醫(yī)學科研論文的的撰寫

醫(yī)學科研論文撰寫HowtowriteamedicalpaperSpeaker:HuafengLiu,Ph.D.醫(yī)學研究論文的種類原創(chuàng)性研究論文（Originalpaper）字數(shù)限制約3000~5000個短訊

(ShortCommunication)字數(shù)限制約500~800個

評論(Comments,Opinion)字數(shù)限制約500~800個致編輯函(LettertoEditor)字數(shù)限制約300~500個

綜述

(Review)字數(shù)一般約5000個系統(tǒng)評價（Metaanalysis）字數(shù)限制約3000~5000個個案報道（Casereport）Howtowriteanoriginalpaper原創(chuàng)性研究論文

OriginalResearchPaper字數(shù)限制約3000~5000個參考文獻數(shù)、圖與表的數(shù)目皆有一定限制所報導的研究須符合實證科學的邏輯，能為此領域提供有價值的新知識或訊息要得出一個結論，提供支持結論所必須的數(shù)據(jù)（結果部分），并對之進行闡釋（討論部分）

Whatisthetopic？——主題Whyyoucarriedouttheresearch？

——立題依據(jù)Whathaveknown/unknown？

——背景Whatyouwantedtoresolve？

——目標Howyoudidit？

——材料與方法Whatyouhavegainedatlast？

——結果與結論Apaperlikeastory!Whatisagoodpaper-The“W”ruleWhatis(are)themajorproblem(s)thatneed(s)tobestudied/addressed(significance)?Whyis(are)this(these)problem(s)important(hypothesis)?Whatkeyexperimentsorinnovativemethodsshouldbecarriedout?Whatarethesignificantoutcomesobtained?Whatproblemshavebeenanswered/addressed?Whatarethemajorcontributionsfromyourpaper?ThebasiccontentofapaperTitle（標題）abstract（摘要）keywords（關鍵詞）introduction（引言）Methods（方法）results

(結果)

Includingtables,figuresandfigurelegenddiscussion（討論）acknowledgements（致謝）disclosure（聲明）references（參考文獻）TitleSpecialistssaid:

Manypeoplewillreadthetitleofyourpaper,butnotreadtheentirepaper,oreventheabstract.Iscentralsubjectofapaper

VeryimportantThestyleofaTitle單一短語:ProteinuriaasaRiskFactorinrenalfailure短語組合:Proteinuria:aRiskFactorinRenalFailure陳述:proteinuriaisaRiskFactorinRenalFailure組合性陳述:ProteinuriaisaRiskFactorinRenalFailure:aclinicalstudy問題:IsProteinuriaaRiskFactorinRenalFailure?組合性問題:IsProteinuriaaRiskFactorinRenalFailure?LessonslearnfromclinicalstudyAgoodTitle

Creative(有創(chuàng)造性)

Abstractive(有吸引力)

Accurate（正確）Complete（完整）Specific（具體）Unambiguous（清晰）Concise（簡練）TroubleshootingoftheTitle

Toomanywords（字數(shù)太多）

Ambiguous（含糊不清）

Boring（主題無聊）

Nothingnew（沒有新意）

UsingAbbreviationorchemicalformula(縮寫詞、化學式）復合感染法聯(lián)合5/6腎切除制作IgAN腎小球硬化模型的建立及其評價(語法錯誤)腎糖顆粒對糖尿病腎病大鼠腎臟的保護作用及病理形態(tài)的影響（內(nèi)容重復，不簡練）金雀異黃素對晚期糖基化終末產(chǎn)物刺激大鼠系膜細胞氧化應激反應的保護作用（模糊不清，字太多）慢性腎臟病患者血清TGFβ1與纖維化指標的相關性研究（相互包含，不夠具體）腎炎康復片對腎臟細胞外基質作用及機制研究（不夠具體，無新意太泛）BadtitleAbstractBesidesthetitle,reveiwersorreadersmaybeonlyreadtheabstract.

ThemostimportpartofapaperYouawayswritetheabstractpartattheendThecontentsofaAbstract

Introduction/Backgroud：

Problem,hypothesis,andobjective（15%)Methods：Researchdesign、methodandstatistics（15-20%）Results：theimportantdiscover（50-55%Conclusion：Thesignificanceofyourdiscover（15%）AgoodabstractFollowingtheguidlineofthejournalHangouttogether(自成一段),clear,includingkeywords,noabbreviation,norefrencesIsaindependentpartofapaperIncludingspecificdataAccurateReadableandlogicalHowtowriteagoodabstractSteps:1.Readtheguidlineofthejournal(wordsnumberandformat)2.Summerizethekeypiontsofyourresearch3.

Write4.Reviseandsimplify5.Phaseandwordsimprovement6.DoublecheckIntroduction/Backgroud/Aim重點在于研究目的和要解決的問題(15%)Theslitdiaphragm(SD)ofpodocyteimpairmentcontributesto

massiveproteinuriaandprogressiveglomerulosclerosisinmanyhuman

glomerulardiseases.Theaimofthestudywastodetermineifthiazolidinedione

(TZD)reduceproteinuriaandglomerulosclerosisinfocalsegmental

glomerulosclerosis

(FSGS)bypreservingthestructureandfunction

ofSD.Methods研究是怎樣設計的？采用了哪些技術？使用何種統(tǒng)計學方法？(15-20%)

Adriamycin-inducedFSGSratmodelswereemployed.Urinaryproteincontentwasmeasureddynamicallyduringtheexperiment.Additionalbiochemicalparametersinserumsamplesweremeasuredaftertheanimalswerekilled.Glomerularsclerosisindex(SI)andpodocytefootprocessesfusionrate(PFR)wereevaluated.TheproteinandmRNAexpressinglevelsofnephrin,podocinandCD2-associatedprotein(CD2AP)inglomeruliwereassessedbyimmunohistochemistryandreal-timequantitativepolymerasechainreaction,respectively.Thedensityofpodocyteswasalsoevaluatedafteranti-Wilms’tumour-1immunohistochemicalstaining.Results最重要的發(fā)現(xiàn)是什么？(50-55%)

Rosiglitazonetreatmentpartiallyreducedproteinuria,butdidnot

significantlyaffecttheserumlevelsoftriglyceride,cholesterol,albumin,

glucose,ureanitrogenandcreatinineinAdriamycin-inducedFSGSrats.

GlomerularSIandpodocytefootPFRweresignificantlyattenuatedbyrosiglitazonetreatment.Rosiglitazonepreventedthereductionofnephrin,

podocinandCD2APproteinexpressioninducedbyAdriamycin,however,

themRNAexpressionlevelsoftheseSD-relatedmarkersdidnotchange

significantly.RosiglitazonetherapydidnotreverseAdriamycin-mediated

reductionofthedensityofpodocytes.Conclusion結果為什么重要？意義？(15%)

ThestudydatasuggestthatTZDarepromisingtherapeutic

agentsonFSGS,andthemechanismmaybemediatedinpartbydirectly

protectingthestructureandfunctionofSD.不合格IntroductionBeginningthestory……Whathaveknown?

Whatisstillunclearorunkown?

Theaim/hypothesisThedefinitionoftheresearchproblemIntroduction

——已知的方面為研究提供背景以背景開始，描述研究的范圍和意義介紹與課題相關的前期研究結果（包括陽性結果和陰性結果）Makesurebackgroundrelatesonlytospecificsubjectofpaper.

Alargebodyofresearchoverthepastdecaderevealedthat……...Itiswellknownthat………Introduction

——未知的方面為研究提供理論依據(jù)確定問題所在或突破口盡量精簡參考文獻數(shù)量避免使用其他研究者的名字省略不必要的細節(jié)

Sporadicstudiesshowedthat……….Heretofore,therewasnowell-recognizeddrugavailableinpodocytopathytherapy.Consequently,anadditionalresearchisnecessarytodevelopnewtherapeuticagents.……However,Therewasnoinformationavailableon……Introduction

——提出假設為研究提供理論依據(jù)確定問題所在或突破口盡量精簡參考文獻數(shù)量避免使用其他研究者的名字省略不必要的細節(jié)

……..PPAR-gexpressionwasincreasedinpodocytesinrenalscleroticstatus.6AlltheseresultssuggestedthatTZDmaybepromisingpharmacologicalagentsinpodocytopathytherapy.

Introduction

——說明研究目的陳述你研究的特定問題，以及你如何回答這個問題或者假說“Inthisstudy,we?”or“Toanswerthisquestion,we?”ItwasemployedinthepresentstudytodetermineifTZDcanprotectthestructureandfunctionofSDtoattenuateproteinuriaandglomerulosclerosisinFSGS.寫Introduction注意事項研究目的必須清楚陳述背景知識:要有針對性，勿離題，勿寫成綜述如果為實證研究，則必須要有假說如果是報導性的文章，報導的動機與其獨特性要交代清楚。不合格的前言MethodsAcompleteanddetaileddescriptionofwhatwasdone.Themethodsmustbedescribedinenoughdetailtopermittheexperimenttobereproducedbyotherinvestigators.UsallyyouwritethispartfirstThecontentsofMethods

材料：實驗材料，實驗對象(動物和人類)方法：實驗設計、實驗目的和手段統(tǒng)計分析HowtowriteMethods臨床研究(clinicaltrail)患者群體資料實驗方案（分組、對照）每個方案采用的方法數(shù)據(jù)分析實驗室研究材料/動物樣本制備操作步驟數(shù)據(jù)分析何謂臨床測試(Clinicaltrail)？

臨床測試針對自愿參與的個人，在人權與倫理規(guī)范下，進行與人類健康相關的研究，探討與人類疾病有關的問題，以尋找能增進人類健康與生活質量的方案Clinicaltrail

----------研究設計例：“Thestudywasadouble-blind,randomized,placebo-controlleddesignedtocompare…”

聲明遵守相關倫理規(guī)定的內(nèi)容“TheprotocolwasapprovedbytheIRBofeachparticipatinghospital…”要提供倫理審查委員會（IRB）實驗設計編號或臨床試驗編號Clinicaltrail

--------------研究方案描述被研究的人群的特征提供納入和排除標準對于隨機研究，說明如何做到隨機化；對于多中心研究，說明研究是如何分布的說明你的項目的目標樣本大小及主要和次要觀察終點可使用表格（如病人特征）和圖片（如多中心試驗）進行說明Clinicaltrail

--------------研究方案對照組（controlgroup;placebo）單盲（singleblind）；雙盲（doubleblind）任意編組（randomlyallocate）多單位（一個以上的醫(yī)學機構）副作用（Sideeffect)或不良影響(Adverseeffect)隨訪（followup）退出人數(shù)與原因（withdrew）流失人數(shù)與原因（missingdata）Trialsshouldberegisteredinoneofthefollowingtrialregistries:現(xiàn)網(wǎng)站上一些公共注冊資源可為大家使用，其中一部分還是免費為注冊者開放的。/(ClinicalTrials).au(AustralianClinicalTrialsRegistry)(ISRCTNRegister)http://www.trialregister.nl/trialreg/index.asp(NetherlandsTrialRegister)http://www.umin.ac.jp/ctr(UMINClinicalTrialsRegistry)Clinicaltrial的倫理問題任何與人體相關的研究與文章，一般雜志要求遵守CONSORT的規(guī)范、通過倫理委員會（InstitutionalReviewBoard;IRB），并獲得受試者知情同意書（InformConsent）Whenreportingrandomizedcontrolledtrials,pleaseadheretothe

CONSORT

(ConsolidatedStandardsofReportingTrials，臨床試驗報告統(tǒng)一標準

)statement()DeclarationofHelsinki(1964)ParticipantsEighteenhemiplegicinpatientssufferingfromstrokewererecruitedfromtheXUniversityHospital.Inclusioncriteriawereasfollows:(1)…..(3)orthopedicor…….ThisstudyhasbeenapprovedbytheInstitutionalReviewBoardofXUniversityHospital.

Allsubjectssignedaninformedconsent.Experimentalresearch

---------研究方案描述所有的材料（藥物、培養(yǎng)基、緩沖液，氣體、受試者，儀器/設備等等）如果方法學還沒有很好的建立，說明并給出細節(jié)或參考文獻BALB/cmalemice(6–8weeksold)wereused…...Theanimalswerepurchasedfrom

…….Themicewerehousedin…….Thestandardmousedietandwaterweregivenadlibitum.

實驗動物范例

MaterialsandMethods

Patients.ThisstudywasapprovedbytheInstitutionalReviewBoardoftheAffiliatedHospitalofGuangdongMedicalCollege.Kidneytissuespecimenswereobtainedfrom……Extractionofurinaryproteins.Urinaryproteinswereextractedfrom……asdescribedpreviously.Cellcultureandtreatment.HumanproximaltubularHK-2cells(ATCC,Virginia,USA)weremaintained……PlasmidtransfectionandsmallinterferingRNAs.HK-2cellsweretransfectedwithtfLC3plasmidorsiRNA-BECN1……asdescribedpreviously

Animalexperiments.40maleSprague-Dawleyratsweighing160-250gwererandomlydividedinto……Transmissionelectronicmicroscopy.Kidneytissuespecimensfromhumanorrat,aswellasHK-2cellswerefixed……Immunofluorescentandimmunohistochemicalstudy.Immunostaininganalysisfortissuesorcellswasconducted……StatisticsAnalysis描述所使用的統(tǒng)計方法詳細說明所使用的電腦軟件特殊的或復雜統(tǒng)計方法需要解釋和引用參考文獻為最終環(huán)節(jié)，非常重要！應盡早咨詢統(tǒng)計學專家！StatisticalanalysisTheFAfromnormalandlesionsidesisexpressedasthemean±standarddeviation.Comparisonsonthesamepatient’snormalandlesionsides,aswellascharacteristicsofwhitematterinvolvement,wereperformedbyamixedmodelconsideringtherepeatedmeasure,andmultiplecomparisonsbetweenwhitematterinvolvementwereadjustedusingtheBonferronimethod.StatisticalcalculationswereperformedusingSASversion9.0(SASInstitute,Cary,NC,USA.),withasignificancelevelof0.05.ResultsTopresentwhatyouhavefound,notjustcollectthedata！Youshouldseethroughtheappearancetotheessence，notjustpresentthedatamechanically！AbouttheResults作用：陳述實驗結果，展示支持結果的數(shù)據(jù)內(nèi)容：結果和數(shù)據(jù)組織：時間順序或者從最重要的開始一般使用小標題要有一致性：結果、討論和摘要內(nèi)容的一致性HowtowriteagoodResults每段落一個結果/主題簡潔有序再次簡要提及方法和材料使用過去時態(tài)給出明確的比較提供適當?shù)慕y(tǒng)計學細節(jié)用圖片和表格列出詳細數(shù)據(jù)，文字描述少而精可適當進行總結，但不要深入討論每段落一個結果/主題ResultsAutophagicvacuolesareincreasedinTECsfrompatientswithminimalchangenephroticsyndrome.UrinaryproteinsoverloadtriggersautophagicresponseincultureTECs.WethenemployedaproteinoverloadmodelofculturedTECs……...UrinaryproteinsoverloadincreaseautophagicactivityinTECs.AsshowninFig.2Dand2E,exposureto2-8mg/mlurinaryproteinsor8mg/mlHSA…….ROS-dependentautophagicinductionaccountsfortheautophagyactivation.ItwasreportedthatROSwas…….AutophagyactivationprotectsTECsfromurinaryprotein-inducedinjury.Itisconceivedthat……Results

Autophagicvacuolesare…..innephroticsyndrome.Inthisstudy,wefirstlyutilizedimmune-fluorescenttechnology

（簡要提及方法）toexaminetheexpressionofmicrotubule-associatedprotein1lightchain3(LC3)-II(akeymarkerofautophagy)inTECs.AsshowninFig.1Aand1B,comparedtothecontrol,therewere

（使用過去時態(tài)）significantlymoreLC3-IIpositivedotsseeninrenalTECsfrompatientswithminimalchangenephroticsyndrome(MCNS)(P<0.01).

（提供適當?shù)慕y(tǒng)計學細節(jié)）續(xù)：SimilartoLC3-IIimmunostaining,thenumberofautophagicvacuoleswasalso

increasedsignificantlyinrenalproximalTECsofMCNSpatientswhencomparedtothecontrols(Fig.1D)（明確對比）.用圖片和表格列出詳細數(shù)據(jù)，文字描述少而精Figure1.

QuantitativechangeofautophagicvacuolesinTECsfromMCNSpatients.(AandB)ImmunofluorescentstainingofLC3andthescore

of

LC3-II

expressioninrenaltubuliofMCNSpatientsorcontrols.Scalebar,50μm.(CandD)UltrastructuralimagesofautophagicvacuolesinMCNSpatientsandthecontrols.TEMimagesshowedtherepresentativeinitial/early(AVi)anddegra