Zhang Qingyi(1932~2008), Professor of Internal Medicine, Former Chair of Internal Medicine, Renji Hospital 

Introduction

He began his medical career with a passionate, inquisitive spirit, becoming a leading figure in Shanghai’s integrated Chinese-Western medicine community. His career, anchored at Renji Hospital, was defined by a commitment to overcoming challenges and advancing patient care. Through clinical practice, he gained extensive experience, demonstrating a profound thirst for knowledge and a spirit of exploration in integrating traditional Chinese medicine (TCM) with modern medical diagnostics.

Despite the social and political upheaval that often hindered medical research, he remained dedicated to his path. His research into the integrated treatment of kidney diseases steadily progressed, combining TCM’s syndrome-based approach with Western diagnostic precision to offer patients more comprehensive care.

His academic work continuously pushed the boundaries of medicine. He understood that integrating the profound heritage of TCM with the advanced technology of Western medicine could open new frontiers in treatment, delivering more precise and effective healthcare.

As a kidney disease specialist with unique insights into integrated medicine, his career is a testament to a lifelong pursuit of medical science and a dedication to advancing the field of integrated Chinese-Western medicine and education.

The Path to Medicine

Born on March 24, 1932, in Wuxing, Zhejiang Province, Zhang Qingyi was raised in a physician’s family during an era of national turmoil, which profoundly shaped his career path.

His father, Zhang Youshi, was a respected Chief Physician of Internal Medicine at Shanghai Municipal First Hospital, known for his medical skill and ethical practice. Dr. Zhang’s dedication to both patient care and medical education deeply influenced his son, igniting his passion for medicine.

Growing up in this environment, Zhang developed a strong interest in science and medicine. Excelling academically, his resolve to pursue medicine was solidified during the hardships of the War of Resistance Against Japanese Aggression, as he sought to contribute to his country.

In 1949, as the nation began to rebuild its healthcare system, Zhang Qingyi’s medical journey commenced. He resolved to dedicate his life to the nation’s healthcare and the well-being of its people.

Zhang Qingyi’s formal medical training began at Shanghai Second Medical College, where his association with Renji Hospital started. After graduating with distinction in 1955, he joined Renji Hospital, a leading institution that provided a robust platform for his clinical work. In his first decade, he published numerous papers on integrating TCM syndrome differentiation with modern medicine, particularly in treating hepatitis, laying the groundwork for his future research in nephrology.

A pivotal moment came in June 1954, when Chairman Mao Zedong called for the establishment of TCM research institutions and for Western-trained doctors to study TCM. This led to the creation of the Academy of Traditional Chinese Medicine and the first national training programs for “Western doctors learning TCM.” Zhang Qingyi was among the first cohort of this program, which tasked graduates with inheriting, innovating, and advancing TCM.

Zhang recognized the importance of this integration. In the early 1960s, he participated in clinical studies like “Analysis of 318 Cases: Integrating TCM Syndrome Differentiation with Modern Medicine,” which enriched TCM’s clinical application.

His paper, “Clinical Analysis of 100 Cases of Yin-Deficiency Red Tongue,” demonstrated that while tongue coating changes are not disease-specific, they are valuable indicators of the body’s physiological and pathological state, aiding in diagnosis and treatment. He published further research, including “Syndrome Differentiation and Treatment of Hepatitis,” which provided valuable experience for his future work.

He understood that integrating TCM and Western medicine was challenging due to their different foundational logics. His research on “Primary Hyperaldosteronism” and his work using a “Flat-Plate Artificial Kidney” to treat refractory ascites reflected his commitment to advancing medical technology from a Western perspective as well, showcasing a holistic approach to his field.

New Shoots in Medicine After a Decade of Turmoil

From 1966 to 1976, China’s Cultural Revolution interrupted scientific progress, and Zhang Qingyi’s research was affected. It was only after this period that his work gradually resumed.

The social upheaval of the era impacted many careers, and Zhang Qingyi’s research was no exception. Yet, throughout these difficult years, he demonstrated an unwavering dedication to medicine.

With the end of the decade-long turmoil, Zhang Qingyi’s research and clinical work at Renji Hospital slowly returned to normal. In 1976, he led his department back into nephrology research, continuing to explore integrated treatments for kidney diseases. During this period, his research findings began to be published successively.

In 1977, Zhang Qingyi published studies on integrated Chinese-Western treatments for kidney diseases. This work not only summarized the clinical experience he had accumulated but also showcased his new insights into integrated therapy, providing valuable references for future treatments.

Entering the 1980s, Zhang Qingyi’s research became more profound and extensive. In 1982, his investigation into the misdiagnosis of renal tubular acidosis contributed to improved diagnostic accuracy. Subsequently, his research on managing hypertension in chronic renal insufficiency offered crucial guidance for clinical treatment.

In 1984, Zhang Qingyi published observations on antithrombin III in kidney diseases, providing new perspectives on coagulation mechanisms in nephrology.

Two years later, Zhang Qingyi’s research began to focus on glucose metabolism and pancreatic islet cell function in kidney disease patients, laying the foundation for integrated Chinese-Western studies on diabetic nephropathy. His work offered new insights for early diagnosis, enabling doctors to identify kidney damage sooner and intervene promptly. This research also optimized treatment strategies through personalized plans to control blood glucose more effectively and reduce further kidney damage. His efforts promoted interdisciplinary collaboration and deepened the medical community’s understanding of diabetic nephropathy.

In the following years, Zhang Qingyi achieved further milestones. In 1986, he published “Exploration of the Mechanism of Edema in Kidney Diseases,” providing vital information on the pathophysiology of these disorders. Edema in kidney disease is a common and complex symptom, typically resulting from the kidneys’ impaired ability to regulate water balance, reduced plasma protein levels, and hormonal imbalances.

Furthermore, he conducted detailed observations on using hemodialysis to treat psoriasis, exploring ways to broaden the application of this technology.

By 1988, Zhang Qingyi published research on the clinical application of ultra-high-dose corticosteroid pulse therapy in China. As one of the earliest clinicians to study this technique, which involves administering extremely high doses of corticosteroids over a short period to rapidly control severe inflammation, he offered new methods for immunotherapy in kidney diseases. His work garnered significant attention and was later widely adopted for various acute and autoimmune diseases.

His work on treating cyclosporine nephropathy also provided a foundation for managing post-transplant kidney disease.

During the first decade of China’s reform and opening-up, Zhang Qingyi not only solidified his academic foundation in nephrology but also achieved breakthroughs in the integrated treatment of kidney diseases, paving the way for future growth and development.

Pioneering a New Chapter in Integrated Kidney Disease Research

In 1989, Zhang Qingyi centered his research on the integration of basic medicine, clinical practice, and traditional Chinese medicine. He understood that combining TCM’s syndrome-based treatment with Western medicine’s precise diagnostics could provide kidney disease patients with more comprehensive and in-depth treatment plans.

That year, he published a clinical and pathological report on renal amyloidosis, marking a solid step forward in his integrated research.

Entering the 1990s, Zhang Qingyi’s academic achievements became increasingly prominent, earning him renown in China’s medical community and showcasing the unique strengths of integrated medicine on the international stage. In 1990, his research on treating anemia in chronic renal failure with recombinant human erythropoietin offered new strategies for managing this condition. In 1991, his study on the clinical significance of serial urinary protein measurements further enriched diagnostic tools for kidney diseases.

In 1992, Zhang Qingyi published research on treating latent glomerulonephritis. Latent glomerulonephritis is a chronic condition with subtle or no obvious symptoms that can lead to gradual renal impairment. Integrated Chinese-Western medicine is widely used for its treatment. Western approaches typically involve glucocorticoids, immunosuppressants, and lifestyle changes. TCM focuses on syndrome differentiation, using herbs to tonify the kidneys, improve blood circulation, and clear heat. This integrated approach combines the rapid anti-inflammatory effects of Western medicine with the holistic regulatory effects of TCM, quickly controlling progression while regulating the patient’s constitution long-term, reducing relapses and side effects. This study reflected Zhang Qingyi’s profound understanding of integrated treatment and his innovative thinking in the field.

Subsequently, his evaluation of low-protein diets combined with Keto-Acid Tablets (Shen Ling) for chronic renal failure further confirmed the effectiveness of this integrated therapy.

In 1995, his research deepened with a clinical study on nephrotic syndrome complicated by acute renal failure. This study analyzed the TCM syndrome characteristics of the condition and explored the potential advantages of integrated therapy in improving outcomes. To clarify the pathology of IgA nephropathy, he made significant progress in clinical and pathological analysis over the next few years, enhancing the understanding of its mechanisms and exploring integrated therapy to improve its prognosis.

Later, his exploration of using Agkistrodon halys antithrombotic enzyme to treat nephrotic syndrome represented a methodological innovation. Derived from snake venom used in TCM, this enzyme has anticoagulant and thrombolytic properties. Nephrotic syndrome patients often have a hypercoagulable state, increasing thrombosis risk. This enzyme protects renal function by improving microcirculation and preventing thrombosis. As an adjunctive therapy, it is often combined with other medications to alleviate symptoms and reduce complications. This research demonstrated the effectiveness of integrated therapy in improving both clinical symptoms and pathological changes.

Legacy and Development

Zhang Qingyi not only excelled in medical research but was also deeply committed to education and mentoring future generations. He believed the future of medicine depended on nurturing young talent with both strong theoretical foundations and practical skills. Amid his busy schedule, he consistently taught on the front lines, selflessly imparting his knowledge to young doctors and students.

He emphasized developing his students’ clinical thinking and practical skills, encouraging their participation in research to deepen their understanding. He frequently organized academic discussions and case seminars, providing direct exposure to clinical cases and opportunities to apply integrated medical knowledge.

Furthermore, he highly valued innovation and research capabilities, encouraging students to propose new ideas and explore unknown territories. He supported their involvement in research projects and personally guided them in completing academic papers. Under his mentorship, many students emerged as promising new researchers.

In 2001, collaborating with Professor Mou Shan, Zhang Qingyi published research on the integrated Chinese-Western prevention and treatment of diabetic kidney damage. The study highlighted the unique role of TCM in improving renal function and delaying disease progression, combined with modern antidiabetic drugs for a comprehensive treatment approach. It also explored the application of various TCM formulas to develop personalized treatment plans, providing important guidance for clinical management.

Subsequently, Zhang Qingyi and Professor Mou Shan’s research on the effects of high-glucose environments on renal fibroblasts offered new explanations for the pathological mechanisms of diabetic nephropathy. This study revealed that high-glucose environments induce the abnormal proliferation and activation of renal fibroblasts, leading to renal tissue fibrosis. Furthermore, high glucose promotes this process by activating multiple signaling pathways (such as TGF-β). These findings provided a theoretical basis for understanding diabetic nephropathy and opened new avenues for developing targeted therapies.

With the publication of these high-level research achievements, Zhang Qingyi’s academic standing in integrated medicine gained widespread international recognition. His research outcomes advanced the theory of integrated therapy and provided practical methods for clinical treatment.

In 2008, Zhang Qingyi, still active on the front lines of research and clinical practice, passed away from illness at the age of 76.

His life is a brilliant testament to the journey of exploration and dedication in integrated Chinese-Western medicine and education in China. As an outstanding nephrologist and a pioneer in integrated research, his exceptional academic achievements, profound commitment to education, and relentless pursuit of integration have left an indelible mark on the history of Chinese medicine.