Huang Hairong, Expert on Tuberculosis
In recent years, Huang Hairong has taken the lead in identifying mycobacterium species, applying clinical experience to practice, and improving the diagnosis and treatment of tuberculosis.
In the bright Tuberculosis Clinical Laboratory of the Beijing Chest Hospital, Capital Medical University, Professor Huang Hairong, dressed in a lab coat, is working with three researchers. The four people are surrounded by advanced equipment with data keeping changing on the displays. This is an ordinary day in the laboratory, and all the staff members are conducting experiments under the guidance of Huang Hairong. They know that the conclusions and data they obtain in the laboratory play an important role in guiding clinical treatment and bringing health back to patients in misery.
With a gentle voice, Huang shoulders heavy responsibilities. As a diagnostician, she leads a laboratory that provides technical support for a tuberculosis prevention programme, playing a major role in Beijing's key drug-resistant tuberculosis research laboratories, and represents the highest level of domestic tuberculosis laboratory diagnosis. They test more than 80,000 specimens each year, and offers tuberculosis testing for the Central Health Care Bureau.
In recent years, Huang has taken the lead in identifying species of mycobacteria, providing support for differential diagnosis of non-tuberculosis mycobacteria infections. She has also paid close attention to new diagnostic technologies at home and abroad, and introduced and carried out six latest diagnostic technologies, to ensure that the diagnostic level of her laboratory catches up with international standards, and plays a leading role nationwide. She has completed the pre-market assessments for over ten new diagnostic technologies, published over 90 papers, and led her team to win the honour of “Innovation Studio for the New Clinical Transformation and Application of Tuberculosis” in 2014.
A Tutor’s Enlightenment
Huang majors in clinical medicine from undergraduate to doctorate. Her doctoral tutor Ma Yu is an expert on tuberculosis in China. While studying her doctorate, Huang learned respiratory medicine from her tutor.
For Huang, Professor Ma Yu comes from an older generation of intellectuals. Professor Ma went to the US as a visiting scholar in the 1980s to carry out immunological research, and established an internal medicine laboratory after her return to China. Though Ma is 86 years old, she still sticks to her fulltime job, offering outpatient services.
“A successful person must succeed in both learning and character. Although my tutor is an expert of the Central Health Care Bureau, she is humble and keeps a low profile, which makes her so respectable,” says Huang. Huang admits that she learned a lot from her tutor. Huang came to Beijing to study her doctorate in 1998. At that time, most students lived a frugal life. Her tutor Ma gave 100 yuan to each student of each grade per month as an allowance.
Such kindness has always touched Huang. When she took a job and received her first paycheck of 1,000 yuan in 2001 after graduation, she realised that it was heavy payment for her tutor to give them “pocket money” each month. “My tutor always puts the interests of others above her own and treats us as her own children. She teaches and touches people around her, leading by example as well as verbal instruction, so we find it's a delight to be with her. My tutor will always be my idol, so I try hard to behave like her when I have my own research team. Harmonious relationship with the team is crucial to scientific research,” Huang says.
Under the guidance and support of Ma, Huang took over and completed a scientific research project, and won the Third Prize of Scientific and Technological Progress in Beijing. At that time, domestic scientific research was quite backward. Huang, however, spared no efforts to introduce advanced technologies, and succeeded in applying gene sequencing technology to drug-resistant tuberculosis, making great progress in domestic gene sequencing of tuberculosis. Her related papers were published in the Chinese Journal of Tuberculosis and Respiratory Diseases, and have often been quoted.
The project's success couldn't be achieved without Huang's efforts or her tutor's. Professor Ma offered Huang help from the perspective of a clinical doctor in terms of designing subject matter, analysing data and writing medical articles in English. As the object of Huang's research covered the entire country, her research conclusions are represented nationwide. Before her work was published, the international academic circles lacked sufficient data from China, and her paper soon attracted worldwide attention.
After graduation, Huang felt confused about being a doctor or continuing to carry out lab research. Her tutor again gave her advice that Huang's pragmatic character was more suitable for medical research. In addition, China was in bad need of research talent, so Huang decided to conduct medical research.
“Now in retrospect, my tutor's advice is correct. Current daily work gives me a lot of fun, and our research helps to improve diagnosis and treatment of tuberculosis, which brings us a sense of accomplishment. Over the past 20 years, China's research has advanced steadily, with great improvements in the scientific research environment,” explains Huang.
The past 20 years, which saw Huang's initial engagement in medical science, can be divided into two parts— the first ten years of accumulating knowledge, and the latter ten years of becoming more mature. In her first ten years, aside from studying a doctorate, Huang went to the US for a post- doctoral degree, one of the most meaningful things for her career and providing her a rare opportunity to get a
“For a good scientific researcher, a spontaneous and strong interest in scientific research is the best catalyst for research output.”
world view of medicine.
In 2002, Huang came to Colorado State University for laboratory research. The laboratory she studied at is famous for its study on tuberculosis, with 100 researchers worldwide. At that time, Huang realised the gap between domestic and foreign research. What she learned at home was nearly at a primary level in the US laboratory, making her feel she lacked experience and knowledge.
“Advanced American scientific research really broadened my horizon. They carried out detailed and in-depth studies, including basic research, mechanism and implementation research, which was much closer to clinical practice.” Huang said that during the four years she spent in the US, she not only witnessed world-leading medical research, but also understood the reason why the US held a safe lead in medical research. She continues to say, “American research aims to serve the future and take the lead with strategic meaning. Although the number of tuberculosis cases in the US is quite low, there are many researchers engaged in tuberculosis-related basic research there. Sometimes we joked that tuberculosis researchers are much more than patients. When I joined their team, I realised that we mustn't be impetuous in terms of basic scientific research. Instead, we need to consider it from a long-term perspective for the future of the country. If we focus only on immediate interests, quick success and instant benefits in scientific research, we might lose sight of the future. We have to allow some researches that may seem useless for now.”
During her postdoctoral study, Huang's team engaged in identifying the functions of the unknown genes of mycobacterium tuberculosis. Mycobacterium tuberculosis has more than 4,000 genes, but the functions of many genes are still unknown. Her team specifically identified the functions of a gene and published essays. The experiment provided her new life experiences throughout the years.
A few years ago, an international pharmaceutical company paid a visit to China. The principal of the company spoke with Huang, saying they were working with the US laboratory to develop a pill based on Huang and her team's research in the US. Huang said, “The world is so small. I feel so proud when people find value in my work. I also realise that what I've done may be able to benefit all mankind in the future. As a participant, I may not necessarily get any financial profit from it, but I'm still glad. Research goes like this—it might not generate instant benefit in clinical research, and it may even take a long time. During the first ten years, I tried to study more. My tutor once told me that I'm suitable for scientific research. The truth is I didn't realise how forward-looking and decisive she was in the beginning. As basic research is quite different from clinical research in China, I thought it was simply a routine job. Ten years later, I'm so glad that I made the right choice.”
In 2006, Huang returned to China. At that time, the domestic research environment had improved, with more scientific research projects and easier funding applications. In 2007, she was selected in Beijing's Science and Technology Nova Programme set up by the Beijing Municipal Science & Technology Commission for talent training. In addition to supporting implementation of specific research projects, the programme also focused on training individual capacity, giving professional and technical training, and improving their English proficiency. The programme sponsors organised classes and exchange platforms to cultivate professionals in all of Beijing's sectors.
In 2007, after returning to China, Huang joined the National Tuberculosis Reference Laboratory of Beijing Chest Hospital. Because Huang has been learning clinical medicine, she performs well in the laboratory. Based on a thorough understanding of clinical medicine, Huang succeeds in applying laboratory research to clinical practice, achieving desirable research results.
Due to previous limited scientific research, germs of tuberculosis weren't divided in detail in China, leading to a long-term negligence of non-tuberculous mycobacteria (NTM) infections. On the one hand, different NTM infections need different medicines for treatment, so reliable germ identification technology is the premise for correct diagnosis and treatment; the other hand, NTM isolated from the clinical specimens doesn't necessarily cause a disease, as a considerable proportion
of germs has nothing to do with the disease.
“With detailed information of germs, patients don't need to pay for unnecessary costs, or bear strong side effects of antituberculosis drugs,” says Huang. After joining the laboratory, she has done much for the identification of germs, knowing the infection and species of NTM infections, as well as reporting the clinical relevance of NTM for the first time in China. Meanwhile, she has developed the first software for identifying species of mycobacteria to offer services to clinical and scientific research all over the country. The software puts an end to the situation where Chinese researchers have to log in the US NCBI website to carry out sequence alignment if they want to identify species of mycobacteria based on gene sequencing. It is conducive to protecting the safety of species information in China, providing more professional, convenient and accurate services for domestic basic research and clinical treatment, and improving domestic diagnosis and treatment of NTM infections.
Thanks to her clinical experience, Huang conducts medical research with high proficiency. Her research results serve as a good help for clinicians to enhance clinical treatment. She says that the diagnosis and treatment of NTM infection is not a new thing in foreign countries, but it attracts almost zero attention in China. Today, medical institutions have invited Huang to give lectures. Her research results have inspired many in fields such as tuberculosis, respiratory medicine and infectious diseases. She says proudly, “I write down experts' consensus, and share this experience with the medical community, hoping to open a window to this area. To make things better, outside this window is a vastly different landscape.”
At the same time, Huang made great strides in treating tuberculosis, highlighting advantages in combining research with clinical treatment. Previously, tuberculosis patients had almost the same medication and treatment. But Huang's study shows that different people have different metabolic abilities for the same drug, so different people should be given varied doses according to their metabolic ability, which won't only improve healing, but reduce side effects. Based on previous work, Huang's team has achieved the transformation of a certain technology, which can identify patient's genotype within two hours to guide patient's drug dose. Currently, the technology has been reported to the China Food and Drug Administration (CFDA) for approval. Huang says the reason her team can make it is because many domestic doctors lack knowledge in creating products needed for clinical treatment.
Now a professor of Capital Medical University, Huang is also a doctoral tutor, and CFDA assessment expert of in vitro diagnostic reagents. She also serves as a consultant for in vitro diagnosis for the World Health Organization, to provide technical advice on making strategies for global tuberculosis laboratories, and making rational use of different laboratory diagnostic technologies around the world.
When it comes to her achievements, Huang says she's encountered no great obstacles but has enjoyed her scientific research so far, because she never gives priority to interests. All she wants is to attain mutual benefits for everyone. This work ethic helps her win a reputation and makes cooperation smoother. Her laboratory plays a pivotal role in the hospital. Huang admits that it's not money that inspires her. As long as her results are published, she is willing to do research even if she doesn't receive compensation.
Huang devotes her all energy to her team. The National Tuberculosis Clinical Laboratory now has 21 staff members, of which seven specialise in scientific research and four are post-80 generations. Huang keeps a relaxed outlook in talent management, and doesn't give assignments deliberately. Instead, she gives full support to the younger generation. When researchers apply for projects, she'll help them with counseling. She sometimes also supports those who don't have project funding. Huang has always been a supporter for useful attempt. She says that researchers shouldn't be given too many rules and regulations, but the freedom in both behaviour and thinking. Even if some ideas aren't mature enough, she'll encourage her researchers to give it a shot and find new discoveries.
“For a good scientific researcher, a spontaneous and strong interest in scientific research is the best catalyst for research output. Carrying out scientific research is beneficial to everyone.” Huang says, “There are many young researchers in my team, and they all get along. I feel lucky to respect, help and support them like family.”
Huang's positive attitude makes her work worthwhile. Due to the special function of the laboratory, she often receives calls for assistance after work. Call makers often feel sorry to bother her, but Huang says, “Feeling needed gives me a sense of accomplishment. The strength of our laboratory lies in analysis and advice we offer when other medical institutions can't. Doctors sometimes talk to me about the problems they have. Our communications help them improve their treatment, and help us attain new research subjects, so I'm always very glad to take part.”
Huang Hairong (middle) gathering testing samples to test for TB
Huang Hairong (right) puts blood samples into a blood centrifuge.