对烟草依赖患者的治疗

随着烟草依赖问题对社会的负面影响愈演愈烈,对烟草依赖患者的治疗逐渐引起了社会的广泛关注。目前普遍采用的治疗手段中,药理性治疗方式直接,而且效果明显;非药理性的行为干预,协助患者从心理上摆脱对烟草的恶性依赖。戒断后的复吸问题,是治疗烟草依赖的重大障碍。了解导致复吸的社会、家庭以及个体因素,采取一系列跟踪咨询,有助于巩固治疗效果,从而防止复吸。针对精神病人以及酒精/毒品依赖患者等特殊人群,应考虑到他们特殊性而采取适宜的治疗方式。

Permeabilities of rebamipide via rat intestinal membranes and its colon specific delivery using chitosan capsule as a carrier

AIM: To investigate the permeability characteristics of rebamipide across intestinal mucosa, and examine the effects of some absorption enhancers on the permeability across the colonic tissue. Another purpose is to demonstrate the colon-specific delivery of rebamipide with or without absorption enhancers using chitosan capsule as a carrier. METHODS: The permeability of rebamipide was evaluated using an in vitro diffusion chamber system, and the effects of some absorption enhancers on the permeability via colon were further investigated. The release of rebamipide from chitosan or gelatin capsule was studied by Japan Pharmacopoeia rotating basket method. The colonic and plasma concentrations were analyzed by high performance liquid chromatography (HPLC) to evaluate colon-targeting action after oral administration of various dosage forms, and rebamipide with absorption enhancers in chitosan dosage forms. RESULTS: The permeability of rebamipide across the jejunal or ileal membranes was higher than the colonic membranes. Both sodium laurate (C12) and labrasol signifi cantly increased permeability across the colon membranes. On the other hand, the release of rebamipide from chitosan capsule was less than 10%totally within 6 h. The area under concentration-time profile of drug in the colon mucosa using chitosan capsules (AUCLI, 1 6011.2 ng·h/g) was 2.5 times and 4.4 times greater than using gelatin capsules and CMC suspension, respectively. Meanwhile, the area under concentration-time profile of drug in the plasma (AUCPL) was 1016.0 ng·h/mL for chitosan capsule, 1887.9 ng·h/mL for CMC suspension p and 2163.5 ng·h/mL for gelatin capsule. Overall, both AUCLI and AUCPL were increased when C12 was co-administrated, but the increase of AUCLI was much greater; the drug delivery index (DDI) was more than 1 compared with simple chitosan capsule group. CONCLUSION: There was a regional difference in the permeability of Rabamipide across the jejunum, ileum and the colon, and passive diffusion seems to be one of the major transport mechanisms of rebamipide. Absorption enhancers can increase the permeability of rebamipide across the colon tissue signifi cantly. In addition, chitosan capsule may be a useful carrier to deliver rebamipide to the colon specifi cally and the co-administration of C12 with rebamipide may also be very useful in local treatment.

Relaxin prevents the development of severe acute pancreatitis

AIM： TO investigate the severity of acute pancreatitis （AP） is associated to the intensity of leukocyte activation, inflammatory up-regulation and microcirculatory disruption associated to ischernia-reperfusion injury. Hicrovascular integrity and inhibition of pro-inflammatory mediators are key-factors in the evolution of AP. Relaxin is an insulin-like hormone that has been attributed vasorelaxant properties via the nitric oxide pathway while behaving as a glucocorticoid receptor agonist. METHODS： AP was induced by the bilio-pancreatic duct-outlet-exclusion closed-duodenal-loops model. Treatment with relaxin was done at different timepoints. Nitric oxide synthase inhibition by L-NAME and glucocorticoid receptor （GR） blockage by mifepristone was considered. AP severity was assessed by biochemical and histopathological analyses. RESULTS： Treatment with relaxin reduced serum amylase, lipase, C-reactive protein, IL-6, IL-10, hsp72, LDH and 8-isoprostane as well as pancreatic and lung myeloperoxidase. Acinar and fat necrosis, hemorrhage and neutrophil infiltrate were also decreased. ATP depletion and ADP/ATP ratio were reduced while caspases 2-3-8 and 9 activities were increased. L-NAME and mifepristone decreased the efficiency of relaxin. CONCLUSION： Relaxin resulted beneficial in the treatment of AP combining the properties of a GR agonist while preserving the microcirculation and favoring apoptosis over necrosis.

The rationale behind the four major anti-COVID-19 principles of Chinese herbal medicine based on systems medicine

As the novel coronavirus disease 2019(COVID-19)and its variants continue to rage into the second year of a global pandemic,many success stories of applying Chinese herbal medicine(CHM)to treat COVID-19 patients continue to emerge from China and other part of the world.Herewith,from a systems medicine perspective,the authors analyze those experiences and categorize them into four major treatment principles:(1)focusing on eliminating toxins in the early stage of the disease,(2)tonifying deficiency of the body throughout the entire disease course,(3)treating the affected lung and intestine simultaneously based on visceral interactions,(4)cooling blood and removing blood stasis at the later stage,as well as interpret the rationale of these principles.This is helpful not only in reducing the complexity of promoting the CHM applications to enhance anti-COVID-19 efficacy,but also in ramping out the process of integrating traditional Chinese medicine with modern medical practices.

Heroin Narratives： Normalisation and Demonisation of Heroin Use at a Swedish Online Message Board

Heroin is considered potent and addictive and users are often stigmatised as the other. On the internet, however, hegemonic ideas about drugs can be resisted. This study elucidates how efforts to uormalise and demonise heroin meet at a Swedish online message board （Flashback Forum）. The study aims at analysing how heroin use is given meaning by discussants in a thread called ＂I will start with heroin＂. The data were perceived and structured as a collaborative, overarching narrative about when, why, and for whom heroin use can make sense. Discussants used stories about pleasure-seekers, miserable junkies, and self-medicating addicts to depict the activity as unproblematic and rational, problematic and irrational, or as problematic and rational. No stories about heroin use departed from the plot-lines of pleasure maximisation and pain minimisation. Results elucidate a discursive battle in which： （1） heroin use as minimisation of pain ＂wins＂ over heroin use as maximisation of pleasure; and （2） there is a general agreement that heroin use cannot be irrational and unproblematic at the same time. It is suggested that these features are central to contemporary drug discourse, and that they probably hinder public understanding of why people use heroin and therefore contribute to keep users stigmatised.

Non-Specific Factors Involved in the Treatment： Its Influence on Treatment Adherence

Introduction： The effectiveness of treatment depends on the efficacy of the therapy and the level of compliance of the patient. NF （non-specific factors） involved in treatment are all those effects that do not depend on the pharmacological properties of the drug. Materials and Methods： The job lasted a year. The sample consisted of patients with mental health disorders and was divided into two groups. Treatment compliance was measured with the Morisky-Green Test. Results were compared using the chi square test and relative risk. Results and Discussion： Group A had 23 patients ending 91.3% of them and group B of 22 patients, ending the 77.27%. At the beginning of the study, we found in the group A 0.86 NF/patients while in the group B 0.82 NF/patient. At the end of the study there was a 54.65% decrease in group A while in group B the proportion remained. At the beginning of the study both groups had approximately 40% of compliant patients. Data that remained in the control group rose to 80.95% in group A at the end of the study. Conclusions： The work demonstrates the negative influence of these factors on adherence to treatment.

Exploration of collaborative drug therapy management mode for elderly patients with chronic diseases

As China is accelerating into an aging society,the coexistence of multiple diseases,multiple drugs,and the decline of body function are serious problems faced by elderly patients.Therefore,it is imperative to carry out the comprehensive prevention and control of chronic diseases,strengthen the health guidance and comprehensive intervention of common and chronic diseases of the elderly,and strengthen the health management of elderly patients.Collaborative drug therapy management(CDTM)is a drug treatment management mode that emerged in pharmaceutical services under the situation of new medical reform,aiming to expand the role of pharmacists in the medical team and improve the quality of hospital medical service.Although CDTM has shown some favorable effects in managing chronic diseases in the elderly population,the popularization of CDTM in China is limited by the differences in supporting facilities,management mode,and pharmacist’s abilities in hospitals.By exploring the CDTM mode for elderly patients with chronic diseases,we provided a reference for further promoting the CDTM services and laid a good foundation for displaying pharmacist value and the realization of real pharmaceutical care.