醫(yī)學論文撰寫陳廷超

文章之”道”----醫(yī)學論文的撰寫陳廷超Ph.DPublicationManager上海羅氏制藥有限公司Tingchao.chen@Mobilehanghai,July1２，2014NP-AVS-2014.07-004ValidUntil2016.07聲明

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科研文章的兩種境界發(fā)表論文的數(shù)量和質(zhì)量2003－2013這10年，中國科研人員發(fā)表國際論文114.3萬篇，排名世界第2位。這些論文共被引用709.9萬次，排名世界第5位。平均每篇論文被引用6.9次，世界平均是10.7次！中國科學技術(shù)信息研究所《2013中國科技論文統(tǒng)計結(jié)果》高質(zhì)量的科研論文:清晰簡潔,但不容易缺乏時間不熟悉醫(yī)學論文特征和撰寫方法,無從下筆過去痛苦的記憶和經(jīng)驗(文章被拒稿&被批駁英語不好撰寫科研論文的要有系統(tǒng)的方法為何害怕寫SCI文章?先制定寫作計劃/策略其實并不復雜人人都被拒稿過,貴之以恒英語也可以學,也可以尋求幫助為何不試一試?文章被拒稿的主要因素AspectReasonforrejectionTopicIrrelevanttopicortopicoflocalinterestonlyNewnessPapersoffersnothingnewFocusTopic,objectivesandconclusionsarenotconnectedMethodologicalUnclearandmisleadingargumentationStepsWeakmethodologyorresultsStyleUnclear,unfocusedandincoherenttextDataQualityFlaweddesign;insignificantsamplenumber;preliminaryfindingsonlyStrategy#1發(fā)表計劃是關(guān)鍵,早做準備文章復習/回顧增加專業(yè)知識學習他人經(jīng)驗發(fā)現(xiàn)知識空白(gap)課題申請時就開始勾畫文章寫作早決定文章的作者文章的撰寫始于研究的開始研究完成之前就開始寫:Sketchouttheintroductionatthetimetheinvestigation.Draftthemethodswhiletheresearchisbeingconducted.Finally,developskeletonformsofnumericdataearlyon.早做準備開始撰寫firstdraft時,問自己thefour“Whats？1.Whatisthequestionorpurpose?解決什么問題和研究目的？2.Whatdidyoudo?

做了什么？3.Whatdidyoufind?發(fā)現(xiàn)了什么？4.Whatdoesitmean?意味什么？Strategy#2IdentifycandidatesduringliteraturesearchVisitwebsitesAims&ScopeEditorialBoardInstructionstoauthorsAdvicetocontributorsResourcesforauthorsReviewexamplesoftheirrecentarticlesChoose1primarytargetandseveralsecondaryTipHavingseveralcandidateswithsimilaraudiencesandformatsfacilitatesturnaroundifyou’rerejectedbythefirst.確定目標雜志早做準備Strategy#3Title:InterimresultsofarandomisedcontrolledphaseIIItrialofelectivenodalirradiationpluserlotinibcombinedwithchemotherapyforoesophagealsquamouscellcarcinoma.Abstract:Keywords:Oesophagealcarcinoma,radiationtherapy,electivenodalirradiation,erlotinib,chemotherapyIntroduction:PrevalenceofoesophagealcanceranditsconventionaltreatmentsEfficacyandtoxicityofTKIforcancerandEGFRmutationEffectsofelectivenodalirradiationforoesophagealcancerProblem:norandomisedstudieshavebeencarriedouttoinvestigatewhetherENIiseffectiveinthetreatmentofunresectableoesophagealcancerObjectiveofthisstudy:determinewhethertheadditionofENIanderlotinibtoconcurrentchemoradiotherapycontainingpaclitaxel/cisplatinimprovessurvivalinoesophagealSCC.Methods:ParticipantsStudydesign:fourgroup,ENI+Erlotinib,ENIonly,conventionalradiation+Erlotinib,conventionalradiationonly.Registration,IRB,informedconsentTreatmentandassessment.StatisticalanalysisRoleoftheFundingSourceResults:Patientdemographyanddiseasecharacteristics(Table1)Treatmentcompliance(Figure1)SurvivalanalysisElectivenodalirradiationversusconventionalirradiation(Figure2andsupplementalfigure1)Analysisofindividualgroups(Figure3)Subgroupanalysis(Figure4,supplementalfigure2andsupplementalTable2)Patternsoftreatmentfailure(Table2andsupplementalfigure3)Safetyandadverseeventprofile(Table3andsupplementalTable3)Discussion:MainfindingsSynergisticinteractionbetweenENIandErlotinibComparisonbetweenENIandconventionalradiationErlotinibvsitscompetitorduringthisregimenManegablesafetyforENIanderlotinibIt’sainterimstudyandpossiblefinalresultsConclusion:ConcurrentENIpluserlotinibcombinedwithchemotherapysignificantlyprolongsOSinpatientswithoesophagealSCC.Acknowledgement:Reference:Draw-upanoutlinetopreparethemanuscript先寫個提綱Strategy#4按下面的順序開始撰寫:FiguresandtablesMethods,ResultsandDiscussionConclusionsandIntroductionAbstractandtitle好的規(guī)劃和撰寫順序Strategy#5Hengl,T.andGould,M.,2002.Rulesofthumbforwritingresearcharticles科研論文的組成和邏輯關(guān)系聚焦高度”曝光”部分TitleAbstractTablesFiguresTitleandAbstract:讀者最先看到和閱讀,甚至唯一能夠看到的部分;編輯在審稿是最先看到的部分;TablesandFigures:圖文總勝過文字描述;除了標題和摘要,

緊接著作者想看的部分;

Tables是呈現(xiàn)精確的數(shù)據(jù)和數(shù)字,使移除了數(shù)據(jù)的正文更有可讀性.Strategy#6Conveythemainthemeofthemanuscript，傳遞主題Drawsthereader’sattention，吸引讀者Agoodtitle:盡量少的詞恰當?shù)孛枋鑫恼碌膬?nèi)容簡潔和明確高遷移率族蛋白1在狼瘡腎炎患者腎組織中的表達及意義腹膜透析患者血清瘦素水平的變化及影響因素分析血液透析中血壓變異性及影響因素的初步探討2013年29卷12期AphaseIItrialofoxaliplatin,docetaxel,andbevacizumabasfirst-linetherapyofadvancedcanceroftheovary,peritoneum,andfallopiantubeGynecolOncol.2014MarNEnglJMed2012;367:1783-1791避免使用:“astudyof,”“investigationof,”“developmentof,”or“observationson.”….Objective：XX疾病的患者Intervention:XX藥物，或藥物對比，或手術(shù)方法Assessment：有效，安全，藥物經(jīng)濟學，預后/風險因子(可選）Studydesign：（可選）Results:(可選)Continuationofbevacizumabafterfirstprogressioninmetastaticcolorectalcancer(ML18147):arandomisedphase3trialLancetOncol.2013Jan;14(1):29-37.ImpactofobesityonchemotherapydosingforwomenwithadvancedstageserousovariancancerintheAustralianOvarianCancerStudy(AOCS).Badtitle:ExpressionandSignificanceoftheWip1Proto-oncogeneinColorectalCancer.Alternative:HighExpressionofWip1isCorrelatedwithPoorPrognosisofColorectalCancer.Keyfeaturesofyourstudy:novel,randomized,controlled,blinded,prospectiveMystudyshowedthat

Agoodtitle:盡量少的詞恰當?shù)孛枋鑫恼碌膬?nèi)容簡潔和明確WrittenLAST!AbstractContext/BackgroundObjectiveDesignPopulation/SettingIntervention(ifapplicable)OutcomemeasuresAnalysis3.Results4.Conclusion1.OBJECTIVE2.METHODSIntroductionMethodsResultsDiscussionConclusion科研論文的主要架構(gòu)和撰寫策略簡潔,簡潔,再簡潔條理清晰,邏輯分明,Topicsentence!段與段之間要有邏輯和連貫性Strategy#7Introduction吸引讀者進一步閱讀文章,了解結(jié)果讓編輯和審稿人判斷文章的重要性和價值舉例段落問題例一

(GouldDA,EffClinPract.1999)例二1stTopicanddefinitionsWhatisthegeneralproblemorcurrentsituation?Evidenceisaccumulatingthatcarotidendarterectomyreducesstrokeriskinmanypatientswithcarotidstenosis.Somepatientswithadvancedgastriccancershowresistancetopalitaxel-basedchemotherapywhichisamicrotubule-stabilizingagent,althoughitiswidelyusedtotreatthisdisease.2ndFocus(gap)Whatisthespecificproblemorcontroversy?Despiteincreasinginformation,decisionmakingaboutcarotidendarterectomyremainsdifficult.Thereisnoeffectivepredictivebiomarkerinclinictodefinethoseadvancedgastriccancerpatientswhohavegoodresponsetopalitaxel-basedtherapy.3rdObjectiveWhatisthespecific

purposeofthis?Tohelpcliniciansassesstherelativebenefitsofcarotidendarterectomy,wecalculatedthenumberofoperationsneededtopreventonemajorstrokeordeathunderdifferentconditionsToinvestigatepredictiveeffectofthecombinationofTUBB3andMAP-Tauexpressionin

gastriccancerpatientsonpalitaxel-basedtreatment.FrameworkforaThree-ParagraphIntroductionAbadbeginningmakesabadending.----Euripides簡潔而完整描述研究是如何設計,實施和分析的邏輯順序.一般方法里面包含下面的要素:-Setting,location-Participants(orobjects)-Studydesignincludingplannedsamplesize-Interventions(orexposures)-Outcomes(variables)-Allstatisticalmethods-Ethicalissues(e.g.consent)所有的信息必須

clear,accurate,andcomplete(提供足夠的方法細節(jié),以便他人重復,分析及和其它研究比較)Methods的內(nèi)容必須和Result部分相呼應

MaterialsandMethods臨床研究的ResearchPlanorProtocol必須得到InstitutionalReviewBoard(IRB)的批準病人簽署知情同意書informedconsent必須注冊Clinicaltrial

Trialsshouldberegisteredinoneofthefollowingtrialregistries:/(ClinicalTrials).au(AustralianClinicalTrialsRegistry)(ISRCTNRegister)http://www.trialregister.nl/trialreg/index.asp(NetherlandsTrialRegister)http://www.umin.ac.jp/ctr(UMINClinicalTrialsRegistry)臨床研究的特別注意事項以上三項，都會被高分雜志要求提供證明文件，現(xiàn)在好的雜志對于臨床研究文章，還需要提供protocol.Resultsection是用文字,tables,figures及statistics來報告在Methodsection描述的investigation的結(jié)果,應按一樣的順序.盡可能簡要和清晰,不要遺漏所謂的’negativeresults”.典型的結(jié)構(gòu)和順序是:描述研究的參與者

敘述針對重要問題(從primaryoutcomes開始,然后是secondaryoutcomes,及其它結(jié)果或分析)的答案報告臨床獲益及不良事件說明任何未按先方案的研究或分析要格外認真對待tablesandfigures里面的數(shù)據(jù)文字的呈現(xiàn)如同敘述一個storyUseconfidenceintervalsratherthanpvaluesResultsTable1經(jīng)常是受測者的基本數(shù)據(jù)（對臨床研究，如：Patientdemographicsanddiseasecharacteristics;Baselineinformation等）。NEnglJMed2012;367:1783-1791ResultsCONSORT

Statement(ConsolidatedStandardsofReportingTrials)招募分組隨訪分析不好的Results表達方法：Figure1shows……,Table1showsthat………,Table2tellsus………,Figure2showsthat…,好的Results表達方法；First,wetriedtoinvestigatewhetherIL12couldprotectbonemarrowcellsfromlethalirradiation(Figure1).Wefoundthat……….Thisindicatesthat….Then,wewantedtoknowifthisradioprotectiveeffectwasrelatedwithinterferonsignalpathway.Thebonemarrowlong-termtransplantationassaywasconducted(Figure2).IL-12couldsignificantly……..結(jié)果陳述不清，缺乏邏輯SCI論文常見錯誤Bad:TheMTTvaluesinGroupAandGroupBweresignificantlydifferent(Figure2A,P<0.01)