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1.
Many environmental risk factors for hepatobiliary cancers are known but whether they are associated with specific cancer types is unclear. We present here a novel approach of assessing standardized incidence ratios (SIRs) of previously diagnosed comorbidities for hepatocellular carcinoma (HCC), gallbladder cancer (GBC), cholangiocarcinoma (CCA) and ampullary cancer. The 13 comorbidities included alcohol and nonalcohol related liver disease, chronic obstructive pulmonary disease, gallstone disease, viral and other kinds of hepatitis, infection of bile ducts, hepatic and other autoimmune diseases, obesity and diabetes. Patients were identified from the Swedish Inpatient Register from 1987 to 2018, and their cancers were followed from 1997 onwards. SIRs for HCC were 80 to 100 in men and women diagnosed with hepatitis C virus and they were also >10 in patients diagnosed with hepatitis B virus, other kind of hepatitis, hepatic autoimmune disease and nonalcohol related liver disease. Many of these risks, as well as alcohol related liver disease, were either specific to HCC or were shared with intrahepatic CCA. For GBC, CCA and ampullary cancer infection of bile ducts was the main risk factor. Gallstone disease, nonhepatic autoimmune diseases and diabetes were associated with all hepatobiliary cancers. The limitations of the study include inability to cover some rare risk factors and limited follow-up time. Many of the considered comorbidities are characterized by chronic inflammation and/or overt immune disturbance in autoimmune diseases. The results suggest that local chronic inflammation and a related immune disturbance is the carcinogenic trigger for all these cancers.  相似文献   
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目的 探究内镜逆行胰胆管造影术(ERCP)在胆囊癌合并恶性梗阻性黄疸中的临床应用价值。方法 回顾性分析2016年1月-2019年9月该院收治的20例胆囊癌合并恶性梗阻性黄疸患者的临床资料,比较ERCP治疗前后总胆红素(TBil)和直接胆红素(DBil)水平,以及病理组织情况。结果 ERCP治疗前后TBil[(230.61±100.73)和(110.10±55.02)μmol/L]和DBil[(190.93±99.72)和(88.13±38.30)μmol/L]比较,差异有统计学意义(P < 0.05),采用活检钳和细胞刷联合活检的阳性率高于单项活检(P = 0.019,P = 0.008)。结论 ERCP对于晚期胆囊癌合并恶性梗阻性黄疸患者有较好的退黄效果,改善了患者生活质量,可在患者无外科手术指征时取活检确诊胆囊癌,为进一步综合治疗提供病理依据。  相似文献   
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膀胱癌是泌尿系统常见的肿瘤,其中90%以上的膀胱癌病理类型为尿路上皮癌,按照肿瘤浸润深度可分为非肌层浸润性尿路上皮癌(Non muscle invasive bladder cancer,NMIBC)和肌层浸润性尿路上皮癌。NMIBC主要是指肿瘤侵及固有层(T1)、粘膜层(Ta)和原位癌(Tis),其预后较好。其中Ta、T1期肿瘤占大多数,两者虽然都属于NMIBC,但生物学特性不同,由于固有层血管和淋巴管丰富,故T1期肿瘤较容易发生扩散和复发。本文将重点针对T1期高级别尿路上皮癌的各种治疗方式,包括手术治疗、介入治疗、药物化疗和免疫治疗等方面做一综述,特别探讨了如何利用手术治疗方式以及手术治疗联合化疗提高治疗效果,减少复发,提高生存时间。  相似文献   
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《Cancer radiothérapie》2022,26(5):717-723
PurposeAnaplastic thyroid carcinomas (ATC) are a heterogenous group of tumors of overall dismal prognosis. We designed models to identify relevant prognostic factors of survival of irradiated ATC patients including radiotherapy modalities (field size, dose).Material and methodsBetween 2000 and 2017, 166 ATC patients’ treatments were divided into surgery and postoperative radiotherapy (poRT) or definitive radiotherapy (RT). Multiple imputation approach was used for missing data. Prognostic factors were identified using Lasso-penalized Cox modelling and predicted risk scores were built.ResultsPatients undergoing RT (n = 70) had more adverse patient and disease characteristics than those undergoing poRT (n = 96). Corresponding median survival rates were 5.4 and 12.1 months, respectively. PoRT patients undergoing poRT more likely received extended-field radiotherapy with prophylactic nodal irradiation, but rather received platinum- vs. adriamycin-based chemoradiotherapy. Radiotherapy was conventionally fractionated, delivered > 60 Gy in 51.9% and 61.7% and used extended fields in 88.5% and 71.2% of patients with poRT or RT. Radiotherapy interruption rates for toxicity were similar in the two groups. The best poRT-group model identified age > 45yo, PS  1, pathologic tumor stage  pT4b, > N1 and R2 resection as poor prognostic factors. The best RT-group model (C-index of 0.72) identified PS  3, > N1 and extended-field radiotherapy with prophylactic nodal irradiation (as opposed to tumour-bed irradiation only) as poor prognostic factors.ConclusionIn patients undergoing poRT, radiotherapy parameters had little influence over their survival irrespective of patient, disease characteristics, and quality of resection. In patients undergoing RT, extended-field radiotherapy improved survival in addition to PS and nodal stage.  相似文献   
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BackgroundSurgical resection is recommended for patients with resectable acinar cell carcinoma (ACC). The aim of this study was to investigate the clinical characteristics and surgical outcomes of resectable ACC in comparison to pancreatic ductal adenocarcinoma (PDAC).MethodA retrospective analysis was performed on all patients who consecutively underwent radical resection with pathologically confirmed ACC and PDAC from December 2011 to December 2018. Clinicopathologic characteristics and follow-up information were analyzed. A 1:3 propensity score matching (PSM) method was used to minimize the bias between ACC and PDAC.ResultsA total of 26 patients with ACC and 1351 with PDAC were included. Compared to PDAC, ACC tended to be larger (4.5 vs. 3.0 cm; p < 0.001) and more frequently located in the pancreatic body/tail (61.5% vs. 36.6%, p = 0.009), with lower total bilirubin levels, lower neutrophil lymphocyte ratio (NLR) levels and lower carbohydrate antigen 19-9 (CA19-9) levels and carcinoembryonic antigen (CEA) levels. There was no difference in postoperative morbidities in patients with ACC and PDAC. The median OS and RFS were longer in ACC when compared to PDAC (OS: 43.5 mo vs. 19.0 mo, p = 0.004; RFS: 24.5 mo vs. 11.6 mo, p = 0.023). After the 1:3 PSM, ACC remained to be a better histological type for OS (p = 0.024), but had comparable RFS with PDAC (p = 0.164).ConclusionPatients with ACC after radical resection had better OS than that with PDAC. However, ACC is also an aggressive tumor with a similar trend of RFS with PDAC after the matching, necessitating the multidisciplinary treatment for resectable ACC disease.  相似文献   
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口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)的发病率和死亡率呈年轻化趋势上升,已成为世界范围内的主要公共卫生问题。近年来,慢性牙周炎(chronic periodontitis,CP)与口腔鳞癌之间的关系越来越受到重视,一些研究发现,以慢性炎症和微生物失调为特征的牙周病是口腔肿瘤发生的重要危险因素。本文就慢性牙周炎与口腔鳞癌的相关研究,牙周主要致病菌、细胞因子、NF-κB等在两者中的桥梁作用,以及抗炎药物在口腔鳞癌中的应用做主要阐述。  相似文献   
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目的探讨磁共振弥散加权成像(DWI)在食管鳞癌(ESCC)患者放化疗近期疗效预测中的作用。方法回顾性收集2017年4月至2020年3月承德市第三医院收治的120例ESCC患者,患者放化疗前后均进行DWI扫描,在DWI图像上对病灶表观扩散系数(ADC)进行测量。根据放化疗近期疗效将患者分为缓解组(完全缓解+部分缓解)与非缓解组(进展+稳定),比较两组放化疗前后前后ADC值、ADC值变化量(ΔADC)及ADC值变化率(ADC%)的差异。应用受试者工作特征曲线(ROC)评价治疗前ADC值对放化疗疗效的预测价值。结果120例患者,完全缓解31例(25.83%),部分缓解48例(40.00%),稳定32例(26.67%),进展9例(7.50%);缓解组共79例,未缓解组41例。120例患者放化疗治疗后ADC值为(2.13±0.26)×10-3mm2/s,显著高于治疗前[(1.45±0.18)×10-3mm2/s],差异有统计学意义(P<0.05)。治疗前缓解组ADC值显著低于未缓解组,治疗后缓解组ADC值显著高于未缓解组,差异均有统计学意义(P<0.05)。相比非缓解组,缓解组放化疗治疗前后的ΔADC及ADC%均显著增高,差异均有统计学意义(P<0.05)。放化疗治疗前,完全缓解组ADC值显著低于部分缓解组,而放化疗治疗后,完全缓解组ADC值显著高于部分缓解组,差异均有统计学意义(P<0.05)。治疗前ADC值预测ESCC患者放化疗治疗疗效为缓解的ROC曲线下面积为0.843(95%CI:0.765~0.903),敏感度为92.41%,特异度为65.85%;预测疗效为完全缓解的ROC曲线下面积为0.901(95%CI:0.833~0.948),敏感度为96.77%,特异度为74.16%。结论治疗前ADC值对于ESCC患者放化疗近期疗效有较好的预测价值,DWI可作为ESCC患者疗效评估的影像学手段。  相似文献   
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目的探讨口腔鳞状细胞癌(OSCC)组织中长链非编码RNA(lncRNA)淋巴细胞白血病缺失基因1(DLEU1)的表达及与临床病理参数和预后的关系。 方法收集2017年1月至2017年12月南通大学附属医院保存的98例OSCC组织及癌旁组织,实时荧光定量-聚合酶链式反应(qRT-PCR)检测癌组织和癌旁组织中lncRNA DLEU1表达。分析lncRNA DLEU1表达与OSCC患者临床病理参数的关系,K-M法绘制不同lncRNA DLEU1表达OSCC患者生存曲线,多因素Cox回归分析OSCC患者预后不良影响因素。 结果OSCC组织中lncRNA DLEU1表达(1.863±0.572)高于癌旁组织(1.058±0.211)(t=13.058,P<0.001)。lncRNA DLEU1表达与OSCC患者肿瘤区域淋巴结转移(TNM)分期、淋巴结转移有关(P<0.05)。中位随访26个月,lncRNA DLEU1≥1.863生存率为61.22%,低于lncRNA DLEU1<1.863的79.59%(Log-rank χ2=4.819,P=0.028)。TNM分期Ⅲ~Ⅳ期(HR=4.612,95%CI:1.482~11.352)、淋巴结转移(HR=4.370,95%CI:1.442~10.246)、lncRNA DLEU1≥1.863(HR=4.231,95%CI:1.350~10.260)是OSCC患者预后不良的独立风险因素(P<0.05)。 结论OSCC组织中lncRNA DLEU1高表达,与TNM分期、淋巴结转移和预后相关,可能成为新的OSCC诊治和预后分子标志物。  相似文献   
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