The uptake of oral administered drugs primarily occurs in the small intestine,which also has the capability to metabolize drugs.Both phase Ⅰ and phase Ⅱ metabolic enzymes were expressed in the intestinal mucosa,and cytochromes P450(CYP450s) are the principle enzymes attributed to the biotransformation of drugs.CYP3A and CYP2C are the most abundant subfamilies,accounting for approximately 80% and 16% of total CYP450s in the intestine.Compared to the liver,the expression and activity of CYP450 enzymes in the intestine was susceptible to inducers or inhibitors,leading to drug-drug interaction.This article reviews the expression of CYP enzymes in small intestine and the role of the gut wall in CYP-mediated xenobiotic metabolism.Possible drug-drug interactions due to induction or inhibition of CYP enzymes in the small intestine are also addressed.

Objective To study the effects of traditional Chinese medicine Zuojin Pill on gastrointestinal system.Methods Through ig giving 0.1％ methyl orange solution,the gastric residual rate was calculated,and the effect of Zuojin Pill on gastric emptying in mice was observed.By ig administration of 5％ carbon powder,the advance rate of carbon powder was calculated,and the effect of Zuojin Pill on intestinal motility in normal mice and the antagonistic effect on intestinal motility hyperfunction induced by neostigmine were observed.Effect of Zuojin Pill on contraction of isolated guinea pig ileum induced by histamine was observed.After D-xylose solution was ig given to rats,the serum xylose level was determined 1 h later,and the effect of Zuojin Pill on rat intestinal absorption was observed.The anti-diarrhea effect of Zuojin Pill was observed by giving castor oil to mice.At the same time,we have made a comparison between Zuojin Pill and Wuji Pill-berberine,to evaluate the rationalization of Zuojin Pill.Results It was obvious in experimental results that Zuojin Pill had a regulating effect on gastrointestinal system.Zuojin Pill dose-dependently inhibited the gastric emptying.Zuojin Pill demonstrated more effective suppression on the accelerated movement induced by neostigmine,but did not inhibit normal intestinal transit in mice.Zuojin Pill markedly inhibited sperm motility in mice.Zuojin Pill concentration-dependently inhibited the contraction intensity of isolated ileum muscles in guinea pigs induced by histamine.Zuojin Pill markedly inhibited diarrhea induced by castor oil.Compared with Wuji Pill-berberine,the effect of Zuojin Pill on gastrointestinal system was more visible in the same dose.Conclusion Zuojin Pill has obvious regulation effect on the gastrointestinal tract,there are indications that the application of Zuojin Pill to clinic is scientific and reasonable.

ObjectiveTo investigate the effects of norepinephrine on oxygen metabolism and postoperative outcomes in the elderly patients undergoing fluid-restored abdominal surgery.MethodsAfter hospital ethics committee approval,and written informed consent was obtained from all patients,40 elderly patients,aged ＞ 64 yr,with a body mass index of 18-24 kg/m2,undergoing elective colorectal surgery,were randomly divided into 2 groups (n =20 each):routine fluid administration group (group A) and restricted fluid administration group (group B).In group A,lactated Ringer's solution was given routinely.Lactated Ringer's solution was given at a rate of 5 ml· kg- 1 · h- 1 and small dose of norepinephrine was infused intravenously at 0.01-0.03 μg· kg- 1 · h - 1 simultaneously during the surgery,and MAP was maintained ≥65 mm Hg in group B.Intraoperative blood loss was replaced with the equal volume of 6％ hydroxyethyl starch 130/0.4.Before the surgery ( baseline),1 and 2 h after beginning of the surgery,and while leaving postanesthesia care unit,mean arterial pressure (MAP),heart rate (HR),cardiac index (CI) and central venous pressure (CVP) were recorded,and arterial and central venous blood samples were drawn for blood gas analysis.Oxygen delivery index (DO2 I ),oxygen consumption index (YO2I) and oxygen extraction ratio (ERO2) were calculated.The gastric mucosal pH was determined before the surgery and 1 h after beginning of the surgery.Blood samples were taken form the peripheral vein to determine the concentration of Hb,serum albumin,blood urea nitrogen (BUN) and creatinine (Cr) concentrations before the surgery and 1 day after the surgery.The extubation time,duration of stay in hospital,the time when the patients passed the flatus,pulmonary complications,gastrointestinal complications,and wound infections were recorded.ResultsCompared with group A,CI,Hb,ScvO2 and DO2I were significantly increased,CVP and ERO2 were decreased during the surgery,the concentrations of Hb and serum albumin were significantly increased,1 day after the surgery,and the incidence of pulmonary complications and wound infections was significantly decreased after the surgery in group B (P ＜ 0.05 ).There were no significant differences in gastric muscosal pH,the indexes of renal function,extubatiotn time,the time when the patients passed the flatus,duration of stay in hospital and the incidence of gastrointestinal complications between the two groups ( P ＞ 0.05).ConclusionWhen small dose of norepinephrine is used to treat perioperative hypotension induced by fluid restriction,it can increase oxygen delivery,and reduce the incidence of postoperative complications,and has no adverse effects on gastrointestinal microcirculation and oxygen consumption in the elderly patients undergoing colorectal surgery.

Objective To identify risk factors for anastomotic leakage after low anterior resection (LAR) in rectal cancer patients and study its impact on patients'long-term prognosis.Methods Chnical data were analyzed from 720 patients who underwent low anterior resection(LAR) for rectal cancer between 1996 and 2006.Results Anastomotic leakage after anterior resection occurred in 44 cases(6.1%).The median time of anastomotic leakage after operation was 5.6 days.Muhivariate analysis showed male patients.history of preoperative chemoradiation therapy,diabetes,cancer distance from anus less than 7 cm and hand-sewed anastomosis were independent risk factors predisposing anastomosis leakage (P<0.05).Tumor local recurrence rate was 13.6% in patients suffering from leakage and 5.9% for those without leakage (χ2= 4.116,P<0.05).The distant metastasis rates were 25.0 and 14.1 percent for the leakage and noaleakage groups,respectively(χ2=3.943,P<0.05).The survival rates were 56.8 and 72.5 percent in the leakage and nonleakage groups,respectively(χ2=4.979,P<0.05).Conclusion Sex,preoperative chemoradiation therapy,diabetes,cancer distance from anus less than 7 cm and hand-sewed anastomosis were found to be independent risk factors for anastomotic leakage after rectal cancer surgery.Anastomotic leakage was associated with poor prognosis.

0.05). Compared with the altitude of 1 507 m group, the activity of SOD and GSH-Px significantly decreased in the altitude of 3 850 m and 2 500 m groups, it was contrary in the content of MDA (P

AIM: To study the pharmacological effect of Weichangshu (WCS) (Rhizoma coptidis, Fructus Evodiae., etc.) on rodent gastrointestinal function and gastric mucosa, and to analyze its analgesic and antidiarrheal mechanism. METHOD: Mouse's hypermobility induced by neostigmine and its gastric emptying were treated by WCS in comparison with normal subjects, rat's gastric ulcer induced by absolute ethanol, diarrhea induced by castor oil, pain induced by acetic acid and rat's gastric secretion and absorption were observed. RESULTS: The experimental results showed that WCS did not affect normal mouse's intestinal propulsion but significantly antagonized neostigmine induced intestinal propulsion and inhibited the gastric mucosa injure and decreased the frequency of the writhe and limited diarrhea. CONCLUSION: WCS has power to recover gastrointestinal function and lessen gastric mucosa injury and has analgesic and antidiarrheal effect.

Objective:To evaluate the anti-corrosion property of Ti-Zr alloy fabricated by laser solid forming technic in artificial saliva.Method:The corrosive behavior of Ti-Zr alloy fabricated by laser solid forming was studied by potentiadynamic polarization technique in artificial saliva at 37 ℃(pH=6.8).Ti-Zr alloy formed by casting was applied as the control.With the polarization curves given by the electrochemical corrosive measure system and the picture of corrosive plane given by SEM, the corrosive property of the Ti-Zr alloy were analyzed.Results:Ti-Zr alloy fabricated by laser solid forming showed more relatively positive corrosion potential, smaller corrosion current density and lower passive potential, and did not show any evidence of corrosive phenomena.Conclusion:Ti-Zr alloy fabricated by laser solid forming has good corrosive resistance in oral circumstances.

0.05].Conclusion To the middle-and old-aged GI cancer patients without organ dysfunction,lowering blood transfusion trigger from Hb 100 g/L to Hb 80 g/L during operation can meet the requirement of oxygen,reduce blood transfusion,and do not increase the rates of wound infection or delay wound healing.

Objective:To investigate the expression and significance of serum osteoprotegerin and related inflammatory factors in patients with coronary heart disease.Methods:According to case-control study method, 236 subjects with chest pain admitted to Nanyang Second General Hospital Affiliated to Xinxiang Medical University from March 2018 to July 2019 were collected.According to the results of coronary angiography, they were divided into 132 cases of coronary heart disease group and control group(non-coronary Patients with heart disease) 104 cases.Questionnaire survey to collect general data of patients; 5 mL of fasting peripheral venous blood was collected in the morning, and serum was collected by centrifugation.Enzyme-linked immunosorbent assay was used to detect osteoprotegerin and monoclonal antibody to receptor activator of nuclear factor kappa B(RANK) ligand, interleukin 6 (IL-6), C-reactive protein, insulin-like growth factor 1 (IGF-1), monocyte chemoattractant protein 1 (MCP-1), matrix metalloproteinase 9 (MMP-9) levels.Results:The levels of serum osteoprotegerin, IL-6, C-reactive protein, IGF-1, MCP-1, and MMP-9 in patients with coronary heart disease were (1.85±0.49) μg/L, (65.93±5.18) ng/L, (15.74±2.52) mg/L, (725.19±13.36) μg/L, (302.16±15.92) μg/L and (58.31±7.94) μg/L, respectively, which were significantly higher than those in control group (1.42±0.44) μg/L, (47.56±3.51) ng/L, (1.91±0.67) mg/L, (228.61±12.05) μg/L, (246.39±10.28) μg/L and (37.09±4.76) μg/L.Soluble RANK ligand (332.69± 14.91) ng/L was significantly lower than the control group (380.85±19.56) ng/L.The difference was statistically significant (t value were 4.739, 21.065, 29.721, 27.637, 18.911, 16.463 and 17.085, respectively, all P<0.05). The levels of serum osteoprotegerin, IL-6, C-reactive protein, and IGF-1 were statistically significant among different lesion groups (all P<0.05). The levels of osteoprotegerin, IL-6, C-reactive protein and IGF-1 in three vessel disease group ((2.05±0.51) μg/L, (80.96±25.70) ng/L, (19.79±2.03) mg/L, (849.07±18.95) μg/L) were significantly higher than the double-vessel disease group ((1.83±0.45) μg/L, (62.74±20.61) ng/L, (13.82±1.75) mg/L, (714.84±19.06) μg/L) and single-vessel disease group ((1.61±0.42) μg/L, (53.09±18.37) ng/L, (9.67±1.40) mg/L, (507.51±17.83) μg/L), and the double-vessel disease group was significantly higher than the single-vessel disease group, the difference was statistically significant (all P<0.05). Multivariate unconditional Logistic regression analysis showed that serum osteoprotegerin and IGF-1 are the influencing factors of coronary heart disease.ROC curve analysis showed that the AUC of serum osteoprotegerin was 0.827.At the best cut-off point of 1.54 μg/L, the diagnostic sensitivity was 84.09% (111/132) and the specificity was 73.48% (97/132) ; the AUC of serum IGF-1 was 0.883, which was at the best cut-off point.At 395.78 μg/L, the diagnostic sensitivity was 71.21% (94/132) and the specificity was 96.21% (127/132). Conclusion:Serum osteoprotegerin and related inflammatory factor IGF-1 are influential factors in the occurrence of coronary heart disease, and are positively correlated with the severity of coronary artery disease, and have a good diagnostic value for the occurrence of coronary heart disease.