Blockade of the Dopamine D3 Receptor Attenuates Opioids-Induced Addictive Behaviours Associated with Inhibiting the Mesolimbic Dopamine System / 神经科学通报·英文版

Opioid use disorder (OUD) has become a considerable global public health challenge; however, potential medications for the management of OUD that are effective, safe, and nonaddictive are not available. Accumulating preclinical evidence indicates that antagonists of the dopamine D3 receptor (D3R) have effects on addiction in different animal models. We have previously reported that YQA14, a D3R antagonist, exhibits very high affinity and selectivity for D3Rs over D2Rs, and is able to inhibit cocaine- or methamphetamine-induced reinforcement and reinstatement in self-administration tests. In the present study, our results illustrated that YQA14 dose-dependently reduced infusions under the fixed-ratio 2 procedure and lowered the breakpoint under the progressive-ratio procedure in heroin self-administered rats, also attenuated heroin-induced reinstatement of drug-seeking behavior. On the other hand, YQA14 not only reduced morphine-induced expression of conditioned place preference but also facilitated the extinguishing process in mice. Moreover, we elucidated that YQA14 attenuated opioid-induced reward or reinforcement mainly by inhibiting morphine-induced up-regulation of dopaminergic neuron activity in the ventral tegmental area and decreasing dopamine release in the nucleus accumbens with a fiber photometry recording system. These findings suggest that D3R might play a very important role in opioid addiction, and YQA14 may have pharmacotherapeutic potential in attenuating opioid-induced addictive behaviors dependent on the dopamine system.

Actively separated microneedle patch for sustained-release of growth hormone to treat growth hormone deficiency

Growth hormone deficiency (GHD) has become a serious healthcare burden, and presents a huge impact on the physical and mental health of patients. Here, we developed an actively separated microneedle patch (PAA/NaHCO3-Silk MN) based on silk protein for sustained release of recombinant human growth hormone (rhGH). Silk protein, as a friendly carrier material for proteins, could be constructed in mild full-water conditions and ensure the activity of rhGH. After manually pressing PAA/NaHCO3-Silk MN patch to skin for 1 min, active separation is achieved by absorbing the interstitial fluid (ISF) to trigger HCO3 ‒ in the active backing layer to produce carbon dioxide gas (CO2). In rats, the MN patch could maintain the sustained release of rhGH for more than 7 days, and produce similar effects as daily subcutaneous (S.C.) injections of rhGH in promoting height and weight with well tolerated. Moreover, the PAA/NaHCO3-Silk MN patch with the potential of painless self-administration, does not require cold chain transportation and storage possess great economic benefits. Overall, the PAA/NaHCO3-Silk MN patch can significantly improve patient compliance and increase the availability of drugs, meet current unmet clinical needs, improve clinical treatment effects of GHD patients.

Self-Medication Practice among Amman’s Householders: Prevalence and Factors

Aims:This study is set out to explore the prevalence and the influencing factors of self-medication practice, besides, to assess the knowledge levels of Amman’s householders.Methods:A community-based cross-sectional study was conducted using pre-tested questionnaires. The householders (n=601) were randomly selected from two disparate regions in Amman (West and East), which reflect different segments of the society.Results:Self-medication was practised by more than half (53.1%) of Amman’s Householders. The East of Amman householders shows a relatively lower rate (49.7%) of self-medication than the West of Amman ones (56.5%), which can be attributed to the higher ability to pay for medicines and a higher level of knowledge among West residents that might allow them to go directly to the pharmacies without consulting a physician. The relatively severe illness (e.g. respiratory diseases and eye complaints) showed the lowest influence for self-medication, which indicates a good level of awareness about the importance of consulting the health care professionals. Furthermore, the two main reasons for self-medication were experiencing a good result from previous self-medication (87.8%) and saving time (84.6%). The self-medication practice was associated with the education level and the knowledge level; the knowledge level of West of Amman residents was correlated positively with the self-medication practice prevalence; nevertheless, East ones presented a less notable pattern.Conclusion:There is a knowledge gap regarding the proper SM practice, the health professionals must effectively educate the patients regarding the responsible self-medication practice and thus limit the adverse outcomes

Trait of Pain Killer Self-Administration among the Doctors Serving at General Hospitals Located in the Capital Area of the Republic of Korea

BACKGROUND: The aim of this study was to identify the painkillers preferred for self-administration by doctors working at general hospitals in the capital of the Republic of Korea.METHODS: We collected data, using a questionnaire, from 224 doctors working at secondary or tertiary hospitals in the capital of the Republic of Korea from July 1, 2017 to August 31, 2017. The questionnaire included questions on the preferred type of painkiller for each type of pain and the frequency of painkiller intake. Further, we evaluated the participants on the Likert scale to analyze the consideration and cognition of self-administration of painkillers.RESULTS: The doctors in this study tended to state the trade name of the painkillers rather than the generic name. They preferred acetaminophen for headache and nonsteroidal anti-inflammatory drugs for gastrointestinal (GI) pain, dysmenorrhea, toothache, and musculoskeletal pain. In the choice of painkiller for self-administration, they set utmost importance on the effectiveness of the medicine, followed by the potential side effects, physician's prescription, and the pharmacy's recommendation, in that order. The side effects attribute GI complications, hepatotoxicity, drug tolerance, and delayed diagnosis to painkiller use. There were some remarkable differences between surgeons and non-surgeons, men and women, and specialists and trainees in the conception of painkillers and pain control.CONCLUSION: This is the first study worldwide on the trait of the self-administration of painkillers by doctors, which can serve as a useful reference in clinical settings.

To Assess Medication Compliance and Self Care Practices in Patients with Diabetes Mellitus

Background: The global rise in the prevalence of diabetes mellitus and a wide variation in compliance to self-management of diabetes has become a challenging health care problem. Poor glycaemic control can lead to treatment failures and accelerated development of various diabetes-related complications. Our study aims to find out the compliance rate of the patients with type 2 diabetes to the prescribed medications and to find out its comparison across various socio-demographic variables. Methods: This is a cross sectional questionnaire based study that was conducted amongst patients with type 2 diabetes mellitus. A total of 136 patients were included in the study and interviewed by using a pre tested, structured interview schedule which captured socio-demographic variables and Diabetes Self-Management Questionnaire covering different aspects of diabetes self-management. Participants rate the extent to which each description applies to them on a four-point Likert scale. Results: Mean age of the participants was 44.53 ± 8.13. The mean duration of diabetes was 7.63 ± 6.49 years. The overall compliance score in our participants was 23.44 ± 4.17. None of the participants stated that they check their blood sugar levels regularly. Of self-care activities, 69.1% of the patients agree that they do not skip their diabetes medication. Compliance to the diabetes self-care decreased significantly with an increase in age (p<0.001) and duration of disease (p<0.01). The mean compliance score was also significantly lower among those who were illiterate (p<0.001) and unskilled workers (p=0.02). Conclusion: It can be concluded that the compliance score was not good among the participants. Significant association have been found between mean compliance scores and increasing age, illiteracy, unskilled occupation and longer duration of disease.

Preferencias y satisfacción hacia un programa de tamizaje con pruebas autoadministradas de detección del virus de papiloma humano / Preferences and satisfaction towards a screening program with self-administered human papilloma virus detection tests

Estudio transversal que describe preferencias y satisfacción hacia un programa de tamizaje de cáncer cervical con pruebas rápidas autoadministradas, para la detección del virus de papiloma humano (VPH). De las 2090 usuarias captadas por el programa en Ventanilla Callao-Perú, se seleccionó aleatoriamente a 97 para ser encuestadas. Asimismo, se realizaron entrevistas a mujeres líderes de la comunidad, encargadas de ofrecer las pruebas. El 74,2% de las usuarias se sintió, cuanto menos, satisfecha con el programa. El 68% de las mujeres prefiere la autotoma de la prueba, principalmente por demandar menos tiempo. De las mujeres que prefieren la toma en el centro de salud, el 90,3% lo hace por la seguridad de que la prueba sea realizada correctamente. La inclusión de líderes comunitarias en el programa permitió una buena difusión de la prueba y de los pasos para realizarla.

Cross-sectional study describing preferences and satisfaction towards a cervical cancer screening program with selfadministered rapid tests for the detection of human papillomavirus (HPV). Of 2 090 users picked by the program in Ventanilla Callao - Peru, 97 were randomly selected to be surveyed. In addition, interviews were conducted with women leaders of the community, in charge of providing the evidence. 74.2% of the users felt, at least, satisfied with the program. 68% of women prefer to take the test, mainly by demanding less time. Of women who prefer to take the test at the Health Center, 90.3% do so for the safety of the test being done correctly. The inclusion of community leaders in the program allowed a good diffusion of the test and the steps to carry it out.

Abuse-related effects of synthetic cathinones:importance of DAT/SERT relationships / 中国药理学与毒理学杂志

OBJECTIVE Wide spread abuse of synthetic cathinones found in bath salts preparations has resulted in regulation of some cathinones internationally. Chemists skirt these laws by altering the chemical structures of first-generation cathinones (ie, MDPV, methylone, and mephedrone), resulting in second-generation cathinones (eg, α-PVP, α-PPP, MDPPP, and MDPBP). Although MDPV is a more effective reinforcer than cocaine, little is known about the reinforcing effectiveness of second-generation cathinones. To test the hypothesis that synthetic cathinones with higher selectivity for DAT relative to SERT are more effective reinforcers. METHODS Monoamine transporter inhibition was determined using synaptosomes prepared from rat brains. The relative reinforcing effectiveness of intravenously self-administered MDPV, MDPBP, MDPPP, α-PVP, α-PPP, and cocaine were directly compared through evaluations of ① dose- response curves under a progressive ratio (PR) schedule of reinforcement and ② demand curves obtained for each drug in male Sprague-Dawley rats. RESULTS Rank order selectivity for DAT/SERT was α-PVP>MDPV>α-PPP≈MDPBP>MDPPP>cocaine. Comparisons of the maximum number of infusions obtained under a PR schedule of reinforcement (α-PVP>MDPV>α-PPP>MDPBP≈MDPPP>cocaine) and the essential value obtained for each drug in demand analyses (α-PVP>MDPV>α-PPP≈MDPBP≈MDPPP>cocaine) suggest relative reinforcing effectiveness is related to DAT/SERT selectivity. CONCLUSION These data provide evidence that DAT/SERT selectivity accounts for select synthetic cathinones functioning as more effective reinforcers than cocaine and may predict the abuse-related effects of novel synthetic cathinones in humans.

Self-care competence in the administration of insulin in older people aged 70 or over / Competência para o autocuidado na administração de insulina por idosos septuagenários ou mais de idade / Capacidad de autocuidado en la administración de insulina en adultos mayores de 70 años de edad o más

ABSTRACT Objective: to analyze the self-care competence in the administration of insulin performed by older people aged 70 or over. Method: cross-sectional study carried out with 148 older people aged 70 or over, who performed self-administration of insulin. Data collection was carried out using a structured questionnaire and an adapted guide for the application of the Scale to Identify Self-Care Competence of Patients with Diabetes, at the participants' home. Data analysis included descriptive and inferential statistical tests, with forward logistic regression. Results: the prevalence of self-care competence in the administration of insulin was 35.1%. Handwashing error was the most frequent in self-administration of insulin. Self-care competence was negatively associated with retirees and positively associated with senior patients who performed capillary blood glucose monitoring and skin pinching during insulin application. Conclusion: there was low self-care competence and it was associated with both the sociodemographic and the clinical characteristics with regard to self-application of insulin by the older people.

RESUMO Objetivo: analisar a competência para o autocuidado na administração de insulina por idosos septuagenários ou mais de idade. Método: estudo transversal, com 148 idosos septuagenários ou mais de idade, que realizavam autoadministração de insulina. A coleta de dados deu-se por meio de questionário estruturado e guia adaptado para aplicação da Escala para Identificação da Competência do Diabético para o Autocuidado, no domicílio dos participantes. Na análise dos dados, foram compreendidos testes estatísticos descritivos e inferenciais, com regressão logística forward. Resultados: a prevalência da competência para o autocuidado na administração de insulina foi de 35,1%. Lavagem das mãos foi o erro mais frequente na autoaplicação de insulina. A competência para o autocuidado apresentou associação negativa para os aposentados e associação positiva para os idosos que realizavam glicemia capilar e prega subcutânea, durante a aplicação de insulina. Conclusão: a competência para o autocuidado foi baixa e esteve associada tanto às características sociodemográficas e clínicas quanto ao desempenho do idoso para a autoaplicação de insulina.

RESUMEN Objetivo: analizar la capacidad de autocuidado en la administración de insulina en adultos mayores de 70 años de edad o más. Método: estudio transversal realizado con 148 adultos mayores de 70 años de edad o más, que realizaban la autoadministración de insulina. La recolección de datos se llevó a cabo mediante un cuestionario estructurado y una guía adaptada para la aplicación de la Escala para la Identificación de la Capacidad de Autocuidado de Pacientes con Diabetes, en el hogar de los participantes. En el análisis de los datos, se incluyeron pruebas estadísticas descriptivas e inferenciales, con regresión logística forward. Resultados: la prevalencia de capacidad de autocuidado en la administración de insulina fue del 35,1%. El error en el lavado de manos fue el más frecuente en la autoadministración de insulina. La capacidad de autocuidado se asoció negativamente con los jubilados y se asoció positivamente con los adultos mayores que realizaban la monitorización de la glucemia capilar y el pellizco en la piel durante la aplicación de la insulina. Conclusión: la capacidad de autocuidado fue baja y se asoció con las características sociodemográficas y clínicas con respecto a la auto-aplicación de la insulina por los adultos mayores.

Potential for Dependence on Lisdexamfetamine - In vivo and In vitro Aspects

Although lisdexamfetamine is used as a recreational drug, little research exists regarding its potential for dependence or its precise mechanisms of action. This study aims to evaluate the psychoactivity and dependence profile of lisdexamfetamine using conditioned place preference and self-administration paradigms in rodents. Additionally, biochemical techniques are used to assess alterations in the dopamine levels in striatal synaptosomes following administration of lisdexamfetamine. Lisdexamfetamine increased both conditioned place preference and self-administration. Moreover, after administration of the lisdexamfetamine, dopamine levels in the striatal synaptosomes were significantly increased. Although some modifications should be made to the analytical methods, performing high performance liquid chromatography studies on synaptosomes can aid in predicting dependence liability when studying new psychoactive substances in the future. Collectively, lisdexamfetamine has potential for dependence possible via dopaminergic pathway.

Potential for Dependence on Lisdexamfetamine - In vivo and In vitro Aspects

Although lisdexamfetamine is used as a recreational drug, little research exists regarding its potential for dependence or its precise mechanisms of action. This study aims to evaluate the psychoactivity and dependence profile of lisdexamfetamine using conditioned place preference and self-administration paradigms in rodents. Additionally, biochemical techniques are used to assess alterations in the dopamine levels in striatal synaptosomes following administration of lisdexamfetamine. Lisdexamfetamine increased both conditioned place preference and self-administration. Moreover, after administration of the lisdexamfetamine, dopamine levels in the striatal synaptosomes were significantly increased. Although some modifications should be made to the analytical methods, performing high performance liquid chromatography studies on synaptosomes can aid in predicting dependence liability when studying new psychoactive substances in the future. Collectively, lisdexamfetamine has potential for dependence possible via dopaminergic pathway.

Evaluation of the Abuse Potential of Novel Amphetamine Derivatives with Modifications on the Amine (NBNA) and Phenyl (EDA, PMEA, 2-APN) Sites

Recently, there has been a rise in the number of amphetamine derivatives that serve as substitutes for controlled substances (e.g. amphetamine and methamphetamine) on the global illegal drug market. These substances are capable of producing rewarding effects similar to their parent drug. In anticipation of the future rise of new and similar psychoactive substances, we designed and synthesized four novel amphetamine derivatives with N-benzyl, N-benzylamphetamine HCl (NBNA) substituent on the amine region, 1,4-dioxane ring, ethylenedioxy-amphetamine HCl (EDA), methyl, para-methylamphetamine HCl (PMEA), and naphthalene, 2-(aminopropyl) naphthalene HCl (2-APN) substituents on the phenyl site. Then, we evaluated their abuse potential in the conditioned place preference (CPP) test in mice and self-administration (SA) test in rats. We also investigated the psychostimulant properties of the novel drugs using the locomotor sensitization test in mice. Moreover, we performed qRT-PCR analyses to explore the effects of the novel drugs on the expression of D1 and D2 dopamine receptor genes in the striatum. NBNA, but not EDA, PMEA, and 2-APN, induced CPP and SA in rodents. None of the test drugs have produced locomotor sensitization. qRT-PCR analyses demonstrated that NBNA increased the expression of striatal D1 dopamine receptor genes. These data indicate that NBNA yields rewarding effects, suggesting potential for abuse. Continual observation for the rise of related substances is thus strongly encouraged.

The Abuse Potential of α-Piperidinopropiophenone (PIPP) and α-Piperidinopentiothiophenone (PIVT), Two New Synthetic Cathinones with Piperidine Ring Substituent

A diversity of synthetic cathinones has flooded the recreational drug marketplace worldwide. This variety is often a response to legal control actions for one specific compound (e.g. methcathinone) which has resulted in the emergence of closely related replacement. Based on recent trends, the nitrogen atom is one of the sites in the cathinone molecule being explored by designer type modifications. In this study, we designed and synthesized two new synthetic cathinones, (1) α-piperidinopropiophenone (PIPP) and (2) α-piperidinopentiothiophenone (PIVT), which have piperidine ring substituent on their nitrogen atom. Thereafter, we evaluated whether these two compounds have an abuse potential through the conditioned place preference (CPP) in mice and self-administration (SA) in rats. We also investigated whether the substances can induce locomotor sensitization in mice following 7 days daily injection and challenge. qRT-PCR analyses were conducted to determine their effects on dopamine-related genes in the striatum. PIPP (10 and 30 mg/kg) induced CPP in mice, but not PIVT. However, both synthetic cathinones were not self-administered by the rats and did not induce locomotor sensitization in mice. qRT-PCR analyses showed that PIPP, but not PIVT, reduced dopamine transporter gene expression in the striatum. These data indicate that PIPP, but not PIVT, has rewarding effects, which may be attributed to its ability to affect dopamine transporter gene expression. Altogether, this study suggests that PIPP may have abuse potential. Careful monitoring of this type of cathinone and related drugs are advocated.

Establishment of A Model in Rat Brain Nuclei Microelectrode Recording Coupled Behavioristics for Rehabilitation Experiment / 中国康复理论与实践

@#Objective To establish a coupled model combining the rat brain nuclei microelectrode recordings and the behavioristics for rehabilitation experiment. Methods The modified indwelling tube connection fixed device was put inside the rats' back, and the microprobes were implanted into related neural nucleus. A signal connection was made between self-administration system and electrophysiological data acquisition system. The rat was addicted after training by self-administration system. The related cerebral nucleus electrophysiological sig-nals were recorded in different states of addiction. Results and Conclusion The modified indwelling tube connection fixed device has a bet-ter quality for reducing the phenomenon of leak. The signal was well in the combination of two different systems. The signals for the rat's ac-tion and neural electrical were recorded in the same time.

Competência para o autocuidado na administração de insulina por septuagenários ou mais idosos / Competence for sel-care insulin administration by septuagenarian or more older

O envelhecimento populacional, o aumento da prevalência de diabetes em idosos e o aumento da utilização de insulina no tratamento de diabetes tipo 2, demonstram a necessidade de estudos para orientar abordagens de cuidados para idosos insulinizados. O que se observa no cotidiano de vida do idoso é que as ações que envolvem o autocuidado para o controle da glicemia, como autoaplicação de insulina e automonitorização glicêmica, nem sempre são manejadas de forma adequada, dificultando o controle e expondo o idoso a maiores riscos de complicações crônicas e agudas. A prática de autoadministração de insulina pode sofrer interferências de diversos fatores, como incapacidades cognitivas, deficiências e perda de autonomia e independência, muito comuns em idosos e que precisam ser investigados para serem trabalhados e minimizados pela atuação dos profissionais de saúde. OBJETIVO: Analisar a competência para o autocuidado na administração de insulina por septuagenários ou mais idosos com Diabetes Mellitus (DM). METODOLOGIA: Trata-se de um estudo transversal, realizado por meio de visitas domiciliares, com 148 septuagenários ou mais idosos que adquiriram insulina em algum dos centros de saúde do distrito Noroeste de Belo Horizonte e que realizam a autoadministração domiciliar desse medicamento. Foi realizada a coleta de dados sóciodemográficos e clínicos dos idosos e registro das alterações nas capacidades físicas, mentais e motivacionais. No segundo momento ocorreu a observação no domicílio do processo de autoadministração de insulina e o registro dos erros e acertos encontrados. Para a avaliação das capacidades, foi utilizada a Escala para Identificação da Competência do Diabético para o Autocuidado, proposta por NUNES (1982). RESULTADOS: O perfil dos idosos caracterizou-se como uma população predominantemente feminina (64,2%), proveniente do interior de Minas Gerais (61,5%), sem cônjuge (54,7%), com escolaridade menor ou igual a 4 anos de estudo (59,5%)...

The aging population, the increasing prevalence of diabetes in the elderly and increased use of insulin to treat type 2 diabetes demonstrate the need for studies to guide approaches to care for elderly insulinized. What is observed in the elderly routine is that actions involving self-care to control blood sugar, such as self-administration of insulin and blood glucose monitoring, are not always managed properly, making it difficult to control and expose the elderly to greater risks of acute and chronic complications. The practice of self-administration of insulin may suffer interference from several factors, such as cognitive impairment, disability and loss of autonomy and independence, very common in the elderly, that need to be investigated in order to be worked out and minimized the role of health professionals. OBJECTIVE: To assess the competence for self-care insulin administration by septuagenarian or more older with diabetes. METHODOLOGY: This is a cross-sectional study, carried out through home visits, with 148 septuagenarian or more older who acquired insulin in any of the health centers in the Northwest district of Belo Horizonte and conducting the home self-administration of this drug. Collecting sociodemographic and clinical data of elderly and record of changes in the physical, mental and motivational was held. The second time was the observation of insulin self-administration process and registration of errors and hits found. For the assessment of capabilities, we used the Scale for Diabetic Racing identification for self-care, proposed by NUNES (1982). RESULTS: The profile of the elderly was characterized as a predominantly female population (64.2%), from the country side of Minas Gerais (61.5%), with no spouse (54.7%), with less than or equal to 4 years education study (59.5%). The predominant age group was 70 to 79 years (73.6%). In the evaluation of errors in insulin self-administration, the...

O extrato bruto hidroalcoólico das folhas de Piper caldense C. DC. na redução do consumo de álcool em ratos / The hydroalcoholic extract of leaves of Piper caldense C. DC. decreases alcohol consumption in rats

A investigação de plantas medicinais como recurso terapêutico para combater o alcoolismo ainda é muito insipiente com poucas espécies investigadas. No presente trabalho avaliamos o efeito do extrato hidroalcoólico das folhas da planta Piper caldense C. DC. com relação ao consumo de álcool e também a sua potencialidade ansiolítica. Foram utilizados ratos Wistar machos, os quais foram divididos em grupos controle (solução fisiológica) e tratado (extrato da planta nas doses de 25, 50 e 150 mg/kg, e diazepam 2 mg/kg). Os animais foram tratados através da via intraperitoneal 1 h antes dos experimentos. Os modelos animais utilizados foram: Labirinto em Cruz Elevado (LCE) e auto-administração de álcool (AA). No LCE o extrato não apresentou efeito ansiolítico do tipo benzodiazepínico. Por outro lado, no comportamento relacionado a auto-administração de solução de álcool, o extrato apresentou efeito significativo reduzindo o consumo de álcool em relação ao grupo controle. Apesar do extrato não ter apresentado efeito ansiolítico, o mesmo parece apresentar potencialidades para combater o abuso e a dependência de álcool.

The investigation of medicinal plants as therapeutic resources in the combat of alcoholism is still very incipient with few species being investigated. The purpose of the present study was to examine the effects of the hydroalcoholic extract of leaves of Piper caldense C. DC. in relation to alcohol consumption and also its anxiolytic potentiality. Male Wistar rats, which had been separated into control group (saline) and treated group (Plant extract doses of 25, 50 and 150 mg/kg and 2 mg/kg of diazepam), were used. Animals were injected intraperitoneally 1 h before the tests. The following models were used: Elevated plus maze (EPM) and alcohol self-administration (ASA). In the EPM, the extract did not show benzodiazepine anxiolytic effect. On the other hand, in the behavior related to alcohol self-administration, the extract showed a significant effect, reducing alcohol consumption compared to the control group. Although the extract has not shown any anxiolytic effect, the results suggest that the plant has potential to combat alcohol abuse and addiction.

Belief about medicines in cerebral ischemic stroke patients and its influencing factors / 中华老年心脑血管病杂志

Objective To investigate the belief about medicines in cerebral ischemic stroke (CIS) patients and its influencing factors .Methods The belief about medicines in 212 CIS patients was investigated using questionnaire and compared .Its influencing factors were analyzed by multivari‐ate linear regression analysis .Results The score of belief about medicines was 6 .06 ± 1 .86 in 212 CIS patients .The score of necessity belief was significantly higher than that of concern belief in CIS patients (16 .19 ± 2 .05 vs 10 .13 ± 1 .72 ,P<0 .01) .The score of belief about medicines dif‐fered greatly in CIS patients with different gender ,family income ,occupation ,NIHSS ,hemiplegia , aphasia ,drug taking time ,adverse effect of drugs and depression (P<0 .05) .Multivariate linear regression analysis showed that adverse effect of drugs ,depression ,NIHSS ,hemiplegia ,aphasia , occupation and gender were the influencing factors of belief about medicines in CIS patients (P<0 .05 ,P< 0 .01 ) .Conclusion T he belief about medicine is considerably poor in CIS patients , which is affected by a number of factors .Measures should thus be taken to improve their belief about medicines .

Assessment of the Abuse Liability of Synthetic Cannabinoid Agonists JWH-030, JWH-175, and JWH-176

The emergence and use of synthetic cannabinoids have greatly increased in recent years. These substances are easily dispensed over the internet and on the streets. Some synthetic cannabinoids were shown to have abuse liability and were subsequently regulated by authorities. However, there are compounds that are still not regulated probably due to the lack of abuse liability studies. In the present study, we assessed the abuse liability of three synthetic cannabinoids, namely JWH-030, JWH-175, and JWH-176. The abuse liability of these drugs was evaluated in two of the most widely used animal models for assessing the abuse potential of drugs, the conditioned place preference (CPP) and self-administration (SA) test. In addition, the open-field test was utilized to assess the effects of repeated (7 days) treatment and abrupt cessation of these drugs on the psychomotor activity of animals. Results showed that JWH-175 (0.5 mg/kg), but not JWH-030 or JWH-176 at any dose, significantly decreased the locomotor activity of mice. This alteration in locomotor activity was only evident during acute exposure to the drug and was not observed during repeated treatment and abstinence. Similarly, only JWH-175 (0.1 mg/kg) produced significant CPP in rats. On the other hand, none of the drugs tested was self-administered by rats. Taken together, the present results indicate that JWH-175, but not JWH-030 and JWH-176, may have abuse potential. More importantly, our findings indicate the complex psychopharmacological effects of synthetic cannabinoids and the need to closely monitor the production, dispensation, and use of these substances.

Proyecto PIENSA (Programa de Investigación y Educación en Salud Reproductiva): impacto de la asesoría en la elección anticonceptiva en mujeres peruanas

Introducción: La necesidad insatisfecha de anticoncepción sigue siendo alta en el Perú y a nivel mundial. La asesoría adecuada del profesional de la salud ha demostrado maximizar el uso y cumplimiento de métodos anticonceptivos que se ajusten a las necesidades de cada mujer. Objetivos: Medir el impacto de la asesoría brindada por profesionales de salud ginecoobstetras en la elección de un método anticonceptivo hormonal de autoadministración -píldora diaria, parche transdérmico semanal y anillo vaginal mensual-, así como los factores determinantes de ello. Diseño: Estudio observacional, descriptivo y transversal. Lugar: Lima, Piura, Chiclayo y Trujillo, Perú. Institución: Proyecto Latinoamericano PIENSA: Programa de Investigación y Educación en Salud Anticonceptiva. Participantes: Quinientos ochenta y un mujeres de 18 a 40 años que acudieron a la consulta de 40 ginecoobstetras que brindaron asesoría sobre métodos anticonceptivos. Intervenciones: Se realizó una asesoría estandarizada con material didáctico que contenía información sobre efectividad, mecanismo de acción, modo de uso, beneficios y riesgos, así como idoneidad, respecto a las necesidades individuales. Principales medidas de resultados: Elección original y elección final del método anticonceptivo luego de la asesoría, y factores involucrados. Resultados: La elección inicial del método fue de 57% la píldora, 15% el anillo vaginal y 13% el parche transdérmico; luego de la asesoría fue: 38% la píldora, 33% el anillo vaginal, y 19% el parche transdérmico. Resultó estadísticamente significativa la preferencia entre las usuarias del anillo vaginal de 15% a 33% y la preferencia del parche transdérmico de 13 a 19%; p<0,005. La razón principal para la elección del método fue la facilidad de uso. Conclusiones: Las mujeres peruanas participantes del proyecto PIENSA eligieron inicialmente la píldora diaria, cuyo porcentaje disminuyó luego de la asesoría por un profesional de la salud. Asimismo, el número de mujeres que eligieron los métodos de parche transdérmico y anillo vaginal se incrementó significativamente.

Introduction: Unmet needs for contraception are high in Peru and worldwide. Proper advice from health professionals maximizes use and compliance of contraceptive methods meeting the needs of every woman. Objectives: To determine the impact and determinant factors of gynecologists advice for women choosing a self-administered hormonal contraceptive method, either daily pill, weekly transdermal patch or monthly vaginal ring. Design: Observational, descriptive and transversal study. Location: Lima, Piura, Chiclayo, and Trujillo, Peru. Institution: Latin Project PIENSA: Program for Research and Education on Contraceptive Health. Participants: Five hundred eighty-one women aged 18 to 40 attended by 40 gynecologists providing advice on contraception. Interventions: Standardized counseling with educational material including information on effectiveness, mechanism of action, user mode, benefits and risks as well as suitability in regards to individual needs was conducted. Main outcome measures: Original choice and final election of contraceptive method following counseling as well as factors involved. Results: Initial method choice was 57% for the pill, 15% for the vaginal ring, and 13% for transdermal patch. Following advice election was for pill 38%, vaginal ring 33%, and transdermal patch 19%. Statistically significant preference from 15% to 33% was found in vaginal ring users, and 13% to 19% for transdermal patch; p <0,005. The main reason for methods choice was ease of use. Conclusions: Peruvian women participating in PIENSA Project initially chose the daily contraceptive pill; but this election decreased following health professional counseling. The number of women who chose transdermal patch and vaginal ring increased significantly.

Strengthening self -management improves treatment compliance and outcome in hepatitis B patients with decompen-sated cirrhosis treated with entecavir / 临床肝胆病杂志

Objective To investigate the effect of strengthening self -management on the treatment compliance and outcome in hepatitis B patients with decompensated cirrhosis treated with entecavir.Methods A total of 120 hepatitis B patients with decompensated cirrhosis, who received antiviral therapy with entecavir in our hospital from January 2010 to January 2012,were randomly divided into control group (n=60)and intervention group (n =60).Both groups received routine nursing care;in addition,regular telephone follow -up was performed for the intervention group to provide guidance for the self -management during the comprehensive prevention and treatment of decompensated cirrhosis.The two groups were compared in terms of withdrawal rate,rehospitalization rate,hepatitis B virus (HBV)DNA negative conver-sion rate,incidence of primary liver cancer,and mortality one year later.Continuous data were analyzed by t test,and categorical data by chi -square test or Fisher′s exact test.Results The withdrawal rate and rehospitalization rate in the intervention group were 0 and 18.3%, respectively,versus 8.3% and 35% in the control group (P 0.05 for all).Conclusion Strengthening self -management,as well as regular health education,can improve treatment compliance and promote recovery in hepatitis B patients with decompensated cirrhosis treated with entecavir.

Conditioned Place Preference and Self-Administration Induced by Nicotine in Adolescent and Adult Rats

Nicotine addiction is a worldwide problem. However, previous studies characterizing the rewarding and reinforcing effects of nicotine in animal models have reported inconsistent findings. It was observed that the addictive effects are variable on different factors (e.g. route, dose, and age). Here, we evaluated the rewarding and reinforcing effects of nicotine in different routes of administration, across a wide dose range, and in different age groups. Two of the most widely used animal models of drug addiction were employed: the conditioned place preference (CPP) and self-administration (SA) tests. Nicotine CPP was evaluated in different routes [intraperitoneal (i.p.) and subcutaneous (s.c.)], doses (0.05 to 1.0 mg/kg) and age [adolescent and adult rats]. Similarly, intravenous nicotine SA was assessed in different doses (0.01 to 0.06 mg/kg/infusion) and age (adolescent and adult rats). In the CPP test, s.c. nicotine produced greater response than i.p. The 0.2 mg/kg dose produced highest CPP response in adolescent, while 0.6 mg/kg in adult rats; which were also confirmed in 7 days pretreated rats. In the SA test, adolescent rats readily self-administer 0.03 mg/kg/infusion of nicotine. Doses that produced nicotine CPP and SA induced blood nicotine levels that corresponded well with human smokers. In conclusion, we have demonstrated that nicotine produces reliable CPP [0.2 mg/kg dose (s.c.)] in adolescents and [0.6 mg/kg dose (s.c.)] in adults, and SA [0.03 mg/kg/infusion] in adolescent rats. Both tests indicate that adolescent rats are more sensitive to the rewarding and reinforcing effects of nicotine.