全文获取类型
收费全文 | 254篇 |
免费 | 4篇 |
专业分类
耳鼻咽喉 | 1篇 |
儿科学 | 2篇 |
妇产科学 | 20篇 |
基础医学 | 39篇 |
口腔科学 | 1篇 |
临床医学 | 21篇 |
内科学 | 28篇 |
皮肤病学 | 23篇 |
神经病学 | 18篇 |
特种医学 | 5篇 |
外科学 | 61篇 |
综合类 | 1篇 |
预防医学 | 6篇 |
眼科学 | 2篇 |
药学 | 6篇 |
肿瘤学 | 24篇 |
出版年
2022年 | 3篇 |
2021年 | 2篇 |
2017年 | 6篇 |
2016年 | 1篇 |
2015年 | 4篇 |
2014年 | 9篇 |
2013年 | 14篇 |
2012年 | 20篇 |
2011年 | 17篇 |
2010年 | 13篇 |
2009年 | 9篇 |
2008年 | 16篇 |
2007年 | 20篇 |
2006年 | 24篇 |
2005年 | 16篇 |
2004年 | 23篇 |
2003年 | 17篇 |
2002年 | 12篇 |
2001年 | 1篇 |
1999年 | 1篇 |
1998年 | 1篇 |
1997年 | 1篇 |
1996年 | 2篇 |
1995年 | 3篇 |
1994年 | 2篇 |
1993年 | 5篇 |
1992年 | 2篇 |
1991年 | 1篇 |
1987年 | 1篇 |
1982年 | 1篇 |
1975年 | 1篇 |
1974年 | 1篇 |
1962年 | 1篇 |
1959年 | 2篇 |
1958年 | 1篇 |
1957年 | 2篇 |
1954年 | 2篇 |
1949年 | 1篇 |
排序方式: 共有258条查询结果,搜索用时 15 毫秒
1.
Massimo Chello Costanza Goffredo Giuseppe Patti Dario Candura Rosetta Melfi Stefano Mastrobuoni Germano Di Sciascio Elvio Covino 《European journal of cardio-thoracic surgery》2005,28(6):805-810
Objective: Endothelial dysfunction represents a critical early component of organ injury following cardiopulmonary bypass. Recent studies demonstrate that the treatment with atorvastatin is associated with a significant improvement of endothelial function independently of its efficacy on cholesterol levels. Therefore, we investigated the effects of preoperative atorvastatin treatment on endothelium function after coronary surgery. Methods: Forty patients undergoing coronary surgery were randomized to treatment with atorvastatin (20 mg/die; N = 20) or placebo (N = 20) 3 weeks before surgery. Twenty normal patients served as control group. The flow-mediated dilations (FMD) of the brachial artery after both reactive hyperemia (endothelium dependent) and nitroglycerin administration (endothelium independent) were evaluated at baseline, at 48 h, and 5 days postoperatively. Results: At baseline, the endothelium-dependent FMD was significantly attenuated in coronary versus normal patients (normal 10.3 ± 1.8% vs coronary 4.1 ± 1.6%, p < 0.01). At 48 h postoperatively all patients exhibited a reduced FMD compared with baseline values: the endothelium-dependent dilatation showed a drop of 60.1 + 15% in the patients of the placebo group compared with 45.8 + 16.6% (p < 0.05) those in the atorvastatin group. At the univariate analysis, no significant correlation was found between serum levels of either total cholesterol or HDL cholesterol and FMD. The nitroglycerin-induced dilation was not significantly influenced by extracorporeal circulation as well as by atorvastatin treatment. Conclusions: The endothelial dysfunction following cardiopulmonary bypass is improved by the treatment with atorvastatin, by a mechanism unrelated to the drug efficacy of controlling serum cholesterol levels. 相似文献
2.
Uterine smooth muscle tumors are usually spindle cell lesions, but a minority is composed of epithelioid cells. Foci of clear cells can be found in these latter tumors. Recently, it has been shown that some of these tumors can be positive for HMB45, and some authors have advocated calling these lesions perivascular epithelioid cell (PEC) tumors or PEComas. The case we describe here clearly shows that the so called PEC is just a smooth muscle cell capable of changing its immunophenotype. The patient involved is a 29-year-old black woman who was found to have an epithelioid leiomyosarcoma of the uterus in November 1995. She was treated with a simple hysterectomy and bilateral salpingo-oophorectomy. A metastatic lesion was found in her liver. She, therefore, also received chemotherapy and was free of disease until October 2002, when a recurrent tumor was detected in her spine. After undergoing resection of the lesion at 2 different times, in 2002 and 2003, the patient was treated with radiotherapy and is currently receiving chemotherapy. On microscopic examination, the tumor in the uterus and liver both proved to be an epithelioid leiomyosarcomas that was diffusely positive for smooth muscle actin. Approximately 15% of the cells had clear cytoplasm, but sections from 2 different blocks were completely negative for HMB45. However, although the tumors resected from the spine in 2002 and 2003 showed features similar to those of the uterine neoplasm, but with a lower percentage of cells positive for smooth muscle actin and more clear cells, several of the clear cells were positive for HMB45. To the best of our knowledge, this is the first case of a uterine smooth muscle cell tumor that became positive for HMB45 when it metastasized. 相似文献
3.
Ovarian steroid cell tumors: an immunohistochemical study including a comparison of calretinin with inhibin. 总被引:3,自引:0,他引:3
Michael T Deavers Anais Malpica Nelson G Ordonez Elvio G Silva 《International journal of gynecological pathology》2003,22(2):162-167
Ovarian steroid cell tumors, not otherwise specified (SCTs, NOS) are uncommon sex cord-stromal tumors that may be difficult to distinguish from other oxyphilic or clear-cell neoplasms. Immunohistochemical staining for inhibin, although generally useful in the diagnosis of SCTs, NOS, is not positive in every case and not all laboratories have this marker available. Recently, it has been reported that calretinin is expressed by sex cord-stromal tumors. We studied six SCTs, NOS for both calretinin and inhibin expression to evaluate the sensitivity of calretinin in comparison to inhibin. We also tested for CD99, Melan-A (A103), and S-100, other markers reported to be positive in these tumors. HMB-45 and MART-1 (Ab3) completed our panel of markers. All six tumors were positive for both calretinin and inhibin. Calretinin positivity was present in 60% to >90% of tumor cells, whereas inhibin reactivity ranged from <5% to >90% of tumor cells. Membranous staining for CD99 was present in one tumor. S-100-positive cells were seen in two tumors, whereas four tumors were immunoreactive for HMB-45. All six tumors were positive for Melan-A (A103), but in general the staining was less diffuse than with calretinin. All of the tumors were essentially negative for MART-1 (Ab3). The consistent diffuse staining of the tumors in this study for calretinin, in comparison to inhibin and Melan-A (A103), suggests that it is a sensitive marker for SCTs, NOS. MART-1 (Ab3) immunostaining may be useful for cases in which melanoma is considered in the differential diagnosis. 相似文献
4.
Michele Iester Andrea Perdicchi Gianmaria Venturino Maurizio Rolando Carlo E Traverso Elvio Leonardi Giovanni Calabria 《Journal of ocular pharmacology and therapeutics》2004,20(5):393-400
PURPOSE: A drug utilization trial was performed to investigate acute versus short-term effects after switching or adding bimatoprost in open-angle glaucoma patients over a 3- month observation period. METHODS: One (1) eye was randomly chosen from 47 glaucomatous patients (abnormal visual field and/or abnormal optic nerve and intraocular pressure (IOP) above 21 mmHg without treatment). Only patients who did not reach the target IOP with their ongoing treatment were recruited in this study. IOP was measured at baseline, after 1 hour, and 2 hours from the first instillation and after 1 week, 1, and 3 months of treatment. RESULTS: The IOP before bimatoprost administration was 20.16+/-3.6 mmHg (mean+/-standard deviation). There was no statistically significant decrease of IOP after 1 hour (mean IOP, 19.96+/-4.25 mmHg) and after 2 hours (mean IOP, 17.73+/-3.24 mmHg). Statistically significant (p<0.001) decreases after 1 week (mean IOP, 16.48+/-2.9 mmHg), after 1 month (mean IOP, 16.48+/-2.9 mmHg) and after 3 months (mean IOP, 16.15+/-2.7 mmHg) were found. CONCLUSION: The results suggested that bimatroprost had a significant acute effect on IOP in monotherapy, while no significant effect was found when the therapy was switched or added. The effect for primary open-angle glaucoma was very evident. There was no specific side effect attributable to combining bimatoprost with any of the treatments in use. 相似文献
5.
Vladi Nosenzo Stefano Tornincasa Elvio Bonisoli Marco Brino 《International Journal on Interactive Design and Manufacturing》2014,8(2):91-107
Nowadays, manufacturing industries have to shorten the time to market in order to satisfy needs of customers and to survive in global competitive markets. For these reasons a new type of product data development and management is necessary. The Product Lifecycle Management (PLM) is an emerging philosophy to improve strategic engineering for managing information, processes and resources to support the life cycle of a product, from its conception, development, launch and the withdrawal. The well-established technologies CAD / CAE / CAM are fundamental part of it, although their interactions may be only partially involved. The paper takes into account open questions regarding the relationship between models and simulations and new possible scenarios related to their integration starting from a complete and multi-disciplinary case-test involving the virtual-experimental deliverable process of the fatigue life prediction and related structural modification design applied to a suspension cab for truck vehicle. 相似文献
6.
Cristiano Spadaccio Federico De Marco Fabio Di Domenico Raffaella Coccia Mario Lusini Raffaele Barbato Elvio Covino Massimo Chello 《Thrombosis research》2014
Background
Advanced glycation endproducts (AGEs) and its receptors (RAGEs) are heterogeneous signaling proteins associated to diabetes and responsible of endothelial alterations leading to atherosclerosis progression and graft failure. The aim of this study was to investigate the role of statin in reducing AGEs related endothelial damage.Methods
Endothelial cell(EC) obtained from leftovers of saphenous vein grafts of non-diabetic patients were incubated with AGEs (2 and 20 μM) and subsequently treated with Simvastatin. Neutrophils (PNM) adherence, ROS production and RAGE and peroxisome proliferator-activated receptors-gamma (PPAR-γ) expression were analyzed. As clinical validation of the in vitro findings, ECs of diabetic patients in optimized glycaemic control administered with a 3 weeks Simvastatin regimen were similarly processed.Results
Simvastatin blunted the rise in PMN adhesion and ROS generation following stimulation of saphenous vein EC culture with AGEs in vitro. This effect was time dependent and was associated to an increase in PPAR-γ induction paralleled by a decrease in RAGEs expression. Parallely, data from diabetic patients administered with Simvastatin showed a similar significant reduction in PNM adhesion and ROS generation. Simvastatin treatment significantly decreased RAGEs expression in ECs from diabetic patients and determined a slight increase in PPAR-γ expression but the latter failed to reach statistical significance. Interference in the function of these two crucial pathways might be at the root of the statin antinflammatory and antithrombotic effect in the context of AGEs-associated damage.Conclusions
Despite the recently raised warning on the use of statins in the diabetic population, this study elucidates their cornerstone position in endothelial homeostasis of saphenous grafts in patients with controlled diabetes. 相似文献7.
8.
9.
Elvio A. Heidenreich José M. Ferrero Manuel Doblaré José F. Rodríguez 《Annals of biomedical engineering》2010,38(7):2331-2345
Many problems in Biology and Engineering are governed by anisotropic reaction–diffusion equations with a very rapidly varying
reaction term. This usually implies the use of very fine meshes and small time steps in order to accurately capture the propagating
wave while avoiding the appearance of spurious oscillations in the wave front. This work develops a family of macro finite
elements amenable for solving anisotropic reaction–diffusion equations with stiff reactive terms. The developed elements are
incorporated on a semi-implicit algorithm based on operator splitting that includes adaptive time stepping for handling the
stiff reactive term. A linear system is solved on each time step to update the transmembrane potential, whereas the remaining
ordinary differential equations are solved uncoupled. The method allows solving the linear system on a coarser mesh thanks
to the static condensation of the internal degrees of freedom (DOF) of the macroelements while maintaining the accuracy of
the finer mesh. The method and algorithm have been implemented in parallel. The accuracy of the method has been tested on
two- and three-dimensional examples demonstrating excellent behavior when compared to standard linear elements. The better
performance and scalability of different macro finite elements against standard finite elements have been demonstrated in
the simulation of a human heart and a heterogeneous two-dimensional problem with reentrant activity. Results have shown a
reduction of up to four times in computational cost for the macro finite elements with respect to equivalent (same number
of DOF) standard linear finite elements as well as good scalability properties. 相似文献
10.
David M. Gershenson M.D. Mitchell Morris M.D. Thomas W. Burke M.D. Charles Levenback M.D. John J. Kavanagh M.D. Geri L. Fromm M.D. Elvio G. Silva M.D. Donna Warner R.N. J. Taylor Wharton M.D. 《Gynecologic oncology》1995,58(3)
Purpose. The primary goal of this trial was to evaluate the clinical activity and the toxicity of a combination of cisplatin and carboplatin for women with advanced-stage epithelial ovarian cancer. Patients and methods. Fifty-one consecutive evaluable patients with untreated stage III and IV epithelial ovarian cancer received 360 mg/m2 carboplatin on Day 1 and 50 mg/m2 cisplatin on Day 2 administered intravenously every 28 days for six cycles. Drug doses were adjusted for hematologic toxicity based on nadir counts during the prior therapy course. Dose levels included 300-400 mg/m2 carboplatin and 50-75 mg/m2 cisplatin. Second-look surgery was optional. Endpoints were clinical response, surgical response, progression-free survival, and survival. Results. Of 8 patients with measurable disease, 3 (37.5%) had a clinical compete response, and 3 (37.5%) had a clinical partial response, for an overall clinical response rate of 75%. Of 39 patients who began chemotherapy with abnormal serum levels of CA 125, 31 (79%) achieved normalization of CA 125 at the completion of chemotherapy. Thirteen patients underwent second-look laparotomy. Of these, 7 (54%) had a pathological compete response, and 2 (15%) had a partial response. The median progression-free survival was 14 months, and the overall median survival was 32.5 months. Neutropenia and thrombocytopenia were the main dose-limiting toxicities. In addition, 9 patients developed grade 2 and 3 developed grade 3 ototoxicity. Conclusion. This regimen is very active against advanced-stage epithelial ovarian cancer. The degree of ototoxicity observed is worrisome, but such toxicity may be ameliorated by limiting the dose of cisplatin and increasing the dose of carboplatin. 相似文献