1.Effect of Aerobic Exercise Combined with Anmeidan on Learning Memory and Synaptic Plasticity in Rats with Sleep Deprivation Based on BDNF/TrkB/CREB Signaling Pathway
Yunyuan GUO ; Yuping SHAO ; Qiuchan ZENG ; Lixia LIN ; Guangjing XIE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(17):117-124
ObjectiveThis paper aims to study the effects of four weeks of aerobic exercise combined with Anmeidan on the synaptic plasticity marker protein and synaptic ultrastructure of the hippocampus in the model rats with sleep deprivation, thereby investigating the possible mechanism of its action to improve the learning memory of rats with sleep deprivation. Methods50 Sprague-Dawley (SD) rats were randomly divided into blank control group (group C), sleep deprivation group (group M), aerobic exercise + sleep deprivation group (group MEX), Anmeidan + sleep deprivation group (group MA, 18.18 g∙kg-1∙d-1), and aerobic exercise + Anmeidan + sleep deprivation group (group MEXA, 18.18 g∙kg-1∙d-1). Anmeidan was administered by gavage in the MA group for four weeks. Aerobic exercise was performed in the MEX group for four weeks. Anmeidan was administered by gavage in the MEXA group in combination with aerobic exercise for four weeks, and sleep deprivation was performed for 72 h by using the multi-platform water environment method. At the end of sleep deprivation, Morris water maze was used to assess the learning and memory ability of rats in each group, and hematoxylin-eosin (HE) staining was used to observe the morphological changes of rats' hippocampal neurons. A transmission electron microscope was used to observe the synaptic ultrastructure of rats' hippocampus. The expression levels of brain-derived neurotrophic factor (BDNF), tyrosine kinase receptor B (TrkB), cAMP-response element binding protein (CREB), postsynaptic density-95 (PSD-95), and synaptophysin (SYN) were detected by Western blot, and the real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to detect the relative mRNA expression levels of BDNF, TrkB, and CREB in the rats' hippocampus. ResultsCompared with those in group C, rats in group M had significantly longer latency and total swimming distance on the platform (P<0.01) and a significantly reduced number of traversals across the platform as well as the residence time in the target quadrant (P<0.01). Part of the hippocampal neurons damaged, with a reduced number, disorganized arrangement, fuzzy synaptic gaps, thinning of post-synaptic dense material, and uneven density of synaptic vesicles. The protein expression levels and relative mRNA expression levels of BDNF, TrkB, and CREB were significantly reduced (P<0.01), and the protein expression levels of PSD-95 and SYN were significantly reduced (P<0.01). Compared with those in group M, rats in MA, MEX, and MEXA groups showed a decrease in latency to platform and total distance swum, an increase in the number of traversals across the platform and residence time in the target quadrant (P<0.05, P<0.01), a reduction in hippocampal neuronal damage, a better arrangement, a more intact synaptic structure, a thickening of post-synaptic dense material, a uniform density of synaptic vesicles, and an increase in the protein expression levels and mRNA expression levels of BDNF, TrkB, and CREB (P<0.05, P<0.01). The protein expressions of PSD-95 and SYN rose (P<0.05, P<0.01). ConclusionAerobic exercise combined with Anmeidan can improve learning memory in rats with sleep deprivation, and its mechanism of action may be related to the modulation of the BDNF/TrkB/CERB signalling pathway, up-regulation of the expression of PSD-95 and SYN, and improvement of synaptic structural damage. The combination of interventions is superior to single exercise or drugs.
2.Analysis of factors associated with overweight and obesity among preschool children based on a decision tree model
YAO Tong, XIE Jinting, SHAO Jihong, HAN Yan
Chinese Journal of School Health 2026;47(8):1174-1179
Objective:
To explore the epidemiological characteristics and related factors of overweight and obesity among preschool children in Xuzhou City, so as to provide scientific basis for the formulation of corresponding prevention and control strategies.
Methods:
From October to November 2021, a random cluster sampling method was adopted to select 2 082 preschool children aged 3-7 years from 6 kindergartens in Xuzhou City and their parents for a questionnaire survey. Multivariate Logistic regression and decision tree model were used to analyze the related factors of overweight and obesity among preschool children.
Results:
The detection rates of overweight and obesity among preschool children were 19.8% and 12.4%, respectively. Multivariate Logistic regression analysis showed that preschool children with overweight fathers ( OR=1.40, 95%CI =1.01-1.96), obese fathers ( OR= 2.32 , 95%CI =1.56-3.45), mothers with insufficient gestational weight gain ( OR=2.11, 95%CI =1.24-3.59), cesarean section ( OR=1.42, 95%CI =1.06-1.92), artificial feeding within the first 6 months of life ( OR=2.33, 95%CI =1.35-4.04), and daily screen time ≥1 h ( OR=1.54, 95%CI =1.14-2.08) had higher risks of obesity; children born to pre pregnancy underweight mothers had a lower risk of obesity ( OR=0.23, 95%CI =0.12-0.44); preschool children with obese fathers ( OR=1.66, 95%CI = 1.19- 2.32) and macrosomic infants ( OR=1.82, 95%CI =1.32-2.51) had higher risks of overweight (all P <0.05). The decision tree model revealed that the factors associated with overweight and obesity among preschool children were ranked by importance from highest to lowest as follows: paternal body mass index, residential location, maternal pre pregnancy body mass index, gestational weight gain, birth weight, children s daily screen time, and feeding pattern with the first 6 months of life.
Conclusions
The problem of overweight and obesity among preschool children in Xuzhou City is prominent. In addition to considering prenatal factors, early life feeding practices, and behavioral factors, prevention and control strategies should also focus on paternal factors.
3.Bawei Chenxiang Wan Protects Against Acute Myocardial Ischemia by Activating Phosphatidylinositol 3-Kinase to Inhibit Cuproptosis in Rats
Xiaoying ZHANG ; Yuquan XIE ; Yuchan ZHANG ; Qi SI ; Yuanhu XIAO ; Yuqi GUO ; Xiayu SHAO
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(5):820-832
ObjectiveTo investigate the protective effect and underlying mechanisms of the Bawei Chenxiang Wan (BCW) against myocardial ischemic injury. MethodsMyocardial ischemia in vivo was induced in rats by subcutaneous injection of isoproterenol (ISO), and ex vivo ischemia was established by coronary artery ligation in isolated rat hearts. The effects of BCW, alcohol extracts and its polar extracts were evaluated on ST segment on electrocardiogram (ECG), myocardial damage, hemodynamic parameters, and infarct size. The phosphorylation level of phosphatidylinositol 3-kinase (PI3K), the expression of cuproptosis-related proteins, and the content of Cu²⁺ in myocardial tissue were detected. The regulatory relationship of the signaling pathway was verified using an oxygen-glucose deprivation (OGD) myocardial cell injury model, combined with PI3K agonists and inhibitors. ResultsBCW ameliorated ST-segment elevation on electrocardiograms(P<0.01), reduced serum levels of myocardial injury markers, improved hemodynamic parameters, upregulated PI3K phosphorylation(P<0.01), and decreased Cu²⁺ accumulation in rats with myocardial ischemia(P<0.01). Moreover, BCW reduced the myocardial infarct size. In the isolated rat heart model of ischemia, both the ethanol extract and various solvent fractions of BCW exerted protective effects and reduced Cu²⁺ content, among which the n-butanol fraction exhibited the most potent activity(P<0.01). Specifically, the n-butanol fraction upregulated PI3K phosphorylation(P<0.01) and downregulated the expression of cuproptosis-related proteins, including ferredoxin reductase 1(FDX1)(P<0.05), lipoic acid synthetase(LIAS), and dihydrolipoamide S-acetyltransferase(DLAT) oligomerization(P<0.05). In the OGD-induced cardiomyocyte injury model, treatment with a PI3K agonist inhibited DLAT oligomerization(P<0.05), whereas co-administration of a PI3K inhibitor attenuated the inhibitory effect of the n-butanol fraction on DLAT oligomer formation(P<0.05). ConclusionThe n-butanol fraction of BCW exerts a significant protective effect against myocardial ischemic injury, and its mechanism may involve activation of the PI3K and inhibition of cuproptosis.
4.Bawei Chenxiang Wan Protects Against Acute Myocardial Ischemia by Activating Phosphatidylinositol 3-Kinase to Inhibit Cuproptosis in Rats
Xiaoying ZHANG ; Yuquan XIE ; Yuchan ZHANG ; Qi SI ; Yuanhu XIAO ; Yuqi GUO ; Xiayu SHAO
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(5):820-832
ObjectiveTo investigate the protective effect and underlying mechanisms of the Bawei Chenxiang Wan (BCW) against myocardial ischemic injury. MethodsMyocardial ischemia in vivo was induced in rats by subcutaneous injection of isoproterenol (ISO), and ex vivo ischemia was established by coronary artery ligation in isolated rat hearts. The effects of BCW, alcohol extracts and its polar extracts were evaluated on ST segment on electrocardiogram (ECG), myocardial damage, hemodynamic parameters, and infarct size. The phosphorylation level of phosphatidylinositol 3-kinase (PI3K), the expression of cuproptosis-related proteins, and the content of Cu²⁺ in myocardial tissue were detected. The regulatory relationship of the signaling pathway was verified using an oxygen-glucose deprivation (OGD) myocardial cell injury model, combined with PI3K agonists and inhibitors. ResultsBCW ameliorated ST-segment elevation on electrocardiograms(P<0.01), reduced serum levels of myocardial injury markers, improved hemodynamic parameters, upregulated PI3K phosphorylation(P<0.01), and decreased Cu²⁺ accumulation in rats with myocardial ischemia(P<0.01). Moreover, BCW reduced the myocardial infarct size. In the isolated rat heart model of ischemia, both the ethanol extract and various solvent fractions of BCW exerted protective effects and reduced Cu²⁺ content, among which the n-butanol fraction exhibited the most potent activity(P<0.01). Specifically, the n-butanol fraction upregulated PI3K phosphorylation(P<0.01) and downregulated the expression of cuproptosis-related proteins, including ferredoxin reductase 1(FDX1)(P<0.05), lipoic acid synthetase(LIAS), and dihydrolipoamide S-acetyltransferase(DLAT) oligomerization(P<0.05). In the OGD-induced cardiomyocyte injury model, treatment with a PI3K agonist inhibited DLAT oligomerization(P<0.05), whereas co-administration of a PI3K inhibitor attenuated the inhibitory effect of the n-butanol fraction on DLAT oligomer formation(P<0.05). ConclusionThe n-butanol fraction of BCW exerts a significant protective effect against myocardial ischemic injury, and its mechanism may involve activation of the PI3K and inhibition of cuproptosis.
5.Cordycepin Inhibits Fat Infiltration after Rotator Cuff Tear Injury by Regulating Wnt/β-catenin Signaling Pathway
Qiu'en XIE ; Dengwen LIANG ; Shao WU ; Xuhui HAO ; Liguang LIANG ; Bangxiang JIAN ; Junhong DONG ; Lei YANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):98-106
ObjectiveTo investigate the effect and mechanism of cordycepin in inhibiting fat infiltration after rotator cuff injuries in rats by regulating the Wnt/β-catenin signaling pathway, providing a theoretical basis for clinical treatment of rotator cuff injuries. MethodsFifty SPF-grade female SD rats were used in this study, with 10 randomly selected as the blank group. A rotator cuff injury repair model was established by supraspinatus tendon and suprascapular nerve compression. The successfully modeled rats were randomized into model and low-dose (20 mg·kg-1), medium-dose (40 mg·kg-1), and high-dose (80 mg·kg-1) cordycepin groups. After 6 weeks of treatment, the gait analysis was performed to assess the limb function in rats. Oil red O staining and Masson staining were employed to observe pathological changes in the muscle tissue. Enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in the serum. Immunohistochemistry (IHC) was employed to detect the expression of peroxisome proliferator-activated receptor γ (PPARγ) and CCAAT/enhancer-binding protein α (C/EBPα), which are markers of adipogenesis. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) and Western blot were employed to determine the mRNA and protein levels, respectively, of Wnt3a, Wnt10b, and β-catenin. ResultsCompared with the blank group, the model group showed decreases in stride length and paw print area (P<0.01), an increase in ratio of wet muscle mass reduction and a decrease in muscle fiber cross-sectional area (P<0.05), and decreased ratios of fat infiltration area and collagen fiber area (P<0.01). Additionally, the model group showed elevated levels of IL-1β, IL-6, and TNF-α (P<0.05), up-regulated protein levels of PPARγ and C/EBPα (P<0.01), and down-regulated mRNA and protein levels of Wnt3a, Wnt10b, and β-catenin (P<0.05, P<0.01). Compared with the model group, the low-, medium-, and high-dose cordycepin groups showed increases in stride length and paw print area (P<0.01), a decrease in ratio of wet muscle mass reduction and an increase in muscle fiber cross-sectional area (P<0.05), and increases in ratios of fat infiltration area and collagen fiber area (P<0.05, P<0.01). In addition, cordycepin lowered the serum levels of IL-1β, IL-6, and TNF-α (P<0.05, P<0.01), down-regulated the protein levels of PPARγ and C/EBPα (P<0.01), and up-regulated the mRNA and protein levels of Wnt3a, Wnt10b, and β-catenin (P<0.05, P<0.01). ConclusionCordycepin can improve the limb function, alleviate rotator cuff muscle atrophy, fat infiltration, and fibrosis, and inhibit inflammation in rats by regulating the Wnt/β-catenin signaling pathway.
6.Microchannel-based Electrochemiluminescence Sensor for Tetracycline Detection Using Luminol/Hydrogen Peroxide as Reporter System
Shao-Kun HUANG ; Xiu-Lin XIE ; Hua-Bin CAI ; Yan-Ling HUANG ; Yue LIN ; Zhen-Yu LIN
Chinese Journal of Analytical Chemistry 2025;53(3):356-363
A microchannel-based electrochemiluminescence(ECL)sensor was developed for detection of tetracycline(TC)utilizing luminol/H2O2 as ECL reporting system.The low excitation potential of luminol/H2O2 effectively mitigated the impact of clamping voltage,thereby enhancing the detection performance of the microchannel-based ECL sensor.The microchannel modified with TC aptamer selectively recognized and captured target TC.The positively charged TC reduced the surface charge density within the microchannel,thereby increasing the ionic current in the microchannel,leading to change of ECL signal of system.The experimental conditions such as electrolyte concentration,TC-aptamer concentration,and reaction time between TC and TC-aptamer were optimized.Under optimal conditions,the difference of ECL signal in the absence and presence of TC(?ECL)exhibited a good linear relationship with TC concentration in the range from 1.00 ng/mL to 200 ng/mL,with a detection limit as low as 0.69 ng/mL.The sensor had good selectivity and was successfully used in detection of TC in milk samples.
7.Quantification of Atmospheric Total Reactive Nitrogen Oxides by Thermal Decomposition-Broadband Cavity Enhanced Absorption Spectroscopy
Dou SHAO ; Min QIN ; Wu FANG ; Bao-Bin HAN ; Ke TANG ; Jian-Ye XIE ; Xia-Dan ZHAO ; Zhi-Tang LIAO ; En-Bo REN
Chinese Journal of Analytical Chemistry 2025;53(3):387-396
Nitrogen oxides(NOx=NO+NO2)are important precursors of ozone(O3),and NOx and its oxides together constitute reactive nitrogen oxides(NOy)in the atmosphere.A comprehensive understanding of the total NOy level in the atmosphere is of great significance for a deeper understanding of the atmospheric nitrogen cycle and oxidation,as well as for formulating strategies for air pollution prevention and control.In this work,a thermal decomposition-broadband cavity enhanced absorption spectroscopy(TD-BBCEAS)technique for online measurement of total NOy in the atmosphere was developed.With this method,the NOy was efficiently converted into NO2,and the total NOy concentration in the atmosphere was indirectly obtained by measuring NO2.Focusing on the key factors affecting the measurement of total NOy,the influence of NO titration efficiency and other NOy component TD efficiency on measurement accuracy was emphasized.By changing the oxygen(O2)flow rate through the mercury lamp to alter the O3 concentration for titrating NO,the conversion efficiency of NO was evaluated.At O2 flow rate of 6 mL/min,the conversion efficiency of NO was greater than 99%.TD efficiency testing and analysis on NO2,peroxyacetyl nitrate(PAN),nitric acid(HNO3),and nitrous acid(HONO),which account for a large proportion of atmospheric NOy components,was carried out using 680℃as the optimal TD temperature for efficient conversion of NOy.With NO and HONO sample gases as typical verification gases,the conversion efficiency of NOy and the accuracy of NOy measurement by TD-BBCEAS system were verified by switching the on and off modes of mercury lamp and TD device.At integration time of 60 s,the detection limit of the system for NOy was 2.83×1010 molecules/cm3(60 s,2σ).A comparative measurement of actual atmospheric NOy was conducted between the TD-BBCEAS system and the NOy analyzer.The observation results showed a correlation coefficient(R2)of 0.98 and a slope of 0.93,further verifying the feasibility and accuracy of applying the TD-BBCEAS system to measurement of total NOy.
8.Application of perioperative enhanced recovery after surgery clinical pathway for percutaneous vertebro plasty
Xuehu XIE ; Zhiwu ZHANG ; Jisheng LIN ; Hai MENG ; Tianyu BAI ; Zihan FAN ; Nan SU ; Jiashen SHAO ; Jinjun LI ; Guoyu NI ; Feng JIN ; Yong YANG ; Qi FEI
International Journal of Surgery 2025;52(6):415-422
Objective:To evaluate the perioperative application effect of enhanced recovery after surgery (ERAS) clinical pathway in percutaneous vertebro plasty (PVP).Methods:The clinical data of 274 patients who underwent PVP treatment for osteoporotic vertebral compression fracture (OVCF) in Beijing Friendship Hospital, Capital Medical University from May 2023 to August 2024 were retrospectively analyzed. The patients were divided into two groups according to the different numbers of surgical segments: the single-segment group ( n=211) and the multisegment group ( n=63). Patients in the single-segment group underwent single-segment surgery, while patients in the multisegment group underwent surgery on ≥2 segments. The core points of the ERAS clinical pathway adopted in this study include perioperative education, pain management, early mobilization, application of "outfast", and joint guidance from the departments of nutrition and rehabilitation. Comparison was made between the two groups of patients in terms of visual analog scale (VAS) scores for low back pain at preoperative, 2 h, 6 h, 24 h postoperatively, and on the day of discharge; Oswestry disability index (ODI) scores preoperatively and on the day of discharge; time to first ambulation postoperatively, total length of hospital stay, postoperative length of stay, perioperative complications, and perioperative application of Opioid consumption. Measurement data were expressed as mean±standard deviation ( ± s), and the independent sample t-test was used for comparison between groups; count data were expressed as cases and percentage, and the Chi-square test was used for comparison between groups. The VAS pain scores at each stage of the perioperative period were evaluated using repeated measures analysis of variance or generalized estimating equations. Results:Compared with that before the operation [(6.17±0.93) points, (6.29±0.83) points], the VAS scores of low back pain of patients in the single-segment group and the multisegment group at 2 hours after surgery [(3.09±0.82) points, (3.27±0.65) points], 6 hours after surgery [(2.60±0.79) points, (2.62±0.55) points], and 24 hours after surgery [(1.89±0.77) points, (1.97±0.72) points] and on the day of discharge [(1.72±0.71) points, (1.81±0.64) points] were significantly decreased, and the differences were statistically significant ( P<0.05). At the same stage, the VAS scores of low back pain in both groups were not statistically significant ( P>0.05). The ODI scores of patients in the single-segment group and the multisegment group on the day of discharge [(24.21±2.35) points, (24.63±3.31) points] were significantly lower than those before the operation [(64.50±4.81) points, (65.52±4.08) points], and the differences were statistically significant ( P<0.05). There were no statistically significant differences in perioperative complications and the proportion of Opioid drug application between the two groups of patients ( P>0.05). Conclusion:For patients with single-segment or multisegment OVCF, PVP surgical treatment under ERAS clinical pathway management can achieve immediate pain relief, early ambulation exercise, and satisfactory perioperative efficacy.
9.Changing antimicrobial resistance profiles of Burkholderia cepacia in hospitals across China:results from CHINET Antimicrobial Resistance Surveillance Program,2015-2021
Chunyue GE ; Yunjian HU ; Xiaoman AI ; Yang YANG ; Fupin HU ; Demei ZHU ; Yingchun XU ; Xiaojiang ZHANG ; Hui LI ; Ping JI ; Yi XIE ; Mei KANG ; Chuanqing WANG ; Pan FU ; Yuanhong XU ; Ying HUANG ; Ziyong SUN ; Zhongju CHEN ; Yuxing NI ; Jingyong SUN ; Yunzhuo CHU ; Sufei TIAN ; Zhidong HU ; Jin LI ; Yunsong YU ; Jie LIN ; Bin SHAN ; Yan DU ; Sufang GUO ; Lianhua WEI ; Fengmei ZOU ; Hong ZHANG ; Chun WANG ; Chao ZHUO ; Danhong SU ; Dawen GUO ; Jinying ZHAO ; Hua YU ; Xiangning HUANG ; Wen'en LIU ; Yanming LI ; Yan JIN ; Chunhong SHAO ; Xuesong XU ; Chao YAN ; Shanmei WANG ; Yafei CHU ; Lixia ZHANG ; Juan MA ; Shuping ZHOU ; Yan ZHOU ; Lei ZHU ; Jinhua MENG ; Fang DONG ; Zhiyong LÜ ; Fangfang HU ; Han SHEN ; Wanqing ZHOU ; Wei JIA ; Gang LI ; Jinsong WU ; Yuemei LU ; Jihong LI ; Jinju DUAN ; Jianbang KANG ; Xiaobo MA ; Yanping ZHENG ; Ruyi GUO ; Yan ZHU ; Yunsheng CHEN ; Qing MENG ; Shifu WANG ; Xuefei HU ; Jilu SHEN ; Wenhui HUANG ; Ruizhong WANG ; Hua FANG ; Bixia YU ; Yong ZHAO ; Ping GONG ; Kaizhen WENG ; Yirong ZHANG ; Jiangshan LIU ; Longfeng LIAO ; Hongqin GU ; Lin JIANG ; Wen HE ; Shunhong XUE ; Jiao FENG ; Chunlei YUE
Chinese Journal of Infection and Chemotherapy 2025;25(5):557-562
Objective To examine the changing prevalence and antimicrobial resistance profiles of Burkholderia cepacia in 52 hospitals across China from 2015 to 2021.Methods A total of 9 261 strains of B.cepacia were collected from 52 hospitals between January 1,2015 and December 31,2021.Antimicrobial susceptibility of the strains was tested using Kirby-Bauer method or automated antimicrobial susceptibility testing systems according to a unified protocol.The results were interpreted according to the breakpoints released in the Clinical & Laboratory Standards Institute(CLSI)guidelines(2023 edition).Results A total of 9 261 strains of B.cepacia were isolated from all age groups,especially elderly patients.The proportion was 11.1%(1 032 strains)in children,significantly lower than the proportion in adults.About half(46.5%,4 310/9 261)of the strains were isolated from patients at least 60 years old and 42.3%(3 919/9 261)of the strains were isolated from young adults.Most isolates(71.1%)were isolated from sputum and respiratory secretions,followed by urine(10.7%)and blood samples(8.1%).B.cepacia isolates were highly susceptible to the five antimicrobial agents recommended in the CLSI M100 document(33rd edition,2023).B.cepacia isolates showed relatively higher resistance rates to meropenem and levofloxacin.However,the resistance rates to ceftazidime,trimethoprim-sulfamethoxazole,and minocycline remained below 8.1%.The percentage of B.cepacia strains resistant to levofloxacin was the highest compared to other antibiotics in any of the three age groups(from 12.4%in the patients<18 years old to 20.6%in the patients aged 60 years or older).Conclusions B.cepacia is one of the clinically important non-fermenting gram-negative bacteria.Accurate and timely reporting of antimicrobial susceptibility test results and ongoing antimicrobial resistance surveillance are helpful for rational prescription of antimicrobial agents and proper prevention and control of nosocomial infections.
10.Changing prevalence and antibiotic resistance profiles of carbapenem-resistant Enterobacterales in hospitals across China:data from CHINET Antimicrobial Resistance Surveillance Program,2015-2021
Wenxiang JI ; Tong JIANG ; Jilu SHEN ; Yang YANG ; Fupin HU ; Demei ZHU ; Yuanhong XU ; Ying HUANG ; Fengbo ZHANG ; Ping JI ; Yi XIE ; Mei KANG ; Chuanqing WANG ; Pan FU ; Yingchun XU ; Xiaojiang ZHANG ; Ziyong SUN ; Zhongju CHEN ; Yuxing NI ; Jingyong SUN ; Yunzhuo CHU ; Sufei TIAN ; Zhidong HU ; Jin LI ; Yunsong YU ; Jie LIN ; Bin SHAN ; Yan DU ; Sufang GUO ; Lianhua WEI ; Fengmei ZOU ; Yunjian HU ; Xiaoman AI ; Chao ZHUO ; Danhong SU ; Dawen GUO ; Jinying ZHAO ; Hua YU ; Xiangning HUANG ; Wen'en LIU ; Yanming LI ; Yan JIN ; Chunhong SHAO ; Xuesong XU ; Chao YAN ; Shanmei WANG ; Yafei CHU ; Lixia ZHANG ; Juan MA ; Shuping ZHOU ; Yan ZHOU ; Lei ZHU ; Jinhua MENG ; Fang DONG ; Zhiyong LÜ ; Fangfang HU ; Han SHEN ; Wanqing ZHOU ; Wei JIA ; Gang LI ; Jinsong WU ; Yuemei LU ; Jihong LI ; Jinju DUAN ; Jianbang KANG ; Xiaobo MA ; Yanping ZHENG ; Ruyi GUO ; Yan ZHU ; Yunsheng CHEN ; Qing MENG ; Shifu WANG ; Xuefei HU ; Hong ZHANG ; Chun WANG ; Wenhui HUANG ; Ruizhong WANG ; Hua FANG ; Bixia YU ; Yong ZHAO ; Ping GONG ; Kaizhen WENG ; Yirong ZHANG ; Jiangshan LIU ; Longfeng LIAO ; Hongqin GU ; Lin JIANG ; Wen HE ; Shunhong XUE ; Jiao FENG ; Chunlei YUE
Chinese Journal of Infection and Chemotherapy 2025;25(4):445-454
Objective To summarize the changing prevalence of carbapenem resistance in Enterobacterales based on the data of CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021 for improving antimicrobial treatment in clinical practice.Methods Antimicrobial susceptibility testing was performed using a commercial automated susceptibility testing system according to the unified CHINET protocol.The results were interpreted according to the breakpoints of the Clinical & Laboratory Standards Institute(CLSI)M100 31st ed in 2021.Results Over the seven-year period(2015-2021),the overall prevalence of carbapenem-resistant Enterobacterales(CRE)was 9.43%(62 342/661 235).The prevalence of CRE strains in Klebsiella pneumoniae,Citrobacter freundii,and Enterobacter cloacae was 22.38%,9.73%,and 8.47%,respectively.The prevalence of CRE strains in Escherichia coli was 1.99%.A few CRE strains were also identified in Salmonella and Shigella.The CRE strains were mainly isolated from respiratory specimens(44.23±2.80)%,followed by blood(20.88±3.40)%and urine(18.40±3.45)%.Intensive care units(ICUs)were the major source of the CRE strains(27.43±5.20)%.CRE strains were resistant to all the β-lactam antibiotics tested and most non-β-lactam antimicrobial agents.The CRE strains were relatively susceptible to tigecycline and polymyxins with low resistance rates.Conclusions The prevalence of CRE strains was increasing from 2015 to 2021.CRE strains were highly resistant to most of the antibacterial drugs used in clinical practice.Clinicians should prescribe antimicrobial agents rationally.Hospitals should strengthen antibiotic stewardship in key clinical settings such as ICUs,and take effective infection control measures to curb CRE outbreak and epidemic in hospitals.


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