mingzhu, Huang Bo, Liu Hong, Shen Minxue and Zhao Shuang, have made much progress with the support of the Department of Dermatology. They have made achievements in the fields of translational medicine, medical engineering cooperation, public health and fundamental research, and our discipline construction has successors.
I keep on learning from young people as well, trying to broadcast online and create my WeChat official account to facilitate the science popularization of skin health based on these new media platforms. Many thanks to our school and hospital for the support and assistance over the years. We will work harder to achieve more achievements and make more contributions.
