臨床醫(yī)生如何做科研？

實例：簡單條件下科研選題及實施

臨床醫(yī)生為何做科研1）需要,Theneedofresearchpapersforpromotionetc.shouldNOTbeagoodmotivation,butitisareality.2）興趣,Interestisabetterdriveforresearch,andyoucanseekforcollaborationoncehaveanidea,evenwhenyoudonothaveresourcestodoso.3）永生,Forthoseexpertclinicianswhohaveuniqueandeffectivetherapies,whomayhavethestrongestmotivationtohavetheirexpertisevalidatedviaorganizedclinicaltrialsandpublished,andthusbeingpermanentlyrecordedandre-produced.如何做科研？

…useavailableconditions1.如何選出A+(最可行)的主題

1).文獻(xiàn)復(fù)習(xí)(PubMed,+GoogleScholar) 2).結(jié)合實際(現(xiàn)有條件),尋找最好的材料

3).初步探索，觀察現(xiàn)象或治療效果4).設(shè)計相應(yīng)基礎(chǔ)研究探討或確定機(jī)制

1)文獻(xiàn)復(fù)習(xí)(PubMed,GoogleScholar)

1.SearchPubMedusing:keyword-1ANDkeyword-2…etc;2.Orsimplytypeyourthoughtingooglesearch例1:研究依據(jù)活性氧自由基（ReactiveOxygenSpecies,ROS）介導(dǎo)的脂質(zhì)過氧化被認(rèn)為是缺血再灌注損傷（Ischemia-ReperfusionInjury,IRI）的主要機(jī)制，但臨床抗氧化治療IRI效果不佳15-F2t-isoprostane,一種ROS所致過氧化損傷的特異性標(biāo)記,并且在心肌缺血/再灌注損傷中起作用

科研假設(shè)：阻斷15-F2t-isoprostane的形成或功能應(yīng)該能減弱缺血后心肌的損傷和功能障礙

例1:

首先觀察

[15-F2t-isop]在心臟手術(shù)病人心肌缺血和再灌注中不同時點(diǎn)改變情況，及與手術(shù)后心功能的關(guān)系A(chǔ)nsley,XiaandDhaliwal,JThoracCardiovascSurg2003n=30提出假說（Hypothesis）Blockadeofformationoractionsof15-F2tisoprostaneshouldattenuatepost-ischemicmyocardialdysfunction制定動物實驗方案1

（ExperimentalApproach）Langendorffset-upIsolatedheartsfromyoungmalerats(250-300g)subjectedto40minglobalischemiaand90minreperfusionConstantflowperfusion(10ml/min)Duringischemia,salinewasinfusedat60l/minviaaorta制定動物實驗方案2DrugApplicationProtocol

KH20’10’60’75’150’KHorDrug40min

ischemia(Salineordrug)Drug10’20’60’150’A.Measure

LVMechanics

CoronaryPressure0’10’50’60.5’

65’90’150’

B.Sample

EffluentProtocoldiagramKHKH分析結(jié)果1：PropofolDecreases[15-F2t-isop]

DuringIschemiaandReperfusionXiaZ（夏正遠(yuǎn)）etal.CanJPhysiolPharmacol2003Propofol分析結(jié)果2：HighdosePropofolIncreasedheartantioxidantcapacity,enhancedmyocardialeffectivecontraction(有效收縮,LVDP）XiaZ（夏正遠(yuǎn)）etal.CanJPhysiolPharmacol2003推廣演講：MaintainaBalance(SafetyIssues)--HighdosePropofol安全性SightseeingRideabike(enjoyingandprotectingenvironment)orDriveaBMW(saferandbetterview??)Trytofilleachbasketwithoneofthenumbersbetween1and12,tomakeitbalanced由前述動物研究，回到臨床試驗：HighDosePropofolAttenuatesPost-ischemicMyocardialInjuryinPatientsWithDurationofIschemia60Min:ComparisonWithIsofluraneXiaZ，HuangZetal,Anesth

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