代谢相关因子在物质依赖睡眠障碍中的研究进展

物质依赖是一种慢性脑病,睡眠障碍则是由睡眠质量或时序的改变而引起的机体功能紊乱的综合征。代谢相关因子在睡眠-觉醒节律的调节中发挥重要的作用,并且参与物质依赖的发生发展。本文就代谢相关因子在物质依赖睡眠障碍中的研究作简单综述。

Chronic morphine drinking establishes morphine tolerance, but not addiction in Wistar rats

Objective： Some animal models apply morphine in the drinking water to generate addiction, but related reports are not free of conflicting results. Accordingly, this study aimed to figure out if chronic consumption of morphine in the drinking water can induce morphine addiction in Wistar rats. Methods： For 3 weeks, the animals received a daily morphine dose of 35 mg/kg by offering a calculated volume of sugar water （5% sucrose） with morphine （0. l mg/ml） to each rat; animals receiving just sugar water served as controls. Immediately after the treatment phase, the tail immersion test was used to check for morphine tolerance, and all animals were then kept on tap water for one week （withdrawal phase）. Afterwards, all rats were allowed to choose their drinking source by offering two bottles, containing sugar water without and with morphine, simultaneously for two days （preference phase）. Results： While the chronic consumption of morphine led to a reduction in body weight and to morphine tolerance, the morphine-treated Wistar rats did not show any preference for the opiate-containing sugar water. Conclusion： Body weight loss and tolerance do not reveal a condition of drug craving, and current animal models should be re-evaluated regarding their potential to establish morphine addicted animals.

NATIONAL SURVEY ON PREVALENCE OF CANCER PAIN

Objective. To collect nationwide basic data about cancer related pain. Methods. Sixty cancer patients in each province were randomly selected to participate in this survey. The subjects represented all stages of cancer, tumor sites, and different demographic characteristics. Two self- designed structured questionnaires including reasons, types of pain and pain management were used by patients and physicians respectively. Subjects were asked to report whether he/she had experienced any type of cancer related pain and filled out the equivalent questionnaire. The severity of pain was assessed by using“ visual analogue scale” . Original data input and analysis were using EPI- INFO software package. Results. The result showed that 61.6％ (958/1555) of patients had different types of cancer related pain. Majority of pain (85.1％ ) were caused by advanced cancer. The major reasons (64.4％ ) for poor management or impedimental factors of pain care are due to patient including over- concern on opioid analgesic addiction, reluctance to report pain or refused to use opioid analgesic until at times when pain is intolerable; 26.8％ belonged to physician’s reasons including fear to cause addiction on opioid and lack of knowledge about cancer pain management; 16.2％ are due to lack of different kinds of opioid analgesic for use and 16.1％ belonged to drug regulation. Conclusions. The results showed that majority of patients (61.6％ ) had different types of cancer related pain. In most of patients, cancer pain was relieved when they were treated. The major reason for under- treatment or impeded factors for effective relief of cancer pain was fear of opioid addiction by both medical professionals and patients.

Venlafaxine Dependence： A Case Report

Venlafaxine, an SNRI （serotonin-norepinephrine reuptake inhibitor） drug, is commonly used to treat depression. Although it is very rare, venlafaxine may lead to addiction or abuse in some patients. To date, there are very limited data available on venlafaxine addiction. The aim of this article is to draw an attention to dependence of venlafaxine in clinical practice. Significant point of this article is： Our patient was addicted by ＂high＂ doses of venlafaxine for getting high effects. Overdose of venlafaxine produces an amphethamine-like ＂high＂ with experiences of euphoria by its ability to increase neurotransmitter levels in addiction literature [1-3]. We present a man aged 42 years, who was referred to our clinic for detoxification from venlafaxine addiction. He had been taking venlafaxine upto 1,950-2,100 mg/day to get high for the past 10 years. Physicians must be careful when prescribing antidepressants to patients, especially those with a history of alcohol and/or drug addictions or abuse.

Sex differences in exercise and drug addiction:A mini review of animal studies

Growing literature has demonstrated that exercise may be an effective prevention and treatment option for drug addiction. In the past few years, many studies have suggested that there were sex differences in all phases of drug addiction. However, very limited research has investigated sex differences in the effectiveness of exercise intervention in drug addiction and rehabilitation. In this mini review, we summarize the effect of sex on the results of using exercise to prevent and treat drug addiction. The studies we consider span various animal models and use multiple types of exercise to examine the effectiveness of exercise on the neurobiological mechanism of exercise rehabilitation. We believe that exercise as an adjuvant intervention strategy can be applied better in drug addiction prevention and recovery. Copyright 2014, Shanghai University of Sport. Production and hosting by Elsevier B.V. All rights reserved.

A survey of advanced medical students’ knowledge towards cancer pain management

Objective: The aim of the study was to investigate advanced medical students' knowledge towards cancer pain management, and understand the effect of specialisms and duration of oncology rotation on the advanced medical students' cognitive level towards cancer pain management. Methods: Randomly selected the respondents from a medical school in Wuhan, China. The educational background of the respondents should belong to one of these conditions: (1) clinical master degree candidate; (2) clinical doctor degree candidate; (3) the sixth or seventh year of clinical medicine for seven years. The respondents should also spend more than one year on internship. The self-developed questionnaire papers were distributed to respondents in the unit of dorms selected randomly and recovered them immediately after they're finished. The categori- cal data were expressed at the form of frequency (rate or constituent ratio). Chi-square test was required only as needed. Results: The survey was anonymous. We distributed 300 papers, recovered 300 papers and weeded out 8 invalid papers. Finally there were 292 valid papers, and the valid recovery rate was 97.3%. The 96.7% of oncological medical students and 47.6% non-oncological medical students relied on patients' description for cancer pain assessments; 90.0% of oncological medical students and 53.0% of non-oncological medical students prescribed strong opioid drugs firstly for patients suffering severe cancer pain; only 24.1% of non-oncological medical students recognized that pethidine was not safe and effective to treat cancer pain, which was much lower than oncological medical students (90.0%); 73.3% of oncological medical students and 28.9% of non-oncological medical students had the correct impression of drug addiction; 85.5% of non-oncological medi- cal students worried about the drug addiction, while 60.0% of oncological medical students worried about the strict control over opioid. In respect of the details of cancer pain management, only 66.7% of oncological medical students recognized that there was no upper limit of opioid prescribed clinically, and 16.3% of oncological medical students recognized that there was no psychological dependence if patients took opioid orally. The 69.8% of the students from no-less-than-two-week group relied on patients' description for cancer pain assessments, 76.7% prescribed strong opioid drugs firstly for patients suffer- ing severe cancer pain, 69.8% recognized that pethidine was not safe and effective to treat cancer pain, and 55.8% had the correct impression of drug addiction. All of the data were higher than that in no-rotation group and that in less-than-two-week group. The 51.2% of the students from no-less-than-two-week worried about drug addiction, which was the lowest of all. Conclusion: The cognitive level of advanced medical students towards cancer pain management is so low that it could not satisfy the clinical requirement, especially for the non-oncological medical students and the students spending little time on oncology rotation. Though the oncological medical students know something about cancer pain treatment, they know little about the details.

Internet Addiction： Just Facebook Me! The Role of Social Networking Sites in Internet Addiction

Internet based social-networking sites like Facebook are highly attractive, user-friendly, and increasingly popular. Current estimates indicate over 750 million users of Facebook alone. However, Internet addiction is an increasing problem amongst today＇s youth and as yet, is understudied in the United States. This study looked at the relationship between this new social-networking tool and the increasing phenomenon of internet addiction symptoms using both a US college sample （age 19years） and a US high-school sample （age 14years）. Findings indicate that SNS （Social Networking Site） activity maybe more predictive of addictive behaviors than general internet use and that higher percents of symptomology occur in those users reporting SNS activity as their primary internet activity.

Analysis on the Implicit Internet Attitude of the Internet Addicts and the Intervene Problems

Implicit Internet attitude refers to the implicit, automatic psychological tendency of an individual toward the Internet. A study found that Internet addicts held an implicit attitude and positive evaluation toward the Intemet, and this type of evaluations could be effectively changed through subliminal evaluative conditioning technology. An investigation on IAT effect showed the implicit attitude of the Intemet addicts was stable and variable, and AIA （ambivalence of implicit attitudes） might be an integrated perspective to solve the problem.

Internet Addiction of College Students from the Psychological Perspective

With the rapid development of network, the phenomenon of Internet addiction is prevalent on campuses, which has produced a variety of negative effects on college students in terms of learning, living, working and so on. In recent years, there are many research literatures on Internet addiction overseas, covering all aspects of this psychological phenomenon. Moreover, domestic research on Internet addiction started late. In the light of the fact that college students do not have clear understanding on hazards of Interact addiction, it generally shows their self- control is poor. They do not believe they can control their behavior and results and give up taking responsibility for the results and tend to agree network identity. Based on this phenomenon, we propose the network psychological source control concept. In view of the close contact between the excessive use of the network and the individual time management, this study selected the time dimension of personality characteristics on Internet addiction as another influencing factor, and explored the integrated influence of the psychological source control to Internet addiction.

Influence and Countermeasures of Network to psychology of juvenile delinquency

With the majority of young people increasingly becoming the main force of the use of the network, the network as a new kind of social factors on the growth of young people is increasingly prominent. Network not only help young people broaden their horizons, accept avant-garde concept, concern about the world cutting-edge issues, but also spread some violence, pornographic or reactionary spare, as well as network addiction problem which will cause a serious negative impact on the healthy growth of young people and lead to increasing juvenile crime. The number of juvenile criminals has increased every year in China and has trended to lowering ages, regiment turn and malignant development, which will cause great harm to social stability. Of course, there are many causes of juvenile delinquency, but showing characteristics are also diverse.

Psychological Analysis of Adolescent Internet Addiction

The rapid development of the network had a huge psychological impact on people＇ s life, ideas, and especially makes prominent phenomenon of mental disorder with the network, it has become attention of sociology, psychology, research of clinical industry. In recent years, research on the phenomenon of Internet addiction focused on qualitative descriptions and study of the theoretical phenomenon, their research focused on the popularity of the first network, the U.S. conducted the most extensive study and makes more online survey. China started this study later, and lack of systematic research on the network psychology, which just mostly understanding the aspect of the phenomenon and countermeasures of stating intemet addiction, or to explore from a single aspect （such as： age, gender, etc.）, it lack of theoretical studies of the psychological mechanisms and motives behind the addictive behavior on the network.

A high-performance liquid chromatography with fluorescence detection method for the simultaneous quantitation of monoamine neurotransmitters and their metabolites in subregions of rat brain

Abstract： In the presem study, we simultaneously quantified the levels of monoamine neurotransmitters （MANTs） and their metabolites （levodopa, norepinephrine, epinephrine, dopamine, 5-HT, 3,4-dihydroxyphenylacetic acid, homovanillic acid and 5-hydroxyindole-3-acetic acid） in different brain subregions of rats using a newly developed simple, sensitive and selective high-performance liquid chromatography with fluorescence detection （HPLC-FLD） method. In this new HPLC-FLD method, analytes were directly extracted and separated without deriveatization step within 20 min. The FLD wavelength was set at 280 nm and 330 nm for excitation and emission, respectively. The analytes were separated on an Agilent Eclipse Plus Cls column （4.6 mm×150 mm, 5.0 μm） equipped with an Agilent XDB-C18 security guard column （4.6 mm×12.5 mm, 5.0 lam）, and the column temperature was maintained at 35 ℃. The mobile phase for elution was isocratic. The mobile phase consisted of citric acid buffer （50 mmol/L citric acid, 50 mmol/L sodium acetate, 0.5 mmol/L octane sulfonic acid sodium salt, 0.5 mmol/L Na2EDTA and 5 mmol/L triethylamine, pH 3.8） and methanol （90：10, v/v） at a flow rate of 1.0 mL/min. The detection limit （DL） was 0.9-23 nM for all the MANTs and their metabolites with a sample volume of 50 μL. The method was shown to be highly reproducible in terms of peak area （intraday, 0.08%-1.85% RSD, n = 5）. The simultaneous measurement of these MANTs and their metabolites improved our understanding of the neurochemistry in the central nervous system （CNS） in relation to different addictive drugs （methamphetamine, heroin and their mixture） in drug-addicted rat models.

Effect of acupuncture on expression of AFosB and CREB in hippocampal heroin-relapse rats

Objective To investigate the effect of acupuncture on the addiction memory of rats. Methods A model for heroin re-addicted rats was made by coupling heroin injection in increasing doses on the platform of a Morris water maze with high-frequency sounds cues. The animals were randomly divided into control group, relapse group, acupuncture group, and drug group, with 10 individuals in each group. For the acupuncture group, Baihui （百会 GV 20） and ＂Dazhui＂ （大椎 GV 24） were selected. Morris water maze was used to assess the time elapsed and the distance traveled before a rat reached the platform. The expression levels of A FosB and cAMP response element binding protein （CREB） in hippocampal CA 1 area were assessed with immunohistochemical staining. Results Upon completion of three treatments, the acupuncture group had significantly longer lengths of latency and swimming distance compared to the relapse group （P〈0.05）. Furthermore, the acupuncture group had significantly lowered expression levels of A FosB and CREB compared to the relapse group （P〈0.05）. Conclusion Acupuncture can downregulate A FosB and CREB expression in rats＇ hippocampal area and inhibit the addiction memory.

Regulation of dopamine D3 receptors by protein-protein interactions

Gαi/o protein-coupled dopamine D3 receptors （D3Rs） are preferentially expressed in the limbic system, including the nucleus accumbens. This situates the receptor well in the regulation of limbic function and in the pathogenesis of various neuropsychiatric and neurodegenerative disorders. The intracellular domains of the receptor, mainly the large third intracellular loop and the intracellular C-terminal tail, interact with multiple submembranous proteins. These interactions are critical for the control of surface expression of the receptor and the efficacy of receptor signaling. Recently, a synapse-enriched protein kinase, Ca^2＋/calmodulin-dependent protein kinase II （CaMKII）, has been found to interact with D3R in the above mentioned interaction model. CaMKII directly binds to the N-terminal of the third loop of D3R. This binding is Ca^2＋-dependent and is sustained by the autophosphorylation of the kinase. In rat accumbal neurons, the increase in Ca^2＋ level induces the recruitment of CaMKII to D3R, and CaMKII phosphorylates the receptor at a specific serine site. The CaMKII-induced phosphorylation could inhibit the receptor function and further regulate the behavioral response to the psychostimulant cocaine. These findings reveal a prototypic protein association model between a G protein-coupled receptor and CaMKII. Through the dynamic protein-protein interactions, the abundance, turnover cycle, and function of D3R can be regulated by multiple signals and enzymatic proteins.

Management of femoral artery pseudoaneurysm due to addictive drug injection

Objective: To study surgical management for pati ents with femoral pseudoaneurysm resulting from addictive drug injection. Methods: Clinical data of 34 patients with femoral pseudoaneury sm resulting from addictive drug injection were retrospectively reviewed. Results: Thirteen patients underwent bypass graft (end to side) of external iliac artery and superficial femoral artery using expanded polytetr afluoroethylene (ePTFE). Three patients who had an autogenous saphenous vein gra ft in situs,one of whom was then performed an ePTFE graft when rupture and blee ding occurred at the anastomotic site. Color Doppler image showed patent grafted blood vessels in all the patients after operation. Eighteen patients had their femoral arteries ligated. Limbs of all the 34 patients were saved. Conclusions: Ligating femoral artery is an effective way to tre at femoral artery pseudoaneurysm if autogenous saphenous vein graft or artificia l vessel graft is not applicable.

Analyzing the risk of drug abuse for morphine-containing Chinese patent medicines in China

Chinese patent medicines（CPMs） are widely used across China, and they are differently administrated from chemical drugs. For traditional reasons, CPMs may contain opium-derived compounds, such as morphine, which may pose the issues of drug abuse and addiction. In the present study, we aimed to evaluate the present risk of morphine-containing CPMs in causing drug abuse and addiction, based on a questionnaire-based approach and from a medicinal administrative perspective. We chose 76 CPMs containing morphine from government document and set them as the study group, and 10 chemical drugs containing morphine were set as the control group. Because there is no ready-made method, we created an evaluation sheet consisting of five questions to evaluate each drug and generate a risk-value score. Crosstabs analysis using SPSS 15.0 was conducted to obtain the influencing factors. We found that the study group obtained a mean score of 2.04 for the risk value, which was five times of that of the control group. Specifically, no maximum limit of morphine or codeine was set in product quality standards for more than four-fifth of the drugs. Moreover, 46.0% of package inserts failed to show any warning about addiction or prohibition over the long-term use of the drugs. The number of ingredients, as well as the functions of the drugs, was found to correlate with the risk value. Our findings suggested that CPMs were more risky in causing drug abuse and addiction than chemical drugs. Approaches, such as i） controlling the number of ingredients, ii） setting up maximum limit of morphine or codeine in quality standard, iii） providing more information on the package insert of drugs and iv） monitoring the drug containing both morphine and ephedrine, will be effective in reducing the risk of drug abuse and addiction.

Clinical efficacy observation of acupoint thread-embedding in treating obese patients with food addiction

Objective To observe the effects of acupoint thread-embedding therapy and low-carbohydrate diet therapy on obese patients with food addiction.Methods Sixty-five eligible patients were randomized into a thread-embedding group of 33 cases and a diet group of 32 cases to respectively receive 12-week treatment.Before treatment,after treatment and at 6-month follow-up,the two groups were observed and compared in terms of body mass(BM),waist circumference(WC),hip circumference(HC),waist-to-hip ratio(WHR),body mass index(BMI),body fat rate(BFR),basal metabolic rate(BMR)and Yale food addiction scale version 2.0(YFAS 2.0).Results At the end of treatment,there were no significant differences in the general efficacy,and the improvements in BM,BMI,WC,HC,WHR and BFR between the thread-embedding group and diet group(all P>0.05).At follow-up,the thread-embedding group showed more significant improvements in all the aforementioned indicators compared with the diet group except HC(all P<0.05).At the end of treatment and follow-up,BMR and YFSA 2.0 had more significant improvements in the thread-embedding group than in the diet group(all P<0.05).Conclusion Acupoint thread-embedding therapy can produce significant efficacy in treating obese patients with food addiction;it can improve the food addiction state and work better in maintaining the efficacy compared with low-carbohydrate diet therapy.