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101.
Nancy Young MD Tam Nguyen MD Richard Wiet MD FACS 《Operative Techniques in Otolaryngology》2003,14(4):263-267
Cochlear implants are the single greatest advancement of the late 20th century for the deaf and hearing impaired. Recent expanding guidelines as well as surgical techniques are discussed. Cochlear implantation is currently the only means to restoring partial hearing to patients with severe-to-profound sensorineural loss not aidable with conventional amplification. 相似文献
102.
Abstract: The proximity of the α‐amine and β‐thiol of α‐amino terminal‐cysteine (NT‐Cys) residues in peptides imparts unique chemical properties that have been exploited for inter‐ and intra‐molecular ligation of unprotected peptides obtained through both synthetic and biological means. A reversible protecting group orthogonal to other protection strategies and reversible under mild conditions would be useful in simplifying the synthesis, cleavage, purification and handling of such NT‐Cys peptides. It could also be useful for the sequential ligation of peptides. To this end, we explored tri‐one chemistry and found that ninhydrin (indane‐1,2,3 trione) reacted readily with cysteine or an NT‐Cys‐containing peptide on‐ or off‐resin at pH 2–5 to form Ninhydrin‐protected Cys (Nin‐Cys) as a thiazolidine (Thz). The Thz ring, protecting both the amino and thiol groups in Nin‐Cys, completely avoids the formylation and Thz side reactions found during hydrofluoric acid (HF) cleavage when N‐π‐benzyloxymethyl histidine groups are present. Nin‐Cys is stable during coupling reactions and various cleavage conditions with trifluoroacetic acid or HF, but is deprotected under thiolytic or reducing conditions. These properties enable a facile one‐step deprotection and end‐to‐end‐cyclization reaction of Nin‐Cys peptides containing C‐terminal thioesters. 相似文献
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106.
GA Smith SD Strausbaugh C Harbeck-Weber DM Cohen BJ Shields JD Powers 《Pediatrics》1997,100(5):825-830
OBJECTIVE: To compare the effectiveness of three new topical anesthetics that do not contain cocaine (prilocaine-phenylephrine, tetracaine-phenylephrine [tetraphen], and tetracaine-lidocaine-phenylephrine) to that of tetracaine-adrenaline-cocaine (TAC) during laceration repair in children. DESIGN: Prospective, randomized, double-blind clinical trial. SETTING: The emergency department of an urban children's hospital. PARTICIPANTS: Children 1 year of age or older with a laceration = 5 cm in length that required suturing. Intervention. A total of 240 children were randomly assigned to one of four treatment groups. OUTCOME MEASURES: Pain felt during suturing was scored by suture technicians, research assistants, parents, and patients >/= 5 years of age using a visual analogue scale (VAS). Suture technicians, research assistants, and parents also scored pain using a seven-point Likert scale. In addition, suture technicians completed an anesthetic effectiveness scale. RESULTS: There was consistently no difference demonstrated between the effectiveness of tetraphen and that of TAC for each outcome measure of each observer group. A statistically significant difference was seen among anesthetics when comparing VAS and Likert scale scores of suture technicians and Likert scale scores of research assistants. Based on post hoc analyses, these statistically significant differences were between TAC and prilocaine-phenylephrine (suture technician VAS and Likert scale) and between TAC and tetracaine-lidocaine-phenyl-ephrine (suture technician Likert scale), but not between TAC and tetraphen. When power analyses were performed using alpha = 0.05 and beta = 0.20, it was possible to detect a difference of 1.2 VAS units for each of the observer groups. Based on anesthetic effectiveness scale scores, the three new topical preparations collectively performed significantly better on the face and scalp than on the extremities (relative risk = 1.83; 95% confidence interval 1.20 < relative risk < 2.79). CONCLUSION: This study demonstrated the effectiveness and safety of three new non-cocaine-containing topical anesthetics. Consistently, there was no statistical difference demonstrated between the effectiveness of tetraphen and that of TAC for each outcome measure of each observer group. Tetraphen offers an effective alternative to TAC during laceration repair in children. 相似文献
107.
Increased placental apoptosis in intrauterine growth restriction 总被引:2,自引:0,他引:2
Stephen C. Smith MB ChB Philip N. Baker DM E.Malcolm Symonds MD 《American journal of obstetrics and gynecology》1997,177(6):1395-1401
OBJECTIVES: Our purpose was to investigate a possible role for apoptosis in the pathophysiologic mechanisms of intrauterine growth restriction. STUDY DESIGN: Placental samples were obtained from 43 uncomplicated third-trimester pregnancies and from 26 pregnancies complicated by intrauterine growth restriction. The definition used to identify cases of intrauterine growth restriction depended on three criteria: clinical evidence of suboptimal growth, ultrasonographic evidence of deviation from an appropriate growth percentile, and individualized birth weight ratios <10th percentile. Light microscopy was used to quantify the incidence of apoptosis. Electron microscopy and TUNEL (terminal deoxynucleotidyl transferase–mediated deoxyuridine triphosphate nick end labeling) staining were used to confirm the occurrence of apoptosis. RESULTS: Quantification of apoptosis (medians and interquartile ranges) resulted in the following values: normal third trimester (n = 43) 0.14% of cells (0.08% to 0.20%) and intrauterine growth restriction third trimester (n = 26) 0.24% of cells (0.16% to 0.29%). The incidence of apoptosis was significantly higher in placentas from pregnancies with intrauterine growth restriction compared with normal third-trimester placentas (p < 0.01, Mann Whitney U test). CONCLUSIONS: These results suggest that apoptosis may play a role in the pathophysiologic mechanisms of intrauterine growth restriction.(Am J Obstet Gynecol 1997;177:401) 相似文献
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109.
S. S. Wijesinha B. L. Atkins N. E. Dudley P. K. H. Tam 《Pediatric surgery international》1998,13(2-3):146-148
A prospective study of 25 boys who underwent circumcision for medical reason was performed. Specimens of periurethral bacterial
flora were taken before operation as well as 3 weeks after surgery, so that each boy acted as his own control. Before circumcision,
13 (52%) harboured uropathogenic organisms (Escherichia coli and other coliforms, Enterococcus spp, Proteus spp, Pseudomonas spp, and Klebsiella spp); after circumcision, none of the boys had uropathogens, the only organisms cultured from the periurethral region being
skin commensals. We postulate that circumcision converts a ‘cul-de-sac' that is a reservoir of organisms capable of causing
ascending urinary tract infection into a surface colonised by natural skin organisms. This study provides circumstantial evidence
supporting the idea that circumcision in well-selected patients may confer protection from urine infection.
Accepted: 15 March 1997 相似文献
110.
Gábor RÉPÁssy Csaba Forster-HorvÁth Attila JuhÁsz Róza ÁDÁny Anna TamÁssy József TÍmÁr 《Pathology oncology research : POR》1998,4(1):14-21
Twelve laryngeal squamous cell carcinoma cases (7 laryngeal and 5 hypopharyngeal cancer; 15 samples) were analysed by immunohistochemistry
for the expression of invasion markers CD44v6/v3, NM23 and matrix metalloproteinase, MMP2. The laryngeal epithelium showed
CD44v6+v3+NM23- /MMP2- phenotype. When tumors were grouped into TNM categories the phenotype of the T2 and T3 tumors was similar, characterised
by decreased CD44v3+ and lack of MMP2 expressions. Meanwhile the NM23 expression was more frequent in T3 tumors. In T4 stage the frequency of
NM23 and MMP2 positive cases increased (5/6 and 4/6, respectively) but there was no correlation with the appearence of lymph
node metastasis. Comparison of the phenotype of laryngeal and hypopharyngeal tumors, irrespective of the TNM stages, revealed
characteristic differences: T2 stage laryngeal tumors showed decreased CD44v3 and occasional NM23 and MMP2 positivity, while
in T3 stage these tumors were characterised by increased frequency of NM23 positivity. The phenotype of the hypopharyngeal
tumors was significantly different with a high frequency of MMP2 positive cases (5/6) and NM23+1ow CD44v3+ phenotype. The sharp differences in the phenotypes of laryngeal and hypopharyngeal carcinomas were connected to the differences
in their invasive capacity unlike to the size of the tumors, since the T4 stage hypopharyngeal tumors had a significantly
smaller size than laryngeal ones, even at lower stages.
This work was supported by the Hungarian Ministry of Welfare: ETT No: T-11-100/93 相似文献