News and Events
BEIJING - As the world gets smaller, Michigan Medicine’s place in it gets bigger. That’s thanks to partnerships like the one which recently took nearly 80 faculty abroad to meet with research collaborators in China.
The annual Symposium of the Joint Institute between the University of Michigan Health System and Peking University Health Science Center (PUHSC) took place last month in Beijing. In addition to faculty collaborators across numerous departments, the three-day meeting was attended by organizational leaders like Marschall Runge, MD, Michigan Medicine CEO and Medical School Dean., and Carol Bradford, MD, Executive Vice Dean for Academic Affairs. The annual meeting alternates each year between Ann Arbor and Beijing, and this marked Drs. Runge and Bradford’s first visit to the PUHSC campus in Beijing.
“This is clearly a very unique partnership. I’ve never seen this kind of international collaboration at any of the institutions where I’ve had the privilege of being on faculty,” Runge said. “Attending this meeting, it’s easy to recognize the value. There’s a potential to improve health when our very best scientists work together.”
This year marked the seventh annual JI Symposium, an auspicious anniversary in Chinese culture, said PUHSC President Qimin Zhan, in part because the word for seven in the Mandarin language is similar to the word for arise.”
“Seven is a good number in China because seven is always up,” he said. “For sure, we would say the last seven years have been very successful and we look forward to another seven years.”
Established in 2010, the Joint Institute (JI) has generated 40 individual research projects in numerous divisions and departments, from well-established programs like cardiology and nephrology, to new projects in substance abuse, emergency medicine, sports medicine and other areas.
Each project is led by partner collaborators – or teams of collaborators – from both institutions, and each is driven by a search for discoveries that could improve health in China and the United States. Shortly after establishing one of the United States’ first Emergency Critical Care Centers (EC3) at Michigan Medicine in 2015, Emergency Medicine leaders turned to the JI and partners at PUHSC for some advice and best practices; in China, unlike in the U.S., critical care services within emergency departments are well established, said Associate Professor of Emergency Medicine Kyle Gunnerson, co-PI on a JI project to create an advanced new risk-adjustment outcomes prediction tool for EC3 patients.
“We’ve learned so much from this Chinese ICU model about how they are taking care of patients in a relatively resource-limited environment. They are able to do that very well,” said Gunnerson, MD. “Part of the reason is that they have strong models for how the physicians and nurses work together. As leaders, we should be taking that perspective back to Ann Arbor.”
To date, JI research teams have been published more than 30 peer reviewed manuscripts with average index factor of 8.5 and attracted $7 million extramural funding. JI leaders this year officially added two new focus areas for future projects: precision health and cancer research.
As the JI branches out into new areas of medicine, leaders are also seeking to broaden the partnership’s financial support as well. Seed funding for projects to date has come through equal investments from both institutions, but a newly formed Joint Institute Leadership & Development Council seeks to attract outside funding, too. The group is co-led by longtime Michigan Medicine supporter and UMHS Victors for Michigan campaign co-chair Richard Rogel and Lana Hu, Founder and CEO of Amcare Women’s and Children’s Hospital in Beijing and a graduate of the U-M Ross School of Business. The group comprises prominent philanthropists as well as health and business leaders, primarily from China.
“When you look where the funding for biomedical research is coming from right now, the surge is in China,” said Joe Kolars, MD, Senior Associate Dean for Education and Global Initiatives and co-Director of the JI. “We’ve constituted a group of individuals who are willing not only to help raise funding for the JI, but also advise us on how we might think about building partnerships within industry and business. As we continue to grow, we’re taking a wide look beyond the National Institutes of Health and NSF China.” (China’s National Science Foundation is the NIH equivalent.)
This year’s Symposium delegation was the largest-ever Michigan Medicine group to visit PUHSC. That followed last year’s event, which saw a record 70 PUHSC delegates visit Ann Arbor. As the number of faculty, divisions and projects involved in the JI climbs, the focus on equal partnerships and mutual benefit remains constant.
“Our goal has always been to bring scientists together for the kind of inquiry and discovery that no one side can do alone – discoveries that can transform the health in China and United States,” Kolars said.
A pediatrician from China is finishing up a yearlong visit to Michigan Medicine to study clinical research techniques alongside UMMS faculty.
Dr. Xuhui Zhong, from Beijing’s Peking University First Hospital, spent all of 2017 working on research with Professor of Pediatrics Debbie Gipson and shadowing in clinic with Assistant Professor of Pediatrics Larysa Wickman.
“I have done some research work at PKU, but I was looking for additional training to improve those skills. Of course, I wanted a training experience in America,” said Zhong, MD. “My goal was to learn how to design and implement studies and do analysis on a clinical research project – the whole process.”
Michigan Medicine’s partnership with PKU’s medical school, a research collaboration called the Joint Institute for Clinical and Translational Research, paved the way for the training; Zhong’s PUHSC mentor, Professor of Pediatric Nephrology Jie Ding, is the co-PI on a Joint Institute Project along with Wickman and UMMS Professor Emeritus Roger Wiggins. Wickman learned of Zhong’s wish to train in the US and connected her with Gipson, whose own research dovetailed with Zhong’s interests.
“We’ve hosted visitors for a few days or sometimes a few weeks, but never for a year. This was a first for us,” said Gipson, MD, MS. “We loved having Xuhui here. It was quite special that PKU released her from her local duties for a whole year, because she is a highly skilled nephrologist. Even though she was here to learn, she was also able to share her skills and unique perspectives with us. We learned a great deal, too.”
Gipson helped Zhong develop a research project leveraging a new multi-site registry of Chinese children diagnosed with IgA nephropathy, a prevalent kidney disease associated with progressive loss of kidney function. The registry is collecting patient data across 28 different clinic sites for future study.
“We worked on establishing an online database for the registry, and I learned a lot about database management – finding errors, improving processes, and protocols for entry,” said Zhong. “The project has come a long way in 10 months. We’re just beginning to work on the analysis. The idea is that we will be able to follow patients to see how they respond to different treatments.”
The project also set the groundwork for future joint research projects, now that the registry and database is up and running.
“Our goals are to build collaborations as well as well as conducting research,” Gipson said. “We have established a partnership which should prosper in the coming years.”
One day each week, Zhong spent time in clinic with Dr. Wickman, learning about pre- and post-procedure treatment of children who’ve undergone kidney transplantation, which is on the rise in China.
“While she’s not participating in the treatment of patients at Michigan, she is very advanced and active in the patient discussion meetings with our team here,” said Wickman. “How things are done at PKU is sometimes very different, so she’s enriched our knowledge even as she is learning things here. We’re learning from one another.”
Zhong, a mother of two young boys, is set to return back home to her family, friends and First Hospital position in December.
“To spend a year away from home, you need to make it a meaningful and valuable experience,” she said. “For me, I learned everything I wanted to learn. Initially, I was a bit nervous because it’s a totally different environment, but everyone has been so generous and willing to help me. They helped me a lot to adapt to the new team soon.”
The University of Michigan Health System (UMHS) and the Peking University Health Science Center (PUHSC) Joint Institute for Translational and Clinical Research is accepting joint proposals from investigators working collaboratively at both institutions for funding of projects that will demonstrate an effective team approach to discovery and new findings on diseases relative to both countries, and which can be leveraged for extramural funding opportunities. Full RFP is available here.
This edition of the newsletter provides an overview and highlights from the Sixth Annual JI Symposium. While individual collaborators worked to move forward current projects and create new ones, leaders from PUHSC and UMMS met to discuss future JI strategies to ensure continued growth and success.
You will also find updates from each of the primary JI project areas: Renal, Pulmonary, Liver/GI and Cardiovascular. Beyond that, our work in the JI continues to expand into other areas of medicine. To that end, we recap several meetings that took place during the Symposium week between PUHSC and UMMS leaders in Nursing, Pharmacy and other areas of potential collaboration. Finally, we touch base with several of our PUHSC visitors to talk about their experience at UMMS. As you’ll see, we have much to celebrate and even more to look forward to as 2017 gets under way. Read the December2016 Newsletter here.
Good science transcends culture, language and distance, as it did last week during an annual symposium that attracted a large group of China’s top physician scientists to UMHS.
Faculty members from China’s Peking University Health Science Center, the country’s premier medical school and research institution, joined UMHS colleagues and collaborators in Ann Arbor for the Symposium of the Joint Institute (JI) for Translational and Clinical Research. In all, 75 PUHSC faculty members made the 14-hour journey from Beijing, the largest single delegation of visiting scholars ever hosted by the U-M Medical School.
“It is unusual to have people from such different cultures, with different languages, different approaches, and different ways of working, to partner with each other. What we are doing together is remarkable,” said Joseph C. Kolars, the Josiah Macy, Jr. Professor of Health Professions Education and Senior Associate Dean for Education and Global Initiatives.
The annual meeting is organized through Global REACH, which oversees many of medical school’s international partnerships. In six short years since its launch, the UMHS-PUHSC JI has grown to include more than 30 ongoing research projects, each led by a PI from both institutions, across a number of fields, including liver, pulmonary, renal, cardiovascular and other diseases. This year’s symposium, which took place Oct. 12-14, featured keynote speeches from PUHSC President Qimin Zhan and UMHS Executive Vice President of Medical Affairs and U-M Medical School Dean Marschall Runge, M.D., Ph.D.
“With the Joint Institute, there are many opportunities to leverage our strengths when you take both of these great institutions together,” said Runge. “I know that we have complimentary research strengths and a unique potential for discovery.”
Among the Chinese doctors who traveled to Ann Arbor for the event was Yuwu Jiang, M.D., Ph.D. A pediatrician at PUHSC, Dr. Jiang is partnering with U-M Pharmacology Professor Lori Isom, Ph.D., on a joint study to better understand genetic causes of epilepsy in children. The two met at an international pediatrics conference last year and began planning their joint research project, among eight new studies to be funded this year through the JI. The opportunity to meet again in person at the symposium will accelerate their work, Jiang said.
“This was my first opportunity to visit Lori’s lab, meet her team and see how it runs,” he said. “You have to meet face to face to be able to understand one another more precisely. Collaborating always just by telephone or email isn’t enough.”
In addition to the scientific expertise, among the major benefits of partnering with PUHSC is sheer size of the system. The center is affiliated with more than a dozen hospitals in the Beijing area.
“The population there is a huge resource. If you study a relatively uncommon disease here, you may have five patients to study. There, they have 500,” said Dr. Eugene Chen, U-M Frederick Huetwell Professor of Cardiovascular Medicine and a co-leader of the JI’s extensive cardiovascular disease program. “In addition, each side brings different expertise and experience, so we can learn a lot from each other. This meeting is an opportunity not only for existing partners to get together, but also for people to meet new partners.”
The Symposium took place primarily at the Rackham School for Graduate Studies, but also included hospital and medical campus tours, as well as satellite meetings at the North Campus Research Center, among other places. There were individual partner meetings, group meetings around distinct illness areas and panel discussions. Next year’s meeting will be in Beijing.
“This is an important partnership, and we enjoyed every second of our visit to Ann Arbor,” PUHSC President Qimin Zhan said at the close of the final session. “We look forward to hosting an even larger delegation next year.”
Click here to read more about the Joint Institute and the sixth annual JI Symposium.
JI partnerships aren’t just about faculty; students and physicians-in-training benefit, too. Read about a U-M resident’s influential rotation with PUHSC, as well as several medical students who are now published authors after working in China under JI mentors.
Indeed, we have much to celebrate. Our institutional relationship continues to thrive to the benefit of our colleagues and students, to say nothing of the many future discoveries that will no doubt improve healthcare for people everywhere. Please enjoy this issue and we look forward to seeing many of you at this year’s JI Symposium. Read the September 2016 Newsletter here.
Several medical students are now published authors following the completion of international research projects under the guidance of Hepatology Professor and longtime student mentor Anna Suk-Fong Lok, MD.
Dr. Lok’s projects explored aspects of liver disease treatment and care and included extensive on-the-ground research in China. The resulting publications, in recent issues of Digestive Diseases & Sciences and Liver International, garnered author credits for four U-M Medical School students: Fanny Du, Jiaxin Huang, Mary Guan, and Jeremy Balch.
In addition to the four UMMS students, three undergraduate students, Angela Xie, Shanna Cheng and Cassandra Rodd, also contributed to the projects and are credited co-authors.
Fourth-year University of Michigan Medical School student Fanny Du visited in China the summer of 2014 on a Global REACH scholarship. She and Angela Xi surveyed hundreds of patients seen in liver disease clinics about their care experience. Those results were compared against data from patients seen in Ann Arbor liver clinics. The findings, A Comparative Study of Liver Disease Care in the USA and Urban and Rural China, have been published online ahead of print in Digestive Diseases and Sciences.
“My goal is to work with immigrant populations, so understanding the differences in the healthcare systems in the US and elsewhere will make me a better physician,” Ms. Du said. “The differences we saw were eye opening. The clinics in Beijing are crowded. People don’t make appointments and so they might wait for hours to see a doctor for five minutes. I could see why patients might be less satisfied with their care there (compared to patients in Ann Arbor), which is exactly what we found.”
A second study, Survey of Hepatitis B Knowledge and Stigma among Chronically Infected Patients and Uninfected Persons in Beijing, has also been published online ahead of print in Liver International. Third-year medical student Jiaxin Huang, along with fellow students Jeremy Balch and Mary Guan, spent several weeks in Beijing in the summer of 2015 interviewing more than 1,200 people to study stigma around hepatitis B, a prevalent disease in China. Global REACH supported their international experiences as well.
“Given our findings, we believe that public health education can improve understanding of transmission of hepatitis B and alleviate stigma towards the patients,” Ms. Huang said. “Furthermore, physicians can also actively counsel patients to reduce internal stigma. It was very satisfying to have this research published because we felt our results were important in that they revealed and quantified the stigma hepatitis B patients face every day.”
In addition to the publication, their project garnered a poster presentation at the 2015 Asian Pacific American Medical Student Association conference and an oral presentation, delivered by Ms. Huang, during the 2016 Digestive Disease Week conference held in San Diego in May.
“I mentor a lot of students, but this was the first time a student of mine was selected for an oral presentation at such a big meeting,” said Dr. Lok. “Jiaxin was speaking to a group of distinguished board-certified gastroenterologists who’ve been practicing for years or decades. You can imagine that it’s nerve wracking, but she did very well. I felt like a proud parent.”