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81.
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A P Cope A Jones M Brozovic M S Shafi R N Maini 《Annals of the rheumatic diseases》1992,51(6):803-804
A 59 year old woman presented with an influenza-like illness preceding signs and symptoms strongly suggestive of systemic lupus erythematosus (SLE), which progressed over several months. Owing to these influenza-like symptoms, a viral cause of her illness was sought. Human parvovirus B19 serology was positive and antibodies to DNA were detected by two different methods. This patient is believed to be the first report of human parvovirus B19 infection coinciding with the onset of SLE. The evidence for B19 virus and the part it plays in autoimmunity and arthritis is discussed. 相似文献
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Hope Caughron Dennis Kim Norihiko Kamioka Stamatios Lerakis Altayyeb Yousef Aneesha Maini Shawn Reginauld Anurag Sahu Subhadra Shashidharan Maan Jokhadar Fred H. Rodriguez Wendy M. Book Michael McConnell Peter C. Block Vasilis Babaliaros 《JACC: Cardiovascular Interventions》2018,11(24):2495-2503
Objectives
This study compares 30-day, 1-year, and 3-year echocardiographic findings and clinical outcomes of transcatheter pulmonary valve-in-valve replacement (TPVR) and repeat surgical pulmonary valve replacement (SPVR).Background
In patients with adult congenital heart disease and previous pulmonary valve replacement (PVR) who require redo PVR, it is unclear whether TPVR or repeat SPVR is the preferred strategy.Methods
We retrospectively identified 66 patients (TPVR, n = 36; SPVR, n = 30) with bioprosthetic pulmonary valves (PVs) who underwent either TPVR or repeat SPVR at Emory Healthcare from January 2007 to August 2017.Results
The TPVR cohort had fewer men and more patients with baseline New York Heart Association (NYHA) functional class III or IV. There was no difference in mortality, cardiovascular readmission, or post-procedural PV reintervention at 30 days, 1 year, or 3 years. Post-procedural echocardiographic findings showed no difference in mean PV gradients between the TPVR and SPVR groups at 30 days, 1 year, or 3 years. In the TPVR cohort, there was less right ventricular dysfunction at 30 days (2.9% vs. 46.7%; p < 0.01), despite higher baseline NYHA functional class in the SPVR cohort.Conclusions
In patients with bioprosthetic PV dysfunction who underwent either TPVR or SPVR, there was no difference in mortality, cardiovascular readmission, or repeat PV intervention at 30 days, 1 year, or 3 years. Additionally, TPVR and SPVR had similar intermediate-term PV longevity, with no difference in PV gradients or PVR. The TPVR cohort also had less right ventricular dysfunction at 30 days despite a higher baseline NYHA functional classification. These intermediate-term results suggest that TPVR may be an attractive alternative to SPVR in patients with previous bioprosthetic surgical PVs. 相似文献86.
OBJECTIVE: To compare the incidence of anti-double-stranded DNA (anti-dsDNA) antibodies in rheumatoid arthritis (RA) patients receiving either single or multiple doses of a chimeric anti-tumor necrosis factor alpha (anti-TNFalpha) antibody or placebo infusions, with or without methotrexate, in open-label, randomized, placebo-controlled trials. METHODS: Multiple sera obtained from 156 patients before and after treatment with infliximab and from 37 patients treated with placebo infusions were tested for anti-dsDNA antibodies by 3 methods: Crithidia luciliae indirect immunofluorescence test (CLIFT), a commercial Farr assay (Ortho Diagnostics radioimmunoassay [RIA]) in which the antigen source is mammalian DNA, and a Farr assay employing 125I-labeled circular plasmid DNA (Central Laboratory of The Netherlands Red Cross Blood Transfusion Service [CLB] RIA). Patients with positive findings on the CLIFT were also tested for antibodies to histones (H1-H5) and chromatin and for IgM rheumatoid factors (IgM-RFs). RESULTS: None of the RA patients had a serum sample that was positive for anti-dsDNA antibodies by the CLIFT prior to infliximab therapy. Of the 22 patients who developed a positive CLIFT result, 11 (7% of 156 exposed to infliximab) also had positive findings on the Ortho RIA at a concentration of >10 units/ml and another 8 (5%) were positive at a concentration of >25 units/ml. In all but 1 patient, the anti-dsDNA antibodies were solely of the IgM isotype. Only 1 patient had detectable anti-dsDNA antibodies by the CLB RIA. All sera containing anti-dsDNA by the CLIFT contained antibodies to chromatin, and sera from 2 patients also contained antibodies to histones. IgM-RF titers showed a significant reduction following infliximab therapy in these 22 patients. One patient developed anti-dsDNA antibodies of IgG, IgA, and IgM isotype and had positive results on both Farr assays (peaking at 22 weeks and resolving by 54 weeks); this was associated with a reversible lupus syndrome. CONCLUSION: Anti-dsDNA antibodies of IgM class are induced by infliximab therapy; the frequency is dependent on the assay method used. Only 1 of the 156 patients who were treated with infliximab developed a self-limiting clinical lupus syndrome; that patient developed high titers of anti-dsDNA antibodies of IgG, IgM, and IgA class, as detected by the CLIFT and by 2 different Farr assays. 相似文献
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Differences in immunochemical characteristics of cryoglobulins in rheumatoid arthritis and systemic lupus erythematosus and their complement binding properties. 下载免费PDF全文
Cryoglobulins isolated from sera of patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) were analysed for their immunoglobulin, antibody, and complement components. In both disease categories the cryoglobulins contained predominantly IgG with lesser amounts of IgM and IgA, but relative to serum more IgM was concentrated in the cryoglobulins. IgM rheumatoid factor was found in 65% of RA cryoglobulins but in only 17% of SLE cryoglobulins (p less than 0.02), whereas SLE cryoglobulins contained more DNA binding activity than RA cryoglobulins (p less than 0.01). C1q binding activity was detectable in the majority of SLE and RA sera and SLE cryoglobulins. Paradoxically only two out of 34 RA cryoglobulins bound C1q, although rheumatoid factor activity was present in both cryoglobulins and sera. When isolated from serum the rheumatoid factor fraction strongly bound C1q. Both RA and SLE cryoglobulins contained similar small amounts of C3 and C4. Differences in antibody composition and complement binding activity of cryoglobulins from RA and SLE sera may reflect properties of immune complexes which affect their tissue localisation and pathogenicity. 相似文献
89.
Brennan FM; Browne KA; Green PA; Jaspar JM; Maini RN; Feldmann M 《Rheumatology (Oxford, England)》1997,36(6):643-650
Matrix metalloproteinase (MMP)-1 and MMP-3 levels were measured in serum
samples from rheumatoid arthritis (RA) patients undergoing a double-blinded
placebo-controlled trial with the chimaeric anti-tumour necrosis factor
(TNF)-alpha antibody cA2. Both MMP-1 (P < 0.015), but to a larger extent
MMP-3 (P < 0.001) levels were elevated in all RA patients prior to the
commencement of the trial compared with normal control sera. Following cA2
therapy, MMP-1 and MMP-3 levels were assessed in the placebo, and 1 and 10
mg/kg cA2-treated groups at 7, 14, 21 and 28 days. In both the 1 and the 10
mg/kg cA2-treated groups, a significant decrease in serum MMP-3 levels at
all time points was observed, reducing maximally to 41% of pre-infusion
values at day 7. MMP-1 levels were also reduced, but less dramatically than
MMP-3, to 85% of pre-infusion values after 14 days in the 10 mg/kg cA2
treated group. In a separate non-placebo-controlled study, we also
evaluated the tissue inhibitor of metalloproteinase (TIMP)-1 levels in
plasma following cA2 infusion. Pre-infusion TIMP-1 levels were above the
normal control range, but were significantly reduced (P < 0.035) 14 days
after infusion to 72% of pre-infusion values. This study confirms previous
reports that MMP-3 levels are elevated and correlate with measures of
inflammation in RA, and furthermore demonstrate that serum MMP-3 and MMP-1
levels are downmodulated following anti-TNF-alpha antibody therapy. Whilst
serum MMP-3 levels correlated with C-reactive protein (CRP) both prior to
and following anti-TNF-alpha antibody therapy, it remains to be
demonstrated that serum MMP-3 and/or MMP-1 levels reflect the cartilage and
bone resorptive processes which are evident in this disease.
相似文献
90.