阿片类物质滥用的肝肾损害

滥用或长期使用阿片类物质可增加肝肾细胞脂质过氧化反应,引起肝肾细胞生物化学发生改变,血清丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、乳酸脱氢酶、尿素氮、肌酐和脂质过氧化反应产物丙二醛(MDA)水平显著升高;光学显微镜检查可观察到肝脏中心小叶充血、病灶坏死,肾脏管形细胞空泡化等组织病理学变化。     

阿片类滥用对骨代谢的影响

吗啡、海洛因等阿片类药物的长期滥用可使个体产生强烈的精神依赖和躯体依赖，造成机体多系统功能的损害和改变。本文主要综述长期应用吗啡等阿片类物质对骨代谢影响。     

阿片类物质滥用和依赖的临床诊断与分类问题的探讨

阿片类物质滥用和依赖的诊断与分类,国内采用的标准是CCMD——R〔1〕。产生于九十年代初的CCMD——R可能因当时阿片类物质滥用和依赖造成的医疗问题不如现今突出和普遍,所制定的诊断与分类标准难以适应当今阿片类物质滥用和依赖临床诊断、分类和治疗的需要,其内容有必要充实。本文就阿片类物质滥用和依赖临床诊断、分类中的常见问题,结合CCMD——R,对其相关概念,诊断与分类,略抒浅见,供同道参考。一、对CCMD——R阿片类物质滥用和依赖诊断与分类的认识CCMD——R将阿片类物质依赖归属于精神活性物质所致精神障碍中,阿片类物质依赖…     

非阿片类物质滥用戒毒人员情况分析

目的:分析非阿片类物质滥用情况,讨论戒毒人员滥用特征。方法:收取有完整病历和干警正规笔录的个案65例,按人口学、滥用史、药效消失的特征进行分析讨论。结果:青少年占多数,男性多于女性。低龄、低文化、无业、未婚者属高危人群。躯体损害没有阿片类反应强烈。谈心帮教有效。对初涉、未成瘾者处以强戒和学生吸毒现象令人关注。结论:应加大对非阿片类物质知识的宣传教育。学校加强对学生的管理。戒毒所可协同办案单位组织初涉者接受所外短期重点教育班形式的帮教。     

初涉非阿片类物质滥用者强制戒毒的调查分析

目的:探讨非阿片类物质滥用者的特征和处理对策.方法:对118例接受强制戒毒的非阿片类物质滥用者根据病史进行回顾性调查.结果:女性略多于男性,低龄、低文化、无业与个体业主、未婚和离婚的社会闲散人员是该类毒品滥用的高危人群;2003年1月-10月较之2000年增长3.4倍;滥用毒品中以苯丙胺类兴奋剂占主体,滥用剂量大多＜半粒,使用次数＜5次;滥用场所以宾馆、娱乐场所为主,以猎奇、增加刺激为目的;戒断症状和心理渴求现象并不明显.结论:苯丙胺类兴奋剂增长势头迅猛,值得引起重视.对初涉滥用者应严格按照我国相关的法律、法规精神处理和对高危人群宜加强禁毒宣传教育和对滥用者举办短期学习班等多种方法.     

阿片类物质滥用对女性生殖系统损害的研究进展

一长期应用阿片类物质所致女性生殖内分泌影响1.1长期应用阿片类物质所致女性性激素的改变:长期使用阿片类物质可通过下丘脑、垂体影响人体性腺功能。例如吗啡对女性性腺轴的作用位点在μ型阿片受体,即吗啡分别占据性腺轴各组织中的μ阿片受体,     

阿片类和苯丙胺类依赖人员滥用酒精的分析

目的:观察阿片类和苯丙胺类毒品依赖人员滥用酒精情况,探讨吸毒成瘾人员滥用酒精的行为特征.方法:对187例阿片类物质依赖和270例苯丙胺类物质依赖人员滥用酒精的结果进行比较分析.结果:苯丙胺类物质依赖者滥用酒精的比率高达77%,与阿片类物质依赖者不用酒精差异显著,尤以滥用二亚甲基双氧苯丙胺(摇头丸)人员同时服用酒精最为常见(92%);且滥用苯丙胺类中枢神经兴奋剂躯体依赖潜隐,精神依赖明显,存在危害轻微的误区.结论:滥用苯丙胺类比阿片类更多滥用酒精.     

阿片类和苯丙胺类毒品依赖人员滥用酒精情况调查

目的:观察阿片类和苯丙胺类毒品依赖人员滥用酒精情况,探讨吸毒成瘾人员滥用酒精的行为特征。方法:对187例阿片类物质依赖和270例苯丙胺类物质依赖人员滥用酒精的结果进行比较分析。结果:苯丙胺类物质依赖者滥用酒精的比率高达77%,与阿片类物质依赖者滥用酒精差异显著,尤以滥用亚甲基二氧基甲基苯丙胺(摇头丸)人员同时服用酒精最为常见(92%)。结论:滥用苯丙胺类中枢兴奋剂者普遍滥用酒精,而阿片类滥用者很少使用酒精。     

绵阳市滥用阿片类物质成瘾者艾滋病相关知识、行为及生物学监测分析

目的：了解滥用阿片类物质成瘾者艾滋病相关知识、行为及生物学现状,为开展健康教育和行为干预提供依据。方法：在绵阳市涪城区、游仙区社区内采用滚雪球等方法招募滥用阿片类物质成瘾者319名,在绵阳市强制隔离戒毒中心随机抽取新入所的滥用阿片类物质成瘾者82名,由经过培训的专业人员逐一进行问卷调查,并采血作HIV抗体、HCV抗体和梅毒抗体检测。结果：调查滥用阿片类物质成瘾者401名,艾滋病相关知识总知晓率为92．61％;当前使用的主要毒品为海洛因者占96．01％,静脉注射吸毒占69．33％,最近1个月（或入所前1个月）未与他人共用过针具;最近1次性行为时安全套使用率为62．82％;最近1次与商业性伴发生性行为时安全套使用率为75％;最近1年接受艾滋病预防服务措施覆盖率为97．26％;HIV抗体阳性率为1％,HCV抗体阳性率为66．83％,梅毒抗体阳性率为1．51％。结论：绵阳市滥用阿片类物质成瘾者艾滋病相关知识知晓率较高,HIV抗体阳性率和注射毒品共用针具的比例明显下降,但安全套使用率较低,高危行为依然存在,需要继续加强各项干预措施的落实。     

阿片类成瘾者尿中吗啡的测定及代谢产物的鉴定

建立了阿片类生物碱系统的气相色谱一质谱分离分析方法。在所选色谱条件下八种阿片类生物碱均能得到良好的分离，并用所建方法对阿片类成瘾者尿样进行了吗啡的测定及代谢产物的鉴定，尿中检测出吗啡、可待因、６－单乙酰基吗啡及微量的乙酰可待因，从而确定该吸毒者吸食的毒品为海洛因粗提物。     

An Observational Study of Treatment Seeking Users of Natural Opiates from India

Background: The type of opioid used influences the severity and complications experienced. Natural opiates (opium and poppy husk) use is a socio-culturally accepted phenomenon reported in India. However, studies on their profile, quality of life, and addiction severity are limited. Objectives: The objective of this cross-sectional, observational study was to assess the socio-demographic profile, clinical profile, addiction severity, and quality of life of treatment-seeking natural opiate users. Method: Hundred subjects aged 18–65 years using opium or poppy husk seeking outpatient treatment at a tertiary addiction treatment center in India were interviewed to collect information on their socio-demography, natural opiate, and other substance use. Additionally, their addiction severity and quality of life were assessed using Addiction Severity Index-Lite and WHO Quality of Life-Bref instrument, respectively. Results: All subjects were male with a mean age of 44.6 (±11.0) years. Majority (97%) used poppy husk daily orally. Curiosity/experimentation (63%) was the most common reason for starting opiate use. The past month rates of tobacco, alcohol, cannabis, and sedative-hypnotics use was 58%, 33%, 3%, and 12%, respectively. Only 4% injected any opioid. Inability to afford opiates (72%) was the most common reason for seeking treatment. Rates of medical, familial, social, psychological, and legal complications were low, while the WHOQOL-BREF scores fell between 40 and 50 across various domains. Conclusions/Importance: Natural opiate users may constitute distinct subgroup of opioid users with fewer/no complications despite long duration of uninterrupted use. These findings would be important in planning management strategies for people dependent on natural opiates.     

粘细菌来源的抗HIV活性次级代谢产物研究进展

艾滋病对人类健康造成了巨大的威胁,对公众健康安全提出了巨大的挑战。很多时候,艾滋病患者因合并感染导致病情进一步恶化。当前使用的抗病毒药物因药效问题及易产生抗药性等问题,导致抗病毒效果有限。因此,急需开发具有广谱活性、药效不断提高、作用机制新颖的抗病毒药物。粘细菌能产生大量结构和功能独特的生物活性化合物,其生物活性包括抗肿瘤、抗病毒、抗真菌、抗细菌等。本文对粘细菌来源的抗HIV活性次级代谢产物进行回顾。     

Medical Consequences of Drug Abuse and Co-Occurring Infections: Research at the National Institute on Drug Abuse

ABSTRACT

Substance abuse still remains one of the major problems in the world today, with millions of people abusing legal and illegal drugs. In addition, a billion people may also be infected with one or more infections. Both drugs of abuse and infections are associated with enormous burden of social, economic, and health consequences. This article briefly discusses a few medical consequences of drugs of abuse and infections such as human immunodeficiency virus, hepatitis C virus, psychiatric complications in hepatitis C infection, pharmacokinetic drug–drug interactions among medications used in the treatment of addiction and infections, and new drugs in development for the treatment of infections. Research is encouraged to study interactions between infections, drugs of abuse, and underlying pathophysiologic and molecular/genetic mechanisms of these interactions.     

海洋微生物次级代谢产物抗炎作用研究进展

炎症作为机体抵抗有害刺激修复损伤组织的防御反应,参与多种疾病的发展进程,严重危害人类生命健康。而临床常用的抗炎药物有一定的不良反应,寻找一些高效、低毒的抗炎先导化合物仍是一个重要方向。海洋作为各类生物资源的宝库,由于海洋生态环境的特殊性(高压、高盐,低氧等),使得许多海洋生物在生命过程中产生大量具有特殊结构和抗炎活性的天然产物,成为炎症新药物研发的重要来源。本文总结了2016-2021年从放线菌、真菌、细菌三类海洋微生物中分离出的约73种天然产物,并对其在抑制炎症活性方面进行综述,以期望为今后的研究提供借鉴和启发。     

Opiates and opioid peptides modify sensory evoked potentials and synaptic excitability in the rat dentate gyrus

The effects of morphine and the synthetic opioid peptide D-Ala2-MePhe4-Met-O-ol-enkephalin (FK 33-824) on averaged (AEPS) potentials evoked by a tone and extracellular synaptic potentials (EPSs) in the perforant path, recorded from the outer molecular layer (OM) of the dentate gyrus, were examined in rats trained to respond in an auditory discrimination task. Potentials evoked by a tone were systematically altered by both peripheral (intraperitoneal) and central (intracerebroventricular) administration of opioids. The short-latency negative (N1) component of the average evoked potential was increased in amplitude and the longer-latency negative (N2) component was decreased in amplitude by administration of opioids. At the same time, perforant path extracellular synaptic potentials were enhanced after administration of opioids. The changes in the average evoked potential and extracellular synaptic potentials in the perforant path were reversed by subsequent administration of naloxone. The significance of these results is discussed in terms of a possible role of endogenous opioid peptides in modulating the synaptic efficacy of the perforant path during the transmission of sensory information to the hippocampus from the entorhinal cortex.     

苯乙胺类物质的滥用危害与管制措施探析

2017年《世界毒品报告》显示:苯乙胺类物质已成为继合成大麻素类、合成卡西酮类之后的第三大合成类毒品.在所有因滥用新精神活性物质导致的临床病例中苯乙胺所占比例高达28.4％[1],苯乙胺类物质因其化学结构灵活多变,由此成为众多非法兴奋剂的演变"载体",加之部分苯乙胺类新精神活性物质兼具兴奋与致幻的双重效应,其危害性较之...     

Postgraduate Medical Education in Substance Abuse: An International Perspective on Dissemination of Treatment Research

The relationship of temperament to different patterns and types of alcohol abuse has received much attention over the last decade in order to provide clues to matching patients optimally to treatment strategies. The purpose of this study was to examine the relationship of temperament with a number of relevant substance abuse characteristics in a substance abusing population. One hundred forty‐five male veterans were interviewed on their lifetime use of substances and on their psychiatric symptoms, problems associated with use, context, and family history of substance abuse. Subjects filled out the TPQ and the MPQ, which were subjected to factor analysis and revealed four factors: (1) Negative Affectivity/Impulsivity, (2) Positive Affectivity/Sociability, (3) Persistence/Achievement, and (4) Constraint. There was partial support for the hypotheses. Impulsivity was negatively correlated with age of onset and positively correlated with substance‐related problems and a family history of substance abuse. Subjects with a history of depression scored significantly lower on the Positive Affectivity/ Sociability factor than those who had not experienced a significant depression. Individuals who used alone scored lower on this factor than those who used in social contexts. The temperament factors of Persistence/Achievement and Constraint were, for the most part, unrelated to substance abuse.     

The Role of Child Sexual Abuse in the Etiology of Substance-Related Disorders

ABSTRACT

To elucidate the role of child sexual abuse in the etiology of substance-related disorders, a systematic review of the several articles on the childhood sexual abuse-related risk for developing substance problems in adolescence or adulthood is provided. Seven databases were searched, supplemented with hand-search of reference lists. Six reviews, including 200 studies, were included. Results indicate that child sexual abuse is a statistically significant, although general and nonspecific, risk factor for substance problems. Other biological and psychosocial variables contribute to substance-related disorders, with sexual abuse conferring additional risk, either as a distal, indirect cause or as a proximal, direct cause. Recommendations for future research are provided.     

决明子黄曲霉毒素检测中假阳性的解决方法的探索

目的 探索决明子黄曲霉毒素检测中假阳性的解决方法。方法 采用1%吐温-20的磷酸盐缓冲溶液洗脱除杂,免疫亲和柱净化-高效液相色谱柱后光化学衍生测定,以延胡索药材作为阳性样品进行比较考察,并用HPLC-MS/MS进行验证。结果 该溶液能有效去除决明子中假阳性成分干扰,并能去除延胡索样品中的有色成分,且不影响黄曲霉毒素在免疫亲和柱中的保留。结论 该方法操作简便、结果稳定可靠,能有效排除假阳性干扰,可用于复杂基质中药的前处理,作为黄曲霉毒素测定中假阳性的解决方法。     

阿片类物质依赖的机制与临床治疗研究进展

阿片类物质依赖性的机制十分复杂但在细胞和分子水平上得到较广泛的研究,取得了明显进展。其可能机制主要涉及到对阿片受体和内源性阿片肽以及对阿片受体后效应的调节且与神经系统、内分泌系统和体内一些重要活性物质的调节有密切关系。阿片类物质依赖的药物治疗主要是替代和非替代两种办法,各有利弊。防复吸是目前该领域研究的重点和难点。深入探讨阿片类物质依赖性机制和开发新型药物仍是当今重要研究方向。