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91.
Molecular biology of upper gastrointestinal malignancies 总被引:8,自引:0,他引:8
While cancers of the upper gastrointestinal tract are related by location, they have distinct clinical and molecular characteristics. This review will focus on the molecular biology of esophageal adenocarcinoma (EAC) of which alterations in p53, overexpression of cyclin D1, loss of p16, and aneuploidy have been best characterized. Key similarities and differences, when compared to esophageal squamous cell carcinoma (ESCC), gastric adenocarcinoma (GC), and adenocarcinoma of the gastric cardia (AGC), will also be highlighted. Currently, malignancies of the upper gastrointestinal tract are often diagnosed at an advanced stage and are generally associated with a poor patient prognosis. With an improved understanding of the molecular biology of these tumors, there is hope that new targets for diagnosis, chemoprevention, and therapy will be developed. 相似文献
92.
Obsessive-compulsive severity spectrum in the community: prevalence,comorbidity, and course 总被引:3,自引:0,他引:3
Angst J Gamma A Endrass J Goodwin R Ajdacic V Eich D Rössler W 《European archives of psychiatry and clinical neuroscience》2004,254(3):156-164
OBJECTIVES: To describe lifetime prevalence rates, course and comorbidity of obsessive-compulsive disorder (OCD), obsessive-compulsive syndromes (OCS) and OC-symptoms (OC-sx) up to age 41. METHODS: In the Zurich community cohort study 591 subjects were selected after screening at the age of 19 and studied prospectively by 6 interviews from 20 to 40; they represent 1599 subjects of the normal population. The diagnoses of OCD met DSM-IV criteria.Course was assessed by graphic illustrations and prospective data. RESULTS: The lifetime prevalence rate was 3.5 % for OCD (males 1.7%, females 5.4 %) and 8.7 % for OCS (males 9.9%, females 7.5 %). The onset of OC-sx was 18 years (median); and in 70% before age 20. OCD was treated in one third of cases, OCS in 6.1%. The course of symptoms was chronic in 60%,but OCD and OCS showed in most cases considerable improvements over time. OCD reduced quality of life mostly in the subject's psychological wellbeing and at work but to a considerable extent also in other social roles. Comorbidity was prominent with bipolar disorder, panic disorder and social phobia and also significant with bulimia, binge eating, generalized anxiety disorder and suicide attempts; there was no association with substance abuse/dependence. CONCLUSION: OCD and OCD are manifestations of a wide spectrum of severity with high prevalence and strong clinical validity. The long-term course is better than generally assumed. 相似文献
93.
Angst J Gerber-Werder R Zuberbühler HU Gamma A 《European archives of psychiatry and clinical neuroscience》2004,254(2):82-91
Abstract.Objectives: The question whether bipolar I disorder should be subdivided into a preponderantly manic group (M) with no depression or only mild depression (Md) and a nuclear manic-depressive group (MD) has been rarely studied although the problem was raised more than 50 years ago. This paper seeks to elucidate this question by contributing further data.Methods: 406 patients with mood disorders hospitalised at some time during the period 1959–1963 were followed-up every five years until 1985; mortality data were collected up to 1997. Data on episodes, outcome, suicides and attempted suicides, alcohol and substance abuse/dependence and long-term medication, as well as on personality (melancholic and manic type) were collected. Major mood disorders were subclassified according to their hospitalisation for depression (D) and/or mania (M).Results: 30 manic patients (M/Md), 130 bipolar I (MD), 60 bipolar II patients (Dm) and 186 major depressive patients (D) were compared. The manic group differed from the bipolar I group in several variables: better school achievement, milder course of the illness (fewer recurrences), significantly less suicidality and a trend to less chronicity and more recovery. Manic patients required less long-term medication than bipolars and they differed in personality types from bipolars, the personality of manic patients being more often of the manic rather than the melancholic type, they were also more aggressive than bipolars. The family history data showed that the overall morbidity risk of first degree relatives of manic patients was significantly lower than that of bipolar patients.Conclusions: In accord with several other studies our data point to the existence of a more manic (M/Md) group of bipolar subjects. The diagnosis predicts a better course, lower suicidality and fewer and different treatment needs than does nuclear bipolar I (MD) disorder. The M/Md groups, as clinically interesting subgroups of the mood spectrum, should become a target of further research. 相似文献
94.
Davidson DA Wilkinson AC Kimpe LE Blais JM 《Environmental toxicology and chemistry / SETAC》2004,23(3):540-549
The exchange of chlorinated organic pollutants between air and vegetation in cold, mountain environments was investigated through the extraction of coniferous vegetation and high-volume air samples collected from the Canadian Rocky Mountains during the summers of 1999 and 2000. Concentrations of several compounds in vegetation increased as temperatures decreased, whereas atmospheric concentrations were not related to temperature. Daily cycling of these compounds between air and vegetation as a result of diurnal temperature changes was not observed. Compared with concentrations in vegetation from the Canadian Rocky Mountains, plant samples from the western valley in British Columbia (Canada) showed higher pollutant levels. Chemical partitioning between vegetation and air was not correlated with temperature, indicating that air contamination is governed by long-range transport and not by local revolatilization events. Based on these observations, we show that both deposition at higher altitudes and long-range atmospheric transport influence chemical accumulation in vegetation from the Canadian Rocky Mountains. 相似文献
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99.
Sumkin JH Klaman HM Graham M Ruskauff T Gennari RC King JL Klym AH Ganott MA Gur D 《AJR. American journal of roentgenology》2003,180(1):253-256
OBJECTIVE: We assessed the ability of technologists to accurately classify screening mammograms as either showing negative findings or requiring follow-up. SUBJECTS AND METHODS: In a prospective study, 33 technologists at a central facility and five satellite breast imaging facilities recorded whether mammograms obtained during 3019 examinations showed negative findings or findings that indicated that additional procedures were required. The technologists were not specifically trained for the experiment. The technologists' interpretations were compared with radiologists' interpretations. RESULTS: Technologists and radiologists agreed in 82% of the cases (77% negative findings and 5% requiring follow-up). Of the 175 cases recommended for follow-up by only the radiologists, 17 were ultimately biopsied and two were found to be malignant. CONCLUSION: Even without undergoing additional training, technologists can perform at reasonable levels of accuracy in classifying screening mammograms. The possibility of using technologists to group cases after the technologists have undergone training is an interesting concept that should be explored further. 相似文献
100.
Optimal reference mammography: a comparison of mammograms obtained 1 and 2 years before the present examination 总被引:3,自引:0,他引:3
Sumkin JH Holbert BL Herrmann JS Hakim CA Ganott MA Poller WR Shah R Hardesty LA Gur D 《AJR. American journal of roentgenology》2003,180(2):343-346
OBJECTIVE: We assessed and compared the benefit of using images acquired 1 year or 2 years previously during mammography interpretations. MATERIALS AND METHODS: Eleven radiologists and one resident reviewed 128 cases three times: once without prior mammograms for comparison, once with mammograms from the most recent (1 year) examination, and once with mammograms acquired 2 years previously. They were asked to determine whether the patient should be recalled for additional procedures. Performances under the three conditions were compared. RESULTS: Radiologists were significantly more accurate (p < 0.001) when comparison mammograms (obtained 1 or 2 years previously) were available. Although sensitivity was not significantly affected between the availability of mammograms from 1 or 2 years earlier (p > 0.10), the specificity was. Specificity using mammograms from the latest examination (obtained 1 year previously) as a reference was significantly better (p = 0.03) than specificity using mammograms obtained 2 years previously. CONCLUSION: Comparison mammograms are important for accurate diagnosis-in particular, for increasing specificity. The latest prior examination seems to be the optimal one for this purpose. 相似文献