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91.
Zeba N. Singh Yogesh Jethava Ginell R. Post Daisy Alapat Jeffrey Sawyer Sarah Waheed Bijay Nair Saad Z. Usmani Clyde Bailey Nathan Petty Frits Van Rhee Bart Barlogie 《Clinical Case Reports》2015,3(3):183-192
Assiduous surveillance for genetic aberrations is necessary in patients on cytotoxic therapies to detect therapy‐related myeloid neoplasms (t‐MN). Current modalities include metaphase cytogenetics and FISH. Since t‐MN may develop abruptly in cytogenetically normal patients, a discussion exploring additional methods such as SNP‐array and targeted‐deep‐sequencing to detect subchromosomal abnormalities is needed. 相似文献
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Katherine C. Wu Fiona Bhondoekhan Sabina A. Haberlen Hiroshi Ashikaga Todd T. Brown Matthew J. Budoff Gypsyamber D'Souza Jared W. Magnani Lawrence A. Kingsley Frank J. Palella Joseph B. Margolick Otoniel Martínez‐Maza Sean F. Altekruse Elsayed Z. Soliman Wendy S. Post 《Annals of noninvasive electrocardiology》2020,25(2)
94.
Joshi PH Chaudhari S Blaha MJ Jones SR Martin SS Post WS Cannon CP Fonarow GC Wong ND Amsterdam E Hirshfeld JW Blumenthal RS 《Clinical cardiology》2012,35(7):404-409
Recently, a debate over the merits of statin therapy in primary prevention was published in the Wall Street Journal. The statin opponent claimed that statins should only be used in secondary prevention and never in any primary-prevention patients at risk for cardiovascular events. In this evidence-based rebuttal to those claims, we review the evidence supporting the efficacy of statin therapy in primary prevention. Cardiovascular risk is a continuum in which those at an elevated risk of events stand to benefit from early initiation of therapy. Statins should not be reserved until after a patient suffers the catastrophic consequences of atherosclerosis. Contrary to the assertions of the statin opponent, this principle has been demonstrated through reductions in heart attacks, strokes, and mortality in numerous randomized controlled primary-prevention statin trials. Furthermore, data show that once a patient tolerates the initial treatment period, the few side effects that subsequently emerge are largely reversible. Accordingly, every major guidelines committee endorses statin use in secondary prevention and selectively in primary prevention for those with risk factors. The foundation for prevention remains increased physical activity, better dietary habits, and smoking cessation. However, prevention of heart attacks, strokes, and death from cardiovascular disease does not have to be all or none-all statin or all lifestyle. In selected at-risk individuals, the combination of pharmacotherapy and lifestyle changes is more effective than either alone. Future investigation in prevention should focus on improving our ability to identify these at-risk individuals. 相似文献
95.
The establishment of chest pain units (CPUs) in the USA and UK has led to improvements in the prognosis of patients with chest pain and myocardial infarction, optimizing access to specialized diagnostic and therapeutic facilities and reducing costs. To establish a uniform implementation of this type of service in Germany, the German Cardiac Society (DGK) founded a 'CPU task force' in 2007, which developed a set of standard requirements and a nationwide certification programme. The recommendations for minimum standard requirements were published in 2008. As of November 2011, 132 CPUs were certified and 36 units were in the certification process. The aim of the DGK is to certify as many as 250 centres (units) throughout Germany within the next 2 years, to provide nationwide coverage. Applications from Switzerland are also being filed. Public awareness campaigns in cooperation with national league soccer teams were organized to raise awareness of the importance for early diagnosis and treatment of cardiac diseases and to publicize the existence of these new facilities. The German model of CPU certification allows nationwide and prospectively European-wide standardization of patient care and to improve adherence to international guidelines. Coupled with awareness campaigns and with the launch of a German CPU Registry, this process is aimed at improving the education and treatment of patients with chest pain and to provide scientific information about the quality of patient care. 相似文献
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Bochud PY Bibert S Kutalik Z Patin E Guergnon J Nalpas B Goossens N Kuske L Müllhaupt B Gerlach T Heim MH Moradpour D Cerny A Malinverni R Regenass S Dollenmaier G Hirsch H Martinetti G Gorgiewski M Bourlière M Poynard T Theodorou I Abel L Pol S Dufour JF Negro F;Swiss Hepatitis C Cohort Study Group;ANRS HC EP Genoscan Study Group 《Hepatology (Baltimore, Md.)》2012,55(2):384-394
Genetic polymorphisms near IL28B are associated with spontaneous and treatment-induced clearance of hepatitis C virus (HCV), two processes that require the appropriate activation of the host immune responses. Intrahepatic inflammation is believed to mirror such activation, but its relationship with IL28B polymorphisms has yet to be fully appreciated. We analyzed the association of IL28B polymorphisms with histological and follow-up features in 2335 chronically HCV-infected Caucasian patients. Assessable phenotypes before any antiviral treatment included necroinflammatory activity (n = 1,098), fibrosis (n = 1,527), fibrosis progression rate (n = 1,312), and hepatocellular carcinoma development (n = 1,915). Associations of alleles with the phenotypes were evaluated by univariate analysis and multivariate logistic regression, accounting for all relevant covariates. The rare G allele at IL28B marker rs8099917-previously shown to be at risk of treatment failure-was associated with lower activity (P = 0.04), lower fibrosis (P = 0.02) with a trend toward lower fibrosis progression rate (P = 0.06). When stratified according to HCV genotype, most significant associations were observed in patients infected with non-1 genotypes (P = 0.003 for activity, P = 0.001 for fibrosis, and P = 0.02 for fibrosis progression rate), where the odds ratio of having necroinflammation or rapid fibrosis progression for patients with IL28B genotypes TG or GG versus TT were 0.48 (95% confidence intervals 0.30-0.78) and 0.56 (0.35-0.92), respectively. IL28B polymorphisms were not predictive of the development of hepatocellular carcinoma. CONCLUSION: In chronic hepatitis C, IL28B variants associated with poor response to interferon therapy may predict slower fibrosis progression, especially in patients infected with non-1 HCV genotypes. 相似文献
98.
Boursier J de Ledinghen V Zarski JP Fouchard-Hubert I Gallois Y Oberti F Calès P;multicentric groups from SNIFF VINDIAG ANRS/HC/EP FIBROSTAR studies 《Hepatology (Baltimore, Md.)》2012,55(1):58-67
The sequential algorithm for fibrosis evaluation (SAFE) and the Bordeaux algorithm (BA), which cross-check FibroTest with the aspartate aminotransferase-to-platelet ratio index (APRI) or FibroScan, are very accurate but provide only a binary diagnosis of significant fibrosis (SAFE or BA for Metavir F ≥ 2) or cirrhosis (SAFE or BA for F4). Therefore, in clinical practice, physicians have to apply the algorithm for F ≥ 2, and then, when needed, the algorithm for F4 ("successive algorithms"). We aimed to evaluate successive SAFE, successive BA, and a new, noninvasive, detailed classification of fibrosis. The study included 1785 patients with chronic hepatitis C, liver biopsy, blood fibrosis tests, and FibroScan (the latter in 729 patients). The most accurate synchronous combination of FibroScan with a blood test (FibroMeter) provided a new detailed (six classes) classification (FM+FS). Successive SAFE had a significantly (P < 10(-3) ) lower diagnostic accuracy (87.3%) than individual SAFE for F ≥ 2 (94.6%) or SAFE for F4 (89.5%), and required significantly more biopsies (70.8% versus 64.0% or 6.4%, respectively, P < 10(-3) ). Similarly, successive BA had significantly (P ≤ 10(-3) ) lower diagnostic accuracy (84.7%) than individual BA for F ≥ 2 (88.3%) or BA for F4 (94.2%), and required significantly more biopsies (49.8% versus 34.6% or 24.6%, respectively, P < 10(-3) ). The diagnostic accuracy of the FM+FS classification (86.7%) was not significantly different from those of successive SAFE or BA. However, this new classification required no biopsy. CONCLUSION: SAFE and BA for significant fibrosis or cirrhosis are very accurate. However, their successive use induces a significant decrease in diagnostic accuracy and a significant increase in required liver biopsy. A new fibrosis classification that synchronously combines two fibrosis tests was as accurate as successive SAFE or BA, while providing an entirely noninvasive (0% liver biopsy) and more precise (six versus two or three fibrosis classes) fibrosis diagnosis. 相似文献
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