Search

City reputation is a valuable asset for the local economy and firms in the contemporary society. However, the impact of city reputation on micro-level firms has been largely overlooked by the literature. This paper uses the National Civilized City (NCC) policy in China as a quasi-natural experiment to enhance city reputation. We employ the DID approach to investigate the relationship between city reputation and corporate risk-taking. The result shows that corporate risk-taking significantly increases following the NCC policy adoption. Moreover, information asymmetry can strengthen the positive impact of city reputation on corporate risk-taking. Channel tests show that city reputation improves financial condition and decreases default risk, leading to improved risk-taking tolerance. Overall, our paper indicates that city reputation is an important mechanism to improve corporate financial performance, providing empirical evidence for local governments to pursue the NCC title. [ABSTRACT FROM AUTHOR]

Promoting the development of China's digital economy and the level of urban disaster reduction and governance is of great significance for accelerating the improvement of China's urban resilience and promoting the coordinated development of regional cities. This paper analyzed the spatial and temporal distribution characteristics and driving paths of urban resilience in 31 Chinese provinces, autonomous regions, and municipalities directly under the central government and proposed relevant measures to promote urban resilience. First, the urban resilience evaluation system was constructed and the entropy value method was applied to calculate the urban resilience index of each region. Second, the spatial distribution of urban resilience was explored based on the urban resilience index of each region. Finally, a qualitative comparative analysis method was used to explore the driving paths of urban resilience enhancement. The study showed that there were large regional differences in the urban resilience index, with an overall spatial pattern of "good in the east, middle in the center, and low in the west" and an overall trend of gradual increase. There are five configuration paths to generate a high urban resilience index, which can be specifically digital industry-driven path, technology factor-driven path, government input- and talent pool-driven path under market factors, technology factor- and government factor-driven path, and government investment- and infrastructure-driven path under market factors, and it is found that the digital industry-driven path is a more common path of digital economy-driven urban resilience improvement in China. The finding of this study reveals the nature of complex interactions among drivers in the process of urban resilience enhancement in China, which breaks through the limitations of traditional statistical analysis methods and provides a new perspective for the study of urban resilience issues. [ABSTRACT FROM AUTHOR]

Purpose: As a new category proposed in the International Classification of Diseases (11th Revision) (ICD-11), the reliability and clinical utility of ICD diagnostic guidelines for gaming disorder (GD) in the Chinese population have not been studied. The purpose of this field study is to clarify the reliability, clinical utility, and cultural applicability of ICD diagnostic guidelines for GD in China and its comparability with Internet GD (IGD) in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5). Methods: Participants included 21 paired clinical raters consisting of seven psychiatrists and 200 gaming players aged from 15 to 18 years with different risk levels of Internet addiction based on the scores of Young's Internet Addiction Test. Each participant received a semi-structured face-to-face interview by paired clinical raters at the same time. Then clinical raters made the diagnosis and filled the clinical utility questionnaire independently according to the diagnostic guidelines for GD in both ICD-11 and DSM-5. Results: The diagnostic consistency coefficient (kappa value) between the paired clinical raters was 0.545 (0.490–0.600, p < 0.001) and 0.622 (0.553–0.691, p < 0.001) for ICD-11 and DSM-5 diagnostic guidelines, respectively, for GD. The diagnostic consistency was 0.847 (0.814–0.880, p < 0.001) between GD in ICD-11 and IGD in DSM-5. Meanwhile, 86.7% of responses that agreed with the ICD-11 diagnostic guidelines for GD provided enough detailed implementation characteristics and showed good overall clinical applicability (86.0%), specificity (94.4%), usefulness (84.1%), and acceptable cultural adaptation (74.8%). GD in ICD-11 was slightly more accepted than IGD in DSM-5 (p < 0.001), while the clinical efficiency of ICD-11 was inferior to that of DSM-5 (p < 0.001). Conclusion: This study indicates that the ICD-11 diagnostic guidelines for GD have acceptable clinical reliability and high consistency with IGD in DSM-5. Their clinical applicability and cultural adaption are comparable with those of DSM-5. Although the guidelines still need to be adjusted for better implementation in China, this is already a great step committed to reducing the serious consequences caused by excessive gaming behaviors through effective identification and normative diagnosis, especially for adolescents. [ABSTRACT FROM AUTHOR]

Objective: Alcohol use disorder (AUD) is a serious issue worldwide and frequently co-occurs with depression. However, the quality of life (QOL) of AUD patients with and without depression is not well studied in the Chinese Han population. The aim of this study was to investigate QOL and its correlates in AUD patients with and without depression in China. Methods: Five hundred and fifteen psychiatric patients diagnosed with AUD were recruited. All these patients completed the Beck Depression Inventory (BDI) to assess depression, the Medical Outcome Study 36-Item Short Form Health Survey (SF-36) to evaluate QOL and the Alcohol Use Disorders Identification Test (AUDIT) to measure the severity of drinking. Results: Compared with AUD patients without depression, those with depression had a lower QOL in all eight domains of the SF-36 (all P < 0.001), but were more willing to have alcohol-related treatment (P < 0.05). Negative correlations were noted between (i) the BDI total score and all eight domains of the SF-36 (all P < 0.001); and (ii) between the AUDIT total score and six domains of the SF-36 (all P < 0.05). Conclusions: Depression impairs QOL in patients with AUD in China. Early intervention in comorbid depression to improve QOL is needed. [ABSTRACT FROM AUTHOR]

Methamphetamine (MA) has become one of the most widely used illicit substances in China and the rest of the world as well. Relapse, incarceration or death was observed after compulsory rehabilitation. However, the knowledge of recovery patterns among MA-dependent patients, early or late occurrence of these negative consequences, is limited. The aims were to explore the long-term recovery patterns and associated factors among MA-dependent patients in Shanghai, China. MA-dependent patients discharged from Shanghai compulsory rehabilitation facilities in 2009–2012 were recruited in a baseline survey. The baseline data of 232 patients were then linked with their long-term follow-up data from official records. Group-based trajectory modeling was applied to identify distinctive trajectories of the occurrence of negative consequences (incarceration, or readmission to compulsory rehabilitation, or death). Patients with monthly status data were found recovering with three distinctive trajectories: rare, late, and early occurrence groups. Multinomial logistic regression showed that having alcohol use history was associated with an increased likelihood of being in the late occurrence group relative to the rare occurrence group. Having opioid use history was associated with an increased likelihood of being in the early occurrence group relative to the rare occurrence group. In addition, being female was associated with decreased likelihood of being in the late occurrence group relative to the rare occurrence group. [ABSTRACT FROM AUTHOR]

In this work, Huadian oil shale from China was treated by hydrothermal pretreatment at 200 °C with 1.0–2.5 h in order to investigate the effect of hydrothermal pretreatment on pyrolysis product distribution and characteristics of oil. The differences in the elemental composition and thermal behavior between the untreated and treated oil shale were analyzed and compared. The hydrothermal treatment process could decompose oxygen functional groups and remove some water soluble inorganics in oil shale, which decreased the formation of gas and water during the pyrolysis. However, hydrothermal pretreatment was conducive to increasing shale oil yield. The maximum of oil yield was obtained at the pretreatment time of 2.0 h. The enhancement of the free-radical reactions during the pyrolysis and the reduction of the secondary cracking reactions of the generated oil vapors were considered as the main reasons. The oil obtained by the treated oil shale had a higher H/C ratio, indicating it had high energy content. The analysis results of chemical compositions in oils showed that the relative content of aliphatic hydrocarbons significantly increased after hydrothermal pretreatment. The further analysis demonstrated that the increase in the pretreatment time caused the generated long chain hydrocarbons tended to be directly released from oil shale particles, and were condensed into the oil. [ABSTRACT FROM AUTHOR]

We evaluated the individual and combined effects of salinity and alkalinity on gill Na+/K+-ATPase enzyme activity, plasma ion concentration, and osmotic pressure in Luciobarbus capito. Increasing salinity concentrations (5, 8, 11, and 14 g/L) were associated with an initial increase and then decrease in L. capito gill Na+/K+-ATPase activity. Activity was affected by the difference between internal and external Na+ ion concentrations and osmotic pressure (P<0.05). Both plasma ion (Na+, K+, and Cl−) concentration and osmotic pressure increased significantly (P<0.05). An increase in alkalinity (15, 30, 45, and 60 mM) caused a significant increase in plasma K+ and urea nitrogen concentrations (P<0.05) but had no effect on either plasma osmotic pressure or gill filament ATPase activity. In the two-factor experiment, the saline-alkaline interaction caused a significant increase in plasma ion (Na+, Cl−, and urea nitrogen) and osmotic pressure (P<0.05). Variance analysis revealed that salinity, alkalinity, and their interaction significantly affected osmotic pressure, with salinity being most affected, followed by alkalinity, and their interaction. Gill filament ATPase activity increased at first and then decreased; peak values were observed in the orthogonal experiment group at a salinity of 8 g/L and alkalinity of 30 mM. [ABSTRACT FROM AUTHOR]

Aims: Methadone maintenance treatment (MMT) is widely available in China; but, high rates of illicit opiate use and dropout are problematic. The aim of this study was to test whether cognitive behavioral therapy (CBT) in conjunction with MMT can improve treatment retention and reduce opiate use. Method: A total of 240 opiate-dependent patients in community-based MMT clinics were randomly assigned to either weekly CBT plus standard MMT (CBT group, n=120) or standard MMT (control group, n=120) for 26 weeks. The primary outcomes were treatment retention and opiate-negative urine test results at 12 weeks and 26 weeks. The secondary outcomes were composite scores on the Addiction Severity Index (ASI) and total scores on the Perceived Stress Scale (PSS) at 12 weeks and 26 weeks. Results: Compared to the control group in standard MMT, the CBT group had higher proportion of opiate-negative urine tests at both 12 weeks (59% vs. 69%, p<0.05) and 26 weeks (63% vs. 73%, p<0.05); however, the retention rates at 12 weeks (73.3% vs. 74.2%, p=0.88) and 26 weeks were not different (55.8% vs. 64.2%, p=0.19) between the two groups. At both 12 and 26 weeks, all of the ASI component scores and PSS total scores in the CBT group and control group decreased from baseline; but the CBT group exhibited more decreases in ASI employment scores at week 26 and more decrease in the PSS total score at week 12 and week 26. Conclusions: CBT counselling is effective in reducing opiate use and improving employment function and in decreasing stress level for opiate-dependent patients in MMT in China. Trial Registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]

The study was undertaken to assess the contents of heavy metals (Cu, Zn, Cr, Pb, Cd, As and Hg) in sea cucumber ( Apostichopus japonicus) juveniles from coastal areas of Bohai and Yellow seas in northern China. Sea cucumber juveniles were collected from twenty commercial hatcheries distributed in five coastal cities. The mean concentrations obtained for heavy metals in mg/kg were as follows: Cu (0.179), Zn (2.634), Cr (0.108), Pb (0.065), Cd (0.161), As (0.372), Hg (0.034). All the mean concentrations were below the maximum residual limits set by Chinese legislation, but As in 10 % samples exceeded the safety threshold. Significant differences in contents of Cr, Pb and Hg were found among the five investigated areas. Overall, the heavy metal levels in sea cucumber juveniles were relatively low and more attention should be paid to toxic metals Pb, Cd, As and Hg in future routine monitoring program. [ABSTRACT FROM AUTHOR]

Background China has recently adopted methadone maintenance treatment (MMT) as a national strategy to address the problem of drug abuse and related public health issues such as HIV and HCV infections. However, low enrollment and retention rates suggest that barriers may exist in MMT utilization. This study examined both patients’ perceptions and service providers’ perceptions of challenges in MMT implementation in China. Methods Four focus groups were conducted in two Chinese cities, Shanghai and Kunming, to explore the perceived and experienced barriers in MMT participation in China. All focus group discussions with participants were audio taped and transcribed. Atlas.ti 5.1 was used to analyze data. Results Service providers and patient participants reported positive experiences (e.g. effects of MMT in curbing withdrawal symptoms) but also expressed concerns about side effects and continued heroin use during MMT. They also identified barriers in participating and remaining in MMT, including affordability (fee requirement), acceptability (methadone as a substitution, dose, long-term nature), accommodation and accessibility (inconvenient operation hours, lack of transferability to other MMT clinics during travel) and competition between public health and public security. Conclusions The present findings have implications for reconsidering the current MMT policies and practices in order to improve access, utilization and, ultimately, the effectiveness of MMT in China. [ABSTRACT FROM PUBLISHER]

ABSTRACT Aims Methadone maintenance treatment has been made available in China in response to the rapid spread of human immunodeficiency virus (HIV), but high rates of dropout and relapse are problematic. The aim of this study was to apply and test if a contingency management (or motivational incentives) intervention can improve treatment retention and reduce drug use. Design Random assignment to usual care with ( n = 160) or without ( n = 159) incentives during a 12-week trial. Incentives participants earned draws for a chance to win prizes on two separate tracks targeting opiate-negative urine sample or consecutive attendance; the number of draws increased with continuous abstinence or attendance. Setting Community-based methadone maintenance clinics in Shanghai and Kunming. Participants The sample was 23.8% female, mean age was 38, mean years of drug use was 9.4 and 57.8% had injected drugs in the past 30 days. Measurements Treatment retention and negative drug urine. Findings Relative to the treatment-as-usual (control) group, better retention was observed among the incentive group in Kunming (75% versus 44%), but no difference was found in Shanghai (90% versus 86%). Submission of negative urine samples was more common among the incentive group than the usual care (74% versus 68% in Shanghai, 27% versus 18% in Kunming), as was the longest duration of sustained abstinence (7.7 weeks versus 6.5 in Shanghai, 2.5 versus 1.6 in Kunming). The average total prize amount was 371 Yuan (or $55) per participant (527 for Shanghai versus 216 in Kunming). Conclusions Contingency management improves treatment retention and drug abstinence in methadone maintenance treatment clinics in China, although there can be considerable site differences in magnitude of effects. [ABSTRACT FROM AUTHOR]

Take the Liu Jiao Ting MMT clinic as an example, the clinic is located in central area of the COVID-19 epidemic (close to the Hua Nan Seafood Market) in Wuhan, serving 300 MMT patients living in the surrounding communities. 14 participants reported it was difficulty to go to the clinic for medication, and 2 participants reported having been exposed to COVID-19 patients, while luckily no patients have been infected so far. (3) In order to prevent the client from COVID-19 infection, clinics in epidemic areas could carry out "Take-home dosing plan" based on special provisions for high- and low-risk patients and patients with disabilities ([3]). [Extracted from the article]

Introduction: The purpose of the study is to evaluate the efficacy and safety of buprenorphine/naloxone sublingual tablets for the treatment of opioid dependence in Chinese adults. Methods: This multicenter, double‐blind, placebo‐controlled study included four periods: induction (3‐5 days), stabilization (7‐21 days), randomization/treatment (6 weeks), and postmedication follow‐up (1 week). A total of 442 participants with opioid dependence were enrolled; 260 were randomized to buprenorphine/naloxone or placebo. The primary outcome was retention in treatment, defined as the time from randomization to treatment completion or treatment failure. Secondary outcomes included maximum consecutive days of abstinence from opioids, self‐reported craving and opioid withdrawal symptoms, and urine drug screen results. Safety assessments included adverse event reporting, electrocardiograms, clinical laboratory tests, vital signs, and prior/concomitant medications. Results: The median treatment retention time (95% confidence internal) with buprenorphine/naloxone was 32 days (26‐38) versus 6 days (5‐8) for placebo, with a Cox hazard ratio of 0.28 (95% confidence interval, 0.21‐0.38; P < 0.0001). The median maximum consecutive days of abstinence (95% confidence interval) was: buprenorphine/naloxone, 21 days (26‐38); placebo, 5 days (5‐8) with a Cox hazard ratio of 0.38 (95% confidence interval, 0.25‐0.60; P < 0.0001). Withdrawal and craving symptoms were significantly milder with buprenorphine/naloxone versus placebo (P < 0.001). Urine drug screen results indicated significantly lower opioid usage in the buprenorphine/naloxone group compared with placebo (P < 0.001). The most commonly reported adverse events in the buprenorphine/naloxone group during treatment were aspartate aminotransferase increased and nasopharyngitis. Discussion: Efficacy and safety results from this clinical trial support a positive benefit‐risk ratio for buprenorphine/naloxone sublingual tablet use in the treatment of an opioid‐dependent Chinese population. [ABSTRACT FROM AUTHOR]

• iTBS reduced cue-induced craving in patients with severe methamphetamine use disorder. • iTBS improved cognitive function in patients with severe methamphetamine use disorder. • iTBS improved sleep quality in patients with severe methamphetamine use disorder. Methamphetamine is the most commonly used illicit drug in China. We previously demonstrated that 10 Hz rTMS over the DLPFC reduces craving in methamphetamine users. Here, we applied intermittent theta burst stimulation (iTBS), a new form of rTMS, in a large sample at four clinical centers. 126 participants (age 31.64 ± 6.33; 106 men) with severe methamphetamine use disorder according to DSM-5 were randomized to receive either iTBS or sham over the DLPFC for four weeks (20 daily sessions, 900 pulses per day). Cue-induced craving and cognitive function were assessed before and after rTMS intervention. Relapse was followed up by urine test after discharge from the rehabilitation center. iTBS significantly reduced craving and improved cognition and sleep quality. This study suggests that rTMS may be a useful and safe treatment option for methamphetamine use disorder, warranting future large scale trials. [ABSTRACT FROM AUTHOR]

Summary: Objectives: Injection drug use is a major route of HIV transmission in China, yet relatively little is known about why so few injection drug users utilize free HIV testing services. This study aimed to examine barriers to HIV testing and voluntary counseling and testing (VCT) service utilization among injection drug users in Shanghai, China. Methods: Utilizing mixed methods, we analyzed data from a survey of 540 compulsory drug abuse treatment patients and data from focus groups with 70 service providers and patients. Results: Only 24.4% of patients expressed willingness to be tested for HIV. Willingness to be tested was associated with younger age and more positive attitudes towards condom use. Patients reported several barriers to utilization of voluntary HIV testing services, including lack of information about these services, perceptions of no risk or low-risk for HIV infection, fear of positive results, and the stigma or discrimination that may be experienced by the patient or their family. Having limited skills related to HIV counseling was reported by service providers as the primary barrier to encouraging patients to utilize HIV testing/VCT services. Conclusions: Special intervention programs targeting injection drug users, their family members, and service providers may increase HIV testing in China. [Copyright &y& Elsevier]

Introduction: Benzodiazepine receptor agonists (BZRAs), which include benzodiazepines and Z-drugs, are the most commonly prescribed psychotropic drugs worldwide, and their inappropriate use places a significant burden on public health. Given the widespread use of BZRAs in psychiatric settings, this condition may result from doctors' improper prescribing. Researchers have developed an electronic intervention system to assist psychiatrists in prescribing BZRAs appropriately. This study aims to determine the efficacy and utility of electronic intervention in reducing improper BZRAs prescriptions in real-world psychiatric outpatient settings., Methods and Analysis: A multicentre randomised controlled research study will be conducted in real-world settings with licensed psychiatrists with prescription qualifications from five of Chinese most significant regional hospitals that provide high-quality mental healthcare. Participants will be 1:1 randomly assigned to receive a 3-month electronic intervention (11 related information pushing and 3 online lectures) or be placed on a waiting list. The primary outcome is the change in the proportion of inappropriate BZRAs prescriptions between the baseline period (3 months before the intervention) and 3 months after the intervention. Secondary outcomes will be examined at baseline, the third month and the sixth month. The secondary outcomes include psychiatrists' knowledge and attitudes about appropriate BZRAs prescription, the associated side effects of BZRAs among patients and self-efficacy. To measure the utility, intervention assessment and system utilisation data from the intervention group were collected., Ethics and Dissemination: The institutional review board and ethics committees of Shanghai Mental Health Center, Second Xiangya Hospital, West China Hospital, Guangji Hospital and Wuhan Mental Health Center approved the study. After the study is completed, the results will be published in peer-reviewed journals or presented at conferences. If the educational materials are effective, they are available to the general public., Trial Registration Number: NCT03724669; Pre-results., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Butterfly hillstream loach (Beaufortia kweichowensis), a benthic fish in the torrential mountain streams, possesses a totally flat ventrum, flattened craniofacial and body skeletons, and enlarged paired fins covered by substantially small keratinous structures. However, little is known about the genetic basis of these specialized morphological adaptations. Here we present a 448.52-Mb genome assembly with contig N50 length of 5.53 Mb by integrating Illumina short-read sequencing, Nanopore long-read sequencing and HiC-based chromatin map. Demographic history reconstruction of the butterfly hillstream loach reveals that the population dynamics is correlated with the different stages of uplifting of the Tibetan Plateau. Comparative genomic analysis finds evidence of six keratin genes in butterfly hillstream loach evolving under positive selection. Within these genes, two keratin genes exhibit species-specific and divergent amino acid changes, suggesting a role in the formation of the unculi. Additionally, a series of positively selected genes, rapid evolving genes, specific variant genes and expanded gene families are found, including genes related to Hedgehog, Notch and BMP pathways, which may be involved in craniofacial development. These findings may have important implications for understanding the genetic basis of phenotypic adaptation to torrential mountain stream life., (© 2021 John Wiley & Sons Ltd.)

Background: Drug use disorder has high potential for relapse and imposes an enormous burden on public health in China. Since the promulgation of the Anti-drug law in 2008, community-based rehabilitation has become the primary approach to treat drug addiction. However, multiple problems occurred in the implementation process, leading to a low detoxification rate in the community. Mobile health (mHealth) serves as a promising tool to improve the effectiveness and efficiency of community-based rehabilitation. Community-based addiction rehabilitation electronic system (CAREs) is an interactive system for drug users and their assigned social workers., Objective: The study aimed to examine the feasibility and preliminary efficacy of CAREs in community-based rehabilitation from the perspective of drug users and social workers in Shanghai, China., Methods: In this pilot randomized controlled trial, 40 participants were recruited from the community in Shanghai from January to May 2019. Participants randomized to the intervention group (n=20) received CAREs + community-based rehabilitation, while participants in the control group (n=20) received community-based rehabilitation only for 6 months. CAREs provided education, assessment, and SOS (support) functions for drug users. The assigned social workers provided service and monitored drug use behavior as usual except that the social workers in the intervention group could access the webpage end to obtain drug users' information and fit their routine workflow into CAREs. The primary outcome was the feasibility of CAREs, reflected in the overall proportion and frequency of CAREs features used in both app and webpage end. The secondary outcomes were the effectiveness of CAREs, including the percentage of drug-positive samples, longest period of abstinence, contact times with social workers, and the change of Addiction Severity Index (ASI) from baseline to the 6-month follow-up., Results: The number of participants logged in to the app ranged from 7 to 20 per week, and CAREs had relatively high levels of continued patient use. Drug users preferred assessment and education features in the app end while their social workers showed high levels of use in urine results record and viewing assessment results on the webpage end. After the 6-month intervention, 3.3% (17/520) of samples in the intervention group and 7.5% (39/520) in the control group were drug-positive (F=4.358, P=.04). No significant differences were noted between the control and intervention groups in terms of longest duration of abstinence, number of contact times and ASI composite scores., Conclusions: The study preliminarily demonstrated that with relatively good feasibility and acceptability, CAREs may improve the effectiveness and efficiency of the community-based rehabilitation, which provided instruction for further improvement of the system., Trial Registration: ClinicalTrials.gov NCT03451344; https://clinicaltrials.gov/ct2/show/NCT03451344., International Registered Report Identifier (irrid): RR2-10.3389/fpsyt.2018.00556., (©Xiaomin Xu, Shujuan Chen, Junning Chen, Zhikang Chen, Liming Fu, Dingchen Song, Min Zhao, Haifeng Jiang. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 16.04.2021.)

Objectives: The relationship between past drug use trajectory and long-term relapse risk after rehabilitation among heroin-dependent patients remain understudied. The primary objectives were to identify longitudinal heroin use patterns of heroin-dependent patients, to determine the associative factors with trajectories and to investigate the impact of trajectory groups on relapse after finishing compulsory rehabilitation programs., Materials and Methods: A total of 564 heroin-dependent patients were recruited from 4 compulsory rehabilitation facilities in Shanghai, China between 2007 and 2008. The baseline data was linked to participants' follow-up data on relapse from official records. Group-based trajectory model was used to identify distinctive drug use trajectory groups. The association between the identified group and heroin relapse risk was then analyzed to understand the role of past drug use trajectory on relapse., Results: Five trajectory groups were identified in this cohort: (1) Rapid Decrease (9.9%); (2) Persistent High (32.0%); (3) Slow Decrease (34.1%); (4) Gradual Increase (4.5%); (5) Persistent Low (19.5%). Gender, age, education, and impulsivity were found to be different between the five groups. During the 5 years after discharged from the compulsory program, 291 (59.0%) individuals relapsed. Multivariate logistic regression analysis showed that the persistent high group (OR: 2.77 [1.46-5.24]), slow decrease group (OR: 2.31 [1.32-4.06]) and gradual increase group (OR: 3.50 [1.18-10.39]) was positively associated with the heroin relapse risk when compared to the persistent low group., Conclusions: Heroin use trajectories vary among heroin-dependent patients in China. The trajectories of heroin use before compulsory rehabilitation are associated with subsequent long-term relapse risk., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Aims: To describe the polysubstance use patterns of heroin-dependent patients and to understand the impact of polysubstance use patterns on relapse during the 5 years after completing compulsory rehabilitation programmes., Design: In this secondary analysis, the baseline data of 503 heroin-dependent patients were linked with their 5-year follow-up data from official records., Setting: Four compulsory rehabilitation centres in Shanghai, China., Participants: A total of 564 heroin-dependent patients who were discharged from Shanghai compulsory rehabilitation facilities in 2007 and 2008 were recruited. Among these, 503 patients with available follow-up records were included in this analysis., Measurements: The baseline measurements included the Addiction Severity Index, the Temperament and Character Inventory and the Medical Outcomes Study Social Support Scale. Relapses after discharge from the compulsory rehabilitation centres were extracted monthly from the official electronic record system. Latent class analysis was used to identify different polysubstance use patterns. Associations between the identified latent classes and heroin use and the factors related to relapse during the 5-year follow-up were analysed with the Cox regression model., Findings: Three latent classes were identified in this cohort: (1) alcohol polydrug users (APU; 13.7%), (2) low polydrug users (LPU; 76.5%) and (3) amphetamine-type stimulant polydrug users (ASPU; 9.7%). During the 5-year follow-up, 298 heroin patients relapsed, and the three groups showed different relapse rates (ASPU 69.4 versus LPU 60.5 versus APU 44.9%, P = 0.02). The average durations of abstinence for the three groups differed (ASPU 31.27 ± 3.41 months versus LPU 36.77 ± 1.19 months versus APU 42.46 ± 2.81 months, P = 0.02). Multivariate Cox regression analyses found that the LPU [hazard ratio (HR) = 1.63, 1.06-2.51] and ASPU (HR = 2.10, 1.24-3.56) classes were positively associated with the risk of heroin relapse., Conclusion: Polydrug use patterns differ among heroin-dependent patients in compulsory rehabilitation programmes in China. A history of polydrug use may predict heroin relapse risk among patients in those compulsory rehabilitation programmes., (© 2018 Society for the Study of Addiction.)

Methamphetamine (MA) use disorder is a growing global health challenge marked by a steady increase worldwide. GABAergic system plays an important role in the mechanism of drug dependence, however few studies about the association between methamphetamine use disorder and genes in GABAergic system. Concerning GABBR1 gene which encoding the GABA B receptor subunit 1 is an important regulator in the GABAergic system. The aim of the study is to explore whether GABBR1 gene play a role in methamphetamine dependence and relapse after rehabilitation. Three single nucleotide polymorphisms (SNPs, rs2076483, rs29221, rs715044) of the GABBR1 gene were genotyped in 791 participants with MA use disorder and 448 healthy controls. The distribution of genotypes and alleles of the three SNPs between the two groups and their subgroups (dependence and abuse) was been analyzed. The multivariate logistic model was used to identify factors associate with relapse of MA use disorder during the following 2 years after drug rehabilitation. It was found that the C allele frequency of rs715044 of the GABBR1 gene was associated with MA use disorder and MA dependence. The CGA (rs2076483- rs29221- rs715044) was negatively associated with MA use disorder. The drug use years and rs29221 GG genotype were associated with relapse during the following 2 years after drug rehabilitation. GABBR1 gene may be associated with the susceptibility for MA use disorder and relapse and it indicates that the GABAergic system may play a role in the MA use disorder. Graphical Abstract GABBR1 gene may be associated with the susceptibility for MA use disorder and relapse and it indicates that the GABAergic system may play a role in the MA use disorder.

Relapse is a typical feature of heroin addiction and rooted in genetic and psychological determinants. The aim of this study was to evaluate the effect of personality traits, impulsivity, and COMT gene polymorphism (rs4680) on relapse to heroin use during 5-year follow up. 564 heroin dependent patients were enrolled in compulsory drug rehabilitation center. 12 months prior to their release, personality traits were measured by BIS-11 (Barratt Impulsiveness Scale-11) and Temperament and Character Inventory (TCI). The COMT gene rs4680 polymorphism was genotyped using a DNA sequence detection system. The heroin use status was evaluated for 5 years after discharged. Among the 564 heroin-dependent patients, 500 were followed for 5 years after discharge and 53.0% (n = 265) were considered as relapsed to heroin use according to a strict monitor system. Univariate analysis showed that age, having ever been in methadone maintenance treatment (MMT), the total scores and non-planning scores of BIS-11, and the COMT rs4680 gene variants were different between relapse and abstinent groups. Logistic regression analysis showed higher BIS total score, having ever been in MMT and younger first heroin use age are the predictors of relapse to heroin use during 5 years follow-up, and the COMT rs4680 gene had an interaction with BIS scores. Our findings indicated that the impulsive personality traits, methadone use history, and onset age could predict relapse in heroin-dependent patients during 5 year's follow up. The COMT gene showed a moderational effect in part the relationship of impulsivity with heroin relapse., (© 2015 Wiley Periodicals, Inc.)

Objectives: China is faced with the challenge of community rehabilitation of persons with opioid use disorders. A 1-year comprehensive psychosocial intervention (CPI) was developed, and its effectiveness was assessed in terms of its ability to improve community rehabilitation of persons with opioid use disorders after their release from detention in compulsory treatment centers in Shanghai, China., Methods: Participants were randomized to the CPI (n = 90) condition or the usual community care (UCC, n = 90) as a control condition. The Addiction Severity Index, Symptom Checklist-90, and Medical Outcomes Study 36-Item Short Form Health Survey were administered at baseline and at the end of the intervention. Urine screens were used to increase the validity of self-reported drug use., Results: Compared with the UCC group at follow-up, the CPI group showed lower scores in 6 dimensions of the Symptom Checklist-90: somatization, obsessive-compulsive, anxiety, phobia-anxiety, paranoia, and psychoticism. Members of the CPI group had higher scores in 2 dimensions of the 36-Item Short Form Health Survey—physical role limitation and emotional role limitation—compared with the UCC group (P < 0.05). A logistic regression analysis revealed that phobia-anxiety, lifetime heroin or amphetamine use, and injection drug use were risk factors of relapse, but differences were not found in drug urine test or self-report drug use between the 2 groups (P > 0.05)., Conclusions: The CPI condition improved participants' mental health and quality of life, and it could be a promising community rehabilitation approach for patients with opioid use disorders in recovery.

Objective: The aim of this study was to evaluate the risk factors associated with dropout from Methadone Maintenance Treatment (MMT) clinics within a 1 year follow-up cohort study in China., Methods: A data analysis is to explore the adherence of MMT during one year from three hundred and twenty patients with heroin dependence at five clinics (3 in Shanghai, 2 in Kunming) in China. All participants were from the part of China-United States cooperation project entitled "Research about improving the compliance and efficacy of methadone maintenance treatment in China". Our data analysis includes the patients' attendance in the 6 months clinical study and the data in another 6 months afterward. The data of patients at baseline were collected with the Addiction Severity Index (ASI) which is a semi-structured questionnaire covering socio-demographic characteristics and drug use history. The one year attendance after recruitment at the clinics and daily dose were abstracted from the MMT clinic register system. The Cox proportional hazards model were used to explore the risk factor of dropout, defined as seven consecutive days without methadone., Results: By the end of 1 year of treatment 86 patients still remained in MMT without dropout (87% in Shanghai and 13% patients in Kunming). Over the entire 1-year period the median days of remaining in the program were 84 days (in Shanghai and Kunming were 317 days and 22 days).The factors associated with retention included age (HR=0.98, 95%C.I.:0.96-0.99, P=0.0062) and ASI alcohol scores (HR=5.72, 95%C.I.:1.49-21.92, P=0.0109) at baseline., Conclusion: One year retention of newly recruited patients with heroin dependence was related to age and ASI alcohol scores at baseline. The adherence is poorer for the patients who are young and having more serious alcohol problems.

Previous researches showed that the dopamine receptor D1 (DRD1) may play a critical role in drug dependence. This research aimed to determine whether DRD1 played a role in development of heroin dependence in Chinese heroin-dependent patients. 465 Chinese Han heroin-dependent subjects and 379 healthy controls were recruited in the Shanghai region. Five single-nucleotide-polymorphisms (SNPs) of the DRD1 gene were genotyped in all subjects. The results found that the frequencies of DRD1 SNP genotypes or haplotypes were not different between heroin-dependent patients and controls. Among heroin-dependent patients, subjects with rs5326CC and/or rs6882300AA genotypes develop to heroin-dependent more rapidly than those without rs5326CC and/or rs6882300AA genotypes. The results indicated that DRD1 gene polymorphism may not play an important role in the susceptibility of heroin dependence in the Chinese Han population, but it may be associated with the rapidity of heroin dependence development from first drug use.

Background: Personality traits such as novelty seeking (NS) are associated with substance dependence but the mechanism underlying this association remains uncertain. Previous studies have focused on the role of the dopamine pathway., Objective: Examine the relationships between allelic variants of the catechol-O-methyltransferase (COMT) gene, NS personality traits, and age of onset of drug use in heroin-dependent subjects in China., Methods: The 478 heroin dependent subjects from four drug rehabilitation centers in Shanghai who were genotyped for eight tagging single nucleotide polymorphisms (SNP) on the COMT gene completed the NS subscale from the Temperament and Character Inventory. Multivariate analyses were used to assess the potential mediating role of NS personality traits in the association between COMT gene variants and the age of onset of heroin use., Principal Findings and Conclusions: In the univariate analysis the COMT rs737866 gene variants were independently associated with both NS and age of onset of drug use: those with the TT genotype had higher NS subscale scores and an earlier onset age of heroin use than individuals with CT or CC genotypes. In the multivariate analysis the inclusion of the NS subscore variable weakened the relationship between the COMT rs737866 TT genotype and an earlier age of onset of drug use. Our findings that COMT is associated with both NS personality traits and with the age of onset of heroin use helps to clarify the complex relationship between genetic and psychological factors in the development of substance abuse.