ABSTRACT
OBJECTIVE： To investigate the situation and problems of clinical microecological preparations in pediatrics department of China， and to provide reference for rational application of microecological preparations in children. METHODS： Outpatient/emergency prescriptions of microecological preparations during Jan.-Mar. 2019 were retrieved from information system of 5 “Third Grade Class A” children hospitals， and were investigated and analyzed in respects of the type of microecological agents， age distribution， clinical diagnosis， drug combination， off-label medication， etc. RESULTS： A total of 74 210 outpatient/emergency prescriptions were collected， involving 18 kinds of microecological preparations. Among them， Clostridium butyricum combined viable powder ranked first （31 146， accounting for 41.97％）， followed by Brucella yeast powder （14 289， accounting for 19.25％） and Compound Lactobacillus acidophilus tablets （10 281， 13.85％）. The age of children was less than 18 years old， and the proportion of children aged 1-＜3 years old was the highest （33 753， 45.48％）. The most common clinical diagnosis was digestive tract diseases （54 009， 72.78％）， followed by respiratory infectious diseases （11 744， 15.83％）. In combination with microecological agents， there were Chinese patent medicine for invigorating the spleen and stomach （18 546， 24.99％）， antibacterial medicine （10 595， 14.28％） and oral rehydration salt Ⅲ （8 238， 11.10％）. Off-label drug use was found in 19 532 prescriptions （26.32％）， mainly manifesting as super-indications （15 590， 21.01％）， super-usage and dosage （8 098， 14.52％）， super crowd medication （48， 3.91％） was found in a few prescriptions. CONCLUSIONS： There is a high incidence of off-label use of microecological agents in children. Medical staff should standardize prescription behavior and promote rational use of drugs. At the same time， the improvement of the information of children’s medication in drug instructions to ensure the safety and effectiveness of children’s medication should be encouraged.
ABSTRACT
Objective To investigate the effect of Clostridium butyricum on the intestinal permeability and expression of tight junction proteins in rats with intrahepatic cholestasis.Methods Forty SD rats were random-ly divided into normal control group(Con),model group(Mod),group with low(CBL)and high dose(CBH)of Clostridium butyricum. Animal models of intrahepatic cholestasis were induced by alpha-naphthylisothiocyanate. Then different drugs were administrated via oral gavage for 7 days after modeling.After the last administration,the activities of serum alanin aminotransferase(ALT),aspartate aminotransferase(AST),diamineoxidase(DAO)and the contents of total bilirubin(T-BIL)in serum were detected. Pathological changes of liver tissue were observed. The expression level of Occludin and ZO-1 in small intestine was analysed by Western blot. Results Compared with the normal control group,the levels of ALT,AST,DAO,and T-BIL in mordel group were significantly in-creased. The expression of Occludin and ZO-1 in small intestine was reduced(P < 0.05). Compared with the mordel group,the levels of ALT,AST,DAO,and T-BIL and the expression of Occludin and ZO-1 decreased sig-nificantly(P<0.05)and the liver pathologic changes were improved in CBL and CBH group.Conclusions Clos-tridium butyricum can protect the liver and improve the intestinal permeability in rats with intrahepatic cholestasis, and he mechanism may be related with upregulation of Occludin and ZO-1.