Opioid dependence is based on compensatory adaptations in neurons following chronic exposure to opioids. Recent researches show antagonists of N methyl D aspartate (NMDA) receptors inhibit physical and psychic dependence on opioids. This review focuses on the interactions between opioid receptor system and NMDA receptor system, and on the molecular mechanisms of NMDA receptor contributing to opioid dependence. The clinical prospects of NMDA receptor antagonists and related substances on preventing and treating opioid dependence are aslo discussed.

Objective To study the pregnancy opportunity,treatment of complications,time of ending pregnancy and treatment during and after pregnancy in patients with systemic lupus erythematosus(SLE).Method Prospective study on pregnant patients with SLE was carried out between 2000 and 2003 in Qingdao Municipal Hospital.There were total 29 patients enrolled,all which didn't have cytotoxic drugs at least six months before conception,among whom 23 patients'disease were under control over one year and had low-dose glucocorticoids before pregnancy,two had disease activity under control by mid-and high-dose glucocorticoids within one year and have been pregnant without the direction of the doctor,four new onset during the pregnancy.Results All patients had flares during pregnancy or had multi-complications,10 cases had pregnancy hypertension syndrome,six cases had heart failure during the late pregnancy,three had extensive interstitial lung disease during the late pregnancy.All patients stopped the pregnancy at 30~37 weeks,the total 29 live infants had neither neonatal lupus nor maternal-fetal death.Conclusion The maternal-fetal safety can be increased significantly when disease activity was controlled over one year.Glucocorticoids should be applied when disease flared during pregnancy and postpartum is the key of success,Stop as pregnancy when there are complications in order to improve maternal-fetal safety.

Imidazoline-1 receptors (I1R) are now generally accepted as novel receptors,and IRAS(imidazoline receptor antisera selected protein) is I1R candidate protein.The review summarized the definition,characterization,distribution and signal transduction mechanism of I1R and IRAS,and then compared I1R with IRAS from the above aspects

China ; Environmental Monitoring ; legislation & jurisprudence ; Environmental Pollutants ; Organic Chemicals

Objective To study the diagnostic value of the morphological changes to deep fascia in distinguishing between benign and malignant soft-tissue tumors in lower limbs using 3.0 T MRI. Methods MR images of 40 consecutive patients with 41 pathologically proven soft-tissue tumors of the lower limbs were retrospectively reviewed by two radiologists. Lesions were divided into four groups according to their predominant location with respect to the deep fascia: (1)Subcutaneous lesions superficial to the deep fascia (n=7). (2) Lesions located beneath the deep fascia (n=8). (3) Lesions in the interspaces of the deep fascia investment (n=10). (4) Intramuscular lesions (n=16). The relationship between tumors and the deep fascia and the morphology changes of deep fascia were analyzed. Lesions of groups (1) (2) were considered as superficial lesions, while lesions of group (3) (4) were considered as deeper lesions. The size differences between those had intact deep fascia and those had destructed deep fascia in superficial lesions and in deeper lesions were evaluated by using Mann-Whitney U test, respectively. P values < 0. 05 were considered statistically significant. Results The deep fascial structures were intact in all of the 16 pathologically proven benign lesions. In 23 of the 25 malignant lesions, there was destruction of the deep fascia with the signs of displacement/disruption of the deep fascia and penetrating growth in (1) (2), and displacement/distruption of intermuscular septum as well as involvement of interspaces of the deep fascial investment and loss of integrity of the fascial/muscular planes in (3) (4). Only 2 malignant lesions demonstrate intact deep fascia. In superficial lesions [(1) (2)] , the maximum size were (5.0±3.8) cm (Median ± Interquartile Range) in those had intact deep fascia, and (5.7±6.90) cm in those had destruction signs (T=47.5, P >0.05). In deeper lesions [(3) (4)] the maximum size were (4.6±1.9) cm of those had intact deep fascia, and (13.6±6.5) cm of those had destruction signs (T= 62.5, P <0.01). Distinguish malignant from benign lesions on the signs of destructed deep fascia, the sensitivity, specificity and accuracy were 92.0% (23/25), 100% (16/16), and 95. 1% (39/,41), respectively. Conclusions Tumor involvements and disruption of the deep fascial structures visualized by 3.0 T MR imaging may be of utility in differentiating malignant from benign soft-tissue tumors.

OBJECTIVE: To summarize the therapeutic effect of coronary stent implantation on elderly patients with coronary heart disease(CHD).METHODS: Ten literatures regarding controlled experiment of treating CHD with coronary stent implantation in elderly patients, writing in Chinese language, published from 1990 to 2008, were selected. The literatures were sorted from experimental grouping, materials, observation methods, results, and conclusions. Simultaneously, the baseline data of subjects in the experiment were analyzed, and the follow up and functional evaluation were included to check the results.RESULTS: The literatures showed that treating CHD with coronary stent implantation in elderly patients was a fast developing and challenging field in interventional cardiology, the therapeutic effect and value of which had been proved by evidence based medicine. However, how to elevate the safety of procedures, increase the successful rate, and prevent restenosis were needed to be exploring in future. The exploration of new drugs, new equipment and inserting technique of scaffold implantation were important to solve the existed problems.CONCLUSION: More elderly patients suffered CHD need treating, but plenty of problems still existed in revascularization,therefore, it is necessary to perform large-scale randomized controlled trials containing different ages and pathologic characters for guiding the clinical practice.

Humans ; Hypertension ; Occupational Diseases ; Stress, Psychological

To strengthen the medical students in patient safety education is the first step to effectively prevent medical accidents.But at present patient safety education has not been given enough attention by domestic mnedical colleges.Research group consulted literature at home and abroad related to patient safety courses, according to the Medical colleges patient safety curriculum guide proposed by The World Health Organization (WHO) Alliance for Patient Safety, opened the patient safety course in undergraduate medical education with the goal to improve the medical students to maintain patient safety consciousness, ability and methods and implemented scene simulation teaching and formative assessment.We achieved good teaching effect and appraisal by students.

Aim To analyze the expression of phosphatidylethanolamine-binding protein(PEBP) and ERK in critical brain regions of psychological dependence rats.Methods Morphine-induced rats conditioned place preference(CPP) model was established to mimic different stages of morphine psychological dependence, during which PEBP expression and ERK activity were assayed in different brain regions.Results PEBP expression in hippocampus, prefrontal cortex, striatum and nucleus accumbens showed no change at three stages of psychological dependence.However, ERK activity increased notably in prefrontal cortex on CPP formation, and decreased remarkably in hippocampus on CPP reinstatement.Conclusions The formation and retrieval of associated memory between morphine effects and environment involve different neural circuits, in which ERK activity is critical, and PEBP might not be involved in such a memory-related ERK regulation.