OBJECTIVE To conduct a comprehensive clinical evaluation of four nucleoside （acid） analogues that have been approved and marketed in China， such as entecavir， tenofovir disoproxil fumarate， tenofovir alafenamide fumarate， and tenofovir amibufenamide. METHODS According to the Guideline for the Administration of Clinical Comprehensive Evaluation of Drugs （2021 edition， trial implementation）， a comprehensive search was conducted across databases including CNKI， Wanfang Data， VIP， PubMed， the Cochrane Library， Embase， as well as relevant official websites. Drug package inserts， guidelines， consensus statements， and relevant literature for the four drugs were collected and subjected to a comprehensive evaluation across six dimensions： safety， efficacy， cost-effectiveness， innovativeness， suitability， and accessibility. RESULTS The scores for entecavir in terms of safety， efficacy， cost-effectiveness， innovativeness， suitability， and accessibility-along with its comprehensive score-were 13， 14， 13， 10， 18， and 6， totaling 74 points. For tenofovir disoproxil fumarate， the respective scores were 13， 17， 18， 8， 18， and 7， totaling 81 points. For tenofovir alafenamide fumarate， the scores were 14， 20， 12， 8， 18， and 5， totaling 77 points. Finally， for tenofovir amibufenamide， the scores were 10.5， 17， 10， 6， 15， and 4， totaling 62.5 points. CONCLUSIONS Tenofovir disoproxil fumarate， with the highest score， is recommended as the first-line option， suitable for adults， children， and pregnant women. However， caution is warranted for potential renal impairment. Tenofovir alafenamide fumarate is recommended as a second-line alternative， particularly for individuals at high risk for bone and renal damage. Entecavir has a score similar to tenofovir alafenamide fumarate but requires dosing on an empty stomach and dose adjustment based on renal function of patients. Tenofovir amibufenamide received the lowest score and is considered a weak recommendation. The clinical application of these nucleoside （acid） analogues should be individualized based on the patient’s age， physiological status， and risk factors.

To standardize the management of high-alert medications in medical institutions and ensure their safe and ef-fective use,based on relevant national regulations and normative documents,international high-alert medication management guidelines,and expert opinions,the Pharmaceutical Specialized Committee of the Chinese Hospital Association led the develop-ment of the Pharmaceutical Supply Services—Key Drugs Management—High-alert Medications.This article elaborated on the for-mulation process of this standard and provides an in-depth analysis of its key contents.It aimed to offer guidance and reference for medical personnel,helping them to thoroughly understand and master the management requirements of high-alert medications,thereby enhancing the management level of high-alert medications and ensuring the safe and effective use of medications for pa-tients.

To standardize the management of high-alert medications in medical institutions and ensure their safe and ef-fective use,based on relevant national regulations and normative documents,international high-alert medication management guidelines,and expert opinions,the Pharmaceutical Specialized Committee of the Chinese Hospital Association led the develop-ment of the Pharmaceutical Supply Services—Key Drugs Management—High-alert Medications.This article elaborated on the for-mulation process of this standard and provides an in-depth analysis of its key contents.It aimed to offer guidance and reference for medical personnel,helping them to thoroughly understand and master the management requirements of high-alert medications,thereby enhancing the management level of high-alert medications and ensuring the safe and effective use of medications for pa-tients.

A 55-year-old male patient with a history of hypertension and type 2 diabetes mellitus received sodium phosphates oral solution 45 ml diluted in 750 ml or more warm water in 2 divided doses for bowel cleansing on the night before and the morning of the day of colonoscopy. After the colonoscopy, the patient developed abdominal distension. Eighteen days after the colonoscopy, elevated serum creatinine (Scr) was found with a peak value of 175 μmol/L. Thirty-five days after the colonoscopy, Scr was 168 μmol/L and the glomerular filtration rate calculated by the plasma-creatinine-based equations Chronic Kidney Disease Epidemiology Collaboration was 38.54 ml/min. Renal puncture and pathological examination showed tubular epithelial cell injury with calcium phosphate deposits, and acute phosphate nephropathy was diagnosed. The patient was advised to drink more water and was given symptomatic treatments such as diuretic furosemide. Five months later, the Scr recovered to 105 μmol/L.

A 55-year-old male patient with a history of hypertension and type 2 diabetes mellitus received sodium phosphates oral solution 45 ml diluted in 750 ml or more warm water in 2 divided doses for bowel cleansing on the night before and the morning of the day of colonoscopy. After the colonoscopy, the patient developed abdominal distension. Eighteen days after the colonoscopy, elevated serum creatinine (Scr) was found with a peak value of 175 μmol/L. Thirty-five days after the colonoscopy, Scr was 168 μmol/L and the glomerular filtration rate calculated by the plasma-creatinine-based equations Chronic Kidney Disease Epidemiology Collaboration was 38.54 ml/min. Renal puncture and pathological examination showed tubular epithelial cell injury with calcium phosphate deposits, and acute phosphate nephropathy was diagnosed. The patient was advised to drink more water and was given symptomatic treatments such as diuretic furosemide. Five months later, the Scr recovered to 105 μmol/L.

To set up the pharmacy management organization and improve drug administrative regulations in the hospital based on JCI standards,in the building of the hospital pharmacy management system.Using effective process design principles to implement and improve the drug treatment process in such aspects as drug supply,storage,preparation,distribution,delivery,and drug use monitoring.JCI-based pharmaceutical administrative system prioritizes reasonable and safe drug use to benefit patient drug use safety and improves pharmaceutical service quality.

The paper described the basic theory and methods of tracer methodology. By means of case study, case tracing and system tracing, the authors applied this methodology in review or appraisal work in such aspects as priority focus process, priority focus content, clinical service team, appraisal process, and tracing pathways. All these aim at promoting continuous improvement of the quality of care.