Tian Juan is an attending physician from Department of Rheumatology and Immunology of the First Affiliated Hospital of Xi 'an Jiaotong University (XJTU). At the end of September 2020, she flew to Malawi in Africa with the medical aid team and became a glorious member of the 8th batch of China (Shaanxi province) medical aid team to Malawi.
As early as 1 month before the medical aid mission, attending physician Tian Juan had started the diagnosis and treatment of a patient with ankylosing spondylitis in Malawi. The story line goes as follows. On August 15, 2020, Dr. Tian Juan received a WeChat message from a Chinese patient who worked in Malawi when receiving overseas medical aid training in Xi 'an. The patient was a young man who worked in Malawi for many years and was diagnosed with ankylosing spondylitis when he was a student. After corresponding treatment, relevant symptoms were basically mitigated. He continued taking medicine regularly during working abroad and felt no obvious discomfort. However, at the beginning of 2020, the illness was suddenly worsened due to the increased pressure, especially when sleeping at night, and he suffered from insomnia. After half a month, he presented with the ankle joint swelling pain and walking difficulty.
He failed to control relevant symptoms by oral intake of drugs, and the chest pain and joint swelling pain were aggravated day by day, which severely affected his work and daily life. Unfortunately, no rheumatologists could be found in Malawi, and local doctors had no experience in the diagnosis and treatment of ankylosing spondylitis. Several months later, the severity of disease became worse and worse, and he could not perform ordinary activities and even he could barely live independently. Just when the patient felt desperate, he immediately contacted with Tian Juan upon knowing that she was a physician from Department of Rheumatology and Immunology in the 8thbatch of China Medical Aid Teamto Malawi.
Through WeChat communication, attending physician Tian Juan was familiar with the medical history and current physical condition of the patient and determined a treatment plan for him. However, a realistic problem came up that the recombinant human tumor necrosis factor receptor antibody-II fusion protein in this treatment plan should be transported in cold chain and packed in fragile glass, which cannot be consigned. Considering that the long trip to Malawi up to 36 hours, attending physician Tian Juan finally decided to make a double-layer ice box, and changed the ice bag twice in the hotel and airport to ensure that the medicine was stored at 2-8℃. Using this method, she purchased and brought the most advanced injection drugs for treating ankylosing spondylitis from China to Malawi, and also carried three kinds of oral drugs. After arriving in Malawi, Tian Juan contacted the patient and delivered subcutaneous injection of the recombinant human tumor necrosis factor receptor antibody-II fusion protein, injection of triamcinolone acetonide into ankle joint cavity combined with oral intake of sulfasalazine and etoricoxib. After 1-week treatment, the pain was gradually alleviated, and the activity of spine and ankle joint was improved. Attending physician Tian Juan delivered subcutaneous injection of drugs once a week, and injected the recombinant human tumor necrosis factor receptor antibody-II fusion protein into the ankle joint cavity twice. After three months of attentive treatment, the pain and joint swelling were completely healed, and the patient restored normal work and life.
As an overseas medical aid physician, attending physician Tian Juan provided qualified medical technology and service to a patient in Malawi, demonstrating the positive spirit and image of our hospital and Chinese medical staff and making contributions to strengthening the friendship between the Chinese and Malawi people.
