Comparison of different approaches for direct coupling of solid-phase microextraction to mass spectrometry for drugs of abuse analysis in plasma

The direct coupling of solid-phase microextraction(SPME)to mass spectrometry(MS)(SPME-MS)has proven to be an effective method for the fast screening and quantitative analysis of compounds in complex matrices such as blood and plasma.In recent years,our lab has developed three novel SPME-MS techniques:SPME-microfluidic open interface-MS(SPME-MOI-MS),coated blade spray-MS(CBS-MS),and SPME-probe electrospray ionization-MS(SPME-PESI-MS).The fast and high-throughput nature of these SPME-MS technologies makes them attractive options for point-of-care analysis and anti-doping testing.However,all these three techniques utilize different SPME geometries and were tested with different MS instruments.Lack of comparative data makes it difficult to determine which of these methodologies is the best option for any given application.This work fills this gap by making a comprehensive comparison of these three technologies with different SPME devices including SPME fibers,CBS blades,and SPME-PESI probes and SPME-liquid chromatography-MS(SPME-LC-MS)for the analysis of drugs of abuse using the same MS instrument.Furthermore,for the first time,we developed different desorption chambers for MOI-MS for coupling with SPME fibers,CBS blades,and SPME-PESI probes,thus illustrating the universality of this approach.In total,eight analytical methods were developed,with the experimental data showing that all the SPME-based methods provided good analytical performance with R^(2)of linearities larger than 0.9925,accuracies between 81%and 118%,and good precision with an RSD%≤13%.

Fulminant Hepatitis Associated with Chronic Consumption of 3,4-Methylenedioxy-Methamphetamine;Case Report

The amphetamine derivative 3,4-methylenedioxymethamphetamine (MDMA), also called ecstasy, is a neurotoxin widely consumed among young people that has increased in recent years because it is a recreational drug, of which immediate effects are known such as a greater sensation of well-being, extroversion, increased sensory perception. However, its long-term effects have been described very little in the medical literature, including damage to the heart, central nervous system, kidney, etc. One of its little-known effects is hepatotoxicity, of which few cases are known associated with fulminant hepatitis, which is a rapidly deteriorating condition that is generally associated with a syndrome of multiple organ dysfunction and death. Therefore, it is very important to know this type of damage in the short and long term. The following case is of a 39-year-old man who came to our service due to jaundice syndrome and the only history of MDMA consumption, who as the days went by met the criteria for fulminant liver failure, with damage to multiple organs (organ dysfunction syndrome).

Problem-Based Learning of Drug Use and Abuse during COVID-19 Contingency

Introduction: Nursing students’ experiences during the pandemic provoked social isolation, the way to learn and every context increasing their stress and anxiety leading to drug use and abuse, among others. Problem-based learning (PBL) is a pedagogic strategy to strengthen significant learning;then the objective was to establish PBL influence in nursing students’ experiences on drug use and abuse during COVID-19 contingency. Methods: Qualitative, phenomenological and descriptive paradigm, 12 female and male nursing students aged 20 - 24 years old from the 5th and 6th semesters participated. Information collection was through semi-structured interview and a deep one in four cases. A guide of questions about: How the pandemic impacted your life? How did you face it? And what did you learn during this process? Those questions were used. Qualitative data analysis was based on De Souza Minayo, and signed informed consent was obtained from participants. Results: Students’ experiences allowed four categories to emerge, with six sub-categories. Category I. Students’ experiences on drug use and abuse facing the sanitary contingency;Category II. Students’ skills development to identify a problem and design of appropriate solutions;Category III. Developing skills to favor interpersonal relationships;Category IV. Influence of PBL in nursing students’ experiences on drug use and abuse during the COVID-19 contingency. Conclusion: PBL favored analysis and thoughts in nursing students’ experiences on drug use and abuse during the COVID-19 contingency, they worked collaboratively, developed resilience to daily life situations, and implemented stress coping strategies with their significant learning, which diminished their risk behavior.

Evaluation of Perinatal and Developmental Outcomes in Neonates with Abstinence Syndrome Admitted to NICU

Drug abuse by pregnant women is one of the significant problems for mothers and their neonates.This study aimed to investigate the effects of maternal substance use disorder during pregnancy on neonatal developmental criteria.In a case-control study,clinical records of 90 neonates diagnosed with neonatal abstinence syndrome who were admitted to NICU in one of four hospitals affiliated with Shahid-Beheshti University of Medical Sciences in Tehran,Iran between 2017 and 2020 were compared to 90 neonates without neonatal abstinence syndrome(control group).Demographic information and data for neonatal developmental characteristics and complications were extracted from the clinical records of this convenience sample.Data for the type and method of maternal substance use during pregnancy were collected through a telephone call with mothers.Our data showed that the prevalence of drug addiction was 1.8%among pregnant women,and the most common drugs used by mothers were opium(n=45%,50%),amphetamine(n=30%,33%),and methadone(n=14%,16%).Neonates with abstinence syndrome had a higher prevalence of transient tachypnea of the newborn(TTN)(P=0.004),and a prevalence of being admitted to NICU(P=0.05)and for a longer duration(P<0.001).Their mothers had a higher prevalence of having pre-eclampsia(P=0.010).Using morphine vs.amphetamine showed no difference based on their effects on mothers and neonates.Substance use during pregnancy increased the prevalence of pregnancy complications(pre-eclampsia)and neonatal complications(TTN and prevalence and duration of hospitalization).Therefore,planning for the development of health policies to raise awareness among women and more broadly,all members of the community,is important to prevent the tendency to engage in this potentially high-risk behavior.

A Brief Review of the Relationship between Addiction and Memory Systems

This essay will reexamine research on the relationship between human memory and addiction. This paper will review several studies that discussed how memory systems in the human brain are involved in the acquisition of behavior that is learned and is associated with the development of drug addiction and drug relapse. Additional information reveals that when individuals make the transition from recreational drug or impulsive use to compulsive drug abuse, which may result in a neuroanatomical change in areas of the brain from cognitive control guided by the hippocampus/dorsomedial striatum towards conditioned control of behavior managed by the dorsolateral striatum (DLS) [1]. This review also looked at studies that involved experiments with humans and lower animals, which suggested that the hippocampus mediates a cognitive/spatial type of memory, while the dorsal striatum manages stimulus-response (S-R) habit memory, and the amygdala governs the classical conditioning form of learning and stimulus-affective-associative relationships [1]. Overall, these studies utilize the hypothesis of the memory systems view of addiction, and the involvement of learning and memory in the context of drug addiction, which was proposed by them [2]. This theory has been proposed in response to drug addiction research and includes alcohol, amphetamine, and cocaine [1]. The research also explains how stress and anxiety can play a role in how strong emotional excitement can lead to dependent habit memory in rodents and humans [1]. .

血液回输与促红细胞生成素──竞技体育促力手段的误区

血液回输与促红细胞生成素——竞技体育促力手段的误区狄建杨萍（西安体育学院游泳教研室，７１００６８，西安市；第一作者，４５岁，男，副教授）分类号Ｇ８０４．７１血液回输与促红细胞生成素的概念血液回输又称红细胞回授，它是用输血的方法将已作分离处理的浓缩红...

信息型常见毒物质谱用户库的建立及其在毒物快速筛选上的应用研究

The spectrum user’s librarys containing 1533 familiar toxicants have been built; A method with high separability and sensitivity has been found,The RT and the detection limit of 210 familiar abuse drugs has been confirmed; the processing methods to analyse spectrum data automatically have been found; It is simple,quick,sensitive and reliable,and can take place of manual operation,It is very useful to screen the familiar toxicants in unkown sample.

Evaluation of Effectiveness of Integrated Intervention Program in Improving Drug Addicts' Psychological Health

Objective To investigate the social mental state of drug addicts in a compulsive drug abuse treatment center; evaluate the effectiveness of integrated program for the prevention of abuse relapse and improvement of drug addicts＇ psychological health. Methods The study subjects were addicts from the Wuhan Compulsive Drug Abuse Treatment Center between October 2003 and June 2004, who satisfied the inclusion criteria. A non-randomized control-intervention study design was adopted. Volunteers willing to take part in intervention were put into the intervention group with their full awareness and willingness to prevent drug abuse relapse. The control group was composed of the addicts who were willing to prevent relapse and to be followed up after their discharge. Results The effectiveness of the integrated intervention program in promoting addicts＇ psychological health： before the intervention, the scores of Self-Rating Anxiety Scale （SAS）, the positive and negative dimensionalities of Simple Coping Style Questionnaire （SCSQ） and Chinese Perceived Stress Scales （CPSS） had no significant differences between the intervention group and the control group. After the intervention, except that the SCSQ＇s positive dimensionality in the intervention group was significantly higher than that in the control group, other indices in the intervention group were lower. Before and after the intervention, the psychological health level in both the groups was lower than that in the normal population; there were significant differences between addicts and normal subjects in regards with all of the indices above. Conclusion Drug abuse was associated closely with addicts＇ social mental factors. The integrated intervention program can alleviate anxiety and stress, reduce co-morbid mental disorders and effectively improve their coping style. In conclusion, the program can promote addicts＇ psychological health significantly.

Investigation of Direct Causes of Drug Relapse and Abstainers’ Demands in a Compulsive Detoxification Center in Wuhan City of China

Objective To identify the direct causes of drug relapse and abstainers’ demand, and to develop programs for the prevention of drug relapse. Methods Abstainers in a Compulsive Detoxification Center in Wuhan City, capital of Hubei Province were randomly selected. An investigation on the direct causes of drug relapse and abstainers’ demands was conducted with multiple-choice questionnaires and face to face interviews. Data were analyzed with SPSS 12.0. Results The direct causes leading to drug relapse included： temptation to use drug again by themselves or by their drug mates, seeking pleasure and ecstasy from drug use, relatively well off living, mental stress, irritation, demoralization, family conflicts, unemployment, feeling distrusted by the family, lack of care and love from the family, and discrimination by others. abstainers’ demands after detoxification and returning to the society included： care and support from the family, employment assistance, changing living environment, understanding by others, support from the society, and keeping far away from drugs. Conclusions Environmental factors are the direct causes of drug relapse, and negative irritation is its predisposing causes. Leaving former residence, more care and help given by both the family and the society and raising their overall quality of life are the demands of abstainers.

Short-term Impact of Cognition-Motivation-Emotional IntelligenceResistance Skills Program on Drug Use Prevention for School Students in Wuhan,China

Drug abuse continues to be a serious public health threat worldwide.Most drug abuse prevention research has been conducted with predominantly American or European adolescent populations.Little is known about approaches that work best to prevent the initiation of Chinese adolescent drug use.For targeting risk factors of drug initiation in Chinese adolescents,a school-based health intervention program named "Cognition-Motivation-Emotional IntelligenceResistance Skills" (CMER) was developed to enhance cognition upon drug use,to decrease motivation of drug use and to improve emotional adjusting and drug resistance skills in this study.A total of 798 students from 3 senior high schools in Wuhan,a city in central China,were assigned randomly to intervention and control groups.The intervention group received the CMER program in which knowledge,development of positive attitude and motivation towards drugs and training of peer resistance skills were basic elements.The immediate impact was compared by measuring the above mentioned elements prior to and three-month after the training session.Students from both groups were asked to complete a self-administered questionnaire.The questionnaire included demographic items,self-reported drug use behavior,cognition,attitude,and motivation associated with the initiation of drug use and resistance skills.Three months after the intervention,significant effects were found on "illegal substance use at least once" (P【0.05) between the intervention and control groups.Immediate effects of the intervention were also found on knowledge,motivation and peer resistance skills (P【0.05),but there was no clear evidence for any effects on attitude towards substance use (P】0.05).It was concluded that the CMER program,which significantly increased the knowledge of drugs and peer resistance skills,was effective in the drug abuse prevention in a sample of school students in Wuhan,China.

Drug-abusing Offenders with Co-morbid Mental Disorders:Gender Differences in Problem Severity,Treatment Participation,and Recidivism

Objective This study examined the gender differences in drug‐related problems and predictors of recidivism among a sample of 1444 offenders with co‐morbid drug abuse and mental disorders participating in California＇s Proposition 36 Program.Methods Background characteristics and problem severity in multiple key life areas were assessed at intake by using Addiction Severity Index,and drug treatment participation,mental health diagnoses and arrests were based on official records.Results Women demonstrated greater problem severity than men in family relationships,health,psychological health,and sexual and physical abuse history.Men on the other hand had greater criminal history,high rates of attention disorder,and psychotic disorder.More men than women were rearrested during the year after treatment admission.Logistic regression analyses showed that for the combined sample,male,young age,cocaine use（relative to methamphetamine）,drug abuse severity,methadone treatment,arrest history and fewer prior treatment history were associated with higher recidivism at 12‐month follow‐up;lower education,cocaine use,and arrest history were related to women＇s recidivism,while young age,outpatient treatment,and arrest history were predictors of men＇s recidivism.Conclusion Although the specific type of mental disorder did not seem to be predictive of recidivism,the high rates of mental health disorder and arrest of this population is problematic.Intervention strategies taking into consideration gender‐specific problems and needs can improve outcomes for both.

Modifying current thin-film microextraction(TFME)solutions for analyzing prohibited substances:Evaluating new coatings using liquid chromatography

For identifying and quantifying prohibited substances,solid-phase microextraction(SPME)continues to arouse interest as a sample preparation method.However,the practical implementation of this method in routine laboratory testing is currently hindered by the limited number of coatings compatible with the ubiquitous high-performance liquid chromatography(HPLC)systems.Only octadecyl(C18)and polydimethylsiloxane/divinylbenzene ligands are currently marketed for this purpose.To address this situation,the present study evaluated 12 HPLC-compatible coatings,including several chemistries not currently used in this application.The stationary phases of SPME devices in the geometry of thin filmcoated blades were prepared by applying silica particles bonded with various functional ligands(C18,octyl,phenyl-hexyl,3-cyanopropyl,benzenesulfonic acid,and selected combinations of these),as well as unbonded silica,to a metal support.Most of these chemistries have not been previously used as microextraction coatings.The 48 most commonly misused substances were selected to assess the extraction efficacy of each coating,and eight desorption solvent compositions were used to optimize the desorption conditions.All samples were analyzed using an HPLC system coupled with triple quadrupole tandem mass spectrometry.This evaluation enables selection of the best-performing coatings for quantifying prohibited substances and investigates the relationship between extraction efficacy and the physicochemical characteristics of the analytes.Ultimately,using the most suitable coatings is essential for trace-level analysis of chemically diverse prohibited substances.

Determination of multiple drugs of abuse in human urine using dispersive liquid–liquid microextraction and capillary electrophoresis with PDA detection

A new method was developed for pre-concentration and determination of multiple drugs of abuse in human urine using dispersive liquid–liquid microextraction(DLLME)and capillary electrophoresis(CE)with photodiode array detection.The method was based on the formation of tiny droplets of an organic extractant in the prepared sample solution using water-immiscible organic solvent(chloroform)dissolved in water-miscible organic dispersive solvent(isopropyl alcohol).The organic phase,which extracted eight drugs of abuse from the prepared urine solution,was separated by centrifugation.The sedimented phase was transferred into a small volume CE auto-sampler vial with 10μL of 1%HCl methanol solution and evaporated to dryness.The residue was reconstituted in lidocaine hydrochloride(internal standard)aqueous solution and introduced by electrokinetic injection into CE.Under the optimum conditions,acceptable linear relationship was observed in the range of 3.0–500 ng/mL with the correlation coefficient(r)of 0.9982–0.9994 for spiked urine samples.The limit of detection(LOD)(S/N=3)was estimated to be 1.0 ng/mL.A recovery of 75.7%–90.6%was obtained for spiked samples.The mean relative error(MRE)was within±7.0%and the relative standard deviation(RSD)was less than 6.9%.The proposed DLLME-CE procedure offers an alternative analytical approach for the sensitive detection of drugs of abuse in real urine samples.

Fatal Skin and Soft Tissue Infection, Peritonitis and Bacteriemia Caused by Shewanella petrefaciens

We report a case of skin and soft tissue infection, peritonitis and bacteriemia in a 51-year-old drug abuse male. His wife found him lifeless lying on the kitchen floor at his residence. At the time of autopsy, multiple skin ulcers with deep soft tissue infection and peritonitis were found on gross examination. Cultures of postmortem blood and a swab of soft tissue were positive for Shewanella putrefaciens, a gram-negative bacterium that had been isolated from many foods, sewage and fresh and salt water. This is the first reported case in the United States of fatal skin and soft tissue infection, peritonitis and bacteremia caused by this micro-organism.

Chemsex and its risk factors associated with human immunodeficiency virus among men who have sex with men in Hong Kong

We were intrigued by Hanum et al,who published a study on the prevalence of human immunodeficiency virus(HIV)in homosexual,bisexual,and other men who have sex with men at sexual health clinics in England and the relationship between baseline variables and future HIV occurrence.Chemically-enhanced sexual experience(chemsex)is becoming a global phenomenon.There are increasing medical and academic concerns about chemsex,where substances are used to boost sexual satisfaction,which is prevalent in groups,especially among homosexuals.Lesbians,gays,bisexuals,transgenders,and queers have become increasingly visible,valued,and committed community.However,chemsex requires urgent attention.

An Epidemiological Survey on the Use and Abuse of Antianxiety Drugs among Beijing Residents.

A systematic field survey of 6,567 urban and rural residents out of 3.000 households, through cluster sampling among Beijing residents, was collaborativelv conducted. The results reveal that benzodiazepine has been widely prescribed and its rate of usage for 1 year is 61.82%. whereas rate of de-

Comparison of Hair Fatty Alcohols by N-Alkylpyridinium Isotope Quaternization and Matrix-assisted Laser Desorptionl ionization Mass Spectrometry for Drug Abuse Monitoring

Based on our previous report on N-alkylpyridinium isotope quaternization （NAPIQ） for the analysis of alcoholic and α,β-unsaturated ketone compounds, we have further applied NAPIQ method in the screening of hair lipids in drug abusers. Relative isotopic quantification was used for comparison of fatty alcohols between normal and drug abuse group, The NAPIQ strategy was proven to be a high-throughput method in the metabolic comparison studies of different group samples. The attached N-cationic pyridinium significantly improved the detection sensitivity for these fatty alcohols in matrix-assisted laser desorption/ionization Fourier transform ion cyclotron resonance mass spectrometric （MALDI-FTMS） analysis. The experimental results showed that the levels of fatty alcohols in the hair of heroin abuse group decreased significantly compared with the normal groups, which may be the results of the inducing of peroxidation enzyme. NAPIQ was proven to be an effective and alternative method in the research of fatty alcoholic metabolism for drug abuse monitoring.

Endogenous Klebsiellapneumoniae endophthalmitis associated with intravenous drug abuse

Enndogenous endophthalmitis （EE） accounts for 2%- 15% of endophthalmitis cases;j EE may occur when microorganisms from remote infection site enter into the eye by crossing the blood-ocular barrier and reproduce in the eye. It is well known that EE often occurs secondary to systemic underlying condition, such as diabetes mellitus,