Objective To studythe cephalocaudal relationship ofabdominal aortic bifurcation relative toumbilicus and iliac crest vertex and their correlations with abdominal adipose tissue thickness and age. Methods The vertical distances,cephalocaudal relationship and other related anatomic parameters of aortic bifurcation relative to umbilicus and iliac crest vertex in 108 patientswere measured by consecutive abdominal CT scanning. The correlations of the acquired data with abdominal adipose tissue thickness and age were analyzed using Pearson correlation coefficient. Results Umbilicus was located at cephalad to aortic bifurcation in 67 patients(62.0%), caudal in 34(31.4%)andthe same level in 7(6.5%),with the vertical distance of(4.53 ± 17.51)mm to the aortic bifurcation. No statistically significant relationship was found between abdominal adipose tissue thickness(P>0.05) or age(P>0.05). Iliac crest vertex relative to aortic bifurcationwas located at cephalad,caudal and the same level in 31,71 and 6 patients,taking up 28.7%,65.7%and 5.6%,respectively. Its vertical distance to the bifurcation was(-6.34 ± 14.49)mm,nonrelated with abdominal adipose tissue thickness(P>0.05),but positively correlated with age(P<0.01). The difference in the cephalocaudal relationship of aortic bifurcation relative to umbilicus and iliac crest vertex was statistically significant(P<0.01). Conclusion Compared with iliac crest vertex,umbilicus is an important landmark of locating abdominal aortic terminal occlusion position in vitro because it mostly lies cephalad to aortic bifurcation in the front of the body,not easy to vary with abdominal adipose tissue thickness and age.

Objective To investigate clinical characteristics and emergency managements of postrenal acute renal failure(ARV)induced by melamine in infant.Method Fluid therapy for urine alkalization and hydration,cistoscope drainage and peritoneal dialysis step by step were exerted in those who had both a history of certain milk intake and ARF according to the definition of pediatric ARF which developed by Pediatric Nephrology Assembly of Chinese Pediatric Association in 1994.Results Thirty-four postrenal ARF cases with anuria due to melamine in Nanjing Children's Hospital of Nanjing Medical University were involved in the study.Seventy cases(50%)re-ceived fluid therapy only.Nine cases(26.5%)received fluid thempy and eistoscope drainagemand 4 cases (11.8%)received fluid therapy and cistoscope drainage and peritoneal dialysis.Four cases(11.8%)received ur-gent peritoneal dialysis due to severe hyperkalemia.All cases(100%)survived.The urine pH at the first day.the second day,and after the second day in those who just pass away urine were 6.1±1.0、6.5±0.7.5.3±0.4,respectively(F=4.563,P=0.026).Conclusions Fluid therapy for urine alkalization and hydration and stop sequential thempy are effective in infant with postrenal ARF induced by melamine.

OBJECTIVETo analyze the present situation and influencing factors of discrimination against hepatitis B patients and carriers among rural adults in three eastern provinces in China.

METHODSBy using the method of probability proportionate to size (PPS), we involved a sample of 9 269 rural adults aged above 18 years old from 22 villages of 7 counties in Beijing, Hebei, Shandong in 2011 and 2012. We used a self-designed interview questionnaire with questions about the individual and household characteristics, attitudes toward hepatitis B patients and carriers, individual HBV vaccination history, etc. We analyzed the hepatitis B discrimination score and its distribution, and we also created a multinomial logistic regression model to analyze the influencing factors of discrimination.

RESULTSOf all the participants, 51.15% (4 741) were afraid of being infected with HBV when getting on with hepatitis B patients or carriers; 51.29% (4 754), 61.14% (5 667) and 52.22% (4 841) of them were not willing to accept gifts from hepatitis B patients or carriers, have dinner with them, or hug and shake hands with them, respectively; 73.92% (6 852) were unwilling to their children's playing with kids whose parents were hepatitis B patients or carriers, and 86.68% (8 034) were unwilling to their children's marrying hepatitis B patients or carriers. Of all the participants, only 0.88% (82) were totally discrimination-free (discrimination score = 0); mild or without discrimination (< 0 discrimination score ≤ 5) accounted for 23.70% (2 197/9 269); severe discrimination (discrimination score ≥ 6) accounted for 76.30% (7 072). The multiple multinomial logistic regression showed that migratory workers, other occupations like technician, civil servants and village doctors were less likely to show severe HBV-related discrimination compared with farmers, with OR (95% CI) 0.86 (0.75-0.98), 0.77 (0.67-0.87), 0.57 (0.41-0.79), respectively. Compared with the lowest income group (< 10 000 RMB/year per person), and the highest income group (> 40 000 RMB/year per person) had an OR (95% CI) of 0.57 (0.46-0.70). People with higher education tended to show less severe discrimination. The high education group had an OR (95% CI) of 0.64 (0.51-0.80) based on the low education group. And compared with people whose self-assessment of health status was very good, those who assessed their health status as very poor showed less severe discrimination, with an OR (95% CI) of 0.41 (0.25-0.67).

CONCLUSIONThe situation of discrimination against hepatitis B patients and carriers among rural adults in three eastern provinces was serious. It is of great urgency to eliminate the discrimination. Work on eliminating hepatitis B discrimination should focus on farmers, people with low incomes, and people with low educational level.

Adult ; Beijing ; Carrier State ; Family Characteristics ; Health Knowledge, Attitudes, Practice ; Hepatitis B ; psychology ; Humans ; Logistic Models ; Occupations ; Rural Population ; Social Discrimination ; Surveys and Questionnaires

Objective: To summarize the diagnosis and prognosis of adrenocortical carcinoma in children. Methods: Medical records of 10 pediatric patients with adrenocortical cancer treated in Children's Hospital of Nanjing Medical University from September 2010 to March 2018 were retrospectively reviewed, and their clinical manifestation, laboratory, auxiliary, and pathological examination results, and prognosis were analyzed. Results: The average age of all patients (5 male and 5 female pediatric patients) was (53.3+48.4) months. Clinical mani-festations included abdominal mass, hypertension, cortisol level, and peripheral precocious puberty. Laboratory tests showed that lactate dehydrogenase, neuroenolase, and cortisol levels were high in some patients, and sex hormones were abnormal. Auxiliary examination using the abdominal computed tomography enhancement showed irregular an adrenal gland, uneven density, necrosis, mass calcification, and some infiltration into the surrounding tissue. Pathological examination suggests tumor cell pleomorphism, more frequent pathological division, high mitotic index, abundant interstitial sinusoid, necrosis, tumor infiltration, vascular invasion, and Weiss score of≥3 points. Lactate acid dehydrogenase and cortisol levels; Weiss score; and tumor size, staging, and resection rate were not statistically different among prognostic factors. Conclusions: For pediatric patients with adrenal masses, the survival rate should be improved by combining the clinical manifestation, laboratory examination, and auxiliary examination for the early diagnosis of adrenocortical carcinoma and to select the appropriate treatment. Combined with pathological results, adrenocortical carcinoma can be well differentiated from other adrenal masses.

Objective To analyze the present situation and influencing factors of discrimination against hepatitis B patients and carriers among rural adults in three eastern provinces in China. Methods By using the method of probability proportionate to size (PPS),we involved a sample of 9 269 rural adults aged above 18 years old from 22 villages of 7 counties in Beijing, Hebei,Shandong in 2011 and 2012. We used a self-designed interview questionnaire with questions about the individual and household characteristics, attitudes toward hepatitis B patients and carriers, individual HBV vaccination history, etc. We analyzed the hepatitis B discrimination score and its distribution, and we also created a multinomial logistic regression model to analyze the influencing factors of discrimination. Results Of all the participants, 51.15%(4 741)were afraid of being infected with HBV when getting on with hepatitis B patients or carriers;51.29%(4 754), 61.14%(5 667)and 52.22%(4 841)of them were not willing to accept
gifts from hepatitis B patients or carriers, have dinner with them ,or hug and shake hands with them, respectively; 73.92%(6 852)were unwilling to their children's playing with kids whose parents were hepatitis B patients or carriers, and 86.68%(8 034)were unwilling to their children's marrying hepatitis B patients or carriers. Of all the participants, only 0.88%(82)were totally discrimination-free (discrimination score=0);mild or without discrimination (<0 discrimination score≤5) accounted for 23.70%(2 197/9 269);severe discrimination (discrimination score ≥6) accounted for 76.30%(7 072). The multiple multinomial logistic regression showed that migratory workers, other occupations like technician, civil servants and village doctors were less likely to show severe HBV-related discrimination compared with farmers, with OR (95%CI) 0.86 (0.75-0.98), 0.77 (0.67-0.87), 0.57 (0.41-0.79), respectively. Compared with the lowest income group (<10 000 RMB/year per person), and the highest income group (>40 000 RMB/year per person)had an OR (95%CI) of 0.57 (0.46-0.70). People with higher education tended to show less severe discrimination. The high education group had an OR (95%CI) of 0.64 (0.51-0.80) based on the low education group. And compared with people whose self-assessment of health status was very good, those who assessed their health status as very poor showed less severe discrimination, with an OR (95%CI) of 0.41 (0.25-0.67). Conclusion The situation of discrimination against hepatitis B patients and carriers among rural adults in three eastern provinces was serious. It is of great urgency to eliminate the discrimination. Work on eliminating hepatitis B discrimination should focus on farmers, people with low incomes, and people with low educational level.

Objective To analyze the present situation and influencing factors of discrimination against hepatitis B patients and carriers among rural adults in three eastern provinces in China. Methods By using the method of probability proportionate to size (PPS),we involved a sample of 9 269 rural adults aged above 18 years old from 22 villages of 7 counties in Beijing, Hebei,Shandong in 2011 and 2012. We used a self-designed interview questionnaire with questions about the individual and household characteristics, attitudes toward hepatitis B patients and carriers, individual HBV vaccination history, etc. We analyzed the hepatitis B discrimination score and its distribution, and we also created a multinomial logistic regression model to analyze the influencing factors of discrimination. Results Of all the participants, 51.15%(4 741)were afraid of being infected with HBV when getting on with hepatitis B patients or carriers;51.29%(4 754), 61.14%(5 667)and 52.22%(4 841)of them were not willing to accept
gifts from hepatitis B patients or carriers, have dinner with them ,or hug and shake hands with them, respectively; 73.92%(6 852)were unwilling to their children's playing with kids whose parents were hepatitis B patients or carriers, and 86.68%(8 034)were unwilling to their children's marrying hepatitis B patients or carriers. Of all the participants, only 0.88%(82)were totally discrimination-free (discrimination score=0);mild or without discrimination (<0 discrimination score≤5) accounted for 23.70%(2 197/9 269);severe discrimination (discrimination score ≥6) accounted for 76.30%(7 072). The multiple multinomial logistic regression showed that migratory workers, other occupations like technician, civil servants and village doctors were less likely to show severe HBV-related discrimination compared with farmers, with OR (95%CI) 0.86 (0.75-0.98), 0.77 (0.67-0.87), 0.57 (0.41-0.79), respectively. Compared with the lowest income group (<10 000 RMB/year per person), and the highest income group (>40 000 RMB/year per person)had an OR (95%CI) of 0.57 (0.46-0.70). People with higher education tended to show less severe discrimination. The high education group had an OR (95%CI) of 0.64 (0.51-0.80) based on the low education group. And compared with people whose self-assessment of health status was very good, those who assessed their health status as very poor showed less severe discrimination, with an OR (95%CI) of 0.41 (0.25-0.67). Conclusion The situation of discrimination against hepatitis B patients and carriers among rural adults in three eastern provinces was serious. It is of great urgency to eliminate the discrimination. Work on eliminating hepatitis B discrimination should focus on farmers, people with low incomes, and people with low educational level.

Objective To analyze the prognostic factors of adrenal tumor in children under 12 years of age. Methods A total of 90 children with 97 adrenal tumors admitted from June 2006 to August 2017 were selected in Children's Hospital of Nanjing Medical University.The age distribution,tumor type,biochemistry and tumor indicators, treatment,stage classification and prognosis were analyzed.Results There were 46 males and 44 females in 90 cases. Ages ranged from 4 days to 11 years and 1 month,with an average of (38.1 ± 31.3)months.The main clinical mani-festations were abdominal mass,fever and abdominal pain.Eighty cases (82.5%)underwent surgery,while 17 cases (17. 5%)did not.Open resection was performed in 48 cases,open partial resection in 11 cases,laparoscopic surgery in 10 cases,and just biopsy in 11 cases.The pathological examination showed 43 cases with neuroblastoma,13 cases with ganglioneuroblastoma,8 cases with ganglioneuroma,5 cases with adrenocortical carcinoma,3 cases with teratoma,1 case with pheochromocytoma,1 case with malignant rhabdoid tumor.Statistical analysis revealed that neuron－specific eno-lase(NSE)value of neuroblastoma and lactate dehydrogenase(LDH)value of cortical cancer increased significantly. The age was correlated with tumor stage,and patients had older age on stage Ⅳ.Complete resection in surgery was correlated with the stage of the tumor,as tumor in lower tumor stage seemed easier to be completely removed.Fifty－three cases (58.9%)were followed up for 2 months up to 11 years and 4 months.Forty－four cases survived and 9 ca-ses died.Higher tumor stage predicated worse prognosis.Conclusions Adrenal gland tumors need early diagnosis and active treatment.Earlier onset of age,complete surgical resection with patients have better prognosis.Complete resection of the disease was a key factor in the prognosis.