胸腔积液(PE)是呼吸系统的常见病和多发病,可分为漏出液和渗出液;最常见的渗出性PE病因为结核病、恶性肿瘤和肺炎,三种病因占所有病例的55％[1].进一步区分PE尤其是渗出性PE的病因是临床诊治的焦点和难题,常常需要通过其他有创性检查如胸膜活检或胸腔镜检查,但是其阳性率及并发症的发生率依赖于操作者的技术水平,且在病情危重者难以进行.随着研究的深入,越来越多的生物学标志物展现出对PE的诊断及鉴别诊断的潜在价值.本文总结常见的渗出性PE病因的生物学标志物的研究进展.

肠道微生物谱的构成与呼吸系统疾病存在密切关系，影响肺部的免疫反应强度，肠道微生态失衡及肠源性内毒素的释放，均能直接或间接地促进呼吸系统疾病的发生发展。目前，肠菌移植在呼吸系统疾病方面的研究相对较少。本文总结肠道微生态、肠菌移植与呼吸系统疾病关系的研究进展并提出新思路。肠菌移植在呼吸系统疾病治疗上具有一定的应用前景。

A 53-year-old female patient with advanced lung cancer, who was negative for all types of driving genes, received apatinib mesylate tablets(apatinib) 500 mg/d orally after 2 cycles of ineffective chemotherapy of pemetrexed disodium plus cisplatin (21 days as 1 cycle). After 22 days of medication, apatinib was reduced to 250 mg/d because of the hand-foot skin reactions. After 7 months of treatment with apatinib, the pulmonary neoplasms shrank, but the patient developed shortness of breath. CT examination showed bilateral pulmonary interstitial fibrosis. Apatinib was discontinued and hormone therapy was given. The patient′s symptoms were progressively aggravated. On day 32 of drug discontinuation, CT scan showed that the pulmonary interstitial fibrosis was aggravated and the patient developed typeⅠrespiratory failure. An IV infusion of methylprednisolone 500 mg/d and oxygen inhalation were given. However, the patient′s condition was still deteriorating. On day 37 of drug discontinuation, the patient died. Key words: Protein kinase inhibitors; Apatinib; Adenocarcinoma of lung; Lung diseases, interstitial