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Lader E Egan D Hunsberger S Garg R Czajkowski S McSherry F 《Journal of cardiac failure》2003,9(1):4-12
BACKGROUND: The Digitalis Investigation Group (DIG) trial was a randomized double-blind placebo-controlled study that examined the effect of digoxin on mortality in 7,788 patients with heart failure and sinus rhythm. A prespecified substudy evaluated the effect of digoxin therapy on health-related quality of life (HQOL) in a subset of these patients. METHODS: Patients in the DIG trial had clinical heart failure and were randomized to either digoxin or placebo in addition to their baseline diuretic and angiotensin-converting enzyme therapy (n = 7,788). The patients in this substudy had HQOL measured using a self-administered questionnaire employing scales that measured general health, physical functioning, depression, anger, anxiety, life satisfaction, and disease specific measures. A subjective assessment by the investigator and a 6-minute walk test evaluated functional status. HQOL was measured at baseline and at the 4- and 12-month follow-up visits. RESULTS: The baseline characteristics of the patients in the quality of life substudy (n = 589) were comparable to the remaining patients in the study (n = 7,199) by age and other clinical measures, including history of prior myocardial infarction or etiology of heart failure; heart failure was of shorter duration and the ejection fraction was slightly better than in the main trial. Within the substudy, patients receiving digoxin (n = 298) or placebo (n = 291) were also similar in baseline characteristics. There was no statistically significant difference in any HQOL measure between the digoxin and the placebo groups at baseline. At the 4-month visit, only perceived health was improved in the digoxin group. At 12 months, there was no statistically significant difference in perceived health, physical functioning, Minnesota Living with Heart Failure, depression, anxiety, anger, Ladder of Life, or the 6-minute walk between the digoxin and placebo groups. CONCLUSION: In this subset of the DIG population, digoxin therapy had no effect on the HQOL in patients with heart failure in sinus rhythm. 相似文献
995.
Mechanism of increased angiotensin II levels in glomerular mesangial cells cultured in high glucose 总被引:4,自引:0,他引:4
Singh R Singh AK Alavi N Leehey DJ 《Journal of the American Society of Nephrology : JASN》2003,14(4):873-880
Previous studies have shown that glucose increases angiotensin II (AngII) levels in rat glomerular mesangial cells and that AngII mediates the inhibitory effects of high glucose on matrix degradation in these cells. The present study addresses the following questions: (1) What are the mechanisms for the generation of AngII in mesangial cells? (2) What are the effects of glucose on AngII generation by these mechanisms? Experiments employed primary mesangial cells from normal Sprague-Dawley rats. The levels of immunoreactive angiotensinogen (AGT), angiotensin I (AngI), and angiotensin II (AngII) were measured by ELISA. AGT mRNA expression was determined by Northern blot analysis. Incubation of cells for 24 h in high glucose (30 mM) increased AGT levels by 1.5-fold and increased AGT mRNA expression; this was accompanied by a 1.5-fold increment in AngI and 1.7-fold increment in AngII levels. Renin activity (measured as AngI generation in the presence of excess AGT) and ACE levels and activity were not altered by high glucose. In further experiments, the effect of high glucose on formation of Ang peptides from exogenous AngI in mesangial cell extracts was examined using HPLC. Exogenous AngI was converted into various Ang peptides, including AngII, Ang(1-9), Ang(1-7), and Ang(3-8). A significant increase in formation of AngII from AngI was observed in cells incubated in high glucose. In addition, AngII production from exogenous Ang(1-9) in cell extracts was also stimulated by high glucose. These findings demonstrate that glucose increases mesangial AngII levels via an increase in AGT and AngI. In addition, this study provides new information that Ang(1-9) is produced by mesangial cells, can be converted to AngII, and that this conversion is also stimulated under high-glucose conditions. 相似文献
996.
Expression of the sodium iodide symporter (NIS) gene in tumor cells may provide a novel mechanism for treating cancer. The NIS mediates the normal physiological transport of iodide across the thyroid cell membrane. This mechanism of iodide uptake has been used to both diagnose and treat thyroid cancer. Tissue expression of the NIS is largely limited to the thyroid; therefore, expression of the NIS gene in cancer cells would allow for specific iodine uptake, radioisotope accumulation, and treatment. In this study, we directly compared the human and rat NIS (rNIS) for their ability to concentrate radioisotope into human and rodent cancer cells. Perchlorate-sensitive (125)I uptake in multiple cell lines was demonstrated following transduction with retroviral vectors expressing either the human or rNIS gene. Surprisingly, iodine uptake was consistently higher with the rNIS gene, up to 5-fold greater, when compared to the human gene, even within a variety of human tumor cell lines. This iodine uptake allowed for cell killing following (131)I treatment in NIS-transduced cells when assayed by in vitro clonogenic assays. These results demonstrate that the rNIS gene provides superior iodine uptake ability, and may be preferable for use in designing anticancer gene therapy approaches. 相似文献
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998.
Rekha Matta K. S. Neelakandhan 《Indian Journal of Thoracic and Cardiovascular Surgery》1995,11(2):49-52
We report a case of Massive Thymic Hyperplasia in an adolescent male. The excised mass weighed 1280 gm, one of the largest
ever reported in literature. 相似文献
999.
Frank L. Kretzer Rekha S. Mehta Evelyn S. Brown Helen A. Mintz-Hittner 《Documenta ophthalmologica. Advances in ophthalmology》1990,74(3):205-211
Our current surgical treatment for threshold retinopathy of prematurity (ROP) is based upon three concepts which emerged from
morphologic and biochemical study of 250 pairs of whole eye donations obtained over a ten year period. 1) Spindle cells normally
migrate and canalize to form inner retinal vessels, but when stressed, spindle cells secrete angiogenic factors. The clinical
implication is that transretinal cryotherapy to the avascular retina is efficacious because it obliterates spindle cells.
The number and timing of cryosessions are determined by the migration and kinetics of spindle cells. 2) Myofibroblasts originate
from the shunt, are the major cellular component of extraretinal fibrovascular proliferation (EFP), and contract to produce
retinal distortion and detachment. The clinical implication is that a second transretinal cryotherapy session should obliterate
the shunt and the EFP, and should eliminate the source of retinal traction. 3) Anterior ocular growth occurs exponentially
during the period when ROP develops and is treated. The clinical implication is that a prophylactic scleral buckle supports
the fixed surface area of the developing retina while the choroid and sclera enlarge anteriorly. Retinal distortion produces
misaligned photoreceptors, and retinal detachment results in rapid retinal death. 相似文献
1000.
Esophageal atresia may be associated with a long interval or gap between the upper and lower pouches. Despite a variety of procedures to elongate the esophagus, surgeons have been unable to achieve esophageal continuity in many patients. Three infants with esophageal atresia and long gaps recently underwent hydrostatic dilation of the distal esophageal pouch followed by primary anastomosis. The technique entailed passing a balloon-tipped catheter through a gastrostomy site to the distal esophageal pouch. The balloon was inflated to a diameter sufficient to occlude the distal esophagus. Dilute contrast material was then infused under fluoroscopic visualization to a maximal pressure of 145 cm H2O. Dilations were performed daily over a 2-week period, followed by surgery. Primary anastomosis was accomplished in all patients. The promising results in these patients should stimulate other investigators to assess this technique in infants with this challenging surgical problem. 相似文献