Changes in functional connectivity of ventral anterior cingulate cortex in heroin abusers

Background Previous studies with animal experiments, autopsy, structural magnetic resonance imaging （MRI） and task-related functional MRI （fMRI） have confirmed that brain functional connectivity in addicts has become impaired. The goal of this study was to investigate the alteration of resting-state functional connectivity of the ventral anterior cingulate cortex （vACC） in the heroin abusers＇ brain. Methods Fifteen heroin abusers and fifteen matched healthy volunteers were studied using vACC as the region-of interest （ROI） seed. A 3.0 T scanner with a standard head coil was the imagining apparatus. T2＊-weighted gradient-echo planar imaging （GRE-EPI） was the scanning protocol. A ROI seed based correlation analysis used a SPM5 software package as the tool for all images processing. Results This study showed a functional connection to the insula vACC in heroin abusers. Compared with controls, heroin users showed decreased functional connectivity between the nucleus accumbens （NAc） and vACC, between the parahippocampala gyrus/amgdala （PHC/amygdala） and vACC, between the thalamus and vACC, and between the posterior cingulated cortex/precuneus （PCC/pC） and vACC. Conclusion The altered resting-state functional connectivity to the vACC suggests the neural circuitry on which the addictive drug has an affect and reflects the dysfunction of the addictive brain.     

Disseminated Penicillium marneffei infection in acquired immunodeficiency syndrome: a case report

Penicillium marneffei(P.marneffei) is a facultative intracellular pathogen and the only therrmally dimorphic fugus. This fungal intection is cormmonly found in Southeast Asian,     

Guillan-Barré syndrome in heroin addiction.

In two cases of Guillain-Barré syndrome (acute polyneuritis) as a complication of narcotic abuse, the onset of paralysis began approximately 4 and 12 hours after self-administration of opiates intravenously. Bulbar and respiratory paralysis developed in one patient and required prolonged ventilation therapy; the other patient had peripheral muscular and unilateral facial weakness, with notable pleocytosis was present in both.     

Disseminated Penicilliosis marneffei in a patient with acquired immunodeficiency syndrome: a first case report from China

Ｉｎ 1988 ,ｔｈｅｆｉｒｓｔｔｈｒｅｅｃａｓｅｓｏｆｄｉｓｓｅｍｉｎａｔｅｄｐｅｎｉｃｉｌｌｉｏｓｉｓｄｕｅｔｏＰｅｎｉｃｉｌｌｉｕｍｍａｒｎｅｆｆｅｉ (Ｐ .ｍａｒｎｅｆｆｅｉ)ａｍｏｎｇＡＩＤＳｐａｔｅｉｎｔｓｗｅｒｅｒｅｐｏｒｔｅｄ .Ｅｖｅｒｓｉｎｃｅ ,ｃａｓｅｓｆｒｏｍｏｔｈｅｒａｒｅａｏｆｔｈｅｗｏｒｌｄｗｅｒｅｒｅｐｏｒｔｅｄａｎｄａｌｌｗｅｒｅｒｅｐｏｒｔｅｄｔｏｂｅｉｎｆｅｃｔｅｄｉｎＳｏｕｔｈｅｒｎＡｓｉａｏｒＣｈｉｎａ 1　Ｂｙ 1995,ｔｈｅｎｕｍｂｅｒｏｆｔｈｅＰ ｍａｒｎｅｆｆｅ…     

Candidal endophthalmitis: a manifestation of systemic candidiasis

Two patients on total parenteral nutrition who developed endophthalmitis secondary to Candida albicans are described. Candidal endophthalmitis as a manifestation of systemic candidiasis is discussed and its early diagnosis by bedside fundal examination in patients at risk is stressed.     

Disseminated tuberculosis: still a diagnostic challenge.

Disseminated tuberculosis is notoriously difficult to diagnose and, with the decrease in tuberculosis incidence in Australia, familiarity with its manifestations has dwindled. We describe four bacteriologically proven cases which illustrate the range of presentations and diagnostic difficulties. Surprisingly, immunosuppressive therapy need not cause rapid deterioration. Disseminated tuberculosis should be considered in any patient with multisystem illness who is at risk of tuberculosis, particularly if born overseas. In the absence of confirmatory results, a prompt therapeutic trial may be life-saving.     

Malaria: a new facet of heroin addiction in Australia.

A case of vivax malaria is described. The patient, who had occasionally abused heroin intravenously, shared injection equipment with an addict who had previously contracted malaria in Southeast Asia and who had failed to complete an adequate course of treatment.     

Disseminated histoplasmosis in a non-immunocompromised child

We describe a 2 year-old non-immunocompromised girl with disseminated histoplasmosis who presented with a 2-month history of fever and bloody diarrhoea. On presentation, she was severely wasted and anaemic. There were gross hepatosplenomegaly and multiple lymphadenopathy. A septic screen was negative. A subsequent stool culture isolated Salmonella enteriditis. Serial Widal-Weil Felix (WWF) titres showed serological response after 2 weeks of Ceftriaxone. However, she continued to have spiking fever, bloody diarrhoea and weight loss. She developed pancytopaenia and disseminated intravascular coagulation. A bone marrow aspirate and trephine, and lymph node biopsy showed the presence of Histoplasma capsulatum, confirmed by Gomori-Methenamine Silver staining. She responded to intravenous amphotericin B followed by fluconazole (intravenous then oral) for 6 months after discharge. Human Immunodeficiency Virus screening tests were negative. Complement and immunoglobulin levels were normal. T and B enumeration tests showed gross leucopaenia with very low T cell function with defective phagocytic function. A repeat T and B cell enumeration test and phagocytic function tests done 3 months later were normal.     

海洛因成瘾者冲动行为的事件相关电位P300研究

目的 探讨海洛因成瘾者冲动行为的事件相关电位(ERP)P300的特点.方法 运用神经心理学试验范式,海洛因成瘾组和健康对照组在执行爱荷华赌博任务(IGT)时同步进行ERP脑电描记,数据采集后分析比较2组被试P300的波幅和潜伏期,并与冲动性量表(BIS-11)的测评结果作相关分析.结果 海洛因成瘾组BIS评分、选择“高频损失”纸牌次数[(75.12±12.49)分;(91.14 ±21.35)次]高于正常对照组[(66.54±8.61)分;(73.71 ±18.91)次],均差异有统计学意义(P＜0.05);2组被试在执行IGT时均出现明显的P300的波形,其中海洛因成瘾组P300的波幅、潜伏期[(4.92±1.14) μV;(293.43±36.21)ms]低于对照组[(7.65±1.59) μV;(332.68 ±40.15)ms],且与BIS评分呈负相关(r=-0.76,-0.52),差异及相关性有统计学意义(P＜0.05),而进一步Logistic回归分析显示,BIS评分仅与P300波幅相关(P＜0.05).结论 海洛因成瘾者冲动行为P300的异常可反映成瘾者的冲动行为,海洛因成瘾者的较高冲动性行为可能是成瘾及复吸的原因之一.     

环吡酮胺治疗外阴阴道假丝酵母菌病的随机对照研究

【】 目的 研究环吡酮胺阴道乳膏治疗外阴阴道假丝酵母菌病(VVC)的疗效。 方法 入选患者586例,随机分配观察组和对照组。观察组阴道给药环吡酮胺软膏,5g/d,连用7d;对照组阴道给药硝酸咪康唑栓,200mg/d,连用7d。比较两组临床应用效果。 结果 两组的均衡性良好。观察组和对照组用药24h内的症状缓解率分别为78.25%和41.86%(P＜0.005)。停药后1周总有效率分别为91.92%和85.05%,两组的差异有统计学意义(P＜0.01)。观察组在停药后的3、6 个月的复发率分别为0.49%和2.81%,而对照组的相应复发率分别为7.32%和14.15%,两组比较差异有统计学意义(P＜0.005)。 结论 吡酮胺阴道乳膏治疗VVC 的疗效显著,且可明显降低复发率。该药较硝酸咪康唑更为有效。     

Disseminated Cryptococcus neoformans in a cirrhotic patient

Disseminated cryptococcal infection often occurs in the setting of an immuncompromised patient. We report a case of disseminated Cryptococcus neoformans in a cirrhotic patient, referred for Orthotopic Liver Transplantation evaluation due to acute hepatic decompensation.