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目的: 系统评价重组结核杆菌融合蛋白(EC)相较于结核菌素纯蛋白衍生物(TB-PPD)用于诊断结核分枝杆菌(Mycobacterium tuberculosis,MTB)感染的有效性和安全性。方法: 检索临床指南数据库、生物医学文献数据库、卫生行政部门和行业协会官方网站及不良反应监测官方网站,检索时间均自建库截止到2022年2月。英文检索词:Recombinant Mycobacterium tuberculosis fusion protein、CFP10/ESAT6;中文检索词:重组结核分枝杆菌融合蛋白、重组结核杆菌融合蛋白、宜卡、CFP10/ESAT6。收集重组结核杆菌融合蛋白(EC)和结核菌素纯蛋白衍生物(TB-PPD)诊断MTB感染有效性和安全性的指南、共识、团体标准、系统评价和原始研究等。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险,根据异质性大小采用Meta分析或描述性分析。结果: 纳入指南2部、专家共识3篇、团体标准2部,均指出重组结核杆菌融合蛋白(EC)和结核菌素纯蛋白衍生物(TB-PPD)可用于诊断MTB感染和结核病辅助诊断。纳入系统评价1篇,结果显示,重组结核杆菌融合蛋白(EC)皮肤试验共招募参与者887名,其敏感度为86.06%(95%CI:82.39%~89.07%)。纳入原始研究4篇,均为随机对照试验,有效性Meta分析结果显示,不区分人群,重组结核杆菌融合蛋白(EC)和结核菌素纯蛋白衍生物(TB-PPD)的敏感度(89.3% vs. 90.4%)和阴性似然比(0.177 vs. 0.220)的差异无统计学意义,重组结核杆菌融合蛋白(EC)的特异度(85.5% vs. 47.3%)、诊断比值比(42.238 vs. 8.040)、阳性似然比(6.048 vs. 1.710)、阳性预测值(66.0% vs. 35.1%)、阴性预测值(96.2% vs. 94.0%)优于结核菌素纯蛋白衍生物(TB-PPD),差异有统计学意义。安全性结果显示,重组结核杆菌融合蛋白(EC)和结核菌素纯蛋白衍生物(TB-PPD)不良事件均为局部瘙痒和疼痛,均未发生严重不良事件。结论: 重组结核杆菌融合蛋白(EC)可用于MTB感染诊断、辅助结核病诊断,相较于结核菌素纯蛋白衍生物(TB-PPD),其有效性表现更优。 相似文献
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目的 观察表皮生长因子受体(EGFR)家族成员EGFR、ErbB-2在胶原诱导性关节炎(CIA)大鼠滑膜及软骨中的表达及雷公藤多苷(TWP)对其影响,探讨EGFR、ErbB-2在CIA大鼠发病中的,作用及TWP治疗RA的药理作用机制.方法 建立CIA大鼠模型,分别采用免疫组织化学染色及实时定量聚合酶链反应( PCR)检测EGFR、ErbB-2在滑膜和软骨中的表达.统计学处理采用单因素方差分析.结果 EGFR、ErbB-2的蛋白表达及mRNA水平在CIA模型组滑膜(EGFR 0.268±0.059,ErbB-2 0.25±0.04.EGFR mRNA:14.2±0.55,ErbB-2 mRNA 23.46±3.64)和软骨(EGFR 0.193±0.018,ErbB-2 0.217±0.033,EGFR mRNA:4.16±0.50,ErbB-2 mRNA 9.23±0.66)中明显高于正常组(P<0.01),在治疗组中表达低于模型组(P<0.01).结论 初步证明EGFR、ErbB-2参与了CIA的病理过程.TWP治疗RA的机制可能与其降低EGFR、ErbB-2的表达有关. 相似文献
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补阳还五汤对急性脊髓损伤模型大鼠神经细胞凋亡的影响 总被引:1,自引:0,他引:1
目的观察补阳还五汤对大鼠急性脊髓损伤(ASCI)的治疗作用及其机制。方法 SD大鼠随机分为空白组、损伤对照组、补阳还五汤组,各10只。采用Allen’s打击法建立急性脊髓损伤模型,空白组和损伤对照组造模后予蒸馏水1m L灌胃,补阳还五汤组造模后予补阳还五汤1m L灌胃,均1天1次,连续3天。各组分别于术后1、7、14天观察其行为学BBB评分,14天通过免疫组化的方法观察脊髓损伤部位神经细胞凋亡(caspase-3p20、Bcl-2与Bax)、血管内皮生长因子(VEGF)的表达水平。结果 1行为学观察评分:术后7、14天补阳还五汤组与损伤对照组下肢功能均有恢复(P0.05),且补阳还五汤组较损伤对照组恢复更明显[(9.05±0.95)分比(5.75±1.97)分,(12.6±1.55)分比(8.80±3.34)分,P0.05]。2免疫组化检测:补阳还五汤组caspsase-3p20阳性细胞数表达较损伤对照组少[(16.70±2.21)个比(20.30±4.13)个,P0.05];补阳还五汤组Bcl-2阳性细胞的表达较损伤对照组增加[(10.57±0.97)个比(6.42±3.20)个,P0.05];补阳还五汤组Bax阳性细胞的表达较损伤对照组少[(18.29±2.21)个比(21.14±2.41)个,P0.05];补阳还五汤组VEGF阳性细胞的表达较损伤对照组多[(11.75±1.03)个比(9.50±1.30)个,P0.05]。结论补阳还五汤可提高脊髓损伤部位VEGF的表达,使细胞凋亡明显减少,促进骨髓功能的恢复。 相似文献
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全国优秀博士学位论文体现了人才培养质量及科技创新水平。通过对2003-2012年全部48篇全国优秀博士学位论文(临床医学类)进行计量分析,发现全国优秀博士论文具有集聚和连续等特点。学校、学科、导师是全国优秀博士论文(临床医学类)产出的关键因素。 相似文献
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ObJective To evaluate the value of contrast-enhanced ultrasonography microflow imaging (MFI) in detecting prostate cancer. Methods Sixty-five patients with serum prostate-specific antigen levels higher than 4.00 μg/L were evaluated with transrectal gray-scale,power Doppler,and MFI ultrasonography and then biopsy guided by ultrasonography. Biopsy was performed at twelve sites in the base,the mid gland and the apex in each patient. In these three transverse sections, when any of the three methods showed abnormality,the biopsy site was directed to the abnormal foci. Diagnostic efficiency of the three methods for prostate cancer detection was compared based on biopsy results according to patient and biopsy site. Results Overall prostate cancers were detected in 230 (29.5 %) of 780 specimens in 36(55.4%) of 65 patients. MFI could detect more patients(34) than gray-scale(26) and power Doppler(28) (P = 0.021, P = 0.031), 6(16.7%)of the 36 patients diagnosed with cancer were identified only by MFI. By biopsy site, MFI had higher sensitivity and overall accuracy (80.0% and 83.0%) than gray-scale (47.0% and 76.8%) and power Doppler (37.4% and 74.6%) ultrasonography(P <0.001, P<0.001 ; P = 0.001, P <0.001), while the specificity of MFI was 84.4%, lower than gray-scale (89.3%) and power Doppler (90.2%) ultrasonography(P = 0.009, P < 0.001). Conclusions MFI could detect more patients and improve sensitivity and overall accuracy by biopsy site than conventional uhrasonography. 相似文献
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ObJective To evaluate the value of contrast-enhanced ultrasonography microflow imaging (MFI) in detecting prostate cancer. Methods Sixty-five patients with serum prostate-specific antigen levels higher than 4.00 μg/L were evaluated with transrectal gray-scale,power Doppler,and MFI ultrasonography and then biopsy guided by ultrasonography. Biopsy was performed at twelve sites in the base,the mid gland and the apex in each patient. In these three transverse sections, when any of the three methods showed abnormality,the biopsy site was directed to the abnormal foci. Diagnostic efficiency of the three methods for prostate cancer detection was compared based on biopsy results according to patient and biopsy site. Results Overall prostate cancers were detected in 230 (29.5 %) of 780 specimens in 36(55.4%) of 65 patients. MFI could detect more patients(34) than gray-scale(26) and power Doppler(28) (P = 0.021, P = 0.031), 6(16.7%)of the 36 patients diagnosed with cancer were identified only by MFI. By biopsy site, MFI had higher sensitivity and overall accuracy (80.0% and 83.0%) than gray-scale (47.0% and 76.8%) and power Doppler (37.4% and 74.6%) ultrasonography(P <0.001, P<0.001 ; P = 0.001, P <0.001), while the specificity of MFI was 84.4%, lower than gray-scale (89.3%) and power Doppler (90.2%) ultrasonography(P = 0.009, P < 0.001). Conclusions MFI could detect more patients and improve sensitivity and overall accuracy by biopsy site than conventional uhrasonography. 相似文献
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ObJective To evaluate the value of contrast-enhanced ultrasonography microflow imaging (MFI) in detecting prostate cancer. Methods Sixty-five patients with serum prostate-specific antigen levels higher than 4.00 μg/L were evaluated with transrectal gray-scale,power Doppler,and MFI ultrasonography and then biopsy guided by ultrasonography. Biopsy was performed at twelve sites in the base,the mid gland and the apex in each patient. In these three transverse sections, when any of the three methods showed abnormality,the biopsy site was directed to the abnormal foci. Diagnostic efficiency of the three methods for prostate cancer detection was compared based on biopsy results according to patient and biopsy site. Results Overall prostate cancers were detected in 230 (29.5 %) of 780 specimens in 36(55.4%) of 65 patients. MFI could detect more patients(34) than gray-scale(26) and power Doppler(28) (P = 0.021, P = 0.031), 6(16.7%)of the 36 patients diagnosed with cancer were identified only by MFI. By biopsy site, MFI had higher sensitivity and overall accuracy (80.0% and 83.0%) than gray-scale (47.0% and 76.8%) and power Doppler (37.4% and 74.6%) ultrasonography(P <0.001, P<0.001 ; P = 0.001, P <0.001), while the specificity of MFI was 84.4%, lower than gray-scale (89.3%) and power Doppler (90.2%) ultrasonography(P = 0.009, P < 0.001). Conclusions MFI could detect more patients and improve sensitivity and overall accuracy by biopsy site than conventional uhrasonography. 相似文献