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1.
Neuroendocrine regulation and actions of leptin   总被引:19,自引:0,他引:19  
The discovery of the adipocyte-produced hormone leptin has greatly changed the field of obesity research and our understanding of energy homeostasis. It is now accepted that leptin is the afferent loop informing the hypothalamus about the state of fat stores, with hypothalamic efferents regulating appetite and energy expenditure. In addition, leptin has a role as a metabolic adaptator in overweight and fasting states. New and previously unsuspected neuroendocrine roles have emerged for leptin. In reproduction, leptin is implicated in fertility regulation, and it is a permissive factor for puberty. Relevant gender-based differences in leptin levels exist, with higher levels in women at birth, which persist throughout life. In adult life, there is experimental evidence that leptin is a permissive factor for the ovarian cycle, with a regulatory role exerted at the hypothalamic, pituitary, and gonadal levels, and with unexplained changes in pregnancy and postpartum. Leptin is present in human milk and may play a role in the adaptive responses of the newborn. Leptin plays a role in the neuroendocrine control of GH secretion, through a complex interaction at hypothalamic levels with GHRH and somatostatin. Leptin participates in the expression of CRH in the hypothalamus, interacts at the adrenal level with ACTH, and is regulated by glucocorticoids. Since leptin and cortisol show an inverse circadian rhythm, it has been suggested that a regulatory feedback is present. Finally, regulatory actions on TRH-TSH and PRL secretion have been found. Thus leptin reports the state of fat stores to the hypothalamus and other neuroendocrine areas, and the neuroendocrine systems adapt their function to the current status of energy homeostasis and fat stores.  相似文献
2.
Serum insulin and leptin levels in valproate-associated obesity   总被引:18,自引:4,他引:14  
PURPOSE: Weight gain is an important adverse effect of valproate (VPA) therapy, and it is associated with hyperinsulinemia and hyperandrogenism in women with epilepsy. Leptin is considered a signaling factor regulating body weight and energy metabolism. In human subjects, obesity is in general associated with elevated serum leptin levels, suggesting decreased sensitivity to leptin. The present study aimed at evaluating the role of insulin and leptin in VPA-related obesity. METHODS: Body mass index (BMI) was calculated, and serum insulin and leptin levels were measured in 81 patients with epilepsy taking VPA and in 51 healthy control subjects. RESULTS: Forty (49%) of the patients taking VPA and 25 (49%) of the control subjects were obese. The mean insulin levels were higher in VPA-treated patients than in the control subjects despite similar BMI values, when all subjects were included in the comparison. Both obese male and female patients taking VPA had higher serum insulin levels than the respective control subjects with similar BMI values. Serum insulin levels also were higher in lean male and lean female patients compared with the lean control subjects of same sex. Serum leptin levels did not differ between the VPA-treated patients and the control subjects. CONCLUSIONS: Both obese and lean patients taking VPA for epilepsy have hyperinsulinemia, suggesting development of insulin resistance. This may be one of the factors leading to weight gain during VPA treatment. However, the results of the present study do not suggest an independent role for leptin in the pathogenesis of VPA-related obesity.  相似文献
3.
Activation of the satiety center by auricular acupuncture point stimulation   总被引:13,自引:0,他引:13  
Stimulation of the rat inner auricular regions that correspond to the human pylorus, lung, trachea, stomach, esophagus, endocrine, and heart acupuncture points evoked potentials in the hypothalamic ventromedial nucleus (HVM), the satiety center. Needle implantation into any of these points reduced the body weight to its initial 290 g after the rat had gained about 410 g in 20 days, and significantly reduced initial 450-g body weights (p less than 0.01, Student's t test) in 14 days. Stimulation of other acupuncture points did not evoke HVM potentials and did not reduce body weight. After the HVM was lesioned, body weight increased and acupuncture point needling had no effect on body weight. Needling of the auricular acupuncture points evoked no potentials in the lateral hypothalamus (LHA), the feeding center, and had almost no influence on weight reduction induced by LHA lesion.  相似文献
4.
OBJECTIVE: To compare weight-related concerns and behaviors across ethnicity/race among a population-based sample of adolescent boys and girls. METHODS: The study population included 4746 adolescents from urban public schools in the state of Minnesota who completed surveys and anthropometric measurements as part of Project EAT (Eating Among Teens), a population-based study focusing on eating patterns and weight concerns among teenagers. Main outcome measures included measured body mass index (BMI), weight-related concerns (perceived weight status, weight disparity, body satisfaction and attitudes about weight control) and weight-related behaviors (general/specific weight control behaviors and binge eating). RESULTS: In comparison to White girls, African American girls tended to report fewer weight-related concerns/behaviors, while Hispanic, Asian American and Native American girls tended to report similar or more concerns/behaviors. Among boys, weight-related concerns/behaviors were equally or more prevalent among all non-Whites than among Whites. In particular, African American and Asian American boys were at greater risk for potentially harmful weight-related concerns/behaviors than White boys. CONCLUSIONS: Weight-related concerns and behaviors are prevalent among adolescents, regardless of their ethnic/racial background, indicating a need for prevention and treatment efforts that reach adolescents of different ethnic backgrounds. However, ethnic differences demonstrate a need for ensuring that the specific needs of different groups are addressed in the development of such interventions.  相似文献
5.
A review of psychosocial outcomes of surgery for morbid obesity   总被引:12,自引:0,他引:12  
There is consistent evidence to support the notion that morbid obesity poses serious risks to physical health and has a substantial impact on psychosocial well-being. Researchers agree that bariatric surgery is currently the most viable option for successful weight loss and maintenance in the morbidly obese individual. The drastic, major weight loss and alleviation of medical risks that patients typically experience post-surgically are accompanied by psychosocial changes that appear to be equally remarkable. These psychosocial changes have yet to be studied as systematically or diligently as the physical changes and therefore remain to be fully understood. This paper (1) reviews the literature of psychosocial outcomes of obesity surgery for the past 36 years; (2) provides a critical assessment of the methodology utilized; and (3) suggests future research directions.  相似文献
6.
Bergen HT  Mizuno T  Taylor J  Mobbs CV 《Brain research》1999,851(1-2):198-203
Mechanisms mediating genetic susceptibility to diet-induced obesity have not been completely elucidated. Elevated hypothalamic neuropeptide Y (NPY) and decreased hypothalamic proopiomelanocortin (POMC) are thought to promote the development and maintenance of obesity. To assess the potential role of hypothalamic neuropeptide gene expression in diet-induced obesity, the present study examined effects of a high-fat diet on hypothalamic NPY and POMC mRNA in three strains of mice that differ in susceptibility to develop diet-induced obesity. C57BL/6J, CBA, and A/J mice were fed either normal rodent chow or a high-fat diet for 14 weeks after which hypothalamic gene expression was measured. On the high-fat diet, C57BL/6J mice gained the most weight, whereas A/J mice gained the least weight. On the high-fat diet, NPY mRNA significantly decreased as body weight increased in CBA and A/J mice, but not in C57BL/6J mice. In addition, POMC mRNA significantly increased as body weight increased in A/J mice, but not in CBA and C57BL/6J mice. Since decreased NPY mRNA and increased POMC mRNA would presumably attenuate weight gain, these results suggest that a high-fat diet produces compensatory changes in hypothalamic gene expression in mice resistant to diet-induced obesity but not in mice susceptible to diet-induced obesity.  相似文献
7.
Objectives – Nutritional status in the acute stage of stroke has not been properly evaluated in different stroke subtypes. The objective of this study was to investigate the nutritional status of different subtypes of stroke patients. Subjects and methods – We studied 88 female patients with first-ever strokes. Strokes were divided into cerebral infarction (CI, n =67) and intracerebral hemorrhage (ICH, n =21). We measured the nutritional status of the patients in the acute stage of stroke with the use of 8 parameters including 3 biochemical and 5 anthropometric ones. These variables were assessed in stroke patients and 120 age-matched controls, and were compared with each other. Results – In the acute stage of stroke, undernourishment was significantly ( P =0.000) more prevalent in the ICH group (62%) than in the CI group (25%) or controls (13%). On the other hand obesity was present in 10%, 24% and 17% in patients with ICH, those with CI, and controls, respectively, which was not significantly different ( P =0.461). Only abdominal skinfold thickness was significantly greater in patients with CI than in those with ICH or controls. Conclusions – Our results illustrate that undernourishment is prevalent in acute stroke patients, significantly more so in patients with ICH than in those with CI. Stroke patients, especially those with ICH, should receive special nutritional intervention starting immediately after admission.  相似文献
8.
血清瘦素与抗精神病药源性肥胖及糖尿病的相关性研究   总被引:10,自引:3,他引:7  
目的 调查和探讨长期使用抗精神病药患者血瘦素水平及其与服用抗精神病药后体重 增加、肥胖及糖尿病之间的关系。方法 对符合入组标准的308例长期服用抗精神病药的精神分裂症 患者分为对照组、肥胖组、糖耐量减低组及糖尿病组,比较血清瘦素水平、胰岛素抵抗指数、血清甘油三 酯及总胆固醇水平。结果 (1)肥胖组、糖耐量减低组及糖尿病组患者的血清瘦素水平、胰岛素抵抗指 数、血清甘油三酯及总胆固醇水平均显著高于对照组(P<0.05)。(2)长期应用抗精神病药患者血瘦 素水平与体重指数、简易胰岛素抵抗指数、空腹血糖、血甘油三酯及胆固醇均呈极显著正相关(P<0.01 ~0.0001),而与餐后2h血糖水平及用药时间无相关性。结论 长期应用抗精神病药患者血瘦素水 平在肥胖、糖耐量降低及糖尿病患者中显著升高,且与体重指数、简易胰岛素抵抗指数、空腹血糖水平等 均呈显著正相关,提示高血清瘦素水平是长期应用抗精神病药所致的代谢紊乱综合征的重要指征之一。  相似文献
9.
Many of the leading causes of death and disability in the United States and other countries are associated with socioeconomic position. The least well-off suffer a disproportionate share of the burden of disease, including depression, obesity, and diabetes. Research suggests that the adverse effects of economic hardship on both mental and physical health and functioning are evident at young ages and persist across the lifecourse. Moreover, these associations are seen across cultures. Data from four large epidemiologic studies on the role of psychological characteristics, social factors, and behaviors in health and disease risk are presented that highlight the striking associations between socioeconomic factors and chronic diseases. Data from these studies demonstrate that the effects of economic disadvantage are cumulative, with the greatest risk of poor mental and physical health seen among those who experienced sustained hardship over time.  相似文献
10.
Melanin concentrating hormone (MCH) and the orexins (A and B) have been identified as neuropeptides localized to the lateral hypothalamic area (LHA) and are potential regulators of energy homeostasis. Potential factors regulating expression of both MCH and the orexins include fasting and leptin. Previous studies have generated conflicting data and, as there is little leptin receptor expressed in the lateral hypothalamus, it is likely that any observed leptin effects on these peptides are indirect. In this study, we examined MCH and preproorexin expression in mice in physiological states of starvation, with or without leptin administration, in addition to characterizing MCH and preproorexin expression in well-known obesity models, including ob/ob and UCP-DTA mice. Neuropeptide Y (NPY) expression in the arcuate nucleus was used as a positive control. After a 60-h fast, expression of both NPY and MCH mRNA was increased (by 148 and 33%, respectively) while preproorexin expression in the murine LHA did not change. Leptin administration to fasted mice blunted the rise in MCH and NPY expression towards control levels. In contrast, there was a 78% increase in preproorexin expression in fasted mice in response to peripheral leptin administration. MCH expression was increased (by 116%) in ob/ob mice at baseline, as we have previously reported. In addition, leptin treatment of ob/ob mice blunted the increase in MCH expression. In contrast, preproorexin expression did not differ in the leptin-deficient ob/ob mice or in the obese hyperleptinemic brown adipose tissue deficient (UCP-DTA) mice in comparison with controls. In summary, MCH expression is increased in two states of decreased leptin, fasting and ob/ob mice, and leptin replacement blunts MCH expression in both paradigms. Thus, MCH expression appears to be regulated by leptin. In contrast, preproorexin expression does not respond acutely to fasting, although it is acutely increased by leptin treatment during fasting. These preproorexin responses are in contrast to those seen with well-characterized orexigenic neuropeptides, such as NPY and AgRP, suggesting that appetite regulation may not be a significant physiological role of orexins. This conclusion is further supported by the observation that orexin ablated mice have arousal and not feeding deficits.  相似文献
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