英語醫(yī)學(xué)科研論文的格式和要求(第一單元).doc

英語醫(yī)學(xué)科研論文的格式和要求打開一本醫(yī)學(xué)專業(yè)期刊，可以看到不同文體的文章。除了綜述(review)或述評（comments）、編者按（editorials）和個例報告（case reports）外，大量的是醫(yī)學(xué)科研論文，即原始報告（original articles）。醫(yī)學(xué)科研論文有許多不同的類型，常見的有兩大類：醫(yī)學(xué)基礎(chǔ)研究報告和臨床研究報告。了解英語醫(yī)學(xué)科研論文的結(jié)構(gòu)特點和要求，逐步掌握其寫作技巧，是醫(yī)學(xué)研究人員和臨床醫(yī)學(xué)工作者所必須具備的基本技能。為了寫好醫(yī)學(xué)論文的英文摘要，應(yīng)對醫(yī)學(xué)論文的格式和要求有所了解。1格式根據(jù)國際醫(yī)學(xué)雜志編輯委員會 (The International Committee of Medical Journal Editors, ICMJE) 制定的生物醫(yī)學(xué)雜志投稿統(tǒng)一要求（The Uniform Requirements for Manuscripts Submitted to Biomedical Journals, 5th Ed., 1997），一篇生物醫(yī)學(xué)科研論文（ 以下簡稱“論文” ）應(yīng)包括以下12個部分：1）標(biāo)題（Title）7）致謝（Acknowledgements） 2）摘要（Abstract）8）參考文獻(xiàn)（References） 3）引言（Introduction）9）插圖說明（Legends） 4）材料與方法（Materials and Methods）10）插圖（Figures） 5）結(jié)果（Results）11）表格（Tables） 6）討論（Discussion）12）照片和說明（Plates and Explanations） 以上除7）、9）、10）、11）、12）部分因?qū)嶋H情況不需要外，其他各部分是一篇論文必不可少的內(nèi)容。下面分別介紹對各部分的基本要求，其中“標(biāo)題”和“摘要”兩部分將在以后單元另行討論。2要求1）引言部分 總的要求是：The purpose of an introduction is to bring the reader into the general area of your study and then state the specific area of study (move from the general to the specific). The introduction shows the scope of your investigation efforts. 即：說明研究的總體范圍和目的。 具體內(nèi)容包括： A背景 - 說明所研究問題的目前總體情況或歷史（statement of general area or history of problem） B意義 - 說明研究的意義或必要性（statement of importance or need） C進(jìn)展 - 說明有關(guān)該問題的先有發(fā)現(xiàn)、報告或研究（statement of previous findings, reports or studies）。陳述這部分內(nèi)容時一般要有引文（citations） D目的 - 說明本研究的目的（statement of purpose of current study） E范圍 - 說明要研究問題的具體范圍（statement of specific area of problem to be studied）示例： In the military, it has been common to treat hyperthermic heat casualties by immersion in ice-containing water. 【研究背景】 This method is highly unphysiologic, because the secondary profound cutaneous vasoconstriction shunts blood away from the skin, which greatly slows heat loss from the body core. In addition, shivering occurs soon after immersion, even though core temperature has decreased very little; and this is counterproductive by virtue of muscular heat production. Finally, immersion cooling is extremely unpleasant to the alert patient. 【本研究意義】 Recently Weiner and Khogali have developed a method for cooling hyperthermic patients based on the principle of vaporization of warm water from the body surface by blowing warm dry air over the skin. Their method is an improvement on previous experience with vaporization of cold water from the body surface. 【研究進(jìn)展】 Based on their experience, we have utilized the same physiologic principles in treating heat casualties during a two-week period of desert training (44th MAU,CAX 9-82,MCAGCC,29 Palms, Calif.). In addition, we have applied these principles to normothermic volunteers to study the difference of the method and evaluate untoward effects. 【本研究的目的】2）材料與方法部分 總的要求是：Readers must be able to reproduce your results, evaluate the validity of your results and the soundness of your methods, and follow the logic in the paper. 即：結(jié)果的可重演性、方法的可靠性以及前后的邏輯性。 具體內(nèi)容包括： 簡要說明研究設(shè)計（study design / protocol），如：回顧（retrospective / review），前瞻（prospective），臨床（clinical），動物（animal），實驗（experimental），活體內(nèi)（in vivo）活體外（in vitro），原位（in situ）隨訪（follow-up），對照（controlled），隨機(jī)（random / randomized），雙盲交叉（double-blind crossover），人群（population / cohort / migrant），對比（comparative），流行病學(xué)（epidemiological）等研究性質(zhì)； 詳細(xì)說明研究對象（subject）情況，包括動物（animal）的性別（sex）、年齡（age）、物種（species）、品種（breed）、生理狀態(tài)（physiological state）; 微生物菌株（strain）、血清型（serotype）及其他區(qū)別特性（identity characteristics）；隨機(jī)分組方法（methods of any random assignment of subjects to groups）和選擇標(biāo)準(zhǔn)（criteria for admission to study groups）； 詳細(xì)說明所用的藥物（drug），激素（hormone），試劑（reagent）和其他化學(xué)品（chemical）的名稱、商標(biāo)（trademark）、生產(chǎn)廠家（manufacturer）及所在地（location）； 簡要說明測定方法（method of measurement），包括名稱，引文和偏差（variations）； 簡要說明統(tǒng)計學(xué)分析方法（method of statistic analysis）這部分的陳述程序一般為：研究設(shè)計 研究對象性質(zhì) 處理 / 干預(yù)方法 測定 / 觀察手段 統(tǒng)計分析 除指示性說明外，如：病人資料見表1（Data of the patients are shown in Table 1）“材料與方法”和“結(jié)果”兩部分一律用過去時表達(dá)。 示例：A retrospective analysis was conducted of all adults and pediatric patients (age less than 18 years) who received a prolonged course of parenteral nutrition at UCLA Medical Center from January 1996 through December 2003. 研究設(shè)計：性質(zhì)、時間、地點、對象 Criteria for patient selection included a minimum course of a months and development of calculous or acalculous cholecystitis requiring cholecystectomy. From 1996 through 2003 136 patients underwent a prolonged course of TPN (total parenteral nutrition胃腸道外全面營養(yǎng)) at the UCLA Medical Center. Sixty-two of these patients were found to have gallbladder disease. Cholecystectomy was performed in 21 of these patients before the initiation of TPN, and in 35 patients during or after administration of long term TPN. This latter group of 35 patients forms the basis for this report. 選擇標(biāo)準(zhǔn) Specific data regarding age, sex, length of time receiving TPN, underlying disorders, indication for TPN, number of previous operations, preoperative assessment, and the operative biliary procedure, findings and outcomes were all recorded.研究對象性質(zhì) Patient data are summarized in Table 1. 指示性說明 (以下詳細(xì)說明所選35個研究對象的情況，表格等內(nèi)容，略)3) 結(jié)果部分 總的要求：This section tells the reader what happened in your work. Remember: let your results speak for themselves and dont embellish (leave that for the Discussion section), 即：讓研究的客觀結(jié)果說話，不要添枝加葉。 具體要求： 1） 對所獲結(jié)果進(jìn)行概述（overview of the results）； 2）說明所獲資料或數(shù)據(jù)的統(tǒng)計意義（statistical significance）； 3）統(tǒng)計支持（statistical support），包括圖，表，照片等 （凡用圖表表示的內(nèi)容不再用文字詳述）。 注意：不要用模棱兩可的詞或短語表述結(jié)果，如： “ The results tended to be greater than”, “ showed no promising trends”, “It could / might be inhibited by ” 。示例： Clinical and laboratory findings Although the findings of abdominal pain, nausea, emesis, fever, and chills were present alone or in combination in 31 of 35 patients (88 percent), the diagnosis of biliary disease was often delayed. The initial diagnosis in five of the seven children less than 6 years of age was catheter sepsis. Results of preoperative liver function tests were available in 27 patients. Twenty-five of these 27 patients (93%) had some evidence of hepatic dysfunction. Hyperbilirubinemia was present in 8 patient (30 percent), elevated alkaline phosphatase levels in 25 (93 percent), and elevated transminase levels in 13 patients (48 percent). In almost all these patients, the abnormal results of liver function tests had been noted early after the initiation of TPN and before the diagnosis of biliary tract disease. Either hepatosplenomegaly or laboratory evidence of a coagulation abnormality (prolonged prothrombin or partial thromboplastin time) or both were present in 19 patients (54 percent). Hepatobiliary scans (HIDA or PIPIDA) were performed in eith patients and were suggestive of cystic duct obstruction in six. Abdominal ultrasonography was performed in 24 patients and correctly identified biliary sludge, gallstones, or both in 22 (92 percent). Gallstones were documented in two additional patients by oral cholecystogram in one and endoscopic retrograde cholangiography in the other. The remaining patient was explored with a presumptive diagnosis of cholecystitis without the benefit of any of these diagnostic tests. Although the clinical diagnosis was delayed in many of these patients, a correct preoperative diagnosis of calculous or acalculous cholecytitis was made in all but two patients who were thought to have some other focus of intraabdominal sepsis. 用統(tǒng)計數(shù)字說明臨床和實驗室發(fā)現(xiàn)Four of the 35 patients (11 percent) died after their biliary operation. Two adults and one child died within 30 days of operation, and a second child died as a result of progressive respiratory and hepatic failure. He had previously undergone two attempts at cholecystectomy that had to be aborted because of massive hemorrhage and was being prepared for a third attempt when he died. The other child died as a result of persistent sepsis and respiratory failure. A 75 year-old patient with previously documented carcinoma of the colon and short bowel syndrome secondary to multiple resections for radiation enteritis died 23 days after emergent cholecystectomy for acalculous cholecystitis. His immediate preoperative and postoperative course were complicated by progressive hepatic insufficiency and renal failure. He died on the eighth postoperative day. Hospital mortality was 24 percent in the 14 patients who required urgent operqtions. 死亡率及死亡原因 4) 討論部分 總的要求：The author should tell the reader what the results mean by placing them in the context of previous published studies of the problem, 即：與先有研究相比，本研究有何意義。 具體要求： A簡要說明研究背景（background） B簡要介紹總的發(fā)現(xiàn)（general findings） C介紹具體要點（introduction of points） D與現(xiàn)有發(fā)現(xiàn)（若有）進(jìn)行比較（comparison in the context of other studies） E意義（suggested meaning） F結(jié)論（conclusion） G前瞻研究（future studies） 結(jié)論往往是論文中最長也是最難寫的部分，主要原因是作者要對研究結(jié)果和發(fā)現(xiàn)進(jìn)行分析、推斷、演繹和推理，要求作者具有很強(qiáng)邏輯思維能力和英語文字組織能力。此外，這部分時態(tài)比較復(fù)雜，要分清實驗過程和結(jié)果（過去時）與分析意見（確定：現(xiàn)在時；不確定或假設(shè)：過去時）的區(qū)別；他人研究結(jié)果（過去時或現(xiàn)在完成時）與本研究結(jié)果（過去時）的區(qū)別；普遍適用的結(jié)論（現(xiàn)在時）與只適用本研究的結(jié)論（過去時）的其別等。因此，對于however, may, might, could, would, possibly, probably, be likely to 等詞（組）的使用以及we believe (think / consider) that, to our knowledge, in our experience (practice) 等插入語的使用就顯得格外重要。 示例： Parenteral nutrition is being used with increasing frequency as a primary source of caloric support in adult and pediatric patients with gastrointestinal problems. Numerous complications have been associated with the administration of TPN, including a significantly increased incidence of gallbladder disease 3-5,7. The data here suggest that cholecystectomy is often required for the management of symptomatic gallbladder disease in this group of patients, and is associated with significant risks.【說明研究背景，包括意義】 Of the 35 patients who required cholecystectomy for TPN-induced gallbladder disease, operative morbidity and mortality were 54 percent and 11 percent, respectively. Maingot 8 has stated that cholecystectomy is one of the simplest and safest of the abdominal operations, and is associated with a low operative mortality rate (about 0.5 percent). A review of the pediatric literature suggests that when cholecystectomy is performed in children, the operative morbidity is less than 10 percent, and the mortality is less than 1 percent. 8,9 Glenn 11 has reported a mortality rate of less than 0.1 percent in over 5,000 patients under the age of 50 years who underwent cholecystectomy. The morbidity and mortality observed in our group of receiving long-term TPN, therefore, were far in excess of what would be expected for a population of patients whose mean age was 29 years. 【提出本研究主要發(fā)現(xiàn)并將其與其他研究發(fā)現(xiàn)相比較】 Our data suggest that are specific factors unique to patients who require long-term TPN that contribute to the increased mortality and morbidity associated with cholecystectomy in this select group.以下，作者用較大篇幅分析了這類病人死亡率和并發(fā)癥增高的臨床、實驗室和手術(shù)等方面的原因，說明為什么本研究報告的手術(shù)發(fā)病率和死亡率比其他研究報告的要高，原文從略 Based on the results of our studies, we believe that early cholecystectomy is indicated in patients with TPN-induced gallbladder disease. Obviously, all patients with symptomatic disease should undergo cholecystectomy unless there specific medical contraindications. These operations should be performed in a timely, elective fashion because delay may result in the need for urgent surgery and thereby, increase an already high risk. Although recent studies have suggested that cholecystectomy may not be warranted in otherwise healthy patients with asymptomatic gallbladder disease 20, we believe that this axiom does not apply to patients with TPN-induced gallbladder disease. Out data suggest that the natural history of gallbladder disease in patients receiving TPN is considerably different from that of their counterparts not receiving TPN. Based on our findings, we recommend elective cholecystectomy in patients receiving TPN when gallstones first appear. Furthermore, cholecystectomy should be considered, especially in children without stones who are undergoing laparotomy for other reasons. 【從對結(jié)果的分析及與其他研究的比較得出結(jié)論性意見，這是討論部分最重要的內(nèi)容，也是摘要結(jié)論部分的基礎(chǔ) 】 Whether TPN-induced gallstones can be prevented through daily stimulated gallbladder emptying awaits the results of further studies. 【前瞻研究，即對研究存在或新發(fā)現(xiàn)的問題】 5） 致謝部分 總的要求：Always get approval of your intention to mention someone in the acknowledgement and approval of the form in which you will pre