全文获取类型
收费全文 | 645篇 |
免费 | 83篇 |
国内免费 | 23篇 |
专业分类
耳鼻咽喉 | 1篇 |
儿科学 | 79篇 |
基础医学 | 18篇 |
口腔科学 | 4篇 |
临床医学 | 35篇 |
内科学 | 149篇 |
皮肤病学 | 39篇 |
神经病学 | 1篇 |
特种医学 | 5篇 |
外科学 | 250篇 |
综合类 | 41篇 |
现状与发展 | 1篇 |
预防医学 | 1篇 |
眼科学 | 1篇 |
药学 | 87篇 |
中国医学 | 7篇 |
肿瘤学 | 32篇 |
出版年
2024年 | 2篇 |
2023年 | 6篇 |
2022年 | 7篇 |
2021年 | 18篇 |
2020年 | 23篇 |
2019年 | 31篇 |
2018年 | 29篇 |
2017年 | 20篇 |
2016年 | 23篇 |
2015年 | 33篇 |
2014年 | 39篇 |
2013年 | 73篇 |
2012年 | 37篇 |
2011年 | 41篇 |
2010年 | 44篇 |
2009年 | 41篇 |
2008年 | 47篇 |
2007年 | 48篇 |
2006年 | 56篇 |
2005年 | 59篇 |
2004年 | 42篇 |
2003年 | 13篇 |
2002年 | 11篇 |
2001年 | 4篇 |
2000年 | 2篇 |
1998年 | 1篇 |
1997年 | 1篇 |
排序方式: 共有751条查询结果,搜索用时 31 毫秒
1.
2.
Amandeep Salhotra Matthew Mei Tracey Stiller Sally Mokhtari Alex F. Herrera Robert Chen Leslie Popplewell Jasmine Zain Haris Ali Karamjeet Sandhu Elizabeth Budde Auayporn Nademanee Stephen J. Forman Ryotaro Nakamura 《Biology of blood and marrow transplantation》2019,25(2):287-292
The current standard of care for patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) is high-dose conditioning followed by autologous stem cell transplantation (ASCT). For some patients (ie, those with highest-risk disease, insufficient stem cell numbers after mobilization, or bone marrow involvement) allogeneic hematopoietic cell transplantation (alloHCT) offers the potential for cure. However, the majority of patients undergoing alloHCT receive reduced-intensity conditioning as a preparative regimen, and studies assessing outcomes of patients after alloHCT with myeloablative conditioning are limited. In this retrospective study, we reviewed outcomes of 22 patients with recurrent and refractory NHL who underwent alloHCT with myeloablative BEAM conditioning and received tacrolimus/sirolimus as graft-versus-host disease (GVHD) prophylaxis at City of Hope between 2005 and 2018. With a median follow-up of 2.6 years (range, 1.0 to 11.2 years), the probabilities of 2-year overall survival and event-free survival were 58.3% (95% confidence interval [CI], 35.0% to 75.8%) and 45.5% (95% CI, 24.4% to 64.3%), respectively. The cumulative incidence of grade II to IV acute GVHD was 45.5% (95% CI, 23.8% to 64.9%), with only 1 patient developing grade IV acute GVHD. However, chronic GVHD was seen in 55% of the patients (n?=?12). Of the 22 eligible patients, 2 had undergone previous ASCT and 2 had undergone previous alloHCT. Both patients with previous ASCT developed severe regimen-related toxicity. Patients who underwent alloHCT with chemorefractory disease had lower survival rates, with 1-year OS and EFS of 44.4% and 33.0%, respectively. In conclusion, alloHCT with a BEAM preparative regimen and tacrolimus/sirolimus-based GVHD should be considered as an alternative option for patients with highest-risk lymphoma whose outcomes are expectedly poor after ASCT. 相似文献
3.
4.
The calcineurin inhibitors (CNIs) remain the standard of care for maintenance immunosuppression following renal transplantation. CNIs have demonstrated their effectiveness in reducing acute cellular rejection; however, some evidence suggests that these compounds negatively affect native renal function and are associated with allograft injury in renal transplant recipients. CNIs have also been linked with hypertension, new‐onset diabetes after transplantation, tremor, and thrombotic microangiopathy, which have significant consequences for long‐term allograft function and patient health overall. Thus, converting patients to a non‐CNI‐based regimen may improve renal function and also provide extrarenal benefits. A number of studies have been conducted that explore CNI conversion strategies in renal transplant recipients in an effort to improve long‐term allograft function and survival. These include converting to alternative, non‐nephrotoxic, maintenance immunosuppressants, such as the mammalian target of rapamycin inhibitors (sirolimus and everolimus) and the costimulation blocker belatacept. In this review of literature, evidence for the potential renal and extrarenal benefits of conversion to these non‐CNI‐based regimens is evaluated. Clinical challenges, including the adverse event profiles of non‐CNI‐based regimens and the selection of candidates for conversion, are also examined. 相似文献
5.
The role of mammalian target of rapamycin inhibitors in the management of post‐transplant malignancy
Goran B. Klintmalm Sammy Saab Johnny C. Hong Björn Nashan 《Clinical transplantation》2014,28(6):635-648
Post‐transplant malignancies, which occur either de novo or as cancer recurrences, are due to chronic exposure to immunosuppressive agents and are often more aggressive than those that develop in the non‐transplant setting. Mammalian target of rapamycin (mTOR) inhibitors have antitumor and immunosuppressive effects. The dual effects of this class of agents may provide adequate immunosuppression to prevent organ rejection while simultaneously reducing the risk of post‐transplant malignancy. mTOR inhibitors have become established approved agents for treating renal cell carcinoma and other cancers and, as reviewed herein, accumulating experience among organ transplant recipients collectively points toward a potential to prevent the development of de novo malignancies of various types in the post‐transplant period. To date, most research efforts surrounding mTOR inhibitors and cancer control in the transplant population have been in the area of skin cancer prevention, but there have also been interesting observations regarding regression of post‐transplant Kaposi's sarcoma and post‐transplantation lymphoproliferative disorder that warrant further study. 相似文献
6.
Ferdinand Mühlbacher Hans‐Helmut Neumayer Domingo del Castillo Sergio Stefoni Klemens Budde the European Rapamune Cyclosporine Minimization Study Group 《Transplant international》2014,27(2):176-186
This study evaluated the safety and efficacy of a sirolimus, corticosteroid, and cyclosporine reduction regimen in an open‐label, 12‐month trial of 420 de novo renal allograft recipients at 49 European transplant centers. One month post‐transplantation, 357 patients were randomized to receive standard‐dose cyclosporine (sCsA, n = 179) or reduced‐dose cyclosporine (rCsA, n = 178). All patients also received sirolimus and corticosteroids. The primary end points were the rate of biopsy‐confirmed acute rejection (BCAR) and renal function, as measured by serum creatinine. Baseline demographic and donor characteristics were similar between groups. BCAR rates at 12 months were not significantly different: 11.2% for rCsA patients and 16.2% for sCsA patients. Mean serum creatinine (±SEM) was significantly lower (1.75 ± 0.10 vs. 1.97 ± 0.07 mg/dl, P < 0.001), and creatinine clearance (±SEM; Nankivell method) was significantly higher (57.8 ± 1.78 vs. 49.5 ± 2.46 ml/min, P < 0.001) in patients receiving rCsA versus sCsA at 1 year, respectively. Patient and graft survival exceeded 98% in both groups. No significant differences in infection or malignancy were noted between groups. The rCsA with sirolimus and corticosteroid regimen resulted in excellent 12‐month patient and graft survival, a low incidence of BCAR, and improved renal function in renal allograft recipients. Sirolimus administered with rCsA and corticosteroids provided adequate immunosuppression while reducing the potential for the nephrotoxic effects of cyclosporine. These findings may help to improve long‐term renal allograft outcomes. 相似文献
7.
目的研究肝细胞癌患者肝移植术后使用mTOR抑制剂为主的免疫抑制剂方案对肿瘤复发及生存期的影响。方法收集我中心2005年1月至2008年12月期间因肝细胞癌行肝移植手术的病例建立数据库。根据患者术后所使用的免疫抑制方案分为两组,单CNIs免疫抑制剂组和含西罗莫司(Rapa)组。按照术前肿瘤所符合的移植标准(米兰标准、UCSF标准以及超标准)对组内病例分层分析,对比各组病例之间在肿瘤复率发、无瘤生存期及总生存期方面的差别。结果对于米兰标准及UCSF标准患者,两组间在肿瘤复发率、无瘤生存期和总生存期方面差别无统计学意义;超标准患者两组无瘤生存率无显著差异,含Rapa组总生存期优于单CNIs组(P0.05)。结论超标准肝癌患者术后使用mTOR抑制剂对于延长患者生存期具有一定作用。 相似文献
8.
Elissa R. Engel Adrienne Hammill Denise Adams Roderic J. Phillips Michael Jeng Megha M. Tollefson Ionela Iacobas Deborah Schiff Shoshana Greenberger Michael Kelly Ilona Frieden Nibal Zaghloul Beth Drolet Amy Geddis Dov Goldenberg Kiersten Ricci 《Pediatric blood & cancer》2023,70(4):e30215
Background
Capillary lymphatic venous malformations (CLVM) and associated syndromes, including Klippel–Trenaunay syndrome (KTS) and congenital lipomatous overgrowth, vascular malformation, epidermal nevi, skeletal, and spinal syndrome (CLOVES), are underrecognized disorders associated with high morbidity from chronic pain, recurrent infections, bleeding, and clotting complications. The rarity of these disorders and heterogeneity of clinical presentations make large-scale randomized clinical drug trials challenging. Identification of PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha [gene]) mutations in CLVM has made targeted medications, such as sirolimus, attractive treatment options. The aim of this study was to investigate the safety and efficacy of sirolimus therapy in CLVM.Procedure
A combined prospective and retrospective cohort of pediatric and young adult patients with CLVM treated with sirolimus was evaluated for disease response, including symptom improvement, quality of life (QOL), and radiologic response. Sirolimus dosing regimens and toxicities were also assessed.Results
Twenty-nine patients with CLVM, including KTS and CLOVES, were included. Ninety-three percent of patients reported improved QOL, and 86% had improvement in at least one symptom. Most significantly, improvement was noted in 100% of patients with bleeding and 89% with thrombotic complications with corresponding decreases in mean D-dimer (p = .008) and increases in mean fibrinogen (p = .016). No patients had progressive disease on sirolimus. Most common side effects included neutropenia, lymphopenia, infection, and aphthous ulcers/stomatitis. No toxicities were life-threatening, and none required long-term discontinuation of sirolimus.Conclusion
Sirolimus appears to be effective at reducing complications and improving QOL in patients with CLVM and associated syndromes. In this patient cohort, sirolimus was well tolerated and resulted in few treatment-related toxicities. 相似文献9.
Patricia Cristina Grenzi Érika Fernandes Campos Hélio Tedesco-Silva Claudia Rosso Felipe Maria Fernanda Soares José Medina-Pestana Hinrich Peter Hansen Maria Gerbase-DeLima 《Human immunology》2018,79(7):550-557
Background
Soluble CD30 (sCD30) is a suggested marker for kidney transplantation outcomes. We investigated whether sCD30 serum levels are influenced by immunosuppression and whether they correlate with findings in protocol biopsies and with CD30 gene expression in peripheral blood mononuclear cells (PBMC).Methods
We studied 118 kidney transplant recipients that initially received tacrolimus (TAC) and, at month-3, were converted or not to sirolimus (SRL).Results
sCD30 serum levels gradually declined after transplantation, being the decline more pronounced in the SRL group. CD30 gene expression in PBMC was higher in the SRL group than in the TAC group. Patients with IF/TA?≥?I in the month-24 protocol biopsy had higher sCD30 levels than patients without IF/TA, in the SRL group (P?=?.03) and in the TAC group (P?=?.07). CD30+ cells were observed in three out of 10 biopsies with inflammatory infiltrate from the SRL group. In mixed lymphocyte cultures, SRL and TAC diminished the number of CD30+ T cells and the sCD30 levels in the supernatant, but the effect of SRL was stronger.Conclusions
Overall, sCD30 levels are lower in SRL-treated patients, but the association between increased sCD30 levels and IF/TA at month-24 post-transplantation is stronger in SRL than in TAC-treated patients. 相似文献10.
Mammalian target of rapamycin inhibition after solid organ transplantation: can it,and does it,reduce cancer risk? 下载免费PDF全文
The mammalian target of rapamycin (mTOR) inhibitors sirolimus and everolimus has been increasingly used as immunosuppressants for recipients of solid organ transplants. Over the years, potential advantages unique to this class of immunosuppressants have been recognized, including chemoprevention by virtue of their antiproliferative effects. Prevention of malignancy after transplant through mTOR inhibitor‐based immunosuppression may have a specific practical application in transplant recipients with preexisting malignancy including hepatocellular carcinoma or cholangiocarcinoma. This review will reveal how the biochemistry of the mTOR pathway, as it pertains to chemoprevention, can support a clinical role for mTOR inhibitors in the prevention of malignancies, recurrent or de novo, after solid organ transplantation in selected patients. 相似文献