Shanghai "Team-based" Aid Xinjiang Medical Team Creates More Health Benefits for People of All Ethnicities in Kashgar

Today, August 19th, marks the seventh Chinese Physician's Day, with this year's theme being "Advocating Humanistic Spirit, Demonstrating the Benevolence of Medical Professionals."

Last August, the Shanghai Municipal Health Commission organized Ruijin Hospital, Renji Hospital, Zhongshan Hospital, Huashan Hospital, and nine other top-tier hospitals to sign a deepened "14th Five-Year" mid-to-late period "Hospital-to-Department" team-based assistance agreement with the Second People's Hospital of Kashgar Prefecture, Xinjiang (hereinafter referred to as "Kashgar No. 2 Hospital"), to deepen the "Hospital-to-Department" Shanghai-Kashgar (nine major) Clinical Medical Center cooperation. As an important carrier of Shanghai's medical and health "team-based" aid to Xinjiang, the Shanghai-Kashgar Clinical Medical Center relies on the support from Shanghai, highlights the improvement of specialized diagnosis and treatment capabilities, and forms a batch of characteristic key disciplines with Southern Xinjiang characteristics and Kashgar advantages, turning Kashgar No. 2 Hospital into a representative high-quality diagnosis and treatment center in the Southern Xinjiang region.

Not long ago, the "Fudan University 2024 Kashgar Health Journey" came to the important town of Southern Xinjiang, Kashgar. At Kashgar No. 2 Hospital, the "Brain Health Western Journey" project was signed; the Shanghai-Kashgar Nervous System Disease Diagnosis and Treatment Center, Shanghai-Kashgar Oncology Disease Diagnosis and Treatment Center, Kashgar Maternal and Child Health Alliance, and Shanghai-Kashgar Remote Medical Cooperation Center were inaugurated; the "Heart & Liver Baby" project was officially launched; the 19 provinces and cities' pediatric doctors' alliance for aid to Xinjiang was established...

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The support from the rear has always been the driving force for the front.

Chen Weihua, Deputy Dean of Renji Hospital affiliated with Shanghai Jiao Tong University School of Medicine, leader of the 11th Shanghai Aid Xinjiang Medical Team, Deputy Secretary of the Party Committee and Dean of Kashgar No. 2 Hospital, said that since the 11th Shanghai Aid Xinjiang Medical Team entered Xinjiang, they have continuously deepened and expanded the "team-based" support model for medical talents, promoting aid Xinjiang medical talents to better leverage their professional advantages, relying on advanced technology and equipment and the training of medical talents, introducing high-quality medical resources from Shanghai to Kashgar, and extending to the county, serving the township, and radiating to the village, creating a high-level medical team that cannot be taken away. Shanghai and Kashgar work together, with the benevolence of medical professionals and advanced medical technology, to create more and better health benefits for people of all ethnicities in the Kashgar region and even Southern Xinjiang.

5G Ultra-Remote Robotic Surgery

A Powerful Supplement to the Existing Medical Aid Xinjiang Model

The world's first case, spanning 5000 kilometers, fully domestic 5G surgical robot-assisted, 1-hour completion of lung tumor surgery... Are these keywords a bit incredible when added together? Yes! Recently, such a special operation was completed at Kashgar No. 2 Hospital.

At around 11 a.m. on July 13th, in the Shanghai Thoracic Hospital, Luo Qingquan, the academic leader of the oncology department and an expert in robotic surgery, sat at the robotic surgery console and began to manipulate the robotic arm through high-definition 3D vision assistance. 5000 kilometers away, in the operating room of Kashgar No. 2 Hospital, Chen Tianxiang, an aid Xinjiang cadre from Shanghai Thoracic Hospital and Deputy Dean of Kashgar No. 2 Hospital, and Huang Jia, Deputy Chief Physician of the Oncology Department, led the team to assist the patient throughout the whole process. The two sides only took one hour to "smoothly" complete the world's first ultra-remote domestic robot-assisted radical lung tumor surgery, as if in the same operating room.Chen Tianxiang introduced that the patient of this surgery had early-stage lung cancer. At that time, there happened to be a 5G remote robotic lung tumor surgery project jointly carried out by Shanghai Chest Hospital and Kashgar No. 2 Hospital. Upon hearing that Director Luo would be the main operator, the patient was very willing to participate, "Local patients have great trust in doctors from Shanghai!"

Shanghai Chest Hospital has always maintained the national record of the annual number of robotic chest surgeries; the main operator of this surgery, Dr. Luo Qingquan, is the "double record" holder of China's first robotic-assisted chest surgery and the individual with the highest number of robotic lung resections.

Even so, more than a year of preparation was made beforehand. Chen Tianxiang said, "Before the surgery, we had multiple remote case discussions with Director Luo's team. In March 2023, Director Luo conducted remote animal experiments in Shanghai; last June, we connected and performed remote animal experiments between Shanghai and Kashgar. On the day of the surgery, the main operator was in Shanghai, and the doctors assisting in Xinjiang were in Kashgar. At the same time, there was also a main operating console in the Kashgar operating room, which could be switched at any time in case of poor signal. Fortunately, the backup machine was not used, and the whole process went smoothly."

In Chen Tianxiang's view, 5G remote robotic surgery breaks through spatial limitations, brings high-quality medical resources from the east to the south of Xinjiang, and allows the people in the Kashgar region to enjoy high-quality medical services from Shanghai, which is a strong supplement to the existing medical aid model in Xinjiang.

With the deep integration of "Internet + medical health," remote medical services have become an important means of optimizing medical resources. Relying on the advantages of remote medical services, Shanghai's aid to Xinjiang has comprehensively upgraded the remote diagnosis and treatment system. In June of this year, the remote medical service security center jointly built by the Shaxi County Public Security Bureau and Kashgar No. 2 Hospital was completed and put into use. Through the Internet, police officers and soldiers on the front line can "face to face" with famous medical experts and "zero distance" enjoy high-quality medical resources, ensuring that they can better fulfill their duties and serve the public.

From 2023 to July 31, 2024, Kashgar No. 2 Hospital conducted 2052 remote consultations, including 58 consultations outside the region, 243 consultations in the autonomous region, and 1,751 medical consortium consultations.

Teaching by giving the fish

The "36" plan cultivates a team that cannot be taken away

In southern Xinjiang, cerebrovascular diseases are a high-incidence disease. Wang Zhigao, a doctor from Shanghai who is a deputy chief physician of the Department of Neurology at Huashan Hospital affiliated with Fudan University, still remembers the scene of performing an emergency thrombectomy operation on the third day after arriving in Kashgar in the early morning. As of July this year, as the head of the Department of Neurology at Kashgar No. 2 Hospital, he has led the team to perform 95 emergency thrombectomy operations. In just one year, the DNT time for intravenous thrombolysis at Kashgar No. 2 Hospital was reduced from 75 minutes to 35 minutes, reaching the national full score standard for the first time in history.

In order to truly leave the technology behind, Wang Zhigao formulated the "36" teaching plan: in the first six months, do it for the students to see; in the second six months, do it with the students; in the third six months, watch the students do it. Now, his three local students can basically complete neurointerventional surgeries independently.In early February of this year, Wang Zigao's apprentice, the deputy chief physician of the neurology department of Kashgar Second Hospital, Abudukeyum • Yashen, successfully performed the implantation of intracranial drug-eluting stents (NOVA) for two patients with acute cerebral infarction.

Wang Zigao excitedly said: "It happened to be the Spring Festival, and I was on vacation in Shanghai. Abudukeyum • Yashen can independently complete the stent implantation, which indicates that he has graduated."

Since last April, under the careful guidance of Wang Zigao, the interventional team of the neurology department of Kashgar Second Hospital has been able to fully independently carry out various high-difficulty intracranial/extracranial arterial stenosis stent implantation, acute cerebral infarction mechanical thrombectomy and vascular recanalization, and other complex surgeries, further improving the survival rate of patients with severe cerebral infarction in the Kashgar region and significantly reducing the disability rate of patients.

Not long ago, Abudukeyum • Yashen wrote a paper on the surgery he participated in and published it in the international journal "Neuroimaging."

"In Shanghai, we have a habit: no matter at midnight or dawn, the first thing to do after leaving the operating room is to finish the operation record before doing anything else. The apprentices have also developed such a good habit." Wang Zigao said with satisfaction.

In the future, the neurology team of Kashgar Second Hospital will take the construction of the national advanced stroke center as an opportunity, continuously introduce new technologies and projects, continuously improve professional technical level, and provide more patients with high-quality and efficient diagnosis and treatment services.

It is better to teach a man to fish than to give him a fish. In order to improve the relatively backward ability to identify and treat common critical diseases in children in grassroots hospitals in southern Xinjiang, Tao Jinhao, a doctor from Shanghai who is supporting Xinjiang and is affiliated with the pediatric intensive care department of Fudan University Affiliated Children's Hospital, led a team to teach and train in 10 grassroots hospitals in Kashgar, Hetian, Kizilsu, and other places. "When I receive feedback on successful cases, I am sincerely happy, ten thousand times happier than my own successful treatment."

This time, led by Kashgar Second Hospital, more than 50 pediatric doctors from 19 provinces and cities supporting Xinjiang medical teams formed the Xinjiang Pediatric Doctor Alliance to provide continuous training courses for pediatric doctors in various regions of Xinjiang, to do a solid and detailed "double combination," that is, the combination of online training and offline tutoring, and the combination of specialists and grassroots doctors. On the basis of "team-style" support for Xinjiang, the horizontal integration of specialties across medical teams is realized to enhance the pediatric diagnosis and treatment capabilities of the whole region.

Miraculous Hands Create Miracles

7-day-old, "walnut" heart, great artery switchBorn with a misaligned heart artery, this baby struggled on the brink of life and death as soon as it was born. Fortunately, Zhu Jiaquan, a doctor who assisted in Xinjiang and the chief physician of the Department of Cardiothoracic Surgery at Xinhua Hospital affiliated with Shanghai Jiao Tong University School of Medicine, led his team to perform the arterial switch operation on a heart the size of a walnut, successfully correcting the "normal traffic" of the baby's heart arteries. This also set a new record for the youngest age and the lowest weight of the pediatric cardiac surgery patients of the Kashgar Second Hospital cardiothoracic surgery team.

"At the end of August last year, the baby was sent from Yecheng County because they heard that we had previously performed an arterial switch operation on a two-month-old baby," Zhu Jiaquan recalled. The baby was diagnosed with a complex congenital heart disease - complete transposition of the great arteries - the day after birth, meaning the aorta and pulmonary artery of the heart were in the opposite position of a normal person. Without surgery, it might not have survived for more than two months, and the best window for surgery was within two weeks after birth.

On the day of the surgery, Tao Guorong, an expert in anesthesiology from Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine and the director of the anesthesiology and surgical center of Kashgar Second Hospital, personally attended to ensure the safety of the operation. Zhu Jiaquan was the main operator, "meticulously sculpting" on the baby's walnut-sized heart. The moment the aortic occlusion clamp was opened, the heart started to beat joyfully after resuming blood supply, and the surgery was a success!

After the operation, Gong Xiaolei, an expert who assisted in Xinjiang and the head of the neonatal department of Kashgar Second Hospital, led the team to take meticulous care of the baby, and three weeks later, the baby was discharged. Before leaving the hospital, the parents said excitedly, "Thank you for the help from Shanghai's assistance, which saved our child!" The banner read, "A benevolent heart warms the sick, and the doctor has a parental heart," witnessing the miracle of life.

Zhu Jiaquan revealed that at first, the parents were concerned about the surgery due to economic conditions. Later, the medical team in Xinjiang found a charity fund in Shanghai to fund the 90,000 yuan surgery fee. "With me as the main operator and the Shanghai assistance team, they happily decided on the surgery."

In March of this year, Zhu Jiaquan went to the countryside for a free clinic with the medical team and unexpectedly met the baby. "After the echocardiogram examination, the child is very healthy, just like other half-year-old children, with normal growth and development," Zhu Jiaquan said happily, "President Chen Weihua joked that since it's such a fate, the baby should be given a Han Chinese name, with the surname Zhu. At the end of this month, the baby will be one year old, and the medical team in Xinjiang also plans to visit this 'group favorite' baby together."

Since this round of assistance in Xinjiang, under the leadership of Zhu Jiaquan, the cardiothoracic surgery team of Kashgar Second Hospital has completed more than 280 cardiovascular surgeries. The number of difficult cases ranks at the forefront of Xinjiang's cardiovascular surgery, and the cardiothoracic surgery department has become a shining business card of Kashgar Second Hospital.

Behind the business card, there is no lack of hard work from Zhu Jiaquan. "The acute type A aortic dissection surgery has high risks, great difficulties, and long duration, usually requiring 8-12 hours. Once, I had three consecutive surgeries and didn't sleep for 36 hours. In November last year, I stayed up all night for continuous surgeries, and my fundus exuded, making my vision blurry. At that time, my apprentices were very promising, and I guided them from the side, watching them do it. Every second counts, and the surgery must be timely for the patient to survive. During the Spring Festival holiday, my apprentices were already able to independently complete the acute type A aortic dissection surgery, and the history of transferring such patients to Urumqi has ended."

In 2023, the outpatient and emergency visits of Kashgar Second Hospital increased by 49.45% year-on-year, the number of discharged patients increased by 82.74% year-on-year, the number of surgeries increased by 72.91% year-on-year, and the number of level-four surgery personnel increased by 126.07%... In the first half of this year, almost all medical data increased by more than 25% on the basis of 2023, setting a new high for the hospital.

Sacrificing for the greater goodPromoting Traditional Chinese Medicine Culture and Chronic Disease Screening in Southern Xinjiang

Among the eleventh batch of Shanghai medical aid workers in Xinjiang, Wang Yixi, a deputy chief physician from Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated with Shanghai University of Traditional Chinese Medicine, is a rather special figure. Last April, it was his second time providing medical assistance in Xinjiang.

Wang Yixi, who had just graduated with a Ph.D. before his first aid mission, was initially hesitant due to the unknowns of working in Southern Xinjiang and the lack of understanding from his family. "After in-depth understanding, I gradually realized that the work in Xinjiang is not only a significant strategic deployment of the Party and the state, but also an important measure to achieve the Healthy China strategy, and more importantly, a great opportunity to serve at the grassroots level and improve my professional skills," said Wang Yixi. He proactively persuaded his family, overcame various difficulties, and finally embarked on his first aid mission in Xinjiang on August 26, 2021.

In the Kashgar region, the incidence of chronic kidney disease is high, but the awareness is extremely low. Many patients are already in the advanced stages of the disease when they seek medical treatment, missing the best treatment opportunities. This deeply affected Wang Yixi.

"My specialty is the integrated traditional Chinese and Western medicine for kidney disease. How can I bear to see this? If patients can be detected, diagnosed, and treated early, how wonderful it would be!" After the end of his first aid mission, he proactively applied to continue his work in Xinjiang. "My family's attitude also changed. Seeing that the aid mission in Xinjiang can give me a great opportunity to showcase my abilities, they became very supportive."

"Twice a week, I have expert clinics, which normally end at 2 PM but usually extend to 3-4 PM," said Wang Yixi. On one hand, the language barrier requires translation, and on the other hand, traditional Chinese medicine emphasizes the "four diagnostic methods" (inspection, auscultation and olfaction, inquiry, and palpation), which takes a relatively long time for each visit. "Whether it's going to the countryside for free medical services with the medical team or going to the grassroots with colleagues from the department, I am always the last one to pack up. It's impossible to say I'm not tired, but every improvement in the patient's condition, every affirmation, and every word of thanks are all great encouragement to me."

On occasions such as World Traditional Medicine Day, National Medicine Festival, and Dragon Boat Festival, Wang Yixi also actively promotes traditional Chinese medicine culture, such as the four seasons of health preservation, sachet making, and Shanghai-style paste formulas.

"National unity as one family", "Healthcare to the grassroots, medical benefits to the people", "Shanghai-Kashgar heart to heart, medical benefits to the people's heart"... Since last April, Wang Yixi has participated in more than 30 science popularization and free clinic activities, serving more than 1,000 people. While promoting the concept of "preventive treatment in traditional Chinese medicine", Wang Yixi also does not forget to popularize early screening and prevention methods for chronic kidney diseases such as diabetic nephropathy, and promotes early screening technology for diabetic nephropathy and integrated traditional Chinese and Western medical treatment plans in grassroots hospitals.

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Regarding 5G ultra-long-distance robot-assisted surgery, Chen Tianxiang modestly said: "I am just the one who threads the needle."Three emergency surgeries in a day, although Wang Zigao was apprehensive during the "supervision", he still sincerely praised his apprentices after the operation: "You are gradually learning to walk independently!"

Zhu Jiaquan usually speaks slowly and deliberately, but when he mentions "If acute Type A aortic dissection surgery is not performed, 80% of the patients will die," his speech is extremely fast, saving people as if putting out a fire!

Wang Yixi said three times within half an hour, "The positive feedback of patients' symptoms significantly improved after traditional Chinese medicine treatment makes me very happy."

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In the eyes of the Shanghai medical team aiding Xinjiang, what they have done is just a "small matter for the people"; in our view, they are people with a great heart for the country and the people, and they have made an indispensable contribution to the establishment of a medical highland in the southern Xinjiang region, the health cause of the people in southern Xinjiang, and the unity of the people from Shanghai and Xinjiang in the Kashgar Second Hospital.