Endocrinology

| General overview |--------------

The Department of Endocrinology, Huashan Hospital Affiliated to Fudan University, is one of China’s earliest endocrinology departments. Founded in 1950 by Professor Zhong Xueli, one of the founders of Chinese endocrinology, it is now a National Clinical Key Specialty designated by the National Health Commission. Professor Zhong Xueli and Professor Zhu Xixing, the department’s founder and emeritus professor, respectively served as Vice Chair of the Endocrinology Branch of the Chinese Medical Association and Chair of its Diabetes Branch.

The department currently has 37 members, including 16 professors and associate professors, 5 doctoral supervisors and 3 master’s supervisors. It has 3 Shanghai Pujiang Talents, 2 recipients of the Health Commission’s New Excellent Young Talent program, 1 Outstanding Young Medical Talent of the Medical Garden New Star program, 1 recipient of the Shanghai Talent Development Plan, and 2 recipients of the Shanghai Young Physician Training and Support Program. Professor Li Yiming, the current academic and departmental head, is a Standing Committee member of the Diabetes Branch of the Chinese Medical Association; a member of the Endocrinology and Metabolism Physicians Branch of the Chinese Medical Doctor Association; Vice Chair of the Diabetes Committee of the Chinese Society for Microcirculation; Vice Chair of the Diabetes Branch of the Shanghai Medical Association; Chair of the Diabetes Branch of the Shanghai Rehabilitation Association; Vice Chair of the Endocrinology and Metabolic Diseases Committee of the Shanghai Association of Integrated Traditional and Western Medicine; and Vice Chair of the Diabetes Branch of the Shanghai Association of Traditional Chinese Medicine. The current deputy department heads are Ye Hongying, Yang Yehong and Zhang Chaoyun.

| Academic strengths and subspecialties |--------------

The department follows the strategy of “building the department through distinctive strengths, revitalizing it through innovation, and strengthening it through talent.” Its main clinical and research areas include neuroendocrine disorders; diabetes and chronic complications; obesity and metabolic disorders; thyroid disease; endocrine hypertension; male reproductive endocrinology; and endocrine and metabolic disorders during the peripregnancy and peripartum periods. Specialty clinics cover pituitary disease, hyperprolactinemia and prolactinoma, thyroid disease, obesity, fatty liver, diabetic nephropathy, diabetic neuropathy, diabetic foot, and male endocrinology. The department is also a core discipline of Huashan Hospital’s Rare Disease Center and has extensive experience in rare monogenic endocrine diseases.

Six subspecialties have been established:

[Neuroendocrinology]

Innovative work in neuroendocrine pituitary disease began in the 1950s. Since 2013, the department has integrated neurosurgery, imaging medicine, radiosurgery, neuropathology, laboratory medicine and other strengths to establish a pituitary multidisciplinary team (MDT). After ten years of development, it has become an outstanding national pituitary disease center. It provides routine and complex pituitary MDT clinics and pioneered a multidisciplinary pituitary-tumor ward with one-stop care for difficult and rare cases, including difficult-to-diagnose hypercortisolism, refractory Cushing disease, acromegaly, prolactinoma, hypophysitis, unexplained pituitary-stalk thickening, hypothalamic lesions, hypopituitarism and refractory craniopharyngioma. Endocrine-function tests and inferior petrosal sinus sampling are routinely performed. CXCR4-targeted radionuclide imaging, 68Ga-Pentixafor PET/MR tracing, is innovatively used to localize Cushing disease lesions. The MDT model has repeatedly received national and Shanghai quality-management awards; it received support from the National Major Disease MDT Capacity-Building Project in 2019, won the 2022 Shanghai Excellent Case Award for MDT Clinic Development, and was selected for Fudan University Shanghai Medical College’s 2022–2023 Research Hospital MDT Demonstration Project.

[Diabetes and chronic complications]

As a National Clinical Key Specialty of the former Ministry of Health, the department led China’s first national diabetes epidemiological survey in the 1980s. Professor Zhong Xueli, one of Huashan Endocrinology’s founders, first proposed the concept of “diabetic cardiomyopathy” in China. The younger expert team has long conducted basic and clinical research on vascular complications. Distinctive expertise has been developed in diabetic neuropathy, nephropathy, cardiomyopathy and diabetic foot. In 2019, a diabetic-foot MDT was established with the orthopedic foot-and-ankle group, vascular surgery, antibiotic medicine and the Nursing Department; it received support from the National Clinical Key Specialty Development Project in 2021. Complex refractory diabetic foot is treated with advanced techniques including negative-pressure therapy, bone cement, spinal-cord stimulation and platelet-rich gel to preserve limbs, promote wound healing and improve outcomes. Specialty clinics for diabetic neuropathy/diabetic foot and a joint diabetic-nephropathy clinic with Nephrology are available.

[Thyroid and parathyroid diseases]

The thyroid subspecialty has a long history and standardized, comprehensive clinical pathways. It provides joint care with thyroid surgery, ultrasound, nuclear medicine, pathology and ophthalmology, including radioiodine treatment for hyperthyroidism and fine-needle aspiration of thyroid nodules. A joint thyroid/parathyroid clinic with Thyroid and Breast Surgery was established in 2016. Annual thyroid outpatient visits exceed 80,000, ranking among Shanghai’s leading hospitals. In cooperation with Ophthalmology, the department continues to innovate in difficult moderate-to-severe, refractory thyroid-associated ophthalmopathy.

[Obesity and metabolic disorders]

The obesity subspecialty has operated for more than ten years and conducts clinical and research work in obesity and metabolic disease. Specialty clinics include Nutrition and Obesity with Nutrition, and Obesity and Fatty Liver with Gastroenterology. MDT care is provided with bariatric and metabolic surgery, sports medicine and Gastroenterology for severe obesity and unusual central obesity, with one-stop diagnosis, treatment and follow-up. Comprehensive treatment includes health education, nutrition and exercise therapy, medication and surgery.

[Endocrine hypertension]

Screening and etiological diagnosis of endocrine hypertension are clinical challenges. In 2021, an MDT for secondary hypertension was established with Cardiology and Urology. It provides screening, diagnosis and treatment and patient-centered multidisciplinary, whole-process management. The team efficiently screens for endocrine hypertension and routinely performs adrenal venous sampling, 68Ga-Pentixafor PET/CT and mass-spectrometric aldosterone/plasma-renin-activity testing, enabling precise diagnosis and treatment of primary aldosteronism.

[Male endocrinology]

A comprehensive hypothalamic–pituitary–gonadal-axis assessment and diagnostic system has been established. In cooperation with the Obstetrics and Gynecology Hospital Affiliated to Fudan University, reproductive reconstruction has been successfully performed for secondary hypogonadism caused by hypothalamic–pituitary disease. The team also provides precise assessment and comprehensive management of male menopause and male sexual dysfunction. A male endocrinology specialty clinic has been open since 2023.

| Teaching |--------------

Huashan Endocrinology follows an excellent teaching tradition. Staff continuously improve their clinical work while actively teaching. Regular systems include weekly professional study and research seminars and monthly specialty-topic sessions. The WeChat public account “Huashan Endocrinology” and WeChat groups systematically share knowledge from fundamentals to the frontier with more than 20 affiliated specialty departments, exerting substantial influence.

The department teaches the endocrinology chapters of Internal Medicine to students of the School of Clinical Medicine and supervises clinical observation and internships. As a master’s and doctoral degree site of Fudan University, it has trained more than 100 master’s and doctoral students over the past decade. Each year, dozens of endocrinology physicians from across China undertake further training here.

National courses: for more than ten consecutive years, the department has organized the national continuing-education courses “New Theories and Technologies in Neuroendocrine Diseases,” “Standardized Diagnosis and Treatment of Diabetic Neuropathy,” “New Technologies and Theories in Diagnosis and Treatment of Diabetic Kidney Disease,” and “Inpatient Blood Glucose Management.” Participants from across China exchange and disseminate the latest concepts, technologies and clinical practices.

International exchange: Several doctors have been sent to leading international hospitals. The department maintains extensive and long-term academic cooperation with the Joslin Diabetes Center, Mayo Clinic, Massachusetts General Hospital and other world-class endocrine and metabolic centers in the United States.

| Research |--------------

Research addresses clinical pain points and difficult problems. During the past ten years, the department has undertaken 1 international cooperation project, 1 major Ministry of Science and Technology project, 1 National Science and Technology Major Project, 43 national projects including National Natural Science Foundation projects, and more than 10 provincial- and ministerial-level projects. It has received 4 national/provincial/ministerial awards and 3 national invention patents. More than 100 SCI papers were published during the past 5 years, including papers indexed by Nature Medicine, Nature Communications, Kidney International and Diabetes.

The department is a National Clinical Key Specialty of the National Health Commission. It has edited or co-edited Practical Internal Medicine, Clinical Internal Medicine, Diabetic Vascular Disease, Strategies for Diagnosis and Treatment of Endocrine and Metabolic Diseases, New Clinical Technologies in Endocrine and Metabolic Diseases, Selected Cases of Multidisciplinary Diagnosis and Treatment of Difficult Pituitary Diseases, How to Manage the “Golden Pituitary”? Clinical Standards for Diagnosis and Treatment of Sellar Diseases, and Detailed Analyses of Rare Endocrine Disease Cases at Huashan Hospital Affiliated to Fudan University, and translated/edited Harrison’s Endocrinology.

| Social responsibility |--------------

Since 2003, the department has been among the earliest in China to investigate chronic diabetic complications in community populations, contributing to prevention and treatment of diabetes and its complications. Since 2006, it has conducted diabetes prevention and treatment from central urban districts to urban–rural fringe areas. In 2012, with strong support from the Shanghai Health and Family Planning Commission and the former Jingan District Government, Huashan Endocrinology led the establishment of an innovative 3-2-1 regional medical consortium: a tertiary hospital (Huashan Hospital) providing guidance, a secondary hospital (Jingan District Central Hospital) providing support, and five primary-level community health service centers implementing services. Community diabetes healthcare professionals were also trained, improving diabetes care at primary institutions.

The department actively participates in medical assistance in Tibet, Yunnan, Jiangxi and other regions, bringing high-quality medical resources to remote areas and helping local doctors improve clinical diagnosis and treatment. It also actively participates in building the Fujian Regional Medical Center. In addition, staff actively participate in public-health education through multiple platforms and formats to promote public health.