英语医学科研论文的格式和要求 (下)
4) 讨论部分
总的要求：The author should tell the reader what the results mean by pl
acing them in the context of previous published studies of the problem,
 即：与先有研究相比，本研究有何意义。
具体要求：
A．  简要说明研究背景（background）
B．  简要介绍总的发现（general findings）；
C．  介绍具体要点（introduction of points）
D．  与现有发现（若有）进行比较（comparison in the context of other stu
dies）
E．  意义（suggested meaning）
F．  结论（conclusion）
G．  前瞻研究（future studies）

结论往往是论文中最长也是最难写的部分，主要原因是作者要对研究结果和发现进
行分析、推断、演绎和推理，要求作者具有很强逻辑思维能力和英语文字组织能力
。此外，这部分时态比较复杂，要分清实验过程和结果（过去时）与分析意见（确
定：现在时；不确定或假设：过去时）的区别；他人研究结果（过去时或现在完成
时）与本研究结果（过去时）的区别；普遍适用的结论（现在时）与只适用本研究
的结论（过去时）的其别等。因此，对于however, may, might, could, would,
possibly, probably, be likely to 等词（组）的使用以及we believe (think
/ consider) that, to our knowledge, in our experience (practice) 等插入
语的使用就显得格外重要。

示例：
Parenteral nutrition is being used with increasing frequency as a prima
ry source of caloric support in adult and pediatric patients with gastr
ointestinal problems. Numerous complications have been associated with
the administration of TPN, including a significantly increased incidenc
e of gallbladder disease [3-5,7]. The data here suggest that cholecyste
ctomy is often required for the management of symptomatic gallbladder d
isease in this group of patients, and is associated with significant ri
sks.[说明研究背景，包括意义]
Of the 35 patients who required cholecystectomy for TPN-induced gallbla
dder 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 ass
ociated with a low operative mortality rate (about 0.5 percent). A revi
ew of the pediatric literature suggests that when cholecystectomy is pe
rformed in children, the operative morbidity is less than 10 percent, a
nd 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 mo
rtality observed in our group of receiving long-term TPN, therefore, we
re far in excess of what would be expected for a population of patients
 whose mean age was 29 years. [提出本研究主要发现并将其与其他研究发现相
比较]
Our data suggest that are specific factors unique to patients who requi
re long-term TPN that contribute to the increased mortality and morbidi
ty associated with cholecystectomy in this select group.[以下，作者用较
大篇幅分析了这类病人死亡率和并发症增高的临床、实验室和手术等方面的原因，
原文从略]
Based on the results of our studies, we believe that early cholecystect
omy is indicated in patients with TPN-induced gallbladder disease. Obvi
ously, all patients with symptomatic disease should undergo cholecystec
tomy unless there specific medical contraindications. These operations
should be performed in a timely, elective fashion because delay may res
ult in the need for urgent surgery and thereby, increase an already hig
h risk. Although recent studies have suggested that cholecystectomy may
 not be warranted in otherwise healthy patients with asymptomatic gallb
ladder disease [20], we believe that this axiom does not apply to patie
nts with TPN-induced gallbladder disease. Out data suggest that the nat
ural history of gallbladder disease in patients receiving TPN is consid
erably different from that of their counterparts not receiving TPN. Bas
ed on our findings, we recommend elective cholecystectomy in patients r
eceiving TPN when gallstones first appear. Furthermore, cholecystectomy
 should be considered, especially in children without stones who are un
dergoing laparotomy for other reasons. [从对结果的分析及与其他研究的比较
得出结论性意见，这是讨论部分最重要的内容 ] Whether TPN-induced gallston
es can be prevented through daily stimulated gallbladder emptying await
s the results of further studies. [前瞻研究]