Objective To compare the concentrations of alpha-enolase (ENO1),CYFRA21-1,and CA125 in the patients with malignant pleural effusion ,tuberculous exudative pleural effusion ,or parapneumonia pleural effusion. To explore the clinical value of ENO1 in pleural effusion combined with serum CYFRA21-1 and CA125 in diagnosis of malignant pleural effusion. Methods Enzyme-linked immunosorbent assay(ELISA)was used to detect the concentration of ENO1 in pleural effusions. The concentrations of CA125 and CYFRA21-1 in the blood samples were measured using chemiluminescence and magnetic particle-based chemiluminescence respective-ly. The sensitivity and specificity of ENO1 combined with serum CYFRA21-1 and CA125 detection were calculated. Results The concentration of ENO1 in malignant pleural effusion group was significantly increased(P<0.001);the concentrations of ENO1 did not differ significantly between tuberculous exudative pleural effusion and parapneu-monia pleural effusion(P>0.05). The sensitivity and specificity of ENO1 combined with serum CYFRA21-1 and CA125 detection in malignant pleural effusion were 94％ and 74％,98％ and 98％,respectively. Conclusions ENO1 combined with serum CYFRA21-1 and CA125 detection can improve the sensitivity of diagnosis of malignant pleural effusion and enhance the diagnostic rate of malignant pleural effusion.

Objective To explore the ef fi cacy and safety of long-term use of low dose glucocorticoids in acute respiratory distress syndrome (ARDS). Methods Fifty ARDS patients were randomly divided into two groups. The control group(25 patients)received non-invasive or invasive mechanical ventilation,antibiotics and support treatments. The glucocorticoids group(25 patients)received the same treatments plus long-term use of low dose glucocorticoids. Results The mortality in glucocorticoids group(32％(8/25))was much lower than that in the control group(60％(15/25))(P < 0.05). The ventilator-free days and organ failure-free days within 28d in glucocorticoids group were significantly higher than those in the control group (P < 0.05). The oxygenation index and the serum IL-8 levels in glucocorticoids group at 14d and 28d were higher than those in the control group(P<0.05). Compared to the control group ,long-term use of low dose glucocorticoids in ARDS did not increase fasting blood-glucose at 7d,gastrointestinal bleeding and hospital infections within 28d. Conclusions Long-term use of low dose glucocorticoids in ARDS could reduce the serum IL-8 levels and improve the prognosis.