Aim ToconstructHEK293cellsstablyex-pressing corticotropin releasing factor receptor 1 ( CRFR1 ) , and evaluate its function by the cAMP as-say.Methods CulturedHEK293cellsweretransfect-ed with CRFR1-expressing vector by Lipofectamine 2000 and were selected by using G418 . CRFR1 ex-pression was detected by Western blot, RT-PCR and immunofluorescence.Results Westernblot,RT-PCR and immunofluorescence data revealed that the HEK293 cells expressed CRFR1 protein stably. The dose-responsive relationship experiment revealed that CRF induced a CRFR1-mediated cAMP production in HEK293 cells with EC50 =(5. 64 ± 0. 05) × 10 -10 mol ·L-1.Conclusion HEK293celllinesstablyex-pressing CRFR1 were constructed successfully, which would provide a cellular model to facilitate the research on the biological function of CRFR1 and CRFR1-targe-ted drug screening.

Objective:To improve the knowledge on propythiouracil(PTU)-induced antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis.Methods:6 cases of PTU-induced ANCA-associated vasculitis were analyzed on clinical manifestation,laboratory and biopsy findings,therapy and prognosis.Results:All patients with Grave's disease had been treated with PTU from 2 months to 7 years suffered from ANCA-associated vasculitis, which can also appear after withdrawal of PTU. Clinical manifestations are different with only skin, joint, muscle involvements on mild cases or lung, renal and hematological involvement on severe cases. Sera from all patients were anti MPO-ANCA positive. All patients responded to withdrawal of PTU and administration of prednisone and immuno-suppressants well with ANCA declined or turned to negative.Conclusion:PTU can induce ANCA-associated vasculitis in the part of which lung and kidney can be seriously involved. Early withdrawal of PTU and administration of immunosuppressive agents might improve the prognosis.

Alzheimer′s patients bring heavy burden to their family and society, causing potential safety prob-lems unable to escort for a long time with the family, physical constraints between protection and between self-es-teem and the mental health law,the quality of life and life values produce a series of contradiction and ethical is-sues,also make close contact with their nursing staff have to face the moral and ethical dilemma.The suggestions are:Hospital provides professional full-time, professional pension caregivers of alzheimer′s patients for long-term care, Strengthen the communication of nursing staff and patients′families, Reasonable and legitimate use tools, Perfect medical system construction, buildMedical support combinedcare system, Carry out the comprehensive rehabilitation nursing intervention, improve the patients quality of life, Change service concept, strengthening the study of ethical knowledge and application to promote the doctor-patient relationship.

Objective To explore the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of subserous myoma (SM) and ovarian fibroma.Methods CEUS was performed on 58 patients with SM and 26 patients with ovarian fibroma.The enhancement pattern was observed.The diagnostic performance was evaluated by using diagnostic test.Results SM exhibited homogeneous isoenhancement synchronously with the myometrium in early phase.In the late phase,the pseudocapsule remained hyper-enhancement with obvious membraniform sign.Some myomas showed the feeding artery from uterus.Ovarian fibroma demonstrated hyper-enhancement at the periphery portion and hypoenhancement inside.Conclusions The SM and ovarian myomas showed different enhancement patterns,which may provide us some exact information in the differential diagnosis between the two diseases.

ObjectiveTo assess the diagnostic performance of contrast-enhanced ultrasound(CEUS)in characterization of adnexal masses in comparison with baseline ultrasound.MethodsOne hundred and thirty-seven masses were examined by CEUS and baseline ultrasound.Two independent investigators reviewed the images before and after contrast agent administration.The diagnostic performances were evaluated using receiver operating characteristic (ROC) analysis and the interobserver agreement was analyzed.ResultsAfter review of CEUS,ROC analysis revealed significant improvement in differentiating between malignant and benign pelvic masses that the areas under the ROC curve were 0.731 and 0.738 at baseline ultrasound versus 0.891 and 0.903 at CEUS ( P ＜0.01 ).The accuracy for both investigators also improved significantly after reviewing CEUS.A better interobserver agreement was achieved after reviewing of CEUS (g =0.681 at baseline ultrasound versus κ =0.893 at CEUS) and a better result of specific diagnosis was obtained (73.2％ and 74.2％ at baseline ultrasound versus 90.7％ and 91.2％ at CEUS)(all P ＜ 0.01 ).Conclusions Real-time CEUS improves the diagnostic performance in adnexal masses for discrimination between malignancy and benignity and improves the capability in specific diagnosis compared with baseline ultrasound.

Objective To assess the diagnostic performance of contrast-enhanced ultrasound in characterization of pelvic masses.Methods Contrast-enhanced ultrasound was performed on 137 patients with pelvic masses.The results were compared to pathological diagnostic criteria.The diagnostic performance was evaluated by using diagnostic test.Results Sensitivity,specificity,positive predictive value,negative predictive value,accuracy and area under ROC curve in diagnosing complex pelvic masses by using contrast-enhanced ultrasound were as follows:85.3％ (29/34),93.2％ (96/103),80.6％ (29/36),95.0％ ( 99/101 ),91.2％ ( 125/137 ),0.892,respectively.Conclusions Contrast-enhanced ultrasound provides a simple and curate method for characterization of pelvic masses.

Objective To explore the value of contrast-enhanced ultrasound(CEUS)in the differential diagnosis of endometrial carcinoma and endometrial hyperplasia.Methods Forty-five patients with endometrial carcinoma and 21 patients with hyperplasia were studied by CEUS.Twenty-four normal women were enrolled as contrast group.Results In normal uterus, myometrium exhibited earlier enhancement later washout than the endometrium.Similar phenomenon was observed in patients with hyperplasia.In patients with endometrial carcinoma,the lesion showed wash-in and washout earlier, at least not later than the myometrium.Conclusions Endometrial carcinoma and hyperplasia showed different enhancement patterns,which may be helpful for the diagnosis of the two diseases.

Objective To investigate the contrast enhanced ultrasound(CEUS)features of ovarian tumor torsion(OTT).Methods Seventeen cases with OTT were evaluated using CEUS.CEUS was performed with low mechanical index and the contrast agent of Sono Vue.Results Thirteen cases with total torsion of ovarian tumor appeared as no enhancement.Four cases with partial torsion showecl hyperechoic enhancement in the early phase and hypoechogenicity in the late phase.Conclusions The enhancement of OTT has characteristic,which would be helpful for the diagnosis and differential diagnosis of OTT.

Objective To investigate the application value of transperineal ultrasound in female urethras and pathological change of circum-urethras.Methods 403 female patients were examined by transperineal ultrasound in condition of resting and maximum Valsalva,female urethras and pathological changes of circum-urethras were observed and ultrasonic manifestation were concluded.Results By transperineal ultrasound the images of normal urethras and pathological change of circum-urethras were clearly discernible.403 female patients were examined,380 normal.18 urethral calcification,there was hyperecho stripe in urethras.2 urethral cyst,there was round anechoic area in circum-urethras and no fistula between round anechoic area with urethras.2 urethral diverticulum,there was round anechoic area in circumurethras and a fistula between round anechoic area with urethras.1 urethrovaginal fistula,there was irregular hypoechoic area between urethras with vagina,the irregular hypoechoic area both communicate with urethras and vagina.Conclusions Transperinealr ultrasound can be used for examination urethras and pathological change of circum-urethras in female patients and may provide more reliable information for clinical diagnosis.

Objective To investigate the application value of transperineal ultrasound in female patients with cystocele.Methods Transperineal ultrasound were performed in 36 female patients with cystocele and the bladder neck movement degrees (BND),retrovesical angle and the degree of urethral rotation were observed at maximum Valsalva.The ultrasonic manifestation of 36 female patients with cystocele were summarized.Results On maximal Valsalva bladder neck mobility all increased in 36 patients,32 patients with open retrovesical angle (≥140°) and 30 female patients with urethral rotation ≥ 45°.There were 6 cases with type Ⅰ,bladder neck was lower than inferoposterior margin of the symphysis pubis,cystocele with open retrovesical angle (≥140°) and urethral rotation ＜45°.There were 26 cases with type Ⅱ,bladder neck was lower than inferoposterior margin of the symphysis pubis,cystocele with open retrovesical angle (≥140°) and urethral rotation ≥45°.There were 4 cases with type Ⅲ,bladder was lower than inferoposterior margin of the symphysis pubis,cystocele with intact retrovesical angle (＜ 140°) and urethral rotation ≥45°.Conclusions The transperineal ultrasound can be used for classification of cystocele in female patients and which may provide more reliable information for clinical diagnosis.