ObjectiveTo sum up the experience on diagnosis and treatment for patients of hyperthyroidism complicated by thyroid cancer. MethodsBetween 1994 and 2000, 300 hyperthyroidism patients were admitted, among them 12 suffered concomittent thyroid carcinoma and received surgical therapy and pathologic examination. ResultsIn this series thyroid carcinoma occurred in 4%(12/300) in patients with hyperthyroidism, but correct preoperative diagnosis was obtained in only one (3%) of the 300 cases. Bilateral subtotal thyroidectomy was initially performed in all 12 cases with 7 cases undergoing additionally ipsilateral total thyroidectomy when a cancer was identified. Two cases underwent functional cervical clearance of lymph nodes. Postoperative follow-up of 9 mos to 6 years found no recurrence. ConclusionIn patients of hyperthyroidism a thyroid cancer may develop on the background of immunodeficiency and endocrine dysfunction. In patients with hyperthyroidism, a thyroid nodule found perioperatively must be biopsied for frozen section to guide the surgical modality.

OBJECTIVE: To analyze the clinical manifestations of heart, liver and kidney damages in the early stage of COVID-19 to identify the indicators for these damages. METHODS: We analyzed the clinical features, underlying diseases, and indicators of infection in 12 patients with COVID-19 on the second day after their admission to our hospital between January 20 and February 20, 2020.The data including CK-MB, aTnI, BNP, heart rate, changes in ECG, LVEF (%), left ventricular general longitudinal strain (GLS, measured by color Doppler ultrasound) were collected.The changes of liver function biochemical indicators were dynamically reviewed.BUN, UCR, eGFR, Ccr, and UACR and the levels of MA, A1M, IGU, and TRU were recorded. RESULTS: The 12 patients included 2 severe cases, 8 common type cases, and 2 mild cases.Four of the patients presented with sinus tachycardia, ECG changes and abnormal GLS in spite of normal aTNI and LVEF; 1 patient had abnormal CKMB and BNP.On the first and third days following admission, the patients had normal ALT, AST and GGT levels.On day 7, hepatic function damage occurred in the severe cases, manifested by elevated ALT and AST levels.Abnormalities of eGFR, Ccr and UACR occurred in 8, 5 and 5 of the patients, respectively.Abnormal elevations of MA, A1M, IGU and TRU in urine protein were observed in 4, 4, 5, and 2 of the patients, respectively. CONCLUSIONS In patients with COVID-19, heart damage can be identified early by observing the GLS and new abnormalities on ECG in spite of normal aTNI and LVEF.Early liver injury is not obvious in these patients, but dynamic monitoring of the indicators of should be emplemented, especially in severe cases. In cases with normal CR and BUN, kidney damage can be detected early by calculating eGFR, Ccr and UACR and urine protein tests.
Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Humans ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2