全文获取类型
收费全文 | 458篇 |
免费 | 18篇 |
专业分类
耳鼻咽喉 | 3篇 |
儿科学 | 10篇 |
妇产科学 | 13篇 |
基础医学 | 55篇 |
临床医学 | 28篇 |
内科学 | 69篇 |
皮肤病学 | 22篇 |
神经病学 | 24篇 |
特种医学 | 2篇 |
外科学 | 50篇 |
综合类 | 1篇 |
预防医学 | 161篇 |
眼科学 | 8篇 |
药学 | 13篇 |
中国医学 | 1篇 |
肿瘤学 | 16篇 |
出版年
2024年 | 1篇 |
2023年 | 8篇 |
2022年 | 11篇 |
2021年 | 19篇 |
2020年 | 5篇 |
2019年 | 19篇 |
2018年 | 20篇 |
2017年 | 6篇 |
2016年 | 9篇 |
2015年 | 10篇 |
2014年 | 17篇 |
2013年 | 21篇 |
2012年 | 48篇 |
2011年 | 50篇 |
2010年 | 37篇 |
2009年 | 26篇 |
2008年 | 19篇 |
2007年 | 28篇 |
2006年 | 24篇 |
2005年 | 24篇 |
2004年 | 19篇 |
2003年 | 22篇 |
2002年 | 13篇 |
2001年 | 2篇 |
2000年 | 1篇 |
1992年 | 6篇 |
1991年 | 2篇 |
1986年 | 2篇 |
1984年 | 2篇 |
1983年 | 1篇 |
1979年 | 1篇 |
1973年 | 3篇 |
排序方式: 共有476条查询结果,搜索用时 15 毫秒
1.
Rania El Fekih James Hurley Vasisht Tadigotla Areej Alghamdi Anand Srivastava Christine Coticchia John Choi Hazim Allos Karim Yatim Juliano Alhaddad Siawosh Eskandari Philip Chu Albana B. Mihali Isadora T. Lape Mauricio P. Lima Filho Bruno T. Aoyama Anil Chandraker Kassem Safa James F. Markmann Leonardo V. Riella Richard N. Formica Johan Skog Jamil R. Azzi 《Journal of the American Society of Nephrology : JASN》2021,32(4):994
BackgroundDeveloping a noninvasive clinical test to accurately diagnose kidney allograft rejection is critical to improve allograft outcomes. Urinary exosomes, tiny vesicles released into the urine that carry parent cells’ proteins and nucleic acids, reflect the biologic function of the parent cells within the kidney, including immune cells. Their stability in urine makes them a potentially powerful tool for liquid biopsy and a noninvasive diagnostic biomarker for kidney-transplant rejection.MethodsUsing 192 of 220 urine samples with matched biopsy samples from 175 patients who underwent a clinically indicated kidney-transplant biopsy, we isolated urinary exosomal mRNAs and developed rejection signatures on the basis of differential gene expression. We used crossvalidation to assess the performance of the signatures on multiple data subsets.ResultsAn exosomal mRNA signature discriminated between biopsy samples from patients with all-cause rejection and those with no rejection, yielding an area under the curve (AUC) of 0.93 (95% CI, 0.87 to 0.98), which is significantly better than the current standard of care (increase in eGFR AUC of 0.57; 95% CI, 0.49 to 0.65). The exosome-based signature’s negative predictive value was 93.3% and its positive predictive value was 86.2%. Using the same approach, we identified an additional gene signature that discriminated patients with T cell–mediated rejection from those with antibody-mediated rejection (with an AUC of 0.87; 95% CI, 0.76 to 0.97). This signature’s negative predictive value was 90.6% and its positive predictive value was 77.8%.ConclusionsOur findings show that mRNA signatures derived from urinary exosomes represent a powerful and noninvasive tool to screen for kidney allograft rejection. This finding has the potential to assist clinicians in therapeutic decision making. 相似文献
2.
3.
Clinical and laboratory characteristics in septic arthritis patients with and without isolated germs
Hana Sahli Asma Bachali Rawdha Tekaya Aicha Ben Tekaya Rim Khalfallah Olfa Saidane Ines Mahmoud Leila Abdelmoula 《The Egyptian Rheumatologist》2018,40(4):269-272
Background
The management of septic arthritis without bacteriological evidence is not well codified.Aim of the work
To compare the features of septic arthritis with and without isolated germs.Patients and Methods
This is a retrospective study including all patients with septic arthritis, discharged from the Rheumatology Department of Charles Nicolle Hospital, Tunisia over a period of 17?years [1998–2014]. The epidemiological and clinical data were evaluated. Patients were grouped according to the presence and absence of isolated germs.Results
Fifty-nine septic arthritis patients were collected with an average of 3.5?cases/year. The mean age of the patients was 54.6?±?19?years [15–95] without sex predominance: 28 were male and 31 were female. At least one risk factor for SA was founded in 41 patients (69.5%). It was monoarticular in 50 cases (84.7%), oligoarticular in 6 (10.2%) and polyarticular in 3 (5.1%). The knee was the most often affected (49.2%). Germ was isolated in cultures and/or synovial fluids in 27 patients (45.8%). The age tended to be older in those with isolated germs and the elderly were more frequently infected compared to the non-elderly (51.8% versus 21.9%) (p?=?.01). The synovial fluid analysis, clinical and laboratory characteristics were comparable but the functional disability was significant higher in those without isolated germs (p?=?.024). Sternoclavicular joint was more common in patients with isolated germs (p?=?.016). There was no difference between the two groups regarding the course of the infection.Conclusion
Patients with isolated and non-isolated germs have similar epidemiologic, clinical, biological and radiological characteristics. 相似文献4.
Chaima Rachdi Rahma Damak Feten Fekih Romdhane Haroun Ouertani Majda Cheour 《Primary Care Diabetes》2019,13(1):57-62
Aim
Depression is prevalent in patients with type 2 diabetes. It may have a negative impact on the management of diabetes mellitus and could affect weight. The main aim of the investigation was to evaluate the effect of antidepressant treatment (sertraline) on anthropometric variables and glycemic control in depressed type 2 diabetic patients.Methods
Thirty three type 2 diabetic outpatients depressed received open-label sertraline therapy for up to 12 weeks. Clinical outcome measures included the 17-item Hamilton depression rating. Changes in the anthropometrics variables were evaluated by measuring weight, waist circumference and by calculating body mass index at three, six and 12 weeks of treatment. In addition, fasting, postprandial plasma glucose level, glycosylated hemoglobin-A 1C measures, lipid and renal profile were obtained before and during sertraline therapy.Results
Weight decreased significantly (?2 kg; p = 0.000) and body mass index decreased from 30.41 kg/m2 to 29.6 kg/m2 (p = 0.000). Patients lost on average seven centimeters in waist circumference (p = 0.000). We also observed a modest, non-significant reduction in fasting, postprandial and glycosylated hemoglobin. We observed a significant reduction in mean score according to the Hamilton depression scale (p = 0.000)Conclusion
Our study results suggested that sertraline produced a benefic effect on weight, body mass index and waist circumference at 12-week follow up. 相似文献5.
Ines Mahmoud Aicha Ben Tekaya Mariem Sahli Maha Mahmoud Olfa Saidane Hana Sahli Rawdha Tekaya Leila Abdelmoula 《The Egyptian Rheumatologist》2018,40(2):145-147
Background
Septic arthritis of the costovertebral thoracic joint is a rare site infection. We report an isolated case of septic arthritis of the 10th costo-vertebral right joint with osteitis due to Staphylococcus aureus.Case presentation
A 59 year old Tunisian man presented with a 2 months history of dorsal spinal pain with fever, associated with asthenia, anorexia and loss of weight. There was a raised C-reactive protein (176 mg/L) and erythrocyte sedimentation rate (100 mm/1st h). Tests for tuberculosis and brucellosis were negative. In the present patient, the clinical symptoms were unspecific with lack of obvious predisposing factors. He had neither history of taking immunosuppressors nor of any disease indicative of immunodeficiency. Thoraco-abdominal computed tomography (CT) showed a lytic lesion centered on the 10th costo-vertebral right joint and histo-pathologic exam of the costo-vertebral puncture confirmed chronic active osteitis and bacteriologic culture allowed identifying methicillin-sensitive Staphylococcus aureus. The patient was treated with ciprofloxacin 1500 mg/day, associated with daily rifampin (20 mg/kg) for total treatment duration of 12 weeks after consulting infectious disease specialists. After a follow-up of 6 months, the patient remained asymptomatic and the markers of inflammation negative.Conclusion
Septic arthritis of costovertebral joints should be considered when a patient presents with back pain, fever and elevated inflammatory markers. The diagnosis of septic arthritis of costovertebral joints remain a challenge to clinicians. CT is important to confirm a diagnosis and guide costovertebral biopsy and culture. Early and appropriate antibiotic therapy is important for a required outcome. 相似文献6.
Ayed Della S Kotti A Ben Sik Ali H Ayed S Fekih Hassen M Elatrous S 《Revue de pneumologie clinique》2012,68(3):202-204
The Von Recklinghausen disease is a genetic hereditary neurofibromatosis. It causes neurofibroma, axillary and inguinal lentigines, and café-au-lait spots in the skin. It may affect the lung in 5 to 20% of cases, causing neurofibroma, infiltrative and cystic lesions, emphysematous or bubble injury leading to a chronic respiratory failure. The risk of pneumothorax in theses cases seems higher. Few reviews reported the pulmonary manifestations in the Recklinghausen disease and specially the pneumothorax as a complication while the direct relation between this neurofibromatosis and the lung disease is not clearly established yet. We report a case report of spontaneous pneumothorax with slow evolution complicating the course of a patient with Recklinghausen disease. 相似文献
7.
8.
9.
Marc Laine Richard Toesca Julie Berbis Corinne Frere Pierre Barnay Michel Pansieri Jean-Pascal Peyre Pierre Michelet Jacques Bessereau Elise Camilleri Olfa Helaf Marjorie Camaleonte Franck Paganelli Françoise Dignat-George Laurent Bonello 《Thrombosis research》2013
Background
The level of platelet reactivity (PR) inhibition obtained after P2Y12-ADP receptor antagonist loading dose (LD) is associated with the ischemic and bleeding risk following percutaneous coronary intervention (PCI) in acute coronary syndromes (ACS).Objective
We aimed to evaluate the level of PR inhibition achieved by a 180 mg LD of ticagrelor and the rate of high on-treatment platelet reactivity (HTPR) in ACS patients undergoing PCI.Methods
We performed a multicentre prospective observational study enrolling ACS patients undergoing PCI. Patients were included if they were admitted for ST-elevation myocardial infarction or non ST-elevation ACS. To assess PR, a VASP index was measured at least 6 and within 24 hours following a 180 mg LD of ticagrelor. HTPR was defined as a VASP index ≥ 50%.Results
One hundred and fifteen patients were included: 31.3% of STEMI, 49.6% of NSTEMI and 19.1% of unstable angina. Following ticagrelor LD the mean VASP index was 17 ± 14%. However the response to ticagrelor was not uniform with a small inter-individual variability: inter quartile range: 7.6–22.8% and a rate of HTPR of 3.5%. A high number of patients, 65.6%, had a VASP index < 16%. None of the baseline characteristics of the study population was associated with PR. In addition, PR was similar in STEMI, NSTEMI and unstable angina (p = 0.9).Conclusion
In ACS patients the level of PR inhibition achieved by a 180 mg loading dose of ticagrelor is not uniform and the rate of HTPR is 3.5%. A high proportion of patients exhibited a VASP index < 16%. 相似文献10.