全文获取类型
收费全文 | 8120篇 |
免费 | 360篇 |
国内免费 | 65篇 |
专业分类
耳鼻咽喉 | 105篇 |
儿科学 | 152篇 |
妇产科学 | 69篇 |
基础医学 | 1304篇 |
口腔科学 | 191篇 |
临床医学 | 501篇 |
内科学 | 2219篇 |
皮肤病学 | 141篇 |
神经病学 | 573篇 |
特种医学 | 341篇 |
外科学 | 1301篇 |
综合类 | 17篇 |
预防医学 | 191篇 |
眼科学 | 100篇 |
药学 | 443篇 |
中国医学 | 27篇 |
肿瘤学 | 870篇 |
出版年
2023年 | 55篇 |
2022年 | 93篇 |
2021年 | 142篇 |
2020年 | 75篇 |
2019年 | 112篇 |
2018年 | 140篇 |
2017年 | 128篇 |
2016年 | 141篇 |
2015年 | 182篇 |
2014年 | 233篇 |
2013年 | 321篇 |
2012年 | 410篇 |
2011年 | 422篇 |
2010年 | 251篇 |
2009年 | 238篇 |
2008年 | 399篇 |
2007年 | 497篇 |
2006年 | 498篇 |
2005年 | 457篇 |
2004年 | 490篇 |
2003年 | 460篇 |
2002年 | 496篇 |
2001年 | 174篇 |
2000年 | 151篇 |
1999年 | 177篇 |
1998年 | 128篇 |
1997年 | 112篇 |
1996年 | 101篇 |
1995年 | 90篇 |
1994年 | 100篇 |
1993年 | 80篇 |
1992年 | 117篇 |
1991年 | 106篇 |
1990年 | 81篇 |
1989年 | 79篇 |
1988年 | 51篇 |
1987年 | 83篇 |
1986年 | 78篇 |
1985年 | 50篇 |
1984年 | 45篇 |
1983年 | 40篇 |
1982年 | 46篇 |
1981年 | 53篇 |
1980年 | 41篇 |
1979年 | 36篇 |
1978年 | 35篇 |
1977年 | 30篇 |
1976年 | 29篇 |
1975年 | 29篇 |
1973年 | 28篇 |
排序方式: 共有8545条查询结果,搜索用时 0 毫秒
991.
Tetsuo Hayashi Kenzo Shirasawa Takeshi Maeda Takayoshi Ueta Keiichiro Shiba Yukihide Iwamoto 《Journal of orthopaedic science》2012,17(3):319-322
Spinal cord compression sometimes occurs in patients with multiple myeloma (MM), and it usually involves bone infiltration from proliferative plasma cells leading to vertebral collapse, with the occasional extradural extension of a plasmacytoma [1]. However, a localized amyloid tumor, also known as an amyloidoma in the spine, is rare, and a few patients [2, 3] had underlying multiple myeloma (MM). The present case was unique in the form without osteolysis or vertebral collapse, which did not originate from adjacent spinal vertebrae, in a patient with a known diagnosis of MM. 相似文献
992.
Kakeji Y Nakanoko T Yoshida R Eto K Kumashiro R Ikeda K Egashira A Saeki H Oki E Morita M Ikeda T Maehara Y 《Surgery today》2012,42(6):554-558
Purpose
Gastrointestinal stromal tumors (GISTs) should be surgically resected, even those smaller than 5?cm in size, which is the threshold of clinical malignancy for submucosal tumors (SMTs) in the gastrointestinal tract. This study reviewed the use of laparoscopic surgery for gastric partial resection of GISTs or SMTs that were suspected to be GISTs.Methods
Eighteen patients underwent laparoscopic partial resection of the stomach for GISTs or SMTs. The tumor location was confirmed by intraluminal endoscopy. One-half of the circumference around the tumor was dissected, and the tumor was turned toward the abdominal cavity. The nonresected part of the tumor and the edge of the incision line was lifted up using forceps, and the incision line was closed using laparoscopic stapling devices.Results
Two cases were diagnosed as GIST by endoscopic biopsy. Six patients underwent endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) examinations, which diagnosed five GISTs. There were 18 tumors smaller than 5?cm, including 10 GISTs, 4 leiomyomas, 3 schwannomas, and one heterotopic pancreas.Conclusions
Endoscopic ultrasound-guided FNAB is recommended for definite preoperative diagnosis of histopathologically unknown SMTs to determine the indications for surgery. The laparoscopic approach with the assistance of endoscopy is useful for improving the curability, with minimal invasiveness for the partial resection of GISTs. 相似文献993.
994.
Yoshimitsu Hayashi Tetsuo Katoh Kenichiro Asano Akira Onozaki Kaoru Sakurai Koichi Asahi Masaaki Nakayama Tsuyoshi Watanabe 《Clinical and experimental nephrology》2012,16(5):690-696
Background
Glomerular hypertension aggravates glomerular sclerosis by inducing growth factors, e.g., transforming growth factor-β (TGF-β) to mesangial matrix expansion. Smads are intracellular proteins that transmit signals from TGF-β to nucleus, and Smads are also negatively regulated by inhibitory Smads (I-Smads), Smad6 and Smad7. However, little is known about the role of I-Smads in glomerular hypertension. We studied I-Smad expression in cultured mesangial cells subjected to mechanical stretch as an in vitro model of glomerular hypertension.Methods
Rat mesangial cells were cultured under cyclic mechanical stretch conditions using the Flexercell Strain Unit. Phosphorylated Smad1 and Smad2 were determined by Western blots. The expression of Smad6 and Smad7 mRNAs was determined by Northern blots. Stretch-mediated I-Smad mRNAs of cells pre-treated with MAPK-ERK kinase inhibitor, U0126, were also determined. Localization of phospho-Smad1, Smad6 and Smad7 proteins in the glomerulus of Dahl salt-sensitive rats was determined by immunohistochemistry.Results
Stretch stress increased phospho-Smad1 levels, and significantly decreased Smad6 mRNA to 32?% of control, and increased Smad7 mRNA to 136?% of control. U0126 significantly attenuated stretch-mediated decreases in Smad6 mRNA, but had no effect on stretch-mediated increases in Smad7 mRNA. Phospho-Smad1, Smad6 and Smad7 proteins were localized in podocytes and mesangial cells of Dahl rats.Conclusion
Mechanical stretch increases phospho-Smad1 levels and down-regulates Smad6 mRNA expression in mesangial cells. Stretch-mediated down-regulation of Smad6 is partially involved in ERK1/2 activation. These results indicate that glomerular hypertension might augment Smad1 signaling with concomitant attenuation of Smad6-mediated negative feedback. 相似文献995.
Nozawa Y Sato A Piao H Morioka T Narita I Oite T 《Clinical and experimental nephrology》2012,16(2):221-230
Background and methods
There is increasing evidence that a change in glomerular hemodynamics may promote the development of glomerulosclerosis. In this study, we focused on the pharmacological effects of 2 contrasting agents, etodolac, a preferential cyclooxygenase-2 inhibitor, and beraprost sodium (BPS), a prostaglandin I2 analog, delivered renally, on the disease course of progressive anti-Thy-1 (ATS) glomerulonephritis.Results
Intravital microscopic analysis showed that the diameters of glomerular capillaries and glomerular blood flow in unilaterally nephrectomized (Nx) rats treated locally with BPS were significantly increased, as compared to those of Nx rats treated locally with normal saline (NS) or etodolac. We then examined the effects of BPS and etodolac on the course of progressive glomerulosclerosis. Mesangial cell proliferation, adhesion of glomerular capillary tufts and crescent formation in the BPS-treated group appeared to be more severe compared to the ATS?+?NS and the ATS?+?etodolac groups. Scoring of mesangial proliferation and glomerulosclerosis revealed that local BPS treatment significantly worsened glomerular pathology. At day 28, there were significant differences in blood flow between the ATS?+?etodolac group and both the ATS?+?NS and ATS?+?BPS groups, indicating that local treatment with etodolac enhanced the recovery of glomerular circulation.Conclusion
This study provides hemodynamic-based evidence showing that disturbance of intraglomerular microcirculation is a critical marker for progressive glomerulonephritis. 相似文献996.
Tetsuo Nozaki Yasuhiro Iida Akihiro Morii Yasuyoshi Fujiuchi Hikaru Suzuki Mitsuyo Okazawa Minoru Iwata Hideki Fuse 《Surgical Practice》2012,16(4):154-159
Adrenocorticotropic hormone (ACTH)‐independent bilateral adrenocortical macronodular adrenocortical hyperplasia (AIMAH) is a rare cause of Cushing's syndrome (CS). Traditionally, bilateral adrenalectomy with subsequent lifetime steroid replacement has been considered to be the treatment of choice. In the present study, we evaluated the long‐term results of unilateral adrenalectomy in subclinical CS (SCS) due to AIMAH, with regard to the main laboratory and clinical abnormalities. Two patients with confirmed SCS due to AIMAH underwent unilateral laparoscopic adrenalectomy to reduce the cortisol‐secreting tissue. These procedures were successfully conducted in both cases without open conversion, and no surgery‐related morbidity occurred. In both cases, the size of the remaining adrenal gland appeared quite stable, and neither of the patients showed a Cushingoid appearance. Unilateral adrenalectomy achieved satisfactory and prolonged control of cortisol secretion, and also reduced the risk of metabolic disorders and cardiovascular disease after surgery. It can be a safe and effective treatment for SCS due to AIMAH, while maintaining the patient's quality of life. 相似文献
997.
998.
Shigeru Nakai Kunitoshi Iseki Noritomo Itami Satoshi Ogata Junichiro James Kazama Naoki Kimata Takashi Shigematsu Toshio Shinoda Tetsuo Shoji Kazuyuki Suzuki Masatomo Taniguchi Kenji Tsuchida Hidetomo Nakamoto Hiroshi Nishi Seiji Hashimoto Takeshi Hasegawa Norio Hanafusa Takayuki Hamano Naohiko Fujii Ikuto Masakane Seiji Marubayashi Osamu Morita Kunihiro Yamagata Kenji Wakai Atsushi Wada Yuzo Watanabe Yoshiharu Tsubakihara 《Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy》2012,16(6):483-521
A nationwide statistical survey of 4226 dialysis facilities was conducted at the end of 2010, and 4166 facilities (98.6%) responded. The number of new patients introduced into dialysis was 37 512 in 2010. This number has decreased for two consecutive years since it peaked in 2008. The number of patients who died in 2010 was 28 882, which has been increasing every year. The number of patients undergoing dialysis at the end of 2010 was 298 252, which is an increase of 7591 (2.6%) compared with that at the end of 2009. The number of dialysis patients per million at the end of 2010 was 2329.1. The crude death rate of dialysis patients in 2010 was 9.8%, and has been gradually increasing. The mean age of the new patients introduced into dialysis was 67.8 years and the mean age of the entire dialysis patient population was 66.2 years. Regarding the primary disease of the new patients introduced into dialysis, the percentage of patients with diabetic nephropathy was 43.6%, which is a slight decrease from that in the previous year (44.5%). Patients with diabetic nephropathy as the primary disease accounted for 35.9% of the entire dialysis patient population, which approaches the percentage of patients with chronic glomerulonephritis as the primary disease (36.2%). The percentage of patients who had undergone carpal tunnel release surgery (CTx) was 4.3%, which is a slight decrease from that at the end of 1999 (5.5%). The decrease in the percentage of patients who had undergone CTx was significant among the patients with dialysis durations of 20–24 years (1999, 48.0%; 2010, 23.2%). A total weekly Kt/V attributable to peritoneal dialysis and their residual functional kidney was 1.7 or higher for 59.4% of patients who underwent peritoneal dialysis. 相似文献
999.
Koji Matsuo Shin Nishio Shinya Matsuzaki Haruko Iwase Seiji Kagami Shu Soeda Hirokazu Usui Ryutaro Nishikawa Mikio Mikami Takayuki Enomoto 《Gynecologic oncology》2021,160(3):748-754
ObjectiveTo examine the association between surgical margin status and recurrence pattern in invasive vulvar Paget’s disease.MethodsThis is a preplanned secondary analysis of a previously organized nationwide retrospective study in Japan (JGOG-1075S). Women with stage I-IV invasive vulvar Paget’s disease who received surgical treatment from 2001-2010 were examined (n=139). Multivariable analysis was performed to assess local-recurrence, distant-recurrence, and all-cause mortality based on surgical margin status.ResultsThe median age was 70 years. The majority had stage I disease (61.2%), and the median tumor size was 5.0cm. Nodal metastasis was observed in 15.1%. Simple vulvectomy (46.0%) was the most common surgery type followed by radical vulvectomy (28.1%). More than half received vulvar reconstructive surgery (59.0%). Positive surgical margin was observed in 35.3%, and close margin <1cm was observed in 29.5%. Vulvectomy type was not associated with surgical margin status (P=0.424). The median follow-up was 5.8 years. Positive surgical margin was associated with increased local-recurrence (5-year cumulative rates for positive versus negative margin: 35.8% versus 15.0%, P=0.010) but not distant-recurrence (18.3% versus 16.0%, P=0.567). Positive surgical margin was also associated with increased all-cause mortality (5-year overall survival rates for positive versus negative margin: 72.6% versus 88.2%, P=0.032). In multivariable analysis, positive surgical margin remained an independent factor associated with increased risk of local-recurrence (hazard ratio 2.80, 95% confidence interval 1.18-6.63) and all-cause mortality (hazard ratio 2.87, 95% confidence interval 1.20-6.83).ConclusionPositive surgical margin appears to be common in invasive vulvar Paget’s disease that is associated with increased local-recurrence and all-cause mortality risks. Role of alternative surgical technique or adjuvant therapy merits further investigation to improve local disease control. 相似文献