作为医学科研狗，当你没有经费，没有数据，统计跟英语都是渣渣的时候怎么样才能发表SCI呢，除了Meta分析，病例报道（Case report）可能是你迈向SCI之门的首选论文模式。
Case report是通过对一两个生动的病例进行记录和描述，使抽象的一般性的疾病表现和诊疗过程有了具体的形象的内容，试图在疾病的表现、机理以及诊断治疗等方面提供第一手感性资料的医学报告。
总结发现，一篇漂亮的Case report至少具备三个特征：
1. 临床意义
一篇个案报道最重要的是对临床实践的指导意义，这一点需要明确表达出来。
2. 引人入胜
一篇个案报道必须写成一个简练但引人入胜的故事，这一点可以借鉴别人已经发表的东西。注意：每个人都可能有不良习惯，需要借鉴的是学术界内能被广泛接受的东西，不能认为 “有人这么写，所以我也这么写”。
3. 符合习惯
个案报道的语言表述必须符合学术界普遍认可的基本习惯。
举例
一位医生文章第一句话是：In September 13, a 56-year-old male was admitted with a history of DiscTrode radiofrequency treatment ……
编辑分析
第一句话需要把入院的基本原因（例如双腿肿胀／疼痛2周）写出来。至于以前接受过的治疗（即使被认为是主要症状的原因），需要放在稍后去说。
今天将用大篇幅从专业用词、典型句式、常用语法结构等方面，详细解读一篇Case report，标题为Thinking Inside the Box，于2010年8月发表在新英格兰杂志（The New England Journal of Medicine, IF 51.658）第363期574-579页(获取这篇文献全文可分享此文到朋友圈，截图发给小编后（微信号mrwxiaobian)即可获得。
A 62-year-old woman presented to a community hospital with nausea, vomiting, diarrhea, and fever, all of 1 week's duration.
第一句话：主述。
要点：写明性别、年龄、以及就医主要原因。
句式：A xx-year-old man (woman) presented with ……
She reported no headache, photophobia, dysuria, or cough.
对鉴别诊断有重要价值的阴性信息（没有什么）。
病人自述句式：He/she reported ……
Her medical history included psoriasis and psoriatic arthritis, hypertension, hyperlipidemia, possible fibromyalgia, and degenerative lumbar disk disease.
既往史：His/her medical history included ……
Her medications included the tumor necrosis factor (TNF) inhibitor infliximab (500 mg intravenously every 8 weeks), methotrexate (15 mg orally per week), folic acid, atenolol, diltiazem, hydrochlorothiazide, aspirin, simvastatin, and gabapentin, as well as oxycodone for chronic pain.
病人服药情况：His/her medications included ……
如果可能的话，交代关键／主要药物剂量、给药途径和用药时程。
The patient was an amateur horticulturist and owned several dogs, cats, and parakeets. She lived in the upper Midwest and had not traveled outside the United States. She was widowed and reported no recent sexual contacts or recreational drug use. She drank alcohol occasionally and was a nonsmoker.
交代对诊断／鉴别诊断有意义的生活史：例如感染病人的疫区旅行，性接触史。
On physical examination, the patient was afebrile.
开始交代体检结果句式：On physical examination, the patient ……
Her heart rate was 95 beats per minute, blood pressure 88/53 mm Hg, respiratory rate 20 breaths per minute, and oxygen saturation 98% while she was breathing ambient air.
生命体征，句式：His/her heart rate was ……. 不用 He has a heart rate of ……
She was alert and not in acute distress.
一般情况。
There were no lesions in the oropharynx, and her neck was supple. The lungs were clear, and her heart rate was regular, without a murmur.
肺部无罗音英文表述为：The lungs were clear。注意“lung”前面必须有定冠词，必须是复数。
Her abdomen was not tender, and there was no organomegaly.
触痛英文为 “tender”。
The neurologic examination was unremarkable.
这个句式（was unremarkable）非常有用，表示没有值得描述的异常情况。
The white-cell count was 8500 per cubic millimeter, with 80% neutrophils, 7% lymphocytes, and 13% monocytes; the hematocrit was 41.1%, and the platelet count was 207,000 per cubic millimeter.
“white-cell count”“ hematocrit”“ platelet”这些表述前面必须有定冠词。
The sodium level was 131 mmol per liter, potassium level 3.6 mmol per liter, chloride level 101 mmol per liter, bicarbonate level 22 mmol per liter, blood urea nitrogen level 4 mg per deciliter (1.4 mmol per liter), creatinine level 0.7 mg per deciliter (61.9 μmol per liter), aspartate aminotransferase level 40 U per liter (normal range, 8 to 36), and alanine aminotransferase level 3 U per liter (normal range, 10 to 60).
句子中第一件事情的描述使用完整句子（ The sodium level was …），后面的描述谓语动词可以省略。
The international normalized ratio was 1.1, and the partial-thromboplastin time was 29.1 seconds. Urinalysis showed a specific gravity of 1.012; on dipstick analysis, the protein concentration was 30 mg per deciliter. The urine was negative for glucose and nitrites but positive for leukocyte esterase, and there was moderate heme. Microscopical examination showed 4 white cells, 19 red cells, and 3+ bacteria per high-power field, without casts.
“云翳状浸润”英文表述为“hazy infiltrate”
The patient was treated with 1 g of ceftriaxone daily for 7 days for the urinary tract infection.
治疗的描述通常用“The patient was treated with”或者“The patient received …….”
Her diarrhea diminished, but she continued to have temperatures of up to 40°C (104°F).
症状消减可以用“dminish”或者“dissipate”表述。
“仍然”可以用“continued to ……”表述，
Because of her ongoing fever, a lumbar puncture was performed, which revealed 1 white cell and 1 red cell per cubic millimeter; levels of glucose and protein were within normal limits.
“reveal”是一个非常有用的动词，含义是“显示”。
A transthoracic echocardiogram showed a left ventricular ejection fraction of 45% with no regional wall-motion abnormalities.
中国学者用英文写作常犯的一个错误是：很多该使用不定冠词的地方错误地使用了定冠词。这里的“A transthoracic echocardiogram”给了我们一点启示。
A possible density was noted in the left ventricle, but a follow-up transesophageal echocardiogram revealed no vegetations or thrombus.
“was noted”是一个很常用的表述，含义是“发现”。
The patient continued to have neutrophilia with intermittent lymphocytopenia.
“intermittent”-间断发作／出现的。
A bone marrow biopsy showed a predominance of granulocytic precursor cells without morphologic abnormalities. Smears of the marrow aspirate for routine, acid-fast, and fungal organisms were negative; cultures for these organisms were obtained.
“bone marrow biopsy”前面是不定冠词。
On the 13th hospital day, the patient reported chest tightness, and an ECG revealed ST-segment elevations of 2 to 3 mm in leads II, III, and aVF.
“chest tightness”意为胸闷。
The cardiac troponin I level was 1.10 ng per milliliter (normal range, 0.006 to 0.780).
给出数化的检测结果时同时给出正常范围，这样不是专家的读者也能看懂。
Cardiac catheterization revealed nonobstructive coronary artery disease. She was treated medically with a heparin infusion and a beta-blocker. The troponin level and the degree of ST-segment elevation decreased.
注意“heparin infusion”和“ beta-blocker”前面的不定冠词。
The patient was transferred to a tertiary care hospital.
“tertiary care hospital”是专科医院，通常仅接受“referral － 转诊”，不是“三级医院”。
Her temperature was 38.9°C (102°F), blood pressure 112/62 mm Hg, heart rate 87 beats per minute, respiratory rate 22 breaths per minute, and oxygen saturation 94% while she was receiving 2 liters of oxygen by nasal cannula. The results of a physical examination were unchanged except that alopecia and a faint erythematous rash over her nose and cheeks were now noted. Her white-cell count was 20,000 per cubic millimeter, with 85% neutrophils, 6% lymphocytes, 8% monocytes, and 1% basophils. Her hemoglobin level was 9.5 g per deciliter. Tests of renal and liver function were normal. The erythrocyte sedimentation rate was 96 mm per hour. Two peripheral-blood cultures were ordered.
“开化验单”英文表述是“order ….”
Chest pain recurred, with runs of nonsustained ventricular tachycardia and polymorphic ventricular tachycardia requiring defibrillation. The patient had ST-segment elevations of 1 to 2 mm in the inferior leads. The troponin level was 1.54 ng per milliliter (normal range, 0.0 to 0.29); the creatine kinase level was 89 IU per liter (normal range, 26 to 180), and the creatine kinase MB fraction was 8.3 ng per milliliter (normal range, 0.0 to 4.9).
A transthoracic echocardiogram revealed an ejection fraction of 15% and a mobile, multilobulated soft-tissue mass, 7 mm by 25 mm, attached to the midpoint of the interventricular septum in the left ventricle. A review of the previous transesophageal echocardiogram revealed a mass in the left ventricle that was consistent with these findings. Cardiac catheterization showed 80% atherosclerotic narrowing of the left anterior descending artery (and this finding was consistent with the results of the prior catheterization on review). No intervention was performed, since the stenosis did not correlate with the ECG changes. A heparin infusion was started for probable thrombus and to treat probable myocardial infarction. Additional laboratory findings included an antinuclear antibody titer of 1:640 dilution (normal range, <1:80) and="" an="" anti–double-stranded="" dna="" antibody="" level="" of="" 15.6="" iu="" per="" milliliter="" (normal="" range,="" 0.0="" to="" 7.0).="" tests="" for="" antibodies="" to="" antiphospholipid,="" β2-glycoprotein,="" and="" extractable="" nuclear="" antigens="" were="" all="">
“Additional findings included …”这个句式很有用。
Methylprednisolone (20 mg given intravenously every 8 hours) was started for a presumed diagnosis of SLE induced by TNF-inhibitor therapy, with associated myocarditis. The patient was afebrile and felt better after the initiation of corticosteroid therapy.
“a presumed diagnosis of ….”和上文中的“probable myocardial infarction”大家可以借鉴。
The following day, pulseless electrical activity developed, and the patient died despite resuscitation attempts. When cultures of blood obtained 2 days and 1 day earlier came back, two of the five culture bottles showed a gram-positive rod.
“革兰氏阳性杆菌”的简称（大家普遍接受）为“gram-positive rod”
An autopsy showed rupture of the posterior wall of the ventricle associated with a focal area of suppurative myocardial necrosis with bacilli.
注意“an autopsy”的使用，不是“the autopsy”
来源：长青藤编辑
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