1.The Use of Speech in Screening for Cognitive Decline in Older Adults
Si-Wen WANG ; Xiao-Xiao YIN ; Lin-Lin GAO ; Wen-Jun GUI ; Qiao-Xia HU ; Qiong LOU ; Qin-Wen WANG
Progress in Biochemistry and Biophysics 2025;52(2):456-463
Alzheimer’s disease (AD) is a chronic neurodegenerative disorder that severely affects the health of the elderly, marked by its incurability, high prevalence, and extended latency period. The current approach to AD prevention and treatment emphasizes early detection and intervention, particularly during the pre-AD stage of mild cognitive impairment (MCI), which provides an optimal “window of opportunity” for intervention. Clinical detection methods for MCI, such as cerebrospinal fluid monitoring, genetic testing, and imaging diagnostics, are invasive and costly, limiting their broad clinical application. Speech, as a vital cognitive output, offers a new perspective and tool for computer-assisted analysis and screening of cognitive decline. This is because elderly individuals with cognitive decline exhibit distinct characteristics in semantic and audio information, such as reduced lexical richness, decreased speech coherence and conciseness, and declines in speech rate, voice rhythm, and hesitation rates. The objective presence of these semantic and audio characteristics lays the groundwork for computer-based screening of cognitive decline. Speech information is primarily sourced from databases or collected through tasks involving spontaneous speech, semantic fluency, and reading, followed by analysis using computer models. Spontaneous language tasks include dialogues/interviews, event descriptions, narrative recall, and picture descriptions. Semantic fluency tasks assess controlled retrieval of vocabulary items, requiring participants to extract information at the word level during lexical search. Reading tasks involve participants reading a passage aloud. Summarizing past research, the speech characteristics of the elderly can be divided into two major categories: semantic information and audio information. Semantic information focuses on the meaning of speech across different tasks, highlighting differences in vocabulary and text content in cognitive impairment. Overall, discourse pragmatic disorders in AD can be studied along three dimensions: cohesion, coherence, and conciseness. Cohesion mainly examines the use of vocabulary by participants, with a reduction in the use of nouns, pronouns, verbs, and adjectives in AD patients. Coherence assesses the ability of participants to maintain topics, with a decrease in the number of subordinate clauses in AD patients. Conciseness evaluates the information density of participants, with AD patients producing shorter texts with less information compared to normal elderly individuals. Audio information focuses on acoustic features that are difficult for the human ear to detect. There is a significant degradation in temporal parameters in the later stages of cognitive impairment; AD patients require more time to read the same paragraph, have longer vocalization times, and produce more pauses or silent parts in their spontaneous speech signals compared to normal individuals. Researchers have extracted audio and speech features, developing independent systems for each set of features, achieving an accuracy rate of 82% for both, which increases to 86% when both types of features are combined, demonstrating the advantage of integrating audio and speech information. Currently, deep learning and machine learning are the main methods used for information analysis. The overall diagnostic accuracy rate for AD exceeds 80%, and the diagnostic accuracy rate for MCI also exceeds 80%, indicating significant potential. Deep learning techniques require substantial data support, necessitating future expansion of database scale and continuous algorithm upgrades to transition from laboratory research to practical product implementation.
2.Analysis of the burden and trends of oral disorders among the elderly in China from 1990 to 2021
LI Zhixiao ; LOU Ting ; BAI Xiaoling ; CHEN Su ; GUO Shihong ; YANG Zengzhen ; XIAO Changliang
Journal of Prevention and Treatment for Stomatological Diseases 2025;33(11):954-967
Objective:
To analyze the disease burden and trends of oral diseases among China’s elderly population (1990-2021) and provide evidence for developing targeted intervention strategies
Methods :
Using data from the Global Burden of Disease (GBD) 2021 study, we extracted prevalence, incidence, and disability-adjusted life years (DALYs) for oral conditions (permanent dental caries, edentulism, periodontal diseases, and other oral disorders) in individuals aged ≥60 years in China. Due to data limitations, other oral diseases only included DALYs and prevalence. Age-standardized rates (ASR)—including age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), and age-standardized DALYs rate (ASDR)--were calculated. Trends were assessed via Joinpoint regression using average annual percentage change (AAPC), stratified by sex and age groups (60-64, 65-69, 70-74, 75-79, 80-84, 85-89, 90-94, 95+ years).
Results:
From 1990 to 2021, China’s elderly population exhibited distinct trends in oral disease burden. Overall oral diseases showed declining ASDR and ASPR, yet ASIR slightly increased. Permanent dental caries demonstrated significant rises across ASDR, ASIR, and ASPR. Edentulism showed declining ASDR and ASPR alongside stable ASIR. 95+ age group saw rising rates. Periodontal diseases remained largely stable in ASDR and ASPR but experienced a slight ASIR decline. Other oral disorders showed mild ASDR decline and stable ASPR. Notably, sex and age disparities persisted. Women consistently bore higher burdens for overall oral diseases, caries, edentulism, and other oral diseases but lower periodontal disease rates compared to men. 85-89, 90-95, 95+ age group faced rising DALYs and prevalence for overall oral diseases, while all other age groups demonstrated declining trends in both DALYs and prevalence; for permanent caries, the 60-64 age group showed the largest increases in DALY rate, incidence, and prevalence; edentulism demonstrated the most pronounced and sustained rises in DALY rate and prevalence in the 95+ group, while declining most rapidly in the 60-64 age group; for periodontal disease, both DALY rates and prevalence declined in the 90-94 and 95+ age groups, but increased across all measures (DALY rate, incidence, and prevalence) in the 70-74 and 75-79 age group; other oral conditions exhibited relatively stable burden distributions or minor changes, with no significant age-specific shifting trends observed.
Conclusion
From 1990 to 2021, China’s elderly oral disease burden declined overall, but caries surged, edentulism improved, periodontal diseases stabilized, and other oral diseases slightly declined. Prioritizing older women and the adults aged 85+ is critical to addressing evolving oral health needs.
3.Mechanism of Huayu jiedu formula in alleviating inflammatory injury in chronic kidney disease based on AIM2 pyroptosis pathway
Jinhuan XUE ; Ziwen WU ; Fan YANG ; Yunyun LOU ; Yingjun DING ; Yupeng XIAO ; Xianhui LIU ; Wenjie LIANG
China Pharmacy 2025;36(21):2638-2644
OBJECTIVE To explore the mechanism of Huayu jiedu formula in regulating inflammatory injury in chronic kidney disease (CKD). METHODS Fifty male SD rats were randomly divided into a sham surgery group (10 rats) and a modeling group (40 rats). The CKD model was replicated in the modeling group by unilateral ureteral obstruction surgery. After successful modeling, the rats were randomly divided into model group, esaxerenone group (positive control), and TCM low- and high-dose groups, with 10 rats in each group. The Esaxerenone group was given 1 mg/kg of esaxerenone, while the TCM low- and high-dose groups were given 13.7 and 27.4 g/kg of Huayu jiedu formula respectively, the sham surgery group and model group were given an equal volume of physiological saline, all groups were intervened continuously for 14 days. Hematoxylin eosin and Masson staining were used to observe the pathological changes in rat kidney tissue. Conventional biochemical methods were used to detect serum urea (SUr), serum creatinine (SCr), malondialdehyde (MDA), and superoxide dismutase (SOD) levels; enzyme-linked immunosorbent assay was used to detect the levels of serum interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α(TNF-α); immunohistochemistry and Western blot were used to detect the protein expression of peroxisome proliferator-activated receptor γ coactivator-1α(PGC-1α) , mitochondrial transcription factor A (TFAM), absent in melanoma 2(AIM2), caspase-1, gasdermin D (GSDMD), IL-1β and IL-18 in renal tissue; real-time fluorescence quantitative PCR was used to detect the mRNA expression of AIM2. RESULTS Compared with the sham surgery group, the renal tissue of the model group showed pathological changes such as glomerular deformation and destruction, severe tubular dilation, and increased deposition of blue fibrin; the levels of SUr, SCr, MDA, IL-1β, IL-6, TNF-α,the protein expression of AIM2, GSDMD, caspase-1, IL-1β, IL-18 , and the mRNA expression of AIM2 were significantly increased or up-regulated (P<0.01); the levels of SOD, the protein expression of PGC-1α, TFAM were significantly reduced or down-regulated (P<0.01). Compared with the model group, all treatment groups showed improvement in the above symptoms and most indicators in rats. CONCLUSIONS Huayu jiedu formula may improve renal function, alleviate renal inflammatory damage and pyroptosis, and exert renal protective effects by regulating the AIM2 pyroptosis pathway.
4.Expert Consensus on Clinical Diseases Responding Specifically to Traditional Chinese Medicine: Pulmonary Nodules
Mingwei YU ; Huairui ZHANG ; Xinghan ZHANG ; Xiao LI ; Rengui WANG ; Zhiqiang LONG ; Zhen WANG ; Bo PANG ; Jianwei HUO ; Wei CHEN ; Yong ZHU ; Baoli LIU ; Yanni LOU ; Ganlin ZHANG ; Jiayun NIAN ; Mei MO ; Xiaoxiao ZHANG ; Guowang YANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(6):238-245
In recent years, the incidence of pulmonary nodules has kept rising. To give full play to the advantages of traditional Chinese medicine (TCM) in the treatment of pulmonary nodules and identify the breakthrough points of integrating TCM with Western medicine, the China Association of Chinese Medicine organized medical experts in TCM and western medicine to carry out in-depth discussion regarding this disease. The discussion encompassed the modern medical advances, TCM theories of etiology and pathogenesis, the role and advantages of TCM in the whole course management of pulmonary nodules, contents and methods of research on pulmonary nodules, and science popularization work, aiming to provide a reference for clinical practice and scientific research. After discussion, the experts concluded that the occurrence of pulmonary nodules was rooted in the deficiency of the lung and spleen and triggered by phlegm dampness, blood stasis, and Qi stagnation. TCM can treat pulmonary nodules by controlling and reducing nodules, improving physical constitution, ameliorating multi-system nodular diseases, reducing anxiety and avoiding excessive diagnosis and treatment, and serving as an alternative for patients who are unwilling or unfit for surgical treatment. At present, the optimal diagnosis and treatment strategy for pulmonary nodules has not been formed, which needs to be further studied from multiple perspectives such as clinical epidemiology, biology, and evidence-based medicine. The primary task of current research is to find out the advantages, effective prescriptions, and target populations and determine the effective outcomes of TCM in the treatment of pulmonary nodules. At the same time, basic research should be carried out to explore the etiology and biological behaviors of pulmonary nodules. The expert consensus on the diagnosis and treatment of pulmonary nodules with integrated TCM and Western medicine needs to be continuously revised to guide clinicians to conduct standardized, scientific, and accurate effective diagnosis and treatment.
5.Pharmacokinetics and pharmacodynamics of benzbromarone in patients with hyperuricemia
Li-Qin SUN ; Yang FEI ; Xiao-Yan XU ; Qin-Hua LOU
The Chinese Journal of Clinical Pharmacology 2024;40(12):1813-1817
Objective To evaluate the pharmacokinetics and pharmacodynamics of benzbromarone in patients with hyperuricemia(HUA).Methods Thirty patients with HUA were randomly divided into A,B and C groups,with 10 patients in each group.Three groups was given a single oral dose of benzbromarone 25,50 and 100 mg.After the single administration test,group B continued to take benzbromarone 50 mg orally once a day for 28 days.The concentration of benzbromarone in plasma was measured using liquid chromatography tandem mass spectrometry(LC-MS/MS)method,and the serum uric acid(SUA)level was measured by fully automated biochemical analyzer.Results The single oral administration of benzbromarone tablets exhibited linear pharmacokinetic characteristics within the range of 25-100 mg.The main pharmacokinetic parameters were as follows:t1/2 were(11.67±1.85),(12.84±1.22)and(13.25±1.02)h;tmax values were(2.84±0.15),(3.07±0.18)and(3.15±0.25)h;Cmax values were(2.21±0.85),(2.67±0.68)and(3.25±0.72)mg·L-1;AUC0-24h were(14.25±3.25),(18.20±3.34)and(19.25±3.44)mg·h·L-1,respectively.After continuous administration,there was no significant change in the degree and speed of drug absorption,and there was accumulation in the body.After 28 days of oral treatment with benzbromarone,the SUA levels of 10 HUA patients were significantly reduced,with 8 patients having SUA levels<360 μmol·L-1.Conclusion A single oral dose of benzbromarone tablets exhibits linear pharmacokinetic characteristics at 25-100 mg,and continuous oral doses of benzbromarone tablets can significantly reduce SUA levels in patients with HUA.
6.Preparation of scutellarin solid dispersion based on deep eutectic solvents
Yong-jing LIU ; Li LOU ; Dong-ting HUANG ; Li-rong CHEN ; Xiao-ying WANG
Acta Pharmaceutica Sinica 2024;59(9):2665-2672
In this study, deep eutectic solvents (DESs) were used as excipients to prepare solid dispersion (SD) of scutellarin. The SD of scutellarin were prepared by melting method with cumulative dissolution rate as the index of investigation. The preparation conditions of SD of scutellarin were optimized by single factor experiment, which investigated the type of the carrier material, the type of DESs, and the ratio of the drug to the carrier. The optimum preparation conditions of DESs-SD were as follows: using Poloxamer 407 as the carrier material, PEG 200/urea (2∶1) as the DESs system, and the ratio of carrier, DESs, and drug was 6∶1∶1. The drug loading capacity of scutellarin in SD was 12.53% under the optimum preparation conditions. Differential scanning calorimetry, Fourier transform infrared spectroscopy, X-ray powder diffraction and scanning electron microscope exhibited that scutellarin was amorphous form in the SD system. Furthermore, the stability of the DESs-based SD of scutellarin was evaluated by high temperature, high humidity, and strong light tests, which showed that the cumulative dissolution rate and scutellarin content of SD decreased with time under these conditions. Finally, the result of pharmacokinetic studies indicated that the oral absorption of the scutellarin could be increased using DESs as an excipient in the preparation of SD. The animal experiment was approved by the Experimental Animal Ethics Committee of Fujian University of Traditional Chinese Medicine (approval number: FJTCMIACUC 2023048). Consequently, this research offers a novel and effective approach for using DESs to enhance the oral bioavailability of active substances with low water solubility.
7.Effect of orthopedic insoles on lower extremities function in children and adolescents with flexible flatfoot:a scop-ing review
Zhaoxin HUANG ; Letian TANG ; Xiaofei XIAO ; Yantao LOU
Chinese Journal of Rehabilitation Theory and Practice 2024;30(11):1343-1350
Objective To review the effect of orthopedic insoles on arch morphology,pain and lower limb motor function in chil-dren and adolescents with flexible flatfoot. Methods Relevant literature was retrieved from PubMed,Web of Science,Embase,CNKI,CBM,Wanfang data and VIP databases,from inception to October,2024,and a scoping review was conducted. Results Ten researches were included,comprising seven cohort studies and three randomized controlled trials,originat-ing from China,Korea,Iran and Romania,involving 520 children and adolescents with flexible flatfoot.Orthope-dic insoles could increase the calcaneal pitch angle,reduce the Meary's angle and arch index;improve motor function of feet and lower limbs,stability of anterior and posterior,medial,and overall,adjust the kinematics and ground reaction force in walking;relieve pain and reduce incidence of pain. Conclusion Wearing orthopedic insoles could improve the arch morphology,dynamic balance and gait function,and re-lieve pain in children and adolescents with flexible flatfeet.
8.Effects of butin on regulation of pyroptosis related proteins on proliferation,migration and cycle arrest of human rheumatoid arthritis synovial fibroblast
Hao LI ; Xue-Ming YAO ; Xiao-Ling YAO ; Hua-Yong LOU ; Wei-Dong PAN ; Wu-Kai MA
Chinese Pharmacological Bulletin 2024;40(10):1937-1944
Aim To investigate the regulatory mecha-nism of butin on the proliferation,migration,cycle blockage and pyroptosis related inflammatory factors in human fibroblast-like synoviocytes of rheumatoid arthri-tis(HFLS-RA).Methods Cell proliferation,migra-tion and invasion were studied using cell migration and invasion assays.Cell cycle was detected by flow cytom-etry,and the expression of the pyroptosis-associated in-flammatory factors IL-1β,IL-18,caspase-1 and caspase-3 was detected by ELISA,RT-qPCR and West-ern blot.Results Migration and invasion experiments showed that the cell proliferation rate of the butin group was lower than that of the blank control group(P<0.05).Cell cycle analysis demonstrated that in the G0/G1 phase,the DNA expression was elevated in the medium and high-dose groups of butin(P<0.05),while in the G2 and S phases,the DNA expression was reduced in the medium and high-dose groups of butin(P<0.05).The results of ELISA,RT-qPCR and Western blot assay revealed that the expression of IL-1β,IL-1 8,caspase-1,and caspase-3 decreased in the butin group compared with the IL-1β+caspase-3 in-hibitor group(P<0.05).Conclusions Butin inhib-its HFLS-RA proliferation by inhibiting the synthesis of inflammatory vesicles by caspase-1 in the pyroptosis pathway,thereby reducing the production and release of inflammatory factors such as IL-1β and IL-18 down-stream of the pathway,and also inhibits HFLS-RA pro-liferation by exerting a significant blocking effect in the G1 phase,which may be one of the potential mecha-nisms of butin in the treatment of RA.
9.Effect of Cinobufacini on HepG2 cells based on CXCL5/FOXD1/VEGF pathway
Xiao-Ke RAN ; Xu-Dong LIU ; Hua-Zhen PANG ; Wei-Qiang TAN ; Tie-Xiong WU ; Zhao-Quan PAN ; Yuan YUAN ; Xin-Feng LOU
Chinese Pharmacological Bulletin 2024;40(12):2361-2368
Aim To investigate the impact of Cinobu-facini on the proliferation,invasion,and apoptosis of HepG2 cells and the underlying mechanism.Methods The proliferation of HepG2 cells was assessed using the CCK-8 method following treatment with Cinobufaci-ni.The invasion capability of HepG2 cells was evalua-ted through Transwell assay after exposure to Cinobufa-cini.The apoptosis rates of HepG2 cells post Cinobufa-cini intervention were measured using flow cytometry,and the expression levels of VEGF in the culture medi-um of HepG2 cells were determined using enzyme-linked immunoassay.Furthermore,qRT-PCR and Western blot analyses were conducted to assess the im-pact of Cinobufacini on mRNA and protein expression levels related to the CXCL5/FOXD1/VEGF pathway.The interaction between CXCL5 and FOXD1 was inves-tigated via co-immunoprecipitation.Results Cinobufa-cini treatment led to a gradual decrease in HepG2 cell viability in a dose-dependent manner compared to the control group(P<0.05).Moreover,Cinobufacini sig-nificantly suppressed HepG2 cell invasion(P<0.05)while enhancing cell apoptosis(P<0.05).Notably,Cinobufacini exhibited inhibitory effects on the CX-CL5/FOXD1/VEGF pathway,as evidenced by re-duced expression of related mRNA and proteins(P<0.05).FOXD1 was identified as the binding site of CXCL5.Overexpression of CXCL5 resulted in in-creased proliferation and VEGF secretion by HepG2 cells(P<0.05),and increased expression of FOXD1 and VEGF(P<0.05).However,Cinobufacini inter-vention effectively inhibited liver cancer cell prolifera-tion and invasion(P<0.05),promoted apoptosis(P<0.05),reduced VEGF secretion by HepG2 cells(P<0.05),and downregulated the expression of CXCL5 and FOXD1 in HepG2 cells(P<0.05);but com-pared with the unexpressed group of Cinobufacini,its ability to inhibit cell activity was weakened(P<0.05),and its ability to inhibit the expression of CX-CL5,FOXD1,and VEGF was weakened(P<0.05).Conclusion Cinobufacini may inhibit HepG2 cell pro-liferation and invasion and promote HepG2 cell apopto-sis by regulating the CXCL5/FOXD1/VEGF pathway.
10.Efficacy and Side Effects of Mixed-Strategy Electroconvulsive Therapy: A Proof-of-Concept Randomized Clinical Trial on Late Life Depression
Si-wen LV ; Yan SUN ; Yang CHEN ; Chen WANG ; Xin-hui XIE ; Xiao-min HU ; Hong HONG ; Lou-Feng ZHANG ; Nan-nan ZHU ; Peng-yv XIE ; Li ZHANG ; Ling CHEN ; Xiao-ming KONG
Psychiatry Investigation 2024;21(7):772-781
Objective:
Patients with late life depression sometimes refuse to receive electroconvulsive therapy (ECT) owing to its adverse reactions. To alleviate patient’s resistance, a novel ECT stimulation strategy named mixed-strategy ECT (msECT) was designed in which patients are administered conventional ECT during the first three sessions, followed by low energy stimulation during the subsequent sessions. However, whether low energy electrical stimulation in the subsequent stage of therapy affect its efficacy and reduce adverse reactions in patients with late life depression remains unknown. To explore differences between msECT and regular ECT(RECT) with respect to clinical efficacy and side effects
Methods:
This randomized, controlled trial was conducted from 2019 to 2021 on 60 patients with late life depression who were randomly assigned to two groups: RECT or msECT. A generalized estimating equation (GEE) was used to compare the two stimulation strategies regarding their efficacy and side effects on cognition. Chi-squared test was used to compare side effects in the two strategies.
Results:
In the intent-to-treat group, the GEE model suggested no differences between-group difference in Hamilton Depression Rating Scale-17 score over time (Wald χ2=7.275, p=0.064), whereas the comparison of side effects in the two strategies favored msECT (Wald χ2=8.463, p=0.015) as fewer patients had adverse events during the second phase of treatment with msECT (χ2 =13.467, p=0.004).
Conclusion
msECT presents its similar efficacy to RECT. msECT may have milder side effects on cognition.


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