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121.
Russell SM Elliott R Forshaw D Kelly PJ Golfinos JG 《中国神经肿瘤杂志》2005,3(4):295-295
OBJECT: The goal of this study is to report the incidence and clinical evolution of neurological deficits in patients who underwent resection of gliomas confined to the parietal lobe. METHODS: Patient demographics, findings of serial neurological examinations, tumor location and neuroimaging characteristics, extent of resection, and surgical outcomes were tabulated by reviewing inpatient and office records, as well as all pre- and postoperative magnetic resonance (MR) images obtained in 28 consecutive patients who underwent resection of a glial neoplasm found on imaging studies to be confined to the parietal lobe. Neurological deficits were correlated with hemispheric dominance, location of the lesion within the superior or inferior parietal lobules, subcortical extension, and involvement of the postcentral gyms. The tumors were located in the dominant hemisphere in 18 patients (64%); had a mean diameter of 39 mm (range 14-69 mm); were isolated to the superior parietal lobule in six patients (21%) and to the inferior parietal lobule in eight patients (29%); and involved both lobules in 14 patients (50%). Gross-total resection, documented by MR imaging, was achieved in 24 patients (86%). Postoperatively, nine patients (32%) experienced new neurological deficits, whereas seven (25%) had an improvement in their preoperative deficit. A correlation was noted between larger tumors and the presence of neurological deficits both before and after resection. Postoperatively higher-level (association) parietal deficits were noted only in patients with tumors involving both the superior and inferior parietal lobules in the dominant hemisphere. At the 3-month follow-up examination, five of nine new postoperative deficits had resolved. CONCLUSIONS: Neurological deterioration and improvement occur after resection of parietal lobe gliomas. Parietal lobe association deficits, specifically the components of Gerstmann syndrome, are mostly associated with large tumors that involve both the superior and inferior parietal lobules of the dominant hemisphere. New hemineglect or sensory extinction was not noted in any patient following resection of lesions located in the nondominant hemisphere. Nevertheless, primary parietal lobe deficits (for example, a visual field loss or cortical sensory syndrome) occurred in patients regardless of hemispheric dominance. 相似文献
122.
Maternal reproductive history and birth characteristics in childhood acute lymphoblastic leukemia 总被引:3,自引:0,他引:3
Using birth-registration data, a case-control study was done to investigate the possible associations of childhood acute lymphoblastic leukemia (ALL) with birth characteristics and maternal reproductive history. The data included cases born and diagnosed in Minnesota since 1969. Matched analyses were conducted using 337 cases and 1336 birth year-matched controls. There was a statistically significant increased odds of ALL for birth to older (greater than 35 years) mothers (odds ratio (OR) = 2.14, 95% confidence interval (CI) = 1.28, 3.58), older fathers (OR = 1.62, 95% CI = 1.14, 2.30), mothers with at least a high school education (OR = 1.61, 95% CI = 1.05, 2.48), and larger intervals (greater than 5 years) between the birth of the proband and the preceding sibling (OR = 1.86, 95% CI = 1.12, 3.09). The increased odds of ALL for birth by Caesarean section approached significance (OR = 1.42, P = 0.06). No overall association was found for: gender, race, paternal education, fetal-loss history, birth order, prenatal care history, pregnancy complications, inducement of labor, multiple birth, gestational age, or birth weight. Age at diagnosis was an important effect modifier of some analyses. For cases diagnosed before age 2 years, there was a 2.7-fold increased odds of ALL if the last pregnancy had resulted in a fetal loss (P = 0.03). For cases diagnosed before age 4 years, birth weight greater than 3800 g was associated with a significant 2.05-fold increased odds of ALL. These data strengthen the hypothesis that prenatal events may play a causative role in childhood ALL, particularly in those cases diagnosed at a younger age. 相似文献
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125.
Pacemaker troubleshooting: improved efficacy using a new diagnostic digital Holter recording system.
J P Moak B Gunderson V Freedenberg C Ramwell 《Europace : European pacing, arrhythmias, and cardiac electrophysiology》2002,4(1):55-59
Asymptomatic dysfunction of cardiac pacing systems is not uncommonly detected using long-term ambulatory monitoring techniques. We report two patients with atrial and ventricular sensing abnormalities noted only on Holter monitoring. Multiple empirical attempts at pacemaker reprogramming based on deductive analysis of the pacing anomaly were unsuccessful. Through the use of a new digital recording system that allowed collection of surface electrocardiographic data, intracardiac electrograms, and Marker Channel data a correct diagnosis was made (pacing lead insulation failure). This new recording system has the advantage of significantly improving diagnostic sensitivity and resulting in cost savings. 相似文献
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127.
C H Gunderson 《American family physician》1986,33(1):137-143
Migraine is among the most common disorders seen in office practice. Some epidemiologists believe it may occur in up to 25 percent of the general population. Pharmacologic treatment and behavior therapy, as well as a stable physician-patient relationship, are important factors in reducing the frequency and severity of recurrent head pain. Benefits of migraine therapy include improvements in the patient's overall health and sense of well-being. 相似文献
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129.
Garn.JG 《河南职工医学院学报》2000,12(4):F003-F003
本对医学院校学生就全科医生有关问题给于相应的答复,其中还包括自1997年以来由美国全科医学会举办的学生代表大会上所提出的一些问题,例如:什么是全科医生?全科医生的行业范围是什么?全科医生的工作,生活及收入情况如何等等问题。(Am.Fam.Physician1990.60:167-174)。 相似文献
130.