Objective To evaluate the safety and effectiveness of immunosuppression regimens,postoperative complications,dead causes and risk factors of lung transplantation (LTx).Methods The immunosuppression regimens and clinical data of 100 patients with end-stage lung diseases receiving LTx in our hospital were retrospectively analyzed between Sept.2002 to Dec.2010.There were 72 patients subject to single LTx and 28 patients to bilateral LTx,amongst them 61 patients received LTx under circulation support,including 5 cases of cardopulmonary bypass (CPB) support and 56 cases of extracorporeal membrane oxygenation (ECMO) support.The immunosuppression regimens including Cyclosporin,mycophemolate Mofeil and corticosteroids were utilized in 53 recipients before the year of 2007,and Cyclosporin was switched to Tacrolimus in 47 patients after 2007.All the patients received Daclizumab or Basiliximab as immunosuppression induction regimens.Results The 1-,2-,3-and 5-year survival rate after LTx was 73.3％,61.6％,53.5％ and 40.7％ respectively.The mean survival time post-transplant in the patients who received Cyclosporin-based regimens and Tacrolimus-based regimens were (36.57 ± 3.44) months and (35.00 ± 2.33) months,repectively,with no significant differences (P＞0.05).The main causes of mortality included primary graft dysfunction (PGD),acute rejection (AR),bronchiolitis obliterans (BOS) and sepsis.The incidence of AR and BOS in Tacrolimus group was significantly lower than that in Cyclosporin grou (P ＜0.05),but the incidence of diabetes mellitus was significantly higher in Tacrolimus group.Analysis of Spearman rank correlation revealed that there was a direct correlation between the incidence of AR and BOS (r =0.340,P＜0.01).The use of circulation support,diagnosis of IPF,postoperative complications such as AR,BOS and infection were associated with decreased survival time postoperatively,in both univariate and multivariate proportional hazards regression models (P＜0.05).Conclusion Cyclosporin-and Tacrolimus-based regimens were both effective immunosuppression strategies postoperatively,Consummate follow-up surveillance and prompt treatment of complications were the key points in prolongation of survival time and improving quality of life after LTx.

Objective To summarize the experience of harvesting and using the lungs from donation after citizens death.Method From November 2007 to December 2013,19 cases of potential donation after brain death (DBD) and donation after cardiac death (DCD) were evaluated,including 9 cases of DCD and 10 cases of DBD.All the patients received the tests of sputum culture,bedside bronchoscopes,chest X rays,and blood gas analysis.After clear evaluation,3 cases of DCD and 3 cases of DBD were discharged from the group for bilateral inflammatory infiltration and poor oxygenation index,and the rest one case of DCD was precluded due to long warm ischemic time (＞60 min).The donor lungs from remaining 12 cases were harvested successfully after the declaration of brain death or cardiac death.The donors suitable for the transplant procedure were transported to our transplant center.Result Twelve lung transplants were performed successfully,including 10 cases of bilateral lung transplantation and 2 cases of right single lung transplantation.Two patients was complicated with severe infection and died of sepsis postoperatively,and the remaining 10 patients all recovered uneventfully with dramatic improvement of pulmonary function.During the follow-up period,all the patients lived an active life style with high quality of life.The mean survival time was 34.7 months (4-60 months).Conclusion Lung transplantation using DCD and DBD can be successfully performed after adequate preoperative evaluation of donor lung and abundant preparation for donor harvesting.

Objective To compare the efficacy of amisulpride and other SGAs in treating the negative symptoms of Schizophrenia.Methods The randomized controlled trials (RCTs) about Schizophrenia treated with amisulpride and other SGAs from Jan 1995 to Mar 2013 were searched in The Pubmed,EMbase,Cochrane Library,WanFang Data,CNKI and VIP.Two reviewers independently screened the literatures,extracted the data,and evaluated the methodological quality.Than meta-analyses were conducted by using RevMan 5.1 and Stata 12.0 software.Results The totall3 RCTs were included.Among the 1814 patients involved.The results of meta-analyses showed that the score of PANSS-N was no significant differences between two groups (MD =-0.33,95％ CI:(-0.87,0.21),Z =1.20,P =0.23) ; and the score of SANS was no significant differences between two groups (MD =-0.21,95％ CI:(-1.51,1.50),Z =0.31,P =0.76).The side effects were more in other SGAs group than those in amisulpride group.Conclusion Amisulpride is as effective as other SGAs for the treatment of schizophrenia with predominantly negative symptoms,and it has more advantage than other SGAs in safety.

Objective To investigate the relationship between alexithymia and event-related potential P300 in patients with somatoform disorders.Methods Forty-two patients aged 18 to 65 years fulfilling ICD-10 diagnosis criteria for somatoform disorders were recruited as experiment group.Forty normal healthy persons were selected as control group.The Toronto alexthymia scale-20 (TAS-20) was employed to investigate the alexithymia of the subjects.P300 potentials was employed to investigate the cognitive ability of the subjects.A comparison was made between the patients and the healthy subjects.Results The latencies of N1,P2,N2 and P3 were significantly longer in patients with somatoform disorder than those in the normal controls (P ＜ 0.05 or 0.01),the amplitudes of N2 and P3 were significantly lower in the patients (P ＜ 0.05 or 0.01).The three factors scores and the total score of TAS-20 test in patients with somatoform disorder were significantly lower than those in the normal controls (P ＜ 0.05 or 0.01).There was significant correlation between the latency and the three factors scores and the total score of TAS-20 as well as between the amplitude of P300 and the three factors scores and the total score of TAS-20:the latencies of N1,P2,N2 and P3 recorded at Pz was positively correlated with the factors scores (r =0.32 ～ 0.48,P ＜ 0.05 or 0.01),and the amplitudes of N1,P2,N2 and P3 recorded at Pz was negatively correlated with theTAS-20 scores (r=-0.31 ～-0.51,P＜0.05 or0.01).Conclusions There existed significant correlation between the alexithymia and cognitive impairment in patients with somatoform disorders.Both alexithymia and event-related potential P300 can be used as a clinical evaluation index for patients with somatoform disorder.

Objective To analyze the distribution characteristics and influencing factors of brachial-ankle pulse wave velocity (baPWV) in elderly population in order to direct the early diagnosis and prevention of arteriosclerosis in the elderly.Methods A total of 927 cases of elderly residents were randomly selected from 19 villages in Shengze area,Jiangsu Province.The indexes such as age,gender,height,weight,waist circumference,hip circumference and blood pressure were collected through standardized questionnaire and physical examination.The biochemical indicators including serum bilirubin,creatinine,uric acid,fasting blood glucose and blood lipids were measured,and baPWV was tested by automatic arteriosclerosis measurement system.Results The differences in age,systolic blood pressure,heart rate,serum bilirubin,creatinine,uric acid,triglycerides levels and baPWV were statistically significant between the male and female (all P＜0.05).BaPWV rised with the increase of age.Overall,baPWV was faster in the female than in male (P＜0.01).Blood pressure (r=0.36,0.59,P＜0.001),age (r=0.26,0.30,P＜0.001) and heart rate (r=0.30,0.33,P＜ 0.001) were correlated with baPWV,while uric acid had a correlation with baPWV (r=0.12,0.21,P＜0.01).A correlation was found between total cholesterol and baPWV (r=0.09,0.11,P＜0.05) Multi-variable linear stepwise regression analysis showed that systolic blood pressure,heart rate and age were the influencing factors for baPWV,of which systolic blood pressure had the greatest influence on baPWV (β＞0.5,P＜0.001).Conclusions With the increase of age,the baPWV shows rising trend.The monitor of baPWV may be useful in the elderly,especially in females.Blood pressure control,especially the control of systolic blood pressure can slow the progression of atherosclerosis.

Objective:To investigate the characteristics of perceived stress and coping style and their relationship withsymptoms in college students with psychosis-risk syndrome (PRS).Methods:A two-stage screening process was conducted in 3160 college students.Participants were screened with 16-Item Version of the Prodromal Questionnaire (PQ-16).The students with scores of PQ-16 ≥9 were further interviewed with Structured Interview for Prodromal Syndromes (SIPS).Twenty-two individuals who met the criteria of PRS on SIPS were enrolled as the PRS group.The control group (n =22) were randomly selected from the participants with scores of PQ-16 ＜9 who were matched with age,gender and education level.Two groups were assessed with Chinese Perceived Stress Scale (CPSS),Trait Coping Style Questionnaire (TCSQ) and Self-rating depression scale (SDS) to measure subjective stress,coping style and depressive symptoms.Results:PRS group reported higher CPSS total scores [(34 ± 8)vs.(22 ± 8)] and negative coping styles scores [(35 ± 5)vs.(28 ± 7)],and lowerTCSQ positive coping styles scores [(31 ±6)vs.(37 ±4)] than the controls (Ps ＜0.05).The CPSS scores in PRS group were positively correlated with the scores of negative coping style (r =0.57,P ＜0.01),and the SDS scores were positively correlated with CPSS total scores and scores of negative coping style (r--0.86,0.66,Ps ＜ 0.01).There was no significant relation of psychosis-risk symptoms to scores of CPSS and TCSQ (P ＞0.05).Conclusion:It suggests that college students with PRS have a higher perceived stress and tend to use more negative coping style,which may be positively correlated with depression.

Objective To assess whether metformin prevents body weight gain in patients with schizophrenia who are treated with second-generation antipsychotics(SGA).Methods The randomized controlled trials (RCT) about metformin for prevention of weight gain with SGA for schizophrenia from January 1998 to July 2012 were selected in the Cochrane Library,Medline,Wanfang Data,CNKI and VIP.Two reviewers independently screened the literatures,extracted the data,and evaluated the methodological quality.Than meta-analyses were conducted by using RevMan 5.1 software and Stata 12.0 software.Results The total 7 RCTs were selected and 394 patients were involved.The results of meta-analyses showed that the efficacy of the metformin group was superior to that of the control group in lessen body mass (MD =-3.07,95％ CI:-4.17,-1.98,Z =5.50,P ＜ 0.01),BWI (MD =-1.21,95％ CI:-1.50,-0.92,Z=8.18,P＜0.01) with significant differences.Conclusion Metformin addition therapy is effective in attenuating SGA-induced weight gain.

Objective To summarize the clinical experience ot harvesting and using the lungs from donation after brain death (DBD) and donation after cardiac death (DCD,Maastricht category Ⅳ) in China.Methods Eleven potential DBDs and DCDs were evaluated by our transplant group preoperatively,including 6 cases of DCDs and 5 cases of DBDs,and all of them received the tests of sputum culture bedside bronchoscopy,chest X rays,and blood gas analysis.After clear evaluation,1 case of DCD and 2 cases of DBD were discharged from the group for bilateral inflammatory infiltration and poor oxygenation index,and one case of DCD was precluded due to long warm ischemic time (＞60min).The donor lungs from remaining 7 cases were harvested successfully after the declaration of brain death or cardiac death.The preoperative lymphocytotoxic cross match test was negative,ABO blood types were compatible,and the donors were all suitable for the transplant procedure.Results Seven lung transplants were performed successfully under ECMO support,including 5 cases of bilateral lung transplantation and 2 cases of single lung transplantation.One patient was complicated with severe infection and died of sepsis on postoperative day (POD) 39,and one was succumbed to multiple organ failure.Two patients suffered of acute rejection on POD 30 and POD 19,respectively,and obtained improvements by bolus steroid therapy.The remaining 3 patients all recovered uneventfully.During a follow up period,all the patients lived an active life style with high quality of life.The mean survival time was 23.3 months (3-51 months).Conclusion The DCD and DBD may be one of the available donor resources for lung transplantation after efficient management of the potential donors and detailed preoperative evaluation in China.

Objective To investigate the social cognition and its correlation with social function for attenuated psychosis syndrome (APS). Methods From August, 2014 to December, 2015, 39 patients with APS were recruited as research group. Another 40 normal healthy persons with similar gender, ages, and education levels were selected as control group. The Faux Pas Recognition Test (FPR) and Yoni Task Test were used to evaluate the social cognition, and Social Disability Screening Schedule (SDSS) was used to evaluate the social function. The correlation between FPR, Yoni Task Test and SDSS in the research group was analyzed. Results In FPR test, the faux pas questions score, control questions score and total score of FPR were significantly lower in the research group than in the normal control group (t>2.378, P<0.01). In Yoni Task Test, the cognitive theory of mind total score (Cog), cognitive theory of mind first-level score (Cog1) and cog-nitive theory of mind second-level score (Cog2), and affective theory of mind total score (Aff), affective theory of mind first-level score (Aff1) and affective theory of mind second-level score (Aff2) were significantly lower in the research group than in the normal control group (t>2.341, P<0.01). There was no significant difference in control theory of mind total score (Phy), control theory of mind first-level score (Phy1) and control theory of mind second-level score (Phy2) between two groups (t<1.430, P>0.05). The SDSS total score was signifi-cantly higher in the research group than in the normal control group (t=13.032, P<0.001). In the research group, FPR's faux pas questions score and FPR's total score were negatively correlated with SDSS score (r>0.473, P<0.01); in Yoni task test, Cog's total score and factor scores, Aff's total score and factor scores were negatively correlated with SDSS score (r>0.448, P<0.01). Conclusion Social cognition func-tion in APS is impaired. It is associated with social dysfunction in APS.

Objective To investigate the effectiveness and safety of bilateral lobar lung transplantations (LLTx) in thoracic cavity size mismatching patients with end-stage lung diseases and analyze its prognosis.Method Clinical data of 34 patients receiving LLTx in our hospital were retrospectively analyzed between Sept.2002 to Dec.2012.LLTx were performed on 14 male and 20 female patients,with a mean age of 37.0 ± 6.3 years (ranging from 15 to 56 years).Indications for LLTx were idiopathic pulmonary fibrosis (n =24),idiopathic pulmonary hypertension (n =2),Eisenmenger syndrome (n =3),bronchiectasis (n =2) and lymphangiomyomatosis (n =3).Amongst them 26 patients received LLTx under extracorporeal membrane oxygenation (ECMO) support and 3 on ECMO as a bridge to transplantation.Twenty-four middle/lower right lobes with left lower LLT,4 bilateral lower LLT,2 bilateral superior LLT and 4 split left lung LLT were performed.Ischemic time was 4.4± 1.2 h for the first lobe and 6.3 ± 1.4 h for the second.Result The mortality in postoperative prophase (30 days) was 23.5％.The 1-,2-,3-and 5-year survival rate after LLTx was 70.9％,60.8％,50.6％ and 36.2％ respectively.The main causes of mortality included primary graft dysfunction,acute rejection,multiple organ failure,bronchiolitis obliterans and sepsis.Lung function test was performed on 23 cases after transplantation and forced expiratory volume in first second,maximal voluntary ventilation accounting for the predicted value was (74.23 ± 4.86)％ and (72.0 ± 3.64)％,respectively.Conclusion This study demonstrates that for thoracic cavity size mismatching patients,LLTx are safe and effective in the treatment of end-stage lung diseases,which can ameliorate the lung function and prognosis.