OBJECTIVE: To investigate the effects of using different filters in continuous renal replacement therapy (CRRT) on the mortality, inflammatory mediator level and hemodynamics in patients with sepsis-associated acute kidney injury (SA-AKI). METHODS: A prospective study was conducted. The patients with SA-AKI undergoing first CRRT admitted to the critical care medicine department of General Hospital of Ningxia Medical University from August 2022 to October 2023 were enrolled as the study objects, and they were divided into observation group and control group by random number table method. All patients received routine treatment including anti-infection, optimized volume management and organ function support. On this basis, the observation group was treated with oXiris filter for CRRT, while the control group was treated with ordinary filter for CRRT, and the first treatment time was ≥ 36 hours. General data of the two groups were collected and compared. At the same time, the inflammatory indicators [high-sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT), interleukin-6 (IL-6)], sequential organ failure assessment (SOFA) score, mean arterial pressure (MAP), blood lactic acid (Lac), noradrenaline dosage and other related indicators were collected before CRRT treatment and 24 hours and 48 hours after treatment, and the 7-day and 28-day mortality of patients were recorded. RESULTS: Finally, 65 patients were enrolled, including 30 in the observation group and 35 in the control group. There were no significant differences in baseline data including age, gender, acute kidney injury (AKI) stage and infection source between the two groups. The 7-day mortality of observation group was significantly lower than that of control group [16.7% (5/30) vs. 42.9% (15/35), P < 0.05]. There was no significant difference in 28-day mortality between the observation group and the control group [36.7% (11/30) vs. 54.3% (19/35), P > 0.05]. There were no significant differences in inflammation indicators, SOFA score, MAP, Lac and norepinephrine dosage before treatment between the two groups. After 24-hour and 48-hour treatment, the hemodynamics of the two groups were stable compared with before treatment, the inflammatory indicators, SOFA score, Lac and norepinephrine dosage were reduced to varying degrees, and MAP was significantly increased. In the observation group, hs-CRP, PCT, IL-6, SOFA score, MAP, and norepinephrine dosage showed statistical significance at 24 hours after treatment as compared with before treatment [hs-CRP (mg/L): 125.0 (105.0, 171.2) vs. 280.5 (213.2, 313.8), PCT (μg/L): 51.0 (20.0, 62.8) vs. 71.0 (10.8, 100.0), IL-6 (ng/L): 1 762.2 (300.8, 4 327.5) vs. 4 447.5 (630.4, 5 000.0), SOFA score: 13.0 (12.0, 14.0) vs. 16.0 (15.0, 17.0), MAP (mmHg, 1 mmHg ≈ 0.133 kPa): 79.00±12.87 vs. 65.20±11.70, norepinephrine dosage (μg×kg^-1×min^-1): 0.82±0.33 vs. 1.63±0.51, all P < 0.05]. In the control group, PCT and MAP showed statistical significance after 48 hours of treatment as compared with before treatment. Compared with the control group, hs-CRP, SOFA score and norepinephrine dosage after 48 hours of treatment in the observation group were significantly decreased [hs-CRP (mg/L): 87.2 (74.2, 126.0) vs. 157.0 (88.0, 200.0), SOFA score: 11.0 (10.0, 12.0) vs. 12.0 (10.0, 14.0), norepinephrine dosage (μg×kg^-1×min^-1): 0.51±0.37 vs. 0.81±0.58, all P < 0.05], MAP was significantly increased (mmHg: 82.00±8.71 vs. 77.77±7.80, P < 0.05). CONCLUSION In the treatment of CRRT, oXiris filter can reduce the short-term mortality of SA-AKI patients, lower inflammatory mediators levels and improve hemodynamics, showing therapeutic advantages over conventional filters.
Humans ; Acute Kidney Injury/etiology* ; Sepsis/therapy* ; Prospective Studies ; Interleukin-6 ; Continuous Renal Replacement Therapy/methods* ; C-Reactive Protein ; Male ; Female ; Middle Aged ; Hemodynamics ; Procalcitonin ; Aged

OBJECTIVE: To investigate the predictive value of inflammatory indicator and serum cystatin C (Cys C) for the prognosis of patients with sepsis-associated acute kidney injury (SA-AKI). METHODS: A prospective observational study was conducted. Patients with SA-AKI admitted to the intensive care unit (ICU) of the General Hospital of Ningxia Medical University from January 2022 to December 2023 were selected as the study subjects. General patient data, sequential organ failure assessment (SOFA), acute physiology and chronic health evaluation II (APACHE II), inflammatory indicator, and serum Cys C levels were collected. The 28-day survival status of the patients was observed. A multivariate Logistic regression model was used to analyze the risk factors affecting the poor prognosis of SA-AKI patients. Receiver operator characteristic curve (ROC curve) was plotted to evaluate the predictive efficacy of each risk factor for the prognosis of SA-AKI patients. RESULTS: A total of 111 SA-AKI patients were included, with 65 patients (58.6%) in the survival group and 46 patients (41.4%) in the death group. The SOFA score, APACHE II score, interleukin-6 (IL-6), procalcitonin (PCT), hypersensitive C-reactive protein (hs-CRP), and serum Cys C levels in the death group were significantly higher than those in the survival group [SOFA score: 15.00 (14.00, 17.25) vs. 14.00 (11.00, 16.00), APACHE II score: 26.00 (23.75, 28.00) vs. 23.00 (18.50, 28.00), IL-6 (ng/L): 3 731.00±1 573.61 vs. 2 087.93±1 702.88, PCT (μg/L): 78.19±30.35 vs. 43.56±35.37, hs-CRP (mg/L): 266.50 (183.75, 326.75) vs. 210.00 (188.00, 273.00), serum Cys C (mg/L): 2.01±0.61 vs. 1.62±0.50, all P < 0.05]. Multivariate Logistic regression analysis showed that SOFA score [odds ratio (OR) = 1.273, 95% confidence interval (95%CI) was 1.012-1.600, P = 0.039], IL-6 (OR = 1.000, 95%CI was 1.000-1.001, P = 0.043), PCT (OR = 1.018, 95%CI was 1.002-1.035, P = 0.030), and Cys C (OR = 4.139, 95%CI was 1.727-9.919, P = 0.001) were independent risk factors affecting the 28-day prognosis of SA-AKI patients. ROC curve analysis showed that the area under the curve (AUC) of SOFA score, IL-6, PCT, and Cys C in predicting the 28-day prognosis of SA-AKI patients were 0.682 (95%CI was 0.582-0.782, P = 0.001), 0.753 (95%CI was 0.662-0.843, P < 0.001), 0.765 (95%CI was 0.677-0.854, P < 0.001), and 0.690 (95%CI was 0.583-0.798, P = 0.001), respectively. The combined predictive value of these four indicators for the prognosis of SA-AKI patients were superior to that of any single indicator, with an AUC of 0.847 (95%CI was 0.778-0.916, P < 0.001), a sensitivity of 95.7%, and a specificity of 56.9%. CONCLUSION The combination of SOFA score, IL-6, PCT, and Cys C provides a reliable predictive value for the prognosis of SA-AKI patients.
Humans ; Acute Kidney Injury/mortality* ; APACHE ; C-Reactive Protein ; Cystatin C/blood* ; Interleukin-6/blood* ; Logistic Models ; Predictive Value of Tests ; Procalcitonin/blood* ; Prognosis ; Prospective Studies ; Risk Factors ; ROC Curve ; Sepsis/mortality*

Objective To apply network Meta-analysis to evaluate the clinical efficacy of 3 classical prescriptions Xuebijing,Xijiao Dihuang decoction,and Qingyuan Shenghua decoction in treating sepsis complicated with coagulation dysfunction.Methods Computer-based searches were conducted in the following databases:China National Knowledge Infrastructure(CNKI),VIP Database,Wanfang Database,PubMed Database,and the Cochrane Library,to retrieve randomized controlled trial(RCT)on the treatment of sepsis complicated with coagulation dysfunction and disseminated intravascular coagulation(DIC)using 3 classical prescriptions-Xuebijing,Xijiao Dihuang decoction,and Qingyuan Shenghua decoction.The search period was from database inception to May 1,2023.The control group received conventional Western medicine treatment alone,while the treatment group received additional therapy with Xuebijing,Xijiao Dihuang decoction,or Qingyuan Shenghua decoction.Primary outcome measures included the sequential organ failure assessment(SOFA)score,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,activated partial thromboplastin time(APTT),D-dimer,fibrinogen(Fib),prothrombin time(PT)and platelet count(PLT).Two researchers evaluated and screened the included studies,performed data extraction,and assessed literature quality.The network Meta-analysis was conducted using Stata 17.0 software.Results A total of 27 RCTs were finally included,with 2268 cases enrolled.The network Meta-analysis results showed that the surface under the cumulative ranking curve(SUCRA):①In terms of improving APACHEⅡscores:Qingyuan Shenghua decoction combination group(93.2%)>Xuebijing combination group(67.9%)>Xijiao Dihuang decoction combination group(37.5%)>conventional Western medicine treatment alone group(1.4%);②In terms of improving SOFA scores:Qingyuan Shenghua decoction combination group(93.7%)>Xuebijing combination group(63.0%)>Xijiao Dihuang decoction combination group(41.8%)>conventional Western medicine treatment alone group(1.5%);③In terms of improving APTT:Qingyuan Shenghua decoction combination group(95.6%)>Xijiao Dihuang decoction combination group(57.1%)>Xuebijing combination group(46.6%)>conventional Western medicine treatment alone group(0.7%);④In terms of improving D-dimer:Xijiao Dihuang decoction combination group(86.1%)>Qingyuan Shenghua decoction combination group(80.5%)>Xuebijing combination group(33.3%)>conventional Western medicine treatment alone group(0.0%);⑤In terms of improving Fib:Xijiao Dihuang decoction combination group(97.5%)>Qingyuan Shenghua decoction combination group(63.5%)>conventional Western medicine treatment alone group(37.8%)>Xuebijing combination group(1.2%);⑥In terms of shortening PT:Qingyuan Shenghua decoction combination group(67.5%)>Xuebijing combination group(67.4%)>Xijiao Dihuang decoction combination group(63.0%)>conventional Western medicine treatment alone group(2.2%);⑦In terms of improving PLT:Xuebijing combination group(83.6%)>Qingyuan Shenghua decoction combination group(54.9%)>Xijiao Dihuang decoction combination group(49.4%)>conventional Western medicine treatment alone group(12.1%).Conclusion The 3 classical Chinese herbal prescriptions combined with conventional Western medicine all demonstrated significant improvement effects on sepsis complicated with coagulation dysfunction.Among them,Xuebijing showed the most stable clinical efficacy,improving both disease severity scores and multiple coagulation indicators.Qingyuan Shenghua decoction was more effective in improving overall prognosis compared to the other two prescriptions.As for Xijiao Dihuang decoction,its clinical efficacy in ameliorating sepsis-related thrombosis warrants further exploration.

Human alphaherpesvirus 2 (HSV-2) is the main pathogen resulting human genital herpes, which poses a major threat to the socio-economic development, while there is no effective vaccine. In this study, we developed a novel lipopolyplex (LPP)-delivered mRNA vaccine expressing the HSV-2 envelope glycoprotein gD and evaluated its immunogenicity in mice. The mRNA vaccine was prepared from the genetically modified gD mRNA synthesized in vitro combined with the LPP delivery platform and it was named gD-ORI mRNA. The expression of gD antigen in the mRNA vaccine was validated in vitro by Western blotting and indirect immunofluorescence assay, then the immune responses induced by this mRNA vaccine in mice were evaluated. The immunization with gD mRNA alone induced strong humoral and cellular immune responses in mice. Robust and long-lasting gD-specific IgG antibodies were detected in the mouse serum after booster immunization with gD-ORI mRNA. The immunized mice exhibited a Th1/Th2 balanced IgG response and robust neutralizing antibodies against HSV-2, and a clear dose-response relationship was observed. The gD-specific IgG antibodies were maintained in mice for a long time, up to 18 weeks post-booster immunization. At the same time, multifunctional gD-specific CD4⁺ and CD8⁺ T cells in vaccinated mice were detected by intracellular cytokine staining (ICS). This novel gD-expressing mRNA vaccine delivered by LPP induces strong and long-lasting immune responses in mice post booster immunization and has a promising prospect for development and application. This study provides scientific evidence and reference for the development of a new mRNA vaccine for HSV-2.
Animals ; Herpesvirus 2, Human/genetics* ; Viral Envelope Proteins/genetics* ; Mice ; Herpes Genitalis/immunology* ; RNA, Messenger/immunology* ; Female ; Mice, Inbred BALB C ; Antibodies, Viral/blood* ; mRNA Vaccines/immunology* ; Antibodies, Neutralizing/blood* ; Humans

BACKGROUND:Electromyographic biofeedback therapy has demonstrated unique advantages of non-invasive,real-time feedback,personalized treatment and promotion of neuroplasticity,and can promote the recovery of motor function in patients with spinal cord injury.OBJECTIVE:To review the current application status and therapeutic effects of electromyographic biofeedback combined with exercise therapy,robotic exoskeletons,and virtual reality technology in the recovery of motor function after spinal cord injury.METHODS:Relevant literature was retrieved from CNKI and PubMed databases up to May 2024.The search terms included"spinal cord injury,EMG biofeedback,physical therapy,robotic exoskeleton,VR,motor function,exercise"in both English and Chinese.Finally,71 articles were included for review.RESULTS AND CONCLUSION:Mechanisms by which electromyographic biofeedback therapy promotes spinal cord injury rehabilitation include promoting neural plasticity changes,strengthening neuromuscular connections and improving movement patterns.Electromyographic biofeedback,as an emerging tool for treating spinal cord injury,is often used in conjunction with other therapeutic methods,including exercise therapy,robotic exoskeletons,and VR,to promote the recovery of motor function after spinal cord injury.The effectiveness of combination therapy has been significantly improved.However,there are still some problems and challenges,such as the lack of detailed analysis of the mechanism,the lack of large-scale trials that provide strong evidence for combined efficacy,and the limited adaptability of the technology.Future research can focus on these aspects:to improve the personalization and accuracy of electromyographic biofeedback;to develop new rehabilitation equipment and expand the application areas of electromyographic biofeedback combined with more advanced technologies or engineering equipment;to apply electromyographic biofeedback to gait training systems,respiratory training systems,and limb-linkage rehabilitation systems,so as to improve the accuracy of the feedback and the effect of personalized treatment plans.At the same time,the ease of use and comfort of the equipment will be improved.

Objective To propose a novel method based on three-dimensional depthwise separable convolution network(3D DSN)for the separation of PET images with dual tracers of 18F-FDG and 18F-FAPI.Methods A total of 120 pairs of 18F-FDG and 18F-FAPI PET images of the same patient scanned separately at different time points were collected,and the dual-tracer PET image was generated through simulation.After the image registration of PET images of two tracers for ensuring spatial position matching,the registered PET images were forward-projected to generate sinogram data,and the sinogram data of two tracers were accumulated to obtain mixed sinogram data.Subsequently,the dual-tracer PET image was reconstructed using maximum likelihood expectation maximization and input into a 3D DSN based network for image separation,thereby obtaining PET images of two single tracers.Results Compared with 3D CNN method,the proposed method increased the structure similarity index measure(SSIM)of the separated 18F-FDG images to the real 18F-FDG images by 0.87%,increased the peak signal-to-noise ratio(PSNR)by 11.8%,and reduced the normalized root mean square error(NRMSE)by 52%.The SSIM of the separated 18F-FAPI images to the real 18F-FAPI images increased by 1.1%,PSNR increased by 17.0%,and NRMSE decreased by 51%.Conclusion The proposed method can be effectively applied to simultaneous PET imaging with dual PET tracers,reducing the number of scans and costs in time and money,and providing clinical doctors more accurate and abundant diagnostic information.

Objective To investigate serum levels of eosinophilic neurotoxin(EDN),interleukin(IL)-13 and transforming growth factor(TGF)-β1 in children with recurrent wheezing of mycoplasma pneumoniae(MP)infection and analyze risk factors of recurrent wheezing with MP infection.Methods A total of 80 children with MP infection were divided into the MP infection recurrence wheezing group(45 cases)and the MP infection non-wheezing group(35 cases)according to the previous history of MP infection with wheezing,and 35 children with acute attacks of bronchial asthma were selected as the asthma group.The levels of EDN,IL-13 and TGF-β1 were determined by enzyme-linked immunosorbent assay.Multivariate Logistic regression analysis was performed to analyze risk factors of MP infection recurrence and wheezing.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of EDN,IL-13 and TGF-β1 on MP infection recurrence and wheezing.Results Compared with the non-asthmatic group,levels of EDN,IL-13 and TGF-β1 were higher in the recurrent asthmatic group and the asthmatic group(P＜0.05).There were no significant differences in EDN,IL-13 and TGF-β1 levels between the asthma group and the recurrent asthmatic group.Univariate analysis showed that the birth weight was lower in the recurrent wheezing group than that of the non-wheezing group,and the proportion of atopic constitution,the first and second degree relatives allergy history,smoke exposure and hospital stay≥7 d were higher than those of the non-wheezing group(P＜0.05).Multivariate Logistic regression analysis showed that higher levels of EDN,IL-13,TGF-β1,atopic constitution and smoke exposure were risk factors for recurrent wheezing of MP infection(P＜0.05).ROC curve results showed that the AUC of EDN,IL-13 and TGF-β1 for predicting the recurrence of MP infection and wheeting was 0.688,0.662 and 0.689,respectively,and the AUC of the combined prediction of EDN,IL-13 and TGF-β1 was 0.765,which was the most effective than each single index.Conclusion Serum levels of EDN,IL-13 and TGF-β1 increase in children with recurrent wheezing of MP infection,and their serum levels may predict repeated wheezing in children after MP infection,providing guidance for clinical intervention.

Objective:To explore the effects of magnolol on autophagy in intestinal Cajal cells and intestinal motility in rats with acute necrotizing pancreatitis (ANP).Methods:Forty-five Wistar rats were randomly divided into three groups by a random number table: control group, ANP group and magnolol intervention group, with 15 rats in each group. The ANP model was established by intraperitoneal injection of cerulein. The magnolol intervention group received a tail vein injection of 20 μg/kg magnolol ethanol solution 30 minutes after modeling. After 12 hours, ileal tissues were collected for pathological examination and scoring. Intestinal transit rate was measured using the carbon powder propulsion method, and isolated intestinal muscle strips were prepared to assess amplitude and frequency of spontaneous contraction. Oxidative stress markers in intestinal tissues, including superoxide dismutase (SOD) activity, malondialdehyde (MDA) and nitric oxide (NO) levels, were measured using xanthine oxidase, thiobarbituric acid, and enzymatic reduction assay kits, respectively. Cajal cells were isolated from intestinal smooth muscle tissues, and the expression of autophagy-related proteins (Beclin1, LC3Ⅱ, LC3Ⅰ, p62) and p-Kit was detected by Western blot. Double immunofluorescence staining was used to trace autophagy in Cajal cells.Results:The pathological scores of ileal tissues in the control, ANP, and magnolol intervention groups were (0.33±0.52), (4.83±0.41), and (3.50±0.55), respectively. The score in ANP group was significantly higher than that in the control group, while the score in the magnolol intervention group was lower than that in the ANP group, with statistically significant differences (all P value <0.05). Intestinal transit rate, amplitude and frequency of spontaneous contraction in the ANP group were significantly slower than those in the control group, while these parameters in the magnolol intervention group were significantly improved compared to the ANP group, with statistically significant differences (all P value <0.05). SOD activity in the control, ANP, and magnolol intervention groups were (73.8±8.1), (42.8±7.2), and (71.2±10.4) N/mg prot, respectively; NO levels were (1.72±0.26), (3.19±0.43), and (1.94±0.23) μmol/g prot; and MDA levels were (1.15±0.38), (3.84±0.30), and (1.68±0.33) nmol/mg prot. SOD activity in the ANP group was significantly lower than that in the control group, while NO and MDA contents were significantly higher. In the magnolol intervention group, SOD activity was significantly higher, and NO and MDA contents were significantly lower than those in the ANP group, with statistically significant differences (all P value <0.01). The levels of Beclin1, LC3Ⅱ/Ⅰ ratio, and p-Kit in the intestinal Cajal cells of ANP group were significantly higher than those in the intestinal Cajal cells of control group, while the p62 level was significantly lower. In the intestinal Cajal cells of magnolol intervention group, the levels of Beclin1, LC3Ⅱ/Ⅰ ratio, and p-Kit were significantly lower while the p62 level was significantly higher than those in the intestinal Cajal cells of ANP group, with statistically significant differences (all P value <0.01). The numbers of c-Kit/GFP-LC3 double-positive Cajal cells in the control group, ANP group, and magnolol intervention group were (9.59±5.06), (11.27±8.30), and (10.27±6.30), respectively. The ANP group had significantly more double-positive cells than the control group, while the magnolol intervention group had significantly less double-positive cells than the ANP group, with statistically significant differences (all P value <0.05). Conclusions:Excessive oxidative stress and autophagy in Cajal cells are important mechanisms underlying ANP-induced intestinal motility dysfunction. Magnolol can improve intestinal motility in ANP by antagonizing oxidative stress and reducing autophagy in Cajal cells. p-Kit may play a regulatory role in this process.

Objective:To investigate the efficacy and safety of Doxycycline in the treatment of Mycoplasma pneumoniae pneumonia (MPP). Methods:Case series study.A retrospective observational study was conducted on 202 patients diagnosed with MPP in Beijing United Family Hospital from January 2022 to January 2024.The patients were divided into 3 groups according to antibiotics used: Azithromycin group which enrolled 93 cases, 60 cases (Azithromycin alone group) were included after excluding 33 cases with adding steroids; Doxycycline group which enrolled 32 case, 31 cases (Doxycycline alone group) were included after excluding 1 case with adding steroids; Azithromycin switch to Doxycycline when diagnosed Macrolides-unresponsive MPP(MUMPP). Azithromycin switch to Doxycycline group which enrolled 77 cases, 73 cases (switch group) were included after excluding 4 cases with adding steroids.Results used the Mann-Whitney U test, Chi-square test or exact test analyse, comparing the differences in defervescene time, hospitalization day, outcomes and side effects in each group. Results:The fever duration in the Doxycycline alone group was 48(36, 48) h, which was significantly shorter than that in the Azithromycin alone group[120(120, 144) h] ( Z=-7.646, P<0.001). The hospitalization time in the Doxycycline alone group was [3(3, 4) d], which was significantly shorter than that in the Azithromycin alone group [4(3, 5) d] ( Z=-3.368, P=0.002). The medium fever duration in the switch group after Azithromycin was changed to Doxycycline was 48 h, which was not statistically significantly different from that in the Doxycycline alone group ( Z=-0.571, P=0.849). The medium hospitalization time in the switch group after Azithromycin changed to Doxycycline was 4 d, which was significantly longer than that in the Doxycycline alone group (3 d) ( Z=-2.759, P=0.008). Among 93 cases enrolled in the Azithromycin group, 33 cases (35.5%) converted to unresponsive MPP(UMPP), 23 cases (24.7%) progressed to refractory MPP (RMPP), and 33 cases (35.5%) added steroids.Among 32 cases included in the Doxycycline group, 1 case (3.1%) converted to UMPP, no case developed to RMPP, and 1 case (3.1%) added steroids.The above-mentioned 3 proportions were significantly different between the two groups (all P<0.001). Among 93 cases enrolled in the Azithromycin group, 11 cases (11.8%) progressed to severe MPP (SMPP), and 13 cases (14.0%) developed complications.In 32 cases included in the Doxycycline group, 1 case (3.1%) progressed to SMPP, and 3 cases (9.4%) developed complications.The difference in these 2 proportions was not statistically significant between the two groups ( P=0.294, 0.760). In 77 patients included in the Azithromycin switch to Doxycycline group, there were 4 cases converting to UMPP, 4 cases converting to RMPP and 4 cases adding steroids, which were not statistically significantly different from those in the Doxycycline group (all P=0.540). In the Azithromycin switch to Doxycycline group, there were 3 cases progressing to SMPP, and 7 cases developed complications, which were not statistically significantly different from those in the Doxycycline group (all P=1.000). Conclusions:Doxycycline can improve the fever symptom, shorten illness duration and hospitalization time, and reduce steroid usage and the proportions of UMPP and RMPP in pediatric MPP.Switching to Doxycycline is recommended for MUMPP patients as Doxycycline is effective for the treatment of pediatric MPP and no tetracycline pigmentation teeth now.

Objective:To characterize the minimal inhibitory concentration (MIC) of macrolides against clinical Mycoplasma pneumoniae (MP) isolates and to investigate the significance of 23S rRNA mutations. Methods:Cross-sectional study.A total of 288 clinical MP strains preserved in the laboratory from 2016 to 2021 were taken for macrolide resistance gene testing and the evaluation of in vitro susceptibility to Azithromycin and Erythromycin.MIC 50 and MIC 90 values were calculated separately for macrolide-susceptible and -resistant strains. Results:All 288 MP strains underwent the test of in vitro susceptibility to Azithromycin, while 86 of them were additionally tested for Erythromycin.Among these strains, 22 strains were Azithromycin-sensitive, and 266 strains were Azithromycin-resistant.A2063G mutations were detected in 260 (97.7%) strains, while A2064G mutations were detected in 6 (2.3%) strains.Azithromycin-resistant strains had an MIC 50 of 128.000 μg/mL and an MIC 90 of 512.000 μg/mL, with the MIC ranging between 16.000 and 512.000 μg/mL.Seven strains were sensitive and 79 strains were resistant to Erythromycin.Among Erythromycin-resistant strains, A2063G mutations were detected in 73 (92.4%) strains, while A2064G mutations were detected in 6 (7.6%) strains.Erythromycin-resistant strains had an MIC 50 of 256.000 μg/mL and an MIC 90 of 512.000 μg/mL, with the MIC ranging between 64.000 and 1 024.000 μg/mL. Conclusions:A2063G and A2064G mutations in the 23S rRNA gene of MP are associated with high-level in vitro resistance to Azithromycin and Erythromycin, significantly limiting the clinical effectiveness of these antibiotics.Early resistance gene testing is recommended for suspected MP patients, which can help optimize the treatment, improve prognosis, and prevent resistance spread.