收费全文 | 1177篇 |
免费 | 48篇 |
国内免费 | 3篇 |
耳鼻咽喉 | 3篇 |
儿科学 | 62篇 |
妇产科学 | 16篇 |
基础医学 | 149篇 |
口腔科学 | 14篇 |
临床医学 | 47篇 |
内科学 | 247篇 |
皮肤病学 | 50篇 |
神经病学 | 76篇 |
特种医学 | 14篇 |
外科学 | 128篇 |
综合类 | 58篇 |
一般理论 | 1篇 |
预防医学 | 67篇 |
眼科学 | 66篇 |
药学 | 150篇 |
中国医学 | 8篇 |
肿瘤学 | 72篇 |
2023年 | 9篇 |
2022年 | 14篇 |
2021年 | 53篇 |
2020年 | 45篇 |
2019年 | 33篇 |
2018年 | 45篇 |
2017年 | 28篇 |
2016年 | 46篇 |
2015年 | 48篇 |
2014年 | 61篇 |
2013年 | 76篇 |
2012年 | 104篇 |
2011年 | 94篇 |
2010年 | 59篇 |
2009年 | 47篇 |
2008年 | 64篇 |
2007年 | 53篇 |
2006年 | 43篇 |
2005年 | 40篇 |
2004年 | 22篇 |
2003年 | 21篇 |
2002年 | 25篇 |
2001年 | 23篇 |
2000年 | 22篇 |
1999年 | 14篇 |
1998年 | 4篇 |
1997年 | 2篇 |
1996年 | 2篇 |
1994年 | 2篇 |
1993年 | 3篇 |
1992年 | 16篇 |
1991年 | 15篇 |
1990年 | 15篇 |
1989年 | 6篇 |
1988年 | 11篇 |
1987年 | 3篇 |
1986年 | 3篇 |
1985年 | 5篇 |
1984年 | 4篇 |
1982年 | 3篇 |
1980年 | 4篇 |
1979年 | 3篇 |
1978年 | 3篇 |
1977年 | 6篇 |
1976年 | 5篇 |
1975年 | 4篇 |
1972年 | 4篇 |
1966年 | 5篇 |
1965年 | 3篇 |
1932年 | 1篇 |
Background
Multiple myeloma (MM) is a hematologic malignancy of plasma cell origin. MM primarily affects bone marrow, but extramedullary sites can also be involved. Myelomatous pleural effusion (MPE) is an atypical and rare complication of MM. We aimed to systematically study the incidence and clinicopathologic profile of patients with MPE in a real-world setting.Patients and Methods
In this retrospective study, 415 consecutive patients with MM managed at a tertiary care center in North India during a study period of January 1, 2010 to December 31, 2015 were evaluated for MPE. The patients with MPE were analyzed for their clinical profile, diagnosis, treatment, and outcomes.Results
Of these 415 patients, 11 (2.65%) patients had MPE. The median age of the study population was 50 years with male preponderance. The majority of these patients had immunoglobin (Ig)G Kappa disease. All patients had higher than International Staging System stage I disease. MPE was a presenting feature at MM diagnosis in 45.45% (n = 5) of the patients, whereas the rest developed MPE during follow-up. MPE presented predominantly (81.8%) as a unilateral effusion. Concurrent extramedullary involvement at other site was seen in 45.45% (n = 5), with 3 (27%) patients having concurrent myelomatous ascites. Six of these were managed aggressively, whereas 5 patients opted for palliation. The outcomes were dismal (90.9% mortality), with a median survival of 2.47 months.Conclusion
MPE is a rare entity, and positive outcomes of therapy remain low with dismal prognosis. 相似文献The persistence of residual infection is one of the major factors in failure of the Global Programme to Eliminate Lymphatic Filariasis (GPELF). The present study aims to explore the status of sheath antibody and regulatory T cells (Tregs) known to play key roles in clearance of parasite and patent filarial infection, in individuals with residual infection after MDA. A total of 61 microfilaremic (Mf) individuals were followed up after at least 6 rounds of MDA. Infection status of subjects was assessed through the detection of Mf and circulating filarial antigen (CFA). Antibodies to Mf sheath were determined by immuno-peroxidase assay (IPA). The expression of Tregs was measured by a flow cytometer. IL-10 and IFN-γ were evaluated using the commercially available ELISA kit. The sheath antibody was present in subjects who have cleared both Mf and CFA and absent in individuals who were found to be Mf /CFA positive. Further individuals carrying infection have significantly high levels of Tregs and IL-10. A positive correlation was observed between Tregs, IL-10, and CFA in infected individuals. In contrast, a negative correlation was observed between IFN-γ and IL-10 in both infected and uninfected subjects. Our study reveals that the absence of a sheath antibody and a high level of Tregs and IL-10 are the hallmarks of the persistence of residual filarial infection.
相似文献