20(S)-Ginsenoside Rh1 is one of the important protopanaxatriol ginsenosides and has been reported to be the main hydrolysis product reaching the systemic circulation after oral ingestion of ginseng. However, its pharmacokinetic characteristics and metabolic fate have never been reported. The present study was therefore designed to elucidate its pharmacokinetic profiles and metabolic pathways both in vivo and in vitro. The absolute bioavailability of 20(S)-ginsenoside Rh1 in rats was only 1.01 %. Identification of metabolites showed that, after intragastrical administration of ginsenoside Rh1, two mono-oxygenated metabolites were detected from the urine, bile, liver tissue, and intestinal tract content, while the de-glucosylated product, 20(S)-protopanaxatriol, was only found in the contents of the intestinal tract. An in vitro incubation study confirmed that the CYP450-catalyzed mono-oxygenation, the intestinal bacteria mediated de-glucosylation, and the gastric acid mediated hydration reaction were the main metabolic pathways of 20(S)-ginsenoside Rh1. The presystemic metabolism as evidenced from this study may partially explain its poor bioavailability.

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Objective: To propose countermeasures for online pharmacies and promote the development of online pharmacies in China. Method: To summarize development status of China's online pharmacies through literature analysis. The number of online pharmacies in China has increased year by year, and China's policies have gradually opened up. However, there's still imperfect situation in the medicine quality, pharmaceutical care, logistics and distribution, unopened OTC medicines, the online pharmacies are not docked with the social insurance, and other issues that hinder the development of online pharmacies. Results and Conclusion: Online pharmacies enhance corporate self-discipline, and establish third-party logistics, thus to improve the quality of the pharmaceutical care, gradually opening OTC medicine sales, achieve the docking with the social insurance system and others to promote the development of online pharmacies in China.

AIMS OF THE STUDY: Lung transplantation is an established therapy in selected patients with advanced cystic fibrosis lung disease. Resumption of employment after lung transplantation is generally supported. In Switzerland, there are no data on long-term employment in people with cystic fibrosis undergoing lung transplantation. CONCLUSION: Pre-transplant employment is the dominant factor influencing lung transplantation employment in people with cystic fibrosis. People with cystic fibrosis undergoing lung transplantation should be encouraged to work for as long as their health status permits. Professional reintegration after successful lung transplantation should be supported by a multi-disciplinary lung transplant team.