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1.
Topical treatments for seasonal allergic conjunctivitis: systematic review and meta-analysis of efficacy and effectiveness 总被引:3,自引:0,他引:3
Christopher G Owen Anupa Shah Katherine Henshaw Liam Smeeth Aziz Sheikh 《The British journal of general practice》2004,54(503):451-456
BACKGROUND: Evidence for the effectiveness of topical treatments, in providing symptomatic relief from ocular allergy, remains uncertain. AIMS: To assess the effectiveness and relative efficacy of topical treatments for the management of seasonal allergic conjunctivitis. DESIGN OF STUDY: A systematic review and meta-analysis. SETTING: A literature search of the Cochrane Library, Medline, and EMBASE bibliographic databases. METHOD: Double-masked randomised controlled trials were identified, that compared the use of topical mast cell stabilisers (sodium cromoglycate, nedocromil, lodoxamide) with placebo, topical antihistamines with placebo, and topical mast cell stabilisers with topical antihistamines. RESULTS: A meta-analysis of six trials showed that patients using sodium cromoglycate were 17 times (95% confidence interval [CI] = 4 to 78) more likely to perceive benefit compared with those using a placebo, although this estimate may be partially influenced by publication bias. Five trials indicated that those patients using nedocromil were 1.8 times (95% CI = 1.3 to 2.6) more likely to perceive their allergy to be moderately or totally controlled than those using a placebo. Four trials showed that those using antihistamines were 1.3 times (95% CI = 0.8 to 2.2) more likely to perceive a 'good' treatment effect than those using mast cell stabilisers, although this beneficial effect was not statistically significant. Limited evidence suggests that antihistamines might have a faster therapeutic effect compared to mast cell stabilisers. CONCLUSION: Overall, these findings confirm the benefit of topical mast cell stabilisers and antihistamines over placebo for the treatment of allergic conjunctivitis. There is, however, insufficient evidence to recommend the use of one type of medication over another. Treatment preferences should therefore be based on convenience of use (with reduced frequency of instillation for some preparations), patient preference, and costs, especially as important side effects were not reported with any medication. 相似文献
2.
S Lakhey R L Pradhan M Bishwakarma S Pradhan S Pradhanaga B K Pandey K P Rijal 《Kathmandu University Medical Journal》2006,4(3):316-318
Introduction: Internal fixation of diaphyseal fracture of shaft of femur in an adult by Kuntscher nail is the most common operative method of treatment in Nepal where operative facilities for the same exist. Since the complete range of K-nail sizes and length are not available in most operation theatres in Nepal, most orthopaedic surgeons assess the size and length of the K-nail pre-operatively by various methods and keep one size above and below the assessed length for the planned surgery. Materials and Methods: The following measurements were taken in five hundred people involved in the study: Measurement No. 1: Tip of the greater trochanter to lateral knee joint line minus 2cms. Measurement No. 2: Tip of the olecranon process to the tip of little finger, and Measurement No. 3: Tip of the greater trochanter to the upper pole of patella. An average of all three lengths were analysed to see if there were any differences in their mean lengths. Results: Analysis showed that there were significant differences between the mean lengths measured by the three different methods. The average length of measurement no: 2 was 3 cm longer than the average length of measurement no: 1, which is the reference pre-operative length of K.nail. Conclusion: However, in practice since measurement no:2 is more convenient to perform and can also be used when the patient has sustained bilateral fractures of femur, an accurate pre-operative K-nail length assessment can be done by subtracting 3 cm from measurement no:2, i.e. the tip of the olecranon process to the tip of the little finger. 相似文献
3.
Suraj Shrestha Sushan Homagain Suraj Bhatta Sansar Babu Tiwari Rishikesh Rijal Roshan Aryal Nisha Sharma Pooja Paudyal Neeta Katuwal Suniti Joshi Rawal 《Clinical Case Reports》2022,10(5)
Pure Sertoli cell tumors are an uncommon variant of rare ovarian Sertoli‐Leydig cell tumors. Due to nonspecific clinical and imaging features, diagnosis is often made after histopathological examination. The prognosis is excellent as most are detected in the early stages and surgical resection is often curative in most cases. 相似文献
4.
S. Hendrickx G. Boulet A. Mondelaers J. C. Dujardin S. Rijal L. Lachaud P. Cos P. Delputte L. Maes 《Parasitology research》2014,113(5):1875-1881
Although widespread resistance of Leishmania donovani and L. infantum against miltefosine (MIL) and paromomycin (PMM) has not yet been demonstrated, both run the risk of resistance selection. Unraveling the dynamics and mechanisms of resistance development is key to preserve drug efficacy in the field. In this study, resistance against PMM and MIL was experimentally selected in vitro in intracellular amastigotes of several strains of both species with different antimony susceptibility background. To monitor amastigote susceptibility, microscopic determination of IC50-values and promastigote back-transformation assays were performed. Both techniques were also used to evaluate the susceptibility of field isolates from MIL-relapse patients. PMM-resistance could readily be selected in all species/strains, although promastigotes remained fully PMM-susceptible. Successful MIL-resistance selection was demonstrated only by promastigote back-transformation at increasing MIL-concentrations upon successive selection cycles. Important to note is that amastigotes with the MIL-resistant phenotype could not be visualized after Giemsa staining; hence, MIL-IC50-values showed no shift. The same phenomenon was observed in a set of recent clinical isolates from MIL-relapse patients. This study clearly endorses the need to use intracellular amastigotes for PMM- and MIL-susceptibility testing. When monitoring MIL-resistance, promastigote back-transformation should be used instead of the standard Giemsa staining. In-depth exploration of the mechanistic background of this finding is warranted. 相似文献
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7.
Kuan-Ying A. Huang Pramila Rijal Lisa Schimanski Timothy J. Powell Tzou-Yien Lin John W. McCauley Rodney S. Daniels Alain R. Townsend 《The Journal of clinical investigation》2015,125(7):2631-2645
The selective pressure that drives antigenic changes in influenza viruses is thought to
originate from the human immune response. Here, we have characterized the B cell
repertoire from a previously vaccinated donor whose serum had reduced neutralizing
activity against the recently evolved clade 6B H1N1pdm09 viruses. While the response was
markedly polyclonal, 88% of clones failed to recognize clade 6B viruses; however, the
ability to neutralize A/USSR/90/1977 influenza, to which the donor would have been exposed
in childhood, was retained. In vitro selection of virus variants with representative
monoclonal antibodies revealed that a single amino acid replacement at residue K163 in the
Sa antigenic site, which is characteristic of the clade 6B viruses, was responsible for
resistance to neutralization by multiple monoclonal antibodies and the donor serum. The
K163 residue lies in a part of a conserved surface that is common to the hemagglutinins of
the 1977 and 2009 H1N1 viruses. Vaccination with the 2009 hemagglutinin induced an
antibody response tightly focused on this common surface that is capable of selecting
current antigenic drift variants in H1N1pdm09 influenza viruses. Moreover, amino acid
replacement at K163 was not highlighted by standard ferret antisera. Human monoclonal
antibodies may be a useful adjunct to ferret antisera for detecting antigenic drift in
influenza viruses. 相似文献
8.
Ante mortem diagnosis of human rabies using saliva samples: comparison of real time and conventional RT-PCR techniques. 总被引:1,自引:0,他引:1
T Nagaraj Joel P Vasanth Anita Desai Anupa Kamat S N Madhusudana V Ravi 《Journal of clinical virology》2006,36(1):17-23
BACKGROUND: Rabies is an enzootic and fatal disease and is still a major problem in developing countries. Ante mortem diagnosis in human cases is necessary for medical management of the patient and to ensure appropriate post-exposure treatment of contacts. Both conventional RT-PCR and Real time PCR (TaqMan) have been described for the detection of rabies virus RNA from saliva and tissue respectively, however to date, there have been no studies comparing conventional and real time PCR assays for detection of rabies virus nucleic acid using saliva samples for ante mortem diagnosis. OBJECTIVES: In this study, we evaluated the utility of conventional RT-PCR and SYBR Green I Real time PCR in the ante mortem diagnosis of rabies using saliva samples. STUDY DESIGN: Saliva samples collected from twenty-four patients presenting with typical clinical manifestations of rabies were tested in the two assays. RESULTS: Amongst the 24 samples tested, 21 samples (87.5%) were positive by either of the two molecular methods. Of these 21, rabies virus RNA was detected in 6/21 in the conventional RT-PCR assay while SYBR Green I Real time PCR could detect RNA in 18/21 samples. CONCLUSION: Real time PCR assay was more sensitive than conventional RT-PCR assay (sensitivity 75% versus 37%, p=0.0189). This study highlights the utility of molecular diagnostic tests in establishing ante mortem diagnosis of rabies using saliva samples within a few hours. 相似文献
9.
10.
De Doncker S Hutse V Abdellati S Rijal S Singh Karki BM Decuypere S Jacquet D Le Ray D Boelaert M Koirala S Dujardin JC 《Transactions of the Royal Society of Tropical Medicine and Hygiene》2005,99(1):25-31
The PCR-ELISA represents a promising advance for diagnosis of visceral leishmaniasis (VL) in blood samples. However, the method has been validated mostly with HIV-positive patients who are known to have high levels of parasitaemia. We developed a new PCR-ELISA assay for specific detection of Leishmania in patients' blood and validated it in Nepalese subjects with clinically suspected VL, almost all of whom were HIV-negative. For blood samples, PCR-ELISA was more sensitive (83.9%) than conventional PCR (73.2%), and demonstrated 100% and 87.2% specificity when using healthy controls who had never travelled to a VL-endemic area and controls from a VL-endemic area as references, respectively. We have demonstrated the ability of PCR-ELISA to detect parasites in blood of HIV-negative patients. The method could be used for epidemiological as well as clinical purposes, as it reduces the need for traumatic bone marrow sampling and risky spleen aspiration. 相似文献