Anticholinergic drugs play an important role as bronchodilators in the treatment of obstructive airway diseases, including chronic obstructive pulmonary disease and asthma.Anticholinergic drugs are divided into short-acting muscarinic antagonists(SAMA)and long-acting muscarinic antagonists(LAMA). Ipratropium bromide is a commonly used SAMA in pediatrics and is administered by inhalation.The combination of ipratropium bromide and β 2 receptor agonist can control the acute attack of asthma patients of different ages and degrees.Tiotropium bromide is not only LAMA, but also a long-acting bronchodilator, which selectively and competitively binds to M1, M2, and M3 receptors.Tiotropium bromide can reduce Th2 cytokines and airway inflammation, reduce airway hyperresponsiveness, and inhibit airway remodeling.This article reviews the recent progress of anticholinergic drugs in the treatment of childhood asthma.

Mycoplasma pneumoniae is one of the most common pathogens in children with community-acquired pneumonia.Some cases of mycoplasma pneumoniae pneumonia may develop into refractory mycoplasma pneumoniae pneumonia(RMPP). Glucocorticoid therapy can delay the disease and shorten the hospital stay, which is an effective method for the treatment of children with RMPP.This paper reviews the progress of glucocorticoids in the treatment of RMPP in children.

In recent years, the etiology of periodontitis has tended to be based on the theory of flora imbalance. That is, periodontitis is not caused by specific bacteria but by the breakdown of the oral flora balance, which leads to an immune imbalance. Imbalanced bacterial flora cooperate with each other to produce virulent factors that destroy organism tissues and induce immune cells to produce abnormal levels of cytokines, causing greater damage. This article reviews the initiation of a flora imbalance, the interaction between bacteria, the immune damage of the host and the prevention and treatment of the flora imbalance. The literature review shows that peroxidase released by inflammatory reactions, host immune responses to pathogenic microorganisms and some systemic factors, such as diabetes, can trigger flora imbalance. As a result, ion transport, substance synthesis and metabolism of bacteria change; virulence factors increase; and the oral flora balance is disrupted. Red complex bacteria enter gingival epithelial cells, produce adhesin, and selectively inhibit the expression of specific chemokines, which is beneficial for other pathogenic bacteria to enter gingival epithelial cells. Toxicity factors increase throughout the body, directly destroying body tissues and inducing innate and adaptive immune responses, thus causing related immune damage. The dysbacteriosis model of periodontitis provides a new idea for the prevention and treatment of periodontitis, such as using biological factors, bacteriophages, probiotics and other methods to reduce the number of periodontal pathogens to restore the steady state of periodontal flora.

OBJECTIVE To provide reference and suggestions for dynamic adjustment of classification management lists for clinical use of antibiotics and the promotion of rational use of antibiotics. METHODS The latest version of provincial classification management lists for clinical use of antibiotics were aggregated into the “national list”， which was compared with 2021 WHO AWaRe classification list of antibiotics （hereinafter referred as to “AWaRe classification list”） to make a descriptive statistical analysis about the number of different classes of antibiotics in the two lists and their differences. RESULTS Based on the different classification principles， 262 kinds of antibiotic preparations in the national list were classified into non-restricted （84）， restricted （83） and highly-restricted classes （95）， and 258 kinds in the AWaRe classification list were classified into access （87）， watch （142） and reserve classes （29）； 182 kinds of antibiotic preparations were both included in the two lists. In the national list， among the non-restricted antibiotic preparations， 36 kinds belonged to access class， 30 belonged to watch class and 1 belonged to reserve class； among restricted antibiotic preparations， 7 belonged to access class， 46 kinds belonged to watch class and 3 belonged to reserve class； among highly-restricted antibiotic 82805019。E-mail：yyy211anne@163.com preparations， 9 belonged to access class， 35 belonged to watch class and 15 kinds belonged to reserve class. Among them， 91 kinds of antibiotic preparations were not recommended by WHO （20 kinds） or not included in the AWaRe classification list （71 kinds）. CONCLUSIONS The classification methods of two lists are different in classification principles and grading of some similar drugs. The classification management list of antibiotics is one of the key points of antibiotics management， more research is needed in the future to provide sufficient evidence for optimizing antibiotics classification management.