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Saed H Zyoud Dala N Daraghmeh Diana O Mezyed Razan L Khdeir Mayas N Sawafta Nora A Ayaseh Ghada H Tabeeb Waleed M Sweileh Rahmat Awang Samah W Al-Jabi 《Lancet》2018
Background
Haemodialysis is a life-saving but burdensome therapy for patients with end-stage renal disease, which can substantially impair health-related quality of life (HRQOL) and outcomes. The aim of this study was to determine the patterns of HRQOL and to identify the risk factors for reduced HRQOL in Palestinian patients receiving treatment by haemodialysis.Methods
This cross-sectional study was done between June 15, 2014, and Jan 15, 2015, using the EuroQOL-5 Dimensions instrument (EQ-5D-5L) for the assessment of HRQOL. We approached patients with end-stage renal disease undergoing haemodialysis at inpatient hospitals from ten different settings at a national level. The study protocol was approved by the Ethics Committee of An-Najah National University. Informed verbal consent was obtained from each participant before the start of the interview. Multiple linear regression was used to estimate which variables were significantly associated with reduced HRQOL.Findings
267 (96%) of 277 eligible patients consented to participate. 139 (52%) participants were men, and the mean age was 53·3 years (SD 16·2). 177 (66%) patients had been treated by haemodialysis for less than 4 years. The reported HRQOL, as measured by mean EQ-5D-5L index value, was 0·37 (SD 0·44). We found a moderate positive correlation between the EuroQol-visual analogue scales and the EQ-5D-5L index value (r=0·44; p<0·0001). The results of a multiple linear regression showed a significant association between HRQOL and age (p=0·0011), female sex (p=0·0167), education level (p=0·0057), number of chronic medications (p=0·0493), and number of comorbid diseases (p=0·0001).Interpretation
Our results provide insight into a number of associations between patient variables such as demographics, clinical factors, and their HRQOL. These findings should help raise health-care providers' awareness and improve the quality of life for patients receiving treatment by haemodialysis, especially those who have no formal education, are elderly, are female, are from refugee camps, or have multiple comorbid diseases or chronic medications.Funding
None. 相似文献3.
Background
The increasing incidence of hospital-acquired infections caused by antibiotic-resistant pathogens has led to an increase in morbidity and mortality worldwide. The aim of this study was to assess the frequency and antibiotic susceptibility of bacterial pathogens isolated at An-Najah National University Hospital (NNUH) in Nablus city in the occupied Palestinian territory during 2015.Methods
A retrospective study was conducted of all positive bacterial cultures obtained from the microbiology laboratory of NNUH. Results of culture and sensitivity of patients' specimens were analysed. Approval was obtained from the institutional review board of An-Najah National University.Findings
Of the 4421 cultures processed, 1335 (30·2%) were positive. 621 (46·4%) bacterial isolates were Gram-positive, 565 (42·3%) were Gram-negative organisms and 151 (11·3%) were Candida species. The most frequent Gram-positive organisms were coagulase-negative Staphylococci (CoNS) and Enterococcus species, followed by Staphylococcus aureus (50·2%, 25·0%, and 14·8%, respectively). Enterococcus coli was the most frequent Gram-negative organism followed by Klebsiella pneumonia, Acinetobacter baumannii, and Pseudomonas aeroginosa (28·3%, 21·0%, 18·4%, and 18·4%, respectively). CoNS showed high resistance to oxacillin (89%) and erythromycin (74·6%). Enterococcus spp had the highest resistance to clindamycin (93·5%), followed by tetracycline (85·7%), and erythromycin (74·6%). S aureus isolates were resistant to oxacillin (56·0%) and erythromycin (52·0%). E coli showed high resistance to ampicillin (90·1%), ceftriaxone (77·0%), fluoroquinolones (eg, ciprofloxacin; 75·0%), and erythromycin (70·2%). K pneumoniae was mostly resistant to ampicillin (100·0%), aztreonam (83·3%), and third generation cephalosporins (ceftriaxone, 80·9%; ceftazidime, 78·2%; and cefotaxime, 77·2%). Pseudomonas aeruginosa showed high resistance to tigecycline (95·4%), ceftriaxone (94·1%), and cefotaxime (95·4%). A baumannii was resistant to all tested antibiotics—including amikacin, cephalosporins, fluoroquinolones, and carbapenems—except tetracycline.Interpretation
The high rates of antibiotic resistance are a cause for concern. Similar studies should be carried out at all hospitals in Palestine in an effort to control the development of antibiotic resistance and the spread of these multidrug-resistant organisms.Funding
An-Najah National University. 相似文献4.
Epilepsy surgery is an effective treatment in selected patients with localization-related intractable epilepsy. The success of epilepsy surgery is in part dependent upon identification of a lesion on MRI. In infants, the surgical epileptogenic substrates include focal cortical dysplasia (FCD), hemimegalencephaly, tuberous sclerosis complex, Sturge Weber syndrome, hypoxic-ischemic or cerebrovascular injury and low-grade tumor. The sensitivity of MRI in identifying the epileptogenic substrate is influenced by the nature of the epileptogenic substrate, MRI technique and expertise of the interpreting physician. The MRI features of some lesions such as FCD may differ in infants compared to children and adults; the white matter adjacent to FCD may demonstrate lower T2 and higher T1 signal in some infants due to premature myelination, while in others, the white matter demonstrates higher T2 or lower T1 signal due to demyelination, dysmyelination or gliosis, similar to children and adults. The appearances of some lesions, such as FCD, may change with time, due to brain maturation or seizure related changes. MRI for patients with localization-related intractable epilepsy should have high-resolution, multiplanar and multisequence. In infants, volumetric T1 and high-resolution T2 imaging are recommended. FLAIR and proton density sequences are less helpful in infants due to lack of myelin in the white matter. The physician interpreting the scan should be familiar with the imaging appearances of epileptogenic substrates and may need to review the scan more than once if a lesion is not seen on initial inspection. 相似文献
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Mahmoud A. El Hassab Tamer M. Ibrahim Aly A. Shoun Sara T. Al-Rashood Hamad M. Alkahtani Amal Alharbi Razan O. Eskandrani Wagdy M. Eldehna 《RSC advances》2021,11(26):16026
In the present era, there are many efforts trying to face the emerging and successive waves of the COVID-19 pandemic. This has led to considering new and unusual targets for SARS CoV-2. 2′-O-Methyltransferase (nsp16) is a key and attractive target in the SARS CoV-2 life cycle since it is responsible for the viral RNA protection via a cap formation process. In this study, we propose a new potential inhibitor for SARS COV-2 2′-O-methyltransferase (nsp16). A fragment library was screened against the co-crystal structure of the SARS COV-2 2′-O-methyltransferase complexed with Sinefungin (nsp16 – PDB ID: 6WKQ), and consequently the best proposed fragments were linked via a de novo approach to build molecule AP-20. Molecule AP-20 displayed a superior docking score to Sinefungin and reproduced the key interactions in the binding site of 2′-O-methyltransferase. Three molecular dynamic simulations of the 2′-O-methyltransferase apo structure and its complexed forms with AP-20 and Sinefungin were performed for 150 nano-seconds to provide insights on the dynamic nature of such setups and to assess the stability of the proposed AP-20/enzyme complex. AP-20/enzyme complex demonstrated better stability for the ligand–enzyme complex compared to Sinefungin in a respective setup. Furthermore, MM-PBSA binding free energy calculations showed a better profile for AP-20/enzyme complex compared to Sinefungin/enzyme complex emphasizing the potential inhibitory effect of AP-20 on SARS COV-2 2′-O-methyltransferase. We endorse our designed molecule AP-20 to be further explored via experimental evaluations to confront the spread of the emerging COVID-19. Also, in silico ADME profiling has ascribed to AP-20 an excellent safety and metabolic stability profile.The identification of AP-20 as a potential SARS COV-2 2′-O-methyltransferase inhibitor: fragment-based screening approach and MM-PBSA calculations. 相似文献
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Osamah M. Alfayez Majed S. Al Yami Mohannad Alshibani Saad B. Fallatah Nasser M. Al Khushaym Razan Alsheikh Nimer Alkhatib 《Primary Care Diabetes》2019,13(3):204-211
The aim of this network meta-analysis (NMA) was to indirectly compare the cardiovascular (CV) safety of new antidiabetic medications in patients with type 2 diabetes mellitus (T2DM).Data synthesisA search of the Embase and MEDLINE databases was conducted systematically to identify cardiovascular outcome trials (CVOTs) of new antidiabetic medications (DPP-4 inhibitors, GLP-1 agonists and SGLT-2 inhibitors) in patients with T2DM. The primary outcomes were the composite endpoint of CV death, nonfatal MI, and nonfatal stroke (MACE), death from CV causes, nonfatal MI, nonfatal stroke and death from any cause. Hospitalization for HF and unstable angina were evaluated as secondary endpoints. A total of 9 trials, including 87,162 patients, met the eligibility criteria and were retained for the analysis.The NMA results showed no significant differences among the DPP-4 inhibitors (sitagliptin, alogliptin, and saxagliptin) in any of the CV endpoints. Similarly, no significant changes were seen in the NMA among the GLP-1 receptor agonists nor the SGLT-2 inhibitors. The pairwise meta-analysis showed that DPP-4 inhibitors have a CV safety profiled comparable to placebo. GLP-1 agonists on the other hand, showed significant reduction in MACE (RR 0.92; 95% CI 0.87–0.97), death from CV causes (RR = 0.88; 95% CI 0.80–0.97), and death from any cause (RR = 0.89; 95% CI 0.82–0.96). SGLT-2 inhibitors showed significant reduction in hospitalization for heart failure events (RR 0.72; 95% CI 0.6–0.86) compared to placebo.ConclusionThis meta-analysis has shown that new antidiabetic medications do not impose any additional CV risk. The indirect comparison among the medications of each class resulted in no significant changes regarding CV endpoints and death from any cause. 相似文献