Objective To estimate the lifetime attributable risk (LAR) of thyroid cancer due to radiation in individuals undergoing chest computed tomography (CT) examinations. Methods Scanning parameters were retrospectively collected from DICOM files of 660 individuals who underwent chest CT scans between 2022 and 2024. Individuals were stratified by age and sex. Size-specific dose estimates were calculated using a formula based on the volume CT dose index for each individual. The radiation doses received by the thyroid were estimated. The cancer risk prediction model from the US National Academy of Sciences report on the Biological Effects of Ionizing Radiation was referenced to predict the LAR of thyroid cancer. Results The LAR of thyroid cancer for males/females was 25.170/100 000 and 140.177/100 000 in the ≥ 0 and<5 years of age group, 21.779/100 000 and 102.498/100 000 in the ≥5 and <10 years of age group, 22.987/100 000 and 128.934/100 000 in the ≥10 and <15 years of age group, and 4.979/100 000 and 12.490/100 000 in the ≥15 years of age group. A Spearman correlation analysis showed that age was highly correlated with volume CT dose index, size-specific dose estimates, radiation dose received by the thyroid, and thyroid cancer LAR, with correlation coefficients of 0.887, 0.737, 0.737, and −0.41 (P<0.01), respectively. Sex was correlated with radiation dose received by the thyroid and thyroid cancer LAR, with correlation coefficients of 0.179 and 0.441 (P<0.01), respectively. Conclusion Chest CT scan leads to an increased LAR of thyroid cancer. Appropriate protective measures for the thyroid should be considered during chest CT scan to reduce the impact of radiation on the thyroid.

Cranial bone defect repair remains a significant challenge in craniomaxillofacial surgery， particularly when defects exceed the critical size defect （CSD） threshold， rendering them incapable of spontaneous healing without external intervention. Mechanical forces—including compression， tension， and shear stress—play a pivotal role in cranial development and regeneration. These forces regulate osteoblast differentiation and bone regeneration by activating key mechanotransduction pathways， such as the Wnt/β-catenin signaling pathway， the piezoelectric mechanosensitive ion channel Piezo1， and the transcriptional co-activators Yes-associated protein （Yes-Associated Protein，YAP） and Transcriptional co-activator with PDZ-binding motif （Transcriptional co-activator with PDZ-binding motif，TAZ）. Distinct types of mechanical forces exert specific effects on cellular behavior and the microenvironment. Clinically， applications such as Negative Pressure Wound Therapy （NPWT） have demonstrated efficacy in promoting angiogenesis-osteogenesis coupling， while tensile forces stimulate the dura mater to secrete osteogenic factors. Preliminary studies using artificial periosteum and other biomaterials have further validated that appropriate mechanical stimulation enhances bone repair. This review summarizes the effects of various mechanical forces and their associated signaling pathways on osteoblasts and their microenvironment， alongside an overview of current technological applications in this field.

In recent decades,the incidence of human papillomavirus(HPV)-associated oropharyngeal squamous cell carcinoma(OPSCC)has shown a marked increase.Significant changes have also occurred in the OPSCC diagnosis and treatment paradigm.Deter-mining HPV status prior to treatment is now essential,and radiotherapy/chemotherapy,immunotherapy,and minimally invasive surgical techniques have progressively emerged as key modalities for managing OPSCC.However,alongside these paradigm shifts,a comprehen-sive technical consensus guiding the entire diagnostic and therapeutic process for OPSCC patients is currently lacking.Given China's large population base and the rising incidence of OPSCC,an expert panel convened to develop a clinical technical consensus on OPSCC diagno-sis and management tailored to China's specific context.This consensus aims to further enhance and standardize understanding of OPSCC management techniques among relevant healthcare professionals.

Objective:To explore the application of "flipped classroom + PBL + CBL" in clinical teaching of ultrasound medicine.Methods:Sixty undergraduate students enrolled in the internship of ultrasound medicine at the Department of Ultrasound in The University-Town Hospital of Chongqing Medical University were randomly divided into two groups: 30 in the control group (traditional teaching mode) and 30 in the experimental group (flipped classroom + PBL + CBL teaching mode). After internship, the theoretical knowledge, operational skills, and teaching satisfaction of the two groups of students were compared and analyzed. Moreover, the importance and satisfaction of "flipped classroom + PBL + CBL" teaching mode were analyzed using the importance-satisfaction quadrant chart.Results:The experimental group outperformed the control group in theoretical knowledge scores, medical history collection, equipment adjustment, operation skills, image quality, report writing, and teaching satisfaction ( t values: -22.35, -19.45, -18.65, -18.32, -19.16, and -18.67, respectively; All P<0.001). In the importance-satisfaction quadrant chart of "flipped classroom + PBL + CBL" teaching mode, students attached importance to and were satisfied with courseware making and course difficulty. However, improvements are needed in Mandarin proficiency, ultrasound image selection, and divergent thinking. Conclusions:In the clinical teaching of ultrasound medicine, the "flipped classroom + PBL + CBL" teaching mode is useful to improve the ability of students to identify and solve problems and lifelong self-study. This mode improves the quality of teaching ultrasound medicine and is worthy of promotion and exploration.

Nanchang University and Queen Mary University of London have integrated their educational and teaching advantageous resources to establish a Sino-foreign cooperative clinical medicine program in China. The program awards the degrees of Bachelor of Science in Biomedical Sciences and Bachelor of Clinical Medicine, aiming to cultivate well-rounded medical talents with both clinical and scientific research capabilities and an international perspective. By introducing biomedical courses and integrating them with basic medical courses, the program emphasizes basic knowledge, practical training, active learning, and the cultivation of scientific research skills and critical thinking ability. The evaluation parameters include academic output, innovation competitions, and the number of students pursuing graduate education. The results showed substantial increases in the number of SCI academic articles published by students in this program, the number of awards in innovation competitions, and the number of students pursuing graduate education. This program is a new attempt in the reform of medical education in China.

Objective:To develop the Motivation for Bedtime Procrastination Questionnaire for College Students(CS-MBPQ)and evaluate its validity and reliability.Methods:Based on literature analysis,interviews with severe bedtime procrastinators,and open-ended surveys with college students,the initial questionnaire was formed.A total of 389 college students were recruited to conduct item analysis and exploratory factor analysis.Additionally,691 college students were selected for confirmatory factor analysis,criterion validity testing,and internal consistency reliability analysis,and 132 of them were retested two weeks later.The subscale of behav-ioral intention from the Theory of Planned Behavior Questionnaire(TPBQ),Bedtime Procrastination Scale(BPS),and a self-made question for the frequency of bedtime procrastination were used as criterion tools.Results:The CS-MBPQ consists of 10 items,encompassing three factors:emotional need,external influence,and behavioral attitude,explaining 63.31％of the variance.Confirmatory factor analysis indicated that the three-factor structure model of CS-MBPQ fitted well(x2/df=4.90,RMSEA=0.07,CFI=0.96,TLI=0.94).The CS-MBPQ total scores and scores for each factor were positively associated with the score of intentions to sleep on time,BPS scores,and bed-time procrastination frequency(ICC=0.14-0.53,Ps＜0.05).The internal consistency reliabilities for CS-MBPQ and the three factors were 0.87,0.89,0.74,and 0.66,respectively,and the test-retest reliabilities(ICC)were 0.74,0.66,0.69,and 0.58,respectively.Conclusion:The Motivation for Bedtime Procrastination Questionnaire for College Students(CS-MBPQ)demonstrates good validity and reliability,which could be used as a tool to evaluate motivations for bedtime procrastination among Chinese college students.

In recent decades,the incidence of human papillomavirus(HPV)-associated oropharyngeal squamous cell carcinoma(OPSCC)has shown a marked increase.Significant changes have also occurred in the OPSCC diagnosis and treatment paradigm.Deter-mining HPV status prior to treatment is now essential,and radiotherapy/chemotherapy,immunotherapy,and minimally invasive surgical techniques have progressively emerged as key modalities for managing OPSCC.However,alongside these paradigm shifts,a comprehen-sive technical consensus guiding the entire diagnostic and therapeutic process for OPSCC patients is currently lacking.Given China's large population base and the rising incidence of OPSCC,an expert panel convened to develop a clinical technical consensus on OPSCC diagno-sis and management tailored to China's specific context.This consensus aims to further enhance and standardize understanding of OPSCC management techniques among relevant healthcare professionals.

Nanchang University and Queen Mary University of London have integrated their educational and teaching advantageous resources to establish a Sino-foreign cooperative clinical medicine program in China. The program awards the degrees of Bachelor of Science in Biomedical Sciences and Bachelor of Clinical Medicine, aiming to cultivate well-rounded medical talents with both clinical and scientific research capabilities and an international perspective. By introducing biomedical courses and integrating them with basic medical courses, the program emphasizes basic knowledge, practical training, active learning, and the cultivation of scientific research skills and critical thinking ability. The evaluation parameters include academic output, innovation competitions, and the number of students pursuing graduate education. The results showed substantial increases in the number of SCI academic articles published by students in this program, the number of awards in innovation competitions, and the number of students pursuing graduate education. This program is a new attempt in the reform of medical education in China.

Objective:To develop the Motivation for Bedtime Procrastination Questionnaire for College Students(CS-MBPQ)and evaluate its validity and reliability.Methods:Based on literature analysis,interviews with severe bedtime procrastinators,and open-ended surveys with college students,the initial questionnaire was formed.A total of 389 college students were recruited to conduct item analysis and exploratory factor analysis.Additionally,691 college students were selected for confirmatory factor analysis,criterion validity testing,and internal consistency reliability analysis,and 132 of them were retested two weeks later.The subscale of behav-ioral intention from the Theory of Planned Behavior Questionnaire(TPBQ),Bedtime Procrastination Scale(BPS),and a self-made question for the frequency of bedtime procrastination were used as criterion tools.Results:The CS-MBPQ consists of 10 items,encompassing three factors:emotional need,external influence,and behavioral attitude,explaining 63.31％of the variance.Confirmatory factor analysis indicated that the three-factor structure model of CS-MBPQ fitted well(x2/df=4.90,RMSEA=0.07,CFI=0.96,TLI=0.94).The CS-MBPQ total scores and scores for each factor were positively associated with the score of intentions to sleep on time,BPS scores,and bed-time procrastination frequency(ICC=0.14-0.53,Ps＜0.05).The internal consistency reliabilities for CS-MBPQ and the three factors were 0.87,0.89,0.74,and 0.66,respectively,and the test-retest reliabilities(ICC)were 0.74,0.66,0.69,and 0.58,respectively.Conclusion:The Motivation for Bedtime Procrastination Questionnaire for College Students(CS-MBPQ)demonstrates good validity and reliability,which could be used as a tool to evaluate motivations for bedtime procrastination among Chinese college students.

ObjectiveTo investigate the mechanisms by which the combination of berberine （BBR） and baicalin （BAI） ameliorates type 2 diabetes mellitus （T2DM） due to internal accumulation of dampness-heat from the perspectives of gut microbiota and metabolomics. MethodsAntibiotics were used to induce pseudo-sterile mice. Thirty pseudo-sterile mice were randomized into a normal fecal microbiota transplantation group （n=10） and a T2DM （syndrome of internal accumulation of dampness-heat） fecal microbiota transplantation group （n=20）. The mice were then administrated with suspensions of fecal microbiota from healthy volunteers and a patient with T2DM due to internal accumulation of dampness-heat by gavage， respectively. Each mouse received 200 µL suspension every other day for a total of 15 times to reshape the gut microbiota. The T2DM model mice were then assigned into a model group （n=8） and a BBR-BAI group （n=11）. BBR was administrated at a dose of 200 mg·kg^-1， and BAI was administrated in a ratio of BBR-BAI 10∶1 based on preliminary research findings. The administration lasted for 8 consecutive weeks. Fasting blood glucose （FBG）， glycated hemoglobin （HbA1c）， insulin （INS）， triglycerides （TG）， total cholesterol （CHOL）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， aspartate aminotransferase （AST）， and alanine aminotransferase （ALT） levels were measured to evaluate the effects of the BBR-BAI combination on glucose and lipid metabolism and liver function in T2DM mice. Hematoxylin-eosin staining was employed to observe pathological changes in the colon tissue. The expression of claudin-1， zonula occludens-1 （ZO-1）， and occludin in the colon tissue was determined by Western blot. Real-time quantitative polymerase chain reaction（Real-time PCR） was employed to assess the levels of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and interleukin-6 （IL-6） in the colon tissue. The fecal microbiota composition and differential metabolites were analyzed by 16S rRNA sequencing and ultra-high performance liquid chromatography-quadrupole-time of flight tandem mass spectrometry （UPLC-Q-TOF-MS）， respectively. ResultsThe BBR-BAI combination lowered the FBG， HbA1c， and INS levels （P<0.05， P<0.01） and alleviated insulin resistance （P<0.01） in T2DM mice. Additionally， BBR-BAI elevated the levels of ZO-1， occludin， and claudin-1 （P<0.05， P<0.01） and down-regulated the expression levels of TNF-α， IL-1β， and IL-6 in the colon （P<0.05， P<0.01）. The results of 16S rRNA sequencing showed that BBR-BAI increased the relative abundance of Ligilactobacillus， Phascolarctobacterium， and Akkermansia （P<0.05）， while significantly decreasing the relative abundance of Alistipes， Odoribacter， and Colidextribacter （P<0.05）. UPLC-Q-TOF-MS identified 28 differential metabolites， which were primarily involved in arachidonic acid metabolism and α-linolenic acid metabolism. ConclusionBBR-BAI can ameliorate T2DM due to internal accumulation of dampness-heat by modulating the relative abundance of various bacterial genera in the gut microbiota and the expression of fecal metabolites.