A Review on Attachment and Adolescent Substance Abuse: Empirical Evidence and Implications for Prevention and Treatment

Background: This paper reviews research on the relation of attachment and substance use disorders (SUD) in adolescence. Based on a theoretical introduction, we review evidence for a possible general link between SUD and insecure attachment, for links between specific forms of SUD and specific patterns of attachment, and for studies on family patterns of attachment in adolescence. Methods: Using medical and psychological databases, we identified 10 studies on adolescent SUD and another 13 studies on adult SUD. Results: Empirical evidence strongly supports the assumption of insecure attachment in SUD samples. With regard to specific patterns of attachment, results mainly point towards fearful and dismissing-avoidance, whereas single studies report preoccupied and unresolved patterns. Results indicate different patterns of attachment in different groups of substance abusers, that is, fearful-avoidant attachment in heroin addicts and more heterogeneous results in abusers of other substances. Explorative data suggest different types of insecure family attachment patterns, which might imply different functions of substance abuse and lead to different treatment recommendations. Methodological problems such as poor assessment of SUD and the use of different measures of attachment limit comparability. Conclusions: Although a lot of research is still needed to address the unknowns in the relation between attachment and SUD, there is strong evidence for a general link between SUD and insecure attachment. Data on connections between different patterns of attachment and different pathways towards SUD are less conclusive but mainly point to disorganized and externalizing pathways. Evidence suggests that fostering attachment security might improve the outcome of state-of-the-art approaches in both early interventional treatment and prevention. Implications for individual and family approaches are outlined.     

Examining Potential Substance Use Disorders Among Former Interscholastic Athletes

Background: Despite numerous studies examining the association between competitive sports participation and substance use behaviors among adolescents and young adults, the use of standardized measures to assess potential substance use disorders has been largely neglected. The objective of this study was to examine if past involvement in interscholastic sports (competitive school-sponsored sports) was associated with potential substance use disorders in young adulthood. Methods: Data for this study were taken from the Student Life Survey (SLS). A total of 3442 young adults participated in the SLS during the spring semester in 2013, with 74% of males and 71% of females indicating participation in interscholastic sport during high school. Results: Respondents who participated in interscholastic sports during high school had higher odds of positive screens for potential alcohol use disorders when compared with their peers who did not participate in interscholastic sports. No association was detected between interscholastic sports participation and potential drug abuse disorders. Moreover, previous involvement in certain types of sports was found to be associated with positive screens for potential alcohol use disorders (i.e., crew and football) and positive screens for potential drug abuse disorders (i.e., lacrosse) among the sample of young adults. Conclusions: School and community sport organizations should be aware of the potential link between sports participation and potential substance use disorders, and may consider brief substance use screeners during yearly physicals to monitor potential substance use problems among athletes.     

Psychiatric Morbidity in Ketamine Users Attending Counselling and Youth Outreach Services

Background: No study has examined ketamine users’ psychiatric morbidity using structured diagnostic instruments. The aim of this study was thus to determine the psychiatric comorbidity of community-based ketamine users using the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), Axis I Disorders (SCID). Methods: A convenience sample of 200 frequent ketamine users was recruited from community organizations in Hong Kong. Participants were screened with the Severity of Dependence Scale (SDS), Beck Depression Inventory (BDI), Anxiety subscale of the Hospital Anxiety Depression Scale (HADSA), and SCID psychotic symptoms. Those who scored above the threshold (cutoff point of 8/9 on the BDI and 4/5 on HADSA) or displayed evidence of psychotic symptoms were referred for a structured clinical interview conducted by a psychiatrist. Results: One hundred and seventy participants scored above the cutoff point on 1 or more of the scales, and 115 participants attended the SCID interview. Fifty-one of these 115 participants received a psychiatric diagnosis of 1 or more comorbidities for the month preceding the interview. Mood disorders accounted for 80.4% of the diagnoses, anxiety disorders for 33.3%, and psychotic disorders for 7.8%. Conclusions: Female gender and history of psychiatric/psychological clinic attendance were significantly associated with comorbid psychiatric disorders, whereas ketamine dependence had a borderline association.     

RISK信号通路在1-磷酸鞘氨醇后适应减轻心肌细胞缺氧/复氧损伤中的作用

目的研究再灌注损伤挽救激酶(reperfusion injury salvage kinase,RISK)信号通路在1-磷酸鞘氨醇(sphingosine-1-phosphate,S1P)后适应减轻H9c2心肌细胞缺氧/复氧损伤中的作用。方法将H9c2细胞随机分为7组,即(1)正常对照组(C);(2)缺氧/复氧组(H/R);(3)S1P组;(4)S1P+LY294002组(S1P+LY);(5)LY组;(6)S1P+PD98059组(S1P+PD);(7)PD组。采用MTT法测定各组细胞存活率;比色法测定丙二醛(MDA)含量、总超氧化物歧化酶(TSOD)和锰超氧化物歧化酶(Mn-SOD)活力;采用激光共聚焦显微镜技术检测细胞内游离钙离子浓度变化;流式细胞仪检测心肌细胞凋亡率;Western blot法测定Akt和ERK1/2蛋白的磷酸化水平。结果与H/R组比较,S1P组可明显增加H9c2细胞缺氧/复氧损伤后细胞存活率及凋亡率,增加TSOD及Mn-SOD活力,降低MDA含量,降低钙离子浓度,增加Akt和ERK1/2磷酸化水平,而PI3K/Akt信号通路阻断剂LY294002或ERK1/2阻断剂PD98059可阻断S1P对H9c2的上述作用。结论 S1P能够减轻H9c2细胞缺氧/复氧损伤,加入PI3K/Akt抑制剂LY294002和ERK1/2抑制剂PD98059均使S1P的保护作用被取消,表明S1P通过RISK信号通路发挥抗H9c2细胞缺氧/复氧损伤作用。     

盐酸氯环利嗪有关物质的测定

建立了高效液相色谱法配合气相色谱法测定盐酸氯环利嗪的有关物质.采用GC法测定己知有关物质N-甲基哌嗪.使用Rtx-1毛细管色谱柱,程序升温,氢火焰离子化检测器.N-甲基哌嗪在10～100 μg/ml浓度范围内线性关系良好,平均回收率为99.3％,RSD为1.3％,最低检测限为0.22 μg/ml.采用HPLC法测定其他未知有关物质.使用C18色谱柱,以乙腈∶0.01 mol/L磷酸二氢钾溶液(含0.4％三乙胺,用磷酸调至pH 3.5) (35∶65)为流动相,检测波长231 nm,盐酸氯环利嗪与降解产物能有效分离.     

VEGF、P53及C-erbB2蛋白在卵巢上皮性肿瘤中的表达及临床意义

目的：观察卵巢上皮性肿瘤组织中血管内皮生长因子（VEGF）、抑癌基因P53及人表皮生长因子受体2（ C-erbB2）蛋白的表达情况,探讨三者在卵巢肿瘤发生发展中的作用。方法采用免疫组化SP法检测40例正常卵巢、45例良性、30例交界性、65例卵巢上皮癌中VEGF、P 53及C-erbB2蛋白的表达。结果正常卵巢、良性、交界性、卵巢上皮癌中VEGF蛋白的表达率分别为17?．50％（7／40）,24．44％（11／45）,63．33％（19／30）和73．85％（48／65）,差异有统计学意义（ P ＜0．05）。卵巢癌组VEGF蛋白的表达与肿瘤的临床分期差异有统计学意义（ P ＜0．05）,但与肿瘤的病理类型及组织分化程度差异无统计学意义（ P ＞0．05）;正常卵巢、良性、交界性、卵巢上皮癌中P53蛋白的表达率分别为20．00％（8／40）、24．44％（11／45）、56．67％（17／30）、56．92％（37／65）,4组中C-erbB2蛋白的表达率分别为15．00％（6／40）、15．56％（7／45）、50．00％（15／30）、67．69％（44／65）,4组比较,差异有统计学意义（ P ＜0．05）。 C-erbB2蛋白表达与肿瘤的临床分期差异有统计学意义（ P ＜0．05）。 VEGF蛋白在卵巢上皮癌中的表达与P53及C-erbB2蛋白表达呈正相关（ r值分别为0．44和0．23,两者均P ＜0．05）,共同促进卵巢癌发生发展。结论 VEGF、P53及C-erbB2蛋白在卵巢癌发生、发展中起重要作用,P53及C-erbB2在癌基因方面促进血管生成因子VEGF的发生,共同促进卵巢肿瘤的发生发展。三种蛋白的联合检测对卵巢肿瘤的诊断、治疗及预后评价有一定的指导意义。     

CHADS2 and CHA2DS2-VASc scores as predictors of platelet reactivity in acute coronary syndrome

BackgroundPlatelet function testing (PFT) in patients treated with P2Y₁₂ inhibitors has been widely evaluated for the prediction of stent thrombosis, myocardial infarction, and bleeding events following percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS). Thus, PFT-guided treatment could positively affect patient outcomes. Data regarding clinical parameters for predicting platelet reactivity in ACS patients are limited. Therefore, our study aims to evaluate CHADS2 and CHA2DS2-VASc scores as predictors for platelet reactivity in ACS patients.MethodsTwo hundred and ninety-one consecutive patients who underwent PCI and were treated with aspirin and clopidogrel due to ACS were tested for their CHADS2, CHA2DS2-VASc scores and platelet reactivity using adenosine diphosphate (ADP)-induced aggregation (conventional aggregometry). Patients were classified into groups according to their CHADS2 and CHA2DS2-VASc scores. Low-risk group (0–1 score) for CHADS2 and CHA2DS2-VASc scores and high-risk group (2–6, 2–9) for CHADS2 and CHA2DS2-VASc scores, respectively. Furthermore, platelet reactivity in each group were compared (low CHADS2 group vs high CHADS2 group, and low CHA2DS2-VASc vs high CHA2DS2-VASc). Platelet reactivity was defined as low platelet reactivity (<19 U), optimal platelet reactivity [(OPR); 19–46 U], and high on-treatment platelet reactivity [(HPR); >46 U]. Thereafter receiver operating characteristic curve analysis was conducted to verify whether CHADS2 and CHA2DS2-VASc scores could predict platelet reactivity.ResultsLow CHADS2 and CHA2DS2-VASc scores were significantly correlated with lower mean platelet ADP-induced aggregation as compared with high CHADS2 and CHA2DS2-VASc scores [45.5 U (± 16) vs. 54.8 U (±15) and 44.2 U (±16) vs. 51.0 U (±17), respectively, p = 0.01 for both].ConclusionIn ACS patients treated with clopidogrel following PCI, high CHADS2 and CHA2DS2-VASc scores correlated with HPR and lower scores correlated with OPR. Further studies are needed to evaluate our findings’ clinical implications.     

P2X7 receptor as the regulator of T-cell function in intestinal barrier disruption

The intestinal mucosa is a highly compartmentalized structure that forms a direct barrier between the host intestine and the environment, and its dysfunction could result in a serious disease. As T cells, which are important components of the mucosal immune system, interact with gut microbiota and maintain intestinal homeostasis, they may be involved in the process of intestinal barrier dysfunction. P2X7 receptor (P2X7R), a member of the P2X receptors family, mediates the effects of extracellular adenosine triphosphate and is expressed by most innate or adaptive immune cells, including T cells. Current evidence has demonstrated that P2X7R is involved in inflammation and mediates the survival and differentiation of T lymphocytes, indicating its potential role in the regulation of T cell function. In this review, we summarize the available research about the regulatory role and mechanism of P2X7R on the intestinal mucosa-derived T cells in the setting of intestinal barrier dysfunction.