Endocrinology and Metabolic Diseases

Shandong University Qilu Hospital is a hospital affiliated with and administered by the National Health Commission, a directly affiliated hospital of Shandong University, a key university directly under the Ministry of Education, the leading and principal development institution of the first group of National Regional Medical Centers jointly established by the Commission and provinces (comprehensive category), and an exporting hospital for the development of National Regional Medical Centers. In the 1950s, Professor Zhou Xianteng, a nationally renowned expert and founder of clinical endocrinology in Shandong Province, and Professor Zhang Baozhu founded the Department of Endocrinology and Metabolic Diseases at Shandong University Qilu Hospital, which was also the earliest department of endocrinology and metabolic diseases established in Shandong Province. After more than 60 years of development, particularly over the past 10-plus years under the leadership of Professor Chen Li, the department has developed rapidly. It is currently a deputy-chair institution of the Diabetes Branch of the Chinese Medical Association and is also the chairing unit of multiple provincial academic organizations. In 2011, the department was selected as a national clinical key specialty development unit; in 2020, it was approved for the National Major Disease Multidisciplinary Collaborative Diagnosis and Treatment Capacity Development Project; and in 2022, it was selected as the core team for the clinical medicine discipline development of Shandong University’s national Double First-Class initiative. The department led the establishment of the Institute of Endocrine and Metabolic Diseases of Shandong University and has been designated a Key Laboratory of Medicine and Health of Shandong Province and a Clinical Medical Research Center of Jinan. It has now been approved for multiple national platform projects, including the National Standardized Diabetes Diagnosis and Treatment Center, the Ministry of Health Primary-Care Physician Diabetes Management Training Center, the National Demonstration Unit for Diabetes Health Management, and the National Standardized Metabolic Disease Management Center. It has led the establishment of the Shandong Diabetes Health and Medical Big Data Science and Technology Innovation Alliance and the Endocrine and Metabolic Disease Precision Diagnosis and Treatment Alliance of the regional medical centers jointly developed through health cooperation, and has continuously received the highest nomination in Fudan University’s discipline rankings.

The department adheres to a development framework centered on the outpatient department, wards, laboratory, special examination room, treatment room, and research institute. In addition to outpatient services and wards, it has established an endocrine hormone testing room, an endocrine special examination room, a thyroid minimally invasive intervention room, a radionuclide therapy room, a stem-cell therapy research room, the Institute of Endocrine and Metabolic Diseases of Shandong University, and the Provincial Key Laboratory of Medicine and Health. The Department of Endocrinology and Metabolic Diseases currently has 76 officially opened beds and 8 beds for radioactive iodine-131 therapy. Outpatient services are divided into clinics for renowned experts, expert clinics, specialty clinics, and general clinics, with a total annual volume exceeding 100,000 visits. It currently has 77 active medical, nursing, technical, and research personnel, 5 re-employed personnel, and 2 part-time experts, including 1 jointly appointed academician, 1 distinguished professor under the Taishan Scholars program, 1 Taishan Industry Leading Talent of Shandong Province, 7 doctoral supervisors, 14 master’s supervisors, 12 chief physicians, 9 deputy chief physicians, 4 attending physicians, and 4 full-time postdoctoral fellows. The proportion of personnel holding doctoral degrees is 94%, and the proportion with overseas work or research experience is >80%. This is a vigorous, well-structured, high-level medical team.

[Clinical Medicine and Professional Distinctiveness] As a national clinical key specialty and a leading endocrinology unit in Shandong, the department conducts routine diagnostic and treatment services such as hormone testing and screening for complications and comorbidities, focusing on diabetes prevention, treatment, and chronic disease management. It has developed an integrated inpatient-outpatient blood glucose management system to help patients achieve better glycemic control. It also conducts large-scale epidemiological surveys and has established a biobank. On this basis, it carries out basic and clinical research on stem-cell therapy for diabetes, has established a joint artificial pancreas laboratory, and actively promotes the clinical translation of research findings. In thyroid disease diagnosis and treatment, the department has led the implementation of a series of basic and innovative technologies, including thyroid-related hormone testing, ultrasound-guided thyroid biopsy, genetic testing of biopsy specimens, radiofrequency ablation of thyroid nodules, and radioactive iodine therapy, thereby establishing an integrated diagnosis and treatment system for thyroid diseases. In addition to the diagnosis and treatment of common diseases, it is also at an advanced domestic level in diagnosing difficult and rare diseases. It has established a comprehensive genetic testing, analysis, and research platform and led the Shandong Endocrine and Metabolic Disease Precision Diagnosis and Treatment Alliance, greatly improving the diagnosis and treatment of difficult and rare endocrine diseases in Shandong Province.

The department’s main professional specialties are described below:

1. Establishment of a patient-centered comprehensive diabetes management platform: The prevention and treatment of diabetes and its complications are clinical and research priorities of the Department of Endocrinology and Metabolic Diseases. It has progressively established a comprehensive diabetes management platform, a precision diagnosis and treatment platform, and a medical-engineering interdisciplinary and translational platform. The department emphasizes the screening and prevention and control of chronic diseases, particularly diabetes. It currently conducts diabetes epidemiological surveys and counterpart assistance in multiple primary hospitals and communities, including training programs for primary healthcare workers in the diagnosis and treatment of diabetes and its complications. It established the Endocrine and Metabolic Disease Precision Alliance of the National Regional Medical Center jointly developed by Shandong Province and the relevant national authorities, enabling more accurate identification of diabetes subtypes, particularly special types of diabetes, and providing a reliable basis for precision diagnosis, treatment, and genetic counseling. The department emphasizes the screening and treatment of complications and has achieved breakthroughs in treating diabetic nephropathy and diabetic skin ulcers. In recent years, it has published related articles and filed patent applications totaling more than 10 items, with the prospect of clinical translation. It operates specialty clinics for early diabetes risk assessment and complication screening, diabetes health counseling, insulin pump management, and diabetes care, and has launched an electronic medical-record follow-up system for patients with diabetes, enabling patients to receive comprehensive management during outpatient visits. The Endocrinology and Metabolic Diseases Ward is located in Qilu Building and provides spacious, bright rooms, intelligent healthcare facilities, and a professional physician and nursing management team. In addition to routine diagnosis and treatment, it provides patients with diabetes with individualized nutritional and health education guidance and conducts hospital-wide blood glucose management. The ward is also a National Demonstration Unit for Diabetes Education and a provincial training base for specialized diabetes nursing. It has established a dedicated diabetic foot treatment room equipped with an advanced diabetic foot diagnosis and treatment system, including blood-flow dynamics testing equipment, a transcutaneous oxygen partial pressure monitor, a negative-pressure therapy device, and an ultrasonic debridement device. In active collaboration with the Department of Burns Surgery and the Department of Vascular Surgery, it conducts comprehensive diagnosis and treatment of diabetic foot and is planning to establish the Diabetic Foot Diagnosis and Treatment Center of Shandong University Qilu Hospital.

Since 2005, the department has been committed to regenerative therapy for diabetes, particularly type 1 diabetes. More than 200 patients have now received stem-cell therapy, with good clinical outcomes. Professor Chen Li and her team have demonstrated multiple mechanisms of stem-cell therapy for diabetes through clinical and basic research, and their research received the Second Prize of the Shandong Province Science and Technology Progress Award. The department has now led the establishment of a Cell Therapy Center and is actively conducting clinical research on sequential infusion therapy with umbilical cord/cord-blood stem cells and immune intervention for type 1 diabetes, as well as heterogeneous screening and precision treatment of stem cells and translational applications of exosomes. It also led the drafting of the Position Statement on Stem-Cell Therapy for Diabetes.

2. Obesity prevention and treatment have become an important branch of the discipline: The department has carried out extensive work in obesity prevention and treatment, particularly adolescent obesity prevention and treatment, and was the first in the province to establish an obesity prevention and treatment center. It has established a specialty obesity clinic; conducts body composition monitoring; uses bioelectrical impedance and dual-energy X-ray absorptiometry to determine fat content and distribution in obesity; monitors sleep-disordered breathing; uses the Epworth Sleepiness Scale and Berlin Questionnaire for assessment; and uses the RESMED portable sleep monitor to ensure early diagnosis and treatment of obstructive sleep apnea syndrome. In cooperation with the Department of General Surgery, the department conducts surgical treatment of obesity and has established an expert team for weight-loss and diabetes surgery. Together, they compiled the Handbook of Weight-Loss and Diabetes Surgery of Shandong University Qilu Hospital. The department will continue to advance clinical and basic research at our hospital on surgical treatment of obesity and type 2 diabetes for weight loss, benefiting patients with obesity and diabetes.

3. Distinctive features in thyroid disease prevention, treatment, and research: In recent years, the incidence of thyroid diseases, particularly thyroid cancer, has increased rapidly. The department has consistently emphasized the development of its thyroid subspecialty and has established a relatively comprehensive clinical diagnosis and treatment system for thyroid tumors comprising a thyroid clinic, ward, thyroid function testing room, thyroid fine-needle aspiration room, and radioactive nuclear medicine treatment room. In 2011, the department led the establishment of the Thyroid Club, collaborating with thyroid surgery, otolaryngology, pathology, ultrasound, nuclear medicine, and other disciplines to improve the diagnosis and treatment of thyroid diseases at our hospital. Through the joint efforts of the Thyroid Club, ultrasound-guided thyroid fine-needle aspiration examination was initiated in 2014; more than 30,000 cases have been completed to date, with a pathological concordance rate exceeding 90%. In 2019, molecular testing of thyroid fine-needle aspiration cytology was initiated, further improving the diagnosis and treatment of thyroid tumors at our hospital. In 2021, radiofrequency ablation of thyroid tumors was initiated, improving the thyroid nodule diagnosis and treatment system and substantially strengthening our hospital’s ability to distinguish benign from malignant thyroid nodules and provide standardized diagnosis and treatment. The department has carried out extensive work in iodine-131 therapy for thyroid diseases and performs thyroid radioactive iodine uptake testing. The purchase of advanced instruments, such as an automatic iodine fractionation instrument, has improved treatment efficiency and safety. It currently sees more than 5,000 thyroid patients annually and performs iodine-131 therapy for more than 900 patients annually. The department has established an integrated electronic follow-up and medical-record system for patients with thyroid diseases, further strengthening the diagnosis and treatment of thyroid diseases. The successful implementation of these initiatives has driven an overall improvement in the diagnosis and treatment of thyroid diseases at our hospital.

4. Notable achievements in osteoporosis prevention and treatment: Since the late 1980s, the department has taken the lead in Shandong Province in conducting osteoporosis research and applying it to clinical prevention and treatment. It has progressively established a diagnosis and treatment system comprising a specialty osteoporosis clinic, bone mineral density room, and ward. It has accumulated extensive experience in the diagnosis and treatment of metabolic bone diseases, including primary and secondary osteoporosis, parathyroid diseases, hypophosphatemic osteomalacia, osteogenesis imperfecta, Paget’s disease of bone, and osteopetrosis. It was the first in the province to carry out bisphosphonate treatment for osteogenesis imperfecta, zoledronic acid treatment for Paget’s disease of bone, and teriparatide and denosumab treatment for postmenopausal osteoporosis. The bone mineral density room currently has two dual-energy X-ray bone densitometers and one ultrasound bone densitometer and performs nearly 10,000 bone mineral density measurements annually. The department emphasizes academic dissemination and patient education. Since 2013, it has held national training courses on metabolic bone diseases on multiple occasions and regularly conducts patient education and free consultation activities for osteoporosis. It has established a platform covering prevention and screening, comprehensive standardized diagnosis and treatment, follow-up management, and scientific research, and works with the Departments of Orthopedics, Rheumatology, Radiology, Nuclear Medicine, and Geriatrics to improve the diagnosis and treatment of osteoporosis and bone-mineral-salt disorders at our hospital.

5. Pituitary and adrenal diseases: The hypothalamic-pituitary subspecialty is an important branch of our department. Since its establishment, it has been the first in the province to establish a multidisciplinary team (MDT) for hypothalamic-pituitary diseases, centered on the Departments of Endocrinology and Metabolic Diseases and Neurosurgery and including Pathology, Radiology, Radiation Oncology, Ophthalmology, Reproductive Endocrinology, and other related departments. It conducts multidisciplinary joint outpatient clinics for hypothalamic-pituitary diseases and develops treatment plans jointly for difficult cases that are complex, refractory, or recurrent, greatly improving the clinical diagnosis and treatment of hypothalamic-pituitary diseases at our hospital. The team was the first in the province to perform percutaneous bilateral inferior petrosal sinus sampling for the differential diagnosis of Cushing syndrome and standardized the glucose growth hormone suppression test, dexamethasone suppression test, somatostatin suppression test, and water-deprivation plus vasopressin test. It established a clinical cohort of hypothalamic-pituitary diseases covering acromegaly, Cushing disease, craniopharyngioma, and nonfunctioning pituitary adenoma, and conducts a series of basic and clinical studies. It holds provincial or national training courses on multidisciplinary diagnosis and treatment of hypothalamic-pituitary diseases annually, promoting regional disciplinary development.

6. Growth and development and gonadal diseases: After years of clinical practice, the department has established a professional team for growth, development, and metabolic disorders in adolescents and children and has opened a specialty growth and development clinic. The clinic aims to identify children with abnormalities of growth, development, and metabolism as early as possible and guide treatment scientifically so that they can grow up healthy. The department has accumulated extensive experience in multiple diseases, including short stature, precocious puberty, delayed puberty, hypogonadism, adolescent obesity, gynecomastia, adolescent diabetes, adolescent thyroid diseases, and abnormalities of bone metabolism and development in adolescents.

[Scientific Research and Achievements]

As a department that gives equal importance to clinical care and scientific research, it actively conducts research while completing routine diagnostic and treatment work. The department currently has 1 jointly appointed academician, 1 distinguished professor under the Taishan Scholars program, and 1 Taishan Industry Leading Talent, as well as 17 graduate supervisors. It has established the Academician Ning Guang Workstation and the Chen Li High-Level Skilled Talent Innovation Studio. Scientific research focuses on such cutting-edge topics as stem-cell regulation, islet function and regeneration, and metabolism and biological clock rhythms. Over the past decade, the department has undertaken more than 90 projects of various types, including more than 40 national- and provincial/ministerial-level projects. Among these, young physicians under 45 years of age have collectively received 20 National Natural Science Foundation of China projects. The department has trained more than 300 doctoral and master’s students, received 16 scientific research achievement awards, and published more than 400 papers in authoritative journals including Nature, Cell Research, PNAS, Diabetes Care, and Diabetes, including more than 150 SCI-indexed papers. It has served as editor-in-chief or contributing editor for more than 20 medical books and participated in formulating more than 30 Chinese diabetes-related diagnostic criteria, guidelines, and standards. While actively exploring new findings, the department also emphasizes the clinical translation of research results. It currently cooperates with multiple research institutions and enterprises to translate research achievements through medical-engineering collaboration, medical-data integration, industry-academia cooperation, artificial intelligence development, and other areas. It has established a Clinical Research and Translational Center for Stem Cells, a Joint Artificial Pancreas Laboratory, and a Precision Platform for Genetic and Mass-Spectrometry Testing. It has received 3 Second Prizes of the Shandong Province Science and Technology Progress Award, obtained 5 software copyrights, and applied for or received approval for more than 20 invention patents.

[Academic Exchange and Collaboration] The department attaches importance to the sustainable development of its personnel. It has sent personnel on 15 person-times of study and exchange visits to internationally renowned institutions, including Yale University, Mayo Clinic, Baylor College of Medicine in the United States, the University of Florida, and the University of Sydney. More than 10 key staff members have undertaken further training at leading domestic hospitals, including Peking Union Medical College Hospital, Shanghai Ruijin Hospital, West China Hospital of Sichuan University, and Shanghai Sixth People’s Hospital. Physicians at all levels regularly attend high-level international and domestic academic conferences each year. Renowned professors from China and abroad are appointed as visiting professors to provide guidance in clinical and scientific research. The department has hosted national- and provincial-level academic conferences on many occasions. The Qilu Endocrinology Forum and Endocrinology Frontline Physicians Excellence Training Course has been held for seven consecutive sessions and has received unanimous acclaim from experts and colleagues both inside and outside the province.

In recent years, with the support and assistance of the hospital and sister departments, and under the leadership of Professor Chen Li, the academic leader, the Department of Endocrinology and Metabolic Diseases has made substantial progress. We will continue to uphold the hospital motto, “Pursue medical ethics and strive for excellence in expertise,” and work hard to build a first-class department of endocrinology and metabolic diseases in China.