Wang Ji is an outstanding representative of Xin'an medicine,he has made a lot of achievements in academic thought of acupuncture and moxibustion,which mainly contains the academic features such as"acupuncture treatment mainly purging excessive pathogen"and"use of moxibustion with caution for the disease-free person",as well as"no selection of fixed acupoints for treating diseases".The scholars in past dynasties did a lot of research on his theory of"acupuncture treatment mainly purging excessive pathogen"and"use of moxibustion with caution for the disease-free person",but did less research on his theory of"no selection of fixed acupoints for treating diseases",this paper explores Wang Ji's life and his representative works,and analyzes the theory of"no selection of fixed acupoints for treating diseases".Wang Ji advocates the disease treatment principle of differentiation of meridians and collaterals,qi and blood,as well as yin and yang,and his acupoint selection rules focuses on flexible prescription according to syndrome differentiation,point selection according to disease differentiation,which critically criticizes the dogmatic behavior of the conventional theory that"a certain acupoint corresponding treatment for a certain disease",he reminded the physicians that in treating disease by acupuncture and moxibustion,syndrome differentiation should be according to meridians and collaterals differentiation,acupoint application should be flexible and changeable.

Objective To analyze the correlation of inflammatory indicators of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),monocyte-to-lymphocyte ratio(MLR),and systemic immune-inflammation index(SII)with traditional Chinese medicine(TCM)syndrome types and Chinese version of Thyroid Imaging Reporting and Data System(C-TIRADS)classification and properties of nodules in the patients with thyroid nodules(TN),thus to provide evidence for guiding TCM syndrome differentiation and treatment,and for assessing C-TIRADS classification and properties of the nodules in patients with TN.Methods A retrospective analysis was carried out in 140 inpatients who were diagnosed as TN and had underwent thyroidectomy during the period of January 2021 to January 2024 in the Department of General Surgery of Guangzhou Integrated Chinese and Western Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine(Guangzhou Hospital of Integrated Traditional and West Medicine).The patients were allocated to various group with reference to TCM syndrome types,C-TIRADS classification,and the properties of TN.The correlation of each clinical indicator with TCM syndrome types and C-TIRADS classification and properties of TN was analyzed.The Spearman correlation coefficient was employed for evaluating the correlation of clinical indicators with the C-TIRADS classification and properties of TN,receiver operating characteristic curve(ROC)was used to analyze the predictive value of NLR,MLR,PLR,and SII for the properties of nodules in patients with TN,and the Youden's Index was used to determine the cutoff value for optimal prediction.Results(1)According to the criteria of TCM syndrome differentiation,72 cases were differentiated as qi stagnation and phlegm obstruction syndrome,65 cases as phlegm accumulation and blood stasis syndrome,and 3 cases as heart-liver yin deficiency syndrome.For the number of cases of heart-liver yin deficiency syndrome was too small,only the first two syndromes were included for the analysis.(2)The levels of free T3(FT3)and free T4(FT4)in the patients of qi stagnation and phlegm obstruction syndrome were higher,and the levels of anti-thyroid peroxidase antibody(A-TPO),anti-thyroglobulin antibody(A-TG),neutrophil(NEU),NLR,and SII were lower than those in the patients of phlegm accumulation and blood stasis syndrome,the differences being all statistically significant(P<0.05 or P<0.01).(3)The levels of NLR,PLR,and SII in the patients with C-TIRADS3 classification were lower than those in the patients with C-TIRADS4 classification,the differences being all statistically significant(P<0.05 or P<0.01);no statistically significant difference of MLR was presented between the patients with C-TIRADS3 classification and those with C-TIRADS4 classification(P>0.05).(4)The levels of NLR,PLR,MLR,and SII in patients with benign nodules were lower than those in patients with malignant nodules,the differences being statistically significant(P<0.05 or P<0.01).(5)The Spearman correlation analysis showed that NLR,PLR,and SII were positively correlated with the C-TIRADS classification of the nodules,and NLR,PLR,MLR,and SII were positively correlated with the properties of the nodules,the differences being all statistically significant(P<0.05 or P<0.01).(6)The levels of NLR,MLR,PLR,and SII in patients with high-risk TN exerted a certain predictive value for the properties of the nodules,and their area under the curve(AUC)was 0.645,0.641,0.604,and 0.716,respectively,the differences being statistically significant(P<0.05 or P<0.01).For the prediction of nodule properties by NLR,MLR,PLR,and SII levels in patients with high-risk TN,their cutoff values and the corresponding sensitivities and specificities were 2.261(0.551,0.791),138.108(0.735,0.527),5.132(0.714,0.495),493.114(0.776,0.615),respectively;and their Youden's Index was 0.342,0.262,0.209,0.391,respectively.Conclusion The results indicated that in patients with TN,the FT3 and FT4 levels are positively correlated with the qi stagnation and phlegm obstruction syndrome;the values of A-TPO,A-TG,NEU,NLR,and SII are positively correlated with the phlegm accumulation and blood stasis syndrome;NLR,PLR and SII values are positively correlated with C-TIRADS classification;NLR,PLR,PLR,SII values are positively correlated with malignant TN.NLR,MLR,PLR,SII values exert high efficiency for the prediction of the properties of nodules in patients with TN.

Objective: To explore the relationship of family function with sleep and externalizing problem behaviors of preschool children, so as to provide a guidance for externalizing problem prevention and intervention among preschool children. Methods: From October 2023 to January 2024, a convenience sampling method was used to select 5 138 preschool children from kindergartens in 8 districts of Wuhan City, Hubei Province. Parents completed the survey for Family Adaptability and Cohesion Scale, children s sleep habits and Child Behavior Checklist (CBCL). Spearman correlation analysis was used to examine the correlation of family function with scores of sleep quality and externalizing problem behaviors among preschool children. A mediation model analysis and bootstrap test were conducted to further investigate the mediating role of sleep quality between family function and externalizing problem behaviors. Mplus 8.7 software was used for latent profile analysis of family function. Results: The reported rates of poor sleep quality and externalizing problem behaviors among preschool children were 11.8% ( n =607), 20.0% ( n =1 026). The relevant analysis results showed that family function was negatively correlated with sleep quality and externalizing problem behaviors ( r = -0.20, -0.23), and sleep quality was positively correlated with externalizing problem behaviors ( r =0.27) ( P <0.01). The mediation effect test showed that family function negatively predicted externalizing problem behaviors ( β =-0.079) and sleep quality ( β = -0.075), while sleep quality positively predicted externalizing problem behaviors ( β =0.215) ( P <0.01). The latent profile analysis results showed that family function could be classified into 4 categories: high family function group (23.01%), upper middle family function group (44.65%), moderate family function group (26.24%) and low family function group (6.11%). Compared to high family function, the other three categories significantly positively predicted externalizing problem behaviors, and the mediating effects of sleep quality on different categories of family function were statistically significant [upper middle family function: mediation effect value was 0.022 (95% CI =0.004-0.041) and direct effect value was 0.329 (95% CI =0.263-0.396); middle family function: mediation effect value was 0.087 (95% CI =0.063-0.115) and direct effect value was 0.491 (95% CI =0.416-0.565); low family function: mediation effect value was 0.144 (95% CI =0.107-0.185) and direct effect 0.621 (95% CI =0.503-0.740)] ( P < 0.05 ). Conclusion Family function negatively predicts the externalizing problem behaviors of preschool children, and sleep quality plays a partial mediating role.

BackgroundAtypical antipsychotics have been widely used in patients with chronic schizophrenia， and aripiprazole and risperidone are the most commonly used drugs. The mechanism of action of the two is different， while previous studies have provided insufficient credible evidence from multiple perspectives to support the comparative efficacy of the two drugs in improving symptoms in patients with chronic schizophrenia. ObjectiveTo compare the efficacy of aripiprazole and risperidone on the improvement of symptoms， prepulse inhibition （PPI）， cognitive functioning and neurotrophic factors in patients with chronic schizophrenia， so as to provide effective treatment regimens for these patients. MethodsA total of 86 patients with chronic schizophrenia attending the psychiatry department of the Third People's Hospital of Fuyang from March 2021 to March 2023 and fulfilling the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） were enrolled and grouped using random number table method， each with 43 cases. Aripiprazole group was given oral aripiprazole once daily at an initial dose of 5 mg for one week and then gradually increased to a maximum dose of 25 mg. Risperidone group received oral risperidone twice daily at an initial dose of 0.5 mg for one week and then gradually increased to a maximum dose of 3 mg. Treatment in both groups lasted 3 months. Before treatment and 3 months after treatment， Patients were required to complete Positive and Negative Symptom Scale （PANSS）， detection of both strong and weak PPIs in a startle modification passive attention paradigm， Wisconsin Card Sorting Test （WCST） and the measurement of neurotrophic factors at baseline and after treatment. The adverse reactions were recorded. Analysis of covariance was used to test the difference between the PANSS score， PPI， WCST and neurotrophic factor levels of the groups， with the pretest used as the covariate. Results3 months after treatment， no statistical difference was found in the scores of PANSS general psychopathology subscale， positive symptom subscale， negative symptom subscale and total score between two groups after treatment （F=0.621， 0.815， 0.743， 0.752， P>0.05）. There were no statistically significant differences between the two groups in PPI inhibition rate， single intense stimulus amplitude， single intense stimulus latency， prepulse inhibition amplitude， or prepulse inhibition latency （F=0.174， 0.001， 0.183， 0.171， 0.001， P>0.05）. There was no statistically significant difference in the total number of WCST tests between two groups （F=0.512， P>0.05）， whereas aripiprazole group reported significantly larger total numbers of categories completed and correct responses as well as smaller total numbers of random errors and perseverative errors compared to risperidone group （F=3.737， 4.621， 4.892， 5.130， P<0.05）. A significant increase in brain-derived neurotrophic factor （BDNF） and nerve growth factor （NGF） along with a reduction in glial fibrillary acidic protein （GFAP） were documented in risperidone group when compared to risperidone group （F=4.414， 3.781， 6.319， P<0.05）. No significant difference was demonstrated in the incidence of adverse reactions between the two groups （χ²=0.261， P>0.05）. ConclusionAripiprazole may be more beneficial than risperidone in improving cognitive functioning and neurotrophic factor levels in patients with chronic schizophrenia. ［Funded by Scientific Research Project of Fuyang Municipal Health Commission in 2021 （number， FY2021-147）］

Objective To investigate the distribution and antimicrobial resistance profiles of common pathogens isolated from cerebrospinal fluid(CSF)in CHINET program from 2015 to 2021.Methods The bacterial strains isolated from CSF were identified in accordance with clinical microbiology practice standards.Antimicrobial susceptibility test was conducted using Kirby-Bauer method and automated systems per the unified CHINET protocol.Results A total of 14 014 bacterial strains were isolated from CSF samples from 2015 to 2021,including the strains isolated from inpatients(95.3％)and from outpatient and emergency care patients(4.7％).Overall,19.6％of the isolates were from children and 80.4％were from adults.Gram-positive and Gram-negative bacteria accounted for 68.0％and 32.0％,respectively.Coagulase negative Staphylococcus accounted for 73.0％of the total Gram-positive bacterial isolates.The prevalence of MRSA was 38.2％in children and 45.6％in adults.The prevalence of MRCNS was 67.6％in adults and 69.5％in children.A small number of vancomycin-resistant Enterococcus faecium(2.2％)and linezolid-resistant Enterococcus faecalis(3.1％)were isolated from adult patients.The resistance rates of Escherichia coli and Klebsiella pneumoniae to ceftriaxone were 52.2％and 76.4％in children,70.5％and 63.5％in adults.The prevalence of carbapenem-resistant E.coli and K.pneumoniae(CRKP)was 1.3％and 47.7％in children,6.4％and 47.9％in adults.The prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)and Pseudomonas aeruginosa(CRPA)was 74.0％and 37.1％in children,81.7％and 39.9％in adults.Conclusions The data derived from antimicrobial resistance surveillance are crucial for clinicians to make evidence-based decisions regarding antibiotic therapy.Attention should be paid to the Gram-negative bacteria,especially CRKP and CRAB in central nervous system(CNS)infections.Ongoing antimicrobial resistance surveillance is helpful for optimizing antibiotic use in CNS infections.

Objective To investigate the antimicrobial resistance of clinical isolates from elderly patients(≥65 years)in major medical institutions across China.Methods Bacterial strains were isolated from elderly patients in 52 hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program during the period from 2015 to 2021.Antimicrobial susceptibility test was carried out by disk diffusion method and automated systems according to the same CHINET protocol.The data were interpreted in accordance with the breakpoints recommended by the Clinical and Laboratory Standards Institute(CLSI)in 2021.Results A total of 514 715 nonduplicate clinical isolates were collected from elderly patients in 52 hospitals from January 1,2015 to December 31,2021.The number of isolates accounted for 34.3％of the total number of clinical isolates from all patients.Overall,21.8％of the 514 715 strains were gram-positive bacteria,and 78.2％were gram-negative bacteria.Majority(90.9％)of the strains were isolated from inpatients.About 42.9％of the strains were isolated from respiratory specimens,and 22.9％were isolated from urine.More than half(60.7％)of the strains were isolated from male patients,and 39.3％isolated from females.About 51.1％of the strains were isolated from patients aged 65-＜75 years.The prevalence of methicillin-resistant strains(MRSA)was 38.8％in 32 190 strains of Staphylococcus aureus.No vancomycin-or linezolid-resistant strains were found.The resistance rate of E.faecalis to most antibiotics was significantly lower than that of Enterococcus faecium,but a few vancomycin-resistant strains(0.2％,1.5％)and linezolid-resistant strains(3.4％,0.3％)were found in E.faecalis and E.faecium.The prevalence of penicillin-susceptible S.pneumoniae(PSSP),penicillin-intermediate S.pneumoniae(PISP),and penicillin-resistant S.pneumoniae(PRSP)was 94.3％,4.0％,and 1.7％in nonmeningitis S.pneumoniae isolates.The resistance rates of Klebsiella spp.(Klebsiella pneumoniae 93.2％)to imipenem and meropenem were 20.9％and 22.3％,respectively.Other Enterobacterales species were highly sensitive to carbapenem antibiotics.Only 1.7％-7.8％of other Enterobacterales strains were resistant to carbapenems.The resistance rates of Acinetobacter spp.(Acinetobacter baumannii 90.6％)to imipenem and meropenem were 68.4％and 70.6％respectively,while 28.5％and 24.3％of P.aeruginosa strains were resistant to imipenem and meropenem,respectively.Conclusions The number of clinical isolates from elderly patients is increasing year by year,especially in the 65-＜75 age group.Respiratory tract isolates were more prevalent in male elderly patients,and urinary tract isolates were more prevalent in female elderly patients.Klebsiella isolates were increasingly resistant to multiple antimicrobial agents,especially carbapenems.Antimicrobial resistance surveillance is helpful for accurate empirical antimicrobial therapy in elderly patients.

Objective:To explore the clinical features and prognostic factors of lymphoma-associated hemophagocytic lymphohistiocytosis (LAHS).Methods:A retrospective cohort study was conducted. The clinical data of 44 LAHS patients who diagnosed at the Second Hospital of Shanxi Medical University from September 2016 to September 2022 were retrospectively analyzed. All patients were divided into B cell LAHS (B-LAHS) group (19 cases) and NK/T cell LAHS (NK/T-LAHS) group (19 cases) according to the lymphoma types, except for 4 cases of classic Hodgkin lymphomas and 2 cases of splenic lymphoma lymphomas. The clinical features and the factors influencing the prognosis of both groups were compared. According to whether lymphoma treatment were included in the initial treatment regimen, the patients were divided into the group with lymphoma treatment and the group without lymphoma treatment, and the objective response rate (ORR) of both groups was compared. Kaplan-Meier method was used to analyze the overall survival (OS), the log-rank method was used for univariate analysis, and the Cox proportional hazards model was used for multivariate analysis.Results:Among 44 LAHS patients, 26 cases were male and 18 cases were female, with the age of (69±7) years. Most of them were secondary to diffuse large B-cell lymphoma (DLBCL), and 17 out of 44 patients were secondary to DLBCL. All patients had fever, lymphadenopathy, and ferritinemia. The differences in red blood cells (RBC), hemoglobin (Hb), activated partial thromboplastin time (APTT), peripheral blood Epstein-Barr virus DNA (EBV DNA) load, positive rate of Epstein-Barr virus-encoded small RNA (EBER) in tissues, triglycerides (TG), aspartate aminotransferase (AST) and fibrinogen between NK/T-LAHS patients and B-LAHS patients were statistically significant (all P<0.05). The ORR of 44 patients with LAHS was 52.3% (23/44); the median OS time of LAHS patients was 157 d, and that of NK/T-LAHS patients was 110 d; the median OS time of B-LAHS was 135 d; and the difference was statistically significant ( χ2 = 7.47, P = 0.024). The median OS was not reached in patients receiving initial treatment regimen containing lymphoma, while the median OS time was 65 d in patients receiving treatment without containing lymphoma, and the difference was statistically significant ( χ2 = 3.97, P = 0.046). The results of multivariate Cox proportional hazards model showed that age ≥ 70 years ( HR = 2.502, 95% CI: 1.047-5.978, P = 0.039), serum ferritin (SF) ≥ 1 500 μg/L( HR=0.521,95% CI:0.282~0.960, P=0.037), soluble CD25 ≥ 7 800 U/ml ( HR = 0.536, 95% CI: 0.348-0.828, P = 0.005), interleukin (IL)-10≥100 ng/L ( HR = 0.532, 95% CI: 0.33-0.85, P = 0.009), interferon (IFN)-γ≥5.0 ng/ L ( HR = 0.554, 95% CI: 0.32-0.95, P = 0.033), Th (CD3 + CD4 + T cells)/ Ts (CD3 + CD8 + T cells) < 2 ( HR = 1.731, 95% CI: 1.005-2.982, P = 0.048), and hepatomegaly ( HR = 2.581, 95% CI: 1.059-6.289, P = 0.037) were independent factors influencing the poor outcome of LAHS patients. Conclusions:LAHS is mostly secondary to DLBCL. The early clinical manifestations lack specificity and the prognosis is generally poor, and the worst prognosis occurs in patient with NK/T-LAHS. The initial treatment with lymphoma can prolong OS time in patients with LAHS.

Objective:To evaluate the clinical efficacy of botulinum toxin type A (BTX-A) combined with sodium hyaluronate solution for facial microdroplet injection in improving facial skin photoaging.Methods:A prospective randomized controlled trial was conducted. From January to July 2024, patients with facial photoaging problems were recruited from the Plastic Surgery Department of the Affiliated Hospital of Xuzhou Medical University and randomly divided into a monotherapy group (sodium hyaluronate solution droplet injection) and a combination therapy group (BTX-A + sodium hyaluronate solution droplet injection) by hierarchical block randomization method. The treatment regimen was 3 months, with one treatment for each month, with a total of 3 treatment. The combination therapy group only used a combination therapy of two drugs (BTX-A 25 U+ 5 ml sodium hyaluronate solution) during the first injection. During the three treatments of the monotherapy group and the second and third treatments of the combination therapy group, 5 ml of sodium hyaluronate solution was injected as the solo ingredient. Follow up was conducted at 1, 2, and 4 months after the last treatment. Serum superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels were detected by test kit. Five skin texture indicators (moisture content, transepidermal water loss rate, elasticity, glossiness, and pH) were evaluated using the German CK skin tester. VISIA skin detector was used for facial two-dimensional photography and skin condition analysis. Clinical efficacy (significant improvement, obvious improvement, improvement, no improvement) and global aesthetic improvement scale (GAIS) scores on a 5-point scale were recorded. Patient satisfaction levels (very satisfied, satisfied, and dissatisfied) were investigated. The data were analyzed using SPSS 27.0 software. Count data was presented as examples and(or) percentages, and analyzed using a chi-square test. Normal distribution measurement data was represented by Mean±SD and analyzed using t-test. Results:A total of 100 patients were included, with 50 cases in each group. There were 17 males and 33 females in the monotherapy group, with an age of (31.3±7.1) years, and there were 5, 14, 29 and 2 patients in the Ⅰ to Ⅳ types of Glogau skin photoaging classification, respectively. There were 15 males and 35 females in the combination therapy group, with an age of (32.1±8.4) years old, and there were 4, 15, 27 and 4 patients in the Ⅰ to Ⅳ types of Glogau skin photoaging classification, respectively. There was no statistically significant difference in gender composition, age, and Glogau skin photoaging classification between the two groups (all P>0.05). One month after the first treatment, both groups showed an increase in SOD activity and a decrease in MDA levels, with more significant changes observed in the combination therapy group ( P<0.01 for both). At the follow-up of 1, 2, and 4 months after the last treatment, the combination therapy group outperformed the monotherapy group in all 5 skin texture indicators (all P<0.05). One month after the last treatment, the total effective rate of the combination therapy group was 76.0% (38/50), which were significantly higher than that of the monotherapy group’s 50.0% (25/50) ( P<0.05); in addition, the combination therapy group showed significant advantages in facial aesthetic GAIS scores, as well as patient satisfaction, with a satisfaction rate of up to 98.0% (49/50), which was higher than the 88.0% (44/50) of the monotherapy group ( P<0.01). Throughout the entire treatment process, neither group experienced serious adverse reactions. Conclusion:Facial microdroplet injection of BTX-A combined with sodium hyaluronate solution effectively improves symptoms of facial skin photoaging, enhancing skin hydration and elasticity, reducing transepidermal water loss, improving skin gloss, regulating skin pH, and enhancing skin antioxidant capacity, ultimately achieving facial skin rejuvenation. This method is safe, effective and holds high clinical relevence and patient satisfaction.

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.

Objective To characterize the changing species distribution and antibiotic resistance profiles of respiratory isolates in hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Methods Commercial automated antimicrobial susceptibility testing systems and disk diffusion method were used to test the susceptibility of respiratory bacterial isolates to antimicrobial agents following the standardized technical protocol established by the CHINET program.Results A total of 589 746 respiratory isolates were collected from 2015 to 2021.Overall,82.6％of the isolates were Gram-negative bacteria and 17.4％were Gram-positive bacteria.The bacterial isolates from outpatients and inpatients accounted for(6.0±0.9)％and(94.0±0.1)％,respectively.The top microorganisms were Klebsiella spp.,Acinetobacter spp.,Pseudomonas aeruginosa,Staphylococcus aureus,Haemophilus spp.,Stenotrophomonas maltophilia,Escherichia coli,and Streptococcus pneumoniae.Each microorganism was isolated from significantly more males than from females(P＜0.05).The overall prevalence of methicillin-resistant S.aureus(MRSA)was 39.9％.The prevalence of penicillin-resistant S.pneumoniae was 1.4％.The prevalence of extended-spectrum β-lactamase(ESBL)-producing E.coli and K.pneumoniae was 67.8％and 41.3％,respectively.The overall prevalence of carbapenem-resistant E.coli,K.pneumoniae,Enterobacter cloacae,Pseudomonas aeruginosa,and Acinetobacter baumannii was 3.7％,20.8％,9.4％,29.8％,and 73.3％,respectively.The prevalence of β-lactamase was 96.1％in Moraxella catarrhalis and 60.0％in Haemophilus influenzae.The H.influenzae isolates from children(＜18 years)showed significantly higher resistance rates to β-lactam antibiotics than the isolates from adults(P＜0.05).Conclusions Gram-negative bacteria are still predominant in respiratory isolates associated with serious antibiotic resistance.Antimicrobial resistance surveillance should be strengthened in clinical practice to support accurate etiological diagnosis and appropriate antimicrobial therapy based on antimicrobial susceptibility testing results.