The antecedents and benefits of achieving abstinence in opioid addicts: a 2.5-year follow-up study

This report examines long-term and short-term benefits of achieving abstinence from opioids in a sample of opioid addicts who were reevaluated 2.5 years following seeking treatment. Extensive assessment of drug use history and drug-associated problems had been obtained when the subjects applied for treatment. At follow-up evaluations, detailed information was obtained on intervening course of drug use, treatment, legal problems, psychological problems, social functioning, occupational functioning, and medical status. The results were as follows: (1) Achieving abstinence from illicit opioids was associated with concurrent improvement in other aspects of functioning including reduction of criminal activity, improved medical status, improved social functioning, and reduced abuse of other psychoactive substances. However, many of these improvements were reversed immediately if relapse to opioid use occurred. (2) Achieving abstinence was associated with being in drug treatment, especially treatment in a methadone maintenance program. (3) Achievement of abstinence was not successfully predicted by client characteristics measured at entrance into treatment. (4) Long-range benefits of abstinence were detectable in social functioning even for those who had relapsed at the time of follow-up reevaluation.     

AMPK在妊娠期糖尿病发病机制中的作用

腺苷酸活化蛋白激酶是一种重要的蛋白激酶,主要作用是协调代谢和能量平衡.腺苷酸活化蛋白激酶被激活后,在增加骨骼肌对葡萄糖摄取、增强胰岛素敏感性、增加脂肪酸氧化以及调节基因转录等方面发挥重要作用.已经证实脂联素有调节糖脂代谢的作用,但其作用机制尚不十分清楚,很可能是通过腺苷酸活化蛋白激酶介导,对脂联素信号转导通路的研究将成为进一步理解脂联素作用的关键所在.而脂联素又是妊娠期糖尿病的预测因子,所以腺苷酸活化蛋白激酶逐渐成为对妊娠期糖尿病研究中的焦点.     

Treatment of dual diagnosis patients: A relapse prevention group approach

The authors describe the successful use of an adjunctive group psychotherapy for substance-abusing patients with major psychiatric disorders (bipolar, schizophrenia, schizoaffective, psychotic depression, and atypical psychosis). The group utilizes a psychoeducational approach that focuses on substance abuse causes and consequences, principles of recovery, and relapse prevention strategies. Eight patients with prolonged histories of abuse of cocaine, alcohol, marijuana, or other drugs were enrolled in this weekly group treatment at a community mental health center drug treatment program, while continuing in treatment with their current case manager or primary therapist. Six of the eight patients achieved periods of stable abstinence, documented by self-report, urine toxicology screens, continued group attendance, and improved social functioning. Case examples are utilized to illustrate the group process.     

臂丛神经根性损伤膈神经移位术对青壮年患者早期呼吸功能的影响

目的研究臂丛神经损伤膈神经移位术对青壮年患者早期呼吸功能的影响.方法对16例接受膈神经移位治疗的患者,在术前、术后（10 d）进行肺功能指标的比较,同时定期进行门诊随访,观察呼吸系统自觉症状程度.结果13例术后出现了不同程度的供氧不足症状,16例全部出现一侧膈肌抬高,术后第10天肺活量（VC）、肺活量预计值百分数（VC%）分别比术前减少37.98%和26.88%,两者差异有统计学意义（tvc=11.532、tvc%=0,P＜0.01）.其它项目如残气量（RV）较术前轻度下降,肺总量（TLC）下降值达到术前肺总量的36.49%,残气量/肺总量比值（RV/TLC%）较术前上升了4.75%,上述各指标的差值均有统计学意义.1 s用力呼气量/用力肺活量比值（FEV1/FVC）和术前比基本无改变,但其差值有统计学意义.膈神经移位右侧（10例）与左侧（6例）术前、术后肺活量比较差异有统计学意义.术后随访8个月～2年,所有患者均无明显呼吸困难和胸闷等症状.结论膈神经移位术后对青壮年患者肺容量有较大的丧失,肺通气功能减弱和小气道阻力增加,但其丧失程度在机体自身代偿耐受范围内,不会导致急剧发生的严重呼吸功能障碍.建议对右侧臂丛神经根性损伤的患者,术前进行严格的肺、心功能检查,避免发生较为严重的并发症.     

Sensitivity of psychiatric diagnosis based on the best estimate procedure.

OBJECTIVE: A "best estimate" diagnosis is one made by expert clinicians on the basis of diagnostic information from direct interview conducted by another clinician plus information from medical records and from reports of family members. The authors address the question of whether the best estimate procedure can enhance the classification of psychiatric diagnoses of subjects who are interviewed directly. METHOD: Four hundred seventy-five subjects were interviewed directly: 201 opiate-addicted probands who sought treatment from a university-based clinic and 274 of their spouses and/or first-degree relatives. Subjects were interviewed by trained clinical assessors using the Schedule for Affective Disorders and Schizophrenia and classified according to Research Diagnostic Criteria. Two psychologists independently diagnosed the same subjects by applying the best estimate procedure. Lifetime rates of major and minor depressive disorder, antisocial personality, alcoholism, and drug abuse were calculated. The rates of diagnoses made on the basis of direct interviews alone were compared with the rates of diagnoses made according to the best estimate procedure. RESULTS: Higher rates of diagnoses of all four disorders were made when the best estimate procedure was applied than when direct interview alone was used; the best estimate procedure also resulted in a minimal rate of false positives. CONCLUSIONS: The higher rate of diagnoses based on the best estimate procedure may represent an enhancement in the accuracy of psychiatric diagnoses or an increase in erroneous diagnoses. The authors consider the second possibility less likely.     

An Analytic Model of Subminiature Auditory Sensation System for Sound Source Localization

It is reported that some types of insects have a remarkable ability to detect the direction of an incident sound even though its acoustic sensory organs are in very close proximity each other. Maybe the ears are jointed by a cuticular structure with which the separated motions can be coupled mechanically and thus be magnified. In this paper, a detailed model is setup to describe the principle of this type of localization using a mechanical coupled structure. The transfer functions and the responses of the model in terms of time and frequency are analyzed to describe the mechanism of its ability of directional hearing. This analytical model provides a method to design the experimental model for the predetermined incident sound pressure, and the analysis of this model shows that this structure have the ability to determine the direction of the incident stimulus.