As an innovative form of combining traditional aromatherapy with modern nasal medicine delivery technology， "olfactory administration of Chinese medicine" carries the theoretical essence of traditional Chinese medicine （TCM）， which is "moving and channeling Qi and fragrance， dredging and awakening the mind". Based on the systematic records of olfactory therapies in ancient books in emergency care， disorders of consciousness， lung system， and gynecological diseases， this paper examines the historical evolution of its clinical application， and elucidates the profound historical basis and theoretical feasibility of "olfactory administration of Chinese medicine" as a new form. Combined with the innovation and precise application of modern Chinese medicine olfactory agents in multi-system diseases such as nervous， respiratory， and cardiovascular diseases， this paper further analyzes the multi-dimensional mechanism of olfactory receptor pathway， olfactory brain pathway， nasal mucosal blood vessels， and lymphatic channels， and demonstrates its advantages of rapid onset， targeted brain entry， and systemic regulation. Under the background of continuous growth in the demand for external TCM treatment， continuous breakthroughs in the technology of nasal dosage forms， and increasingly accurate drug delivery paths， Chinese medicine olfactory agents have shown significant practical applicability and development potential. This study aims to provide theoretical support and practical direction for the system construction of this form.

Objective:To analyze the clinical characteristics of patients with pregnancy-related chronic pain visiting the pain clinic.Methods:The number of pregnant patients who completed a pregnancy registration at the Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University from 2022 to 2024 was collected. The medical records were reviewed to identify the patients who visited the department of pain of our hospital due to chronic pain related to pregnancy. The clinical characteristics such as the visiting situation, gestational weeks, age and types of pain were analyzed.Results:From 2022 to 2024, the total number of registered pregnant patients was 64, 818, of which, 2, 224 cases visited the pain clinic, and the annual proportions of pregnancy-related chronic pain visits were 2.540%, 3.836% and 3.889% respectively. Among the patients who attended the clinic, 77.97% were pregnant (5.82% in early pregnancy, 41.93% in mid-pregnancy, and 52.25% in late pregnancy), and 21.03% were postpartum patients. A total of 83.72% were aged 20-34 yr. The types of pain were pelvic girdle pain (40.96%), limb joint pain (28.82%), low back pain (14.16%), cervical spondylosis (3.64%), peripheral nerve entrapment syndrome (3.42%), headache (2.97%), chest and back pain (2.79%), pelvic and perineal pain (1.66%), neuralgia (0.94%) and other pains (0.63%).Conclusions:From 2022 to 2024, the proportion of registered pregnant women at our hospital who visited to the pain clinic due to pregnancy-related chronic pain increases year by year. The common types of pain are pelvic girdle pain, limb joint pain and low back pain.

Although tumor immunotherapy has transformed cancer treatment，its efficacy against solid tumors remains limited by the immunosuppressive tumor microenvironment，inefficient drug delivery，and off-target toxicity. Engineered bacterial therapy has recently attracted considerable interest as a promising therapeutic strategy owing to its capacity for selective tumor colonization and immunomodulation. Meanwhile，ultrasound technology provides a non-invasive，spatially precise，and real-time controllable means to improve the performance and applicability of bacterial-mediated therapies. This review summarizes recent advances in ultrasound-regulated bacterial therapy for cancer immunotherapy. Beginning with an examination of the mechanisms through which engineered bacteria modulate antitumor immunity，it is followed by an elucidation of how ultrasound technology exploits its biological effects and spatiotemporal control capabilities to simultaneously enhance bacterial therapy's safety/efficacy and enable tumor treatment visualization，thereby activating systemic immune responses. Finally，current challenges and future directions for clinical translation are critically discussed. In conclusion，ultrasound-regulated bacterial therapy represents an emerging interdisciplinary approach with the potential to overcome key limitations in solid tumor immunotherapy.

Objective:To analyze the clinical characteristics of patients with pregnancy-related chronic pain visiting the pain clinic.Methods:The number of pregnant patients who completed a pregnancy registration at the Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University from 2022 to 2024 was collected. The medical records were reviewed to identify the patients who visited the department of pain of our hospital due to chronic pain related to pregnancy. The clinical characteristics such as the visiting situation, gestational weeks, age and types of pain were analyzed.Results:From 2022 to 2024, the total number of registered pregnant patients was 64, 818, of which, 2, 224 cases visited the pain clinic, and the annual proportions of pregnancy-related chronic pain visits were 2.540%, 3.836% and 3.889% respectively. Among the patients who attended the clinic, 77.97% were pregnant (5.82% in early pregnancy, 41.93% in mid-pregnancy, and 52.25% in late pregnancy), and 21.03% were postpartum patients. A total of 83.72% were aged 20-34 yr. The types of pain were pelvic girdle pain (40.96%), limb joint pain (28.82%), low back pain (14.16%), cervical spondylosis (3.64%), peripheral nerve entrapment syndrome (3.42%), headache (2.97%), chest and back pain (2.79%), pelvic and perineal pain (1.66%), neuralgia (0.94%) and other pains (0.63%).Conclusions:From 2022 to 2024, the proportion of registered pregnant women at our hospital who visited to the pain clinic due to pregnancy-related chronic pain increases year by year. The common types of pain are pelvic girdle pain, limb joint pain and low back pain.

Although tumor immunotherapy has transformed cancer treatment，its efficacy against solid tumors remains limited by the immunosuppressive tumor microenvironment，inefficient drug delivery，and off-target toxicity. Engineered bacterial therapy has recently attracted considerable interest as a promising therapeutic strategy owing to its capacity for selective tumor colonization and immunomodulation. Meanwhile，ultrasound technology provides a non-invasive，spatially precise，and real-time controllable means to improve the performance and applicability of bacterial-mediated therapies. This review summarizes recent advances in ultrasound-regulated bacterial therapy for cancer immunotherapy. Beginning with an examination of the mechanisms through which engineered bacteria modulate antitumor immunity，it is followed by an elucidation of how ultrasound technology exploits its biological effects and spatiotemporal control capabilities to simultaneously enhance bacterial therapy's safety/efficacy and enable tumor treatment visualization，thereby activating systemic immune responses. Finally，current challenges and future directions for clinical translation are critically discussed. In conclusion，ultrasound-regulated bacterial therapy represents an emerging interdisciplinary approach with the potential to overcome key limitations in solid tumor immunotherapy.

Irinotecan (CPT11) chemotherapy-induced diarrhea affects a substantial cancer population due to β-glucuronidase (Gus) converting 10-O-glucuronyl-7-ethyl-10-hydroxycamptothecin (SN38G) to toxic 7-ethyl-10-hydroxycamptothecin (SN38). Existing interventions primarily address inflammation and Gus enzyme inhibition, neglecting epithelial repair and Gus-expressing bacteria. Herein, we discovered that dehydrodiisoeugenol (DDIE), isolated from nutmeg, alleviates CPT11-induced intestinal mucositis alongside a synergistic antitumor effect with CPT11 by improving weight loss, colon shortening, epithelial barrier dysfunction, goblet cells and intestinal stem cells (ISCs) loss, and wound-healing. The anti-mucositis effect of DDIE is gut microbiota-dependent. Analysis of microbiome profiling data from clinical patients and CPT11-induced mucositis mice reveals a strong correlation between CPT11 chemotoxicity and Gus-expressing bacteria, particularly Enterococcus faecalis (E. faecalis). DDIE counters CPT11-induced augmentation of E. faecalis, leading to decreased intestinal Gus and SN38 levels. The Partial Least Squares Path Model (PLS-PM) algorithm initially links E. faecalis to dysregulated epithelial renovation. This is further validated in a 3D intestinal organoid model, in which both SN38 and E. faecalis hinder the formation and differentiation of organoids. Interestingly, colonization of E. faecalis exacerbates CPT11-induced mucositis and disturbs epithelial differentiation. Our study unveils a microbiota-driven, epithelial reconstruction-mediated action of DDIE against mucositis, proposing the 'Gus bacteria-host-irinotecan axis' as a promising target for mitigating CPT11 chemotoxicity.

To summarize the nursing experience of postoperative arrhythmia after transcatheter aortic valve replacement in an elderly patient with severe aortic stenosis.The key points of nursing include:implementing nurse led triple pre-rehabilitation,goal oriented hemodynamic monitoring and volume management,prevention and management of postoperative complications,psychological adaptation adjustment under the guidance of dual heart medicine,early and gradual rehabilitation training,and follow-up specialist guidance for extended care in the hospital.The patient was discharged from hospital with both stable physical and psychological condition after careful treatment and nursing care by the team in 12 days after operation.

Objective:To search, evaluate and summarize the best research evidence of perioperative intestinal management in patients with cervical spinal cord injury, so as to provide evidence-based basis for clinical nursing practice.Methods:Literature on perioperative intestinal management of cervical spinal cord injury were systematically searched in databases, domestic and foreign relevant guidlines network and professional associations, such as UpToDate, Cochrane Library, PubMed, China National Knowledge Infrastructure, Wanfang Database, etc. The search period was from the establishment of the databases to October 1, 2023. The quality of the included literature was evaluated and the evidence was extracted and summarized.Results:Finally, 9 articles were included, including 2 guidelines, 2 expert consensuses, 1 randomized controlled trials, and 4 observational studies. Twenty-five pieces of evidence were summarized across six aspects: assessment, diet management, physical activity, physical therapy, drug therapy, prevention and management of intestinal complications.Conclusions:The best evidence of perioperative intestinal management in patients with cervical spinal cord injury summarized in this study can provide reference for clinical nursing practice.

Objective:To explore the risk factors for recurrence of intussusception in children after successful ultrasound-guided saline enema reduction.Methods:The clinical and follow up data of 355 hospitalized children with intussusception at the First Affiliated Hospital of Zhengzhou University from Feb 2018 to Feb 2023 were reviewed.Patients were divided into two groups by recurrence develped and the differences were compared, Data with significant differences were incorporated into multi-factor logistic analysis.Results:The overall recurrence rate was 15.8% (56/355). By univariate variable analysis model, there were statistically significant differences between the two groups in age, previous intussusception history, vomiting, maximum diameter of concentric circles shown by ultrasound, and concurrent bowel organic diseases (lead points) (all P<0.05). In multivariate Logistic regression model, age, previous intussusception history, maximum diameter of concentric circles, and lead points were independent risk factors for recurrent intussusception after saline enema.The optimal cut-off values for age and maximum diameter of concentric circles were 2 years and 33.5 mm, respectively, according to ROC curve analysis. Conclusion:Age older than 2 years, previous intussusception history, maximum diameter of concentric circles longer than 33.5 mm, and lead points are independent risk factors for recurrence after saline enema.

Objective To investigate the best evidence application of exercise prescription in patients with chronic heart failure in clinical practice and evaluate its effectiveness.Methods The best evidence of exercise prescription for patients with chronic heart failure was summarized,and the evidence-based practice plan was developed,and it was implemented in the cardiology department of a tertiary hospital in Zhejiang Province from August to October,2022.Nurses'exercise prescription knowledge-attitude-practice level,implementation rate of review indicators,the length of hospital stay,exercise endurance,daily living ability and grip strength of both groups before and after the intervention were compared.Results After the application of the best evidence,the score of knowledge dimension was(9.34±0.98)points;the score of attitude dimension was(63.29±1.37)points;the score of practice dimension was(25.49±1.51)points,which were statistically significant compared with the scores before the application of evidence(P<0.05).After the application of the best evidence,the implementation rate of 16 review indicators was higher than that before the application of evidence(P<0.001).The length of hospital stay in the evidence application group was shorter than that in the baseline examination group(Z=-2.610,P<0.001).After intervention,the exercise endurance,daily living ability and grip strength of patients in the evidence application group were improved compared with the baseline review group,and the difference was statistically significant(P<0.05).Conclusion After the application of the best evidence of exercise prescription in patients with chronic heart failure,it can improve the level of knowledge,attitude and practice of nurses on exercise prescription,standardize the compliance of nurses'exercise prescription,reduce the number of days in the hospital,and improve patients'exercise endurance,daily living ability and grip strength.