The high rate of relapse among heroin users remains a significant public concern in China. In the present study, we utilized a Motivation-Skill-Desensitization-Mental Energy (MSDE) intervention and evaluated its effec...The high rate of relapse among heroin users remains a significant public concern in China. In the present study, we utilized a Motivation-Skill-Desensitization-Mental Energy (MSDE) intervention and evaluated its effects on abstinence and mental health. Eighty-nine male heroin users in a drug rehabilitation center were enrolled in the study. The participants in the MSDE intervention group (n=46) received MSDE intervention, which included motivational interviewing, coping skills training, eye movement desensitization and reprocessing, and mindfulness-based psychotherapy. The participants in the control group (h=43) received a series of lectures on skills training. A significant increase in Contemplation Ladder score (P<0.001) and decreases in scores on the Obsessive Compulsive Drug Use Scale (P<0.001), Beck Depression Inventory (P<0.001), and Aggression Questionnaire (P=O.O33) were found immediately after intervention. Compared to the control group, the MSDE intervention group reported significantly higher abstinence rates (P=0.027) and retention rates (P<0.001) at follow-up. Overall, the MSDE intervention, which uses a combined strategy for relapse prevention, could be a promising approach for preventing relapse among heroin users in China.展开更多
Background: Whilst several studies have demonstrated poor cardiovascular health in opiate dependence, its role as a cardiovascular risk factor has not been considered. Methods: Pulse wave analysis was undertaken by ra...Background: Whilst several studies have demonstrated poor cardiovascular health in opiate dependence, its role as a cardiovascular risk factor has not been considered. Methods: Pulse wave analysis was undertaken by radial arterial tonometry (SphygmoCor) in female control and opiate-dependent patients and compared to lifetime opiate use. Results: 222 opiate dependent women were compared to 175 controls. Opiate dependent patients were receiving treatment with buprenorphine (83.3%), methadone (13.5%), or naltrexone (3.2%). Non log transformed chronologic age (CA) for the two groups was 33.58 ± 0.57 (opiate) vs. 32.62 ± 0.96 (controls) years (mean ± S.E.M.;P = 0.39). Vascular Reference Age (RA) 39.30 ± 1.28, vs. 35.03 ± 1.41 the RA-CA difference (5.73 ± 1.02 vs. 2.41 ± 0.91) and the RA/CA ratio (1.16 ± 0.03 vs. 1.07 ± 0.02;all P < 0.02), and all measurements of central arterial stiffness (P < 0.02) were significantly worse for opiates compared to controls. When adjusted for CA, RA and central augmentation pressure and index were all worse by themselves and in interaction with CA (all P < 0.005). At 60 years the modelled RA’s were 83.79 and 67.52 years respectively. The opiate dose-duration interaction showed a dose-response effect with RA (P = 0.0033). After full adjustment for established cardiovascular risk factors, the dose-duration interaction remained significant (P = 10-6), was included in 10 other terms, and dose or duration was included in 15 other interactions. Conclusion: These data show that lifetime opiate use is significantly associated with increased arterial stiffness and vascular age and suggest a dose-response relationship. This relationship is robust and persists after full multivariate adjustment. These findings carry far-reaching implications for opiate-induced generalized acceleration of organismal ageing.展开更多
435 heroin addicts were treated for 10 days to evaluate the therapeutic effectiveness ofabstinence capsule on heroin withdrawal symptoms and its main adverse actions.Lofexidine was applied in a control group of 48 add...435 heroin addicts were treated for 10 days to evaluate the therapeutic effectiveness ofabstinence capsule on heroin withdrawal symptoms and its main adverse actions.Lofexidine was applied in a control group of 48 addicts.The single blind method and somedetermination methods used internationally were employed to evaluate the therapeuticeffectiveness and adverse actions of the drugs.The results showed that the abstinence capsulehas better therapeutic effectiveness,with less adverse actions,wider safety range,longer timeof action and less cost than lofexidine.展开更多
目的:探讨1,4,5-三磷酸肌醇1型受体(inositol 1,4,5-trisphosphate receptor type 1,IP3R1)调控钙/钙调蛋白依赖性蛋白激酶Ⅱ(calcium/calmodulin-dependent protein kinaseⅡ,CaMKⅡ)和电压依赖性阴离子通道1(voltage-dependent anion ...目的:探讨1,4,5-三磷酸肌醇1型受体(inositol 1,4,5-trisphosphate receptor type 1,IP3R1)调控钙/钙调蛋白依赖性蛋白激酶Ⅱ(calcium/calmodulin-dependent protein kinaseⅡ,CaMKⅡ)和电压依赖性阴离子通道1(voltage-dependent anion channel 1,VDAC1)在海洛因(heroin,HE)致心肌细胞节律异常中的作用。方法:联合蛋白组学和GEO(Gene Expression Omnibus)数据库分析心律失常芯片数据,寻找关键调控因子。构建IP3R1基因敲减慢病毒并感染原代乳大鼠心肌细胞(neonatal rat cardiomyocytes,NRCMs),实验分为对照(control)组、HE组和HE+shIP3R1组。结晶紫染色观察心肌细胞形态;ELISA法检测乳酸脱氢酶(lactate dehydrogenase,LDH)和天冬氨酸转氨酶(aspartate aminotransferase,AST)水平;透射电镜观察线粒体形态学变化;Fluo-4/AM探针法检测细胞内Ca^(2+)浓度;DCFH-DA荧光探针检测细胞内活性氧(reactive oxygen species,ROS)含量;JC-1染色法检测线粒体膜电位(mitochondrial membrane potential,MMP)水平;ATP检测试剂盒检测细胞内ATP水平;免疫共沉淀(co-immunopre-cipitation,Co-IP)分析IP3R1与CaMKⅡδ和VDAC1蛋白之间的相互作用;Western blot检测IP3R1、CaMKⅡδ、p-CaM-KⅡδ(T287)和VDAC1的蛋白水平。结果:结合蛋白质组学和基因表达谱数据集GSE89410分析,筛选得到80个差异共表达分子,基于基因本体论(Gene Ontology,GO)功能注释和京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Genomes,KEGG)富集分析结果,最终筛选出关键因子IP3R1,且通过STRING数据库获得IP3R1结合蛋白:CaMKⅡδ和VDAC1。Co-IP结果验证IP3R1与CaMKⅡδ和VDAC1存在相互作用,且HE干预后NRCMs中IP3R1与CaMKⅡδ和VDAC1之间的相互作用增强。体外细胞实验显示,与control组相比,HE组NRCMs数量急剧减少,细胞膜变窄,伪足减少,细胞核结构模糊;LDH和AST水平均显著上升(P<0.05);线粒体超微结构损伤严重,证实HE对NRCMs具有毒性作用并导致线粒体损伤。与control组相比,HE组心肌细胞内Ca^(2+)浓度、ROS水平、MMP以及IP3R1、p-CaMKⅡδ(T287)和VDAC1蛋白水平均显著升高(P<0.05),而HE+shIP3R1组这些指标均显著减低(P<0.05);ATP水平则相反。这证实沉默IP3R1表达可减轻HE干预后NRCMs的钙超载及线粒体损伤。结论:IP3R1通过调控CaMKⅡ和VDAC1引起心肌细胞钙超载和ROS生成增多,参与HE诱导的心肌细胞节律异常。展开更多
The switch from methadone to buprenorphine-naloxone for individuals with heroin dependence is associated with several obstacles and challenges.Such patients may experience discomfort from discontinuing methadone, prec...The switch from methadone to buprenorphine-naloxone for individuals with heroin dependence is associated with several obstacles and challenges.Such patients may experience discomfort from discontinuing methadone, precipitated withdrawal symptoms induced by buprenorphine-naloxone,and poor psychosocial adjustments such as anticipatory anxiety regarding severe opioid withdrawal.We herein describe a 46-year-old man with a history of heroin dependence who underwent Traditional Chinese Medicine(TCM)-facilitated switching from methadone to buprenorphine-naloxone. No precipitated withdrawal was induced by buprenorphine-naloxone. The drug-switching process was successful and smooth. He maintained abstinence from heroin for the following year. In this case, we applied TCM for enhancement of methadone metabolism and detoxification, analgesic effects, and anxiolytic and hypnotic effects during the drug switch. We observed that TCM effectively facilitated the switch from methadone to buprenorphine-naloxone in our case. Further studies regarding TCM-facilitated treatment for heroin dependence should be conducted.展开更多
Obj ective: To observe and analyze the intervention effects of needling different points for post- withdrawal syndrome of heroin dependence, and thus provide clinical basis for screening specific points. Methods: A ...Obj ective: To observe and analyze the intervention effects of needling different points for post- withdrawal syndrome of heroin dependence, and thus provide clinical basis for screening specific points. Methods: A total of 60 males with heroin dependence were randomly allocated into 3 groups, the Neiguan (PC 6) group, the Shenmen (HT 7) group and the control group. The results were observed and evaluated before, during, and 3 weeks after treatment using the rating scale for post-withdrawal syndrome and Hamilton anxiety scale (HAMA). Results: In regards to the control of post-withdrawal symptoms, the groups of Neiguan (PC 6) and Shenmen (HT 7) showed statistical difference when compared with the control group (P〈0.05, P〈0.01); however, there was no statistical difference between the Neiguan (PC 6) group and Shenmen (HT 7) group (P〉0.05). Conclusion: Acupuncture can alleviate the post-withdrawal syndrome and anxiety of heroin dependence. Although both Neiguan (PC 6) and Shenmen (HT 7) have equally remarkable effects, Shenmen (HT 7) have a better tendency for marked effect for heart-mind related symptoms.展开更多
Objective: To observe the influence of acupuncture on sleep disorders and anxiety in patients with heroin dependence. Methods: Sixty-two male patients with heroin dependence were divided into two groups by random nu...Objective: To observe the influence of acupuncture on sleep disorders and anxiety in patients with heroin dependence. Methods: Sixty-two male patients with heroin dependence were divided into two groups by random number table. Thirty-five cases in the acupuncture group were treated by puncturing Baihui (GV 20), Neiguan (PC 6), and Shenmen (HT 7) and moxibustion at Zusanli (ST 36). Twenty-seven cases in the control group did not receive any therapeutic measures. The therapeutic effects were summarized after observation of 8 weeks. Results: After treatment, the global scores and standard scores of anxiety declined in comparison with those before the treatment in both two groups, but there was statistical difference only in the acupuncture group (P〈0.05). There were no statistical differences in the global score and the standard score of anxiety between the two groups, but the standard scores in the acupuncture group reached the normal level. After treatment, only the sleep latency was obviously improved in the control group (P〈0.05). The syndromes of sleep disorder were improved noticeable in the acupuncture group (P〈0.05), and the actual sleep time was improved better than those in the control group (P〈0.05), and PSQI global scores decreased below the normal level. Conclusion: Acupuncture has the effects to improve sleep disorders and anxious emotion in the patients with heroin dependence.展开更多
基金This study was funded by the National Natural Science Foundation of China (No.30872175,No.81573236).
文摘The high rate of relapse among heroin users remains a significant public concern in China. In the present study, we utilized a Motivation-Skill-Desensitization-Mental Energy (MSDE) intervention and evaluated its effects on abstinence and mental health. Eighty-nine male heroin users in a drug rehabilitation center were enrolled in the study. The participants in the MSDE intervention group (n=46) received MSDE intervention, which included motivational interviewing, coping skills training, eye movement desensitization and reprocessing, and mindfulness-based psychotherapy. The participants in the control group (h=43) received a series of lectures on skills training. A significant increase in Contemplation Ladder score (P<0.001) and decreases in scores on the Obsessive Compulsive Drug Use Scale (P<0.001), Beck Depression Inventory (P<0.001), and Aggression Questionnaire (P=O.O33) were found immediately after intervention. Compared to the control group, the MSDE intervention group reported significantly higher abstinence rates (P=0.027) and retention rates (P<0.001) at follow-up. Overall, the MSDE intervention, which uses a combined strategy for relapse prevention, could be a promising approach for preventing relapse among heroin users in China.
文摘Background: Whilst several studies have demonstrated poor cardiovascular health in opiate dependence, its role as a cardiovascular risk factor has not been considered. Methods: Pulse wave analysis was undertaken by radial arterial tonometry (SphygmoCor) in female control and opiate-dependent patients and compared to lifetime opiate use. Results: 222 opiate dependent women were compared to 175 controls. Opiate dependent patients were receiving treatment with buprenorphine (83.3%), methadone (13.5%), or naltrexone (3.2%). Non log transformed chronologic age (CA) for the two groups was 33.58 ± 0.57 (opiate) vs. 32.62 ± 0.96 (controls) years (mean ± S.E.M.;P = 0.39). Vascular Reference Age (RA) 39.30 ± 1.28, vs. 35.03 ± 1.41 the RA-CA difference (5.73 ± 1.02 vs. 2.41 ± 0.91) and the RA/CA ratio (1.16 ± 0.03 vs. 1.07 ± 0.02;all P < 0.02), and all measurements of central arterial stiffness (P < 0.02) were significantly worse for opiates compared to controls. When adjusted for CA, RA and central augmentation pressure and index were all worse by themselves and in interaction with CA (all P < 0.005). At 60 years the modelled RA’s were 83.79 and 67.52 years respectively. The opiate dose-duration interaction showed a dose-response effect with RA (P = 0.0033). After full adjustment for established cardiovascular risk factors, the dose-duration interaction remained significant (P = 10-6), was included in 10 other terms, and dose or duration was included in 15 other interactions. Conclusion: These data show that lifetime opiate use is significantly associated with increased arterial stiffness and vascular age and suggest a dose-response relationship. This relationship is robust and persists after full multivariate adjustment. These findings carry far-reaching implications for opiate-induced generalized acceleration of organismal ageing.
文摘435 heroin addicts were treated for 10 days to evaluate the therapeutic effectiveness ofabstinence capsule on heroin withdrawal symptoms and its main adverse actions.Lofexidine was applied in a control group of 48 addicts.The single blind method and somedetermination methods used internationally were employed to evaluate the therapeuticeffectiveness and adverse actions of the drugs.The results showed that the abstinence capsulehas better therapeutic effectiveness,with less adverse actions,wider safety range,longer timeof action and less cost than lofexidine.
文摘The switch from methadone to buprenorphine-naloxone for individuals with heroin dependence is associated with several obstacles and challenges.Such patients may experience discomfort from discontinuing methadone, precipitated withdrawal symptoms induced by buprenorphine-naloxone,and poor psychosocial adjustments such as anticipatory anxiety regarding severe opioid withdrawal.We herein describe a 46-year-old man with a history of heroin dependence who underwent Traditional Chinese Medicine(TCM)-facilitated switching from methadone to buprenorphine-naloxone. No precipitated withdrawal was induced by buprenorphine-naloxone. The drug-switching process was successful and smooth. He maintained abstinence from heroin for the following year. In this case, we applied TCM for enhancement of methadone metabolism and detoxification, analgesic effects, and anxiolytic and hypnotic effects during the drug switch. We observed that TCM effectively facilitated the switch from methadone to buprenorphine-naloxone in our case. Further studies regarding TCM-facilitated treatment for heroin dependence should be conducted.
基金supported by Shanghai Leading Academic Discipline Project(S30304)Youth Foundation of Shanghai Municipal Health Bureau(2008Y124)Innovation Project of Shanghai Municipal Education Commission(12YZ070)
文摘Obj ective: To observe and analyze the intervention effects of needling different points for post- withdrawal syndrome of heroin dependence, and thus provide clinical basis for screening specific points. Methods: A total of 60 males with heroin dependence were randomly allocated into 3 groups, the Neiguan (PC 6) group, the Shenmen (HT 7) group and the control group. The results were observed and evaluated before, during, and 3 weeks after treatment using the rating scale for post-withdrawal syndrome and Hamilton anxiety scale (HAMA). Results: In regards to the control of post-withdrawal symptoms, the groups of Neiguan (PC 6) and Shenmen (HT 7) showed statistical difference when compared with the control group (P〈0.05, P〈0.01); however, there was no statistical difference between the Neiguan (PC 6) group and Shenmen (HT 7) group (P〉0.05). Conclusion: Acupuncture can alleviate the post-withdrawal syndrome and anxiety of heroin dependence. Although both Neiguan (PC 6) and Shenmen (HT 7) have equally remarkable effects, Shenmen (HT 7) have a better tendency for marked effect for heart-mind related symptoms.
基金supported by Anhui Provincial Programs for Science and Technology Development(07010302205) and Provincial Key Lab of Acupuncture Basis and Technology
文摘Objective: To observe the influence of acupuncture on sleep disorders and anxiety in patients with heroin dependence. Methods: Sixty-two male patients with heroin dependence were divided into two groups by random number table. Thirty-five cases in the acupuncture group were treated by puncturing Baihui (GV 20), Neiguan (PC 6), and Shenmen (HT 7) and moxibustion at Zusanli (ST 36). Twenty-seven cases in the control group did not receive any therapeutic measures. The therapeutic effects were summarized after observation of 8 weeks. Results: After treatment, the global scores and standard scores of anxiety declined in comparison with those before the treatment in both two groups, but there was statistical difference only in the acupuncture group (P〈0.05). There were no statistical differences in the global score and the standard score of anxiety between the two groups, but the standard scores in the acupuncture group reached the normal level. After treatment, only the sleep latency was obviously improved in the control group (P〈0.05). The syndromes of sleep disorder were improved noticeable in the acupuncture group (P〈0.05), and the actual sleep time was improved better than those in the control group (P〈0.05), and PSQI global scores decreased below the normal level. Conclusion: Acupuncture has the effects to improve sleep disorders and anxious emotion in the patients with heroin dependence.