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 apply doctor-patient communication model to improve students doctor-patient communication, and to raise medical quality. Methods 200 patients were allocated to observation group and control group randomly. In the observation group, we applied doctor-patient communication model,the other with common education schema. In order to appraise clinic effect,60 students were allocated to observation group and control group randomly. We applied doctor-patient communication model based on common medical education to the observation group, the other with common medical education. Results Patients in treatment group had more apparent clinic effect than control group.Students in treatment group. had more apparent capability than control group. Conclusion Application of doctor-patient communication in department of Neurology can improve stu-dents'clinic study and improve their clinic quality,and it can also completely cultivate the ability .of new type of medical talents.

Objective To evaluate the performance of self‐established angiotensin converting enzyme (ACE) detection system . Methods The performance evaluation of ACE reagent kit produced by the Jiuqiang Company including precision ,linearity ,correla‐tion with the reference reagent and reportable range were conducted by using the automatic biochemical analyzer according to the re‐quirements of the EP5‐A2 and EP9‐A documentation in the Clinical and Laboratory Standards Institute (CLSI) .Results Intra‐as‐say CV of the system were 6 .87% ,2 .39% and inter‐assay CV were 6 .09% ,1 .81% ,respectively .During the day CV were 8 .00 %and 2 .8% respectively ,which were less than those provided by the manufacturer (<10% );the lenearity result was R2 =0 .99 .The correlation coefficient (r) of the system comparing with the reference reagent was 0 .990 56 ,moreover the average bias was 8 .55% , showing good correlation ;the repotable range was 9 .0U/L‐600U/L .Conclusion Self‐established ACE detection system can meet the requirements for clinical application .

Microbiological data deviations ( MDD) investigation differs from out of the standard ( OOS) investigation in chemical inspection items. Investigating Out-of-Specification( OOS) Test Results for Pharmaceutical Production issued by FDA specifically ex-cludes microbiological and other biological assays. Until recently, there is not a definitive guideline for MDD investigation in the world. Some institutions and experts have explored the practice and theory of MDD investigation. Referred to the existing practical experience and theoretical achievement and based on the provisions of Chinese GMP (2010 revision) and the requirements of Chinese Pharmaco-poeia Ⅱ(2010 edition) Appendix XIX Q, the article discussed the methods for MDD laboratory investigation.

Objective:To investigate the growth-promoting properties and applicability of the mycoplasma test culture media pre-scribed in Chinese pharmacopoeia, and provide reference for the standardization of the drug mycoplasma test method. Methods: Re-spectively using four quantitative detection methods including sensitivity, degree of color change, colony counts and colony diameter, and mycoplasma media widely used in the world as the reference media, the growth-promoting properties of 4 batches of mycoplasma broth and 4 batches of arginine mycoplasma broth from four domestic manufacturers were investigated. Results:The results of sensitivity assay and absorbance detection showed that all the media inoculated with below 100 CFU test microorganisms exhibited visible color change. Furthermore, the results of color change degree and colony diameter showed that there were significant differences among the media products from different manufacturers(P<0. 01). Conclusion:Mycoplasma broth and arginine mycoplasma broth both can sup-port the growth of below 100 CFU test microorganisms. Due to the difference in the growth-promoting properties among the media prod-ucts from different manufacturers, the drug mycoplasma test workers should use more sensitive methods to examine the applicability of the media.

Objective:To provide the basic data for the further revision of mycoplasma test method described in Chinese Pharma-copoeia and some references for the operation standardization of drug mycoplasma test. Methods:Two incubation conditions,namely aerobic conditions and microaerophilic conditions,were compared with respect to the growth status of mycoplasma in liquid and solid media. Results:The growth of mycoplasma was obvious difference between the two incubation conditions,and the microaerophilic con-ditions were better than the aerobic conditions. Conclusion:The microaerophilic conditions can be used in the incubation of mycoplas-ma test,which should be defined and standardized in the future Chinese Pharmacopoeia.

Objective: To investigate the awareness of and participation in Healthy City construction among residents in Hangzhou City, so as to provide insights into promotion of participation in Healthy City construction. Methods: Residents at ages of 15 to 75 years were sampled using the multi-stage stratified random sampling method, from 30 townships in Jianggan, Xiaoshan and Tonglu counties of Hangzhou City from November 2019 to July 2020, and a questionnaire survey of 10 representative projects pertaining to Healthy City construction in Hangzhou City was performed to investigate the awareness of and participation in Healthy City construction. Results: A total of 5 559 questionnaires were allocated, and 5 211 valid questionnaires were recovered, with an effective recovery rate of 93.74%. The respondents had a mean age of ( 43.82±17.25 ) years, and included 2 280 males ( 43.75% ) and 2 931 females ( 56.25% ). The overall standardized awareness and participation rates of Healthy City construction were 81.73% and 48.58% among the respondents. The projects with the three highest awareness included healthy environment improvements ( 92.67% ), travelling by public transportation ( 92.22% ) and tobacco control action ( 91.04% ), while the projects with the three lowest awareness included chronic disease management ( 75.57% ), maternal and child healthcare ( 72.73% ) and “Healthy Cell” Program ( 45.56% ). The projects with the three highest participation rates included travelling by public transportation ( 74.59% ), healthy environment improvements ( 65.17% ), tobacco control action ( 61.52% ), while the projects with the three lowest participation rate included chronic disease management ( 35.92% ), “Healthy Cell” Program ( 34.96% ) and maternal and child healthcare ( 33.20% ). Conclusions The overall proportion of participation in Healthy City construction is low among residents in Hangzhou City, and notably, the awareness rate of and the proportion of participation in chronic disease management, maternal and child healthcare and “Healthy cell” Program are both low.

Objective To investigate the brain magnetic resonance imaging(MRI)findings in 33 patients with neuromyelitis optica(NMO).Methods Patients who fulfilled the latest diagnostic criteria of NMO and whose brain MRI did not satisfied with diagnostic criteria of multiple sclerosis(MS)were enrolled.All the patients underwent brain MRI and spinal cord scannings and subsequent images analysis.Results Thirty-three patients with NMO were included to study.Five out of 33(15.2%)patients did not have brain parenchymal abnormalities,28 out of 33 patients(84.8%)were detected to have brain abnormal findings.Brain parenchymal lesions were well-defined in 22 patients(66.7%),no non-specific or atypical brain parenchymal lesions were found in the supratentorium or infratentorium in the other 6 cases(18.2%).However,brain MRI disclosed macroscopic,symmetrical diffuse FLAIR and T2-visible hyperintensity in deep white matter.Fifteen cases had more than one lesion(≥2 lesions),and the other 7 cases had single lesion.Supratentorial lesions were mostly punctate or small dots in nonspecific hyperintensity in juxtacortical,subcortical and deep white matter regions,a few were atypical patches.In the infratentorium,brainstem was an easily involved region(14/33,42.4%),especially in medulla(7/33,21.2%).Conclusions Brain MRI abnormalities are common in Chinese NMO,and brain lesions do not exclude the diagnosis of NMO.The observations of brain lesions are helpful to improve and revise diagnostic criteria of NMO.

To explore the establishment of a scientific and innovative working mode of the national drug reference standards. Methods:Project management was adopted. Results and Conclusion: The project management mode can effectively ar-range the work of the national drug reference standards including raw material collection, research, review, subpackage, package and so on, which exhibits guiding significance for the development direction and improving products supplement.

Objective To explore the values of diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)measurements in various lesions of multiple sclerosis(MS).Methods Sixty patients with clinically diagnosed remitting-relapsing MS(RRMS)were included to undergo conventional brain MRI and DWI scans.the lesions were included when the diameter was more than 5 mm.mean ADC values were measured for various lesions of MS.The statistical analyses were performed to determine the differences of mean ADC values among various lesions of MS.and to compare the correlation between ADC values of lesions and Expanded Disability Status Scale(EDSS)scores.Results (1)The ADC value of hypointense lesions was significantly higher than that of isointense lesions(F=55.90,P<0.05),the ADC values were(127.5 ±9.3)×10-5mm2/s and(95.7 ±6.3)×10-5mm/s respectively.The nodular enhancing lesions had a significantly lower ADC value than the ring-enhancing lesions(F=64.18,P<0.01).the ADC values were(114.7 ±12.3)×10-5mm2/s and(140.7 ±11.0)×10-5mm2/s respectively.The ADC value of confluent lesions was substantially higher that of discrete lesions(t=9.04,P<0.01).the ADC values were(141.4±6.5)×10-5mm2/s and(105.4±13.9)×10-5mm2/s respectively.(2)No correlation between ADC of lesions and EDSS scores was found(r=0.35,P>0.05).Conclusion DWI and quantitative ADC are useful to explain the pathological changes in different lesions and to monitor the disease duration of MS.