1、国外和国内国外和国内医学期刊的医学期刊的 不同之处不同之处照日格图照日格图中华医学杂志英文版中华医学杂志英文版(Chin Med J)总编辑总编辑中国医学论坛报 理事会理事、顾问、前总编辑美国新英格兰医学杂志美国新英格兰医学杂志(N Engl J Med)编委编委中华儿科杂志中华儿科杂志 副总编辑副总编辑欧洲临床研究杂志欧洲临床研究杂志(Eur J Clin Invest)编委编委 国外的和国内的医学期刊有许多不同国外的和国内的医学期刊有许多不同国外不少期刊历史长、经验丰富、办刊质国外不少期刊历史长、经验丰富、办刊质量高、刊登高质量高水平医学论文多、及量高、刊登高质量高水平医学论文多、及时反映
2、医学科学研究的进展、收录到国际时反映医学科学研究的进展、收录到国际大型科学文献数据库的多、高影响因子的大型科学文献数据库的多、高影响因子的期刊多。期刊多。刊名创刊年N Engl J Med1812Lancet1823BMJ1840JAMA1883Arch Intern Med1908Ann Intern Med1927Chest 1935Chin Med J 1887国外，特别是西方国家，以及澳大利亚、新国外，特别是西方国家，以及澳大利亚、新西兰和日本的医学期刊，收录到西兰和日本的医学期刊，收录到SCI和和Medline等大型数据库的很多。我国医学期刊，等大型数据库的很多。我国医学期刊，近几年
3、已有近几年已有20余部被余部被SCI收录。收录。2007年我国年我国(包括港澳包括港澳)收录到收录到Medline的期刊的期刊87部。部。收录到收录到SCISCI的我国内地医学及的我国内地医学及相关学科期刊相关学科期刊(原有原有)Journal Titles Impact factor Journal Titles Impact factor Chinese Medical Journal (中华医学杂志中华医学杂志 英文版英文版)0.858 Acta Pharmacol Sin(中国药理学报中国药理学报)1.397 Cell Res(细胞研究细胞研究)3.426 Acta Biochim B
4、iophys Sin(中国生物化学生物物理学报中国生物化学生物物理学报)0.931 Asian J Androl(亚洲男性学亚洲男性学)1.737 Fungal Diversity(真菌多样性真菌多样性)2.297 Science in China Series C,Life Sciences 0.533收录到收录到SCISCI的我国内地医学及的我国内地医学及相关学科期刊相关学科期刊(新增，临床医学新增，临床医学)2.0920.3650.524收录到收录到SCISCI的我国内地医学及的我国内地医学及相关学科期刊相关学科期刊(新增，基础和综合新增，基础和综合)审稿方面的不同审稿方面的不同 国外很
5、多期刊对审稿工作和审稿人的要求国外很多期刊对审稿工作和审稿人的要求很高、很严格。很高、很严格。要求作到：公平、公正、严格遵守时间要要求作到：公平、公正、严格遵守时间要求，保密，有高度负责的精神，认真进行审稿。求，保密，有高度负责的精神，认真进行审稿。有利益冲突时及时向编辑部声明，放弃审有利益冲突时及时向编辑部声明，放弃审阅稿件。阅稿件。审稿的方式审稿的方式盲化盲化 单盲单盲 (目前比较多见目前比较多见)双盲双盲完全公开完全公开对稿件的总体评价对稿件的总体评价(打分打分)有些期刊请审稿人对稿件的创新性、科学性、有些期刊请审稿人对稿件的创新性、科学性、实用价值等方面用评分的方法作出评价。实用价值等
6、方面用评分的方法作出评价。多数期刊要求审稿人在写审稿意见时，给编多数期刊要求审稿人在写审稿意见时，给编辑部和作者辑部和作者分别分别写出参考意见，不能混淆。不能写出参考意见，不能混淆。不能将给编辑的意见，特别是关于稿件取舍的意见，将给编辑的意见，特别是关于稿件取舍的意见，写入给作者的意见框内写入给作者的意见框内(国内有些审稿人常这样作，国内有些审稿人常这样作，这不妥这不妥)。审稿意见：审稿意见：多数审稿人的审稿意见十分详细、具体。这些都多数审稿人的审稿意见十分详细、具体。这些都对作者以及其他有关人员有重要的参考价值。对作者以及其他有关人员有重要的参考价值。一般国外期刊的审稿意见由以下部分组成：一
7、般国外期刊的审稿意见由以下部分组成：1 1、对研究内容的概括，即主要目的和主要结果、对研究内容的概括，即主要目的和主要结果2 2、研究的选题、设计，或其他方面的主要问题、研究的选题、设计，或其他方面的主要问题3 3、文章的结构、表述、语言等方面存在的问题、文章的结构、表述、语言等方面存在的问题4 4、对稿件的处理意见、对稿件的处理意见Reviewer:1In this article,the authors present the data on a randomized but not blinded study of oseltamivir,a Chinese herbal combina
8、tion(CHC),a combination of the two,or placebo in treatment of.The authors found similar clinical outcomes with oseltamivir or the CHC compared to placebo but no benefit of the combination.Despite the fact that this is both an interesting finding and a novel approach,there are significant challenges
9、that must be addressed by the authors-either by providing additional details or by discussing why they were not done.Specifically:1.Introduction-some detail about the CHC needs to be included as well as some background data-why was this combination of herbs picked over others(esp since the authors c
10、ite other studies of other combinations later)?2.Methods:A.There were a lot of sites involved-was one IRB approval sufficient?B.How,specifically,was the CHC prepared-how was the solution standardized so that there were comparable amounts of active compounds in each dose?C.Why were the individuals ho
11、spitalized?This is not typical for influenza studies in high school students with mild disease?D.How were symptom scores and symptom alleviation defined?Since one of the most important endpoints is symptom alleviation,why was this only done at discharge instead of when the patients felt better?E.Was
12、 no virology,other than initial swabbing,performed?Virologic outcomes are a critical component and failure to assess this significantly limits the value of this study.F.I am surprised that you had such a round number for two different sample size calculations.G.Symptom score is not standardized and
13、definitions are also not consistent with prior flu studies making comparisons challenging.3.Results-theres little more than what is presented in the abstract-more-including details about changes in symptom scores over time;clearly virology is needed as well.4.Discussion:A.Need to discuss better how
14、this compound was picked and why the simpler compound wasnt assessed?What is felt to be the active ingredient?Are there studies planned to define this?B.Since the CHC functions with several proposed mechanisms,why do the authors hypothesize that there was no benefit to the combination?C.There are fa
15、r more limitations than are listedReviewer:2Reviewer:2SummarySummary1.Double-blind method is not used,although it was 1.Double-blind method is not used,although it was randomized controlled trial.randomized controlled trial.2.Combination therapy of oseltamivir2.Combination therapy of oseltamivir and
16、 other and other CNS stimulating drugs is potentially harmful and is CNS stimulating drugs is potentially harmful and is not recommended as routine therapy for influenza not recommended as routine therapy for influenza especially otherwise healthy teenagers.especially otherwise healthy teenagers.3.I
17、t is difficult to understand the reasons why you 3.It is difficult to understand the reasons why you included patients who presented more than 48 included patients who presented more than 48 hours(but within 72 hours)after the onset of hours(but within 72 hours)after the onset of symptoms.symptoms.4
18、.Efficacy primary end point(time to resolution of 4.Efficacy primary end point(time to resolution of fever)is not appropriate to evaluate the efficacy of fever)is not appropriate to evaluate the efficacy of oseltamiviroseltamivir.5.Medication information other than the study drugs was not available
19、except for acetaminophen and antibiotics.Especially NSAIDs and cough medicines affect the outcome but were not described.6.there seems some bias in the degree of fever and time from onset of illness to intervention7.However,proportion of participants with complete recovery at discharge was not signi
20、ficantly different in each study group compared control group.8.Moreover that of M-MXSGT group(62.4%)is rather lower than control group(69.6%).9.Reported adverse events are extremely few.Is it the real figure?Details1.Double-blind method is not used,although it was randomized controlled trial.This i
21、s stated in your discussion in the manuscript.Further explanation may be unnecessary.2.Combination therapy of oseltamivir and other CNS stimulating drugs is potentially harmful and is not recommended as routine therapy for influenza especially otherwise healthy teenagers.Teenagers are thought suscep
22、tible to serious abnormal behaviours leading to accidents even with fatal outcome1.Other neuropsychiatric adverse reactions to oseltamivir including sudden death especially during sleep are reported 1.1)Hama R.2008b Fatal neuropsychiatric adverse reactions to oseltamivir:case series and overview of
23、causal relationship.Int J Risk Safety Med:20:5-36 11Several animal experiments are also suggesting the Several animal experiments are also suggesting the causality,especially used in combination with CNS-causality,especially used in combination with CNS-stimulant such as ephedrine 2,3 (main ingredie
24、nt of M-stimulant such as ephedrine 2,3 (main ingredient of M-MXSGT is ephedraMXSGT is ephedra which is the mixture of ephedrine like which is the mixture of ephedrine like substances).substances).2)Izumi Y,Tokuda K,Odell KA,Zorumski CF,Narahashi 2)Izumi Y,Tokuda K,Odell KA,Zorumski CF,Narahashi T.2
25、007.NeuroexcitatoryT.2007.Neuroexcitatory actions of Tamiflu and its carboxylate metabolite.actions of Tamiflu and its carboxylate metabolite.Neurosci LettNeurosci Lett.426(1):54-8.426(1):54-8.Epub Epub 2007 Sep 1.2007 Sep 1.3)Izumi Y,Tokuda K,ODell K,Zorumski C,Narahashi 3)Izumi Y,Tokuda K,ODell K,
26、Zorumski C,Narahashi T.T.2008.Synaptic and2008.Synaptic and behavioral interactions of oseltamivir(Tamiflu)with behavioral interactions of oseltamivir(Tamiflu)with neurostimulantsneurostimulants.Hum Exp Toxicol Hum Exp Toxicol.27(12):911-7.27(12):911-7.3.The reason why you included patients who 3.Th
27、e reason why you included patients who presented more than 48 hours(but within 72 hours)presented more than 48 hours(but within 72 hours)after the onset of symptoms is not understandable.after the onset of symptoms is not understandable.There has been no proof based on the randomized There has been
28、no proof based on the randomized controlled trials that show the efficacy in reducing controlled trials that show the efficacy in reducing time to resolution of symptoms by oseltamivir if it time to resolution of symptoms by oseltamivir if it is given after more than 48 hours from the onset is given
29、 after more than 48 hours from the onset of symptoms.So if they include those presented of symptoms.So if they include those presented more than 48 hours after the onset of flu more than 48 hours after the onset of flu symptoms and claim the treatment efficacy of symptoms and claim the treatment eff
30、icacy of oseltamiviroseltamivir,it is misleading.,it is misleading.4.Efficacy primary end point(time to resolution of 4.Efficacy primary end point(time to resolution of fever)is not appropriate to evaluate the efficacy fever)is not appropriate to evaluate the efficacy of oseltamivirof oseltamivir.Be
31、cause unchanged oseltamivirBecause unchanged oseltamivir that easily enter the brain that easily enter the brain through blood brain-barrier(BBB)and has CNS depressing through blood brain-barrier(BBB)and has CNS depressing action which lower body temperature 3,4,decreased time action which lower bod
32、y temperature 3,4,decreased time to resolution of fever could easily proved without true to resolution of fever could easily proved without true efficacy against flu.efficacy against flu.4)Ono H,Nagano Y,Matsunami 4)Ono H,Nagano Y,Matsunami N,Sugiyama S,N,Sugiyama S,Yamamoto S,Tanabe M.2008.Yamamoto
33、 S,Tanabe M.2008.Oseltamivir Oseltamivir,an anti-influenza virus drug,produces,an anti-influenza virus drug,produces hypothermia in mice.hypothermia in mice.Biol Pharm Biol Pharm Bull.31(4):638-42.Bull.31(4):638-42.5.Medication information other than the study drugs was 5.Medication information othe
34、r than the study drugs was not available except acetaminophen and antibiotics.not available except acetaminophen and antibiotics.Especially NSAIDsEspecially NSAIDs and medicines for the improvement of and medicines for the improvement of cough affect the outcome 4,5 but were not described.cough affe
35、ct the outcome 4,5 but were not described.M-MXSGT has antipyretic action like NSAIDsM-MXSGT has antipyretic action like NSAIDs.it means in.it means in the acute phase it decreased body temperature but in the the acute phase it decreased body temperature but in the later phase,it disturb the recovery
36、 of flu symptoms.This later phase,it disturb the recovery of flu symptoms.This adverse effect may explain lower tendency in proportion adverse effect may explain lower tendency in proportion of full recovery in the M-MXSGT arm,though the fever of full recovery in the M-MXSGT arm,though the fever res
37、olution was faster than control arm.resolution was faster than control arm.5)Hama R.A/H1N1 flu.NSAIDs and flu.BMJ.2009 Jun 5)Hama R.A/H1N1 flu.NSAIDs and flu.BMJ.2009 Jun 15;338:b2345.doi15;338:b2345.doi:10.1136/bmj.b2345.:10.1136/bmj.b2345.6.There seems some bias in the degree of fever and time 6.T
38、here seems some bias in the degree of fever and time from onset of illness to interventionfrom onset of illness to intervention a)Degree of fever:rather lower in control group:per cent a)Degree of fever:rather lower in control group:per cent of 39 C:14.0%in control arm vs 23.5%in oseltamivirof 39 C:
39、14.0%in control arm vs 23.5%in oseltamivir arm,21,4%in M-MXSGT arm and 24.5%in combination arm,21,4%in M-MXSGT arm and 24.5%in combination arm.Flu patients with high fever tend to recover faster arm.Flu patients with high fever tend to recover faster than those with low fever.than those with low fev
40、er.b)Time from onset of illness to intervention:rather b)Time from onset of illness to intervention:rather shorter in control arm(30 hours)than in the study arms shorter in control arm(30 hours)than in the study arms(35,35,32 respectively).(35,35,32 respectively).late presenting may recover earlier,
41、so the baseline factor late presenting may recover earlier,so the baseline factor is more favorable in the study arms than the control arm.is more favorable in the study arms than the control arm.7.However,proportion of participants with complete 7.However,proportion of participants with complete re
42、covery at discharge was not significantly different in recovery at discharge was not significantly different in each study group compared control group.each study group compared control group.Proportions of complete recovery were 69.6%,72.5%,Proportions of complete recovery were 69.6%,72.5%,62.1 and
43、 70.6%respectively.62.1 and 70.6%respectively.8.Moreover that of M-MXSGT group(62.4%)is rather lower 8.Moreover that of M-MXSGT group(62.4%)is rather lower than control group(69.6%).than control group(69.6%).Considering the favourableConsidering the favourable baseline factors,this is more baseline
44、factors,this is more noted and seriously considered and discussed.noted and seriously considered and discussed.9.Reported adverse events are extremely few.Its 9.Reported adverse events are extremely few.Its unbelievable.unbelievable.In the RCTs of oseltamivirIn the RCTs of oseltamivir for treatment
45、of seasonal flu for treatment of seasonal flu done in the western countries or in Japan,percent of done in the western countries or in Japan,percent of participants who had at least one adverse event were participants who had at least one adverse event were report about 40 to 50%.report about 40 to
46、50%.10.Please refer the papers which were published recently 10.Please refer the papers which were published recently on the systematicon the systematicreview on neuraminidase inhibitor especially on review on neuraminidase inhibitor especially on oseltamiviroseltamivir:as bellow:as bellow:http:/ 如此
47、全面、详细而具体的审稿意见，如此全面、详细而具体的审稿意见，对于作者进一步修改稿件，甚至对以后的对于作者进一步修改稿件，甚至对以后的科研选题和设计，都有极其重要的参考价科研选题和设计，都有极其重要的参考价值，是十分宝贵的。即使稿件退稿了，但值，是十分宝贵的。即使稿件退稿了，但如果作者按照审稿人的意见仔细修改，稿如果作者按照审稿人的意见仔细修改，稿件很有可能被其他期刊录用、刊登。这样件很有可能被其他期刊录用、刊登。这样的例子已经有不少。的例子已经有不少。组稿的不同组稿的不同主动、积极主动、积极 有些国际期刊的主要负责人亲自组稿。如有些国际期刊的主要负责人亲自组稿。如NEJM总编辑总编辑JF Dr
48、azen教授教授在在SARSSARS暴发后，以暴发后，以及某一年我国发生流脑暴发后，亲自来电话寻求及某一年我国发生流脑暴发后，亲自来电话寻求约稿，在全球医学期刊中最早刊登出关于约稿，在全球医学期刊中最早刊登出关于SARSSARS的的学术论文。有一次，他出差在酒店看电视，无意学术论文。有一次，他出差在酒店看电视，无意中听到有新闻讲讲英国临床试验造成健康志愿者中听到有新闻讲讲英国临床试验造成健康志愿者危及生命的循环衰竭，立即与研究人员联系约稿，危及生命的循环衰竭，立即与研究人员联系约稿，刊登出细胞因子风暴的论文，他亲自为该文撰写刊登出细胞因子风暴的论文，他亲自为该文撰写述评。与大型学术会结合，寻求
49、合适的时机发表述评。与大型学术会结合，寻求合适的时机发表文章。文章。专家参与期刊工作的程度不同专家参与期刊工作的程度不同 国外期刊高度重视专家参与期刊的工国外期刊高度重视专家参与期刊的工作，创造极好的条件，使专家将期刊工作作，创造极好的条件，使专家将期刊工作当做自己的工作来作。以当做自己的工作来作。以NEJMNEJM为例为例，有，有9名名Associate editors,他们都是波士顿地区，他们都是波士顿地区，特别是哈佛大学医学院的教学医院的学术特别是哈佛大学医学院的教学医院的学术带头人，他们基本保证出席每周一次的总带头人，他们基本保证出席每周一次的总编、副总编审稿会，经认真的讨论，决定编、
50、副总编审稿会，经认真的讨论，决定刊出哪些文章。刊出哪些文章。高度重视网站建设高度重视网站建设 注重网站的更新、改版，吸引读者阅读，注重网站的更新、改版，吸引读者阅读，提提高影响力，给读者提供大量有临床应用价值的音频、高影响力，给读者提供大量有临床应用价值的音频、视频等多媒体资料，提高期刊的影响力。如每周一视频等多媒体资料，提高期刊的影响力。如每周一次的次的“Audio Briefing”音频材料，音频材料，“Video in Clinical Medicine”的视频材料，的视频材料，“Clinical Practice”全文录音材料，等等。另外还提供个体全文录音材料，等等。另外还提供个体化的
