Prof. Liyan Jiang: view respiratory medicine from a developmental perspective

In June 2017, Prof. Liyan Jiang (Figure 1), Chief of Dept. of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University and Director of Clinical Trial Institute, accepted our interview to share her views on the status quo and prospects of respiratory medicine. During the interview, she also kept an eye on clinical experiments and answered questions from other doctors with great patience and prudence.

Figure 1 Prof. Liyan Jiang.

Balance clinical practice and scientific research

Prof. Jiang has been devoted to clinical practice and scientific research for three decades. She holds that the two are closely related and complementary. For her, clinical practice is synonymous with patients. She said the large population of patients in China is an advantage in some way, as it means more information for doctors to study the cases. Now the key is to build an effective clinical database like those in foreign countries. Among the most urgent priorities are to decide which patients need first-line treatment, what clinical trials should be conducted for first-line treatment, and what kind of patient information should be put in the database.

Prof. Jiang said, aside from treating patients, their work also includes collecting and analyzing clinical cases. By inputting the unanswered problems into the database, these clinical data will “speak” and help solve problems in clinical trials and researches, so as to expedite the process of drug research and development. If we try to expand the database as much as possible, we may discover relations between things that appear irrelevant, such as beer and diaper, and we may be moving closer to the truth of science. “Clinicians should not overlook scientific research, and clinicians should always keep thinking.” Said Prof. Jiang. The doctors should apply the latest theories into practice as well as study new clinical problems and then use the research results to guide the treatment of patients. This is just the essence of translational medicine.

Inherit and develop featured brand

Thanks to the efforts of generations of experts at Shanghai Chest Hospital, lung cancer treatment has become a strong point of the hospital. When asked about the features and future developments of respiratory medicine, Prof. Jiang first recalled the huge contributions made by several professors—Changwen Xu, Meilin Liao, Yurong Chen, and the hospital’s vice president Baohui Han—to the development of respiratory medicine.

Prof. Jiang pledged to maintain their competitive edges in respiratory medicine and keep momentum alive. Meanwhile, she said respiratory medicine is not just about the studies of lungs, admitting her hospital has some areas of weakness. But she held that it is unnecessary to struggle to eliminate the weak spots, and each hospital should have its own characteristics and set appropriate goals.

Prof. Jiang pointed out that their primary objective is to lead in lung transplantation, where they are confronted with three challenges—preoperative screening of patients, perioperative operations, and follow-up visits. Lung transplant recipients have different health conditions. First, the recipients need to take immunosuppressive drugs and are clinically known as immunocompromised patients; second, they often suffer from rejection. During follow-up visits, bronchoscopy is often required, and Shanghai Chest Hospital is strong at this technique. In addition, with improved postoperative observations of acute, sub-acute, and chronic rejection, the hospital enjoys advantages in this area.

The second area of interest is sleep disorders. Many lung cancer patients are struggling with sleep disorders due to respiratory complications. Shanghai has rolled out policies aimed to improve and monitor the sleep quality of patients. All this will be favorable to sleep disorder treatment.

The last is infection. Infections are common among patients with lung diseases. The department of respiratory medicine not only treats patients with immunosuppression resulting from chemotherapy, but also joins consultations of patients in other departments. The department helps patients with infections from cardiology department, surgery department and ICU as well. Therefore, infection control will be a priority area in the department of respiratory medicine.

“We are not in a rush to lead in all areas of respiratory medicine, but sharpen our focus to develop strength in the mentioned aspects above so as to enhance our hospital’s competitive advantages,” said Prof. Jiang.

Cultivate talents through multiple means

When talking about training young doctors, Prof. Jiang lamented that the domestic education system should be improved, and nowadays basic training of young doctors is insufficient, as compared with the five years of rotation when she was young. She proposed that the approach to improve the cultivation of young doctors be two-pronged. In terms of clinical skills, young doctors, without the experience of rotation or basic training, tend to be narrow-minded when handling clinical issues, and they will need to rotate through different departments so as to accumulate experience. From the perspective of scientific research, hospitals should devise flexible talent training schemes for ambitious young doctors as well as engage in national and local talent training programs. Systematic training will not only help provide better services for patients but also benefit the career development of young doctors. Prof. Jiang is enthusiastic to encourage young doctors to compete for joining talent-training programs to improve their medical skills.

Publish scientific journal for young doctors and patients

As the associate editor-in-chief of Shanghai Chest, Prof. Jiang is clear about the development direction and potential readers of the journal. As a pragmatic manager,she hopes the journal will better serve young doctors and patients than experts. She vividly compared the journal as “two walking sticks” for young doctors in the field of chest disease, helping them improve academic competence through the steps from research design, article writing, revision, to publication.

Besides, Prof. Jiang proposed introducing a “Respiratory Medicine” column to study rare cases and analyze classic cases and standardized treatment algorithms.

In her medical career, Prof. Jiang has emphasized both clinical practice and scientific research. She is committed to maintaining the strength of Shanghai Chest Hospital in respiratory medicine. Being concerned about the training of young doctors, she tries to disseminate medical knowledge by publishing academic journals. She is pursuing her lofty ideals in a down-to-earth manner.

Expert’s introduction

Liyan Jiang, MD, chief physician, doctoral tutor, executive deputy director of the Department of Pulmonary Medicine. She currently serves as the director of the Office for National Agency for Clinical Trials of Drugs in Shanghai Chest Hospital, deputy director of Clinical Research Office of Lung Cancer in Shanghai Chest Tumor Institute, and deputy director of the Department of Pulmonary Medicine of Shanghai Chest Hospital. She is specialized in the diagnosis, differential diagnosis, and multidisciplinary treatment of lung cancer, management of pulmonary infectious diseases, and diagnosis and treatment of complex diseases in respiratory system. In these areas, she has accumulated rich clinical experiences, with fruitful research findings.

She is a member of the editorial board of the Chinese edition of the Annals of Oncology and the international member of editorial board of the Annals of Oncology, the member of the editorial board of International Journal of Respiration, committee member of Geriatrics & Health Care, reviewer of Chinese Journal of Lung Cancer, invited contributor of “People and Health Weekly” and “People and Health” series media, deputy head of the infectious disease group of Shanghai Pulmonary Medicine Society of Chinese Medical Association, director of Shanghai Anti-tuberculosis Society, member of Shanghai Respiratory Branch of Chinese Association of Rehabilitation Medicine, and deputy chief of Exercise Rehabilitation Panel of Respiratory Rehabilitation Specialized Committee of Shanghai Society of Rehabilitation Medicine. She was voted “New Star in Medical Sciences” by Shanghai Health Bureau. She is also a member of ASCO and CSCO.

In 2000, she was awarded the “Excellent Paper” in the fifth academic conference of China Cancer Research foundation; in 2002, she was voted “New Star in Medical Sciences” by Shanghai Health Bureau. She has carried out several bureau- or higher-level research projects, including one international cooperation project, 4 projects supported by the Shanghai Science and Technology Commission, 1 project supported by the Key Basic Projects of Shanghai Science and Technology Commission, and 1 project supported by the Youth Research Foundation of Shanghai Health Bureau.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the Editorial Office, Shanghai Chest. The article did not undergo external peer review.

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/shc.2017.07.05). The authors have no conflicts of interest to declare.

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(Interviewers: Silvia L. Zhou, Sucy X. Wu; Manuscript editors: Jasmyn W. Ding, Minica L. Liu; Translator: Liangjun Gu)