参与阿片奖赏效应的脑区及其纤维投射探讨

阿片类物质引起的奖赏效应是导致阿片成瘾的直接原因。哪些脑区参与阿片奖赏效应的形成、它们之间存在着什么样的神经联系 ,阿片奖赏效应产生的始动位点何在 ?为了寻找上述问题的答案 ,人们作了大量研究 ,特别是伏核、中脑被盖区、额叶内侧皮层、脚桥被盖核、海马、下丘脑、腹侧苍白球和广义的杏仁核等更为研究者们所关注。现就有关研究现状综述如下。1.　伏核 Nucleus accumbens(NAc)伏核是成瘾性药物奖赏效应的共用结构 ,位于尾壳核吻侧下方 ,视神经管顶部。过去认为它是一个单一的结构 ,但最近的研究发现它可以分成壳部 (shell) ,核部 …     

阿片类药物的条件性位置偏爱效应及其奖赏机制

药物成瘾是以失去控制地应用某种成瘾药物为特征的慢性、复发性疾病.造成成瘾的原因包括正性强化因素(欣快感、奖赏效应)、负性强化因素(逃避现实、减轻戒断症状)及条件性强化因素.目前认为,负性强化因素主要与阿片类药物造成的身体依赖性有关,而追求阿片类药物带来的正性强化作用即奖赏效应是引起阿片精神依赖性、导致强迫性觅药行为和复吸的最主要原因[1].     

慢性阿片依赖与皮质醇,生长激素相关性探讨

现在,吸毒在全球泛滥,对社会及人民的健康造成极大的威胁,吸毒与阿片依赖的关系已众所周知,有大量文献报道。对已吸毒成瘾者,戒毒则成为最主要的难题,戒毒的关键也就是解决阿片成瘾问题,国内外学者也做了大量研究;本文基于内分泌及内分泌对免疫系统的影响,对30例慢性阿片依赖者进行治疗前后血中皮质醇(COR)及生长激素(GH)水平的测定,并以30例正常健康人作为对照,旨在寻求它们之间的相关性,其结果报告如下。 对象和方法 一,对象:慢性阿片依赖者30例,选自西安市某戒毒所和看守所,均符合WHO对药物依赖的定义,有明确的阿片类毒品滥用史,且连续使用半年     

阿片类物质引起细胞内钙离子和环磷腺苷含量变化及其对心肌细胞功能的调节

本文观察了阿片类物质影响体外培养心肌细胞搏动功能的生化机制。发现阿片物质对心肌细胞的直接作用机制涉及胞内[Ca~(2+)]i浓度和腺苷酸环化酶(AC)活性改变的调节,方式较复杂。广谱型阿片受体激动剂(κ-δ-μ)依托啡促进外钙内流和内钙释放,增加心肌细胞内[Ca~(2+)]i,其他一些阿片物质则未发现此种作用,吗啡,甲硫脑啡肽对AC活性具有双相调节;强啡肽,β-内啡肽则表现为刺激AC活性。AC活性改变受G蛋白亚基Gi和Gs的共同调控,但以Gs为主。     

新合成阿片受体配基对δ受体的激动作用

研究新合成的阿片受体配基对δ阿片受体的激动作用。采用生物鉴定的方法 ,检测新型阿片受体配基、DP DPE和吗啡对小白鼠输精管 (MVD)收缩的抑制作用和检测所激动的阿片受体亚型 ,以达到最大抑制作用的 5 0 %的药物浓度 (IC50 值 )评价效价强度。结果表明新型阿片受体配基、DPDPE和吗啡 (Mor)都可抑制MVD的电刺激收缩 ,显示纯激动剂作用。认为新型阿片受体配基与阿片受体的结合为可逆性结合。新型阿片受体配基A、C、D、E、F和G以及典型的阿片受体激动剂DPDPE和吗啡的IC50 值分别为 31 73± 3 5 4、15 92± 9 19、88 70± 16 2 6、10 74 0 0± 2 6 3 0 0、74 88± 5 8 6 9和 6 7 16± 8 4 9、3 2 0± 0 0 5、6 9 84± 2 7 5 8nmol L。竞争性拮抗剂纳洛酮 (Nal)可拮抗配基的激动作用 ,使新型阿片受体配基 ,DPDPE和吗啡的量效曲线平行右移。新型阿片受体配基可激动δ阿片受体 ,是典型的δ受体激动剂     

阿片类药物成瘾机制的研究进展

阿片（ｏｐｉｏｉｄ）包括天然的鸦片如吗啡,半合成的如海洛因,和全合成的如可待因、羟吗啡、美沙硐、二氢埃托啡、度冷丁、芬太尼,兼有激动剂和拮抗剂作用的镇痛新和丁丙诺啡由于产生类似于阿片激动剂的生理和行为效应也归类于阿片类。阿片类药物在临床上主要用于镇痛麻醉、止泻和镇咳。然而现在阿片类药物滥用已成为一个紧迫的社会问题,尤其是海洛因,在我国登记在册的海洛因成瘾者,１９９７年就已达５４万人之多。目前关于阿片成瘾的研究主要集中于躯体依赖和精神依赖机制。躯体依赖主要表现为耐受和戒断反应,而精神依赖主要表现为…     

内吗啡肽的构效关系研究

 疼痛药物的研发一直是全球性的热点和难点。阿片类药物在其中占有重要的地位，然而它们在起到镇痛作用的同时往往伴随很多副作用。20 世纪 70 年代起，多个阿片受体亚型被相继克隆出来，并且相应的内源性配体不断发现，但是 μ 阿片受体的内源性配体——内吗啡肽（endomorphins）的发现却经历了较长一段时间，直到 1997 年，Zadina 等[1]于牛脑中发现了 2 个四肽，分别命名为 endomorphin-1（EM-1）和 endomorphin-2（EM-2）。之后韩济生等[2]建议它们的中文译名为内吗啡肽-1 和内吗啡肽-2。内吗啡肽的发现促使 3 种阿片受体的内源性配体——脑啡肽、内啡肽和强啡肽全部找到，为了开发基于内吗啡肽的镇痛药物，人们对它们的生物学作用和构效关系的研究日益深入，本文针对近年来国内外对内吗啡肽构效关系研究的代表性论文进行归纳整理，主要目的是对内吗啡肽的构效关系研究现状做一总结，以便为今后更好的开展相关领域的研究工作奠定基础。。。。。     

阿片类物质诱导的痛觉过敏与趋化因子及其受体

阿片类物质(如吗啡)是当前缓解由创伤、手术,以及癌症引起的严重疼痛的首选药物.阿片类药物也越来越多的被应用于慢性以及非癌性的病理性疼痛的治疗.但是,长时间应用阿片类药物可引起诸如药物耐受等一系列严重的问题,患者需要使用更大剂量的药物才能达到相同的镇痛效果.     

阿片类物质对淋巴细胞内环磷酸腺苷及游离钙的影响

文本观察了几种阿片类物质对小鼠脾脏淋巴细胞内环磷酸腺苷,游离钙及钙调蛋白的影响。结果表明:吗啡、α-CAO、MENK、DADLE及强啡肽均降低小鼠脾脏淋巴细胞内环磷酸腺苷水平,升高淋巴细胞内游离钙浓度,增加淋巴细胞内钙调蛋白活性。预先给予纳洛酮能够阻断阿片类物质的作用。说明阿片类物质的作用是通过阿片受体介导的。     

内吗啡肽结构改造及其对心血管系统的作用

<正>阿片(opium),又叫鸦片,俗称大烟,源于罂粟植物蒴果,其作为药用的历史可追溯自6000年前。目前已经明确,阿片所含主要生物碱是吗啡(morphine)。吗啡具有镇痛、镇静、减轻心脏负荷、缓解恐惧情绪、暂时缓解肺水肿症状等作用;但是长期或过量使用,则造成药物依赖性甚至造成死亡。     

产后抑郁症血浆儿茶酚胺浓度对照研究

产后抑郁症是一组严重程度不等的不良情绪或情感障碍 ,一般认为其发病与分娩前后诸多社会 ,心理及生物因素有关。在社会 ,心理方面 ,国内外研究较多[1,2 ] ,但在生物因素方面 ,国内外研究相对较少。众所周知 ,抑郁症发病与儿茶酚胺类递质 (CAs)改变有关 ,那么 ,产后抑郁症血浆CAs浓度情况如何 ?与产前、正常人及非产后抑郁症有否差异 ?本文对此进行了对照研究。1　对象与方法1.1　对象1.1.1　产前组　为 1998年 3月～ 5月在深圳市第一人民医院和深圳市妇儿医院住院待产妇 ,小学以上文化 ,既往无重大伤病史及精神病史 ,经用精神症状自评量…     

中医药院校大学生中医体质与抑郁情绪的关系

目的:探讨中医药院校大学生中医体质与抑郁情绪之间的关系。方法:本研究以某中医药院校的在校本科生为研究对象,采用方便抽样与整群抽样相结合的方法,以684例大学生作为样本,以中医体质量表、贝克抑郁量表进行评定。结果:1446人(65%)无抑郁,91人(13%)轻度抑郁,137人(20%)中度抑郁,10人(1%)严重抑郁且得分均值大(21.50±2.64);2通过独立样本非参数检验,不同性别(χ~2=12.049,P0.01)、不同专业(χ~2=5.910,P0.05),是否独生子女(χ~2=6.806,P0.01)和不同年级(χ~2=16.305,P0.01)的抑郁情况都有显著性差异;3中医体质以偏颇质为主,阳虚质(21%)、气虚质(17.6%)、气郁质(16%)的人最多;4抑郁情绪与平和质、阳虚质类型呈显著负相关(r=-0.364,-0.173;P0.01);与其余体质类型呈显著正相关;5通过有序多分类Logistic回归分析筛选危险因素,中医体质为气虚质(OR=1.649,P0.01)、气郁质(OR=1.878,P0.01)时,抑郁情况越严重。结论:体质之间的差异会影响抑郁情绪的严重程度,气虚质、气郁质体质类型的中医药院校大学生抑郁情绪较为严重。     

Does family history of depression predict major depression in midlife women? Study of Women’s Health Across the Nation Mental Health Study (SWAN MHS)

This study aims to determine whether family history of depression predicts major depression in midlife women independent of psychosocial and health profiles at midlife. Participants were 303 African American and Caucasian women (42–52 years at baseline) recruited into the Study of Women’s Health Across the Nation (SWAN) and the Women’s Mental Health Study (MHS) in Pittsburgh. Major depression was assessed annually with the Structured Clinical Interview for DSM-IV. Family mental health history was collected at the ninth or tenth follow-up. Multivariable logistic regression was used to determine whether family history of depression predicted major depression in midlife, adjusting for covariates. The odds of experiencing major depression during the study were three times greater for those with a family history than for those without a family history (OR?=?3.22, 95 % CI?=?1.95–5.31). Family history predicted depression (OR?=?2.67, 95 % CI?=?1.50–4.78) after adjusting for lifetime history of depression, age, trait anxiety, chronic medical conditions, and stressful life events. In analyses stratified by lifetime history of depression, family history significantly predicted depression only among women with a lifetime history of depression. Family history of depression predicts major depression in midlife women generally, but particularly in those with a lifetime history of depression prior to midlife.     

Temperament and character in women with postpartum depression

Summary Objective: To investigate whether women with postpartum depression differ in personality traits from healthy postpartum women, healthy controls from the normal Swedish population and non-postpartum women with major depression. Methods: Forty-five women with postpartum depression were compared with 62 healthy postpartum women, 62 age-matched, healthy, non-postpartum women from a normal sample and 74 non-postpartum women with major depression from a clinical sample. The edinburgh postnatal depression scale was used in order to screen for postpartum depression. A clinical diagnostic interview was done including a rating with the Montgomery-Asberg depression rating scale. Personality i.e. temperament and character was measured by the temperament and character inventory. Results: Harm avoidance (HA) was higher (p < 0.001) and self-directedness (SD) scored lower (p < 0.001) in women with postpartum depression compared to healthy postpartum women. These differences were the most important differences between these two groups. Women with postpartum depression scored lower (p = 0.001) in cooperativeness (CO) and higher (p = 0.019) in self-transcendence (ST) compared to healthy postpartum women. Women with postpartum depression scored overall similar to women with major depression. Conclusion: High HA and low SD can be seen as vulnerability factors for developing a depression and especially in a stressful situation as childbirth.     

Increase of medical hospital length of stay by depression in stroke and amputation patients: a pilot study.

Past studies have found that medical patients with the diagnosis of depression (comorbidity) have longer hospital lengths of stay (LOS) than those without the diagnosis of depression. This suggested that scores on a depression scale would be positively correlated with LOS. On a rehabilitation ward, 14 stroke and 17 amputee patients were given the Geriatric Depression Scale (GDS) and lengths of stay were recorded. Correlations between GDS scores and LOS were +0.575 for stroke and +0.266 for amputee patients, both in the hypothesized direction. Explanations considered included: (1) depression and medical illness each produce morbidity which summate to require increased LOS; (2) depression delays medical recovery as well as the appearance of medical recovery, and (3) discharge planning is complicated by depression. When depression is associated with inpatient medical illness, DRGs may need to be reevaluated.     

Prevalence of depression and its correlates in a general medical practice

A screening scale for depression, based on HSCL depression scale items, was used during a one-year period in a rural general medical practice. The estimated prevalence of depression was 8.8% for severe (probable depressive disorder) depression, 18.3% for moderate (depressive syndrome) depression, and 28.3% for mild depression. For all three levels of depression, there were significant relationships to sex and to marital status. For the higher level of depression, probable depressive disorder, there were significant relationships to age and to retirement status; these relationships were not evident at the moderate or the mild levels of depression.     

抑郁症患者抑郁水平、生活质量与自杀风险关系

目的:探讨抑郁症患者的抑郁水平、生活质量和自杀风险之间的关系。方法:采用一般状况调查问卷、简明国际神经精神访谈(M.I.N.I)、贝克抑郁自评问卷(BDI)和健康状况调查问卷(SF-36)对山东省某医院210例抑郁症患者进行调查。结果:1重度抑郁组自杀风险高于轻中度抑郁组(t=9.793,P0.01),在生活质量及各维度上,重度抑郁组低于轻中度抑郁组(t=-9.413~-2.746,P0.01),差异有统计学意义;2自杀风险与抑郁水平存在正相关(r=0.665,P0.01),与生活质量及生理机能、躯体疼痛、一般健康、精力、社会功能、精神健康等维度呈负相关(r=-0.590~-0.420,P0.01);3中介效应检验表明,生活质量在抑郁水平和自杀风险之间起部分中介作用,中介效应为21.0%。结论:抑郁症患者的抑郁水平和生活质量均能预测其自杀风险,生活质量是抑郁水平预测自杀风险的部分中介因素。     

Prevalence of depression in general practice patients over 75 years of age

The prevalence of depression among 74 male and 211 female patients aged 75 years or over registered with a group general practice was assessed, using the geriatric depression scale. Test scores of 0- 10, suggesting no depressive illness, were observed in 63 (85%) men and 172 (82%) women. Mild depression (scores 11-20) was observed in 10 (14%) men and 36(17%) women and severe depression (scores 21-30) in one (1%) man and three (1%) women. No significant statistical association was found with age or sex, suggesting that elderly men and women are equally prone to depression.

A general practitioner found clinical manifestations of depression in 29 of the patients (10%). The geriatric depression scale scores were compared with clinical diagnoses of depression. Those with high scores were more likely to be depressed and vice versa. Thirty two elderly patients (11%) with no clinical manifestation of depression recorded high scores on the geriatric depression scale. These patients may be described as `psychiatric cases'. Uncertainty about the importance of early identification of these cases necessitates further screening and regular follow-up of elderly patients.

     

Chronic morphine exposure impairs short-term synaptic depression of geniculo-cortical visual pathway in vivo

Chronic morphine exposure can induce addiction and affect synaptic plasticity, but the underlying neuronal mechanisms remain unknown. Two forms of short-term synaptic depression (paired-pulse depression (PPD) and frequency depression) were investigated in vivo in the geniculo-cortical visual pathway of morphine-treated and saline-treated (as control) adult rats. Acute exposure to morphine had no effect on paired-pulse synaptic depression and 10–40 Hz induced frequency synaptic depression. However, chronic morphine exposure reduced markedly the paired-pulse depression and frequency depression at 40 Hz. The effect of chronic morphine exposure on short-term synaptic plasticity in the geniculo-cortical visual pathway was sensitization given that morphine re-exposure further significantly reduced the short-term synaptic depression. Interestingly, the further reduction in short-term synaptic depression due to re-exposure of morphine was recovered to normal (control) levels at 3 to 6 h after morphine re-exposure. These findings suggest that chronic morphine treatment could significantly degrade the short-term synaptic plasticity of geniculo-cortical visual pathway.     

Unipolar depression in the aged: determinants of familial aggregation.

Late-onset depression (greater than or equal to 60 years) is believed to be less associated with a risk of depression in first-degree relatives than early-onset depression. However, family studies in elderly probands fitting the current methodological standards of family studies are not available. The reported family study in geriatric inpatients with unipolar major depression (n = 92) supported the proposed relationship between age at onset and the proposed familial loading. A comparison to families of age-matched controls (n = 33) revealed that relatives of probands with late-onset depression are still at an increased risk of depression. However, late-onset depression was not more common in families of probands with late-onset depression than in families of probands with early-onset depression. Besides the age at onset, the recurrence of depressive episodes defined distinct patterns of familial aggregation.