全文获取类型
收费全文 | 307篇 |
免费 | 20篇 |
国内免费 | 20篇 |
专业分类
儿科学 | 6篇 |
妇产科学 | 7篇 |
基础医学 | 61篇 |
口腔科学 | 1篇 |
临床医学 | 42篇 |
内科学 | 114篇 |
特种医学 | 6篇 |
外科学 | 17篇 |
综合类 | 44篇 |
预防医学 | 26篇 |
药学 | 15篇 |
中国医学 | 4篇 |
肿瘤学 | 4篇 |
出版年
2024年 | 1篇 |
2023年 | 6篇 |
2022年 | 11篇 |
2021年 | 22篇 |
2020年 | 20篇 |
2019年 | 11篇 |
2018年 | 15篇 |
2017年 | 4篇 |
2016年 | 21篇 |
2015年 | 11篇 |
2014年 | 16篇 |
2013年 | 26篇 |
2012年 | 14篇 |
2011年 | 12篇 |
2010年 | 16篇 |
2009年 | 17篇 |
2008年 | 17篇 |
2007年 | 12篇 |
2006年 | 11篇 |
2005年 | 9篇 |
2004年 | 9篇 |
2003年 | 14篇 |
2002年 | 9篇 |
2001年 | 5篇 |
2000年 | 3篇 |
1999年 | 4篇 |
1998年 | 4篇 |
1997年 | 3篇 |
1996年 | 4篇 |
1995年 | 5篇 |
1994年 | 1篇 |
1993年 | 2篇 |
1991年 | 2篇 |
1990年 | 3篇 |
1989年 | 1篇 |
1988年 | 1篇 |
1986年 | 1篇 |
1978年 | 1篇 |
1977年 | 2篇 |
1972年 | 1篇 |
排序方式: 共有347条查询结果,搜索用时 0 毫秒
1.
2.
Karen Hoffman Frankie Ann Holmes Giuseppe Fraschini Laura Esparza Debra Frye Martin N. Raber Robert A. Newman Gabriel N. Hortobagyi 《Cancer chemotherapy and pharmacology》1995,37(3):254-258
Triciribine is a purine analogue which inhibits DNA and protein synthesis. We performed two studies to define its activity against metastatic breast cancer. The first study was a phase II study in 14 patients with metastatic breast cancer who had received two or fewer chemotherapy treatments. The treatment schedule was triciribine 20 mg/m2 per day by 24-h infusion (CI) daily for 5 days every 6 weeks as recommended by a previous open phase I trial. When neither response nor toxicity was seen in the phase II trial, we assumed the starting dose was too low for this group of patients with good performance status and repeated the phase I trial in patients with metastatic breast cancer with good performance status. The starting dose was 35 mg/m2 per day using the same 5-day CI schedule, and starting doses were increased in subsequent cohorts of three patients in increments of 5 mg/m2 until toxicity occurred. In the initial (phase II) study, one patient had stable disease for 18 weeks (three courses), the remainder progressed. There were no significant toxic effects. In the subsequent phase I study, ten patients were treated until the study was closed The maximum dose was 40 mg/m2. Two patients died, one each at the 35 and 40 mg/m2 levels, respectively, 3 months and 6 weeks after their last course, one without interveing disease progression. Both had severe hypertriglyceridemia (18- and 21-fold elevation) and severe fatigue. At postmortem examination, one had congestive cardiomyopathy, and the other had severe pancreatitis and hypothyroidism. One patient had severe exacerbation of psoriasis which made her bedridden for more than 30 days. Four patients had hyperglycemia. Plasma pharmacology studies showed erratic drug levels, presumably related to enterohepatic circulation. Postmortem pharmacology studies showed residual drug present as long as 12 weeks after the last dose. We conclude that triciribine is ineffective at all doses tested and at doses of 35 mg/m2 has unacceptable toxic effects.This work was performed under National Cancer Institute contract 1-CM-57739 相似文献
3.
4.
《Pancreatology》2016,16(4):469-476
ObjectiveWe sought to define the severity and natural history of hypertriglyceridemia induced acute pancreatitis (HTG-AP), specifically whether HTG-AP causes more severe AP than that caused by other etiologies.MethodsSystematic review of the English literature.ResultsThirty-four studies (15 countries; 1972–2015) included 1340 HTG-AP patients (weighted mean prevalence of 9%). The median admission triglyceride concentration was 2622 mg/dl (range 1160–9769). Patients with HTG have a 14% weighted mean prevalence of AP. Plasmapheresis decreased circulating triglycerides, but did not conclusively affect AP mortality. Only 7 reports (n = 392 patients) compared severity of HTG-AP to that of AP from other etiologies. Of these, 2 studies found no difference in severity, while 5 suggested that HTG-AP patients may have increased severity compared to AP of other etiology.Conclusions1) hypertriglyceridemia is a relatively uncommon (9%) cause of acute pancreatitis; however, patients with hypertriglyceridemia have a high (14%) incidence of acute pancreatitis; 2) plasmapheresis may offer specific therapy unique to this patient population; and 3) data specifically comparing the severity of HTG-AP with AP caused by other etiologies are heterogeneous and scarce. 相似文献
5.
J.J. Dalal R.R. Kasliwal A.L. Dutta J.P.S. Sawhney S.S. Iyengar S. Dani N. Desai I. Sathyamurthy D. Rao A. Menon A. Dasbiswas G.S. Wander M. Chadha M.S. Hiremath D.G. Roy V. Gupta N. Shivakadaksham 《Indian heart journal》2012,64(5):503-507
IntroductionSudden cardiac death (SCD) is the most lethal manifestation of heart disease. In an Indian study the SCDs contribute about 10% of the total mortality and SCD post ST elevation myocardial infarction (MI) constitutes for about half of total deaths.ObjectiveGiven the limitations of existing therapy there is a need for an effective, easy to use, broadly applicable and affordable intervention to prevent SCD post MI. Leading cardiologists from all over India came together to discuss the potential role of n-3 acid ethyl esters (90%) of eicosapentaenoic acid (EPA) 460 mg & docosahexaenoic acid (DHA) 380 mg in the management of post MI patients and those with hypertriglyceridemia.RecommendationsHighly purified & concentrated omega-3 ethyl esters (90%) of EPA (460 mg) & DHA (380 mg) has clinically proven benefits in improving post MI outcomes (significant 15% risk reduction for all-cause mortality, 20% risk reduction for CVD and 45% risk reduction in SCD in GISSI-Prevenzione trial) and in reducing hypertriglyceridemia, and hence, represent an interesting option adding to the treatment armamentarium in the secondary prevention after MI based on its anti-arrhythmogenic effects and also in reducing hypertriglyceridemia. 相似文献
6.
Ronen Arbel Enis Aboalhasan Ariel Hammerman Joseph Azuri 《The American journal of medicine》2021,134(7):e415-e419
BackgroundIcosapent ethyl (IPE) is approved for the prevention of major adverse cardiovascular events (MACE) in patients with hypertriglyceridemia. However, due to budget constraints, access to IPE will inevitably be limited to a fraction of eligible patients. To help maximize value for money spent, we estimated the number of preventable MACE when providing IPE for primary versus secondary prevention.MethodsThe number of preventable MACE was estimated by dividing the available budget by the cost needed to treat (CNT) to prevent one MACE. CNT was calculated as the product of the number needed to treat (NNT) to prevent 1 MACE by therapy cost. NNT values were determined according to the Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial (REDUCE-IT) results. The budget limit was set as the United States’ threshold suggested by the Institute for Clinical and Economic Review. Sensitivity analysis was performed regarding the cost of IPE in the United States.ResultsThe NNT to prevent 1 MACE over 4.9 years in the Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial primary prevention cohort was 59 (95% confidence interval [CI]: 24-∞) versus 14 (11-21) for secondary prevention. At an annual IPE cost of $2915, the CNT to prevent 1 MACE was $842,726 (95% CI: $342,804-∞) and $199,969 ($157,118-$299,953) accordingly. A total of $819 million worth of IPE can avoid 4762 MACE (95% CI: 0-11,707) versus 20,069 (13,379-25,541), when provided as primary versus secondary prevention therapy; P < .001. The number of avoided MACE is sensitive to IPE price.ConclusionsPrioritizing IPE therapy for patients with an established cardiovascular disease may provide significantly more value for money than primary prevention. 相似文献
7.
Talha M. Qureshi Anam Khan Huma Javaid Abdalaziz Tabash Mohammed S. Hussein Mohamed O. Othman 《The American journal of the medical sciences》2021,361(5):616-623
BackgroundHypertriglyceridemia induced acute pancreatitis (HIAP) is the third common cause of acute pancreatitis. HIAP can result in recurrent attacks of severe AP with significant morbidity and mortality. Hypertriglyceridemia (HTG) could be primary or secondary. Although genetic causes of HTG are well studied, the prevalence of secondary causes of HTG in patients presenting with HIAP is not well characterized. This study aimed to identify the prevalence of risk factors for secondary hypertriglyceridemia among patients presenting with HIAP in a tertiary referral center in a large metropolitan area.MethodsThis is a retrospective analysis of all patients admitted with AP from August 2012–2017. A subgroup of patients with triglycerides >880 mg/dl were included for analysis. Secondary causes of HTG were identified. Secondary analysis evaluating the severity of pancreatitis was performed.ResultsThere were 3,746 patients admitted for AP of which 57 patients had AP and HTG. Of these 57 patients, 70.2% had history of diabetes mellitus, 26.3% had history of heavy alcohol use, 22.8% had chronic kidney disease, 47.3% with obesity, and 21.1% with metabolic syndrome. Two patients were classified as unexplained HTG. Secondary analysis showed a total of 45.6% of patients requiring ICU admission. 26.3% of patients with severe inflammatory pancreatitis and 17.5% of patients with severe necrotizing pancreatitis.ConclusionsIn our cohort of HIAP, 55 out of 57 patients had secondary causes for HTG. Identifying secondary causes of HTG during acute hospitalization is important to tailor outpatient treatment in order to prevent future admissions with HIAP. 相似文献
8.
Masaru Nakagawa Syogo Kimura Keiji Fujimoto Hirokatsu Atumi Jyunko Imura Yoshihiro Chikazawa Hidetsugu Imamura Hiroshi Okuyama Hideki Yamaya Toshihiro Fukushima Atsushi Nakagawa Mitsuhiro Asaka Hitoshi Yokoyama 《Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy》2008,12(6):509-513
Plasmapheresis for the treatment of hypertriglyceridemia has previously been performed in patients with sudden onset severe hypertriglyceridemia and acute pancreatitis; however, only a few reports of this procedure have been published. We report here on a case showing severe hypertriglyceridemia during asparaginase (Asp) treatment for acute lymphocytic leukemia (ALL), and give an overview of a lipid‐lowering apheresis therapy. To prevent the complication of pancreatitis due to hypertriglyceridemia, we performed plasma exchange (PE) three times using fresh frozen plasma. PE remarkably reduced both serum triglyceride and total cholesterol levels from 5430 mg/dL to 403 mg/dL and from 623 mg/dL to 204 mg/dL, respectively. The causes of severe hyperlipidemia in this patient were considered to include: the Asp treatment for ALL, and a genetic background with a heterozygote of familial lipoprotein lipase (LPL) defect syndrome, because the patient's plasma LPL level after intravenous heparin injection was low at 137 ng/mL. Hence, PE using fresh frozen plasma may be useful not only to remove lipoproteins, but also to supply defective factors, such as LPL, in similar cases. 相似文献
9.
《Best Practice & Research: Clinical Haematology》2022,35(3):101386
Reports of racial and ethnic disparities regarding both rates of infection of the SARS-CoV-2 virus and morbidity of the coronavirus disease-19 (COVID-19) contain profound differences depending on the population. Our previous study has shown that patients with COVID-19 who developed hypertriglyceridemia during hospitalization have a 2.3 times higher mortality rate. However, whether the correlation between hypertriglyceridemia and mortality has disparity among different racial and ethnic groups is unknown.In this study, we investigated the impact of race/ethnicity on the correlation between hypertriglyceridemia and mortality in hospitalized patients with COVID-19. De-identified information from 904 hospitalized patients diagnosed with COVID-19 between March 2020 and June 2021 were extracted from the Medical College of Wisconsin Clinical Data Warehouse. A multivariable regression analysis suggested that the Asians and non-White Hispanics had 4 or 3.9 times higher mortality rate, respectively, after adjusting for age, morbid obesity (BMI ≥40), and gender. The hypertriglyceridemia (≥150 mg/dL) was associated with higher mortality, after adjusting for age, gender, and morbid obesity. The baseline hypertriglyceridemia occurrence had relevantly more consistent percentages among all racial/ethnic groups. However, non-White Hispanic and Asian patients had the highest frequencies of peak hypertriglyceridemia occurrence during hospitalization. The peak hypertriglyceridemia developed during hospitalization correlates with the incidence of thrombosis after adjusting for morbid obesity, age, and sex. In summary, in this retrospective study of 904 hospitalized COVID-19 patients, Asians and non-White Hispanics had a greater likelihood of developing hypertriglyceridemia during hospitalization and mortality than White patients. 相似文献
10.
目的 回顾性分析近20年广州市第一人民医院收治的高三酰甘油血症性急性胰腺炎(HLAP)的发病率及其临床特征变化.方法 收集1991年1月至2010年12月广州医科大学附属广州市第一人民医院急性胰腺炎(AP)病例1 362例,根据时间划分为4个年度段(1991年至1995年,1996年至2000年,2001年至2005年,2006年至2010年),比较HLAP患者的发病构成、临床特征和预后.结果 HLAP患者共99例,其中男性61例,女性38例,平均年龄(44±12)岁,以年轻男性居多.HLAP患者占总AP患者的7.3%,4个年度构成比分别为5.4%、5.7%、6.7%和8.3%,20年间增加了1.5倍.99例HLAP患者平均血淀粉酶活性为(513.3±462.7) mmol/L,TG为(12.7±7.0) mmol/L,Ranson评分为(1.2±1.1)分,CT严重指数(CTSI)为(2.2±1.1)分,全身炎症反应综合征(SIRS)发生率为36.4%,脏器功能衰竭发生率为18.2%,胰腺假性囊肿发生率5.1%,但重度急性胰腺炎(SAP)发生率和病死率并不随年代变迁而变化.HLAP患者SAP发生率和病死率均显著高于胆源性AP(分别为20.2%比8.5%,6.1%比2.8%).血液净化应用率从第1年度段的0上升到第4年度段的10.7%.HLAP患者的住院时间从第1年度段的26 d逐渐下降至第4年度段的14 d,差异具有统计学意义(P<0.05).结论 HLAP发生率呈逐年升高趋势,有重症化倾向,但患者预后有所改善. 相似文献