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生物医学论文的构件及其撰写要点(三)

本篇,我们将以韩国首尔国立大学医学院 Keam 教授的文章为例(Prognostic impact of clinicopathologic parameters instage II/III breast cancer treated with neoadjuvant docetaxel and doxorubicin chemotherapy: paradoxical features of the triple negative breast cancer),简要介绍论文的讨论、结论与致谢。这篇论文的英文经过我们修改后发表于 2007 年的 BMC Cancer 上(BMC Cancer 2007;7:203)。

讨论

讨论的目的是对您的研究结果进行分析与解释,并使用实验证据和普遍接受的知识来支持您的结论。在适当的深度解释您讨论中的数据,阐述可能解释现象的机制。如果您的结果与预期不同,说明为什么可能发生;如果您的结果与您的预期相同,那么阐述证据支持的理论,清楚地描述研究结果的意义以及尚存在的问题。

  • 阐述方法的所有局限性、分析的缺陷、研究设计的缺点、假设条件的有效性,如,“In our results, pCR which is considered to be the most powerful prognostic factor did not show significant prognostic value. Possible explanations for the weakened prognostic power of pCR are the relatively lower rate of pCR (7.6%), the short course of neoadjuvant chemotherapy, and the short duration of follow up (18.6 months). ”

  • 与其它研究的对比,指出一致性及不相符合之处,如,“In one study, higher bcl-2 expression was predictive for pCR [26], while other studies did not find any correlation between bcl-2 expression and clinical response [25,27].”

  • 确定实验设计是否充分解决了您的假设,以及对照是否适当

  • 决定每个假设是否得到支持、拒绝、或者不能自信地做出决定。不要简单地将研究或部分研究视为“不确定”

  • 避免下述陈述:“To the best of our knowledge, this is the first study to investigate albinism in gerbils.”

  • 尽可能多地解释所有观察,重点关注机制

  • 一个实验不会回答一个大问题,所以要指出下一步的目标。最好的研究为新的研究开辟途径或方向。还有哪些问题需要解决?

  • 当您提到已发表的研究信息时,用英语过去时态,无论是自己的还是他人的;对普遍接受的事实和原则用英语现在时态。例如,“Optimal treatment after neoadjuvant chemotherapy remains still uncertain [31]. Unlike early breast cancer, it is not yet clear whether adjuvant therapy should be conducted according to initial clinical stage or post operative pathologic stage. In our homogeneous patient population, initial clinical stage was an independent prognostic factor for survival, while pathologic stage failed to reflect ultimate survival.”

 

在讨论中最大的错误是提供比较肤浅的解释,或多或少地重复说明结果。

结论

一个结论就像一首歌中最后的和弦,这使得听众觉得该作品是完整的、已完成了。必须简短,通常只有一小段。这是 Keam 教授文章的结论,“Several molecular markers play a role as predictive and prognostic factors in stage II and III breast cancer patients receiving neoadjuvant chemotherapy. We also confirmed the usefulness of initial clinical stage, as a predictor of survival. We found that triple negative phenotype was associated with shorter survival, even though it was associated with a higher response rate to neoadjuvant chemotherapy. These results might assist in identifying and understanding the importance of clinically useful markers in the neoadjuvant setting, and help to optimize treatments.”

  • 您要明确重申您的论点,“The clinical course of breast cancer patients treated with neoadjuvant chemotherapy remains difficult to predict, …. As a result, many researchers have tried to identify prognostic factors in order to give optimal individualized therapy in locally advanced breast cancer, as well as in early breast cancer.”

  • 基本上是重复您的 Introduction 中最后一段末尾的内容,“The purpose of this study was to identify the clinical significance of potential predictive and prognostic factors in the neoadjuvant setting.”

  • 您要为读者总结您论证的结论:“Several molecular markers play a role as predictive and prognostic factors in stage II and III breast cancer patients receiving neoadjuvant chemotherapy. We also confirmed the usefulness of initial clinical stage, as a predictor of survival. We found that triple negative phenotype was associated with shorter survival, even though it was associated with a higher response rate to neoadjuvant chemotherapy.”

  • 阐述您的结论的生物学或临床意义,提出有待进一步研究的内容,“These results might assist in identifying and understanding the importance of clinically useful markers in the neoadjuvant setting, and help to optimizetreatments.”  

致谢

  • 向为您的研究提供帮助、但未包含在作者列表内的所有个人或小组表示致谢。首先致谢最值得感谢的人或组织

  • 切勿简单仅表示致谢,应阐述他们的贡献,例如,“This study was supported by a Korean Research Foundation Grant funded by the Korean Government (KRF-2006-531-E00034), a grant from the Seoul National University Hospital Research Fund (05-800-20050148) and a grant from the Korean Health 21 R &D Project, Ministry of Health & Welfare, Republic of Korea (03-PJ10-PG13-GD01-0002). We would like to thank our clinical research nurse Kyung-Hee Lee for her assistance of clinical trial. We thank BioMed Proofreading for English editing services.”

  • 要询问个人或组织他们是否希望出现在您的致谢中 – 他们可能对您的数据的解释有不同看法而不希望被提及

  • 要感谢经费资助。部分期刊要求资助单位应列在标题页中,而不是在致谢章节

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