Objective To investigate the causes of an outbreak of healthcare-associated infection with methicillin-resist-ant Staphylococcus aureus (MRSA)in a neurosurgical intensive care unit(NSICU).Methods Epidemiological investigation on 8 patients with lower respiratory tract infection (LRTI)in a NSICU between June 15 and June 28,2104 were performed by combination methods of prospective and retrospective survey.Results The attack rate of MRSA LRTI in NSICU patients was 22.86%,a total of 16 MRSA isolates were detected from patients’clinical specimens,nasal vestibule,as well as hospital surroundings during the period,pulsed-field gel electrophoresis (PFGE)result revealed that infection outbreak was caused by two subtypes of MRSA;risk factors analysis showed that long length of stay in ICU and aspiration of spu-tum through bronchoscopy were risk factors for MRSA LRTI.Conclusion Contamination of bronchoscope was the key factor for this epidemic spread of healthcare-associated MRSA infection.

Objective To describe the level of self-perceived burden (SPB) and analyze its influencing factors among the patients with advanced lung cancer, in order to provide a theoretical basis for individualized nursing care. Methods A total of 102 hospitalized patients with lung cancer from 3 hospitals in Shandong province were investigated by the Self-Perceived Burden Scale for Cancer Patient (SPBS-CP). Results The total score of the SPBS-CP was (60.31±17.06) points, which indicated at a moderate level. Those patients rated the highest score on the sub-scale of economic/family burden (22.04±6.72) points, the lowest score on the sub scale of care burden (10.28±3.62) points. Single factor analysis and regression results showed that different work conditions, different stages were related with SPB. Conclusions Patients with moderate and advanced lung cancer had a moderate or higher level of SPB. Staff nurses should focus on the psychological status of the patients and take positive interventions to release the negative emotional experiences.

Objective:To investigate the clinical characteristics, changes in lactate dehydrogenase (LDH) levels, and prognosis in cases of Amanita oberwinklerana poisoning.Methods:A retrospective analysis was conducted on the clinical data of 12 patients who were diagnosed with Amanita oberwinklerana poisoning at Xiangya Changde Hospital between January 2019 and December 2022. The analysis included an assessment of clinical manifestations, renal function changes, LDH levels, and patient prognosis. All statistical analyses were performed using SPSS25.0 Comparisons of ratios between groups were performed using the t test, correlation analyses were performed using scatter diagram and Pearson correlation method, P<0.05 was considered statistically significant. Results:The latency period for symptom onset ranged from 6 to 18 hours, with early symptoms primarily consisting of nausea and vomiting. Three patients developed anuria in the early stage. All patients experienced acute kidney injury (AKI) accompanied by mild liver injury. LDH levels were significantly elevated compared to other types of mushroom poisoning cases ( P < 0.01), with a mean peak value exceeding 2000 U/L. While no correlation was found between LDH levels and kidney injury severity, a positive correlation was observed between LDH levels and length of the course. All 12 patients recovered following dialysis treatment, with recovery periods ranging from 20 to 60 days. No cases of chronic renal failure or mortality were reported. Conclusions:Amanita oberwinklerana poisoning primarily causes acute renal injury. A significant elevation in LDH levels may serve as a potential marker for this type of poisoning. LDH levels did not correlate with kidney injury severity, while positively corrected with the length of the course. All patients in this study achieved good prognosis with full renal recovery.