海洛因依赖者戒断期反流性呕吐的护理

本文总结１９９３年７月－１９９４年１０月我中心收治的２６６例海洛因依赖者中６１例（占２２．９３％）在戒断期出现反流性呕吐情况。从护理学角度分析临床资料，认为吸毒成瘾者在戒断期出现的反流性呕吐是一种严重的戒断综合症状，它是因吸毒期肠道麻痹，蠕动减弱，排空迟缓，肠内容物长期不能正常排泄，肠内积液过量，戒断时胃肠蠕动不协调而出现的的逆蠕动现象，给护理工作造成困难。为此本文提出护理中应注意的问题，同时建议在戒毒护理工作中应提高护理人员的护理经验、素质、综合判断能力和应激能力。     

参附脱毒胶囊治疗海洛因依赖者戒断症状对照研究

目的·· :评价参附脱毒胶囊的脱毒效果、不良反应及安全性。方法·· :按照卫生部原药政管理局制定的《抗阿片类戒断症状药物临床试验指导原则》 ,对参附脱毒胶囊与盐酸可乐定进行随机双盲对照研究。结果·· :参附脱毒胶囊组和可乐定组治疗d3的有效率分别为88.3 %和78.9 % ,戒断症状总分分别为322.84±s141.97和365.90±s127.35,均无统计学差异。参附脱毒胶囊组的不良反应总分16.07±s16.47 ,明显低于可乐定组(40.10±s30.72) ,P<0.01。两组治疗前后白细胞、肝、肾功能和心电图检查异常情况出现率经 χ2 检验差异无显著性。结论·· :参附脱毒胶囊的脱毒效果与可乐定相当 ;参附脱毒胶囊的不良反应发生率低、程度轻微 ,且临床使用安全 ,无明显毒副作用     

药物滥用量表在78例海洛因滥用者中使用结果分析

对78例海洛因滥用者及其对照回答DMS结果分析显示,病例组在此量表上的得分明显高于对照组,且得分超过界值的人数也明显多于对照组,效度分析表明它在我国具有一定的实用性。本文结果提示,此量表对识别人群中具有药物滥用倾向的个体有一定的价值。     

丁丙诺啡用于海洛因依赖戒毒50例临床研究

本文报告用丁丙诺啡对50例海洛因依赖者戒毒观察10 d,研究结果表明丁丙诺啡与美沙酮作用相似,能较好地控制海洛因戒断症状,戒毒所需时间较短,病人乐于接受但早期戒断症状较重,需要合理掌握首次用药.     

Opiate tolerance by heroin self-administration: an fMRI study in rat.

Functional MRI (fMRI) was employed to determine whether repeated heroin self-administration (SA) produces tolerance or sensitization in the brain of heroin-SA rats. Twelve rats were evenly divided into saline and heroin (0.06 mg/kg, 4 hr/day) SA groups. There was a progressive increase in drug-SA behavior and daily heroin intake during the 8-9 days of heroin-SA training. Within 24 hr after the last session of daily SA, acute heroin (0.1 mg/kg) administration induced regional blood oxygen level-dependent (BOLD) signals in both groups of rats. The positive BOLD signals appeared mainly in the cortical regions, including the prefrontal cortex, cingulate, and olfactory cortex, while the negative BOLD signals were predominantly located in subcortical regions such as caudate and putamen, nucleus accumbens, thalamus, and hypothalamus. However, the number of activated voxels or BOLD-signal intensity was significantly less in heroin-SA rat in regions of prefrontal cortex, nucleus accumbens, and thalamus, etc., compared to the changes in the saline control rats. Application of gamma-vinyl GABA (100 mg/kg), an irreversible GABA-transaminase inhibitor, failed to block opiate actions in the heroin-SA rats. Together, these data suggest that repeated heroin-SA produces tolerance or desensitization of opiate actions in the rat brain, which may in turn potentiate drug SA behavior and drug intake.     

Candida endophthalmitis in heroin addicts

The clinical course of endophthalmitis, presumably due to Candida albicans, in nine eyes of heroin addicts is described. In six of the seven eyes in which pars plana vitrectomy was performed the diagnosis was confirmed by the cultivation of Candida albicans from the rinsing fluid. Both purely intraocular treatment and a combination of local and systemic antimycotic therapy caused the intraocular infection to disappear. In this small group of patients the results were most favourable when treatment was started early.     

Prevalence of HIV-1 seropositivity in syringes discarded by intravenous drug users in Barcelona

We tested the syringes recently abandoned in the inner cityof Barcelona for HIV-1 antibodies. We stratified the 416 syringescollected and analysed them according to several variables.Of those with visible blood and needles 57.3% were positive.Multivariate analysis confirmed as predictors the presence ofvisible blood (OR=2.62; 95% Cl: 1.12–6.13), dirty appearance(OR=1.63; 95% Cl: 1.01–2.65), the neighbourhood in whichthey were collected (p=0.06) and the second collection period(OR=1.92; 95% Cl: 1.21–3.05), with an interaction betweenthe presence of visible blood plus needles (OR=7, 82; 95% Cl:2.17–28.22). The findings suggest that the syringes withthese characteristics have the highest risk for the intravenousdrug-user population who still share needles.     

海洛因依赖者红细胞免疫功能的变化

采用红细胞Ｃ３ｂ受体花环试验和红细胞免疫复合物花环试验对８６倒海洛因依赖者的红细胞免疫功能进行了研究。结果表明海洛因依赖者红细胞Ｃ３ｂ受体花环率和红细胞免疫复合物花环率都比对照组明显降低（Ｐ＜０．０１）。并发现其变化与毒品滥用量密切相关。治疗可改善红细胞免疫功能。红细胞免疫功能的变化在临床上有重要意义。     

Opiate rewarding action: independence of the cells of the lateral hypothalamus

The posterior lateral hypothalamic area has been suggested as a possible site of action for the reinforcing effects of opiates on the basis of the finding that rats would lever-press for direct microinjections of opiates into this region. The present study reports the effects of kainic acid-induced lateral hypothalamic cell loss on the intravenous self-administration of heroin. Kainic acid injection resulted in marked cellular depletion yet failed to alter heroin self-administration.     

75例海洛因滥用者巨细胞病毒感染

巨细胞病毒感染一生均可罹患,当免疫受损,器官移植或抵抗力低下时则易感染。本文对75例海洛因滥用者检查CMV/IgM抗体,有20％阳性,其中性混乱者31例,阳性占12例(38.70％),滥用毒品无性乱者44例,仅3例阳性(6.81％),因此CMV感染对有性混乱与性病者潜在感染,须引起重视,毒品滥用人群中有性乱史者更易发生。