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81.
82.
Bergman GJ Winters JC van der Heijden GJ Postema K Meyboom-de Jong B 《Journal of manipulative and physiological therapeutics》2002,25(9):543-549
BACKGROUND: We present the design of the Groningen Manipulation Study. This randomized controlled trial is part of the Dutch Shoulder Disability Study, a comprehensive prognostic cohort study on shoulder disorders, with randomized controlled interventions in subcohorts. OBJECTIVE: To evaluate the effectiveness of manipulative treatment of the structures of the shoulder girdle, in addition to standard treatment by the general practitioner for relief of shoulder symptoms and prevention of persistent or recurrent shoulder symptoms. METHODS: A total of 250 patients with shoulder symptoms and a functional limitation of the shoulder girdle will be included from 30 general practices in Groningen, The Netherlands. All participating patients receive standard treatment by the general practitioner and will be randomly allocated to additional manipulative treatment. Evaluation measurements take place 6, 12, 26, and 52 weeks after randomization. CONCLUSION: The short-term primary outcome measure is the proportion of patients with relief of shoulder complaints and the long-term primary outcome is the proportion of patients without persistent or recurrent shoulder symptoms. Dependent and independent variables include a structured medical history, a physical examination of the shoulder and shoulder girdle, and a measure of the mobility of the cervico-thoracic spine with a 6-degree-of-freedom electromagnetic tracking device. 相似文献
83.
Hoos MB Plasqui G Gerver WJ Westerterp KR 《European journal of applied physiology》2003,89(6):624-626
The present study investigated the use of a tri-axial accelerometer, Tracmor2, for the measurement of physical activity in children. Eleven children [age 6.9 (2.2) years, body mass 19.5 (5.3) kg and height 112.3 (14.4) cm] were studied. Total daily energy expenditure (TDEE) was measured using the doubly labeled water method over a 2-week period. In addition, basal metabolic rate (BMR) was determined by the ventilated hood system. Physical activity level (PAL) was defined as TDEE/BMR. Tracmor2 was worn during the same 2-week period throughout waking hours after which average counts per day were calculated. The average counts per day were shown to be highly correlated to PAL values measured by doubly labeled water: PAL = 1.156×10–5×Tracmor2 average counts day–1 + 0.978 (r=0.79, P<0.01). In conclusion, Tracmor2 is a valid instrument to measure physical activity in children under free-living conditions. 相似文献
84.
Robach P Lafforgue E Olsen NV Déchaux M Fouqueray B Westerterp-Plantenga M Westerterp K Richalet JP 《Pflügers Archiv : European journal of physiology》2002,444(6):821-828
Plasma volume (PV) decreases at high altitude, but is rapidly restored upon return to sea-level (RSL). The aim of this study was (1) to describe PV recovery upon RSL with concomitant changes in major fluid regulating hormones, and (2) to test the hypothesis that PV recovery is promoted by the administration of a plasma expander. Ten male subjects were evaluated at rest and during submaximal exercise at sea-level (SL), after 7 days at 4,350 m (H7), and on RSL, on day 1 (RSL1, rest only) and day 2 (RSL2). PV (measured by carbon monoxide rebreathing), plasma renin (Ren), aldosterone (Aldo), atrial natriuretic factor (ANF) and arginine vasopressin (AVP) were measured at rest and during exercise. The subjects were divided into two groups 1 h before RSL, one group receiving PV expansion (475+/-219 ml) to ensure normovolemia (PVX, n=6), the others serving as controls (Control, n=4). PV decreased by 13.6% in H7 ( n=10), but was restored in RSL2, regardless of PVX. Ren, Aldo and AVP, which were similar in both groups, were reduced in H7, but were higher in RSL2 (rest or exercise). ANF was modified neither by hypoxia nor by PVX. Total water intake was reduced in H7, but remained normal in RSL in both groups, whereas water output dropped in RSL. PVX increased urine flow rate in RSL1 compared with subjects not given PVX. The present results suggest that PV recovery during early RSL is mainly due to a decreased diuresis, promoted at least in part by changes in fluid regulating hormones. However, neither PV recovery, nor hormonal responses were altered with PVX-induced normovolemia upon RSL. 相似文献
85.
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87.
Comparison of CT and sonography in the diagnosis of acute appendicitis: a blinded prospective study 总被引:7,自引:0,他引:7
Poortman P Lohle PN Schoemaker CM Oostvogel HJ Teepen HJ Zwinderman KA Hamming JF 《AJR. American journal of roentgenology》2003,181(5):1355-1359
OBJECTIVE: Our objective was to compare the accuracy of CT and sonography in a general community teaching hospital for the diagnosis of acute appendicitis in patients with suspected acute appendicitis. SUBJECTS AND METHODS. In this prospective study, 199 consecutive patients with clinical signs and symptoms of acute appendicitis were examined with sonography (graded compression technique) and CT (focused unenhanced single-detector helical CT [5-mm section thickness]. CT was performed from the L2 vertebral body to the pubic symphysis, and no patients were given oral, rectal, or IV contrast medium. The primary sonographic criterion for diagnosing acute appendicitis was an incompressible appendix with a transverse outer diameter of 6 mm or larger with incompressible periappendicular inflamed fat with or without an appendicolith. The primary CT criterion for diagnosing acute appendicitis was the identification of an appendix with a transverse outer diameter of 6 mm or larger with associated periappendiceal inflammatory changes. The results, independently reported, were correlated with surgical and histopathologic findings. RESULTS: One hundred thirty-two patients had acute appendicitis at surgery, and 67 patients did not. The sensitivity of CT and sonography was 76% and 79%, respectively; the specificity was 83% and 78%; the accuracy was 78% and 78%; the positive predictive value was 90% and 87%; and the negative predictive value was 64% and 65%. CONCLUSION: Unenhanced focused single-detector helical CT and graded compression sonography performed in a general community teaching hospital by both body imaging radiologists and general radiology staff members have a similar accuracy for the diagnosis of acute appendicitis. 相似文献
88.
6-L-18F-fluorodihydroxyphenylalanine PET in neuroendocrine tumors: basic aspects and emerging clinical applications. 总被引:2,自引:0,他引:2
Pieter L Jager Raman Chirakal Christopher J Marriott Adrienne H Brouwers Klaas Pieter Koopmans Karen Y Gulenchyn 《Journal of nuclear medicine》2008,49(4):573-586
In recent years, 6-l-18F-fluorodihydroxyphenylalanine (18F-DOPA) PET has emerged as a new diagnostic tool for the imaging of neuroendocrine tumors. This application is based on the unique property of neuroendocrine tumors to produce and secrete various substances, a process that requires the uptake of metabolic precursors, which leads to the uptake of 18F-DOPA. This nonsystematic review first describes basic aspects of 18F-DOPA imaging, including radiosynthesis, factors involved in tracer uptake, and various aspects of metabolism and imaging. Subsequently, this review provides an overview of current clinical applications in neuroendocrine tumors, including carcinoid tumors, pancreatic islet cell tumors, pheochromocytoma, paraganglioma, medullary thyroid cancer, hyperinsulinism, and various other clinical entities. The application of PET/CT in carcinoid tumors has unsurpassed sensitivity. In medullary thyroid cancer, pheochromocytoma, and hyperinsulinism, results are also excellent and contribute significantly to clinical management. In the remaining conditions, the initial experience with 18F-DOPA PET indicates that it seems to be less valuable, but further study is required. 相似文献
89.
Cystic fibrosis is the most common serious genetic disorder in people of European descent. Treatment of these patients is
ongoing throughout life and until now has been aimed at the consequences and is still not curative. Over the past 10–20 years,
there has been a dramatic improvement of mortality rates for cystic fibrosis, due in large part to advances in medical care.
The average age of survival for young people with cystic fibrosis is pushing well into the 20s with one third living into
their 30s. Consequently, education plays a major role in management of patients with cystic fibrosis, and starts directly
after being sure of the diagnosis. Growing up, these patients experience a lot of problems, and these are especially marked
in the adolescent. A special problem, for many cystic fibrosis patients is becoming an adult. Continuity in care for these
patients from the pediatric to the adult department is not always guaranteed.
It is concluded that patients with cystic fibrosis should be treated in specialized centers, and such treatment cannot be
carried out sufficiently by one person, but has to be embedded in a team of caregivers. 相似文献
90.
Helle-Brit Fiebrich Adrienne H. Brouwers Klaas Pieter Koopmans Elisabeth G.E. de Vries 《European journal of cancer (Oxford, England : 1990)》2009,45(13):2312-2315
AimCarcinoid patients frequently develop a second primary malignancy (SPM), which can deserve full treatment. Distinguishing a SPM from carcinoid lesions is therefore important. Differentiation can be achieved using the difference in uptake between different positron emission tomography (PET) tracers.Methods and resultsBetween January 2005 and August 2008, 105 carcinoid patients were seen at the Department of Medical Oncology for treatment and follow-up. We identified 3 patients who presented with a new SPM in whom differentiation between carcinoid lesions and the SPM was guided by functional imaging of the catecholamine pathway with 6-fluoro-[18F]l-dihydroxyphenylalanine (18F-DOPA) PET and [18F]fluoro-2-deoxy-d-glucose (18F-FDG) PET as radiotracer for the glucose metabolism. All 3 patients had metastatic carcinoid disease and localised adenocarcinoma based on the PET-scans. For the adenocarcinoma they received curative treatment.ConclusionThe difference in uptake between these PET techniques can be used for decision making when a primary or metastatic SPM is suspected. 相似文献