Thousands of variant gene sequences of SARS-CoV-2 have been emerged since the COVID-19 epidemic broke out in Dec.2019.Alpha(B.1.1.7),Beta(B.1.351),Gamma(P.1),Delta(B.1.617.2)and Omicron(B.1.1.529)were the most representative variants.With the continuous emergence of new variants,the predomi-nant strain in the global pandemic as of Jan.2025 is the Omicron BA.2.86-derived mutant,JN.1.The effectiveness of drugs against Omicron variants remains a key research focus in the treatment of SARS-CoV-2 infections.The infectiousness and pathogenicity of the variants altered remarkably due to mutations in the genome on S protein of the mutant strains,and these emerging variants are more likely to evade immunity and were more infectious than the previous prevalent variants.During the process of combating with the constantly emerging novel variants,drugs showed various effects on treatment of diseases caused by different variants.New drugs and treatment coun-termeasures are constantly updated with the prevalence of various variants.The current status of research on pres-ent drugs for treatment of SARS-CoV-2 and the therapeutic effects on emerging variants are reviewed in the article so as to provide reference for prevention and treatment of the upcoming evolved variants.

OBJECTIVE:To systematically evaluate the correlation between phase angle and sarcopenia and its diagnostic indexes.METHODS:The PubMed,EMbase,Cochrane Library,Web of Science,CNKI,WanFang Data,VIP and SinoMed databases were electronically searched to collect studies on the correlation between phase angle and sarcopenia and its diagnostic indexes from database inception to May 8,2024. Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 and Stata 14.0 software. RESULTS:A total of 50 eligible articles were included. Meta-analysis results showed that compared with the non-sarcopenic population,the phase angle was significantly reduced in sarcopenic patients[standardized mean difference (SMD)=-0.99,95％ confidence interval (CI) (-1.09,-0.90),P<0.00001]. The results of subgroup analysis indicated that the difference of phase angle was more significant in patients with severe sarcopenia and Asian sarcopenia. Moreover,reduction in the phase angle was more obvious in patients with malignant tumors and respiratory diseases with sarcopenia. And skeletal muscle mass index (Pearson's r=0.565,P<0.00001),grip strength (Pearson's r=0.446,P<0.00001),and gait speed (Pearson's r=0.405,P<0.00001) all showed a moderate positive correlation with phase angle. However,appendicular skeletal muscle mass index showed a very weak positive correlation with phase angle (Pearson's r=0.139,P=0.02). CONCLUSION:Phase angle has a significant difference between sarcopenia and non-sarcopenia population,and it is correlated with the diagnostic indexes of sarcopenia to different extents. It suggests that phase angle has some clinical values in the objective diagnosis of sarcopenia. However,the results may be influenced by some factors such as sarcopenia severity and detection instruments of phase angle. Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.

Thousands of variant gene sequences of SARS-CoV-2 have been emerged since the COVID-19 epidemic broke out in Dec.2019.Alpha(B.1.1.7),Beta(B.1.351),Gamma(P.1),Delta(B.1.617.2)and Omicron(B.1.1.529)were the most representative variants.With the continuous emergence of new variants,the predomi-nant strain in the global pandemic as of Jan.2025 is the Omicron BA.2.86-derived mutant,JN.1.The effectiveness of drugs against Omicron variants remains a key research focus in the treatment of SARS-CoV-2 infections.The infectiousness and pathogenicity of the variants altered remarkably due to mutations in the genome on S protein of the mutant strains,and these emerging variants are more likely to evade immunity and were more infectious than the previous prevalent variants.During the process of combating with the constantly emerging novel variants,drugs showed various effects on treatment of diseases caused by different variants.New drugs and treatment coun-termeasures are constantly updated with the prevalence of various variants.The current status of research on pres-ent drugs for treatment of SARS-CoV-2 and the therapeutic effects on emerging variants are reviewed in the article so as to provide reference for prevention and treatment of the upcoming evolved variants.

Objective:To explore the clinical efficacy of a free superficial palmar branch of the radial artery (SPBRA)-pedicled wrist crease flap for bridging and repairing finger C-shape soft tissue defect.Methods:From March 2021 to January 2023, the clinical data of patients with finger C-shape soft tissue defects in Department of Orthopedics, the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University were retrospectively analyzed. Preoperatively, color Doppler was used to locate the perforator point, and the position and size of the flap were designed. A free SPBRA-pedicled wrist crease flap was used in a Flow-through method to bridge and repair the defects. Postoperatively, the survival, color, texture, sense, and shape of the skin flap were observe, and the healing of the donor site was assessed. The clinical efficacy was evaluated using Evaluation Trail Standards for Replantation Function of Chinese Society of Hand Surgery.Results:All 10 patients completed the entry result analysis, including 8 males and 2 females. The age ranged from 22 to 54 years old. Among them, 3 cases involved the index finger, 5 cases involved the middle finger, and 2 cases involved the ring finger. All of them showed segmental defects of the unilateral volar medial artery with combined digital nerve defects, including 7 cases of radial injury and 3 cases of ulnar injury. 3 cases of the vascular defect ranged in the proximal phalanx areas, 6 cases in the middle phalanx region, and 1 case in the middle to distal phalanx region. The length of the proper artery defect ranged from 1.0 cm to 1.8 cm, the area of skin defect ranged from 1.0 cm×2.5 cm to 2.2 cm×4.0 cm, and the harvested flap area range ranged from 1.2 cm×2.8 cm to 2.5 cm×5.0 cm. The patients were followed up for 10 to 19 months. All flaps survived and healed well, with no bulky appearance, and a texture similar to normal finger skin. The static two-point discrimination ranged from 7.0~ 10.0 mm (average 8.5 mm). Superficial infection around the flap occurred in 1 case after surgery. It improved after dressing change. No vascular crisis occurred. The wounds at the donor site healed primarily, leaving linear scars. The flexion and extension activities of the wrist joint were not affected. According to the Evaluation Trail Standards for Replantation Function of Chinese Society of Hand Surgery: 8 cases received excellent results, 2 cases were good, and the patient satisfaction was high.Conclusion:The free SPBRA-pedicled wrist crease flap has good and accurate efficacy in bridging and repairing finger C-shape soft tissue defects. It has the advantages of convenient harvesting, minimal trauma, and low complication rate, and has clinical promotion and application value.

OBJECTIVE:To systematically evaluate the correlation between phase angle and sarcopenia and its diagnostic indexes.METHODS:The PubMed,EMbase,Cochrane Library,Web of Science,CNKI,WanFang Data,VIP and SinoMed databases were electronically searched to collect studies on the correlation between phase angle and sarcopenia and its diagnostic indexes from database inception to May 8,2024. Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 and Stata 14.0 software. RESULTS:A total of 50 eligible articles were included. Meta-analysis results showed that compared with the non-sarcopenic population,the phase angle was significantly reduced in sarcopenic patients[standardized mean difference (SMD)=-0.99,95％ confidence interval (CI) (-1.09,-0.90),P<0.00001]. The results of subgroup analysis indicated that the difference of phase angle was more significant in patients with severe sarcopenia and Asian sarcopenia. Moreover,reduction in the phase angle was more obvious in patients with malignant tumors and respiratory diseases with sarcopenia. And skeletal muscle mass index (Pearson's r=0.565,P<0.00001),grip strength (Pearson's r=0.446,P<0.00001),and gait speed (Pearson's r=0.405,P<0.00001) all showed a moderate positive correlation with phase angle. However,appendicular skeletal muscle mass index showed a very weak positive correlation with phase angle (Pearson's r=0.139,P=0.02). CONCLUSION:Phase angle has a significant difference between sarcopenia and non-sarcopenia population,and it is correlated with the diagnostic indexes of sarcopenia to different extents. It suggests that phase angle has some clinical values in the objective diagnosis of sarcopenia. However,the results may be influenced by some factors such as sarcopenia severity and detection instruments of phase angle. Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.

Objective:To explore the clinical efficacy of a free superficial palmar branch of the radial artery (SPBRA)-pedicled wrist crease flap for bridging and repairing finger C-shape soft tissue defect.Methods:From March 2021 to January 2023, the clinical data of patients with finger C-shape soft tissue defects in Department of Orthopedics, the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University were retrospectively analyzed. Preoperatively, color Doppler was used to locate the perforator point, and the position and size of the flap were designed. A free SPBRA-pedicled wrist crease flap was used in a Flow-through method to bridge and repair the defects. Postoperatively, the survival, color, texture, sense, and shape of the skin flap were observe, and the healing of the donor site was assessed. The clinical efficacy was evaluated using Evaluation Trail Standards for Replantation Function of Chinese Society of Hand Surgery.Results:All 10 patients completed the entry result analysis, including 8 males and 2 females. The age ranged from 22 to 54 years old. Among them, 3 cases involved the index finger, 5 cases involved the middle finger, and 2 cases involved the ring finger. All of them showed segmental defects of the unilateral volar medial artery with combined digital nerve defects, including 7 cases of radial injury and 3 cases of ulnar injury. 3 cases of the vascular defect ranged in the proximal phalanx areas, 6 cases in the middle phalanx region, and 1 case in the middle to distal phalanx region. The length of the proper artery defect ranged from 1.0 cm to 1.8 cm, the area of skin defect ranged from 1.0 cm×2.5 cm to 2.2 cm×4.0 cm, and the harvested flap area range ranged from 1.2 cm×2.8 cm to 2.5 cm×5.0 cm. The patients were followed up for 10 to 19 months. All flaps survived and healed well, with no bulky appearance, and a texture similar to normal finger skin. The static two-point discrimination ranged from 7.0~ 10.0 mm (average 8.5 mm). Superficial infection around the flap occurred in 1 case after surgery. It improved after dressing change. No vascular crisis occurred. The wounds at the donor site healed primarily, leaving linear scars. The flexion and extension activities of the wrist joint were not affected. According to the Evaluation Trail Standards for Replantation Function of Chinese Society of Hand Surgery: 8 cases received excellent results, 2 cases were good, and the patient satisfaction was high.Conclusion:The free SPBRA-pedicled wrist crease flap has good and accurate efficacy in bridging and repairing finger C-shape soft tissue defects. It has the advantages of convenient harvesting, minimal trauma, and low complication rate, and has clinical promotion and application value.

Objective:To systematically evaluate the connection between polycystic ovary syndrome (PCOS) and age at menarche.Methods:We searched 11 databases from inception to September 1st 2023 to collect studies about the association between age at menarche and PCOS. Two reviewers independently screened literatures, accordance with the inclusion criteria and extracting the data, extracted data and performed meta-analysis by Stata17.0 software.Results:A total of 10 literatures, including 6 462 subjects, were included at last in the study. A meta-analysis revealed that there was no statistically significant difference in the risk of getting PCOS between early and normal age at menarche, and the risk of PCOS with delayed age at menarche was 1.84 (95% CI: 1.14-2.97) times greater than that with normal age at menarche. Conclusion:There may be a connection between delayed age at menarche and the development of PCOS.

Objective:To systematically evaluate the connection between polycystic ovary syndrome (PCOS) and age at menarche.Methods:We searched 11 databases from inception to September 1st 2023 to collect studies about the association between age at menarche and PCOS. Two reviewers independently screened literatures, accordance with the inclusion criteria and extracting the data, extracted data and performed meta-analysis by Stata17.0 software.Results:A total of 10 literatures, including 6 462 subjects, were included at last in the study. A meta-analysis revealed that there was no statistically significant difference in the risk of getting PCOS between early and normal age at menarche, and the risk of PCOS with delayed age at menarche was 1.84 (95% CI: 1.14-2.97) times greater than that with normal age at menarche. Conclusion:There may be a connection between delayed age at menarche and the development of PCOS.

The ChatGPT, a lite and conversational variant of Generative Pretrained Transformer 4 (GPT-4) developed by OpenAI, is one of the milestone Large Language Models (LLMs) with billions of parameters. LLMs have stirred up much interest among researchers and practitioners in their impressive skills in natural language processing tasks, which profoundly impact various fields. This paper mainly discusses the future applications of LLMs in dentistry. We introduce two primary LLM deployment methods in dentistry, including automated dental diagnosis and cross-modal dental diagnosis, and examine their potential applications. Especially, equipped with a cross-modal encoder, a single LLM can manage multi-source data and conduct advanced natural language reasoning to perform complex clinical operations. We also present cases to demonstrate the potential of a fully automatic Multi-Modal LLM AI system for dentistry clinical application. While LLMs offer significant potential benefits, the challenges, such as data privacy, data quality, and model bias, need further study. Overall, LLMs have the potential to revolutionize dental diagnosis and treatment, which indicates a promising avenue for clinical application and research in dentistry.
Dentistry ; Artificial Intelligence

Objective:To investigate the self-perceived aging status of the elderly in Changsha and analyze its influencing factors.Methods:From July to August in 2020, the convenient sampling method was used to select 402 elderly people in Changsha as the research object, the general data questionnaire, the elderly self-perceived aging questionnaire, the family care questionnaire and the positive psychological capital questionnaire were used to investigate them. Multiple linear regression analysis was used to analyze the influencing factors of self-perceived aging after logarithmic transformation.Results:The total score of self-perceived aging of the elderly was 109.00(102.00, 112.00), the total score of family care was 5.00(3.00, 8.00) and the total score of psychological capital was 80.00(66.00, 87.25). Regression analysis showed that the gender, educational level, age, the forms of health care, quarrels in family relationships, children visit frequency and the degree of family care were the important factors affecting the self-perceived aging of the elderly( P<0.05). Conclusions:The self-perceived aging level of the elderly is at a medium level, it is suggested that relevant departments take comprehensive measures to create positive self-aging environment.