[Analysis of factors related to systemic embolism in patients≥75 years old with non-valvular atrial fibrillation].

Objective: To explore the related risk factors for systemic embolism (SE) in patients aged≥75 years with non-valvular atrial fibrillation (NVAF). Methods: A case-control study. NVAF patients aged≥75 years who were hospitalized at the First Affiliated Hospital of Xinjiang Medical University from October 2018 to October 2020 were divided into no SE (n=1 127) and SE (n=433) groups according to the occurrence of SE after NVAF. Multivariate logistic regression was used to analyze SE-related factors in patients with NVAF without anticoagulation treatment. Results: In the multivariate model, the following factors were associated with an increased risk of SE in patients with NVAF: history of AF≥5 years [odds ratio (OR)=2.75, 95% confidence interval (CI) 1.98-3.82, P<0.01], lipoprotein(a)>300 g/L (OR=2.07, 95%CI 1.50-2.84, P<0.01), apolipoprotein (Apo)B>1.2 g/L (OR=1.91, 95%CI 1.25-2.93, P=0.003), left ventricular ejection fraction (LVEF) of 30%-49% (OR=2.45, 95%CI 1.63-3.69, P<0.01), left atrial diameter>40 mm (OR=1.54, 95%CI 1.16-2.07, P=0.003), and CHA2DS2-VASc score≥3 (OR=15.14, 95%CI 2.05-112.13, P=0.01). ApoAI>1.6 g/L was negatively correlated with the occurrence of SE (OR=0.28, 95%CI 0.15-0.51, P<0.01). Conclusions: History of AF≥5 years, lipoprotein(a)>300 g/L, elevated ApoB, left atrial diameter>40 mm, LVEF of 30%-49%, and CHA2DS2-VASC score≥3 are independent risk factors for SE whereas ApoAI>1.6 g/L is a protective factor against SE in patients with NVAF.

[Application of ultrasound in diagnosis of uterine prolapse by measuring area of levator hiatus].

Objective: To investigate the value of the area of levator hiatusin diagnosis of uterine prolapse. Methods: From September 2017 to December 2018, 80 patients diagnosed with uterine prolapse by Department of Gynecology, Xiangya Hospital of Central South University were selected as the case group, and 80 cases of normal women in the same period were selected as the control group. All subjects in both groups were examined by transperineal three-dimensional ultrasound. The anteroposterior and transverse diameters and the area of levator hiatus were measured at rest and during maximum Valsalva maneuver respectively. The ROC curve was drawn to determine the cut-off value of area of levator hiatus in diagnosis of uterine prolapse and to evaluate its diagnostic value. Results: At rest and during maximum Valsalva maneuver, the anteroposterior and transverse diameters and the area of levator hiatus in study group were larger than those in control group, the difference was statistically significant (P<0.05). During maximum Valsalva maneuver, the above values in both groups were greater than those of the same group at rest state, but there was no significant difference between the two groups (P>0.05). During maximum Valsalva maneuver, the best cut-off value of area of levator hiatus for the diagnosis of uterine prolapse was 22.09 cm(2), the area under curve was 0.893. The sensitivity, specificity and accuracy were 90.0%, 95.0% and 92.5%, respectively. Conclusion: Transperineal three-dimensional ultrasound can evaluate the morphological changes of levator hiatus in patients with uterine prolapse, and the area of levator hiatus has high diagnostic value for uterine prolapse.

[Correlation between diameter and primary closure rate by internal limiting membrane peeling and air tamponade in large idiopathic macular holes].

Objective: To analyze surgical outcomes by internal limiting membrane peeling and air tamponade in large idiopathic macular holes (IMHs) and the correlation between the minimal diameter and the primary closure rate. Methods: Retrospective study. A total of 282 patients (300 eyes) with IMHs larger than 400 µm who underwent vitrectomy and internal limiting membrane peeling in Beijing Tongren Hospital from July 2015 to January 2019 were enrolled, including 56 males (61 eyes) and 226 females (239 eyes) with an medium age of 65(62, 68) years. Before July 2016, gas tamponade was applied while after that, air tamponade was used. The minimal diameter of the IMH was measured. IMHs were divided into intervals every 50 µm by minimal diameter, and the primary closure rate of the two tamponades were compared between intervals by Chi-square test. The receiver operating characteristic (ROC) curve was drawn to show the correlation between the minimal diameter and the primary closure rate by air tamponde. Results: The mean minimal diameter of all the IMHs was (615.7±126.0)µm. In general, the primary closure rate was 91.7% (275/300), and the BCVA at last visit (0.5(0.3, 0.7)) improved significantly (P<0.001) comparing to the preoperative one (0.1(0.05, 0.2)). A total of 187 eyes with air tamponade exhibited a primary closure rate of 88.2%, which was significantly lower (P=0.005) than that with gas tamponade (97.3%). For IMHs with air tamponade, the optimal closure rate was 100% among all intervals; from the interval of (650, 700)µm on, the primary closure rates of every interval gradually decreased and were significantly lower than the optimal one (P<0.05) respectively; the ROC curve revealed that IMHs larger than 664.5 µm tended to exhibit a smaller chance of primary closure. For IMHs ≤650 µm, the two tamponades exhibited comparable primary closure rate (96.1% for air, 100.0% for gas, P=0.17), while for IMHs>650 µm, air tamponade (71.2%) presented significantly lower rate (93.5% for gas, P=0.002). IMHs ≤650 µm exhibited significantly better BCVA compared to those larger (P<0.01), no matter which tamponade was applied. In IMHs ≤650 µm, BCVA exhibited no significant difference between the two tamponades, so as in IMHs>650 µm. Conclusions: For IMHs with air tamponade, the minimal diameter is closely related to both the primary closure rate and the postoperative BCVA. IMHs>650 µm exhibited evidently poorer anatomical and functional outcomes compared with those ≤650 µm, which suggested that maybe other techniques for the internal limiting membrane could be applied to improve surgical outcomes for these large IMHs. (Chin J Ophthalmol, 2019, 55:739-746).

[Application of transperineal pelvic floor ultrasonography in the diagnosis of female stress urinary incontinence].

Objective: To explore the application of transperineal pelvic floor ultrasonography in the diagnosis of female stress urinary incontinence(SUI). Methods: From March 2017 to December 2017, 60 patients diagnosed with SUI by department of gynecology, Xiangya Hospital of Central South University were selected as the case group, and 30 cases of normal women in the same period were selected as the control group. All subjects in both groups were examined by transperineal pelvic floor ultrasonography, that is, to be measured the bladder neck descent(BND), the urethral inclination angle(UIA), the posterior urethrovesical angle(PUVA) and the levator hiatus area(LHA) in resting state and during Valsalva maneuver. Results: (1)The differences in the measured values of the two groups were statistically significant(P<0.05). (2)The receiver operating characteristic curve(ROC) was used to find the cut-off values of SUI: when BND>31.5 mm; in Valsalva state, UIA>33.5°, PUVA>150.5° and LHA>20.6 cm2, with their sensitivity of 77.6%, 71.4%, 68.3% and 61.4%, respectively; the specificity of 68.9%, 74.6%, 73.9% and 78.0%, respectively. The area under the curve(AUC) were 0.753, 0.812, 0.721 and 0.712, respectively, when combined analysis of these indexes, reaching to 0.912. Conclusions: (1) Transperineal pelvic floor ultrasonography has a certain diagnostic value for SUI. (2)Combined analysis of various ultrasonic parameters can significantly improve the diagnostic efficiency of SUI.

OA10 is a novel p38alpha mitogen-activated protein kinase inhibitor that suppresses osteoclast differentiation and bone resorption.

In search of anti-bone resorbing agents for the potential treatment of osteoporosis, we synthesized a novel compound Tert-butyl 4-(3-[1H-indole-2-carboxamido]benzoyl)piperazine-1-carboxylate (OA10) and found that OA10 is capable of inhibiting RANKL-mediated osteoclast formation and osteoclastic bone resorption in a dose-dependent manner. This biological effect is further supported by the fact that OA10 suppressed osteoclastic-specific gene expression, including tartrate-resistant acid phosphatase, cathepsin K receptor, and calcitonin receptor. Further molecular mechanism investigation revealed OA10 inhibited p38 phosphorylation, suppressed c-fos and NFATc1 expression without affecting NF-κB or JNK signaling pathways. Taken together, this study suggested that OA10 can inhibit osteoclastogenesis by suppressing p38-c-Fos-NFATc1 cascade. OA10 may be developed as a therapeutic drug for osteoclast-related osteolytic diseases.

Development in biomarkers of breast cancer: a bibliometric analysis from 2011 to 2020.

OBJECTIVE: Breast cancer (BC) is a prevalent cancer all over the world. We conducted a bibliometric study to analyze global scientific results over the past 10 years, including the hotspots and frontiers of biomarker research in BC. MATERIALS AND METHODS: From 2011 to 2020, literature research from the Web of Science Core Collection (WoSCC) was performed. VOSviewer was applied to analyze and visualize the frontiers and hotspots related to biomarker research in BC. RESULTS: 13,680 papers were retrieved. There was an increasing number of annual publications (Np) related to biomarkers in BC during the past decade. The United States (US) published the greatest number of papers, which had the highest number of citations (Nc) and ranked first in terms of H-index. PLoS One and the University of Texas System were the most productive journals and affiliations, respectively. In 2014, Chetan Bettegowda published a paper with the world's highest global citation score (GCS). In recent years, keywords such as "expression", "microRNA", and "cell" have appeared most frequently. In addition, research related to COVID-19 in this field has become a hot topic in recent years. This bibliometric study found an increasing trend in publications related to biomarkers in British Columbia and the US was found to be an influential producer in this field. CONCLUSIONS: In the past decade, most research has focused on basic and clinical studies, of which microRNAs (miRNAs) and circulating tumor DNAs (ctDNAs) associated with the inhibition and attenuation of BC have become the focus of recent research.

LncRNA NEAT1 alleviates sepsis-induced myocardial injury by regulating the TLR2/NF-κB signaling pathway.

OBJECTIVE: To investigate the effect of long non-coding ribonucleic acid nuclear paraspeckle assembly transcript 1 (lncRNA NEAT1) on lipopolysaccharide (LPS)-induced myocardial injury in mice and the underlying mechanism. This study aims to provide some references for the prevention and treatment of sepsis-induced myocardial injury. MATERIALS AND METHODS: According to the random number table, 60 male C57 mice were divided into the Sham group (n=20), LPS group (n=20) and LPS + NEAT1 small interfering ribonucleic acid (siRNA) group (n=20). Sepsis-induced myocardial injury model in mice was established by intraperitoneal injection of LPS (10 mg/kg), and the NEAT1 knockout model was established by tail vein injection of NEAT1 siRNAs. After 12 h, the cardiac function of mice in each group was detected via the two-dimensional ultrasound; ejection fraction [EF (%)] and fraction shortening [FS (%)] were recorded. Hematoxylin and eosin (H&E) staining was conducted to evaluate the pathological changes in the heart tissues in each group. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining was used to detect the apoptotic levels of myocardial cells and fibroblasts in each group. In addition, the expression level of the oxidative stress marker 4-hydroxynonena (4-HNE) and the positive proportions of cluster of differentiation 45 (CD45) and CD68 in the mouse heart of three groups were detected via immunohistochemical staining. Moreover, the messenger RNA (mRNA) expression levels of inflammatory indicators [interleukin-1 (IL-1), IL-6, monocyte chemotactic protein 1 (MCP-1) and tumor necrosis factor-alpha (TNF-α)] in mouse serum of the three groups were examined by enzyme-linked immunosorbent assay (ELISA). Finally, the effects of NEAT1 siRNAs on the Toll-like receptor 2 (TLR2)/nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling pathway were detected by Western blotting. RESULTS: ENEAT1 knockdown could significantly improve ischemia/reperfusion (I/R)-induced cardiac insufficiency in rats, and increase EF (%) and FS (%) (p<0.05). Besides, NEAT1 knockdown remarkably inhibited the LPS-induced myocardial injury. Compared with the LPS group, LPS + NEAT 1 siRNA group has more orderly arranged cardiac myofilament, a lower degree of degradation and necrosis, and significantly reduced cell edema. TUNEL staining showed that NEAT1 knockdown markedly reduced LPS-induced apoptosis of cardiac cells (p<0.05). Immunohistochemical results revealed that NEAT1 knockdown could remarkably reverse LPS-induced elevation of the myocardial 4-HNE expression and decrease the oxidative stress in the heart (p<0.05). At the same time, CD45+ and CD68+ cells were reduced after NEAT1 knockdown in myocardial tissues (p<0.05). Reverse Transcription-Polymerase Chain Reaction (RT-PCR) showed that the mRNA levels of inflammatory indicators in LPS + NEAT1 siRNA group were lower than that in the LPS group (p<0.05). According to Western blotting results, NEAT1 siRNAs could significantly downregulate the protein expressions of TLR2 and p-p65. CONCLUSIONS: NEAT1 knockdown can improve LPS-induced myocardial injury in mice by inhibiting the TLR2/NF-κB signaling pathway. LncRNA NEAT1 is expected to be a potential target for clinical treatment of the sepsis-induced myocardial injury.

MCM7 amplification and overexpression are associated with prostate cancer progression.

The genomic DNA profiles of prostate cancers with aggressive features were compared to the profiles of matched normal DNA to identify genes that are selectively amplified in the cancer cells. One of the identified genes, MCM7, which is a component of the DNA replication licensing complex, has been studied extensively both at the DNA and protein levels in human prostate tissues. Approximately half of the prostate cancer specimens studied showed MCM7 gene amplification, and 60% of the aggressive prostate cancer specimens had increased MCM7 protein expression. Amplification or overexpression of MCM7 was significantly associated with relapse, local invasion and a worse tumor grade. Constitutive expression of MCM7 in a human prostate cancer cell line, DU145, resulted in markedly increased DNA synthesis and cell proliferation compared to vector-only controls, and an increased cell invasion in vitro. Indeed, MCM7 overexpression produced primary tumors 12 times larger than vector-only controls and resulted in a rapid demise of mice bearing those tumors. These studies implicate MCM7, and the DNA replication licensing gene family, in prostate cancer progression, growth and invasion.

Oncogenic activity of amplified miniature chromosome maintenance 8 in human malignancies.

Miniature chromosome maintenance (MCM) proteins play critical roles in DNA replication licensing, initiation and elongation. MCM8, one of the MCM proteins playing a critical role in DNA repairing and recombination, was found to have overexpression and increased DNA copy number in a variety of human malignancies. The gain of MCM8 is associated with aggressive clinical features of several human cancers. Increased expression of MCM8 in prostate cancer is associated with cancer recurrence. Forced expression of MCM8 in RWPE1 cells, the immortalized but non-transformed prostate epithelial cell line, exhibited fast cell growth and transformation, while knock down of MCM8 in PC3, DU145 and LNCaP cells induced cell growth arrest, and decreased tumour volumes and mortality of severe combined immunodeficiency mice xenografted with PC3 and DU145 cells. MCM8 bound cyclin D1 and activated Rb protein phosphorylation by cyclin-dependent kinase 4 in vitro and in vivo. The cyclin D1/MCM8 interaction is required for Rb phosphorylation and S-phase entry in cancer cells. As a result, our study showed that copy number increase and overexpression of MCM8 may play critical roles in human cancer development.

[An analysis of various diseases and hearing screening in NICU infants].

Objective:It is the first time to study the hearing screening results in NICU infants in Heilongjiang province,to analyze the various diseases and hearing loss distribution in NICU infants.Method:Three hundred and thirty four newborns(668 ears) in NICU received hearing screening with TEOAE and AABR test.We compared the results of different risk factors.Result:The failed ratio of different diseases in NICU are as follow: premature infants 61%,hypoxic-ischemic encephalopathy(HIE) 35%,neonatal infectious pneumonia 30%,neonatal sepsis 30%,neonatal aspiration pneumonitis 36%,neonatal jaundice 29%.Conclusion:The positive ratio of preterm infants was 61%,which is higher than the other diseases in NICU infants of Heilongjiang province.Both TEOAE and AABR failure have a high incidence of abnormal hearing status.Neonatal jaundice,neonatal infectious pneumonia and premature infants diseases are the high risk factors of auditory neuropathy spectrum disorder(ANSD) in NICU infants of Heilongjiang.

Neuronal Cdc2-like kinases: neuron-specific forms of Cdk5.

Neuronal Cdc2-like kinase, Nclk, is a heterodimer of a Cdk5 catalytic subunit and a 25 kDa regulatory subunit derived proteolytically from a neuron- and central nervous system-specific 35 kDa protein. The regulatory subunit is mandatory for kinase activity, hence it is designated the neuronal Cdk5 activator, p25/p35nck5a. Nclk has been suggested to play a regulatory role in neuro-cytoskeleton dynamics and in neuronal differentiation. In addition to the activation by Nck5a, Cdk5 is regulated by other mechanisms including additional activator proteins and inhibition by phosphorylation of specific amino acid residues. While Nclk shares common catalytic and regulatory properties with other members of the cdc2-like kinase family, it also displays unique characteristics that may be important for its neuronal functions.

Clinical phenomenology of mental disorders caused by Qigong exercise.

One hundred and nine patients with mental disorders caused by Qigong psychophysical exercise deviation are studied. These patients were divided into schizophrenic type (47 cases) and neurotic type (62 cases) and were analyzed by standard psychiatric rating scales and improved Minnesota multiphasic personality inventory (MMPI). The results show that patients with Qigong deviation presented abnormalities in perception, thinking, and behavior of varying degree. The clinical characteristics could not be classified into extent psychiatric disease units. Most of these patients manifested specific physical symptoms of Qigong deviation. The authors suggest that this kind of mild, benign mental disorder associated with the unique culture of our country be studied to contribute to the study of the classification of mental disorders. Qigong triggered disorders usually normalized during short term follow-up.

[Is hepatitis B virus (HBV) the pathogenic antigen of IgA nephropathy].

IgA nephropathy (IgA N) is one of the commonest glomerular diseases in China, where HBV carrier is not rare. In order to know whether HBsAg or HBcAg may induce IgA N, 105 cases of IgA N from most parts of China were studied. 8 of them were associated with HBs antigenemia. Neither HBsAg or HBcAg could be detected in the glomeruli of these 8 patients with and of 30 patients without HBs antigenemia by PAP method. IgA type anti HBc antibody was also negative in the serum of 21 cases of IgA N regardless of presence of absence of HBs antigenemia. It is concluded that HBsAg or HBcAg could not be confirmed to be pathogenic antigen of IgA N in our series.

[An in situ hybridization and immunofluorescent double staining study on the pathogenesis of HBV in kidney disease].

The exact role of HBV in the pathogenesis of renal lesions is still unconfirmed. In order to investigate whether HBV replicates and causes direct injury in the kidney as it does in other extrahepatic organs or acts as an antigen to cause an immune reaction, we did in situ hybridization combined with IF double staining study of kidney and liver specimens from 8 patients with HBV infection and positive HBsAg in the glomeruli. In situ hybridization was performed with 3H and biotin labelled HBV-DNA probes, their specificity was determined by verified HBV-DNA positive and negative samples as controls. DNase predigestion and HBV-DNA probe replacement Rhodamine labelled rabbit antihuman IgG, goat nati-HBsAg, FITC labelled rabbit anti-goat IgG were used for IF double-staining. Their specificity was confirmed by positive, negative controls and blocking test. The double-staining revealing HBsAg deposition was in the same position with that of IgG. HBV-DNA was not detectable in all the 8 patients even though 3 of them had HBV-DNA in the liver. It is suggested that HBV replication does not occur in the kidney, but its antigen components may cause a progressive immune reaction which results in renal damage.

[Renal lesions of post-hepatitis cirrhosis].

There have been many reports on renal lesions of alcoholic cirrhosis, but not on those of post-hepatitis cirrhosis (PHC) up to present. A clinical and pathological observation on PHC was carried out prospectively in 18 and retrospectively in 34 cases. Renal specimens were examined with light and electron microscopy and immunopathological methods (immunofluorescence and peroxidase anti-peroxidase). Clinically, recurrent gross hematuria was observed in 2 and wild urinary abnormality in 17 cases. One case developed renal failure and the remaining 32 cases had no clinical evidence of renal involvement. Light microscopy showed wild mesangial lesions in 44 cases and glomerular basement membrane (GBM) thickening with segmental splitting in 29 and diffuse splitting in 2 cases. Massive protein deposition was found in the GBM, mesangium (Ms) and tubular basement membrane as well as the epithelium and endothelium. Immunopathological examination showed massive deposition of various immunoglobulins and complements in GBM and Ms, with IgG dominant in 8, IgM dominant in 7, IgA dominant in 6 and "full house" in 11 cases. HBsAg was detectable in GBM and Ms in 5 cases (9.6%) and HBcAg in one. Focal interstitial fibrosis and lymphocytic infiltration were found in 15 (28.3%). Our data revealed that renal lesions of post-hepatitis cirrhosis are different from those of the so-called "cirrhotic glomerulonephritis" in certain aspects. They are characterized by definite GBM involvement and massive deposition of immunoglobulins and complements. Its pathogenesis may be more complicated than that of other types of liver cirrhosis.

[Complications of percutaneous renal biopsy: an analysis of 1000 consecutive biopsies].

The complications of percutaneous renal biopsies in 1000 cases are analysed in this paper. Because the modern techniques for biopsy localization and operation were used, both accidental puncture of other organs and infection were avoided. However, the hemorrhage of renal wound was still a predominate complication. Gross hematuria developed in 7.4% of biopsies, perirenal hematomas 4.4% of biopsies, and serious renal bleeding complications, including arteriovenous fistula, requiring transfusion of more than 1000 ml of blood were detected in 0.6% of biopsies. In this paper the manifestations, diagnosis and treatment for every renal bleeding complication are discussed. It is emphasized that renal arteriography should be done for the patients with persistent or recurrent renal hemorrhage, and that selective arterial embolization by using self-blood coagulative pieces should be considered before deciding surgical correction of these serious bleeding complications.

[Effect of SR-140333, a tachykinin NK-1 antagonist, on antigen-induced airway hyperresponsiveness in sensitized rats].

In the present study, the effects of SR-140333, ((S)-1-(2-[3,4-dichlorophenyl)-1-(3-isopropoxyphenylacetyl)piperidin- 3yl]ethyl)-4-phenyl-1-azoniabicyclo[2.2.2]octane.chloride), a nonpeptide antagonist for tachykinin NK-1 receptor, on the antigen-induced airway response to methacholine (MCh) aerosol and airway inflammation in sensitized SD rats were investigated. The baseline respiratory frequencies, tachypnea response to methacholine(MCh), the -log PC30 values of MCh and the leukocyte counts in bronchoalveolar lavage significantly increased after inhalation of 1% oval albumin(OA) aerosol. SR-140333 (152 nmol.kg-1, i.p.) or dexamethasone(368 nmol.kg-1, i.p.), bid x 3 d inhibited these responses. SR-140333 at a low dose of 0.01 mg.kg-1 showed an incomplete inhibition. From these results, we conclude that antigen challenge causes airway hyperresponsiveness and airway inflammation and that tachykinin NK-1 receptor antagonist inhibits these responses.

[Correlation between syndrome types of traditional Chinese medicine and peripheral T lymphocytes subsets in Graves' disease].

This paper reports the determined results of OKT3, OKT4, OKT8, ERFC, smIg and CIC, TMCA, TGA in 31 cases of Graves disease and in 20 normal controls. The results showed that the OKT3, OKT4, OKT8, ERFC were significantly lower than those in the normal controls, whereas the smIg was higher than that in normal controls. The difference between the two groups was very significant. Even though the ratio of OKT4/OKT8 showed no significance of both. Typology of Graves disease according to the theory of TCM, all 31 cases were divided into two types: (1) 14 cases of depression of Liver-energy and asthenia of Spleen; (2) 17 cases of deficiency of yin leads to hyperactivity of Fire. The OKT8 and the ratio of OKT4/OKT8 in the latter respectively were lower and higher than those of the former. The difference between the two types was significant (P less than 0.01, P less than 0.05) whereas the positive rates of the CIC, TMCA, TGA also were higher in the deficiency of Yin leads to hyperactivity of Fire than those in the depression of Liver-energy and asthenia of Spleen. After treatment with combined TCM-WM on 31 cases of Graves disease, it was found that the OKT4, OKT8, ERFC were significantly elevated, the smIg was markedly decreased than those without treatment. It was also found that smIg markedly decreased in two types, OKT8, ratio of OKT4/OKT8 in the latter and ERFC in both types all returned to normal. Remainder indexes had no obvious change before and after treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

[Diagnosis of bullae and blebs using contrast pleurography].

Twenty-five patients with spontaneous pneumothorax were studied with contrast pleurography. The technique was referred to that of rudy introduced. It could clearly show not only the shape of pleural surfaces and the anatomic relations of interlobular spaces, parietal and visceral pleurae, mediastinal and diaphragmatic boundaries, but also the signs of bullae and blebs, while the contrast agent flowed in pleural cavity. The diagnostic rate on bulla and bleb was 100%, which was superior to that of the plain roentgenogram. The big or small hyperlucent vesicular inflated lesions, most were multiple and got together, were observed in the lung with pneumothorax. Thoracotomies were performed in 4 cases and the locations of bullae were found to accord with the results of pleurography. Side-effect was not observed during or after this procedure.