Possible age-associated bias in reporting of clinical features of drug dependence: epidemiological evidence on adolescent-onset marijuana use

Aims To probe recent evidence on apparent excess occurrence of marijuana dependence when marijuana smoking starts in adolescence. Design and participants A national sample of recent‐onset marijuana users was identified within public data files of the National Household Survey on Drug Abuse (NHSDA), 1995–98 (1866 adolescents and 762 adults). Measurements Marijuana dependence was assessed via seven standardized questions about its clinical features, such as being unable to cut down. Multivariate response models (GLM/GEE and MIMIC) were used to evaluate adolescent excess risk and possible item biases. Findings Among people who had just started to use marijuana, clinical features of marijuana dependence occurred twice as often among adolescents compared to adults, even with statistical adjustment for other covariates (P < 0.01 from GLM/GEE). MIMIC analyses suggest that adolescent‐onset users have somewhat higher levels of marijuana dependence, and they also provide evidence of age‐associated response bias for some but not all clinical features of marijuana dependence. That is, even with level of marijuana dependence held constant, adolescent recent‐onset users were more likely than adults to report being unable to cut down (P = 0.01) and tolerance (P = 0.029). Conclusion Nosologic, methodological and substantive reasons for observed age‐related excess in occurrence of marijuana dependence problems among early onset users deserve more attention in future research.     

Addiction research centres and the nurturing of creativity. The Korean Institute on Alcohol Problems (KIAP)

The aim of this paper is to provide an account of the history, current status and vision of the Korean Institute on Alcohol Problems (KIAP). In the context of increasing alcohol consumption, rising second‐hand effects and industry‐friendly government policy, the Korean College Alcohol Study (KCAS) was established in the Republic of Korea in 1999, and changed its name to the Korean Institute on Alcohol Problems (KIAP) in 2005. KIAP's mission is to decrease alcohol consumption and its related harms by promoting research, advocating policy, developing intervention programmes and preparing media communications. Since 1999, KIAP has published scientific papers and books in alcohol research and used the internet and other media for dissemination of specialized information to the general population. In the last decade, KIAP has trained front‐line alcohol researchers, and advanced domestic and international networks to promote evidence‐based alcohol control policy in Korea. The light of hope shines brightly as KIAP grows and establishes critical linkages to move forward in its mission.     

Can Creative Writing,as an Add-on to Treatment for Alcohol Use Disorder,Support Rehabilitation?

ABSTRACT

Creative writing may help patients find new powers in the acts of making art and expanding horizons beyond illness, including addiction. The aim of the present pilot study was to introduce creative writing workshops to alcohol use disorder (AUD) patients and investigate self-perceived rehabilitating impact, improvement in quality of life, and executive functions. The study was conducted in a mixed methods design; primarily semi-structured group and individual interviews as well as participant observation, supplemented by a small evaluation questionnaire at baseline and follow-up at the end of exposure. The patients had experienced the workshop as having influenced their lives in a positive direction, impacted by doing creative writing, sharing and receiving feedback, and the community of the group. The patients perceived both advantages and disadvantages about discussing alcohol in the workshop. The patients experienced an increase in quality of life from the beginning to the end of the workshop. There could be a need for creative writing workshops as add-ons to ordinary AUD treatment. In such an offer, creative writing might function as a means to improve patient rehabilitation, quality of life, and executive functions.     

纤溶酶原对星形胶质细胞纤溶酶原激活因子及其抑制的调节作用

目的 探讨纤溶酶原（PGn)对大鼠脑星菜胶质细胞纤溶酶原激活因子（PAI）及其抑制剂(PA)的调节作用。方法 利用大鼠血纤溶酶原对体外培养的星形胶质细胞进行诱导刺激,采用酶谱分析法、反射酶谱分析法、免疫印迹法对所产生的PAs和PAIs进行分析测定。结果 实验所用PGn调uPA和PAI－1,下调tPA活性,并且诱导产生一个28kDa的低分子量的uPA活性分子。结论 在体外,纤溶酶原有调节星形胶质细胞的功能。     

Synthesis and Characterization of Fe(III) and Pb(II) Complexes with 3-Hydroxypyridine-2(1H)-Thiones

Two kinds of 3-hydroxypyridine-2(1H)-thiones were synthesized. The visible (VIS) spectroscopic analysis indicated that 3-hydroxy-1-methylpyridine-2(1H)-thione (4a) and 3-hydroxy-1-(2-hydroxyethyl)pyridine-2(1H)-thione (4b) formed stable 3:1 Fe(III) complexes. The stability constant of the 4b-Fe(III) complex was estimated from the competitive reaction with EDTA and was found to be 36.7 in logβ₃. Treatment of compound 4b with Ga(acac)₃ in D₂O:CD₃OD (9:1) solution afforded 3:1 Ga(III) complex, which was assigned by means of ¹H nuclear magnetic resonance (¹H NMR) spectroscopy. Treatment of compound 4b with Pb(NO₃)₂ gave 4b-Pb(II) complex. The Pb(II) selectivity over biologically relevant Mg(II) and Ca(II) was remarkably improved by adopting N-hydroxyethyl functionality instead of N-methyl group.     

原发性干燥综合征573例临床分析

目的 探讨原发性干燥综合征(pSS)患者的临床及免疫学特点.方法 回顾性分析1985年1月至2005年12月在北京协和医院诊治,符合2002年pSS国际分类(诊断)标准患者,并采用非参数检验,t检验和X~2检验与既往各研究组进行比较.结果 ①573例pSS中女性占91.4%,平均发病年龄显著早于国外患者[(39.0±13.7)岁与(52.7±0.9)岁,P<0.01].从发病到确诊的平均间隔时间达48个月.②口干(84.5%)是pSS最常见的症状,其次是眼干(70.0%),但均低于国外报道(P<0.01)口干燥症、干燥性角结膜炎及唇腺活检的阳性率高(分别为91.9%、94.8%和90.7%).③pSS合并系统损害者达91.4%,其中发热41.0%、肌炎4.9%、心包积液14.8%、肺部受累42.3%、肾脏受累33.5%、甲状腺受累32.7%、胰腺受累5.6%,发生率均高于国外研究(P<0.01);而乏力、淋巴结肿大及雷诺现象低于围外研究(P<0.01).④预后危险因素包括肺动脉高压、高IgM血症、肝功能损害及间质性肺疾病.结论 本组pSS患者的发病年龄、系统受累状况、自身抗体谱及死因构成均明显不同于国外患者.肺部和肝脏损害是中国人pSS预后的危险因素.     

Heparin-induced thrombocytopenia: cross-reactivity between standard heparin, low molecular weight heparin, dalteparin (Fragmin) and heparinoid, danaparoid (Orgaran)

Summary. The incidence of cross-reactivity between unfractionated heparin and LMWH, fragmin, in patients with HIT is significantly lower (6/15, 40%) than hitherto reported in the literature. 7/9 patients with a negative cross-reactivity test were treated with dalteparin sodium (Fragmin) without any untoward events.     

单孔腹腔镜结直肠手术专家共识（2019版）

近年来，国内外单孔腹腔镜结直肠手术的开展越来越多，但仍然缺乏高级别的前瞻性随机对照研究，许多问题亟待讨论和规范。为了进一步规范单孔腹腔镜结直肠手术的实施和开展，特邀请国内众多开展单孔腹腔镜结直肠手术专家编写此共识，以促进单孔腹腔镜结直肠手术规范、健康、有序发展。     

Longitudinal gut microbiome changes in alcohol use disorder are influenced by abstinence and drinking quantity

ABSTRACT

Many patients with alcohol use disorder (AUD) consume alcohol chronically and in large amounts that alter intestinal microbiota, damage the gastrointestinal tract, and thereby injure other organs via malabsorption and intestinal inflammation. We hypothesized that alcohol consumption and subsequent abstinence would change the gut microbiome in adults admitted to a treatment program. Stool and oral specimens, diet data, gastrointestinal assessment scores, anxiety, depression measures and drinking amounts were collected longitudinally for up to 4 weeks in 22 newly abstinent inpatients with AUD who were dichotomized as less heavy drinkers (LHD, <10 drinks/d) and very heavy drinkers (VHD, 10 or more drinks/d). Next-generation 16 S rRNA gene sequencing was performed to measure the gut and oral microbiome at up to ten time points/subject and LHD and VHD were compared for change in principal components, Shannon diversity index and specific genera. The first three principal components explained 46.7% of the variance in gut microbiome diversity across time and all study subjects, indicating the change in gut microbiome following abstinence. The first time point was an outlier in three-dimensional principal component space versus all other time points. The gut microbiota in LHD and VHD were significantly dissimilar in change from day 1 to day 5 (p = .03) and from day 1 to week 3 (p = .02). The VHD drinking group displayed greater change from baseline. The Shannon diversity index of the gut microbiome changed significantly during abstinence in five participants. In both groups, the Shannon diversity was lower in the oral microbiome than gut. Ten total genera were shared between oral and stool in the AUD participants. These data were compared with healthy controls from the Human Microbiome Project to investigate the concept of a core microbiome. Rapid changes in gut microbiome following abstinence from alcohol suggest resilience of the gut microbiome in AUD and reflects the benefits of refraining from the highest levels of alcohol and potential benefits of abstinence.