全文获取类型
收费全文 | 118篇 |
免费 | 12篇 |
国内免费 | 1篇 |
专业分类
耳鼻咽喉 | 4篇 |
儿科学 | 4篇 |
妇产科学 | 12篇 |
基础医学 | 26篇 |
口腔科学 | 1篇 |
临床医学 | 26篇 |
内科学 | 15篇 |
皮肤病学 | 2篇 |
神经病学 | 15篇 |
外科学 | 2篇 |
综合类 | 2篇 |
预防医学 | 8篇 |
眼科学 | 5篇 |
药学 | 4篇 |
肿瘤学 | 5篇 |
出版年
2023年 | 1篇 |
2021年 | 6篇 |
2020年 | 3篇 |
2019年 | 8篇 |
2018年 | 5篇 |
2017年 | 5篇 |
2016年 | 2篇 |
2015年 | 6篇 |
2014年 | 2篇 |
2013年 | 9篇 |
2012年 | 4篇 |
2011年 | 9篇 |
2010年 | 2篇 |
2009年 | 5篇 |
2008年 | 5篇 |
2007年 | 4篇 |
2006年 | 4篇 |
2005年 | 9篇 |
2004年 | 7篇 |
2003年 | 5篇 |
2002年 | 4篇 |
2001年 | 3篇 |
2000年 | 7篇 |
1999年 | 5篇 |
1998年 | 1篇 |
1997年 | 1篇 |
1996年 | 2篇 |
1995年 | 1篇 |
1991年 | 1篇 |
1986年 | 1篇 |
1985年 | 1篇 |
1975年 | 1篇 |
1933年 | 1篇 |
1923年 | 1篇 |
排序方式: 共有131条查询结果,搜索用时 15 毫秒
21.
22.
Melissa A. Stec Megan W. Arbour Heather Findletar Hines 《Journal of Midwifery & Women's Health》2019,64(3):324-329
The use of mobile devices and applications (apps) to monitor or assist in health behaviors is rapidly expanding in many areas of society. Clinicians desire evidence‐based app recommendations for their clients to increase self‐care and wellness management in such areas as mindfulness, weight loss and activity tracking, glycemic control, and consumer medication information. Given the constant influx of new apps into the major app repositories, clinicians need to be able to ensure the quality of information and interaction that occurs within the mobile health (mHealth) marketplace. The Mobile Application Rating Scale (MARS) and the user version of the scale are valid and reliable instruments used to examine the engagement, functionality, aesthetics, and quality of information in mHealth apps. MARS‐rated apps can be readily available resources for busy clinicians to make app suggestions to assist clients on a variety of topics that promote improved outcomes. This article reviews the MARS instrument and utilization of the instrument by clinicians and summarizes several primary care and wellness apps that have been evaluated using this tool. 相似文献
23.
Céline Gélinas Madalina Boitor Kathleen A. Puntillo Caroline Arbour Jane Topolovec-Vranic Michael D. Cusimano Manon Choinière David L. Streiner 《Journal of pain and symptom management》2019,57(4):761-773
Context
Many brain-injured patients are unable to self-report their pain during their hospitalization in the intensive care unit (ICU), and existing behavioral pain scales may not be well suited.Objectives
The objectives of this study were to describe and compare behaviors in brain-injured patients with different levels of consciousness during nociceptive and nonnociceptive care procedures in the ICU and to examine interrater agreement of individual behaviors as well as discriminative and criterion validation of putative pain behaviors.Methods
Brain-injured ICU patients were observed using a 40-item behavioral checklist before and during soft touch (i.e., nonnociceptive procedure), turning, and other care procedures (nociceptive) by pairs of trained raters. When possible, patients self-reported their pain on a 0–10 visual thermometer. Patients were classified into unconscious (Glasgow Coma Scale, 3<GCS≤8), altered consciousness (9≤GCS≤12), or conscious (13≤GCS≤15).Results
A sample of 147 patients participated (65 conscious, 56 altered consciousness, and 26 unconscious). Active behaviors (e.g., face expressions and body movements) were more frequent in conscious patients. High-percentage interrater agreement (80%–98%) was obtained for most behaviors. The total number of active behaviors was significantly higher during turning and other nociceptive procedures compared with rest (Wilcoxon = 9.873, P < 0.001) and soft touch (Wilcoxon = 9.486, P < 0.001) regardless of levels of consciousness. The strongest predictors of pain intensity (n = 33) were grimace, mouth opening, orbit tightening, eye weeping, and eyes tightly closed; these behaviors were moderately correlated with self-reported pain intensity (Spearman rho = 0.47).Conclusion
These findings may guide the revision of existing pain scales to make their content more suited for this population. 相似文献24.
Henry V Chung Mark Riley Jin K Ho Benjamin Leung Gareth P Jevon Laura T Arbour Colin Barker Richard Schreiber Eric M Yoshida 《Journal canadien de gastroenterologie》2007,21(9):565-568
BACKGROUND: It has been previously reported that British Columbia's (BC's) First Nations (Aboriginal) community has an increased risk of autoimmune diseases, including rheumatological conditions (rheumatoid arthritis, systemic lupus) and primary biliary cirrhosis. The researchers hypothesized that this community may also be at increased risk for autoimmune hepatitis (AIH). METHODS: Independent, retrospective reviews of the databases of two separate tertiary/quaternary British Columbia university-affiliated health care institutions, the Adult Liver Transplant Program of the BC Transplant Society and the Division of Pediatric Gastroenterology, BC Children's Hospital (Vancouver, BC), were performed. All patients referred with a diagnosis of probable or definite AIH who identified themselves as being of First Nations descent from 1988 to 2004 were reviewed. The liver transplant database records all adult patients in the province referred for transplant assessment. The pediatric database records all children referred to the BC Children's Hospital. RESULTS: A total of 68 adult patients with a definite or probable diagnosis of AIH were referred to the liver transplant program. Twelve patients (17.6%) were Aboriginal, 11 of which were female. Similarly, a total of 30 children with probable or definite AIH were identified from the pediatric database. Six of these cases (20%) were identified in Aboriginal children. CONCLUSIONS: The findings suggest an increased prevalence of AIH among BC's First Nations community. A disproportionate First Nations representation was found on independent review of two databases. Future studies are needed to determine the true prevalence of AIH in this community, and to uncover the genetic predisposition and the environmental triggers explaining this phenomenon. 相似文献
25.
26.
Sorcha A. Collins Graham Sinclair Sarah McIntosh Fiona Bamforth Robert Thompson Isaac Sobol Geraldine Osborne Andre Corriveau Maria Santos Brendan Hanley Cheryl R. Greenberg Hilary Vallance Laura Arbour 《Molecular genetics and metabolism》2010,99(2-3):200-204
Carnitine palmitoyltransferase 1A (CPT1A), encoded by the gene CPT1A, is the hepatic isoform of CPT1 and is a major regulatory point in long-chain fatty acid oxidation. CPT1A deficiency confers risk for hypoketotic hypoglycaemia, hepatic encephalopathy, seizures, and sudden unexpected death in infancy (SUDI). It remains controversial whether the CPT1A gene variant, c.1436C>T (p.P479L), identified in Inuit, First Nations, and Alaska Native infants, causes susceptibility to decompensation, in particular during times of fever and intercurrent illness. Although newborn screening for the P479L variant occurs in some jurisdictions, background knowledge about the presence of the variant in Canadian Aboriginal populations is lacking. In an effort to understand the population implications of the variant in northern Canada, overall frequencies of the variant were assessed. Further studies are underway to determine associated risk. Ethics approval was obtained from university REBs, local research institutes, and with consultation with territorial Aboriginal groups. Newborn screening blood spots from all infants born in 2006 in the three territories were genotyped for the p.P479L variant. p.P479L (c.1436C>T) allele frequencies in the three territories were 0.02, 0.08, and 0.77 in Yukon (n = 325), Northwest Territories (n = 564), and Nunavut (n = 695), respectively. Homozygosity rates were 0%, 3%, and 64%. Aboriginal status was available only in NWT, with allele frequencies of 0.04, 0.44, 0.00, and 0.01 for First Nations, Inuvialuit/Inuit, Métis, and non-Aboriginal populations. Although individual blood spots were not identified for Aboriginal ethnicity in Nunavut infants, ~ 90% of infants in Nunavut are born to Inuit women. The allele frequency and rate of homozygosity for the CPT1A P479L variant were high in Inuit and Inuvialuit who reside in northern coastal regions. The variant is present at a low frequency in First Nations populations, who reside in areas less coastal than the Inuit or Inuvialuit in the two western territories. The significance of the population and geographic distribution remains unclear, but the high population frequencies of the variant suggest a historically low penetrance for adverse outcomes. Further evidence is needed to determine if there is an increased risk for infant mortality and morbidity and whether newborn screening will be indicated on a population basis. 相似文献
27.
Arbour R 《Critical Care Nursing Clinics of North America》2006,18(2):227-41, xi
In situations in which clinical assessment of sedation level is compromised, such as deep sedation/analgesia with and without neuromuscular blockade (NMB), electroencephalogram-based monitoring may potentially assist in achieving balance between inadequate and excessive levels of sedation. To validate the bispectral index (BIS) for use in clinical practice, correlation and possible differences in outcome using clinical assessment versus clinical assessment augmented by electroencephalogram-based monitoring were determined. BIS monitoring was decisive in ICU care in 9 of 15 patients in this series. The most significant potential benefit was obtained in the subset of patients receiving NMB. 相似文献
28.
Genetic polymorphisms in methylenetetrahydrofolate reductase and methionine synthase, folate levels in red blood cells, and risk of neural tube defects. 总被引:23,自引:0,他引:23
B Christensen L Arbour P Tran D Leclerc N Sabbaghian R Platt B M Gilfix D S Rosenblatt R A Gravel P Forbes R Rozen 《American journal of medical genetics》1999,84(2):151-157
Folic acid administration to women in the periconceptional period reduces the occurrence of neural tube defects (NTDs) in their offspring. A polymorphism in the gene encoding methylenetetrahydrofolate reductase (MTHFR), 677C-->T, is the first genetic risk factor for NTDs in man identified at the molecular level. The gene encoding another folate-dependent enzyme, methionine synthase (MTR), has recently been cloned and a common variant, 2756A-->G, has been identified. We assessed genotypes and folate status in 56 patients with spina bifida, 62 mothers of patients, 97 children without NTDs (controls), and 90 mothers of controls, to determine the impact of these factors on NTD risk. Twenty percent of cases and 18% of case mothers were homozygous for the MTHFR polymorphism, compared to 11% of controls and 11% of control mothers, indicating that the mutant genotype conferred an increased risk for NTDs. The risk was further increased if both mother and child had this genotype. The MTR polymorphism was associated with a decreased O.R. (O.R.); none of the cases and only 10% of controls were homozygous for this variant. Red blood cell (RBC) folate was lower in cases and in case mothers, compared to their respective controls. Having a RBC folate in the lowest quartile of the control distribution was associated with an O.R. of 2.56 (95% CI 1.28-5.13) for being a case and of 3.05 (95% CI 1.54-6.03) for being a case mother. The combination of homozygous mutant MTHFR genotype and RBC folate in the lowest quartile conferred an O.R. for being a NTD case of 13.43 (CI 2.49-72.33) and an O.R. for having a child with NTD of 3.28 (CI 0.84-12.85). We propose that the genetic-nutrient interaction--MTHFR polymorphism and low folate status--is associated with a greater risk for NTDs than either variable alone. 相似文献
29.
The paradoxical expression of maspin in ovarian carcinoma. 总被引:17,自引:0,他引:17
Anil K Sood Mavis S Fletcher Lynn M Gruman Jeremy E Coffin Sarvenaz Jabbari Zhila Khalkhali-Ellis Nancy Arbour Elisabeth A Seftor Mary J C Hendrix 《Clinical cancer research》2002,8(9):2924-2932
Maspin is a noninhibitory member of the serpin family that is down-regulated in breast carcinoma but overexpressed in pancreatic carcinoma. There are no published data regarding the role of maspin in ovarian carcinoma, which is the focus of the present study. Ovarian cell lines (normal and cancer) and tumors (80 invasive, 14 benign, and 10 low malignant potential) were evaluated for maspin expression and localization. Normal ovarian surface epithelial cells had low levels of maspin. Two of four ovarian cancer cell lines (OVCAR3 and SKOV3) expressed maspin, whereas the cell line EG had weak expression, and 222 had no detectable maspin. Subcellular fractionation studies revealed that the two maspin-positive ovarian cancer cell lines contained maspin in both the nuclear and cytosolic compartments. Wild-type maspin was transfected into the aggressive ovarian cancer cell lines SKOV3 and 222. The in vitro invasive activity of the maspin-transfected cell lines was 44-68% lower than respective controls. The histopathology analysis revealed that among the ovarian tumors examined, 57 (71%) were ranked positive for maspin. Thirty (37%) of the invasive tumors overexpressed maspin. Invasive cancers were more likely to have predominantly cytoplasmic staining compared with benign and low-malignant-potential tumors. Maspin overexpression was significantly associated with a high tumor grade (P = 0.004), the presence of ascites (P = 0.02), a lower likelihood of optimal surgical cytoreduction (P = 0.04), and a shorter duration of overall survival (median survival, 6.33 versus 2.67 years; P = 0.003). The Cox proportional hazards multivariate model revealed that maspin overexpression and high stage were independent predictors of survival. Thus, maspin was found to be overexpressed in a substantial proportion of ovarian tumors, which may serve as an adverse prognostic factor; however, its localization may provide new clues as to its activity and function. These paradoxical results may offer new insights regarding the role of maspin in ovarian cancer progression that may also impact diagnosis and treatment strategies. 相似文献
30.
Patients with severe traumatic brain injury resulting in increased intracranial pressure refractory to first-tier interventions challenge the critical care team. After exhausting these initial interventions, critical care practitioners may utilize barbiturate-induced coma in an attempt to reduce the intracranial pressure. Titrating appropriate levels of barbiturate is imperative. Underdosing the drug may fail to control the intracranial pressure, whereas overdosing may lead to untoward effects such as hypotension and cardiac compromise. Monitoring for a therapeutic level of barbiturate coma includes targeting drug levels and using continuous electroencephalogram monitoring, considered the gold standard. New technology, the Bispectral Index monitor, utilizes electroencephalogram principles to monitor the level of sedation and hypnosis in the critical care environment. This technology is now being considered for targeting appropriate levels of barbiturate coma. 相似文献