Dr. Zeng Mingde, Leading Hepatologist, Liver Fibrosis Research Pioneer, and Distinguished Professor

Introduction

He was a leading figure in liver fibrosis research, known for his profound insights into this complex medical challenge. In the field of clinical drug research, he was an innovator who effectively bridged theory and practice to advance treatments for liver disease.

Focusing on the liver’s extracellular matrix, he pioneered non-invasive diagnostic methods that enabled early detection and effective intervention for liver fibrosis. His influential research guided clinical therapies and significantly improved outcomes and quality of life for patients with liver diseases.

His contributions to clinical drug research were also significant. He played a pivotal role in evaluating new and imported drugs in China, advocating for standardized and rigorous clinical trials. The institution he led became a central hub for digestive and liver disease drug trials, elevating China’s research capabilities and clinical standards in this domain.

Dedicated to the study and treatment of liver diseases, he combined his professional expertise with a compassionate approach to patient care, advancing the field of liver fibrosis research.

The Path to Medicine

In May 1936, Zeng Minde was born on Gulangyu Island in Xiamen, a location celebrated as China’s “Piano Island” for its scenic beauty. His childhood unfolded in this picturesque environment.

Growing up in the early years of the People’s Republic of China, a time of national rebuilding and limited educational resources, his studies at Jimei and Shuangshi Middle Schools required immense resilience. This environment forged a determined spirit and a deep commitment to learning.

Reflecting on his youth, a period marked by the aftermath of the Opium Wars and Japanese occupation, Zeng developed a profound understanding of the link between national strength and individual well-being. He came to believe that fulfilling one’s potential required both physical and mental health.

In 1955, he was admitted to the Medical Department of Shanghai Second Medical College, driven by a desire to become a “benevolent physician.” In that era, being a doctor was seen as a solemn duty to heal the wounded and save lives.

From a young age, Zeng had a passion for literature, especially the poetry of Ai Qing and Zang Kejia. He often noted that poetry sparked his intellectual curiosity and deepened his understanding of the physician’s role. He continued to read and write poetry throughout his life, using it as an outlet for his emotions and insights.

The Path of Liver Research

Early in his career, Zeng Minde focused on multiple aspects of liver disease, including metabolic liver disorders, liver fibrosis, cirrhosis and its complications, chronic hepatitis treatment, and the interplay between the liver and endocrine system.

His work spanned from foundational cell culture to innovations in clinical diagnostics and therapeutics. He conducted in-depth research on chronic hepatic encephalopathy, refractory duodenal ulcers, and the serological diagnosis of hepatitis B. He also explored the application of traditional Chinese medicine (TCM) in treating liver diseases.

As early as the 1980s, Zeng investigated the relationship between steroidal contraceptives and internal diseases, publishing his findings in Foreign Medical Sciences (Internal Medicine). Collaborating with Professor Shaoji Jiang, he explored liver diseases and porphyrin metabolism disorders, offering new perspectives for clinical treatment.

In 1981, Zeng published a paper on the successful treatment of chronic hepatic encephalopathy with bromocriptine. The following year, he reported on clinical observations of using Yunzhi tablets to treat chronic hepatitis, demonstrating his command of both TCM theory and practice.

In 1984, collaborating with Shaoji Jiang and Shudong Xiao, he researched the relationship between endotoxins and clinical internal medicine. That same year, he also explored connections between liver diseases and endocrine changes, laying the groundwork for interdisciplinary research.

As one of China’s earliest pioneers in liver fibrosis research, Zeng Minde’s scientific contributions were exceptional.

Liver fibrosis is the excessive formation of scar tissue in the liver due to chronic injury, which progressively replaces healthy liver structure. While fibrosis can be reversed, its unchecked progression leads to cirrhosis, an irreversible condition.

The danger of liver fibrosis lies in its gradual impairment of liver function and life-threatening complications like portal hypertension and liver failure. Early-stage fibrosis often has no obvious symptoms, so early diagnosis and intervention are critical to halt its progression.

From the 1990s onward, Zeng’s research focus shifted decisively to liver fibrosis. In 1991, collaborating with Professors Dekai Qiu and Jixiang Zhang, he studied the inhibitory effects of Danshen (Salvia miltiorrhiza) and Qingmuxiang (Aristolochia debilis) on extracellular matrix production, offering novel therapeutic strategies.

His work on fibrosis diagnosis became particularly prominent. He conducted foundational research on extracellular matrix alterations and established non-invasive diagnostic methods, providing new pathways for early detection. Concurrently, he examined links between liver diseases and socio-environmental factors, such as alcoholic liver disease (ALD), providing critical data for public health policies.

In 1995, he investigated serum biomarkers in patients with alcoholic fatty liver and studied changes in collagen-degrading enzyme activity during fibrosis, offering fresh insights into its pathological mechanisms.

In 1999, as Chief Scientist, he led a major project: “Non-invasive Diagnosis and Effective Interventions for Liver Fibrosis.” This research pioneered the first internationally recognized non-invasive predictive model for identifying significant fibrosis in chronic hepatitis B patients and led to the development of China’s first Consensus on Diagnosis and Treatment of Liver Fibrosis.

Zeng Minde’s contributions to fatty liver disease were equally transformative.

He founded China’s Fatty Liver and Alcoholic Liver Disease Study Group and established the Shanghai Fatty Liver Disease Research and Treatment Center. By leading nationwide multicenter surveys, he provided robust data for developing diagnostic and treatment guidelines. Under his leadership, the group formulated and promoted national standards for non-alcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD), dramatically advancing standardized care in China.

Alcoholic Liver Disease (ALD) results from prolonged excessive alcohol consumption, progressing from fatty liver to hepatitis, fibrosis, and cirrhosis. Abstinence is the cornerstone of ALD prevention and treatment.

Non-alcoholic Fatty Liver Disease (NAFLD), increasingly prevalent in China, is linked to obesity, insulin resistance, and type 2 diabetes. It is characterized by excessive fat in the liver without significant alcohol consumption and can progress to a more severe form (NASH), fibrosis, or liver cancer. Lifestyle modifications are pivotal to prevention and treatment.

Zeng played a key role in developing national guidelines for both NAFLD and ALD, providing a scientific foundation for clinical practice nationwide. He also emphasized translational medicine, fostering collaboration among hepatology, endocrinology, and cardiology to rapidly bring laboratory findings to the clinic. Furthermore, he promoted international academic exchange, positioning China’s fatty liver disease research on the

Academically, Zeng Minde authored over 300 research papers, including two published in Hepatology, a premier global journal. This achievement highlighted his scholarly excellence and the growing international recognition of China’s research in digestive and liver diseases. He also edited influential medical monographs, including The Liver and Endocrine System, Fatty Liver, and Fatty Liver Disease, and contributed to over 20 professional books.

Legacy of Mentorship and Gateway to New Therapies

Zeng Minde’s students now play vital roles across diverse medical frontiers—a source of immense pride for him. He humbly regarded his disciples as his greatest legacy, echoing the ancient proverb: “Spring rain nurtures silently; peach and plum trees blossom in full splendor.” Through his teachings and example, generations of medical talent have flourished, advancing China’s healthcare landscape.

Professor Yimin Mao, one of Zeng’s students, remarked: “Professor Zeng’s influence on our growth has been immense. He nurtured not only our academic prowess but also cared deeply for our personal and professional well-being.”

Recognizing the liver’s central role in drug metabolism and safety, Zeng was among China’s earliest experts in clinical research for digestive and liver disease drugs.

In 1991, he began evaluating new and imported drugs in China, serving as a key member of the Pharmacopoeia Commission. For two consecutive terms, he chaired the Digestive and Liver Disease Evaluation Group and the National Essential Drug Selection Digestive Group. He co-authored China’s Guiding Principles for Clinical Trial Summary Reports and Guiding Principles for Biostatistics in Drug Clinical Trials, laying a robust foundation for standardized and scientific drug trials in the country.

In 1995, Zeng established the National Drug Clinical Research Base at the Shanghai Institute of Digestive Disease. In 2004, he founded the National Drug Clinical Research Institution at Renji Hospital, Shanghai Jiao Tong University School of Medicine, serving as its director. Under his leadership, these institutions became pivotal hubs for digestive and liver disease drug trials in China. He has since overseen more than 100 clinical trials, cultivating a highly influential professional team and making exceptional contributions to advancing drug research and therapeutic standards in these fields.

Furthermore, Zeng served as Chief Advisor for the National “Eleventh Five-Year” Major Special Project—“Construction of a Clinical Evaluation Platform for Novel Anti-Chronic Hepatitis B Drugs.” In this role, he fostered international academic collaboration, establishing long-term partnerships with overseas research institutions. These collaborations elevated China’s research capabilities and opened new gateways for innovative drug development, solidifying the nation’s standing in global medical research.

Beyond academia and education, Zeng Minde was passionate about medical public engagement. He recognized that fatty liver disease, increasingly prevalent due to modern lifestyles and dietary habits, was often underestimated by the public. Many overlooked early lifestyle interventions, leading to disease progression and severe liver complications. Through public outreach, he aimed to raise awareness of fatty liver’s risks, prevention strategies, and management, empowering individuals to adopt proactive measures and curb this growing health threat.

He frequently contributed popular science articles and authored Famous Doctors Talk About Common Diseases: Fatty Liver, disseminating specialized knowledge to the general public. He also delivered lectures on liver disease prevention via platforms like CCTV’s Health Road, East Urban Radio’s Famous Doctors in the Clinic, and National Liver Love Day events. These efforts significantly boosted public understanding of liver diseases and contributed substantially to national prevention and health promotion initiatives.

Zeng Minde’s journey in medicine not only achieved remarkable professional success but also embodied profound humanistic care and educational commitment, nurturing generations of medical talent.

As he expressed through his poetry:
“Spring rain nurtures silently; peach and plum trees blossom in full splendor.”
His teachings and influence will continue to inspire future generations to explore and advance on the path of medicine.

Zeng Minde illuminated the study and development of hepatology through a lifetime of dedication and discovery. He embodied the true essence of a “benevolent physician” through his actions, advanced medical science with unwavering commitment, and cared for every patient with profound compassion. His life, much like the poetry he cherished, radiated warmth and strength, inspiring all to pursue higher ideals and lives of greater purpose.

Editor: Chen Qing @ 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