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Zhang Jun Jun
Endocrinology
About me
Zhang Junjun, female, member of the Communist Party of China, master's degree student, chief physician, currently working at Hunan Provincial People's Hospital, member of the Chinese Women Doctors Association Youth Committee, director of the Hunan Health Services Association Metabolism and Endocrine Health Branch, engaged in endocrine work for 5 years, authored several papers and popular science articles on endocrine diseases.
Proficient in diseases
Have extensive experience in endocrine diseases such as diabetes, thyroid, adrenal gland, gonad, osteoporosis, etc.
Voices
Can people with obesity eat pork?
Patients with obesity are advised to primarily consume lean pork, as it generally contains more protein. If the pork is fatty, it has a higher fat content. Since obesity is a disease of nutritional excess, it is necessary to strictly control the total calorie intake, including carbohydrates, proteins, and fats — particularly the intake of carbohydrates and fats, which are strictly limited. However, patients with obesity can eat lean pork, as it contains high-quality protein which is beneficial for their physical health. Thus, people with obesity can eat pork, but they should focus on consuming lean cuts.
There are several types of thyroiditis.
Thyroiditis primarily includes acute, subacute, and chronic forms. Acute and subacute thyroiditis are generally seen in bacterial and viral infections, while chronic thyroiditis mainly consists of autoimmune thyroiditis, painless thyroiditis, and postpartum thyroiditis. However, autoimmune thyroiditis itself encompasses five scenarios, including Hashimoto's thyroiditis, atrophic thyroiditis, painless thyroiditis, euthyroid thyroiditis, and Hashitoxicosis. These types of thyroiditis are mainly seen in chronic thyroid conditions and are all autoimmune diseases. Therefore, the type of thyroiditis should be determined based on the cause to develop appropriate treatment plans.
Pre-symptomatic hyperuricemia
Hyperuricemia in the preclinical phase can be asymptomatic, only showing fluctuating or persistent hyperuricemia during blood tests. From the increase in uric acid to the onset of symptoms, it can generally take several years to decades. Additionally, some changes in the kidneys due to the deposition of uric acid can cause manifestations of gouty nephropathy. Early stages may present intermittent proteinuria and increased urine foam. As the condition progresses, the kidney's concentrating ability may decrease, resulting in increased nighttime urination. Further progression can lead to renal insufficiency, elevated creatinine and urea nitrogen, and possibly swelling and hypertension. In severe cases, acute renal failure may occur, showing symptoms of oliguria or anuria. This type of uric acid nephropathy is primarily due to the deposition in the kidneys, causing episodes of kidney stones and back pain, with stone episodes also accompanied by hematuria. Therefore, the main presentations are associated with the deposition of uric acid in the kidneys during the preclinical phase of hyperuricemia.
Does Hashimoto's thyroiditis cause a sore throat?
Hashimoto's thyroiditis does not cause a sore throat; the type of thyroiditis that primarily causes a sore throat is subacute thyroiditis. Subacute thyroiditis is a viral infection and is a self-limiting disease. Its main clinical manifestations include sore throat, thyroid enlargement, as well as accompanying fever and elevated erythrocyte sedimentation rate. Meanwhile, Hashimoto's thyroiditis is an autoimmune disease, whose most common clinical manifestation is painless thyroid enlargement, progressing to hypothyroidism in later stages. Additionally, it involves thyroid antibodies, especially positive TPO antibodies. Because the treatments for each are different, it is important to note that Hashimoto's thyroiditis does not cause a sore throat.
Which department should I go to for cholecystitis?
Firstly, it is necessary to determine the cause of the cholecystitis. The most common type of cholecystitis is caused by gallstones. If the cholecystitis is an acute episode caused by gallstones, leading to pain, nausea, vomiting, or even high fever, surgical intervention is usually indicated. It is generally recommended to consult with departments such as general surgery or hepatobiliary surgery, as emergency surgery may be needed. The second scenario involves cases where cholecystitis is detected during routine physical examinations without symptoms. Ultrasound may show gallstones or gallbladder polyps. In symptom-free situations, it is possible to consult general departments like gastroenterology, and regular follow-ups and checks of inflammation indicators, as well as abdominal ultrasonography, can be performed to monitor the dynamic changes of the cholecystitis. The third scenario pertains to cholecystitis where new techniques such as MRCP are available. With this technology, gallstones can be removed under endoscopic guidance. Generally, these procedures are performed in the gastroenterology department. Thus, for acute cholecystitis with choledocholithiasis and concurrent biliary pancreatitis, it may be treated with endoscopic techniques under gastroenterology, avoiding the need for traditional or minimally invasive surgery. Therefore, patients with cholecystitis may visit either the hepatobiliary surgery or gastroenterology departments.
Is leukopenia very harmful?
Leukopenia primarily depends on the extent of the decrease in white blood cells, which can be classified into mild, moderate, and severe levels. Mild leukopenia generally means less than 4.0 X 10⁹/L, and if granulocytes are decreased, it typically means an absolute value of granulocytes less than 2.0 X 10⁹/L. A lack of granulocytes indicates a more severe condition, usually less than 0.5 X 10⁹/L. For patients with mild leukopenia, special preventive measures are generally not necessary. However, for moderate and severe leukopenia, the greatest risk is an increased chance of infection, as white blood cells are a marker of our ability to defend against external threats. With fewer of these defensive guards, the probability of resisting infections and the chance of acquiring infections significantly increase. Therefore, for patients with moderate leukopenia, their rate of infection increases, and it is important to take precautions, reduce visits to public places, maintain hygiene, and eliminate chronic infectious foci. For patients with severe leukopenia, aseptic isolation measures should be adopted. For patients who have infections, it is crucial to find sensitive antibiotics, preferably broad-spectrum antibiotics. If there is a concurrent fungal or viral infection, antifungal or antiviral medications should also be used, as the decrease in white blood cells can destroy a person's immune capacity, lowering immunity and increasing the chance of infections and the invasion of pathogenic bacteria, which in severe cases could even lead to sepsis or septic shock.
How to Diagnose Cholecystitis
The definitive diagnosis of cholecystitis mainly involves the following aspects: First, clinical manifestations are crucial. The most common symptoms include nausea, vomiting, abdominal distension, and loss of appetite. Regarding physical examination, there is typically pain in the lower right abdomen and mid-lower right abdomen, with tenderness upon palpation. Furthermore, the onset of cholecystitis is characterized by postprandial pain, particularly after consuming fatty foods or feeling overly full. If these symptoms are present, further examination such as gallbladder ultrasound can be conducted to check for thickening of the gallbladder wall. Additionally, blood tests for inflammatory markers like complete blood count and CRP (C-reactive protein) can be performed. The diagnosis of cholecystitis can be confirmed by combining these symptoms and test results.
What are the symptoms of leukopenia?
The most common cause of leukopenia is viral infections, along with some severe bacterial infections. Common symptoms of viral and bacterial infections include dizziness, headache, nausea, vomiting, chills, fever, cough, expectoration, abdominal pain, diarrhea, urgent urination, and frequent urination. Generally, further examinations can be conducted through blood draws and routine tests of blood, urine, and stool cultures. If there is an accompanying hematological disease, such as thrombocytopenia, symptoms can include general weakness, body aches, and bone pain; further bone marrow examinations should be conducted.
Is leukopenia leukemia?
Leukopenia is not necessarily indicative of leukemia. There are many causes for a decrease in white blood cells, some of which can be due to medications. Currently, many drugs can cause a reduction in white blood cells, and in such cases, stopping the drug will typically allow the white blood cells to return to normal. A second scenario, especially in patients with an enlarged spleen or those suffering from cirrhosis, can also lead to a decrease in white blood cells. In these cases, it is mainly the abnormal function of the spleen that causes the reduction in white cells. Additionally, there are blood-related diseases, which might be leukemia or other types of blood disorders. In these situations, not only is there a reduction in white blood cells, but there is also a decrease in hemoglobin and platelets. Moreover, a significant increase in white blood cells is also a manifestation of leukemia, thus a decrease in white cells is not definitively indicative of leukemia.
What to check for the cause of leukopenia?
If there is a decrease in white blood cells, we mainly look at the total number of white blood cells and the absolute value of neutrophils in our routine blood test. The causes of leukopenia are inseparable from neutrophils, and can be mainly divided into three categories. The first category is a production defect of neutrophils, the second is excessive destruction and consumption of neutrophils, and the third is abnormal distribution of neutrophils. A major cause of decreased production of white cells and neutrophils is damage to hematopoietic stem cells by ionizing chemicals. Additionally, immune reactions and bone marrow diseases can also lead to decreased production. Another cause is a production defect due to maturation disorders in neutrophils within white blood cells, leading to reduced white blood cell production. Maturation disorders are mainly due to a lack of raw materials needed for white blood cell production. Excessive destruction and consumption of white blood cells are often due to immune factors. Immune factors are common in autoimmune diseases, thus such diseases can also lead to leukopenia. The last category, abnormal distribution, can be a severe infection that causes an abnormal distribution of white cells, retaining them alongside other substances, such as in patients with enlarged spleens, which can provoke leukopenia by causing granulocytes to be retained in circulation, especially in areas like the spleen.