医学论文单句写作的基本要领
长青藤医学编辑
专业英语医学论文
写好论文需要掌握很多本领，其中包括对写作框架背景的把握，对研究方法基本逻辑的了解，对写作规范的掌握，还有对目标读者的知识背景和阅读习惯的洞察，以及对论文组织框架的驾驭等等。
这些高层次的能力都建立在单句的写作基础之上。如果单句写不好，一切都是白扯。
今天，我们用柳叶刀杂志正刊2020年8月发表一篇论文作为案例，解读单句写作的技巧和策略。
论文标题：
Surgery versus cast immobilisation for adults with a bicortical fracture of the scaphoid waist (SWIFFT): a pragmatic, multicentre, open-label, randomised superiority trial
成人舟状骨腰部双皮层骨折手术和外固定的对比
(DOI:10.1016/S0140-6736(20)30931-4)
柳叶刀杂志的原始论文有一个特殊的模块Research in context，要求作者把研究放在学科和历史框架中，让读者对研究的基本点有所把握。
Research in context包括三部分，第一个部分是Evidence before this study，第二部分是Added value of this study，第三部分是Implications of all the available evidence。
我们今天用Research in context第一部分Evidence before this study的前5句话作为素材，解析单句的写作的要领。
我们大家先一起浏览一遍这段话，然后再进行深入解读。
第一句：
Fracture of the scaphoid bone, one of eight small bones in the wrist, is common in young active people and is typically caused by a fall on the hand or the hand being suddenly forced backwards.
第二句：
Traditionally, the treatment has been to rest the wrist in a plaster cast for 6–10 weeks to allow the broken bone to heal.
第三句：
The 10% of cases that do not heal are then operated on and the fracture is held in place with a screw.
第四句：
In recent years, another method of holding these fractures still as they heal has been to operate on the wrist early after injury and to fix the broken bone with a specialised screw.
第五句：
Even though there is an increasing trend to perform more invasive and costly surgery, which has a bigger effect on service delivery and use of theatre time compared with the minimal intervention of cast immobilisation, there is inconclusive evidence that it produces better patient outcomes.
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第一句
Fracture of the scaphoid bone, one of eight small bones in the wrist, is common in young active people and is typically caused by a fall on the hand or the hand being suddenly forced backwards.
这句话的主体结构是“Fracture of the scaphoid bone is common in young active people and is typically caused by a fall on the hand or the hand being suddenly forced backwards.”
主语是“fracture of the scaphoid bone-舟状骨骨折”，后面是2个并列的谓语和宾语，第一个是“is common in young active people-好动的年轻人常见”，第二个是“is typically caused by a fall on the hand or the hand being suddenly forced backwards-通常发生于手掌着地跌倒或者手掌被突然向后撞击时”。
这个句子有1个主语和2组平行的谓语和宾语，整体是一个简单的主谓宾结构，因此很容易理解。
除了主谓宾结构的内容，句子还讲述了另一个解剖学的重要概念：舟状骨是什么，在哪里。
解释的内容是“one of eight small bones in the wrist”，作者把它放在主语舟状骨的后面，用逗号隔开，不影响整个句子的主体结构，不增加读者的阅读难度。
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第二句
Traditionally, the treatment has been to rest the wrist in a plaster cast for 6-10 weeks to allow the broken bone to heal.
主体结构是“treatment is to rest the wrist in a plaster cast for 6-10 weeks”，其他的内容（比如打石膏的目的）在不影响整体结构的前提下带出，和第一句话有异曲同工之效。
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第三句
The 10% of cases that do not heal are then operated on and the fracture is held in place with a screw.
打石膏不愈合的10%病例，再行手术用螺丝固定。
这句话是由2个平行的主谓宾结构组合在一起。
第一部分主语“the 10% of casesthat do not heal”，谓语“are then operated on”；第二部分主语“the fracture”，谓语“is held in place with a screw”。
这两部分的主谓宾结构是并列的，没有逻辑上的从属关系。因此，也很容易理解。
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第四句
In recent years, another method of holding these fractures still as they heal has been to operate on the wrist early after injury and to fix the broken bone with a specialised screw.
近年来出现了另一种固定方法，这种方法是损伤发生后早期用螺丝固定。换句话说不打石膏，直接手术。
句子的主体结构是“another method”，谓语是“is to operate on the wrist early … and to fix the broken bone …” 零散的东西装在这个框架下面。
以上这四句话，都有一个共同的特征，就是使用的是简单结构，每个句子都讲一个话题，因此很容易被读懂。
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第五句
Even though there is an increasing trend to perform more invasive and costly surgery, which has a bigger effect on service delivery and use of theatre time compared with the minimal intervention of cast immobilisation, there is inconclusive evidence that it produces better patient outcomes.
这个句子读起来比较麻烦，句子包括3个内容：
1、直接手术是一个趋势，现在用得越来越多；
2、直接手术费用会增加，占用医疗资源也更多；
3、直接手术和先打石膏，哪个病人的转归更好，还没有让人信服的证据。
这3件事情的逻辑关系是什么？换句话说，作者想说的重点是什么？理解起来有点难度。
我们可以再读一遍尝试着理解一下：
Even though there is an increasing trend to perform more invasive and costly surgery, which has a bigger effect on service delivery and use of theatre time compared with the minimal intervention of cast immobilisation, there is inconclusive evidence that it produces better patient outcomes.
平心而论，作者的语言组织能力是不错的，句子含义应当说是清晰的，但阅读理解并不轻松。究其原因，是句子里面的东西太多。
同样的内容，我分成下面3句话，大家看看是否会更好：
Compared to cast immobilization, early operation results in higher cost and demand on service delivery and use of theatre time.
Thus, the trend of using early operation as the standard treatment should be justified by clear and strong evidence of better patient outcomes.
Unfortunately, evidence available up to date has not been conclusive.
这三句话篇幅的确长一点，但理解起来更加容易。