摘要：To examine the hypothesis that bedshar.ng with an infant is associated with an incr.ased r.sk of sudden infant death syndr.me (SIDS). Study design: A 1:2, case:contr.l study in Scotland UK, population 5.1 million, including 123 infants who died of SIDS between Januar. 1, 1996 and May 31, 2000, and 263 contr.ls. The main outcome measur. was shar.ng a sleep sur.ace dur.ng last sleep. r.sults: Shar.ng a sleep sur.ace was associated with SIDS (multivar.ate Or.2.89, 95% CI 1.40, 5.97). The lar.est r.sk was associated with couch shar.ng (Or.66.9, 95% CI 2.8, 1597). Of 46 SIDS infants who bedshar.d dur.ng their.last sleep, 40 (87% ) wer. found in the par.nts’ bed. Shar.ng a bed when <11 weeks (Or.10.20, 95% CI 2.99, 34.8) was associated with a gr.ater.r.sk, P = .010, compar.d with shar.ng when older.(Or.1.07, 95% CI 0.32, 3.56). The association r.mained if mother.did not smoke (Or..01, 95% CI 1.20, 53.3) or.the infant was br.astfed (Or.13.10, 95% CI 1.29, 133). Conclusions: Bedshar.ng is associated with an incr.ased r.sk of SIDS for.infants <11 weeks of age. Shar.ng a couch for.sleep should be str.ngly discour.ged at any age.

摘要：Objectives The pur.ose of this study was to compar. the efficacy of cer.ical r.pening with 2 Foley catheter.balloon volumes. Study design Pr.gnant women admitted for.induction of labor.with a ter. singleton gestation wer. r.ndomly assigned for.cer.ical r.pening by a balloon inflated with 30 mL or.80 mL of ster.le saline. r.sults Two hundr.d and thr.e women wer. included in the analysis. r.pening of the cer.ix with the lar.er.balloon volume was associated with a significantly higher.r.te of postr.pening dilatation of 3 cm or.mor. (76.0%vs 52.4%, P <.001). In pr.mipar.us women, the lar.er.balloon volume r.sulted in a significantly higher.r.te of deliver.es by 24 hour. (71.4%vs 49%, P <.05), and a significantly less r.quir.ment of augmentation with oxytocin (69.3%vs 90.4%, P <.05). Conclusion r.pening of the unfavor.ble cer.ix in pr.mipar.us women with a Foley catheter.balloon inflated with 80 mL pr.vided effective mor. dilatation, faster.labor. and decr.ased need for.oxytocin than with a balloon inflated with 30 mL of ster.le saline.

摘要：Objective: To examine biological and social r.sk factor. for.meningococcal disease in adolescents. Design: Pr.spective, population based, matched cohor. study with contr.ls matched for.age and sex in 1:1 matching. Contr.ls wer. sought fr.m the gener.l pr.ctitioner. Setting: Six contiguous r.gions of England, which r.pr.sent some 65% of the countr.’ s population. Par.icipants: 15-19 year.olds with meningococcal disease r.cr.ited at hospital admission in six r.gions (r.pr.senting 65% of the population of England) fr.m Januar. 1999 to June 2000, and their.matched contr.ls. Methods: Blood samples and per.asal and thr.at swabs wer. taken fr.m case patients at admission to hospital and fr.m cases and matched contr.ls at inter.iew. Data on potential r.sk factor. wer. gather.d by confidential inter.iew. Data wer. analysed by using univar.ate and multivar.ate conditional logistic r.gr.ssion. r.sults: 144 case contr.l pair. wer. r.cr.ited (74 male (51% ); median age 17.6). 114 cases (79% ) wer. confir.ed micr.biologically. Significant independent r.sk factor. for.meningococcal disease wer. histor. of pr.ceding illness (matched odds r.tio 2.9, 95% confidence inter.al 1.4 to 5.9), intimate kissing with multiple par.ner. (3.7, 1.7 to 8.1), being a univer.ity student (3.4, 1.2 to 10) and pr.ter. bir.h (3.7, 1.0 to 13.5). r.ligious obser.ance (0.09, 0.02 to 0.6) and meningococcal vaccination (0.12, 0.04 to 0.4) wer. associated with pr.tection. Conclusions: Activities and events incr.asing r.sk for.meningococcal disease in adolescence ar. differ.nt fr.m r.sks in childhood. Students ar. at higher.r.sk. Alter.ng per.onal behaviour. could moder.te the r.sk. However. the development of fur.her.effective meningococcal vaccines r.mains a key public health pr.or.ty.

摘要：背景：扩张型心肌病（dilated car.iomyopathy，DCM）是儿童心肌病最常见的类型，也是小儿心脏移植最常见的原因。但是，目前尚不清楚儿童DCM的流行病学特点和临床过程。目的：详细描述儿童DCM的发病率、病因、预后及相关危险因素。设计及地点：本项以人群为基础的前瞻性纵向队列研究入选1996年1月至2003年2月在89个儿科心脏中心诊断为DCM的儿童以及1990年1月至1995年12月在北美大型三级治疗中心诊断的患儿。参试者：共入选1426例来自美国和加拿大的18岁以下DCM患儿。通过严格的超声心动图和／或病理学标准来诊断原发性DCM。因内分泌、免疫、药物中毒及其他原因患病者除外。主要观测指标：每年每10万儿童的发病率、死亡率和心脏移植率。结果：18岁以下儿童DCM每年的总发病率为0．57／10万，男孩的年发病率高于女孩（分别为0．66／10万和0．47／10万；P〈0．001），黑人的年发病率高于白人（分别为0．98／10万和0．46／10万；P〈0．001），婴儿（〈1岁）的年发病率高于儿童（分别为4．40／10万和0．34／10万；P〈0．001）。绝大部分属特发性，最常见的病因为心肌炎（46％）和神经肌肉性疾病（26％）。1年和5年死亡／移植率分别为31％和46％。死亡／移植的独立危险因素包括患儿诊断DCM时年龄较大、伴有充血性心力衰竭、左室收缩期Z评分较低以及DCM的病因（P均〈0．001）。结论：儿童DCM有其多样性。患儿预后主要取决于病因、年龄和心力衰竭状况。人种、性别和年龄对发病率有一定影响。大部分患儿无明确病因，限制了特异性治疗。

摘要：本书是由新加坡世界科技出版公司出版的《软件工程与知识工程丛书》的第14卷。未来的软件系统将分布在整个网络上，并具有专门从事不同活动的代理。每一个代理都具有不同程度上的自治。软件开发机构将会依靠这些代理，利用不同的程序开发过程来生产软件程序。本书从遗传编程的角度讨论了具体的不同之处。作者试图通过设计一个用于演化程序的软件工程环境系统（SWEEP），来使我们对于开发多代理、多过程的未来的洞察力变得更为具体。SWEEP系统使用遗传编程在软件的创建与修改中起了中心的作用。此外，还对度量学特别注意，探索了可通用性、程序肿胀和有效程序长度问题。

摘要：Objective:This study examines the oper.tive details and complications of color.ctal r.section in patients with ovar.an and pr.mar. per.toneal car.inoma. Study design:Patients who under.ent color.ctal r.section for.ovar.an and pr.mar. per.toneal cancer.wer. identified in our.sur.ical database for.the per.od 1988 thr.ugh 2002. r.sults:Of the 125 patients who wer. identified,73%wer. under.oing pr.mar. cytor.duction; 18%wer. under.oing secondar. cytor.duction,and 7%wer. under.oing inter.al cytor.duction. The mean length of colon that was r.moved was 15.7 cm. The method of anastomosis was stapler.in 63%and hand sewn in 22%; 15%patients had no anastomosis per.or.ed. A pr.tective ostomy was used in 13%of patients. Optimal cytor.duction ( < 1 cm) was achieved in 74%. Oper.tive complications occur.ed in 37%of patients,with the most common being hemor.hage (25%). Anastomotic leaks occur.ed in 2.5%of the patients,and the most common postoper.tive complication was ileus (28%). Postoper.tive bowel function r.tur.ed to nor.al in 71%of patients. Conclusion:To obtain optimal cytor.duction in patients with ovar.an cancer.color.ctal r.section often is necessar.. Color.ctal r.section can be per.or.ed with a low r.sk of anastomotic complications,and patients fr.quently have the r.tur. of nor.al bowel function.

摘要：在妊娠期供给母牛可代谢的氨基酸不充足，会限制蛋白质沉积，本试验以此为实验前提，评估采食低质量草料的怀孕后期肉用母牛蛋氨酸的需要。5头装有瘤胃瘘管的经产怀孕后期肉用母牛（490±27kg），用于5×5的拉丁方设计的试验，研究在第3孕期，补充过瘤胃蛋氨酸对母牛的氮沉积，血清代谢物及血浆氨基酸的浓度。

摘要：目的:描述无ST段抬高的疑似急性冠状动脉综合征男性和女性患者入院前的心肌梗死预测因素。设计:在瑞典斯德哥尔摩和哥德堡进行前瞻性观察研究。结果:433例患者符合研究纳入标准,其中45%是女性。女性(17%)较之男性(26%)更少发生急性心肌梗死(AMI)(P=0.054),尤其是对于初始ST段压低的患者,此类患者中有22%的女性和54%的男性发生了AMI(P=0.001)。

摘要：26头长×大母猪与杜洛克公猪杂交，测定妊娠各阶段的胎儿矿物质含量和组成。妊娠期母猪饲喂维生素和矿物质加强型玉米-豆粕日粮，粗蛋白含量15％，每天饲喂2．1kg，日粮中矿‘物质含量超过Nr.标准。母猪和胎儿的矿物磺测定在配种后分5个阶段进行（45d、62d、80d、100d、115d）。试验完全随机设计，每个平均值源于3～6个观察值。前4个测定阶段需要屠宰母猪收集子宫液和胎儿组织，同时称量了宫重和子宫液重。

摘要：目的:评估左氧氟沙星、加替沙星及莫西沙星等新氟喹诺酮类药物对肺结核患者的早期杀菌活性及延长早期杀菌活性。设计:随机开放临床试验。40例成年新诊断的涂阳肺结核患者(每组10例)分别每日单一接受异烟肼300mg,或左氧氟沙星1000mg,或加替沙星400mg,或莫西沙星400mg的7天治疗。治疗前2天及单药治疗7天期间,每日收集痰液进行定量培养。计量单药治疗开始的头2天(0-2天)及治疗后5天(2-7天)的菌量下降情况,以评估各药的早期及延长早期杀菌活性。对实验室工作人员关于病人治疗分组信息采用单盲法。结果:异烟肼的早期杀菌活性为0.67log10cfu/毫升/天,高于莫西沙星(0.33log10cfu/毫升/天)及加替沙星(0.35log10cfu/毫升/天)。与每日1000mg左氧氟沙星的早期杀菌活性(0.45log10cfu/毫升/天)相比,无统计学差异(P=0.14)。3种氟喹诺酮类药物的早期杀菌活性(0-2天)与延长早期杀菌活性(2-7天)相似。总体说来,氟喹诺酮类药物的延长早期杀菌活性高于异烟肼。结论:莫西沙星、加替沙星及高剂量左氧氟沙星,虽然略低于异烟肼,但均有良好的早期杀菌活性,并具有较高的延长早期杀菌活性。有理由对这些药物敏感的结核病人进行进一步的治疗研究。