Background:Bushen Zhuanggu Formula(BZF),derived from the classic Yougui Pills,has shown favorable clinical efficacy in treating advanced nontraumatic osteonecrosis of the femoral head(NONFH),particularly by promoting bone repair.However,its underlying mechanisms remain unclear.Objective:This study aimed to explore the mechanisms by which BZF promotes bone repair in advanced NONFH.Materials and methods:A total of 518 potential BZF targets were identified from the ETCM v2.0 database.Transcriptomic profiling of clinical cohorts revealed 485 differentially expressed genes in advanced NONFH patients compared to healthy controls.A drug target-disease gene interaction network was constructed to identify candidate BZF targets involved in NONFH pathogenesis.In vivo experiments were conducted to validate the effects of BZF in a rat model of advanced NONFH.Results:Network analysis identified key pathways associated with blood circulation obstruction,immune-inflammatory imbalance,and abnormal bone metabolism.Protein kinase C alpha(PKCA),Ras proto-oncogene(RAS),mitogen-activated protein kinase 3(ERK),ETS proto-oncogene 1(ETS1),and receptor activator of nuclear factor-κB ligand(RANKL)formed a signaling axis implicated in NONFH pathogenesis.BZF treatment alleviated joint inflammation,preserved trabecular bone morphology,reduced bone loss,and promoted bone repair.Mechanistically,BZF significantly downregulated the expression of PKCA,RAS,ERK,ETS1,and RANKL,improved blood circulation,and inhibited osteoclast activation while promoting osteoblast activation.Conclusion:BZF may promote bone repair in advanced NONFH by enhancing blood circulation and modulating the PKC-RAS-ERK-ETS1-RANKL signaling axis,thereby reversing dysregulated bone metabolism.

Objective To analyze the related factors of high-grade squamous intraepithelial lesion(HSIL)and squamous cell carcinoma in patients with low-grade lesion features under colposcopy.Methods A total of 639 patients who underwent colposcopy due to abnormal cervical cancer screening and showed low-grade lesion features under colposcopy from February 2021 to June 2022 were included.The median age was35 years old(range,21-78 years old).Colposcopy biopsy pathology confirmed180 cases(28.2%)of HSIL and above,including132 cases(20.7%)of cervical intraepithelial neoplasia grade2(CIN2),47 cases(7.4%)of CIN3,and 1 case(0.2%)of squamous cell carcinoma.Taking the biopsy pathology results of the cervix as the diagnostic standard,univariate and multivariate analyses were conducted on clinical data and colposcopic image features.Results Multivariate analysis showed that age≥40 years old(OR=2.094,95%CI:1.346-3.258,P=0.001),cytology result of low-grade abnormality(OR=0.467,95%CI:0.300-0.727,P<0.001),coexistence of thin acetowhite epithelium,fine punctation and/or fine mosaic under colposcopy(OR=7.922,95%CI:5.036-12.461,P<0.001;OR=7.787,95%CI:3.239-18.724,P<0.001),and lesion involving 2,3 or 4 quadrants(OR=3.152,95%CI:1.865-5.327,P<0.001;OR=4.079,95%CI:2.080-7.996,P<0.001;OR=7.647,95%CI:3.841-15.228,P<0.001)were independent influencing factors for HSIL and above in patients with low-grade lesion features under colposcopy.Among them,cytology result of low-grade abnormality was a protective factor.However,HPV16 positive and cytology result of high-grade abnormality were not independent influencing factors(P>0.05).Conclusions Patients aged≥40 years old,with multi-quadrant involvement,and with the coexistence of 2 to 3 low-grade lesion images under colposcopy have an increased risk of HSIL and above.These patients should undergo adequate biopsy to reduce the risk of missed diagnosis of HSIL and above.For patients with cytology result of low-grade abnormality,biopsy can be reduced.

Background: Bushen Zhuanggu Formula (BZF), derived from the classic Yougui Pills, has shown favorable clinical efficacy in treating advanced nontraumatic osteonecrosis of the femoral head (NONFH), particularly by promoting bone repair. However, its underlying mechanisms remain unclear. Objective: This study aimed to explore the mechanisms by which BZF promotes bone repair in advanced NONFH. Materials and methods: A total of 518 potential BZF targets were identified from the ETCM v2.0 database. Transcriptomic profiling of clinical cohorts revealed 485 differentially expressed genes in advanced NONFH patients compared to healthy controls. A drug target-disease gene interaction network was constructed to identify candidate BZF targets involved in NONFH pathogenesis. In vivo experiments were conducted to validate the effects of BZF in a rat model of advanced NONFH. Results: Network analysis identified key pathways associated with blood circulation obstruction, immune-inflammatory imbalance, and abnormal bone metabolism. Protein kinase C alpha (PKCA), Ras proto-oncogene (RAS), mitogen-activated protein kinase 3(ERK), ETS proto-oncogene 1 (ETS1), and receptor activator of nuclear factor-κB ligand (RANKL) formed a signaling axis implicated in NONFH pathogenesis. BZF treatment alleviated joint inflammation, preserved trabecular bone morphology, reduced bone loss, and promoted bone repair. Mechanistically, BZF significantly downregulated the expression of PKCA, RAS, ERK, ETS1, and RANKL, improved blood circulation, and inhibited osteoclast activation while promoting osteoblast activation. Conclusion: BZF may promote bone repair in advanced NONFH by enhancing blood circulation and modulating the PKC-RAS-ERK-ETS1-RANKL signaling axis, thereby reversing dysregulated bone metabolism.

Background:Bushen Zhuanggu Formula(BZF),derived from the classic Yougui Pills,has shown favorable clinical efficacy in treating advanced nontraumatic osteonecrosis of the femoral head(NONFH),particularly by promoting bone repair.However,its underlying mechanisms remain unclear.Objective:This study aimed to explore the mechanisms by which BZF promotes bone repair in advanced NONFH.Materials and methods:A total of 518 potential BZF targets were identified from the ETCM v2.0 database.Transcriptomic profiling of clinical cohorts revealed 485 differentially expressed genes in advanced NONFH patients compared to healthy controls.A drug target-disease gene interaction network was constructed to identify candidate BZF targets involved in NONFH pathogenesis.In vivo experiments were conducted to validate the effects of BZF in a rat model of advanced NONFH.Results:Network analysis identified key pathways associated with blood circulation obstruction,immune-inflammatory imbalance,and abnormal bone metabolism.Protein kinase C alpha(PKCA),Ras proto-oncogene(RAS),mitogen-activated protein kinase 3(ERK),ETS proto-oncogene 1(ETS1),and receptor activator of nuclear factor-κB ligand(RANKL)formed a signaling axis implicated in NONFH pathogenesis.BZF treatment alleviated joint inflammation,preserved trabecular bone morphology,reduced bone loss,and promoted bone repair.Mechanistically,BZF significantly downregulated the expression of PKCA,RAS,ERK,ETS1,and RANKL,improved blood circulation,and inhibited osteoclast activation while promoting osteoblast activation.Conclusion:BZF may promote bone repair in advanced NONFH by enhancing blood circulation and modulating the PKC-RAS-ERK-ETS1-RANKL signaling axis,thereby reversing dysregulated bone metabolism.

Objective To analyze the related factors of high-grade squamous intraepithelial lesion(HSIL)and squamous cell carcinoma in patients with low-grade lesion features under colposcopy.Methods A total of 639 patients who underwent colposcopy due to abnormal cervical cancer screening and showed low-grade lesion features under colposcopy from February 2021 to June 2022 were included.The median age was35 years old(range,21-78 years old).Colposcopy biopsy pathology confirmed180 cases(28.2%)of HSIL and above,including132 cases(20.7%)of cervical intraepithelial neoplasia grade2(CIN2),47 cases(7.4%)of CIN3,and 1 case(0.2%)of squamous cell carcinoma.Taking the biopsy pathology results of the cervix as the diagnostic standard,univariate and multivariate analyses were conducted on clinical data and colposcopic image features.Results Multivariate analysis showed that age≥40 years old(OR=2.094,95%CI:1.346-3.258,P=0.001),cytology result of low-grade abnormality(OR=0.467,95%CI:0.300-0.727,P<0.001),coexistence of thin acetowhite epithelium,fine punctation and/or fine mosaic under colposcopy(OR=7.922,95%CI:5.036-12.461,P<0.001;OR=7.787,95%CI:3.239-18.724,P<0.001),and lesion involving 2,3 or 4 quadrants(OR=3.152,95%CI:1.865-5.327,P<0.001;OR=4.079,95%CI:2.080-7.996,P<0.001;OR=7.647,95%CI:3.841-15.228,P<0.001)were independent influencing factors for HSIL and above in patients with low-grade lesion features under colposcopy.Among them,cytology result of low-grade abnormality was a protective factor.However,HPV16 positive and cytology result of high-grade abnormality were not independent influencing factors(P>0.05).Conclusions Patients aged≥40 years old,with multi-quadrant involvement,and with the coexistence of 2 to 3 low-grade lesion images under colposcopy have an increased risk of HSIL and above.These patients should undergo adequate biopsy to reduce the risk of missed diagnosis of HSIL and above.For patients with cytology result of low-grade abnormality,biopsy can be reduced.

Objective:To estimate the healthy life expectancy (HALE) of registered residents in Jing′an District, Shanghai City.Methods:From June to August in 2017, 14 districts (towns) were selected as the research sites, and 4 159 registered residents were selected as the subjects. The health status data of subjects were collected by using the self-rated health scale, and the health rate of subjects was obtained by using the CHOPIT model. The health rate of residents under 18 years old was replaced by the parameters of 18-year-old group, and Sullivan method was used to calculate the HALE of registered residents in Jing′an District, Shanghai City.Results:The age of 4 159 subjects was (56.46±15.19) years old, ranging from 18 to 98 years old. There were 1 768 males (42.5%). The overall health rate of subjects was 74.96%, of which the health rates of male and female were 76.87% and 72.45% respectively. With the increase of age, the health rate decreased ( Z=265.51, P<0.001), and the health rate of male was higher than that of female (χ2=2 154.54, P<0.001). The HALE of the 0-year-old group was 64.29 years old, in which the male and female were 66.25 and 63.57 years old respectively. Among the 18-year-old group, the HALE was 48.18 years old, with 49.07 years old for male and 47.46 years old for female. The HALE of male was higher than that of female in all age groups. With the increase of age, the HALE decreased gradually. Conclusion:There are significant sex and age differences in HALE in Jing′an District, Shanghai City. The health issue of female and older people should be given more attention.

Objective:To estimate the healthy life expectancy (HALE) of registered residents in Jing′an District, Shanghai City.Methods:From June to August in 2017, 14 districts (towns) were selected as the research sites, and 4 159 registered residents were selected as the subjects. The health status data of subjects were collected by using the self-rated health scale, and the health rate of subjects was obtained by using the CHOPIT model. The health rate of residents under 18 years old was replaced by the parameters of 18-year-old group, and Sullivan method was used to calculate the HALE of registered residents in Jing′an District, Shanghai City.Results:The age of 4 159 subjects was (56.46±15.19) years old, ranging from 18 to 98 years old. There were 1 768 males (42.5%). The overall health rate of subjects was 74.96%, of which the health rates of male and female were 76.87% and 72.45% respectively. With the increase of age, the health rate decreased ( Z=265.51, P<0.001), and the health rate of male was higher than that of female (χ2=2 154.54, P<0.001). The HALE of the 0-year-old group was 64.29 years old, in which the male and female were 66.25 and 63.57 years old respectively. Among the 18-year-old group, the HALE was 48.18 years old, with 49.07 years old for male and 47.46 years old for female. The HALE of male was higher than that of female in all age groups. With the increase of age, the HALE decreased gradually. Conclusion:There are significant sex and age differences in HALE in Jing′an District, Shanghai City. The health issue of female and older people should be given more attention.

Objective To compare the detection performance of the modified serum test (TRUST) method and the traditional method in syphilis screening.Methods A series of TRUST high titer syphilis serum was diluted,and the positive rate of each method was calculated by using the improved method and the traditional method.Comparison of two detection methods of C50,C5 ～ C95 interval,as well as the accuracy of the density curve,and the consistency of the two methods were compared,and diagnostic performance were compared.Results The improved method of C50 was less than the traditional method of C50,and the improved method of C5 ～ C95 range was narrower than the traditional method,compared with the traditional method.The improved method of the non precision density curve was steeper than the traditional method,and the two confidence interval of the consistency degree of the 95％ methods was 73.4％ to 95.8％.The diagnostic sensitivity (SEN),diagnostic specificity (SPE),positive predictive value (PPV),negative predictive value (NPV) and diagnostic efficiency(DF) of the improved method were 64.29 ％,99.1％,85.71％,97.05 ％ and 96.39 ％,respectively.The SEN,SPE,PPV,NPV and DF of the traditional methods were 3.75 ％,98.49 ％,75 ％,96.18 ％ and 95 ％,respectively.The improved method was superior to the traditional methods in the two aspects of SEN and PPV (x2 =8.25,10.03,all P＜0.05),with the statistically significant difference.The improved method was slightly higher than the traditional method in SPE,NPV and DF (x2 =2.39,3.45,4.03,all P＞0.05),with the no statistically significant difference.Conclusion The precision,diagnostic sensitivity and diagnostic specificity of the improved method was higher than that of the traditional method,and it can be applied to the detection of large batch samples with the aid of the full automatic enzyme immunoassay instrument.The improved method can be used to replace the traditional method for syphilis screening.