目的 介绍基层妇幼保健院成功开展126例小儿先天性心脏病(先心病)外科治疗经验。方法 2018年9月开始,在基层妇幼保健院设立小儿先心病治疗中心,开展小儿先心病外科治疗。结果 共收治126例小儿先心病患儿进行先心病手术治疗,全部痊愈出院。结论 在有经验的先心病治疗中心的协助下,基层妇幼保健院可以成功开展小儿先心病外科治疗。

目的 分析中枢神经系统孤立性纤维瘤(SFT)11例患者的临床特点、影像学及病理学表现、手术结果。方法 回顾性分析2013年—2021年于广州医科大学附属第二医院神经外科接受手术并经病理检查证实为中枢神经系统SFT的11例患者的临床资料。结果 11例患者主要症状为头晕、头痛或肢体乏力。MRI:病灶主要表现为T1WI等-低信号,T2WI混杂信号或等-稍高信号。病理组织学:镜下表现为疏密不一的梭形肿瘤细胞呈交替排列。免疫组化:肿瘤细胞主要表现为STAT6阳性、CD34阳性等特点。病灶全切除患者预后较好,病灶次全切除或既往有SFT复发病史患者容易再次复发。结论 中枢神经系统SFT患者MRI T2WI信号有助于诊断,但是最终诊断依靠病理学检查。手术切除是首选的治疗方式。

Objective To analyze the clinical features,radiological and pathological manifestations and surgical results of 11 patients with solitary fibrous tumors (SFT) of the central nervous system (CNS). Methods The clinical data of 11 patients with SFT of CNS confirmed by pathological examination in the Neurosurgery Department of the Second Affiliated Hospital of Guangzhou Medical University from 2013 to 2021 were retrospectively analyzed. Results The main symptoms of 11 patients were dizziness,headache or extremity weakness. MRI: the lesions mainly showed iso-low signal on T1WI,mixed signal or iso-slightly high signal on T2WI. Histopathological features: microscopically,there were alternating rows of spindle tumor cells with irregular density. Immunohistochemistry showed that the tumor cells were STAT6 positive,CD34 positive,etc. Patients with total resection of the lesion had a better prognosis. Patients with subtotal resection of the lesion or previous history of SFT relapse were prone to relapse. Conclusions MRI T2WI signals in patients with CNS SFT were helpful for diagnosis,but the final diagnosis depended on pathology. Surgical excision is the preferred treatment.

目的 总结新生儿红斑狼疮(NLE)的临床特征和预后,提高对NLE的认识。方法 回顾分析2015年1月—2020年12月在广州市妇女儿童医疗中心住院诊治的19例NLE的临床资料,并进行文献复习。结果 收集19例新生儿红斑狼疮,男10例,女9例。皮肤受累者19例;心血管系统受累者7例,其中心电生理异常7例:Ⅲ度房室传导阻滞(AVB)2例,交界性心律1例,Ⅱ度AVB 2例,完全性左束支传导阻滞(CLBBB)1例,T波低平1例;扩张型心肌病(DCM)1例;房间隔缺损1例。血液系统受累者3例;消化系统受累者7例。患儿抗SSA或抗SSB阳性18人,抗核抗体阳性18人,dsDNA阳性2人,抗RNP阳性3人。孕母产前诊断系统性红斑狼疮4例,干燥综合征8例,未分化结缔组织病1例,无任何临床症状6例(有无诊断疾病),其中10例予糖皮质激素治疗。随访时间5月~62月,随访18例。心血管系统受累者的预后差异大,2例Ⅲ度AVB予心脏起搏器治疗,1例交界性心律者建议安装起搏器。1例CLBBB并DCM者的内科治疗效果差。2例Ⅱ度AVB 者无明显临床症状。T波低平者复查为正常。随访中未发现患儿及其母亲有新发自身免疫性疾病。结论 新生儿红斑狼疮临床表现以心血管系统受累为突出特征,其房室结外病变需引起关注。患儿和其母亲的长期随访非常重要。

Objective To summarize the clinical features and prognosis characteristics of neonatal lupus erythematosus (NLE).Methods The clinical data of 19 cases of NLE who were hospitalized in Guangzhou Women and Children's Medical Center from January 2015 to December 2020 were retrospectively analyzed,and the literature was reviewed.Results A total of 19 cases of neonatal lupus erythematosus were enrolled,10 males and 9 females.There were 19 cases of cutaneous lesions; 7 cases of cardiac system involvement,including 7 cases of electrophysiological abnormalities: 2 cases of third-degree atrioventricular block (AVB),1 case of junctional heart rhythm,2 cases of second-degree AVB,1 case of complete left bundle branch block (CLBBB),1 case of low T-wave.Dilated cardiomyopathy(DCM)was found in 1 case,and atrial septal defect was found in 1 case.There were 3 cases of blood system abnormalities and 7 cases of digestive system problems.Eighteen children were positive for anti-SSA or anti-SSB test,18 were positive for ANA,2 were positive for dsDNA,and 3 were positive for anti-RNP.Four cases of mother was prenatal diagnosed with systemic lupus erythematosus,8 cases of Sjgren's syndrome,1 case of undifferentiated connective tissue disease,and 6 cases without any clinical symptoms,among them,10 cases were treated with glucocorticoids.The follow-up time varied from 5 months to 62 months,and 18 cases were followed up.The prognosis of patients with cardiac system involvement varied greatly.Two patients with third-degree AVB were treated with pacemaker,and 1 patient with junctional rhythm was recommended to install pacemaker.The patient with CLBBB and DCM had poor outcome with medical treatment.Two patients with second-degree AVB had no clinical symptoms,and the low T-wave one returned to normal.During the follow-up,no new autoimmune diseases were found in the children and their mothers.Conclusions The clinical manifestations of neonatal lupus erythematosus are prominently characterized by involvement of the cardiovascular system,and the extranodal lesion need to be paid attention to.Long-term follow-up of children and their mothers is critically important.

目的 通过测定川崎病(KD)患儿血清1,25(OH)₂D₃水平,探讨其与冠脉损伤(CAL)之间的关系。方法 选取在我院儿科住院的KD患儿200例,依据是否发生CAL分成CAL组(172例)和非冠脉损伤组(NCAL,28 例),并分别检测静脉内丙种球蛋白(IVIG)注射前后血清1,25(OH)₂D₃水平。选取35例健康儿童作为对照组,检测其血清1,25(OH)₂D₃水平,并进行比较。结果 IVIG输注前:CAL组和NCAL组血清1,25(OH)₂D₃水平较对照组低下(P＜0.05),CAL组最低(P＜0.05);IVIG输注后:NCAL组血清1,25(OH)₂D₃水平与对照组相比,差异无统计学意义(P＞0.05),CAL组血清1,25(OH)₂D₃水平较NCAL组和对照组低(P＜0.05);IVIG输注前后比较:CAL组和NCAL组血清1,25(OH)₂D₃水平在IVIG输注后均较输注前升高(P<0.001)。结论 KD患儿血清1,25(OH)₂D₃水平低下,而且血清1.25(OH)₂D₃水平越低,出现CAL的几率越大。

Objective The serum level of 1,25(OH)₂D₃ was detected to investigate the its relationship with coronary artery lesion (CAL) in children with Kawasaki disease (KD).Methods A total of 200 children with KD in our hospital were divided into CAL group (172 cases) and no CAL group (NCAL,28 cases) according to the CAL situation.Serum 1,25(OH)₂D₃ level before and after intravenous immunoglobulin (IVIG) injection was detected respectively.While 35 healthy children were enrolled as control group, comparing with KD children.Results Before IVIG injection,the levels of 1,25(OH)₂D₃ in the CAL and NCAL groups were lower than that in the control group (P＜0.05),and which in the CAL group was the lowest (P＜0.05).After IVIG injection,the level of 1,25(OH)₂D₃ showed no significant difference between the NCAL group and the control group (P＞0.05),and the level of 1,25(OH)₂D₃ in CAL group was lower than that in the NCAL group and control group (P＜0.05).Serum 1,25(OH)₂D₃ level in both CAL and NCAL groups increased after IVIG injection compared with that before injection (P<0.001).Conclusions The serum 1,25(OH)₂D₃ level was low in children with KD,and the lower serum 1,25(OH)₂D₃ level,the higher the incidence of CAL.

目的 观察新疆石河子地区绝经后女性2型糖尿病(T2DM)患者糖、脂、骨代谢特征及骨密度(BMD)情况,探讨该人群中低密度脂蛋白受体相关蛋白5(LRP5)基因rs3736228、rs3781586位点的基因多态性及突变与糖、脂、骨代谢指标的关系。方法 将新疆石河子地区2016年10月—2017年10月社区、医院门诊及住院绝经后女性按照纳入标准和排除标准选取136例为研究对象,根据患者病史、糖耐量实验及骨密度仪测定骨密度分4组,糖耐量正常与骨量正常组(A组),糖耐量正常与骨量异常组(B组),T2DM与骨量正常组(C组),T2DM与骨量异常组(D组)。测定并记录患者年龄、绝经年限等基线资料,计算体质指数(BMI)等,并检测糖代谢指标(空腹血糖等)、骨代谢指标(血Ca等)、脂代谢指标(甘油三酯等)。采用MALDI-TOF-MS法测定LRP5基因该两个位点基因多态性并进行统计分析。结果 ①糖代谢指标:与A组比较,C组、D组FPG、HbA1c均高于A组(P<0.01)。脂代谢指标:与A组比较,B组、D组TG低于A组(P<0.05)。骨代谢指标:与A组比较,B组、D组BMD(L1-4)、BMD(股骨颈)低于A组(P<0.01)。②LRP5基因该两个位点SNP基因分型分布符合Hardy-Weinberg遗传平衡定律(P>0.05);同时,该两个位点不同基因型的分布频率和等位基因频率在组间的比较经Pearson Chi-Square检验后发现暂无显著差异(P>0.05)。③LRP5基因rs3736228位点:A组,与CC型(野生型)相比,CT/TT型(突变型)甘油三酯(TG)降低(P<0.05),BMD(L1-4)降低(P<0.05);C组,与CC型(野生型)相比,CT/TT型(突变型)高密度脂蛋白(HDL-C)升高(P<0.01),磷(P)升高(P<0.05);LRP5基因rs3781586位点:B组,与GG型(野生型)相比,GT/TT(突变型)高密度脂蛋白(HDL-C)升高(P<0.05)。结论 在新疆石河子地区绝经后女性2型糖尿病人群中,LRP5基因rs3736228、rs3781586位点的基因多态性可能与糖代谢无关,但LRP5基因rs3736228位点的突变可能与脂代谢(TG、HDL-C)、骨代谢(P、BMD)有关,rs3781586位点的突变可能与脂代谢(HDL)有关。

Objective To observe the characteristics of glucose, lipid and bone metabolism and bone mineral density (BMD)in postmenopausal women with type 2 diabetes mellitus (T2DM)in Shihezi district of Xinjiang province, and to investigate the relationship in the polymorphism and mutation of rs3736228 and rs3781586 of LRP5 gene and glucose,lipid and bone metabolism indexes in this population. Method A total of 136 postmenopausal Han women, who were related in the outpatient department, community, and hospital after hospitalization in Shihezi district of Xinjiang province from October 2016 to October 2017, were selected as the study subjects by the inclusion criteria and exclusion criteria.According to the patient's medicalhistory, glucosetolerance test results and bone mineral density (BMD), they were divided into 4 groups: normal glucose tolerance and normal bone mass (group A), normal glucose tolerance and abnormal bone mass (group B), type 2 diabetes and normal bone mass (group C), and type 2 diabetes mellitus and abnormal bone mass (group D). Baseline data such as patient's age, menopause years were measured and recorded, and body mass index (BMI)was calculated. Simultaneously, glucose metabolism indicators including fasting blood glucose (FBG, etc), bone metabolism indicators (blood Ca, etc), lipid metabolism indicators(triglycerides, etc)were detected. The polymorphisms of rs3736228 and rs3781586 of LRP5 gene were determined by Maldi-Tof-Ms and those data were analyzed statistically. Results ①Glucose metabolism index: compared with group A: FPG and HbAlc in group C, group D were all higher than group A (P<0.01). Lipid metabolism index: compared with group A, TG in group B and group D was lower than that in group A (P<0.05). Bone metabolism index: compared with group A, BMD (L1- 4)and BMD (femoral neck)in group B and group D were lower than those in group A (P<0.01). ②The distribution of SNP genotypes at rs3736228, rs3781586 of LRP5 conformsed to the Hardy-Weinberg genetic equilibrium law (P>0.05). The distribution frequency and allele frequency of LRP5 genotypes rs3736228, rs3781586 were compared among the groups. Pearson chi-square test showed no significant difference (P>0.05). ③Rs 3736228 locus of LRP5 gene:in group A, compared with CC (wild type), CT/TT (mutated type)triglyceride (TG)decreased (P<0.05), BMD (L1- 4)decreased (P<0.05). In group C, compared with CC (wild type), CT/TT (mutated type)high-density lipoprotein (HDL-C)increased (P<0.05), phosphorus increased (P<0.05). Rs 3781586 locus of LRP5 gene: in group B, compared with GG (wild type), GT/TT (mutated type)high-density lipoprotein (HDL-C)increased (P<0.05).Conclusion In the Xinjiang Shihezi district among postmenopausal women with type 2 diabetes, rs3736228, rs3781586 loci of LRP5 gene polymorphism may be irrelevant to glucose metabolism, but the mutation of rs3736228 of LRP5 gene locus may be related to lipid metabolism and bone metabolism (TG, HDL-C, BMD, P), and the mutation of rs3781586 may be related to lipid metabolism (HDL-C).

目的 对我院静脉用药调配中心2017年1月—2019年12月期间的不合理医嘱情况进行汇总及分析,以提高合理用药水平。方法 收集2017年1月—2019年12月广州市第一人民医院静脉用药调配中心的不合理医嘱资料进行回顾性分析,归纳不合理医嘱类型、汇总分析不合理医嘱表现以及改正不合理情况。结果 主要不合理医嘱类型包括溶媒选择错误、溶媒量过多或过少、药物剂量不合理、药物配伍禁忌、其他(用药频次错误、药物选择错误、重复用药等)。结论 根据不合理医嘱情况的汇总分析,及时与临床科室沟通改正,保证合理用药。

Objective To summarize and analyze their rational prescriptions in pharmacy intravenous admixture services(PIVAS)of our hospital from January 2017 to December 2019,so as to improve the level of rational drug use. Methods The data of irrational prescriptions from January 2017 to December 2019 in the pharmacy intravenous admixture services of Guangzhou First People's Hospital were collected for retrospective analysis, and the types of irrational prescriptions were summarized, the performance of irrational prescriptions was analyzed and the irrational situation was corrected. Results The main types of irrational prescriptions include incorrect selection of solvent, improper consumption of solvent, improper drug dosage, incompatibility and others(improper frequency of administration, incorrect selection of drug, repeated administration, etc.). Conclusion According to the summary and analysis of irrational prescriptions, we timely communicate with clinical departments and ensure rational drug use.

目的 通过血常规分析和C反应蛋白(CRP)水平检测,探讨其对儿童甲型和乙型流感的辅助诊断价值,为临床治疗提供参考依据。方法 选择3 069名甲型流感患儿、2 307名乙型流感患儿、855名健康儿童,统计分析血常规参数以及CRP水平。采用ROC曲线分析血常规对甲乙型流感的区分效能。结果 甲组白细胞计数(WBC)均值高于正常组,乙组则相反,甲乙组中性粒细胞百分比(Neut%)、中性粒细胞与淋巴细胞百分比比值(NLR)、单核细胞百分比(Mono%)的均值高于正常组,甲乙组淋巴细胞百分比(Lymph%)、血小板计数(PLT)的均值低于正常组。甲组中性粒细胞计数(Neut#)、单核细胞计数(Mono#)、CRP、PLT的均值均高于乙组,Lymph%和淋巴细胞计数(Lymph#)的均值低于乙组。甲组在WBC>13×10⁹/L、Neut%>70.7、Lymph%<19.1的构成比高于乙组。NLR预测甲型流感临界值为2.08(敏感度为75.9%,特异度为89.4%),预测乙型流感临界值为2.11(敏感度为50.5%,特异度为89.8%)。结论 血常规参数和CRP水平变化可用于判断流感患儿是否存在细菌感染,指导临床用药;NLR作为一种新型预测标志物,其变化可以对区分甲型、乙型流感,尤其是甲型流感具有临床价值。

Objective Through blood analysis and C-reactive protein (CRP) level detection, to explore its value in the auxiliary diagnosis of influenza A and B in children, and to provide reference for clinical treatment. Methods 3 069 children with influenza A, 2 307 children with influenza B, and 855 healthy children were selected, and blood routine parameters and CRP levels were statistically analyzed. The ROC curve was used to analyze the discriminatory efficacy of blood routine on influenza A and B. Results The mean value of white blood cell count (WBC) in group A was higher than that in normal group, but in group B it had the opposite result. The percentage of neutrophils (Neut%), the ratio of neutrophils to lymphocytes (NLR), and the percentage of monocytes (the mean value of Mono%) is higher than that of normal group, and the mean value of lymphocyte percentage (Lymph%) and platelet count (PLT) of group A and B is lower than that of normal group. The mean values of neutrophil count (Neut#), monocyte count (Mono#), CRP and PLT in group A were higher than those in group B, and the mean values of Lymph% and lymphocyte count (Lymph#) were lower than those in group B. The composition ratios of group A in WBC>13×10⁹/L, Neut%>70.7, Lymph%<19.1 were higher than that in group B. The NLR predicted the critical value of influenza A was 2.08 (sensitivity 75.9%, specificity 89.4%), and the predicted influenza B threshold value was 2.11 (sensitivity 50.5%, specificity 89.8%). Conclusion Changes in blood routine parameters and CRP levels can be used to determine whether there is a bacterial infection in children with influenza and to guide clinical medication; NLR as a new predictive marker, its changes can distinguish influenza A or B. Especially in influenza A determination, it has clinical value.

目的 观察免疫球蛋白联合甲泼尼龙疗法对自身免疫性脑炎患者T淋巴细胞亚群、免疫球蛋白、白介素-6(IL-6)和CXC趋化因子13(CXC13)水平影响。方法 选取2017年1月—2020年3月本院收治的60例自身免疫性脑炎患者,采用随机数字表法分为观察组30例与对照组30例。对照组给予甲泼尼龙疗法,观察组在对照组结合免疫球蛋白治疗。两组均以4周后评价。比较两组疗效,治疗前后T淋巴细胞亚群、免疫球蛋白、IL-6、CXC13及简易智能精神状态检查量表(MMSE)变化。结果 观察组总有效率(83.33%)高于对照组(60.00%)(P<0.05)。观察组治疗后CD⁺₃、CD⁺₄和CD⁺₄/CD⁺₈高于对照组(P<0.05)。观察组治疗后血清IgA、IgG和IgM水平低于对照组(P<0.05)。观察组治疗后血清IL-6和CXC13水平低于对照组(P<0.05)。观察组治疗后MMSE评分高于对照组(P<0.05)。结论 免疫球蛋白联合甲泼尼龙疗法对自身免疫性脑炎患者疗效良好,且可增强机体细胞和体液免疫功能,降低IL-6和CXC13水平。

Objective To observe the effect of immunoglobulin combined with methylprednisolone on T lymphocyte subsets, immunoglobulin, interleukin-6 (IL-6) and CXC chemokine 13 (CXC13) in patients with autoimmune encephalitis. Methods 60 patients with autoimmune encephalitis admitted to our hospital from January 2017 to March 2020 were divided into 30 cases of observation group and 30 cases of control group. The control group was treated with methylprednisolone, and observation group was treated with immunoglobulin compared with the control group. The course of treatment in both groups was 4 weeks. The effects of the two groups were compared. The changes of T lymphocyte subsets, immunoglobulin, IL-6, CXC13 and MMSE before and after treatment were compared. Results Total effective rate (83.33%) of the observation group was higher than that of control group (60.00%) (P<0.05). After treatment, in the observation group, CD⁺₃, CD⁺₄ and CD⁺₄/CD⁺₈ were higher than that of control group (P<0.05); levels of serum IgA, IgG and IgM were lower than that of control group (P<0.05); serum levels of IL-6 and CXC13 were lower than that of control group (P<0.05); MMSE score was higher than that of control group (P<0.05). Conclusion Immunoglobulin combined with methylprednisolone is effective in the treatment of autoimmune encephalitis. It may enhance the cellular and humoral immune function, and reduce the levels of IL-6 and CXC13.

目的 探讨¹³¹I联合甘氨双唑钠治疗分化型甲状腺癌(differentiated thyroid carcinoma,DTC)骨转移的临床疗效。方法 以我院96例DTC骨转移患者为研究对象,随机分为对照组和观察组各48例,对照组仅予¹³¹I治疗,观察组予¹³¹I联合甘氨双唑钠治疗,比较两组的临床疗效、转移灶清除效果及不良反应。结果 根据骨痛评价标准,观察组的有效率(71.00%)高于对照组(48.00%)(P＜0.05)。根据血清甲状腺球蛋白(thyroglobulin,Tg)评价标准,观察组的有效率(77.00%)高于对照组(58.00%)(P＜0.05)。根据病灶影像学评价标准,观察组的有效率(48.00%)高于对照组(27.00%)(P＜0.05)。两组不良反应发生率差异无统计学意义(P＞0.05)。结论 ¹³¹I联合甘氨双唑钠可提高DTC骨转移患者临床疗效,具有临床推广意义。

Objective To explore the clinical effect of ¹³¹I combined with sodium glycididazole in the treatment of differentiated thyroid cancer (DTC) with bone metastasis. Methods Ninty-six patients with DTC bone metastasis were randomly divided into the control group and the observation group, forty-eight patients in each group. The control group was treated with ¹³¹I only, while the observation group was treated with ¹³¹I combined with glycididazole sodium. The clinical effect, metastasis clearance effect and adverse reactions of the two groups were compared. Results The effective rate of the observation group (71.00%) was higher than that of the control group (48.00%) (P<0.05) according to the evaluation criteria of bone pain. The effective rate of the observation group (77.00%) was higher than that of the control group (58.00%) (P<0.05) according to the evaluation criteria of serum thyroglobulin (Tg). The effective rate of the observation group (48.00%) was higher than that of the control group (27.00%) (P<0.05) according to the imaging evaluation criteria. There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The combination of ¹³¹I and sodium glycidazole can improve the clinical effect of patients with DTC bone metastasis, which has clinical significance for promotion.

目的 探讨Napsin A、TTF-1和CK7在恶性胸水细胞蜡块中的表达及对肺腺癌的诊断价值。方法 收集已确诊为恶性胸水且行Napsin A、TTF-1及CK7免疫组化标记,并收集患者的血清和胸水CEA,将患者按组织来源分为肺腺癌组和非肺腺癌组,比较Napsin A、TTF-1、CK7、血清CEA和胸水CEA在两组中的表达和浓度并计算它们的诊断价值。结果 相对于非肺腺癌组,肺腺癌组患者的Napsin A(83.9% vs 16.1%,P<0.001)、TTF-1(93.5% vs 6.5%,P<0.001)和CK7(98.1% vs 1.9%,P<0.001)阳性表达升高。Napsin A诊断肺腺癌的敏感度为83.9%,特异度为93.9%,TTF-1诊断肺腺癌的敏感度为93.5%,特异度为90.9%;CK7诊断肺腺癌的敏感度为98.1%,特异度为42.4%;明显高于传统肿瘤标志物血清CEA(诊断肺腺癌的敏感度为69.7%,特异度为58.5%)和胸水CEA(诊断肺腺癌的敏感度为69.0%,特异度为66.7%)。结论 Napsin A、TTF-1及CK7对于鉴别肺腺癌恶性胸水及其他肿瘤所致的恶性胸水具有较高的诊断价值。

Objective To investigate the expression of Napsin A, TTF-1 and CK7 in paraffin cells block of malignant pleural effusion and their diagnostic value for lung adenocarcinoma. Methods Immunohistochemistry of Napsin A, TTF-1, CK7, serum and pleural fluid CEA were collected from patients with malignant pleural effusion. The patients were divided into lung adenocarcinoma group and non-lung adenocarcinoma groups according to tissue source. The expression of Napsin A, TTF-1, CK7, CEA and the levels of serum and CEA in pleural fluid were compared and their diagnostic value was calculated. Results The positive expression of Napsin A (83.9% vs 16.1%, P<0.001), TTF-1 (93.5% vs 6.5%, P<0.001) and CK7 (98.1% vs 1.9%, P<0.001) in malignant pleural effusion caused by lung adenocarcinoma were higher compared to other tumors. The sensitivity and specificity of Napsin A were 83.9% and 93.9%,the sensitivity and specificity of TTF-1 were 93.5% and 90.9%, and those of CK7 were 98.1% and 42.4%; which were higher than those of serum CEA (69.7% and 58.5%) and pleural fluid CEA (69.0% and 66.7%) respectively. Conclusion Napsin A, TTF-1 and CK7 are of high value in the diagnosis of malignant pleural effusion caused by lung adenocarcinoma from other tumors.