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2016 Vol. 46, No. 11 Published: 2016-11-25   781 Analysis of the characteristics of gene seguence of human cytomegalovirus US31 and predication of B cell epitopes GUO Gangqiang, XIE Shangdan, YE Sisi, SUN Xiangwei, ZHANG Liang, ZHANG Lifang, XUE Xiangyang Objective: To analyze the sequence of human cytomegalovirus US31 gene and predict the B cell epitopes of US31 protein. Methods: The hydrophilicity, accessibility, antigenicity and flexibility index were used to predict the potential B cell epitopes of protein based on the US31 amino acid sequence. Results: Most amino acid sequence of US31 was highly conserved  while only a few strains had variation, and most of them were sense mutation. HCMV pUS31 contained 162 amino acid residues, the relative molecular mass was 20 kD and the isoelectric point was 7.66. It’s a soluble protein and its secondary structure occurred more frequently as random coil region. The predicted B-cell epitopes of the pUS31 might exist at N-terminal of amino acid sequence: 5~19, 32~47, 58~68, 110~124. Conclusion: The B-epitopes of pUS31 are predicted successfully, which provides a theoretic  basis for the further study of protein characteristics, development of epitopes based vaccine, and preparation of monoclonal antibody against fusion protein. 2016 Vol. 46 (11): 781-786 [Abstract] ( 923 ) HTML (1 KB)  PDF (1866 KB)  ( 1247 ) 787 Preliminary application of a new series of endoscopic instruments for endoscopic anterior transcervical odontoidectomy LIN Zhongke, JIN Haiming, WANG Xiangyang, WU Aimin, CHI Yonglong. Objective: To overcome the drawbacks of the current instruments, a series of novel endoscopic instruments was designed and its feasibility in endoscopic transcervical odontoidectomy was assessed. Methods: In 1 fresh frozen adult cadaver, the series of novel endoscopic instruments was applied for endoscopic transcervical odontoidectomy. Sixteen formalin-fixed adult cadavers were randomly divided into two groups (the experimental group and the control group). In the experimental group, the series of novel endoscopic instruments was applied. And in the control group, conventional surgical instruments were applied. Cooperating between the instruments in left and right anterior transcervical approaches, all the 16 formalin-fixed cadavers underwent endoscopic transcervical odontoidectomy. The operating time and X-ray exposure frequency of the two groups were recorded. Results: In all cadavers, the anterior arch of atlas and odontoid were successfully resected. The expected advantages of the series of novel endoscopic instruments were achieved. Compared with the control group, the experimental group showed superiority in the operating time and X-ray exposure frequency. Conclusion: The series of novel endoscopic instruments can overcome the drawbacks of the current instruments for endoscopic cervical surgery. Cooperating between the instruments in left and right approaches, the series of novel endoscopic instruments can reduce the operating time and X-ray exposure frequencies, and can make the operation safer, more convenient and more accurate. 2016 Vol. 46 (11): 787-792 [Abstract] ( 616 ) HTML (1 KB)  PDF (1931 KB)  ( 858 ) 793 Effect of different arterial blood collecting methods on the accuracy of blood gas analysis in mice WU Peiliang, WANG Liangxing, HUANG Xiaoying. Objective: To explore ideal arterial blood collecting method in order to monitor blood gas analysis. Methods: Ninety male Balb/c mice were randomly divided into three groups: carotid artery cannula group, celiac artery puncture group, and cardiac punture group. 0.5-1.0 mL arterial blood samples were collected from carotid artery, celiac artery and left ventricle. These samples were tested in a Radiometer ABL90 Flex blood gas analyzer (Radiometer, Denmark) at 37 ℃ for pH, PaO2, SaO2, hemoglobin concentration tHb, oxyhemoglobin O2Hb, base excess cBase, standard bicarbonate SBC, P50, carboxyhemoglobin (COHb), reduced hemoglobin (RHb), K+, Na+, Cl-, Ca2+, as well as lactate and glucose concentrations. Results: There was significant difference in success rate, either in operative incision length or collection time among the three groups. Compared with the carotid artery cannula and celiac artery puncture group respectively, the parameters of PO2, SaO2, O2Hb were decreased, while RHb was significantly increased in cardiac punture group (P<0.05). And cBase, tHb in cardiac punture group were sharply lower than those in celiac artery puncture group (P<0.05). Increased K+ concentration, decreased Na+, Cl- concentration were found in the celiac artery puncture group compared with other two groups (carotid artery cannula group and cardiac punture group) (P<0.05). The concentrations of lactic acid, glucose in celiac artery puncture group were higher than those in carotid artery cannula group (P<0.05). Conclusion: Carotid artery cannula is a good and feasible method for arterial blood collecting, by which blood gas analysis, electrolytes and energy metabolism can be detected more accurately. 2016 Vol. 46 (11): 793-797 [Abstract] ( 1336 ) HTML (1 KB)  PDF (1554 KB)  ( 1480 ) 798 Data analysis of virulence factors in uropathogemic Escherichia coli NB8 by whole genome sequencing WENG Xingbei, MI Zuhuang, WANG Chunxin, ZHU Jianming. Objective: To investigate virulence factors and pathogenic mechanisms in uropathogemic Escherichia coli (UPEC) NB8. Methods: UPEC NB8 was collected from urine sample of an inpatient in Ningbo First Hospital, in April, 2012. Sequencing gyrA and parC, BLASTn algorithm were performed to identify E.coli. Then, whole genome were sequenced by Illumina HiSeq and Ion Torrent PGM, and PCR was performed to fill gaps. Data mining of virulence factors were performed, and comparative genomics of virulence factors in NB8 and 9 strains of UPEC after whole genome sequencing were performed. Results: By whole genome sequencing, a putative chromosome sequence (14 gaps inside) was 4 550 369 bp, a putative plasmid sequence (33 gaps inside) was 635 377 bp. Some classes of virulence factors were positive in NB8, including adhesion (adhesin, type P fimbriae, type I fimbriae, Escherichia coli common pilus), iron uptake(aerobactin, heme, enterobactin), protease (secreted autotransporter toxin), toxin (hemolysin), Ag43, SHI-2 pathogenicity island protein. Conclusion: Virulence factors in UPEC NB8 played an important role in adhesion, invasion, cell viability, cell toxicity, and contribute to enhance the survival and virulence of the bacteria, so lead to urinary tract infection. Whole genome sequencing technology has the advantages of high speed, high throughput, low cost and high efficiency, which is worth of promoting. 2016 Vol. 46 (11): 798-806 [Abstract] ( 728 ) HTML (1 KB)  PDF (1691 KB)  ( 1320 ) 807 Nucleos(t)ides antiviral therapy and the changes of serum HBsAg and HBcrAg levels in patients with chronic hepatitis B LI Jian, LU Wei, ZHANG Zhanqing, WANG Yanbing, WENG Qicheng, ZHANG Zhiyong, DING Rongrong, ZHOU Xinlan Objective: To investigate the changes of serum hepatitis B surface antigen (HBsAg) and hepatitis B core-related antigen (HBcrAg) levels in patients with chronic hepatitis B treated with nucleos(t)ides antiviral therapy. Methods: One hundred and eight patients of chronic hepatitis B patients were enrolled in this study, 46 patients and 20 patients of HBeAg-positive patients respectively were divided into the antiviral group and the non-antiviral group, 31 patients and 11 patients of HBeAg-negative patients respectively were into the antiviral group and the non-antiviral group. Serum HBsAg and HBcrAg levels were respectively detected by chemiluminescence microparticle immunoassay and chemiluminescence enzyme immunoassay. Results: In both HBeAg-positive and HBeAg-negative patients, the differences of the follow-up time between antiviral and non-antiviral group were no statistically significant (P>0.05); the differences of serum HBsAg and HBcrAg levels between the follow-up start and the follow-up end were statistically significant in antiviral group (P<0.05), and which of serum HBsAg and HBcrAg levels between the follow-up start and the follow-up end were not statistically significant in non-antiviral group (P>0.05); the differences of serum HBsAg levels decline extent and proportion from follow-up start to the follow-up end between antiviral and non-antiviral group were not statistically significant (P>0.05), and which of HBcrAg decline extent and proportion from follow-up start to the follow-up end between antiviral and non-antiviral group were statistically significant. Conclusion: The antiviral therapy of CHB patients can lead to the significant decrease of serum HBsAg and HBcrAg levels, but can only get the significant decline extent and proportion of serum HBcrAg. 2016 Vol. 46 (11): 807-812,817 [Abstract] ( 917 ) HTML (1 KB)  PDF (2892 KB)  ( 1538 ) 813 Effect of the measles vaccination taken by women of childbearing age on the measles antibody and measles vaccination of their infants Xia Chan, Liu Qi, Wen Zhengwang, Dong Lei, Lin Hailong Objective: To study the dynamic changes of the measles antibody in infants born to women who were vaccinated against measles, and to understand the effect of measles vaccination on the infants. Methods: This study was performed from January 01, 2012 to December 31, 2012 on 300 women of childbearing age. The infants born to these women were divided into the following 4 groups in a randomized and controlled trial (RCT) for measles IgG antibody detection: High antibody non-vaccination group (Group I, 52 cases), High antibody vaccination group (Group II, 53 cases), Low antibody non-vaccination group (Group III, 98 cases), and Low antibody vaccination group (Group IV, 97 cases). Group I and Group III were not vaccinated, while Group II and Group IV were vaccinated with the measles-mumps-rubella vaccine. In all cases, the expectant mothers had the IgG antibodies. All the infants showed IgG antibodies at birth and at the age of 8-and-half months and at 3 months after vaccination. Moreover, measles IgM antibody was detected within half a month after vaccination. A correlation analysis of the level of measles IgG antibody in the infants at birth and the expecting women of childbearing age was performed to study the dynamic changes in the IgG antibody and the IgM antibody levels in infants. Results: There was a significant correlation between the antibody level of the expectant women of childbearing age and the infants at birth (r=0.85). The results of repeated measures analysis showed that there were significant differences in the changes of IgG levels between Group I and III and Group II and IV (all P=0.00), while there was no significant difference between Group I and III and Group II and IV (P=0.11 and P=0.45). At 3 months after inoculation, the groups were compared and F=1.36 and P=0.26, which indicated that there was no significant difference in the time between the groups. The trend chart of IgG antibody showed that the level of infants’ measles fetal transmission antibody decreased gradually with time, and increased at 3 months after vaccination. The ratio of the IgM sample/clinical value of infant measles (S/CO value) of all the groups was analyzed by single factor analysis of variance, and no significant difference was found between each group (F=0.95, P=0.42). Conclusion: The findings of this study show that infants of women of childbearing age who undergo measles vaccination have sufficient protective antibodies before their vaccination, and these antibodies do not affect their measles vaccination. 2016 Vol. 46 (11): 813-817 [Abstract] ( 623 ) HTML (1 KB)  PDF (1313 KB)  ( 878 ) 818 Application of ultrasound-guided anterior approach to sciatic nerve block and femoral nerve block for patients with fracture surgery below the knee joint Wang Quanguang, CHEN Limei, LIU Le, SHI Kejian, ZHANG Xuezheng, XU Xuzhong. Objective: To compare the clinical effects of anesthesia and postoperative analgesia for patients with below-knee fracture surgery between ultrasound-guided anterior approach to sciatic nerve block combined with femoral nerve block and epidural anesthesia. Methods: Sixty patients undergoing below-knee surgery were randomly divided into two groups, group A (n=30) and group B (n=30). Patients in group A underwent ultrasound-guided anterior approach to sciatic nerve block combined with femoral nerve block. Patients in group B underwent epidural anesthesia. The onset time, duration of sensory block and operation time were recorded. Visual analogue scales (VAS) were used to score the pain intensity during anesthesia operation of the swing position and 48 h postoperatively. The mean arterial pressure and heart rate were measured in the perioperative period. The time of first foodintake of patients after operation , the side effects (vomiting, pruritus and urinary retention) within 48 h postoperatively and satisfaction intensity of patients were also noted. Results: The duration of sensor nerve block of femoral nerve and sciatic nerve was longer in Group A. The nerve block group also reduced the pain intensity during position changes for anesthesia. The mean arterial pressure was decreased more significantly in group B at the time of 15 min, 30 min and 45 min after anesthesia. Group A significantly decreased urinary retention incidence (P<0.05) and the time of first food-intake (P<0.001). Conclusion: For patients with below-knee fracture surgery, ultrasound-guided anterior approach to sciatic nerve block combined with femoral nerve block can provide better intraoperative and postoperative pain control, fewer complications and improve the overall patient satisfaction. 2016 Vol. 46 (11): 818-821,825 [Abstract] ( 677 ) HTML (1 KB)  PDF (2532 KB)  ( 1146 ) 822 The clinical value of MRI whole body diffusion weighted imaging in diagnosis of multiple myeloma#br# ZHANG Zhijing, ZHENG Wenlong, DUAN Weimin, MAO Chuanwan, YU Zhikang, YAN Zhihan, WU Aiqin. Objective: To investigate the application value of MRI whole body diffusion weighted imaging (WBDWI) in diagnosis of multiple myeloma. Methods: Twenty one patients with multiple myeloma were underwent WBDWI by GE Signa HDxt 3.0T MR scaner. The positive results were diagnosed and analyzed by double-blind method, and the apparent diffusion coefficient (ADC) values of the lesions were measured on ADC imaging. Results: The diffuse infiltration of bone marrow were demonstrated in all cases of multiple myeloma on WBDWI images. The lesions mainly occurred in the sternum, ribs, vertebrae, pelvis and upper segment of the femur. The lesions showed mottled and patchy hyperintensity on MIP imaging, hypointensity on flipped imaging and ADC imaging. Of 7 cases with follow-up examination after treatment, 6 cases showed that the number of lesions reduced and the signal intensity decreased on MIP imaging, and the ADC values increased. Conclusion: As a new functional MR imaging technology, WBDWI has some application value in diagnosis and therapy evaluation of the multiple myeloma. 2016 Vol. 46 (11): 822-825 [Abstract] ( 699 ) HTML (1 KB)  PDF (1502 KB)  ( 1117 ) 826 The feasibility of ultrasound-guided C7 approach for stellate ganglion block LIN Hai, Wang Jiao, Li Pei, Peng Yu, Jin Yuan, Zhang Junkai, Pi Zhibing. Objective: To investigate the feasibility of ultrasound guided antero-lateral approach of stellate ganglion block at C7 level. Methods: Infiltration site by methylene blue was observed after stellate ganglion block underwent by ultrasound on the cadaver. Meanwhile, 20 in-patient cases who underwent ultrasound guided stellate ganglion block at C7 level were included. After administration of 4 mL (mixed with contrast agent) local nacrotic drug followed by 3D-CT reconstruction, the diffusion range, therapeutic effect and complications were recorded. Results: When injecting into the space between inferior of prevertebral fascia and anteriolateral of longus colli muscle at C7 level, methylene blue had satisfactory infiltration on sympathetic trunk in autopsy. 3D-CT reconstruction  showed that 4 mL of local nacrotic drug could spread to C3-T1 and even to T2 level. Ultrasound guided stellate ganglion block at C7 level showed perfect effect without failure, as well as 1 case of transient hoarseness. Conclusion: Ultrasound-guided stellate ganglion block at C7 level was a safe and effective approach. 2016 Vol. 46 (11): 826-829 [Abstract] ( 690 ) HTML (1 KB)  PDF (1609 KB)  ( 1086 ) 830 Clinical analysis of 165 cases whose bronchoalveolar lavage fluid bacterial culture were positive LI Haiyan, YU Lu, YE Leping, YANG Jinhong, DONG Lin, LI Changchong. Objective: To investigate the clinical characteristics, pathogen spectrum and antibiotic drug sensitive test of patients whose bronchoalveolar lavage fluid culture were positive. To provide the theory basis for clinical diagnosis and treatment for lower respiratory infection in children. Methods: A retrospective review was performed on 1 159 hospitalized cases from January 1, 2013 to December 31, 2015. The information of the patients whose BLAF were sent to lab including clinical data, bacterial culture and drug sensitivity was analyzed. Results: The bacterial culture of BALF in 165 cases were positive, among whom 99(60.0%) were male and 66(40.0%) female. Overall, 70.4% cases were suffered from pneumonia, especially bronchopneumonia. 19 cases (11.5%) were diagnosed as bronchiolitis and combined with bacterial infection. And 12 cases (7.3%) had protracted bacterial bronchitis. One hundred and sixty five organisms from BALF were collected in the survey period, including 112(67.9%) gram-positive bacteria and 53(32.1%) gram-negative bacteria. The five most frequently isolated pathogens were Streptococcus pneumoniae (102 strains), Haemophilus influenza (14 strains), Pseudomonas aeruginosa (13 strains), Escherichia coli (8 strains) and Straphylococcus aureus (8 strains). Sixty five cases (39.4%) had underlying disease and the most common one was deformity of respiratory tract (22 cases) such as malacia, stenosis of trachea or bronchus. There were 14 cases suffered from bronchial asthma. Among 102 Streptococcus pneumoniae strains, there were 25 strains penicillin-sensitive S. pneumoniae, 35 strains penicillin-intermediate S. pneumonia and 42 penicillin-resistant S. pneumonia. Most Staphylococcus aureus strains were methicillin-resistant and there was no vancomycin and linezolid-resistant strain. The drug resistant rates of Haemophilus influenzae to penicillin and the second generation of cephalosporin were high. However, it was sensitive to the third generation of cephalosporin. There were 8 strains of Escherichia coli and five strains produced extended spectrum β-lactamase (ESBL). And 3 of 5 strains of Klebsiella pneumonia were ESBL positive. Conclusion: The most common diagnosis of patients whose bronchoalveolar lavage fluid culture were positive was pneumonia, followed with bronchiolitis which combined with bacterial infection and protracted bacterial bronchitis. The predominant bacteria were Streptococcus pneumonia and Haemophilus influenza. 2016 Vol. 46 (11): 830-834,839 [Abstract] ( 821 ) HTML (1 KB)  PDF (2318 KB)  ( 969 ) 835 Early diagnostic value of DWI in neonatal cerebral infarction XU Wen, ZHOU Yongjin, HUANG Xiaoyan, LIU Kun, ZHANG Siyu, ZHU Yaxin, YANG Di, YAN Zhihan. Objective: To explore the clinical feature and the applied value of diffusion weighted imaging (DWI) in neonatal cerebral infarction (NCI). Methods: The imaging studies and clinical records of eight newborn infants with cerebral infarction were reviewed. All patients underwent conventional MRI and DWI examination, seven patients had a follow up, three patients received a follow-up conventional MRI and DWI scan.  Results: All the patients were full term infants, 4 patients had perinatal risks. Seven patients presented seizure as their major symptoms. All cases were misdiagnosed before MRI examinations. Five cases were in acute phase, 2 cases in sub-acute phase, and 1 case in chronic phase. All patients had unilateral infarction, the cortices was involved in 5 cases, the basal ganglia regions in 4 cases, periventricular areas in 2 cases, and the centrum semiovale in 1 case. The infarction areas showed hyperintensity on DWI in acute phase, and showed hypointensity in sub-acute and chronic phase. At follow-up, 7 cases had good prognosis, and the lesions of 3 cases showed persistent hypointensity on DWI. Conclusion: Seizure is the most common primary symptom of NCI, it is easily misdiagnosed without imaging studies, and the definite diagnosis requires early MRI examination. DWI can show the infarction and involvement areas in acute state, and this will provide important clue for the prognostic prediction. 2016 Vol. 46 (11): 835-839 [Abstract] ( 638 ) HTML (1 KB)  PDF (3432 KB)  ( 912 ) 840 Observation on the curative effect of tandospirone for the male sexual dysfunction induced by paroxetine WANG Weiqian, ZHAO Yongzhong, DU Songmei, YANG Chuang Objective: To investigate whether tandospirone can cure the male sexual dysfunction caused by paroxetine. Methods: Patients with the single treatment of paroxetine for more than 3 months were selected, evaluation of HAMA, HAMD-17 was adopted, HAMA score <7 points and HAMD score<7 points were choosed in the rehabilitation period patients, then Arizona Sexual Experience Scale (ASEX) was used. Eighty four patients whose ASEX score>19 were randomly divided into two groups, with 30 mg/d and 60 mg/d of tandospirone of each group. ASEX, IIEF-5 and sex life quality questionnaire (mSLQQ-QoL) before treatment were evaluated, treatment for 4 weeks and 8 weeks. The scale before and after treatment and the scale between groups were contrasted. Results: Compared with the total score of mSLQQ-QoL, the two groups’ total average in 4 weeks and 8 weeks all had been significantly increased (P<0.05), the two groups’ increased of total score of 30 mg/d and 60 mg/d had been significantly increased (P<0.01); comparison on the cure rate of sexual dysfunction, the 30 mg group was 56%, the 60 mg group was 62.5%, the two groups had no significant difference (x2=0.21, P=0.64). Conclusion: Tandospirone cure the sexual dysfunction caused by paroxetine has a certain therapeutic effect, and there is a certain dose-effect relationship. 2016 Vol. 46 (11): 840-842,845 [Abstract] ( 1075 ) HTML (1 KB)  PDF (2304 KB)  ( 1384 ) 843 Correlative evaluation between the volume of postcaesarean section scar defects after cesarean section and abnormal uterine bleeding by transvaginal three-dimensional ultrasound LAN Li, TANG Feiyun, YUE Ting, ZHENG Huamin, ZHENG Lei, ZHOU Menglin. Objective: To explore the correlation between the size of post-caesarean section scar defects (PCSD) after cesarean section and abnormal uterine bleeding by transvaginal three-dimensional ultrasound. Methods: Seventy two patients with PCSD of ultrasound images with regard to the PCSD of deep muscle layer ratio, volume of the diverticulum, width, height and length were analyzed, compared with the parameters of PCSD in the normal group and the abnormal utrine bleeding group. Results: All patients in this group with PCSD were found by transvaginal three-dimensional ultrasound examination. The abnormal uterine bleeding group was greater than the normal menstruation group in regard of PCSD of deep muscle layer ratio, volume of the diverticulum, width, height and length (P<0.05). By multivariate logistic regression analysis, PCSD volume was the risk factor for abnormal uterine bleeding after cesarean section (OR=2.211, P<0.01). Conclusion: Transvaginal three-dimensional ultrasound can reconstruct the volume of selected sections of PCSD, which is a risk factor for abnormal uterine bleeding. 2016 Vol. 46 (11): 843-845 [Abstract] ( 643 ) HTML (1 KB)  PDF (1302 KB)  ( 986 ) 846 The prognostic factors of affecting intrauterine pregnancy of heterotopic pregnancy treated by surgery WAN Xiaojie, ZHENG Feiyun. Objective: To study the prognostic factors of affecting intrauterine pregnancy of heterotopic pregnancy treated by surgery. Methods: Thirty patients with heterotopic pregnancy treated by surgery from June 2013 to June 2015 in our hospital were included, the prognostic factors of affecting intrauterine pregnancy were analyzed by chi-square test and Logistic regression analysis. Results: Thirty patients were treated with surgery, 12 cases were full-term birth (newborns without deformity), 18 cases embryonic development were stoped, the difference of the effect of pelvic adhesion degree and the operation time on survival rate of intrauterine pregnancy was statistically significant. The survival rate of intrauterine pregnancy is not to do with  patients’ age, transplanting time, pelvic blood, the size of ectopic pregnancy bag, operation method and way of anesthesia. Conclusion: The related factors affecting the survival rate of intrauterine pregnancy are pelvic adhesion degree and operation time. For patients with heterotopic pregnancy, whaterver the operation taken, the pelvic adhesion is light, the operation time is short, the survival rate of intrauterine pregnancy is higher. 2016 Vol. 46 (11): 846-848 [Abstract] ( 685 ) HTML (1 KB)  PDF (1247 KB)  ( 810 ) 849 Clinical significance of CA-125 and CA19-9 levels in spontaneous ruptured ovarian endometrioma HUANG Min, LIN Feng, ZHENG FeiYun. Objective: To explore the clinical roles of serum CA-125 and CA19-9 in women with spontaneous ruptured ovarian endometriomas. Methods: Retrospective data were collected from 50 women who were diagnosed as spontaneous ruptures ovarian endometriomas from January 2006 to October 2015. In addition, 70 women diagnosed with unruptured ovarian endometriomas were chosen to serve as control subjects. Serum CA-125 and CA19-9 levels, together with the clinical materials, were collected. Results: Serum CA-125, CA19-9, and the combined biomarkers were shown to be obviously elevated in the spontaneous ruptured ovarian endometrioma group (P<0.05). The AUC value of CA-125 was 0.966 (95%CI: 0.937-0.995), the sensitivity and specificity were 86.8%, 95.4%, and AUC value of CA19-9 was 0.939 (95%CI: 0.884-0.994), the sensitivity and specificity were 93.5% and 89.4%, respectively. The AUC value for the combined biomarkers was 0.992 (95%CI: 0.981-1.000), with a high sensitivity and specificity of 99.9% and 93.6%, respectively. Moreover, The diameter of the tumor in the rupture group (7.78±3.12) cm was greater than that in the non rupture group (5.80±1.63) cm (P<0.05). Conclusion: Serum CA-125 and CA19-9 are significantly increased in the patients with spontaneous ruptured ovarian endometriomas. Moreover, the combined CA-125 with CA19-9 is better than alone in the diagnosis of a spontaneous ruptured ovarian endometrioma. 2016 Vol. 46 (11): 849-852 [Abstract] ( 721 ) HTML (1 KB)  PDF (1348 KB)  ( 1045 )

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