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目的探讨曲妥珠单抗对人表皮生长因子受体2(HER2)阳性Ⅳ期乳腺癌的治疗效果及患者预后的影响因素。方法收集229例应用曲妥珠单抗治疗的HER2阳性Ⅳ期乳腺癌患者的临床资料,采用Cox比例风险回归模型分析HER2阳性Ⅳ期乳腺癌患者无进展生存时间(PFS)和总生存时间(OS)的影响因素。结果229例HER2阳性Ⅳ期乳腺癌患者行曲妥珠单抗总体治疗的客观有效率为44.5%,疾病控制率为90.8%,中位PFS为10个月(95%CI:8.748~11.252),中位OS为29个月(95%CI:27.551~30.449)。单因素分析结果显示,激素受体状态和曲妥珠单抗不同线治疗均可能与HER2阳性Ⅳ期乳腺癌的PFS有关,激素受体状态、曲妥珠单抗不同线治疗和进展后是否继续行曲妥珠单抗治疗均可能与HER2阳性Ⅳ期乳腺癌的OS有关(P﹤0.05)。多因素分析结果显示,激素受体状态和曲妥珠单抗不同线治疗是HER2阳性Ⅳ期乳腺癌PFS和OS的独立影响因素(P﹤0.05)。结论一线应用曲妥珠单抗是治疗HER2阳性Ⅳ期乳腺癌的有效手段,在治疗进展后继续应用曲妥珠单抗治疗仍有生存获益。  相似文献   
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赵军 《当代医学》2022,28(6):16-18
目的分析补肾活血汤联合曲妥珠单抗对肝肾阴虚型人表皮生长因子受体2(Her-2)阳性晚期乳腺癌患者的影响。方法选取2020年7月至2021年12月本院收治的80例肝肾阴虚型Her-2阳性晚期乳腺癌患者作为研究对象,根据随机数字表法分为对照组与研究组,各40例。对照组采用单一曲妥珠单抗治疗,研究组采用补肾活血汤联合曲妥珠单抗治疗,比较两组治疗前后肿瘤标志物水平、免疫蛋白水平以及不良反应发生率。结果治疗后,研究组CEA、CA125与CA15-3水平均明显低于对照组(P<0.05);研究组IgA、IgG与IgM水平明显高于对照组(P<0.05);两组不良反应发生率比较差异无统计学意义。结论补肾活血汤联合曲妥珠单抗治疗肝肾阴虚型Her-2阳性晚期乳腺癌患者效果显著,能有效降低患者血清肿瘤标志物水平,改善其机体免疫功能,且不会增加不良反应。  相似文献   
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Lateral lymph nodes in low, locally advanced, rectal cancer have proven implications for local recurrence rates, which increase drastically in the presence of persistently enlarged lateral lymph nodes. These clinical implications warrant a thorough understanding of lateral nodal disease with awareness and knowledge from all three specialties involved – radiology, radiation oncology, and surgery – to ensure proper treatment. Relevant literature for each specialty, including all current guidelines and perspectives, were examined. Variations in definitions and treatment paradigms were evaluated. There is still no consensus for the standardized treatment of lateral nodal disease. Each discipline works according to their own available evidence, but relevant data are scarce. Current international guidelines and standard recommendations for the diagnostics and treatment of lateral lymph nodes are lacking. This results in differing perspectives and interpretations between the disciplines which can lead to challenging communication in an area where multidisciplinary collaboration is essential. This review addresses this by presenting the current evidence, perspectives and practices of each specialty and makes suggestions for each phase of the diagnostic and treatment process for patients with lateral nodal disease. By doing this, steps are taken toward achieving international consensus, and multidisciplinary collaboration.  相似文献   
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BackgroundAnaphylaxis is a severe and potentially fatal allergic response. Early-life exposure to rural environments may help protect against allergic reaction. This study assesses urban/rural differences by age and race/ethnicity in emergency department (ED) pediatric visit rates for food-induced anaphylaxis.MethodsThis observational study examined 2009–2014 inpatient and ED data from New York and Florida, using ICD-9-CM diagnostic code (995.6) to identify food-induced anaphylaxis cases <18 y/o. Primary predictor of interest was urban/rural setting, with race/ethnicity and age also evaluated. Associations between ED visit rates and urban/rural setting were evaluated by multivariable hierarchical negative binomial regression with state and year fixed effects.ResultsED visit rates (per 100,000) for food-induced anaphylaxis were 12.31 and 4.60 in urban and rural settings, respectively. Rates were highest among Blacks (15.26) younger urban children (17.29) and older rural children (6.99). Compared to rural, urban children had significantly higher anaphalaxis ED visit rates (IRR 2.77).ConclusionsFood-induced anaphylaxis ED visit rates were highest among younger urban children and Black children, with a notable contrast in age distribution between urban and rural rates. Higher urban rates may be attributed to Hygiene Hypothesis, though racial, economic and emergency care access disparities may also influence these outcomes.  相似文献   
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《Clinical breast cancer》2020,20(2):e181-e187
BackgroundT-DM1 improves progression-free survival (PFS) and overall survival (OS) in patients with metastatic human epidermal growth factor receptor 2-positive (HER2+) breast cancer progressing on prior trastuzumab plus a taxane. A paucity of data is available on T-DM1 efficacy after dual anti-HER2 blockade with pertuzumab and trastuzumab plus a taxane, which represents the current first-line standard of care. The present study is a retrospective/prospective evaluation of the efficacy and activity of second-line T-DM1 after front-line pertuzumab-based therapy.Patients and MethodsEligible patients were identified within the Gruppo Italiano Mammella (GIM) 14/BIOMETA study, a retrospective/prospective multicenter study on treatment patterns and outcomes of patients with metastatic breast cancer (ClinicalTrials.gov Identifier: NCT02284581). We searched for patients who received second-line T-DM1 after taxane plus trastuzumab and pertuzumab between November 15, 2013 and May 31, 2018. We calculated median PFS, median time to treatment failure (TTF), prolonged duration of therapy (PDT), objective response rate (ORR), and 1-year OS.ResultsOf 445 patients with HER2+ metastatic breast cancer, 77 were eligible for the analysis. At a median follow-up of 7 months, median PFS was 6.3 months (95% confidence intervals [CI], 4.8-7.7 months), and median TTF was 6.2 months (95% CI, 4-8.6 months). More than one-third of patients (37.6%; n = 29) experienced PDT with an ORR of 27.1%. At data cutoff, the median OS was not reached, and the 1-year OS was 82%.ConclusionsOur results show meaningful activity of T-DM1 after front-line pertuzumab plus trastuzumab and a taxane, with about 27% of patients having an objective response and 40% of patients achieving durable disease control.  相似文献   
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《中国现代医生》2020,58(4):149-152
目的 探讨芪胶升白胶囊对曲妥珠单抗和多西紫杉醇治疗转移性乳腺癌的影响。方法 选择我院肿瘤内科转移性乳腺癌患者100 例,分为对照组与观察组,各50 例。对照组给予曲妥珠单抗和多西紫杉醇治疗;观察组给予芪胶升白胶囊联合曲妥珠单抗和多西紫杉醇治疗:疗程均25 周,疗程结束时观察两组临床疗效、生活质量和不良反应,并观察1 年内生存情况。结果 两组临床效果比较,差异无显著性(Z=-1.50,P>0.05);两组1 年内生存情况比较,差异无显著性(χ2=1.00,P>0.05);两组生活质量比较,观察组高于对照组(t=2.37,P<0.05);两组治疗后骨髓抑制比较差异有显著性(χ2=4.76,P<0.05),而肝肾功能损害比较差异具有显著性(χ2=7.90,P<0.01)。结论芪胶升白胶囊可提高曲妥珠单抗和多西紫杉醇治疗转移性乳腺癌患者的生活质量,显著减轻化疗所引起的肝肾损伤和骨髓抑制。  相似文献   
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《Clinical breast cancer》2020,20(3):e251-e260
Expression of human epidermal growth factor receptor 2 (HER2) in breast cancer defines a subset of patients (∼15%-20%) who are candidates for anti-HER2 therapies, most notably, trastuzumab, pertuzumab, antibody drug conjugates (eg, T-DM1), and tyrosine kinase inhibitor (TKI) drugs (eg, lapatinib and neratinib), all of which have dramatically changed the prognosis for this aggressive subtype of breast cancer. A roundtable meeting of the Breast Cancer Therapy Expert Group (BCTEG) was convened in March 2018 in an effort to discuss and clarify, from the perspective of the practicing community oncologist, recent developments in the diagnosis and treatment of HER2-positive (HER2+) breast cancer. Members of the group selected 4 key topics for discussion prior to the meeting, including diagnosis of HER2+ disease, and its treatment in the neoadjuvant, adjuvant, and metastatic settings. Approved testing methods, such as immunohistochemistry and fluorescence in situ hybridization, are used to demonstrate overexpression and/or amplification of HER2 in breast tumors, and established clinical guidelines are used to appropriately define treatment plans for patients with HER2+ disease. The panel acknowledges a range of treatment options now available for treatment of HER2+ breast cancer in the neoadjuvant, adjuvant, and advanced/metastatic settings, although it is noted that many controversies remain, including the optimal sequence of therapies, the most appropriate treatment(s) for subsets of patients with HER2+ disease (eg, hormone receptor-negative or -positive/HER2+), and uncertainties surrounding the diagnosis and definition of HER2+ disease. The current report summarizes the discussion of the BCTEG panel on this topic.  相似文献   
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