Objective To discuss the application of combined probiotics pretreatment and late triple therapy with helicobacter pylori infection in children.Methods 300 children with helicobacter pylori infection were randomly divided into three groups according to the way of random table.Group A was treated with standard triple therapy, omeprazole,amoxicillin and clarithromycin treatment,and 10 d was 1 treatment course.B group was given probiotic pretreatment,prior to the triple therapy using compound lactobacillus acidophilus piece 1 piece /time,cold water to take after meals,taking 2 weeks,follow -up treatment with triple therapy for 10d.In group C,triple therapy before using compound lactobacillus acidophilus piece 1 piece /time,cold water to take after meals,taking 2 weeks,follow -up treatment with triple therapy for 10d.To take one week after the completion of compound lactobacillus acidophilus piece 1 piece /time,cold water after meals.The clinical therapeutic effects were recorded.Results The helicobacter pylori clearance rate of group A was 55.00%,that of group B was 86.00%,that in group C was 89.00%,the helico-bacter pylori clearance rate of group B and group C was significantly higher than that in group A,the difference was statistically significant (χ2 =23.103 7,28.670 6,all P <0.05).The treatment effect between group B and group C had no statistically significant difference (χ2 =0.411 4,P >0.05 ).In A group,nausea and vomiting occurred in 5 cases,2 cases of diarrhea,abdominal distension abdominal pain in 4 cases,skin rash in 5 cases.In group B,nausea and vomiting occurred in 2 cases,0 cases of diarrhea,abdominal distension abdominal pain in 1 case,skin rash in 1 case.In group C,nausea and vomiting occurred in 1 case,0 cases of diarrhea,abdominal distension abdominal pain 0 cases,skin rashes in 1 case.The incidence rate of adverse reactions in group B and group C was lower than that in group A,the difference was statistically significant (χ2 =11.965 8,8.000 0,all P <0.05).The incidence rate of ad-verse reactions between group B and group C had no statistically significant difference (χ2 =0.687 3,P >0.05). Conclusion Joint probiotics pretreatment and late triple therapy application in helicobacter pylori in children can promote helicobacter pylori clearance,reduce the triple therapy drug adverse reactions,it is worthy of popularization and application in clinic.

Objective To investigate the effect of montelukast combined with budesonide suspension inhalation in the treatment of children with cough variant asthma (CVA),and its effect on inflammatory cytokines. Methods 96 patients with CVA were selected ,and they were randomly divided into observation group ( n=48 ) and control group ( n=48 ) according to the digital table .The control group was treated with routine western medicine only.On the basis of the control group , the observation group was treated with aerosol inhalation of budesonide suspension and montelukast sodium tablets .The children in the two groups were treated for 3 months, then the treatment effect was evaluated.Results The total effective rate in the observation group was 95.8％,which was significantly higher than 77.1％in the control group(χ2 =4.914,P<0.05).After treatment,the FVC,FEV1,FEV1/FVC and PEF in the two groups were significantly improved (t=4.98,3.09,4.33,4.11,all P<0.01).There were statistically significant differences between the two groups after treatment (t=2.03,2.15,2.33,2.91,all P<0.01). After treatment,the MDA level of the observation group was significantly lower ,SOD value was significantly higher , compared with before treatment,the differences were statistically significant(t=5.13,4.09,all P<0.01).But there were no statistically significant differences between before and after treatment in the control group (t=0.12,0.32,all P>0.05).After treatment,the levels of IL-8,IL-6 and TNF-αin the two groups were significantly lower than before treatment(t=2.09,3.13,2.97,all P<0.01).The decrease of inflammatory cytokines was more significant in the observation group(t=2.67,3.45,2.14,all P<0.01).After treatment,the levels of IgA and IgG in the observa-tion group were significantly higher than those in the control group (all P<0.05),but the IgM level in the observation group was not significantly changed (t=3.44,3.53,3.22,all P<0.05).The IgE,IgM and IgG levels in the control group were significantly lower than those before treatment (t=2.09,2.33,2.76,all P>0.05).There were no serious adverse reactions in the treatment group , and the treatment cycle was completed successfully .Conclusion Monte-lukast combined with budesonide suspension inhalation in the treatment of children with CVA can significantly improve pulmonary ventilation function , reduce cough symptoms , it is safe and effective , which is worthy of clinical reference .

OBJECTIVE:To investigate off-label drug use of Ambroxol hydrochloride injection,and to provide reference for further evidence-based evaluation on rationality and standardized management of off-label drug use. METHODS:All medical orders for inpatients receiving Ambroxol hydrochloride injection were selected from 10 hospitals of Guangdong province during Apr. 2014 to Mar. 2015. Situation of drug use in different categories of departments was summarized,the incidence of off-label administation route and off-label dosage were analyzed;according to drug package inserts,prescription daily dose(PDD)and drug utilization in-dex(DUI)were calculated for each category of department,and the degree of off-label dosage was evaluated. RESULTS:A total of 761 821 person·day who used Ambroxol hydrochloride injection was included. Off-label drug use occurred in each category of departments,and the incidence of off-label drug use was 62.10%. The incidence of off-label administration route was 40.51%, mainly atomization inhalation;the incidence of it was the high-est in gynecology and obstetrics department(92.70%).The in-cidence of off-label dosage was 36.30%,and the incidence of it was the highest in cardiothoracic surgery department (85.36%). Departments whose PDDs were higher than the drug package inserts were cardiothoracic surgery department,ICU,surgical department,cardiovascular medicine department,emer-gency department,department of internal medicine and pediatrics department.CONCLUSIONS:Off-label drug use of Ambroxol hy-drochloride injection is common,and the effectiveness,safety and necessity remain controversial,which need to be proved by multi-center randomized controlled prospective trial.