全文获取类型
收费全文 | 4726篇 |
免费 | 584篇 |
国内免费 | 101篇 |
专业分类
耳鼻咽喉 | 17篇 |
儿科学 | 154篇 |
妇产科学 | 27篇 |
基础医学 | 524篇 |
口腔科学 | 20篇 |
临床医学 | 304篇 |
内科学 | 382篇 |
皮肤病学 | 13篇 |
神经病学 | 1945篇 |
特种医学 | 451篇 |
外科学 | 85篇 |
综合类 | 301篇 |
预防医学 | 551篇 |
眼科学 | 12篇 |
药学 | 504篇 |
1篇 | |
中国医学 | 78篇 |
肿瘤学 | 42篇 |
出版年
2024年 | 3篇 |
2023年 | 97篇 |
2022年 | 106篇 |
2021年 | 226篇 |
2020年 | 225篇 |
2019年 | 239篇 |
2018年 | 216篇 |
2017年 | 259篇 |
2016年 | 267篇 |
2015年 | 259篇 |
2014年 | 331篇 |
2013年 | 400篇 |
2012年 | 326篇 |
2011年 | 375篇 |
2010年 | 225篇 |
2009年 | 245篇 |
2008年 | 282篇 |
2007年 | 207篇 |
2006年 | 190篇 |
2005年 | 153篇 |
2004年 | 103篇 |
2003年 | 99篇 |
2002年 | 86篇 |
2001年 | 55篇 |
2000年 | 31篇 |
1999年 | 31篇 |
1998年 | 28篇 |
1997年 | 34篇 |
1996年 | 27篇 |
1995年 | 22篇 |
1994年 | 20篇 |
1993年 | 18篇 |
1992年 | 28篇 |
1991年 | 24篇 |
1990年 | 13篇 |
1989年 | 19篇 |
1988年 | 12篇 |
1987年 | 11篇 |
1986年 | 12篇 |
1985年 | 15篇 |
1984年 | 21篇 |
1983年 | 11篇 |
1982年 | 21篇 |
1981年 | 8篇 |
1980年 | 9篇 |
1979年 | 3篇 |
1978年 | 6篇 |
1977年 | 4篇 |
1976年 | 5篇 |
1973年 | 2篇 |
排序方式: 共有5411条查询结果,搜索用时 15 毫秒
1.
视觉通路包括视神经、视交叉、视束、视放射及视皮质。常规磁共振检查技术难以发现视路损伤后白质纤维微结构改变,眼科学检查也存在一定的局限性及主观性,且不能探测后视路的变化。弥散张量成像(diffusion tensor imaging,DTI)作为一种新兴的磁共振成像技术,通过各种后处理分析方法结合不同的参数进行分析,可提供组织的微结构信息,并能够直观显示活体白质纤维束,在无创地探索疾病的神经病理机制、评估预后方面起着重要的作用。近年来随着DTI后处理方法的不断创新,其在视路损伤中的研究越来越多。本文在介绍DTI的主要参数及常见脑白质微结构分析方法的同时,阐述了其在视路损伤研究中的应用,并进一步对各种分析方法的优缺点进行总结。 相似文献
2.
The current evidence on the association of leukocyte telomere length (LTL) with age-related structural and cognitive changes in the brain is mixed. Herein conforming to PRISMA 2020 guidelines, we performed a systematic review and meta-analysis using data from 27 observational studies in non-demented individuals. We used effect size and p-value based meta-analysis methods considering marked heterogeneity among studies. We found that the longer LTL was associated with higher brain volume (β = 0.43, 95%CI: 0.36–0.50%, p = 0.008, N = 1102) and with higher global cognition (β = 0.01; 95%CI: 0.00–0.02, p = 0.03, N = 19609) by effect size based meta-analysis and with brain volume, hippocampal volume, global cognition, cognitive domains of attention/speed as well as executive functions by p-value based meta-analysis. No significant association of LTL with brain white matter hyperintensities was detected. Furthermore, the evidence strongly suggests a subgroup-specific canonical effect of telomeres, notably in older individuals and females. In conclusion, we provide meta-analytic evidence on the beneficial effect of telomeres on brain structure as well as cognition and advocate for a beneficial subgroup-specific effect that warrants further attention. 相似文献
3.
4.
Margaret A Hamner Ashley McDonough Davin C Gong Levi J Todd German Rojas Sibylle Hodecker Christopher B Ransom Thomas A Reh Bruce R Ransom Jonathan RWeinstein 杜一星 《神经损伤与功能重建》2022,(2)
缺血预处理(ischemic preconditioning,IPC)是通过短暂、无害的缺血性暴露增强对随后发生的缺血障碍耐受性的现象。IPC的机制主要在灰质约占大脑85%的啮齿动物卒中模型中进行研究。人类脑白质占脑容量的50%,是卒中损伤的关键组成部分。我们使用小鼠视神经开发了一种新的中枢神经系统白质IPC模型,并确定了相关的免疫信号通路。我们验证了小胶质细胞对于白质IPC是必需的这一假说。首先用集落刺激因子1受体抑制剂PLX5622处理以耗尽小胶质细胞。视神经在体内暴露于短暂性缺血,72 h后急性分离,并进行氧-葡萄糖剥夺(OGD)以模拟缺血性损伤。通过记录复合动作电位(CAPs)和使用定量体视学的显微镜来评估轴突功能和结构的恢复。结果显示小胶质细胞耗竭消除了IPC介导的保护作用。在对照小鼠中,与非预处理视神经相比,预处理视神经的CAP恢复有所改善。然而在PLX5622处理的小鼠中,预处理和非预处理视神经之间的CAP恢复没有差异。小胶质细胞缺失还消除了IPC对OGD后轴突完整性和成熟(APC+)少突胶质细胞存活的保护作用。IPC介导的保护与视网膜损伤无关,表明它是由白质缺血暴露的固有的机械过程引起的。我们得出结论,预处理的小胶质细胞对白质中的IPC至关重要。"预处理的小胶质细胞"表型可能对其他中枢神经系统病变有保护作用,是值得探索的神经治疗领域。 相似文献
5.
目的评估颗粒物(particulate matter,PM)污染对呼吸系统疾病(respiratory disease,RD)住院人数的影响,估计降低PM水平可避免的经济损失,为评估空气污染治理的成本-效益提供依据。方法收集武汉市2015—2019年两家三甲医院RD住院患者资料、同期武汉市PM浓度和气象数据。采用广义相加模型(generalized additive model,GAM)估计PM对RD住院人数的影响,采用疾病成本法(cost of illness approach,COI)估算PM浓度降低带来的可避免经济损失。结果PM污染造成RD住院人数增加,PM2.5和PM10浓度每上升10μg/m3,分别导致RD住院人数上升1.71%和0.71%。其中男性和0~14岁人群受影响较大,PM2.5浓度每上升10μg/m3,男性和0~14岁住院人数分别上升1.97%和2.65%;PM10浓度每上升10μg/m3,男性和0~14岁住院人数分别上升0.87%和0.88%。2015—2019年PM污染造成武汉市6.33万人住院和12.14亿元经济损失。若PM浓度降低至同期世界卫生组织建议值,武汉市每年可避免1.94亿元经济损失和1.01万人住院。结论PM暴露可导致沉重的疾病负担和经济损失,采取有效的措施控制PM浓度,将带来较大的经济效益。 相似文献
6.
《Mayo Clinic proceedings. Mayo Clinic》2022,97(6):1114-1122
ObjectiveTo assess the frequency of silent brain infarcts (SBIs) and white matter disease (WMD) and associations with stroke risk factors (RFs) in a real-world population.Patients and MethodsThis was an observational study of patients 50 years or older in the Kaiser Permanente Southern California health system from January 1, 2009, through June 30, 2019, with head computed tomography or magnetic resonance imaging for nonstroke indications and no history of stroke, transient ischemic attack, or dementia. A natural language processing (NLP) algorithm was applied to the electronic health record to identify individuals with reported SBIs or WMD. Multivariable Poisson regression estimated risk ratios of demographic characteristics, RFs, and scan modality on the presence of SBIs or WMD.ResultsAmong 262,875 individuals, the NLP identified 13,154 (5.0%) with SBIs and 78,330 (29.8%) with WMD. Stroke RFs were highly prevalent. Advanced age was strongly associated with increased risk of SBIs (adjusted relative risks [aRRs], 1.90, 3.23, and 4.72 for those aged in their 60s, 70s, and ≥80s compared with those in their 50s) and increased risk of WMD (aRRs, 1.79, 3.02, and 4.53 for those aged in their 60s, 70s, and ≥80s compared with those in their 50s). Magnetic resonance imaging was associated with a reduced risk of SBIs (aRR, 0.87; 95% CI, 0.83 to 0.91) and an increased risk of WMD (aRR, 2.86; 95% CI, 2.83 to 2.90). Stroke RFs had modest associations with increased risk of SBIs or WMD.ConclusionAn NLP algorithm can identify a large cohort of patients with incidentally discovered SBIs and WMD. Advanced age is strongly associated with incidentally discovered SBIs and WMD. 相似文献
7.
Seulbi Lee Hyesook Park Soontae Kim Eun-Kyung Lee Jiyoung Lee Young Sun Hong Eunhee Ha 《International journal of hygiene and environmental health》2019,222(3):533-540
Background
It has been reported that particulate matter (PM) is associated with cardiovascular diseases (CVD) while metabolic syndrome is also an important risk factor for CVD. However, few studies have investigated the epidemiological association between PM and metabolic syndrome.Objective
To investigate the association between one-year exposure to PM with an aerodynamic diameter <2.5?μm (PM2.5) and the risk of metabolic syndrome in Korean adults without CVD.Methods
Exposure to PM2.5 was assessed using a Community Multiscale Air Quality (CMAQ) model. Metabolic syndrome was defined by National Cholesterol Education Program Adult Treatment Panel III. Andersen and Gill model with time-varying covariates, considering recurrent events, was used to investigate the association between one-year average PM2.5 and the risk of incident metabolic syndrome in 119,998 adults from the national health screening cohort provided by Korea National Health Insurance from 2009 to 2013.Results
Higher risk of metabolic syndrome, waist-based obesity, hypertension, hypertriglyceridemia, low HDL cholesterol, and hyperglycemia were significantly associated with a 10-μg/m3 increase in PM2.5 [adjusted hazard ratio (HR): 1.070, 1.510, 1.499, 1.468, 1.627 and 1.380, respectively]. In addition, the risk of metabolic syndrome associated with PM2.5 exposure was significant in the consistently obese group (obese at baseline and endpoint).Conclusion
Exposure to one-year average PM2.5 is associated with an increased risk of metabolic syndrome and its components in adults without CVD. These associations are particularly prominent in the consistently obese group (obese at baseline and endpoint). Our findings indicate that PM2.5 affects the onset of MS and its components which may lead to increase the risk of CVD. 相似文献8.
Chien-Hua Tseng Ben-Jei Tsuang Chun-Ju Chiang Kai-Chen Ku Jeng-Sen Tseng Tsung-Ying Yang Kuo-Hsuan Hsu Kun-Chieh Chen Sung-Liang Yu Wen-Chung Lee Tsang-Wu Liu Chang-Chuan Chan Gee-Chen Chang 《Journal of thoracic oncology》2019,14(5):784-792
Introduction
For never-smokers (smoked <100 lifetime cigarettes), lung cancer (LC) has emerged as an important issue. We aimed to investigate the effects of prevalence changes in tobacco smoking and particulate matter (PM) 2.5 (PM2.5) levels on LC in Taiwan, in relation to contrasting PM2.5 levels, between Northern Taiwan (NT) and Southern Taiwan (ST).Methods
We reviewed 371,084 patients with LC to assess smoking prevalence and correlations between the incidence of adenocarcinoma lung cancer (AdLC) and non-AdLC. Two subsets were selected to assess different AdLC stage trends and the effect of PM2.5 on survival of patients with AdLC.Results
From 1995 to 2015, the proportion of male adult ever-smokers decreased from 59.4% to 29.9% whereas the female smoking rate remained low (3.2% to 5.3%). AdLC incidence in males and females increased from 9.06 to 23.25 and 7.05 to 24.22 per 100,000 population, respectively. Since 1993, atmospheric visibility in NT improved (from 7.6 to 11.5 km), but deteriorated in ST (from 16.3 to 4.2 km). The annual percent change in AdLC stages IB to IV was 0.3% since 2009 (95% confidence interval [CI]: -1.9%–2.6%) in NT, and 4.6% since 2007 (95% CI: 3.3%–5.8%) in ST; 53% patients with LC had never smoked. Five-year survival rates for never-smokers, those with EGFR wild-type genes, and female patients with AdLC were 12.6% in NT and 4.5% in ST (hazard ratio: 0.79, 95% CI: 0.70–0.90).Conclusions
In Taiwan, greater than 50% of patients with LC had never smoked. PM2.5 level changes can affect AdLC incidence and patient survival. 相似文献9.
目的: 采用Tox21毒性检测数据库中通路数据对2017年石家庄市供暖期大气细颗粒物(PM2.5)中多环芳烃(PAHs)的检测数据进行分析计算,评估PM2.5引起毒性通路激活的风险。方法: 在石家庄市河北医科大学远离工业污染源设置1个采样点收集大气PM2.5,通过气相色谱-串联质谱法(GC-MS)检测美国环境保护署优先控制的16种PAHs的浓度。利用MPPD软件计算各PAHs单体在成人肺泡中的沉积量;检索Tox21毒性检测数据库中芳烃受体(AhR)、核因子E2相关因子(Nrf2)、p53和核因子κB(NF-κB)各通路的剂量反应关系数据,计算各PAHs单体激活各通路的单位强度;结合PAHs在肺泡的沉积量和PAHs激活通路的强度,评估PM2.5激活各个通路的风险。结果: 石家庄市供暖期PM2.5中PAHs检测结果显示,苯并[a]芘的日均浓度为9.13 ng/m3,日均浓度排名前3的苯并[b]荧蒽、荧蒽和芘的浓度分别为22.88、17.86及14.31 ng/m3。这16种PAHs以苯并[a]芘为参照的毒性当量浓度为17.74 ng/m3。毒性通路激活风险预测结果提示激活强度最大的是NF-κB通路,其次是AhR、Nrf2,p53被激活的可能性最弱,其中相对应的活性暴露比(AER)值分别为1.97、1.71、0.58和0.28。结论: 石家庄市大气细颗粒物中PAHs的暴露,可能通过激活NF-κB和AhR信号通路增加致癌风险。 相似文献
10.
Reports show that particulate matter (PM) is related to respiratory and cardiovascular diseases. We previously reported the biological effects of PM in vivo and the endocytosis of PM by primary neutrophils from mice. Cell lines can be used to elucidate the mechanism underlying immune responses in detail; however, information is limited regarding the functions of neutrophils after PM exposure. Here, we investigated the immune response of primary neutrophils and dimethyl sulfoxide (DMSO)- and all-trans retinoic acid (ATRA)-differentiated HL-60 (neutrophil-like) cells to PM. We showed that endocytosis by ATRA-HL cells was enhanced compared to that by DMSO-HL cells and that endocytosis in both cells was inhibited by dynamin inhibitors. A MEK inhibitor, but not p38 or JNK inhibitors, inhibited endocytosis. The MEK inhibitor also inhibited the differentiation of ATRA-HL cells to neutrophils. We identified that endocytosis of PM by neutrophils activated the MAPK ERK and p38 pathways. DMSO-HL and ATRA-HL cells both produced TNF-α and IL-8 after lipopolysaccharide (LPS) or PM treatment, whereas non-differentiated HL-60 cells did not. MCP-1 production was enhanced in DMSO-HL cells after LPS or PM treatment, whereas it was high in ATRA-HL cells. Reactive oxygen species (ROS) production was enhanced after PM treatment to DMSO-HL cells. Further, extracellular extracts promoted endocytosis. The MEK inhibitor also reduced the production of TNF-α, IL-8, and MCP-1. Taken together, ERK activation is key for both differentiation and endocytosis, and DMSO-HL cells at day 6 can serve as a model of inflammatory neutrophils, such as bronchus neutrophils, and a good tool to analyze the molecular events involved in immune responses to PM. 相似文献