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Urticaria as a cutaneous sign of adult-onset Still's disease 总被引:2,自引:0,他引:2
Criado RF Criado PR Vasconcellos C Szajubok JC Michalany NS Kadunc BV Costa Martins JE 《Journal of cutaneous medicine and surgery》2006,10(2):99-103
BACKGROUND: The cardinal signs and symptoms of adult-onset Still's disease (AOSD) include periodic fever, arthralgia and arthritis, lymphadenopathy, hepatosplenomegaly, an evanescent rash accompanied by neutrophilic granulocytosis, and a negative rheumatoid factor and antinuclear antibody test. OBJECTIVE: To alert clinicians and dermatologists to internal diseases such as AOSD when assisting patients with urticarial eruptions and systemic symptoms. METHODS: A case report of a 52-year-old white woman who received conventional therapy for urticaria for 3 years, with no improvement. Following this period, a diagnosis of AOSD was performed based on the presence of systemic symptoms. RESULTS: The inflammatory activity markers decreased by the second month of methotrexate therapy; however, the cutaneous lesions failed to disappear. Thalidomide was initiated, and total improvement of the cutaneous lesions was observed after 2 weeks. CONCLUSION: Urticarial rash is an uncommon presentation of AOSD, and clinicians must be alert to the possibility of a misdiagnosis in these cases. 相似文献
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Ravichandran Gurumurthi Ramesh BV Nimmagadda Subhashini Mohan 《Indian journal of dermatology》2013,58(5):380-382
Hand and foot syndrome (HFS) is a well-known complication of chemotherapeutic drugs given in a dose-dense manner. Our patient was a 52-year-old female with metastatic breast carcinoma on salvage chemotherapy regimen with docetaxel at a dose of 60 mg/m2. The patient had grade 3 HFS characterized by symmetrical, tender, and erythematous skin lesions over the palms and soles associated with dysesthesia necessitating interruption of treatment. She developed this syndrome at a much lower dose than previously described due to her altered hepatic function. An insight regarding this unique distressing side-effect and assessment of various contributing factors would help us identify and treat the patient at the earliest. 相似文献
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KV Sarkissyan IS Aslibekyan BV Shabalkin 《Indian Journal of Thoracic and Cardiovascular Surgery》1989,6(1):55-57
One-hundred and seven patients with unstable angina were treated between 1981 and 1987. Platelet dysfunction and elevation
of fibrinogen was observed. The efficacy of aspirin, dipyridamole and heparin on coagulation profile is compared. Left main
disease was seen in 11.4 per cent. Left anterior descending was occluded in 90.7 per cent. Aortocoronary bypass graft using
saphenous vein graft was carried out on all patients. On an average, each patients received 3.5 grafts. Emergency surgery
was done in nineteen. Associated ventricular aneurysm was resected in nine. Thirteen patients died. Operative mortality decreased
to nil in 1986–1987. Perioperative infarction was seen in five patients.
Clinical improvement was seen in 80.3 per cent and 48.9 per cent were asymptomatic. Actuarial survival was 92 per cent after
six years. Postoperative coronary angiography in 28 patients showed patency of grafts in 18, partial patency in six and occlusion
in four. Aspirin was found useful after surgery to relieve angina. Spiroergometry and Thallium201 scintigraphy was useful to assess medical and surgical treatment. 相似文献
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SK SHANKAR V SURYANARAYANA S VASANTHA V RAVI BV RAVI KUMAR 《Medical Journal Armed Forces India》1994,50(2):79-88
Neurocysticercosis, caused by infestation of the nervous system by the larval form of Taenia solium, continues to baffle the neurologist, because of varied clinical manifestations. A large body of the literature related to this disease is clinically oriented, enough attention has not been given to parasite related factors modulating the host response. Using immunohistochemical techniques, three features related to the biology of the Cysticercus cellulosa e were studied. Firstly, to the question as to which part of the worm is recognised by the host immune system, the surface glycoprotein is found to be immunolabelled by the CSF from patients of neurocysticercosis. This surface protein is depleted following specific antihelmenthic therapy, thus accounting for a fall in anticysticercal antibosy level in the CSF. Secondly, the cysticercal cyst, by immunochemical and histochemical methods, is found to have “ACTH like” molecule in the body wall and has neurotransmitter and mitochondrial metabolic pathways similar to the host, facilitating the immune evasion and successful parasitisation. Finally, Cysticercus cellulosae is found to contain a “peptide” opening the blood brain barrier at the arteriolar level when injected into mice intravenously. Similar phenomenon may be functional in the patients as well, resulting in cerebral oedema, especially following praziquintel therapy.KEY WORDS: Cystericercus cellulosae, I mmunohistochemistry, Blood Brain Barrier, Immune evasion, Parasite metabolism 相似文献
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Improving Botulinum Toxin Therapy for Palmar Hyperhidrosis: Wrist Block and Technical Considerations
Ada Regina Trindade de Almeida MD Bogdana Victoria Kadunc MD Eduardo Missias Martins de Oliveira MD 《Dermatologic surgery》2001,27(1):34-36
Botulinum A exotoxin has become an excellent therapeutic option to treat focal hyperhidrosis, but when the problem affects the palmar region the technique has some drawbacks. Pain with injection is difficult to tolerate and the large dose needed to treat both hands are two concerns, as well as muscle weakness secondary to botulinum toxin diffusion and the possibility of antibody production. All these problems limit the number of patients treated. The author's suggestion is to treat only the dominant hand, after performing a wrist block. The use of a device adapted from a cartridge rubber may help to control the injection depth and the risk of muscular weakness. 相似文献
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