研究性论文的结尾应是“结论”而非“讨论”

针对某些科技期刊(如医学、生物学等期刊)研究性论文的结尾普遍采用“讨论”而不是“结论”的现象,对“讨论”与“结论”的概念及内容进行对比分析,并指出:在一般情况下研究性论文的结尾应该是“结论”而非“讨论”。

医学论文摘要中“结论撰写之我见

医学论文论著篇中摘要撰写的要求，近数年来，共认：目的、方法、结果、结论“四部结构式”，具有可操作性，规范化。笔者从审修大量的文稿中发现多数作者，对前三部的撰写基本能掌握，但对“结论”部分的撰写还不够娴熟，有一定的难度。原因是有部分作者不甚了解人们思维的过程中，不仅须要概念明确和判断恰当，而且要推理合乎逻辑，准确地从已知判断推出未知的新判断。现就实例分析及如何掌握要领陈述如下。

精研真题一题多解 洞察结构二度创造

追求“一题多法求解”不仅是一个思维碰撞、能力提升的过程,更是在自我否定与肯定的思维摩擦中淬炼智慧的火花.文章以2022年湖南省长沙市数学中考试题第24题为例,精研真题,展开多解探究,在思路突破之后,挖掘试题的核心结构,并开展基于“条件”改编和“结论”拓展这两个方面的“习题二度创造”的教学策略与教学思考.

Security Assurance for One-stage Resection of Left Colon Cancer with Acute Obstruction—Thorough and Prompt Enteral Decompression without Contamination

Objective: Thorough, prompt enteral decompression technique without contamination was de- veloped to ensure safety for emergent colon resection and primary anastomosis. Methods: After isolating the mesentery, the “to be resected colon segment” was cut at its lower end, then the proximal cut end was put into a plastic bag which was adhered to one side of the operating table. After releasing the clamp, the content could ?ow into this bag. The operator could squeeze the bowel with two hands by turns, from proximal to farness, and from small bowel to large bowel, until the entire bowel content was fully discharged. Then the upper end of this “to be resected colon segment” was cut, and was removed together with the plastic bag. Results: 31 cases of left colon cancer with acute obstruction were decompressed with this technique. They all recovered smoothly, without anastomosis ?stula. Another 6 cases of hepatic seg- mentectomy with incidental colonectomy were decompressed with this technique and had the same results. This technique was also used in di?erent kinds of acute small intestinal obstruction and gained satisfactory results. Conclusion: This technique could be considered as the preferable choice for intraoperative enteral decompression.

Characterization of ST13 Protein Expression in Human Colorectal Cancer Tissues

Objective: To characterize the expression of ST13 protein in human tissuesfor investigation of the function of colorectal cancer related gene ST13. Methods: ST13 ORF wascloned and over-expressed in E.coli. The recombinant ST13 protein was purified by affinitychromatography. ST13 monoclonal antibodies were generated and affinity purified with the recombinantprotein. Immunoblot and immunohistochemical staining were employed to analyze ST13 proteinexpression in human tissues. Results: The expression and purification of the recombinant ST13protein were confirmed by SDS-PAGE. The protein yield reached about 2.5 mg/L of induced bacterialculture with a purity of 91.3%. Three strains of hybridoma were obtained with antibody titers from10~4 to 10~5 in ascites fluids and with high specificity for ST13 protein. Immunoblot showed thatthe apparent Mr of ST13 protein in SW480 cells and human tissues estimated by SDS-PAGE mobility wasapproximately 50 000, which was about 10 000 larger than the 41 324 calculated, but theglycosylation of the protein was excluded. Computer modeling revealed the protein to be ahydrophilic molecule. Immunohistochemical staining showed that ST13 protein was evenly distributedin cytoplasm and expressed in colon, stomach, liver, and other epithelial cells. Differences in thestaining intensity of the protein were observed between normal and cancer tissues as well as amongdifferent normal or carcinoma tissues. Conclusion: ST13 protein is a cytoplasmic molecule with anapparent Mr of 50 000. The protein is expressed in colorectal and other epithelial tissues. Theexpression level of the protein is down-regulated in colorectal cancer and varies among differentnormal and/or carcinoma tissues. Comparison of cDNA sequences and protein characteristics indicatesthat ST13 protein and hsp70-interacting protein (Hip) are same proteins, raising the possibilitythat ST13 protein is involved in the development of colorectal cancer through Hsp70 molecularchaperone machinery.

Expression of PPAR-γ in Lung Cancer and the Role of PPAR-γ in Apoptosis of Lung Cancer

Objective: To investigate the relationship between peroxisomeproliferators-activated receptor-gamma (PPAR-γ) and clinical pathology of lung cancer, and to studythe inhibitory effect of PPAR-γ activators on lung cancer growth and the mechanism of inducingapoptosis of lung cancer. Methods: Expression of PPAR-γ in 15 cases of non-cancerous lung tissuesand 64 cases of lung cancer tissues was detected by using immunohistochemistry. The average A valueswere measured by using image analysis. The expression of PPAR-γ in lung cancer cells was detectedby using RT-PCR. After being treated with PPAR-γ activators, apoptosis was detected by using flowcytometry, and meanwhile, the change in caspase-3 activity was detected by caspase-3 kits. Results:Expression levels of PPAR-γ in cancerous tissues were higher than those in non-cancerous lungtissues. In four types of lung cancer, the sequence of PPAR-γ expression from high to low levelswas small-cell lung cancer, squamous carcinom, large-cell lung cancer, adenocarcinoma in turns. Theexpression of PPAR-γ was correlated with differentiation and postoperative TNM staging of lungcancer tissues, but not with lymph node metastasis. PPAR-γ expressed in two lung cancer cell lines,which could induce apoptosis of lung cancer cells after being treated with PPAR-γ activators, andcaspase-3 activity in cells treated with PPAR-γ activators was significantly increased. Conclusion:PPAR-γ is correlated with clinical pathology and apoptosis of lung cancer closely, and activatedPPAR-γ can increase caspase-3 activity to induce cells apoptosis. PPAR-γ will be able to become anew target for therapy of lung cancer in the future.

Three-dimensional Imaging of Multi-slice Spiral CT in Bronchial Artery Correlative Study on Blood Supply of Central Lung Cancer and Its Clinical Significance

Objective: To evaluate three-dimensional bronchial artery imaging charactersin central lung cancer and applied values with multi-slice spiral CT (MSCT) to provide theoreticalevidence on blood supply and intervention therapy. Methods: Eighteen patients with central lungcancer underwent MSCT with real time helical thin-slice CT scanning. Three-dimensional bronchialartery reconstruction was done at the console work-station. The space anatomical characters ofbronchial artery were observed through different rotations. Results: For 6 cases, thethree-dimensional images of bronchial artery (33.33%) could exactly show the origins, the routes(lung inner segment and mediatism segment) and the diameters of bronchial arteries. Vision rate ofbronchial arteries was the highest in pulmonary artery stricture and truncation groups, and thevessels' diameter became larger apparently. These characters demonstrated blood supply of this kindof central lung cancer come from bronchial artery. Volume rendering images were the best ones amongthree-dimensional images. Conclusion: Three-dimensional imaging with MSCT in bronchial artery canreveal the anatomical characters of bronchial artery and provide theoretical evidence on bloodsupply and intervention therapy of central lung cancer.

Pilot Study of Molecular Mechanism on Vasculogenic Mimicry in Bi-directional Differentiated Malignant Tumors

Objective: To investigate the role of collagen IV and PAS positive substancesecreted by tumor cells in vasculogenic mimicry (VM) and the effects of VM on tumor cells expressingVEGF. Methods: 158 cases of bi-direction differential malignant tumor specimens withparaffin-embedded were enrolled into our study and made tissue microarray which were dual-stainedwith CD31-PAS and stained with collagen IV. The difference of the areas and distribution withpattern surrounded by between CD31 and PAS positive respectively were identified via grid-counting,as well as the difference of VEGF expression with VE absent and present. Results: The basementmembrane of VM was both PAS and collagen IV positive. VEGF expression in the bi-directiondifferential malignant tumor was higher VM-absent than VM-present and the difference wasstatistically significance in malignant melanoma and alveolar rhabdomyosarcoma (P 【 0.05).Conclusion: PAS positive substance and collagen IV compose the wall of VE and VE could provide theoxygen and nutrition for tumor growth and progression.

Regulation of Bcl-2 Family in TIP30-Induced Apoptosis in Hepatoblastoma Cells

Objective: To investigate the role of TIP30 in the apoptotic signal pathwayin HepG2, and Hep3B and Hu-7 hepatoblastoma cell lines. Methods: In order to confirm whether TIP30conducted Bcl-2 family was involved in apoptosis signal pathway, MTT assay, in situ 3' end labellingof DNA assay and Western blot were carried out to detect the diverse apoptotic function of TIP30and the regulation of Bcl-2 family. Results: TIP30 induced apoptosis as evidenced by morphologicalchanges in hepatoblastoma cells, which was accompanied by up-regulating Bax and Bad proteins andstimulating them from cytoplasm to mitochondria, and down-regulating Bcl-xl, while it had no effecton the level of Bak protein. Conclusion: TIP30 induced apoptosis partly by modulating the proteinlevels of members of Bcl-2 family in hepatoblastoma cells. Elucidating the mechanism by which TIP30induces cell death might establish it as an anticancer factor.

Role of Tissue Factor Pathway Inhibitor-2 in Ovarian Tumor Migration and Invasion

Objective: To elucidate the relation between human tissue factor pathwayinhibitor-2 (TFPI-2) expression and ovarian tumor migration and invasion. Methods: Human TFPI-2expression vector pBos-Cite-neo/TFPI-2 was transfected into ovarian tumor cells line A2780- Afterthe transfected cells were selected by G418, transfected and nontransfected cells were screened forTFPI-2 mRNA and protein by reverse transcription-polymerase chain reaction and Western blotanalysis, respectively. The number of transfected or nontransfected cells passing through membraneof Boyden chamber was counted as the basis assessing tumor cells migratory and invasive behaviors.Results: Expression of mRNA and protein of TFPI-2 was detectable in transfected cells. In invasionassay, the number of TFPI-2-expressing cells to traverse a Matrigel-coated membrane was obviouslydecreased compared with that of nonexpressing cells (59.3±6.5 vs 109.7±5.5, P 【 0.01); While inmigration assay, no significant difference through a noncoated membrane was observed amongtransfected and nontransfected cells (114.7±8.6 vs 127.3±7.1, P 】 0.05). Conclusion: Expression ofTFPI-2 may strongly inhibit the invasive ability of ovarian tumor cells in vitro, but has no effecton the migratory ability which provides an experimental basis for genotherapy of human ovariantumor.

Clinical Features of Renal Insufficiency due to Multiple Myeloma and Related Risk Factors

Objective: To study clinical features of the patients with multiple myeloma(MM) accompanied by renal insufficiency and investigate the related risk factors of renalimpairment. Methods: A control study of clinical characteristics was performed between 91 patientswith renal insufficiency due to MM and 165 patients with normal renal function in MM during the sameperiod. The data were statistically analyzed by chi-square test and logistic regression analysis.Results: Renal insufficiency was the initial presentation in 48 (52.7%) of the 91 patients, and 30(62.5%) of the 48 patients were misdiagnosed. The prognosis of group with renal insufficiency wassignificantly poorer than that of group with normal renal function: mortality in 3 months, 3months-1 year was 26/91 vs 14/165 (P 【 0.0001), 14/91 vs 12/165 (P 【 0.05) respectively, andpatients survived 】 1 year was 18/91 vs 95/165 (P 【 0.0001). The incidence of hypercalcemia,hyperuricemic, severe anemia, high serum M-protein concentration and lytic bone lesions weresignificantly higher in renal insufficiency group than those in control group (P 【 0.05). Logisticregression analysis identified 5 risk factors of renal impairment, including, severe anemia(Exp(β)=13.819, P 【 0.0001), use of nephrotoxic drugs (Exp(β)=6.217, P = 0.001), high serumM-protein concentration (Exp(β) = 5.026, P = 0.001), male (Exp(β)=3.745, P=0.006), andhypercalcemia (Exp(β)=3A72, P=0.006), but age, serum density of uric acid, type of serum M-protein,and Bence Jones proteinuria were not significantly associated with renal insufficiency. Conclusion:Renal insufficiency was a common early complication of MM, which often resulted in misdiagnosis.The status of these patients tended to be very bad, with many other complications, when MM wasdiagnosed, so their prognosis was poor. The occurrence of renal insufficiency in patients with MMand hypercalcemia, severe anemia, high serum M-protein concentration, especially use of nephrotoxicdrugs should be alert.

Research on Economic Impact of Super Rice on Rice Growers and Contribution to Food Security

Super rice is an essendal part of China＇s rice production. Through survey on actual situation of 1568 households of rice growers in Heilongjiang, Hunan and Zhejiang provinces, this paper focused on influence of super rice development on increase of China＇s grain yield, influence on increase of rice growers＇ economic in- come, difference in production cost and profit between the North and the South, as well as profit percentage of super rice in production, processing, and sales. It obtained following results： rice price determines rice growers＇ income; expansion of super rice extension area plays a great role in increase of China＇s grain yield; by 2015 and 2020, keeping the yield of other crops not changed, merely the extension of super rice can increase grain for 5 million tons and 11 million tons separately; super rice significantly increases rice growers＇ economic income; for production cost of super rice, the South is higher than the North, and the profit ratio of cost is up to 35.54% on average; with respect of profit in production, processing, and sales, the ratio is 1：2：1.5; with the yield of other crops unchanged, every increase of 1% in area percentage of super rice to rice will additionally produce 1 million tons of grain for China, which is equivalent to saving the yield of 133 300 hm2 farmland and can additional feed 3.5 million people. In view of importance of super rice production, at the same time of strengthening research on super rice variety, it is required to accelerate expanding production area of super rice in suitable areas. Since the development of super rice can support China＇s ration demand of increasing population, China should make effort to realize ＂one yuan for one mu＂ financial subsidy for super rice of main grain production provinces and counties. Besides, China should establish special financial plan for extension of super rice.

The Prognostic Value of Pathological and Molecular Margins Marked by p53 and eIF4E in Laryngeal Carcinoma

Objective: To study the prognostic value of the pathological margin and molecular margin marked by eIF4E and P53 protein in laryngeal carcinoma. Methods: The prognostic value of pathological and molecular margin was studied in 253 cases and 67 cases respectively, the latter were pathological negative margin chosen from the former. Immunohistochemisty was used to detect the expression of eIF4E and p53 proteins. Results: The rate of pathological, p53 and eIF4E positive margins was 20.2%, 19.4% and 32.8% respectively. The recurrent rate of those with positive margins was higher than that of negative margins, which including pathological margin (70.6% vs 35.1%, P =0.0000), p53 margin (69.2% vs 33.3%, P =0.018) and eIF4E margin (63.6% vs 28.9%, P =0.018); The survival rate of those with negative margins was higher than those with positive margins, including pathological margin (the 5-year cumulative survival rate was 37.52% and 64.37% respectively, P =0.0023), p53 margin (the 5-year cumulative survival rate was 24.62% and 75.69% respectively, P =0.0012) and eIF4E margin (the 5-year cumulative survival rate was 43.31% and 77.52% respectively, P =0.0006). Conclusion: The prognosis of those with both pathological and molecular positive margins was worse than that of the negative margins; Both the eIF4E and p53 were useful markers to pick out the poor prognostic patients from those with pathological negative margin, and the former seemed to be more potential.

Primary Lymphoma of Respiratory System (A Report of 11 Cases)

Objective: To analyze the clinical and pathologic features and the treatmentoutcomes of primary lymphoma of respiratory system (PLRS). Methods: The clinical manifestation,imaging changes, pathologic subtypes, treatment and overall survival of 11 patients with PLRS wereanalyzed retrospectively. Results: Of the 11 patients diagnosed with PLRS by histopathology, thetumor of 2 patients occurred in trachea and the other 9 in lung. Cough, dyspnea and fever were themost frequent symptoms. Mass or infiltrative changes could be found on the chest X-ray and/or CTscan. Two patients were diagnosed as having Hodgkin's Lymphoma (HL) and 9 having non-Hodgkin'sLymphoma (NHL), including 7 patients with low degree NHL [5 of them (55.6%) were mucosa-associatedlymphoid tissue (MALT) lymphoma] and 2 with intermediate degree NHL. Of 10 patients undergoingexploratory thoracotomy and surgical treatment, 8 received adjuvant chemotherapy and 2 adjuvant ofradiotherapy. The remaining patient was subjected to combined chemotherapy. Both of HL patientssurvived more than 5 years without clinical disease. The median survival of MALT lymphoma and othertype of NHL was 39 months and 34 months respectively. Conclusion: Both the clinical manifestationand imaging changes are non-specific. The diagnosis was made through exploratory thoracotomy (10cases) and fiber-optical bronchoscopy (1 case). MALT lymphoma is the most frequent pathologicsubtype. Majority of patients are diagnosed and treated by surgical resection. The prognosis isacceptable.

Multivariate Analysis of Recurrence in Meningioma

Objective: To evaluate the clinical and radiological factors that affect therecurrence of the meningioma patient so as to effectively prevent and cure recurrence of meningiomapatients more earlier. Methods: The clinical features and radiological aspects in 145 cases ofmeningiomas undergoing operation during 1993-1997 were retrospectively studied. The data of only 83cases of all 145 cases were available. The factors were evaluated with univariate and multivariateanalysis. Results: With univariate analysis, 7 factors showed highly significance to recurrence ofmeningiomas: tumor size, tumor location, tumor shape, edema, extent of resection, pathologicalgrade, CT enhancement. With multivariate analysis, 4 factors showed significant danger to recurrenceof meningiomas: pathological grade, extent of resection, tumor shape and CT enhancement.Conclusion: The main factors that affect the recurrence of meningioma patients are pathologicalgrade, extent of resection, tumor shape and CT enhancement.

Imaging of the Extra-axial Tumors and Tumor-like Lesions Involving both Middle and Posterior Cranial Fossae: Classification and Diagnosis

Objective: To study the imaging features of extra-axial tumors and tumor-likelesions involving both middle and posterior cranial fossae and to make a classification. Methods:Sixty cases of pathologically confirmed extra-axil tumors and tumor-like lesions involving bothmiddle and posterior cranial fossae were analyzed. They were divided into central and lateral types,the latter of which were subdivided into three types: middle cranial fossae type, posterior cranialfossae type and the over-riding type. The constitution and imaging features of each type wereanalyzed. Results: There were 12 cases of central type, including chordoma (n=5), pituitary adenoma(n=3), nasopharyngeal carcinoma (n=2), craniopharyn-gioma (n=1) and meningioma (n=l). 48 cases oflateral type including trigeminal nerve tumors (n=14), meningioma (n=12), epidermoid cyst (n=11),dural cavernous hemangioma (n=4), dermoid cyst (n=2), metastasis (n=2), hemangiopericytoma (n=1),paraganglioma of glonius jugular (n=1) and nasopharyngeal carcinoma (n=1). Each type of the lesionshad its own shape features, some of which were characteristic for some specific tumors. Most of thetumors and tumor-like lesions could be qualitatively diagnosed according to their imagingcharacteristics and the extent of the lesions could be defined definitely. Conclusion: It is helpfulto categorize extra-axial tumors and tumor-like lesions involving both middle and posterior cranialfossae according to their location for qualitative diagnosis and description of the extent of theselesions. It is of great clinical value in providing more precise and thorough imaging informationfor planning therapeutic methods and route of operation.

Magnetic Resonance Imaging and Biological Markers in Pituitary Adenomas with Invasion of the Cavernous Sinus Space

Objective: To investigate the predictability of MRI and the possiblebiological markers of cavernous sinus invasion of pituitary adenomas associated with fourphenomenas: angiogenesis, cell proliferation, apoptosis and matrix metalloproteinase. Methods: Weevaluated 45 patients with pituitary adenoma according to the MRI, surgical findings and theimmunohistochemistry staining of tumor tissues. Results: The results have shown that the sensitivityof MRI for predicting cavernous sinus invasion in this prospective study was 60%, its specificity85%, its positive predictive value 83.33%, negative predictive value 62.96%. 45 specimens ofpituitary adenomas were analyzed for expression of F8, VEGF, Ki-67, c-myc, Bcl-2, nm23 and MMP-9immunoreactivity using immunoperoxidase staining. MVD was assessed using F8-related antigen. Theresults have shown that MVD of invasive pituitary adenomas was significantly higher than that ofnoninvasive (P 【 0.001). There was an association between the invasion of pituitary adenomas andKi-67 LI (P = 0.039) or the expression of VEGF (P 【 0.001) and MMP-9 (P 【 0.001). But c-myc LI andBcl-2 expression have no association with invasiveness of pituitary adenomas (P = 0.061 versus P =0.201). On the other hand, there is an inverse relationship between nm23 expression and tumorinvasion (P 【 0.001). Conclusion: Parasellar extension of pituitary adenomas through the medial wallof the cavernous sinus is diagnosed at surgery, and with sensitive gadolinium-enhanced MRI, itsextent can be partly determined by radiology. Although our study has shown that MVD and theexpression of VEGF, Ki-67, nm23 and MMP-9 have associations with invasiveness of pituitary adenomas,they are lack of specificity. These markers can only provide some useful information.