Xiao Shudong (1931-2016), Professor of Internal Medicine, Former Director of the Department of Gastroenterology at Renji Hospital

Introduction

The journey of youth is often a turbulent one, a voyage of navigating rough waters and sometimes flowing with the current. He embarked on this journey with his heart set on a dream. His childhood was vibrant, a time of running freely through fields, his eyes filled with hope. He faced his share of storms and trials, yet he always moved forward with resolve, constantly pushing beyond his limits. Though the path of medicine was fraught with hardship, he never wavered in his commitment. Today, his name is honored at Renji Hospital, his teachings continue to inspire generations of its staff, and his contributions are forever etched in the history of medicine.

Way to be a Doctor

Born in 1931 to a middle-class family in Shanghai, Xiao Shudong benefited from a strong upbringing and extensive travel from an early age. His parents took him to experience diverse regions, exposing him to various cultures and landscapes that broadened his perspective and enriched his thinking.

As Xiao Shudong himself recalled, living in places like Macau, Hong Kong, Jiangxi, and Shanghai profoundly shaped his worldview. He understood early on that while the world was vast, making a real impact required finding one’s purpose and pursuing it with ambition and courage.

A pivotal moment in his youth was his mother’s serious illness. Witnessing her pain and feeling utterly helpless, able only to pray, he was struck by a profound sense of powerlessness. From that moment, he resolved to become a doctor, believing it was the only way he could truly save lives and alleviate the suffering of his loved ones.

In 1948, Xiao was admitted to the Medical College of Aurora University on his academic merit. However, the country’s civil war forced a two-year delay before he could begin his studies. Once enrolled, his dedication was exceptional. He was the first in the library each morning, meticulously planning his day and immersing himself in medical texts. In class, he was a meticulous note-taker, and his evenings were spent in deep study and discussion with peers, analyzing clinical cases. This rigorous approach allowed him to master a vast body of medical literature and build a solid foundation for his future career.

In 1952, a significant institutional change occurred when the Medical College of Aurora University merged with St. John’s University and Tongde Medical College to form Shanghai Second Medical College, symbolizing a new era for medical education in the city.

Xiao graduated with honors in 1955 and was hired as a resident physician in internal medicine at Shanghai Hongren Hospital. His talent and commitment quickly impressed his colleagues and mentors. For him, this was the true beginning of his journey to heal the sick, a path he knew required relentless study and hands-on practice.

On the clinical front line, his diagnostic skill and medical ethics left a lasting impression. He never shied away from difficult cases, dedicating himself to in-depth research and exploration.

In 1957, after departmental realignments, Xiao joined the internal medicine department at Renji Hospital. Although he initially aspired to be a cardiologist, his path was shaped by the national crisis of schistosomiasis. Led by Professors Huang Mingxin and Jiang Shaoji, he was sent to the rural counties of Shanghai, like Songjiang and Qingpu, to combat the disease. For the next six to seven years, he worked under difficult conditions, helping to pioneer effective treatments. His team was the first in China to use high-dose atropine to treat severe arrhythmia caused by antimony agents, a breakthrough that saved countless lives. This experience ultimately led Xiao and Professor Jiang Shaoji to establish Renji Hospital’s Department of Gastroenterology.

Xiao Shudong’s reputation was built on a combination of relentless pursuit, academic rigor, and innovative thinking. But it was his patient-centered ethics and generous, selfless nature that truly earned him the prestige and respect he held throughout his distinguished medical career.

Diving deep into Gastroenterology

Following the decade-long Cultural Revolution, China’s science and technology sector began to recover from a period of stagnation, and a renewed sense of energy emerged in the academic community. Many disciplines, including medicine, began to flourish once more. This resurgence was largely driven by the country’s reform and opening-up policy, which prioritized scientific and technological advancement. With increased government investment and a series of supportive policies, the nation’s scientific and technological landscape was like a spring bud, full of upward potential.

Against this backdrop, Renji Hospital embraced new opportunities for growth.

In 1984, the Shanghai Institute of Digestive Disease was officially established, marking a new era for the field of gastroenterology in China.

Casting back to the early 1960s, medical conditions in China were extremely challenging, and hospital laboratories were rudimentary. At Renji Hospital, the diagnosis of digestive diseases relied primarily on X-ray barium meals, barium enemas, and basic liver function tests. The lack of necessary equipment and materials severely limited medical research and scientific exploration across the country.

During that period, the development of gastroenterology in China was significantly behind. It was Academician Jiang Shaoji who first proposed establishing a dedicated department, firmly believing it to be a promising new frontier in internal medicine. He upheld the belief that “if the people have a need, we must act, even without proper staff or equipment,” and was determined to advance the field. Xiao Shudong and Academician Jiang Shaoji began building this new discipline from scratch, continuously conducting research and practical work.

This was a historic exploration. Through the persistence of Xiao Shudong and Academician Jiang Shaoji, combined with the collaborative efforts of their team, they not only focused on theoretical research but also accumulated a wealth of practical experience through clinical treatment. As the field matured, Academician Jiang and his team guided gastroenterology in China into a new stage of development.

After the mid-1960s, progress in Chinese medicine began to accelerate. In the mid-1970s, with the hospital’s support, Xiao Shudong finally acquired a set of fiber endoscopes. Although the conditions in the internal medicine laboratory remained difficult, this equipment allowed them to conduct basic experimental research.

Driven by great enthusiasm, Xiao Shudong dedicated himself to exploring solutions to these challenges. Under the guidance of Academician Jiang Shaoji, he constantly broadened his thinking and explored new research directions.

In the early 1970s, by observing changes in gastrointestinal motility, Xiao Shudong identified it as a pathophysiological basis for certain digestive diseases and began researching biliary tract pressure. Later, using tools like SPECT, self-made catheters, and pH monitors, his team made significant strides in medical research.

In the early 1980s, after the reform and opening-up period began, Xiao Shudong’s team diagnosed the first case in the country of Type A gastritis (atrophic body gastritis) complicated by pernicious anemia. The patient, referred from the hematology department, presented a classic case. Building on this discovery, Xiao’s team studied the classification of chronic gastritis and published their findings, earning the third prize of the National Science and Technology Progress Award and providing tremendous momentum for their research.

Xiao Shudong did not rest on his laurels. He felt a pressing need to make up for the lost decade by achieving even better results and systematically elevating the professional standards of doctors. Despite poor laboratory conditions, they actively pursued innovation and the latest research directions. In 1984, thanks to the leadership and unremitting efforts of Academician Jiang Shaoji, the hospital finally established the Shanghai Institute of Digestive Disease.

At its inception in 1984, the institute faced severe shortages of office space, laboratories, funding, and talent. The staff endured a difficult period. As Renji Hospital was the most overcrowded in Shanghai at the time, the institute was initially given only a small room within the internal medicine office.

The lack of laboratory space was a particularly acute problem. To solve this, Xiao’s team sought external help. The leadership of Shanghai Second Medical College learned of their plight and lent them two classrooms at its Xietu Road branch, meeting their immediate needs. However, scientific research required specific equipment. Fortunately, a new policy allowed hospitals to apply for funding to purchase experimental equipment. Xiao’s team seized this opportunity, securing all the necessary instruments and laying the foundation for a new laboratory.

Furthermore, the institute needed a dedicated laboratory and office space within Renji Hospital itself. After careful consideration, the hospital leadership decided to allocate the seventh floor of the main building for the institute. However, adding a seventh floor was a difficult and risky engineering challenge, as the original west wing building, constructed in 1931, had already had six floors added.

Xiao Shudong approached several design institutes in Shanghai, but all were pessimistic about the feasibility of adding another floor. Unwilling to give up, and with the full support of the hospital leadership, he persisted. Finally, a designer agreed to take on the project, accepting responsibility for the construction. His design solution was to center the gravity of the new floor on the building’s surrounding load-bearing walls, allowing it to be safely “mounted” on top of the existing structure. Through this determination, Xiao’s team successfully built the new laboratory and offices for the institute.

After its establishment, Academician Jiang Shaoji and Xiao Shudong, with their keen insight into the forefront of the field, set the strategic direction for the institute’s various subspecialties. Xiao’s team focused on gastroenterology itself, and in the early 1980s, Helicobacter pylori became his primary research focus. After persistent exploration, his team made breakthroughs in this area, opening a new door for the development of gastroenterology in China. Concurrently, institute professors Zeng Minde and Qiu Dekai concentrated on hepatology.

For Xiao Shudong, Helicobacter pylori-associated gastritis and digestive tract tumors were also critical research areas. In these challenging fields, his team continuously pioneered and innovated, driving the progress of gastroenterology in China.

Clinically, digestive endoscopy is a core tool in gastroenterology. From the beginning, Xiao’s team recognized it as an indispensable component of their department. Today, endoscopic technology has evolved from a simple diagnostic tool to a platform for minimally invasive treatment, becoming essential for the diagnosis and management of digestive diseases.

Xiao Shudong and his team started their endoscopy unit with a single fiber gastroscope. With the support of Renji Hospital’s leadership, they spent many years building the unit into a first-class facility in China and a leader internationally. This achievement was the result of immense effort and dedication from Xiao’s entire team.

Since the introduction of digestive endoscopy, the diagnostic and treatment capabilities for digestive diseases at Renji Hospital have improved dramatically, an achievement in which Xiao Shudong’s efforts were indispensable.

New Achievements on a New Platform

With the establishment of the institute and the endoscopy room as two new platforms, the Department of Gastroenterology at Renji Hospital was able to significantly expand its research capabilities.

Xiao Shudong’s team organized the institute into two main laboratories: the Gastroenterology Research Laboratory and the Hepatology Research Laboratory. They equipped these labs with relatively advanced instruments for biochemistry, immunology, pathology, gastrointestinal hormone research, microbiology, and flow cytometry. The team’s research focused on functional dyspepsia, irritable bowel syndrome, inflammatory bowel disease (particularly Crohn’s disease), and Helicobacter pylori, with a special emphasis on microecological preparations. They also investigated the link between H. pylori and the pathogenesis of gastric cancer.

In the field of esophageal diseases, as the number of patients with gastroesophageal reflux disease grew in China, research into non-erosive reflux disease (NERD), erosive esophagitis (EE), and Barrett’s esophagus was just emerging. These conditions had long been a focus in Western countries, and some of Xiao’s experts began conducting in-depth research in this area.

In the mid-1980s, shortly after the institute was founded, Xiao’s team developed a rapid urease test kit—the first of its kind developed in China for the rapid detection of H. pylori during gastroscopy. He led the establishment of the hospital’s own “Huitai Company” to mass-produce the kit, which was soon adopted by gastroenterology departments across the country and even exported to European nations. This was a prime example of successfully translating early research into clinical application.

Xiao Shudong was a lifelong learner who read extensively to stay current with international trends. Recognizing that diagnosing small bowel diseases was a major challenge, he noted the rising importance of capsule endoscopy, a technology not yet available in China. During a trip to the American Digestive Disease Week in 2003, he gathered information on the technology and subsequently overcame numerous obstacles to introduce it, pioneering its clinical use in China. Around the same time, a special research group at the Cancer Institute was dedicated to developing new diagnostic and therapeutic methods for the small intestine, successfully creating both capsule endoscopy and double-balloon enteroscopy.

With capsule endoscopy, patients simply swallow a camera capsule that transmits images of the hard-to-reach small intestine to a computer. It is particularly effective for diagnosing obscure gastrointestinal bleeding. Double-balloon enteroscopy is even more comprehensive, allowing for a nearly blind-spot-free examination of the entire small intestine and the ability to perform biopsies. Leveraging this technology, and at Xiao’s suggestion, Professor Ge Zhizheng conducted clinical research on obscure small intestinal bleeding. After years of persistent work, he was the first in the world to confirm that thalidomide is clearly effective in treating bleeding caused by small intestinal angiodysplasia. In 2023, this groundbreaking result was published in the New England Journal of Medicine, which has an impact factor of 158.5.

Xiao’s team also researched a small, transnasal endoscope for observing the esophagus and stomach, a natural orifice transluminal endoscopic surgery (NOTES) method that avoids the nausea and discomfort of oral insertion.

Xiao Shudong’s team never stopped innovating, and their breakthrough progress in these fields earned wide recognition and praise.

Global Integration and a Bright Future

Following China’s reform and opening-up, Xiao Shudong championed international academic exchange, believing deeply in the power of global collaboration. He fostered multifaceted partnerships with the medical community worldwide, creating extensive platforms for mutual learning. Through these efforts, he connected with Professor Meinhard Classen, then-President of the World Gastroenterology Organisation, forging a vital two-way dialogue between the Chinese Society of Gastroenterology and the global community. The extensive collaborations between Renji’s department and its international counterparts accelerated its development and spurred high-level research, benefiting all parties involved.

At the same time, Xiao invited renowned international scholars to China to lecture and share their expertise, building deep friendships and fostering a rich academic exchange. Among the earliest collaborators were Professor Minoru Kurihara from Japan and Professor Guido Tytgat from the Academic Medical Center in Amsterdam. They took a keen interest in the development of Renji’s department and were instrumental in its academic advancement, collaborating on the introduction of numerous practical and advanced medical technologies.

To further accelerate progress, Xiao created a vibrant forum for exchange by inviting many more domestic and international scholars to lecture at Renji. This included figures like Professor Joseph J.Y. Sung, an honorary professor at Shanghai Jiao Tong University; Dr. Francis W. Ruscetti from the NIH/NCI in the United States; and Professor Anthony Kalloo from Johns Hopkins University, among others.

Xiao Shudong also unreservedly supported the development of various sub-specialties. Leveraging his influence, he facilitated opportunities for outstanding young doctors from each sub-specialty to pursue advanced training at renowned universities abroad, such as Johns Hopkins Hospital, SUNY College of Medicine, Harvard Medical School’s VA Hospital, Lund University in Sweden, and the Technical University of Munich in Germany. In turn, the department also recruited many overseas talents, including molecular oncology expert Hong Jie from Brown University, who is now the deputy director of the Institute of Digestive Disease.

To deepen its international integration, the department continuously hosted the Shanghai International Digestive Disease Week. This biennial international conference, which continues to this day, provides a platform to both learn from global advancements and showcase China’s own research findings, making the department’s development more systematic and multidimensional. Xiao believed such conferences and Sino-US or Sino-European workshops were excellent ways to facilitate a dynamic exchange of knowledge with global experts. Many of the academic activities he led were supported by Chen Minzhang, who was China’s Minister of Health at the time.

In November 2009, Professor Xiao Shudong was named a “World Gastroenterology Organisation (WGO) Master” for his outstanding contributions, becoming the only expert in China to receive this prestigious honor. This accolade signified the global recognition of his status and role in the field. He also served as a member of the International Liaison Committee of the American Gastroenterological Association and as a council member of the International Digestive Cancer Alliance, ensuring that Chinese perspectives were integral to the global conversation in gastroenterology.

To enable more medical professionals in China to access cutting-edge research and contribute their own findings to the world, Xiao founded the Journal of Digestive Diseases. Co-founded with Professor Liu Houyu, this English-language publication was indexed by SCI, creating a new channel for Chinese research to reach a global audience. Furthermore, Xiao served on the editorial boards of renowned international journals like Alimentary Pharmacology & Therapeutics and Gut. Of his published papers, 116 were indexed by Medline and more than 40 by SCI-E. He also edited over 10 academic monographs.

The award-winning research projects he led or participated in include two second prizes and one third prize from the National Science and Technology Progress Award, a first prize from the Chinese Medical Science and Technology Award, five second prizes from the State Education Commission’s Science and Technology Progress Award, and one first prize and six second prizes from the Shanghai Science and Technology Progress Award. These awards serve as a powerful testament to his outstanding contributions.

On July 22, 2016, Xiao Shudong passed away at Renji Hospital at the age of 85. At that year’s European Helicobacter Pylori Annual Meeting, all attending delegates stood in a moment of silence to mourn this renowned Chinese scholar.

Xiao Shudong dedicated his life to medical research. He was a physician and a mentor who gave his utmost to the cause of digestive diseases, establishing himself as a leading figure in Chinese gastroenterology. His achievements lie not only in his academic research but also in the clinical and research systems he pioneered. Countless Chinese patients have recovered and been given a new lease on life thanks to the advancements in gastroenterological techniques and treatments that he championed.

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