Analysis of quality of life in patients after transgastric natural orifice transluminal endoscopic gallbladder-preserving surgery.

BACKGROUND: At present, laparoscopic cholecystectomy (LC) is the main surgical treatment for gallstones. But, after gallbladder removal, there are many complications. Therefore, it is hoped to remove stones while preserving the function of the gallbladder, and with the development of endoscopic technology, natural orifice transluminal endoscopic surgery came into being. AIM: To compare the quality of life, perioperative indicators, adverse events after LC and transgastric natural orifice transluminal endoscopic gallbladder-preserving surgery (EGPS) in patients with gallstones. METHODS: Patients who were admitted to The First Affiliated Hospital of Xinjiang Medical University from 2020 to 2022 were retrospectively collected. We adopted propensity score matching (1:1) to compare EGPS and LC patients. RESULTS: A total of 662 cases were collected, of which 589 cases underwent LC, and 73 cases underwent EGPS. Propensity score matching was performed, and 40 patients were included in each of the groups. In the EGPS group, except the gastrointestinal defecation (P = 0.603), the total score, physical well-being, mental well-being, and gastrointestinal digestion were statistically significant compared with the preoperative score after surgery (P < 0.05). In the LC group, except the mental well-being, the total score, physical well-being, gastrointestinal digestion, the gastrointestinal defecation was statistically significant compared with the preoperative score after surgery (P < 0.05). When comparing between groups, gastrointestinal defecation had significantly difference (P = 0.002) between the two groups, there was no statistically significant difference in the total postoperative score and the other three subscales. In the surgery duration, hospital stay and cost, LC group were lower than EGPS group. The recurrence factors of gallstones after EGPS were analyzed: and recurrence was not correlated with gender, age, body mass index, number of stones, and preoperative score. CONCLUSION: Whether EGPS or LC, it can improve the patient's symptoms, and the EGPS has less impact on the patient's defecation. It needed to, prospective, multicenter, long-term follow-up, large-sample related studies to prove.

Overview of Panax ginseng and its active ingredients protective mechanism on cardiovascular diseases.

ETHNIC PHARMACOLOGICAL RELEVANCE: Panax ginseng is a traditional Chinese herbal medicine used to treat cardiovascular diseases (CVDs), and it is still widely used to improve the clinical symptoms of various CVDs. However, there is currently a lack of summary and analysis on the mechanism of Panax ginseng exerts its cardiovascular protective effects. This article provides a review of in vivo and in vitro pharmacological studies on Panax ginseng and its active ingredients in reducing CVDs damage. AIM OF THIS REVIEW: This review summarized the latest literature on Panax ginseng and its active ingredients in CVDs research, aiming to have a comprehensive and in-depth understanding of the cardiovascular protection mechanism of Panax ginseng, and to provide new ideas for the treatment of CVDs, as well as to optimize the clinical application of Panax ginseng. METHODS: Enrichment of pathways and biological terms using the traditional Chinese medicine molecular mechanism bioinformatics analysis tool (BATMAN-TCM). The literature search is based on electronic databases such as PubMed, ScienceDirect, Scopus, CNKI, with a search period of 2002-2023. The search terms include Panax ginseng, Panax ginseng ingredients, ginsenosides, ginseng polysaccharides, ginseng glycoproteins, ginseng volatile oil, CVDs, heart, and cardiac. RESULTS: 132 articles were ultimately included in the review. The ingredients in Panax ginseng that manifested cardiovascular protective effects are mainly ginsenosides (especially ginsenoside Rb1). Ginsenosides protected against CVDs such as ischemic reperfusion injury, atherosclerosis and heart failure mainly through improving energy metabolism, inhibiting hyper-autophagy, antioxidant, anti-inflammatory and promoting secretion of exosomes. CONCLUSION: Panax ginseng and its active ingredients have a particularly prominent effect on improving myocardial energy metabolism remodeling in protecting against CVDs. The AMPK and PPAR signaling pathways are the key targets through which Panax ginseng produces multiple mechanisms of cardiovascular protection. Extracellular vesicles and nanoparticles as carriers are potential delivery ways for optimizing the bioavailability of Panax ginseng and its active ingredients.

Understanding adjustment profiles among Mexican-origin adolescents over time: A focus on cultural risk and resilience factors.

This study used a three-wave longitudinal dataset to: identify adjustment profiles of U.S. Mexican-origin adolescents based on their physical, academic, and psychosocial health adjustment; track adjustment profile changes throughout adolescence; and examine the associations between cultural stressors, family obligation, and adjustment profile membership over time. Participants were 604 Mexican-origin adolescents (54% female, Mage = 12.41, SD = 0.97) in Texas (Wave 1: 2012-2015; Wave 2: 2013-2016; Wave 3: 2017-2020). Three concurrent profiles (Well-adjusted, Moderate, and Poorly-adjusted) emerged at each wave, whereas three transition profiles (Improved, Stable well-adjusted, and Overall poorly-adjusted) were identified across three waves. The results suggest that cultural stressors pose risks for Mexican-origin adolescents' adjustment, and family obligation values play a protective role in these associations.

Human ß-defensin-1 affects the mammalian target of rapamycin pathway and autophagy in colon cancer cells through long non-coding RNA TCONS_00014506.

BACKGROUND: Colorectal cancer has a low 5-year survival rate and high mortality. Human ß-defensin-1 (hBD-1) may play an integral function in the innate immune system, contributing to the recognition and destruction of cancer cells. Long non-coding RNAs (lncRNAs) are involved in the process of cell differentiation and growth. AIM: To investigate the effect of hBD-1 on the mammalian target of rapamycin (mTOR) pathway and autophagy in human colon cancer SW620 cells. METHODS: CCK8 assay was utilized for the detection of cell proliferation and determination of the optimal drug concentration. Colony formation assay was employed to assess the effect of hBD-1 on SW620 cell proliferation. Bioinformatics was used to screen potentially biologically significant lncRNAs related to the mTOR pathway. Additionally, p-mTOR (Ser2448), Beclin1, and LC3II/I expression levels in SW620 cells were assessed through Western blot analysis. RESULTS: hBD-1 inhibited the proliferative ability of SW620 cells, as evidenced by the reduction in the colony formation capacity of SW620 cells upon exposure to hBD-1. hBD-1 decreased the expression of p-mTOR (Ser2448) protein and increased the expression of Beclin1 and LC3II/I protein. Furthermore, bioinformatics analysis identified seven lncRNAs (2 upregulated and 5 downregulated) related to the mTOR pathway. The lncRNA TCONS_00014506 was ultimately selected. Following the inhibition of the lncRNA TCONS_00014506, exposure to hBD-1 inhibited p-mTOR (Ser2448) and promoted Beclin1 and LC3II/I protein expression. CONCLUSION: hBD-1 inhibits the mTOR pathway and promotes autophagy by upregulating the expression of the lncRNA TCONS_00014506 in SW620 cells.

Physical exercise plays a role in rebalancing the bile acids of enterohepatic axis in non-alcoholic fatty liver disease.

Non-alcoholic fatty liver disease (NAFLD) is considered as one of the most common diseases of lipid metabolism disorders, which is closely related to bile acids disorders and gut microbiota disorders. Bile acids are synthesized from cholesterol in the liver, and processed by gut microbiota in intestinal tract, and participate in metabolic regulation through the enterohepatic circulation. Bile acids not only promote the consumption and absorption of intestinal fat but also play an important role in biological metabolic signaling network, affecting fat metabolism and glucose metabolism. Studies have demonstrated that exercise plays an important role in regulating the composition and function of bile acid pool in enterohepatic axis, which maintains the homeostasis of the enterohepatic circulation and the health of the host gut microbiota. Exercise has been recommended by several health guidelines as the first-line intervention for patients with NAFLD. Can exercise alter bile acids through the microbiota in the enterohepatic axis? If so, regulating bile acids through exercise may be a promising treatment strategy for NAFLD. However, the specific mechanisms underlying this potential connection are largely unknown. Therefore, in this review, we tried to review the relationship among NAFLD, physical exercise, bile acids, and gut microbiota through the existing data and literature, highlighting the role of physical exercise in rebalancing bile acid and microbial dysbiosis.

Current Progress and Challenges in the Study of Adjuvants for Oral Vaccines.

Over the past 20 years, a variety of potential adjuvants have been studied to enhance the effect of oral vaccines in the intestinal mucosal immune system; however, no licensed adjuvant for clinical application in oral vaccines is available. In this review, we systematically updated the research progress of oral vaccine adjuvants over the past 2 decades, including biogenic adjuvants, non-biogenic adjuvants, and their multi-type composite adjuvant materials, and introduced their immune mechanisms of adjuvanticity, aiming at providing theoretical basis for developing feasible and effective adjuvants for oral vaccines. Based on these insights, we briefly discussed the challenges in the development of oral vaccine adjuvants and prospects for their future development.

Deletion of the cheZ gene results in the loss of swimming ability and the decrease of adhesion ability to Caco-2 cells in Escherichia coli Nissle 1917.

The aim of this study was to elucidate the biological functions of the motility regulatory protein CheZ in the probiotic strain Escherichia coli Nissle 1917. A cheZ gene deletion strain Nissle 1917ΔcheZ was constructed using the CRISPR/Cas9 two-plasmid system, and the corresponding complemented strain Nissle 1917ΔcheZ/pBR322-cheZ was established. Combined studies of growth kinetics testing, motility assays, swarming motility assays, and bacterial adherence assays were performed to study the motility regulatory protein CheZ-mediated functions in the prototype Nissle 1917 strain, its isogenic cheZ mutant, and the corresponding complemented strain. The growth rate of the cheZ mutant strain was lower than that of the wild-type strain in the exponential growth phase. The motility of the cheZ mutant strain was significantly lower than that of the wild-type strain. And the adhesion ability of ΔcheZ mutant to the Caco-2 cells was significantly lower than that of the wild-type strain and complemented strain. In conclusion, the results presented in our study suggested that the deletion of the cheZ gene in E. coli Nissle 1917 led to a significant reduction of its swimming ability and a subsequent marked decrease of adhesion to the Caco-2 cells.

t(4;11) translocation in hyperdiploid de novo adult acute myeloid leukemia: A case report.

BACKGROUND: MLL gene rearrangement is a common genetic abnormality of acute myeloid leukemia (AML), which predicts poor prognosis and is important in clinical diagnosis. MLL rearrangement involves many chromosomes, among which, t(4;11) translocation is rare in AML. The present case was t(4;11) AML, accompanied by a hyperdiploid karyotype. Such cases have not been reported previously. CASE SUMMARY: An adult male with self-reported symptoms of fatigue, febrility and hyperleukocytosis was diagnosed with AML by morphology and confirmed by immunophenotype analysis. Uncommonly, chromosomal and fluorescence in situ hybridization (FISH) analysis showed a hyperdiploid karyotype with t(4;11) translocation and MLL rearrangement, and a negative MLL-AF4 fusion gene result. The patient died of respiratory and circulatory failure 5 days after diagnosis. CONCLUSION: t(4;11) AML with hyperdiploid karyotype has not been reported. In this case, t(4;11) was only detected by karyotype analysis and FISH, suggesting their importance in MLL rearrangement detection.

A Deep Learning Model System for Diagnosis and Management of Adnexal Masses.

Appropriate clinical management of adnexal masses requires a detailed diagnosis. We retrospectively collected ultrasound images of 1559 cases from the first Center of Chinese PLA General Hospital and developed a fully automatic deep learning (DL) model system to diagnose adnexal masses. The DL system contained five models: a detector, a mass segmentor, a papillary segmentor, a type classifier, and a pathological subtype classifier. To test the DL system, 462 cases from another two hospitals were recruited. The DL system identified benign, borderline, and malignant tumors with macro-F1 scores that varied from 0.684 to 0.791, a benefit to preventing both delayed and overextensive treatment. The macro-F1 scores of the pathological subtype classifier to categorize the benign masses varied from 0.714 to 0.831. The detailed classification can inform clinicians of the corresponding complications of each pathological subtype of benign tumors. The distinguishment between borderline and malignant tumors and inflammation from other subtypes of benign tumors need further study. The accuracy and sensitivity of the DL system were comparable to that of the expert and intermediate sonographers and exceeded that of the junior sonographer.

Yi-Xin-Shu capsule ameliorates cardiac hypertrophy by regulating RB/HDAC1/GATA4 signaling pathway based on proteomic and mass spectrometry image analysis.

BACKGROUND: Cardiac hypertrophy (CH) forms the main pathological basis of chronic heart failure (CHF). Mitigating and preventing CH is the key strategy for the treatment of ventricular remodeling in CHF. Yi-Xin-Shu capsule (YXS) has been commonly applied in the clinical treatment of CHF in Asian countries for several decades. However, the underlying mechanism of YXS has not been revealed yet. PURPOSE: To assess the efficiency of YXS in CH and identify its potential therapeutic targets for the managing of CH. METHOD: Ultrasonic cardiogram was used to evaluate the cardiac function of CH rats. Hematein Eosin (HE)-staining, Masson-staining and transmission electron microscope were used to measure the morphological changes, cardiac fibrosis degree and ultrastructure characteristics of cardiomyocytes, respectively. ELISA was used to detect the myocardial injury biomarkers. Then, the potential targets regulated by YXS were screened out via proteomic analysis and mass spectrometry image analysis. Finally, the targets were validated by real-time quantitative (RT-q) PCR, immunofluorescence, immunohistochemistry, and western-blotting methods. RESULTS: YXS improved the cardiac function of CH rats and attenuated the injuries in morphology and subcellular structure of cardiomyocytes. A core protein-protein interaction network was established on differentially expressed proteins (DEP) using proteomics analysis. GATA binding protein 4 (GATA4) was identified as the key target regulated by YXS. The results of mass spectrometry image analysis indicated that the expressions of histone deacetylase 1 (HDAC1) and retinoblastoma (RB) could also be regulated by YXS. Further valuative experiments showed that YXS may attenuate CH by regulating the RB/HDAC1/GATA4 signaling pathway. CONCLUSIONS: For the first time, this study discloses the precise mechanism investigation of the efficacy of YXS against CH. These data demonstrate that YXS may protect against CH by regulating the RB/HDAC1/GATA4 signaling pathway.

Mexican-origin youths' language brokering for fathers and mothers: Daily experiences and youths' diurnal cortisol slopes.

This study examined the associations of language brokering stress intensity and exposure with Mexican-origin youths' cortisol responses when brokering for fathers and mothers, and the moderating role of youths' brokering efficacy in these relations. Participants were 289 adolescents (Mage  = 17.38, SD = .94, 52% girls) in immigrant families. When brokering for mothers, stress exposure was related to flatter (less healthy) same-day diurnal slopes in youth. When brokering for fathers, daily brokering efficacy buffered the detrimental link between stress intensity and youths' same-day cortisol slopes. When brokering for fathers/mothers, stress intensity and exposure were related to flatter (less healthy) next-day diurnal slopes. Although daily brokering stress can relate to youth physiologic functioning, feeling efficacious about brokering may buffer the negative ramifications of stress.

Attentional orienting abilities in bilinguals: Evidence from a large infant sample.

A key question in studies of cognitive development is whether bilingual environments impact higher-cognitive functions. Inconclusive evidence in search of a "bilingual cognitive advantage" has sparked debates on the reliability of these findings. Few studies with infants have examined this question, but most of them include small samples. The current study presents evidence from a large sample of 6- and 10-month-old monolingual- and bilingual-exposed infants (N = 152), which includes a longitudinal subset (n = 31), who completed a cueing attentional orienting task. The results suggest bilingual infants showed significant developmental gains in latency performance during the condition that was most cognitively demanding (Incongruent). The results also revealed bilingual infants' performance was associated with their parents' dual-language switching behavior. Taken together, these results provide support that bilingual experiences (i.e., dual-language mixing) influence infants' shifting and orienting of attention.

Longitudinal change in adolescent hope among recent immigrant Latinx adolescents: Links with adolescent and parent cultural stress, family functioning, emotional well-being, and behavioral health.

Adolescent hope can promote the emotional and behavioral well-being of Latinx families. Positive family functioning may foster adolescent hope, whereas cultural stress may compromise adolescent hope and well-being. We examined how adolescent hope changed over time, and whether cultural stress and family functioning predicted emotional and behavioral health via adolescent hope intercept and slope. Recent Latinx immigrant adolescents (Mage  = 14.51) and parents (Mage  = 41.09; N = 302; n = 150 from Los Angeles; n = 152 from Miami) completed measures of above constructs over 3 years (Summer 2010 to Spring 2013). Latent growth curve modeling indicated that adolescent hope increased over time. Higher cultural stress predicted lower initial hope. Higher family functioning predicted higher initial levels of and less steep increase in hope. Increase in hope predicted better emotional and behavioral health. Family functioning predicted better health outcomes by way of hope.

Combining data augmentation and domain information with TENER model for Clinical Event Detection.

BACKGROUND: In recent years, with the development of artificial intelligence, the use of deep learning technology for clinical information extraction has become a new trend. Clinical Event Detection (CED) as its subtask has attracted the attention from academia and industry. However, directly applying the advancements in deep learning to CED task often yields unsatisfactory results. The main reasons are due to the following two points: (1) A great number of obscure professional terms in the electronic medical record leads to poor recognition performance of model. (2) The scarcity of datasets required for the task leads to poor model robustness. Therefore, it is urgent to solve these two problems to improve model performance. METHODS: This paper proposes a combining data augmentation and domain information with TENER Model for Clinical Event Detection. RESULTS: We use two evaluation metrics to compare the overall performance of the proposed model with the existing model on the 2012 i2b2 challenge dataset. Experimental results demonstrate that our proposed model achieves the best F1-score of 80.26%, type accuracy of 93% and Span F1-score of 90.33%, and outperforms the state-of-the-art approaches. CONCLUSIONS: This paper proposes a multi-granularity information fusion encoder-decoder framework, which applies the TENER model to the CED task for the first time. It uses the pre-trained language model (BioBERT) to generate word-level features, solving the problem of a great number of obscure professional terms in the electronic medical record lead to poor recognition performance of model. In addition, this paper proposes a new data augmentation method for sequence labeling tasks, solving the problem of the scarcity of datasets required for the task leads to poor model robustness.

Culturally relevant stressors as moderators of intergenerational transmission of mother-adolescent executive function in Mexican immigrant families.

The intergenerational transmission of executive function may be enhanced or interrupted by culturally salient environmental stressors that shape the practice of executive function in the family. Building upon past research, the current study tests whether culturally relevant stressors such as economic stress and foreigner stress have a direct effect on adolescent executive function, as well as whether they modify the intergenerational transmission of mother-child executive function (i.e., working memory, inhibitory control, and shifting) in low-income Mexican immigrant families. The sample consists of 179 Mexican American adolescents (Mage = 17.03 years; SDage = 0.83; 58% females) and their Mexico-born mothers (Mage = 43.25 years; SDage = 5.90). Results show that mothers' perceived economic stress is associated with poor inhibitory control in adolescents. Low levels of mothers' perceived foreigner stress related to a stronger association between mothers' and adolescents' working memory, while high levels of mothers' perceived foreigner stress related to enhanced intergenerational transmission of poor shifting ability. Study findings demonstrate the prominence of perceived foreigner stress as a contextually relevant factor moderating the intergenerational transmission of mother-child executive function in low-income Mexican immigrant families.

Language Brokering-Stress Transition Profiles and Marijuana Use in Mexican-Origin Adolescents.

Although Mexican-origin adolescents experience multiple contextual stressors (e.g., discrimination, economic stress, and foreigner stress) that may result in increased marijuana use, they actively engage in cultural practices (e.g., language brokering) that may protect them from adverse developmental outcomes. Yet, the joint influence of contextual stressors and language brokering on marijuana use has rarely been studied from a developmental perspective. Using a sample of 604 Mexican-origin adolescent brokers (54% female, Mage.Wave1 = 12.41), we examined how stability and change of language brokering-contextual stress (i.e., broker-stress) profiles across three waves are related to adolescent marijuana use. We hypothesized that adolescents with positive brokering experiences and lower contextual stress across three waves (i.e., those in the Stable Protective profile) would be the least likely to use marijuana. For brokering for mothers, the Stable Protective and the Change to Protective groups were less likely than other groups to use marijuana. For brokering for fathers, the Stable Protective group was the least likely to use marijuana and the Change to Protective group was less likely than the Risk at Any Wave group to use marijuana. Interventions could foster brokering-related positive feelings across the course of adolescence to reduce marijuana use among Mexican-origin adolescents.

Human α-defensin 5 suppressed colon cancer growth by targeting PI3K pathway.

Defensins are highly conserved antimicrobial peptides, which ubiquitously expressed in different species. In addition to the functions in host defense, their aberrant expression have also been documented in cancerous tissue including breast cancer, lung caner and renal carcinoma etc. Whereas, roles of Defensin Alpha 5 (DEFA5) in colon cancer has not been explored. Bioinformatic analysis was used to study the expression of DEFA5 and its correlation with clinical outcomes; Western blot, qPCR, Co-immunoprecipitation, xenograft models were used to the study the molecular mechanism. Decreased expression of DEFA5 at protein level was observed in colon tissues. Colon cancer cell lines proliferation and colony formation capacity were significantly suppressed by DEFA5 overexpression. Moreover, in vivo tumor growth in nude mice was also suppressed by DEFA5 overexpression, suggesting a tumor suppressor role of DEFA5 in colon cancer. Mechanistically, DEFA5 directly binds to the subunits of PI3K complex, thus attenuates the downstream signaling transduction, leads to delayed cell growth and metastasis. Collectively, we concluded that DEFA5 showed an inhibitory effect in colon cancer cell growth and may serve as a potential tumor suppressor in colon cancer.

Inoculation with arbuscular mycorrhizal fungus modulates defense-related genes expression in banana seedlings susceptible to wilt disease.

Banana as an important economic crop worldwide, often suffers from serious damage caused by Fusarium oxysporum f. sp. Cubense. Arbuscular mycorrhizal (AM) fungi have been considered as one of the promising plant biocontrol agents in preventing from root pathogens. This study examined the effect of AM fungal inoculation on plant growth and differential expressions of growth- and defense-related genes in banana seedlings. Tissue-cultured seedlings of Brazilian banana (Musa acuminate Cavendish cv. Brail) were inoculated with AM fungus (Rhizophagus irregularis, Ri), and developed good mycorrhizal symbiosis from 4 to 11 weeks after inoculation with an infection rate up to 71.7% of the roots system. Microbial abundance revealed that Ri abundance in banana roots was 1.85×106 copies/ml at 11 weeks after inoculaiton. Inoculation improved plant dry weights by 47.5, 124, and 129% for stem, leaf, and the whole plant, respectively, during phosphate depletion. Among a total of 1411 differentially expressed genes (DEGs) obtained from the transcriptome data analysis, genes related to plant resistance (e.g. POD, PAL, PYR, and HBP-1b) and those related to plant growth (e.g. IAA, GH3, SAUR, and ARR8) were up-regulated in AM plants. This study demonstrates that AM fungus effectively promoted the growth of banana plants and induced defense-related genes which could help suppress wilt disease. The outcomes of this study form a basis for further study on the mechanism of banana disease resistance induced by AM fungi.

RETRACTED ARTICLE: Ultrasound microbubble-mediated miR-150-5p inhibits gastric cancer cell growth by targeting the expression of NR2F2.

We, the Editor and Publisher of the Journal of Receptors and Signal Transduction, have retracted the following article: Ultrasound microbubble-mediated miR-150-5p inhibits gastric cancer cell growth by targeting the expression of NR2F2; Wei Wei, Xiaoguang Wei, Minyu Zhang & Cheng Peng; https://doi/10.1080/10799893.2021.1884260Since publication, concerns have been raised about the integrity of the following figures in the article. 2(A) miR-NC and 2(D) miR-NC-MBs;2(A) Control and 5(C) NR2F2-MBs + miR-NC-MBsWhen approached for an explanation, the authors were unable to provide original data in a suitable format that would confirm the authenticity of the data. The authors have been notified of the retraction but have not responded.We have been informed in our decision-making by our policy on publishing ethics and integrity and the COPE guidelines on retractions.The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as 'Retracted'.

Coexistence of Fosfomycin Resistance Determinant fosA and fosA3 in Enterobacter cloacae Isolated from Pets with Urinary Tract Infection in Taiwan.

To analyze the characteristics of fosA and fosA3 in Enterobacter cloacae isolated from aspirated and catheterized urine culture specimens of companion pets in Taiwan. A total of 19 E. cloacae isolates from pets with urinary tract infection were screened for the presence of fosA, fosA3, and fosC2 and for the genetic context of them by PCR amplification and sequencing. The transferability, resistance phenotypes, plasmid replicon typing properties and genetic environments of fosA- and/or fosA3-positive strains were characterized. Five E. cloacae isolates were positive for fosA and three coharbored fosA and fosA3. No fosC determinant was detected. Transconjugants of fosA3 were successfully acquired, while the acquisition of fosA transconjugants was failed. The minimum inhibitory concentrations (MICs) of the three fosA3-positive isolates and their transconjugants were ≥256 mg/L, whereas the MICs of the five fosA-positive isolates ranged from 64 mg/L to 256 mg/L. Three plasmid replicons (InCFrepB, InCL/M, and InCHI2) were identified in fosA- and fosA3-positive E. cloacae isolates. Different genetic contexts lay in the downstream region of fosA and fosA3, respectively. Eight distinct patterns based on the similarity value of more than 80% were typed for all the 8 fosA-positive isolates. In conclusion, the fosA concomitant with fosA3 were found in E. cloacae isolates. The fosA3 not only exhibits stronger activity of inactivating fosfomycin than fosA but also possesses stronger potential to spread than fosA. Different genetic backgrounds exist in these fosA- and fosA3-positive isolates, and different mobile elements may confer the dissemination of fosA and fosA3.