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1.
Journal of Public Health and Preventive Medicine ; (6): 35-38, 2023.
Article in Chinese | WPRIM | ID: wpr-959042

ABSTRACT

Objective To analyze the epidemiological characteristics of pulmonary tuberculosis in the elderly people in Wuhan during 2016-2020, and to provide a basis for formulating effective prevention and control strategies and measures. Methods Using the National Tuberculosis Information Management System, a descriptive statistical analysis was performed on the medical records of elderly (≥60 years old) pulmonary tuberculosis patients registered in Wuhan from 2016 to 2020. Results A total of 9 427 elderly pulmonary tuberculosis patients were registered in Wuhan during 2016-2020, accounting for 32.07% of the total number of registrations in the whole population. The reported incidence rate of tuberculosis in the elderly was significantly higher than that in the total population, and the reported incidence rates in both the elderly and the general population showed declining trends (whole population χ2trend=216.97, P2trend=153.57, P<0.05). The time distribution showed that more cases occurred from April to November (70.90%). The top three districts with the largest number of registered cases were far urban areas, namely Huangpi District (13.81%), Xinzhou District (11.55%), and Jiangxia District (9.82%). The ratio of male to female with pulmonary tuberculosis in elderly patients was 2.85:1. Among the elderly pulmonary tuberculosis, the most registered cases were in the age group of 60 ~ years old, followed by 65 ~ years old. The proportion of smear-positive in elderly patients with pulmonary tuberculosis retreatment was 16.83%. Conclusion From 2016 to 2020, the epidemic situation of elderly pulmonary tuberculosis showed a downward trend in Wuhan. However, the elderly population with tuberculosis registrations still accounted for a relatively high proportion of the total population. According to the epidemiological characteristics of pulmonary tuberculosis among the elderly, the city should carry out tuberculosis prevention and control work in a timely, appropriate and focused manner.

2.
Neuroscience Bulletin ; (6): 463-474, 2020.
Article in English | WPRIM | ID: wpr-826801

ABSTRACT

Chemical stimulation of the kidney increases sympathetic activity and blood pressure in rats. The hypothalamic paraventricular nucleus (PVN) is important in mediating the excitatory renal reflex (ERR). In this study, we examined the role of molecular signaling in the PVN in mediating the capsaicin-induced ERR and sympathetic activation. Bilateral PVN microinjections were performed in rats under anesthesia. The ERR was elicited by infusion of capsaicin into the cortico-medullary border of the right kidney. The reflex was evaluated as the capsaicin-induced changes in left renal sympathetic nerve activity and mean arterial pressure. Blockade of angiotensin type 1 receptors with losartan or inhibition of angiotensin-converting enzyme with captopril in the PVN abolished the capsaicin-induced ERR. Renal infusion of capsaicin significantly increased NAD(P)H oxidase activity and superoxide anion production in the PVN, which were prevented by ipsilateral renal denervation or microinjection of losartan into the PVN. Furthermore, either scavenging of superoxide anions or inhibition of NAD(P)H oxidase in the PVN abolished the capsaicin-induced ERR. We conclude that the ERR induced by renal infusion of capsaicin is mediated by angiotensin type 1 receptor-related NAD(P)H oxidase activation and superoxide anion production within the PVN.

3.
Chinese Journal of Immunology ; (12): 156-160, 2019.
Article in Chinese | WPRIM | ID: wpr-744625

ABSTRACT

Objective: To investigate the effect of COX-2 inhibitor bevacizumab on the activity and apoptosis of retinal ganglion RGC-5 cells induced by H2O2 and the regulation of p38 MAPK signaling pathway. Methods: Retinal ganglion RGC-5 cells was stimulated using H2O2 ( 200, 300, 400, 600, 800 μmol/L) to establish a H2O2 damage model, H2O2 concentration was selected based on half inhibitory concentration, COX-2 inhibitor bevacizumab treated RGC-5 cell induced by H2O2 for 7 h, SB203580 as a p38 MAPK signaling pathway inhibitor, cell viability and apoptosis rate were detected by MTT method and flow cytometry, respectively; the expression of PCNA, p53, p38 and p-p38 protein were detected by Western blot. Results: Different concentrations of H2O2 could inhibit the viability of RGC-5 cells, and the cell viability decreased with the increase of H2O2 concentration, because 400 μmol/L H2O2 inhibited half of the cell viability, it was selected as an object of study. Compared with the control group, the cell viability and the expression of PCNA were decreased significantly in H2O2 group, the apoptosis rate and the expression of p53 and p-p38 protein was increased significantly; compared with H2O2 group, the cell viability and PCNA expression were increased significantly in the H2O2+bevacizumab group, the apoptosis rate and the expression of p53 and p-p38 protein were decreased significantly ( P < 0. 05); compared with H2O2+ bevacizumab group, the cell viability and PCNA expression were increased significantly in H2O2+bevacizumab+SB203580 group, the apoptosis rate and the expression of p53 and p-p38 protein were decreased significantly ( P<0. 05). Conclusion: Inhibition of immunosuppressive factor COX-2 expression can improve the activity of retinal ganglion cells and inhibit apoptosis by regulating the p38 MAPK signaling pathway.

4.
Chinese Journal of Zoonoses ; (12): 710-715, 2017.
Article in Chinese | WPRIM | ID: wpr-703032

ABSTRACT

We established a multiplex direct PCR for rapid detection of E.coli,Salmonella,Staphylococcus aureus,Listeria and Yersinia enterocolitica bacteria.Multiplex direct PCR primers were designed according to gene sequences of phoA (E.coli),inv A (Salmonella),nuc (S.aureus),hl y (Listeria),and ail (Y.enterocolitica).After the multiplex direct PCR were established,the specificity and sensitivity of primers were detected.Then,multiplex direct PCR was applied to examine 60 swine product samples,the detection specificity,accuracy and positive predictive value were calculated compared with the gold standard culture method.Results showed that multiplex direct PCR primers could be used for specific detection of E.coli,Salmonella,S.aureus,Listeria and Y.enterocolitica,with the minimal detectable limit of 10,1,100,1 and 1 CFU,respectively.For the examination of 60 swine product samples using multiplex direct PCR,15 were positive for E.coli,6 positive for Salmonella,21 positive for S.aureus,20 positive for Listeria,and 35 positive for Y.enterocolitica,with all positive detection rates higher than that of culture.The total detection sensitivity was 100%,accuracy was 94%,and positive predictive value was 81.44%.Multiplex direct PCR could be used for specific and sensitive detection of common food-borne pathogens,and the testing time was shorten to be 3 hours because of saving time for template extraction.Multiplex direct PCR might serve the detection of food-borne pathogens in food safety risk monitoring much better.

5.
Chinese Medical Journal ; (24): 2478-2484, 2015.
Article in English | WPRIM | ID: wpr-315310

ABSTRACT

<p><b>BACKGROUND</b>About 50% of the cerebral ischemia events are induced by intracranial and extracranial atherosclerosis. This study aimed to evaluate the feasibility and accuracy for displaying atherosclerotic plaques in carotid arteries and analyzing their ingredients by using high-resolution new magnetic resonance imaging (MRI) techniques.</p><p><b>METHODS</b>Totally, 49 patients suspected of extracranial carotid artery stenosis were subjected to cranial MRI scan and magnetic resonance angiography (MRA) examination on carotid arteries, and high-resolution bright-blood and black-blood MRI analysis was carried out within 1 week. Digital subtraction angiography (DSA) examination was carried out for 16 patients within 1 month.</p><p><b>RESULTS</b>Totally, 103 plaques were detected in the 49 patients, which were characterized by localized or diffusive thickening of the vessel wall, with the intrusion of crescent-shaped abnormal signal into lumens. Fibrous cap was displayed as isointensity in T1-weighted image (T1WI) and hyperintensities in proton density weighted image (PDWI) and T2-weighted image (T2WI), lipid core was displayed as isointensity or slight hyperintensities in T1WI, isointensity, hyperintensities or hypointensity in PDWI, and hypointensity in T2WI. Calcification in plaques was detected in 11 patients. Eight patients were detected with irregular plaque surface or ulcerative plaques, which were characterized by irregular intravascular space surface in the black-blood sequences, black hypointensity band was not detected in three-dimensional time-of-flight, or the hypointensity band was not continuous, and intrusion of hyperintensities into plaques can be detected. Bright-blood and black-blood techniques were highly correlated with the diagnosis of contrast-enhanced MRA in angiostenosis degree, Rs = 0.97, P < 0.001. In comparison to DSA, the sensitivity, specificity, and accuracy of MRI diagnosis of stenosis for ≥50% were 88.9%, 100%, and 97.9%, respectively.</p><p><b>CONCLUSIONS</b>High-resolution bright-blood and black-blood sequential MRI analysis can accurately analyze ingredients in atherosclerotic plaques. Determined by DSA, MRI diagnosis of stenosis can correctly evaluate the serious degree of arteriostenosis.</p>


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Angiography, Digital Subtraction , Carotid Artery Diseases , Diagnosis , Carotid Stenosis , Magnetic Resonance Angiography , Magnetic Resonance Imaging , Methods , Plaque, Atherosclerotic , Diagnosis , Sensitivity and Specificity
6.
Chinese Medical Journal ; (24): 942-948, 2013.
Article in English | WPRIM | ID: wpr-342270

ABSTRACT

<p><b>BACKGROUND</b>The association between fish consumption and heart failure (HF) incidence is inconsistent.</p><p><b>METHODS</b>We performed a systematic search of Pubmed and Embase (from 1953 to June 2012) using key words related to fish and HF. Studies with at least three categories of fish consumption reporting both relative risk (RR) and corresponding 95% confidence interval (CI) for HF incidence were included. The pooled RR and 95%CI were calculated using a fixed or random-effects model. The generalized least squares regression model was used to quantify the dose-response relationship between fish consumption and HF incidence.</p><p><b>RESULTS</b>Five prospective cohort studies including 4750 HF events of 170 231 participants with an average of 9.7-year follow-up were selected and identified. Compared with those who never ate fish, individuals with higher fish consumption had a lower HF incidence. The pooled RRs for HF incidence was 0.99 (95%CI, 0.91 to 1.08) for fish consumption 1 to 3 times per month, 0.91 (95%CI, 0.84 to 0.99) for once a week, 0.87 (95%CI, 0.81 to 0.95) for 2 to 4 times per week, and 0.86 (95%CI, 0.84 to 0.99) for 5 or more times per week. An increment of 20 g of daily fish intake was related to a 6% lower risk of HF (RR: 0.94, 95%CI, 0.90 to 0.97; P for trend = 0.001).</p><p><b>CONCLUSIONS</b>This meta-analysis suggests that there is a dose-dependent inverse relationship between fish consumption and HF incidence. Fish intake once or more times a week could reduce HF incidence.</p>


Subject(s)
Animals , Female , Humans , Male , Fishes , Heart Failure , Epidemiology , Incidence , Prospective Studies , Seafood
7.
China Journal of Chinese Materia Medica ; (24): 4281-4286, 2013.
Article in Chinese | WPRIM | ID: wpr-287597

ABSTRACT

The contents of schisandrin, schizandrin A, B and C were determined by HPLC, and the effects of the climate factors and altitude on lignin contents were analyzed in order to select the optimal cultivation area of S. chinensis. The lignin contents were analyzed by HPLC using a ZORBAX SB-C18 column (4.6 mm x 250 mm, 5 microm). The column temperature and detection wave length were set at 35 degrees C and 254 nm, respectively. Methanol-water was used as the mobile phase in gradient elution mode and the flow-rate was 1.0 mL min(-1). The method had a good repeatability, stability and accuracy. The correlation of climate factors and lignins contents was analyzed by SPSS software. The results showed that the schizandrin A content in S. chinensis fruits were higher than 0.4% in Ji'an, Liuhe, Antu and Fusong in Jilin province, which met the quality requirement. It had significant linear negative correlation relationship between schisandrin, schizandrin A, B and altitude, the contents decreased with the increase of altitude. The significant negative linear fitting coefficient was 0.844 1 between schisandrin and altitude; but it had not significant correlation between schizandrin C and altitude. A significant positive correlation of climate factors and the contents of S. chinensis lignins were mainly the temperature factors (the average annual temperature, the highest temperature in July, the average temperature in July, the highest temperature in January, the average temperature in January) and precipitation factor (average annual precipitation), which reveals that higher temperature and precipitation were helpful to the formation and accumulation of lignins of S. chinensis. So the cultivation area of S. chinensis should be in the low elevations region with warm and rainy climate.


Subject(s)
Chromatography, High Pressure Liquid , Ecological and Environmental Phenomena , Geography , Lignin , Metabolism , Schisandra , Metabolism
8.
Chinese Medical Journal ; (24): 1401-1404, 2012.
Article in English | WPRIM | ID: wpr-324966

ABSTRACT

<p><b>BACKGROUND</b>Liddle's syndrome is a rare autosomal-dominant monogenic form of salt-sensitive hypertension. This study aimed to screen the gene mutation in β and γ subunits of the epithelial sodium channel (ENaC) of a Chinese family with Liddle's syndrome, an autosomal dominant form of hypertension.</p><p><b>METHODS</b>DNA samples from the proband with early-onset, treatment-resistant hypertension and suppressed plasma renin activity were initially screened for mutations in the C-terminal exons of the ENaC β or γ subunit genes, using amplification by polymerase chain reaction and direct DNA sequencing. We also screened the C-terminus of SCNN1B and SCNN1G in family members, and screened for the mutation in 150 controls.</p><p><b>RESULTS</b>Genetic analysis of the β ENaC gene revealed a missense mutation of CCC to TCC at codon 616 in the proband, her mother and her grandmother. One hundred and fifty randomly selected controls had not the mutation, indicating that this is not a common genetic polymorphism. There was no mutation of the γ ENaC gene in any of the individuals examined.</p><p><b>CONCLUSIONS</b>Through direct DNA sequencing analysis, we established the diagnosis of Liddle's syndrome for the proband and her families, and provided tailored therapies to this abnormality. These results provide further evidence that Pro616Ser is a critical amino acid that has a key role in the inhibition of sodium channel activity.</p>


Subject(s)
Adolescent , Female , Humans , Male , DNA Mutational Analysis , Epithelial Sodium Channels , Genetics , Liddle Syndrome , Genetics , Mutation, Missense , Pedigree
9.
Academic Journal of Second Military Medical University ; (12): 169-172, 2010.
Article in Chinese | WPRIM | ID: wpr-840377

ABSTRACT

Objective: To analyze the correlation of intervetebral disc degeneration with the diffusion values of lumbar vertebral discs and lumbar blood supply in patients with suspected lumbar intervertebral problems, so as to assess ADC value in diagnosis of intervertebral degeneration and the related blood supply. Methods: Sixty-five patients with suspected lumbar intervertebral problems were included in the present study; they had a mean age of (52.3±28.5) years and an age range of 16-76 years. Eleven of them had low back pain complicated with sciatica, 16 had low back pain without sciatica, 33 had sciatica without low back pain, and 5 had intermittent claudication. The disease course was 1-57 weeks, with a mean of (13.4±6.3) weeks. MR angiography and diffusion imaging were performed to evaluate the status of lumbar arteries and to obtain the ADC values of L1-4, so as to analyze the correlation of ADC values, lumbar blood supply, and intervetebral disc degeneration. Results: The ADC values of L1-4 were negatively correlated with the degeneration of lumbar discs (P<0.05). There was a relation between the artery status of L1, L2 and L3 with the degeneration of corresponding lumbar discs of L1-2, L2-3, and L 3-4, (r3 = 0.823, P = 0.016 3 ; r5 = 0.791, P = 0.019 2; r, = 0.835, P = 0.010 3). The artery status of L4 and the L4-5 discs was not significantly correlated with degeneration of corresponding lumbar discs(r3 =0.306, P = 0.209 2). Conclusion: The ADC values of lumbar intervertebral disc can reflect the degeneration of L 1-4 , and degeneration of L1-2, L2-3 is and L3-4 is correlated with the artery status of corresponding discs.

10.
Chinese Journal of Integrated Traditional and Western Medicine ; (12): 493-495, 2010.
Article in Chinese | WPRIM | ID: wpr-231495

ABSTRACT

<p><b>OBJECTIVE</b>To study the distribution of Chinese syndrome type in patients with primary osteoporosis (POP) and its relationship with bone fracture.</p><p><b>METHODS</b>Materials of 180 POP patients who visited Xiyuan Hospital were investigated, their incidence of bone fracture observed and Chinese syndrome types differentiated. And the outcomes were analyzed statistically using SPSS 13.0.</p><p><b>RESULTS</b>The morbidity of POP in female was higher than that in male, the sex ratio (M/F) being 1:3 (41 cases vs 139 cases). Chinese syndrome type distribution in the POP patients was: Shen-deficiency syndrome (SDS) type in 7.8% patients (14 cases), Pi-Shen deficiency syndrome (PSDS) type in 21.7% (39 cases), Pi-Shen deficiency and blood-stasis syndrome (PBS) type in 70.6% (127 cases), the difference of partition between types was significant (P < 0.05). Bone fracture had occurred in 12.78% (23 cases) of patients, the occurrence in patients with different types was 4.34%, 17.39%, and 78.26%, respectively. Incidence of bone fracture was also different in patients of various age section, being 5.3% in 50-59 years section, up to 15.0% in 60-69 years section (P < 0.05), and down to 12.24% in 70-80 years Section.</p><p><b>CONCLUSION</b>The risk of bone fracture in POP patients of PBS type is higher than that in those with SDS or PSDS type, and 60-69 years is the high risk age section of bone fracture in POP patients.</p>


Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Age Distribution , Bone Density , Fractures, Bone , Epidemiology , Incidence , Medicine, Chinese Traditional , Osteoporosis , Diagnosis , Sex Distribution
11.
Chinese Journal of Preventive Medicine ; (12): 1073-1076, 2009.
Article in Chinese | WPRIM | ID: wpr-316058

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the secular trend of advanced maternal age woman (>or= 35 year-old) in our country.</p><p><b>METHODS</b>Data on maternal woman at different age were collected at surveillance hospital in Chinese Birth Defects Monitoring Network from 1996 to 2007 and retrospective analysis of the trend of advanced maternal women were carried out. Trend analysis of the advanced maternal age in urban and rural areas of west, middle and east areas was also conducted. Chi-square test was applied to test the differences and the fitting model analysis was also applied.</p><p><b>RESULTS</b>A total of 6,308,594 parturient woman were monitored, included 354,511 woman (5.62%) of advanced maternal age. In 1996 and 2007, the proportion of the advanced maternal woman were 2.96% (12,508/422,486) and 8.56% (66,351/775,333), respectively. It showed an increasing trend for the national woman proportion of advanced maternal age from 1996 to 2007 (chi(2) = 45 376.16, P < 0.01). In city, the proportion of advanced maternal age woman were 2.95% (8755/296,975) and 7.69% (40,197/522,596) in 1996 and 2007, respectively. In rural region, the proportion of advanced maternal age woman were 2.99% (3753/125,511) and 10.35% (26,154/252,737) in 1996 and 2007, respectively. It showed increasing both in city and rural areas (chi(2)(city) = 24,152.86, P < 0.01; chi(2)(rural) = 20,809.79, P < 0.01). And the proportions in urban area and rural area were 5.13% (221,655/4,317,533) and 6.67% (132,856/1,991,061), the proportions difference was significant in statistics (chi(2) = 1536.260, P < 0.01). An Exponential model was established, ln(Y) = ln(2.52) + (0.103 x t). In east areas, the proportion were 3.90%and 8.81% in 1996 and 2007, respectively, in middle areas the respective proportions were 2.49% and 8.56%, in west areas were 2.11% and 8.21%. They all showed increasing trend in proportion of advanced maternal age from 1996 to 2007 year in east areas, middle areas and west areas (chi(2)(east) = 11,746.87, P < 0.01; chi(2)(middle) = 17,350.21, P < 0.01; chi(2)(west) = 16,432.68, P < 0.01). But the proportions of city and rural were different in those areas.</p><p><b>CONCLUSION</b>The proportion of advanced maternal woman had secular increasing trend and the rates were lower in city than in rural areas.</p>


Subject(s)
Adult , Female , Humans , Middle Aged , Pregnancy , Age Distribution , China , Hospitals, Maternity , Maternal Age , Retrospective Studies , Rural Population , Urban Population
12.
Chinese Medical Journal ; (24): 1615-1620, 2009.
Article in English | WPRIM | ID: wpr-292659

ABSTRACT

<p><b>BACKGROUND</b>Cholesterol-lowering therapy with statins has been reported to reduce the morbidity and mortality of cardiovascular diseases. This study aimed to investigate the effects of combined application of extended-release niacin and atorvastatin on lipid profile modification and the risks of adverse events in patients with coronary artery disease.</p><p><b>METHODS</b>Consecutive 108 patients with coronary artery disease and serum total cholesterol (TC) > or = 3.5 mmol/L were randomized into two groups: group A using atorvastatin and group B using extended-release niacin (niacin ER) and atorvastatin. Plasma lipid profile, glucose, and adverse events were assessed at the hospitalization, and 6 and 12 months after treatment. In addition, clinical cardiovascular events were evaluated after 12 months of treatment.</p><p><b>RESULTS</b>The levels of TC, low density lipoprotein cholesterol (LDL-C) were significantly decreased (P < 0.05) in groups A and B, but the levels of high density lipoprotein cholesterol (HDL-C) and ApoA increased by 29.36% and 40.81% respectively after 12 months of treatment in group B (P < 0.01). The medications were generally well tolerated in the two groups. No significant difference of adverse events was found between the two groups (group A: 3.2% vs group B 5.1%, P > 0.05).</p><p><b>CONCLUSIONS</b>Combined use of extended-release niacin with atorvastatin was superior to atorvastatin monotherapy alone in lipid profile regulation. Combination therapy with niacin ER and atorvastatin was well tolerated and safe in patients with coronary artery disease.</p>


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Anticholesteremic Agents , Pharmacology , Therapeutic Uses , Apolipoproteins A , Blood , Atorvastatin , Cholesterol , Blood , Cholesterol, HDL , Blood , Cholesterol, LDL , Blood , Coronary Artery Disease , Drug Therapy , Heptanoic Acids , Pharmacology , Therapeutic Uses , Lipid Metabolism , Niacin , Pharmacology , Therapeutic Uses , Pyrroles , Pharmacology , Therapeutic Uses
13.
Chinese Journal of Integrated Traditional and Western Medicine ; (12): 281-284, 2006.
Article in Chinese | WPRIM | ID: wpr-331701

ABSTRACT

This paper summarized the researches on diagnosis and treatment of senile depression with integrative Chinese and Western medicine in the recent 5 years, and some problems existed at present were also submitted. It is pointed out that it's necessary to expand the study with senior electrocerebral neurotransmitter analysis technique (SET) for the diagnosis and efficacy evaluation of senile depression by either traditional Chinese or Western medicine. By which it would also be able to offer convincing evidence for diagnosis of depression, TCM syndrome differentiation dependant therapy and the efficacy evaluation.


Subject(s)
Humans , Antidepressive Agents , Therapeutic Uses , Depressive Disorder , Diagnosis , Drug Therapy , Diagnosis, Differential , Drug Therapy, Combination , Drugs, Chinese Herbal , Therapeutic Uses , Medicine, Chinese Traditional , Phytotherapy
14.
Acta Physiologica Sinica ; (6): 147-152, 2003.
Article in Chinese | WPRIM | ID: wpr-318926

ABSTRACT

To define the molecular basis of ethanol dependence, changes in the phosphorylation of cAMP response element binding protein (CREB) in the nucleus accumbens of rats after acute and chronic ethanol administration were detected using immunohistochemistry. The results demonstrate that the expression of phospho-CREB (p-CREB) protein in the rat nucleus accumbens significantly increased after 15 min of acute ethanol exposure, reaching a peak at 30 min after ethanol administration. The increment remained after 1 or 6 h of ethanol exposure compared to the control rats. In contrast, chronic intake of ethanol solution obviously decreased the expression of p-CREB protein compared to the control rats. The decrement remained 24 h or 72 h after ethanol withdrawal, and returned to the control levels after 7 d of ethanol withdrawal. The results suggest that an acute ethanol administration led to an increase in the phosphorylation of CREB in the nucleus accumbens, but chronic ethanol administration produced a decrement, which is possibly one of the molecular mechanisms of alcohol dependence.


Subject(s)
Animals , Male , Rats , Alcoholism , Metabolism , Cyclic AMP Response Element-Binding Protein , Chemistry , Metabolism , Ethanol , Pharmacology , Nucleus Accumbens , Metabolism , Phosphorylation , Rats, Sprague-Dawley , Substance Withdrawal Syndrome , Metabolism , Substance-Related Disorders , Metabolism
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