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I'd looked at toxicity earlier, So I'm not going to spend any more time on it today
之前我讲过毒性，今天我就不再细讲了
Just to reassure you that we don't have to worry about toxicity. The experience of Dr. Wagner Wagner,
请放心，毒性不需要操心太多。医生经验说明，
good doses in pregnant women without the slightest in the hypercalcemia or any other types of excessive problems
给孕妇较大量的维生素D，没有出现任何高钙血症这样的过量问题
You know just trumps all the rest of this
所有这些都没有问题
So the preponderance of the evidence indicates that 32 is needed for a full benefits of vitamin D
大量证据显示，维生素D发挥全部效果需要32纳克
In some systems observation studies supports this conclusion
一些系统中，观测研究支持这个结论
Now I want to stress the working together of randomized trials and observational studies
下面强调下随机试验同观测研究的结合
Randomized trials have very poor generalizability because the people in trials are not like the ones in youroffice
随机试验的一般性很差，接受试验的人没有足够的代表性
They're not. So you can prove that stuff works
你可以证明东西有效
You just can't prove that works in your patients
但无法证明对所有患者有效
And so when you've got positive evidence from randomized trials plus concordant evidence from observation studies. You've got the best of both worlds
所以，随机试验中获得正面证据后，还需要观测研究的证据配合，两者都需要
So instead of throwing out the observations. We need them for generalizability
不能撇开观测，因为它们具有一般性
So, for some endpoints that is cancer, the data suggests that even 32 is not high enough, So 40 to 60 is a range we've been talking about today
对于一些极端情况，如癌症，数据显示32纳克还不够，40到60才是足够的范围
and I stress once again I don't need to because everybody else has that such levels are physiological and they're safe
我再强调一次，虽然大家都讲过这个水平有生理学依据而且安全
So this has to be what our goal is and once again as I said this morning
所以，这就是我们的目标，早上说的话我再说一次
I'd like to think about it with a single number 75 international units per kilogram per day
我喜欢只考虑一个数字75国际单位/千克/天
just about approximates what you have to use for most of your patients whether they're fat or thin, young orold
是大多数患者的合适剂量，不论胖瘦，不论老少
It pretty much covers it at all
基本都覆盖了
You have to look at them too because there's this huge variability in vigil response
你当然需要监控，监控反应差异性会非常大
I wouldn't watch it that the average value works in your patient, it doesn't
平均值不可能合适每个患者，
but we still have to work around some averages, so I thank you with that
不过仍然需要给出一个平均值。谢谢大家
