Long-term use of Lacticaseibacillus paracasei N1115 from early life alleviates high-fat-diet-induced obesity and dysmetabolism in mice.

Obesity has become one of the most serious public health problems worldwide, and an increasing number of studies indicate that the gut microbiota can affect host metabolism. Therefore, the present study was conducted to evaluate whether long-term use of probiotics can alleviate host obesity and metabolism by altering gut microbiota. The high-fat diet (HFD) starting from weaned period led to higher levels of visceral fat and a significantly heavier liver in male mice. Moreover, HFD resulted in disorders of glucose and lipid metabolism, changes in insulin-resistance indices (IR), and an increase in serum insulin and leptin in mice. Of note, 15 weeks use of Lacticaseibacillus paracasei N1115 decreased visceral fat, liver weight, serum levels of insulin and leptin, and IR and alleviated lipid dysmetabolism. HFD resulted in a significant increase in the relative abundance of Bilophila, Lachnoclostridium, and Blautia and may decrease the faecal short-chain fatty acid (SCFA) levels in mice; in turn, treatment with the potential probiotic strain L. paracasei N1115 protected mice from these negative effects. HFD significant impaired the physiology of the host especially in male mice and dramatically changed the composition of host gut microbiota. However, the use of potential probiotic strain, such as L. paracasei N1115, may prevent these impairments due to HFD via effecting the host gut microbiota and SCFA.

[The prevention and management of approach-specific complications of abdominal aortic balloon occlusion in pelvic and sacral surgery].

Objective: To investigate the causes,prevention and treatment of femoral artery puncture related complications caused by the application of resuscitative endovascular balloon occlusion of the aorta (REBOA) in the resection of pelvic and sacral tumors. Methods: Clinical data of 23 patients with femoral artery puncture related complications who received REBOA in the resection of pelvic and sacral tumors from August 2010 to August 2018 at the Musculoskeletal Tumor Center,Peking University People's Hospital were retrospectively analyzed.There were 8 males and 15 females,with the an age of (37.0±16.2) years (range:15 to 65 years).Arterial access via the Seldinger technique for REBOA was obtained in the right common femoral artery of 18 cases,and in the left of 6 cases.An arterial sheath with a diameter of 11 to 12 F(1 F≈0.33 mm) was used for the patient.The occurrence and treatment of postoperative complications were analyzed. Results: Acute femoral arterial thrombosis occurred in 18 patients,which was managed by open repair 48 hours postoperatively.Among the 349 patients admitted before 2015 who received hemostasis by compression after femoral artery sheath removal,12 patients (3.4%) developed acute femoral artery thrombosis.While the 476 patients admitted after 2015 who used a vascular stapler to close the femoral artery wound,6 patients (1.3%) developed acute femoral artery thrombosis.One case of retroperitoneal hematoma and 1 case of femoral pseudoaneurysm were found and surgically fixed.Postoperative follow-up was (40±18) months (range:13 to 108 months).Three cases with chronic lower extremity ischemia were confirmed by Doppler ultrasonography during 1 to 5 years follow-up.Two of them had minimal symptoms and denied further treatment,while the other one received femoral-femoral artery bypass surgery to restore distal flow for pain and numbness relief. Conclusions: Acute femoral arterial thrombosis was the most common femoral artery puncture.Technique refinement of REBOA,the use of percutaneous suture device and close follow-up can reduce the approach-specific complications,and help to detect and treat the complications timely,which may popularize the clinical application of REBOA.

Dysbiosis of intestinal microbiota in early life aggravates high-fat diet induced dysmetabolism in adult mice.

BACKGROUND: Accumulating evidence have shown that the intestinal microbiota plays an important role in prevention of host obesity and metabolism disorders. Recent studies also demonstrate that early life is the key time for the colonization of intestinal microbes in host. However, there are few studies focusing on possible association between intestinal microbiota in the early life and metabolism in adulthood. Therefore the present study was conducted to examine whether the short term antibiotic and/or probiotic exposure in early life could affect intestinal microbes and their possible long term effects on host metabolism. RESULTS: A high-fat diet resulted in glucose and lipid metabolism disorders with higher levels of visceral fat rate, insulin-resistance indices, and leptin. Exposure to ceftriaxone in early life aggravated the negative influences of a high-fat diet on mouse physiology. Orally fed TMC3115 protected mice, especially those who had received treatment throughout the whole study, from damage due to a high-fat diet, such as increases in levels of fasting blood glucose and serum levels of insulin, leptin, and IR indices. Exposure to ceftriaxone during the first 2 weeks of life was linked to dysbiosis of the fecal microbiota with a significant decrease in the species richness and diversity. However, the influence of orally fed ceftriaxone on the fecal microbiota was limited to 12 weeks after the termination of treatment. Of note, at week 12 there were still some differences in the composition of intestinal microbiota between mice provided with high fat diet and antibiotic exposure and those only fed a high fat diet. CONCLUSIONS: These results indicated that exposure to antibiotics, such as ceftriaxone, in early life may aggravate the negative influences of a high-fat diet on the physiology of the host animal. These results also suggest that the crosstalk between the host and their intestinal microbiota in early life may be more important than that in adulthood, even though the same intestinal microbes are present in adulthood.

[An investigation of insulin injection-related needlestick injuries among clinical nurses in Hunan, China].

Objective: To investigate the incidence rate of insulin injection-related needlestick injuries, links causing such injuries, and reporting of occupational exposure among nurses in the wards of general hospitals in Hunan, China. Methods: From January 2017 to March 2019, stratified cluster sampling was performed to select 4368 nurses as respondents from 54 hospitals at different levels in 14 prefectures and cities of Hunan. The current status of insulin injection-related needlestick injuries was investigated, including the high-risk links causing insulin injection-related needlestick injuries during the use of insulin syringe (pen) , time and number of needlestick injuries, infection after needlestick injuries, and reporting of needlestick injuries, and a statistical analysis was performed. Continuous data were described as mean±standard deviation, and categorical data were described by percentage (%) . Results: Among the 3697 nurses who were investigated, 1419 (38.4%) once had needlestick injuries related to insulin injection, among whom 413 (29.1%) had needlestick injuries in the past 1 year. The mean number of insulin injection-related needle stick injuries was 1.92±1.80, with a mean number of 0.57±1.18 caused by insulin syringe, 1.30±1.15 caused by the anterior segment of insulin pen, and 0.32±0.81 caused by the posterior end of insulin pen. Among the 1419 nurses with a history of needlestick injuries, 90 (6.3%) had related infection, mainly HBV infection, and after the occurrence of needlestick injuries, 26.0% (369/1419) of these nurses reported it every time and 15.2% (215/1419) never reported it. "Fear of trouble" was the main reason for no reporting (69.1%, 980/1419) , followed by "the thought of no risk" (43.2%, 613/1419) and "no related policy in hospital" (10.9%, 154/1419) ". Among these 1419 nurses, 49.8% (706/1419) were treated according to the standard process for needlestick injuries in hospital every time, and 3.6% (51/1419) did not know such process or there was no such standard process. Conclusion: The current situation of insulin injection-related needlestick injuries is not optimistic among clinical nurses in Hunan, and the incidence rate of needlestick injuries cannot be ignored.

Ground-to-satellite time and frequency synchronization link with active carrier phase compensation.

In this paper, a synchronization link between one ground station and one geostationary satellite is established. The ground station receives retransmitted signals from the satellite, measures phase delay along the propagation route, and actively compensates back to its sending signals, realizing real-time phase fluctuation compensation. The transmitted signal contains two frequencies to eliminate common-mode phase noise. The difference between their carrier phase delays is measured. Different modes of carrier phase variation are separated and compensated, achieving a remaining time jitter of ±200 ps. Major sources of error are analyzed, and potential methods for improvement are discussed. The proposed ground-to-satellite link and active compensation method has potential applications in frequency standard dissemination to remote receivers (including ground stations or satellites). These potential applications justify further study of this system.

[Soft-tissue angiosarcoma with pulmonary metastases: case report and literature review].

Objective: To investigate the differential diagnosis between pulmonary metastases from soft-tissue angiosarcoma and primary pulmonary angiosarcoma. Methods: A case of soft-tissue angiosarcoma with pulmonary metastases was reported and related literatures were reviewed. Results: A 39 year-old man complaining of hemoptysis, cough, and sputum for 10 months was admitted to our hospital in September 2013. He was initially diagnosed as having primary pulmonary angiosarcoma after wedge-resection biopsy of the lung. After 22 months since onset, he felt discomfort in his leg, which led to the confirmative diagnosis of soft-tissue angiosarcoma of the leg with multiple pulmonary metastases by a full-body PET/CT scan and core needle biopsy of the leg. Twenty-three articles concerning primary pulmonary angiosarcoma with complete records of history, treatment and follow-up of patients were included in the literature review. A total of 26 patients were reported in these articles, including 18 males, 8 females, age 19-85 years, average (52±18) years. Primary pulmonary angiosarcoma was mainly manifested as single or multiple pulmonary nodules or masses, with or without ground glass opacity. In our case, chest CT showed multiple thin-wall cysts and ground glass opacities, and recurrent spontaneous pneumothorax, which had never been reported in literatures on primary pulmonary angiosarcoma. Conclusions: Pulmonary metastases from soft-tissue angiosarcoma differed from primary pulmonary lesions in terms of chest imaging, with the former usually showing thin-wall cysts and pneumothorax. A full-body PET-CT was essential for differential diagnosis between primary and metastatic pulmonary angiosarcoma.

Lack of association between EPHX1 polymorphism and esophageal cancer risk: evidence from meta-analysis.

The microsomal epoxide hydrolase 1 (EPHX1) Tyr113His and His139Arg polymorphisms have been reported to be associated with esophageal cancer (EC) risk, yet the results of these previous results have been inconsistent or controversial. The objective of this study was to explore whether the EPHX1 Tyr113His and His139Arg polymorphisms confer risk to EC. The relevant studies were identified through a search of PubMed, Excerpta Medica Database (Embase), Elsevier Science Direct, and Chinese Biomedical Literature Database until May 2013. The association between the EPHX1 Tyr113His and His139Arg polymorphisms and EC risk was pooled by odds ratios (ORs) together with their 95% confidence intervals (95%CIs). A total of eight case-control studies with 1163 EC patients and 1868 controls (seven studies for both Tyr113His and His139Arg polymorphisms, one study only for Tyr113His polymorphism) were eventually identified. We found no association between EPHX1 Tyr113His and His139Arg polymorphisms and EC risk in overall population (For Tyr113His: His vs. Tyr: OR = 1.05, 95%CI = 0.95-1.15, P = 0.379; His/His vs. Tyr/Tyr: OR = 1.04, 95%CI = 0.88-1.22, P = 0.208; His/Tyr vs. Tyr/Tyr: OR = 0.96, 95%CI = 0.80-1.15, P = 0.577; His/His vs. His/Tyr + Tyr/Tyr: OR = 1.10, 95%CI = 0.96-1.26, P = 0.164; His/His + His/Tyr vs. Tyr/Tyr: OR = 1.01, 95%CI = 0.90-1.12, P = 0.543. For His139Arg: Arg vs. His: OR = 1.04, 95%CI = 0.94-1.14, P = 0.465; Arg/Arg vs. His/His: OR = 1.06, 95%CI = 0.91-1.24, P = 0.470; Arg/His vs. His/His: OR = 1.03, 95%CI = 0.91-1.16, P = 0.673; Arg/Arg vs. Arg/His + His/His: OR = 1.04, 95%CI = 0.85-1.27, P = 0.708; Arg/Arg + Arg/His vs. His/His: OR = 1.02, 95%CI = 0.93-1.13, P = 0.617). In subgroup analysis based on ethnicity, significant association has been found in neither EPHX1 Tyr113His nor His139Arg polymorphism. The current meta-analysis suggests no evidence of association between the EPHX1 polymorphism and EC risk.

Analysis of drug-resistant gene detection of blaOXA-like genes from Acinetobacter baumannii.

Our study determines the resistance gene profile of a set of Acinetobacter baumannii hospital isolates. A. baumannii is responsible for nosocomial outbreaks and sporadic infections. We extracted and PCR amplified bacterial DNA isolated from patients with ages below 60 years (23.36%) and above 60 years (76.64%). Most of the patients were admitted in the ICU (36.13%) and pneumology departments (28.47%). Of 164 isolated strains, 16 (9.75%) contained OXA-51, 8 (4.88%) contained OXA-58, and 140 (85.37%) contained both OXA-51 and OXA-23. Additionally, 8 (7.41%) strains containing OXA-58 and 100 (92.59%) strains containing both OXA-51 and OXA-23 showed multidrug-resistance. Drug resistance rates of A. baumannii to amikacin, tobramycin-levofloxacin, and cotrimoxazole were above 90%, while drug resistance rates to ampicillin, cefotetan, cefazolin, cefoperazone, and nitrofurantoin were 100%. In conclusion, we found that isolated strains containing OXA-51 and OXA-23 were more likely to be resistant or have decreased sensitivity to carbapenems.

Thrombin generation and fibrin formation under flow on biomimetic tissue factor-rich surfaces.

BACKGROUND: Blood flow regulates coagulation and fibrin assembly by controlling the rate of transport of zymogens, enzymes and plasma proteins to and from the site of an injury. OBJECTIVE: The objective of this work was to define the hemodynamic conditions under which fibrin can form under flow on tissue factor (TF)-rich substrates. METHODS: TF-coated silica beads (~ 800 nm) were patterned into 18-85-µm spots. Normal pooled plasma and factors VIII, IX and XI deficient plasmas were perfused over the beads coated with 0.08, 0.8 and 8 molecules-TF µm(-2) at shear rates of 50-1000 s(-1) . Fibrin deposition and thrombin generation were measured by fluorescence microscopy in a hydrodynamic focusing microfluidic device. RESULTS AND CONCLUSIONS: Fibrin deposition was supported on patterned bead spots, but not planar TF substrates at the same surface TF concentration. There was a threshold spot size and a shear rate dependent TF concentration that was necessary to support fibrin polymerization. FVIII and FIX had minor effects on fibrin dynamics at 8 molecules-TF µm(-2) , but were essential at 0.8 molecules-TF µm(-2) . The absence of FXI influenced thrombin generation and fibrin deposition at both 0.8 and 8 molecules-TF µm(-2) . These results show that fibrin deposition requires perturbations in the flow field that protect reactions from dilution by flow under venous and arterial conditions. FVIII and FIX have a modest effect on fibrin deposition at high TF concentrations, but are necessary for fibrin deposition at low TF concentrations. FXI amplifies thrombin generation under flow at both low and high TF concentrations.

Cognitive impairments in poly-drug ketamine users.

RATIONALE: Cognitive impairment has been found to be reversible in people with substance abuse, particularly those using ketamine. Ketamine users are often poly-substance users. This study compared the cognitive functions of current and former ketamine users who were also abusing other psychoactive substances with those of non-users of illicit drugs as controls. METHODS: One hundred ketamine poly-drug users and 100 controls were recruited. Drug users were divided into current (n = 32) and ex-users (n = 64) according to the duration of abstinence from ketamine (>30 days). The Beck Depression Inventory (BDI), the Hospital Anxiety Depression Scale (HADSA) and the Severity of Dependence Scale (SDS) were used to evaluate depression and anxiety symptoms and the severity of drug use, respectively. The cognitive test battery comprised verbal memory (Wechsler Memory Scale III: Logic Memory and Word List), visual memory (Rey-Osterrieth Complex Figure, ROCF), executive function (Stroop, Wisconsin Card Sorting Test, and Modified Verbal Fluency Test), working memory (Digit Span Backward), and general intelligence (Information, Arithmetic and Digit-Symbol Coding) tests. RESULTS: Current users had higher BDI and HADSA scores than ex-users (p < 0.001 for BDI and p = 0.022 for HADSA) and controls (p < 0.001 for BDI and p = 0.002 for HADSA). Ex-users had higher BDI (p = 0.006) but equal HADSA scores (p = 1.000) compared to controls. Both current and ex-users had lower scores on Logical Memory delayed recall (p = 0.038 for current users and p = 0.032 for ex-users) and ROCF delayed recall (p = 0.033 for current users and p = 0.014 for ex-users) than controls. Current users also performed worse on ROCF recognition than controls (p = 0.002). No difference was found between the cognitive functions of current and ex-users. CONCLUSIONS: Ketamine poly-drug users displayed predominantly verbal and visual memory impairments, which persisted in ex-users. The interactive effect of ketamine and poly-drug use on memory needs further investigation.

Location of infarcts and apathy in ischemic stroke.

BACKGROUND: Apathy is common in stroke survivors. Unlike poststroke depression, apathy after stroke has not been extensively investigated and the significance of the location of infarcts in the development of apathy following a stroke is unknown. This study examined the association between poststroke apathy (PSA) and the location of infarcts. METHODS: A cohort of 185 patients with acute ischemic stroke admitted to the Stroke Unit of a university-affiliated regional hospital in Hong Kong was recruited. Three months after the index stroke, a psychiatrist administered the Apathy Evaluation Scale (AES). PSA was defined as an AES score of 37 or above. The presence and location of infarcts were evaluated with magnetic resonance imaging. RESULTS: Altogether 185 patients met the entry criteria and formed the study sample; 20 (10.8%) had PSA. PSA patients were older and had higher stroke severity and more depressive symptoms. The PSA group also had lower levels of physical and cognitive functioning. Compared with the non-PSA group, PSA patients were more likely to have acute pontine infarcts (35.0% vs. 11.5%; p = 0.011). They had a higher mean number (0.5 ± 0.7 vs. 0.1 ± 0.3; p = 0.003) and larger volume (0.6 ± 1.4 vs. 0.1 ± 0.3 ml; p = 0.002) of acute pontine infarcts. Six variables were entered into the predictive regression model: age, the presence, number and volume of acute pontine infarcts, the number of old infarcts and periventricular white matter hyperintensities scores. The volume of infarcts remained an independent predictor of PSA in the multivariate analysis, with an odds ratio of 3.9 (p = 0.007). The Geriatric Depression Scale, National Institutes of Health Stroke Scale, Barthel Index and Mini-Mental State Examination scores were also entered into the subsequent associative regression model; the volume of acute pontine infarcts remained a significant predictor (odds ratio = 3.8). CONCLUSIONS: This is the first report of an association between pontine infarcts and the risk of PSA. The results suggest that pontine infarcts may play a role in the development of PSA. The importance of acute pontine infarcts in the pathogenesis of PSA warrants further investigation.

Serotonin receptor 2C gene polymorphism associated with post-stroke depression in Chinese patients.

The serotonin receptor 2C (HTR2C) gene has been shown to play a pivotal role in major depression. We examined the association between post-stroke depression (PSD) and polymorphism in HTR2C. A cohort of 223 patients with acute lacunar stroke admitted to the stroke unit of a university-affiliated regional hospital in Hong Kong was recruited. Three months after the onset of the index stroke, a research assistant administered the locally validated 15-item Geriatric Depression Scale. PSD was defined as a geriatric depression scale score of 7 or above. Possible confounding factors, including previous history of stroke, severity of stroke, level of social support, and recent life events, were investigated. All patients were genotyped for polymorphisms of HTR2C. Separate analyses were performed for males and females. Sixty-one patients were found to have PSD. There were significant associations between the HTR2C gene and PSD status in the male patients, but not in the female ones. After adjusting for possible confounders, the rs12837651 T allele (odds ratio = 4.020) and the rs2192371 G allele (odds ratio = 2.866) were found to be significantly associated with PSD in males. Genetic variation in HTR2C receptors appears to be involved in the pathogenesis of PSD in Chinese males.

Relationship between cognitive impairment and depressive symptoms in current ketamine users.

OBJECTIVE: Both cognitive impairment and depressive symptoms have been reported in ketamine users. However, no previous study has examined the relationship between them. This study aimed to examine cognitive functions and depressive symptoms and their relationship in young ketamine users in Hong Kong. METHOD: Fifty-one current ketamine users, 49 ex-ketamine users, and 100 healthy controls were recruited from counseling and youth centers in Hong Kong in this cross-sectional study. Cognitive assessment included mental and motor speed; working, verbal, and visual memory; and executive functions. Depressive symptoms were measured using the Beck Depression Inventory. One-way analyses of covariance (ANCOVA) and chi-square tests were used to analyze participants' demographic data, patterns of drug use, Beck Depression Inventory score, and performance in a cognitive battery. Cognitive functions were adjusted for age, gender, and education using ANCOVA. Correlations between the Beck Depression Inventory score and cognitive functions were examined using Pearson's correlation coefficient. RESULTS: Cognitive impairment was found only in current ketamine users in the domains of mental and motor speed (p < .001), visual and verbal memory (p < .001), and executive functions (p < .001). Depressive symptoms were also more frequently found in current ketamine users (p < .001). Correlations between depressive symptoms and certain cognitive scores were statistically significant but modest. CONCLUSIONS: Current ketamine use is associated with cognitive impairment. Illicit substance treatment and rehabilitation services should pay attention to ketamine's cognitive effects and motivate their clients to quit using ketamine and stay abstinent.

Poststroke fatigue is associated with caudate infarcts.

OBJECTIVE: The caudate nucleus may be involved in the pathogenesis of the fatigue observed in neurological disorders. However, the significance of caudate lesions in poststroke fatigue (PSF) is unknown. This study examined the association between caudate infarcts and PSF. METHODS: Five hundred Chinese patients with acute ischemic stroke admitted to the acute stroke unit of a university-affiliated regional hospital in Hong Kong participated in the study. All participants were assessed for PSF with the Fatigue Severity Scale (FSS) three months after their index stroke. PSF was defined as a mean FSS score of 4.0 or more. Physical functioning and depressive symptoms were measured by the Barthel Index (BI) and the Geriatric Depression Scale (GDS). RESULTS: One hundred and twenty-five (25.0%) of the patients had PSF. Compared to the non-fatigue group, the PSF patients were more likely to be women and had hyperlipidemia, lower BI and higher GDS scores. Caudate (8.0% versus 1.3%, p=0.001) and putamen (19.2% versus 12.0%, p=0.043) acute infarcts were more common in the PSF group, whereas pons infarcts (13.6% versus 22.2%, p=0.038) were less common. Acute caudate infarcts remained an independent predictor of PSF in the multivariate analysis, with an odds ratio of 6.4. CONCLUSIONS: The results suggest that patients with PSF are more likely to have caudate infarcts.

White matter hyperintensities and quality of life in acute lacunar stroke.

White matter hyperintensities (WMH) are common in stroke. The influence of WMH on health-related quality of life (HRQoL) following a lacunar stroke is unknown. This study evaluated the impact of WMH on HRQoL in acute lacunar stroke. A cohort of 160 patients with acute lacunar stroke admitted to the stroke unit of a university-affiliated regional hospital in Hong Kong was recruited. Three months after the index stroke, a research assistant administered the Short Form-36 (SF-36) to assess HRQoL. The severity of WMH was evaluated with magnetic resonance imaging (MRI). In univariate analysis, the severity of deep WMH (DWMH) negatively correlated with patients' vitality (VT; p < 0.05), social function (SF; p < 0.001), role-emotional (RE; p < 0.01), mental health (MH; p < 0.01), and mental component summary (MCS; p < 0.001) scores of HRQoL. DWMH was independently associated with all of the above five SF-36 scores (p < 0.05) in linear regression analysis. These findings suggest that DWMH has a significant impact on the HRQoL of stroke survivors. The importance of DWMH in the long-term HRQoL in lacunar stroke warrants further investigation.

Clinical characteristics of cough mixture abusers referred to three substance abuse clinics in Hong Kong: a retrospective study.

OBJECTIVES. Cough mixture is the third most commonly abused substance in patients attending the Prince of Wales Hospital Substance Abuse Clinic. The content of the local cough mixture is not well researched. Paranoid psychosis manifesting as persecutory delusions and derogatory hallucination, as well as mood symptoms, is common in these patients. The natural history and outcome of such psychoses associated with cough mixture abuse are not well known. This study aimed to address these questions. METHODS. This was a retrospective study of cough mixture abuse in Hong Kong. Case records of cough mixture abusers currently receiving treatment at the 3 substance abuse clinics at the Prince of Wales Hospital, Alice Ho Miu Ling Nethersole Hospital, and the North District Hospital were retrieved for data collection. The patients' demographic data, duration and intake pattern of cough mixture, and use of any other drugs were documented. The presenting psychopathology, first urine toxicology results, diagnosis, treatment, number of hospitalizations, and course of the illness were also recorded. RESULTS. A total of 63 patients with the diagnosis of cough mixture abuse were identified in the database; 89% were male. The mean +/- SD age of the patients was 34.4 +/- 6.2 years; 67% were single and 83% were unemployed. The mean +/- SD age of onset of cough mixture abuse was 20 +/- 5 years. Psychiatric symptoms developed a mean +/- SD of 7.6 +/- 6.0 years after onset of abuse. According to the ICD-10 Mental and Behavioural Disorders criteria, the top psychiatric diagnoses were substance-induced psychotic disorder (67%), schizophrenia (19%), depressive disorder (11%), and dysthymia (10%). The most common ingredients in the urine sample at first presentation were promethazine (75%), pseudoephedrine (67%), codeine (60%), ephedrine (57%), zopiclone (17%), and hydrocodone (16%). Additionally, 16% of patients were in the priority follow-up group. The mean +/- SD follow-up period was 6.2 +/- 7.1 years during which there were 3.2 +/- 3.7 episodes of hospitalizations, with a mean +/- SD length of stay in each admission of 25.0 +/- 40.9 days. CONCLUSIONS. Promethazine, ephedrine, pseudoephedrine, codeine, and hydrocodone are the most common ingredients of cough mixture abused in this locality. Psychotic disorders are the most frequent psychiatric diagnosis associated with cough mixture abuse.

Referral patterns and clinical characteristics of subjects referred to substance abuse clinic of a regional hospital in Hong Kong.

OBJECTIVES: To examine the clinical characteristics of subjects referred to the Substance Abuse Clinic of the Prince of Wales Hospital between 1 January 2007 and 31 December 2009 in Hong Kong. METHODS: A chart review of 131 subjects referred to the Substance Abuse Clinic during the study period was carried out. Psychiatric diagnoses were made by a psychiatrist, according to the 10th edition of the International Classification of Diseases. RESULTS: Social workers were increasingly a main source of referrals, accounting for 34% of referrals during the entire study period (and 43% in 2009). Another important referral source was the Hospital Authority system in Hong Kong, which accounted for 38% of referrals over the 3-year study period. Ketamine, methamphetamine, and cough mixtures were the most common drugs of primary misuse, the proportion of users being 34%, 24% and 12%, respectively. In these referals, the most common psychiatric diagnosis was substance-induced psychotic disorder, followed by depressive disorder, made in 44% and 22% of the subjects, respectively. CONCLUSIONS: Among Hong Kong substance abusers, psychotic and depressive disorders are common, and ketamine is the most commonly misused drug.

Psychiatric morbidity at a female residential drug treatment centre in Hong Kong.

OBJECTIVE: To describe the psychiatric co-morbidity of female psychotropic substance abusers treated at a residential treatment centre. METHODS: Subjects were recruited from a female residential substance abuse treatment centre in Hong Kong--the Society for the Aid and Rehabilitation for Drug Abusers. Demographic data and substance abuse habits were recorded. Psychiatric diagnoses were established with the Structured Clinical Interview for the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders. RESULTS: Of the 42 residents, 32 agreed to participate in the study. All of whom completed the questionnaire and the Structured Clinical Interview for the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders. Concerning substance abuse, 84%, 38%, and 34% of the subjects were dependent on ketamine, methamphetamine and cocaine, respectively. The most common lifetime psychiatric diagnosis was substance-induced mood disorder (47%), followed by substance-induced psychotic disorder (16%). CONCLUSIONS: Psychiatric disorders complicate heavy substance abuse in the majority of female patients. Regular screening of this population with standardised diagnostic instruments for psychiatric comorbidity is clearly warranted.

Structure of a tubular membrane confining spherical particles.

We investigate the structure of the system consisting of rigid spherical particles confined in a freely supported soft membrane tube. We show that a number of characteristically different phases exist depending on the phenomenological parameters in the Helfrich model describing the tubular membrane as well as an adsorption energy describing the attraction between the sphere surface and the tube interior wall.