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71.
Haim N Shulman K Goldberg H Tsalic M 《Medical oncology (Northwood, London, England)》2005,22(3):229-232
Secondary prophylactic administration of recombinant human granulocyte colony stimulating factor (G-CSF) following an episode
of febrile neutropenia is recommended if maintenance of dose-intensity is desired. This policy was adopted in our center in
patients treated with an intent for cure or durable complete response. The purpose of this study was to evaluate the safety
and feasibility of this policy. Patients in whom neutropenia was associated with a life-threatening infection and those who
developed prolonged myelosuppression were excluded. Fifty-one patients who developed febrile neutropenia that required intravenous
antibiotics following moderately myelotoxic chemotherapy were included. These patients received the next cycle of the same
chemotherapy regime without dose modification but with the support of filgrastim (300 or 480 mg/d sc for at least 10 consecutive
days). Diagnoses included lymphoma (n=19), breast cancer (n=15), germ cell tumor (n=7), small-cell lung cancer (n=5), and other solid tumors (n=5). The incidence of febrile neutropenia during the first cycle given with filgrastim support (N1) was 8/51 (16%). Intravenous
antibiotics were required for 3–7 d (median, 4.5 d). During the following cycle (N2), febrile neutropenia developed in 4/41
(10%) patients. Intravenous antibiotics were given for 2, 4, 5, and 7 d. Other dose-limiting toxicities developed in 1/51
patients who received N1 and in 1/41 patients who received N2. There was no drug-related death associated with either cycle.
In conclusion, a policy of full-dose chemotherapy with secondary G-CSF support in patients who develop febrile neutropenia
following moderately myelotoxic chemotherapy is relatively safe and feasible. 相似文献
72.
Wenisch C Werkgartner T Sailer H Patruta S Krause R Daxboeck F Parschalk B 《European journal of clinical investigation》2000,30(5):460-466
BACKGROUND: Cancer surgery is known to lead to a deterioration in host defence mechanisms and an increase in susceptibility to infection after operation. Filgrastim enhances important antimicrobial functions of neutrophils including chemotaxis, phagocytosis and oxidative killing mechanisms. METHODS: The effects of additional (all patients received perioperative 3 ' 25 mg kg-1 cefotiam and 1 ' 20 mg kg-1 metronidazole) preoperative prophylaxis with filgrastim (5 microg kg-1 12 h prior to surgery plus 5 microg kg-1 0 h prior to surgery) on neutrophil phagocytosis and reactive oxygen radical production and postoperative infections in 24 patients undergoing cancer neck dissection were studied. Phagocytic capacity was assessed by measuring the uptake of fluorescein isothiocyanate-labelled Escherichia coli and Staphylococcus aureus by flow cytometry. Reactive oxygen generation after phagocytosis was estimated by determining the amount of dihydrorhodamine 123 converted to rhodamine 123, intracellularly. RESULTS: In the filgrastim-treated patients a higher neutrophil phagocytic capacity was seen intraoperatively, and 1-5 days postoperative, but not prior to surgery. Reactive oxygen radical production was significantly higher in filgrastim-treated patients prior to surgery, intraoperative and postoperative (1-5 days). 2/12 (17%) patients had postoperative infections in the filgrastim group and 9/12 (75%) patients had infections in the placebo group (P < 0.001). In particular, wound infections were recorded more often in the placebo group (1/12 vs. 6/12; P = 0.004). CONCLUSION: We conclude that filgrastim enhances perioperative neutrophil function and could be useful in the prophylaxis of postoperative wound infections in patients undergoing cancer neck dissection. 相似文献
73.
74.
PAOLO ANDERLINI DONNA PRZEPIORKA YANG HUH JO LAUPPE PAULA MILLER JANICE SUNDBERG DAVID SEONG RICHARD CHAMPLIN & MARTIN KÖRBLING 《British journal of haematology》1996,93(4):940-942
Seventy-seven normal donors underwent leukapheresis for peripheral blood progenitor cell collection beginning on day 4 ( n = 45) or day 5 ( n = 32) of filgrastim mobilization (12 μg/kg/d). The two groups were comparable for age, weight, blood volumes processed during leukapheresis and target CD34+ cell dose to be collected. The day 5 schedule allowed a more consistent achievement of the target cell dose with one apheresis ( P = 0.005) and resulted in the initial collection of a significantly larger number of CD34+ cells ( P = 0.009). There was no statistically significant difference in the leukapheresis yield of lymphoid subsets and natural killer cells. 相似文献
75.
A phase II dose finding study of darbepoetin alpha and filgrastim for the management of anaemia and neutropenia in chronic hepatitis C treatment 总被引:1,自引:0,他引:1
Younossi ZM Nader FH Bai C Sjogren R Ong JP Collantes R Sjogren M Farmer D Ramsey L Terra K Gujral H Gurung C Srishord M Fang Y 《Journal of viral hepatitis》2008,15(5):370-378
Summary. Dose reductions of pegylated interferon alpha and ribavirin may be avoided by using growth factors. This phase II clinical trial assesses the dose, efficacy and safety of darbepoetin alpha and filgrastim for treatment of anaemia and neutropenia associated with combination therapy for hepatitis C virus (HCV). Chronic hepatitis C patients (n = 101) received pegylated interferon alpha‐2b (1.5 μg/kg once weekly) and ribavirin (800–1400 mg once daily). Patients with anaemia [haemoglobin (Hb) ≤ 10.5 g/dL] received darbepoetin alpha (3 μg/kg once every 2 weeks); the dose was titrated to achieve a Hb level of 12.0 g/dL. Patients with neutropenia [absolute neutrophil count (ANC) ≤ 0.75 × 109/L] received filgrastim with the dose titrated from 150 μg QW to 300 μg thrice weekly to maintain ANC ≥ 0.75 × 109/L and <10 × 109/L. During antiviral therapy, 52% of patients required darbepoetin alpha, filgrastim or both. Hb at the time of darbepoetin alpha initiation was 10.2 ± 0.4 g/dL. After 81 days of darbepoetin alpha, Hb increased by 1.9 ± 1.0 g/dL to 12.1 ± 1.1 g/dL (P < 0.0001). Filgrastim resulted in a significant increase in ANC [0.75 ± 0.16 × 109/L to 8.28 ± 5.67 × 109/L (P < 0.0001)]. In treatment‐naïve patients, 48% achieved sustained virological response (SVR), whereas 27% of patients previously treated with a course of pegylated interferon alpha achieved SVR. Low viral load, nongenotype 1 and treatment with growth factors were independently associated with SVR. Mild and severe anaemia were associated with quality of life impairments. Darbepoetin alpha resulted in an improvement in the Vitality domain of Short Form‐36. No significant adverse events were related to growth factors. During anti‐HCV therapy, filgrastim improved neutropenia and darbepoetin alpha improved both anaemia and quality of life. Future randomized clinical trials are needed to establish the impact of growth factors in improving sustained virological response. 相似文献
76.
Collection of peripheral blood stem cells from normal donors 60 years of age or older 总被引:2,自引:0,他引:2
Paolo Anderlini Donna Przepiorka Jo Lauppe David Seong Sergio Giralt Richard Champlin & Martin Körbling 《British journal of haematology》1997,97(2):485-487
We report 14 normal peripheral blood stem cell (PBSC) donors ≥ 60 years of age who had cytokine mobilization followed by PBSC apheresis for allogeneic transplantation. Mobilization was achieved with filgrastim (6 μg/kg twice daily). Their median age was 63.5 years (range 60–77), and 43% had a positive medical history, mainly hypertension and/or cardiac problems. Their median pre-apheresis leucocyte count (×109 /l) was 38.6 (range 29.6–63.4). The median apheresis yield (×106 CD34+ cells/litre blood processed, first apheresis) was 27.9 (range 1.6–54.8). The target cell dose (≥4& times; 106 CD34+ cells/kg recipient) was reached with one procedure in eight (57%) donors. Filgrastim-related adverse events were acceptable and apheresis was well tolerated. When compared to younger donors (<60 years of age), a trend to a lower CD34+ apheresis yield and a requirement for more than one apheresis to achieve the collection target (≥4 ×106 CD34+ cells/kg) was evident. Although older (≥60 years) donors seem to mobilize less effectively, these data suggest that PBSC collection from them is feasible and has an acceptable short-term safety profile. 相似文献
77.
Flow cytometric detection of cytomegalovirus antigen in peripheral blood cells after bone marrow transplantation 总被引:5,自引:0,他引:5
Junichi Honda Yasumitsu Okubo Yutaka Imamura Mikako Kusaba Naoko Saruwatari & Kotaro Oizumi 《British journal of haematology》1997,99(2):415-417
We report 13 normal peripheral blood stem cell (PBSC) donors who had a second PBSC collection for allogeneic transplantation performed after the first. The median interval between the first and second collection was 5 months. Mobilization was achieved with filgrastim (12 μg/kg/d). No significant difference was found in the median pre-apheresis leucocyte count (×109 /l) between the two donations (40.2 v 38.5; P = 0.91). The median apheresis yield (×106 CD34+ cells/litre blood processed, first apheresis) was also similar (28 v 27.3; P = 0.91). Filgrastim-related adverse events were comparable. These data suggest that second PBSC collections are feasible, similarly tolerated and provide comparable apheresis yields. 相似文献
78.
Kümmel S Krocker J Kohls A Breitbach GP Morack G Budner M Blohmer JU Elling D 《British journal of cancer》2006,94(9):1237-1244
We evaluated the survival benefit, safety, feasibility, and tolerability of dose-dense (DD) adjuvant chemotherapy with epirubicin and paclitaxel for women with node-positive primary breast cancer. Randomised patients (n=216) received DD or conventional-schedule (CS) chemotherapy. Dose-dense regimen patients (n=108) received epirubicin 90 mg m-2 plus paclitaxel 175 mg m-2 in four 14-day cycles, then cyclophosphamide 600 mg m-2, methotrexate 40 mg m-2, and fluorouracil 600 mg m-2 (CMF 600/40/600) in three 14-day cycles, plus filgrastim 5 microg kg day-1 as growth support in every cycle. Conventional-schedule regimen patients (n=108) received epirubicin 90 mg m-2 plus cyclophosphamide 600 mg m-2 in four 21-day cycles, then CMF 600/40/600 in three 21-day cycles, plus filgrastim if required. After a median follow-up of 38.4 months, 71 patients (33%) relapsed or died: DD, 33 patients (15 deaths); CS, 38 patients (22 deaths). Dose dense showed a trend for improved disease-free survival (DFS) and overall survival (OS). Four-year rates of DFS and OS were 64 and 85% for DD, and 58 and 75% for CS. All seven cycles were administered to 208 patients (96%). Rates of cycle delay, discontinuation, dose reduction, and adverse events were similar in both groups. Dose-dense sequential chemotherapy with epirubicin/paclitaxel then CMF, supported by filgrastim, is safe and improves survival for patients with node-positive breast cancer. 相似文献
79.
Alessandra Romano Michele Giusti MaryAnn Di Giorgio Giovanni Lumera Nunziatina Laura Parrinello Sebastiano Cosentino Massimo Ippolito Loredana Villari Giuseppe Alberto Palumbo Francesco Di Raimondo Salvatore Santo Signorelli 《Clinical Case Reports》2021,9(9)
In CMML, neoplastic monocytes can be distinguished based on their immunophenotype. Supportive care myeloid growth factors in concomitant extranodal non‐Hodgkin Lymphoma are safe. 相似文献