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91.
Human leukocyte antigen matching and fetal loss: results of a 10 year prospective study 总被引:6,自引:0,他引:6
Ober C; Hyslop T; Elias S; Weitkamp LR; Hauck WW 《Human reproduction (Oxford, England)》1998,13(1):33-38
The role that maternal and fetal human leukocyte antigen (HLA) genes play
in pregnancy is unknown, but it has been suggested that fetuses whose HLA
alleles do not differ from maternal alleles (i.e. histocompatible fetuses)
are more likely to be aborted than fetuses with HLA alleles that differ
from maternal alleles (i.e. histoincompatible fetuses). To elucidate the
role of HLA compatibility in pregnancy, we tested the hypothesis that
couples who match for HLA alleles or haplotypes would have reduced
fertility because only these couples could produce histocompatible fetuses.
We conducted a 10 year prospective study of HLA matching and pregnancy
outcome in 111 Hutterite couples, providing information on 251 pregnancies.
A logistic regression analysis was performed to determine the effects of
HLA matching at HLA regions and loci on pregnancy outcome (fetal loss
versus delivery). Significantly increased fetal loss rates were observed
among couples matching for the entire 16-locus haplotype (P = 0.002). Among
the individual loci, loss rates were increased among couples matching for
HLA-B (P = 0.019), HLA-C (P = 0.033) and the complement component, C4 (P =
0.043). We interpret these results as evidence that matching for the entire
16-locus haplotype and/or alleles at an HLA-B-linked locus confers
significant risk for fetal loss.
相似文献
92.
93.
Rhinitis as an independent risk factor for adult-onset asthma 总被引:27,自引:0,他引:27
Guerra S Sherrill DL Martinez FD Barbee RA 《The Journal of allergy and clinical immunology》2002,109(3):419-425
BACKGROUND: For many years, the association between asthma and rhinitis has primarily been attributed to a common allergic background. Recently, it has been suggested that asthma and rhinitis are associated in the absence of atopy. The nature of this association is not well known. OBJECTIVE: The purpose of this study, which was performed in a large, longitudinal community population, was to determine the extent to which rhinitis is an independent risk factor for adult-onset asthma. METHODS: We carried out a nested case-control study from the longitudinal cohort of the Tucson Epidemiologic Study of Obstructive Lung Diseases. One hundred seventy-three incident patients with physician-confirmed asthma were compared with 2177 subjects who reported no asthma or shortness of breath with wheezing. Potential risk factors, including the presence of rhinitis, were assessed before the onset of asthma (patients) or before the last completed survey (control subjects). RESULTS: Rhinitis was a significant risk factor for asthma (crude odds ratio, 4.13; 95% confidence interval, 2.88-5.92). After adjustment for years of follow-up, age, sex, atopic status, smoking status, and presence of chronic obstructive pulmonary disease, the magnitude of the association was reduced but still highly significant (adjusted odds ratio, 3.21; 95% confidence interval, 2.19-4.71). After stratification, rhinitis increased the risk of development of asthma by about 3 times both among atopic and nonatopic patients and by more than 5 times among patients in the highest IgE tertile. Patients with rhinitis with persistent and severe nasal symptoms and a personal history of physician-confirmed sinusitis had an additional increased risk of asthma development. CONCLUSION: We conclude that rhinitis is a significant risk factor for adult-onset asthma in both atopic and nonatopic subjects. The nature of the association between rhinitis and asthma is open to interpretation. 相似文献
94.
Schover LR; Thomas AJ; Falcone T; Attaran M; Goldberg J 《Human reproduction (Oxford, England)》1998,13(4):862-866
Many couples undergoing in-vitro fertilization (IVF) are at a higher risk
of having a child with a genetic abnormality. In a sample of 55 consecutive
couples starting IVF, only 33% had no genetic risk factor. The most common
genetic risks were advanced maternal age and possible abnormalities
associated with severe male infertility. Despite education on these risks,
71% of couples had no interest in receiving formal genetic counselling.
Only 14% of couples at risk would consider using a gamete donor to avoid
transmitting a genetic disorder to a child. The triple test to screen for
fetal abnormalities was acceptable to 82% of couples, but only 47% planned
to have amniocentesis or chorionic villi sampling. Couples were
significantly more likely to opt for prenatal testing if they would
consider terminating a pregnancy should the fetus have a severe genetic
abnormality (P < 0.01). Roman Catholic couples tended to have more
conservative attitudes about pregnancy termination. Socio-economic status
and whether the infertility factor was male or female were not predictors
of a couple's attitudes.
相似文献
95.
96.
Diminished lung function as a predisposing factor for wheezing respiratory illness in infants 总被引:22,自引:0,他引:22
F D Martinez W J Morgan A L Wright C J Holberg L M Taussig 《The New England journal of medicine》1988,319(17):1112-1117
In a prospective study of 124 infants enrolled as newborns, we assessed the relation between initial lung function and the subsequent incidence of lower respiratory tract illness during the first year of life. The risk of having a wheezing illness was 3.7 times higher (95 percent confidence interval, 0.9 to 15.5; P = 0.06) among infants whose values for total respiratory conductance (the reciprocal of the resistance to air flow of the entire respiratory system) were in the lowest third, as compared with infants with values in the upper two thirds of the range of values for the group. Boys with initial values in the lowest third for an indirect index of airway conductance had a 10-fold increase (95 percent confidence interval, 2.2 to 44.2; P = 0.001) in the risk of having a wheezing illness. A 16-fold increase (95 percent confidence interval, 1.7 to 147.1; P = 0.002) in the risk of having a wheezing illness was found among girls whose initial values for lung volume at the end of tidal expiration were in the lowest third. We conclude that diminished lung function is a predisposing factor for the development of a first wheezing illness in infants. 相似文献
97.
98.
Holt PG Sly PD Martinez FD Weiss ST Björkstén B von Mutius E Wahn U 《Nature immunology》2004,5(7):695-698
The spiraling costs of asthma treatment seem set to continue rising, given the equivocal performance of the latest generation of specific anti-inflammatory drugs in trials in adult asthmatics. We argue that the continuation of this trend is inevitable unless there is a substantial realignment of entrenched drug development policy in the pharmaceutical industry and a parallel shift in licensing policy by regulatory authorities to encourage the development of drugs capable of halting the progression from acute to chronic asthma when the disease first manifests in childhood. The theoretical framework for such an approach, including proof-of-principle data from studies in children with early-stage disease and a range of candidate drugs, already exists. What is needed is informed debate on the risks versus potential benefits of this approach. 相似文献
99.