[Analysis on off-label use of drugs in pediatric guidelines and consensus published by Chinese authors].

Objective: To understand the current situation regarding pediatric off-label use of drugs recommendations in Chinese clinical practice guidelines and to make recommendations for standardized reporting format regarding off-label use of drugs for children. Methods: This cross-sectional study was carried out by systematically searching the databases for Chinese guideline consensus articles published in journals between 2018 and 2020 and extracting recommendations regarding off-label use of drugs from those articles. The essential characteristics of the included guidelines, the ranking of off-label drug types, the order of drug information, the type of off-label drug use, and the percentage of citation studies on which the recommendations were based were analyzed. Results: Among 108 studies that included Chinese off-label guidelines and consensus, 364 recommendations on pediatric off-label use of drugs were included. The Chinese Medical Association published the most, 48 out of the 108 studies (44.4%), and of those 14 studies (13.0%) were on infectious and parasitic diseases. Of the 364 recommendations on off-label use of drugs, the most commonly addressed drugs were 16 recommendations (4.4%) for cyclosporine A, 11 recommendations (3.0%) for methotrexate , and 11 recommendations (3.0%) for fentanyl. The most commonly addressed drug categories were as follows: 68 recommendations (18.6%) were immune system drugs, 66 recommendations (18.1%) were anti-infectives, and 56 recommendations (15.4%) were oncology drugs. The most commonly addressed drug information accounts were as follows: 364 recommendations (100.0%) were indications, 204 recommendations (56.0%) were dosages, and 198 recommendations (54.4%) were the route of administration. Based on the instructions approved by the Chinese Food and Drug Administration, the main forms of the off-label drug were as follows: 175 recommendations (48.1%) were unapproved indications, 127 recommendations (34.9%) were unapproved populations, and 72 recommendations (19.8%) were unapproved ages. Only 129 recommendations (35.4%) were cited, mainly including clinical guidelines (48 studies, 23.4%), reviews (22 studies, 10.7%), and pediatric randomized controlled trials (22 studies, 10.7%). Conclusions: Off-label use of drugs is commonly recommended in pediatric guidelines and consensus documents written by Chinese authors. However, the reporting of the recommendations varies widely, and the quality of the supporting evidence is poor.

[Current situation and reflection on the treatment of relative low-heat burns].

Relative low-heat burn can cause primary and secondary damage, and its basic research and clinical studies need to be carried out urgently. In this article, we review content related to relative low-heat burn, including pathogenesis, epidemiological characteristics, and prevention and treatment based on retrieving relevant domestic literature.

[Bacteriology and disinfection of porcine skin].

The microbial flora and counting were studied in split porcine skin. The results indicated that the routine method for the preparation of porcine heterograft could not reduce the indigenous flora in the dermal appendages efficiently. The indigenous flora of porcine skin consists of not only Gram positive cocci and Gram negative rods, fungus are the another predominant ones, the later may contribute to the frequent complication of fungal infection and the early rejection of porcine heterograft. A tincture of iodine compound was prepared and used for the purpose of disinfection, a better result was obtained.

[Prolongation of rejection of porcine skin using iodine tincture].

Tincture of iodine compound with strong penetrating and broad spectrum disinfectant properties was used locally to prolong the rejection of porcine skin heterograft. We believed that injury of epidermis of porcine skin and infection may be the important factors for accelerating rejection phenomena after porcine skin grafting. The possible mechanisms for prolongation of rejection of porcine skin by tincture of iodine compound may by due to effective control of infection and coagulation of protein in epidermis whose antigenic property is very high, so the primary trigger factor inducing early skin necrosis is diminished.