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81.
Cho DK Ha JW Chang BC Lee SH Yoon SJ Shim CY Cho JR Kim JS Choi EY Rim SJ Chung N 《The American journal of cardiology》2008,101(3):374-377
This study aimed to investigate the factors determining early left atrial (LA) reverse remodeling after mitral valve (MV) surgery. The left atrium is frequently dilated in patients with mitral stenosis (MS) or mitral regurgitation (MR). MV surgery usually results in LA volume reduction. However, the factors associated with LA reverse remodeling after MV surgery are not clearly defined. One hundred thirty-eight patients (51 men, 87 women; mean age, 53 years) underwent transthoracic echocardiography before and after MV surgery. Maximal LA volume was measured using the prolate ellipsoid model. The percentage of LA volume change was calculated. The patients were grouped according to age (<50 vs >or=50 years), predominant lesion (pure MR vs some degree of MS), type of surgery (MV repair vs MV replacement), and preoperative rhythm (sinus rhythm vs atrial fibrillation). LA volume decreased from 147+/-93 to 103+/-43 ml (p<0.001) after surgery. LA reverse remodeling was more prominent in patients who were <50 years old (percentage of LA volume change -31.2+/-17.4 vs -18.4+/-19.2, p<0.001), had pure MR (percentage of LA volume change -30.4+/-18.6 vs -17.3+/-18.2, p<0.001), and had a preoperative sinus rhythm (percentage of LA volume change -28.5+/-17.7 vs -20.5+/-20.0, p=0.019). In conclusion, on stepwise multiple regression analysis, preoperative LA volume, predominant lesion, age, and cardiac rhythm were significant predictors of LA reverse remodeling. A larger preoperative LA volume, MR rather than MS, younger age at the time of surgery, and sinus rhythm were important predictors of LA reverse remodeling after MV surgery. 相似文献
82.
Shim CY Park S Choi EY Kang SM Cha BS Ha JW Rim SJ Lee HC Chung N 《Metabolism: clinical and experimental》2008,57(4):448-452
The aim of this study was to address whether albuminuria could predict myocardial dysfunction in diabetic patients without overt heart disease. We studied 67 patients with normal left ventricular (LV) ejection fraction and no evidence of LV hypertrophy or coronary artery disease (47 patients with type 2 diabetes mellitus and hypertension and 20 patients with hypertension only). Diabetes patients were divided into 3 groups based on albuminuria status: group II = no albuminuria (n = 20, <30 mg/d), group III = microalbuminuria (n = 13, 30-300 mg/d), and group IV = macroalbuminuria (n = 14, >300 mg/d). Twenty patients with hypertension only served as a control group (group I). Conventional 2-dimensional and Doppler echocardiography was done. Peak strain, peak systolic strain rate (SR), and peak diastolic SR of 6 LV segments in the apical views were measured and averaged in each patient. Conventional 2-dimensional parameters such as LV ejection fraction; left atrium volume index; LV mass; deceleration time; and mitral early peak, mitral late peak, myocardial early peak diastolic, and myocardial peak systolic velocities were not different among the 4 groups. However, peak strains were significantly lower in group III (P = .002) and group IV (P < .001) than in group I; and the absolute value of peak systolic SR was lower in group III (P = .033) and group IV (P < .001) than in group I. Furthermore, the value of peak diastolic SR was lower in group IV than in group I (P = .014). In diabetic patients with albuminuria, Doppler strain and SR imaging detected subclinical LV systolic and diastolic dysfunction; and albuminuria was associated with myocardial dysfunction in diabetic patients without overt heart disease. 相似文献
83.
Kyungeun Kim Yong Mee Cho Bong-Hee Park Jae-Lyun Lee Jae Y Ro Heounjeong Go Jung Weon Shim 《International journal of clinical and experimental pathology》2015,8(1):743-750
High-grade non-muscle-invasive bladder cancer (Non-MIBC) has a high risk of stage progression to muscle-invasive bladder cancer (MIBC) and could be managed either conservatively by transurethral resection of bladder tumor (TURBT) or more aggressively by radical cystectomy. The selection of patients who may benefit from early radical intervention is a challenge. To define useful prognostic markers for progression, we analyzed clinicopathological features and immunohistochemical expression patterns of E2F1, p27, survivin, p53, EZH2, IMP3, TSC1/hamartin, fatty acid synthase, androgen receptor, 14-3-3σ, MAGEA4, and NY-ESO-1 on 118 cases of high-grade Non-MIBC. During the mean follow-up period of 64.3 months, progression occurred in 18 patients (15.3%). Histologically, large amount of invasive component (> 50%) was noted in 35 cases (29.7%) and was strongly associated with progression. Among the 12 biomarkers, high expressions of E2F1 and nuclear p27 were noted in 46 cases (40.0%) and 14 cases (12.7%), respectively, and were associated with frequent progression. Using multivariate analysis, the proportion of invasive component and high E2F1 expression were independent prognostic factors for the prediction of progression. Our results indicated that large amount of invasive carcinoma component and high expressions of p27 and E2F1 were predictive markers for progression in Non-MIBC. Therefore, we suggest that these parameters, especially proportion of invasive carcinoma component and E2F1 expression, should be evaluated during pathologic examination and considered during selection of the appropriate management strategy for high grade Non-MIBC patients. 相似文献
84.
Song-I Yang Byoung-Ju Kim So-Yeon Lee Hyo-Bin Kim Cheol Min Lee Jinho Yu Mi-Jin Kang Ho-Sung Yu Eun Lee Young-Ho Jung Hyung Young Kim Ju-Hee Seo Ji-Won Kwon Dae Jin Song GwangCheon Jang Woo-Kyung Kim Jung Yeon Shim Soo-Young Lee Hyeon Jong Yang Dong In Suh Seo Ah Hong Kil-Yong Choi Youn Ho Shin Kangmo Ahn Kyung Won Kim Eun-Jin Kim Soo-Jong Hong COCOA Study Group 《Allergy, asthma & immunology research》2015,7(6):573-582
Purpose
To investigate whether prenatal exposure to indoor fine particulate matter (PM2.5) and environmental tobacco smoke (ETS) affects susceptibility to respiratory tract infections (RTIs) in infancy, to compare their effects between prenatal and postnatal exposure, and to determine whether genetic factors modify these environmental effects.Methods
The study population consisted of 307 birth cohort infants. A diagnosis of RTIs was based on parental report of a physician''s diagnosis. Indoor PM2.5 and ETS levels were measured during pregnancy and infancy. TaqMan was used for genotyping of nuclear factor erythroid 2-related factor (Nrf2) (rs6726395), glutathione-S-transferase-pi (GSTP) 1 (rs1695), and glutathione-S-transferase-mu (GSTM) 1. Microarrays were used for genome-wide methylation analysis.Results
Prenatal exposure to indoor PM2.5 increased the susceptibility of lower RTIs (LRTIs) in infancy (adjusted odds ratio [aOR]=2.11). In terms of combined exposure to both indoor PM2.5 and ETS, prenatal exposure to both pollutants increased susceptibility to LRTIs (aOR=6.56); however, this association was not found for postnatal exposure. The Nrf2 GG (aOR=23.69), GSTM1 null (aOR=8.18), and GSTP1 AG or GG (aOR=7.37) genotypes increased the combined LRTIs-promoting effects of prenatal exposure to the 2 indoor pollutants. Such effects of prenatal indoor PM2.5 and ETS exposure were not found for upper RTIs.Conclusions
Prenatal exposure to both indoor PM2.5 and ETS may increase susceptibility to LRTIs. This effect can be modified by polymorphisms in reactive oxygen species-related genes. 相似文献85.
Comparison of gait before and after superficial trunk muscle exercise and
deep trunk muscle exercise
[Purpose] The purpose of this study was to examine the effects of superficial trunk
muscle and deep trunk muscle exercise on gait. [Subjects] The subjects were 45 young
adults who voluntarily consented to participate. The subjects were divided into a control
group, a superficial muscle exercise group, and a deep muscle exercise group with 15
participants in each group. [Methods] Each group performed the exercises 5 times a week
for 4 weeks. A Gait Analyzer was used to measure the subjects’ gait. A one-way ANOVA was
conducted for analysis between each group. [Results] After 4 weeks, the values from right
heel contact to foot flat, left foot flat to heel off, right foot flat to heel off, and
left heel off to toe off significantly differed among the groups. [Conclusion] The
superficial trunk muscle exercise improved stability, such as the period of mid stance
during gait. The deep trunk muscle exercise improved mobility, such as heel contact to
foot flat and heel off to toe off during gait.Key words: Superficial trunk muscle exercise, Deep trunk muscle exercise, Gait 相似文献
86.
[Purpose] The purpose of this study was to compare shoulder stabilization muscle
activities according to postural changes during flexi-bar exercise. [Subjects] The
subjects included 18 students (10 males, 8 females) at B University. [Methods] The
subjects performed the following flexi-bar exercises: 1) medio-lateral oscillation with
the 90° shoulder abduction, with the hand in the neutral position; 2) dorso-ventral
oscillation with 90° shoulder flexion, with the hand in the neutral position; 3)
superior-inferior oscillation with 90° shoulder flexion, with the 80° hand pronation.
[Results] The activity of the serratus anterior showed significant differences between
each position; however, activities of the upper trapezius and middle trapezius were not
significantly different. [Conclusion] The results of this study indicate that posture
control is important for selective strengthening of the serratus anterior muscle during
flexi-bar exercises.Key words: Flexi-bar exercise, Shoulder stabilization, Muscle activity 相似文献
87.
Mi Na Kim Hyun Ki Kim Choong Nam Shim Hyun Jik Lee Hyuk Lee Jun Chul Park Sung Kwan Shin Sang Kil Lee Yong Chan Lee 《Digestive and liver disease》2014,46(10):898-902
Background
Endoscopic submucosal dissection is applied in selected cases of signet ring cell early gastric cancer. However, factors related to curability of signet ring cell early gastric cancer with this method have not been fully evaluated. Our aim was to evaluate factors related to incomplete resection in signet ring cell early gastric cancer with endoscopic submucosal dissection.Methods
A retrospective analysis was performed on a total of 126 consecutive patients with signet ring cell early gastric cancer who had undergone endoscopic submucosal dissection at the Severance Hospital in Korea, between March 2007 and March 2012. The clinical outcomes were reviewed and factors related to incomplete resection were analysed.Results
Multivariate analysis showed that large tumour size was the only significant factor related to incomplete resection (P = 0.006; hazard ratio, 1.040; 95% confidence interval, 1.101–1.084). In addition, large tumour size was the only significant factor related to endoscopic size underestimation (P < 0.001; hazard ratio, 1.391; 95% confidence interval, 1.221–1.586). The rate of endoscopic size underestimation was significantly higher in tumours with a size ≥20 mm (P < 0.001).Conclusions
To improve the curability of signet ring cell early gastric cancer with endoscopic submucosal dissection, larger tumours (especially tumour with a size ≥20 mm) should be resected with a larger margin. 相似文献88.
Jong Min Lee Ji Young Jang Seung Hwan Lee Hongjin Shim Jae Gil Lee 《Yonsei medical journal》2014,55(6):1606-1610
Purpose
The aim of this study was to evaluate the feasibility of short hospital stays after laparoscopic appendectomy for uncomplicated appendicitis.Materials and Methods
The records of 142 patients who underwent laparoscopic appendectomy for uncomplicated appendicitis from January 2010 to December 2012 were analyzed retrospectively. Patients were allocated to an early (<48 hours) or a late (>48 hours) group by postoperative hospital stay. Postoperative complications and readmission rates in the two groups were evaluated and compared.Results
Overall mean patient age was 50.1 (±16.0) years, and mean hospital stay was 3.8 (±2.8) days. Fifty-four patients (group E, 38.0%) were discharged within 48 hours of surgery, and 88 patients (group L, 62.0%) stayed more than 48 hours. Overall complication rates were similar in the two groups (14.8% vs. 21.6%, p=0.318), and wound complications (13.0% vs. 12.5%), postoperative bowel obstruction (1.9% vs. 2.3%), and abdominal pain (1.9% vs. 3.4%) were not significantly different.Conclusion
Patients that undergo laparoscopic appendectomy due to uncomplicated appendicitis may be safely discharged within 48 hours. Further study should be conducted to determine the optimal length of hospital stay after laparoscopic appendectomy to reduce hospital costs. 相似文献89.
Sung-Jin Hong Myeong-Ki Hong Young-Guk Ko Donghoon Choi Geu-Ru Hong Jae-Kwang Shim Young-Lan Kwak Sak Lee Byung-Chul Chang Yangsoo Jang 《Yonsei medical journal》2014,55(5):1246-1252
Purpose
We sought to evaluate the clinical usefulness of decision making by a multidisciplinary heart team for identifying potential candidates for transcatheter aortic valve implantation (TAVI) in patients with symptomatic severe aortic stenosis.Materials and Methods
The multidisciplinary team consisted of two interventional cardiologists, two cardiovascular surgeons, one cardiac imaging specialist, and two cardiac anesthesiologists.Results
Out of 60 patients who were screened as potential TAVI candidates, 31 patients were initially recommended as appropriate for TAVI, and 20 of these 31 eventually underwent TAVI. Twenty-two patients underwent surgical aortic valve replacement (AVR), and 17 patients received only medical treatment. Patients who underwent TAVI and medical therapy were older than those who underwent surgical AVR (p<0.001). The logistic Euroscore was significantly highest in the TAVI group and lowest in the surgical AVR group (p=0.012). Most patients in the TAVI group (90%) and the surgical AVR group (91%) had severe cardiac symptoms, but only 47% in the medical therapy group had severe symptoms. The cumulative percentages of survival without re-hospitalization or all-cause death at 6 months for the surgical AVR, TAVI, and medical therapy groups were 84%, 75%, and 28%, respectively (p=0.007, by log-rank).Conclusion
TAVI was recommended in half of the potential candidates following a multidisciplinary team approach and was eventually performed in one-third of these patients. One-third of the patients who were initially considered potential candidates received surgical AVR with favorable clinical outcomes. 相似文献90.
Jong Bum Choi Yon Hee Shim Youn-Woo Lee Jeong Soo Lee Jong-Rim Choi Chul Ho Chang 《Yonsei medical journal》2014,55(5):1430-1435