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791.
BACKGROUND: Investigations of pruritogenic substances in humans have involved intradermal injections in normal skin; itching of inflamed skin has been little studied. OBJECTIVES: To develop an itch model with provocation of itch in experimentally inflamed skin as well as in normal skin, using subjects as self-controls. METHODS: In 32 non-atopic volunteers aged 21-30 years, the skin of five selected test sites on one volar forearm was pretreated for 24 h with large Finn chambers containing 1% sodium lauryl sulphate (SLS) used as a standard contact irritant to induce inflammation. Twenty microlitres of different pruritogenic substances [histamine, substance P, neurokinin A, neurokinin B, trypsin, platelet-activating factor (PAF) and serotonin] and saline as control were injected intradermally into the inflamed test sites and in corresponding non-treated sites on the opposite forearm. The test individuals scored itch intensity on a visual analogue scale for 20 min, and weal area was then measured. : RESULTS: Histamine and substance P induced itch in both normal and inflamed skin compared with a saline reference. Neurokinin A, trypsin, PAF and serotonin only elicited itch in normal skin, and neurokinin B neither elicited itch in normal skin nor in inflamed skin. Itch was induced in normal and SLS-inflamed skin to a similar magnitude. However, weal area after histamine was significantly (P < 0.001) larger in inflamed skin when compared with normal skin. CONCLUSIONS: Histamine and substance P elicited itch to the same degree in normal skin and inflamed skin pretreated with SLS despite a stronger weal response in inflamed skin. Mediators present in inflamed skin did not potentiate itch, a c-fibre-mediated neuronal response. The weal reaction is based on enhanced vascular permeability (protein extravasation). A greater skin perfusion in inflamed skin may therefore have increased the weal size. We propose an experimental model in humans for testing of itch involving both normal and inflamed skin. The model has the potential for use in evaluating new topical and systemic treatments of itch.  相似文献   
792.
793.
薛梅  陈宏 《西部中医药》2015,(2):138-141
通过对老年瘙痒症定义、病机、辨证论治、中成药、中医外治、药浴熏蒸法、联合疗法、其他疗法、日常护理等几个方面的综述,表明中医在本病治疗中发挥了临床针对性强、方法多样、副作用小且有效的特点,也阐明了中医药在治疗过程中存在的不足。  相似文献   
794.
795.
BACKGROUND: Although some patients with psoriasis vulgaris also complain of severe pruritus, the data available regarding pruritus in psoriasis are sparse. OBJECTIVES: To clarify the mechanism and mediators involved in the pruritus of psoriasis vulgaris, we compared itch-associated factors in lesional skin from psoriatic patients vs. skin without pruritus quantitatively using a panel of histological and immunohistological parameters. PATIENTS AND METHODS: Biopsied specimens were obtained from 38 patients with psoriasis vulgaris who were divided into two groups according to the presence or absence of pruritus. RESULTS: When compared with psoriatic patients devoid of pruritus, lesional skin from patients with pruritus showed the following characteristic features: (i) a rich innervation both in the epidermis and in the papillary dermis; (ii) an increase in neuropeptide substance P-containing nerve fibres in perivascular areas; (iii) decreased expression of neutral endopeptidase in the epidermal basal layer as well as in the endothelia of blood vessels; (iv) many mast cells showing degranulating processes in the papillary dermis; (v) a strong immunoreactivity for nerve growth factor (NGF) throughout the entire epidermis and an increased NGF content in lesional skin homogenates; (vi) an increase in the expression of high-affinity receptors for NGF (Trk A) in basal keratinocytes and in dermal nerves; (vii) an increased population of interleukin-2-immunoreactive lymphocytes; and (viii) a strong expression of E-selectin on vascular endothelial cells. A significant correlation was observed between the severity of pruritus and protein gene product 9.5-immunoreactive intraepidermal nerve fibres, NGF-immunoreactive keratinocytes, expression of Trk A in the epidermis and the density of immunoreactive vessels for E-selectin. These findings indicate that possible pruritogenic mediators in psoriatic lesional skin are neurogenic factors including innervation, neuropeptide substance P, neuropeptide-degrading enzymes and NGF, activated mast cells, one or more cytokines and endothelial-leucocyte adhesion molecules. CONCLUSIONS: These data document for the first time itch-related local markers in psoriasis, and suggest complex and multifactorial mechanisms of pruritus in the disease. These results provide the groundwork for further studies to evaluate the efficacy of antipruritic treatment for psoriatic patients.  相似文献   
796.
Background: Topical application of the calcineurin inhibitors pimecrolimus and tacrolimus is a current major advance in the therapy of atopic dermatitis. The aims of this post‐marketing surveillance were: a) to acquire data on the efficacy and tolerability of pimecrolimus ointment (Elidel®) on a very large cohort of patients from outpatient clinics, and b) to assess changes in their quality of life, a parameter not often considered in previous studies. Patients and methods: Included were 5,665 patients with atopic dermatitis. During the observation period, data on efficacy and tolerability were obtained at the beginning of the study, 3 to 10 days after initiation of therapy and after 4 to 6 weeks. Evaluation of symptoms as well as assessment of efficacy and tolerability were based on linear scales and on the percentage of the body surface area (% BSA) involved. Quality of life was assessed by the German version of the “Dermatology Life Quality Index (DLQI)” or the “Children's Dermatology Life Quality Index (CDLQI)”. Results: In this largest post‐marketing surveillance hitherto performed in Germany, the efficacy of pimecrolimus was judged as “good” by 79.3 % of physicians and by 76.5 % of patients. Tolerability was assessed as “good” by 87.2 % of physicians and by 83.1 % of patients. Major symptoms of atopic dermatitis such as pruritus, erythema or lichenification showed marked reduction after just 3 to 10 days, signalling general improvement of the skin disease. In addition, application of pimecrolimus resulted in a significant improvement of the quality of life scores in both children and adults. Conclusion: The present study demonstrates that the good efficacy and tolerability of pimecrolimus ointment which had been shown in controlled trials: i) could also be demonstrated on a very large cohort of patients with atopic dermatitis when used in the outpatient setting, and ii) were paralleled by a significant improvement in the quality of life.  相似文献   
797.
Hydroxyethyl starch (HES) is widely used for fluid management in broad populations of patients, particularly in the surgery and intensive care settings. Pruritus, often manifested as pruritic crises, is increasingly being recognized as a common major adverse effect of HES administration. This iatrogenic form of pruritus is frequently severe and protracted with a serious negative impact on patient quality of life, including sleep disturbance, disruption of daily routine and mental distress. Such pruritus is generally refractory to available therapies and can persist for up to 12-24 months. All currently clinically available HES solutions entail the risk of pruritus, including those of diverse molecular weights and substitutions. Although dose dependent, HES-induced pruritus nevertheless can often be provoked by relatively low routine doses. The pathophysiological basis for pruritus is the widespread tissue deposition of HES, prominently in macrophages. HES tissue deposits are long lasting and sometimes massive. Usually several weeks elapse between HES exposure and the onset of pruritus. Consequently, it is important to inquire about prior HES exposure in the diagnostic evaluation of pruritus sine materia. Awareness about the scope of the pruritus problem needs to increase among physicians administering HES. Well-designed clinical outcome studies are needed to assess more fully the incidence, dose dependency and mechanisms of pruritus with particular HES solutions.  相似文献   
798.
Skin symptoms among workers in a spice factory   总被引:1,自引:0,他引:1  
Workers in a Swedish spice factory ( n = 70). and in the office ( n =23) of the same company, were investigated by questionnaire regarding skin symptoms. In a 2nd part of the study, subjects reporting skin symptoms were examined and investigated by patch and prick testing. Skin symptoms were reported by 1/2 the factory workers. Pruritus and skin irritation, particular from cinnamon powder, were common, Patch test reactions to cinnamic aldehyde were found in 11/25 factory workers, but in several cases, the nature of the reactions was difficult to evaluate. Irritant patch test reactions were seen from powders of cardamom, paprika and white pepper. On prick testing, 6/25 workers reacted to cinnamic aldehyde. The results illustrate the difficulties of patch testing with spices and indicate the need for further research and validation of methods.  相似文献   
799.
目的:比较枸地氯雷他定片单独使用和与针灸配合使用的疗效差异。方法:将160例门诊病人随机分为治疗组和对照组,各80例,治疗组采用针灸加口服枸地氯雷他定片;对照组单纯口服枸地氯雷他定片。结果:治疗组痊愈39例(占48.8%),显效30例(占37.5%),总有效率86.3%;对照组痊愈23例(占28.8%),显效33例(占41.3%),总有效率70.1%;治疗组与对照组疗效比较有显著性差异(P〈0.05)。结论:针灸配合口服枸地氯雷他定片对老年皮肤瘙痒症有较好的疗效。  相似文献   
800.
Dandruff/seborrhoeic dermatitis (D/SD) is characterized by Malassezia colonization, impaired barrier function with subsequent inflammation, resulting in dandruff and itching. Histamine is one of the biomarkers of pruritus now widely used in treatment efficacy trials. The exact mechanism leading to histamine release and pruritus is not yet clear. However, it could involve cathepsin S, an activator of proteinase‐activated receptor 2 (PAR2). The purpose of this study was to evaluate the levels of cathepsin S, PAR2 and histamine in patients with D/SD compared with healthy subjects through non‐invasive sampling of the scalp and to correlate those markers with D/SD clinical parameters. A significant increase in the three biological markers was observed in the D/SD group versus healthy subjects, and those markers were correlated with clinical parameters. In conclusion, cathepsin S could be a potential marker of pruritus in D/SD and could help assessing the effect of treatments.  相似文献   
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