第4节 结果和讨论
医学基础研究论文的结果和讨论部分是一篇论文的精髓，也是整个研究工作的核心内容。研究结果部分主要介绍整个研究的发现，大部分期刊要求该部分不能引用既往文献，仅单纯地叙述研究结果。研究结果部分虽然没有固定的格式，但通常也具有一定的逻辑性。对于研究结果的描述，多数论文先介绍功能实验的结果，然后叙述机制研究相关结果。对于体内和体外实验的结果，有的作者喜欢一起介绍，有的喜欢分开描述。结果的介绍需要简明，最好能够层层递进，以便读者阅读时能够将前后的数据连贯起来，便于理解。
对于讨论撰写，作者需要围绕研究结果进行讨论，但并不是简单地陈述研究结果，而是将研究所取得的发现与既往研究进行比较和探讨。讨论目前所取得研究结果的可能原因，探讨当前的研究结果可能对该研究方向的意义。如果目前取得的研究结果与既往研究结果不一致，需要在讨论部分给出可能造成此差异的原因。对于研究中涉及的一些模型选择及药物应用剂量等问题也可以加以讨论。此外，讨论还需涵盖本研究存在的不足、未来研究中如何避免这些不足以及本研究的意义。大部分期刊要求结果和讨论分开撰写，也有部分杂志要求将结果和讨论整合到一起。需要根据期刊的要求进行相应的调整。现将结果与讨论中的一些撰写要点，进行举例说明。
（1）结果可以分成若干段落，每个段落有一个亚标题去概括该部分结果的主要内容。亚标题的时态可用一般过去时或一般现在时；段落中的内容多使用一般过去时和被动语态。但是，引出图表中内容时，多使用一般现在时（例如，Figure 1 shows）常用的句式，包括：To further investigate whether...或We found that...等。如示例3-21和示例3-22所示。
示例3-21 结果举例1
miR-193b-3p regulated the expression of HDAC3 in hMSCs during chondrogenesis【亚标题，使用了过去式】
To further investigate whether miR-193b-3p regulates HDAC3 expression during chondrogenesis，we inhibited or overexpressed miR-193b-3p in hMSCs.hMSCs were transfected with either miR-193b-3p or anti-miR-193b-3p and then induced to differentiate into chondrocytes for 21 days（Figure 2）.【介绍相应的目的和内容】The relative expression levels of HDAC3，SOX9，COL2A1，AGGRECAN，and COMP mRNAs were assessed by qRT-PCR（Figure 2A），and HDAC3，SOX9，and COL2A1 protein-expression levels were assessed by western blotting（Figure 2B）.【介绍结果，多用被动语态】The relative expression levels of miR-193b-3p on days 7 and 14 are shown in Figure S1.【引出图中展示的内容，多用一般现在时】
示例3-22 结果举例2
Wnt/β-catenin，AKT and NF-κB pathways are involved in Li-BGC-mediated angiogenesis【亚标题，使用了一般现在时】
To examine the intracellular signaling mechanism responsible for Li-BGC-mediated angiogenesis，HUVECs were stimulated by the 1/32 dilution of BGC and Li-BGC extracts for 30，60，90，and 120min，followed by western blotting to detect the activation of Wnt/β-catenin，AKT，and NF-κB pathways.【介绍相应的研究目的和内容】As shown in Fig.2A and B，the expression of phosphorylated glycogen synthase kinase-3（p-GSK-3β），phosphorylated AKT（p-AKT）and NF-κB P65（p-P65）and cytoplasmic β-catenin were significantly enhanced by Li-BGC extracts.【介绍结果，多用被动语态】
医学基础论文，多会通过与图表相结合的方式，对研究结果进行描述。对于图片，需要格外注意的是Figure legend的撰写。Figure legend是对论文中图片的描述，其主要目的是帮助读者和审稿人快速理解图的含义和结果，不应包括方法细节，通常放在论文的最后。一般情况下，Figure legend需要包含图片的名称，要求简明准确，要有较好的说明性和专指性；结果中未能表达又必须表达的信息应在Figure legend中说明。如图中含有误差线，则应阐述是标准误、标准差、可信区间还是范围。当图片中含有箭头、数字、符号或字母时，则要在相应的位置进行说明，如示例3-23所示。
示例3-23 图示(https://www.daowen.com)
Figure 1.Analysis of the relative expression levels of miR-193b and HDAC3 during the chondrogenesis of hMSCs
The relative expression levels of（A）miR-193b-3p and（B）HDAC3.（C-E）The relative expression levels of the chondrogenic markers SOX9，COL2A1，AGGRECAN，and COMP.（G-H）The relative expression levels of the hypertrophic markers COL10A1 and RUNX2.（I）The protein-expression levels of HDAC3.（J）Western blots data from three experiments were quantified by densitometric analysis.RNU6B and GAPDH were detected as endogenous controls.The data shown represent the mean±standard error（SE）of three independent experiments in samples from three different donors.*P＜O.05；**P＜O.001.
（2）讨论部分并没有固定的格式。通常情况下，第一段会简要地探讨开展本研究的重要性、必要性、主要研究结果及意义；后面的段落会围绕着研究结果展开探讨，通过与既往的研究结果进行对比分析，体现该论文研究工作的合理性、可靠性及必要性；讨论的最后通常会介绍研究的结论和意义。如示例3-24、示例3-25、示例3-26和示例3-27所示。
示例3-24 讨论第一段举例1
讨论第一段落，再次说明本研究的必要性和重要性。In the process of skeletal development and remodeling，accumulating evidence has demonstrated that cell-cell communication between the vascular endothelium and bone-forming cells is necessary and prerequisite for neovascularization and functional bone formation［3，5］.As the main precursor of osteoblastic cells，BMSCs have been well recognized to play a predominant role in osteogenesis and bone regeneration，and simultaneously serving as a potential regulator of angiogenesis.A broad spectrum of pro-angiogenic factors，growth factors，and cytokines，which have been identified in the MSCs secretome，could influence endothelial cell behavior in vitro and induce angiogenesis in vivo［32，33］.Moreover，a recent study also revealed that the dysfunction of OVX-BMSCs resulted in the decreased secretion of VEGF，along with the reduced potential in promoting the migration，tube formation，and survival of endothelial cells，which has been considered as an important mechanism of impaired angiogenesis in osteoporosis［34］.Hence，the function of BMSCs and BMSCs-ECs communication is of great importance in the initial phase of vascularized bone regeneration.More importantly，a recent study revealed that the chemical signals of biomaterials could boost BMSCs-ECs communication via paracrine secretion and cell contact-mediated mechanisms，consequently resulting in enhanced vascularization and osteogenic differentiation［14］.【引用以往研究工作的基础上，递进式说明研究工作的重要性】However，the detailed mechanisms involved in the chemical signals of biomaterials-mediated BMSCs-ECs communication still need to be further elucidated.【提出研究的必要性】
示例3-25 讨论第一段举例2
讨论第一段，简要概述本研究的主要研究结果及意义。Our results indicate an association between autophagy reduction and apoptosis increase in alveolar process osteocytes of estrogen-deficient rats.Conversely，estrogen replacement increased osteocyte viability by inhibiting apoptosis and maintaining autophagy in these cells，【简述研究结果】reinforcing the idea that autophagy exerts an important role in the maintenance of osteocyte survival and that the antiapoptotic effect of estrogen is in part related to autophagy in alveolar process osteocytes.【体现研究意义】
示例3-26 讨论主体段落
讨论部分的主体段落，将本研究结果与既往类似研究进行比较。HDAC3 was previously shown to be up-regulated during inflammation and to play a central role in this process［40-41］.【列举既往研究结果】In this study，we found that the expression of HDAC3 increased when human PHCs were stimulated with IL-1β，suggesting a biological role that HDAC3 could play in IL-1β-induced PHC responses.【将本研究结果与既往研究进行比较】The cause of increased HDAC3 expression in IL-1β-stimulated PHCs is unclear，but may be attributable to the down-regulation of miR-193b in IL-1β-stimulated PHCs.Previous data showed a positive role for HDAC3 in the transcription of most IL-1-induced human genes.The effect could be mediated by the HDAC3-mediated deacetylation of NF-Kb p65 at lysines 122，123，314，and 315［42］.Further studies are needed to clarify the exact function of HDAC3 in IL-1β-induced PHC responses.【列举既往研究，对研究结果进行分析和解释，并引出未来研究方向】
示例3-27 讨论最后一段
讨论的最后一段，通常为结论段并说明研究的意义。In summary，the present study demonstrates that Li+released from biomaterials exhibits great potential to promote angiogenesis and vascularization.Li-BGC directly promotes the angiogenesis of HUVECs in vitro and new blood vessel formation in vivo.These enhanced effects may be attributed to the activation of Wnt/β-catenin，AKT and NF-κB signaling pathways，while AKT signaling pathway functions as the upstream of Wnt/β-catenin and NF-κB signaling pathways.Moreover，LiBGC further indirectly facilitates the angiogenic capacity of HUVECs by eliciting the expression of exosomal pro-angiogenic factors through the paracrine secretion of BMSCs.Exosomes secreted by Li-BGC-stimulated BMSCs transfer more pro-angiogenic miR-130a to HUVECs，which in turn activate the PTEN/AKT signaling pathway and enhance the proangiogenic capacity of endothelial cells.【总结研究主要结果】Our findings may provide novel insights into the stimulatory role and underlying mechanisms of the chemical signals of biomaterials-mediated communication between BMSCs and ECs in the bone remodeling microenvironment.It is suggested that 3D-printed Li-incorporated bioactive materials may be considered as a promising scaffold for vascularized bone regeneration，especially for large-sized defect repair.【总结研究主要义】