全文获取类型
收费全文 | 28976篇 |
免费 | 2307篇 |
国内免费 | 1248篇 |
专业分类
耳鼻咽喉 | 257篇 |
儿科学 | 1048篇 |
妇产科学 | 453篇 |
基础医学 | 2721篇 |
口腔科学 | 570篇 |
临床医学 | 2896篇 |
内科学 | 4064篇 |
皮肤病学 | 729篇 |
神经病学 | 1007篇 |
特种医学 | 1680篇 |
外国民族医学 | 17篇 |
外科学 | 3905篇 |
综合类 | 3779篇 |
现状与发展 | 3篇 |
预防医学 | 975篇 |
眼科学 | 328篇 |
药学 | 1664篇 |
28篇 | |
中国医学 | 727篇 |
肿瘤学 | 5680篇 |
出版年
2024年 | 38篇 |
2023年 | 484篇 |
2022年 | 726篇 |
2021年 | 1242篇 |
2020年 | 1120篇 |
2019年 | 878篇 |
2018年 | 871篇 |
2017年 | 888篇 |
2016年 | 1083篇 |
2015年 | 1077篇 |
2014年 | 1940篇 |
2013年 | 2035篇 |
2012年 | 1610篇 |
2011年 | 1734篇 |
2010年 | 1361篇 |
2009年 | 1265篇 |
2008年 | 1423篇 |
2007年 | 1379篇 |
2006年 | 1278篇 |
2005年 | 1079篇 |
2004年 | 906篇 |
2003年 | 769篇 |
2002年 | 643篇 |
2001年 | 622篇 |
2000年 | 530篇 |
1999年 | 465篇 |
1998年 | 463篇 |
1997年 | 438篇 |
1996年 | 414篇 |
1995年 | 370篇 |
1994年 | 375篇 |
1993年 | 283篇 |
1992年 | 284篇 |
1991年 | 293篇 |
1990年 | 257篇 |
1989年 | 220篇 |
1988年 | 185篇 |
1987年 | 152篇 |
1986年 | 170篇 |
1985年 | 176篇 |
1984年 | 163篇 |
1983年 | 106篇 |
1982年 | 144篇 |
1981年 | 139篇 |
1980年 | 122篇 |
1979年 | 94篇 |
1978年 | 74篇 |
1977年 | 71篇 |
1976年 | 46篇 |
1975年 | 12篇 |
排序方式: 共有10000条查询结果,搜索用时 187 毫秒
21.
Sebastian P. Mondaca MD Dazhi Liu PharmD BCOP Jessica R. Flynn Sandy Badson Stefan Hamaway BS Mrinal M. Gounder MD Danny N. Khalil MD PhD Alexander E. Drilon MD Bob T. Li MD MPH Komal L. Jhaveri MD Alison M. Schram MD Katherine E. Kargus RN Mary Kate Kasler DNP MSN Natalie M. Blauvelt Neil H. Segal MD PhD Marinela Capanu PhD Margaret K. Callahan MD PhD David M. Hyman MD Maya Gambarin-Gelwan MD James J. Harding MD 《Cancer》2020,126(22):4967-4974
22.
Breast Elastography: How to Perform and Integrate Into a “Best-Practice” Patient Treatment Algorithm
Breast elastography has been available for more than 15 years but is not widely incorporated into clinical practice. Many publications report extremely high accuracy for various breast elastographic techniques. However, results in the literature are extremely variable. This variability is most likely due to variations in technique, a relatively steep learning curve, and variability in methods between vendors. This article describes our protocol for performing breast elastography using both strain elastography and shear wave elastography, which produces high sensitivity and specificity. Additionally, we will describe the most commonly known false-positive and false-negative lesions as well as how to detect them. 相似文献
23.
Ragnhild B. Wijma Marloes Emous Merel van den Broek Anke Laskewitz Anneke C. Muller Kobold André P. van Beek 《Surgery for obesity and related diseases》2019,15(1):73-81
Background
Early dumping is a poorly defined and incompletely understood complication after Roux-en-Y gastric (RYGB).Objective
We performed a mixed-meal tolerance test in patients after RYGB to address the prevalence of early dumping and to gain further insight into its pathophysiology.Setting
The study was conducted in a regional hospital in the northern part of the Netherlands.Methods
From a random sample of patients who underwent primary RYGB between 2008 and 2011, 46 patients completed the mixed-meal tolerance test. The dumping severity score for early dumping was assessed every 30 minutes. A sum score at 30 or 60 minutes of ≥5 and an incremental score of ≥3 points were defined as indicating a high suspicion of early dumping. Blood samples were collected at baseline, every 10 minutes during the first half hour, and at 60 minutes after the start.Results
The prevalence of a high suspicion of early dumping was 26%. No differences were seen for absolute hematocrit value, inactive glucagon-like peptide-1, and vasoactive intestinal peptide between patients with or without early dumping. Patients at high suspicion of early dumping had higher levels of active glucagon-like peptide-1 and peptide YY.Conclusion
The prevalence of complaints at high suspicion of early dumping in a random population of patients after RYGB is 26% in response to a mixed-meal tolerance test. Postprandial increases in both glucagon-like peptide-1 and peptide YY are associated with symptoms of early dumping, suggesting gut L-cell overactivity in this syndrome. 相似文献24.
《Journal of pediatric surgery》2023,58(6):1213-1218
IntroductionEndoscopic surveillance guidelines for patients with repaired esophageal atresia (EA) rely primarily on expert opinion. Prior to embarking on a prospective EA surveillance registry, we sought to understand EA surveillance practices within the Eastern Pediatric Surgery Network (EPSN).MethodsAn anonymous, 23-question Qualtrics survey was emailed to 181 physicians (surgeons and gastroenterologists) at 19 member institutions. Likert scale questions gauged agreement with international EA surveillance guideline-derived statements. Multiple-choice questions assessed individual and institutional practices.ResultsThe response rate was 77%. Most respondents (80%) strongly agree or agree that EA surveillance endoscopy should follow a set schedule, while only 36% claimed to perform routine upper GI endoscopy regardless of symptoms. Many institutions (77%) have an aerodigestive clinic, even if some lack a multi-disciplinary EA team. Most physicians (72%) expressed strong interest in helping develop evidence-based guidelines.ConclusionsOur survey reveals physician agreement with current guidelines but weak adherence. Surveillance methods vary greatly, underscoring the lack of evidence-based data to guide EA care. Aerodigestive clinics may help implement surveillance schedules. Respondents support evidence-based protocols, which bodes well for care standardization. Results will inform the first multi-institutional EA databases in the United States (US), which will be essential for evidence-based care.Level of EvidenceThis is a prognosis study with level 4 evidence. 相似文献
25.
26.
目的观察重灸中脘穴对脾胃虚寒型2型糖尿病胃轻瘫患者胃肠激素、胃动力学的影响。方法选取符合纳入标准的88例脾胃虚寒型糖尿病胃轻瘫患者,按随机数字表法分为治疗组和对照组,每组44例。对照组采用常规药物治疗,治疗组采用重灸中脘穴治疗。疗程结束后记录并对比分析两组临床疗效、胃肠激素[胃泌素(GAS)、胃动素(MTL)]、胃动力学(胃收缩频率、胃排空时间、胃排空率)、主要临床症状评分等变化。结果治疗组临床疗效明显优于对照组,差异具有统计学意义(P<0.05);两组治疗后GAS、MTL均明显优于治疗前(P<0.05),且治疗组明显优于对照组(P<0.05);两组治疗后胃收缩频率、胃排空时间、胃排空率均明显优于治疗前(P<0.05),且治疗组明显优于对照组(P<0.05);两组治疗后主要临床症状评分均明显优于治疗前(P<0.05),且治疗组明显优于对照组(P<0.05)。结论在常规药物治疗基础上重灸中脘穴治疗脾胃虚寒型2型糖尿病胃轻瘫,可调节胃肠激素,改善胃肠动力,促进胃肠功能恢复。 相似文献
27.
Phonphimon Wongthida Matthew R Schuelke Christopher B Driscoll Timothy Kottke Jill M Thompson Jason Tonne Cathy Stone Amanda L Huff Cynthia Wetmore James A Davies Alan L Parker Laura Evgin Richard G Vile 《Neuro-oncology》2020,22(12):1757
BackgroundDiffuse midline glioma, formerly DIPG (diffuse intrinsic pontine glioma), is the deadliest pediatric brainstem tumor with median survival of less than one year. Here, we investigated (i) whether direct delivery of adenovirus-expressing cluster of differentiation (CD)40 ligand (Ad-CD40L) to brainstem tumors would induce immune-mediated tumor clearance and (ii) if so, whether therapy would be associated with a manageable toxicity due to immune-mediated inflammation in the brainstem.MethodsSyngeneic gliomas in the brainstems of immunocompetent mice were treated with Ad-CD40L and survival, toxicity, and immune profiles determined. A clinically translatable vector, whose replication would be tightly restricted to tumor cells, rAd-Δ24-CD40L, was tested in human patient–derived diffuse midline gliomas and immunocompetent models.ResultsExpression of Ad-CD40L restricted to brainstem gliomas by pre-infection induced complete rejection, associated with immune cell infiltration, of which CD4+ T cells were critical for therapy. Direct intratumoral injection of Ad-CD40L into established brainstem tumors improved survival and induced some complete cures but with some acute toxicity. RNA-sequencing analysis showed that Ad-CD40L therapy induced neuroinflammatory immune responses associated with interleukin (IL)-6, IL-1β, and tumor necrosis factor α. Therefore, to generate a vector whose replication, and transgene expression, would be tightly restricted to tumor cells, we constructed rAd-Δ24-CD40L, the backbone of which has already entered clinical trials for diffuse midline gliomas. Direct intratumoral injection of rAd-Δ24-CD40L, with systemic blockade of IL-6 and IL-1β, generated significant numbers of cures with readily manageable toxicity.ConclusionsVirus-mediated delivery of CD40L has the potential to be effective in treating diffuse midline gliomas without obligatory neuroinflammation-associated toxicity. 相似文献
28.
29.
BackgroundThis study sought to determine trends in out-patient visits for gastrointestinal cancer (GC) at a quaternary hospital in KwaZulu-Natal (KZN), South Africa; and identify geographical regions which contribute most to GC-related out-patient clinic utilization at this hospital.MethodData for GC-related outpatient visits over an 11-year period was obtained from the hospital''s administrative database. Trends were analyzed using simple regression and trend line analyses. Patient residential postal codes from the administrative database were used to determine the geospatial distribution of complex GC in KZN.ResultsStrong increasing trends in GC-related out-patient visits were noted for age >65 years old (R2=0.8014), male (R2=0.7020), female (R2=0.7292), lower GC (R2=0.7094), and rural residence (R2=0.7008). Moderate increasing trends in GC-related out-patient visits were noted for age ≤65 years old (R2=0.6556), upper GC (R2=0.6498), and urban residence (R2=0.6988). The magnitude at which the number of out-patient visits increased was greater for urban residence when compared with rural residence (p=0.006). Urban centers and some regions along the North and South coast of KZN contributed the most toward GC-related out-patient visits.ConclusionOut-patient visits for complex GC in KZN are increasing. Several regions have been identified for anti-cancer interventions and decentralized out-patient services. 相似文献
30.
Taisuke Inada Satoshi Fukushima Masayuki Murai Masatoshi Jinnin Azusa Miyashita Satoshi Nakahara Junji Yamashita Jun Aoi Shinichi Masuguchi Hironobu Ihn 《The Journal of dermatology》2015,42(2):198-201
miRNA‐221 (miR‐221) is known to be abnormally expressed in many human cancers. The serum levels of miR‐221 have been reported as a tumor marker for malignant melanoma (MM). We hypothesized that the hair shaft miR‐221 levels may be increased in patients with MM. We therefore assessed the possibility that hair shaft miR‐221 levels could be a marker for MM. The hair shaft miR‐221 levels were significantly higher in patients with MM than controls. The rates of increased hair shaft miR‐221 levels above the cut‐off value were comparable to those of serum 5‐S‐CD, which is a tumor marker commonly used for MM. Measurements of the hair shaft miR‐221 levels could have potential clinical value in the detection of MM. This is the first report investigating the hair shaft levels of an miRNA in patients with MM. Our investigations offer new insight into the relationship between miR‐221 and MM, and may provide a new, non‐invasive way to screen for melanoma. 相似文献