创伤后应激障碍的组蛋白修饰机制

创伤后应激障碍是一种具有复杂病因学的精神疾病,多发生于个体受到重大创伤事件后。创伤后应激障碍的发生发展过程受到环境和遗传易感性的共同作用,存在着较大的个体差异;而表观遗传学作为一门研究多变环境因素调控基因表达的可遗传变化的学科,近年来在创伤后应激障碍的研究中受到越来越多的重视。表观遗传机制之一——组蛋白修饰机制在创伤后应激障碍的发生中起着重要作用,并且由于组蛋白修饰可以受到多种酶的调控,其灵活的可逆化和精细调控为相应的药物研发提供了可能性和便利。因此,深入探讨创伤后应激障碍的组蛋白修饰机制,对于相关疾病的临床治疗及药物研发具有十分重要的意义。当前创伤后应激障碍的组蛋白修饰研究主要使用动物模型,临床研究较少;组蛋白的类型则主要关注组蛋白H3和H4乙酰化;此外,同以往的研究结果一致,组蛋白修饰水平的变化主要发生在前额叶、海马体和杏仁核区域,参与免疫系统、血清素系统和神经肽Y能系统等相关通路的调节。当前PTSD组蛋白修饰的研究结果间还存在较大的异质性,未来的研究应采用更加一致和实用的分析和报道方法,以最大限度地发挥研究的影响。     

合理药物治疗的辩证观

介绍合理药物治疗的手段及其对临床治疗产生的影响.指出把治疗药物监测和药物基因组学方法相结合应是以后药物治疗的最佳模式.     

糖皮质激素在SARS治疗中利与弊的分析

糖皮质激素在重症SARS治疗过程中发挥了非常重要的作用,绝大部分SARS患者都不同程度地使用了糖皮质激素制剂.但也带来了许多不良后果,尤其是不合理应用更易产生,使病情加重,甚至导致治疗失败.因此,对该类药物的使用应权衡利弊,合理地使用.     

对临床药学发展的几点思考

经过30余年的探索与实践,我国的临床药学发展已初具规模,其开展的必要性和重要性得到社会各界的肯定。但就开展程度而言,临床药学仍为一门年轻的学科,其内容和体系均凾待完善。在回顾过去,总结经验教训的基础上,我们有针对性地提出了一些关于临床药学体系建设的建议,期望对我国临床药学工作的全面开展有所帮助。     

重症加强治疗病房鲍曼不动杆菌的耐药性分析

为了了解重症加强治疗病房标本分离出的鲍曼不动杆菌对常用抗生素耐药性,指导临床用药。回顾性调查分析2009年1月至2010年1月大连医科大学附属第一医院重症加强治疗病房标本分离的鲍曼不动杆菌对常用抗生素药敏结果。发现目前重症加强治疗病房标本分离的鲍曼不动杆菌已呈现出十分严重的耐药性,应引起高度重视。     

Testing the properties of the triarchic model of psychopathy in a community sample: Self‐reported trait aggression and drug consumption associations

The triarchic model of psychopathy encompasses different conceptions of psychopathic personality characterized by three phenotypic components: boldness, disinhibition, and meanness. Psychopathy is a complex construct at both emotional and behavioral level. The aim of this study was to determine the core elements of psychopathic personality in a community sample and analyze the relation between these elements and other personality traits such as aggression, and certain specific behavioral manifestations such as substance use. The study sample comprised 1,159 participants aged between 17 and 74 years, who were administered the Triarchic Psychopathy Questionnaire, the Impulsive‐Premeditated Aggression Scale, and the Aggression Questionnaire. The results show that the constructs of meanness and disinhibition are more highly associated with different forms of both impulsive and premeditated aggression. Furthermore, men scored higher on all three components of the triarchic model compared to women. Finally, higher substance use (tobacco and drugs) was associated with higher scores in meanness, boldness, and disinhibition. These findings demonstrate the importance of assessing psychopathy in a community sample, and the detection of possible risk factors for the disorder.     

Infant mental health home visiting in the context of an infant—toddler court team: Changes in parental responsiveness and reflective functioning

This article describes an infant–toddler court team in Michigan, the community-based participatory research approach to the implementation evaluation, and the resulting changes in parenting. Like other court teams, Michigan's Baby Court is led by a science-informed jurist, and all service providers are knowledgeable about the developmental needs of young children and engage in collaborative communication throughout the case. Relationship-based treatment in the form of infant mental health home-visiting was provided to families. Sixteen parents participated in pre- and posttest evaluation visits to assess changes in parents’ reflective functioning and interactions with their child. Findings suggest improvements in parents’ responsiveness, positive affect, and reflective functioning, with moderate effects. Higher risk parents demonstrated significant changes in reflective functioning, as compared to those at lower risk. These findings add to and support the limited literature on the effectiveness of infant–toddler court teams, which include relationship-based and trauma-informed services.     

Comorbidity of drug abuse treatment

Research has suggested that comorbidity, the concurrence of substance abuse disorders with other psychiatric disorders, may have prognostic value and important implications for the treatment of substance abuse. Knowledge of the prevalence of comorbid disorder is important because it will enable treatment services to be appropriately configured and designed for clinical drug treatment populations. The form and duration of comorbidity may be influenced by a variety of factors, which include the class of drug being abused, the duration of drug use, the individual sensitivity to drug effects, and whether the drug effects are acute or due to withdrawal or residual conditions. This paper addresses three important scientific questions: (1) What is the prevalence of comorbid disorders in a drug abuser population? (2) What is the stability of psychiatric diagnoses in a drug abuser population? (3) Does the existence of a comorbid disorder influence the outcome of drug abuse treatment?     

Three predictions of the economic concept of unit price in a choice context

Economic theory makes three predictions about consumption and response output in a choice situation: (a) When plotted on logarithmic coordinates, total consumption (i.e., summed across concurrent sources of reinforcement) should be a positively decelerating function, and total response output should be a bitonic function of unit price increases; (b) total consumption and response output should be determined by the value of the unit price ratio, independent of its cost and benefit components; and (c) when a reinforcer is available at the same unit price across all sources of reinforcement, consumption should be equal between these sources. These predictions were assessed in human cigarette smokers who earned cigarette puffs in a two-choice situation at a range of unit prices. In some sessions, smokers chose between different amounts of puffs, both available at identical unit prices. Individual subjects' data supported the first two predictions but failed to support the third. Instead, at low unit prices, the relatively larger reinforcer (and larger response requirement) was preferred, whereas at high unit prices, the smaller reinforcer (and smaller response requirement) was preferred. An expansion of unit price is proposed in which handling costs and the discounted value of reinforcers available according to ratio schedules are incorporated.     

Effects of compounding drug-related stimuli: escalation of heroin self-administration

Previous experiments have demonstrated that presenting independently established discriminative stimuli in compound can substantially increase operant responding maintained by food reinforcement or shock avoidance. Recently, this phenomenon was also shown to occur with cocaine self-administration. The present study further assessed the generality of these stimulus-compounding effects by systematically replicating them with heroin self-administration. Rats' nose-poke responses produced intravenous heroin (0.025 mg/kg per infusion) on a variable-ratio schedule when either a tone or a light was present. In the absence of these stimuli, responding was not reinforced. Once discriminative control by the tone and light had been established, the stimuli were presented in compound under extinction (with heroin discontinued) or maintenance conditions (with heroin available during test-stimulus presentations). In extinction, the tone-light compound increased responding approximately threefold compared to tone or light alone. Under maintenance conditions, compounding increased heroin intake approximately twofold. These effects closely matched those obtained earlier with cocaine. This consistency across pharmacological classes and across drug and nondrug reinforcers further confirms that (a) self-administered drugs support conditioning and learning in a manner similar to that supported by other reinforcers; and (b) multiple drug-related cues interact in lawful and predictable ways to affect drug seeking and consumption.