Objective To analyze the current situation of domestic multi-center study of medicine research in order to improve the scientific research level.Method Using the bibliometrics method to analyze the number of coauthors,research institutions, research states distribution,foundation paper numbers and large sample papers of 200 multicenter original research papers published in 10 domestic and foreign journals in 2010.Results There were 112 domestic original research papers,the number of average coauthor was 6.1± 1.1; 15.2％ of them were more than 3research institutions; 2.7％ of them were cooperative study of more than 2 countries.49 papers (43.8％)were supported by fund; 10.7％ of which were more than 3 foundations; large sample papers account for 24.1 ％.In 88 foreign original research papers,the number of average coauthors is 9.8± 2.7; 86.4％ of them are under more than 3 research institutions; 44.3％ of them are cooperative study of more than 2 countries.Fund papers account for 69.3 ％ ; large sample papers account for 50％.There were significant difference in the number of coauthors,research institutions,number of countries,large sample papers and the number of ≥3 foundation papers between both domestic and international paper(P ＜ 0.05).The number of domestic and foreign funded papers had no significant difference (P ＞0.05).ConclusionThere are some differences between domestic and foreign medical cooperative research. We should strengthen the international and domestic cooperative research in order to improve the scientific research level and reduce the waste of resources.

Objective To explore the quality of clinical trial papers published in medical SCI-tech journal.Methods A total of 1201 original research projects were published in 6 medical journals from Mar.2012 to Mar.2014 in China.Fifty-four of them were selected according to the key words randomizedcontrolled,and they were evaluated using 2010 CONSORT statement.Results In 54 articles,the section of background and abstract were described clearly and standardize.Fifty-one (94.44 ％)papers described intervention method in details.Thirty-five (64.81％) papers described the experimental design method.Thirty-one (57.41％) papers defined the primary and secondary outcome indicators,only 3 (5.56％)of them described distribution order,and the method of blindness.Four (7.41％) papers provides the information on sample size calculation.The using of flow chart accounted for 7.41％.Ten (18.52％) papers described the reason of drop out.Two (3.70％) papers evaluated the effect and accuracy,and the trial results were explained clearly and consider other evidences.Only 18 (33.33％) papers wrote the limitation of the studies.For other information of the studies,5 (9.26％) of them was registered somewhere,the information on funding support was on 20 (37.04％)papers.Conclusions The description on most RCT papers were clear and complete,but close attention should be paid to the method of blindness and sample size determine.

Objective To evaluate the application value of high-risk human papillomavirus (HR-HPV)DNA de-tection and ThinPrep liquid-based cytology testing(TCT)in cervical disease screening.Methods Cervical specimens of women with cervical lesions in a hospital between October 2012 and December 2013 were taken and performed hu-man papillomavirus DNA genotyping (HPV DNA)and ThinPrep liquid-based cytology testing(TCT).Positive pa-tients were performed colposcopy pathological detection.HPV DNA positive rates among different TCT groups, and different cervical lesion groups were compared,the sensitivity and specificity of TCT and HPV DNA detection, as well as differences between separate and joint detection were also compared.Results The positive rate of HPV DNA was 28.07% (1 045/3 723),most were HR-HPV (21 .57%,n=803),the major HR-HPV genotypes were HPV 16,58,52,and 18 type.HR-HPV positive rates were statistically different among different age groups(χ2 =31 .74,P <0.001 ),positive rate was highest in 20 -30 year old age group .Positive rate of TCT was 13.46%(n=501),a total of 971 patients were performed pathological detection,293 were positive.Patients were divided according to different TCT and different lesion type,χ2 testing of HR-HPV DNA positive rate showed that positive rate of HR-HPV had a increasing tendency with the increase in severity of diseases(all P <0.01).Pathological de-
tection was as a gold standard ,the sensitivity of HR-HPV DNA and TCT was 90.44%(265/293)and 85.32%(250/293)respectively,the sensitivity of joint HR-HPV DNA detection and TCT was 95.90%.In positive patho-logical group,the detection rate of TCT and HR-HPV DNA was 85.32% and 90.44%,respectively,joint detec-tion rate was 95.90%,the difference among three groups was significant (χ2 =18.185,P <0.001).Joint detection rate was higher than separate detection rate of TCT or HPV DNA.Conclusion HPV DNA detection is a useful supplement for cervical cancer screening,HPV DNA detection combined with TCT can reduce the misdiagnosis rate.

Objective To investigate arsenic trioxide (As2O3)-mediated apoptosis of synovlal cells in pa-tients with rheumatoid arthritis (RA) through culturing the synoviocytes in vitro. Methods Primary synovial cells were cultured by means of two-enzymatic digestion and the third cells were adopted in this test. The cultured cells were defined by MTT and flow cytometry (FCM). Results Certain concentration of As2O3 could inhibit the viability of synoviocytes at 48 h by means of MTT, which was dose-dependent. Certain concentration of As2O3 could induce the apoptosis of synoviocytos pro rata at 48h by means of FCM ,which was dose-dependent within range of 10-80 μmol/L concentration. Conclusion Certain concentration of As2O3 following 48 h effect could induce the apoptosis of syno-viocytes of RA,which is dose-dependent.

Objective To explore whether glutamine can ameliorate oxidative stress injury in mice with sepsis in order to provide an experimental basis for clinical application.Methods Thirty 5-week old Qunming male mice were randomly divided into three groups: control, model and glutamine groups, 10 mice in each group. Lipopolysaccharide (LPS) 5 mL/kg was injected into intraperitoneal cavity to establish septic model in model and glutamine groups, and an equal amount of normal saline was injected into the cavity in control group. After the septic model was successfully established, propylene ammonia acyl-glutamine 0.75 g/kg was immediately injected through tail vein in the glutamine group, and an equal amount of sterile normal saline was injected into the vein in the model and control groups. After 6 hours, the experiment was terminated, the blood was collected from the orbital cavity and the animal was sacrificed; serum, liver and renal tissue homogenates were taken to detect the indexes of oxidative stress, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and lipid metabolite malonaldehyde (MDA).Results Compared with the control group, the levels of SOD activities and GSH-Px of serum and liver, kidney tissue in the model group were significantly lower, and the MDA content was significantly higher. Compared with the model group, the levels of SOD activities and GSH-Px of serum and liver, kidney tissue in the glutamine group were significantly higher, and the MDA content was significantly lower [SOD in the serum (U/mL): 134.78±3.74 vs. 124.60±3.49, SOD in the liver (U/mg): 56.71±1.35 vs. 49.84±0.86, SOD in the kidney (U/mg): 46.22±1.22 vs. 43.22±1.52; GSH-Px in serum (U/mL): 325.15±21.86 vs. 267.04±13.5, GSH-Px in liver (U/mg): 91.35±1.59 vs. 83.40±1.33, GSH-Px in kidney (U/mg): 136.08±0.58 vs. 132.97±0.74; MDA in serum (μmol/L): 9.20±0.32 vs. 13.67±1.24, MDA in liver (nmol/mg): 1.85±0.10 vs. 4.88±0.17, MDA in kidney (nmol/mg): 2.47±0.12 vs. 3.52±0.27, allP < 0.01].Conclusion Sepsis can cause oxidative stress and oxidative damage, glutamine not only can improve the levels of antioxidant enzymes of GSH-Px and SOD, enhance antioxidant capacity, reduce the MDA content of lipid metabolites, but also can reduce the toxic metabolites, so as glutamine has the effect of ameliorating oxidative stress injury.

Objective:About half of Community Health Services ( CHS) in China are not government-owned, forming a multi-ownership situation of CHS .This study aims to examine the effect of “multi-ownership policy” on the development of CHS and put forward suggestions for improving the governance of CHS .Methods:We applied maxi-mum variation sampling to select health workers of different CHS specialties and administrators from local health bu -reaus in District T of Shaanxi province and District X of Shandong province .Inductive thematic analysis was utilized to interpret the development and ramification of multi-ownership policy , and then to formulate substantive theory .Re-sults:The adoption of multi-ownership in two districts was an adaptive strategy based on the limited public finance , institutional restriction of government , and diversity of health resources .This policy promoted the establishment of CHS network , and meanwhile the government's leadership of CHS development was transferred to multiple owners of CHS, which caused the lack of CHS autonomy , fragmented regulation power and deviated development of CHS .Con-clusions:The key problem of multi-ownership situation in CHS development is the problematic partition of governance power.In order to redeem the leadership of CHS development to the local government , it is necessary to strengthen service regulation while to decentralize the facility management power to CHS , to adjust service price ,and to deepen medical insurance coverage of CHS to enhance autonomy of CHS .

Objective:To investigate the characteristics of health-related risky behaviors in adolescents with bipolar disorder.Methods:Fifty adolescents aged 12 -18 years,fulfilled the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision(ICD-10)criteria for bipolar disorder(29 in depressive state, 19 in manic state,and 2 in mixed state)and 100 healthy-matched controls were recruited.Their health-related risky behaviors were assessed using the Questionnaire for Adolescents Health-related Risky Behavior Inventory (AHRBI) and the Questionnaire for Adolescents Health-related Risky Behavior Inventory for Parent (AHRBI-P).Results:The bipolar group had higher AHRBI scores in the total scale and six subscales than controls,including Aggression and Violence (AV),Health-Compromising Behavior (HCB),Rule Breaking (RB),Unprotected Sex (US),Self-injury and Suicide (SS),and Smoking and Drinking(SD)[Total scores,55.5(38,119)vs.46(38,65);P <0.05].Besides, the scores of 26 items of bipolar group were all higher than controls(Ps <0.05).The scores in the total scale and six subscales had no difference between AHRBI and AHRBI-P.According to the partial correlation analysis (de-pressive state =0;manic state =1),the AHRBI and AHRBI-P scores of Self-injury and Suicide subscale were nega-tively associated with the episode state (r =-0.32,-0.33;Ps <0.05).The AHRBI scores of'destroy properties'which belongs to the Aggression and Violence subscale were positively associated with the episode state (r =0.32, P <0.05).Conclusion:The adolescents with bipolar disorder have more health-related risky behaviors than the healthy adolescents.The depressive patients have higher risk of suicide.While,the risky behavior of destroying properties tend to occur among the manic patients.

Objective To investigate the genomic amplification of the human telomerase RNA component (hTERC) gene in cervical cytology and evaluate its role in screening of cervical lesions. Methods A total of 301 cases were recruited, with liquid-based cytology diaghoses as normal (n=203), atypical squamous cells (ASC, n=66), low-grade squamous intraepithelial lesions ( LSIL,n=18), and high-grade squamous intraepithelial lesions ( HSIL, n=14). Following cytological examination, the slides were analyzed using a two-color fluorescence in aitu hybridization ( FISH ) probe targeted to chromosome 3q26 containing hTERC. The hTERC findings were compared to the cytologic and histologie results, as well as high-risk human papilloma viruses (HPV) results. Results Genomie amplification of hTERC was found in 3.0% (6/203)of normal specimens, 21.2% (14/66) of ASC, 44.4% (8/18) of LSIL and 92.9% (13/14) of HSIL, with a significant difference in each pair wise (all P<0.05). Significantly more cells with 3q26 gain were found in cervical intraepithelial lesion (CIN) Ⅱ than in CIN Ⅰ(75.0% vs. 20.0% ), as well as in CIN Ⅲ (86.7% vs. 20.0% ) and squamous cervical cancer (SCC) than in CIN Ⅰ (100.0% vs. 20.0%) ( all P<0.01). The sensitivity of hTERC amplification was significantly higher than cytological screening (82.6% vs. 17.4%, P<0.01), and its specificity was higher than high-risk HPV test (67.8%-73.5% vs. 25.6%-27.7%, P<0.01) in the diagnosis of HSIL (CIN Ⅱ - Ⅲ). The abnormal hTERC signal type mostly was 2:3 in CIN Ⅰ (84.9% ) ; whereas in CIN Ⅱ-Ⅲ, 2: 3, 2:4 and 4:4 accounted for 44.6%, 24.8% and 17.8%, respectively. Conclusion Testing the gain of chromosome 3q26 in cytological specimens using specific probe for hTERC is powerful in screening of HSIL, and the amplification patterns of 2:4 and 4:4 may serve as potential prognosis markers.

Objective To investigate the significance of genomic amplification of the telomerase RNA component (TERC) gene to serve as a genetic biomarker in the screening of cervicallesions.Methods A total of 715 cases were recruited,with liquid-based cytology diagnosis as normal (n=347),atypical squamous cells of undetermined significance (ASCUS,n=180),atypical squamous cells cannot exclude a high-grade lesion (ASC-H,n=13),low-grade squamous intraepithelial lesions (LSIL,n=115),high-grade squamous intraepithelial lesions(HSIL,n=59)and atypical glandular cells(AGC,n=1).The remaining cervical cells in the cytological preserving fluid were analyzed using a two-color fluorescence in situ hybridization (FISH) probe targeted to chromosome 3q26 containing TERC gene.The TERC gene findings were compared to the cytological and histological detected results,as well as high-risk human papillomavirus (HPV) detected results.Results Genomic amplification of TERC gene was found in 5.8% of normal specimens,22.2% of ASCUS.30.8% of ASC-H,27.8% of LSIL,86.4% of HSIL and 1/1 of AGC.The positive rate was significantly lower in normal,ASCUS,ASC-H and ISIL.compared with HSIL(all P<0.01).Significantly more cells with genomic amplification of TERC gene were found in cervical intraepithelial lesion(CIN) Ⅱ-Ⅲ than CIN Ⅰ (77.8% vs.9.3%),as well as invasive cervical cancer (96.7% vs.9.3%).both P < 0.01.The rate of TERC gene amplification was higher in HPV positive patients (33.5%) than in HPV negative patients(5.2%,P<0.01).The sensitivity of TERC gene amplification was significantly higher than that of cytological screening (81.88% vs.36.96%,P<0.01) in the differentiation of CIN Ⅱ or higher and CIN Ⅰ or lower diseases,its specificity Was hisher than high-risk HPV test (93.32% vs.33.93%,P<0.01) and positive prediction value (81.29%) was similar with cytological method (86.44%,P>0.05);but its negative prediction value (93.56%) was lower than HPV test (97.06%,P<0.05).Conclusions The positive rates of TERC gene amplification increased as cervical diseases worsened.TERC gene amplification is related to HPV infection.The gain of chromosome 3q26 in cytological specimens is an effective molecular genetic biomarker in screening of CIN Ⅱ or higher and invasive cervical cancer.

Cervical cancer is still a serious threat to the health of women in China. The current strategy is a three-level prevention strategy, among which the diversion of screening and screening abnormalities in the secondary prevention is an important link in preventing cervical cancer. For more than 20 years, China has implemented diversified screening methods such as cytological examination, high-risk human papillomavirus (HPV) testing, and naked eye screening. With the discovery that high-risk HPV infection is closely related to the occurrence of cervical cancer, the screening method for cervical cancer has shifted from cytological examination to HPV testing as the preferred screening method. This article introduces the advantages and disadvantages of high-risk HPV testing and cytological examination as screening methods, and proposes the issues that need to be paid attention to in screening; The principle of diverting screening abnormalities was proposed, and it was proposed that in the process of diverting, individualized and refined management principles should be implemented for screening abnormality projects based on the patient′s age and fertility requirements.