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1　引言(Introduction)

引言即是论文的开场白。在论文的引言中,作者主要介绍研究的背景和理由,具体说明研究的内容、目的、特点和意义。论文的背景和理由主要指研究主题的历史,现状,进展以及仍然存在的问题。引言可以对前人研究的结果,文献摘用进行评述,并且叙述作者着手研究的原因及研究的新发展等。

该部分内容在时态上常运用一般过去时,一般现在时及现在完成时。举例:

Introduction

The feasibility of ultrasonography for diagnosis of fetal cardiacabnormality was recognised in the early 1980s,and cardiac scanningis gradually being incorporated into fetal screening protocols.Theeffect of the screening process on the incidence and types ofcongenital heartdisease atterm has been difficultto ascertain becausemany pregnant women and infants travel great distances to specialistcentres which are farfrom their health authority.For a single centre,the geographical area from which its fetal referrals arrive is generallynot the same as the area attracting postnatal referrals,and the numberof births that each serves is impossible to define.The BritishPaediatric Cardiac Association(BPCA)undertook a nationalcollaborative study of fetal cardiac screening.The aim was to assessthe effect of fetal diagnosis of congenital heart disease on the patternof serious congenital heart disease at term.

2　方法(Methods)

该部分可依据所研究的对象或使用的材料和采用的方法,也可分别称之为:对象与方法(Subjects and methods or Patients and methods),材料与方法(Materials and methods)。方法部分实际上是论文的主体,它是对论文的内容和采用的方法作出详细的论述。具体的顺序为:首先是所使用的材料或研究的对象,其次是程序安排,最后是结果计算或统计方法。方法部分一般为回顾性叙述,在时态上多采用一般过去时,偶尔也有用过去完成时。不过,假若叙述的是定义,理论,图表内容及数值,属于客观现象,故可采用一般现在时。举例:

Patients and methods

The Information and Statistics Department of the Scottish Homeand Health Department collected data on the demographics andlaboratory results of all possible outbreak cases.We collected clinicaldata by reviewing the case notes of all cases admitted to hospital inthe Lanarkshire area.

All confirmed or probable cases ofEscherilchia coli(E coli)0157 infection,identified in the Lanarkshire area during the outbreakperiod,were included in the assessment and analysis.Confirmedcaseswere those in whom the outbreak strain ofE coliO157 wasisolated from stool samples.If stool cultureswere negative atthe locallaboratories,specimens were sent to Scotland'sE colireferencelaboratory in Aberdeen,for the more sensitive isolation method ofimmunomagnetic separation.Probable cases were those with bloodydiarrhoea or haemolytic uraemic syndrome(HUS)/thromboticthrombocytopenic purpura(TTP),an association with food sourcesimplicated in the outbreak,noE coliO157 isolated,and no otherorganism isolated.Adults were defined as patients 15 years of age orolder.

To allow standardisation of diagnosis in the face of a hugeclinical workload,a case definition for HUS and TTP was developedat the beginning of the outbreak.HUS was defined as evidence ofred-cell haemolysis(red-cell fragmentation on blood film and lactatedehydrogenase>1.5 times the upper limitof normal[our laboratory 0～480 IU/L])plus thrombocytopenia(platelets<150×109/L)with rising urea and creatinine concentrations.All three criteria hadto be met before the diagnosis could be made,but not necessarily onthe same blood sample.A diagnosis of TTPwas given to patientswhomet these laboratory criteria and developed new neurologicalsymptoms and signs.One patient was included as having developedHUS despite a minimum platelet count of 228×109/L(on death).

He had bloody diarrhoea,an association with an implicated foodsource,acute renal failure,the criteria for red-cell haemolysis,and afalling platelet count.

In the assessment of premorbid illness,medical historiesincluded as relevant were ischaemic heart disease,cardiac failure,hypertention,cerebrovascular disease,renal disease,diabetes,andimmunosuppression.Pulmonary oedemawas diagnosed on clinical andradiological evidence.

TPE was performed at three centres with three Cobe SpectraApheresis Systems(Cobe Laboratories Ltd,Gloucester,UK)and aBaxter Fenwal CS-3000 Plus Cell Separator(Baxter Healthcare,Newberry,UK).Plasma was exchanged with 2.0～2.4 Lfresh frozenplasma or cryosupernatant in refractory patients.The anticoagulantused was ACD-A.A combination of central and peripheral venousaccess was used.Intravenous hydrocortisone was given with eachexchange.Intravenous prostacyclin was also given to cases receivingTPE,at doses between 40 mg/h and 200 mg/h,where tolerated.Datawere analysed by means of SPSS(version 7.5).

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