1.Oral Absorption and Labeling Techniques of Traditional Chinese Medicine Polysaccharides: A Review
Weifeng ZHU ; Shuangyan DENG ; Hui OUYANG ; Wenjing YANG ; Jianing FU ; Huangqing WEI ; Qiong LI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(12):261-269
Polysaccharides are the important material basis of traditional Chinese medicine(TCM), and have various pharmacological activities such as immunomodulation, antitumor and anti-aging. Due to the large molecular weight of TCM polysaccharides, their structural analysis and oral absorption mechanism are facing technical challenges, and the current research on their structure-activity relationships has made some breakthroughs, while the research on their oral absorption mechanisms is relatively slow. In-depth study of the oral absorption mechanism of TCM polysaccharides is not only crucial for the interpretation of their action pathways and efficacy in vivo, but also helpful for the interpretation of their pharmacological effects, rational clinical applications and the discovery of new targets. In recent years, the application of fluorescent labeling and isotopic labeling methods has provided new technical means for the oral absorption studies of polysaccharides, which has promoted the development of oral absorption studies of TCM polysaccharides. In this paper, we reviewed the oral absorption pathways and labeling techniques of TCM polysaccharides, and concluded that they can be absorbed orally through transmembrane, cellular bypass, and M-cell-mediated transport, of which transmembrane pathway is the main absorption pathway, and summarized the labeling reactions of four fluorescent labeling and isotopic labeling methods with TCM polysaccharides, which can provide references for evaluating the absorption pathways of TCM polysaccharides, screening active TCM polysaccharides, establishing pharmacodynamic models and comprehensively elucidating the mechanism of TCM polysaccharides.
2.Antimicrobial resistance and related risk factors of carbapenem-resistant Klebsiella pneumoniae isolated from blood
Pei-Juan TANG ; Peng-Wen OUYANG ; Sheng LONG ; Na PENG ; Zi-Han WANG ; Qiong LIU ; Wen XU ; Liang-Yi XIE
Chinese Journal of Infection Control 2024;23(1):49-57
Objective To explore the antimicrobial resistance of carbapenem-resistant Klebsiella pneumoniae(CRKP)isolated from blood and the related risk factors for infection in patients.Methods Clinical data of 383 KP-infected patients from whose blood Klebsiella pneumoniae(KP)were isolated during hospitalization period in a hos-pital from January 2018 to December 2021 were retrospectively analyzed.Patients were divided into CRKP group(n=114)and non-CRKP group(n=269)based on antimicrobial resistance.According to the prognosis,114 patients in the CRKP group were subdivided into the death group(n=30)and the survival group(n=84).General informa-tion,underlying diseases,antimicrobial use,and infection outcomes of two groups of patients were compared,and risk factors for infection and death after infection were analyzed.Results The resistance rates of KP to tigecycline and compound sulfamethoxazole showed upward trends,with statistically significant differences(both P=0.008).The CRKP group had higher resistance rates to amikacin,aztreonam,compound sulfamethoxazole,ciprofloxacin,cefepime,cefoperazone/sulbactam,piperacillin/tazobactam,tigecycline,ceftazidime,tobramycin,and levofloxacin,as well as higher in-hospital mortality than the non-CRKP group,with statistically significant differences(all P<0.05).Acute pancreatitis prior to infection(OR=16.564,P<0.001),hypoalbuminemia(OR=8.588,P<0.001),stay in in-tensive care unit prior to infection(OR=2.733,P=0.017),blood transfusion(OR=3.968,P=0.001),broncho-scopy(OR=5.194,P=0.014),surgery within 30 days prior to infection(OR=2.603,P=0.010),and treatment with carbapenems(OR=2.663,P=0.011)were independent risk factors for the development of CRKP blood-stream infection(BSI).Cardiac insufficiency before infection(OR=11.094,P=0.001),combined with pulmonary infection(OR=20.801,P=0.010),septic shock(OR=9.783,P=0.002),disturbance of consciousness(OR=11.648,P=0.001),and receiving glucocorticoid treatment(OR=5.333,P=0.018)were independent risk factors for mortality in patients with CRKP BSI.Conclusion The resistance rate of KP from BSI to tigecycline and com-pound sulfamethoxazole presents upward trend.Underlying diseases,invasive procedures,and carbapenem treat-ment are closely related to CRKP BSI.Cardiac insufficiency,pulmonary infection,septic shock,disturbance of con-sciousness,and glucocorticoid treatment can lead to death of patients with CRKP BSI.
3.Curcumin inhibits the proliferation and migration of osteosarcoma by regulating the expression of super-enhancer-associated genes
Zhanbo OUYANG ; Haihong ZHU ; Zhongyue LIU ; Chao TU ; Jian QU ; Qiong LU ; Min XU
Journal of Central South University(Medical Sciences) 2024;49(4):541-552
Objective:Super-enhancer-associated genes may be closely related to the progression of osteosarcoma,curcumin exhibits a certain inhibitory effect on tumors such as osteosarcoma.This study aims to investigate the effects of curcumin on osteosarcoma in vitro and in vivo,and to determine whether curcumin can inhibit the progression of osteosarcoma by suppressing the expression of super-enhancer-associated genes LIM and senescent cell antigen-like-containing domain 1(LIMS1),secreted protein acidic and rich in cysteine(SPARC),and sterile alpha motif domain containing 4A(SAMD4A). Methods:Human osteosarcoma cell lines(MG63 cells or U2OS cells)were treated with 5 to 50 μmol/L curcumin for 24,48,and 72 hours,followed by the methyl thiazolyl tetrazolium(MTT)assay to detect cell viability.Cells were incubated with dimethyl sulfoxide(DMSO)or curcumin(2.5,5.0 μmol/L)for 7 days,and a colony formation assay was used to measure in vitro cell proliferation.After treatment with DMSO or curcumin(10,15 μmol/L),a scratch healing assay and a transwell migration assay were performed to evaluate cell migration ability.Real-time reverse transcription polymerase chain reaction(real-time RT-PCR)and Western blotting were used to detect mRNA and protein expression levels of LIMS1,SPARC,and SAMD4A in the cells.An osteosarcoma-bearing nude mouse model was established,and curcumin was administered via gavage for 14 days to assess the impact of curcumin on tumor volume and weight in vivo.Real-time RT-PCR was used to measure mRNA expression levels of LIMS1,SPARC,and SAMD4A in the cancer and adjacent tissues from 12 osteosarcoma patients. Results:After treating cells with different concentrations of curcumin for 24,48,and 72 hours,cell viability were all significantly decreased.Compared with the DMSO group,the colony formation rates in the 2.5 μmol/L and 5.0 μmol/L curcumin groups significantly declined(both P<0.01).The scratch healing assay showed that,compared with the DMSO group,the migration rates of cells in the 10 μmol/L and 15 μmol/L curcumin groups were significantly reduced.The exception was the 10 μmol/L curcumin group at 24 h,where the migration rate of U2OS cells did not show a statistically significant difference(P>0.05),while all other differences were statistically significant(P<0.01 or P<0.001).The transwell migration assay results showed that the number of migrating cells in the 10 μmol/L and 15 μmol/L curcumin groups was significantly lower than that in the DMSO group(both P<0.001).In the in vivo tumor-bearing mouse experiment,the curcumin group showed a reduction in tumor mass(P<0.01)and a significant reduction in tumor volume(P<0.001)compared with the control group.Compared with the DMSO group,the mRNA expression levels of LIMS1,SPARC,and SAMD4A in the 10 μmol/L and 15 μmol/L curcumin groups were significantly down-regulated(all P<0.05).Additionally,the protein expression level of LIMS1 in U2OS cells in the 10 μmol/L curcumin group was significantly lower than that in the DMSO group(P<0.05).Compared with adjacent tissues,the mRNA expression level of SPARC in osteosarcoma tissues was significantly increased(P<0.00l),while the mRNA expression levels of LIMS1 and SAMD4A did not show statistically significant differences(both P>0.05). Conclusion:Curcumin inhibits the proliferation and migration of osteosarcoma both in vitro and in vivo,which may be associated with the inactivation of super-enhancer-associated gene LIMS1.
4.Analysis of Chemical Constituents in Puerariae Lobatae Radix Dispensing Granules by UPLC-Q-TOF-MS/MS
Meiqing CHEN ; Weifeng ZHU ; Yongmei GUAN ; Yulin FENG ; Yanli ZHANG ; Xiucun JING ; Wanqian PENG ; Hui OUYANG ; Qiong LI
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(19):176-186
ObjectiveA rapid method for identification of chemical constituents in Puerariae Lobatae Radix dispensing granules was established in order to clarify the material basis. MethodThe chemical constituents of Puerariae Lobatae Radix dispensing granules was qualitatively analyzed by ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS/MS) under positive and negative ion modes, and the chromatographic conditions were on an ACQUITY UPLC HSS T3 column(2.1 mm×100 mm, 1.8 μm) with 0.1% formic acid aqueous solution(A)-0.1% formic acid acetonitrile solution(B) as mobile phase for gradient elution(0-4 min, 5%-10%B; 4-10 min, 10%-15%B; 10-20 min, 15%-16%B; 20-27 min, 16%-31%B; 27-33 min, 31%-59%B; 33-42 min, 59%-95%B; 42-42.1 min, 95%-5%B; 42.1-45 min, 5%B), the flow rate was 0.35 mL·min-1, the column temperature was 40 ℃, the injection volume was 5 μL, and electrospray ionization(ESI) was selected. Then these chemical constituents were comprehensively identified based on PeakView 1.2, PubChem, ChemicalBook, ChemSpider, comparative control profiles and literature information. ResultA total of 128 chemical constituents were identified from the dispensing granules, including 60 flavonoids, 26 organic acids, 7 glycosides, 6 coumarins, 3 nucleosides and 26 other compounds. By focusing on the cleavage patterns of flavonoids, organic acids, glycosides, coumarins, nucleosides and other compounds, 12 compounds that have not been reported in Puerariae Lobatae Radix species were identified from the dispensing granules. ConclusionThe established method can systematically and rapidly identify the chemical constituents in Puerariae Lobatae Radix dispensing granules, and cleared it composition is mainly flavonoids and organic acids. Laying a foundation for the study of the material basis, mechanism of action and clinical application of the dispensing granules.
5.Baimai Ointment relieves chronic pain induced by chronic compression of dorsal root ganglion in rats by regulating neuroactive ligand-receptor interaction and HIF-1 signaling pathway.
Fang-Ting ZHOU ; Ying ZONG ; Wu-Qiong HOU ; Sen-Sen LI ; Fei YANG ; Li-Ting XU ; Xia MAO ; Yu-Dong LIU ; Xiao-Hui SU ; Hong-Ye WAN ; Jing-Feng OUYANG ; Qiu-Yan GUO ; Wei-Jie LI ; Zhen WANG ; Chao WANG ; Na LIN
China Journal of Chinese Materia Medica 2023;48(23):6457-6474
The Baimai Ointment with the effect of relaxing sinew and activating collaterals demonstrates a definite effect on Baimai disease with pain, spasm, stiffness and other symptoms, while the pharmacodynamic characteristics and mechanism of this agent remain unclear. In this study, a rat model of chronic compression of L4 dorsal root ganglion(CCD) was established by lumbar disc herniation, and the efficacy and mechanism of Baimai Ointment in the treatment of CCD were preliminarily explored by behavioral tests, side effect evaluation, network analysis, antagonist and molecular biology verification. The pharmacodynamic experiment indicated that Baimai Ointment significantly improved the pain thresholds(mechanical pain, thermal pain, and cold pain) and gait behavior of CCD model rats without causing tolerance or obvious toxic and side effects. Baimai Ointment inhibited the second-phase nociceptive response of mice in the formalin test, increased the hot plate threshold of normal mice, and down-regulated the expression of inflammatory cytokines in the spinal cord. Network analysis showed that Baimai Ointment had synergistic effect in the treatment of CCD and was related to descending inhibition/facilitation system and neuroinflammation. Furthermore, behavioral tests, Western blot, and immunofluorescence assay revealed that the pain-relieving effect of Baimai Ointment on CCD may be related to the regulation of the interaction between neuroactive ligand and receptors(neuroligands) such as CHRNA7, ADRA2A, and ADRB2, and the down-regulation of the expression of NOS2/pERK/PI3K, the core regulatory element of HIF-1 signaling pathway in spinal microglia. The findings preliminarily reveal the mechanism of relaxing sinew and activating collaterals of Baimai Ointment in the treatment of Baimai disease, providing a reference for the rational drug use and further research of this agent.
Rats
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Mice
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Animals
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Chronic Pain/metabolism*
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Rats, Sprague-Dawley
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Ganglia, Spinal/metabolism*
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Ligands
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Signal Transduction
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Hyperalgesia/metabolism*
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Drugs, Chinese Herbal
6.Eucommia lignans alleviate the progression of diabetic nephropathy through mediating the AR/Nrf2/HO-1/AMPK axis in vivo and in vitro.
Qi HUANG ; Yinfan ZHANG ; Yueping JIANG ; Ling HUANG ; Qiong LIU ; Dongsheng OUYANG
Chinese Journal of Natural Medicines (English Ed.) 2023;21(7):516-526
Lignans derived from Eucommia ulmoides Oliver (Eucommia lignans) inhibit the progression of inflammatory diseases, while their effect on the progression of diabetic nephropathy (DN) remained unclear. This work was designed to assess the function of Eucommia lignans in DN. The major constituents of Eucommia lignans were analyzed by UPLC-Q-TOF-MS/MS. The binding between Eucommia lignans and aldose reductase (AR) was predicted by molecular docking. Eucommia lignans (200, 100, and 50 mg·kg-1) were used in model animals to evaluate their renal function changes. Rat glomerular mesangial cells (HBZY-1) were transfected with sh-AR, sh-AMPK, and oe-AR in the presence of high glucose (HG) or HG combined with Eucommia lignans to evaluate whether Eucommia lignans affected HG-induced cell injury and mitochondrial dysfunction through the AR/Nrf2/HO-1/AMPK axis. Eucommia lignans significantly attenuated the progression of DN in vivo. Eucommia lignans notably reversed HG-induced upregulation of inflammatory cytokines and mitochondrial injury, while downregulating the levels of Cyto c, caspase 9, AR, and NOX4 in HBZY-1 cells. In contrast, HG-induced downregulation of Nrf2, HO-1 and p-AMPKα levels were abolished by Eucommia lignans. Meanwhile, knockdown of AR exerted similar therapeutic effect of Eucommia lignans on DN progression, and AR overexpression reversed the effect of Eucommia lignans. Eucommia lignans alleviated renal injury through the AR/Nrf2/HO-1/AMPK axis. Thus, these findings might provide evidence for the use of Eucommia lignans in treating DN.
Animals
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Rats
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AMP-Activated Protein Kinases/genetics*
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Diabetes Mellitus
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Diabetic Nephropathies/prevention & control*
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Eucommiaceae/metabolism*
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Lignans/therapeutic use*
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Molecular Docking Simulation
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NF-E2-Related Factor 2/metabolism*
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Tandem Mass Spectrometry
7.Identification of Cordyceps cicadae and Tolypocladium dujiaolongae based on ITS sequences and chemical pattern recognition method.
Xiao-Cui HE ; Jing-Qiong WAN ; Yi-Ling ZHU ; Yuan WEI ; Heng-Lin CUI ; Bin YANG ; Zhen OUYANG
China Journal of Chinese Materia Medica 2022;47(2):403-411
Based on ITS sequences, the molecular identification of Cordyceps cicadae and Tolypocladium dujiaolongae was carried out, and high-performance liquid chromatography(HPLC) fingerprint combined with chemical pattern recognition method was established to differentiate C. cicadae from its adulterant T. dujiaolongae. The genomic DNA from 10 batches of C. cicadae and five batches of T. dujiaolongae was extracted, and ITS sequences were amplified by PCR and sequenced. The stable differential sites of these two species were compared and the phylogenetic tree was constructed via MEGA 7.0. HPLC was used to establish the fingerprints of C. cicadae and T. dujiaolongae, and similarity evaluation, cluster analysis(CA), principal component analysis(PCA), and partial least squares discriminant analysis(PLS-DA) were applied to investigate the chemical pattern recognition. The result showed that the sources of these two species were different, and there were 115 stable differential sites in ITS sequences of C. cicadae and T. dujiao-longae. The phylogenetic tree could distinguish them effectively. HPLC fingerprints of 18 batches of C. cicadae and 5 batches of T. dujiaolongae were established. The results of CA, PCA, and PLS-DA were consistent, which could distinguish them well, indicating that there were great differences in chemical components between C. cicadae and T. dujiaolongae. The results of PLS-DA showed that six components such as uridine, guanosine, adenosine, and N~6-(2-hydroxyethyl) adenosine were the main differential markers of the two species. ITS sequences and HPLC fingerprint combined with the chemical pattern recognition method can serve as the identification and differentiation methods for C. cicadae and T. dujiaolongae.
Chromatography, High Pressure Liquid/methods*
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Cordyceps/genetics*
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Hypocreales
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Phylogeny
8.Herbal Textual Research on Mori in Famous Classical Formulas
Wen-min DU ; Zhi-lai ZHAN ; Jing-qiong WAN ; Tian-yue LIAO ; Hui JIANG ; Zhao-yong ZHOU ; Zhen OUYANG
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(10):11-21
Through consulting the ancient herbs, medical books and modern literature, this paper made textual research on the name, origin, producing area, quality evaluation, collection and processing of medicinal materials of Sang (Mori Folium, Mori Cortex, Mori Ramulus, Mori Fructus) in famous classical formulas, in order to provide a basis for the development of famous classical formulas containing medicinal materials of Sang. According to the research, Mori Folium and Mori Cortex were first used as medicines in Shengnong Bencaojing , Mori Ramulus was first used as medicine in Jinxiaofang, and Mori Fructus was first used as medicine in Xinxiu Bencao. Before the Tang dynasty, there were Nyusang and Shansang. Since Tang dynasty, there were many sources of medicinal materials of Sang, including Baisang (Morus alba), Jisang (M. australis), Shansang (M. mongolica), etc. According to textual research, the mainstream varieties were M. australis, M. alba and their cultivated varieties. In modern times, according to the relevant information and the Chinese Pharmacopoeia, M. alba is the original base. In ancient times, the origin of mulberry changed with the development of sericulture, mulberry has been widely planted since the Song dynasty. In the Ming and Qing dynasties, mulberry has been planted most in Jiangsu and Zhejiang. In modern times, they are mainly produced in Jiangsu, Zhejiang, Anhui, Hunan and other places. In recent years, due to the related policies and strategies such as "moving silkworms from east to west", the center of silkworm breeding has gradually transferred to the west. As for the quality evaluation and harvesting and processing of mulberry medicinal materials, Most of the ancient and modern records of Mori Folium are the same. They are harvested after frost, and dried after removing impurities. The quality is better when the leaves are large and thick, yellowish green, holding prickly hands and undergoing frost. The harvesting period of Mori Cortex is slightly different in ancient and modern records. Ancient books record that it can be harvested all the year round, but in modern times, it is mostly harvested from late autumn to the next spring. The processing methods include removing soil and fibrous roots, scraping off yellow-brown rough skin, peeling off white skin and drying in the sun. The quality is better when they are white, thick, flexible, free of rough skin and full of powder. There are few records about the collection, processing and quality evaluation of Mori Ramulus and Mori Fructus in ancient Chinese herbal books. According to modern literature, Mori Ramulus is usually collected in late spring and early summer, with leaves removed, slightly dried, sliced while fresh, and dried in the sun. The best quality of Mori Ramulus is fine and tender with the yellow and white section. Mori Fructus is harvested from April to June when the fruit turns red, and dried in the sun, or slightly steamed and dried in the sun, and it is better to be big, dark purple, oily and thick. There are many processing methods of mulberry medicinal materials. Ancient books record stir frying, baking, burning and steaming of Mori Folium, in modern times, there is honey-roasted method, but most of them are used as raw products. In ancient materia medica, Mori Cortex has firing method, baking method, stir-frying method, honey-fried method, etc. In modern times, there are stir-fried and honey-fried methods, and most of them are used as raw products. Ancient books record that Mori Ramulus has cutting and frying methods, while modern ones have cutting, frying, wine-processed and bran-processed methods. Processing methods of Mori Fructus are consistent in ancient and modern times, and they are mostly dried after being cleaned or steamed. Based on the research results, it is suggested that M. alba should be selected as mulberry medicinal materials in the famous classical formulas, and appropriate medicinal parts and processing methods can be selected according to the indications of the famous classical formulas.
9.Herbal Textual Research on Menthae Haplocalycis Herba in Famous Classical Formulas
Hui JIANG ; Tian-yue LIAO ; Jing-qiong WAN ; Jin XU ; Wen-min DU ; Zhi-lai ZHAN ; Zhen OUYANG
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(10):150-158
In this paper, the name, origin, producing area and other aspects of Menthae Haplocalycis Herba in the famous classical formulas were carried out by consulting herbal literature, medical books, prescription books in the past dynasties and related modern documents. Through the textual research, it can be seen that the name of Bohe was used as the correct name in the mainstream of the past dynasties, and there were still multiple synonyms, most of which originated from the false transmission of dialectal accent, producing area and efficacy. There are many varieties recorded in the literature of the past dynasties such as Bohe, Longnao Bohe, Hubohe and Shibohe. According to the textual research, Bohe, Longnao Bohe and Yebohe are consistent with Mentha haplocalyx, whcih is the mainstream variety. Longnao Bohe is named for its form of producing area, Shibohe is Mosla chinensis, Daye Bohe is Agastache rugosa, and Nanbohe is M. crispata. Menthae Haplocalycis Herba has been widely planted since Tang dynasty. It was mainly grown in Jiangsu, Zhejiang, Jiangxi and Sichuan in Ming and Qing dynasties, and Jiangsu is the genuine production area. Its quality is best if it has dry body, no roots, many leaves, green color and strong smell. In ancient times, the stems and leaves of Menthae Haplocalycis Herba were often picked and dried in summer and autumn, which is basically the same as the records of modern times when the stems and leaves are luxuriant in summer and autumn, or when the flowers bloom to three rounds, they are picked in sunny days and cut in different times, and then dried in the sun or in the shade, and the raw products was often used as medicine in ancient and modern times. Before the Song dynasty, Menthae Haplocalycis Herba was recorded as pungent and warm. Until the Song dynasty, it was written as “extremely cool” in Lyuchanyan Bencao. It may have been thought in the early stage that it was similar to several warm herbs, such as Perilla frutescens, Stachys japonica, Elsholtzia ciliata and M. chinensis in appearance, all of which have the function of Xinsan, so it was recorded as warm. Since the Qing dynasty, Menthae Haplocalycis Herba has been recorded as cool property in the mainstream materia medica, Menthae Haplocalycis Herba recorded as pungent and cool in the 2020 edition of Chinese Pharmacopoeia, and its effect is to dissipate wind heat, clear the head, relieve the pharynx and so on, the records of efficacy in ancient and modern times are basically the same. Based on the research results, it is suggested that raw products of M. haplocalyx should be selected when developing the famous classical formulas containing Menthae Haplocalycis Herba.
10.Risk factors and prognosis analysis of carbapenem-resistant Klebsiella pneumoniae infection for inpatients in hepatobiliary surgery
Pengwen OUYANG ; Peijuan TANG ; Sheng LONG ; Na PENG ; Rui GONG ; Qiong LIU ; Wen XU ; Liangyi XIE
Chinese Journal of Hepatobiliary Surgery 2022;28(12):924-930
Objective:To explore the risk factors and prognosis of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection for inpatients in hepatobiliary surgery. Methods:The clinical data of patients with Klebsiella pneumoniae infection admitted to the Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital from January 2016 to December 2020 were retrospectively analyzed. For each patient with CRKP infection, two patients with non-carbapenem-resistant Klebsiella pneumoniae (non-CRKP) infection were selected for matching. A total of 720 patients with Klebsiella pneumoniae infection were involved, including 444 males and 276 females, aged (58.0±11.6) years old. According to the infection conditions, they were divided into two groups: CRKP group ( n=240) and non-CRKP group ( n=480). The 240 CRKP patients were divided into two subgroups according to their prognosis: death group ( n=34) and survival group ( n=206). The general information, laboratory test results, antibiotic use and infection outcomes of patients were recorded to analyze the risk factors of infection and death after infection. Results:Acute pancreatitis ( OR=3.473, 95% CI: 1.844-6.541), chronic cardiovascular disease before infection ( OR=2.028, 95% CI: 1.228-3.347), chronic renal failure ( OR=1.873, 95% CI: 1.142-3.073), hypoalbuminemia ( OR=3.060, 95% CI: 1.869-5.010), use of carbapenems ( OR=3.882, 95% CI: 2.518-5.985), admission to intensive care unit ( OR=1.783, 95% CI: 1.034-3.075) and surgery within 30 days before infection ( OR=13.463, 95% CI: 7.482-24.223) were independent risk factors for CRKP infection inpatients in hepatobiliary surgery(all P<0.05). Chronic respiratory disease before infection ( OR=3.784, 95% CI: 1.420-10.089), mechanical ventilation ( OR=5.085, 95% CI: 1.436-18.011), disturbance of consciousness ( OR=40.710, 95% CI: 3.564-464.943), hormone therapy ( OR=14.977, 95% CI: 3.819-58.743) and treatment of quinolone antibiotics ( OR=4.102, 95% CI: 1.226-13.726) were independent risk factors for death of inpatients with CRKP infection in hepatobiliary surgery (all P<0.05). The resistance of amikacin, tobramycin, ceftazidime, cefepime, aztreonam, ciprofloxacin, levofloxacin, co-sulfamethoxazole and piperacillin/tazobactamand in CRKP group were significantly different compared with non-CRKP group (all P<0.05). Conclusion:The occurrence of CRKP infection for inpatients in hepatobiliary surgery is related to various factors such as underlying diseases, antibiotic use and self-barrier destruction, and these factors affect the infection outcome of patients.

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