ObjectiveTo characterize a carbapenem-resistant Citrobacter freundii (CR-CFR) clinical isolate belonging to the sequence type ST116 and to investigate the public-genome distribution of ST116 among carbapenem-resistant C. freundii.MethodsA carbapenem-resistant C. freundii isolate (WF1033) was recovered from a patient with a urinary tract infection. Antimicrobial susceptibility testing, whole-genome sequencing, and detailed plasmid structural analyses were performed. To contextualize this isolate, a large-scale genomic analysis of publicly available CR-CFR genomes was conducted, including multilocus sequence typing (MLST), minimum spanning tree analysis, global distribution mapping, and phylogenetic reconstruction of sequence type ST116.ResultsWF1033 exhibited an extensively drug-resistant phenotype and harbored three carbapenemase genes, blaKPC-2, blaIMP-8, and blaNDM-1. Genomic analysis revealed that WF1033 belongs to ST116 and carries four plasmids. Notably, blaKPC-2 and blaIMP-8 were co-located on a novel hybrid IncFIB/IncFII plasmid (pWF1033-KPC-IMP), formed through the integration of distinct mobile genetic elements, whereas blaNDM-1 was carried on a typical IncX3 plasmid. Analysis of 2,436 CR-CFR genomes identified 171 sequence types, with ST22 being the most prevalent globally. However, ST116 showed marked regional enrichment in China, accounting for 56.97% of all ST116 isolates. ST116 also displayed a higher proportion of strains carrying multiple carbapenem resistance genes (CRGs) compared with other major sequence types. Phylogenetic analysis of 165 ST116 isolates revealed multiple clades, suggesting possible lineage expansion and geographic persistence within this sequence type, with WF1033 representing the only ST116 strain identified to date carrying three CRGs simultaneously.ConclusionsOur findings suggest that ST116 represents a lineage associated with increased carriage of multiple carbapenem resistance genes in CR-CFR. Continuous genomic surveillance is warranted to monitor the dissemination of multidrug-resistant C. freundii, particularly among ST116-associated lineages.

As a rare opportunistic pathogen of Gram-positive bacillus, Nocardia is capable of entering the human body through the respiratory tract and wounds, leading to disseminated infections in the lungs, skin, or systemically. The majority of patients infected with Nocardia exhibit defective or suppressed immune function. Herein, in this report, we present a case of systemic lupus erythematosus (SLE) complicated by a central nervous system infection caused by Nocardia nova. Specifically, a female patient was admitted to our hospital for treatment with a three-day history of headache, nausea, and vomiting, and was diagnosed with purulent meningitis caused by Nocardia nova after culture of her cerebrospinal fluid (CSF). Based on the characteristics of Nocardia nova and the results of the drug sensitivity test, we developed a clinical treatment plan, which led to the successful discharge of the patient. As research progresses, an increasing number of reports on infections caused by Nocardia are being released. The purpose of reporting this case is to provide a reference for both laboratory identification and clinical treatment.

Metarhizium exhibits a high tolerance to abiotic stress, which has led to its widespread use as a biopesticide in agricultural production. The green pigment in Metarhizium spores is important because it plays a key role in helping the spores resist abiotic stress. However, extracting this pigment with common solvents has proven difficult. This difficulty hinders both the identification and functional analysis of the pigment. In this study, we selected the high pigment-producing strain RCEF6989 of Metarhizium flavoviride for pigment extraction and identification. Extraction tests using acids, alkalis, enzymes, ionic reagents, and cell wall dissolution reagents revealed that formic acid is the most effective for extracting the green pigment. The green pigment was purified using preparative HPLC after extraction. The molecular formula of the pigment was determined by HPLC-PADESI-HRMS to be C18H12N8O14. 1D and 2D NMR analyses revealed that the pigment is a novel compound, named metarhiziviridisin A. The identification of the pigment provides a scientific basis for further research into its function and biosynthetic pathways.

Pseudomonas aeruginosa is a significant pathogen responsible for severe multisite infections with high morbidity and mortality rates. This study analyzed carbapenem-resistant Pseudomonas aeruginosa (CRPA) at a tertiary hospital in Shandong, China, using whole-genome sequencing (WGS). The objective was to explore the mechanisms and molecular characteristics of carbapenem resistance. A retrospective analysis of 91 isolates from January 2022 to March 2023 was performed, which included strain identification and antimicrobial susceptibility testing. WGS was utilized to determine the genome sequences of these CRPA strains, and the species were precisely identified using average nucleotide identification (ANI), with further analysis on multilocus sequence typing and strain relatedness. Some strains were found to carry the ampD and oprD genes, while only a few harbored carbapenemase genes or related genes. Notably, all strains possessed the mexA, mexE, and mexX genes. The major lineage identified was ST244, followed by ST235. The study revealed a diverse array of carbapenem resistance mechanisms among hospital isolates, differing from previous studies in mainland China. It highlighted that carbapenem resistance is not due to a single mechanism but rather a combination of enzyme-mediated resistance, AmpC overexpression, OprD dysfunction, and efflux pump overexpression. This research provides valuable insights into the evolutionary mechanisms and molecular features of CRPA resistance in this region, aiding in the national prevention and control of CRPA, and offering references for targeting and developing new drugs.

Stephanoascus ciferrii , a conditional pathogenic fungus prevalent in nature, is more frequently encountered in patients with compromised immunity. However, the literature rarely reports infections caused by Stephanoascus ciferrii in peritoneal dialysis patients. Here, we detail the case of a 66-year-old female suffering from renal failure who experienced catheter-related infection during peritoneal dialysis. Dialysate turbidity prompted the detection of Stephanoascus ciferrii in both peritoneal dialysate and tubes through microbiological cultures. Subsequent treatment involved antifungal drugs and a transition to hemodialysis, resulting in the disappearance of peritonitis symptoms and the patient's discharge. In recent years, fungal infections, particularly dialysis-related infections, are on the rise. This marks the first reported case of catheter-related peritonitis infection caused by Stephanoascus ciferrii . Compared to bacterial infections, fungal infections pose challenges due to limited drug options, significant side effects, and prolonged treatment durations. Hence, prompt pathogen diagnosis and drug sensitivity testing are crucial for effective clinical treatment. In essence, this scientific case report underscores the uncommon occurrence of catheter-related peritonitis attributed to Stephanoascus ciferrii in a peritoneal dialysis patient with renal failure, emphasizing the distinctive management challenges and underscoring the critical significance of prompt diagnosis and suitable intervention in such instances.

Abstract Objective To analyze the clinical infection characteristics and genetic environments of resistance genes in carbapenem-resistant Citrobacter europaeus using whole-genome sequencing. Methods The susceptibility of two clinical isolates of C. europaeus (WF0003 and WF1643) to 24 antimicrobial agents was assessed using the BD Phoenix™ M50 System and Kirby-Bauer (K-B) disk-diffusion method. Whole-genome sequencing was performed on the Illumina and Nanopore platforms, and ABRicate software was used to predict resistance and virulence genes of carbapenem-resistant C. europaeus. The characteristics of plasmids carrying carbapenem-resistance genes and their genetic environments were analyzed. Single nucleotide polymorphisms were used to construct a phylogenetic tree to analyze the homology of these two C. europaeus strains with ten strains of C. europaeus in the NCBI database. Results The two strains of carbapenem-resistant C. europaeus are resistant to various antimicrobial agents, particularly carbapenems and β-lactams. WF0003 carries blaNDM− 1, which is located on an IncX3 plasmid that has high homology to the pNDM-HN380 plasmid. blaNDM− 1 is located on a truncated Tn125. It differs from Tn125 by the insertion of IS5 in the upstream ISAba125 and the deletion of the downstream ISAba125, which is replaced by IS26. WF1643 carries blaOXA− 48 in a Tn1999 transposon on the IncL/M plasmid, carrying only that single drug resistance gene. Homology analysis of these two strains of C. europaeus with ten C. europaeus strains in the NCBI database revealed that the 12 strains can be classified into three clades, with both WF0003 and WF1643 in the B clade. Conclusion To the best of our knowledge, this is the first study to report an IncX3 plasmid carrying blaNDM− 1 in C. europaeus in China. C. europaeus strains harboring carbapenem-resistance genes are concerning in relation to the spread of antimicrobial resistance, and the presence of carbapenem-resistance genes in C. europaeus should be continuously monitored.

Abstract Objective This study aims to conduct an in-depth genomic analysis of a carbapenem-resistant Proteus mirabilis strain to uncover the distribution and mechanisms of its resistance genes. Methods The research primarily utilized whole-genome sequencing to analyze the genome of the Proteus mirabilis strain. Additionally, antibiotic susceptibility tests were conducted to evaluate the strain’s sensitivity to various antibiotics, and related case information was collected to analyze the clinical distribution characteristics of the resistant strain. Results Study on bacterial strain WF3430 from a tetanus and pneumonia patient reveals resistance to multiple antibiotics due to extensive use. Whole-genome sequencing exposes a 4,045,480 bp chromosome carrying 29 antibiotic resistance genes. Two multidrug-resistant (MDR) gene regions, resembling Tn6577 and Tn6589, were identified (MDR Region 1: 64.83 Kb, MDR Region 2: 85.64 Kbp). These regions, consist of integrative and conjugative elements (ICE) structures, highlight the intricate multidrug resistance in clinical settings. Conclusion This study found that a CR-PMI strain exhibits a unique mechanism for acquiring antimicrobial resistance genes, such as bla NDM−1, located on the chromosome instead of plasmids. According to the results, there is increasing complexity in the mechanisms of horizontal transmission of resistance, necessitating a comprehensive understanding and implementation of targeted control measures in both hospital and community settings.

We present a case of bloodstream infection with Saprochaete clavata following an abdominal steel impact injury in a 52-year-old man, whose non-healing abdominal wound was also highly suspected of being caused by Saprochaete clavata. Saprochaete clavata is a very uncommon fungal pathogen. Our case is distinctive in that previous reports have typically involved immunocompromised, malignant, or leukemic patients. In contrast, our case involved a middle-aged man in good health who had ileal perforation repair for gastrointestinal perforation. Post-surgery, Saprochaete clavata was isolated from the incision exudate and blood samples. The pathogen was characterized and the drug sensitivity test was performed, and based on their results a clinical treatment plan was devised. The combination antifungal treatment comprising voriconazole and caspofungin significantly controlled the patient's infection and gradually healed the wound. Therefore, early isolation and characterization are essential because invasive fungal diseases have a high death rate.

Introduction. The emergence of antibiotic-resistant Salmonella isolates is a global concern and has been attributed to the indiscriminate use of antibiotics in humans and animals. Integrons are mobile gene elements closely related to bacterial drug resistance. Among them, class 1 integrons containing various resistance gene cassettes could play an important role in disseminating and maintaining antibiotic resistance in Salmonella isolates. Hypothesis. Salmonella class 1 integrons have a relationship with Salmonella drug resistance. Aim. This study aims to investigate the distribution of class 1 integrons and their variable regional molecular characteristics, as well as the diversity of the promoters and drug sensitivity among Salmonella strains. Methodology. A total of 111 Salmonella strains, collected between 2018 and 2020, underwent fully automated bacterial identification using the VITEK 2 Compact system and an antibiotic sensitivity test. PCR was employed to screen class 1 integrase genes (IntI1) and integron variable regions, while promoter type and variable region gene cassette characteristics were determined using sequencing analysis. Results. A total of 24 IntI1- positive strains were detected in 111 Salmonella strains. Moreover, IntI1- positive strains exhibited statistically significant resistance to ceftazidime, ciprofloxacin, levofloxacin, ceftriaxone, trimethoprim/sulfamethoxazole and azithromycin compared to integronnegative strains (P < 0.05). The multidrug resistance rate of IntI1- positive strains was significantly higher than that of negative strains. Variable regions were observed in 6 of the 24 IntI1- positive strains. Four gene cassettes were detected, namely dfrA17-aadA5, dfrA12-aadA2, aadA22 and aar-3-dfrA27. Finally, 3 types of class 1 integron variable region promoters were identified in 24 strains, including PcW, PcH1 and PcWTGN-10; they are all relatively weak promoters. Conclusion. The integron and the drug resistance genes carried by integron have a certain relationship with drug resistance.

Objective To investigate the distribution of class 1 integrons and their variable regional molecular characteristics, as well as the diversity of promoter and drug sensitivity of CR-Eco (carbapenem-resistant E. coli) strains.Method A total of 117 CR-Eco strains, collected between 2012.01 and 2019.12, underwent fully automated bacterial identification and sensitization using VITEK 2 Compact and supplemented by K-B assay. PCR was used to screen class 1 integrase genes and integron variable regions, while promoter type and variable region gene cassette characteristics were determined by sequencing analysis.Results The positive rate of the class 1 integron of the CR-Eco strains in this experiment was 83.70% (92/117). Moreover, class 1 integrase-positive strains exhibited statistically significant resistance to Aminoglycosides, ceftazidime, ciprofloxacin, ceftriaxone, gentamicin, meropenem, and trimethoprim-sulfamethoxazole compared to integron-negative strains (P<0.05). Variable regions were observed in 77 of the 92 class 1 integrase-positive strains.A total of seven gene cassettes were detected, namely dfrA17-aadA5, aadA22, dfrA12-aadA2, dfrA12, dfrA17, dfrA27 and aadA. Finally, five types of class 1 integron variable region promoters were identified in those 77 strains, including PcW, PcH1, PcWTGN-10, PcH1TGN-10, and P2; they were detected in 48, 18, 8, 2, and 1, respectively.ConclusionThe main integrator variable region gene cassettes of this class were dfrA and aadA. The integron-positive strains simultaneously displayed high resistance to multiple antimicrobial drugs. The integrator variable region promoters of the CR-Eco strains are primarily weak and can potentially form and spread drug resistance.

Mycobacterium mucogenicum is a nontuberculous mycobacterium that is ubiquitous in nature. However, M. mucogenicum infection in patients with orthopedic trauma is rarely reported in the literature. Herein, we describe a 48 year old male Han Chinese patient whose right leg was squeezed by agricultural machinery, resulting in open tibial fractures. Postoperative antimicrobial treatment was administered because the wound had been contaminated by soil. However, no long-term wound closure occurred, and a culture of the wound exudation tested positive for M. mucogenicum. We established the clinical treatment plan according to the characteristics and drug sensitivity test results of M. mucogenicum, and the patient was discharged uneventfully. Increasingly, more reports of infection caused by nontuberculous mycobacteria are being published; however, to our knowledge, this is the first report of an orthopedic infection caused by M. mucogenicum. Because the treatment process of M. mucogenicum infection is long and complex, isolation and identification of M. mucogenicum are of great significance to effective clinical treatment.

To investigate the antimicrobial resistance and molecular characterization of gene cassettes from class 1 integrons in Escherichia coli strains isolated from hospitalized patients. Bacterial identification was conducted using the Vitek-2 Compact system, and antimicrobial susceptibility analysis was performed using the Kirby-Bauer method. Class 1 integrons, integrase genes, the variable regions of integrons and promoters from the isolated E. coli were screened by polymerase chain reaction, and subjected to DNA sequencing. In total, 138 E. coli strains were collected from the hospitalized patients, most from urine specimens (41.30%, 57/138). Antimicrobial resistance to ampicillin (89.86%) was most prevalent, with 79.99% of strains being multidrug-resistant (MDR). The class 1 integron integrase intI1 gene was detected in 67.39% of the isolates (93/138). Three gene cassette arrays and 5 antimicrobial resistance gene cassettes were detected in 69 of the class 1 integron-positive strains. The most common gene cassette array was dfrA17-aadA5. Of the 93 intI1-positive strains, 5 different common promoters were detected. The most prevalent common promoter was PcH1, and most isolates contained the dfrA17-aadA5 gene cassette array. In summary, antimicrobial resistance and MDR were prevalent among E. coli isolates in our city Weifang in Shandong Provence China. Gene cassettes of the class 1 integron variable region mostly conferred resistance to traditional antimicrobials. Weak promoters in the variable regions were predominant in this study. Integrons pose a great threat to the treatment of MDR bacterial infections and further investigations are needed.

目的 筛查临床分离大肠埃希菌中第一类整合子的分布,研究其对大肠埃希菌耐药性的影响,为临床治疗和控制院内播撒提供理论依据.方法 收集就诊患者临床标本中分离的非重复大肠埃希菌138株.应用Vitek 2 Compact进行鉴定并做药敏试验;应用PCR方法筛查第一类整合子基因,确定整合子在大肠埃希菌中的分布.结果 临床常用药物耐药率最高的药物为氨苄西林89.86％(124/138),其次为环丙沙星73.91％(102/138);第一类整合子阳性率为67.39％(93/138);庆大霉素、妥布霉素、复方新诺明、环丙沙星整合子阳性菌株耐药率显著高于整合子阴性菌株,其他药物均无统计学差异.结论 本次实验菌株对β-内酰胺类及氟喹诺酮类药物耐药率最高.Ⅰ类整合子阳性率处于较高水平且其对大肠埃希菌耐药起到关键作用,应当引起足够的重视.

目的:回顾性分析临床分离肠球菌的临床分布及耐药变迁,为临床合理选用抗菌药物提供理论指导.方法:收集2015年1月～2019年12月潍坊市人民医院临床泌尿系感染患者分离自清洁中段尿标本的肠球菌,采用法国梅里埃VITEK-2/compact细菌鉴定及药敏分析系统对其进行细菌鉴定及药敏试验,分析病原菌临床分布及耐药情况.结果:尿培养分离的肠球菌株共385株,以泌尿外科分离率最高,粪肠球菌较屎肠球菌分离率高,两者耐药率比较除利福平外均有统计学差异.结论:泌尿系感染患者中肠球菌的检出率有逐年上升的趋势,我院应加强对肠球菌的防控,有效控制其所导致的医院感染.

Background: In recent years, the widespread use of antibiotics has resulted in increased rates of antibiotic resistance (ABR). Pseudomonas aeruginosa is one of the most important opportunistic pathogens causing hospital-acquired infections. Pseudomonas aeruginosa has continuously increased resistance to commonly used clinical antimicrobial drugs, bringing great difficulties to clinical treatment. Objectives: This retrospective study investigated the epidemiological characteristics of P. aeruginosa and changes in ABR over a 5-year period at a hospital in Shandong Province, China. Methods: Pseudomonas aeruginosa strains were collected from 2015 to 2019. The antimicrobial susceptibility testing employed the Kirby-Bauer disk diffusion method and the broth microdilution method (VITEK-2 compact system), according to the guidelines by the Clinical and Laboratory Standards Institute. Data were analyzed using WHONET 5.6 and SPSS V. 21.0 software. Results: A total of 3,324 P. aeruginosa strains were isolated from clinical specimens (604, 631, 700, 595, and 794 strains from 2015 to 2019, respectively). The highest P. aeruginosa detection rates were from respiratory tract specimens (72.54%). The highest resistance was seen in aztreonam, followed by ciprofloxacin, levofloxacin, and imipenem. The isolation rates for carbapenem-resistant P. aeruginosa (CRPA) and multidrug-resistant P. aeruginosa (MDRPA) ranged from 15.21 - 18.38% and 17.31 - 27.31%, respectively. Also, the isolation rates for extensively drug-resistant P. aeruginosa (XDRPA) ranged from 1.86 - 3.52%. Conclusions: The main sources of the P. aeruginosa isolates were older adult patients with chronic respiratory diseases. The isolation rates for CRPA, MDRPA, and XDRPA strains decreased over the 5-year period. However, the drug resistance situation remains a serious concern. Hence, continued infection control and antimicrobial stewardship and basic and clinical research on bacterial resistance are essential.

整合子是广泛存在于细菌中的一种可移动基因元件,它可以捕获外来基因盒并使其在细菌体内得到表达,在细菌耐药性的传播过程中扮演着重要角色.过去研究认为,细菌耐药是在质粒及转座子[1]等基因水平上广泛传播,近几年大量研究表明,细菌可通过位点特异性重组的方式将耐药基因盒捕获并整合到自身的染色体或者质粒DNA上,即细菌体内存在一种天然的基因克隆表达系统——整合子.细菌耐药的高频次出现已成为临床医疗工作中的瓶颈,整合子不仅在细菌耐药中起关键作用,而且在细菌适应性及基因进化中具有普遍又重要的意义.

We investigated the antibiotic-resistance phenotypes and molecularly characterized class 1 integron gene cassettes from 113 Pseudomonas aeruginosa isolates from patients. Primers specific for the class 1 integron integrase (intI1) gene were used to screen for these integrons using polymerase chain reactions (PCRs). The variable regions of the integrons were PCR-amplified and sequenced. Sputum was the most common specimen (69.9%; 79/113) followed by aseptic sites (21.2%; 24/113). Of the 113 isolates with phenotypic resistance to the tested antimicrobials, the highest resistances were to ciprofloxacin (CIP) (26.55%), imipenem (IPM) (23.89%), and meropenem (MEM) (23%). Carbapenem-sensitive P. aeruginosa (CS-PA) isolates displayed 23 patterns, and the predominant multidrug resistance phenotype was CIP-levofloxacin (7.23%, 6/83). Carbapenem-resistant P. aeruginosa (CR-PA) isolates displayed 12 patterns, and the predominant multidrug resistance phenotype was IPM-MEM (23.33%, 7/30). Class 1 integrons were detected in 14 (12.4%, 14/113) isolates, 7.22% (6/83) in CS-PA isolates, and 26.67% (8/30) in CR-PA isolates. Six gene cassette arrays were detected, the most prevalent being aacA4-blaOXA101-aadA5 in five isolates (4.4%, 5/113). Seventeen gene cassettes were detected. The most prevalent antibiotic-resistance gene cassettes were aacA4 (6.2%, 7/113), blaOXA-1, and blaOXA-101. Extended-spectrum β-lactamase resistance genes were detected. Some of the genes carried were similar to those in other species, but some had shared characteristics among the P. aeruginosa isolates. Long-standing drug resistance genes appeared to be under elimination in P. aeruginosa, whereas integrons conferring resistance to commonly used clinical drugs such as β-lactamases, fluoroquinolones, and even carbapenems, as well as some other gene elements, were found to be newly integrated.

目的 回顾分析本院近5年分离自无菌部位的白色念珠菌的临床分布情况及其对5种常用抗真菌药物的敏感性变化.方法 收集本院2014年-2018年分离自尿液、分泌物、穿刺液等无菌部位的白色念珠菌,采用科玛嘉显色培养基和VITEK 2 Compact全自动细菌鉴定系统鉴定筛选出白色念珠菌,用ATB药敏板条进行药敏试验.结果 189株白色念珠菌株主要来自泌尿外科、ICU及神经内科,标本类型主要为尿液及分泌物.药敏检测最小抑菌浓度(MIC)发现,白色念珠菌对两性霉素B的5年敏感率均为100.00％,3种唑类药物2015年-2017年其敏感率较高(＞83.00％),2017年均出现下降趋势(73.00％ ～80.00％).另外,由于5-氟胞嘧啶无具体的药敏判定标准,在此次白色念珠菌药敏结果中,MIC值≤4 mg/L者187株,占98.94％.结论 白色念珠菌对两性霉素B联合5-氟胞嘧啶敏感性最高,氟康唑及伏立康唑药物敏感性高于伊曲康唑.

目的 通过对耐万古霉素肠球菌(Vancomycin-resistant Enterococci,VRE)及分离非耐万古霉素肠球菌(Vancomycin-sensitive Enterococci,VSE)致病基因的筛查,了解致病基因分布情况,探索肠球菌致病机制,为日后致病机制的研究提供基线资料.方法 收集浙江省人民医院的部分临床患者标本中分离出的VRE,与ICU采集的患者肛周和手臂标本分离的肠球菌属细菌.以PCR方法筛查出ace、asa1、cylA、efaA、esp、gelE和hyl七种致病基因.结果 VRE组esp总体阳性率最高,约占71.4％,其中屎肠球菌中esp最高,约占73.5％,其致病基因携带谱以“esp-hyl”基因组合为主;粪肠球菌全部菌株均携带efaA基因,其致病基因均为三种以上基因组合,以“esp-c yl A-gelE-asa 1-e aA”多见.VSE组总体阳性率同样esp最高,约占40.0％;其中屎肠球菌以esp、hyl单个基因携带为主;粪肠球菌以“esp-ace-cylA-gelE-asa1-efaA”最多见.结论 两种肠球菌各种致病基因携带率差异较大,两种肠球菌致病机制存在差异,本地区致病基因发挥作用的以esp、hyl为主.

Lentinan is a biologically active ingredient isolated from the fruiting body of Lentinula edodes (shiitake) and has antitumor properties. Cytokines, at the same time, are a key factor in regulating immune responses in physiological and pathological states. Many cytokines have shown positive effect on different malignancies in clinical trials. Studies have shown that such cytokines as IL6, TNF- α , and TGF- β play a quite important role in the formation of tumor microenvironment. In this study, we investigated the antitumor effect of combined medication of lentinan and cisplatin, another antitumor drug, and its impact on cytokines IL-6, TNF- α , and TGF- β in the treatment of tumor. The results showed that lentinan enhanced the cytotoxic effect of cisplatin on tumor cells. Furthermore, it was proved that the combined treatment of lentinan and cisplatin enhanced the inhibitory effect of cisplatin on the expression of IL-6, TNF- α , TGF- β and tumor growth in mice bearing human ovarian cancer xenograft, human prostate tumor xenograft, and human non-small cell lung cancer xenograft.