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).

3　结果(Results)。

　　结果部分是指作者在实验过程中对实验所获得的结果进行客观的评述,也可以说是对实验结果作出归纳。而且结果部分只是系统地介绍与主题研究紧密相关的数据,例如,显着的差异性,P值等,其结果部分是对过去的实验作出归纳概述,在时态上通常运用一般过去时。举例:

Results

　　There were 262 cases ofE coliO157 infection in theLanarkshire area:200 confirmed cases and 62 probable cases.Themedian age of all affected was 53 years,but there were highernumbers at the extremes of age.47%(124/262)of infectedindividualswere over 55 years of age.13(5%)people died.In 10cases death was associated with the systemic complications ofE coliO157 infection.

　　28(11%)of the Lanarkshire cases ofE coliO157 met thediagnostic criteria forHUS/TTP.Casesmet the criteria forHUS/TTPa median of 7 days(range 4～15)after the onset of gastrointestinalsymptoms.A further eight cases had evidence of thromboticmicroangiopathy but did not meet the criteria for HUS/TTP and werenot eligible for TPE.22(79%)cases with HUS/TTP were adultsand six(21%)were children.The median age of adults whodeveloped HUS/TTP was 71 years and the median age of children 6years.The demographics,clinical features,treatment,laboratoryresults,and outcome of the adult cases with HUS/TTP are shown intable 1.Blood results are taken from the day that the diagnosticcriteria for HUS/TTP were met,before TPE in cases so treated.

　　The mortality rate in adults with HUS/TTP was 45%(ten of22).Seven of 12 cases aged over 70 years and three of ten aged 70years or less died.There were no deaths in children.Necropsiesweredone for all cases who died.Causes of death in patients with HUS/TTPwere acute renal failure secondary to HUS(two cases),cardiacarrest(two cases),intracerebral haemorrhage,cerebral infarction,acute myocardial infarction,multiple organ failure,hepatorenalsyndrome secondary to macronodular cirrhosis and septic shock.

　　TPE was used in 16 of the 22 adultpatientswithHUS/TTP.Forpatients treated with TPE later received haemodialysis,because ofdeteriorating renal function.Patients who did not receive TPE wereeither too unwell to tolerate the procedure or died before TPE couldbe carried out.

　　In all 16 cases treated with TPE,the first exchange was firstdone within 24h of the criteria for HUS/TTP being met.Theminimum number of changes was one,the maximum 16,and themedian six.Patients underwent a total of 107 procedures,and 1100units of fresh frozen plasmawere used.Two patients proved refractoryto treatment with fresh frozen plasma,after five and six exchanges,but were successfully treated by additional TPE with cryosupernatantas the exchange fluid.Five of the 16(31%)TPE-treated patientsdied,four of eight aged over 70 years and one of eight aged 70 yearsor less.Premorbid illness,neurological features,treatment withciprofloxacin or prostacyclin,and the laboratory severity of HUS/TTPwere not associated with death,although the number of caseswas toosmall to allow statistical conclusion.

　　The most frequent complication associated with plasma exchangewas pulmonary oedema,which was diagnosed on clinical andradiological grounds in 11 cases.Pulmonary oedema was not confinedto patients undergoing TPE;three of six HUS/TTP cases not treatedwith TPE had pulmonary oedema.Hypocalcaemia(calcium<2.12mmol/L)occurred in 15 of the 16 patients treated with TPE.

　　Although severe(minimum serum calcium 1.32mmol/L)in manycases,intravenous magnesium was given when appropriate and noclinical effects were observed.Other complications associated withTPEwere line infectionwithmeticillin-resistantStaphylococcus aureusand extravasation infusion.

4　讨论(Discussion)

　　讨论部分也称之为结论(Conclusion),或者评论(Comments)。作者在该部分中要采用归纳,分析,推理,对比的方法来对自己的实验所涉及到问题进行探讨,从而得出自己的结论或者提出自己的建议,是作者阐述自己观点的重要部分;也是阅读论文应注意的地方。并且作者要简明扼要的引出论文所要讨论的主题,接着把自己的实验数据、结果与前人研究的实验数据、结果进行对比,并以推理、比较等方法来分析其异同性;最后用一句或一段文字引出结论或提出建议等。时态运用上多采用一般过去时和一般现在时。举例: