Self-reported time-to-relapse following smoking cessation: Comparison by operationalization of initial abstinence classification

Aims: Relapse rates among cigarette smokers are high. Few studies have examined time-to-relapse using survival analysis in racially/ethnically diverse smokers and initial abstinence criteria have been inconsistent or unspecified. This study compared survival curves using two common definitions of initial abstinence. We hypothesized greater relapse rates among participants abstinent for only 24 hours (h) at the end-of-therapy (EOT) compared with 7 days. Methods: Adult smokers (59% Black, 22% Hispanic and 17% White) received 8-sessions of group cognitive behavioural therapy (CBT) plus transdermal nicotine patches and were assessed monthly up to 12 months post-EOT. Participants reporting abstinence (7-day point prevalence abstinence [ppa] or 24-h ppa) at the EOT were included in Kaplan–Meier curves. Results: Of 301 participants, 120 (40%) reported 7-day ppa at the EOT and an additional 29 (10%) reported 24-h ppa only. Over the 12-month follow-up period, nearly 50% remained abstinent. Of those who resumed smoking, most relapses occurred within the first three months. Survival curves indicated that median survival was 207 and 225 days for 7-day and 24-h definitions of abstinence, respectively. The difference in time-to-relapse between participants abstinent for 24?h at the EOT versus 7-days was not significant (p?=?0.14). Conclusions: Operationalization of initial abstinence is important for relapse analyses and comparisons of survival curves across samples. Participants reported high rates of abstinence and relapse rates were relatively low. Contrary to expectations, 24-h ppa at the EOT was not associated with greater relapse than 7-day abstinence. This suggests either measure may be utilized in relapse prevention research in racially/ethnically diverse treatment-seekers.     

Craving-induced effects of different drug cues on persons abstaining from heroin

Background: The key factors of inducing drug cravings in persons abstaining from drug use remain a focus of addictions research. Given the accumulating evidences, the scope of cues investigated in the cue-reactivity paradigm has increased considerably. Yet, few studies have examined the effects of the intensity and endurance of different types of cues on their ability to induce craving. This study investigated differences among drug-cue words, negative physiological-cue words, and negative social-cue words in the induction of drug cravings among persons abstaining from heroin.

Methods: The sample consisted of 149 male abstinent heroin abusers from four addiction rehabilitation centers in China. Based on their abstinence lengths, they were labeled as short-term, medium-term, and long-term abstainer participants respectively. All participants completed a stress-imagery task and rated craving by visual analog scale.

Results: There was a significant interaction of cue type and abstinence length. There was no difference on the craving induced by three types of cue words in the short-term group. In the medium-term group, craving induced by negative social-cue words was significantly stronger than that by negative physiological-cue words, but not that by drug-cue words. In the long-term group, the craving induced by negative social-cue words remained the strongest, significantly stronger than that by both drug-cue words and negative physiological-cue words.

Conclusion: Negative social-cue words presented in the current study retain the ability to induce craving in heroin abstainers; this finding suggests that negative social cues encountered under more general circumstances could be a risk factor for relapse.     

从“血不利则为水”探讨乳腺癌相关淋巴水肿

导致血不利的原因一是不足,即由于气、血、津、液等物质的缺乏致无源行血;一是不通,即水、湿、痰、饮、瘀、食积、火郁、内风、外伤等病理因素阻滞,致血行不畅。血瘀经脉之内,则水亦瘀积脉中,致脉络胀满,形成水肿。乳腺癌术后患者,金刃本已损伤血脉,术后的放疗、化疗又属祛邪之法,故机体元气受损,气虚无力行血,血运行不畅,导致患侧上肢水肿。故治疗乳腺癌相关淋巴水肿时,应当血水同治,即活血利水之法要贯穿始终。先病血而后病水者,可以活血化瘀为主,利水为辅;先病水后病血者,则以利水消肿为主,酌加活血养血之品。但需要注意的是:①临证时切不可拘泥于单纯的活血利水法,而忽视乳腺癌相关淋巴水肿(breast cancer related lymphedema,BCRL)患者机体本身的状况。②临证勿忽视五脏与血、水的关系,以及肺、脾、肾、三焦与水肿的内在关系。③可多种方法联合运用,审证求因,标本同治。BCRL术后宜补气活血,通脉利水;术后兼化疗者可疏肝健脾、利水消肿;早期可在活血利水基础上,侧重利湿消肿,后期多湿聚为痰,治疗侧重化痰软坚。     

小儿内伤头痛辨治

74例小儿慢性头痛经辨证治疗,显效80.95%,好转16.67%,无效2.38%。痰浊头痛二陈汤或半夏白术天麻汤加减;肾虚头痛,杞菊地黄汤加减;淤血头痛,补阳还五汤;气血虚头痛八珍汤加减。指出了小儿内伤头痛的病因病机,并指出脑电图,脑阻抗血流图、CT、甲皱微循环可做为此病的诊断及疗效指标。     

中风毒邪论与神经保护治疗的研究

中风毒邪论是一种与传统中医中风病理有所不同的理论 ,在中风毒邪论指导下形成解毒通络方是较为理想的神经保护剂 ,可解决目前神经保护治疗的主要障碍 ,有望成为提高中医治疗中风急性期疗效的关键     

102例海洛因依赖患者者戒毒出院后复吸原因分析

对１０２例海洛因依赖患者戒毒出院后操守时间及复吸原因进行分析，发现复吸原因主要与精神依赖及对精神依赖的错误认识等有关，用药维持治疗可明显操守时间．提出在戒毒出院后应采用象治疗神经症或精神病那样的方法来长期维持治疗。     

Quality of ulcer healing influences the relapse of gastric ulcers in humans

The usefulness of dye-contrast endoscopy for the evaluation of the quality of gastric ulcer healing and the prediction of relapse was investigated. Sixty consenting patients whose ulcers healed during 3 months of treatment underwent endoscopy for the identification of the pattern of mucosal regeneration. Patients were monitored for relapses for up to 18 months after antiulcer therapy had ended. The pattern of regeneration was flat in 24 patients, nodular in 25 and intermediate in 11. Internal hypoechoic areas seen by endoscopic ultrasonography were less common and histological maturity was better in the patient group with the flat pattern compared with the patient group with the nodular pattern of mucosal regeneration. Prostaglandin E, synthesis was highest in the group with the flat pattern of mucosal regeneration and the relapse rate was lowest in this group. We conclude that the evaluation of the quality of ulcer healing is possible and that findings in individuals may aid the prediction of relapse for particular patients.     

Investigation of Direct Causes of Drug Relapse and Abstainers’ Demands in a Compulsive Detoxification Center in Wuhan City of China

Objective To identify the direct causes of drug relapse and abstainers’ demand, and to develop programs for the prevention of drug relapse. Methods Abstainers in a Compulsive Detoxification Center in Wuhan City, capital of Hubei Province were randomly selected. An investigation on the direct causes of drug relapse and abstainers’ demands was conducted with multiple-choice questionnaires and face to face interviews. Data were analyzed with SPSS 12.0. Results The direct causes leading to drug relapse included: temptation to use drug again by themselves or by their drug mates, seeking pleasure and ecstasy from drug use, relatively well off living, mental stress, irritation, demoralization, family conflicts, unemployment, feeling distrusted by the family, lack of care and love from the family, and discrimination by others. abstainers’ demands after detoxification and returning to the society included: care and support from the family, employment assistance, changing living environment, understanding by others, support from the society, and keeping far away from drugs. Conclusions Environmental factors are the direct causes of drug relapse, and negative irritation is its predisposing causes. Leaving former residence, more care and help given by both the family and the society and raising their overall quality of life are the demands of abstainers.     

溃疡散预防消化性溃疡复发临床观察

目的 :观察溃疡散对消化性溃疡的抗复发治疗的临床效果。方法 :随机将 80例患者分成溃疡散治疗组 (4 2例 )和雷尼替丁对照组 (38例 )并同时观察两组患者治疗前后溃疡复发情况。结果 :治疗后治疗组溃疡复发率明显低于对照组 ,P <0 .0 1,两组对比有非常显著性差异。结论 :治疗组能明显的改善患者临床症状和降低消化性溃疡复发率。