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 analyze the efficiency of chronic disease prevention and control of primary health service institutions in Shandong, and provide policy references. Methods:Using CRS and VRS models from DEA to analyze the representative input and output indicators in primary health Service institutions. Results: The overall efficiency of chronic disease prevention and control in primary health service institutions is low, and the actual output was insufficient compared with the target output. Conclusion: Strengthening chronic disease control measures in high-risk group and establishing management mechanism leaded by the goal of chronic prevention and control in order to achieve optimal allocation of resources.

Objective To investigate the effect of losartan on tubulointerstitial fibrosis of rat unilateral ureteral obstruction(UUO) model, and to study whether the use of large dose could be better exert a superior renoprotective effect than conventional dose. Methods Three days after UUO, rats were randomly assigned to conventional dose and large dose of losartan group, shamoperated group and operation group. Two treatment groups were administered orally with a daily dose of losartan 50 mg/kg or 500 mg/kg by gastric gavage. Sham-operated group and operation group received the same volume of physiological saline. Rats were sacrificed 7, 14, 21 days after obstruction. Daily urinary albumin excretion(UalbV), tail-cuff pressure(TCP), the percentage of renal tubular lesions, fractional interstitial area (INT), macrophage infiltration and the expression of transforming growth factor (TGF)-β1 mRNA were assessed and compared. Results The TCP, UalbV, percentage of tubular lesions and interstitial fibrosis, the number of interstitial macrophages and the expression of TGF-β1 mRNA were significantly increased in operation group as compared with other groups (P<0.05). Furthermore, in comparison with conventional dose, the large dose treatment significantly reduced TCP and UalbV, attenuated interstitial fibrosis and tubular lesions, suppressed macrophages infiltration and the expression of TGF-β1 mRNA. Conclusion The large dose of losartan provides superior renoprotection compared to the treatment with conventional dose in UUO model, which interrupts the positive feedback involved in the vicious cycle between inflammatory cell and Ang Ⅱ.

The internal audit is important for the management system of laboratory .The article stated how to effectively implement internal audit in drug testing laboratories in terms of the planning , checklist, pattern, problem observation , CAPA of non-compliance and application of results in internal audit .

An indexing system is constructed,based on the implementation of prevention and control technology for chronic non-communicable diseases in community health service institutions,using both literature review and Delphi method,and using the Analytic Hierarchy Process (AHP) to calculate the weight of the indexing system.The system comprises three level-1 indexes,8 level-2 indexes and 33 level-3 indexes.The research proposed a transition from emphasis of therapeutic means to prevention,and emphasis on prevention and control technologies to the high-risk population in the prevention and control technology of chronic non-communicable diseases,along with development of techniques and measures to encourage behavioral changes of the population with chronic diseases.

Depending on the meaning and function of the liver in traditional Chinese medicine and modern medicine,this paper explores the important role of liver in the pathogenesis of DM (Diabetes Mellitus,DM).Combined with treatment based on syndrome differentiation and specific case report study,this paper has stressed the importance of treating DM from liver and so to set a sound basis for the systemic treatment based on syndrome differentiation from internal organs for DM.

ObjectiveTo evaluate clinical efficacy ofYupingfeng Granules combined with western medicine for children with recurrent respiratory tract infection (RRTI).Methods CNKI, VIP, WANFANG DATA, SinoMed, PubMed, Embase, and Cochrane Library were searched for the randomized controlled trials (RCTs) that investigated the clinical and immune effects ofYupingfeng Granules in children with RRTI from inception to October 2015. Two researchers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of included studies. Then Meta analysis was performed through the software RevMan 5.3.Results A total of 8 articles involving 550 patients were included. The results of Meta analysis showed effective rate ofYupingfeng Granules combined with western medicine for children with RRTI [OR=4.16, 95%CI (2.49, 6.95),P<0.000 01], IgA level [MD=0.52, 95%CI (0.26, 0.78),P<0.000 1], IgG level [MD=2.75, 95%CI (1.25, 4.25),P=0.000 3], CD4+ level [MD=6.15, 95%CI (4.76, 7.54),P<0.000 01], CD4+/CD8+ level [MD=0.36, 95%CI (0.25, 0.47),P<0.000 01]. All of the above were superior to single western medicine treatment. There was no statistical significance in levels of IgM and CD8+(P>0.05). ConclusionYupingfeng Granules combined with western medicine can improve effective rate, antibody level and T-cell level in the treatment of children with RRTI. The overall clinical efficacy is better than single western medicine treatment. However, RCTs with large samples, multiple centers and high quality are needed for further verification.

Objective To analyze the laws of acupoint selection of acupuncture for generalized anxiety disorder (GAD); To provide references for clinical treatment.Methods Computers were used to search articles about acupuncture for GAD from China National Knowledge Infrastructure (CNKI), Wanfang Database Resource System, Chinese Scientific Journal Database (VIP database) and Chinese BioMedical Literature (CBM) from their respective founding dates to Dec. 31, 2015. The corresponding database was established with NoteExpress2, and the laws of acupoints were analyzed.Results Totally 41 articles were included, including 56 acupuncture prescriptions, involving 50 acupoints in 14 meridians. The frequency for acupoint selection was 287 times. There were 49 main acupoints (225 times of acupoint selection, accounting for 98.0%) and 23 matching acupoints (62 times of acupoint selection, accounting for 46.0%) in the treatment of GAD. Main acupoints with high frequency were Baihui (GV20), Shenmen (HT07), Neiguan (PC06), Sanyinjiao (SP06) and Yintang (GV29). Matching acupoints with high frequency were Zusanli (ST36), Taichong (LR3), Neiguan (PC06), Shenmen (HT07), and Fenglong (ST40). Selecting acupoints along meridian mainly depended on Governor Meridian, Taiyang Bladder Meridian of Foot, Shaoyin Heart Meridian of Hand and Jueyin Pericardium Meridian of Hand.ConclusionPrinciples of acupuncture for GAD is treatment determination from heart and brain, emphasizing syndrome differentiation and identification of diseases, and the clinic mainly adopts acupoints along meridian with symptomatic acupoints treatment.

Objective To observe the effects ofShenshuaiⅡ Prescription on expressions of pathologic morphology and TNF-α in nephridial tissue of chronic renal failure (CRF) rats induced by 5/6th kidney (ablation/infarction, A/I); To investigate its possible mechanism of action.Methods 5/6 (A/I) nephrectomized CRF rat models were prepared and randomly divided into sham-operation group, model group, Western medicine group and TCM group. Each medication group was given relevant medicine. The levels of serum creatinine (SCr), blood urea nitrogen (BUN), hemoglobin (Hb) and endogenous creatinine clearance (Ccr) were measured after 60 days of administration. The histopathology of residual kidney was observed, and the expression of TNF-α in residual renal tissue was detected by immunohistochemistry.Results Compared with the model group, the levels of SCr and BUN significantly decreased, while Hb and Ccr significantly increased in each medication group (P<0.05,P<0.01). The pathological changes of the residual renal tissue were improved in each medication group. The expression of TNF-α protein in the rats of medication group was significantly lower than that in the Western medicine group (P<0.05, P<0.01).Conclusions henshuaiⅡ Prescription can improve renal function and alleviate changes of renal pathology in CRF rats. The mechanism of anti-renal interstitial fibrosis may be related to the improvement of renal ischemia and hypoxia and the regulation of the expression of TNF-α.