1.Effect Analysis of Different Interventions to Improve Neuroinflammation in The Treatment of Alzheimer’s Disease
Jiang-Hui SHAN ; Chao-Yang CHU ; Shi-Yu CHEN ; Zhi-Cheng LIN ; Yu-Yu ZHOU ; Tian-Yuan FANG ; Chu-Xia ZHANG ; Biao XIAO ; Kai XIE ; Qing-Juan WANG ; Zhi-Tao LIU ; Li-Ping LI
Progress in Biochemistry and Biophysics 2025;52(2):310-333
Alzheimer’s disease (AD) is a central neurodegenerative disease characterized by progressive cognitive decline and memory impairment in clinical. Currently, there are no effective treatments for AD. In recent years, a variety of therapeutic approaches from different perspectives have been explored to treat AD. Although the drug therapies targeted at the clearance of amyloid β-protein (Aβ) had made a breakthrough in clinical trials, there were associated with adverse events. Neuroinflammation plays a crucial role in the onset and progression of AD. Continuous neuroinflammatory was considered to be the third major pathological feature of AD, which could promote the formation of extracellular amyloid plaques and intracellular neurofibrillary tangles. At the same time, these toxic substances could accelerate the development of neuroinflammation, form a vicious cycle, and exacerbate disease progression. Reducing neuroinflammation could break the feedback loop pattern between neuroinflammation, Aβ plaque deposition and Tau tangles, which might be an effective therapeutic strategy for treating AD. Traditional Chinese herbs such as Polygonum multiflorum and Curcuma were utilized in the treatment of AD due to their ability to mitigate neuroinflammation. Non-steroidal anti-inflammatory drugs such as ibuprofen and indomethacin had been shown to reduce the level of inflammasomes in the body, and taking these drugs was associated with a low incidence of AD. Biosynthetic nanomaterials loaded with oxytocin were demonstrated to have the capability to anti-inflammatory and penetrate the blood-brain barrier effectively, and they played an anti-inflammatory role via sustained-releasing oxytocin in the brain. Transplantation of mesenchymal stem cells could reduce neuroinflammation and inhibit the activation of microglia. The secretion of mesenchymal stem cells could not only improve neuroinflammation, but also exert a multi-target comprehensive therapeutic effect, making it potentially more suitable for the treatment of AD. Enhancing the level of TREM2 in microglial cells using gene editing technologies, or application of TREM2 antibodies such as Ab-T1, hT2AB could improve microglial cell function and reduce the level of neuroinflammation, which might be a potential treatment for AD. Probiotic therapy, fecal flora transplantation, antibiotic therapy, and dietary intervention could reshape the composition of the gut microbiota and alleviate neuroinflammation through the gut-brain axis. However, the drugs of sodium oligomannose remain controversial. Both exercise intervention and electromagnetic intervention had the potential to attenuate neuroinflammation, thereby delaying AD process. This article focuses on the role of drug therapy, gene therapy, stem cell therapy, gut microbiota therapy, exercise intervention, and brain stimulation in improving neuroinflammation in recent years, aiming to provide a novel insight for the treatment of AD by intervening neuroinflammation in the future.
2.Identification of chemical components and determination of vitexin in the raw powder of Tongluo Shenggu capsule
Gelin WU ; Ruixin FAN ; Chuling LIANG ; Leng XING ; Yongjian XIE ; Ping GONG ; Peng ZHOU ; BO LI
Journal of China Pharmaceutical University 2025;56(2):166-175
The present study employed UPLC-MS/MS to analyze and identify compounds in the raw powder of Tongluo Shenggu capsules. An HPLC method for the determination of vitexin content was established. The analysis of this drug was performed on a 30 ℃ thermostatic Acquity UPLC® BEH C18 (2.1 mm×100 mm,1.7 μm) column, with the mobile phase comprising 0.2% formic acid-methanol flowing at 0.3 mL /min in a gradient elution manner. Mass spectrometry was detected by ESI sources in both positive and negative ion modes for qualitative identification of chemical constituents. 12 flavonoid and 3 stilbenes compounds in the raw powder of Tongluo Shenggu capsules were successfully identified. Additionally, an HPLC method for the determination of vitexin content was established using a XBridge C18 column (4.6 mm × 250 mm, 5 µm) with a mobile phase of 0.05% glacial acetic acid in methanol for gradient elution, at a column temperature of 30 °C, a flow rate of 1.0 mL/min, and an injection volume of 20 μL. The method demonstrated good linearity in the concentration range of 10 µg/mL to 40 µg/mL (R=1.000) with an average recovery rate of 96.7%. The establishment of these methods provides a scientific basis for the quality control and development of the raw powder of Tongluo Shenggu capsules.
3.Effects and mechanism of Tianma xiongling zhixuan tablet on autophagy of vascular endothelial cells
Sunan YONG ; Chi FANG ; Yuanxiong LONG ; Ping LI ; Xiaobing XIE
China Pharmacy 2025;36(14):1737-1742
OBJECTIVE To explore the effects of Tianma xiongling zhixuan tablet on autophagy in vascular endothelial cells of rats and its potential mechanism. METHODS The rat aortic endothelial cells (RAECs) were divided into normal group, model group, blank serum group, traditional Chinese medicine (TCM) medicated serum group, autophagy blocker group, autophagy agonist group, and TCM combined with autophagy agonist group. Except for normal group, other groups were given 10 μg/mL lipopolysaccharide for 24 hours to induce RAECs inflammation injury model. Blank serum group was treated with 10% blank serum; TCM medicated serum group received 10% medicated serum derived from Tianma xiongling zhixuan tablet; autophagy blocker group was treated with 20 μmol/L of PD98059; autophagy agonist group was administered 50 μmol/L Honokiol. Lastly, the TCM combined with autophagy agonist group was given both 10% medicated serum derived from Tianma xiongling zhixuan tablet and 50 μmol/L Honokiol. The morphological characteristics of RAECs in each group were observed. The cell viability of each group, the contents of endothelin-1 (ET-1) and nitric oxide (NO), mitochondrial reactive oxygen species, mitochondrial membrane potential, and the expression levels of PTEN-induced kinase 1 (PINK1), Parkin, ubiquitin-binding protein (p62), and microtubule-associated protein 1 light chain 3 (LC3) were detected. RESULTS Compared with model group, the levels of ET-1, mitochondrial reactive oxygen species, and the relative expressions of PINK1, Parkin, and LC3 proteins in the autophagy blocker group and TCM medicated serum group were decreased or down-regulated significantly (P<0.05 or P<0.01); the cell viability rate (only autophagy blocker group), NO level, mitochondrial membrane potential, and the E-mail:46164660@qq.com relative expression level of p62 protein were increased or up-regulated significantly (P<0.05 or P<0.01); the pathological damage of RAECs was significantly improved, the number of cells increased significantly, and the typical paving stone-like characteristics were restored. The levels of ET-1, mitochondrial reactive oxygen species, and the relative expression levels of Parkin and LC3 proteins in the autophagy agonist group were increased or up-regulated significantly (P<0.05 or P<0.01), while cell viability rate was decreased significantly (P<0.05), the damage of RAECs was aggravated. Compared with the autophagy agonist group, the cell viability rate and the relative expression level of p62 protein in TCM combined autophagy agonist group were increased or up-regulated significantly (P<0.05 or P<0.01), while the levels of ET-1, the relative expression levels of PINK1, Parkin, and LC3 proteins were down-regulated significantly (P< 0.01), the damage of RAECs was reversed to a certain extent. CONCLUSIONS Tianma xiongling zhixuan tablet protects vascular endothelial function by regulating mitochondrial autophagy, the mechanism of which may be associated with the regulation of PINK1/Parkin signaling pathway and the inhibition of mitochondrial autophagy.
4.Chaihu and Longgu Mulitang Regulates ERK/CREB Signaling Pathway to Ameliorate Hippocampal Nerve Injury in Mouse Model of Depression
Shiyu JI ; Li WANG ; Zhuo ZHANG ; Yingzhe GAO ; Zefeng ZHANG ; Siyu CHEN ; Guangjing XIE ; Ping WANG ; Panpan HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(22):1-9
ObjectiveTo investigate the effects of Chaihu and Longgu Mulitang (CLMT) on hippocampal neural damage in the mouse model of depression via the extracellular signal-regulated protein kinase (ERK)/cAMP-response element-binding protein (CREB) signaling pathway. MethodsSeventy-eight male C57BL/6 mice were randomly allocated into normal control, model, low/medium/high-dose (2.89, 5.78, and 11.56 g·kg-1, respectively) CLMT, and paroxetine (10 mg·kg-1) groups. A depression model was established by chronic unpredictable mild stress (CUMS) combined with social isolation. Behavioral tests were carried out to evaluate depressive-like behaviors. Hematoxylin-eosin staining and Nissl staining were performed to assess hippocampal morphology and neuronal damage. Immunofluorescence was employed to detect glial fibrillary acidic protein (GFAP) and ionized calcium-binding adapter molecule 1 (Iba1). Real-time PCR was employed to measure the mRNA levels of ERK and CREB. Western blot was employed to determine the expression of ERK/CREB pathway proteins and brain-derived neurotrophic factor (BDNF) in the hippocampal tissue. Molecular Operating Environment (MOE) software was used for molecular docking to evaluate the interactions between CLMT components and target proteins. ResultsCompared with the normal control group, the model group showed decreased sucrose preference (P0.01), increased tail-suspension immobility time (P0.01), decreased activity in the central region of the open field test (P0.01), and decreased activity in the middle and open-arm region of the elevated plus maze test (P0.01). The hippocampal area in the model group showed wrinkled cells and a reduction in the number of cells, neurons with reduced sizes and Nissl bodies, enhanced fluorescence intensity of GFAP and Iba1 (P0.01), and down-regulated expression of phosphorylated (p)-ERK, p-CREB, and BDNF (P0.05, P0.01) and mRNA levels of ERK and CREB (P0.01). Compared with the model group, the CLMT group showed increased body weight (P0.05, P0.01), restored cell morphology, with only a small number of ruptured cells, normal neuronal structure and morphology with obvious nuclei and abundant Nissl bodies, weakened fluorescence intensity of GFAP and Iba1 (P0.05, P0.01), up-regulated mRNA levels of ERK and CREB (P0.05, P0.01) and protein levels of phosphorylated (p)-ERK, p-CREB, and BDNF in the hippocampal tissue (P0.05, P0.01). The results of molecular docking indicated that nine active ingredients in CLMT had good binding affinity with ERK and CREB. ConclusionCLMT may ameliorate the hippocampal nerve injury in the mouse model of depression by regulating the ERK/CREB pathway.
5.Bioequivalence study of sidenafil citrate tablets in Chinese healthy subjects
Xiao-Bin LI ; Lu CHEN ; Xiu-Jun WU ; Yu-Xin GE ; Wen-Chao LU ; Ting XIAO ; He XIE ; Hua-Wei WANG ; Wen-Ping WANG
The Chinese Journal of Clinical Pharmacology 2024;40(3):430-434
Objective To evaluate the bioequivalence of oral sidenafil citrate tablets manufactured(100 mg)test preparations and reference preparations in healthy subjects under fasting and fed conditions.Methods Using a single-dose,randomized,open-lable,two-period,two-way crossover design,36 healthy subjects respectively for fasting and fed study were enrolled,and randomized into two groups to receive a single dose of test 100 mg with 7-day washout period.Plasma concentration of sidenafil and N-demethylsildenafil was determined by liquid chromatography-tandem mass spectrometry(LC-MS/MS)method.The pharmacokinetic parameters were calculated by Analyst 1.6.3(AB Scie)using non-compartmental model,and bioequivalence evaluation was performed for the two preparations.Relevant safety evaluations were performed during the trial.Results The main pharmacokinetic parameters of sidenafil after a single oral dose of sidenafil citrate tablets under fasting condition for test and reference were as follows:Cmax were(494.69±230.94)and(558.78±289.83)ng·mL-1,AUC0-t were(1 336.21±509.78)and(1 410.82±625.99)h·ng·mL-1,AUC0-were(1 366.49±512.16)and(1 441.84±628.04)h·ng·mL-1,respectively.The main pharmacokinetic parameters of sidenafil under fed condition for T and R were as follows:Cmax were(381.89±126.53)and(432.47±175.91)ng·mL-1,AUC0-t were(1 366.34±366.99)and(1 412.76±420.37)h·ng·mL-1,AUC0-were(1 403.28±375.32)and(1 454.13±429.87)h·ng·mL-1,respectively.The results demonstrated the bioequivalence of sidenafil citrate tablets between T and R.The incidence of adverse events in fasting and fed tests were 33.33%and 25.00%,respectively.No serious adverse event was reported.Conclusion The test and reference formulation of sidenafil citrate tablets were equivalent and was safe.
6.Clinical trial of bevacizumab combined with paclitaxel and carboplatin in the treatment patients with of recurrent/metastatic cervical cancer
Yang XIANG ; Jin-Long CAO ; Gui-Mei NIE ; Ying LI ; Yan-Ying SUN ; Shu WANG ; Ping-Rong XIE
The Chinese Journal of Clinical Pharmacology 2024;40(8):1121-1125
Objective To analyze the efficacy of bevacizumab combined with paclitaxel+carboplatin in the treatment of recurrent/metastatic cervical cancer,and to explore the influence on survival prognosis of patients.Methods Patients with recurrent/metastatic cervical cancer were divided into control group and treatment group according to different treatment methods.The control group received paclitaxel combined with carboplatin chemotherapy regimen(intravenous infusion of 170 mg·m-2 paclitaxel and carboplatin(AUC=5 mg·mL-1·min)for 3 weeks as a course of chemotherapy),and the treatment group was given bevacizumab on the basis of control group,intravenous infusion of 15 mg·kg-1 bevacizumab,once every 3 weeks.Both groups were treated for 3 cycles of treatment by taking 3 weeks as 1 treatment cycle.The clinical efficacy,levels of serum tumor markers,quality of life,survival prognosis and occurrence of drug-related adverse reactions during treatment were compared between the two groups.Results There were 41 cases in treatment group and 48 cases in control group.After treatment,the overall response rate(ORR)of treatment group and control group were 31.71%(13 cases/41 cases)and 14.58%(7 cases/48 cases),with no statistical significance(P>0.05).After treatment,the disease control rate(DCR)in control group and treatment group were 62.50%(30 cases/48 cases)and 82.93%(34 cases/41 cases);the squamous cell carcinoma antigen(SCCA)levels were(3.58±0.73)and(2.52±0.57)ng·mL-1;carbohydrate antigen 19-9(CA19-9)levels were(23.60±4.29)and(19.19±3.72)U·mL-1;carbohydrate antigen 15-3(CA15-3)levels were(27.13±5.36)and(22.86±3.94)U·mL-1;carbohydrate antigen 125(CA125)levels were(39.24±6.88)and(26.47±5.09)U·mL-1;the overall improvement rates of quality of life were 41.67%(20 cases/48 cases)and 73.17%(30 cases/41 cases),the progression-free survival times were 8.67 months(95%CI:7.82-9.53)and 10.25 months(95%CI:9.68-10.81),the total survival times were 9.96 months(95%CI:9.13-10.79)and 11.47 months(95%CI:11.00-11.93),all with significant difference(all P<0.05).There were no statistically significant differences in the incidence of nausea and vomiting,leukopenia,thrombocytopenia and liver-kidney function impairment between both groups(all P>0.05).Conclusion Bevacizumab combined with chemotherapy has significant efficacy in the treatment of recurrent/metastatic cervical cancer,and it can reduce the levels of serum tumor markers,enhance the quality of life,and improve the survival prognosis,and it has good safety.
7.Bioequivalence study of tenofovir alafenamide fumarate tablets in Chinese healthy subjects
Xiao-Bin LI ; Nan WANG ; Ni-Na HU ; Ning WANG ; Chen-Dong DONG ; Xiao-Tong CUI ; He XIE ; Yan TIAN ; Wen-Ping WANG
The Chinese Journal of Clinical Pharmacology 2024;40(14):2113-2117
Objective To evaluate the pharmacokinetics(PK)of tenofovir alafenamide Fumarate tablets(25 mg)in healthy Chinese subjects after single oral administration to provide a basis for bioequivalence evaluation.Methods Using a single-dose,randomized,open-lable,two-period,two-way crossover design under fasting condition,while three-way crossover design under fed condition,42 healthy subjects respectively for fasting and fed study were enrolled,and randomized into two groups to receive a single dose of test product(T)or reference product(R)25 mg.Plasma concentration of tenofovir alafenamide and tenofovir were determined by liquid chromatography-tandem mass spectrometry(LC-MS/MS)method.The pharmacokinetic parameters were calculated by WinNonlin software(8.1 version)using non-compartmental model,and bioequivalence evaluation was performed for the two preparations.Relevant safety evaluations were performed during the trial.Results The test product and the reference product under fasting study,the main PK parameters of tenofovir alafenamide were as follows:Cmax were(215.17±94.24)and(199.30±71.11)ng·mL-1;AUC0-t were(135.44±71.60)and(123.91±53.82)h·ng·mL-1;the main PK parameters of tenofovir were as follows:Cmax were(7.30±2.27)and(7.12±1.74)ng·mL-1,AUC0-t of tenofovir were(237.16±47.09)and(230.06±43.41)h·ng·mL-1,respectively.The test product and the reference product under fed study,the main PK parameters of tenofovir were as follows:Cmax were(197.69±82.19)and(197.10±110.54)ng·mL-1;AUC0-t were(197.69±82.19)and(197.10±110.54)h·ng·mL-1;the main PK parameters of tenofovir were as follows:CMax were(2.57±1.37)and(2.58±1.31)ng·mL-1;AUC0-t were(227.08±74.33)and(238.51±128.30)h·ng·mL-1,respectively.The 90%confidence interval for geometric mean ratio of Cmax,AUC0-tof T and R under fed condition were between 80.00%-125.00%,respectively.The incidence of adverse events in fasting and fed tests was 21.43%and 30.95%,respectively,and no serious adverse event was reported.Conclusion The test formulation and reference formulation of tenofovir alafenamide fumarate tablets were equivalent and was safe.
8.Elemene Antitumor Drugs Development Based on "Molecular Compatibility Theory" and Clinical Application: A Retrospective and Prospective Outlook.
Xiao-Ying JIANG ; Li-Ping SHI ; Jun-Long ZHU ; Ren-Ren BAI ; Tian XIE
Chinese journal of integrative medicine 2024;30(1):62-74
Elemene, derived from Curcuma wenyujin, one of the "8 famous genuine medicinal materials of Zhejiang province," exhibits remarkable antitumor activity. It has gained wide recognition in clinical practice for effectiveness on tumors. Dr. XIE Tian, introduced the innovative concept of "molecular compatibility theory" by combining Chinese medicine principles, specifically the "monarch, minister, assistant, and envoy" theory, with modern biomedical technology. This groundbreaking approach, along with a systematic analysis of Chinese medicine and modern biomedical knowledge, led to the development of elemene nanoliposome formulations. These novel formulations offer numerous advantages, including low toxicity, well-defined composition, synergistic effects on multiple targets, and excellent biocompatibility. Following the principles of the "molecular compatibility theory", further exploration of cancer treatment strategies and methods based on elemene was undertaken. This comprehensive review consolidates the current understanding of elemene's potential antitumor mechanisms, recent clinical investigations, advancements in drug delivery systems, and structural modifications. The ultimate goal of this review is to establish a solid theoretical foundation for researchers, empowering them to develop more effective antitumor drugs based on the principles of "molecular compatibility theory".
Humans
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Retrospective Studies
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Antineoplastic Agents/therapeutic use*
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Neoplasms/drug therapy*
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Drugs, Chinese Herbal/therapeutic use*
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Sesquiterpenes/therapeutic use*
9.The effect of cuproptosis related gene methylation on the prognosis of cervical cancer
Yu DING ; Jiaqi PENG ; Jinhui CHEN ; Zhiwei ZHOU ; Qian WU ; Ping LI ; Yuli LIU ; Ping TAN ; Yan HU ; Xiaobing XIE ; Dingsheng WEN
Chinese Journal of Laboratory Medicine 2024;47(4):407-412
To investigate the differences in methylation levels of cuproptosis related genes in cervical cancer and their effects on clinical prognosis.Methods:The methylation data of 310 cervical tissue specimens were acquired from public databases. The UALCAN database was used to analyze the methylation level differences of 12 cuproptosis-related genes and study their level in different stages or grades of cervical cancer. Genes with statistically significant differences were selected for prognosis analysis using the EWAS datahub. Finally, gene-enrichment analysis, pathway analysis, immune infiltration analysis, the mutation rate and tumor mutation burden (TMB) of the genes in cervical cancer were analyzed using the cBioportal database. Two independent samples rank-sum test was used for differences in methylation levels and immune cell infiltration; comparative analyses of overall survival were performed using KM survival curves and Log-rank two-sided tests. TMB analyses were performed using the Wilcoxon Test for statistical analyses; Pearson correlation analysis was used for assessment in GSEA and pathway analyses.Results:The methylationβvalue of Cyclin Dependent Kinase Inhibitor 2A (CDKN2A gene) in the cervical cancer tissues of patients was 0.075 which was significantly higher than the methylationβvalue of 0.049 in normal human tissues ( P=0.008). Dihydrolipoamide S-Acetyltransferase (DLAT gene) methylation with a β value of 0.102 was significantly higher than normal human tissue methylation with a β value of 0.08 ( P=0.002), and the methylation level β value of Lipoyltransferase 1 (LIPT1 gene) in cervical cancer tissues was 0.06,which was significantly lower than normal human tissue methylation value of 0.092 ( P=0.009). Patients with CDKN2A gene methylation levels≥0.199 had an overall survival of 14.75 years, which was lower than that of patients with methylation levels<0.199 (17.56 years) ( P=0.034).The results of gene enrichment analysis indicated that it mainly involves biological processes such as the response to type I interferon and DNA replication. The expression of CDKN2A gene is positively correlated with the number of neutrophils and dendritic cells in the tumor microenvironment( P<0.05), and negatively correlated with the number ofmacrophages( P<0.05). TMB was higher in the group of variants of the CDKN2A gene than in the group of non-variants ( P=0.019). Conclusion:CDKN2A methylation is a potential biomarker for predicting the prognosis of cervical cancer.
10.Feasibility Evaluation of using PAX1/JAM3 methylation markers as cervical cancer screening for female self-collected samples
Furong YU ; Jiezhi MA ; Xi ZHOU ; Genlin LI ; Jiaqi PENG ; Ping LI ; Fei ZENG ; Xiaobing XIE ; Weilei DONG
Chinese Journal of Laboratory Medicine 2024;47(4):419-427
Objective:To explore the application value of PAX1/JAM3 methylation detection by cervical self-collected specimen in cervical cancer screening and the management of premenopausal and postmenopausal women.Method:This study is a single center cross-sectional study. From January 2023 to November 2023, cervical self-collected and physician-collected specimens at the colposcopy clinic were detected the PAX1/JAM3 methylation (PAX1 m/JAM3 m) testing. The consistency between self-collected and physician-collected specimens for PAX1 m/JAM3 m detection were compared based on histopathology. In addition, the clinical efficacy of methylation detection with high-risk human papillomavirus (hrHPV), liquid-based cytology (LBC), and their combination for cervical cancer screening were compared in the study. Results:A total of 301 women were recruited to undergo referral colposcopy examination, and statistical analysis was conducted on 272 women with pathological and diagnostic information. Among them, 102 cases (37.5%) were diagnosed as normal cervical tissue or chronic cervicitis, 72 cases (26.4%) were cervical intraepithelial neoplasia grade 1 (CIN1), 43 cases (15.8%) were CIN2, 29 cases (10.7%) were CIN3, and 26 cases (9.6%) were cervical cancer. According to the minimum quantity formula, they were divided into a consistency cohort of 81 participants and a validation cohort of 191 participants. The consistency between cervical self-collected and physician-collected specimens for detecting PAX1 m/JAM3 m. Results from spearman correlation analysis showed a positive correlation between the self-collected and physician-collected results of PAX1 m/JAM3 m detection, and the correlation coefficient R values are 0.858 ( P<0.001) and 0.828 ( P<0.001). The sensitivity and specificity of PAX1 m/JAM3 m detection for diagnosing CIN2 or more severe lesions (CIN2+) were 77.6% [95% confidence interval ( CI) 65.3%-86.4%] and 87.2% (95% CI 80.5%-91.9%), respectively. In clinical performance comparison, the sensitivity of PAX1 m/JAM3 m combined with HPV16/18 detection, 89.7% (95% CI 79.2%-95.2%), was the same as that of hrHPV detection in CIN2+and 96.0% (95% CI 80.4%-99.3%) in CIN3+, which is higher than 92.0% (95% CI 75.0%-97.8%) of hrHPV and 82.6% (95% CI 62.9%-93.0%) of LBC or the combination of sPAX1 m/JAM3 m and LBC low-grade and higher squamous intraepithelial lesion testing [87.0% (95% CI 67.9%-95.5%)]. Conclusions:Self-collected specimens by women for detection of PAX1 and JAM3 methylation as a promising screening tool for cervical cancer has operational and clinical feasibility. The methylation test can optimize the current cervical cancer screening plan, reduce the number of referral women with false positive diagnosis to colposcopy, and is of great significance for reducing fertility protection and preventing missed diagnosis in women of childbearing age.

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