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女性健康研究:一项关于小剂量阿司匹林在癌症初级预防中作用的随机对照试验

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世界核心医学期刊文摘（心脏病学分册） 2005年第12期1卷 19-20页

作者： cook n. R. Lee I. -M. Gaziano J. M. 杜媛 Department of Medicine Brigham and Women's Hospital Harvard Medical School 900 Commonwealth Ave E Boston MA 02215 United States

Context: Basic research and observational evidence as well as results from trials of colon polyp recurrence suggest a role for aspirin in the chemoprevention of cancer. Objective: To examine the effect of aspirin on the risk of cancer among healthy women. Design, Setting, and Participants: In the Women’s Health Study, a randomized 2×2 factorial trial of aspirin and vitamin E conducted between September 1992 and March 2004, 39 876 US women aged at least 45 years and initially without previous history of cancer, cardiovascular disease, or other major chronic illness were randomly assigned to receive either aspirin or aspirin placebo and followed up for an average of 10.1 years. Intervention: A dose of 100 mg of aspirin(n=19 934) or aspirin placebo(n=19 942) administered every other day. Main Outcome Measures: Confirmed newly diagnosed invasive cancer at any site, except for nonmelanoma skin cancer. Incidence of breast, colorectal, and lung cancer were secondary end points. Results: no effect of aspirin was observed on total cancer(n=2865; relative risk[RR], 1.01; 95%confidence interval[CI], 0.94-1.08; P=.87), breast cancer(n=1230; RR, 0.98; 95%CI, 0.87-1.09; P=.68), colorectal cancer(n=269; RR, 0.97; 95%CI, 0.77-1.24; P=.83), or cancer of any other site, with the exception of lung cancer for which there was a trend toward reduction in risk(n=205; RR, 0.78; 95%CI, 0.59-1.03; P=.08). There was also no reduction in cancer mortality either overall(n=583; RR, 0.95; 95%CI, 0.81-1.11; P=.51) or by site, except for lung cancer mortality(n=140; RR, 0.70; 95%CI, 0.50-0.99; P=.04). no evidence of differential effects of aspirin by follow-up time or interaction with vitamin E was found. Conclusions: Results from this large-scale, long-term trial suggest that alternate day use of low-dose aspirin(100 mg) for an average 10 years of treatment does not lower risk of total, breast, colorectal, or other site-specific cancers. A protective effect on lung cancer or a benefit of higher do

关键词：初级预防女性健康随机对照试验结肠直肠癌疾病病史肺癌死亡率次要终点非黑色素皮肤癌结肠息肉药物预防

关于小剂量阿司匹林用于女性心血管疾病一级预防的随机试验

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世界核心医学期刊文摘（心脏病学分册） 2005年第9期1卷 20-21页

作者： Ridker P.M. cook n.R. Lee I.-M. J.E. Buring 任付先 Dr. Division of Preventive Medicine Brigham and Women's Hospital 900 Commonwealth Ave. East Boston MA 02215 United States

BACKGROUnD: Randomized trials have shown that lowdose aspirin decreases the risk of a first myocardial infarction in men, with little effect on the risk of ischemic stroke. There are few similar data in women. METHODS: We randomly assigned 39,876 initially healthy women 45 years of age or older to receive 100 mg of aspirin on alternate days or placebo and then monitored them for 10 years for a first major cardiovascular event(i.e., nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes). RESULTS: During followup, 477 major cardiovascular events were confirmed in the aspirin group, as compared with 522 in the placebo group, for a nonsignificant reduction in risk with aspirin of 9 percent(relative risk, 0.91; 95 percent confidence interval, 0.80 to 1.03; P=0.13). With regard to individual end points, there was a 17 percent reduction in the risk of stroke in the aspirin group, as compared with the placebo group(relative risk, 0.83; 95 percent confidence interval, 0.69 to 0.99; P=0.04), owing to a 24 percent reduction in the risk of ischemic stroke(relative risk, 0.76; 95 percent confidence interval, 0.63 to 0.93; P=0.009) and a nonsignificant increase in the risk of hemorrhagic stroke(relative risk, 1.24; 95 percent confidence interval, 0.82 to 1.87; P=0.31). As compared with placebo, aspirin had no significant effect on the risk of fatal or nonfatal myocardial infarction(relative risk, 1.02; 95 percent confidence interval, 0.84 to 1.25; P=0.83) or death from cardiovascular causes(relative risk, 0.95; 95 percent confidence interval, 0.74 to 1.22; P=0.68). Gastrointestinal bleeding requiring transfusion was more frequent in the aspirin group than in the placebo group(relative risk, 1.40;95 percent confidence interval, 1.07 to 1.83; P=0.02). Subgroup analyses showed that aspirin significantly reduced the risk of major cardiovascular events, ischemic stroke, and myocardial infarction among women 65 years of age or older. COnCLUSIOnS: In this

关键词：心血管疾病一级预防随机试验非致死性缺血性卒中卒中风险安慰剂出血性卒中死亡风险风险降低

通过观察放射性核素在肠道的运送情况来评估慢性特发性便秘患儿大肠运送功能阻滞的部位

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世界核心医学期刊文摘（儿科学分册） 2005年第8期1卷 39-40页

作者： cook B.J. Lim E. cook D. J.M. Hutson 宁亮 Department of Pediatric Surgery Royal Children's Hospital Parkville Vic. 3052 Australia

Purpose: Chronic idiopathic constipation (CIC) with soiling in children may r esult from slow colonic transit (SCT) or anorectal dysfunction and/or psychologi cal problems known as functional fecal retention (FFR). Evidence is accumulating that SCT and FFR need different treatments, but they are poorly distinguished b y solid marker studies. The authors used radionuclear transit scintigraphy to ca tegorize children with CIC as having either FFR or SCT. Methods: Children (n = 1 01) with CIC (and soiling) who were referred for further investigation after failure of standard treatments (diet, laxatives) received radiolabeled colloid orally, and scintillation images were collected at 0 to 2, 6, 24, 30 and 48 hours (total radiation dosage = 2 st andard x- rays). Radioactivity in 6 regions (precolonic, ascending, transverse, descending, rectosigmoid, and evacuated feces) was measured, and the median pos ition (geometric center) of radioactivity at each time was determined. Results: In children, meals normally reach the cecum at 6 hours and are evacuated in 30 t o 58 hours. Fifty patients had retention of radioactivity in the proximal colon at 48 hours, indicating SCT. Analysis of the images and the geometric center sho wed that passage through the ascending colon and transverse colon was delayed in SCT. In 24 patients, radioactivity was passed by 30 hours, indicating normal tr ansit or possible FFR. Twenty- two patients had retention in the rectum, indica ting definite FFR. Five studies were borderline. Conclusions: Radionuclear trans it scintigraphy is useful for categorizing patients with CIC as having either FF R or SCT, allowing for different treatments. Radionuclear transit scintigraphy p rovides more detail and greater sensitivity than solid marker studies in diagnos ing CIC. Radionuclear transit scintigraphy showed that half of our patients had SCT.

关键词：放射性核素慢性特发性便秘放射强度直肠乙状结肠放射性标记放射剂量缓泻剂肛门直肠标准化治疗小儿则

Emerging technologies for uranium extraction from seawater

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Science China Chemistry 2022年第12期65卷 2335-2337页

作者： Hui Yang Yanfang Liu Zhongshan Chen Geoffery I.n.Waterhouse Shengqian Ma Xiangke Wang College of Environmental Science and Engineering North China Electric Power UniversityBeijing102206China School of Chemical Sciences The University of AucklandAuckland1142New Zealand Department of Chemistry University of North TexasDentonTexas76201USA

The use of enriched uranium(^(235)U)in nuclear fission reactors allows electricity generation with negligible CO_(2) ***,nuclear energy is expected to play an important role in global efforts to decarbonize the energy sector[1].To meet the energy needs of future societies and achieve zero-emissions targets,more nuclear reactors will be needed,which increases demand for uranium fuel.

关键词： negligible seawater

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循证实践者与循证卫生保健

中国循证医学杂志 2005年第2期5卷 99-100页

作者： Gordon H.Guyatt MaureenO.Meade RomanZ.Jaeschke DeborahJ.cook R.BrianHaynes 杜亮 Department of Clinical Epidemiology & Biostatistics Mc Master University1200 Main Street WestHamiltonOntarioCanadaL8N3Z5

高质量的卫生保健是基于最佳证据的医疗实践(循证保健).而实施循证保健的方法就是培训能够独立检索、评价并正确应用最佳证据的临床医生(循证实践者).以下将着重讨论该策略的局限性并推荐两个补充办法,以供选择.……

关键词：循证实践者循证卫生保健策略

小剂量阿司匹林在女性心血管疾病一级预防中所起作用的随机试验研究

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世界核心医学期刊文摘（神经病学分册） 2005年第9期1卷 8-9页

作者： Ridker P.M. cook n.R. Lee I.-M. J.E. Buring 黄卫东 Division of Preventive Medicine Brigham and Women's Hospital 900 Commonwealth Ave. East Boston MA 02215 United StatesDr.

BACKGROUnD: Randomized trials have shown that lowdose aspirin decreases the ri sk of a first myocardial infarction in men, with little effect on the risk of is chemic stroke. There are few similar data in women. METHODS: We randomly assigne d 39,876 initially healthy women 45 years of age or older to receive 100 mg of a spirin on alternate days or placebo and then monitored them for 10 years for a f irst major cardiovascular event (i.e., nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes). RESULTS: During followup, 477 majo r cardiovascular events were confirmed in the aspirin group, as compared with 52 2 in the placebo group, for a nonsignificant reduction in risk with aspirin of 9 percent (relative risk, 0.91; 95 percent confidence interval, 0.80 to 1.03; P=0 .13). With regard to individual end points, there was a 17 percent reduction in the risk of stroke in the aspirin group, as compared with the placebo group (rel ative risk, 0.83; 95 percent confidence interval, 0.69 to 0.99; P=0.04), owing t o a 24 percent reduction in the risk of ischemic stroke (relative risk, 0.76; 95 percent confidence interval, 0.63 to 0.93; P=0.009) and a nonsignificant increa se in the risk of hemorrhagic stroke (relative risk, 1.24; 95 percent confidence interval, 0.82 to 1.87; P=0.31). As compared with placebo, aspirin had no signi ficant effect on the risk of fatal or nonfatal myocardial infarction (relative r isk, 1.02; 95 percent confidence interval, 0.84 to 1.25; P=0.83) or death from c ardiovascular causes (relative risk, 0.95; 95 percent confidence interval, 0.74 to 1.22; P=0.68). Gastrointestinal bleeding requiring transfusion was more frequ ent in the aspirin group than in the placebo group (relative risk, 1.40; 95 perc ent confidence interval, 1.07 to 1.83; P=0.02). Subgroup analyses showed that as pirin significantly reduced the risk of major cardiovascular events, ischemic st roke, and myocardial infarction among women 65 years of age or o

关键词：心血管疾病一级预防非致死性随机试验缺血性卒中安慰剂对照组差异无显著性出血性卒中中所无显著性差异

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胆固醇栓塞综合征

英国医学杂志中文版 2004年第4期7卷 247-249页

作者： Peter J Dupont Liz Lightstone Elaine J Clutterbuck Gillian Gaskin Charles D Pusey Terry cook Anthony n Warrens 赵元攸 Renal Section Imperial College School of Medicine Hammersmith Hospital London W12 ONN Department of Histopathology Hammersmith Hospital

胆固醇栓塞是老年患者于动脉造影、血管外科手术、溶栓及抗凝治疗后常见的并发症，但这一疾病的诊断常被忽略。在此，我们介绍在过去6个月中发生于我们肾科病房的3个胆固醇栓塞的病例。每例均以急性肾衰为始发症状。

关键词：胆固醇栓塞综合征并发症肾病诊断治疗

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循证医学进展下一个十年将同样精彩

中国循证医学杂志 2005年第8期5卷 583-584页

作者： Gordon Guyatt Deborah cook Brian Haynes 廖加群 Department of Clinical Epidemiology and Biostatistics McMaster University Hamilton ON Canda L8N 3Z5

循证医学力求帮助医生建立对医疗保险支付及其争议的独立观点。尽管有许多人为建立循证医学作出了贡献，但Archie Cochrane坚持临床医学应是临床实践证据总结、Alvan Feinstei对定量临床推论原则的定义以及David Sackett对质量评价的教... 详细信息

循证医学力求帮助医生建立对医疗保险支付及其争议的独立观点。尽管有许多人为建立循证医学作出了贡献，但Archie Cochrane坚持临床医学应是临床实践证据总结、Alvan Feinstei对定量临床推论原则的定义以及David Sackett对质量评价的教育改革，仍被证实是奠基性和开拓性的。

关键词：循证医学医疗保险临床医学临床实践

Prevalence of hyponatremia in acute medical admissions in tropical Asia Pacific Australia

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Asian Pacific Journal of Tropical Medicine 2014年第1期7卷 40-43页

作者： Usman H.Malabu David Porter Venkat n.Vangaveti Monsur Kazi R.Lee Kennedy Department of Medicine Townsville Hospital/James Cook UniversityQueenslandAustralia Department of Pathology Townsville Hospital/James Cook UniversityQueenslandAustralia Department of Medicine Deakin UniversityVictoriaAustralia

Objective:To determine prevalence of hyponatremia in acute medical admissions in northern ***:We studied 469 consecutive acute medical admissions to a hospital in Australia's Far north Queensland during the colder months of June and July *** of hyponatremia and its relationship with gender,age,diagnosis and prognosis in acute medical admissions were ***:On admission,hyponatremia(plasma sodiumnt in 39.4%of patients,with mild(130—135 mmol/L),moderate(126-129 mmol/L)and severe?126 mmol/L)hyponatremia being present in 25.2%,10.7*and 3.6****,adding together admission hyponatremia with that developing during admission,45.2%of patients were affected with 11.5%moderate hyponatremia cases and 4.1%severe *** and hyperkalemia were present in 17.0%and 18.1*,***,275/469 patients(58.6*)presented with an electrolyte *** were significant correlations of hyponatremia with age but not with gender and in-hospital *** of hyponatremia was high across all diagnostic ***:The prevalence of hyponatremia appears to be high in the tropical north Australian population,being the highest prevalence reported amongst acute hospital *** previously reported correlations with age and mortality do appear to hold good for this population with a high prevalence of electrolyte *** prospective analysis on a larger population in the area is needed to confirm our findings.

关键词： Hyponatremia Prevalence Acute admissions Tropical Asia Pacific Australia