1.Research progress on DNA identification methods of narcotic plants
Jingzhi RAN ; Yankun WANG ; Peng XU ; Mengxiang SU ; Kaiming YAN ; Jin YAN
Journal of China Pharmaceutical University 2026;57(2):181-188
Narcotic plants are strictly regulated worldwide due to their ability to extract drug alkaloids and drug precursor components. Besides the three traditional core species, cannabis, opium poppy, and coca, the misuse of psychoactive plants with addictive properties has become increasingly prevalent globally in recent years, and the establishment of accurate identification methods for such plants has become an urgent need in the field of narcotics control. Within existing identification frameworks, the conventional morphological and chemical analysis methods, despite their long-term application, have demonstrated considerable limitations. In contrast, DNA-based molecular identification techniques have achieved significant advancement in recent years due to their high specificity and stability. This review comprehensively examines current DNA-based identification approaches for narcotic plants through three key dimensions: DNA molecular marker technology, DNA barcoding technology, and emerging molecular biological techniques, and elaborates on the principles, technical characteristics, application scenarios, and research progress of each technology, providing some reference for the scientific selection of DNA identification strategies for narcotic plants in different specific scenarios.
2.DING Ying's Clinical Experience in Treating Systemic Lupus Erythematosus Based on Differentiation of Yin Fire,Latent Fire,and Fire Toxin
Hongji WU ; Min GAO ; Yan XU ; Xuejun LI ; Jiexin SU ;
Journal of Traditional Chinese Medicine 2026;67(4):365-369
This paper summarizes Professor DING Ying's clinical experience in the treatment of systemic lupus erythematosus (SLE) through differentiation of three states, yin fire, latent fire, and fire toxin. It is proposed that fire pathogenic factors constitute a key pathological element running throughout the entire disease course of SLE. The evolution of its pathogenesis centers on these three states, spleen-kidney deficiency with the initial emergence of yin fire as the onset of disease, damage to yin by medicinal toxicity with internal blazing of latent fire as the driver of disease progression, and the interlocking of blood stasis and heat with intense scorching by fire toxin as the critical factor leading to severe and life-threatening conditions. Corresponding to these three stages, targeted prescriptions are formulated, Jiuwei Yishen Formulation (九味益肾方) to tonify the spleen and kidney, raise yang, and disperse fire; Ziyin Xiehuo Decoction (滋阴泄火汤) to nourish yin and fluids while clearing latent fire; and Santeng Changluo Jiedu Decoction (三藤畅络解毒汤) to dispel blood stasis, unblock the collaterals, detoxify, and restrain fire. This staged and integrated therapeutic strategy aims to address both root and branch and to achieve overall regulation, providing valuable guidance for the clinical differentiation and treatment of SLE.
3.Influencing Factors of Urate Crystal Deposition in Patients with Hyperuricemia and Prediction Model of TCM Syndrome Types-inflammatory Indicators
Jiaqi XU ; Bin AI ; Chao LIN ; Qiaoxuan LIN ; Changning LI ; Jing CAI ; Yan XIAO ; Jiemei GUO ; Youxin SU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):66-73
ObjectiveTo identify potential influencing factors of urate crystal deposition at ankle/foot in patients with hyperuricemia (HUA), and to analyze the predictive value of inflammatory indicators for urate crystal deposition in patients with different traditional Chinese medicine (TCM) syndromes, so as to provide potential reference for clinical risk assessment and individualized TCM intervention. MethodsA retrospective study was carried out with the enrollment of 231 HUA patients from The Third Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine between January 2021 and December 2024. The enrolled patients were further divided into a crystal deposition-positive group (143 cases) and a crystal deposition-negative group (88 cases) according to the results of dual-energy computed tomography (CT). Sociodemographic data, living habits, serum uric acid levels, and inflammatory indicators of the enrolled patients were collcted, and TCM syndrome differentiation was performed. Furthermore, univariate analysis was used to compare inter-group differences in clinical characteristics. MMultivariate Logistic regression was applied to identify the influencing factors of urate crystal deposition. In addition, the receiver operating characteristic (ROC) curves were plotted to evaluate the predictive efficacy of inflammatory indicators for crystal deposition across different TCM syndromes. ResultsThere were statistically significant inter-group differences in the proportion of males, age, body mass index, proportion of mental labor, rate of low water intake, and rate of high-sugar beverage consumption (P<0.05),whereas no significant difference in low exercise intensity was found between the two groups. Furthermore, compared with the negative group, the positive group had higher serum uric acid level, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), but lower systemic immune-inflammation index (SIRI) (P<0.05). Regarding the distribution of TCM syndromes, the positive group was dominated by the dampness-heat accumulation syndrome (55/143,38.46%), while the negative group was mainly characterized by the phlegm-turbidity obstruction syndrome (44/88,50.00%). Multivariate Logistic regression analysis revealed that high-sugar beverage consumption, elevated NLR, and elevated PLR were risk factors for urate crystal deposition [odd ratio (OR) = 8.002, 5.377, 1.034, respectively; 95% CI 1.572-40.732, 2.179-13.270, 1.013-1.054,all P<0.05], while SIRI was a protective factor (OR = 0.869, 95% CI 0.778-0.971, P<0.05). In the positive group, patients with the dampness-heat accumulation syndrome exhibited the highest NLR, while the lowest PLR and SIRI, showing statistically significant differences with those of other syndromes (all P<0.05). In addition, ROC curve analysis indicated that for the dampness-heat accumulation syndrome, the combined "NLR + PLR" model had an area under the curve (AUC) of 0.901 (95% CI 0.850-0.951, P<0.01), with a sensitivity of 89.1% and a specificity of 79.5%; for the blood stasis-heat obstruction syndrome, the combined "NLR + PLR" model had an AUC of 0.880 (95% CI 0.825-0.934, P<0.01), with a sensitivity of 100.0% and a specificity of 67.3%; for the liver-kidney Yin-deficiency syndrome, the single PLR model had an AUC of 0.842 (95% CI 0.731-0.952, P<0.01), with a sensitivity of 83.3% and a specificity of 84.0%. ConclusionUrate crystal deposition in HUA patients exhibits intimate associations with high-sugar beverage consumption as well as elevated NLR and PLR levels. Meanwhile, TCM syndrome differentiation has potential correlation with inflammatory characteristics. The inflammatory indicator-based prediction model constructed based on TCM syndromes exhibits good predictive value.
4.Effects of Zuogui Pill (左归丸) Decoction on Cerebral Perfusion and Corticospinal Tract Remodeling in Patients With Ischemic Stroke of the Liver-Kidney Yin Deficiency Syndrome
Xinyu XU ; Dan WU ; Xiaohui YAN ; Hao HUA ; Siqi MEI ; Zihan ZHOU ; Jinglin ZHAO ; Shiyu HE ; Xiaoyu FEI ; Yangfan LIU ; Yue SU ; Li LI ; Wenlei LI
Journal of Traditional Chinese Medicine 2026;67(21):2302-2310
ObjectiveTo evaluate the clinical efficacy of Zuogui Pill (左归丸,ZGP) decoction on neurological function, motor function, and activities of daily living in patients with ischemic stroke (IS) of liver-kidney yin deficiency syndrome, and to assess its potential mechanisms from the perspectives of cerebral perfusion and corticospinal tract (CST) remodeling. MethodsA total of 108 patients with IS of liver-kidney yin deficiency syndrome and onset time ≤14 days were enrolled and randomly divided into a control group and a treatment group, with 54 cases in each group. The control group received conventional western medicine, while the treatment group received ZGP decoction (one dose per day) in addition to the conventional treatment. Both groups were treated for 90 days. The National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), modified Barthel Index (MBI), Fugl-Meyer Assessment (FMA), and Chinese medicine syndrome score (CMS) were evaluated before treatment and after (90±3) days of treatment. Three-dimensional arterial spin labeling (3D-ASL) and diffusion tensor imaging (DTI) were performed to obtain ipsilesional cerebral blood flow (CBF) in the unaffected and affected hemispheres, relative CBF (rCBF), and fractional anisotropy (FA) of the CST. Nodal analysis of FA values along the CST was also conducted. Correlation analysis was used to assess the relationships between post-treatment cerebral perfusion parameters (CBF and rCBF), and FA values with clinical neurological function scores. ResultsAfter treatment, both groups showed significantly decreased NIHSS, mRS and CMS scores, together with significantly increased FMA and MBI scores (P<0.01). Intergroup comparison showed that NIHSS, mRS, and CMS scores in the treatment group were significantly lower than those in the control group , while MBI and FMA scores were significantly higher (P<0.01). The 3D-ASL results revealed that CBF and rCBF values in the affected hemisphere significantly increased in both groups after treatment, and the treatment group had significantly higher values (P<0.01). DTI showed that the FA value of the CST on the affected side in the treatment group was significantly higher than that in the control group after treatment (P<0.05). Nodal analysis along the CST further demonstrated that the continuity of FA values at lesion-related nodes 45~99 in the treatment group was significantly better than that in the control group (P<0.01), with significant increases at nodes 65~71 and 76~81 compared with baseline (P<0.05 or P<0.01), whereas the control group showed a decreasing trend at nodes 80~93 (P<0.05). Correlation analysis indicated that CBF and rCBF values in the affected hemisphere were negatively correlated with NIHSS and mRS scores and positively correlated with MBI score (P<0.05). FA value of the CST on the affected side, both before and after treatment, were negatively correlated with NIHSS score and positively correlated with FMA score (P<0.05 or P<0.01). ConclusionZGP decoction can effectively improve neurological function, motor function, and activities of daily living in IS patients with liver-kidney yin deficiency syndrome, and its mechanism may be related to enhanced cerebral perfusion in the affected hemisphere and corticospinal tract structural remodeling.
5.Clinical effects of Mahuang Fuzi Xixin Decoction combined with non-immunosuppressive treatment on patients with focal segmental glomerulosclerosis due to Spleen-Kidney Yang Deficiency
Tian-wen YAO ; Shi-sheng HAN ; Zhe-ling SU ; Yan-qiu XU ; Yi WANG
Chinese Traditional Patent Medicine 2025;47(7):2238-2242
AIM To investigate the clinical effects of Mahuang Fuzi Xixin Decoction combined with non-immunosuppressive treatment on patients with focal segmental glomerulosclerosis due to Spleen-Kidney Yang Deficiency.METHODS Sixty patients were randomly assigned into control group(30 cases)for 24-week intervention of non-immunosuppressive treatment,and observation group(30 cases)for 24-week intervention of both Mahuang Fuzi Xixin Decoction and non-immunosuppressive treatment.The changes in clinical effects,TCM syndrome effects,TCM syndrome score,24 h UTP,ALB,eGFR,Nephrin,Podocin and safety indices were detected.RESULTS The observation group demonstrated higher total effective rate and TCM syndrome effective rate than the control group(P<0.05).After the treatment,the two groups displayed decreased TCM syndrome score,24 h UTP,Nephrin,Podocin(P<0.05),and increased ALB(P<0.05),especially for the observation group(P<0.05).No obvious adverse reactions occured in the two groups.CONCLUSION For the patients with focal segmental glomerulosclerosis due to Spleen-Kidney Yang Deficiency,Mahuang Fuzi Xixin Decoction combined with non-immunosuppressive treatment can improve TCM syndromes,whose action mechanism may be contribute to the alleviation of podocyte injury.
6.Measurement of intervertebral disc height and analysis of strength after induced resorption of herniated nucleus pulpous
Liang BAI ; Su FU ; Xu YAN ; Chunlin ZHANG ; Ying LI
Chinese Journal of Tissue Engineering Research 2025;29(27):5785-5794
BACKGROUND:Induced resorption of herniated nucleus pulpous is a minimally invasive,non-invasive and innovative method for the treatment of cervical/lumbar intervertebral disc herniation.After induced resorption of herniated nucleus pulpous,the research about whether cervical/lumbar intervertebral disc can maintain the original biomechanical strength has not been reported.OBJECTIVE:To measure the height of adjacent vertebral centroid of cervical/lumbar intervertebral disc before and after induced resorption of herniated nucleus pulpous operation to analyze the changes of the biomechanical strength of the intervertebral disc after reclining and to provide a new basis for induced resorption of herniated nucleus pulpous treatment of cervical and lumbar intervertebral disc herniation.METHODS:A retrospective analysis was performed on 140 patients with cervical/lumbar intervertebral disc herniation who received induced resorption of herniated nucleus pulpous surgery in the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2023.Related software was used to measure the height of adjacent vertebral centroid of cervical/lumbar intervertebral disc of patients at each follow-up time point before and after induced resorption of herniated nucleus pulpous surgery in Magnetic Resonance Imaging image data under Artificial Intelligence-assisted calibration.Unoperated T1/T2 and T12/L1 segments were taken respectively as controls.Those with preoperative height of adjacent vertebral centroid less than 8%of the corresponding T1/T2 or T12/L1 control segment were in the"height reduction group"(hereafter referred to as group A)and the rest were in the"height unchanged group"(hereafter referred to as group B).The difference of height of adjacent vertebral centroid before and after operation between the group A and the group B was statistically analyzed.Simultaneously,the correlation between the volume of cervical and lumbar herniated discs and the changes of height of adjacent vertebral centroid was analyzed according to the result measured by artificial intelligence.RESULTS AND CONCLUSION:(1)The study maintained a total of 140 patients,including 60 cases of cervical disc herniation and 80 cases of lumbar disc herniation.The postoperative follow-up period was 7 days to 12 months.(2)A total of 281 discs were measured in the cervical vertebra group,including 60 intervertebral discs in the control group.The mean value of height of adjacent vertebral centroid before and at the last postoperative follow-up was about 20.46 mm and 20.17 mm,respectively,with no statistical difference(P>0.05).There were 162 cervical discs in group A.The average height of adjacent vertebral centroid before and after operation was 16.65 mm and 15.92 mm,respectively,with no statistically significant difference(P>0.05).The mean cervical disc herniation volume before and after surgery was 510.28 mm3 and 364.76 mm3,respectively,which was not significantly correlated with height of adjacent vertebral centroid change(P>0.05).There were 64 discs in the group B,with average of 20.15 mm before operation and 19.09 mm at the last follow-up,and there was no significant difference(P>0.05).The mean volume of cervical disc herniation before and after surgery was 515.32 mm3 and 361.98 mm3,respectively,and there was no significant correlation with the change of height of adjacent vertebral centroid(P>0.05).(3)A total of 258 discs were measured in the lumbar spine group,of which 80 intervertebral discs in the control group,the average height of adjacent vertebral centroid was 33.03 mm before operation and 32.40 mm at the last follow-up,and there was no significant difference.There were 59 discs in the group A,and the average height of adjacent vertebral centroid before and after operation was 30.08 mm and 31.67 mm,respectively,with no statistically significant difference.The mean volume of lumbar disc herniation before and after operation was 690.51 mm3 and 496.58 mm3,respectively,and there was no significant correlation with the change of height of adjacent vertebral centroid(P>0.05).There were 119 discs in the group B,with an average height of adjacent vertebral centroid of 35.91 mm before surgery and 34.12 mm at the last follow-up.The mean volume of lumbar disc herniation before and after operation was 698.70 mm3 and 535.99 mm3,respectively,and there was no significant correlation with the change of height of adjacent vertebral centroid.(4)It is concluded that patients with cervical/lumbar intervertebral disc herniation can maintain the same intervertebral height level after induced resorption of herniated nucleus pulpous regardless of whether the intervertebral height has decreased before operation.It can be inferred that the resorption of the herniated disc does not affect its biomechanical strength.It suggests that induced resorption of herniated nucleus pulpous surgery should be performed before the intervertebral height of the degenerate segment has decreased.The induced resorption of herniated nucleus pulpous is more valuable to maintain the biomechanical strength of the resorptive disc.
7.Expert consensus:Prevention and treatment of dental implant biological complications
Xing WANG ; Liping WANG ; Qintao WANG ; Rong SHU ; Dongying XUAN ; Yiqun WU ; Lixin QIU ; Derong ZOU ; Yingliang SONG ; Jiang CHEN ; Yan XU ; Jincai ZHANG ; Yucheng SU ; Linhu GE ; Yufeng XIE
STOMATOLOGY 2025;45(11):801-807
Dental implantology has developed rapidly for over half a century,since pure titanium(99.7%)dental cylindrical threaded implants were exploited and osseointegration was introduced in 1960s by Prof.Br?nemark.The long term retention rates of 10 years or more are over 95%.However,the biological complications jeopardize the long term effects of dental implant treatment seriously.The prevalence of dental implant biological complications varies greatly among different reports resulting from the disparities on the defini-tions of dental implant biological complications.After analyzing and summarizing the major opinions proposed internationally in recent years,the consensus for the definition of dental implant biological complications has been reached.Generally the dental implant biologi-cal implications can be classified into early stage(before restoration)biological complications and late stage(after restoration)biological complications.The early stage biological complications include acute and chronic infections,pain,soft tissue deficiency,and osseointegration failure,etc.The late stage complications include peri-implant diseases(peri-implant mucositis and peri-implantitis),soft tissue deficiency around implant,implant loosening and dropping off,etc.The various risk factors related to different dental implant biological complications,the strategies of the prevention and treatment for the dental implant biological complications have been discussed comprehensively,and the consensus has been reached.It is aimed to advocate the dentist to pay more attention to the early prevention of the biological implant complications,to promote more researches on the implant biological complications,and to help elevate the level of dental implantology in our country.
8.Environmental Temperature and the Risk of Hand, Foot, and Mouth Disease Transmission in the Yangtze River Region of China.
Yan Qing YANG ; Min CHEN ; Jin LI ; Kai Qi LIU ; Xue Yan GUO ; Xin XU ; Qian LIANG ; Xing Lu WU ; Su Wen LEI ; Jing LI
Biomedical and Environmental Sciences 2025;38(3):290-302
OBJECTIVE:
To assess health equity in the Yangtze River region to improve understanding of the correlation between hand, foot, and mouth disease (HFMD) and socioeconomic factors.
METHODS:
From 2014-2016, data on HFMD incidence, population statistics, economic indicators, and meteorology from 26 cities along the Yangtze River were analyzed. A multi-city random-effects meta-analysis was performed to study the relationship between temperature and HFMD transmission, and health equity was assessed with respect to socio-economic impact.
RESULTS:
Over the study period, 919,458 HFMD cases were reported, with Shanghai (162,303) having the highest incidence and Tongling (5,513) having the lowest. Males were more commonly affected (male-to-female ratio, 1.49:1). The exposure-response relationship had an M-shaped curve, with two HFMD peaks occurring at 4 °C and 26 °C. The relative risk had two peaks at 1.30 °C (1.834, 95% CI: 1.204-2.794) and 31.4 °C (1.143, 95% CI: 0.901-1.451), forming an M shape, with the first peak higher than the second. The most significant impact of temperature on HFMD was observed between -2 °C and 18.1 °C. The concentration index (0.2463) indicated moderate concentration differences, whereas the Theil index (0.0418) showed low inequality in distribution.
CONCLUSION
The incidence of HFMD varied across cities, particularly with changes in temperature. Economically prosperous areas showed higher risks, indicating disparities. Targeted interventions in these areas are crucial for mitigating the risk of HFMD.
Female
;
Humans
;
Male
;
China/epidemiology*
;
Cities/epidemiology*
;
Hand, Foot and Mouth Disease/transmission*
;
Incidence
;
Risk Factors
;
Temperature
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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