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111.
Vik Khullar Subspecialty Trainee Rocco Damiano Research Registrar Phil Toozs-Hobson Specialist Registrar Linda Cardozo Professor 《BJOG : an international journal of obstetrics and gynaecology》1998,105(11):1211-1213
Four hundred and sixty-five women attending a urodynamic clinic were interviewed, and completed a detailed bowel questionnaire, about their urinary and bowel symptoms. All the women underwent video-cystourethrography with pressure and flow studies. The reported incidence of faecal incontinence was 15.3% ( n = 71 ) on direct questioning and 26% 0( n = 121 ) on the postal questionnaire. Faecal incontinence was more common in women with a urodynamic diagnosis of detrusor instability (30'%1 ( n = 26 )) than among women diagnosed as having genuine stress incontinence (21% ( n = 38 )). Denervation and myogenic injuries sustained during childbirth have been suggested as a common cause for genuine stress and faecal incontinence, but there may be an alternative mechanism to explain why women with detrusor instability suffer from faecal incontinence. 相似文献
112.
An immunohistochemical study of androgen, oestrogen and progesterone receptors in the vulva and vagina 总被引:2,自引:0,他引:2
Malcolm B. Hodgins Senior Lecturer Rosemary C. Spike Research Fellow Rona M. Mackie Professor Allan B. MacLean Senior Lecturer † 《BJOG : an international journal of obstetrics and gynaecology》1998,105(2):216-222
Objective Tomap potential sites of sex steroid action in the human vulva.
Methods Monoclonal antibodies to androgen, oestrogen and progesterone receptors were used to stainfrozen sections of vulval skin, vagina and suprapubic skin. A scoring system was devised to comparereceptor distribution in the epidermis and dermis of skin with vaginal epithelium and stroma.
Results Androgen receptors were seen in epidermal keratinocytes, sebaceous glands, sweat glands, hairfollicles and dermal fibroblasts of skin, and epithelial cells and stromal fibroblasts of the vagina. Androgen receptor scores were significantly higher in the epidermis of labia majora and minora thanin vaginal epithelium. Oestrogen receptors were seen in basal and suprabasal cells of vaginalepithelium and epidermis of labia minora but were restricted to basal keratinocytes in true skin.They were seen in stromal fibroblasts and vaginal smooth muscle, and dermal fibroblasts of theskin. Oestrogen receptors were highest in vaginal epithelium and stroma, and lowest insuprapubic skin. Progesterone receptors were seen in vaginal epithelium, fibroblasts and smoothmuscle but not in the vulva. There was no evidence of significant differences in androgen oroestrogen receptor staining in the vulva of pre- or postmenopausal women.
Conclusion The transition from vagina to vulva is marked by an increase in androgen and a decrease inoestrogen and progesterone receptors. This distribution of receptors would indicate a limited role foroestrogen creams on the vulva. 相似文献
Methods Monoclonal antibodies to androgen, oestrogen and progesterone receptors were used to stainfrozen sections of vulval skin, vagina and suprapubic skin. A scoring system was devised to comparereceptor distribution in the epidermis and dermis of skin with vaginal epithelium and stroma.
Results Androgen receptors were seen in epidermal keratinocytes, sebaceous glands, sweat glands, hairfollicles and dermal fibroblasts of skin, and epithelial cells and stromal fibroblasts of the vagina. Androgen receptor scores were significantly higher in the epidermis of labia majora and minora thanin vaginal epithelium. Oestrogen receptors were seen in basal and suprabasal cells of vaginalepithelium and epidermis of labia minora but were restricted to basal keratinocytes in true skin.They were seen in stromal fibroblasts and vaginal smooth muscle, and dermal fibroblasts of theskin. Oestrogen receptors were highest in vaginal epithelium and stroma, and lowest insuprapubic skin. Progesterone receptors were seen in vaginal epithelium, fibroblasts and smoothmuscle but not in the vulva. There was no evidence of significant differences in androgen oroestrogen receptor staining in the vulva of pre- or postmenopausal women.
Conclusion The transition from vagina to vulva is marked by an increase in androgen and a decrease inoestrogen and progesterone receptors. This distribution of receptors would indicate a limited role foroestrogen creams on the vulva. 相似文献
113.
J. Golding Professor 《BJOG : an international journal of obstetrics and gynaecology》1998,105(3):293-299
Objective To investigate whether low dose aspirin medication given to primiparous women provides benefit in preventing pre-eclampsia or intrauterine growth retardation.
Design Randomised double-blind controlled trial of low dose aspirin and placebo in pregnancy.
Population Residents of the parishes of Kingston and St Andrew, Jamaica; 6275 primiparae enrolled between 12 and 32 weeks of gestation.
Main outcome measures Hypertensive disorders of pregnancy (including pre-eclampsia and eclampsia), preterm delivery, and low birthweight. In addition, to assess whether enrolment early, rather than late had more beneficial effect. Possible adverse effects on the woman and her infant were monitored.
Results Of enrolled primiparae, 97% were followed throughout pregnancy. There were no differences between those on aspirin and those on placebo in the development of hypertensive disorders (e.g. for a rise in diastolic pressure of 25 mmHg the odds ratio [OR] was 1.02 [95% CI 0.86–1.211; for proteinuric pre-eclampsia OR 1.15 [95% CI 0.92–1.44]; eclampsia OR 0.82 [95% CI 0.44–1.531); except for oedema which was significantly less prevalent in those on aspirin (OR 0.85 [95% CI 0.75–0.961). Women on aspirin were not significantly less likely to deliver preterm (OR 0.93 [95% CI 0–79-1.091) or have a larger fetus (mean birthweight difference 18 g [95% CI -9 to 451). They were, however, significantly more likely to suffer from bleeding disorders antenatally, intrapartum and postpartum; for postpartum haemorrhage OR 1.40 (95% CI 1.13–1-73).
Conclusions This trial shows that low dose aspirin has no consistent beneficial effect in primiparae. 相似文献
Design Randomised double-blind controlled trial of low dose aspirin and placebo in pregnancy.
Population Residents of the parishes of Kingston and St Andrew, Jamaica; 6275 primiparae enrolled between 12 and 32 weeks of gestation.
Main outcome measures Hypertensive disorders of pregnancy (including pre-eclampsia and eclampsia), preterm delivery, and low birthweight. In addition, to assess whether enrolment early, rather than late had more beneficial effect. Possible adverse effects on the woman and her infant were monitored.
Results Of enrolled primiparae, 97% were followed throughout pregnancy. There were no differences between those on aspirin and those on placebo in the development of hypertensive disorders (e.g. for a rise in diastolic pressure of 25 mmHg the odds ratio [OR] was 1.02 [95% CI 0.86–1.211; for proteinuric pre-eclampsia OR 1.15 [95% CI 0.92–1.44]; eclampsia OR 0.82 [95% CI 0.44–1.531); except for oedema which was significantly less prevalent in those on aspirin (OR 0.85 [95% CI 0.75–0.961). Women on aspirin were not significantly less likely to deliver preterm (OR 0.93 [95% CI 0–79-1.091) or have a larger fetus (mean birthweight difference 18 g [95% CI -9 to 451). They were, however, significantly more likely to suffer from bleeding disorders antenatally, intrapartum and postpartum; for postpartum haemorrhage OR 1.40 (95% CI 1.13–1-73).
Conclusions This trial shows that low dose aspirin has no consistent beneficial effect in primiparae. 相似文献
114.
S. Chua Senior Lecturer/Consultant M. Lee House Officer K. Vanaja Registrar Y. S. Chong Registrar L. Nordstrom Senior Teaching Fellow S. Arulkumaran Professor/Head 《BJOG : an international journal of obstetrics and gynaecology》1998,105(3):352-356
In order to assess the reliability of intrauterine pressure measurements in the third stage of labour, catheter-tip transducers were used in 20 women randomly allocated into two groups of 10. In each case in the first group two catheters were tied together and introduced transcervically into the uterine cavity after delivery of the placenta. In each case in the second group two catheters were inserted independently into the same uterine cavity. The active and cumulative active pressures recorded from the pairs of catheters within each uterine cavity were compared. Comparison of individual active pressure readings from separate transducers revealed good agreement whether the catheters were tied together or were seperate. Cumulative active pressure was very similar when assessed by each catheter in the same uterus. Intrauterine catheter-tip transducers can be used reliably to measure uterine activity in the third stage of labour although there may be minor contraction by contraction differences in recordings of individual active pressures. 相似文献
115.
Incidence of urinary incontinence and constipation during pregnancy and postpartum: survey of current findings at the Rotunda Lying-in Hospital 总被引:5,自引:0,他引:5
Kathleen Marshall Superintendent Physiotherapist Kate A. Thompson Research Officer † Deirdre M. Walsh Lecturer † George D. Baxter Professor † 《BJOG : an international journal of obstetrics and gynaecology》1998,105(4):400-402
Objective To assess the impact of pregnancy upon continence and constipation.
Design A questionnaire survey.
Setting Maternity wards in the Rotunda Lying In Hospital, Dublin, Republic of Ireland.
Population 7771 women who were delivered of liveborn infants.
Methods Questionnaires were delivered and collected by physiotherapy staff as part of routine postnatal care.
Results Analysis of data using χ2 tests showed significant differences between three parity groups [primigravidae, multigravidae (2–4) and multigravidae (5+)] for symptoms of both urinary incontinence ( χ2 = 119.54 , df = 2, P = 0.000) and constipation ( χ2 = 12.53 , df = 3, P = 0.002); the incidence of both constipation and urinary incontinence increased with parity.
Conclusion The results of this survey have emphasised the relation between parity and postpartum incontinence which stresses the importance of early diagnosis and intervention. 相似文献
Design A questionnaire survey.
Setting Maternity wards in the Rotunda Lying In Hospital, Dublin, Republic of Ireland.
Population 7771 women who were delivered of liveborn infants.
Methods Questionnaires were delivered and collected by physiotherapy staff as part of routine postnatal care.
Results Analysis of data using χ
Conclusion The results of this survey have emphasised the relation between parity and postpartum incontinence which stresses the importance of early diagnosis and intervention. 相似文献
116.
Linda Cardozo Professor Christopher Benness Consultant Denise Abbott Research Nurse 《BJOG : an international journal of obstetrics and gynaecology》1998,105(4):403-407
Objective To assess the efficacy of oral oestriol in the prevention of recurrent Urinary tract infections in elderly women.
Design Double-blind, randomised, parallel group, placebo controlled trial
Setting Urogynaecology Unit at King's College Hospital with some women recruited from the geriatric units of St. Pancras Hospital and Dulwich Hospital, London (UK).
Participants Seventy-two postmenopausal women older than 60 years of age (mean 73.2 years) suffering from recurrent urinary tract infections.
Intervention Oral oestriol (3 mg per day) or placebo for six months.
Main outcome measures Urinary tract infection rates.
Results The study was difficult to conduct because of its design and the age of the participants. Oral oestriol (3 mg per day) was not shown to be superior to placebo in the prevention of recurrent urinary tract infections, but both oestriol and placebo improved urinary symptoms during the trial.
Conclusion The power of the study might have been too low to detect a significant difference between the groups, or oral oestriol(3 mg per day) may have been either the wrong dose or the wrong route of administration for this indication. 相似文献
Design Double-blind, randomised, parallel group, placebo controlled trial
Setting Urogynaecology Unit at King's College Hospital with some women recruited from the geriatric units of St. Pancras Hospital and Dulwich Hospital, London (UK).
Participants Seventy-two postmenopausal women older than 60 years of age (mean 73.2 years) suffering from recurrent urinary tract infections.
Intervention Oral oestriol (3 mg per day) or placebo for six months.
Main outcome measures Urinary tract infection rates.
Results The study was difficult to conduct because of its design and the age of the participants. Oral oestriol (3 mg per day) was not shown to be superior to placebo in the prevention of recurrent urinary tract infections, but both oestriol and placebo improved urinary symptoms during the trial.
Conclusion The power of the study might have been too low to detect a significant difference between the groups, or oral oestriol(3 mg per day) may have been either the wrong dose or the wrong route of administration for this indication. 相似文献
117.
118.
Plasma from pre-eclamptic women and functional change in myometrial resistance arteries 总被引:1,自引:0,他引:1
Janet R. Ashworth Specialist Registrar Averil Y. Warren Chief Technician Ian R. Johnson Professor Philip N. Baker Senior Lecturer 《BJOG : an international journal of obstetrics and gynaecology》1998,105(4):459-461
This study assesses the ability of plasma from women with pre-eclampsia to induce altered endothelial function in myometrial resistance vessels from normotensive women. Vessels from normotensive pregnant women (n= 7) were incubated with plasma from other pregnant women who were normotensive (n= 6)or had pre-eclampsia (n= 7). A wire myograph was used to test the endothelium-dependent relaxatory response to bradykinin of preconstricted vessels. The relaxation in vessels incubated with plasma from women with pre-eclampsia was markedly less than in vessels incubated with plasma from normotensive pregnant women ( P = 0.039 ). This supports the theory that a plasma-borne factor contributes to the endothelial changes seen in pre-eclampsia. 相似文献
119.
Pekka Venesmaa Clinical Research Fellow Ulf-Håkan Stenman Consultant † Matti Forss Physicist Arto Leminen Consultant Pentti Lehtovirta Consultant Juhani Vartiainen Clinical Research Fellow Jorma Paavonen Associate Professor 《BJOG : an international journal of obstetrics and gynaecology》1998,105(5):508-511
Objective To evaluate the use of the pre-operative tumour-associated trypsin inhibitor (TATI) level and residual tumour size at primary surgery as a prognostic indicators for patients with Stage III epithelial ovarian cancer.
Design Retrospective cohort study.
Setting Department of Obstetrics and Gynaecology, University Hospital, Helsinki, Finland.
Participants Ninety-eight women with Stage III ovarian cancer.
Methods TATI was measured by radioimmunoassay from serum samples obtained within one week before surgery. A cutoff value of 22 μg/L was used. Multivariate analysis included pre-operative TATI level, age, histologic grade and histologic type. Mantel-Cox test was used for calculating statistical significance of differences in survival between groups.
Main outcome measures Cumulative five-year survival, pre-operative serum TATI level and residual tumour size.
Results Surgery was optimal (residual tumour size ≤ 2 cm) in 55 patients and suboptimal (residual tumour size > 2 cm) in 43. Pre-operative TATI level ≤ 22 μg/L predicted better prognosis both in patients with optimal and suboptimal surgery compared with patients with pre-operative TATI level > 22 μ/L. Patients with optimal surgery and a pre-operative TATI > 22 μg/L had a twofold relative risk of death compared with those with a pre-operative TATI ≤ 22 μg/L. The cumulative survival was less than three years for patients with suboptimal surgery and pre-operative TATI > 22 μg/L.
Conclusions Pre-operative serum TATI in combination with residual tumour size may be useful in stratifying patients with Stage III ovarian cancer into different categories in randomised treatment trials. 相似文献
Design Retrospective cohort study.
Setting Department of Obstetrics and Gynaecology, University Hospital, Helsinki, Finland.
Participants Ninety-eight women with Stage III ovarian cancer.
Methods TATI was measured by radioimmunoassay from serum samples obtained within one week before surgery. A cutoff value of 22 μg/L was used. Multivariate analysis included pre-operative TATI level, age, histologic grade and histologic type. Mantel-Cox test was used for calculating statistical significance of differences in survival between groups.
Main outcome measures Cumulative five-year survival, pre-operative serum TATI level and residual tumour size.
Results Surgery was optimal (residual tumour size ≤ 2 cm) in 55 patients and suboptimal (residual tumour size > 2 cm) in 43. Pre-operative TATI level ≤ 22 μg/L predicted better prognosis both in patients with optimal and suboptimal surgery compared with patients with pre-operative TATI level > 22 μ/L. Patients with optimal surgery and a pre-operative TATI > 22 μg/L had a twofold relative risk of death compared with those with a pre-operative TATI ≤ 22 μg/L. The cumulative survival was less than three years for patients with suboptimal surgery and pre-operative TATI > 22 μg/L.
Conclusions Pre-operative serum TATI in combination with residual tumour size may be useful in stratifying patients with Stage III ovarian cancer into different categories in randomised treatment trials. 相似文献
120.
Uterine thermal balloon therapy for the treatment of menorrhagia: the first 300 patients from a multi-centre study 总被引:6,自引:0,他引:6
Nazar N. Amso Consultant Seth A. Stabinsky Clinical Assistant Professor/Associate Medical Director †‡ Peter McFaul Consultant Bernard Blanc Professor †† Laura Pendley Manager ‡ Robert Neuwirth Professor/Chairman Emeritus § 《BJOG : an international journal of obstetrics and gynaecology》1998,105(5):517-523