全文获取类型
收费全文 | 34554篇 |
免费 | 2720篇 |
国内免费 | 420篇 |
专业分类
耳鼻咽喉 | 363篇 |
儿科学 | 1015篇 |
妇产科学 | 616篇 |
基础医学 | 4978篇 |
口腔科学 | 519篇 |
临床医学 | 3260篇 |
内科学 | 7403篇 |
皮肤病学 | 763篇 |
神经病学 | 2596篇 |
特种医学 | 1297篇 |
外国民族医学 | 16篇 |
外科学 | 4286篇 |
综合类 | 1285篇 |
现状与发展 | 1篇 |
一般理论 | 2篇 |
预防医学 | 2710篇 |
眼科学 | 706篇 |
药学 | 2596篇 |
6篇 | |
中国医学 | 622篇 |
肿瘤学 | 2654篇 |
出版年
2023年 | 272篇 |
2022年 | 668篇 |
2021年 | 1101篇 |
2020年 | 681篇 |
2019年 | 859篇 |
2018年 | 1056篇 |
2017年 | 762篇 |
2016年 | 760篇 |
2015年 | 926篇 |
2014年 | 1188篇 |
2013年 | 1541篇 |
2012年 | 2210篇 |
2011年 | 2214篇 |
2010年 | 1365篇 |
2009年 | 1137篇 |
2008年 | 1636篇 |
2007年 | 1666篇 |
2006年 | 1599篇 |
2005年 | 1503篇 |
2004年 | 1337篇 |
2003年 | 1273篇 |
2002年 | 1203篇 |
2001年 | 1115篇 |
2000年 | 1101篇 |
1999年 | 978篇 |
1998年 | 349篇 |
1997年 | 300篇 |
1996年 | 265篇 |
1995年 | 211篇 |
1994年 | 208篇 |
1993年 | 175篇 |
1992年 | 518篇 |
1991年 | 499篇 |
1990年 | 475篇 |
1989年 | 432篇 |
1988年 | 452篇 |
1987年 | 381篇 |
1986年 | 372篇 |
1985年 | 365篇 |
1984年 | 255篇 |
1983年 | 187篇 |
1982年 | 119篇 |
1981年 | 103篇 |
1979年 | 210篇 |
1978年 | 111篇 |
1977年 | 124篇 |
1976年 | 113篇 |
1974年 | 130篇 |
1972年 | 128篇 |
1969年 | 104篇 |
排序方式: 共有10000条查询结果,搜索用时 33 毫秒
911.
目的系统评价同伴教育对2型糖尿病患者血糖控制的干预效果。方法通过检索PubMed、Embase、中国期刊全文数据库(CNKI)、万方数据库等资源,收集同伴教育对2型糖尿病患者血糖控制干预的随机对照试验,并进行文献质量评价和数据提取。对于糖化血红蛋白(HbA1c)的结局指标采用多时间点Meta分析,而对于餐前和餐后血糖则采用终末时间点Meta分析。结果最终纳入9篇文献,文献质量B级6篇,A级3篇。Meta分析结果显示,中等时间长度(13~26周)的同伴教育干预后,HbA1c低于对照组,差异有统计学意义(P0.05),长期同伴教育(26周以上)对HbA1c改善的作用尚未被证实;中等时间长度(13~26周)同伴教育干预后,餐前和餐后血糖低于对照组,差异有统计学意义(均P0.01)。结论同伴教育可以有效控制餐前和餐后血糖,中等时间长度(13~26周)的同伴教育项目对于HbA1c的改善有一定作用。 相似文献
912.
913.
Yu-Te Hsu Mt Hartstein Alexander J. Davies Alexander J. Hickey Mun K. Chan Juan Porras Toshinao Loew Sofia V. Taylor Hsu Liu Alexander G. Eaton Matthieu Le Tacon Huakun Zuo Jinhua Wang Zengwei Zhu Gilbert G. Lonzarich Bernhard Keimer Neil Harrison Suchitra E. Sebastian 《Proceedings of the National Academy of Sciences of the United States of America》2021,118(7)
914.
Muhammad Ahsan Javed Georg Beyer Nha Le Alessio Vinci Helen Wong Daniel Palmer Robert D. Morgan Angela Lamarca Richard A. Hubner Juan W. Valle Salma Alam Sumsur Chowdhury Yuk Ting Ma Livia Archibugi Gabriele Capurso Patrick Maisonneuve Albrecht Neesse Malin Sund Sebastian Krug 《Pancreatology》2019,19(1):97-104
Background
Pancreatic ductal adenocarcinoma (PDAC) is associated with poor prognosis. Gemcitabine is the standard chemotherapy for patients with metastatic pancreatic adenocarcinoma (MPA). Randomized clinical trials evaluating intensified chemotherapies including FOLFIRINOX and nab-paclitaxel plus gemcitabine (NAB+GEM) have shown improvement in survival. Here, we have evaluated the efficacy of intensified chemotherapy versus gemcitabine monotherapy in real-life settings across Europe.Methods
A retrospective multi-center study including 1056 MPA patients, between 2012 and 2015, from nine centers in UK, Germany, Italy, Hungary and the Swedish registry was performed. Follow-up was at least 12 months. Cox proportional Harzards regression was used for uni- and multivariable evaluation of prognostic factors.Results
Of 1056 MPA patients, 1030 (98.7%) were assessable for survival analysis. Gemcitabine monotherapy was the most commonly used regimen (41.3%), compared to FOLFIRINOX (n = 204, 19.3%), NAB+GEM (n = 81, 7.7%) and other gemcitabine- or 5-FU-based regimens (n = 335, 31.7%). The median overall survival (OS) was: FOLFIRINOX 9.9 months (95%CI 8.4–12.6), NAB+GEM 7.9 months (95%CI 6.2–10.0), other combinations 8.5 months (95%CI 7.7–9.3) and gemcitabine monotherapy 4.9 months (95%CI 4.4–5.6). Compared to gemcitabine monotherapy, any combination of chemotherapeutics improved the survival with no significant difference between the intensified regimens. Multivariable analysis showed an association between treatment center, male gender, inoperability at diagnosis and performance status (ECOG 1–3) with poor prognosis.Conclusion
Gemcitabine monotherapy was predominantly used in 2012–2015. Intensified chemotherapy improved OS in comparison to gemcitabine monotherapy. In real-life settings, the OS rates of different treatment approaches are lower than shown in randomized phase III trials. 相似文献915.
In recent years we have had the occasion to observe hyperthyroidism in 6 patients with Hodgkin's disease. All patients had received Mantlefield irradiation and were disease-free when hyperthyroidism appeared. Hyperthyroidism allows three different pictures to be distinguished: 1 case report of Graves' disease without ophthalmopathy, 1 case report of Hashimoto's thyroiditis corresponding to a particular form called hashitoxicosis, and 4 case reports of atypical silent thyroiditis. Reports concerning case studies of postirradiation Graves' disease or Hashimoto's thyroiditis during Hodgkin's disease are only to be found exceptionally. Atypical silent thyroiditis was recently individualized, but no postirradiation case studies have been reported. It is suggested that these 6 cases represent a radiation-induced immune thyroid disease: physiopathology and predisposing factors are discussed. 相似文献
916.
Physical proximity and functional interplay of PECAM-1 with the Fc receptor Fc gamma RIIa on the platelet plasma membrane 下载免费PDF全文
We and others have recently defined that Platelet Endothelial Cell Adhesion Molecule-1 (PECAM-1/CD31) functions as a negative regulator of platelet-collagen interactions involving the glycoprotein VI/Fc receptor gamma chain (GPVI/FcR-gamma chain) signaling pathway.1,2 In this study, we hypothesized that PECAM-1 may be physically and functionally associated with Fc gamma RIIa on the platelet membrane. The functional relationship between PECAM-1 and Fc gamma RIIa was assessed by determining the effect of anti-PECAM-1 monoclonal antibody Fab fragments on Fc gamma RIIa-mediated platelet aggregation and heparin-induced thrombocytopenia (HITS)-mediated platelet aggregation. Preincubation of washed platelets with monoclonal antibody fragments of 2BD4 directed against PECAM-1 and IV.3 directed against Fc gamma RIIa completely blocked Fc gamma RIIa-mediated platelet aggregation and HITS-mediated platelet aggregation, whereas anti-CD151 antibody had no blocking effect. Coengagement of Fc gamma RIIa and PECAM-1 resulted in negative regulation of Fc gamma RIIa-mediated phospholipase C gamma 2 activation, calcium mobilization, and phosphoinositide 3-kinase-dependent signaling pathways. In addition, the physical proximity of Fc gamma RIIa and PECAM-1 was confirmed by using fluorescence resonance energy transfer and coimmunoprecipitation studies. These results indicate that PECAM-1 and Fc gamma RIIa are colocalized on the platelet membrane and PECAM-1 down-regulates Fc gamma RIIa-mediated platelet responses. 相似文献
917.
Martino R Caballero MD de la Serna J Díez-Martín JL Urbano-Ispízua A Tomás JF Odriozola J León A Canals C San Miguel J Sierra J 《Bone marrow transplantation》2002,30(2):63-68
Standard allogeneic stem cell transplantation (SCT) has been associated with a high transplant-related mortality (TRM) in patients who have failed a prior autologous SCT (ASCT). Reduced-intensity conditioning (RIC) regimens may reduce the toxicities and TRM of traditional myeloablative transplants. We report 46 adults who received a RIC peripheral blood SCT from an HLA-identical sibling in two multicenter prospective studies. The median interval between ASCT and allograft was 16 months, and the patients were allografted due to disease progression (n = 43) and/or secondary myelodysplasia (n = 4). Conditioning regimens consisted of fludarabine plus melphalan (n = 41) or busulphan (n = 5). The 100-day incidence of grade II-IV acute graft-versus-host disease (GVHD) was 42% (24% grade III-IV), and 10/30 evaluable patients developed chronic extensive GVHD. Early complete donor chimerism in bone marrow and peripheral blood was observed in 35/42 (83%) patients, and 16 evaluable patients had complete chimerism 1 year post transplant. With a median follow-up of 358 days (450 in 29 survivors), the 1-year incidence of TRM was 24%, and the 1-year overall (OS) and progression-free survival were 63% and 57%, respectively. Patients who had chemorefractory/ progressive disease, a low performance status or received GVHD prophylaxis with cyclosporine A alone (n = 32) had a 1-year TRM of 35% and an OS of 46%, while patients who had none of these characteristics (n = 32) had a 1-year TRM of 35% and an OS of 46% while patients who had none of these characteristics (n = 14) had a TRM of 0% and an OS of 100%. Our results suggest that adult patients who fail a prior ASCT can be salvaged with a RIC allogeneic PBSCT with a low risk of TRM, although patient selection has a profound influence on early outcome. 相似文献
918.
Grabar S Le Moing V Goujard C Leport C Kazatchkine MD Costagliola D Weiss L 《Annals of internal medicine》2000,133(6):401-410
BACKGROUND: The prognostic value of discordant immunologic (CD4 cell increase) and virologic (plasma HIV RNA level decrease) responses to antiretroviral treatment is not known. OBJECTIVE: To study the relation between clinical outcome of HIV-infected patients receiving highly active antiretroviral therapy (HAART) and early immunologic and virologic responses to such therapy. DESIGN: Prospective cohort study. SETTING: 68 hospitals in France. PATIENTS: 2236 protease inhibitor-naive patients. INTERVENTION: Initiation of HAART with one protease inhibitor and two nucleoside analogues between July 1996 and March 1997. MEASUREMENTS: Immunologic and virologic response at 6 months. Multivariate Cox models were used to assess the relation between these responses and progression to a new AIDS-defining event or death. RESULTS: On the basis of 6-month immunologic and virologic responses, patients were classified into four groups: complete response (47.5%), complete nonresponse (16.2%), immunologic response only (19.0%), and virologic response only (17.3%). After month 6 and within a median of 18 months, 69 patients died and 123 experienced a new AIDS-defining event. After adjustment, complete nonresponders and those with only a virologic response had significantly higher risks for clinical progression at 6 months (relative risk, 3.38 [95% CI, 2.28 to 5.02] and 1.98 [CI, 1.26 to 3.10], respectively) than complete responders. The difference between complete responders and those with only an immunologic response at 6 months was weaker and nonsignificant (relative risk, 1.55 [CI, 0.96 to 2.50]). CONCLUSIONS: Immunologic response after 6 months of HAART indicates a favorable clinical outcome in HIV-infected patients regardless of virologic response. This suggests that both immunologic and virologic markers should be used in clinical practice to evaluate treatment response. 相似文献
919.
Sujata Tewari Marcel Diano Rimal Bera Quoc Nguyen Hemalatha Parekh 《Alcoholism, clinical and experimental research》1992,16(3):436-442
The long-term effects of prenatal ethanol exposure on the properties of brain polysomes and the proliferative responses of lymphocytes to mitogenic stimulation in adult offspring were assessed. Female Sprague-Dawley rats either ingested the control or 6.6% ethanol-containing Lieber-DeCarli liquid diet during the 3rd trimester of pregnancy. Controls were age-matched and pair-fed. At 42 to 72 days of age, ethanol effects were evaluated on the (1) polysomal properties in the cerebral hemispheres, cerebellum, and hippocampal regions of the brain after translation in a messenger RNA (mRNA)-dependent rabbit reticulocyte lysate system and (2) immunologic functions of lymphocytes cultured from spleen cells by measuring their responses to mitogenic stimulation. Results showed long-term adverse effects of in utero ethanol exposure on the polysomal RNA translation in each of the three brain regions tested with free polysomal mRNAs affected more than the bound polysomal mRNAs. Of these, the hippocampal region appeared to sustain the most injurious effects. In addition, a suppression of the mitogen-induced lymphocyte proliferative responses were present under these conditions. The degree of suppression varied with the specific mitogen used. Data suggest that the ethanol effects on the CNS and lymphocyte proliferation are most possibly irreversible, and in the case of the CNS, a post-translational modification by ethanol is indicated. The reduced lymphocyte responses are suggestive of a possible interference by ethanol of the synthesis of interleukin-2 (IL-2) and/or a reduced binding of IL-2 with its receptor (IL-2 receptors). 相似文献
920.
Nsimba B Malonga DA Mouata AM Louya F Kiori J Malanda M Yocka D Oko-Ossho J Ebata-Mongo S Le Bras J 《The American journal of tropical medicine and hygiene》2004,70(2):133-138
Congo is facing frequent failures of treatment of Plasmodium falciparum malaria with chloroquine (CQ), which is still recommended and used as a first-line drug. In Pointe-Noire and Brazzaville, the two largest cities that contain approximately 60% of the population of Congo, we compared the efficacy of CQ versus sulfadoxine/pyrimethamine (SP) for treatment of uncomplicated malaria in children 6-59 months old (mean = 33 months) using the standard World Health Organization (WHO) 14-day in vivo test in two phases between 1999 and 2002. Patients enrolled were randomly assigned to receive SP (25 mg/kg of sulfadoxine and 1.25 mg/kg of pyrimethamine) or CQ (25 mg/kg). In the first phase of the study, 46 patients were assigned to the CQ (n = 23) or SP (n = 23) groups in Pointe-Noire and 52 children were assigned to the CQ (n = 26) or to SP (n = 26) groups in Brazzaville. Results were interpreted according to the WHO lot quality assurance sampling method, and treatment failure rates for SP versus CQ were < 25% versus > 25% in both cities. In the second phase of the study, we accurately determined the actual proportion of treatment failures for SP in Brazzaville. Thus, in 75 of the 80 children enrolled and followed-up until day 14, no clinical or parasitologic failure was recorded and no serious adverse reaction was observed. Since the CQ treatment failure rate exceeds the unacceptable upper limit, SP seems well to be an appropriate alternative for the first-line treatment of uncomplicated P. falciparum malaria, at least in the settings of the present study. 相似文献