1.Shaoyaotang Regulates TLR4/MyD88/NF-κB Signaling Pathway to Protect Intestinal Mucosal Barrier in Ulcerative Colitis
Dongsheng WU ; Yu ZHANG ; Wenjing QUAN ; Wanqing XIONG ; Bo ZOU ; Youwei XIAO ; Ruoru HUANG ; Yan GONG ; Hui CAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):69-75
ObjectiveTo investigate the role of the Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)/nuclear factor-κB (NF-κB) signaling pathway in intestinal mucosal barrier damage in ulcerative colitis, as well as the intervention mechanism of Shaoyaotang. MethodsSixty SD rats were allocated into a blank group, a model group, a mesalazine (0.42 g·kg-1) group, and low-, medium-, and high-dose (11.1, 22.2, 44.4 g·kg-1, respectively) Shaoyaotang groups. A model of ulcerative colitis was induced by 2,4,6-trinitrobenzenesulfonic acid (TNBS). After successful modeling, rats were administrated with corresponding agents via gavage for 7 days. Changes in colon length and colon weight were observed. Hematoxylin-eosin staining was performed to examine the pathological changes of the colon, and immunohistochemistry was employed to detect the expression of the inflammatory cytokine interleukin-8 (IL-8), cyclooxygenase-2 (COX-2), junction adhesion molecule-1 (JAM-1), and claudin-1 in the colon. Western blot analysis was performed to determine the protein levels of TLR4, MyD88, and NF-κB in the colon. ResultsCompared with the blank group, the model group showed elevated DAI score (P<0.01), reduced colon length and colon weight (P<0.01), down-regulated protein levels of JAM-1 and claudin-1 (P<0.01), and up-regulated protein levels of IL-8, COX-2, TLR4, MyD88, and NF-κB p65 (P<0.01) in the colon tissue. Compared with the model group, each treatment group showed decreased DAI score (P<0.05, P<0.01), increased colon length and colon weight (P<0.05, P<0.01), up-regulated protein levels of JAM-1 and claudin-1 (P<0.01), and down-regulated protein levels of IL-8, COX-2, TLR4, MyD88, and NF-κB p65 (P<0.01) in the colon tissue. ConclusionShaoyaotang alleviates intestinal inflammation and intestinal mucosal damage to protect intestinal barrier integrity by regulating the TLR4/MyD88/NF-κB signaling pathway.
2.Nitrogen-doped Carbon-supported Ruthenium Metal Atom Nanozyme for Colorimetric Determination of Xanthine Oxidase Inhibitors
Quan-Yi LIU ; Qi FANG ; Hui WEI ; Yan DU
Chinese Journal of Analytical Chemistry 2025;53(4):516-524
A colorimetric detection method for xanthine oxidase activity and its inhibitors(XOI)based on nitrogen-doped carbon-supported ruthenium metal atom(Ru/NC)nanozyme was developed.Through a host-guest strategy,Ru/NC nanozyme with excellent peroxidase-like activity was prepared using zeolitic imidazolate framework-8(ZIF-8)as the host molecule and ruthenium acetylacetonate(Ru(acac)3)as the guest molecule.Based on its peroxidase-like catalytic activity,the visual method for detection of hydrogen peroxide(H 2O 2)and analysis of xanthine oxidase(XO)activity were developed.Under optimized experimental conditions,the linear detection range for H 2O 2 was 10-500 μmol/L,with a detection limit of 4.8 μmol/L(3σ);for XO activity analysis,the linear range was 1-7 mU/mL,with a detection limit of 0.69 mU/mL(3σ).Furthermore,an effective method for screening XOI was developed,which had the advantages of low cost,simplicity,and visualization.
3.An RNA-cleaving DNAzyme and G-Quadruplex DNAzyme-Cascade System for Sensing of Small Molecules in Organic Cosolvent
Su-Hui LI ; Shuai-Qi ZHANG ; Yi-Bo ZHANG ; Quan ZHENG ; Tian-Jun CHANG
Chinese Journal of Analytical Chemistry 2025;53(6):914-923
Detection of poor-water-soluble substances typically requires an organic solvent containing solution,and therefore,the biosensors that can operate in such conditions are highly promising for practical applications.However,most existing biosensors have been developed in aqueous solution and it is hard to work effectively in organic solvent systems.In this work,we uncovered that the G-quadruplex(G4)/hemin DNAzyme(G4HD)could be strongly reactivated by NH4 in organic solvents at concentration up to 30%,and the activity was significantly higher than that in aqueous solutions containing K+.Based on this discovery,a biosensing system was developed for small molecule in 40%methanol by coupling G4HD with our previously identified RNA-cleaving DNAzyme(E3).This system comprised an ATP-activated aptazyme that was made of E3 and a G4HD that was activated by the cleavage product of the aptazyme.By using a manmade pipette tip filter to separate the reaction products,the subsequent colorimetric reaction of the G4HD could be triggered.This biosensing system enabled the visualization of target molecules in organic cosolvents without any other instruments.The activable DNAzyme-cascade sensing system had potential in point-of-care detection of poor-water-soluble pollutants,thereby enhancing the practical values of functional nucleic acid-based biosensors in real-world detection conditions.
4.Effect of salidroside combined with rosavin on ischemic brain injury in rats
Wen-fang LAI ; Yu-ting JIANG ; Jing-quan CHEN ; Xue-rui ZHENG ; Hui-ling WU ; Qing-qing WU ; Yan CHEN ; Ya LIN
Chinese Pharmacological Bulletin 2025;41(11):2058-2065
Aim To study the mechanism of salidro-side combined with rosavin in rats with ischemic stroke.Methods The MCAO rats was established by using thread-embolic method.The rats were divided into the sham group,MCAO group,salidroside com-bined with rosavin group,and positive control group;the drug was given continuously for seven days.Western blot was used to detect apoptosis indicators.Proteomics was used to analyse differential proteins(DEPs).STEP receptor inhibitor was injected into the lateral ventricles,the rats were administered for seven days,then the apoptosis indicators were detected.Re-sults Salidroside combined with rosavin could reduce neurological function scores in MCAO rats and inhibit cell apoptosis.Quantitative proteomics identified 496 DEPs in brain tissue and discovered core proteins STEP,p38,and CRTC1.Salidroside combined with rosavin could promote the STEP and CRTC1 while in-hibiting p38 protein.After treatment with STEP inhibi-tor,those effects were reversed.Conclusion Salidro-side combined with rosavin can inhibit cell apoptosis in MCAO rats,which is closely related to the regulation of the STEP/p38/CRTC1 signaling pathway.
5.Astragaloside IV delayed the epithelial-mesenchymal transition in peritoneal fibrosis by inhibiting the activation of EGFR and PI3K-AKT pathways.
Ying HUANG ; Chen-Ling CHU ; Wen-Hui QIU ; Jia-Yi CHEN ; Lu-Xi CAO ; Shui-Yu JI ; Bin ZHU ; Guo-Kun WANG ; Quan-Quan SHEN
Journal of Integrative Medicine 2025;23(6):694-705
OBJECTIVE:
Peritoneal fibrosis (PF) is an adverse event that occurs during long-term peritoneal dialysis, significantly impairing treatment efficiency and adversely affecting patient outcomes. Astragaloside IV (AS-IV), a principal active component derived from Astragalus membranaceus (Fisch.) Bunge, has exhibited anti-inflammatory and antifibrotic effects in various settings. This study aims to investigate the potential therapeutic efficacy and mechanism of AS-IV in the treatment of PF.
METHODS:
The PF mouse model was established by intraperitoneal injection of 4.25% peritoneal dialysis fluid (100 mL/kg). The epithelial-mesenchymal transition (EMT) of HMrSV5 cells was induced by the addition of 10 ng/mL transforming growth factor β (TGF-β). The differentially expressed genes in HMrSV5 cells treated with AS-IV were screened using transcriptome sequencing analysis. The potential targets of AS-IV were screened using network pharmacology and analyzed using molecular docking and molecular dynamics simulations.
RESULTS:
Administration of AS-IV at doses of 20, 40, or 80 mg/kg effectively mitigated the increase in peritoneal thickness and the development of fibrosis in mice with PF. The expression of the fibrosis marker α-smooth muscle actin in the peritoneum was significantly decreased in AS-IV-treated mice. The treatment of AS-IV (10, 20, and 40 μmol/L) significantly delayed the EMT of HMrSV5 cells induced by TGF-β, as demonstrated by the decreased number of 5-ethynyl-2'-deoxyuridine-positive cells, reduced migrated area, and decreased expression of fibrosis markers. A total of 460 differentially expressed genes were detected in AS-IV-treated HMrSV5 cells through transcriptome sequencing, with notable enrichment in the phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K)-AKT serine/threonine kinase 1 (AKT) signaling pathway. The reduced levels of phosphorylated PI3K (p-PI3K) and p-AKT were detected in HMrSV5 cells with AS-IV treatment. Epidermal growth factor receptor (EGFR) was predicted as a direct target of AS-IV, exhibiting strong hydrogen bond interactions. The activation of the PI3K-AKT pathway by the compound 740Y-P, and the activation of the EGFR pathway by NSC 228155 each partially counteracted the inhibitory effect of AS-IV on the EMT of HMrSV5 cells.
CONCLUSION
AS-IV delayed the EMT process in peritoneal mesothelial cells and slowed the progression of PF, potentially serving as a therapeutic agent for the early prevention and treatment of PF. Please cite this article as: Huang Y, Chu CL, Qiu WH, Chen JY, Cao LX, Ji SY, Zhu B, Wang GK, Shen QQ. Astragaloside IV delayed the epithelial-mesenchymal transition in peritoneal fibrosis by inhibiting the activation of EGFR and PI3K-AKT pathways. J Integr Med. 2025; 23(6):694-705.
Epithelial-Mesenchymal Transition/drug effects*
;
Animals
;
Saponins/pharmacology*
;
Triterpenes/pharmacology*
;
Mice
;
Peritoneal Fibrosis/pathology*
;
Proto-Oncogene Proteins c-akt/metabolism*
;
ErbB Receptors/metabolism*
;
Phosphatidylinositol 3-Kinases/metabolism*
;
Signal Transduction/drug effects*
;
Male
;
Humans
;
Molecular Docking Simulation
;
Cell Line
;
Mice, Inbred C57BL
6.Nogo-A Protein Mediates Oxidative Stress and Synaptic Damage Induced by High-Altitude Hypoxia in the Rat Hippocampus.
Jin Yu FANG ; Huai Cun LIU ; Yan Fei ZHANG ; Quan Cheng CHENG ; Zi Yuan WANG ; Xuan FANG ; Hui Ru DING ; Wei Guang ZHANG ; Chun Hua CHEN
Biomedical and Environmental Sciences 2025;38(1):79-93
OBJECTIVE:
High-altitude hypoxia exposure often damages hippocampus-dependent learning and memory. Nogo-A is an important axonal growth inhibitory factor. However, its function in high-altitude hypoxia and its mechanism of action remain unclear.
METHODS:
In an in vivo study, a low-pressure oxygen chamber was used to simulate high-altitude hypoxia, and genetic or pharmacological intervention was used to block the Nogo-A/NgR1 signaling pathway. Contextual fear conditioning and Morris water maze behavioral tests were used to assess learning and memory in rats, and synaptic damage in the hippocampus and changes in oxidative stress levels were observed. In vitro, SH-SY5Y cells were used to assess oxidative stress and mitochondrial function with or without Nogo-A knockdown in Oxygen Glucose-Deprivation/Reperfusion (OGD/R) models.
RESULTS:
Exposure to acute high-altitude hypoxia for 3 or 7 days impaired learning and memory in rats, triggered oxidative stress in the hippocampal tissue, and reduced the dendritic spine density of hippocampal neurons. Blocking the Nogo-A/NgR1 pathway ameliorated oxidative stress, synaptic damage, and the learning and memory impairment induced by high-altitude exposure.
CONCLUSION:
Our results demonstrate the detrimental role of Nogo-A protein in mediating learning and memory impairment under high-altitude hypoxia and suggest the potential of the Nogo-A/NgR1 signaling pathway as a crucial therapeutic target for alleviating learning and memory dysfunction induced by high-altitude exposure.
GRAPHICAL ABSTRACT
available in www.besjournal.com.
Animals
;
Oxidative Stress
;
Hippocampus/metabolism*
;
Rats
;
Nogo Proteins/genetics*
;
Male
;
Rats, Sprague-Dawley
;
Hypoxia/metabolism*
;
Altitude
;
Synapses
;
Humans
;
Altitude Sickness/metabolism*
7.Effect of salidroside combined with rosavin on ischemic brain injury in rats
Wen-fang LAI ; Yu-ting JIANG ; Jing-quan CHEN ; Xue-rui ZHENG ; Hui-ling WU ; Qing-qing WU ; Yan CHEN ; Ya LIN
Chinese Pharmacological Bulletin 2025;41(11):2058-2065
Aim To study the mechanism of salidro-side combined with rosavin in rats with ischemic stroke.Methods The MCAO rats was established by using thread-embolic method.The rats were divided into the sham group,MCAO group,salidroside com-bined with rosavin group,and positive control group;the drug was given continuously for seven days.Western blot was used to detect apoptosis indicators.Proteomics was used to analyse differential proteins(DEPs).STEP receptor inhibitor was injected into the lateral ventricles,the rats were administered for seven days,then the apoptosis indicators were detected.Re-sults Salidroside combined with rosavin could reduce neurological function scores in MCAO rats and inhibit cell apoptosis.Quantitative proteomics identified 496 DEPs in brain tissue and discovered core proteins STEP,p38,and CRTC1.Salidroside combined with rosavin could promote the STEP and CRTC1 while in-hibiting p38 protein.After treatment with STEP inhibi-tor,those effects were reversed.Conclusion Salidro-side combined with rosavin can inhibit cell apoptosis in MCAO rats,which is closely related to the regulation of the STEP/p38/CRTC1 signaling pathway.
8.Effects and related mechanisms of long non-coding RNA AC092295.2 on proliferation and invasion abilities of endometrial cancer cells
Xiaojie XUE ; Feirong LI ; Haiying DAI ; Duan CHEN ; Hui LIU ; Quan LI
Cancer Research and Clinic 2025;37(2):81-86
Objective:To investigate the effects and related mechanisms of long non-coding RNA (lncRNA) AC092295.2 expression on the proliferation and invasion abilities of endometrial cancer cells.Methods:The correlations between AC092295.2 expression level and overall survival (OS) and disease-free survival (DFS) of endometrial cancer patients (180 cases) were analyzed by cBioPortal database (updated in 2022). The miRNA with complementary nucleotide sequences to AC092295.2 was predicted by DIANA Tools sequencing tool. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the relative expression of AC092295.2 in human immortalised endometrial epithelial cell line hEEC and human endometrial cancer cell lines (KLE, AN3CA, Ishikawa, HEC-1A). Ishikawa cells with the lowest expression level of AC092295.2 were selected and divided into AC092295.2 overexpression group and control group, which were transfected with pGEX-AC092295.2 plasmid and pGEX-NC plasmid, respectively. qRT-PCR was used to detect the relative expression levels of AC092295.2 and miRNA-200c-3p (miR-200c-3p) in the two groups of cells. Methyl thiazol tetrazolium (MTT) method was used to detect cell viability. Transwell assay was used to detect cell invasion ability. Western blotting was used to detect the expression of proteins related to PTEN-AKT pathway. The dual luciferase reporter gene assay was used to verify the targeting relationship between AC092295.2 and miR-200c-3p.Results:The analysis results of cBioPortal database showed that the OS and DFS of endometrial cancer patients with high expression of AC092295.2 were better than those of patients with low expression (both P < 0.001); the expression levels of AC092295.2 and miR-200c-3p in endometrial cancer tissues were negatively correlated ( r = -0.846, P < 0.001). The results of qRT-PCR detection showed that the relative expression levels of AC092295.2 in endometrial cancer cell lines KLE, AN3CA, Ishikawa, HEC-1A and immortalized endometrial epithelial cell line hEEC were 0.56±0.09, 0.68±0.06, 0.17±0.07, 0.49±0.12 and 0.99±0.11, respectively, and the difference was statistically significant ( F = 35.10, P < 0.001); the relative expression levels of AC092295.2 in Ishikawa cells in the AC092295.2 overexpression group and the control group were 8.92±1.78 and 1.06±0.39, respectively, and the difference was statistically significant ( t = 4.31, P = 0.005). MTT assay results showed that the cell viability of Ishikawa cells in the AC092295.2 overexpression group was lower than that in the control group on days 2, 3, 4, and 5 (all P < 0.05). Transwell assay results showed that the number of invasive Ishikawa cells in the AC092295.2 overexpression group and the control group were 73±4 and 135±14, respectively, and the difference was statistically significant ( t = 4.25, P = 0.005). Western blotting results showed that the relative expression level of phosphatase and tensin homolog (PTEN) protein in Ishikawa cells in the AC092295.2 overexpression group was higher than that in the control group, while the relative expression levels of phosphorylated protein kinase B (p-AKT), Yes associated protein (YAP), murine double mimute 2 (MDM2), and bcl-2-associated death-promoting factor (BAD) proteins were lower than those in the control group. Dual luciferase reporter gene assay and qRT-PCR verified that AC092295.2 targeted negative regulation of miR-200c-3p expression. Conclusions:AC092295.2 is lowly expressed in endometrial cancer cells. Overexpression of AC092295.2 can inhibit the proliferation and invasion abilities of endometrial cancer cells, and its mechanism may be related to the expression of miR-200c-3p-PTEN-AKT signaling pathway.
9.National bloodstream infection bacterial resistance surveillance report 2023: Gram-positive bacteria
Chaoqun YING ; Jinru JI ; Zhiying LIU ; Qing YANG ; Haishen KONG ; Jiangqin SONG ; Hui DING ; Yanyan LI ; Yuanyuan DAI ; Haifeng MAO ; Pengpeng TIAN ; Lu WANG ; Yongyun LIU ; Yizheng ZHOU ; Jiliang WANG ; Yan JIN ; Donghong HUANG ; Hongyun XU ; Peng ZHANG ; Xinhua QIANG ; Hong HE ; Lin ZHENG ; Junmin CAO ; Zhou LIU ; Ying HUANG ; Yan GENG ; Haiquan KANG ; Dan LIU ; Guolin LIAO ; Lixia ZHANG ; Fenghong CHEN ; Yanhong LI ; Baohua ZHANG ; Haixin DONG ; Xiaoyan LI ; Donghua LIU ; Qiuying ZHANG ; Xuefei HU ; Liang GUO ; Sijin MAN ; Dijing SONG ; Rong XU ; Youdong YIN ; Kunpeng LIANG ; Aiyun LI ; Zhuo LI ; Hongxia HU ; Guoping LU ; Jinhua LIANG ; Qiang LIU ; Yinqiao DONG ; Jilu SHEN ; Shuyan HU ; Liang LUAN ; Jian LI ; Ling MENG ; Dengyan QIAO ; Xiusan XIA ; Bo QUAN ; Dahong WANG ; Chunhua HAN ; Xiaoping YAN ; Fei LI ; Shifu WANG ; Ping SHEN ; Yunbo CHEN ; Yonghong XIAO
Chinese Journal of Clinical Infectious Diseases 2025;18(2):118-132
Objective:To report the nationwide surveillance results of pathogenic profiles and antimicrobial resistance patterns of Gram-positive bloodstream infections in China in 2023.Methods:The clinical isolates of Gram-posttive bacteria from blood cultures were collected in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System(BRICS)during January to December 2023. Antimicrobial susceptibility testing was performed using the dilution method recommended by the Clinical and Laboratory Standards Institute(CLSI). Statistical analyses were conducted using WHONET 5.6 and SPSS 25.0 software.Results:A total of 4 385 Gram-positive bacterial isolates were obtained from 60 participating center. The top five pathogens were Staphylococcus aureus( n=1 544,35.2%),coagulase-negative Staphylococci( n=1 441,32.9%), Enterococcus faecium( n=574,13.1%), Enterococcus faecalis( n=385,8.8%),and α-hemolytic Streptococci( n=187,4.3%). The prevalence of methicillin-resistant Staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative Staphylococci(MRCNS)was 26.2%(405/1 544)and 69.8%(1 006/1 441),respectively. Notably,all Staphylococci remained susceptible to glycopeptide or daptomycin. Staphylococcus aureus demonstrated excellent susceptibility(>97.0%)to cephalobiol,rifampicin,trimethoprim-sulfamethoxazole,linezolid,minocycline,tigecycline,and eravacycline. No Enterococcus exhibiting resistance to linezolid were detected. Glycopeptide resistance was uncommon but more frequent in Enterococcus faecium(resistance to vancomycin and teicoplanin:both 1.7%)compared to Enterococcus faecalis(both 0.3%). The detection rates of MRSA and MRCNS exhibited significant regional variations across the country( χ2=17.674 and 148.650,respectively,both P<0.001). No vancomycin-resistant Enterococci were detected in central China. Institutional comparison demonstrated higher prevalence of MRSA( χ2=14.111, P<0.001)and MRCNS( χ2=4.828, P=0.028)in provincial hospitals than that in municipal hospitals. Socioeconomic analysis identified elevated detection rates of both MRSA( χ2=18.986, P<0.001)and MRCNS( χ2=4.477, P=0.034)in less developed regions(per capita GDP
10.National bloodstream infection bacterial resistance surveillance report (2023) : Gram-negative bacteria
Jinru JI ; Zhiying LIU ; Chaoqun YING ; Qing YANG ; Haishen KONG ; Jiangqin SONG ; Hui DING ; Yanyan LI ; Yuanyuan DAI ; Haifeng MAO ; Pengpeng TIAN ; Lu WANG ; Yongyun LIU ; Yizheng ZHOU ; Jiliang WANG ; Yan JIN ; Donghong HUANG ; Hongyun XU ; Peng ZHANG ; Xinhua QIANG ; Hong HE ; Lin ZHENG ; Junmin CAO ; Zhou LIU ; Ying HUANG ; Yan GENG ; Haiquan KANG ; Dan LIU ; Guolin LIAO ; Lixia ZHANG ; Fenghong CHEN ; Yanhong LI ; Baohua ZHANG ; Haixin DONG ; Xiaoyan LI ; Donghua LIU ; Qiuying ZHANG ; Xuefei HU ; Liang GUO ; Sijin MAN ; Dijing SONG ; Rong XU ; Youdong YIN ; Kunpeng LIANG ; Aiyun LI ; Zhuo LI ; Hongxia HU ; Guoping LU ; Jinhua LIANG ; Qiang LIU ; Yinqiao DONG ; Jilu SHEN ; Shuyan HU ; Liang LUAN ; Jian LI ; Ling MENG ; Dengyan QIAO ; Xiusan XIA ; Bo QUAN ; Dahong WANG ; Chunhua HAN ; Xiaoping YAN ; Fei LI ; Shifu WANG ; Ping SHEN ; Yunbo CHEN ; Yonghong XIAO
Chinese Journal of Clinical Infectious Diseases 2025;18(1):47-62
Objective:To report the results of bacterial resistant investigation collaborative system(BRICS)on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2023,and provide reference for clinical tretment of bloodstream infections and prevention and control of bacterial resistance.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of BRICS were collected during January 2023 to December 2023. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute(CLSI). WHONET 5.6 and SPSS 25.0 were used to analyze the data.Results:During the study period,11 492 strains of Gram-negative bacteria were collected from 60 hospitals,of which 10 098(87.9%)were Enterobacterales and 1 394(12.1%)were non-fermentative bacteria. The top 5 bacterial species were Escherichia coli(50.0%), Klebsiella pneumoniae(26.1%), Pseudomonas aeruginosa(5.1%), Acinetobacter baumannii complex(5.0%)and Enterobacter cloacae complex(4.1%). The ESBL-producing rates in Escherichia coli, Klebsiella pneumoniae and Proteus mirablilis were 46.8%(2 685/5 741),18.3%(549/2 999)and 44.0%(77/175),respectively. The prevalence of carbapenem-resistant Escherichia coli(CREC)and carbapenem-resistant Klebsiella pneumoniae(CRKP)were 1.3%(76/5 741)and 15.0%(450/2 999);32.9%(25/76)and 78.0%(351/450)of CREC and CRKP were sensitive to ceftazidime/avibactam combination,respectively. 94.7%(72/76)and 90.2%(406/450)of CREC and CRKP were sensitive to aztreonam/avibactam combination. Furthermore,57.9%(44/76)and 79.1%(356/450)were sensitive to imipenem/relebactam combination. The prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)complex was 64.6%(370/573),while more than 80.0% of CRAB complex was sensitive to tigecycline,eravacycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa(CRPA)was 17.0%(99/581). There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of important Gram-negative bacteria resistance among different regions in China,with statistically significant differences in the prevalence of CREC,CRKP,CRPA and CRAB complex( χ2=10.6,28.6,10.8 and 19.3, P<0.05). The prevalence of ESBL-producing Escherichia coli, CREC,CRAB complex and CRKP were higher in provincial hospitals than those in municipal hospitals( χ2=12.5,9.8,12.7 and 57.8,all P<0.01). Conclusions:Gram-negative bacteria are the main pathogens causing bloodstream infections in China,and Escherichia coli is ranked in the top,while the trend of Klebsiella pneumoniae increases continuously with time. CRKP infection shows a slow upward trend,CREC infecton maintains a low prevalence level,and CRAB complex infection continues to exhibit a high prevalence rate. The composition and resistance patterns of pathogens causing bloodstream infections vary to some extent across different regions and levels of hospitals in China.

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