Mao Yimin, Professor of Gastroenterology, Chief Physician at Renji Hospital’s Department of Gastroenterology, Director of the Shanghai Fatty Liver Disease Diagnosis and Treatment Research Center

Introduction:
        In the early 1990s, within the gastroenterology ward of Renji Hospital, there was a young doctor who likely spent the longest time rotating through the emergency department among his peers.

Medicine is a profound discipline, extending far beyond the accumulation of knowledge; it embodies a reverence for life and a sense of responsibility. His journey, from an eager student to a seasoned physician, from an inquisitive researcher to a mentor guiding others, has been marked by steadfastness and strength at every step.

He is a leading expert in China in the fields of drug-induced liver disease (DILI) and fatty liver disease, and a pioneer in clinical trials for new drugs in China. His dream is to dedicate a lifetime of perseverance to painting canvases that save lives.

He is a physician who particularly enjoys sharing stories—about himself, Renji Hospital, his mentors, and the future. Whether recounting moments from work or daily life, his narratives always bring joy and vividness to his listeners.

The Path to Medicine

In the scorching summer of 1986, Mao Yimin stood at a crossroads in his life. For every Chinese student, the Gaokao (National College Entrance Examination) is an unforgettable experience.

In an era with limited information, his parents’ subscription to Popular Medical Journal became his window into medicine. From middle school through high school, the seemingly dry medical knowledge and stories within its pages quietly took root in his heart. “My medical启蒙 (enlightenment) is entirely thanks to Popular Medical Journal. By high school, I could already understand the disease information it presented. From then on, I developed a deep interest in medicine.”

Although his family had no medical background and his parents hoped he would pursue science or engineering, Mao Yimin had already made up his mind. He was captivated by the allure of medicine—the fascinating physiological and pathological mechanisms, the life-and-death medical decisions—all sparking immense curiosity and excitement.

“In my final year of high school, we got a television at home. I remember, about a month before the Gaokao, while we were all studying at home, I turned on the TV one morning. Coincidentally, it was broadcasting a correspondence course on hyperthyroidism. I was instantly drawn to the medical knowledge, set aside my language, math, and English review, and followed the entire course, understanding it completely. After that day, I faithfully turned on the TV every morning at that time, finishing the course before resuming my exam prep.”

When the Gaokao results were announced, he scored 601—a score high enough to open the doors to any top university in China. Yet, faced with numerous choices, Mao Yimin hesitated not; his heart held its answer: Medical University. “That score was likely the highest among those admitted to the Second Medical University in '86,” Mao Yimin recalls with a smile.

It felt like a calling, a destined choice. No indecision, no external influence—only a deep-seated love and yearning for medicine within. His decision, long rooted, had finally grown into a towering tree.

Upon entering Shanghai Second Medical University, Mao Yimin did not relax his standards despite his high score. He knew the path of medicine was long and arduous, demanding constant learning and practice to become a qualified doctor.

During his university years, Mao Yimin absorbed knowledge like a sponge. He gave his all in every exam and internship, striving for excellence. In his third year, faced with a choice to transfer to an English-language program based on his grades, he declined. Instead, he joined the university’s first-ever educational reform pilot class—the inaugural PBC (Problem-Based Curriculum) class, comprising just over 30 students. Theoretical knowledge was primarily self-studied, and clinical exposure began in the third year. When asked why, Mao Yimin explained, “As medical students, this allowed us to encounter patients much earlier.”

After graduating with distinction, he was assigned to the Department of Internal Medicine at Renji Hospital, embarking on his residency. Here, he would face greater challenges and tests.

“When I first arrived at the hospital, my first rotation was in gastroenterology. Fresh out of school, despite my theoretical knowledge, I didn’t yet know how to diagnose and treat patients. To quickly grasp the management of common digestive diseases, I lived at the hospital 24 hours a day for the entire first month. At night, I slept on a sofa in the gastroenterology department’s doctors’ office. Whenever there was a patient emergency or resuscitation in the ward, I would get up to learn from the senior doctors and assist. So, back then, I was truly a resident physician living in the hospital.”

A Supportive Culture in Renji’s Gastroenterology Department

Throughout his rotations at Renji Hospital, Mao Yimin recognized the profound value of this experience. Each department offered distinct medical knowledge and skills, and only through comprehensive training could he build the foundation for his future career.

The rotations were demanding yet transformative. Mao Yimin committed to excelling in every specialty, knowing this dedication would unlock greater learning and growth opportunities.

During his cardiology rotation, an 18-year-old girl was admitted with fever and ventricular arrhythmia—a life-threatening condition requiring urgent intervention. “She was critically ill,” Mao recalls. “After developing torsades de pointes with Adams-Stokes syndrome, her survival odds were slim. Senior cardiologists tried standard antiarrhythmic drugs and electrical cardioversion, but nothing stabilized her.”

As hope faded, Professor Wang Binyao suggested magnesium sulfate—an unconventional approach at the time. “It was a weekend,” Mao explains. “Given her instability, Professor Wang requested round-the-clock monitoring. Though off-duty, I volunteered immediately. For 24 hours, I tracked her vital signs, ready to alert the team to any deterioration. After the magnesium sulfate took effect, her arrhythmia subsided, and she regained consciousness. I witnessed a miracle.” This case remains the most memorable of Mao’s career, deepening his reverence for life and his sense of purpose as a physician.

The emergency department presented its own challenges. Over five years as a resident, Mao spent 22 months in ER rotations, plus additional years covering weekend shifts. From treating minor injuries to rescuing critically ill patients, each experience reinforced his respect for life. “The ER taught me more than any textbook,” he reflects. “It’s medicine’s front line—a constant race against death. Every successful rescue brought profound pride and fulfillment.”

After years of rotations, Mao chose gastroenterology as his specialty—a mutual decision driven by his passion and the department’s recognition of his potential. “Gastroenterology encompasses vital organs and offers endless challenges,” he notes. “It also receives complex cases with unclear origins, exposing me to diverse internal medicine conditions. This was invaluable for developing my clinical reasoning.”

Four exceptional mentors shaped Mao’s medical philosophy. “I was fortunate to learn from giants in Chinese gastroenterology,” he says. “Rounds with them were both intimidating and exhilarating. Intimidating because they demanded precision; exhilarating because each session revealed new clinical insights and compassionate care. Academician Jiang Shaoji taught me meticulousness. Professor Xiao Shudong showed me how to find clarity in complexity. Professor Qiu Dekai demonstrated how to grow through experience.”

Among them, Professor Zeng Minde held a special place. His intellect, passion, and dedication inspired Mao deeply. “Professor Zeng was both a demanding mentor and a supportive friend,” Mao recalls. “As a junior doctor, he’d invite me to discuss new literature. Our debates were free and spirited—sometimes we agreed, sometimes we didn’t. It was true intellectual exchange.” Mao remembers Professor Zeng reading medical journals even on Chinese New Year’s Eve. “His thirst for knowledge was boundless. When I struggled, he’d say, ‘Reflect on what you might have missed.’ That habit of self-assessment stays with me.”

Renji’s gastroenterology department fostered a unique camaraderie. “We celebrated birthdays together,” Mao shares. “Several colleagues, including Professor Xiao Shudong and I, shared January birthdays. We’d coordinate celebrations around his schedule. This tradition built remarkable harmony.”

This environment reinforced Mao’s commitment to medical education. “Education isn’t just transferring knowledge—it’s inspiring critical thinking and innovation,” he asserts. “I encourage students to challenge existing practices and propose new ideas.”

Mao integrates clinical practice with research, urging students to transform patient cases into scientific inquiries. “Early clinical exposure is essential,” he emphasizes. “It cultivates reasoning and empathy—the bedrock of exceptional clinicians.”

In today’s interconnected world, Mao prioritizes global perspectives. “I urge students to engage internationally—attend conferences, collaborate, and absorb advancements. This broadens their vision and career potential.”

Medicine evolves relentlessly. “Lifelong learning is non-negotiable,” Mao concludes. “Only by continuously updating knowledge can we deliver optimal care. This embodies the spirit of Renji’s gastroenterology department—a legacy I’m committed to passing on.”

Pioneering Clinical Trials in China

In the 1990s, clinical trials in China were in their infancy, with most physicians unfamiliar with the field. Professor Zeng Minde, a visionary leader, emerged as one of the earliest champions of clinical research. Under his mentorship, Mao Yimin began exploring this emerging frontier.

“Professor Zeng was my guiding light in clinical trials,” Mao recalls. “He constantly encouraged us to pioneer new treatments and venture into uncharted territory. Inspired by him, I took on hands-on responsibilities in trials. Though demanding, this became one of the most formative experiences of my career.”

Under Professor Zeng’s tutelage, Mao began designing clinical trial protocols. Each protocol presented unique challenges. Zeng’s exacting standards compelled Mao to continuously learn, innovate, and refine his approach. “I remember Professor Zeng meticulously reviewing every protocol. Each iteration taught me invaluable lessons. His rigor and deep insights transformed my understanding of clinical trials. Together, we gradually built a robust clinical trial framework.”

Through direct involvement in trials, Mao gained irreplaceable frontline experience. He personally managed patient screening, data collection/analysis, and report compilation—every step reflecting his dedication and expertise. “Working on the front lines taught me profoundly: clinical trials aren’t merely scientific experiments; they’re a covenant with patients. Every successful trial reinforced my belief that our work could deliver real hope.”

In 2003, Mao’s career reached a pivotal moment. He served as a six-month external expert at China’s FDA (CFDA) Center for Drug Evaluation (CDE), independently completing over 400 technical reviews for new drugs in gastroenterology and hepatology. As the nation’s premier drug evaluation body, the CDE experience shifted Mao’s perspective from “player” to “referee” in drug development.

“My time at the CFDA provided a panoramic view of drug development and trials,” Mao explains. “I learned to rigorously evaluate a drug’s quality, efficacy, and safety to ensure post-approval performance.”

Upon returning, Mao and Professor Zeng co-founded Renji Hospital’s National Drug Clinical Research Institution, earning certification from China’s drug regulator. This enabled nearly 20 hospital departments to conduct new drug trials. Simultaneously, Mao began representing China globally. In 2008, he presented China’s role in international multicenter trials at conferences. While acknowledging gaps with global standards, this fueled his determination to advance domestic research.

“Fifteen years ago, presenting China’s trial landscape at conferences in the US, Australia, and Asia revealed two realities,” Mao notes. “Internationally, there was skepticism toward Chinese data. Crucially, we lagged in investigator-initiated trials (IITs)—studies reflecting our unique medical practices and patient needs. These are vital for elevating China’s clinical research quality and influence.” Today, Mao celebrates China’s remarkable progress in both quantity and quality of clinical research.

Through relentless dedication, Mao earned recognition as China’s clinical trials leader. He joined the Drug Information Association (DIA), becoming the sole clinician on DIA China’s inaugural advisory board, collaborating with global experts. He also served as Chief Expert for China’s “Major New Drug Innovation” GCP platform during three consecutive Five-Year Plans.

Over nearly three decades, Mao has witnessed China’s clinical trials evolve from infancy to robust maturity. Seeing numerous new drugs approved to treat Chinese patients brings him deep satisfaction. “I’m proud to have contributed to this journey,” he reflects.

Since leading China’s first lamivudine hepatitis B trial in 1996, Mao has directed or participated in nearly 300 trials, enabling countless drug approvals. Each trial advanced medical knowledge while offering patients new therapeutic options. Reflecting on this legacy, Mao encourages young physicians: “Participate in drug trials. You’ll not only expand treatment options for patients but also develop rigorous clinical practices that elevate our entire field.”

Addressing Drug-Induced Liver Injury

While medications are indispensable in modern medicine, they can pose hidden risks to liver health. Among gastroenterologists, Mao Yimin stands out for his specialized expertise in this critical area.

Medications are powerful tools for treating disease, yet many carry the potential for liver damage—a risk often overlooked by both patients and healthcare providers. Recognizing numerous undiagnosed cases of drug-induced hepatitis, Dr. Mao dedicated his career to this field. He emphasizes that both pharmaceuticals and traditional Chinese herbs can cause liver injury.

In 2014, he founded Hepatox—China’s first and the world’s second specialized platform for drug-induced liver injury (DILI)—and established the world’s largest DILI database. He has led national guideline development and contributed to international standards, representing China in a European prospective cohort and presenting research to the U.S. FDA, amplifying China’s global voice in hepatology.

“Recently, we updated China’s DILI guidelines, created a primary care version, and collaborated with oncology, hematology, and rheumatology specialists to develop cross-disciplinary protocols,” Dr. Mao notes. “Despite chairing multiple guidelines, this is just the beginning. DILI research faces immense challenges—from prevention to diagnosis and treatment. Public and professional awareness remains critically inadequate.”

Diagnosing DILI is complex due to nonspecific symptoms and limited biomarkers. Yet Dr. Mao insists on clear documentation when evidence strongly points to drug-induced injury. “Many primary care physicians hesitate to diagnose DILI, fearing patient disputes,” he explains. “But accurate diagnosis is our duty to patients.”

Beyond research, Dr. Mao prioritizes public education. Through lectures, articles, and media, he promotes safe medication practices and proper home pharmacy management. His outreach covers drug selection, dosage control, and side-effect recognition to prevent DILI and improve quality of life. This year, he plans a national survey on DILI and rational drug use, alongside developing public-friendly guidelines.

Despite significant achievements, Dr. Mao remains focused on unmet needs. “Future research must examine more drugs’ hepatic effects to strengthen clinical evidence,” he states. “Equally vital is expanding public education to protect more lives.”

Dr. Mao’s pioneering work has advanced DILI research and elevated public health awareness. “I’m confident our continued efforts will bring greater attention to this field,” he reflects. “One day, safe and informed medication use will be a reality for all.”

Editor: Chen Qing @ ShanghaiDoctor.cn, If you'd like to contact to Dr. Chen, please be free to contact the email of Chenqing@ShanghaiDoctor.cn.

Note: Chinese Sources from “The Path of Benevolent Medicine” which was published in 2024. It records 90 important medical figures in the history of Renji Hospital. Yewen Renyi (ShanghaiDoctor.cn) team was one of the major writers of the book and is authorized by Renji hospital to create English version on the website of ShanghaiDoctor.cn