OBJECTIVE To compare the efficacy， safety， and cost-effectiveness of two different formulations of short-acting recombinant human growth hormone （rhGH） in the treatment of patients with short stature. METHODS Data from patients with short stature treated with short-acting rhGH at the Leshan People’s Hospital from August 2016 to June 2023 were collected. Patients were divided into powder formulation group and aqueous formulation group based on the rhGH formulation used. The changes in growth-related efficacy indicators and the occurrence of adverse drug reactions were compared between two groups after 12 months of treatment； cost-effectiveness analysis and sensitivity analysis were used to compare the cost per unit of effect achieved； subgroup analysis was performed by dividing the patients into growth hormone deficiency （GHD） subgroup and idiopathic short stature （ISS） subgroup based on clinical diagnosis. RESULTS After 12 months of treatment， the height and the levels of insulin-like growth factor-1 and insulin-like growth factor binding protein-3 in serum in aqueous formulation group and powder formulation group were significantly increased compared to before treatment （P＜0.001）， but there was no statistically significant difference in the changes of the above indicators between the two groups（P＞0.05）. The analysis results of GHD and ISS subgroups were consistent with the overall population. In the overall population， the cost-effectiveness ratio of powder formulation group （2 582 yuan/cm） was significantly better than that of aqueous formulation group （6 729 yuan/cm）， with a statistically significant difference （P＜0.001）， and the result was consistent in the GHD and ISS subgroups as well as in the sensitivity analysis. No serious adverse drug reactions occurred in either powder formulation or aqueous formulation group， and there was no statistically significant difference in the incidence of various adverse reactions between two groups （P＞0.05）. CONCLUSIONS Short-acting rhGH powder and aqueous formulations have equivalent efficacy and safety， but the powder formulation has greater economic advantages.

For patients with abnormal thyroid function,the detection of peripheral blood coagulation indicators may be irregular,and there is a potential risk of thrombosis or bleeding.Patients with hyperthyroidism have significant endothelial dysfunction and risk of thrombosis.However,the reports on the effect of hypothyroidism on coagulation function are still controversial.The potential risk of abnormal thyroid function to the coagulation system may interfere with the safety of anticoagulant therapy,and the interaction between thyroid disease treatment drugs and anticoagulant drugs also affects the safety of the patient's medication.Therefore,this article is based on previous research literature,analyzes the correlation between abnormal thyroid function and coagulation function,and evaluates and discusses the impact of abnormal thyroid function on the coagulation system and related therapeutic drug interactions.It is expected to provide a reference for diagnosing and treating patients with thyroid dysfunction and abnormal coagulation function.

OBJECTIVE To evaluate the effectiveness of Polyene phosphatidylcholine capsules （PPC） as adjuvant therapy for chronic hepatitis B （CHB）. METHODS Retrospective data were collected from the patients diagnosed with CHB， treated with hepatoprotective drugs combined with antiviral drugs or antiviral drugs alone， and underwent long-term follow-up in the outpatient department of Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital from January 1， 2017 to December 31， 2022. After balancing confounding factors through propensity score matching， the effectiveness of PPC combined with antiviral therapy versus antiviral therapy alone （PPC+antiviral group versus antiviral group） and PPC+Diammonium glycyrrhizinate enteric- coated capsules （DGC） combined with antiviral therapy versus DGC combined with antiviral therapy （PPC+DGC+antiviral group versus DGC+antiviral group） as therapy for CHB were compared under real medical conditions. RESULTS Totally 382 patients with CHB who received hepatoprotective agents based on antiviral therapy （221， 63 and 98 patients who received DGC， PPC and combination therapy， respectively） and 400 patients who received antiviral therapy alone were ultimately included. After propensity score matching， there were 47 patients each in the PPC+antiviral group and the antiviral group， respectively； after treatment， the alanine transaminase （ALT） levels in the PPC+antiviral group were significantly reduced compared to before treatment and the antiviral group at the same time （P＜0.05）， while there was no statistically significant difference in the ALT normalization rate between the two groups （P＞0.05）. There were 74 patients each in the PPC+DGC+antiviral group and the DGC+antiviral group， respectively； after treatment， the ALT levels of patients in both groups were significantly reduced compared to before treatment， the ALT levels of PPC+DGC+antiviral group were significantly lower than those in the DGC+antiviral group at the same time， and the ALT normalization rate was significantly higher in the PPC+DGC+antiviral group than that in the DGC+antiviral group （P＜0.05）. CONCLUSIONS Based on using antiviral drugs to treat CHB， adjuvant therapy combined with PPC has a significant advantage in reducing liver enzymes； in addition， compared with the DGC combined antiviral regimen， the dual hepatoprotective drug of DGC and PPC combined with an antiviral regimen has better effects on liver protection and reduction of liver enzymes.

With the widespread use of carbapenem antibiotics,the clinical detection rate of carbapenem-resistant Gram-negative bacilli has shown a significant increase.Carbapenem-resistant Gram-negative bacilli isolates are often extensively or fully resistant,resulting in limited antimicrobial treatment options and high morbidity and mortality rates,posing a serious public health threat.The clinical treatment of carbapenem-resistant Gram-negative bacilli includes the use of single or combination antimicrobials such as polymyxin,tigecycline,and fosfomycin.A number of new antimicrobials and therapeutic approaches are under development.The clinical management of carbapenem-resistant Gram-negative infections is severely challenged by the limited choice of antimicrobial agents.Therefore,this article reviews the current status and progress of antimicrobial treatment for carbapenem-resistant Gram-negative bacilli to providing clinical reference.

OBJECTIVE To analyze the current status， hotspots and development trends of research on the treatment of non-alcoholic fatty liver disease （NAFLD）， providing reference for subsequent research. METHODS Searching the Web of Science database， the literature related to the treatment of NAFLD from the establishment of the database to December 31， 2022 were collected. CiteSpace 6.1.R6 was used to construct a visual atlas， perform collaborative network analysis on authors， countries and institutions， and conduct keyword co-occurrence， clustering and emergence analysis to explore its research status and hotspots. RESULTS A total of 3 882 articles were included， and the number of publications had been increasing year by year. The top three countries in terms of publication volume were China， the United States， and Japan. The author with the highest volume of publications was Sanyal from the United States （37 articles）， while the institution with the highest volume of publications was the University of California， San Diego （75 articles）. A closely connected research team abroad mainly conducted large-scale randomized controlled trials （RCT） to evaluate the effectiveness and safety of various interventions， including medication and lifestyle， in treating NAFLD. However， domestic researches mainly focused on basic researches about the treatment of NAFLD with effective medicinal ingredients， and were characterized by traditional Chinese medicine. There were relatively few high-quality large-scale RCT studies related to it. Keyword analysis showed that researches in various countries mainly focused on regulating liver oxidative stress and inflammation， improving the overall balance of glucose and lipid metabolism. Except for hypoglycemic drugs， drugs that act on various comprehensive metabolic homeostasis targets in the body had entered clinical research， and had enormous therapeutic potential. CONCLUSIONS The research on NAFLD treatment continues to grow in popularity and tends to research targets and drugs for regulating systemic metabolic homeostasis. As the main force of research， China should strengthen communication with the international community， grasp the trends and directions of basic research， attach importance to clinical research， and continuously tap the therapeutic potential of traditional Chinese medicine.

Clinical comprehensive evaluation of drugs is an important technical tool for drug supply assurance decision - making，which requires evaluation subjects to use multiple evaluation methods and tools to carry out a comprehensive evaluation of multi-dimensional and multi -level evidence for drugs . Multi-criteria decision analysis （MCDA）is an important method for clinical comprehensive evaluation of drugs ，including weight assignment and comprehensive evaluation . Step-wise weight assessment ratio analysis（SWARA）is a weighting method for MCDA ，which can determine indicator weight concisely and accurately compared to other methods . This paper introduces the method of SWARA ，and systematically reviews the application of SWARA in the comprehensive clinical evaluation of drugs . Currently，the SWARA method is used in various research areas . Within the field of pharmaceuticals，researchers use the SWARA method to build MCDA models and calculate specific weight values for each drug evaluation criterion by consulting a team of experts . The advantage of SWARA is that it provides a brand -new way of assigning the weight of drug evaluation criterion by consulting experts ’opinions or judgments according to corresponding steps to solve the MCDA problem in the medical field ；however，it has certain subjectivity and uncertainty in solving complex decision -making problems，and there may also be problems such as insufficient screening of evaluation criterion and incomplete coverage of topics ， which should be paid attention to in application .

Objective To investigate the application prospect of the most extensive genome engineering pig internationally in preclinical xenotransplantation. Methods Porcine endogenous retrovirus (PERV) knockout combined with 3 major heterologous antigen gene knockouts and 9 humanized genes for inhibition of complement activation, regulation of coagulation disorders, anti-inflammatory and anti-phagocytosis were transferred into a pig (PERV-KO/3-KO/9-TG) as a donor, and the heart, liver and kidney were obtained and transplanted to 3 Rhesus macaque recipients respectively to establish a preclinical research model of pig-to-Rhesus macaque xenotransplantation. The functional status of xenografts after blood flow reconstruction was observed and the survival of recipients was summarized. The hemodynamics of xenografts were monitored. The change of hematological indexes of each recipient was compared. The histopathological manifestation of xenografts was observed. Results After the blood flow was reconstructed, all xenografts showed ruddy color, soft texture and good perfusion. The transplant heart, liver and kidney showed full arterial and venous blood flow and good perfusion at 1 d after operation. The postoperative survival time of heart, liver, and kidney transplant recipients was 7, 26, and 1 d, respectively. The levels of creatine kinase, creatine kinase isoenzyme, and lactate dehydrogenase increased in heart transplant recipient at 1 d after operation, and gradually recovered to near normal levels at 6 d after operation. All indexes increased sharply at 7 d after operation. The level of aspartate aminotransferase increased in liver transplant recipients at 2 d after operation, and the alanine aminotransferase basically returned to normal at 10 d after operation, but the total bilirubin continued to increase. Both aspartate aminotransferase and alanine aminotransferase increased at 12 d after operation, and reached a peak at 15 d after operation. The kidney transplant recipient developed mild proteinuria at 1 d after operation, and died of sudden severe arrhythmia. Histopathology showed that the tissue structure of cardiac and renal xenografts was close to normal, and liver xenografts presented with patchy necrosis, the liver tissue structure was disordered, accompanied by inflammatory damage, interstitial hemorrhage and thrombotic microangiopathy. Conclusions PERV-KO/3-KO/9-TG pig shows advantages in overcoming hyperacute rejection, mitigating humoral rejection and coagulation dysregulation. However, whether it can be used as potential donor for clinical xenotransplantation needs further evaluation.

OBJECTIVE：To provide reference for clinical safe and rational drug use by mining adverse drug events （ADE） signals for tocilizumab. METHODS ：Data of ADE reports related to tocilizumab in the first quarter of 2015 to second quarter of 2020 were collected from US FDA adverse event reporting system. After data standardization ，the proportional imbalance method was used for ADE signal mining. RESULTS ：A total of 163 718 ADE reports were extracted ，in which tocilizumab was primary suspected drug ，involving 26 674 patients. In 26 674 patients，the proportion of female （73.69％）was higher than that of male （19.04％），and the age was mainly 60-74 years old （21.19％）. Among the 163 718 ADE reports ，the main reporting countries were the United States （70.15％），Canada（15.95％），Japan（3.33％），Australia（3.05％）and Brazil （1.43％）；consumers （31.35％）and doctors （24.94％）were the main reporting staff. A total of 747 ADE signals for tocilizumab were obtained ， commonly rheumatoid arthritis ，joint pain and pain ；and the signals as the increase of disability assessment scale score ，the decrease of disability assessment scale score ，abnormal diastolic blood pressure and abnormal systolic blood pressure were strong. A total of 33 kinds of ADE signals were found ，which were not recorded in the instructions of tocilizumab ，and mainly abnormal laboratory indicators such as decreased oxygen saturation ，decreased blood pressure and abnormal heart rate. ADE mainly involved 27 system organs ，including musculoskeletal and connective tissue ，various reactions of systemic diseases and drug delivery site ， various examinations. CONCLUSIONS ：In addition to the ADE mentioned in the drug instructions ，when using tocilizumab in clinic，attention should also be paid close to blood oxygen saturation ，blood pressure ，blood routine indexes and other laboratory indicators，and intervention measures should be taken early when ADE occurs ，so as to ensure the safety and effectiveness of drug use.

OBJECTIVE： To explore the role of clinical pharmacists in medication therapy management （MTM）. METHODS： Referring to the practice model of MTM in the United States， taking a noninfectious chronic disease （obesity diabetes mellitus） patient as an example， clinical pharmacists of endocrinology specialty carried out MTM according to five processes， such as patient information collection， medication therapy review， the formulation of medication-related action plan （MRP）， interventions related to direct communication with physicians or advising patients to consult relevant medical service personnel， record and follow-up. RESULTS： The information of patients collected by clinical pharmacists included past medical history， family history， allergy history and medication history， etc. It was the top priority MRP for this patient to identify inappropriate hypoglycemic drug therapy， obesity-induced obstructive sleep apnea-hypopnea syndrome and hyperlipidemia. For obesity patients with type 2 diabetes mellitus， clinical pharmacists recommend that patients changed insulin drugs to non-insulin drugs， and liraglutide was recommended. In view of the poor control of blood lipid level， fenofibrate was recommended for patients on the basis of oral administration of simvastatin. The patient’s attending physician agreed with the above suggestion and adjusted the prescription. Clinical pharmacists provided medication education for the patients about the importance of each drug， control of total energy intake， balanced diet and physical exercise. The follow-up results after 6 months showed that blood glucose （fasting blood glucose 5-7 mmol/L， postprandial blood glucose 8-10 mmol/L） and blood lipid （total cholesterol 4.80 mmol/L， triglyceride 1.60 mmol/L， low density lipoprotein 3.05 mmol/L） of the patient were effectively controlled and body weight was reduced by 3 kg， but the improvement of lifestyle was poor， mainly due to the nature of his work. Clinical pharmacists once again communicated with him and emphasized the importance of proper physical exercise. The patients agreed to continue the follow-up. CONCLUSIONS： Clinical pharmacists can provide professional consultation and service for patients with chronic diseases by means of MTM service mode， which has certain value for improving medical quality.

OBJECTIVE:To investigate the status quo of knowledge-attitude-practice(KAP)of medication in residents,and to explore potential risk factors that may affect medication. METHODS:By approximate random sampling,online(wenjuanxing)and offline method (5 communities of Chengdu city) were used to collect general information (gender, age, monthly income, residence,medical insurance,education level,working condition,occupation)of the residents aged 19 year-old above and conduct KAP investigation during Jul.-Aug. 2017. Multiple linear regression analysis was used to analyze the influence of residents'general information on KAP. RESULTS:A total of 517 online and offline valid questionnaires were obtained, including 200 offline questionnaires were sent out and 184 valid questionnaires were returned with recovery rate of 92％. Average scores of medication knowledge,attitude and practice were (71.4 ± 32.3),(33.7 ± 14.0),(60.7 ± 19.4),which all reached"good"in the evaluation standard of questionnaire results. The results of multiple linear regression showed that elderly and low education level were the significant influential factors of residents'lack of medication knowledge. The male,elderly,low income and low education level were the influential factors of poor drug use behavior. The residents with poor attitudes towards medication were low income and low educated population. CONCLUSIONS:The average risk of residents'medication in China is low,but it is still necessary to strengthen medication education for special people. It is requisite to focus on the elderly,the low education level,the low income population and the male residents.