1.Identification of a JAK-STAT-miR155HG positive feedback loop in regulating natural killer (NK) cells proliferation and effector functions.
Songyang LI ; Yongjie LIU ; Xiaofeng YIN ; Yao YANG ; Xinjia LIU ; Jiaxing QIU ; Qinglan YANG ; Yana LI ; Zhiguo TAN ; Hongyan PENG ; Peiwen XIONG ; Shuting WU ; Lanlan HUANG ; Xiangyu WANG ; Sulai LIU ; Yuxing GONG ; Yuan GAO ; Lingling ZHANG ; Junping WANG ; Yafei DENG ; Zhaoyang ZHONG ; Youcai DENG
Acta Pharmaceutica Sinica B 2025;15(4):1922-1937
The Janus kinase/signal transducers and activators of transcription (JAK-STAT) control natural killer (NK) cells development and cytotoxic functions, however, whether long non-coding RNAs (lncRNAs) are involved in this pathway remains unknown. We found that miR155HG was elevated in activated NK cells and promoted their proliferation and effector functions in both NK92 and induced-pluripotent stem cells (iPSCs)-derived NK (iPSC-NK) cells, without reliance on its derived miR-155 and micropeptide P155. Mechanistically, miR155HG bound to miR-6756 and relieved its repression of JAK3 expression, thereby promoting the JAK-STAT pathway and enhancing NK cell proliferation and function. Further investigations disclosed that upon cytokine stimulation, STAT3 directly interacts with miR155HG promoter and induces miR155HG transcription. Collectively, we identify a miR155HG-mediated positive feedback loop of the JAK-STAT signaling. Our study will also provide a power target regarding miR155HG for improving NK cell generation and effector function in the field of NK cell adoptive transfer therapy against cancer, especially iPSC-derived NK cells.
2.Ethnic differences in genotype distribution of thalassemia between Han and Li populations in southern Hainan
Yongjing TANG ; Zhixia LI ; Bangruo QI ; Feichen XIU ; Lin YANG ; Qin YANG ; Qinglan TANG ; Xiaopeng LAN ; Yufeng WANG
Chinese Journal of Preventive Medicine 2025;59(9):1540-1545
To analyze the ethnic differences in the genotype distribution of thalassemia between the Han and Li ethnic groups in the Qiongnan region (southern Hainan). A cross-sectional study employing a stratified multistage sampling method was conducted from January 2019 to December 2023. A total of 4 493 high-risk individuals (2 734 Han and 1 759 Li) from southern Hainan (including Sanya, Ledong, Baoting, Lingshui, and other counties) underwent thalassemia genetic testing. The genotype distribution was statistically analyzed. Inter-group comparisons were performed using χ2 test or Fisher′s exact test. The results showed an overall thalassemia positivity rate of 66.70% (2 997/4 493), with carrier, intermediate and major thalassemia rates of 62.01% (2 786/4 493), 3.98% (179/4 493) and 0.71% (32/4 493), respectively. The positivity rates for thalassemia were 87.83% (1 545/1 759) in the Li ethnic group and 53.11% (1 452/2 734) in the Han ethnic group. Among them, the Li ethnic group exhibited significantly higher positivity rates for α-thalassemia (71.12% vs. 40.64%, χ2=398.90, P<0.001) and α/β-compound thalassemia (13.36% vs. 3.33%, χ2=160.06, P<0.001) compared to the Han ethnic group, whereas the Han ethnic group had a higher β-thalassemia rate (9.14% vs. 3.35%, χ2=56.03, P<0.001). Both ethnic groups shared common α-thalassemia alleles (-α 3.7 and -α 4.2), but the -- SEA allele proportion was significantly higher in Han (21.33% vs. 4.34%, χ2=231.45, P<0.001). Six rare -α 21.9 mutations (0.26%) were exclusively identified in the Li ethnic group, whereas none were found in Han. For β-thalassemia, the β CD41-42 allele was predominant in Li (96.60% vs. 71.01%, χ2=77.24, P<0.001), whereas other alleles (β IVS-II-654, β CD71-72, β CD17, and β -28) were more prevalent in Han (11.01%, 6.96%, 4.64%, and 3.19% vs. 1.54%, 0.00%, 0.31%, and 0.62%, respectively),all P<0.05. In conclusion, distinct ethnic disparities in thalassemia genotype distribution are observed in southern Hainan. The Li ethnic group is predominantly characterized by α-thalassemia and α/β-compound genotypes with a predominant β CD41-42 mutation. In contrast, the Han ethnic group displays higher -- SEA proportion and heterogeneous β-thalassemia genotypes.
3.Clinical effect of collagen injection in improving periorbital aging
Qinglan LAI ; Yang BAO ; Guangyu CHEN
Chinese Journal of Plastic Surgery 2025;41(3):256-263
Objective:To investigate the clinical efficacy and safety of collagen injection in improving periorbital aging.Methods:The data of patients receiving collagen injections treated for periorbital aging at Hangzhou Xueran Medical Beauty Clinic from December 2023 to July 2024 were analyzed retrospectively. Pre-injection facial photographs were taken to assess periorbital aging severity. A domestic collagen filler (35 mg/ml premixed with 0.3% lidocaine) was injected. First, 30 G sharp needle was used to inject filler into the periorbital periosteal layer through 6 points on each side. After that, 27 G blunt needle was used to give falloped flat injection in the subcutaneous and under the orbicularis oculi muscle, respectively, from 2 points on each side. Total doses (1-6 ml) were determined by aging severity. Based on prior pain perception experiences, injection sites were categorized into three zones. Psychological interventions were implemented during left facial injections, while right facial injections served as non-intervention controls. Post-procedure care included erythromycin ointment application and ice compression. Patient images were obtained immediately post-treatment, at 1 month, and 3 months after treatment. Periorbital aging rating scale (PARS) was assessed by third-party. The higher the scale rating, the more severe the periorbital aging. After treatment, a reduction of 1 grade from the pre-treatment rating was regarded as effective improvement, and a reduction of ≥2 grades was regarded as significant improvement. Global aesthetic improvement scale (GAIS) was assessed by the patients. The full score was 5, the higher the score, the greater the improvement. The patient satisfaction was evaluated by self-made scale. The effectiveness of psychological intervention was evaluated by patients immediately after treatment. The complications were followed up and recorded. SPSS 26.0 software was used for statistical analysis, and the measurement data were expressed as Mean±SD. Paired sample t-test was used to compare the same patient before and after treatment. Counting data was expressed as cases (%). Results:A total of 45 patients were included, including 10 males and 35 females, aged (35.6±8.0) years (25-55 years). All patients were followed up. PARS evaluation showed that, PARS rating at immediately after injection, 1 month and 3 months after injection[(1.3±0.7), (1.1±0.6), (1.2±0.7) grade] was significantly decreased ( t=23.45, 25.38, 26.36, all P<0.001), compared with that before treatment[(2.2±0.6) grade]. All patients achieved significant or effective improvement immediately and 1 month after treatment. Only 1 patient’s rating recovered to the pre-treatment level 3 months after treatment. After treatment, GAIS scores remained stable as 4.8±0.4 (immediate) vs. 4.9±0.3 (1-month) vs. 4.6±0.5 (3-month), showing no significant differecnce ( t=-1.98, 1.52; P=0.058, 0.135). 44 cases (97.8%) reported satisfied results and maintained improvement with high satisfaction, while 1 case (2.2%) noted mostly loss at 3 months. All patients (100%) perceived enhanced comfort during left-side psychological interventions. Adverse events included 1 case (2.2%) of transient ecchymosis resolving within 5 days. No allergies, nodules, or vascular complications occurred. Natural dynamic expressions were maintained in all patients at 3 months. Conclusion:Periocular collagen injection can effectively improve the signs of aging around the eyes and exhibit good long-term effect. The implementation of psychological interventions during the injection treatment can effectively alleviate fear and anxiety, significantly enhance treatment comfort.
4.Progress in antioxidant effect of exercise for alleviating skeletal muscle dysfunction in chronic obstructive pulmonary disease
Chen YANG ; Peijun LI ; Yingqi WANG ; Lihua HAN ; Qinglan HE ; Xiaodan LIU ; Weibing WU
Chinese Journal of Pathophysiology 2025;41(1):195-201
Skeletal muscle dysfunction is a common extra-pulmonary complication in patients with chronic ob-structive pulmonary disease(COPD),significantly impacting exercise capacity and quality of life,leading to a poorer prognosis and increased mortality.Oxidative stress closely associates with the development and progression of skeletal muscle dysfunction in COPD.Exercise,a core component of pulmonary rehabilitation,stands as the primary non-pharma-cological treatment for skeletal muscle dysfunction in COPD patients and exerts a positive modulating effect on oxidative stress.This paper reviews the effects of oxidative stress on skeletal muscle dysfunction in COPD and discusses the mecha-nisms by which exercise improves skeletal muscle dysfunction in COPD from an anti-oxidative stress perspective.It has been found that oxidative stress affects the structure and function of muscles in COPD patients by upregulating the protein hydrolysis system,disrupting mitochondrial function,and impairing calcium homeostasis.Mechanisms by which exercise modulates oxidative stress to improve skeletal muscle dysfunction include the activation of antioxidant genes such as silent mating type information regulation 2 homolog 1 and nuclear factor erythroid 2 related factor to enhance the body's antioxi-dant capacity,inhibiting muscle atrophy.Exercise also regulates mitochondrial reactive oxygen species metabolism,im-proving mitochondrial function,and reduces oxidase activity to protect sarcoplasmic reticulum calcium regulation.In con-clusion,the regulation of skeletal muscle oxidative stress by exercise is a crucial target for improving skeletal muscle dys-function in COPD.
5.Feature of Cardiovascular-kidney-metabolic Syndrome Among Ethnic Minorities in Yunnan,China
Nuerguli TUERDI ; Xue CAO ; Yujie ZHANG ; Zixuan DONG ; Weiping LI ; Fan LI ; Xin WANG ; Congyi ZHENG ; Yixin TIAN ; Chenye CHANG ; Xuyan PEI ; Qinglan JIA ; Jialu YANG ; Zengwu WANG
Chinese Circulation Journal 2025;40(10):1022-1029
Objectives:To investigate the epidemiological characteristics and ethnic differences of cardiovascular-kidney-metabolic syndrome(CKM)among the Hani,Dai,Bai,and Lisu populations in Yunnan Province,and to provide evidence for developing effective prevention and control strategies for CKM.Methods:A cross-sectional survey was conducted among four ethnic minority groups.A total of 3 906 permanent residents aged 18 years and older were enrolled using a multistage cluster random sampling method.CKM stages(0-4)were defined based on the 2023 American Heart Association criteria,stages 3-4 were classified as advanced CKM.Descriptive statistics and chi-square tests were used to compare the prevalence of CKM stages across ethnic groups.Modified Poisson regression was applied to estimate relative risk(RR)and 95%confidence intervals(CI)for factors associated with advanced CKM.Results:The prevalence rates of CKM stage 1 and above among the Hani,Dai,Bai and Lisu ethnic groups were 80.1%,87.3%,84.8%and 67.8%,respectively.The prevalence of CKM was generally higher in males than in females,and the prevalence of CKM increased significantly with age.The Dai ethnic group had the highest prevalence of advanced CKM(24.7%,95%CI:22.1%-27.4%),while the Lisu ethnic group had the lowest prevalence of advanced CKM(13.7%,95%CI:11.5%-15.9%).Modified Poisson regression analysis showed that older age and higher body mass index were common risk factors for advanced CKM across all four ethnic groups.Additionally,except for the Lisu ethnic group,the other three ethnic groups had specific individual risk factors:among the Hani ethnic group,low educational attainment(RR=2.18,95%CI:1.12-4.25)and low income(RR=1.47,95%CI:1.00-2.18)were the primary risk factors of CKM.Among the Dai ethnic group,smoking(RR=1.60,95%CI:1.07-2.37)and a family history of cardiovascular disease(RR=1.61,95%CI:1.14-2.27)are the primary risk factors of CKM.Among the Bai ethnic group,male gender(RR=0.48,95%CI:0.29-0.79)was the primary risk factor of CKM.Conclusions:The prevalence of CKM stage 1 or higher is relatively high among the four minority ethnic groups in Yunnan province.There are significant differences in staging characteristics and primary risk factors across ethnic groups,necessitating the development of stratified,differentiated intervention strategies to achieve precise prevention and control and ethnic health equity in terms of CKM.
6.Feature of Cardiovascular-kidney-metabolic Syndrome Among Ethnic Minorities in Yunnan,China
Nuerguli TUERDI ; Xue CAO ; Yujie ZHANG ; Zixuan DONG ; Weiping LI ; Fan LI ; Xin WANG ; Congyi ZHENG ; Yixin TIAN ; Chenye CHANG ; Xuyan PEI ; Qinglan JIA ; Jialu YANG ; Zengwu WANG
Chinese Circulation Journal 2025;40(10):1022-1029
Objectives:To investigate the epidemiological characteristics and ethnic differences of cardiovascular-kidney-metabolic syndrome(CKM)among the Hani,Dai,Bai,and Lisu populations in Yunnan Province,and to provide evidence for developing effective prevention and control strategies for CKM.Methods:A cross-sectional survey was conducted among four ethnic minority groups.A total of 3 906 permanent residents aged 18 years and older were enrolled using a multistage cluster random sampling method.CKM stages(0-4)were defined based on the 2023 American Heart Association criteria,stages 3-4 were classified as advanced CKM.Descriptive statistics and chi-square tests were used to compare the prevalence of CKM stages across ethnic groups.Modified Poisson regression was applied to estimate relative risk(RR)and 95%confidence intervals(CI)for factors associated with advanced CKM.Results:The prevalence rates of CKM stage 1 and above among the Hani,Dai,Bai and Lisu ethnic groups were 80.1%,87.3%,84.8%and 67.8%,respectively.The prevalence of CKM was generally higher in males than in females,and the prevalence of CKM increased significantly with age.The Dai ethnic group had the highest prevalence of advanced CKM(24.7%,95%CI:22.1%-27.4%),while the Lisu ethnic group had the lowest prevalence of advanced CKM(13.7%,95%CI:11.5%-15.9%).Modified Poisson regression analysis showed that older age and higher body mass index were common risk factors for advanced CKM across all four ethnic groups.Additionally,except for the Lisu ethnic group,the other three ethnic groups had specific individual risk factors:among the Hani ethnic group,low educational attainment(RR=2.18,95%CI:1.12-4.25)and low income(RR=1.47,95%CI:1.00-2.18)were the primary risk factors of CKM.Among the Dai ethnic group,smoking(RR=1.60,95%CI:1.07-2.37)and a family history of cardiovascular disease(RR=1.61,95%CI:1.14-2.27)are the primary risk factors of CKM.Among the Bai ethnic group,male gender(RR=0.48,95%CI:0.29-0.79)was the primary risk factor of CKM.Conclusions:The prevalence of CKM stage 1 or higher is relatively high among the four minority ethnic groups in Yunnan province.There are significant differences in staging characteristics and primary risk factors across ethnic groups,necessitating the development of stratified,differentiated intervention strategies to achieve precise prevention and control and ethnic health equity in terms of CKM.
7.Ethnic differences in genotype distribution of thalassemia between Han and Li populations in southern Hainan
Yongjing TANG ; Zhixia LI ; Bangruo QI ; Feichen XIU ; Lin YANG ; Qin YANG ; Qinglan TANG ; Xiaopeng LAN ; Yufeng WANG
Chinese Journal of Preventive Medicine 2025;59(9):1540-1545
To analyze the ethnic differences in the genotype distribution of thalassemia between the Han and Li ethnic groups in the Qiongnan region (southern Hainan). A cross-sectional study employing a stratified multistage sampling method was conducted from January 2019 to December 2023. A total of 4 493 high-risk individuals (2 734 Han and 1 759 Li) from southern Hainan (including Sanya, Ledong, Baoting, Lingshui, and other counties) underwent thalassemia genetic testing. The genotype distribution was statistically analyzed. Inter-group comparisons were performed using χ2 test or Fisher′s exact test. The results showed an overall thalassemia positivity rate of 66.70% (2 997/4 493), with carrier, intermediate and major thalassemia rates of 62.01% (2 786/4 493), 3.98% (179/4 493) and 0.71% (32/4 493), respectively. The positivity rates for thalassemia were 87.83% (1 545/1 759) in the Li ethnic group and 53.11% (1 452/2 734) in the Han ethnic group. Among them, the Li ethnic group exhibited significantly higher positivity rates for α-thalassemia (71.12% vs. 40.64%, χ2=398.90, P<0.001) and α/β-compound thalassemia (13.36% vs. 3.33%, χ2=160.06, P<0.001) compared to the Han ethnic group, whereas the Han ethnic group had a higher β-thalassemia rate (9.14% vs. 3.35%, χ2=56.03, P<0.001). Both ethnic groups shared common α-thalassemia alleles (-α 3.7 and -α 4.2), but the -- SEA allele proportion was significantly higher in Han (21.33% vs. 4.34%, χ2=231.45, P<0.001). Six rare -α 21.9 mutations (0.26%) were exclusively identified in the Li ethnic group, whereas none were found in Han. For β-thalassemia, the β CD41-42 allele was predominant in Li (96.60% vs. 71.01%, χ2=77.24, P<0.001), whereas other alleles (β IVS-II-654, β CD71-72, β CD17, and β -28) were more prevalent in Han (11.01%, 6.96%, 4.64%, and 3.19% vs. 1.54%, 0.00%, 0.31%, and 0.62%, respectively),all P<0.05. In conclusion, distinct ethnic disparities in thalassemia genotype distribution are observed in southern Hainan. The Li ethnic group is predominantly characterized by α-thalassemia and α/β-compound genotypes with a predominant β CD41-42 mutation. In contrast, the Han ethnic group displays higher -- SEA proportion and heterogeneous β-thalassemia genotypes.
8.Progress in antioxidant effect of exercise for alleviating skeletal muscle dysfunction in chronic obstructive pulmonary disease
Chen YANG ; Peijun LI ; Yingqi WANG ; Lihua HAN ; Qinglan HE ; Xiaodan LIU ; Weibing WU
Chinese Journal of Pathophysiology 2025;41(1):195-201
Skeletal muscle dysfunction is a common extra-pulmonary complication in patients with chronic ob-structive pulmonary disease(COPD),significantly impacting exercise capacity and quality of life,leading to a poorer prognosis and increased mortality.Oxidative stress closely associates with the development and progression of skeletal muscle dysfunction in COPD.Exercise,a core component of pulmonary rehabilitation,stands as the primary non-pharma-cological treatment for skeletal muscle dysfunction in COPD patients and exerts a positive modulating effect on oxidative stress.This paper reviews the effects of oxidative stress on skeletal muscle dysfunction in COPD and discusses the mecha-nisms by which exercise improves skeletal muscle dysfunction in COPD from an anti-oxidative stress perspective.It has been found that oxidative stress affects the structure and function of muscles in COPD patients by upregulating the protein hydrolysis system,disrupting mitochondrial function,and impairing calcium homeostasis.Mechanisms by which exercise modulates oxidative stress to improve skeletal muscle dysfunction include the activation of antioxidant genes such as silent mating type information regulation 2 homolog 1 and nuclear factor erythroid 2 related factor to enhance the body's antioxi-dant capacity,inhibiting muscle atrophy.Exercise also regulates mitochondrial reactive oxygen species metabolism,im-proving mitochondrial function,and reduces oxidase activity to protect sarcoplasmic reticulum calcium regulation.In con-clusion,the regulation of skeletal muscle oxidative stress by exercise is a crucial target for improving skeletal muscle dys-function in COPD.
9.Clinical effect of collagen injection in improving periorbital aging
Qinglan LAI ; Yang BAO ; Guangyu CHEN
Chinese Journal of Plastic Surgery 2025;41(3):256-263
Objective:To investigate the clinical efficacy and safety of collagen injection in improving periorbital aging.Methods:The data of patients receiving collagen injections treated for periorbital aging at Hangzhou Xueran Medical Beauty Clinic from December 2023 to July 2024 were analyzed retrospectively. Pre-injection facial photographs were taken to assess periorbital aging severity. A domestic collagen filler (35 mg/ml premixed with 0.3% lidocaine) was injected. First, 30 G sharp needle was used to inject filler into the periorbital periosteal layer through 6 points on each side. After that, 27 G blunt needle was used to give falloped flat injection in the subcutaneous and under the orbicularis oculi muscle, respectively, from 2 points on each side. Total doses (1-6 ml) were determined by aging severity. Based on prior pain perception experiences, injection sites were categorized into three zones. Psychological interventions were implemented during left facial injections, while right facial injections served as non-intervention controls. Post-procedure care included erythromycin ointment application and ice compression. Patient images were obtained immediately post-treatment, at 1 month, and 3 months after treatment. Periorbital aging rating scale (PARS) was assessed by third-party. The higher the scale rating, the more severe the periorbital aging. After treatment, a reduction of 1 grade from the pre-treatment rating was regarded as effective improvement, and a reduction of ≥2 grades was regarded as significant improvement. Global aesthetic improvement scale (GAIS) was assessed by the patients. The full score was 5, the higher the score, the greater the improvement. The patient satisfaction was evaluated by self-made scale. The effectiveness of psychological intervention was evaluated by patients immediately after treatment. The complications were followed up and recorded. SPSS 26.0 software was used for statistical analysis, and the measurement data were expressed as Mean±SD. Paired sample t-test was used to compare the same patient before and after treatment. Counting data was expressed as cases (%). Results:A total of 45 patients were included, including 10 males and 35 females, aged (35.6±8.0) years (25-55 years). All patients were followed up. PARS evaluation showed that, PARS rating at immediately after injection, 1 month and 3 months after injection[(1.3±0.7), (1.1±0.6), (1.2±0.7) grade] was significantly decreased ( t=23.45, 25.38, 26.36, all P<0.001), compared with that before treatment[(2.2±0.6) grade]. All patients achieved significant or effective improvement immediately and 1 month after treatment. Only 1 patient’s rating recovered to the pre-treatment level 3 months after treatment. After treatment, GAIS scores remained stable as 4.8±0.4 (immediate) vs. 4.9±0.3 (1-month) vs. 4.6±0.5 (3-month), showing no significant differecnce ( t=-1.98, 1.52; P=0.058, 0.135). 44 cases (97.8%) reported satisfied results and maintained improvement with high satisfaction, while 1 case (2.2%) noted mostly loss at 3 months. All patients (100%) perceived enhanced comfort during left-side psychological interventions. Adverse events included 1 case (2.2%) of transient ecchymosis resolving within 5 days. No allergies, nodules, or vascular complications occurred. Natural dynamic expressions were maintained in all patients at 3 months. Conclusion:Periocular collagen injection can effectively improve the signs of aging around the eyes and exhibit good long-term effect. The implementation of psychological interventions during the injection treatment can effectively alleviate fear and anxiety, significantly enhance treatment comfort.
10.Distribution and antimicrobial resistance of Enterobacter cloacae complex isolated from a tertiary hospital in Shanghai
Xiaoying YANG ; Chen WANG ; Mengyun YIN ; Youxing SHAO ; Fupin HU ; Minggui WANG ; Qinglan GUO
Chinese Journal of Infection and Chemotherapy 2024;24(3):332-337
Objective To investigate the distribution and antimicrobial resistance of Enterobacter cloacae complex(ECC)isolated from a tertiary hospital in Shanghai.Methods Clinical ECC isolates were collected from 2018 to 2020.Antimicrobial susceptibility test was performed with broth microdilution and agar dilution methods.PCR was applied to detect five carbapenemase genes(blaKPC,blaNDM,blaIMP,blaVIM and blaOXA-48).Results A total of 222 ECC isolates were collected from 2018-2020,including 36 strains(16.2%)from general surgery department.The strains were mainly isolated from sputum(41.0%)and urine(20.3%).MIC results showed that the isolates were highly resistant to trimethoprim-sulfamethoxazole,the second-and third-generation cephalosporins,aztreonam and quinolones(31.1%-71.2%resistant),but low resistance rates to tigecycline,amikacin,mecillinam,and ceftazidime-avibactam(0.5%-9.0%resistant).About 9.5%and 10.4%of the strains were resistant to meropenem and imipenem,respectively.A total of 34 ECC strains were carbapenem-nonsusceptible strains,of which 23 strains were resistant to carbapenems.Among the 34 carbapenem-nonsusceptible strains,25(73.5%)strains were susceptible to mecillinam,including 15 strains producing metallo-β-lactamase.PCR assay identified carbapenemase genes in 21 of the 34 carbapenem-nonsusceptible strains,including blaNDM(14 strains),blaIMP(5 strains)and blaKPC(2 strains).Compared with the strains isolated in 2018,the ECC strains isolated in 2019 and 2020 showed significantly higher resistance rates to imipenem and ceftazidime-avibactam(P<0.05),primarily associated with the production of NDM.Among the ECC strains resistant to third-generation cephalosporins,20.4%were resistant to imipenem and meropenem,while 4.9%and 8.7%were resistant to amikacin and mecillinam,respectively,and 9.7%were nonsusceptible to tigecycline.Conclusions The ECC isolates in 2019 and 2020 showed increasing resistance rates to carbapenems and ceftazidime-avibactam due to the production of metallo-β-lactamases.Some of the metallo-β-lactamase-producing ECC isolates were susceptible to mecillinam.

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