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Suzanne AV Van Asten Adam Nichols Javier La Fontaine Kavita Bhavan Edgar JG Peters Lawrence A Lavery 《International wound journal》2017,14(1):40-45
In this study, we assessed the effectiveness of inflammatory markers to diagnose and monitor the treatment of osteomyelitis in the diabetic foot. We evaluated 35 consecutive patients admitted to our hospital with infected foot ulcers. Patients were divided in two groups based on the results of bone culture and histopathology: osteomyelitis and no osteomyelitis. The erythrocyte sedimentation rate (ESR), C‐reactive protein (CRP), procalcitonin (PCT), interleukin‐6 (IL‐6), interleukin‐8 (IL‐8), tumor necrosis factor alpha (TNFα), monocyte chemotactic protein‐1 (MCP‐1) and macrophage inflammatory protein‐1 alpha (MIP1α) were measured at baseline after 3 and 6 weeks of standard therapy. PCT levels in the osteomyelitis group were significantly higher at baseline than in the group with no osteomyelitis (P = 0·049). There were no significant differences between the two groups in the levels of the other markers. CRP, ESR, PCT and IL‐6 levels significantly declined in the group with osteomyelitis after starting therapy, while MCP‐1 increased (P = 0·002). TNFα and MIP1α levels were below range in 80 out of 97 samples and therefore not reported. Our results suggest that PCT might be useful to distinguish osteomyelitis in infected foot ulcers. CRP, ESR, PCT and IL‐6 are valuable when monitoring the effect of therapy. 相似文献
68.
Drexler HG; Brenner MK; Coustan-Smith E; Wickremasinghe RG; Hoffbrand AV 《Blood》1987,70(5):1536-1542
The peripheral blood mononuclear cells from 16 patients with B-chronic lymphocytic leukemia (B-CLL, n = 13), B-prolymphocytic leukemia (B-PLL, n = 2) or hairy cell leukemia (n = 1) were incubated in the presence of the phorbol ester 12-0-tetradecanoylphorbol-13-acetate (TPA) and the calcium ionophore A23187. A synergy between these inducers was found with respect to morphological changes and B cell proliferation and differentiation. A23187 used alone did not activate the cells. B-CLL cells treated with the double stimulus acquired a plasmacytoid morphology, showed significantly higher incorporation of 3H-thymidine and 3H-uridine, and produced significantly higher amounts of monoclonal immunoglobulin compared with the same cells exposed to either of the inducers alone. These results indicate that phorbol ester and calcium ionophore act synergistically on B-CLL cells to induce proliferation and differentiation. B-PLL cells responded more vigorously to the signals provided by TPA and A23187. Previous studies showed that TPA and A23187 can mimic the two physiological second messengers diacylglycerol and inositol trisphosphate in the transduction of signals leading to cell activation, proliferation, and differentiation in normal B cells. The present findings suggest that the capacity of B- CLL and B-PLL cells to differentiate in response to signals of the second messenger pathway is intact. 相似文献
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During a 4-year multicenter cooperative study of acquired factor VIII inhibitors in persons with hemophilia A, new inhibitors were detected in 31 of 1,306 patients who entered the study without an inhibitor or the history of an inhibitor. The incidence of new inhibitors was eight per 1,000 patient-years of observation. The factor VIII:C level before inhibitor development was less than or equal to 0.03 U/mL in 29 individuals and 0.06 U/mL and 0.07 U/mL in the remaining two. Factor VIII:Ag levels were measured in 27 individuals and were less than 0.03 U/mL in 23 and 0.05 to 0.11 U/mL in the remaining four. Maximum inhibitor levels ranged from 1.0 to 9,044 Bethesda U/mL. In seven patients under the age of 20, relatively weak inhibitors (none higher than 4.3 Bethesda U/mL) were detected on only a single occasion despite continued factor VIII challenge. In the other 24 patients with inhibitors detected on multiple occasions, 50% had appeared by age 20 and 71% by age 30. Seventeen of the 31 inhibitors, including 12 of 15 with maximum values greater than 10 Bethesda U/mL, developed within 75 exposure days to factor VIII. 相似文献
70.
Cytotoxic T lymphocytes (CTL) have been implicated in immunity to
Plasmodium falciparum infection and disease. We have previously described
the use of peptides to define malaria-specific CTL epitopes. To determine
whether these peptide epitopes are processed intracellularly from the whole
antigen we have developed recombinant vaccinia viruses (rVV) expressing
three malaria antigens: thrombospondin-related adhesive protein (TRAP),
Pfs16 and the C- terminal half of liver-stage antigen (LSA)-1. Target cells
infected with recombinant viruses were lysed by malaria-specific CTL from
semi- immune African donors. We also tested the ability of cells infected
with these recombinant vaccinia viruses to re-stimulate malaria- specific
CTL in peripheral blood lymphocytes from malaria immune adults. Two other
pox virus recombinants, NYVAC, an attenuated vaccinia virus, and ALVAC, a
canarypox virus, both expressing malaria antigens were also evaluated for
their ability to stimulate malaria-specific CTL in contrast to peptide,
none of these viruses successfully re- stimulated CTL from the peripheral
blood lymphocytes of semi-immune donors. The ability of human CTL from
naturally exposed individuals to recognize processed antigen supports the
relevance of these cells in protective immunity to malaria.
相似文献