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排序方式: 共有183条查询结果,搜索用时 15 毫秒
1.
Tazeen Hasan Jafar Ngiap Chuan Tan Rupesh Madhukar Shirore John Carson Allen Eric Andrew Finkelstein Siew Wai Hwang Agnes Ying Leng Koong Peter Kirm Seng Moey Gary Chun-Yun Kang Chris Wan Teng Goh Reena Chandhini Subramanian Anandan Gerard Thiagarajah Chandrika Ramakrishnan Ching Wee Lim Jianying Liu for SingHypertension Study Group 《PLoS medicine》2022,19(6)
BackgroundDespite availability of clinical practice guidelines for hypertension management, blood pressure (BP) control remains sub-optimal (<30%) even in high-income countries. This study aims to assess the effectiveness of a potentially scalable multicomponent intervention integrated into primary care system compared to usual care on BP control.Methods and findingsA cluster-randomized controlled trial was conducted in 8 government clinics in Singapore. The trial enrolled 916 patients aged ≥40 years with uncontrolled hypertension (systolic BP (SBP) ≥140 mmHg or diastolic BP (DBP) ≥90 mmHg).Multicomponent intervention consisted of physician training in risk-based treatment of hypertension, subsidized losartan-HCTZ single-pill combination (SPC) medications, nurse training in motivational conversations (MCs), and telephone follow-ups. Usual care (controls) comprised of routine care in the clinics, no MC or telephone follow-ups, and no subsidy on SPCs. The primary outcome was mean SBP at 24 months’ post-baseline. Four clinics (447 patients) were randomized to intervention and 4 (469) to usual care. Patient enrolment commenced in January 2017, and follow-up was during December 2018 to September 2020. Analysis used intention-to-treat principles. The primary outcome was SBP at 24 months. BP at baseline, 12 and 24 months was modeled at the patient level in a likelihood-based, linear mixed model repeated measures analysis with treatment group, follow-up, treatment group × follow-up interaction as fixed effects, and random cluster (clinic) effects.A total of 766 (83.6%) patients completed 2-year follow-up. A total of 63 (14.1%) and 87 (18.6%) patients in intervention and in usual care, respectively, were lost to follow-up. At 24 months, the adjusted mean SBP was significantly lower in the intervention group compared to usual care (−3.3 mmHg; 95% CI: −6.34, −0.32; p = 0.03). The intervention led to higher BP control (odds ratio 1.51; 95% CI: 1.10, 2.09; p = 0.01), lower odds of high (>20%) 10-year cardiovascular risk score (OR 0.67; 95% CI: 0.47, 0.97; p = 0.03), and lower mean log albuminuria (−0.22; 95% CI: −0.41, −0.02; p = 0.03). Mean DBP, mortality rates, and serious adverse events including hospitalizations were not different between groups. The main limitation was no masking in the trial.ConclusionsA multicomponent intervention consisting of physicians trained in risk-based treatment, subsidized SPC medications, nurse-delivered motivational conversation, and telephone follow-ups improved BP control and lowered cardiovascular risk. Wide-scale implementation of a multicomponent intervention such as the one in our trial is likely to reduce hypertension-related morbidity and mortality globally.Trial registrationTrial Registration: Clinicaltrials.gov .Tazeen H Jafar and colleagues present findings from a cluster-randomized controlled trial conducted to evaluate the effectiveness of an intervention designed to manage hypertension. NCT02972619相似文献
2.
Annamalai Senthilvelan Muthian Shanmugasundaram 《Nucleosides, nucleotides & nucleic acids》2020,39(7):1011-1019
AbstractA facile, straightforward, reliable, and an efficient chemical synthesis of inosine nucleotides such as 7-methylinosine 5′-O-monophosphate, 7-methylinosine 5′-O-diphosphate, and 7-methylinosine 5′-O-triphosphate, starting from the corresponding inosine nucleotide is delineated. The present methylation reaction of inosine nucleotide utilizes dimethyl sulfate as a methylating agent and water as a solvent at room temperature. It is noteworthy that the present methylation reaction proceeds smoothly under aqueous conditions that is highly regioselective to afford exclusive 7-methylinosine nucleotide in good yields with high purity (>99.5%). 相似文献
3.
Shin-Hee Kim Nanchaya Wanasen Anandan Paldurai Sa Xiao Peter L. Collins Siba K. Samal 《PloS one》2013,8(8)
Virulent strains of Newcastle disease virus (NDV) can cause devastating disease in chickens worldwide. Although the current vaccines are substantially effective, they do not completely prevent infection, virus shedding and disease. To produce genotype-matched vaccines, a full-genome reverse genetics system has been used to generate a recombinant virus in which the F protein cleavage site has been changed to that of avirulent vaccine virus. In the other strategy, the vaccines have been generated by replacing the F and HN genes of a commercial vaccine strain with those from a genotype-matched virus. However, the protective efficacy of a chimeric virus vaccine has not been directly compared with that of a full-genome virus vaccine developed by reverse genetics. Therefore, in this study, we evaluated the protective efficacy of genotype VII matched chimeric vaccines by generating three recombinant viruses based on avirulent LaSota (genotype II) strain in which the open reading frames (ORFs) encoding the F and HN proteins were replaced, individually or together, with those of the circulating and highly virulent Indonesian NDV strain Ban/010. The cleavage site of the Ban/010 F protein was mutated to the avirulent motif found in strain LaSota. In vitro growth characteristics and a pathogenicity test indicated that all three chimeric viruses retained the highly attenuated phenotype of the parental viruses. Immunization of chickens with chimeric and full-length genome VII vaccines followed by challenge with virulent Ban/010 or Texas GB (genotype II) virus demonstrated protection against clinical disease and death. However, only those chickens immunized with chimeric rLaSota expressing the F or F plus HN proteins of the Indonesian strain were efficiently protected against shedding of Ban/010 virus. Our findings showed that genotype-matched vaccines can provide protection to chickens by efficiently preventing spread of virus, primarily due to the F protein. 相似文献
4.
Dong Xiao Anandan Palani Xianhai Huang Michael Sofolarides Wei Zhou Xiao Chen Robert Aslanian Zhuyan Guo James Fossetta Fang Tian Prashant Trivedi Peter Spacciapoli Charles E. Whitehurst Daniel Lundell 《Bioorganic & medicinal chemistry letters》2013,23(11):3262-3266
Conformation restriction of linear N-alkylanilide MK2 inhibitors to their E-conformer was developed. This strategy enabled rapid advance in identifying a series of potent non-ATP competitive inhibitors that exhibited cell based activity in anti-TNFα assay. 相似文献
5.
Annamalai Muthusamy Huliyar Narasimhamurthy Nagendra Prasad Erathodi Ramachandran Sanjay Mattu Radhakrishna Rao Kapaettu Satyamoorthy 《In vitro cellular & developmental biology. Plant》2016,52(6):598-607
The production of specific secondary metabolites in vitro can be improved through medium supplementation with secondary metabolite precursors, plant growth regulators (PGRs), and abiotic and biotic elicitors. In the present study, node and internode explants of Phyllanthus amarus and P. urinaria collected from Karkala region, Udupi District, Karnataka, India, were inoculated aseptically onto Murashige and Skoog (MS) medium for callus induction. Uniform calluses were inoculated onto MS medium fortified with one of two precursor’s cinnamic acid (CA) or phenylalanine (PA), or with naphthalene acetic acid (NAA). After 30 d of treatment, calluses from treatment and control groups were harvested and quantitatively analyzed for three lignans (phyllanthin, hypophyllanthin and niranthin) and an antioxidant (ellagic acid). Increased amounts of the lignans and ellagic acid were obtained through supplementation with CA, PA, and NAA, and higher ellagic acid was present at higher amounts than the three lignans. These results demonstrated that the Phyllanthus species collected from Karkala region (designated “Accessions3”) show substantial response to CA, PA, and NAA treatment and represent a potential source of donor plants with higher amounts of lignans and antioxidants. These plants can be cultivated on a large scale both in vitro and in vivo for production of important bioactive compounds. Production of these compounds can be further enhanced through induction of somaclonal variant plants with higher amounts of bioactive molecule production and through production of transgenic plants overexpressing genes related to lignan- and phenolic-compound biosynthesis. 相似文献
6.
Chandrasekaran Uma Burkhoff Daniel Ishikawa Kiyotake Swain Lija Sunagawa Kenji Mller Jacob Santos-Gallego Carlos Annamalai Shiva Udelson James Westenfeld Ralf Kapur Navin Qiao Xiaoying Wiora Julian Schfer Andreas Bernhardt Alexander Kochar Ajar Kloner Robert Faraz Haroon 《BMC cardiovascular disorders》2019,19(2):1-17
7.
Goulder PJ Addo MM Altfeld MA Rosenberg ES Tang Y Govender U Mngqundaniso N Annamalai K Vogel TU Hammond M Bunce M Coovadia HM Walker BD 《Journal of virology》2001,75(3):1339-1347
Human immunodeficiency virus (HIV)-specific cytotoxic T lymphocytes (CTL) play a major role in control of viral replication. To understand the contribution of this antiviral response, an initial step is to fully define the specific epitopes targeted by CTL. These studies focused on CTL responses restricted by HLA-A*3002, one of the HLA-A molecules most prominent in African populations. To avoid the time-consuming effort and expense involved in culturing CTL prior to defining epitopes and restricting alleles, we developed a method combining Elispot assays with intracellular gamma interferon staining of peripheral blood mononuclear cells to first map the optimal epitopes targeted and then define the HLA restriction of novel epitopes. In two A*3002-positive subjects whose CTL responses were characterized in detail, the strongest response in both cases was to an epitope in p17 Gag, RSLYNTVATLY (residues 76 to 86). Using this method, CTL epitopes for which there were no motif predictions were optimized and the HLA restriction was established within 48 to 72 h of receipt of blood. This simple and convenient approach should prove useful especially in the characterization of CTL responses specific to HIV and other viruses, particularly in localities where performing cytotoxicity assays would be problematic. 相似文献
8.
Genetic characterization of a signal transduction pathway requires the isolation of mutations in the pathway. Characterization of these mutated genes and their loci enumerates the components of the pathway and leads to an understanding of the role of each gene locus in the pathway under study. We have designed and developed a strategy based on resistance to the chemical flucytosine for the identification of mutations in a given pathway. In this study, the Escherichia coli codA gene, which encodes the enzyme cytosine deaminase, was fused to the light-intensity-regulated gene promoter psbDII. Cytosine deaminase converts 5'-fluorocytosine to the toxic product 5-fluorouracil. Wild-type cells containing an intact signal transduction pathway that regulates the psbDII promoter will die in the presence of this chemical. Cells that carry mutations in the pathway that inactivate the psbDII promoter will not express the codA gene and, consequently, will live on 5'-fluorocytosine, allowing the isolation and subsequent characterization of mutations in this signaling pathway. Utilizing this selection method, we have successfully isolated and characterized mutations in the psbDII pathway. This selection scheme can be used with a tissue-specific or phase-specific promoter fused to the codA gene to direct the timing of expression of codA to obtain mutants defective in temporal or cell-specific expression of a particular pathway. This scheme also allows the isolation of mutants even when a clearly identifiable phenotype is not available. The selection scheme presented here extends the molecular tools available for the genetic dissection of signal transduction pathways. 相似文献
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