Subscribe
27
Gan Jun
Endocrinology
About me
Associate Chief Physician. Graduated from Wan Nan Medical College Clinical Medical Department in 1997, awarded as attending physician in Endocrinology in 2002, and promoted to Associate Chief Physician in Endocrinology at the end of 2008. Has developed mature diagnostic and treatment methods, as well as management principles for various endocrine acute and chronic diseases including pancreatic, thyroid, pituitary, adrenal, and gonadal diseases, with rich clinical experience.
In 2002, attended the postgraduate program in Endocrinology at Nanjing Medical University, obtained the completion certificate in 2004, independently designed the research project "Study on the Relevance of Type 2 Diabetes Mellitus Combined with Metabolic Syndrome and Early Diabetic Nephropathy" and conducted in-depth research, finally obtaining a Master's Degree in Endocrinology for on-the-job postgraduates in 2007. Undertook a one-year internship at Jiangsu Provincial People's Hospital from July 2005 to July 2006 and obtained a national second-level computer certificate by the end of 2006.
Proficient in diseases
Diagnosis and treatment of various endocrine acute and chronic diseases such as pancreatic, thyroid, pituitary, adrenal, and gonadal diseases.
Voices
What should I do if a pheochromocytoma ruptures?
When a pheochromocytoma ruptures, it is advised that the patient immediately goes to the emergency department of the hospital for relevant examinations to confirm the diagnosis and to immediately control the blood pressure to a relatively stable and safe level. After a comprehensive evaluation, the urology department will perform emergency surgical removal to save the patient's life. Spontaneous rupture and bleeding of adrenal pheochromocytoma is quite rare. The possible reasons might be long-term hypertension leading to poor vascular function, or rapid tumor growth with high capsule pressure causing vascular rupture. Additionally, intense exercise, excessive fatigue, and transient increases in blood pressure could also be triggering factors.
How to determine if you have diabetes
If a patient experiences significant symptoms of dry mouth, excessive thirst, increased urination with more foamy urine, increased appetite, but an unexplained weight loss, known as the "three polys and one low" symptoms, it is necessary to monitor fasting blood glucose. If the fasting blood glucose exceeds 7.0 mmol/L or the blood glucose two hours after a meal exceeds 11.1 mmol/L, or if there are no clear "three polys and one low" symptoms but random blood glucose levels exceed 11.1 mmol/L on two occasions, a diagnosis of diabetes can be confirmed. At the same time, it is essential to rule out secondary effects on blood sugar levels caused by infections, trauma, or the use of steroid medications. It is also recommended that the patient undergo tests for glycated hemoglobin, as well as insulin and C-peptide release tests, to further clarify the diagnosis.
Can malignant pheochromocytoma be cured?
When pheochromocytoma becomes malignant, it can be cured through clinical approaches, although malignant pheochromocytoma mainly refers to those that have distant metastases. It primarily exhibits aggressive growth or is accompanied by metastases to other organs, and surgery cannot completely remove it, leading to a high recurrence rate post-surgery. Generally, the five-year survival rate for patients with malignant pheochromocytoma does not exceed half. If treated with chemotherapy or arterial embolization, it can control the patient's blood pressure and alleviate the tumor burden, thereby extending the survival period. In summary, the treatment of malignant pheochromocytoma is relatively challenging, has a high recurrence rate, and poses a significant threat to human life.
What should I do if hypokalemia suddenly occurs?
Hypokalemia is very common in clinical settings, generally caused by improper diet, insufficient supplementation, or excessive loss. It is recommended that patients first seek further examination at a hospital. If potassium deficiency is confirmed, mild cases can be treated with oral potassium supplements, while moderate to severe cases who experience muscle weakness, flaccid paralysis, and arrhythmias should receive intravenous potassium supplementation in conjunction with oral treatment. It is also important to dynamically monitor electrolyte levels. In daily life, it is important to plan a diet that is rich in vitamins and trace elements, and treat the specific causes of the condition. It is recommended that patients continually monitor their fluid and electrolyte balance, abstain from smoking and limit alcohol consumption, and maintain good daily habits.
What should I do about Hashimoto's thyroiditis?
Hashimoto's thyroiditis is an autoimmune inflammatory thyroid disease caused by the diffuse enlargement of thyroid follicular cells, and may present with transient hyperthyroidism during different clinical stages. During the period of normal thyroid function as well as the eventual phase of reduced thyroid function, appropriate anti-hyperthyroidism medications can be administered symptomatically when the patient is clinically hyperthyroid. When the patient is hypothyroid, it is necessary to timely supplement with thyroid hormones for treatment, and it is essential to dynamically monitor the individual’s thyroid hormone levels, thyroid hormone antibodies, and thyroid ultrasound to make a comprehensive assessment. It is always important to maintain a low iodine diet and avoid consuming foods that are high in iodine.
Why is the urine acidic in hypokalemia?
When hypokalemia occurs, the concentration of potassium ions in the extracellular fluid decreases, causing potassium ions to shift from the inside to the outside of the cell. Meanwhile, two sodium ions and one hydrogen ion from the extracellular fluid move into the cell, decreasing the concentration of hydrogen ions outside the cell, thus resulting in metabolic alkalosis. At the same time, due to the reduction of blood potassium, the potassium-sodium exchange in the renal tubules is reduced. The renal tubule cells exchange more hydrogen ions and sodium ions, thus increasing the reabsorption of bicarbonate ions and raising the pH value. This type of metabolic alkalosis increases the number of hydrogen ions inside cells, while the kidney secretes more hydrogen, thereby producing acidic urine, also known as paradoxical aciduria.
Does hypothyroidism lead to thyroid cancer?
Hypothyroidism and thyroid cancer are two different types of thyroid diseases; hypothyroidism does not cause thyroid cancer, and there is no necessary connection between the two. Hypothyroidism refers to a decrease in thyroid function levels, caused by abnormalities in the secretion and synthesis functions of the thyroid, closely related to disorders of the endocrine system. In contrast, thyroid cancer is a change in tissue nature due to malignant transformation in thyroid tissue cells, it is not related to the thyroid's endocrine functions, and currently, there is no research indicating that hypothyroidism increases the likelihood of developing thyroid cancer. Patients with thyroid diseases should undergo dynamic thyroid ultrasonography and monitoring of thyroid function to further clarify their condition.
Patients with hypokalemia can have what kind of urine?
When patients have hypokalemia, they often exhibit paradoxical aciduria, which is a typical manifestation of hypokalemia. In hyperkalemia, however, there is paradoxical alkaline urine. When serum potassium ions decrease, the renal tubular epithelium reduces its potassium excretion function and instead increases hydrogen excretion, leading to increased reabsorption of sodium and bicarbonate. This results in metabolic alkalosis, causing an increase in plasma bicarbonate, unlike typical alkalosis where alkaline urine is excreted. However, in the case of hypokalemia, acidic urine is excreted, hence it is called paradoxical aciduria.
What are the clinical manifestations of hypokalemia?
When patients present with hypokalemia, the first symptoms often include significant muscle weakness and episodic flaccid paralysis. Additionally, there may be a decrease in the stress tolerance of cardiac myocytes, leading to arrhythmias or an increased heart rate. Hypokalemia can also cause damage to the renal tubules, leading to a decline in kidney excretion functions. The most crucial manifestation is endocrine disorder, which can lead to kidney failure. The primary treatment for hypokalemia is potassium supplementation. For mild hypokalemia, it is advisable to consume foods high in potassium, such as oranges, bananas, and other fruits and vegetables. In cases of severe hypokalemia, potassium can be administered intravenously or orally, and blood potassium levels should be dynamically monitored.
How much potassium should be supplemented daily for hypokalemia?
For patients with hypokalemia, the amount of potassium ions needed each day depends on the severity of the hypokalemia. There are specific causes for the occurrence of hypokalemia; it does not occur without relevant medical history. It is commonly seen in cases of inadequate diet, diarrhea, insufficient intake of potassium ions, clinical use of diuretics, and acid-base imbalance. That is to say, hypokalemia can be caused only if these factors are present. Without these factors, hypokalemia will not occur. Patients with hypokalemia need potassium supplementation therapy. If it's not severe, oral potassium chloride can be administered. For a few severe cases of hypokalemia, patients may receive intravenous fluids. Generally, the principle is to supplement four to six grams of potassium chloride per day. Potassium supplementation should be strictly in accordance with medical advice, and it's important to monitor the concentration of blood potassium regularly to adjust the treatment plan appropriately. (Medication use should be under the guidance of a physician.)