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Ahmed Hafez Afifi Tarek Abdel Samie Abdel Maksoud Khaled Ibrahim EL-noueam Mohamed A. Ataa Dina Mohamad Abdallah 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(2):493-507
Objectives
To evaluate role of multiparametric-MRI as comprehensive technique for determining local staging of UB cancer and predicting histological grading of lymphadenopathy.Materials and methods
Fifty patients diagnosed as cancer bladder prospectively included and mp-MRI data were interpreted. Multiparametric techniques included added role of high resolution T2 weighted images (HR T2WI), diffusion weighted MRI (DW-MRI) and dynamic contrast enhanced MRI (DCE-MRI). Accuracy of these techniques separately and in conjunction were evaluated using histopathological findings as reference gold standard. Diagnosis of bladder cancer was performed either clinically, through urine cytology or using other radiologic investigations including ultrasonography or computed tomography.Results
Histopathological confirmation for local T staging done in 40 patients (80%) using cystoscopy/biopsy or from transurethral resection of bladder tumors (TURT) and in 10 patients (20%) from radical cystectomy. Metastatic lymphadenopathy was histopatholgically proved after radical cystectomy in 5 patients (10%), of them 3 were stage N1 and 2 were stage N2. Diagnostic accuracy of mp-MRI (88%) was superior to DW-MRI (82%), DCE-MRI (74%) and high resolution T2W-MRI (52%) in differentiating non-muscle invasive from muscle invasive and in differentiating organ-confined from non organ-confined tumors respectively. The agreement between the mp-MRI and histopathological staging were greater than DW-MRI (κ = 0.679), DCE-MRI (κ = 0.566) and high resolution T2W-MRI (κ = 0.274). Over staging decreased from (48%) using high resolution T2W or (26%) using DCE-MRI, or (18%) using DW to (12%) using multiparametric-MRI. Low ADC values and time-intensity curve were compared with histological grades and showed significant correlation. Size criteria of the lymph nodes, their restriction and low ADC values in DW-MRI suggest their metastatic nature.Conclusion
Mp-MRI is comprehensive & effective tool for determining local T stages, and the histological grades of urinary bladder cancers. Also, it predicts nature & stages of local lymph nodes, exhibiting high diagnostic performance with excellent objectivity. 相似文献3.
Mohammed Ali Kazem 《The surgeon》2017,15(2):93-97
Background
Predictive tools in cancer management are used to predict different outcomes including survival probability or risk of recurrence. The uptake of these tools by clinicians involved in cancer management has not been as common as other clinical tools, which may be due to the complexity of some of these tools or a lack of understanding of how they can aid decision-making in particular clinical situations.Aims
The aim of this article is to improve clinicians' knowledge and understanding of predictive tools used in cancer management, including how they are built, how they can be applied to medical practice, and what their limitations may be.Methods
Literature review was conducted to investigate the role of predictive tools in cancer management.Results
All predictive models share similar characteristics, but depending on the type of the tool its ability to predict an outcome will differ. Each type has its own pros and cons, and its generalisability will depend on the cohort used to build the tool. These factors will affect the clinician's decision whether to apply the model to their cohort or not.Conclusions
Before a model is used in clinical practice, it is important to appreciate how the model is constructed, what its use may add over and above traditional decision-making tools, and what problems or limitations may be associated with it. Understanding all the above is an important step for any clinician who wants to decide whether or not use predictive tools in their practice. 相似文献4.
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肥大细胞普遍存在于含有血管的组织中,它通常因在过敏性疾病和IgE相关的过敏反应中发挥的重要作用而为人们所知,然而大量的研究表明,肥大细胞还参与了许多其他疾病的发生发展,例如在肿瘤生物学中肥大细胞就扮演着具有特殊意义的角色.在促进肿瘤生长方面,肥大细胞对肿瘤的血管生成、组织重塑等方面具有正面的影响,而在抑制肿瘤生长方面,肥大细胞则通过对肿瘤的免疫应答而产生负面的效应,因此肥大细胞的作用仍旧备受争议.因而研究肥大细胞对肿瘤生长的促进与抑制等几个方面的机制具有重要意义. 相似文献
6.
目的 探讨恶性肿瘤晚期多发骨转移患者采用唑来膦酸联合89 Sr治疗的临床疗效.方法 将90例恶性肿瘤晚期多发骨转移患者,按照随机抛硬币法将其分组为对照组(唑来膦酸静脉滴注)与观察组(唑来膦酸静脉滴注联合89 Sr静脉注射),各45例.采用疼痛视觉模拟法(VAS)评价两组患者治疗前、后疼痛情况,通过问卷调查表调查两组患者治疗前、后生活质量改善情况,统计两组临床疗效及不良反应.结果 治疗后,两组患者VAS评分及生活质量各项指标均较治疗前明显改善,而观察组各项指标改善程度优于对照组,P<0.05.观察组治疗临床有效率为84.4%,明显高于对照组(66.7%),P<0.05;两组患者不良反应率比较,P>0.05.结论 唑来膦酸联合89 Sr治疗恶性肿瘤晚期多发骨转移可缓解患者疼痛,提高临床治疗效果,改善其生活质量,同时不会增加治疗期间所产生的不良反应,因此值得深入研究以利于其推广应用. 相似文献
7.
Vânia Diogo Joana Teixeira Patrícia M.A. Silva Hassan Bousbaa 《Clinical colorectal cancer》2017,16(1):1-8
Colorectal cancer (CRC), one of the most common malignancies worldwide, is often diagnosed at an advanced stage, and resistance to chemotherapeutic and existing targeted therapy is a major obstacle to its successful treatment. New targets that offer alternative clinical options are therefore urgently needed. Recently, perturbation of the spindle assembly checkpoint (SAC), the surveillance mechanism that maintains anaphase inhibition until all chromosomes reach the metaphase plate, has been regarded as a promising target to fight cancer cells, either alone or in combination regimens. Consistent with this strategy, many cancers, including CRC, exhibit altered expression of SAC genes. In this article, we review our current knowledge on SAC activity status in CRC, and on current anti-CRC strategies and future therapeutic perspectives on the basis of SAC targeting experiments in vitro and in animal models. 相似文献
8.
Leonardo S. Lino-Silva Reynaldo Loaeza-Belmont Miguel A. Gómez Álvarez Itzel Vela-Sarmiento José M. Aguilar-Romero Jorge A. Domínguez-Rodríguez Rosa A. Salcedo-Hernández Erika B. Ruiz-García Héctor A. Maldonado-Martínez Ángel Herrera-Gómez 《Clinical colorectal cancer》2017,16(1):73-77
Background
Most cases of rectal cancer (RC) in our institution are in pathologic stage T3. They are a heterogeneous group but have been classified in a single-stage category. We performed the present study to validate the prognostic significance of the mesorectal extension depth (MED) in T3 RC measured in millimeters beyond the muscularis propria plane.Materials and Methods
We performed a retrospective analysis of 104 patients with T3 RC who had undergone curative surgery after a course of preoperative chemoradiotherapy at a tertiary referral cancer hospital. The patients were grouped by MED (T3a, < 1 mm; T3b, 1-5 mm; T3c > 5-10 mm; and T3d > 10 mm). The clinicopathologic data and disease-free survival were analyzed.Results
The 5-year disease-free survival rate according to the T3 subclassification was 87.5% for those with T3a, 57.9% for T3b, 38.7% for T3c, and 40.3% for those with T3d tumors (P = .050). On univariate and multivariate analysis, the prognostic factors affecting survival were overall recurrence (hazard ratio [HR], 3.670; 95% confidence interval [CI], 1.710-7.837; P = .001), histologic grade (HR, 2.204; 95% CI, 1.156-4.199; P = .016), mesorectal invasion depth (HR, 1.885; 95% CI, 1.164-3.052; P = .010), and lymph node metastasis (HR, 1.211; 95% CI, 1.015-1.444; P = .033).Conclusion
MED is a significant prognostic factor in patients with T3 RC who have undergone neoadjuvant chemoradiotherapy, especially when the MED is > 5 mm. The MED could be as important as other clinicopathologic factors in predicting disease-specific survival. 相似文献9.
10.
细胞角蛋白(Krt)作为一种中间丝,存在于所有的上皮细胞及部分非上皮细胞.主要作用是维持上皮细胞的机械稳定性和完整性.近年来细胞角蛋白的研究集中在肿瘤的诊断方面,即利用细胞角蛋白在上皮细胞表达的特异性,通过免疫组化技术,运用单克隆抗体进行比对分析,来确定肿瘤的分类、分型或者来源.其中Krt7是一个代表.探讨Krt7的作用,在上皮肿瘤中的分布,以及与细胞角蛋白20(Krt20)在上皮肿瘤中的联合表达情况,对肿瘤的诊断、转移性与原发肿瘤的鉴别等有重要意义.除此之外,Krt7还是一个炎性指标,发挥信号转导中的作用,参与炎症的发生发展,其表达也有利于对某些疾病早期及预后进行监测. 相似文献