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排序方式: 共有109条查询结果,搜索用时 15 毫秒
1.
目的 通过分析糖尿病高危足患者临床资料及预后,为糖尿病足溃疡的预防提供临床依据。方法 对2012年1月1日-2018年12月31日在四川大学华西医院住院的糖尿病高危足患者进行了回顾性分析,按照既往是否有足溃疡或者截肢(趾)史,分为高风险组和低风险组。比较两组患者的临床特征,并随访患者从出院至2021年1月31日,对患者生存及溃疡复发或新发状况进行了评估。结果 最终纳入患者123例,高风险组患者29例,低风险组患者94例。两组患者的糖尿病病程、吸烟史、饮酒史、受教育程度、接受正规治疗比例、定期监测血糖比例、体质量指数、合并糖尿病周围神经病变、胼胝、足畸形、糖尿病肾病、糖尿病视网膜病变、糖尿病心脏自主神经病变、糖尿病胃肠自主神经病变、高血压、冠心病的比例和实验室检查结果差异无统计学意义(P>0.05)。高风险组的女性比例(51.7%vs. 29.8%)、年龄[(69.8±10.3)vs.(64.4±11.3)岁]、合并下肢动脉病变比例(62.1%vs. 34.4%)、合并高尿酸血症比例(27.6%vs. 10.6%)高于低风险组(P<0.05)。在随访(67±20)个月后,有2... 相似文献
2.
Puri V Ranjit S Konda S Nicoloro SM Straubhaar J Chawla A Chouinard M Lin C Burkart A Corvera S Perugini RA Czech MP 《Proceedings of the National Academy of Sciences of the United States of America》2008,105(22):7833-7838
Storage of energy as triglyceride in large adipose-specific lipid droplets is a fundamental need in all mammals. Efficient sequestration of fat in adipocytes also prevents fatty acid overload in skeletal muscle and liver, which can impair insulin signaling. Here we report that the Cide domain-containing protein Cidea, previously thought to be a mitochondrial protein, colocalizes around lipid droplets with perilipin, a regulator of lipolysis. Cidea-GFP greatly enhances lipid droplet size when ectopically expressed in preadipocytes or COS cells. These results explain previous findings showing that depletion of Cidea with RNAi markedly elevates lipolysis in human adipocytes. Like perilipin, Cidea and the related lipid droplet protein Cidec/FSP27 are controlled by peroxisome proliferator-activated receptor gamma (PPARgamma). Treatment of lean or obese mice with the PPARgamma agonist rosiglitazone markedly up-regulates Cidea expression in white adipose tissue (WAT), increasing lipid deposition. Strikingly, in both omental and s.c. WAT from BMI-matched obese humans, expression of Cidea, Cidec/FSP27, and perilipin correlates positively with insulin sensitivity (HOMA-IR index). Thus, Cidea and other lipid droplet proteins define a novel, highly regulated pathway of triglyceride deposition in human WAT. The data support a model whereby failure of this pathway results in ectopic lipid accumulation, insulin resistance, and its associated comorbidities in humans. 相似文献
3.
4.
Petra Ehling Manuela Cerina Patrick Meuth Tatyana Kanyshkova Pawan Bista Philippe Coulon Sven G. Meuth Hans-Christian Pape Thomas Budde 《Pflügers Archiv : European journal of physiology》2013,465(4):469-480
Mutations in genes coding for Ca2+ channels were found in patients with childhood absence epilepsy (CAE) indicating a contribution of Ca2+-dependent mechanisms to the generation of spike-wave discharges (SWD) in humans. Since the involvement of Ca2+ signals remains unclear, the aim of the present study was to elucidate the function of a Ca2+-dependent K+ channel (BKCa) under physiological conditions and in the pathophysiological state of CAE. The activation of BKCa channels is dependent on both voltage and intracellular Ca2+ concentrations. Moreover, these channels exhibit an outstandingly high level of regulatory heterogeneity that builds the basis for the influence of BKCa channels on different aspects of neuronal activity. Here, we analyse the contribution of BKCa channels to firing of thalamocortical relay neurons, and we test the hypothesis that BKCa channel activity affects the phenotype of a genetic rat model of CAE. We found that the activation of the β2-adrenergic receptor/protein kinase A pathway resulted in BKCa channel inhibition. Furthermore, BKCa channels affect the number of action potentials fired in a burst and produced spike frequency adaptation during tonic activity. The latter result was confirmed by a computer modelling approach. We demonstrate that the β2-adrenergic inhibition of BKCa channels prevents spike frequency adaptation and, thus, might significantly support the tonic firing mode of thalamocortical relay neurons. In addition, we show that BKCa channel functioning differs in epileptic WAG/Rij and thereby likely contributes to highly synchronised, epileptic network activity. 相似文献
5.
Richard S. Finkel Erika Finanger Krista Vandenborne H. Lee Sweeney Gihan Tennekoon Perry B. Shieh Rebecca Willcocks Glenn Walter William D. Rooney Sean C. Forbes William T. Triplett Sabrina W. Yum Maria Mancini James MacDougall Angelika Fretzen Pradeep Bista Andrew Nichols Joanne M. Donovan 《Neuromuscular disorders : NMD》2021,31(5):385-396
Chronic activation of NF-κB is a key driver of muscle degeneration and suppression of muscle regeneration in Duchenne muscular dystrophy. Edasalonexent (CAT-1004) is an orally-administered novel small molecule that covalently links two bioactive compounds (salicylic acid and docosahexaenoic acid) that inhibit NF-κB. This placebo-controlled, proof-of-concept phase 2 study with open-label extension in boys ≥4-<8 years old with any dystrophin mutation examined the effect of edasalonexent (67 or 100 mg/kg/day) compared to placebo or off-treatment control. Endpoints were safety/tolerability, change from baseline in MRI T2 relaxation time of lower leg muscles and functional assessment, as well as pharmacodynamics and biomarkers. Treatment was well-tolerated and the majority of adverse events were mild, and most commonly of the gastrointestinal system (primarily diarrhea). There were no serious adverse events in the edasalonexent groups. Edasalonexent 100 mg/kg was associated with slowing of disease progression and preservation of muscle function compared to an off-treatment control period, with decrease in levels of NF-κB-regulated genes and improvements in biomarkers of muscle health and inflammation. These results support investigating edasalonexent in future trials and have informed the design of the edasalonexent phase 3 clinical trial in boys with Duchenne. 相似文献
6.
Bertram L. Kasiske Darren E. Stewart Bipin R. Bista Nicholas Salkowski Jon J. Snyder Ajay K. Israni Gretchen S. Crary John D. Rosendale Arthur J. Matas Francis L. Delmonico 《Clinical journal of the American Society of Nephrology》2014,9(3):562-571
Background and objectives
There is a shortage of kidneys for transplant, and many patients on the deceased donor kidney transplant waiting list would likely benefit from kidneys that are currently being discarded. In the United States, the most common reason given for discarding kidneys retrieved for transplant is procurement biopsy results. This study aimed to compare biopsy results from discarded kidneys with discard attributed to biopsy findings, with biopsy results from comparable kidneys that were successfully transplanted.Design, setting, participants, & measurements
In this retrospective, observational, case-control study, biopsy reports were examined from 83 kidneys discarded in 2010 due to biopsy findings (cases), 83 contralateral transplanted kidneys from the same donor (contralateral controls), and 83 deceased donors randomly matched to cases by donor risk profile (randomly matched controls). A second procurement biopsy was obtained in 64 of 332 kidneys (19.3%).Results
The quality of biopsy reports was low, with amounts of tubular atrophy, interstitial inflammation, arteriolar hyalinosis, and acute tubular necrosis often not indicated; 69% were wedge biopsies and 94% used frozen tissue. The correlation between first and second procurement biopsies was poor; only 25% of the variability (R2) in glomerulosclerosis was explained by biopsies being from the same kidney. The percentages of glomerulosclerosis overlapped substantially between cases, contralateral controls, and randomly matched controls: 17.1%±15.3%, 9.0%±6.6%, and 5.0%±5.9%, respectively. Of all biopsy findings, only glomerulosclerosis>20% was independently correlated with discard (cases versus contralateral controls; odds ratio, 15.09; 95% confidence interval, 2.47 to 92.41; P=0.003), suggesting that only this biopsy result was used in acceptance decisions. One-year graft survival was 79.5% and 90.7% in contralateral and randomly matched controls, respectively, versus 91.6% among all deceased donor transplants in the Scientific Registry of Transplant Recipients.Conclusions
Routine use of biopsies could lead to unnecessary kidney discards. 相似文献7.
The quality-of-life construct can be used to assess how well an individual's needs are met or being met by the society. However, in the dominant narratives of quality of life in old age, exploration of the impact of cultural differences on how older adults define and assess their quality of life has been limited. Moreover, the examination of heterogeneity within one culture and its influence on quality of life has been largely ignored. The present study compares the quality of life as defined by two samples of Nepali elderly women, those who live with their families and those who live in an old-age home, and presents data on factors associated with quality of life in the two samples. The results show that social and cultural norms, informed by religious principles that prescribe familial elder care, impact how quality of life is described by both groups of women. 相似文献
8.
Scott D. Spritzer Srijana Zarkou Stephen P. Ireland Jonathon L. Carter Brent P. Goodman 《Clinical autonomic research》2013,23(6):333-338
Background
Alexander disease (AxD) is an astrogliopathy, resulting from a mutation in the glial fibrillary astrocytic protein gene. Different clinical subtypes have been described, including infantile, juvenile, and adult onset, based upon the age at which symptoms begin. Patients with the adult-onset form, develop a progressive, spastic paraparesis, palatal myoclonus, ataxia, and bulbar weakness. Autonomic nervous system (ANS) dysfunction has been reported as a potential manifestation of adult-onset AxD, but has not been well characterized.Objective
We report a case of adult-onset AxD with symptomatic orthostatic hypotension (OH) and heat intolerance that underwent formal autonomic testing. In addition, a comprehensive literature search was conducted to review the frequency and pattern of autonomic dysfunction in this patient population.Results
A 51-year-old patient was diagnosed with AxD at the age of 47, following an 8-year history of vertigo, intermittent diplopia, and sleep disturbance. The patient developed symptoms of OH, erectile dysfunction, and heat intolerance soon after his diagnosis. Autonomic testing demonstrated OH on tilt-table testing (47 mmHg decrease in BP with 18 BPM heart rate increment) with absent late phase II and IV responses during the Valsalva maneuver, severe cardiovagal impairment, and preserved postganglionic sympathetic sudomotor function. These findings were interpreted as being consistent with central autonomic failure. The most common autonomic symptoms reported in other AxD cases include constipation, urinary incontinence, and sphincter dysfunction. To our knowledge, this is the first report of formal autonomic testing in AxD.Conclusion
Signs and symptoms of ANS impairment can occur in patients with AxD, and can include orthostatic hypotension and bowel/bladder dysfunction. Autonomic testing in our patient suggests impairment in central autonomic pathways. 相似文献9.
10.
Durga Bista Leanne Chalmers Luke Bereznicki Gregory Peterson 《European journal of clinical pharmacology》2014,70(7):817-828