Medical road ahead

"Director Qin, how did you know that my uncle suffers from endocrine osteoporosis? Isn't this disease common in female patients? Especially postmenopausal women." Qiao Tan was puzzled.

As far as she knows, endocrine osteoporosis belongs to idiopathic osteoporosis. The reason is that this disease is very special and occurs more frequently in postmenopausal women.

After women's menopause, the estrogen level will drop suddenly, causing bone metabolism imbalance, resulting in massive bone loss, which is the same as the result of primary osteoporosis, but the cause is different.

"Since endocrine osteoporosis is classified as idiopathic osteoporosis, it naturally stems from its particularity." Qin Xiao explained, which coincides with Qiao Tan's cognition.

However, his subsequent analysis of Tanjiang's condition allowed Qiao Tan to open a new door to endocrine knowledge.

"But in addition to postmenopausal women, it is also common in patients with hypercortisolism, hyperthyroidism, diabetes, acromegaly, primary hyperparathyroidism with osteoporosis , and my uncle is mostly a patient with hyperthyroidism."

"Thyroid? You mean my uncle has osteoporosis due to thyroid disease?" Qiao Tan was still half-aware.

"Yes."

Qin Xiao nodded, and further analyzed: "The last time your uncle had a thyroid nodule, it was a signal light for thyroid disease. However, I think your uncle's optimist personality probably didn't take this matter to heart. As a result, he did not improve his living habits, which led to the progression of thyroid disease from shallow to deep, which in turn led to the problem of osteoporosis.”

"You're right. My uncle is a person who doesn't cry when he doesn't see the coffin. As long as the sky doesn't fall, he can still live happily."

Qiao Tan frowned and nodded, suddenly worried about Tan Jiang's optimistic personality.

The so-called, if there is no distance, there must be near worry, it seems to be especially suitable for Tanjiang.

"Then how does hyperthyroidism cause osteoporosis?" Qiao Tan asked again.

"A large amount of thyroid hormone has a direct effect on bones, which can strengthen bone resorption and bone formation at the same time, and bone resorption is more prominent. However, patients with hyperthyroidism have hypermetabolism throughout the body, which will cause insufficient protein matrix in bones and calcium salt deposition disorders. Ultimately this leads to a loss of bone mass in the body.

In addition, 1.25-(OH)2-D3, an active vitamin D hormone, can increase the intestinal absorption of calcium and phosphorus, thereby stimulating bone growth and bone mineralization, but a large amount of thyroid hormone in the human body will affect kidney function. 1-a-hydroxylase activity interferes with the decomposition of 1.25-(OH)2-D3. Therefore, when metabolic hyperthyroidism occurs, the level of 1.25-(OH)2-D3 will decrease, resulting in reduced intestinal absorption of calcium and excretion of fecal calcium Increased, decreased calcium absorption by the kidneys, increased calcium excretion by the kidneys, resulting in decreased bone density. "Qin Xiao elaborated.

Qiao Tan was a little dazed when he heard it, and after a while, he frowned and asked: "Is there a cure for this disease? Is it just to cure the hyperthyroidism?"

"Yes! First of all, hyperthyroidism must be controlled to restore hormones to normal levels as much as possible, and then calcium supplementation treatment should be performed according to the degree of osteoporosis, mainly calcium carbonate, vitamin D supplementation at the same time, plus appropriate activities, more exposure to the sun, slowly land, you can recover." Qin Xiao nodded.

"Then I'll go talk to my uncle later."

Qiao Tan nodded, and continued: "No wonder I found his recent behavior a little too excited. I thought it was because Xiao Jian will be promoted to primary school next year. He and his little aunt can enjoy the time when the child is studying and the hot pot restaurant is not yet open." Only a real two-person world can let you forget your worries and be happy all day. It turns out that he has hyperthyroidism. I noticed that his eyes became slightly protruding, but I didn't pay much attention to it. It seems that he still I don't care enough about him."

After finishing speaking, Qiao Tan couldn't help but frowned and blamed himself.

"I can't blame you. As doctors, we care about our patients, but we often ignore the problems of ourselves and those around us. Don't you think Director Xue and Director Jin are like this?" Qin Xiao comforted, and lightly He patted Qiao Tan on the back of his hand.

"cough!"

After he withdrew his hand, Qiao Tan blushed and scratched the place he touched, and continued: "Call my little aunt together tomorrow, she often complains of back pain, let her go to the orthopedic department to see if there is something wrong with the lumbar spine. question."

"By the way, is Xiaojian the youngest son of my uncle, or is he the only child?" Qin Xiao asked curiously.

Qin Xiao looked at Tan Jiang's medical records and found that he was born in the [-]s, but even if he married late, his children would at most be born in the [-]s, not the [-]s.

He secretly estimated that Tan Jiang should have been born around the age of 50, Tan Xiaojian, who is already considered old enough.

"Just such a child, my uncle is married twice, and the current little aunt is born in the 90s." Qiao Tan explained his confusion.

"I see."

Qin Xiao understood, and asked again: "Then he and his ex-wife have no children?"

"It was because they had been married for many years and had no children that they got divorced. It is strange to say that my uncle and his ex-aunt have been married for six or seven years, and they have never had children. There was no abnormality in the body. The doctor said that pregnancy needs fate. For this reason, they worshiped many Guanyin temples. But my uncle disagreed, feeling that the child he got in this way is not like his own, what did he say exactly?"

Qiao Tan scratched his chin, recalled it carefully, and then continued: "Whatever you sow, you will reap. What do you need to cultivate by yourself, instead of handing over the seeds to others to cultivate."

"puff!"

Hearing this, Qin Xiao chuckled, "Your uncle is quite real."

"He just did it!"

Qiao Tan wrinkled his nose and complained: "The two of them have struggled for so many years, and even the former little aunt agreed to suffer this crime, but the little uncle refused to agree. In the end, the two had a big fight, saying that they had nothing to do with each other. Because of the fate of having a child, I decided to divorce. However, in order to compensate my ex-aunt, my uncle chose to leave the house and left the two restaurants he opened before to my ex-aunt. Later, I borrowed money from my mother to open it. This is 'spicy'. Fortunately, God did not treat him poorly. When he was middle-aged, he fell in love with the cashier in the store. After the two got married, they had Xiaojian soon, and finally let him taste What it's like to be a father."

"I also feel the joy of farming." Qin Xiao teased.

"cough!"

Qiao Tan pretended not to understand the meaning of Qin Xiao's grown-up joke, but scratched his cheeks, and said, "But my uncle and aunt dote on Xiaojian so much, they give him whatever he wants, and if he likes sweets, give him as much as he can." Buying candy, no, Xiao Jian ate his teeth badly, and when he gets his teeth filled tomorrow, he will have to yell again."

"It's normal for children to love sweets, but there should be a limit to petting."

Qin Xiao's tone sounded like someone who had been a father before, and Qiao Tan couldn't help being curious: "Do you have mischievous and spoiled younger siblings, or cousins?"

"No."

Qin Xiao shook his head, raised his hand and glanced at his watch, "It's getting late, I'll take you home."

"okay."

Qiao Tan nodded unwillingly. In fact, she hadn't enjoyed herself to the fullest yet, and there were still many questions in her heart that she hadn't asked, such as the title "brother-in-law-to-be".

"I'm not just trying to get him to see the dentist."

Qin Xiao got up and held Qiao Tan's hand, and said what she was eager to ask, "I want to be Xiaojian's future brother-in-law, do you agree?"