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21.
Ishizaki Y Tezuka J Ohga S Nomura A Suga N Kuromaru R Kusuhara K Mizuno Y Kasuga N Hara T 《The Journal of infection》2003,47(2):133-138
Varicella zoster virus (VZV)-DNA was quantified in peripheral blood of 2 patients with visceral varicella due to endogenous reactivation. An 18-year-old male contracted varicella following the courses of chemotherapy for T cell lymphoma. Another 18-year-old male suffered from varicella 16 months after the complete engraftment of hematopoietic stem cell transplantation. Both patients had past VZV infection, but no recent contact with the disease. Paralytic ileus and ascites preceded the skin lesions. Quantitative real-time polymerase chain reaction revealed >200 copies of VZV per 1 ml of whole blood before or at the time when cropping vesicles emerged. The viral load reflected their prolonged clinical courses. Similar levels of VZV-DNA were detected in primary varicella patients, but not in herpes zoster patients or immunocompromised children without varicella or zoster. Quantitative monitoring of circulating VZV-DNA may be useful for the diagnosis and assessing the treatment response of visceral varicella in immunocompromized hosts. 相似文献
22.
Yoshihiko Fujinaka Masaru Morita Takefumi Ohga Yoshihiro Kakeji Tokujiro Yano Yoshihiko Maehara 《International surgery》2014,99(5):640-644
The prognosis of esophageal cancer with distant metastasis is dismal. We report a 70-year-old man with esophageal cancer and multiple lung and lymph node metastases. Complete response was achieved following definitive chemoradiotherapy. Twenty-four months after the initial chemoradiotherapy, local recurrence was detected but there was no evidence of distant metastasis. Therefore, the patient underwent salvage esophagectomy. The surgery was well tolerated without any postoperative complications. The patient is still alive 48 months after the salvage surgery. Our experience suggests that salvage esophagectomy is an important component of multimodal therapy for the recurrence of esophageal cancer.Key words: Esophageal cancer, Chemoradiotherapy, Salvage surgeryThe prognosis of esophageal cancer has improved in recent years, but remains poor despite curative resection.1 The prognosis is extremely dismal in patients with distant metastasis. The Radiation Therapy Oncology Group (RTOG) trial 85-01 showed that chemoradiotherapy (CRT) improved outcomes, with a 5-year overall survival rate of 26% compared with 0% following radiotherapy alone. Moreover, residual cancer was less common following CRT (26%) than following radiotherapy alone (37%).2 However, local recurrence occurs in 37% of patients after definitive CRT.3 Salvage esophagectomy is one strategy for residual cancer or local recurrence after definitive CRT. Of note, when R0 resection is achieved, long-term survival can be expected.4−6 On the other hand, this is an invasive procedure associated with high morbidity and mortality6 and the patient''s prognosis is extremely poor after R1/R2 resection.4−6 Therefore, salvage esophagectomy should only be performed if complete removal of the tumor is expected.Here, we report a rare case with esophageal cancer and multiple lung metastases, in which complete response (CR) was achieved after definitive CRT and salvage esophagectomy was effective for the local recurrence. 相似文献
23.
Tadahiro Nozoe Rumi Matono Hideki Ijichi Takefumi Ohga Takahiro Ezaki 《International surgery》2014,99(5):512-517
The Glasgow Prognostic Score (GPS), an inflammation-based score, has been used to predict the biologic behavior of malignant tumors. The aim of the current study was to elucidate a further significance of GPS in colorectal carcinoma. Correlation of GPS and modified GPS (mGPS), which are composed of combined score provided for serum elevation of C-reactive protein and hypoalbuminemia examined before surgical treatment, with clinicopathologic features was investigated in 272 patients with colorectal carcinoma. Survival of GPS 1 patients was significantly worse than that of GPS 0 patients (P= 0.009), and survival of GPS 2 patients was significantly worse than that of GPS 1 patients (P < 0.0001). Similarly, survival of mGPS 1 patients was significantly worse than that of mGPS 0 patients (P = 0.009), and survival of mGPS 2 patients was significantly worse than that of mGPS 1 patients (P = 0.0006). Multivariate analysis demonstrated that GPS (P < 0.0001) as well as tumor stage (P= 0.004) and venous invasion (P = 0.011) were factors independently associated with worse prognosis. Both GPS and mGPS could classify outcome of patients with a clear stratification, and could be applied as prognostic indicators in colorectal carcinoma.Key words: Colorectal carcinoma, Glasgow prognostic score (GPS), Prognostic indicatorAlthough many tumor-environmental elements, including both tumor-related and host-related factors, have been linked with tumor progression, host inflammatory response is one of the more important factors that has a role in the progression and/or development of tumors.1Serum elevation of C-reactive protein (CRP), an acute phase protein, has been shown to be a prognostic indicator in a variety of neoplasms, including colorectal carcinoma.2–5 Moreover, hypoalbuminemia brought about by malnutrition and related to cachexic condition has been reported to be correlated with an unfavorable prognosis of some gastrointestinal tumors.6,7The Glasgow prognostic score (GPS), which is a cumulative inflammation-based cancer-prognostic marker composed of serum elevation of CRP and decrease in albumin concentration, is likely to reflect host systemic inflammatory response and has been reported to be significant as a prognostic indicator in cancer-bearing patients.8–10Moreover, it has been found that hypoalbuminemia alone is unlikely to be associated with reduced survival likelihood in patients with colorectal carcinoma11; therefore, the GPS has been modified (mGPS), providing a score of 1 only for a case with serum elevation of CRP, and score of 0 for a case only with hypoalbuminemia or where neither was elevated. Although, until now, there have been some reports regarding the significance of GPS as a prognostic indicator in colorectal carcinoma,9,11–16 the aim of this study was to elucidate further the significance of GPS and mGPS in colorectal carcinoma. 相似文献
24.
Hirotoshi Sakaguchi Nobuhiro Nishio Asahito Hama Nozomu Kawashima Xinan Wang Atsushi Narita Sayoko Doisaki Yinyan Xu Hideki Muramatsu Nao Yoshida Yoshiyuki Takahashi Kazuko Kudo Hiroshi Moritake Kazuhiro Nakamura Ryoji Kobayashi Etsuro Ito Hiromasa Yabe Shouichi Ohga Akira Ohara Seiji Kojima 《Haematologica》2014,99(8):1312-1316
Predicting the response to immunosuppressive therapy could provide useful information to help the clinician define treatment strategies for patients with aplastic anemia. In our current study, we evaluated the relationship between telomere length of lymphocytes at diagnosis and the response to immunosuppressive therapy in 64 children with aplastic anemia, using flow fluorescence in situ hybridization. Median age of patients was ten years (range 1.5–16.2 years). Severity of the disease was classified as very severe in 23, severe in 21, and moderate in 20 patients. All patients were enrolled in multicenter studies using antithymocyte globulin and cyclosporine. The response rate to immunosuppressive therapy at six months was 52% (33 of 64). The probability of 5-year failure-free survival and overall survival were 56% (95% confidence interval (CI): 41–69%) and 97% (95%CI: 87–99%), respectively. Median telomere length in responders was −0.4 standard deviation (SD) (−2.7 to +3.0 SD) and −1.5 SD (−4.0 to +1.6 (SD)) in non-responders (P<0.001). Multivariate analysis showed that telomere length shorter than −1.0 SD (hazard ratio (HR): 22.0; 95%CI: 4.19–115; P<0.001), platelet count at diagnosis less than 25×109/L (HR: 13.9; 95%CI: 2.00–96.1; P=0.008), and interval from diagnosis to immunosuppressive therapy longer than 25 days (HR: 4.81; 95%CI: 1.15–20.1; P=0.031) were the significant variables for poor response to immunosuppressive therapy. Conversely to what has been found in adult patients, measurement of the telomere length of lymphocytes at diagnosis is a promising assay in predicting the response to immunosuppressive therapy in children with aplastic anemia. 相似文献
25.
Nao Yoshida Ryoji Kobayashi Hiromasa Yabe Yoshiyuki Kosaka Hiroshi Yagasaki Ken-ichiro Watanabe Kazuko Kudo Akira Morimoto Shouichi Ohga Hideki Muramatsu Yoshiyuki Takahashi Koji Kato Ritsuro Suzuki Akira Ohara Seiji Kojima 《Haematologica》2014,99(12):1784-1791
The current treatment approach for severe aplastic anemia in children is based on studies performed in the 1980s, and updated evidence is required. We retrospectively compared the outcomes of children with acquired severe aplastic anemia who received immunosuppressive therapy within prospective trials conducted by the Japanese Childhood Aplastic Anemia Study Group or who underwent bone marrow transplantation from an HLA-matched family donor registered in the Japanese Society for Hematopoietic Cell Transplantation Registry. Between 1992 and 2009, 599 children (younger than 17 years) with severe aplastic anemia received a bone marrow transplant from an HLA-matched family donor (n=213) or immunosuppressive therapy (n=386) as first-line treatment. While the overall survival did not differ between patients treated with immunosuppressive therapy or bone marrow transplantation [88% (95% confidence interval: 86–90) versus 92% (90–94)], failure-free survival was significantly inferior in patients receiving immunosuppressive therapy than in those undergoing bone marrow transplantation [56% (54–59) versus 87% (85–90); P<0.0001]. There was no significant improvement in outcomes over the two time periods (1992–1999 versus 2000–2009). In multivariate analysis, age <10 years was identified as a favorable factor for overall survival (P=0.007), and choice of first-line immunosuppressive therapy was the only unfavorable factor for failure-free survival (P<0.0001). These support the current algorithm for treatment decisions, which recommends bone marrow transplantation when an HLA-matched family donor is available in pediatric severe aplastic anemia. 相似文献
26.
Prognostic factors for chronic active Epstein-Barr virus infection 总被引:11,自引:0,他引:11
Kimura H Morishima T Kanegane H Ohga S Hoshino Y Maeda A Imai S Okano M Morio T Yokota S Tsuchiya S Yachie A Imashuku S Kawa K Wakiguchi H;Japanese Association for Research on Epstein-Barr Virus Related Diseases 《The Journal of infectious diseases》2003,187(4):527-533
Chronic active Epstein-Barr virus infection (CAEBV) is a high-mortality and high-morbidity disease. To clarify the prognostic factors, a national survey was performed in Japan, and data for 82 patients who met the criteria for CAEBV were analyzed. Of these 82 patients, 47 were alive and 35 had already died. Multivariate analysis revealed that thromobocytopenia and age at disease onset were correlated with mortality. The probability of 5-year survival was 0.45 for older patients (onset age, > or = 8 years), 0.94 for younger patients (P<.001), 0.38 for patients with thrombocytopenia (platelet count < 12 x 10(4) platelets/microL at diagnosis), and 0.76 for patients without thrombocytopenia (P=.01). Furthermore, patients with T cell infection by EBV had shorter survival times than patients with natural killer cell infection (probability of 5-year survival, 0.59 vs. 0.87; P<.009). Patients with CAEBV with late onset of disease, thrombocytopenia, and T cell infection had significantly poorer outcomes. 相似文献
27.
28.
29.
A rare case of metastatic renal cell carcinoma resembling a nerve sheath tumor of the cauda equina. 总被引:1,自引:0,他引:1
Motoo Kubota Naokatsu Saeki Akira Yamaura Toshihiko Iuchi Masaru Ohga Katsunobu Osato 《Journal of clinical neuroscience》2004,11(5):530-532
We present a rare case of solitary metastasis to the cauda equina from the kidney. The patient was a 68-year-old man with a two-year history of low back pain. His past medical history revealed a renal cell carcinoma diagnosed seven years earlier. His lumbosacral MR imaging showed a well-demarcated, intradural extramedullary mass at the L3 level. He underwent an L2-4 laminectomy. The operative findings of the tumor quite resembled that of a nerve sheath tumor. It did not infiltrate into the subarachnoid space and involved only one spinal nerve. Pathology of the tumor was a metastasis of the renal cell carcinoma. Only 10 cases with such a metastasis to the cauda equina have been reported in the English literature. We added the 11th and reviewed the literature with reference to tumor pathologies, clinical findings and route of metastasis to the cauda equina. 相似文献
30.
Tetsuo Ikeda Hiroyuki Kawano Yuichi Hisamatsu Koji Ando Hiroshi Saeki Eiji Oki Takefumi Ohga Yoshihiro Kakeji Shunichi Tsujitani Shunji Kohnoe Yoshihiko Maehara 《Surgical endoscopy》2013,27(1):325-332