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51.
52.
Alginate Encapsulant Incorporating CXCL12 Supports Long‐Term Allo‐ and Xenoislet Transplantation Without Systemic Immune Suppression 下载免费PDF全文
53.
Kidney‐Induced Cardiac Allograft Tolerance in Miniature Swine is Dependent on MHC‐Matching of Donor Cardiac and Renal Parenchyma 下载免费PDF全文
M. L. Madariaga S. G. Michel G. M. La Muraglia II M. Sekijima V. Villani D. A. Leonard H. J. Powell J. M. Kurtz E. A. Farkash R. B. Colvin J. S. Allan C. L. Cetrulo Jr C. A. Huang D. H. Sachs K. Yamada J. C. Madsen 《American journal of transplantation》2015,15(6):1580-1590
Kidney allografts possess the ability to enable a short course of immunosuppression to induce tolerance of themselves and of cardiac allografts across a full‐MHC barrier in miniature swine. However, the renal element(s) responsible for kidney‐induced cardiac allograft tolerance (KICAT) are unknown. Here we investigated whether MHC disparities between parenchyma versus hematopoietic‐derived “passenger” cells of the heart and kidney allografts affected KICAT. Heart and kidney allografts were co‐transplanted into MHC‐mismatched recipients treated with high‐dose tacrolimus for 12 days. Group 1 animals (n = 3) received kidney and heart allografts fully MHC‐mismatched to each other and to the recipient. Group 2 animals (n = 3) received kidney and heart allografts MHC‐matched to each other but MHC‐mismatched to the recipient. Group 3 animals (n = 3) received chimeric kidney allografts whose parenchyma was MHC‐mismatched to the donor heart. Group 4 animals (n = 3) received chimeric kidney allografts whose passenger leukocytes were MHC‐mismatched to the donor heart. Five of six heart allografts in Groups 1 and 3 rejected <40 days. In contrast, heart allografts in Groups 2 and 4 survived >150 days without rejection (p < 0.05). These data demonstrate that KICAT requires MHC‐matching between kidney allograft parenchyma and heart allografts, suggesting that cells intrinsic to the kidney enable cardiac allograft tolerance. 相似文献
54.
Vascular Management During Live Donor Nephrectomy: An Online Survey Among Transplant Surgeons 下载免费PDF全文
S. Janki D. Verver K. W. J. Klop A. L. Friedman T. G. Peters L. E. Ratner J. N. M. Ijzermans F. J. M. F. Dor 《American journal of transplantation》2015,15(6):1701-1707
55.
56.
Immune Reconstitution Inflammatory Syndrome Secondary to Mycobacterium kansasii Infection in a Kidney Transplant Recipient 下载免费PDF全文
M. Lemoine C. Laurent M. Hanoy J. Leporrier A. François D. Guerrot M. Godin D. Bertrand 《American journal of transplantation》2015,15(12):3255-3258
Nontuberculous mycobacteria (NTM) infection is a challenging diagnosis for clinicians in solid organ transplantation. Immune reconstitution inflammatory syndrome (IRIS) is so far unreported in this context. We report here the case of a renal transplant recipient who developed Mycobacterium kansasii–associated lymphadenitis complicated by IRIS while undergoing reduction of his immunosuppressive therapy. For IRIS, the patient required low‐dose steroids and an increase in global immunosuppression, in association with NTM antibiotherapy. 相似文献
57.
KDIGO Guidelines and Kidney Transplantation: Is the Cystatin‐C Based Recommendation Relevant? 下载免费PDF全文
I. Masson N. Maillard E. Cavalier E. Alamartine P. Delanaye 《American journal of transplantation》2015,15(8):2211-2214
The KDIGO guidelines propose a new approach to diagnose chronic kidney disease (CKD) based on estimated glomerular filtration rate (GFR). In patients with a GFR value comprised between 45 and 59 mL/min/1.73 m2 as estimated by the CKD‐EPI creatinine equation (eGFRcreat), it is suggested to confirm the diagnosis with a second estimation using the CKD‐EPI cystatin C‐based equations (eGFRcys/eGFRcreat‐cys). We sought to determine whether this new diagnostic strategy might extend to kidney transplant recipients (KTR) and help to identify those with decreased GFR. In 670 KTR for whom a measured GFR was available, we simulated the detection of CKD using the two‐steps approach recommended by the guidelines in comparison to the conventional approach relying on creatinine equation. One hundred forty‐five patients with no albuminuria had eGFRcreat between 45 and 59 mL/min/1.73 m2. Among them, 23% had inulin clearance over 60 mL/min/1.73 m2 and were thus incorrectly classified as CKD patients. When applying the Kidney Disease: Improving Global Outcomes (KDIGO) strategy, 138 patients were confirmed as having a GFR below 60 mL/min with eGFRcreat‐cys. However, 21% of them were misclassified in reference to measured GFR. Our data do no not support the use of cystatin C as a confirmatory test of stage 3 A CKD in KTR. 相似文献
58.
R. L. Heilman M. L. Smith S. M. Kurian J. Huskey R. K. Batra H. A. Chakkera N. N. Katariya H. Khamash A. Moss D. R. Salomon K. S. Reddy 《American journal of transplantation》2015,15(8):2143-2151
Our aim was to determine outcomes with transplanting kidneys from deceased donors with acute kidney injury, defined as a donor with terminal serum creatinine ≥2.0 mg/dL, or a donor requiring acute renal replacement therapy. We included all patients who received deceased donor kidney transplant from June 2004 to October 2013. There were 162 AKI donor transplant recipients (21% of deceased donor transplants): 139 in the standard criteria donor (SCD) and 23 in the expanded criteria donor (ECD) cohort. 71% of the AKI donors had stage 3 (severe AKI), based on acute kidney injury network (AKIN) staging. Protocol biopsies were done at 1, 4, and 12 months posttransplant. One and four month formalin‐fixed paraffin embedded (FFPE) biopsies from 48 patients (24 AKI donors, 24 non‐AKI) underwent global gene expression profiling using DNA microarrays (96 arrays). DGF was more common in the AKI group but eGFR, graft survival at 1 year and proportion with IF/TA>2 at 1 year were similar for the two groups. At 1 month, there were 898 differentially expressed genes in the AKI group (p‐value <0.005; FDR <10%), but by 4 months there were no differences. Transplanting selected kidneys from deceased donors with AKI is safe and has excellent outcomes. 相似文献
59.
The Donor Kidney Biopsy and Its Implications in Predicting Graft Outcomes: A Systematic Review 下载免费PDF全文
C. J. Wang J. B. Wetmore G. S. Crary B. L. Kasiske 《American journal of transplantation》2015,15(7):1903-1914
Despite a growing organ shortage in the United States, many deceased donor kidneys removed for transplantation are discarded. Kidney biopsy findings often play a role in these discards, although it is not clear whether biopsies reliably inform acceptance decisions. Therefore, we carried out a systematic review of the medical literature on the utility of both procurement and implantation biopsies for predicting posttransplant outcomes. Between January 1, 1994 and July 1, 2014, 47 studies were published in the English language literature that examined the association between pretransplant donor biopsy findings from 50 or more donors (with more than half being from deceased donors) and either posttransplant graft failure, delayed graft function, or graft function. In general, study quality was poor. All were retrospective or did not indicate if they were prospective. Results were heterogeneous, with authors as often as not concluding that biopsy results did not predict posttransplant outcomes. The percent glomerular sclerosis was most often examined, and failed to predict graft failure in 7 of 14 studies. Of 15 semiquantitative scoring systems proposed, none consistently predicted posttransplant outcomes across studies. Routine use of biopsies to help determine whether or not to transplant a kidney should be reexamined. 相似文献
60.
Laparoscopic Transplantation Following Transvaginal Insertion of the Kidney: Description of Technique and Outcome 下载免费PDF全文
P. Modi B. Pal S. Kumar J. Modi Y. Saifee R. Nagraj J. Qadri A. Sharmah R. Agrawal M. Modi V. Shah V. Kute H. Trivedi 《American journal of transplantation》2015,15(7):1915-1922
Laparoscopic kidney transplantation (LKT) is well accepted modality of treatment for ESRD patients at our center. Usually, the kidney is inserted through small Pfannenstiel incision. With the permission of the Internal Review Board, we carried out LKT in eight female recipients following insertion of the kidney through the vagina. The kidney was procured by the retroperitoneoscopic approach. Antibiotic prophylaxis was given. All cases were carried out successfully with immediate graft function and 100% graft and patient survival at 1 year of follow‐up. Estimated glomerular filtration rate at 1 month and 1 year was similar to eight randomly selected female recipients who underwent open kidney transplantation (OKT). No analgesia was required in seven out of eight patients after the 3rd postoperative day. In summary, vaginal insertion of kidney and LKT is safe and feasible in a selected group of patients. It is associated with better analgesia and has similar allograft function as compare to OKT. 相似文献