全文获取类型
收费全文 | 8343篇 |
免费 | 726篇 |
国内免费 | 16篇 |
专业分类
耳鼻咽喉 | 85篇 |
儿科学 | 274篇 |
妇产科学 | 161篇 |
基础医学 | 1093篇 |
口腔科学 | 166篇 |
临床医学 | 906篇 |
内科学 | 1568篇 |
皮肤病学 | 156篇 |
神经病学 | 630篇 |
特种医学 | 246篇 |
外科学 | 1241篇 |
综合类 | 91篇 |
一般理论 | 11篇 |
预防医学 | 1017篇 |
眼科学 | 133篇 |
药学 | 595篇 |
中国医学 | 4篇 |
肿瘤学 | 708篇 |
出版年
2023年 | 111篇 |
2022年 | 204篇 |
2021年 | 442篇 |
2020年 | 248篇 |
2019年 | 367篇 |
2018年 | 424篇 |
2017年 | 293篇 |
2016年 | 295篇 |
2015年 | 309篇 |
2014年 | 432篇 |
2013年 | 496篇 |
2012年 | 752篇 |
2011年 | 703篇 |
2010年 | 379篇 |
2009年 | 258篇 |
2008年 | 468篇 |
2007年 | 359篇 |
2006年 | 351篇 |
2005年 | 313篇 |
2004年 | 324篇 |
2003年 | 232篇 |
2002年 | 255篇 |
2001年 | 90篇 |
2000年 | 71篇 |
1999年 | 78篇 |
1998年 | 40篇 |
1997年 | 45篇 |
1996年 | 43篇 |
1995年 | 31篇 |
1994年 | 35篇 |
1992年 | 34篇 |
1991年 | 35篇 |
1990年 | 52篇 |
1989年 | 49篇 |
1988年 | 37篇 |
1987年 | 24篇 |
1986年 | 20篇 |
1985年 | 31篇 |
1984年 | 19篇 |
1983年 | 17篇 |
1979年 | 19篇 |
1978年 | 28篇 |
1977年 | 18篇 |
1976年 | 23篇 |
1975年 | 16篇 |
1974年 | 17篇 |
1973年 | 23篇 |
1972年 | 20篇 |
1969年 | 21篇 |
1967年 | 14篇 |
排序方式: 共有9085条查询结果,搜索用时 15 毫秒
61.
The potassium titanyl phosphate (KTP-532) laser has been applied to otologic surgery with a proven record of both safety and efficacy. The aim of this study was to demonstrate the use, safety, and advantages of laser dissection in the surgical treatment of acoustic neuromas. The authors' experience with 111 patients in whom laser surgery was used in acoustic neuroma is presented, with emphasis on surgical technique employed and facial nerve functional outcome. The method of laser dissection did not result in deleterious neurologic sequelae or laser-specific complications. In addition, laser dissection afforded certain advantages to traditional techniques, especially in larger tumors. The facial nerve functional outcome as assessed by the House-Brackmann grading system revealed that 90.2% of small tumors, 72.2% of medium tumors, and 75.0% of large tumors achieved satisfactory (grades I and II) functional results. These results compare favorably with the literature describing nonlaser dissection techniques. The observations and results reported in this article demonstrate the safety of the KTP-532 laser in the posterior cranial fossa, and specific advantages that this technology may offer to the surgical armamentarium of the neuro-otologist are outlined. 相似文献
62.
T. F. Hickish I. E. Smith M. C. Nicolson S. Ashley K. Priest L. Spencer A. Norman G. Middleton M. E. O'Brien 《British journal of cancer》1998,77(11):1966-1970
MVP chemotherapy (mitomycin C 8 mg m(-2), courses 1, 2, 4 and 6, vinblastine 6 mg m(-2), cisplatin 50 mg m(-2)) is an active low-toxicity regimen in non-small-cell lung cancer (NSCLC). Based on the single-agent activity of these agents in SCLC, we have conducted a phase II trial of MVP in SCLC. Fifty chemo-naive patients with SCLC were entered in this trial. There were 33 men and 17 women with median age 66 years (range 46-83 years); 18 patients had limited disease (LD) and 32 extensive disease (ED). WHO performance status (PS) was: three patients PS 0, 33 patients PS 1, ten patients PS 2, four patients PS 3. A maximum of six cycles was given in responding patients. On completion of chemotherapy, patients with LD obtaining complete response (CR)/good partial response (PR) received thoracic irradiation and those obtaining CR were offered entry into the ongoing MRC Prophylactic Cranial Irradiation Trial. The overall response was 79% with 17% CR and 62% PR. For LD patients, 38% obtained CR but for ED only one patient achieved CR. Median response duration for LD patients was 8 months and for ED patients 5 months. Median survival was 10 months for LD patients and 6 months for ED patients. There was complete resolution of symptoms in 24%, partial improvement in 68%, no change in 2% and progressive symptoms in 6%. As regards toxicity, 24% developed WHO grade 3/4 neutropenia, 16% grade 3/4 thrombocytopenia and 6% significant hair loss. Two patients died during the first week of treatment with neutropenic infection. Quality of life using the EORTC questionnaire (QLC-C30) with lung cancer module demonstrated significant improvements from baseline levels in emotional and cognitive functioning, global QOL, of pain, dyspnoea and cough. MVP, an effective palliative regimen for NSCLC, is also active against SCLC with low toxicity and merits comparison with more toxic conventional schedules. 相似文献
63.
Mitch Dowsett Steve R Ebbs J Michael Dixon Anthony Skene Clive Griffith Irene Boeddinghaus Janine Salter Simone Detre Margaret Hills Susan Ashley Stephen Francis Geraldine Walsh Ian E Smith 《Journal of clinical oncology》2005,23(11):2477-2492
PURPOSE: To investigate the relationships between biomarker changes in breast cancer during neoadjuvant (preoperative) endocrine therapy. PATIENTS AND METHODS: The IMPACT trial compared the preoperative use of tamoxifen with anastrozole alone or in combination in postmenopausal women (n = 330) with primary breast cancer. Biomarkers were measured in tumor biopsy specimens taken at baseline, and after 2 and 12 weeks of treatment. RESULTS: 52 (93%) of 56, 46 (85%) of 54, and 37 (84%) of 44 patients in the anastrozole, tamoxifen, and combination groups, respectively. There was a significantly greater suppression of Ki67 in the anastrozole-treated group than in the tamoxifen- or combination-treated groups, which is parallel to the greater efficacy seen for anastrozole over these two treatments in the Arimidex, Tamoxifen, Alone or in Combination adjuvant trial. A positive relationship was noted between estrogen-receptor level and Ki67 suppression in all patients. Ki67 was reduced to a greater extent in progesterone receptor-positive tumors compared with progesterone receptor-negative tumors. HER-2-negative tumors tended to show a greater reduction in Ki67 compared with HER-2-positive tumors, but the difference was only significant in the tamoxifen group after 2 weeks, and in the anastrozole group after 12 weeks. CONCLUSION: These results confirm the value of Ki67 as a molecular marker, and provide information regarding the relationships between treatment-induced changes in Ki67 and other important biomarkers. Studies such as this should help integrate agents targeted at growth factor signaling with endocrine agents in breast cancer. 相似文献
64.
RNA interference demonstrates a novel role for integrin-linked kinase as a determinant of pancreatic adenocarcinoma cell gemcitabine chemoresistance. 总被引:10,自引:0,他引:10
Mark S Duxbury Hiromichi Ito Eric Benoit Talat Waseem Stanley W Ashley Edward E Whang 《Clinical cancer research》2005,11(9):3433-3438
Integrin-linked kinase (ILK) facilitates signal transduction between extracellular events and important intracellular survival pathways involving protein kinase B/Akt. We examined the role of ILK in determining pancreatic adenocarcinoma cellular chemoresistance to the nucleoside analogue gemcitabine. Cellular ILK expression was quantified by Western blot analysis. We examined the effects of overexpression of active ILK and of ILK knockdown induced by RNA interference on gemcitabine chemoresistance. We also examined the effects of modulating ILK expression on gemcitabine-induced caspase 3-mediated apoptosis, phosphorylation status of Akt (Ser473) and glycogen synthase kinase. Overexpression of ILK increased cellular gemcitabine chemoresistance, whereas ILK knockdown induced chemosensitization via increased caspase 3-mediated apoptosis. ILK knockdown attenuated Akt Ser473 and glycogen synthase kinase phosphorylation, whereas overexpression of constitutively active myristoylated Akt was sufficient to induce significant recovery in gemcitabine chemoresistance in the presence of ILK knockdown. Levels of ILK expression affect gemcitabine chemoresistance in pancreatic adenocarcinoma cells. This novel finding suggests that therapies directed against ILK and its downstream signaling targets may have the potential to enhance the efficacy of gemcitabine-based chemotherapy. 相似文献
65.
James Prah David Ashley Benjamin Blount Martin Case Teresa Leavens Joachim Pleil Frederick Cardinali 《Toxicological sciences》2004,77(2):195-205
Methyl tertiary butyl ether (MTBE), a gasoline additive used to increase octane and reduce carbon monoxide emissions and ozone precursors, has contaminated drinking water and can lead to exposure by oral, inhalation, and dermal routes. To determine its dermal, oral, and inhalation kinetics, 14 volunteers were exposed to 51.3 microg/ml MTBE dermally in tap water for 1 h, drank 2.8 mg MTBE in 250 ml Gatorade(R), and inhaled 3.1 ppm. MTBE for 1 h. Blood and exhaled breath samples were then obtained. Blood MTBE peaked between 15 and 30 min following oral exposure, at the end of inhalation exposure, and ~5 min after dermal exposure. Elimination by each route was described well by a three-compartment model (Rsq >0.9). The Akaike Information Criterion for the three-compartment model was smaller than the two-compartment model, supporting it over the two-compartment model. One metabolite, tertiary butyl alcohol (TBA), measured in blood slowly increased and plateaued, but it did not return to the pre-exposure baseline at the 24-h follow-up. TBA is very water-soluble and has a blood:air partition ratio of 462, reducing elimination by exhalation. Oral exposure resulted in a significantly greater MTBE metabolism into TBA than by other routes based on a greater blood TBA:MTBE AUC ratio, implying significant first-pass metabolism. The slower TBA elimination may make it a better biomarker of MTBE exposure, though one must consider the exposure route when estimating MTBE exposure from TBA because of first-pass metabolism. Most subjects had a baseline blood TBA of 1-3 ppb. Because TBA is found in consumer products and can be used as a fuel additive, it is not a definitive marker of MTBE exposure. These data provide the risk assessment process of pharmacokinetic information relevant to the media through which most exposures occur-air and drinking water. 相似文献
66.
Continuous exposure to dibromoacetic acid delays pubertal development and compromises sperm quality in the rat. 总被引:1,自引:0,他引:1
Gary R Klinefelter Lillian F Strader Juan D Suarez Naomi L Roberts Jerome M Goldman Ashley S Murr 《Toxicological sciences》2004,81(2):419-429
Previously our work on the haloacid by-products of drinking water disinfection focused on adult exposures. Herein we evaluate the consequence of continuous exposure to dibromoacetic acid (DBA) via drinking water through reproductive development into adulthood. An initial study in which offspring were exposed from gestation day (GD) 15 through adulthood revealed significant delays in preputial separation and vaginal opening, dose-related decreases in the fertility of cauda epididymal sperm, and dose-related diminutions in the sperm membrane protein SP22. Subsequent studies consisted of groups in which exposure ceased on postnatal day 21 (PND 21) versus adulthood. For each exposure, animals were evaluated after puberty (PND 56) as well as at adulthood (PND 120). Exposure to 4, 40, or 400 ppm DBA from GD 15 through PND 21 failed to result in any significant reproductive alterations. By contrast, continuous exposure until adulthood resulted in dose-related alterations consistent with those observed in the dose-finding study. Preputial separation and vaginal opening were delayed 4 and 3 days in males and females exposed to 400 ppm (76.3 mg/kg) DBA. This was associated with increased responsiveness of both the testis and ovary to hCG ex vivo; hCG-stimulated testosterone production by testicular parenchyma on PND 56 was increased at 4 ppm (0.6 mg/kg) DBA and higher. Finally, the quality of proximal cauda epididymal sperm was compromised by continuous exposure to DBA. The sperm membrane proteome was altered in a dose-related manner with SP22, and one of its charged variants, diminished at 40 ppm (3.6 mg/kg) DBA and higher. As more sensitive endpoints are evaluated, lower effect levels can be attributed to haloacid exposure. We are now extending our evaluations to epidemiology studies designed to evaluate sperm quality in men exposed to varying levels of disinfection by-products. 相似文献
67.
68.
69.
Lehman AD Dunkel FV Klein RA Ouattara S Diallo D Gamby KT N'diaye M 《Journal of ethnopharmacology》2007,110(2):235-249
In material-resource poor countries like Mali, traditional practices incorporate the use of plants for medicinal purposes. Ethnobotanical research has documented traditional uses of plants, while concomitant studies by natural product chemists, ethnobotanists, and microbiologists have verified the efficacy of using traditional medicinal plants that have proven antimicrobial activity. These plants may also be used to protect agricultural crops pre-harvest and post-harvest from insect herbivory. In Mali, subsistence farmers, regional scientists, and extension specialists rely on local plants for many medicinal needs and are amenable to using traditional plant materials for insect pest management. The goal of this research was to develop Integrated Pest Management (IPM) strategies using Malian traditional medicine as a discovery lead. The discovery premise was based on identifying plants through a matrix approach utilizing agricultural scientists, traditional practitioners, and subsistence farmers. We hypothesized that plants used in traditional medicine with antimicrobial activity lead to potential insect pest management agents. To test our hypothesis, we developed a four-step process for selecting Malian plant species. Seven criteria were selected to create a systematic matrix to identify the most promising plant materials for practical, affordable, ecologically-sound insect management by Malian farmers. In the first step of the process, we developed a list of 294 medicinal Malian plant species which were evaluated using the matrix. Sixty-seven plant species met our main criteria. After the environmental soundness of these species was evaluated using four minor criteria, 50 species emerged from this pre-chemical, pre-bioassay process for further consideration in IPM programs in Mali. 相似文献
70.
Combining CGM and an Online Peer Support Community for Hispanic
Adults with T2D: A Feasibility Study
Michelle L. Litchman Ashley Ng Ana Sanchez-Birkhead Nancy A. Allen Bruno Rodriguez-Gonzales Eli Iacob Deborah A. Greenwood 《Journal of diabetes science and technology》2022,16(4):866
Background:Previous research has identified that people with type 2 diabetes (T2D) within the Hispanic community would benefit from an online peer support community (OPSC) and continuous glucose monitoring (CGM) data to facilitate diabetes self-management.Methods:A mixed-methods feasibility study enrolled Hispanic, Spanish-speaking adults with T2D, not on insulin. Participants were provided with CGM and access to an OPSC for 12 weeks. Feasibility was assessed by number of eligible participants who enrolled, attrition, quantity of CGM data, validated clinical measures of self-efficacy, quality of life and adverse events. Engagement in the OPSC was measured using objective metrics on the online platform. Qualitative interviews were conducted upon conclusion of the intervention to assess feasibility, acceptability, participant satisfaction, and key recommendations for improvement.Results:Of 46 participants screened, 39 were eligible and 26 completed the study. Participants significantly improved self-efficacy scores. Posts in the OPSC related to goal setting had the highest engagement followed by mid-week and end of week check-in posts respectively. Participant interviews described challenges accessing the OPSC platform as a barrier to engagement. Despite this, all participants were satisfied with the intervention. Key recommendations for improvement included providing greater variety of and individualized education and the use of a peer support platform that is easily accessible.Conclusions:The CGM + OPSC intervention tailored to the Hispanic community with T2D was feasible, acceptable and satisfactory and improved participant self-efficacy for diabetes management which may lead to improved clinical outcomes. 相似文献