1.Dural arteriovenous fistula in a neonate presenting with respiratory distress.
Yue DU ; Jing-Hua ZHANG ; Jun-Liang LI ; Zhou-Ping WANG ; Mei-Gui WU
Chinese Journal of Contemporary Pediatrics 2025;27(4):500-504
The patient, a 20-day-old male, was admitted due to respiratory distress that had persisted for 20 days after birth. The main clinical manifestations included gradually worsening respiratory distress and edema. The patient received treatment including mechanical ventilation and diuretics. Echocardiography indicated cardiomegaly, pulmonary hypertension, and heart failure. A comprehensive systemic examination revealed a significant blowing vascular murmur upon auscultation over the anterior fontanelle and bilateral temporal regions. Further imaging studies including cranial magnetic resonance imaging, magnetic resonance angiography, and magnetic resonance venography showed marked dilation of the superior sagittal sinus, transverse sinus, and sigmoid sinus, leading to a definitive diagnosis of dural arteriovenous fistula. After a multidisciplinary consultation, the patient underwent cerebral angiography and partial embolization of the left parietal arteriovenous fistula. Postoperatively, the patient was treated with positive inotropes, diuretics, and fluid restriction. Ultimately, the patient was weaned off the ventilator and discharged in improved condition. This article reports a case of neonatal dural arteriovenous fistula presenting with respiratory distress and discusses the multidisciplinary approach to managing this condition, which aids in early disease recognition and guides clinical decision-making.
Humans
;
Male
;
Infant, Newborn
;
Central Nervous System Vascular Malformations/diagnosis*
;
Respiratory Distress Syndrome, Newborn/etiology*
;
Embolization, Therapeutic
2.Lu'e Biyan Formula for Treatment of Allergic Rhinitis Patients with Fei (Lung)-Qi Deficiency-Coldness Syndrome: A Randomized, Double Blind, and Placebo-Controlled Trial.
Ming-Yue JIA ; Mei-Yi ZHANG ; Si-Yao XIAO ; Yang YU ; Xiang SHAO ; Chun-Sheng HAN ; Gui-Ling HAN
Chinese journal of integrative medicine 2025;31(11):1029-1036
OBJECTIVE:
To observe the clinical effect and safety of Lu'e Biyan Formula (LBF) combined with loratadine in the treatment of moderate to severe allergic rhinitis (AR) patients with Fei (Lung)-qi deficiency-coldness (FQDC) syndrome.
METHODS:
From September 2023 to December 2024, moderate to severe AR patients with FQDC syndrome were recruited from the Outpatient Department of Integrated Traditional Chinese and Western Medicine for Pulmonary Diseases Part 1, China-Japan Friendship Hospital. Participants were randomly assigned to a test group and a control group by using a random number table at a ratio of 1:1. Both groups received oral loratadine tablets (10 mg, once daily) for 2 weeks. In addition, the test group received oral LBF (30 mL, twice daily), and the control group received a placebo of LBF. Changes in the Total Nasal Symptom Score (TNSS), Total Non-nasal Symptom Score (TNNSS), Visual Analog Scale (VAS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and Chinese medicine (CM) syndrome scores before and after treatment were compared between groups. Moreover, the total effective rates and disease recurrence rates were compared. Adverse events (AEs) during the study period were also recorded.
RESULTS:
Totally 109 participants were recruited, and the full analysis set included 105 cases, 54 in the test group and 51 in the control group. Compared with the pre-treatment values, the scores of sneezing, runny nose, nasal obstruction, nasal itching, TNSS, TNNSS, VAS, RQLQ, and CM syndrome were significantly reduced in both groups at 1 and 2 weeks post-treatment and 12 weeks post-drug withdrawal (P<0.01). After treatment, the aforementioned scores in the test group were all markedly lower than those in the control group (P<0.01). Moreover, the total effective rate in the test group was higher than that in the control group (98.15% vs. 70.59%, P<0.01). After 12 weeks of drug withdrawal, there was no significant difference in the recurrence rate between groups (13.21% vs. 22.22%, P>0.05). No obvious AEs were observed in either group following treatment.
CONCLUSIONS
The combination of LBF with loratadine can effectively alleviate the symptoms of moderate to severe AR patients with FQDC syndrome, thereby improving their quality of life. This therapy demonstrated both precise effect and high safety. (Trial registration No. ITMCTR2025000589).
Humans
;
Drugs, Chinese Herbal/therapeutic use*
;
Male
;
Rhinitis, Allergic/drug therapy*
;
Female
;
Adult
;
Double-Blind Method
;
Quality of Life
;
Qi
;
Middle Aged
;
Loratadine/therapeutic use*
;
Medicine, Chinese Traditional
;
Syndrome
;
Lung/drug effects*
;
Young Adult
;
Treatment Outcome
3.Correlation Analysis of Postoperative Perceived Stress,Quality of Life and Fear of Cancer Recurrence in Elderly Non-Small Cell Lung Cancer Patients
Xiao-lan BI ; Gui-mei LIU ; Xin ZHANG
Progress in Modern Biomedicine 2025;25(18):2956-2964
Objective:To investigate the correlation between postoperative perceived stress,quality of life and fear of cancer recurrence(FCR)in elderly non-small-cell lung cancer(NSCLC)patients.Methods:This study was a prospective research design,a total of 147 elderly NSCLC patients who visited Shanxi Integrated Traditional Chinese and Western Medicine Hospital from January 2023 to June 2024 were prospectively selected for the study.All patients underwent thoracoscopic lobectomy.FCR in patients was evaluated by fear of disease progression simplified scale(FoP-Q-SF),and they were divided into dysregulation group and non dysregulation group according to the FoP-Q-SF score.Quality of life was evaluated by functional assessment of cancer therapy-lung cancer(FACT-L).Perceived stress was evaluated by Chinese version of the perceived stress scale(CPSS)score.The scores of postoperative perceived stress,quality of life and postoperative FCR in elderly NSCLC patients were analyzed,and the influence of demographic and clinical characteristics on the postoperative FCR in elderly NSCLC patients.The postoperative perceived stress and quality of life scores of elderly NSCLC patients with different FCR were compared,the correlation between postoperative FCR and perceived stress and quality of life in elderly NSCLC patients were analyzed,as well as the model fitting index of the influence of postoperative perceived stress and quality of life on FCR in elderly NSCLC patients.Results:The postoperative CPSS score in elderly NSCLC patients was(52.17±4.02)points,the FACT-L score was(80.39±4.56)points,and the total score of FoP-Q-SF was(31.16±8.69)points.Family relationship,economic burden of disease,chemotherapy and clinical stage were closely associated with the postoperative FCR in elderly NSCLC patients(P<0.05).The CPSS score in dysregulation group was higher than that in nondysregulation group,and the FACT-L score was lower than that in nondysregulation group(P<0.05).Pearson correlation analysis,postoperative FCR in elderly NSCLC patients was positively correlated with perceived stress,but negatively correlated with quality of life(P<0.05).The postoperative quality of life in elderly NSCLC patients was recorded as the independent variable,the postoperative perceived stress was recorded as the mediating variable,and the postoperative FCR was recorded as the dependent variable,a structural model of the mediating effect was routinely constructed.The results showed that the model fits well.Quality of life had a direct negative predictive effect on postoperative FCR in elderly NSCLC patients(P<0.05),and could affect FCR through postoperative perceived pressure(P<0.05),with the mediating effect accounting for 34.15%of the total effect.After repeatedly sampling the data using the Bootstrap method and implementing the mediating effect,the 95%CI of each model path did not include 0,indicating that the difference in the mediating effect was statistically significant(P<0.05).Conclusion:Postoperative FCR in elderly NSCLC patients is positively correlated with perceived stress,but negatively correlated with quality of life,clinically,monitoring such indicators can be considered to better evaluate the postoperative FCR in elderly NSCLC patients.
4.Polysaccharides from armillariella tabescens mycelia alleviates 5-fluorouracil-induced chemotherapy-induced intestinal mucositis via inhibiting the TLR4/MyD88/NF-κB signaling pathway
Mengru Yuan ; Zhongxuan Gui ; Xinru Wan ; Wenna Zhang ; Yan Chen ; Mei Zhang
Acta Universitatis Medicinalis Anhui 2025;60(7):1275-1281, 1290
Objective:
To investigate whether armillariella tabescens polysaccharides (ATPS) alleviates inflamma- tory responses and tissue damage in 5-fluorouracil ( 5-FU ) -induced chemotherapy-induced intestinal mucositis ( CIM) by inhibiting the TLR4 /MyD88 /NF-κB signaling pathway.
Methods:
Thirty 8-weeks-old male C57BL/6J mice were randomly divided into five groups ( n = 6 per group) : control group,model group ,and ATPS-treated groups (low,medium,high dose : 100,200,400 mg / kg) .Body weight changes were recorded ; Disease activity in- dex (DAI) scores were evaluated ; small intestinal length and histopathology were measured ; HE staining and his- topathological scoring were performed ; immunohistochemistry was used to detect the expression of tight junction pro- teins (ZO-1,Occludin) in the small intestine ; serum levels of inflammatory cytokines interleukin-6 ( IL-6 ) and tumor necrosis factor-alpha (TNF-α) were analyzed by enzyme-linked immunosorbent assay (ELISA) kit ; Western blot was employed to quantify ZO-1,Occludin,and TLR4 /MyD88 /NF-κB pathway-related protein TLR4,MyD88,NF-κB p65,IκBα , p-NF-κB p65,p-IκBα protein expression.
Results :
Compared with the control group,mice in the model group exhibited significant reductions in body weight ,elevated DAI scores ,shortened small intestinal length,increased histopathological scores,marked downregulation of ZO-1 and Occludin expression,and elevated levels of inflammatory cytokines TNF-α and IL-6.Additionally,protein expression levels of TLR4,MyD88,p-NF- κB p65,and p-IκBα were significantly upregulated ( all P <0. 01 ) . In contrast ,mice in ATPS-treated groups showed dose-dependent improvements,attenuated weight loss,reduced DAI scores,restored intestinal length,de- creased histopathological scores,upregulated ZO-1 and Occludin expression,reduced TNF-α and IL-6 levels,and downregulated TLR4,MyD88,p-NF-κB p65,and p-IκBα protein expression (all P<0. 01) .
Conclusion
ATPS alleviates 5-FU-induced CIM by inhibiting the TLR4 /MyD88 /NF-κB signaling pathway.
5.Correlation Analysis of Northwest Dryness Syndrome with Pulmonary Tuberculosis in Moyu County,Hetian Prefecture,Xinjiang
Xiu-mei WANG ; Huan LIU ; Yu-cun ZHANG ; GULISHALA·TURSUN ; Hua-gui LI
Progress in Modern Biomedicine 2025;25(11):1788-1798
Objective:To explore the incidence characteristics and correlation analysis of Western dryness syndrome in pulmonary tuberculosis patients in Moyu County,Hetian Prefecture,Xinjiang,and to provide a basis for the prevention and treatment strategies and effectiveness evaluation of pulmonary tuberculosis in Xinjiang.Methods:89 confirmed cases of pulmonary tuberculosis in Moyu County,Hotian Prefecture,Xinjiang from October 2023 to October 2024 were selected as the case group,and 117 healthy individuals matched with the case group in terms of gender,age,and education level in Moyu County,Hotian Prefecture,Xinjiang during the same period were selected as the control group.The general information and incidence of Northwest dryness syndrome between two groups were compared.The incidence and severity of Northwest dryness syndrome in tuberculosis patients,as well as the main and secondary syndrome scores of Northwest dryness syndrome were analyzed.The influencing factors of pulmonary tuberculosis were analyzed.The scores of the main syndrome of Northwest dryness syndrome(lung wei kong pi dryness syndrome)and the concurrent syndrome of Northwest dryness syndrome(heart kidney yin deficiency syndrome,lung heart spleen wind fire dryness syndrome,liver kidney essence blood deficiency syndrome,spleen stomach dampness syndrome,spleen stomach yin deficiency syndrome)between the control group and the case group were compared.The correlation between pulmonary tuberculosis and the on set of Northwest dryness syndrome were analyzed by Spearman rank sum test.Results:There was no significant difference between the control group and the case group in terms of body mass index(BMI),age,education level,gender,etc.(P>0.05).The incidence of Northwest dryness syndrome in the case group was significantly higher than that in the control group(P<0.05).The Northwest Dry Syndrome Scale score in the severe group was higher than that in the mild and moderate groups,and the Northwest Dry Syndrome Scale score in the moderate group was higher than that in the mild group(P<0.05).Among 89 patients with pulmonary tuberculosis,the main syndrome of lung wei kong pi dryness syndrome had the highest number of cases,totaling 42 cases(47.19%).The highest number of concurrent syndromes were heart kidney yin deficiency syndrome,totaling 36 cases(40.45%),followed by spleen stomach yin deficiency syndrome,totaling 35 cases(39.33%).The results showed that suffering from Northwest dryness syndrome was a risk factor for pulmonary tuberculosis(P<0.05).There were significant differences in the scores of the main syndrome of Northwest dryness(Lung Wei Kong Pi dryness syndrome),the concurrent syndrome of Northwest dryness(Lung Heart Spleen Wind Fire dryness syndrome),and the concurrent syndrome of Northwest dryness(Spleen Stomach Yin Deficiency syndrome)between the control group and the case group(P<0.05).There was no significant difference in the scores of Northwest dryness syndrome(liver and kidney essence and blood deficiency syndrome),Northwest dryness syndrome(heart and kidney yin deficiency syndrome),and Northwest dryness syndrome(spleen and stomach dampness syndrome)between the control group and the case group(P>0.05).The score of pulmonary tuberculosis syndrome was positively correlated with various types of Northwest dryness syndrome(P<0.05),and there was a significant correlation at the 0.001 level between pulmonary Wei Kong Pi dryness syndrome,pulmonary heart spleen wind fire dryness syndrome,and spleen stomach dampness syndrome(P<0.05).The correlation between liver and kidney essence and blood deficiency syndrome and spleen and stomach yin deficiency syndrome is significant at the 0.01 level(P<0.05).The correlation between heart and kidney yin deficiency syndrome is significant at the 0.05 level(P<0.05).Conclusion:The northwest dryness syndrome is related to the occurrence of pulmonary tuberculosis in Moyu County,Hotan Prefecture,Xinjiang,and is a risk factor for the occurrence of pulmonary tuberculosis.There is a significant positive correlation between the pulmonary tuberculosis syndrome score and various types of northwest dryness syndrome,among which the lung wei kong pi dryness syndrome,lung heart spleen wind fire dryness syndrome,and spleen stomach dampness syndrome have the most significant impact on the pulmonary nucleus syndrome score.
6.Pharmaceutical considerations on novel pharmaceutical preparations in China encourage generic drug catalogue(first to third batches)
Xiao-fei SI ; Gui-xia SUN ; Bao-mei ZHANG ; Tian-xing DAI ; Yan-xiu GE ; Dian-zhuo JIANG
The Chinese Journal of Clinical Pharmacology 2025;41(1):143-148
To meet the domestic clinical demand timely,the national health commission has released three batches of encourage generic drug catalogues,which plays a good guiding role in improving the supply level and accessibility of generic drugs.Based on literature investigation,the typical cases of novel pharmaceutical preparations were analyzed,and the pharmaceutical considerations were put forward in terms formulation,manufacturing process and quality control,aimed to provide scientific reference for research and development of such drugs.
7.Correlation Analysis of Northwest Dryness Syndrome with Pulmonary Tuberculosis in Moyu County,Hetian Prefecture,Xinjiang
Xiu-mei WANG ; Huan LIU ; Yu-cun ZHANG ; GULISHALA·TURSUN ; Hua-gui LI
Progress in Modern Biomedicine 2025;25(11):1788-1798
Objective:To explore the incidence characteristics and correlation analysis of Western dryness syndrome in pulmonary tuberculosis patients in Moyu County,Hetian Prefecture,Xinjiang,and to provide a basis for the prevention and treatment strategies and effectiveness evaluation of pulmonary tuberculosis in Xinjiang.Methods:89 confirmed cases of pulmonary tuberculosis in Moyu County,Hotian Prefecture,Xinjiang from October 2023 to October 2024 were selected as the case group,and 117 healthy individuals matched with the case group in terms of gender,age,and education level in Moyu County,Hotian Prefecture,Xinjiang during the same period were selected as the control group.The general information and incidence of Northwest dryness syndrome between two groups were compared.The incidence and severity of Northwest dryness syndrome in tuberculosis patients,as well as the main and secondary syndrome scores of Northwest dryness syndrome were analyzed.The influencing factors of pulmonary tuberculosis were analyzed.The scores of the main syndrome of Northwest dryness syndrome(lung wei kong pi dryness syndrome)and the concurrent syndrome of Northwest dryness syndrome(heart kidney yin deficiency syndrome,lung heart spleen wind fire dryness syndrome,liver kidney essence blood deficiency syndrome,spleen stomach dampness syndrome,spleen stomach yin deficiency syndrome)between the control group and the case group were compared.The correlation between pulmonary tuberculosis and the on set of Northwest dryness syndrome were analyzed by Spearman rank sum test.Results:There was no significant difference between the control group and the case group in terms of body mass index(BMI),age,education level,gender,etc.(P>0.05).The incidence of Northwest dryness syndrome in the case group was significantly higher than that in the control group(P<0.05).The Northwest Dry Syndrome Scale score in the severe group was higher than that in the mild and moderate groups,and the Northwest Dry Syndrome Scale score in the moderate group was higher than that in the mild group(P<0.05).Among 89 patients with pulmonary tuberculosis,the main syndrome of lung wei kong pi dryness syndrome had the highest number of cases,totaling 42 cases(47.19%).The highest number of concurrent syndromes were heart kidney yin deficiency syndrome,totaling 36 cases(40.45%),followed by spleen stomach yin deficiency syndrome,totaling 35 cases(39.33%).The results showed that suffering from Northwest dryness syndrome was a risk factor for pulmonary tuberculosis(P<0.05).There were significant differences in the scores of the main syndrome of Northwest dryness(Lung Wei Kong Pi dryness syndrome),the concurrent syndrome of Northwest dryness(Lung Heart Spleen Wind Fire dryness syndrome),and the concurrent syndrome of Northwest dryness(Spleen Stomach Yin Deficiency syndrome)between the control group and the case group(P<0.05).There was no significant difference in the scores of Northwest dryness syndrome(liver and kidney essence and blood deficiency syndrome),Northwest dryness syndrome(heart and kidney yin deficiency syndrome),and Northwest dryness syndrome(spleen and stomach dampness syndrome)between the control group and the case group(P>0.05).The score of pulmonary tuberculosis syndrome was positively correlated with various types of Northwest dryness syndrome(P<0.05),and there was a significant correlation at the 0.001 level between pulmonary Wei Kong Pi dryness syndrome,pulmonary heart spleen wind fire dryness syndrome,and spleen stomach dampness syndrome(P<0.05).The correlation between liver and kidney essence and blood deficiency syndrome and spleen and stomach yin deficiency syndrome is significant at the 0.01 level(P<0.05).The correlation between heart and kidney yin deficiency syndrome is significant at the 0.05 level(P<0.05).Conclusion:The northwest dryness syndrome is related to the occurrence of pulmonary tuberculosis in Moyu County,Hotan Prefecture,Xinjiang,and is a risk factor for the occurrence of pulmonary tuberculosis.There is a significant positive correlation between the pulmonary tuberculosis syndrome score and various types of northwest dryness syndrome,among which the lung wei kong pi dryness syndrome,lung heart spleen wind fire dryness syndrome,and spleen stomach dampness syndrome have the most significant impact on the pulmonary nucleus syndrome score.
8.Pharmaceutical considerations on novel pharmaceutical preparations in China encourage generic drug catalogue(first to third batches)
Xiao-fei SI ; Gui-xia SUN ; Bao-mei ZHANG ; Tian-xing DAI ; Yan-xiu GE ; Dian-zhuo JIANG
The Chinese Journal of Clinical Pharmacology 2025;41(1):143-148
To meet the domestic clinical demand timely,the national health commission has released three batches of encourage generic drug catalogues,which plays a good guiding role in improving the supply level and accessibility of generic drugs.Based on literature investigation,the typical cases of novel pharmaceutical preparations were analyzed,and the pharmaceutical considerations were put forward in terms formulation,manufacturing process and quality control,aimed to provide scientific reference for research and development of such drugs.
9.Correlation Analysis of Postoperative Perceived Stress,Quality of Life and Fear of Cancer Recurrence in Elderly Non-Small Cell Lung Cancer Patients
Xiao-lan BI ; Gui-mei LIU ; Xin ZHANG
Progress in Modern Biomedicine 2025;25(18):2956-2964
Objective:To investigate the correlation between postoperative perceived stress,quality of life and fear of cancer recurrence(FCR)in elderly non-small-cell lung cancer(NSCLC)patients.Methods:This study was a prospective research design,a total of 147 elderly NSCLC patients who visited Shanxi Integrated Traditional Chinese and Western Medicine Hospital from January 2023 to June 2024 were prospectively selected for the study.All patients underwent thoracoscopic lobectomy.FCR in patients was evaluated by fear of disease progression simplified scale(FoP-Q-SF),and they were divided into dysregulation group and non dysregulation group according to the FoP-Q-SF score.Quality of life was evaluated by functional assessment of cancer therapy-lung cancer(FACT-L).Perceived stress was evaluated by Chinese version of the perceived stress scale(CPSS)score.The scores of postoperative perceived stress,quality of life and postoperative FCR in elderly NSCLC patients were analyzed,and the influence of demographic and clinical characteristics on the postoperative FCR in elderly NSCLC patients.The postoperative perceived stress and quality of life scores of elderly NSCLC patients with different FCR were compared,the correlation between postoperative FCR and perceived stress and quality of life in elderly NSCLC patients were analyzed,as well as the model fitting index of the influence of postoperative perceived stress and quality of life on FCR in elderly NSCLC patients.Results:The postoperative CPSS score in elderly NSCLC patients was(52.17±4.02)points,the FACT-L score was(80.39±4.56)points,and the total score of FoP-Q-SF was(31.16±8.69)points.Family relationship,economic burden of disease,chemotherapy and clinical stage were closely associated with the postoperative FCR in elderly NSCLC patients(P<0.05).The CPSS score in dysregulation group was higher than that in nondysregulation group,and the FACT-L score was lower than that in nondysregulation group(P<0.05).Pearson correlation analysis,postoperative FCR in elderly NSCLC patients was positively correlated with perceived stress,but negatively correlated with quality of life(P<0.05).The postoperative quality of life in elderly NSCLC patients was recorded as the independent variable,the postoperative perceived stress was recorded as the mediating variable,and the postoperative FCR was recorded as the dependent variable,a structural model of the mediating effect was routinely constructed.The results showed that the model fits well.Quality of life had a direct negative predictive effect on postoperative FCR in elderly NSCLC patients(P<0.05),and could affect FCR through postoperative perceived pressure(P<0.05),with the mediating effect accounting for 34.15%of the total effect.After repeatedly sampling the data using the Bootstrap method and implementing the mediating effect,the 95%CI of each model path did not include 0,indicating that the difference in the mediating effect was statistically significant(P<0.05).Conclusion:Postoperative FCR in elderly NSCLC patients is positively correlated with perceived stress,but negatively correlated with quality of life,clinically,monitoring such indicators can be considered to better evaluate the postoperative FCR in elderly NSCLC patients.
10.Investigation on a suspected outbreak of carbapenem-resistant Acinetobacter baumannii nosocomial infection in an intensive care unit
Mei HUANG ; Xiaobo GUI ; Ya YANG ; Feng LU ; Juanxiu QIN ; Yan LI ; Shuyi ZHANG ; Wenqin ZHOU ; Xiaofang FU ; Haiqun BAN
Shanghai Journal of Preventive Medicine 2024;36(5):435-438
ObjectiveTo investigate a suspected outbreak of carbapenem-resistant Acinetobacter baumannii (CRAB) nosocomial infection in an intensive care unit (ICU) and provide scientific evidence for prevention and control of multi-drug resistant nosocomial infection. MethodsClinical and epidemiological data of 4 patients with CRAB infection were retrospectively investigated in the ICU of Renji Hospital in November 2021. Environmental hygiene monitoring and multilocus sequence typing (MLST) were conducted and intervention measures were taken. ResultsA total of 4 cases with CRAB infection were identified, among which 1 case was determined to be community-acquired and3 cases were hospital-acquired. The isolated strains shared the same drug resistance, and were all classified into ST368 type. In the surface and hand samples (n=40), 2 CRAB strains were detected in the air filter beside the bed of the first case, with a detection rate of 5%. After adopting comprehensive prevention and control strategies, including environmental cleaning and disinfection, hand hygiene, staff management and training, and supervision, no similar case with CRAB infection was found. ConclusionThis suspected outbreak of CRAB nosocomial infection may be induced by inadequate environmental cleaning and disinfection, and inadequate implementation of hand hygiene. Timely identification, investigation, and targeted measures remain crucial to effective control of possible nosocomial infection.


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