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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
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.)
What size of pheochromocytoma is malignant?
The size of pheochromocytomas and the benign or malignant nature of the tumor are not greatly related. Usually, most are familial pheochromocytomas, which are most commonly bilateral, but they have a relatively high recurrence rate and are difficult to treat with fewer available treatment options. Once a pheochromocytoma is detected, it should be taken seriously and treated promptly. The presence of a tumor often indicates that it has developed to the mid and late stages, where it becomes relatively difficult to cure. Regardless of whether the tumor is large or small, it must be taken seriously and treated with care, otherwise, it may easily worsen and affect health.
What should not be eaten if you have high blood lipids?
For patients with hyperlipidemia, it is certainly necessary to avoid foods rich in fats. Also, do not consume spicy and irritating foods, and do not use animal fats as the main cooking oil. Try to reduce the intake of lard, beef, fatty lamb, and fatty beef, and avoid foods high in cholesterol, including animal organs and egg yolks. Simultaneously, it's crucial to avoid alcohol, as it can inhibit protease and promote the synthesis of endogenous cholesterol and triglycerides, thus leading to elevated blood lipid levels. Therefore, patients with hyperlipidemia should regularly consume a variety of fruits and vegetables, including hawthorn, apples, pears, cucumbers, tomatoes, and the like. It is also advised that patients maintain appropriate physical exercise to increase energy expenditure, reduce weight, and lower blood lipid levels.
Mild hyperkalemia clinical manifestations
When blood potassium exceeds 5.5 millimoles per liter, it is referred to as hyperkalemia. Clinically, mild manifestations of hyperkalemia commonly involve the cardiovascular system, including bradycardia, audible enlargement of the heart, and weakened heart sounds. The electrocardiogram may show a shortened QT interval and peaked T waves. Symptoms related to the neuromuscular system include numbness in the lips and limbs, muscle soreness, and, in severe cases, paralysis of the respiratory muscles, which can lead to suffocation. All cases of hyperkalemia present various degrees of metabolic acidosis or azotemia, among other symptoms.
Is a hypoechoic area definitely thyroid cancer?
A thyroid nodule underwent an ultrasound B-examination and showed hypoechoic features, but this does not necessarily indicate thyroid cancer. It is essential to conduct relevant tests to determine the cause. For such thyroid nodules, it is first important to check their specific size. If there is concern about the presence of a malignant tumor, it is advisable to perform a fine needle aspiration for pathological examination to confirm the diagnosis. If the thyroid nodule exceeds one centimeter and causes local pain or affects surrounding blood vessels, leading to symptoms of compression, it is recommended that patients should promptly undergo surgical removal for treatment.
Is thyroid swelling malignancy the same as thyroid cancer?
Thyroid malignancy refers to thyroid cancer, but even malignant thyroid cancer generally has a good prognosis. However, it is crucial to achieve early detection, diagnosis, and treatment. It is advised to promptly visit a thyroid specialty department for comprehensive examinations, including thyroid ultrasound, evaluation of thyroid function, and related thyroid antibodies. A fine needle aspiration biopsy should be conducted for a clear pathological diagnosis, followed by immediate active treatment, primarily surgical. Thyroid cancer includes papillary thyroid cancer, follicular thyroid cancer, medullary thyroid cancer, and undifferentiated cancer. The surgery mainly involves minimally invasive and traditional methods. Post-surgery, it is recommended to perform lymph node dissection, assess the extent of metastasis, and decide whether to proceed with Iodine-131 radiotherapy. Due to the loss of thyroid function, proactive thyroid hormone replacement therapy is advised, along with dynamic monitoring of thyroid health through ultrasound and related examinations.
Characteristics of thyroid cancer lymph node enlargement
Thyroid cancer is a type of malignant tumor. However, if it is detected early, diagnosed early, and treated early, it generally has a relatively good prognosis compared to other malignant tumors. Once a patient is afflicted with this disease, it is crucial to seek treatment promptly. Without treatment, thyroid cancer can spread to lymph nodes. Initially, the cancerous lymph nodes may invade surrounding blood vessels and nerves, leading to symptoms such as hoarseness. If it compresses the throat area, it can cause discomfort in the throat accompanied by breathing difficulties and coughing while drinking. If the optimal time for treatment is missed, cancer cells can spread, potentially moving not only to the lungs but also to the respiratory system and bones, among other distant sites.