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11.
J.T. Carter M.L. Melcher L.L. Carlson M.E. Roland P.G. Stock 《American journal of transplantation》2006,6(4):753-760
HIV-infected patients are increasingly referred for kidney transplantation, and may be at an increased risk for rejection. Treatment for rejection frequently includes thymoglobulin. We studied thymoglobulin's effect on CD4+ T-cell count, risk of infection and rejection reversal in 20 consecutive HIV-infected kidney recipients. All patients used antiretroviral therapy and opportunistic infection prophylaxis. Maintenance immunosuppression consisted of prednisone, mycophenolate mofetil and cyclosporine. Eleven patients received thymoglobulin (7 for rejection and 4 for delayed/slow graft function) while 9 did not. These two groups were similar in age, gender, race, donor characteristics and immunosuppression. Mean CD4+ T-cell counts remained stable in patients who did not receive thymoglobulin, but became profoundly suppressed in those who did, decreasing from 475 +/- 192 to 9 +/- 10 cells/microL (p < 0.001). Recovery time ranged from 3 weeks to 2 years despite effective HIV suppression. Although opportunistic infections were successfully suppressed, low CD4+ T-cell count was associated with increased risk of serious infections requiring hospitalization. Rejection reversed in 6 of 7 patients receiving thymoglobulin. We conclude that thymoglobulin reverses acute rejection in HIV-infected kidney recipients, but produces profound and long-lasting suppression of the CD4+ T-cell count associated with increased risk of infections requiring hospitalization. 相似文献
12.
Using pupillometry and sympathetic skin responses we compared the changes in local and systemic autonomic function within
one week of a migraine attack. We investigated whether the measurement of the pupillary light reflex provides further information
on the pathophysiology of migraine.
Forty-two migraine patients and forty-two healthy age-matched controls were included. The parameters that were measured were
the amplitude of the pupillary light reflex, the pupil size at the beginning of the measurement, the latency, the velocity
of constriction and the velocity at the end of the dilatation.
The average pupil size was 6.43 mm in the migraine group and 6.7 mm in the control group (p < 0.01). Reduced velocity of
constriction and smaller amplitude of constriction in migraine patients within two days of an attack were signs of a parasympathetic
dysfunction (p < 0.05). The sympathetic skin response did not differ significantly between migraine sufferers and controls.
These findings indicate that both parasympathetic and sympathetic nerves supplying the eye are involved in migraine headache
presumably due to effects on the pericarotid sympathetic fibers and involvement of trigeminal-parasympathetic reflexes.
Received: 24 July 2001, Accepted: 16 July 2002
Correspondence to K. Schepelmann, M. D. 相似文献
13.
Imaging of activated microglia with PET and [11C]PK 11195 in corticobasal degeneration. 总被引:3,自引:0,他引:3
Karsten Henkel Jochen Karitzky Michaela Schmid Irina Mader Gerhard Glatting Jürgen W Unger Bernd Neumaier Albert C Ludolph Sven N Reske G Bernhard Landwehrmeyer 《Movement disorders》2004,19(7):817-821
Positron emission tomography (PET) using [(11)C]PK 11195, a ligand for peripheral benzodiazepine receptor binding sites, offers the opportunity to image activated microglia in vivo. This tool may therefore be used to display the occurrence of microglial activation in the course of neurodegeneration. A patient with the clinical diagnosis of corticobasal degeneration (CBD) and left-sided symptoms was studied using fluorodeoxyglucose (FDG) and [(11)C]PK 11195 PET. We found a marked right hemispheric hypometabolism and asymmetric microglial activation in corresponding areas of the basal ganglia and right temporal and parietal cortex. [(11)C]PK 11195 PET suggests involvement of microglial activation in the pathogenesis of CBD. 相似文献
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Manic episode with psychotic symptoms induced by subthalamic nucleus stimulation in a patient with Parkinson's disease. 总被引:5,自引:0,他引:5
Jan Herzog Julia Reiff Paul Krack Karsten Witt Bettina Schrader Dieter Müller Günther Deuschl 《Movement disorders》2003,18(11):1382-1384
Deep brain stimulation of the subthalamic nucleus (STN-DBS) is an established therapy for Parkinson's disease (PD). A manic episode with psychotic symptoms induced by STN-DBS occurred in a previously psychiatrically healthy patient, focusing on the role of STN-DBS in influencing not only motor but also emotional behaviour. 相似文献
16.
R. Vijayaraghavan M. Schaper R. Thompson M. F. Stock Y. Alarie 《Archives of toxicology》1993,67(7):478-490
A system was developed for exposure of unanesthetized mice to airborne chemicals and for continuous measurement of their breathing pattern prior to, during and following exposure. By measuring inspiratory and expiratory airflows (VI and VE), and integration with time to yield tidal volume (VT), we obtained characteristic modifications to the normal breathing pattern. These permitted recognition that a specific portion of the respiratory tract was affected by the selected airborne chemicals. Following recognition, we also quantitated the degree of effect using one specific measurement in each case. An effect on the upper respiratory tract, induced by the sensory irritant, 2-chlorobenzylchloride, was quantitated by measuring a decrease in respiratory frequency. An effect on the conducting airways, induced by the airway constrictor, carbamylcholine, was quantitated by a decrease in VE at the mid-point of VT. An effect at the alveolar level, induced either by the vagal nerve ending stimulant, propranolol, or by the pulmonary irritant, machining fluid G, was quantitated by an increase in the length of a pause induced at the end of expiration. The system is easy to construct and operate and can be used to rapidly evaluate the effects of airborne chemicals on the respiratory tract. 相似文献
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In a prospective randomized study was conducted on 80 patients undergoing elective hernia repair to assess whether a new slit-suction drainage is less painful than a Redon-suction drainage. Main endpoint of the study was the traction power in order to remove the drain. Other endpoints were pain at the time of removal of the drain and the effectiveness to draw off secretion. To remove redon drain the average traction power was 226 pond and to remove slit drain the average traction power was only 25 pond. The difference was significant (p less than 0.01). At the time of removal patients with slit drain rarely complained about pain (p less than 0.01). On contrary, patients with Redon drain always complained about pain. Clotting were seldom shown in slit drains and were frequently shown in redon drains. Both slit drains and redon drains were effective to drain secretion. As the new slit drain was more comfortable for patients following hernia repair slit drain should always be used as subcutaneous suction drainage. 相似文献
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