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Objective:To investigate the changes of nitric oxide, endothelin-1 (ET-1), homocysteine (Hcy), C-reactive protein (CRP) levels in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) combined with hypertension and the relationship between the changes and polysomnography monitoring indicators.Methods:A retrospective case-control study was conducted to analyze the clinical data of 115 patients with OSAHS complicated with hypertension, 110 patients with simple OSAHS and 136 healthy persons in Kailuan general hospital and Linxi Hospital of Kailuan general hospital from March 2016 to March 2018. The relationship between sleep related indexes and serological indexes was compared among the three groups.Results:In the control group, simple OSAHS group, OSAHS with hypertension group, the apnea hypopnea index (AHI) was (2.4±0.8), (35.7±12.1), (46.8±13.9) times/h, the lowest oxygen saturation(LSaO 2) was (87.1±6.8) %, (77.8±6.5) %, (66.9±5.1) %, and the mean oxygen saturation(MSpO 2) was (92.7±6.9) %, (80.9±6.7) %, (71.4±6.3) %, and the longest apnea time (LAT) was(4.5±0.7), (48.6±11.3), (58.2±10.4) s. The difference between the three groups was statistically significant ( F values were 637.92, 329.49, 322.96, 1 420.03, respectively, all P<0.05). Nitric oxide in control group, simple OSAHS group and OSAHS combined with hypertension group were (72.8±8.8), (53.7±7.4), (42.6±5.9) μmol/L.Endothelin-1 was(31.1±6.5), (45.4±6.7), (56.6±7.8) ng/L.Hcy was (8.7±1.9), (15.9±6.7), (31.4±6.3) μmol/L.CRP was (1.8±0.6), (18.6±4.3), (25.2±6.4) mg/L.The difference between the three groups was statistically significant ( F valves were 517.46, 419.02, 594.40, 982.14, respectively, all P<0.05). Pearson correlation analysis showed that the levels of endothelin 1, Hcy and CRP in OSAHS patients with hypertension were positively correlated with AHI and LAT (r values were 0.525, 0.704, 0.578, 0.434, 0.464 and 0.449, respectively; all P<0.05), and negatively correlated with LSaO 2 and MSpO 2 (r values were-0.477, -0.458, -0.429, -0.517, -0.534 and -0.617, respectively; all P<0.05). Conclusion:In OSAHS patients with hypertension, nitric oxide decreased, ET-1, Hcy, CRP increased, and polysomnography monitoring indicators were closely related to endothelin-1, Hcy, CRP.
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Echinostoma revolutum is a zoonotic food-borne intestinal trematode that can cause intestinal bleeding, enteritis, and diarrhea in human and birds. To identify a suspected E. revolutum trematode from a red-crowned crane (Grus japonensis) and to reveal the genetic characteristics of its mitochondrial (mt) genome, the internal transcribed spacer (ITS) and complete mt genome sequence of this trematode were amplified. The results identified the trematode as E. revolutum. Its entire mt genome sequence was 15,714 bp in length, including 12 protein-coding genes, 22 transfer RNA genes, 2 ribosomal RNA genes and one non-coding region (NCR), with 61.73% A+T base content and a significant AT preference. The length of the 22 tRNA genes ranged from 59 bp to 70 bp, and their secondary structure showed the typical cloverleaf and D-loop structure. The length of the large subunit of rRNA (rrnL) and the small subunit of rRNA (rrnS) gene was 1,011 bp and 742 bp, respectively. Phylogenetic trees showed that E. revolutum and E. miyagawai clustered together, belonging to Echinostomatidae with Hypoderaeum conoideum. This study may enrich the mitochondrial gene database of Echinostoma trematodes and provide valuable data for studying the molecular identification and phylogeny of some digenean trematodes.
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Melting temperature shift (T(m)-shift) is a new detection method that analyze the melting curve on real-time PCR thermocycler using SYBR Green I fluorescent dye. To establish a T(m)-shift method for the detection of Ancylostoma ceylanicum and A. tubaeforme in cats, specific primers, with GC tail of unequal length attached to their 5′ end, were designed based on 2 SNP loci (ITS101 and ITS296) of the internal transcribed spacer 1 (ITS1) sequences. The standard curve of T(m)-shift was established using the standard plasmids of A. ceylanicum (AceP) and A. tubaeforme (AtuP). The T(m)-shift method stability, sensitivity, and accuracy were tested with reference to the standard curve, and clinical fecal samples were also examined. The results demonstrated that the 2 sets of primers based on the 2 SNPs could accurately distinguish between A. ceylanicum and A. tubaeforme. The coefficient of variation (CV) of T(m)-values of AceP and AtuP was 0.07% and 0.06% in ITS101 and was 0.06% and 0.08% in ITS296, respectively. The minimum detectable DNA concentration was 5.22×10⁻⁶ and 5.28×10⁻⁶ ng/μl samples of AceP and AtuP, respectively. The accuracy of T(m)-shift method reached 100% based on examination of 10 hookworm DNA samples with known species. In the clinical detection of hookworm in 69 stray cat fecal sample, the T(m)-shift detection results were consistent with the microscopic examination and successfully differentiated between the 2-hookworm species. In conclusion, the developed method is a rapid, sensitive and accurate technique and can provide a promising tool for clinical detection and epidemiological investigation of cat-derived hookworms.
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Animals , Cats , Ancylostoma , Ancylostomatoidea , DNA , Freezing , Methods , Plasmids , Polymorphism, Single Nucleotide , Real-Time Polymerase Chain Reaction , TailABSTRACT
Objective To investigate the diagnostic value of Astograph methacholine provocation test in patients with chest tightness variant asthma ( CTVA)??Methods From January 2011 to February 2017,156 patients with CTVA in outpatient or inpatient department of respiratory medicine of Kailuan General Hospital affiliated to North China University of Science and Technology were selected as case group ( chest tightness variant asthma group )??The control group were 361 non?asthmatic patients including interstitial lung disease ( 23 cases), coronary disease ( 157 cases), hypertensive cardiopathy ( 22 cases), myocardiosis (16 cases),congenital heart disease ( 3 cases),rheumatic valvular heart disease (6 cases), central airway disease (3 cases),thyromegaly (10 cases),mediastinal tumor (5 cases),thoracic or spinal deformity (8 cases),phrenoparalysis (2 cases) and vegetative nerve functional disturbance (106 cases)??All participants received pulmonay ventilation test, average daily and nightly variation rate of PEF ( Peak expiratory flow) or PEF weekly variability, Astograph methacholine provocation test ( forced expirataory volume in one second≥70% expectation),and other relevant examinations??The diagnostic value of Astograph methacholine provocation test on CTVA was assessed by analyzing the sensitivity, specificity, positive predictive value,negative predictive value,and Yunden index of Astograph methacholine airway??Results Compared with the control group (( 1??18 ± 0??44)%), theforced expiratory flow from 75% of Forced vital capcacity ( FEF75 ) index of CTVA group (( 1??29 ± 0??50 )%) had significant difference (, t= 2??96, P=0??006)??The sensitivity,specificity,positive predictive value,negative predictive value,Yunden index,and diagnostic accuracy of Astograph methacholine provocation test on CTVA were 0??814,0??695,0??536,0??305, 0??509 and 0??731, respectively??Conclusion The sensitivity, negative predictive value, Yunden index and diagnostic accuracy of Astograph methacholine provocation test on CTVA were higher,whereas the specificity and positive predictive value were relatively lower,suggesting that Astograph methacholine provocation test had a reliable diagnostic value on CTVA,with lower false negative and higher false positive??
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Objective To study the application of combined detection of serum eosinophil cationic protein (ECP) ,C reactive protein (CRP ) and fractional exhaled nitric oxide (FeNO ) in the bronchial asthma . Methods 50 patients of bronchial asthma who received therapy from October 2014 to October 2016 in Tangs-han city union hospital were selected as research objects ,and selected 50 healthy people who received physical examination at the same time in the hospital as control group .The expression of serum ECP and CRP was de-tected by enzyme-linked immunosorbent assay ,and the FeNO concentration was detected using FeNO detec-tor .The expressions of serum ECP ,CRP and FeNO between the bronchial asthma group and the control group were compared ,and the expressions of serum ECP ,CRP and FeNO in patients with different severity of bron-chial asthma were compared ;the bronchial asthma group received 3 months of symptomatic treatment ,The ex-pression of serum ECP ,CRP and FeNO in patients with different therapeutic effects were compared .Results The serum ECP ,CRP and FeNO in the bronchial asthma group [(15 .86 ± 1 .47)ng/L ,(4 .87 ± 0 .52)mg/L , (61 .23 ± 11 .52)ppb]were significantly higher than those in the control group [(6 .62 ± 0 .63)ng/L ,(1 .04 ± 0 .23)mg/L ,(23 .58 ± 3 .40)ppb] ,the difference was statistically significant (P<0 .05) ;The serum ECP ,CRP and FeNO in the acute attack of bronchial asthma[(18 .56 ± 1 .85)ng/L ,(5 .74 ± 0 .70)mg/L ,(66 .93 ± 10 .62) ppb] were higher than those in the remission stage[(12 .34 ± 1 .47)ng/L ,(3 .69 ± 0 .37)mg/L ,(54 .54 ± 8 .02) ppb] ,the difference was statistically significant (P<0 .05) ;The patients with bronchial asthma were treated 3 months later ,clinical control in 28 cases ,partial control in 18 cases ,uncontrolled in 4 cases ,the serum ECP , CRP and FeNO in the clinical control group were significantly lower than those in the partial control group and the uncontrolled group ,the difference was statistically significant (P<0 .05) .Conclusion The combined detection of serum ECP ,CRP and FeNO expression in patients with bronchial asthma is helpful to understand the severity of the disease ,it′s of positive significance in the early diagnosis and treatment of diseases .
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Objective To investigate D-Dimer, C-reactive protein and brain natriuretic peptide in clinical diagnosis of patients with pulmonary embolism and to compare the sensitivity, specificity and accuracy.Methods 45 cases of large area pulmonary embolism and 45 cases of small areapulmonary embolism were selected, at the same time, 45 cases of normal people were selected as the control group.D-dimer, CRP and BNP levels were detected and compared of each group before and after treatment.The relevance between D-Dimer, CRP, BNP levels and pulmonary embolism was analyzed by Logistic analysis.The gold standard of pulmonary embolism with D-dimer test, CRP test and BNP test were compared.the sensitivity, specificity and accuracy ofD-dimer test, CRP test and BNP test wer calculated.Results D-Dimer, CRP and BNP levels of the large area group and small area group were significantly higher than those in the control group before treatment (P<0.05);the D-Dimer, CRP and BNP levels of large area group were significantly higher than those in small area group (P<0.05).After treatment, the D-Dimer, CRP and BNP levels of large area group and small area were significantly decreased (P<0.05), and had no significant difference compared with normal control group.Logistic analysis showed that there was significant positive correlation between plasma, D-Dimer, CRP and BNP levels and pulmonary embolism (r=3.11, P<0.05;r=4.36, P<0.05;r=2.86, P<0.05) .There was no significant difference of sensitivity, specificity and accuracy of three methods.Conclusion There is a positive correlation between the occurrence of pulmonary embolism and D-dimer, CRP, BNP levels, which are important indexs to evaluate the patient's condition, it has very important clinical value.
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Objective: To evaluate the predictive value for baseline levels of high sensitivity C-reactive protein (hs-CRP) in morbidity of pulmonary embolism (PE). Methods: We conducted a prospective cohort study of 101510 subjects in Kailuan Group by regular physical examination from 2006-07 to 2007-10, and 94314 subjects were enrolled by relevant criteria including 75252 male and 19062 female. The baseline levels of hs-CRP were divided by quartile levels as①hs-CRP0.05. As the increased baseline level of hs-CRP, PE occurrence was elevated accordingly,P0.05. WBC counts had the increasing trend in quartile①,②,③ groups and had the decreasing trend in quartile④ group, while it was similar between quartile③ and quartile④ groups,P>0.05. Conclusion: Baseline hs-CRP level may predict the risk of PE morbidity; the increased hs-CRP level could be used as one of the predictors for PE occurrence.
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Objective To analysis the effect of caffeine citrate on pulmonary function, vascular endothelial growth factor (VEGF)and insulin like growth factor -1 (IGF-1) in the apnea syndrome rats.Methods 80 male Wistar rats were selected, 20 were randomly selected to be the control group, the rest of the rats were replicated of apnea syndrome model.The rats were randomly divided into model group, experiment group and positive drug group, 20 of each group.The experimental group was given caffeine citrate injection of 5 mg/kg intraperitoneal injection, the positive drug group was given intraperitoneal injection of aminophylline 3 mg/kg, the model group was given intraperitoneal injection of normal saline, once a day, continuously for 1 week.Pulmonary function, serum VEGF, IGF-1 levels and sleep apnea were compared after the experiment.ResuIts Compared with the positive drug group, the related indexes of pulmonary function of the experimental group increased significantly ( P<0.05 ) .Serum VEGF levels decreased significantly (P<0.05).The serum IGF-1 level increased significantly (P<0.05).The sleep apnea index decreased significantly during the period of NREM and REM.(P<0.05).ConcIusion Caffeine citrate can improve apnea syndrome rats lung function, reduce the serum VEGF level, promote the formation of serum IGF-1, reduce the sleep apnea index.
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Objective To analyze the clinical characteristics and risk factors for adult community-acquired pneumonia (CAP) caused by Gram-negative bacilli in Tangshan, and provide reference for the early identification of Gram-negative bac?teria CAP and the clinical use of antibiotics. Methods Data of retrospective general information, physical examination, aux?iliary examination and pathogen were collected in patients with CAP in respiratory department from 6 hospitals in Tangshan between October 2011 to September 2012. According to the above data, the prognosis of patients with the team score (PORT) was calculated. The sputum samples were isolated for pathogen identification. Univariate logistic regression analysis and multivariate logistic regression analysis were performed for risk factors of Gram-negative bacilli. Results A total of 195 strains were isolated from 172 (32.45%) patients in 530 patients with CAP. There were 154 strains of Gram-negative ba?cilli (78.97%) and 41 strains of Gram-positive bacteria (21.03%) in 195 bacterial strains. Univariate logistic regression anal?ysis showed the possible risk factors of Gram-negative bacilli in patients with CAP including age≥65 years old, using antibi?otics before hospitalization, basic diseases, cerebrovascular disease, malnutrion, white blood cell abnormal, neutrophil count17.1μmol/L and blood urea nitrogen>7.1 mmol/L. Multivariate logistic regression analysis showed the independent risk factors of Gram-negative bacilli in patients with CAP including us?ing antibiotics before hospitalization (OR=2.327, 95%CI 1.453-3.725), white blood cell abnormal (OR=2.904, 95%CI 1.879-4.490), PORT classification≥Ⅲ(OR=3.839, 95%CI 2.427-6.071), and blood urea nitrogen elevated (OR=4.133, 95%CI 2.585-6.606). Conclusion Clinical empirical anti-infection treatment should consider the risk factors including using antibiotics before hospitalization, white blood cell abnormal, PORT classification≥Ⅲ and blood urea nitrogen>7.1 mmol/L in patients with susceptible to Gram-negative bacteria infection.
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Objective To investigate the CT imaging features of pneumonic type Bronchio-loalveolar carcinoma(BAC) and the value of CT-guided percutaneous puncture biopsy in pneumonic type BAC.Methods Twenty-five cases of suspected pneumonic type BAC were biopsied with CT-guided percutaneous puncture.GE 64-slices plain and post contrast CT scans were performed in all patients.Two radiologists finished imaging determination.Site of puncture was selected in suspicious areas of the tumor.The negative pressure aspiration needle were used to be biopsy in the ideal location after vertically into the needle and again performed CT scanning were performed to observe the complications such as hemorrhage,pneumothorax.Specimens were fixed by formalin.Results Twenty-five samples were successfully got from 25 patients.Pathology data showed that 14 cases were pneumonia with BAC,6 cases with pneumonia,2 cases with offungus infection,and 3 cases with caseous pneumonia.Of 14 cases (71.4%) with pneumonia type BAC,CT images of 10 cases showed air bronchogram of lung tissue,5 cases(35.7%) with alveolar gas cavity or cavity of lung tissue,5 cases(35.7%) with ground glass opacity and multiple nodules.Enhanced CT scanning the area of consolidation showed that 11 cases(78.6%) were with mixed low density area angiography and the mean peak time was 90 s,9 cases (64.2%) were with the time density curve of speed up and slow down type.Conclusion The method of CT guided lung biopsy combined with typical imaging findings can enhance early diagnosis rate of pneumonia type BAC.Meanwhile CT feature of pneumonia type BAC shows honeycomb air cavity,void,angiographic sign,dead branches syndrome,multiple peripheral acinar nodules and ground glass density.Enhanced scan area of consolidation shows visible angiogran sign,slow drop type of time density curve of a fast rise.
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Objective To investigate the relationship between polymorphism of interleukin-1β(IL-1β)-31,-511C/T and chronic obstructive pulmonary disease.Methods Two hundred and sixty patients with chronic obstructive pulmonary disease (COPD) were selected as our subjects who were hospitalized in General Hospital of Kailuan from January 2009 to June 2012.At same time,the 260 healthy controls were recruited in medical examine center.The data was collected by the physical examination and a unified questionnaire.Enzyme-linked immunosorbent assay (ELISA) was used to measure the level of IL-1β in serum.Polymerize chain reaction-Restriction fragment length polymorphism (PCR-RLFP) was used to detect the genotypes of IL-1β (-31,-511).Multivariate logistic regression was used to analyze the relations between risk factors with susceptibility of COPD.Results The level of serum IL-1β was (3.92 ± 0.42) μg/L in COPD group,higher than that in control group ((2.69 ± 0.11) μg/L,t =12.889,P < 0.001).The frequency of genotype of IL-1β-31 site in COPD group were 20.8% (54/260) for TT,58.1% (151/260) for CT and 21.2% (55/260) for CC respectively.Meanwhile IL-1β-31 genotype rate were 19.2% (50/260),58.8% (153/260) and 21.9% (57/260) respectively in control group and no significant difference was found between two groups (x2 =0.203,P =0.904).The frequency of genotype of IL-1β-511 site were 20.0% (52/260) for CC,63.1% (164/260) for CT and 16.9% (44/260) for TT in COPD group.The three genotype rate in control group were 21.9% (57/260),60.8% (158/260) and 17.3% (45/260) respectively,and no significant difference was found between two groups (x2 =0.352,P =0.838).Moreover there was also no significant difference in terms of gender(P > 0.05)Conclusion The concentration of IL-1β in serum in COPD group was higher than in control group.The polymorphism of-31 and-511 were proved non association with COPD.
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Objective To investigate the distribution of pathogens in adult patients with community-acquired pneumonia (CAP) in Tangshan area. Methods The clinical data of 530 hospitalized patients with CAP were retrospectively collected in department of respiratory medicine from 6 hospitals in Tangshan area from October 2011 to September 2012. The sputum samples were isolated and cultured. Results A total of 195 strains were isolated from 530 patients with CAP. The most common types of pathogens included Klebsiella pneumoniae (64 strains,12.08%), Streptococcus pneumoniae (24 strains, 4.53%) and Bauman Acinetobacter (19 strain, 3.58%). The detective rates of Klebsiella pneumoniae and Pseudomonas aeruginosa were significantly higher in patients with basic diseases than those of patients without basic diseases (P0.05). Conclusion The gram-negative bacterial pathogens were the majority isolated from patients with CAP in Tangshan area. And Klebsiella pneumoniae was the primary bacteria. Patients with serious illness, above 60 years old, without antibiotic treatment before hospitalization, with basic diseases and above PORTⅢlevels should be given treatment of anti-gram-negative bacteria.
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Objective To evaluate the clinical value and relationship between the serum levels of the Pro-gastrin-releasing peptide 31-98 (ProGRP) , neuron-specific enolase NSE and the different pathohistology types of lung cancer. Methods 353 lung cancer patients were divided into two groups according to pathohistology types: SCLC group( n = 96), NSCLC group( n = 257). 90 lung benign lesion were taken as control group. ProGRP and neu-ron specific enolase in all patients were detected by ELISA. The levels of the ProGRP, NSE and the clinical value were compared among lung cancer,lung benign lesion patients and the different pathohistology types of lung cancer patients . Results The levels of the ProGRP and NSE of SCLC and NSCLC group were higher obviously than that of lung benign lesion( P <0.01 ). In SCLC diagnosis, the sensitivity, specificity, Youden index and Kappa value of the ProGRP and NSE were O. 7708,0. 9444,0. 7153,0.7111 and 0. 7604,0. 8778 ,0. 6382 ,0. 6355 in the monomial de-tection ; Those indexes above were 0.7604,0. 9667,0.7271 and 0. 7221 in combined assay of ProGRP + NSE( on se-quence test) ; and were O. 8229,0.9000,0. 7229 and 0. 7209 in combined assay of ProGRP + NSE( on parallell test). In NSCLC diagnosis,the above indexes were all lower. Conclusions in SCLC diagnosis,the detection of the serum ProGRP is superior to the detection of NSE, the combined assay of ProGRP + NSE (on parallell test) and Pro-GRP + NSE( on sequence test) are superior to the monomial detection of the ProGRP or NSE,and the combined as-say of ProGRP + NSE(on parallell test) is superiro to ProGRP + NSE(on sequence test) ; The diagnosis value of the monomial arid united detection of ProGRP and NSE to NSCLC is not as expected.
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Objective To study the relationship and clinical significance of the serum level of Pro-gastrinreleasing peptide31-98 (ProGRP)and bronchoalveolar lavage fluid for small cell lung cancer of different TNM staging.Methods 96 cases of SCLC with definite pathohistological typing were divided into stage Ⅰ~Ⅱ SCLC group (n=30),stage ⅢSCLC group (n=31),stage IVSCLC group (n=35),and the benign cases (n=90)were taken as control.Using enzyme-linked immunoserbent assay ( ELISA),the serum levels of ProGRP and bronchoalveolar layage fluid of all patients were detected,meanwhile the neuronspecific enolase were served as controls.The relation between serum and bronchoalveolar lavage fluid ProGRP level and small cell lung cancer of different TNM staging was analyzed.Results The serum level of ProGRP in stage Ⅰ~Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were (295.33±118.56),(421.13±196.66),(758.76±326.19)and (29.68±16.32)μg/mol,respectively (P<0.01 ).The level in bronchoalveolar lavage fluid ProGRP were ( 516.67 ±208.45),( 1170.55±414.65 ),( 1739.12±696.08 )and (49.23±22.50)μg/mol,respectively (P<0.01 ).The serum level of NSE in stage Ⅰ~Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were (10.36±6.76),(24.19±10.88 ),(35.76±17.30)and (9.70 ±5.28)mg/mol.The level in bronchoalveolar lavage fluid NSE were (16.66±11.62),(45.47±20.74),(65.18±29.87)and (9.70±5.28)mg/mol,respectively (P<0.01).The positive rate of serum ProGRP in stage Ⅰ~Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were 0.6000,0.7097,0.8286 and 0.0667 ,respectively(P<0.01).The positive rate in bronchoalveolar lavage fluid ProGRP were 0.6333,0.7419,0.8571 and 0.0444,respectively (P<0.01).The positive rate of serum NSE in stage Ⅰ~Ⅱ SCLC group,stage Ⅲ SCLC group ,stage Ⅳ SCLC group,and the benign group were 0.2333,0.6774,0.8000 and 0.2222.The positive rate in bronchoalveolar lavage fluid NSE were 0.2667,0.7097,0.8286 and 0.2667 ,respectively(P<0.01 ).Both the ProGRP level and positive rate in serum and bronchoalveolar lavage fluid were obviously higher in stage Ⅰ~Ⅱ,Ⅲ,and Ⅳ SCLC group than in benign group (P<0.01 ),both the ProGRP and NSE level and positive rate in bronchoalveolar lavage fluid were obviously higher than that in the serum.The positive rate in serum and bronchoalveolar lavage fluid ProGRP in stage Ⅰ~Ⅱ SCLC group were obviously higher than that in the NSE (P<0.01),but there was no significant difference in stage Ⅲ and Ⅳ SCLC group.Conclusion ProGRP level in serum and bronchoalveolar lavage fluid have great value to the diagnosis and clinical stages of SCLC,especially the early diagnosis,ProGRP is better than NSE;As to the diagnosis of small cell lung cancer of different TNM staging,ProGRP detection in bronchoalveolar lavage fluid is better than in serum.
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<p><b>BACKGROUND</b>Malignant pleural effusion is usually caused by lung cancer, and tumor markers may be helpful to its differential diagnosis. The aim of this study is to explore the clinical value of serum and pleural effusion pro-gastrin-releasing peptide (ProGRP), neuron specific enolase (NSE), cyto- keratin fragment 19 (CYFRA21-1) and carcinoembryonic antigen (CEA) in differential diagnosis and histological typing of malignant pleural effusion caused by lung cancer.</p><p><b>METHODS</b>According to histological type of primary tumor, 99 patients with malignant pleural effusion caused by lung cancer were divided into small cell lung cancer (SCLC) group, adenocarcinoma group and squamous cell carcinoma group, with 37 patients with benign pleural effusion and 35 healthy persons as controls. Diagnostic value of serum and pleural effusion ProGRP , NSE, CYFRA21-1 and CEA was evaluated for each group.</p><p><b>RESULTS</b>The levels of ProGRP, NSE, CYFRA21-1 and CEA in serum and pleural effusion of all the malignant groups were significantly higher than those in the control groups (P < 0.01). In the SCLC group, detection of pleural effusion ProGRP showed the highest Youden index and accuracy. In the adenocarcinoma group and squamous cell carcinoma group, combined detection of pleural effusion CEA+CYFRA21-1 (on parallel test) showed the highest Youden index and accuracy.</p><p><b>CONCLUSIONS</b>Detection of pleural effusion tumor markers ProGRP, CYFRA21-1, NSE and CEA is of great clinical value in differential diagnosis and histological typing of malignant pleural effusion. Pleural effusion ProGRP is the optimal tumor marker for malignant pleural effusion caused by SCLC. Pleural effusion CEA+CYFRA21-1 (on parallel test) is a good auxiliary diagnosis index for malignant pleural effusion caused by adenocarcinoma and squamous cell carcinoma of the lung.</p>