1.Standardization Challenges in Outcome Evaluation Systems of Animal Experiments and Considerations for Core Outcome Set Construction Strategies
Qingyong ZHENG ; Yongjia ZHOU ; Tengfei LI ; Jianguo XU ; Chen TIAN ; Hui LIU ; Min TIAN ; Ziyu ZHOU ; Caihua XU ; Yating CUI ; Junfei WANG ; Jinhui TIAN
Laboratory Animal and Comparative Medicine 2026;46(1):138-148
Animal experimentation constitutes a critical link between basic research and clinical application, making its research quality and translational efficiency paramount. Although considerable progress has been made in standardizing operational procedures and ethical guidelines, the standardization of outcome evaluation systems has significantly lagged, creating a key bottleneck that constrains the quality of biomedical research and evidence synthesis. This deficiency is manifested by pronounced heterogeneity in outcome selection across similar studies, incomplete methodological reporting, and disparate criteria for result interpretation, which severely impairs the comparability of findings and the evidence integration. To cope with this challenge, this paper systematically introduces a mature methodological tool from clinical research–the core outcome set (COS)–and explores its construction strategies and application potential in the field of animal experimentation. Given the extensive diversity of animal experiments, a pragmatic strategy of "focusing on key areas, implementing phased pilots, and promoting gradual expansion" should be adopted. This approach prioritizes the development of domain-specific COS for disease areas characterized by high research volume, urgent translational needs, and well-established animal models. A multi-source integration pathway for COS development is detailed, comprising systematic literature searches, methodological appraisals, and expert consensus, with the feasibility of leveraging artificial intelligence (AI) to enhance efficiency also being examined. The development and promotion of such COS are not intended to restrict scientific exploration; rather, they aim to establish a new, tiered evaluation paradigm consisting of "core outcomes" (mandatory), "recommended outcomes" (encouraged), and "exploratory outcomes" (optional). This framework is expected not only to enhance research quality through standardization and to adhere to the "3R" principles but also to accelerate the accumulation of high-quality evidence. This, in turn, provides a solid foundation for higher-level evidence synthesis, ultimately facilitating the effective translation of basic research findings into clinical practice and providing an essential methodological framework for scientific advancement in relevant disciplines.
2.Research progress on the molecular mechanisms of traditional Chinese medicine monomers in ameliorating renal ischemia-reperfusion injury
Jinrui HUANG ; Wei LIU ; Jinhui WEI ; Yubo CHANG ; Hongbin MA
China Pharmacy 2026;37(4):540-546
Renal ischemia-reperfusion injury (RIRI) is a major cause of acute kidney injury during kidney transplantation and peri-operative settings, and there is still a lack of safe and effective targeted preventive and therapeutic drugs in clinical practice. Specifically, xanthohumol, luteolin, dracorhodin C, naringin, senkyunolide Ⅰ, verbascoside, and shikonin enhance antioxidant defenses, and inhibit lipid peroxidation and ferroptosis via the nuclear factor-erythroid 2-related factor 2/heme oxygenase-1 pathway. Apigenin, nobiletin, tanshinone Ⅱ A , and salidroside activate the phosphatidylinositol 3-kinase/protein kinase B pathway to inhibit mitochondria- dependent apoptosis and facilitate renal repair. Quercetin, methyleugenol, cyanidin-3-glucoside, and platycodin D promote autophagy and improve mitochondrial homeostasis through the adenosine monophosphate-activated protein kinase(AMPK)/mTOR or AMPK/phosphatase and tensin homolog-induced kinase 1/Parkin pathways. In addition, hesperidin, curcumin, ganoderic acid, pulsatilla saponin B4, capsaicin, and diosgenin mitigate inflammatory responses and decrease renal tubular injury markers by inhibiting the Toll-like receptor 4/nuclear factor κB, high mobility group box 1, Janus kinase/signal transducer and activator of transcription pathways, thereby exerting multi-target, multi-stage renoprotective effects.
3.Trends of changes in classroom lighting and illumination of primary and secondary schools in Beijing from 2016 to 2023
Chinese Journal of School Health 2026;47(1):134-139
Objective:
To understand the trends of classroom lighting and illumination of primary and secondary schools in Beijing from 2016 to 2023, so as to provide a scientific basis for targeted improvement measures.
Methods:
A sampling survey was conducted on the lighting and illumination indicators of 8 390 classrooms in primary and secondary schools in Beijing from 2016 to 2023. The survey included classroom daylight factor, window to floor area ratio, average illuminance and illuminance uniformity on the desks, average illuminance and illuminance uniformity on blackboards, as well as classroom lighting and blackboard illumination sources. Intergroup comparisons were performed using the Kruskal-Wallis H test and the Chi square test, and Spearman correlation analysis was used to examine the trend of classroom lighting and illumination changes.
Results:
Except the window to floor area ratio, the measured values and compliance rates of all lighting and illumination indicators showed an overall upward trend from 2016 to 2023 (daylight factor r = 0.27, χ 2 trend =206.80, average illuminance on the desk surface r =0.30, χ 2 trend =87.97, illuminance uniformity on the desk surface r =0.14, χ 2 trend =73.59, average illuminance on the blackboard r =0.33, χ 2 trend =477.43, illuminance uniformity on the blackboard r = 0.09, χ 2 trend =50.76) (all P <0.01). The lighting and illumination indicators of classrooms (included classroom daylight factor, average illuminance and illuminance uniformity on the desks, average illuminance and illuminance uniformity on blackboards) in urban schools, primary schools, and secondary schools from 2016 to 2023 showed an upward trend (urban r =0.23-0.40, χ 2 trend =88.66-392.18; primary school r =0.12-0.36, χ 2 trend =39.50-281.44; secondary schools r =0.06-0.31, χ 2 trend =11.79-213.73) (all P < 0.01 ). The illuminance uniformity on the blackboard in suburban schools showed a downward trend ( r = -0.09, χ 2 trend =31.53, both P <0.01). The illuminance uniformity on the desk surface in suburban schools showed no significant change ( r =0.03, χ 2 trend =1.23, both P >0.05). The other indicators showed an upward trend (daylight factor r =0.28, χ 2 trend =40.69, average illuminance on the desk surface r =0.24, χ 2 trend =16.35, average illuminance on the blackboard r =0.25, χ 2 trend =118.05, all P <0.01). The trends of classroom and blackboard illumination sources were that fluorescent lamps decreased year by year and LED lamps increased by year (classroom illumination sources χ 2 trend =1 059.82, blackboard illumination sources χ 2 trend =1 070.25, both P <0.01).
Conclusions
The classroom lighting and illumination in primary and secondary schools in Beijing has shown an overall improving trend from 2016 to 2023. However, problems remain, such as limited improvement of illuminance uniformity indicators, late start and poor effect of reconstruction in suburban schools. Further improvements are still needed.
4.Effect of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on motor function and gait in children with cerebral palsy:a network meta-analysis
Xinyan CAO ; Zifu YU ; Xiaoxuan LENG ; Shiai GAO ; Jinhui CHEN ; Xihua LIU
Chinese Journal of Tissue Engineering Research 2026;30(6):1539-1548
OBJECTIVE:Repetitive transcranial magnetic stimulation and transcranial direct current stimulation have shown positive effects in improving gross motor function in children with cerebral palsy.A network meta-analysis was performed to analyze the clinical efficacy of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on the improvement of lower limb motor function and gait in children with cerebral palsy.METHODS:Randomized controlled trials(RCT)about repetitive transcranial magnetic stimulation and transcranial direct current stimulation on lower limb motor function and gait in children with cerebral palsy were collected from CNKI,WanFang,VIP,SinoMed,PubMed,Web of Science,Medline.The search time limit was from the inception to October 5,2024.After screening literature,extracting data and evaluating the risk of bias of included studies,Stata 15.0 software was used for network meta-analysis,AND GRADE profiler was used for quality evaluation.RESULTS:A total of 19 studies were included,involving 4 treatment measures:conventional therapy,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation and anodic transcranial direct current stimulation.The results of network meta-analysis showed that in terms of improving gross motor function,low-frequency repetitive transcranial magnetic stimulation[mean difference(MD)=9.48,95%confidence interval(CI)(6.61,12.34),P<0.05]was the most effective.In terms of alleviating spasticity,high-frequency repetitive transcranial magnetic stimulation[MD=-0.63,95%CI(-1.72,0.45),P<0.05]had the best efficacy.In terms of improving ankle joint range of motion and step speed,transcranial direct current stimulation[MD=2.27,95%CI(1.37,3.17),P<0.05;MD=0.11,95%CI(0.05,0.17),P<0.05]was the most effective.CONCLUSION:Existing clinical evidence suggests that low-frequency repetitive transcranial magnetic stimulation has the best therapeutic effect compared with other intervention measures in terms of improving lower limb gross motor function.In terms of reducing spasticity,high-frequency repetitive transcranial magnetic stimulation has a more significant effect.In terms of improving gait,transcranial direct current stimulation has more advantages.
5.Effect of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on motor function and gait in children with cerebral palsy:a network meta-analysis
Xinyan CAO ; Zifu YU ; Xiaoxuan LENG ; Shiai GAO ; Jinhui CHEN ; Xihua LIU
Chinese Journal of Tissue Engineering Research 2026;30(6):1539-1548
OBJECTIVE:Repetitive transcranial magnetic stimulation and transcranial direct current stimulation have shown positive effects in improving gross motor function in children with cerebral palsy.A network meta-analysis was performed to analyze the clinical efficacy of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on the improvement of lower limb motor function and gait in children with cerebral palsy.METHODS:Randomized controlled trials(RCT)about repetitive transcranial magnetic stimulation and transcranial direct current stimulation on lower limb motor function and gait in children with cerebral palsy were collected from CNKI,WanFang,VIP,SinoMed,PubMed,Web of Science,Medline.The search time limit was from the inception to October 5,2024.After screening literature,extracting data and evaluating the risk of bias of included studies,Stata 15.0 software was used for network meta-analysis,AND GRADE profiler was used for quality evaluation.RESULTS:A total of 19 studies were included,involving 4 treatment measures:conventional therapy,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation and anodic transcranial direct current stimulation.The results of network meta-analysis showed that in terms of improving gross motor function,low-frequency repetitive transcranial magnetic stimulation[mean difference(MD)=9.48,95%confidence interval(CI)(6.61,12.34),P<0.05]was the most effective.In terms of alleviating spasticity,high-frequency repetitive transcranial magnetic stimulation[MD=-0.63,95%CI(-1.72,0.45),P<0.05]had the best efficacy.In terms of improving ankle joint range of motion and step speed,transcranial direct current stimulation[MD=2.27,95%CI(1.37,3.17),P<0.05;MD=0.11,95%CI(0.05,0.17),P<0.05]was the most effective.CONCLUSION:Existing clinical evidence suggests that low-frequency repetitive transcranial magnetic stimulation has the best therapeutic effect compared with other intervention measures in terms of improving lower limb gross motor function.In terms of reducing spasticity,high-frequency repetitive transcranial magnetic stimulation has a more significant effect.In terms of improving gait,transcranial direct current stimulation has more advantages.
6.Clinical value of PHR in predicting poor prognosis after intravenous thrombolysis in patients with acute cerebral infarction
Fang CHENG ; Yanhua NIU ; Jinhui LIU
International Journal of Laboratory Medicine 2025;46(16):1947-1952
Objective To explore the clinical value of the platelet count(PLT)to high-density lipoprotein cholesterol(HDL-C)ratio(PHR)in predicting poor prognosis after intravenous thrombolysis in patients with acute cerebral infarction(ACI).Methods A total of 304 patients with ACI who received intravenous thrombolytic therapy in this hospital from January 2021 to December 2023 were selected as the research sub-jects.According to the modified Rankin scale score at 6-month follow-up,the 304 patients with ACI were di-vided into the good prognosis group(n=216)and the poor prognosis group(n=88).Clinical data of all pa-tients were collected.The levels of PLT,HDL-C and PHR were compared between the two groups.The pre-dictive value of PLT,HDL-C and PHR for the prognosis of ACI patients was analyzed by using the receiver operating characteristic(ROC)curve.Binary Logistic stepwise regression analysis was used to explore the in-fluencing factors of prognosis in ACI patients.Results Compared with the good prognosis group,the HDL-C level in the poor prognosis group decreased,while the PLT level and PHR increased(P<0.05).The results of the ROC curve showed that the area under the curve(AUC)and 95%CI of PLT,HDL-C,and PHR for pre-dicting poor prognosis after intravenous thrombolysis in ACI patients was 0.829(0.784-0.874),0.743(0.693-0.788),and 0.918(0.873-0.968),respectively.The AUC of PHR in predicting poor prognosis af-ter intravenous thrombolysis in ACI patients was higher than that of PLT and HDL-C alone(Z=13.239,10.776,P<0.001).The proportions of National Institutes of Health Stroke Scale(NIHSS)score ≥8 points at admission,transformation of previous symptomatic hemorrhage,combined hypertension,and combined dia-betes in the poor prognosis group were all higher than those in the good prognosis group(P<0.05).The re-sults of binary Logistic stepwise regression showed that the NIHSS score at admission(OR=2.565,95%CI:1.292-5.094),the transformation of previous symptomatic hemorrhage(OR=2.073,95%CI:1.179-8.645),and PHR(OR=3.732,95%CI:2.037-6.839)were risk factors for poor prognosis in ACI patients(P<0.05).Conclusion PHR is expected to become an important reference index for predicting the prognosis of ACI patients after intravenous thrombolysis therapy.PHR,NIHSS score at admission,and the transforma-tion of previous symptomatic hemorrhage are all influencing factors for the prognosis of ACI patients after in-travenous thrombolysis therapy.
7.Clinical study of double-channel core decompression combined with medullary cavity irrigation for non-traumatic osteonecrosis of femoral head.
Jinhui MA ; Hongxu LI ; Haoyang LIU ; Bailiang WANG ; Weiguo WANG ; Fuqiang GAO ; Wei SUN ; Liming CHENG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(4):399-405
OBJECTIVE:
To compare the effects of double-channel core decompression (CD) combined with medullary cavity irrigation with those of simple CD on progression of collapse and clinical outcomes in non-traumatic osteonecrosis of the femoral head (ONFH).
METHODS:
A retrospective analysis was conducted on the clinical data of 19 patients (30 hips) with non-traumatic ONFH who underwent double-channel CD combined with medullary cavity irrigation and admitted between January 2024 and October 2024 (CD+irrigation group). According to a 1: 2 ratio, 54 patients (60 hips) who underwent simple CD and were matched in terms of age, gender, and body mass index (BMI) were included as the control (CD group). There was no significant difference in baseline data such as age, gender, BMI, affected side, ONFH type, preoperative Association Research Circulation Osseous (ARCO) stage, bone marrow edema stage, visual analogue scale (VAS) score for pain, and Harris score between the two groups ( P>0.05). The postoperative discharge time and occurrence of complications were recorded for both groups. The VAS scores before operation and at discharge after operation were compared, and the differences between pre- and post-operation (change values) were calculated for intergroup comparison. The Harris scores before operation and at discharge and 3 months after operation were also compared. During follow-up, X-ray film, CT, and MRI were performed for reexamination. The ARCO stage and bone marrow edema stage were evaluated at 3 months after operation and compared with those before operation to determine whether there was radiological progression or relief.
RESULTS:
All incisions in both groups healed by first intention after operation, with no infection, femoral neck fracture, or other operation-related complications. All patients were followed up, and the follow-up time of the CD+irrigation group was (146.8±27.7) days, and that of the CD group was (164.3±48.2) days; there was no significant difference between the two groups ( t=1.840, P=0.069). There was no significant difference in the length of hospital stay between the two groups ( P>0.05). At discharge after operation, the VAS score of the CD+irrigation group was significantly lower than that of the CD group ( P<0.05), and the change value was significantly higher than that of the CD group ( P<0.05). The Harris scores at discharge and 3 months after operation in the CD+irrigation group were significantly higher than those in the CD group ( P<0.05). The Harris score gradually increased with time, and the differences between different time points were significant ( P<0.05). Radiological reexamination showed that there was no significant difference in the ARCO stage and the incidence of radiological progression between the two groups at 3 months after operation ( P>0.05); however, the bone marrow edema stage and the degree of bone marrow edema relief in the CD+irrigation group were better than those in the CD group, with significant differences ( P<0.05).
CONCLUSION
Double-channel CD combined with medullary cavity irrigation can significantly alleviate hip joint pain and improve joint function in patients with non-traumatic ONFH, reduce the degree of bone marrow edema in the femoral head, and delay the progression of ONFH.
Humans
;
Femur Head Necrosis/therapy*
;
Retrospective Studies
;
Male
;
Female
;
Decompression, Surgical/methods*
;
Therapeutic Irrigation/methods*
;
Adult
;
Treatment Outcome
;
Middle Aged
;
Femur Head/surgery*
8.Analysis of effectiveness of Holosight robot navigation-assisted percutaneous cannulated screw fixation in treatment of femoral neck fractures.
Weizhen XU ; Zhenqi DING ; Hui LIU ; Jinhui ZHANG ; Yuanfei XIONG ; Jin WU
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(6):673-679
OBJECTIVE:
To investigate the effectiveness of Holosight robotic navigation-assisted percutaneous cannulated screw fixation for femoral neck fractures.
METHODS:
A retrospective analysis was conducted on 65 patients with femoral neck fractures treated with cannulated screw fixation between January 2022 and February 2024. Among them, 31 patients underwent robotic navigation-assisted screw placement (navigation group), while 34 underwent conventional freehand percutaneous screw fixation (freehand group). Baseline characteristics, including age, gender, fracture side, injury mechanism, Garden classification, Pauwels classification, and time from injury to operation, showed no significant differences between the two groups ( P>0.05). The operation time, intraoperative blood loss, fluoroscopy frequency, fracture healing time, and complications were recorded and compared, and hip function was evaluated by Harris score at last follow-up. Postoperative anteroposterior and lateral hip X-ray films were taken to assess screw distribution accuracy, including deviation from the femoral neck axis, inter-screw parallelism, and distance from screws to the femoral neck cortex.
RESULTS:
No significant difference was observed in operation time between the two groups ( P>0.05). However, the navigation group demonstrated superior outcomes in intraoperative blood loss, fluoroscopy frequency, deviation from the femoral neck axis, inter-screw parallelism, and distance from screws to the femoral neck cortex ( P<0.05). No incision infections or deep vein thrombosis occurred. All patients were followed up 12-18 months (mean, 16 months). In the freehand group, 1 case suffered from cannulated screw dislodgement and nonunion secondary to osteonecrosis of femoral head at 1 year after operation, 1 case suffered from screw penetration secondary to osteonecrosis of femoral head at 5 months after operation; and 1 case suffered from nonunion secondary to osteonecrosis of femoral head at 6 months after operation in the navigation group. All the 3 patients underwent internal fixators removal and total hip arthroplasty. There was no significant difference in the incidence of complications between the two groups ( P>0.05). The fracture healing time and hip Harris score at last follow-up in the navigation group were significantly better than those in the freehand group ( P<0.05).
CONCLUSION
Compared to freehand percutaneous screw fixation, Holosight robotic navigation-assisted cannulated screw fixation for femoral neck fractures achieves higher precision, reduced intraoperative radiation exposure, smaller incisions, and superior postoperative hip function recovery.
Humans
;
Femoral Neck Fractures/diagnostic imaging*
;
Bone Screws
;
Fracture Fixation, Internal/instrumentation*
;
Male
;
Female
;
Retrospective Studies
;
Robotic Surgical Procedures/methods*
;
Middle Aged
;
Aged
;
Adult
;
Treatment Outcome
;
Operative Time
;
Fracture Healing
;
Surgery, Computer-Assisted/methods*
;
Fluoroscopy
9.Independent component analysis for assessing functional abnormalities in frontoparietal attention network of patients with traumatic brain injury and analyzing neural mechanism of attention disorders
Gaiyun ZHANG ; Xingxing JIN ; Hongxia WANG ; Wangyi LIU ; Jinhui DUAN ; Ruifang YAN
Chinese Journal of Medical Imaging Technology 2025;41(7):1062-1067
Objective To assess functional abnormalities in frontoparietal attention network of patients with traumatic brain injury(TBI),and to analyze neural mechanism of its attention disorders based on independent component analysis(ICA).Methods Totally 84 TBI patients were prospectively enrolled and divided into mild(n=33),moderate(n=27)and severe TBI groups(n=24)according to symptoms,non-contrast enhanced MRI findings,Glasgow coma scale(GCS)and Mayo craniocerebral trauma grading criteria.ICA was used to extract and analyze the optimal independent components(IC)of the dorsal attention network(DAN)and ventral attention network(VAN).Multiple linear regression analyses were performed to explore the correlations of functional connectivity(FC)of brain regions being significantly different among groups within attention network and the scores of trail making test A/B(TMT-A/B).Results Compared with control group and mild TBI group,spatial distribution of DAN(especially bilateral frontal eye field[FEF])in moderate and severe TBI groups were significantly smaller,the clusters tended to be discrete,and the intensity were significantly weakened.The right temporal parietal junction(TPJ)and right ventral frontal cortex(VFC)of VAN in control group,mild and moderate TBI groups were significantly affected,and VFC connection strength was the highest in severe TBI group.FC intensity in right VFC of TBI patients was positively correlated with TMT-A score(r=0.654,P<0.001),which in left FEF was negatively correlated with TMT-B score(r=—0.383,P<0.001).Conclusion FC of frontoparietal attention network was abnormal in TBI patients,which might be neural mechanism for its attention behavior disorders.
10.Study on transmission characteristics and genetic variation of carbapenem-resistant Klebsiella pneumonia based on whole genome sequencing
Jiachen LI ; Yanying CHEN ; Yanlei GE ; Jinrui HU ; Xiaoli DU ; Jinyue LIU ; Huan XING ; Pengfang GAO ; Xiao HAN ; Yuelong LI ; Yating TANG ; Juan LI ; Zhigang CUI ; Jinhui ZHANG ; Haijian ZHOU ; Aiying DONG
Chinese Journal of Preventive Medicine 2025;59(6):892-900
Objective:To analyze the short-term hospital-based transmission characteristics and gene variation of Carbapenem-Resistant Klebsiella pneumoniae (CRKP) by genome-wide technique to provide evidence for transmission control. Methods:The experimental strain was derived from all the CRKP isolated in Affiliated Hospital of North China University of Science and Technology from October 2022 to December 2023. Strain identification and drug susceptibility were tested with VITEK 2-Compact automatic bacterial identification drug susceptibility analyzer or disk method, and the results were interpreted through whole genome sequencing. The ST type, carbapenem resistance gene, virulence factor, and O serotype of the collected strains were analyzed.Results:Among the 115 strains of CRKP, 94 strains were isolated from the intensive care unit (ICU), accounting for 81.7%, and 21 strains were isolated from the non-intensive care unit (NICU), accounting for 18.3%. The 115 strains of CRKP can be divided into 11 ST types, of which ST11 type was the most (54.8%, 63/115), followed by ST15 type (22.6%, 26/115) and ST5492 type (15.7%, 18/115). Type ST5492 was a new clonal group in the region. The 115 strains of CRKP could be divided into 7 O serotypes, most of which were O2a type(32.2%,37/115), followed by O5 type(30.4%,35/115) and O1 type(27.8%,32/115). The resistance genes of carbapenem antibiotics showed that there were 107 strains carrying the blaKPC-2 gene, one strain with the blaNDM-1 gene, and one strain with both the blaKPC-2 and blaNDM-13 genes. Virulence genes were detected in 55 CRKP strains (47.8%, 55/115), among which six strains detected peg-344, iucA, iroB, rmpA, and rmpA2 virulence genes (5.2%, 6/115). Four virulence genes ( peg-344, iucA, rmpA, and rmpA2) were detected in 34 strains (29.6%, 34/115). Three virulence genes ( iucA, iroB and rmpA) were detected in two strains (1.7%, 2/115). Three virulence genes ( peg-344, iucA and rmpA) were detected in one strain (0.8%, 1/115). IucA and rmpA virulence genes were detected in 12 strains (10.4%, 12/115). KPC-2_ST11_O2a, KPC-2_ST15_O1 and KPC-2_ST5492_O5 were dominant clones, and their distribution was mainly in the intensive care unit. The whole genome sequence analysis showed that there were three dominant clones, among which ST11 clones were subdivided into three dominant O serotypes, all of which were mainly in the intensive care unit. Conclusion:The popular strain in the hospital of CRKP is a KPC-2_ST11 clone group carrying iucA, rmpA/rmpA2, with cross-department transmission and mutation. ST5492 is a newly-launched clone type. The intensive care unit of hvKP carrying five virulence genes, including peg-344, should be alert to the epidemic risk of CR-hvKP outbreak.


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