全文获取类型
收费全文 | 4748篇 |
免费 | 459篇 |
国内免费 | 130篇 |
专业分类
耳鼻咽喉 | 47篇 |
儿科学 | 126篇 |
妇产科学 | 72篇 |
基础医学 | 680篇 |
口腔科学 | 135篇 |
临床医学 | 452篇 |
内科学 | 771篇 |
皮肤病学 | 97篇 |
神经病学 | 332篇 |
特种医学 | 156篇 |
外国民族医学 | 1篇 |
外科学 | 531篇 |
综合类 | 352篇 |
现状与发展 | 1篇 |
预防医学 | 361篇 |
眼科学 | 131篇 |
药学 | 432篇 |
1篇 | |
中国医学 | 85篇 |
肿瘤学 | 574篇 |
出版年
2023年 | 73篇 |
2022年 | 74篇 |
2021年 | 197篇 |
2020年 | 154篇 |
2019年 | 198篇 |
2018年 | 183篇 |
2017年 | 163篇 |
2016年 | 175篇 |
2015年 | 204篇 |
2014年 | 238篇 |
2013年 | 268篇 |
2012年 | 341篇 |
2011年 | 357篇 |
2010年 | 186篇 |
2009年 | 168篇 |
2008年 | 250篇 |
2007年 | 261篇 |
2006年 | 230篇 |
2005年 | 271篇 |
2004年 | 202篇 |
2003年 | 168篇 |
2002年 | 153篇 |
2001年 | 105篇 |
2000年 | 93篇 |
1999年 | 82篇 |
1998年 | 40篇 |
1997年 | 46篇 |
1996年 | 30篇 |
1995年 | 32篇 |
1994年 | 31篇 |
1993年 | 25篇 |
1992年 | 44篇 |
1991年 | 48篇 |
1990年 | 28篇 |
1989年 | 25篇 |
1988年 | 29篇 |
1987年 | 25篇 |
1986年 | 21篇 |
1985年 | 15篇 |
1984年 | 8篇 |
1982年 | 5篇 |
1981年 | 5篇 |
1979年 | 7篇 |
1976年 | 4篇 |
1974年 | 5篇 |
1972年 | 8篇 |
1970年 | 8篇 |
1969年 | 8篇 |
1966年 | 3篇 |
1939年 | 4篇 |
排序方式: 共有5337条查询结果,搜索用时 125 毫秒
1.
目的 基于网络药理学进行前列消汤治疗慢性前列腺炎的预测,同时采用临床试验进行验证,证明前列消汤对ⅢA型前列腺炎患者的临床疗效及对前列腺液(Expressed Prostatic Secretion, EPS)中白细胞介素17(interleukin 17, IL-17)及双头叉转录因子p3(Forkhead box p3, Foxp3)表达的影响。方法 采用网络信息学分析方法,筛选出前列消汤在ⅢA型前列腺炎治疗中发挥疗效的主要作用靶点,采用临床随机非盲法,将符合纳入标准的80例ⅢA型前列腺炎湿热下注证患者随机分为观察组和对照组各40例,观察组口服自拟前列消汤,对照组口服银花泌炎灵片。观察治疗前后两组的症状及证候评分情况、前列腺按摩液以及其IL17、Foxp3表达的差异。取40例正常男性前列腺液为正常对照。结果 网络药理学分析结果提示IL17信号通路为前列消汤治疗慢性前列腺炎的重要通路之一,临床试验结果提示经治疗后观察组有效率达89.19%,较对照组的73.68%为优(P < 0.05)。两组患者服药后的临床表现、前列腺按摩液WBC、症状及证候评分均存在明显改善。观察组和对照组IL-17水平较治疗前下降,Foxp3表达较治疗前升高(P < 0.05)。观察组对降低IL-17表达和提升Foxp3表达上较对照组差异更大(P < 0.05)。观察组治疗后与正常组IL-17和Foxp3水平比较差异较小(P > 0.05)。结论 网络药理学能一定程度上预测中药作用于疾病的相应靶点,前列消汤对ⅢA型前列腺炎湿热下注证患者的临床症状有明显改善作用,并能降低IL-17表达,对Foxp3表达有提升作用,在总有效率和对细胞因子的影响上较银花泌炎灵片组明显。 相似文献
2.
Norio Itokawa Masanori Atsukawa Akihito Tsubota Noritomo Shimada Hidenori Toyoda Koichi Takaguchi Atsushi Hiraoka Tomonori Senoh Mai Koeda Yuji Yoshida Tomomi Okubo Taeang Arai Korenobu Hayama Ai Nakagawa-Iwashita Chisa Kondo Katsuhiko Iwakiri 《Internal medicine (Tokyo, Japan)》2021,60(4):507
Objective Pegylated-interferon monotherapy is the standard treatment for patients with chronic hepatitis B; however, the factors associated with its therapeutic effects remain unclear. Methods Patients with chronic hepatitis B were treated with pegylated interferon α-2a for 48 weeks. We evaluated the kinetics of hepatitis B surface antigen (HBsAg) during treatment and follow-up periods and the factors associated with an HBsAg response (defined as a change in HBsAg of ≥-1 log IU/mL from baseline). Results The study population comprised 50 patients. The median baseline levels of hepatitis B virus DNA and HBsAg were 5.00 and 3.40 log IU/mL. The median values of HBsAg reduction from baseline were -0.44 (n=48), -0.41 (n=40), and -0.68 (n=11) log IU/mL at the end of treatment and at 48 and 144 weeks post-treatment, respectively. The rates of HBsAg response were 24.0% and 22.5% at the end of treatment and at 48 weeks post-treatment, respectively. A multivariate analysis identified HBsAg <3.00 log IU/mL as an independent baseline factor contributing to the HBsAg response at the end of treatment and 48 weeks post-treatment (p=1.07×10-2 and 4.42×10-2, respectively). There were significant differences in the reduction of the HBsAg levels at 12 weeks of treatment and in the incidence of serum ALT increase during treatment between patients with and without an HBsAg response. Conclusion These findings suggest that the baseline HBsAg level, HBsAg kinetics at 12 weeks of treatment, and ALT increase during treatment are important factors contributing to the HBsAg response in pegylated interferon α-2a monotherapy for patients with chronic hepatitis B. 相似文献
3.
Pauline A. J. Mendelaar Jaco Kraan Mai Van Leonie L. Zeune Leon W. M. M. Terstappen Esther Oomende Hoop John W. M. Martens Stefan Sleijfer 《Molecular oncology》2021,15(1):116
Circulating tumor cells (CTCs) in the blood of cancer patients are of high clinical relevance. Since detection and isolation of CTCs often rely on cell dimensions, knowledge of their size is key. We analyzed the median CTC size in a large cohort of breast (BC), prostate (PC), colorectal (CRC), and bladder (BLC) cancer patients. Images of patient‐derived CTCs acquired on cartridges of the FDA‐cleared CellSearch® method were retrospectively collected and automatically re‐analyzed using the accept software package. The median CTC diameter (μm) was computed per tumor type. The size differences between the different tumor types and references (tumor cell lines and leukocytes) were nonparametrically tested. A total of 1962 CellSearch® cartridges containing 71 612 CTCs were included. In BC, the median computed diameter (CD) of patient‐derived CTCs was 12.4 μm vs 18.4 μm for cultured cell line cells. For PC, CDs were 10.3 μm for CTCs vs 20.7 μm for cultured cell line cells. CDs for CTCs of CRC and BLC were 7.5 μm and 8.6 μm, respectively. Finally, leukocytes were 9.4 μm. CTC size differed statistically significantly between the four tumor types and between CTCs and the reference data. CTC size differences between tumor types are striking and CTCs are smaller than cell line tumor cells, whose size is often used as reference when developing CTC analysis methods. Based on our data, we suggest that the size of CTCs matters and should be kept in mind when designing and optimizing size‐based isolation methods.
Abbreviations
- ACCEPT
- Automated CTC Classification, Enumeration, and PhenoTyping software
- BC
- breast cancer
- BLC
- bladder cancer
- CD
- computed diameter
- CEL
- cultured tumor cell (cell line)
- CK
- cytokeratin
- CRC
- colorectal cancer
- CTC‐L
- circulating tumor cells derived from cerebrospinal fluid (liquor)
- CTCs
- circulating tumor cells
- DAPI
- 4′6‐diamidino‐2‐phenylindole
- EMT
- epithelial–mesenchymal transition
- EpCAM
- epithelial cell adhesion molecule
- IQR
- interquartile range
- KW test
- Kruskal–Wallis test
- MWU test
- Mann–Whitney U test
- NCR
- nucleus/cytoplasm ratio
- P2A
- perimeter to area
- PC
- prostate cancer
- TIF
- tagged Image Format files
- TXT
- text file
- μm
- micrometer
- µm2
- square micrometers
4.
目的比较腹腔镜保留自主神经D3根治术与开腹术治疗中低位直肠癌的安全性及生存质量差异。
方法回顾性分析2015年6月至2017年8月间84例低位直肠癌患者资料,根据手术方式不同分为腹腔镜组(n=46)和开腹组(n=38),应用SPSS21.0软件完成数据分析。手术相关指标采用(
±s)表示,独立样本t检验;并发症发生率、复发率及生存率等指标采用χ2检验;P<0.05为差异有统计学意义。
结果腹腔镜组患者的手术时间长于开腹组(P<0.05),而术中出血量、住院时间、尿管保留时间、肛门排气时间均短于开腹组(均P<0.05)。腹腔镜组术后并发症总发生率为6.5%低于开腹组的26.3%(χ2=4.6517,P<0.05)。两组患者1年局部复发率及生存率差异均无统计学意义(均P>0.05)。腹腔镜组患者术后10 d排尿功能、术后2个月勃起功能、术后2个月射精功能均优于开腹组(均P<0.05)。
结论腹腔镜保留自主神经D3根治术治疗中低位直肠癌安全性较高,复发率及生存率与开腹术相当,并能显著提高患者的生存质量,值得推广应用。 相似文献
5.
Objective: This was a retrospective study designed to examine the relationship between inpatient neuropsychological status and future utilization costs. Methods: We completed a retrospective chart review of 280 patients admitted to a large academic medical center who were referred for bedside neuropsychological evaluation. Patients were grouped based on neuropsychological recommendation regarding level of supportive needs post-discharge (low, moderate, high). Level of support was used as a gross surrogate indicator of cognitive status in this heterogeneous sample. We also included patients who refused assessment. Outcome variables included time to readmission, number of emergency department visits, inpatient admissions, length of hospitalization, and total costs of hospitalizations, 30 days and 1 year following discharge. Results: Multivariate analysis indicated patients who refused assessment had higher inpatient service utilization (number of ED visits, number of admissions, and total cost of hospitalization) compared to those with moderate needs. Also, high needs patients had higher total cost of hospitalization at 1 year, and those with low needs used the ED more, compared to those with moderate needs. Conclusions: Our findings replicate prior studies linking refusal of neuropsychological evaluation to higher service utilization costs, and suggest a nonlinear relationship between cognitive impairment severity and future costs for medical inpatients (different groups incur different types of costs). Results preliminarily highlight the potential utility of inpatient neuropsychological assessment in identifying patients at risk for greater hospital utilization, which may allow for the development of appropriate interventions for these patients. 相似文献
6.
Sergey Motov Stefan Mann Jefferson Drapkin Mahlaqa Butt Antonios Likourezos Elizabeth Yetter Jason Brady Nechama Rothberger Ankit Gohel Peter Flom Mo Mai Christian Fromm John Marshall 《The American journal of emergency medicine》2019,37(2):220-227
Study objective
We compare the analgesic efficacy and safety of subdissociative intravenous-dose ketamine (SDK) versus morphine in geriatric Emergency Department (ED) patients.Methods
This was a prospective, randomized, double-blind trial evaluating ED patients aged 65 and older experiencing moderate to severe acute abdominal, flank, musculoskeletal, or malignant pain. Patients were randomized to receive SDK at 0.3?mg/kg or morphine at 0.1?mg/kg by short intravenous infusion over 15?min. Evaluations occurred at 15, 30, 60, 90, and 120?min. Primary outcome was reduction in pain at 30?min. Secondary outcomes included overall rates of adverse effects and incidence of rescue analgesia.Results
Thirty patients per group were enrolled in the study. The primary change in mean pain scores was not significantly different in the ketamine and morphine groups: 9.0 versus 8.4 at baseline (mean difference 0.6; 95% CI ?0.30 to 1.43) and 4.2 versus 4.4 at 30?min (mean difference ?0.2; 95% CI ?1.93 to1.46). Patients in the SDK group reported higher rates of psychoperceptual adverse effects at 15, 30, and 60?min post drug administration. Two patients in the ketamine group and one in the morphine group experienced brief desaturation episodes. There were no statistically significant differences with respect to changes in vital signs and need for rescue medication.Conclusion
SDK administered at 0.3?mg/kg over 15?min provides analgesic efficacy comparable to morphine for short-term treatment of acute pain in the geriatric ED patients but results in higher rates of psychoperceptual adverse effects.ClinicalTrials.gov Registration #: NCT02673372. 相似文献7.
Agricultural biomass residues are emerged from harvesting and processing of agricultural crops. When the crop production increases, a large amount of biomass residues is produced and remained after cutting of peel, bunch, straw and stalk of crops. In this work, agricultural biomass residues (cassava rhizome, durian peel, pineapple peel and corncob) were selected as feedstock for carbon-rich biochar (CRB) production using a facile pyrolysis method. Proximate analysis and thermogravimetric analysis (TGA) were used to characterize biomass feedstock. The results showed that the percentage of fixed carbon in biomass feedstock ranged between 11.91% and 17.51%. Characteristic differences of the CRB were investigated using scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), Fourier transform infrared spectroscopy (FTIR) and Raman spectroscopy. The carbon content in the CRB was found to significantly depend on biomass origin. Interestingly, cassava rhizome, which has a higher percentage of fixed carbon, is a superior precursor for CRB production. The study of different pyrolysis temperature indicated that the carbon content of cassava rhizome derived CRB is increased with pyrolysis temperature. The tensile properties of composite between poly(lactic acid) PLA and different types of biomass-derived CRB were investigated. PLA composite incorporated with a higher carbon content-CRB tended to exhibit improved mechanical properties. Specifically, the elastic modulus and impact energy of PLA/CRB composite specimens increased remarkably with the incorporation of CRB powder. The current research indicates that CRB prepared from agricultural biomass residues could be a sustainable material for utilization in PLA biocomposites. 相似文献
8.
Mai Do Paul Hutchinson Elizabeth Omoluabi Akanni Akinyemi Babatunde Akano 《Journal of health communication》2020,25(2):115-125
Evidence suggests that despite high knowledge of family planning (FP), unwanted pregnancies and birth rates remain high among young Nigerians. There is a critical gap in understanding the nexus between exposure to FP information and contraception practices among this population. This study aimed to fill this gap and tested a pathway of the impact of media exposure to FP messages on modern contraceptive use. Data came from a 2018 cross-sectional baseline survey of young people aged 15–24 in three urban centers in Nigeria – Lagos, Kaduna, and Kano. This was part of an impact evaluation of a television-based drama designed to improve contraceptive use among young individuals. The study was limited to 777 young men and women who were sexually active. We found evidence of the mediation effect of media exposure to FP messages on partner discussion about FP, which in turn was associated with an increased likelihood of modern contraceptive use. Contraceptive self-efficacy also had positive associations with contraception. Our study elucidated a potential pathway through which media communication programs can significantly contribute to increased modern contraceptive use and underlined the importance of providing young people in Nigeria with opportunities to learn and practice obtaining and using contraception. 相似文献
9.
目的:对氯氮平片在帕金森病(Parkinson’s disease,PD)合并精神障碍辅助治疗中的应用价值予以探讨。方法:选取50例我院2013年1月1日—2019年6月30日接诊的PD合并精神障碍患者进行研究,按照随机数表法分为对照组和观察组。对照组用多巴丝肼,观察组联合氯氮平片,对比治疗效果。结果:观察组疾病治疗总有效率96.00%(24/25)高于对照组68.00%(17/25),差异有统计学意义(P<0.05),不良反应发生率8.00%(2/25)与对照组20.00%(5/25)差异无统计学意义(P>0.05);观察组UPDRD评分、VGI-S评分和BPRS评分明显低于对照组,差异有统计学意义(P<0.05)。结论:氯氮平片辅助治疗PD合并精神障碍患者,既可提高临床疗效,也不会增加用药后不良反应,安全性高,值得推广。 相似文献
10.
Eriko Yanagida Hiroaki Miyoshi Mai Takeuchi Noriaki Yoshida Kazutaka Nakashima Kyohei Yamada Takeshi Umeno Yasumasa Shimasaki Takuya Furuta Masao Seto Koichi Ohshima 《Hematological oncology》2020,38(5):680-688
The interaction of CD47 and signal-regulatory protein alpha (SIRPα) induces “don't eat me signal”, leading suppression of phagocytosis. This signal can affect the clinical course of malignant disease. Although CD47 and SIRPα expression are associated with clinicopathological features in several neoplasms, the investigation for adult T-cell leukemia/lymphoma (ATLL) has not been well-documented. This study aimed to declare the association between CD47 and SIRPα expression and clinicopathological features in ATLL. We performed immunostaining on 73 biopsy samples and found that CD47 is primarily expressed in tumor cells, while SIRPα is expressed in non-neoplastic stromal cells. CD47 positive cases showed significantly higher FoxP3 (P = .0232) and lower CCR4 (P = .0214). SIRPα positive cases presented significantly better overall survival than SIRPα negative cases (P = .0132). SIRPα positive cases showed significantly HLA class I (P = .0062), HLA class II (P = .0133), microenvironment PD-L1 (miPD-L1) (P = .0032), and FoxP3 (P = .0229) positivity. In univariate analysis, SIRPα expression was significantly related to prognosis (Hazard ratio [HR] 0.470; 95% confidence interval [CI] 0.253-0.870; P = .0167], although multivariate analysis did not show SIPRα as an independent prognostic factor. The expression of SIRPα on stromal cells reflects activated immune surveillance mechanism in tumor microenvironment and induce good prognosis in ATLL. More detailed studies for gene expression or genomic abnormalities will disclose clinical and biological significance of the CD47 and SIRPα in ATLL. 相似文献