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1.
A Neopane M Poudel B Pradhan R Dhakal D B Karki 《Kathmandu University Medical Journal》2006,4(3):307-315
Objectives: to evaluate the diagnostic value of clinical symptoms and signs in enteric fever and to propose a clinical diagnostic criterion. Design: Prospective observational study Setting: Kathmandu Medical College, Teaching Hospital, Kathmandu, Nepal Materials and methods: febrile patients with clinical diagnosis of enteric fever were included in the study with the aim of confirming diagnosis with blood culture, or bone marrow culture and evaluating the diagnostic accuracy of various clinical signs and symptoms. Results: 64% of the clinically diagnosed cases had blood/ bone marrow culture positive. The diagnostic accuracy of the various symptoms and signs excluding fever was between 42%-75.5%. Majority of the symptom and sign did not have very high diagnostic accuracy. Hence a diagnostic criterion was proposed and clinical features with diagnostic accuracy more than 50% were taken into consideration. Major criteria included fever with diagnostic accuracy of 64%, headache with accuracy of 75.5% and relative bradycardia with an accuracy of 66%. Minor criteria included vomiting, diarrhoea, Splenomegaly, chills and abdominal pain /discomfort with diagnostic accuracy of 57%, 55%, 55%, 53% and 51% respectively. Finally after combination of various major and minor criteria a final diagnostic criterion was proposed having an accuracy of 66% and including both major and minor clinical symptom and sign. Conclusion: clinical diagnosis of enteric fever will be very helpful in a country like ours. Though none of the clinical symptoms and sign have very high diagnostic accuracy a diagnostic criteria may be helpful. Criteria including both major and minor signs and symptoms would be the most appropriate diagnostic tool as it includes the important abdominal symptoms and signs of enteric fever. Key words: enteric fever, clinical features, diagnostic criteria. 相似文献
2.
Poudel KC Okumura J Sherchand JB Jimba M Murakami I Wakai S 《Tropical medicine & international health : TM & IH》2003,8(10):933-939
OBJECTIVE: To measure the seroprevalence of human immunodeficiency virus (HIV) infection and syphilis, and to assess the behavioural risk factors for these infections among migrant-returnees and non-migrants in far western Nepal. METHODS: In April 2001, we recruited 97 male migrant-returnees and 40 non-migrants from five rural villages in Doti district where migration to Mumbai is common. For data collection, we conducted a serological examination for HIV and syphilis, and a perception and behaviour survey on HIV and other sexually transmitted infections. RESULTS: We found that 11 of 137 men (8%) were positive for HIV infection and 30 men (22%) for syphilis. The respondents, especially the migrant-returnees from Mumbai, were engaging in risky behaviours such as pre- or extramarital sex, and sex with multiple partners, including sex workers. CONCLUSIONS: This study revealed high HIV and syphilis prevalence among the male migrant-returnees and non-migrants in far western Nepal where migration to Mumbai is common. The prevalent behaviours, particularly among the migrant-returnees, imply urgent needs of the behavioural modification programme in this area to prevent the spread of HIV infection to general population. 相似文献
3.
Stanley JL Andersson IJ Poudel R Rueda-Clausen CF Sibley CP Davidge ST Baker PN 《Hypertension》2012,59(5):1021-1028
Preeclampsia and fetal growth restriction are responsible for the majority of maternal and perinatal morbidity and mortality associated with complicated pregnancies. Although their etiologies are complex and multifactorial, both are associated with increased uterine artery resistance. Sildenafil citrate is able to rescue the dysfunction observed ex vivo in uterine arteries of women with preeclampsia. The ability of sildenafil citrate to increase uterine artery vasodilation, thereby decreasing uterine artery resistance and, hence, ameliorated preeclampsia and fetal growth restriction, was tested in a mouse model of preeclampsia, the catechol-O-methyl transferase knockout mouse (COMT(-/-)). COMT(-/-) and C57BL/6J mice were treated (0.2 mg/mL in drinking water, n=6-12) from gestational day 12.5 to 18.5. Measures of pup growth, including body weight, crown/rump length, and abdominal circumference, were reduced in COMT(-/-) mice; this was normalized after treatment with Sildenafil. COMT(-/-) mice also demonstrated abnormal umbilical Doppler waveforms, including reverse arterial blood flow velocity. This was normalized after treatment with Sildenafil. Abnormal uterine artery Doppler waveforms were not demonstrated in COMT(-/-) mice, although ex vivo responses of uterine arteries to phenylephrine were increased; moreover, treatment with Sildenafil did improve ex vivo sensitivity to an endothelium-dependent vasodilator. The data presented here demonstrate that Sildenafil can rescue pup growth and improve abnormal umbilical Doppler waveforms, providing support for a potential new therapeutic strategy targeting fetal growth restriction. 相似文献
4.
Masato Asahina David A. Low Christopher J. Mathias Yoshikatsu Fujinuma Akira Katagiri Yoshitaka Yamanaka Junichiro Shimada Anupama Poudel Satoshi Kuwabara 《Parkinsonism & related disorders》2013,19(5):560-562
AimA previous study on a small number of patients showed that low skin temperature of the hands, the so called “cold hands sign”, may be useful for distinguishing multiple system atrophy (MSA) from Parkinson's disease (PD). We have further investigated skin temperature of the hand in a larger number of patients.MethodsSkin temperature on the palm was measured in 50 MSA (11 MSA-P and 39 MSA-C patients) and 50 PD patients, and 25 normal healthy subjects.ResultsPalm skin temperature was significantly lower in MSA patients (32.0 ± 2.7 °C) than in controls (34.1 ± 0.9 °C, p = 0.0002), but was not different compared with the PD group (32.9 ± 1.8 °C, p = 0.06). Temperatures of <28 °C were observed in 3 MSA patients (6%) and none of the PD patients and controls. There was no significant difference in palm skin temperature between patients with and without orthostatic hypotension for each patient group, or between MSA-P and MSA-C patients.ConclusionThe cold hand (<28 °C) is a useful marker for distinguishing MSA from PD, but it is not common in MSA patients, and its sensitivity may be low for differentiating between MSA and PD. 相似文献
5.
6.
Govinda R. Poudel Gary F. Egan Andrew Churchyard Phyllis Chua Julie C. Stout Nellie Georgiou-Karistianis 《Journal of psychiatry & neuroscience : JPN》2014,39(2):87-96
Background
Functional neural impairments have been documented in people with symptomatic Huntington disease (symp-HD) and in premanifest gene carriers (pre-HD). This study aimed to characterize synchrony in resting state cerebral networks in both pre-HD and symp-HD populations and to determine its association with disease burden and neurocognitive functions.Methods
We acquired functional magnetic resonance imaging (fMRI) data from pre-HD, symp-HD and healthy control participants. The fMRI data were analyzed using multisubject independent component analysis and dual regression. We compared networks of interest among the groups using a nonparametric permutation method and correcting for multiple comparisons.Results
Our study included 25 people in the pre-HD, 23 in the symp-HD and 18 in the healthy control groups. Compared with the control group, the pre-HD group showed decreased synchrony in the sensorimotor and dorsal attention networks; decreased level of synchrony in the sensorimotor network was associated with poorer motor performance. Compared with the control group, the symp-HD group showed widespread reduction in synchrony in the dorsal attention network, which was associated with poorer cognitive performance. The posterior putamen and superior parietal cortex were functionally disconnected from the frontal executive network in the symp-HD compared with control and pre-HD groups. Furthermore, the left frontoparietal network showed areas of increased synchrony in the symp-HD compared with the pre-HD group.Limitations
We could not directly correct for influence of autonomic changes (e.g., heart rate) and respiration on resting state synchronization.Conclusion
Our findings suggest that aberrant synchrony in the sensorimotor and dorsal attention networks may serve as an early signature of neural change in pre-HD individuals. The altered synchrony in dorsal attention, frontoparietal and corticostriatal networks may contribute to the development of clinical symptoms in people with Huntington disease. 相似文献7.
8.
We compared the nutritional status of children aged 1-5 years from slums attending two day-care centres (DCCs) in Nepal (one in an urban slum area) with that of non-attendees to evaluate the impact of supplementary feeding. We measured the anthropometrics of 23 children attending two DCCs and 23 matched controls from the same neighbourhood and interviewed their mothers. We found a better nutritional status, particularly the height-for-age Z-score, among the attendees of the DCC with children's longer attendance, but no difference at the other, although attendees who had been fed for longer tended to show better nutrition. Our study indicates that in the least developed countries good quality day-care of sufficient duration has the potential to improve child nutrition. 相似文献
9.
Traffic fatalities in Nepal 总被引:1,自引:0,他引:1
10.
Phenolic compounds and antioxidant activities of skins and seeds of five wild grapes and two hybrids native to Japan 总被引:2,自引:0,他引:2
Puspa Raj Poudel Hirotoshi Tamura Ikuo Kataoka Ryosuke Mochioka 《Journal of food composition and analysis》2008,21(8):622-625
Grape skins and seeds are sources of phenolic compounds that contribute to the sensory characteristics and beneficial bioactivity of wines and other processed foods. Hence, the study was aimed to evaluate and characterize the phenolic composition and antioxidant activities of five wild grapes native to Japan and two hybrids derived from the wild ones. Finally, the results were compared with those of two cultivated grapes (Vitis vinifera cv. Muscat of Alexandria, a white and V. labruscana cv. Bailey Alicante A, a tenturier-type grape). Among the skins of wild grapes, those of Shiohitashibudou (V. sp., an unidentified wild grape) contained the highest amount of total phenolics (13.8 mg g−1 gallic acid equivalent of fresh weight) and antiradical activities (61.7 mmol g−1 trolox equivalent of fresh weight). In contrast, Shiragabudou (V. shiragai) contained highest amount of seed total phenolics (16.5 mg g−1 gallic acid equivalent of fresh weight). All wild grape seeds were rich in procyanidin monomers. The total phenolics and antiradical activities in skins of a hybrid grape Kadainou R-1 were higher than those of its parents. This study demonstrates that wild grapes are potential sources of neutraceutical phenolics and can thus be utilized as novel breeding resources. 相似文献