Objective To discuss the possible etiology,pathogenesis,clinical features,diagnosis and treatment of epidermoid cysts of the jaw and to provide a reference for clinical diagnosis and treatment.Methods A case of an epi-dermoid cyst in the right mandible with retained deciduous teeth and succedaneous impacted teeth was reviewed and an-alyzed in combination with the relevant literature.Results A patient presented with a mass in the right mandible that had persisted for 1 month after being found at imaging examination.Tooth 83 was retained,and tooth 43 was unerupted.Swelling was characterized by no obvious tenderness,fluctuation,or table tennis sensation and was observed in the lin-gual alveoli of teeth 83,44,and 45.Imaging revealed a low-density shadow in the apex of teeth 83,44,45,and 46,approximately 1.9 cm × 2.6 cm × 1.6 cm in size,which wrapped around the dental crown of tooth 43.Preliminary diag-noses were as follows:right mandibular mass thought to be a dentigerous cyst;impacted tooth 43;and retained primary tooth 83.The mass in the right mandible was removed,and teeth 43 and 83 were extracted under intravenous and inha-lation anesthesia.During the operation,the mass was observed to have a thin cyst wall and contained bean-like residue.Histopathological examination indicated an epidermoid cyst in the right mandible.At the 1-week follow-up examination,the patient reported no discomfort,and the surgical area showed good recovery.According to the literature,epidermoid cysts are benign cysts originating from ectopic ectodermal tissue that can occur throughout the body but rarely in the oral cavity and are even extremely rarer in the jaw.Epidermoid cysts of the jaw,which have no specific clinical manifes-tations,can be confused with odontogenic cysts such as dentigerous cysts and odontogenic tumors.Dental pulp tests and other techniques can serve as a reference for clinicians.The diagnosis is confirmed via histopathology.Surgical removal is a common treatment,with a good prognosis and a low recurrence rate.Conclusion The principle of treatment for an epidermoid cyst of the jaw is similar to that for a jaw cyst.The prognosis is good when the cyst is removed completely.

Objective To investigate the effect of aqueous extract of Scrophularia ningpoensis(AESN)on AMP-activated protein kinase(AMPK)activity in INS-1 cells under high glucose(HG)conditions.Methods INS-1 cells were cultured in HG medium and treated with different concentrations of AESN.The influences of AESN on cell viability and pyroptotic body formation were detected using the CCK-8 assay.Western blotting was used to observe the effects of AESN on AMPK expression and phosphorylation.The effect of AESN on AMPK activity was measured using time-resolved fluorescence resonance energy transfer(TR-FRET)assay.Results Compared with normal glucose controls,INS-1 cells exposed to HG showed decreased cell viabilities and increased formation of pyroptotic bubbles using CCK-8 assay.Western blotting results indicated that HG exposure led to a decrease in intracellular AMPK phosphorylation levels.However,co-incubation with AESN under HG exposure AESN treatment increased the cell viabilities and phosphorylation of AMPK and decreased the pyroptotic bubbles formation in a concentration-dependent manner.In addition,the results of TR-FRET revealed that AESN treatment effectively increased AMPK activity in a concentration-dependent manner.Conclusion AESN has an activating effect on AMPK activity in HG-treated INS-1 cells.

Objective:To explore the relationship between the maternal dietary patterns during pregnancy and the early childhood BMI change trajectory.Methods:The subjects were 1 241 pairs of pregnant women and their children in Ma'anshan maternal and infant health cohort. The food frequency questionnaire was used to collect the maternal diet data during pregnancy. The cohort children were followed up at birth, month 3, 6, 12, 18 and 24, respectively. The body height and weight data of the cohort children were collected. The principal component analysis was used to determine the categories of maternal dietary patterns during pregnancy, group-based multi-trajectory modeling was used to fit the early childhood BMI change trajectory, and the multiple classification logistic regression model was used to evaluate the relationship between the maternal dietary patterns during pregnancy and the early childhood BMI change trajectory.Results:The maternal dietary patterns during pregnancy included protein type, healthy type, vegetarian type, processing type and beverage type, which could explain 50.04% of the total dietary variation. Among them, the protein type, main dietary pattern, could explain 21.34% of the total dietary variation. The early childhood BMI change trajectory was from thinnish stature to average stature, then to mild obesity, accounting for 42.9%, 45.6% and 11.5% respectively. After controlling the potential confounding factors, it was found that there was a statistical correlation between healthy type and beverage type of maternal dietary patterns during pregnancy and early childhood BMI change trajectory ( P<0.05). Comparison of change trajectories between thinnish type and average stature type, children in the low-level group of healthy diet pattern tended to have a thinnish type change trajectory in early life ( OR=1.286, 95% CI: 1.002-1.651). Comparison of change trajectories between mild obesity type and average stature type, children in the high-level group of beverage diet pattern tended to have a mild obesity type change trajectory in early life ( OR=0.565, 95% CI: 0.342-0.935). The other dietary patterns had no statistical correlation with the early childhood BMI change trajectory. Conclusions:Maternal dietary patterns during pregnancy can affect the early childhood BMI change trajectory, and the low-level healthy type diet is an independent risk factor for thinnish type change trajectory, and the high-level beverage type diet is an independent risk factor for the mild obesity type change trajectory.

Objective:To search, screen, and summarize the best evidence-based evidence for procedural pain management in adult patients in the Intensive Care Unit (ICU), so as to provide reference for clinical practice.Methods:Guidelines, clinical decisions, expert consensus, systematic reviews, and randomized controlled trial (RCT) on procedural pain management for adult patients in ICU were searched in domestic and foreign databases, guide websites, and professional association websites. The search time limit was from the establishment of the database to August 31, 2022.Results:A total of 14 articles were included, including six guidelines, three RCTs, three systematic reviews, and two clinical decisions. A total of 8 themes and 27 best evidence were extracted.Conclusions:It is recommended that clinical medical and nursing personnel provide personalized and multimodal procedural pain intervention measures for adult patients in ICU in a timely manner in accordance with the medication principles of procedural pain management, in order to improve the procedural pain experience of ICU patients and the quality of nursing.

Objective : To investigate the association between adiposity rebound and metabolic abnormalities in pre- schools． Methods : A prospective cohort study was designed on the basis of the Maanshan birth cohort． Venous blood samples were collected at 5 to 6 years of age to detect metabolic indicators．2022 children aged 0 to 6 years with ≥8 consecutive measurements were enrolled. χ2 test and Logistic regression model were used to analyze the data. Results : The detection rate of abnormal metabolism in preschool children was 16. 9% ，and the risk of meta- bolic abnormalities in preschool children with high BMI level at the AR time point and earlier AR time phase was 2. 59 and 1. 82 times that of the normal group respectively． Conclusion High AR level and earlier AR phase can increase the prevalence of metabolic abnormalities in preschool children.

Purpose: This study was to investigate the work experience of newly recruited male nurses during the COVID-19 pandemic. Methods: With a phenomenological approach, this qualitative study was adopted semistructured interviews by phone or video calls. A total of 9 male nurses newly recruited for the COVID-19 wards in Chinese hospitals were interviewed for this study. And Colaizzi's method was applied for evaluation in the data analysis. Results: Based on our findings, three themes were extracted. First, the newly recruited male nurses showed negative emotions at the beginning of COVID-19 epidemic, which was caused by changes in working conditions and content, but also prompted the nurses to change the way of coping with the crisis. Second, they gradually mastered the working skills and psychological training to cope with COVID-19 and developed a positive attitude toward life and a high sense of professional responsibility. Finally, we learned about their needs to respond to public health emergencies such as the COVID-19 pandemic. Conclusion COVID-19 is a disaster for all of humanity. The newly recruited male nurses are an important force in emergency rescue. Although they suffered from short-term negative emotions, they quickly adapted to the crisis. In order to better prepare for future emergencies, the disaster response capacity of newly recruited male nurses needs to be further improved. In addition, newly recruited male nurses have a strong demand for timely and personalized career development guidance.

Purpose: This study was to investigate the work experience of newly recruited male nurses during the COVID-19 pandemic. Methods: With a phenomenological approach, this qualitative study was adopted semistructured interviews by phone or video calls. A total of 9 male nurses newly recruited for the COVID-19 wards in Chinese hospitals were interviewed for this study. And Colaizzi's method was applied for evaluation in the data analysis. Results: Based on our findings, three themes were extracted. First, the newly recruited male nurses showed negative emotions at the beginning of COVID-19 epidemic, which was caused by changes in working conditions and content, but also prompted the nurses to change the way of coping with the crisis. Second, they gradually mastered the working skills and psychological training to cope with COVID-19 and developed a positive attitude toward life and a high sense of professional responsibility. Finally, we learned about their needs to respond to public health emergencies such as the COVID-19 pandemic. Conclusion COVID-19 is a disaster for all of humanity. The newly recruited male nurses are an important force in emergency rescue. Although they suffered from short-term negative emotions, they quickly adapted to the crisis. In order to better prepare for future emergencies, the disaster response capacity of newly recruited male nurses needs to be further improved. In addition, newly recruited male nurses have a strong demand for timely and personalized career development guidance.

Objective: To evaluate the application value of ultrasound and dermoscopy in the precise preoperative evaluation of basal cell carcinoma (BCC) , and to analyze the association of high-frequency ultrasound and dermoscopic findings with pathological recurrence risk of BCC. Methods: Clinical data were collected from 33 outpatients with confirmed BCC in the Department of Dermatology, Peking Union Medical College Hospital between April 2016 and December 2018, and high-frequency ultrasonographic and dermoscopic findings from 36 BCC lesions were analyzed. The lesions were classified into high-risk and low-risk groups based on pathological findings. Statistical differences in ultrasound and dermoscopic characteristics between high-risk and low-risk BCC groups were analyzed by using Fisher′s exact test, and the correspondence between high-frequency ultrasonographic and dermoscopic features of BCC was analyzed by calculating the simple matching coefficient. Results: Of the 36 BCC skin lesions, 4 were high-risk lesions and 32 were low-risk lesions. Ultrasonographic features of the high-risk and low-risk lesions overlapped markedly, and no significant differences were observed between the high-risk and low-risk lesions with regard to the shape, boundary, internal echo, hyperechoic spots, or posterior echo (all P > 0.05) . However, 24 (75.0%) low-risk lesions were confined to the dermis, whereas 4 high-risk lesions involved the subcutaneous tissue, and there was a significant difference between the high-risk and low-risk BCC groups with regard to the distribution of BCC (P = 0.008) . In 5 BCC lesions, ultrasound could identify small easy-to-ignore lesions or deep and invisible lesions besides obvious lesions. There were no significant differences in dermoscopic features between high-risk and low-risk groups. However, none of spoke-wheel area, milky-red structureless area, milia-like cysts, comedo-like openings and rainbow pattern was observed in 4 high-risk BCC lesions. The simple matching coefficient between enhanced hyperechoic spots in the lesion observed by ultrasound and milia-like cysts under a dermoscope was 36.1%, and the simple matching coefficient between discontinuous hyperechoic echo in the epidermis on ultrasonography and ulcer/erosion under a dermoscope was 75.0%. Conclusion High-frequency ultrasound and dermoscopy both provide important information for preoperative evaluation of risk of BCC lesions, and high-frequency ultrasound can identify easy-to-ignore hidden lesions in clinical practice.

Objective:To explore the needs for discharge plans in patients with ischemic stroke and their family members, and provide a reference for formulating a scientific and standardized discharge plan.Methods:Totally 15 patients with hemiplegia after ischemic stroke admitted in our hospital between January and March 2019 and 15 family members received semi-structured in-depth interviews using phenomenological research methods in qualitative studies. Colaizzi analysis was used to encode, analyze, categorize and refine the data.Results:The needs for discharge plans in patients with hemiplegia after ischemic stroke were summarized into 5 themes, namely, disease knowledge, rehabilitation exercise, psychological support, financial support, and referral services; the needs for discharge plans in family members were summarized into 3 themes, namely, care knowledge/skills guidance, rehabilitation equipment guidance and respite care needs.Conclusions:Patients with hemiplegia after ischemic stroke and their family members have high needs for discharge plans. A personalized multidisciplinary collaborative discharge plan should be provided, and the role of communities in the follow-up rehabilitation treatment should be given full play to.

Objective To compare the diagnostic accuracies of deep convolutional neural network (CNN) and dermatologists for pigmented nevus and seborrheic keratosis.Methods CNN network ResNet-50 was trained with 5 094 dermoscopic images of pigmented nevus and seborrheic keratosis using transfer learning,so as to establish a CNN two-classification model.Then,this model was applied to the automatic classification of 30 dermoscopic images of pigmented nevus and 30 dermoscopic images of seborrheic keratosis.Meanwhile,in combination with clinical photos of skin lesions,95 experienced dermatologists who had received dermoscopy training gave their diagnosis for the above 60 dermoscopic images.The diagnostic accuracies were compared between the two methods,and misclassified images were further analyzed.Results The CNN automatic classification model had the diagnostic accuracies of 100％ (30/30)and 76.67％ (23/30) for pigmented nevus and seborrheic keratosis respectively,and the total accuracy was 88.33％ (53/60).The average diagnostic accuracies of 95 dermatologists were 82.98％ (25.8/30) and 85.96％ (24.9/30) for pigmented nevus and seborrheic keratosis respectively,and the total accuracy was 84.47％ (50.7/60).There were no significant differences in the diagnostic accuracies for pigmented nevus or seborrheic keratosis between the CNN automatic classification model and 95 dermatologists (x2 =0.38,P ＞ 0.05).The dermoscopic images misclassified by CNN were divided into 3 categories:special-type lesions with high pigment content and marked keratosis,typical skin lesions with interference factors,and typical skin lesions without definite reasons for misclassification.Conclusions The performance of CNN automatic classification model is similar to that of experienced dermatologists in the two classification of pigmented nevus and seborrheic keratosis.The reasons for misclassification by CNN still need to be explored by dermatologists and professionals in artificial intelligence.