Searching for Responders to Acamprosate and Naltrexone in Alcoholism Treatment: Rationale and Design of the Predict Study

Background:  Alcoholism represents a major public health issue and treating alcohol dependent patients remains an imminent challenge. Evidence based psychotherapies and pharmacotherapies are available. However, when administered to heterogeneous populations of patients effect sizes are only modest. We present the rationale and design of a double-blind randomized trial comparing acamprosate, naltrexone, and placebo. Additionally we subtype patients on the basis of biological and psychometric measures and explore their treatment response to both acamprosate and naltrexone. According to our initial hypothesis, the "relief drinker/craver" is an endophenotype associated with glutamatergic dysfunction who responds to acamprosate. The "reward drinker/craver" is mainly associated with alterations in the dopaminergic and opioidergic system and responds to naltrexone.
Methods:  The study is planned for 430 patients (2:2:1 for both drugs and placebo) over 12 weeks of medication. All receive manualized counselling to improve compliance (Medical Management) which is extended to 6 months. Subtyping is primarily done using the acoustic startle reflex, functional magnetic resonance imaging, positron emission tomography (in a subset of patients), and the Inventory of Drinking Situations. Relapsers will be re-randomized into a second study where additional psychotherapy (Cognitive Behavioral Intervention) is used in a stepped care approach. Genotyping and additional analyses such as health economy are being done as well. The study follows the assessment methods, treatments, and medications used in the U.S. based COMBINE study, which will allow for a direct comparison between this U.S. study trial and a study performed in Europe.     

Comparison between Tc-99m N-NOET and Tl-201 in the assessment of patients with known or suspected coronary artery disease

BACKGROUND: Technetium 99m N-ethoxy-N-ethyl dithiocarbamate (N-NOET) is a new radionuclide tracer for cardiac single photon emission computed tomography (SPECT) imaging. It combines the advantageous properties of a Tc-99m agent with the redistribution characteristics of thallium 201. We directly compared the two agents in patients with known or suspected coronary artery disease. METHODS AND RESULTS: Fifty patients underwent treadmill exercise Tc-99m N-NOET and Tl-201 SPECT studies. Images were acquired at stress, redistribution, and reinjection. Segmental analysis was carried out, and direct comparisons were made with corresponding segments. A stress score index was calculated and compared with the degree of lung uptake for each patient. From the 50 patients, 2657 of 2664 exercise, redistribution, and reinjection segments (99%) were interpreted. There was excellent agreement between the two modalities (weighted kappa = 0.83). Of the patients, 24 demonstrated reversible ischemia by Tl-201 SPECT reinjection imaging, of which Tc-99m N-NOET stress-redistribution imaging correctly identified 14 (58%); this improved significantly to 20 patients (83%) ( P = .03) when a reinjection protocol was used. A higher stress score index was seen in those patients with significant lung uptake (lung-heart ratio > or =0.6) after Tc-99m N-NOET stress imaging (1.6 vs 1.3, P = .03). CONCLUSION: SPECT imaging with Tc-99m N-NOET is comparable to Tl-201 for the diagnosis of coronary artery disease. Significant lung uptake with stress Tc-99m N-NOET may also indicate the severity of disease.     

中药放疗增敏散对鼻咽癌放疗增敏作用的临床观察

目的：探讨中西医结合治疗鼻咽癌的合理途径。方法：60例Ⅱ，Ⅲ期低分化鳞状细胞癌且有颈淋巴转移灶的鼻咽癌随机分为实验组30例，对照组30例，实验组使用常规放疗加中药放疗增敏散治疗，对照组单用常规放疗，观察两组近期疗效，颈淋巴转移灶缩小及放疗副反应情况。结果：实验组与对照组CR（完全缓解），PR（部分缓解）分别为83．3％、16．7％胶73．3％、26．7％；颈淋巴转移灶缩小50％及完全消退时，实验组与对照组的中位放疗时间分别为14．7天、23．5天和18．7天、28．9天。实验组优于对照组（P＜0．01）。结论：中药放疗增敏散配合鼻咽癌放射治疗能缩短肿瘤的消退时间，提高治疗效果，优于单纯放射治疗疗法。     

基因芯片技术在中药研究中的应用

目的 论述基因芯片技术的概念、基本过程及其在中药研究中的应用。方法 主要利用近期资料，论述基因芯片技术基本概念、基本过程及其在中药学领域中的研究状况、发展前景和存在的问题。结果 基因芯片技术可广泛应用于中药药理研究、新药开发、中药鉴定、安全性评价及中药理论的现代研究。结论 我们应克服困难，充分利用基因芯片这一新技术为中药的研究开发服务。     

猕猴舌下——舌神经移位移植的病理学研究

目的 通过猴桃舌下－舌神经移位移植后的病理改变,证实舌神经移位移植后运动神经可以再生,舌肌可以重建其动力功能的临床应用价值。方法 采用ＨＥ常规染色,嗜银,髓鞘特殊染色及免疫酶标记、透射电镜,观察不同时期神经移位移植后舌肌的组织反应及神经重建状况,测定肌纤维中羟脯氨酸的含量。结果 神经移植３月、６月、１２占膜未见萎缩,舌肌间肌纤维萎缩以舌前份较为明显,Ｓ－１００蛋白染色显示肌束及肌纤维间可见神经纤维     

2型糖尿病地鼠肝组织蛋白质组学研究

糖尿病(d iabetes,DM)的发病率大约是6%,由于其发病率高、病程长、并发症危害大,因此每年的社会耗费相当巨大。糖尿病患者中大部分是2型糖尿病(T2DM),发病年龄大约在40岁,但近些年有提前的趋势,患者多伴有肥胖、高血压、高血脂、心脏及外周血管疾病,表现出代谢功能障碍综合征。