Pan Jiaxiang(1923-1992), Professor of Obstetrics and Gynecology, Former Director of the Department of Obstetrics and Gynecology, Renji Hospital

Introduction

Dr. Pan Jiaxiang was a pioneering obstetrician-gynecologist whose work left an indelible mark on modern medicine. He dedicated his career to advancing the field, combining exceptional surgical skill with profound compassion to heal and comfort countless women. He approached every diagnosis with a deep sense of responsibility for the life before him and every surgery as a defense of health. Whether confronting uterine prolapse or gynecologic tumors, he relentlessly researched and developed more effective treatments. His work not only pushed medical progress forward but also brought hope to women across China. In his field, Pan constantly challenged established practices, seeking innovative solutions that offered patients new possibilities. He faced every challenge with a unique blend of compassion, curiosity, and gratitude, and his journey in medicine was one of relentless forward momentum. His legacy continues to inspire new generations of physicians to push the boundaries of medical science.

The Path to Medicine

Pan Jiaxiang’s hometown, Shaoxing, is a city steeped in the rich cultural heritage of the Jiangnan region, a place known for nurturing scholars and preserving a deep historical legacy. To walk its ancient streets is to step back in time, with stone-paved lanes, traditional homes, and winding canals that evoke the classic charm of a Chinese water town.

Born into a scholarly family, Pan demonstrated a keen intellect and curiosity from an early age, receiving an excellent education. As a boy, he was idealistic and inquisitive, his eyes bright with a thirst for knowledge. Influenced by his parents, he developed a profound interest in medicine.

After high school, Pan enrolled at St. John’s University, a journey that presented formidable challenges. In the late 1940s, China was ravaged by war and political turmoil. Scarce resources and social upheaval made academic pursuits extraordinarily difficult. The St. John’s University School of Medicine was one of China’s most prestigious institutions at the time, renowned for its rigorous standards and demanding curriculum.

Upon entering medical school, Pan was met with immense academic pressure. The curriculum was a relentless grind, with days filled from dawn to dusk by courses in anatomy, physiology, biochemistry, and pathology. These subjects demanded not only extensive memorization but also sharp logical reasoning and hands-on practical skills.

In anatomy class, students learned the intricacies of the human body by dissecting cadavers. The dissection hall was a harsh environment, filled with the pungent smell of formaldehyde and a chilling cold that made prolonged work unbearable. Yet, Pan was undeterred; he was always the first to arrive and the last to leave.

During his clinical internships, Pan and his classmates rotated through various hospital departments. With medical resources in short supply, they often had to perform complex procedures under austere conditions. Sometimes, they worked for consecutive hours, treating wave after wave of patients while battling physical and mental exhaustion. This experience, however, forged his clinical skills and hardened his resolve to pursue medicine.

In 1949, Pan Jiaxiang graduated from St. John’s University with a medical doctorate, ready to begin his journey as a physician.

Early 1949 was a decisive phase in the Chinese Civil War. Following a series of major victories, the People’s Liberation Army (PLA) advanced south of the Yangtze River. In May, after a fierce campaign, the PLA captured and liberated Shanghai. It was against this backdrop of national transformation that Pan Jiaxiang joined the Department of Obstetrics and Gynecology at Renji Hospital, driven by a desire to contribute to the nation’s rebuilding.

New China Needed New Medicine

In 1954, a catastrophic flood, the worst in a century, devastated Anhui Province in East China. Pan Jiaxiang, then an obstetrician-gynecologist at Shanghai’s Renji Hospital, was appointed commander of the Shanghai Anti-Flood Medical Relief Team, tasked with leading the critical mission to Anhui.

Pan understood the gravity and difficulty of this task and immediately began preparations. Medical supplies were scarce, transportation was a major challenge, and the post-flood environment was a breeding ground for disease. Yet, he demonstrated exceptional leadership and courage. Under his direction, the team mobilized swiftly, overcoming logistical obstacles to deliver limited medical supplies and equipment to the disaster zone.

Upon arrival, Pan plunged directly into the work. The flooded region faced an imminent threat of epidemics. He led his team into high-risk areas to provide urgent care, treating injuries and infections while working to prevent the spread of disease. Drawing on his medical expertise and clinical experience, Pan devised effective treatment protocols and personally oversaw every aspect of the relief effort.

During the mission, Pan worked with extraordinary stamina, often sleeping only a few hours a night and dedicating the rest of his time to treating patients and guiding his team. He repeatedly risked his own life to visit the hardest-hit areas, conducting door-to-door visits to ensure no victim was left without care. After months of relentless effort, his team successfully controlled potential outbreaks and saved countless lives.

For his outstanding contributions, Pan was awarded a second-class merit citation for the Anhui relief mission, a significant national honor that recognized not only his personal dedication but also the selfless spirit of Renji Hospital’s medical staff. The following year, 1955, he was named an Advanced Health Worker at both Renji Hospital and across the city of Shanghai, further cementing his reputation in the medical community.

Between 1963 and 1973, during a period of significant political and social upheaval in China, Pan practiced medicine independently. This decade proved to be a crucial period for him to accumulate clinical experience. He never ceased exploring or researching, making significant strides in the areas of vaginal surgery, cancer chemotherapy, family planning, and perinatal medicine.

To map the prevalence of pelvic floor disorders among Shanghai’s women, Pan launched a large-scale epidemiological study. His team investigated nearly 2,700 cases of uterine prolapse, meticulously analyzing its causes, underlying mechanisms, and treatment outcomes.

Uterine prolapse—a condition characterized by pelvic pressure, lower back pain, and, in severe cases, the uterus protruding from the vagina—caused immense suffering. Many women were unable to work or perform daily tasks due to the pain and discomfort.

Before 1949, China’s healthcare system was underdeveloped. With high fertility rates and limited access to medical care, uterine prolapse was a common and severe problem. Widespread economic hardship led to malnutrition, which weakened pelvic muscles and ligaments. Women’s health was often neglected, and postpartum care was scarce, allowing the condition to worsen unchecked.

Based on this extensive clinical work, Pan authored the paper Analysis of 2,700 Clinical Cases Using Pessaries in Shanghai Over Two Years. With its detailed data and practical insights, the study provided invaluable guidance for obstetrician-gynecologists nationwide.

Pan also addressed the confusion many women felt about using pessaries. He traveled to local communities, personally educating them on proper usage and care.

Additionally, he published Analysis of 1,026 Uterine Prolapse Cases in Fengxian County and Exploration of Clinical Mechanisms, a paper that became a key reference for obstetrician-gynecologists around the world and advanced the global research and treatment of pelvic floor disorders.

Concurrently, Pan shifted his focus to the chemotherapy of ovarian cancer. At the time, ovarian cancer was the most lethal gynecologic malignancy, with extremely low survival rates, largely because it was often detected at a late stage. Facing this challenge, Pan recognized that traditional treatments were inadequate and began to seek new approaches.

In his research, Pan explored the potential of chemotherapy for treating ovarian cancer. By analyzing patient data, he studied how chemotherapy drugs affected cancer cells. In 1964, he pioneered the concept in China of “low-dose chemotherapy and living with tumor.” This was a groundbreaking idea. Conventional wisdom favored aggressive, high-dose chemotherapy to eradicate cancer, but Pan observed that while high doses killed cancer cells in the short term, they also severely damaged a patient’s overall health, weakened their immune system, and sometimes accelerated their decline.

His low-dose strategy aimed to effectively control the cancer while minimizing harm to healthy tissue, thereby preserving the patient’s quality of life. The philosophy of “living with tumor” was a paradigm shift, redefining the goal of treatment from complete remission to long-term disease control to extend survival. This forward-thinking approach would later prove valuable across many different cancer therapies.

Pan also achieved major surgical breakthroughs. He refined the vaginal radical hysterectomy for cervical cancer, a technique that reduced surgical trauma and significantly improved patient recovery and postoperative quality of life. This innovation offered new hope to many patients and became a reference point for gynecologic surgeons worldwide.

In his research on ovarian cancer, Pan also explored the potential of bone marrow transplantation. Recognizing that chemotherapy’s primary toxicity was to the bone marrow, he investigated the possibility of transplanting healthy marrow cells to repair this damage. This work laid an early foundation for the use of bone marrow transplantation in cancer treatment.

Leading New Trends in Obstetrics

After the Cultural Revolution ended in 1976, as China gradually reopened to the world, Pan Jiaxiang’s career entered a dynamic new phase. He held a firm belief that interdisciplinary collaboration was the key to driving clinical medicine forward. To this end, he actively partnered with the Shanghai University of Engineering Science and the Shanghai University of Science and Technology to co-develop the “multi-probe ultrasound Doppler fetal monitor.” This breakthrough represented a major advance in obstetric monitoring technology within China.

In the late 1970s and early 1980s, perinatal mortality was a critical challenge in obstetrics. Traditional monitoring methods were unable to track the status of the fetus in real-time during labor. Pan Jiaxiang recognized the immense potential of ultrasound Doppler technology and, by collaborating with experts across various fields, spearheaded the creation of the innovative multi-probe monitor.

This device revolutionized obstetric care. It enabled the real-time monitoring of the fetal heart rate and blood flow, allowing for timely intervention when abnormalities were detected and ultimately reducing perinatal deaths. Its compact and portable design made it usable in both major urban hospitals and rural clinics, benefiting countless mothers and infants across the country.

Pan Jiaxiang’s invention was rapidly adopted nationwide and had a significant clinical impact. In 1981, he and his colleagues published Clinical Application of the Domestic Ultrasound Doppler Fetal Monitor (TFJ-I, II Models): Analysis of 217 Cases, a study that documented its efficacy in lowering perinatal mortality. This achievement solidified his leadership in the field of obstetrics and played a key role in elevating China’s overall standards for maternal healthcare.

Throughout the 1980s, Pan Jiaxiang continued to excel in family planning and gynecologic research. He led key national projects during China’s Sixth and Seventh Five-Year Plans, including pivotal studies on a “compound megestrol acetate injection” and the “mechanisms of bleeding associated with intrauterine devices (IUDs).”

The “compound megestrol acetate injection” project was vital for national family planning initiatives. As a novel contraceptive, its safety and efficacy had direct implications for women’s health. Pan Jiaxiang’s team conducted thorough investigations into its pharmacology and validated its advantages through rigorous clinical trials. In 1987, he published Progress in Clinical Research on Compound Megestrol Acetate Contraceptive Injection, providing crucial scientific evidence to inform China’s family planning policies.

The study on “IUD bleeding mechanisms” addressed a persistent and widespread problem: the abnormal bleeding caused by IUDs, which were then the most common form of contraception. Pan Jiaxiang identified the key mechanisms behind this side effect and designed a novel “key-shaped IUD slow-release system,” which significantly reduced bleeding and improved both the safety and user compliance of the device. This innovative system became the only state-funded IUD research project and was widely adopted throughout the nation.

Beyond research, Pan Jiaxiang was also a surgical innovator. He refined and promoted the extraperitoneal cesarean section, a technique that offered less trauma, reduced bleeding, and faster recovery compared to traditional methods. In 1985, he co-authored Extraperitoneal Cesarean Section and Its Evaluation, detailing the technique and its benefits. This method spread rapidly across China, enhancing the safety of cesarean deliveries for both mothers and infants.

In the 1990s, Pan Jiaxiang expanded his work into interdisciplinary research with rheumatology, focusing on pregnancy complicated by systemic lupus erythematosus (SLE). SLE, an autoimmune disease, posed dual risks to both mother and fetus during pregnancy. Collaborating with Professors Chen Shunle and Gu Yueying, Pan conducted foundational and clinical studies on SLE and pregnancy. Through meticulous case analyses and experiments, he uncovered the profound impact of SLE on pregnancy and proposed effective treatment strategies. This work provided critical guidance for managing SLE pregnancies and improving outcomes for high-risk mothers.

Pan Jiaxiang remained at the forefront of his field, consistently blending theoretical innovation with technical breakthroughs. Every achievement reflected his deep care for patients and his relentless pursuit of medical progress. From fetal monitors to family planning research, his work had a profound and lasting impact on the advancement of medicine in China.

Cultivating Talent and Advancing Clinical Education

Over his decades-long career in medicine, Pan Jiaxiang rose from an attending physician to associate director, director, and ultimately the head of the Department of Obstetrics and Gynecology at Renji Hospital. A master of his specialty, he was deeply dedicated to medical education and research, mentoring numerous outstanding obstetricians-gynecologists who would follow in his footsteps.

As an educator, Pan Jiaxiang was committed to imparting knowledge to the next generation. As director of the First Family Planning Research Laboratory for Women at Shanghai Second Medical College, he led pivotal research projects, particularly in family planning, that not only influenced contemporary clinical practice but also built a foundation for future research in the field.

He trained many renowned experts in obstetrics-gynecology and reproductive immunology, including Professor Di Wen, the current director of Renji Hospital’s Department of Obstetrics and Gynecology, who stands as one of his most distinguished protégés.

Pan Jiaxiang’s career was inseparable from the cause of women’s health. He understood the profound responsibility of obstetrician-gynecologists, who not only guide women through childbirth but also safeguard their overall well-being. He often said: “An obstetrician-gynecologist holds two lives in their hands—ensuring the mother’s safety and the newborn’s health.” This statement reflected his deep reverence for the profession and his profound empathy for his patients.

Academically, Pan Jiaxiang was a rare talent. He served on the editorial boards of the Chinese Journal of Obstetrics and Gynecology and the World Medical Journal, contributing significantly to the dissemination of medical knowledge. His research emphasized practical application, advancing the field of obstetrics-gynecology through clinical trials—especially in the area of family planning—which markedly elevated China’s standards in the field.

In 1992, after a lifetime of dedication to medicine, Pan Jiaxiang passed away peacefully at the age of 69.

His life was defined by a passion for and perseverance in medicine. From his early focus on gynecology and obstetrics to his later innovations and interdisciplinary collaborations, he remained a true pioneer. With his expertise and selflessness, he helped countless families and saved innumerable lives. His idealism shone through his unwavering commitment to medicine and his profound concern for society. Through both knowledge and action, he transformed the destinies of his patients, embodying his medical journey with his very life.

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