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Objective@#To test the differences in diffusion properties-namely fractional anisotropy (FA) and apparent diffusion coefficient(ADC)-between amateur marathon runners and healthy volunteers′ thigh muscles using diffusion tensor imaging (DTI) at rest.@*Methods@#Thirty amateur marathon runners(Group A) and 20 healthy volunteers (Group B) were recruited. All were males and their age was between 28 to 53 years. All subjects underwent both thigh DTI examination. DTI parameters FA and ADC were evaluated in thigh muscles(rectus femoris, vastus lateralis, vastus intermedius, vastus medialis, adductor longus, adductor magnus, biceps femoris long head, semitendinosus and semimembranosus)in all subjects. We tested the differences in diffusion properties between GroupA and B using independent sample t test.@*Results@#The average FA value of the thigh muscles measured in Group A was (0.24±0.03), which was significantly lower than that in Group B=(0.27±0.03)(t=5.164,P<0.01). The average ADC value of the thigh muscles measured in Group A was (1.74±0.10)×10-3mm2/s, which was significantly higher than that in Group B=(1.70±0.09)×10-3mm2/s (t=2.060,P<0.05). The FA value of Group A was lower than that of Group B in the rectus femoris, vastus lateralis, vastus medialis, biceps femoris long head, semitendinosus and semimembranosus (P<0.05). The ADC value of Group A was higher than that of Group B in the vastus intermedius, vastus medialis and biceps femoris long head (P<0.05).@*Conclusions@#In the absence of positive findings from conventional MRI, DTI technique can non-invasively assess the subtle changes in the bilateral thigh muscles of amateur marathon runners at rest in the early stage of microscopic molecular level, providing important imaging evidence for early changes in skeletal muscle caused by marathon.
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Objective@#To study the effects of half marathon loading on the T2* mapping assessment of knee joint cartilage.@*Methods@#Twenty male amateur marathon runners with more than three years of running age were enrolled. The T1WI, PDWI, 3D-DESS, and T2* mapping were performed on right knee joint before and after the half marathon within 3h and after a period of approximately 1 week. Cartilage was divided into 6 regions: medial and lateral femoral cartilage, medial and lateral tibial cartilage and patella and trochlea cartilage. Femoral cartilage was partitioned into central weight-bearing regions, posterior cartilage nonweight-bearing regions with the posterior boundary of the meniscus as the dividing mark. All cartilage was further divided into deep and superficial layers according to the thickness 1/2, and the ROI was delineated to obtain the T2* value of the corresponding area. One-way repeated measures analysis was performed to test the difference of T2* values pre- and post-marathon. LSD tests were used to estimate the different influences of physiological activities on each articular cartilage area.@*Results@#All cartilage areas of the knee joint did not show cartilage injury during the examination. The differences in the global T2* values of the superficial layers of the knee cartilage before and after the half-marathon marathon were statistically significant (t=5.145, P<0.05), but the global T2* value of the deep region were not (t=1.864, P>0.05). After a week, the T2* values of all cartilage areas were not statistically different from those before running (t=1.062, 0.309; P>0.05).@*Conclusion@#After a single half marathon, the changes of knee cartilage composition in male amateur marathon runners are reversible. In the absence of positive findings in conventional MRI, T2* mapping can indirectly reflect changes in biochemical composition of the articular cartilage during exercise.
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Objective To test the differences in diffusion properties?namely fractional anisotropy (FA) and apparent diffusion coefficient(ADC)?between amateur marathon runners and healthy volunteers′thigh muscles using diffusion tensor imaging (DTI) at rest. Methods Thirty amateur marathon runners(Group A) and 20 healthy volunteers (Group B) were recruited. All were males and their age was between 28 to 53 years. All subjects underwent both thigh DTI examination. DTI parameters FA and ADC were evaluated in thigh muscles(rectus femoris, vastus lateralis, vastus intermedius, vastus medialis, adductor longus, adductor magnus, biceps femoris long head, semitendinosus and semimembranosus)in all subjects. We tested the differences in diffusion properties between GroupA and B using independent sample t test. Results The average FA value of the thigh muscles measured in Group A was (0.24 ± 0.03), which was significantly lower than that in Group B=(0.27±0.03)(t=5.164,P<0.01). The average ADC value of the thigh muscles measured in Group A was (1.74±0.10)×10?3mm2/s, which was significantly higher than that in Group B=(1.70±0.09)×10?3mm2/s (t=2.060,P<0.05). The FA value of Group A was lower than that of Group B in the rectus femoris, vastus lateralis, vastus medialis, biceps femoris long head, semitendinosus and semimembranosus (P<0.05). The ADC value of Group A was higher than that of Group B in the vastus intermedius, vastus medialis and biceps femoris long head(P<0.05). Conclusions In the absence of positive findings from conventional MRI, DTI technique can non?invasively assess the subtle changes in the bilateral thigh muscles of amateur marathon runners at rest in the early stage of microscopic molecular level, providing important imaging evidence for early changes in skeletal muscle caused by marathon.
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Objective To study the effects of half marathon loading on the T2* mapping assessment of knee joint cartilage. Methods Twenty male amateur marathon runners with more than three years of running age were enrolled. The T1WI, PDWI, 3D?DESS, and T2*mapping were performed on right knee joint before and after the half marathon within 3h and after a period of approximately 1 week. Cartilage was divided into 6 regions: medial and lateral femoral cartilage, medial and lateral tibial cartilage and patella and trochlea cartilage. Femoral cartilage was partitioned into central weight?bearing regions, posterior cartilage nonweight?bearing regions with the posterior boundary of the meniscus as the dividing mark. All cartilage was further divided into deep and superficial layers according to the thickness 1/2, and the ROI was delineated to obtain the T2* value of the corresponding area. One?way repeated measures analysis was performed to test the difference of T2*values pre?and post?marathon. LSD tests were used to estimate the different influences of physiological activities on each articular cartilage area. Results All cartilage areas of the knee joint did not show cartilage injury during the examination. The differences in the global T2*values of the superficial layers of the knee cartilage before and after the half?marathon marathon were statistically significant (t=5.145, P<0.05), but the global T2*value of the deep region were not (t=1.864, P>0.05). After a week, the T2* values of all cartilage areas were not statistically different from those before running (t=1.062, 0.309; P>0.05). Conclusion After a single half marathon, the changes of knee cartilage composition in male amateur marathon runners are reversible. In the absence of positive findings in conventional MRI, T2* mapping can indirectly reflect changes in biochemical composition of the articular cartilage during exercise.
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Objective:To investigate the role of anaphylatoxin C 5 a in patients with asthma .Methods:A prospective study was performed between September 2006 and February 2007.A total of 33 patients with acute exacerbation of asthma and 13 healthy subjects were recruited into the study .The patients with acute exacerbation of asthma were also studied when they returned to the remission state .Levels of lung function, levels of C5a in induced sputum and cell differential count in induced sputum were determined . Results:The level of C5 a in induced sputum was significantly higher in patients with acute exacerbation of asthma [0.85(0.68-2.13) μg/L] than that in patients with stable asthma [0.45(0.26-0.88)μg/L, Z=-2.193, P=0.013];Sputum C5a levels in stable asthma patients were significantly higher than those in healthy controls [0.14(0.06-0.45) μg/L, Z=-2.141, P=0.015].The level of C5a in patients with severe exacerbation [2.21(1.27 -9.0) μg/L] was significantly higher than those in patients with mild exacerbation [0.34(0.17-0.63) μg/L] and moderate exacerbation [0.85(0.55-1.67) μg/L,χ2 =12.330, P=0.001].The level of C5a in induced sputum was positively correlated with the number of total cells count (r=0.797, P=0.004), neutrophils (r=0.504, P=0.032) and macrophages ( r =0.424, P=0.036 ) in acute exacerbation of asthma .Conclusion: C5a levels in induced sputum could be identified as an important prognostic biomarker , which involved in asthma ’ s pathogenesis .
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Objective To investigate the current status of prevalence, prevention and management of chronic obstructive pulmonary disease(COPD) in rural area in China. Methods A cross-sectional survey of COPD was conducted in Beijing city, Shanghai city, Guangdong province, Liaoning province,Tianjin city, Chongqing province and Shanxi province. A population-based cluster sample was randomly selected from each rural area. In the selected community,all residents at least 40 years old were recruited,and interviewed with a modified standardized questionnaire from the international burden of obstructive lung diseases (BOLD) study. All participants were tested with spirometry. Those with airflow limitation were performed on post-bronchedilator spirometry. The post-bronchedilator a ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) less than 70% was defined as the diagnostic criteria of COPD. Results (1) Data of 9434 participants was valid for analysis, with a valid response rate of 83. 6% ;the prevalence of COPD in rural was 8. 8% (830/9434), 12. 8% in male and 5.4% in female. (2)The percentage of smoking and the exposure to biomass smoke in rural was 43. 0% (4059/9434) and 83. 1% (7835/9434) respectively; cigarettes cessation rate was 17.5% ; only 12. 4% ( 502/4059 ) of smokers had received advice to quit smoking. (3) Among COPD patients, only 30. 0% (249/830) had ever been diagnosed as COPD, bronchitis, emphysema, or asthma, 2. 4% (20/830) had ever received spirometric tests, and 74. 5% were current smokers; only 7.9% (50/634)COPD patients in stage two or over had received regular drug treatment. Conclusion There was high prevalence and poor prevention and management for COPD in rural areas. Therefore, an enforced prevention and management for COPD are urgent.
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Objective To investigate the role of endogenous Hydrogen Sulfide (H2S) in airway inflammation and responsiveness in a rat model of chronic passive-smoking.Methods Male SD rats were randomly divided into a control group (breathing fresh air) and a passive smoking group [cigarette smoking (CS) passively] ,with 18 rats in each group.Six rats in each group were randomly intraporitoneally injected with normal saline, sodium hydrosulfide (NailS) or propargylglycine (PPG, an irreversible inhibitor of cystathionine-γ-lyase).The animals were divided into six subgroups,ie.Con group, Naris group, and PPG group, CS group, CS + Naris group, and CS + PPG group.After 4 months,lung histological change and airway tension were measured.The H2 S levels of plasma and lung tissue were analyzed by the sensitive sulphur electrode assay.The expression of cystathionine-γ-lyase (CSE) was measured by western blot.Results Compared with the Con group, CSE protein expression in lung tissues was increased in CS group(P < 0.05) ; the H2S levels of plasma were significantly higher in GS group,NariS group and CS + Naris group,and much lower in PPG group (P < 0.05, respectively).Compared with CS group, the H2 S levels of plasma were significantly higher in CS + Naris group, and much lower in CS + PPG group (P < 0.05, respectively).The H2S level of lung tissue in each group had no significant difference (P > 0.05).Compared with Con group, score of lung pathology was significant elevated, and the responsiveness of airway smooth muscles to Ach and KCI was significant augmented in CS group.Compared with CS group, the score of lung pathology was decreased, and the responsiveness of airway smooth muscles was decreased in CS + NariS group(P < 0.05), and vise versa in CS + PPG group (P < 0.01).Conclusion H2 S can alleviate airway inflammation and hyperresponsiveness induced by CS, and administration of H2S might be of clinical benefit in airway inflammation and airway responsiveness.
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Objective To explore the changes of pathogens and antibiotic susceptibility in a respiratory ward.Methods All pathogens isolated from patients in a respiratory ward from 2001 to 2005 and the drug susceptibility results were retrospectively analyzed.For patients with more than 1 isolates of the same species, only the first strain of pathogen was included for analysis. The isolation and identification procedure was based on guidelines for national clinical laboratories.The susceptibility test was performed by disk diffusion method.WHONET 5.3 software was used for statistical analysis.Results A total of 876 strains were analyzed.The majority was gram negative bacteria.MRSA prevalence was 72.4% and showed a trend of increase.No vancomycin resistant Staphylococcus aureus or Enterococcus was detected.Streptococcus pneumoniae was highly resistant to macrolides.The non-sensitivity rate to penicillin was 25.5%-66.7% over years.The resistance rate to levofloxacin was 22.2%-27.3%.Enterobacter and Acinetobacter baumannii showed stable susceptibility to imipenem.ESBLs-producing Esche- richia coli and Klebsiella pneumoniae accounted for 33.3%-38.9% and 14.3%-19.2% respectively.P.aeruginosa strains were relatively susceptible to ceftazidime, amikaein, cefoperazone-sulbactam, imipenem, piperacillin-tazobactam and cefepime. The sensitivity rate was 87%, 82.6%, 78.3%, 73.9%, 73.9% and 71.4% respectively in 2005.Conclusions The changes of pathogens and antibiotic resistance in the respiratory ward were consistent with the surveillance data in this country, which were influenced by underlying diseases, severity of illness and antibiotic use.Our data are useful for the guidance of rational use of antibiotics.
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<p><b>OBJECTIVE</b>To investigate the role of calcineurin (CaN) in the lung fibroblast proliferation and collagen synthesis induced by basic fibroblast growth factor (bFGF).</p><p><b>METHODS</b>We used Western blot and immunohistochemical methods for investigating the content and distribution of calcineurin in the lung tissue. Calcineurin activity in different tissues was measured using (32)P-labelled substrate. In the primary culture of lung fibroblasts, (3)H-thymidine ((3)H-TdR) and (3)H-proline incorporation methods were used to study the effect of cyclosporin A (CsA), an inhibitor of calcineurin, on the lung fibroblast DNA and collagen synthesis stimulated by bFGF.</p><p><b>RESULTS</b>We found that calcineurin was expressed in lung tissue and has phosphatase activity (7.1 +/- 2.0 pmol Pi/mg pr/min). CsA (10(-8) - 10(-6) mol/L) inhibited lung fibroblast (3)H-TdR incorporation induced by bFGF in a dose-dependent manner, with the inhibitory rates by 20%, 46% and 66% (P < 0.01). CsA (10(-7) - 10(-6) mol/L) inhibited (3)H-proline incorporation in lung fibroblasts stimulated by bFGF, with the inhibitory rates by 21% and 37% (P < 0.01). In a culture medium, CsA (10(-8) - 10(-6) mol/L) inhibited (3)H-proline secretion induced by bFGF in a dose-dependent manner, with the inhibitory rates by 19%, 29% (P < 0.05) and 56% (P < 0.01). CsA (10(-7) mol/L) could inhibit calcineurin activity by 44% in lung fibroblasts (P < 0.01).</p><p><b>CONCLUSIONS</b>Calcineurin is expressed in lung tissue and has phosphatase activity. It is involved in the bFGF stimulated lung fibroblast DNA and collagen synthesis.</p>
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Animais , Ratos , Calcineurina , Fisiologia , Divisão Celular , Sobrevivência Celular , Colágeno , Fator 2 de Crescimento de Fibroblastos , Farmacologia , Fibroblastos , Fisiologia , Pulmão , Biologia Celular , Metabolismo , Ratos Sprague-DawleyRESUMO
<p><b>OBJECTIVE</b>To analyze diagnostic approach to severe acute respiratory syndrome (SARS) according to the diagnostic criteria issued by the Ministry of Health of China (MHC).</p><p><b>METHODS</b>The clinical data and the diagnostic results of 108 cases of SARS were retrospectively reviewed according to the MHC criteria.</p><p><b>RESULTS</b>There were 55 men and 53 women, with a median age of 34.5 years (range, 12 - 78 years). The interval between their first visit and clinical diagnosis was 3 days (range, 0 - 14 days). The diagnosis was made at the first visit in 7 (6.5%, 7/108) cases with a history of exposure to SARS patients and infiltrates on chest radiograph. Eighty-nine (82.4%) and 12 (11.1%) patients were categorized as probable cases and suspected cases respectively at their first visit and a clinical diagnosis of SARS was made subsequently. The interval between first visit and reaching the final diagnosis was 1 - 3 days in 72 (66.7%) cases and 4 days in 29 (26.9%) cases. The final diagnosis was made in 0 - 14 days (median, 2 days) for those (n = 59, 54.6%) with a history of close contact with SARS patients and 2 - 8 days (median, 3 days) for those (n = 49, 45.4%) living in Beijing but without such a history (P = 0.03). The chest radiograph was interpreted as unremarkable in 26 (24.1%) cases at their first visit, and the diagnosis was made in 4 days (range 2 - 8 days), which was significantly longer compared with other cases (P < 0.001). In patients without a history of close contact with SARS patients, all the five criteria were met after combination antibiotic therapy had failed.</p><p><b>CONCLUSIONS</b>A chest radiograph without infiltrates at the early stage of SARS is an important factor responsible for delayed diagnosis. In patients without a history of close contact with SARS cases, antibiotic effect was a major factor influencing doctors' diagnosis.</p>
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Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Torácica , Estudos Retrospectivos , Síndrome Respiratória Aguda Grave , DiagnósticoRESUMO
Objective:To investigate the changes and clinical implications of serum procalcitonin in exacerbation of chronic obstructive pulmonary disease(COPD).Methods:We have evaluated PCT measurement in 45 patients with an exacerbation of COPD(group A) and 25 patients with stable COPD(group B),quantitative sputum culture was performed,too.PPMs were only regarded as significant if they reached a growth of ≥10~7cfu/mL,indicating the presence of bacterial infection.Results:In patients with an exacerbation,15 patients,sputum yielded a high(≥10~7cfu/mL) bacterial load(group A_1),30 patients,sputum yielded a low(0.05).Using a cut-off point of 0.155?g/L for PCT,the sensitivities and specificities for bacterial infection in patients with an exacerbation of COPD were 93.3% and 60% respectively.Conclusion: Serum procalcitonin measurements in patients of an exacerbation of chronic obstructive pulmonary disease play a role in the diagnosis of bacterial infection.
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Objective: To determine the role of cross-talk between calcineurin-dependent signal transduction pathway and protein kinase C (PKC), mitogen-activated protein kinase (MAPK) and protein kinase A (PKA) in airway remodeling in asthma. Methods: Male guinea pigs were sensitized with intraperitoneal injections of ovabumin (OVA), then treated with cyclosporin A (CsA,5 mg/kg), an inhibitor of calcineurin, then inhaled OVA for 2 weeks 14 days later. Activities of calcineurin, PKC, MAPK, and PKA were was analyzed by phosphorylation and dephosphorylation. In primary cultures of rat airway smooth muscle cells (ASMC), activities of calcineurin, PKC, MAPK, and cross-talk induced by urotensin Ⅱ (UⅡ), a recently identified strong mitogen, were measured. Results: (1) The activities of calcineurin, MAPK and PKC increased by 19% (P0.05). (4) CsA 10 -6 mol/L inhibited UⅡ-stimulated PKC activity by 14% (P0.05). Conclusion:The signal transduction pathways between calcineurin and other protein kinases such as PKC, MAPK and PKA have cross-talk in airway remodeling in asthma.
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Objective : To investigate the changes of leukotriene B4 (LTB4) in both the airways and the blood circulation in an animal model of chronic obstructive pulmonary disease (COPD) and the effects of theophylline on LTB4. Methods: Thirty-two male Wistar rats were divided into four groups by random number meter: Group A (normal controls), group B (COPD), group C (smoking+low dose theophylline), and group D (smoking+high dose theophylline ),with 8 rats in each group. Pulmonary functions of the rats were assessed, and pathological changes of airways were scored. Cell counts and cell differentiation in bronchoalveolar lavage fluid (BALF) were also performed. Concentrations of IL-8 and LTB4 in BALF, plasma and lung tissue were measured by enzyme-linked immunosorbent assay (ELISA) and enzyme immunoassay (EIA). Results: LTB4 concentrations in BALF of COPD rats increased significantly as compared with the normal controls, and positively correlated with the percentage of neutrophil and IL-8 in BALF (r=0.794,0.863 ; P=0.007,0.012), and negatively correlated with peak expiratory flow (PEF) (r=-0.718, P=0.028). Positive correlations were also found between levels of LTB4 in BALF and the scores of inflammatory cell infiltration of COPD rats (r=0.836, P=0.036). Treatment with theophylline decreased the percentage of neutrophil and the concentrations of LTB4 in BALF of the COPD rats, attenuated the pathological changes of small airways, such as airway occlusion, goblet-cell metaplasia, inflammatory cell infiltration, and fibrosis and smooth muscle proliferation. The effect was more significant on goblet-cell metaplasia and inflammatory cell infiltration in the high dose group. However theophylline had little effect on PEF. Conclusion: Our results suggest that LTB4 is involved in airway inflammation in COPD. Theophylline is effective in decreasing the levels of LTB4 in BALF of COPD rats, reducing the percentage of neutrophil, and attenuating pathological changes of small airways.
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Objective To study the pulmonary function changes in patients cured from severe acute respiratory syndrome(SARS) Methods Pulmonary function tests were performed in 11 SARS patients one month after their discharge from hospital Results The subjects (3 males and 9 females) were aged from 21 to 62 years (31 0?10 0) The days after their discharge from hospital were 22 to 43 days (32 2?4 7) Pulmonary function showed:vital capacity(VC) (95 6?19 0)% predicted,forced vital capacity(FVC) (97 2?9 9)% predicted,forced expiratory volume in one second(FEV 1)(97 5?9 8)% predicted,FEV 1/FVC (85 9?5 6)%,total lung capacity(TLC) (102 4?10 4)% predicted,residual volume(RV)/TLC (32 6?5 0)%,RV (116 8?25 0)% predicted,and diffusing capacity of CO(DLCO) (73 6?10 9)% predicted Conclusion The patients cured from SARS demonstrated relatively normal ventilatory function but mild impaired diffusing capacity
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Objective:To study the role of interleukin 9 in the airway inflammation from patients with COPD. Methods: Induced sputum was obtained from 30 COPD patients with stable disease(group A) ,31 asthmatics patients with stable disease(group B) and 15 healthy individuals(group C). IL 9,IL 5 and IL 8 in sputum supernatants were measured by sandwich enzyme linked immunosorbent assay(ELISA) and IL 9 positive expression and quantitative analysis were conducted by Streptavidin peroxidase method and image analysis technology. Results:The levels of IL 9 in group A and B were all significantly higher than those in groups C. IL 9 positive expression mainly located in the cytoplasm of macrophages. The positive rates of IL 9 in group A and B were all significantly higher than that of group C(? 2=20.821, 19.908, P
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Objective:To investigate the role of endogenous hydrogen sulfide(H2S)in patients with asthma.Methods:Levels of serum H2S,lung function and cell differential count in induced sputum were studied in 44 patients with acute exacerbation of asthma,33 patients with stable asthma and 12 health subjects.Of the 33 patients with stable asthma,3 failed to achieve induced sputum.Results:The serum H2S level was(75.2?13.0)?mol/L in controls(12 cases),(55.8?13.6)?mol/L in patients with stable asthma(33 cases),(57.8?6.3)?mol/L in patients with mild of acute exacerbation asthma(9 cases),(40.8?5.1)?mol/L in that with moderate of acute exacerbation asthma(13 cases),and(31.3?2.9)?mol/L in that with severe of acute exacerbation asthma(22 cases,F=44.592,P
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Objective To analyze the antimicrobial resistance of Staphylococcus aureus isolated from clinical samples.Methods Staphylococcus aureus and methicillin-resistance Staphylococcus aureus were collected in the microorganism lab from 2004 to 2008,and the antimicrobial susceptibility test was conducted by disk diffusion technique(K-B method).Results A total of 1521 Staphylococcus aureus were collected in 5 years,of which 890 were MRSA(58.5%).Of all the SAU strains,255 were isolated from emergency room(16.8%),201 from surgery wards(13.2%)and 171 from surgical intensive care unit(SICU)(11.2%).Of all the MASA strains,199 were collected from emergency room(22.4%),148 from SICU(16.6%)and 131 from RICU(14.7%).Most of the MRSA strains(725,81.5%)were isolated from sputum,and the others from wound secretions(62,14.7%),blood(27,3.0%),throat(17,1.9%)and urine(16,1.8%),etc.MASA was resistant to most antibiotocs,but quite sensitive to SMZ.No strains resisted to vancomycin or teicoplanin were found in this study.MASA from all the departments showed a feature of highly resisting to variety antibiotics.Conclusion SAU,especially MASA were increasing in the past 5 years in our hospital.MASA was resistant to 90% of the ? lactan,macrolides and quinolones.No strains resistant to vancomycin or teicoplanin were found yet.It is of great value to monitoring the antimicrobial resistance of SAU and MRSA during the clinical practice.
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Objective To evaluate the optimal time of the use of non-invasive positive pressure ventilation on the patients with acute exacerbation of COPD(AECOPD).Methods 131 patients were divided at random conventional therapy group(control group)and conventional therapy plus NIPPV group,the patients of NIPPV group were again divided into PaCO2≥9.31 kPa,7.98～
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Objective To evaluate the value of thoracoscopy in the diagnosis ot pleural effussion. Methods 45 cases of pleural effussion were exeamined by thoracoscopy, biopsy took place in the abnormal pleurae under thoracoscopy. Results Positive rate was 91.1% (41/45) under thoracoscopy.The morphology of pleural mesothelioma, metastatic carcinoma and tuberculous pleurisy was different. No serious complication occurred in all cases. Conclusions Thoracoscopy is a safe and effective procedure in the diagnosis of pleural effussion.