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961.
962.
Study Type – Therapy (case series)
Level of Evidence 4

OBJECTIVE

? To investigate the optimal management and prognostic factors of patients with malignant transformation (MT) in germ‐cell tumour (GCT) by re‐evaluating Institutional series.

PATIENTS AND METHODS

? Patients with an MT within GCT have been identified from the institutional database and all slides have been reviewed by the referral pathologist.

RESULTS

? From June 1982 to October 2009, 48 patients and 13 somatic histologies have been identified. Twelve patients presented with stage I, 12 with stage II and 24 with stage III disease. All stage I patients are alive and disease‐free after a median follow up of 88 months (interquartile range 38–103). ? Of the 36 metastatic cases, 11 underwent GCT‐oriented chemotherapy plus surgery and seven of them are currently disease‐free. Three patients underwent MT‐chemotherapy, one relapsed and is still under treatment. Overall, 17 patients relapsed (35%) and three of them have been rescued by GCT‐chemotherapy. Five‐year overall survival was 100% for stage I, 80% (95% CI 40–94) for stage II and 44% (95% CI 19–67) for stage III patients. Stage III disease at MT, incomplete surgical removal and primitive neuroectodermal tumours plus adenocarcinoma histologies were significant adverse prognostic factors for survival.

CONCLUSIONS

? New insights emerged into the impact of histology and chemotherapy on MT. The development of an adenocarcinoma component as well as the possible efficacy of a GCT‐tailored chemotherapy in a multimodal strategy are addressed for the first time, while disease extent at transformation and extent of radical surgery are confirmed as significant prognosticators. ? An international web database for registration of all cases of MT worldwide is presented.  相似文献   
963.
Brassicaceae are widely consumed in many parts of the world and their dietary intake has been associated with cancer risk reduction. Extracts and metabolites derived from cruciferous vegetables have thus gained popularity as potential cancer chemopreventive agents. We have previously found, unexpectly, that glucoraphanin, the most extensively present glucosinolate in these vegetables, is a potent mutagen bioactivating Phase-I enzyme inducer. In the present study, the influence of black cabbage seed extract, rich in glucoraphanin, was investigated on Phase-I enzymes in different organs of male or female rats. Oral seed extract injection at 120 or 240 mg/kg b.w. for one or four consecutive days, significantly affected various cytochrome P450 (CYP) –linked monooxygenases in a complex way being the lung the most responsive organ (in males, up to ∼2600% increase for CYP2B1/2 isoform and ∼96% loss for CYP1A1, CYP3A1/2). These findings indicate that the extract may strongly enhance and/or suppress rat xenobiotic biotransformation pathways and that caution should be paid to the possible influence on human metabolism. These data suggest an overall evaluation of the balance between beneficial vs. possible adverse effects for each agent, even if of natural origin, prior to routinely, preventive mass use.  相似文献   
964.
External beam radiotherapy (RT) is an essential part of the management of intracranial tumors and has been used in treating pituitary adenomas for more than five decades. It has been demonstrated that conventional RT for postoperative residual or progressive nonfunctioning pituitary adenomas (NFAs) present an excellent long-term local tumor control, although its use has been limited because of the potential late toxicity related to radiation treatments. Recent advances in radiation techniques have led to more accurate treatments, rendering obsolete many commonly held views of the “old” radiotherapy. New techniques include intensity modulated radiotherapy, volumetric-modulated arc therapy, and stereotactic techniques, either stereotactic radiosurgery or fractionated stereotactic radiotherapy. New techniques allow the delivering of higher radiation doses to the target with rapid dose fall-off in the surrounding normal tissues, and potentially limiting the long term toxicity of radiation. In this review, we present a critical analysis of the most recent available literature on the use of radiation in patients with NFAs, focusing particularly on the efficacy and safety of radiation stereotactic techniques.  相似文献   
965.
966.
Aims and objectives. To examine the psychometric properties of the Nurses’ Observation Scale for Cognitive Abilities. Background. Nurses’ Observation Scale for Cognitive Abilities is a behavioural rating scale comprising eight subscales that represent different cognitive domains. It is based on observations during contact between nurse and patient. Design. Observational study. Methods. A total of 50 patients from two geriatric wards in acute care hospitals participated in this study. Reliability was examined via internal consistency and inter‐rater reliability. Construct validity of the Nurses’ Observation Scale for Cognitive Abilities and its subscales were explored by means of convergent and divergent validity and post hoc analyses for group differences. Results. Cronbach’s αs of the total Nurses’ Observation Scale for Cognitive Abilities and its subscales were 0·98 and 0·66–0·93, respectively. The item–total correlations were satisfactory (overall > 0·4). The intra‐class coefficients were good (37 of 39 items > 0·4). The convergent validity of the Nurses’ Observation Scale for Cognitive Abilities against cognitive ratings (MMSE, NOSGER) and severity of dementia (Clinical Dementia Rating) demonstrated satisfactory correlations (0·59–0·70, p < 0·01), except for IQCODE (0·30, p > 0·05). The divergent validity of the Nurses’ Observation Scale for Cognitive Abilities against depressive symptoms was low (0·12, p > 0·05). The construct validity of the Nurses’ Observation Scale for Cognitive Abilities subscales against 13 specific neuropsychological tests showed correlations varying from poor to fair (0·18–0·74; 10 of 13 correlations p < 0·05). Conclusions. Validity and reliability of the total Nurses’ Observation Scale for Cognitive Abilities are excellent. The correlations between the Nurses’ Observation Scale for Cognitive Abilities subscales and standard neuropsychological tests were moderate. More conclusive results may be found if the Nurses’ Observation Scale for Cognitive Abilities subscales were to be validated using more ecologically valid tests and in a patient population with less cognitive impairment. Relevance to clinical practice. Use of the Nurses’ Observation Scale for Cognitive Abilities yields standardised, reliable and valid information about patient’s cognitive behaviour in daily practice. The Nurses’ Observation Scale for Cognitive Abilities aids in tailoring nursing interventions to patients’ specific cognitive needs. We advocate the implementation of the Nurses’ Observation Scale for Cognitive Abilities both in research and at geriatric units in acute care hospitals.  相似文献   
967.
Ochratoxin A (OTA) is a secondary metabolite of Asper-gillus and Penicillium, microorganisms that can be haz-ardous to health when present as food contaminants. OTA is a potent member of a group of mycotoxins. Prolonged exposure to mycotoxins in the diet is related to cancer, among other diseases. Hepatocellular car-cinoma (HCC) accounts for 70%-90% of primary liver cancers and is the third leading cause of cancer-related deaths worldwide. In a recent study, Ibrahim et al proposed a correlation between the incidence of HCC and contamination with OTA. Analysis of OTA in serum samples showed that HCC patients had the highest incidence of OTA of the subjects examined (5-fold higher than that of the control group). OTA levels were significantly increased in HCC patients. This study demonstrates that chronic exposure to high levels of OTA may be associated with a high risk of liver cancer development. Future epidemiologic studies of HCC should focus on good practices in food preparation, food storage and the consumption of OTA-containing foods.  相似文献   
968.
969.

Background

There is limited research about IPV against women and associated factors in Sub-Saharan Africa, not least Mozambique. The objective of this study was to examine the occurrence, severity, chronicity and “predictors” of IPV against women in Maputo City (Mozambique).

Methods

Data were collected during a 12?month-period (consecutive cases, with each woman seen only once) from 1,442 women aged 15–49?years old seeking help for abuse by an intimate partner at the Forensic Services at the Maputo Central Hospital, Maputo City, Mozambique. Interviews were conducted by trained female interviewers, and data collected included demographics and lifestyle variables, violence (using the previously validated Revised Conflict Tactics Scale (CTS2), and control (using the Controlling Behaviour Scale Revised (CBS-R). The data were analysed using bivariate and multivariate methods.

Results

The overall experienced IPV during the past 12?months across severity (one or more types, minor and severe) was 70.2% (chronicity, 85.8?±?120.9).a Severe IPV varied between 26.3-45.9% and chronicity between 3.1?±?9.1-12.8?±?26.9, depending on IPV type. Severity and chronicity figures were higher in psychological aggression than in the other IPV types. Further, 26.8% (chronicity, 55.3?±?117.6) of women experienced all IPV types across severity. The experience of other composite IPV types across severity (4 combinations of 3 types of IPV) varied between 27.1-42.6% and chronicity between 35.7?±?80.3-64.9?±?110.9, depending on the type of combination. The combination psychological aggression, physical assault and sexual coercion had the highest figures compared with the other combinations. The multiple regressions showed that controlling behaviours, own perpetration and co-occurring victimization were more important in “explaining” the experience of IPV than other variables (e.g. abuse as a child).

Conclusions

In our study, controlling behaviours over/by partner, own perpetration, co-occurring victimization and childhood abuse were more important factors in “explaining” sustained IPV. More investigation into women’s IPV exposure and its “predictors” is warranted in Sub-Saharan Africa, particularly Mozambique.
  相似文献   
970.
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