全文获取类型
收费全文 | 353篇 |
免费 | 30篇 |
国内免费 | 5篇 |
专业分类
耳鼻咽喉 | 1篇 |
妇产科学 | 1篇 |
基础医学 | 45篇 |
口腔科学 | 3篇 |
临床医学 | 33篇 |
内科学 | 85篇 |
神经病学 | 15篇 |
特种医学 | 14篇 |
外科学 | 19篇 |
综合类 | 82篇 |
预防医学 | 16篇 |
药学 | 24篇 |
1篇 | |
中国医学 | 26篇 |
肿瘤学 | 23篇 |
出版年
2023年 | 8篇 |
2022年 | 15篇 |
2021年 | 19篇 |
2020年 | 26篇 |
2019年 | 12篇 |
2018年 | 8篇 |
2017年 | 10篇 |
2016年 | 12篇 |
2015年 | 20篇 |
2014年 | 20篇 |
2013年 | 17篇 |
2012年 | 15篇 |
2011年 | 24篇 |
2010年 | 15篇 |
2009年 | 15篇 |
2008年 | 10篇 |
2007年 | 18篇 |
2006年 | 12篇 |
2005年 | 9篇 |
2004年 | 5篇 |
2003年 | 10篇 |
2002年 | 10篇 |
2001年 | 8篇 |
2000年 | 9篇 |
1999年 | 13篇 |
1998年 | 6篇 |
1997年 | 8篇 |
1996年 | 8篇 |
1995年 | 10篇 |
1994年 | 6篇 |
1992年 | 7篇 |
1991年 | 1篇 |
1990年 | 1篇 |
1988年 | 1篇 |
排序方式: 共有388条查询结果,搜索用时 15 毫秒
91.
Huaxia Yang Yinghao Sun Lidan Zhao Xuan Zhang Fengchun Zhang 《Clinical rheumatology》2018,37(5):1207-1213
The aim of this study is to describe the clinical features of cerebellar involvement in patients with primary Sjögren’s syndrome (pSS). We retrospectively analyzed the manifestations, treatments, and outcomes in patients with pSS-cerebellar complication in Peking Union Medical College Hospital and cases reported in literature. Altogether 13 patients were identified. They were 2 males and 11 females with a mean age at disease onset of 45.2?±?14.6 years. Nine (69.2%) patients went to the clinic because of ataxia, and pSS was not suspected until accidental screening for autoantibodies. Dysarthria (7, 59.8%), limb tremor (4, 30.8%), and nystagmus (2, 15.4%) were the rest symptoms related to cerebellum. Of the patients, 81.8% (9/11) had abnormal cerebrospinal fluid findings, and 11 patients (84.6%) had cerebellar atrophy in the brain MRI. Dry eyes and dry mouth were detected in 9 (69.2%) and 7 (59.8%) patients, while positive objective xerostomia and ocular test in 82.5% (7/8) and 100% (10/10) of the patients, respectively. Anti-Ro/SSA antibody was positive in 12 (92.3%) and anti-La/SSB in 6 (46.2%) patients. Glucocorticoids were applied in 12 patients (92.3%). Cyclophosphamide (3, 20.1%), mycophenolatemofetil (1, 7.7%), and hydroxychloroquine (4, 30.8%) were chosen as immunosuppressants or anti-inflammatory drug. During a median follow-up of 9 months (range, 1–18 months), 8 (61.5%) patients remained stable, 3 (20.1%) patients were in remission, and 2 (15.4%) patients were in progression. Clinical cerebellar complication secondary to pSS was rare, and sometimes pSS was not suspected until accidental screening for autoantibodies. Because the onset of cerebellar manifestation is often insidious and rapid deteriorates, early diagnosis and empirical aggressive glucocorticoid treatment is warranted. 相似文献
92.
TIPS术治疗50例,其中49例为肝炎后肝硬化,1例为门静脉海绵窦样变,45例有反复呕血及黑便史,5例无上消化道出血史,均有中-重度食管静脉曲张。16例有中-大量腹水。结果:(1)45例门静脉建立有效分流,成功率为90%。门静脉主干压力从术前的3.95±0.85kPa降至2.33±0.72kPa(P<0.001)。(2)胃镜检查TIPS术后食管静脉曲张消失和基本消失率为41.43%,减轻为37.9%。(3)术后腹水消失或减轻为62%。(4)并发症与操作有关的为12%,总发生率为36%。(5)术后肝功能观察:血清总胆红质升高,血清白蛋白降低。随访1993年3月至1994年3月置入Gianturc-RoschZ型、网型支架的24例患者,随访3个月至22个月者20例,支架狭窄、闭塞率半年为20%,1年为55%;复发出血8例为40%。1994年4月至1995年1月置入wallstent支架的21例中,尚无支架闭塞及反复出血。全组现共死亡8例,死亡率为15.6% 相似文献
93.
Lin Qiao Qian Wang Yunyun Fei Wen Zhang Yan Xu Yao Zhang Yan Zhao Xiaofeng Zeng Fengchun Zhang 《Medicine》2015,94(28)
The aim of the present study was to analyze the clinical characteristics of primary Sjogren''s syndrome (pSS) with neuromyelitis optica spectrum disorder (NMOSD). We retrospectively reviewed the medical records of 616 patients who were admitted to the Peking Union Medical College Hospital from 1985 to 2013. Of these patients, 43 developed NMOSD. The median duration of symptoms was 60 months and 72% of the patients experienced neurological complications onset in the pSS with NMOSD group. Twenty-one out of 43 patients had neuromyelitis optica (NMO), and 22 exhibited a limited form of NMO. Serum anti-aquaporin-4 (AQP4) antibody positivity was detected in 89.3% of the patients. A total of 60.5% of the patients (26 patients) complained of dry mouth, 72.1% were positive for objective xerostomia, 53.5% complained of dry eyes, and 74.4% had a positive ocular test. Biopsy of the minor salivary glands was performed in 33 patients, 28 of whom (84.8%) had a lymphocytic focus score of ≥1. Anti-Ro/SSA or anti-La/SSB antibodies were detected in 41 patients (95.3%). Compared with the pSS patients without NMOSD, the incidences of xerophthalmia, xerostomia, arthritis, interstitial lung disease, and renal tubular acidosis were significantly lower in the patients with NMOSD.NMOSD is a neurologic complication of pSS. The presence of anti-AQP4 antibody may be a predictor for pSS patients with NMOSD. Neurological manifestations are prominent in these patients. In clinical scenarios involving pSS or NMOSD, rheumatologists and neurologists should be aware of this association and perform the appropriate tests. 相似文献
94.
Related factors of fetal loss in Chinese women with systemic lupus erythematosus: data from Chinese SLE Treatment and Research Group registry IV
下载免费PDF全文
![点击此处可从《International journal of rheumatic diseases》网站下载免费的PDF全文](/ch/ext_images/free.gif)
95.
Xuan Zhang Zhaohui Zhu Fengchun Zhang Huijun Shu Fang Li Yi Dong 《Arthritis care & research》2005,53(6):845-849
Objective
To evaluate the diagnostic value of single‐photon–emission computed tomography (SPECT) in severe central nervous system (CNS) involvement of systemic lupus erythematosus (SLE).Methods
Forty‐three patients with SLE, including 22 with CNS‐SLE and 21 with non–CNS‐SLE, underwent SPECT and magnetic resonance imaging (MRI) examinations. SPECT was repeated 1–2 months after treatment in patients with abnormal findings.Results
SPECT and MRI abnormalities were detected in 20 (90.9%) and 10 (45.5%) of the 22 patients with CNS‐SLE, respectively (P < 0.01). For 4 patients with cerebral infarction or hemorrhage, SPECT was equally as sensitive as MRI (100%). For the patients with CNS‐SLE with diffuse presentations, SPECT was more sensitive than MRI in revealing abnormalities (16 [88.9%] of 18 patients versus 6 [33.3%] of 18 patients; P < 0.01). In 19 (95.0%) patients, the abnormal SPECT finding manifested as moderate to severe perfusion defect (15 in frontal lobe, 11 in parietal lobe, 11 in basal ganglia, 3 in temporal lobe, and 17 in multiple regions). Although mild perfusion defect was also detected in 4 (19.0%) of the patients with non–CNS‐SLE, it only involved a single region and spared the frontal and parietal lobes. Repeated SPECT after treatment showed that perfusion defect had improved significantly or even disappeared in 11 (84.6%) of 13 patients with diffuse CNS‐SLE with abnormal findings before treatment.Conclusion
Moderate to severe perfusion defect in SPECT involving multiple regions, especially in the frontal and parietal lobes and basal ganglia, in patients with lupus suggests CNS involvement. SPECT is more sensitive than MRI in revealing damage in diffuse CNS‐SLE, and is useful in followup, especially for monitoring disease severity and guiding treatment.96.
97.
Medulloblastoma is the most common malignant tumor of the central nervous system in children. The insulin-like growth factor-I receptor (IGF-IR) is an important growth factor for medulloblastoma. The novel IGF-I receptor (IGF-IR) kinase inhibitor NVP-ADW742 has in vitro activity against tumors. Daoy cells were treated with NVP-ADW742 combined with temozolomide, which is commonly used in the chemotherapy of medulloblastoma. The effects on proliferation were assayed by CCK-8 assay. Cell cycle status and apoptosis were assayed by FACS analysis. The IGF-IR signaling pathway was analyzed by RT2 Profiler? PCR arrays and Western blotting. NVP-ADW742 inhibited IGF-IR-mediated proliferation with an IC50 of 11.12 μmol/l. The PCR array data suggested that 14 genes were down-regulated at the mRNA level after NVP-ADW742 treatment. Western blot analysis suggested that NVP-ADW742 induced early suppression of Akt, P38 and GSK-3β phosphorylation, as well as a decrease in the intracellular levels of PI3K, Akt, P38, GSK-3β and Bcl-2. Combined with NVP-ADW742 (2 μmol/l), IC50 of Daoy to temozolomide was decreased from 452.12 to 256.81 μmol/l. Cell apoptosis was enhanced from 16.18±2.47% to 23.20 ± 2.80%. G phase arrest was also found in both the temozolomide alone group and the temozolomide combined with NVP-ADW742 group. NVP-ADW742 inhibited the activation of PI3K, Akt, P38 and GSK-3β caused by temozolomide. NVP-ADW742 enhanced the chemosensitivity of Daoy to temozolomide in vitro, as a potent anti-tumor agent highly selective against IGF-IR. 相似文献
98.
Objective. To analyze the incidence, clinical features, and prognosis of patients with primary biliary cirrhosis (PBC) complicated by pulmonary hypertension (PH). Material and methods. A total of 178 consecutive PBC patients, who were admitted to Peking Union Medical College Hospital from January 2001 to March 2007, were included in this prospective study. A structured interview, systemic rheumatological examination, laboratory tests (including autoantibodies), and Doppler echocardiography were conducted for each patient and compared between patients with and without PH. Results. Twenty-one PBC patients (11.8%) had PH. Among them, four patients (19.0%) had moderate to severe PH, and one patient died of right heart failure instead of liver failure. The incidences of Raynaud's phenomenon, interstitial lung disease, Sjögren's syndrome, and portal hypertension, the proportion of patients with a positive anti-SSA, the level of serum IgA, as well as the Mayo risk score in the PH–PBC patients were significantly higher than in the non-PH-PBC group (p = 0.02, 0.001, 0.02, 0.03, 0.006, 0.04 and 0.02, respectively). Conclusions. PH, including moderate to severe PH, is not a rare complication of PBC. This complication is closely associated with portal hypertension and immunological dysregulation and indicates a poor prognosis. 相似文献
99.
100.
目的:比较巩膜瓣下咬切结合膜瓣可调节缝线和单纯巩膜瓣下咬切术治疗青光眼的疗效和并发症。方法:采用随机分组平行对照临床验证的方法,将148例(175眼)青光眼分为实验组和对照组,并对其临床资料进行回顾性分析。结果:实验组手术效果优于对照组;实验组术后浅前房、低眼压、无功能性滤过泡形成等并发症发生率均低于对照组(P〈0.05、P〈0.01)。结论:巩膜瓣下咬切术结合可调节缝线能明显减少并发症,提高抗青光眼手术成功率。 相似文献