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51.
Yukinao Sakai Tomoyuki Otsuka Dai Ohno Tsuneo Murasawa Saori Sakai Shuichi Tsuruoka 《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》2014,18(2):181-184
Because active vitamin D preparations and calcimimetics have been widely used to treat secondary hyperparathyroidism, maintenance of acceptable serum calcium and phosphate levels is important. A 2.75 mEq/L dialysate calcium product, which may bring the calcium balance closer to 0, has recently been launched, and we had an opportunity to examine its possible benefits. We performed a 6‐month retrospective review after switching from 3.0 mEq/L to 2.75 mEq/L calcium dialysate in 85 outpatients undergoing chronic hemodialysis. We evaluated blood biochemical parameters, including predialysis and postdialysis serum calcium and phosphate levels, predialysis intact parathyroid hormone (iPTH) levels; dialysis dose (Kt/V); and doses of concomitant active vitamin D preparations, calcimimetics, phosphate binder, and erythropoiesis‐stimulating agents. Postdialysis calcium levels were significantly lower and predialysis corrected calcium levels significantly decreased. The change in calcium levels before and after dialysis was smaller after switching of the dialysate than before. iPTH levels significantly increased 1 month after switching of the dialysate. No remarkable changes were observed in phosphate levels or Kt/V. The dose of alfacalcidol, one of the concomitant drugs, somewhat increased, and no remarkable changes in dosage were observed for other concomitant drugs. These results were favorable in terms of calcium balance. However, there may be limitations in interpreting the results, but the resultant calcium levels suggest that switching to 2.75 mEq/L calcium dialysate may improve the control of calcium levels. In addition, it is hoped that the treatment choice of secondary hyperparathyroidism is extended. 相似文献
52.
Igarashi K Hayashi M Sato M Aiba T Yoneyama O Waguri N Furukawa K Sugimura K Shibuya H 《Nihon Shokakibyo Gakkai zasshi》2012,109(3):451-459
A 64-year-old man with a 2-month history of abdominal distension was admitted for transient cerebral ischemic attack. A CT scan revealed massive ascites. Laparoscopy showed multiple whitish nodules on the visceral peritoneum and the omentum. Peritoneal biopsy revealed tumor cells consistent with malignant peritoneal mesothelioma (MPeM). Pemetrexed in combination with cisplatin was administered because it has been reported to be active in patients with MPeM. However his disease progressed. As second-line therapy paclitaxel was tried which yielded a complete response (CR). Eighteen months later he developed abdominal pain of the right upper region where a CT scan showed a mass with surrounding inflammation. As third-line therapy, gemcitabine was administered and again resulted in a CR. He is alive at 3 years from first presenting. Searches for case studies published in medical journals on MPeM were carried out, and 59 cases were analyzed in comparison with this case. 相似文献
53.
Yoshiaki Nagao Tsuneo Tatara Kimihiko Fujita Takashi Sugi Joji Kotani Munetaka Hirose 《Journal of anesthesia》2013,27(3):359-365
Purpose
Despite the importance of the inhibition of catabolic response to surgery, the effects of different anesthetic techniques on the catabolic response in surgical patients are controversial. This study compared the endocrine-metabolic responses and protein catabolism during gastrectomy in patients who received either sevoflurane or propofol anesthesia with remifentanil.Methods
Thirty-seven patients (American Society of Anesthesiologists status I–III) aged 20–79 years undergoing elective gastrectomy were randomly assigned to receive sevoflurane anesthesia with remifentanil (n = 19) or intravenous propofol anesthesia (Propofol-Lipuro® 1 %; B. Braun, Melshungen AG, Germany) with remifentanil (n = 18). Urine samples were collected every 1 h after skin incision (0 h) and the urinary 3-methylhistidine:creatinine ratio (3-MH/Cr ratio) was used as a marker of protein catabolism. Respiratory quotient was measured during a 1 h period following skin incision.Results
The 3-MH/Cr ratio significantly increased at 1–2 and 2–3 h compared to 0 and 0–1 h in both groups, but the propofol group exhibited a lower 3-MH/Cr ratio (nmol/μmol) than the sevoflurane group at 1–2 h (15.7 vs. 18.2, P = 0.012) and 2–3 h (15.9 vs. 18.1, P = 0.025). A difference was observed in the respiratory quotient between the sevoflurane and propofol groups (0.726 vs. 0.707, P = 0.003).Conclusion
A lower 3-MH/Cr ratio and a lower respiratory quotient during propofol anesthesia, compared to those exhibited during sevoflurane anesthesia, suggest that protein sparing probably occurs through the utilization of medium-chain triglycerides contained in the fat emulsion of propofol solution as a fuel source. 相似文献54.
Toru Nakano Koh Sugawara Kenji Hirau Yutaka Hirano Masaji Hashimoto Tsuneo Kaiho Noriaki Ohuchi 《International journal of surgery case reports》2013,4(7):619-622
INTRODUCTIONPrimary adenocarcinoma of the 4th portion of the duodenum is reported less frequently than those other portions of the duodenum. Therefore, few reports discuss the diagnosis and treatment of this malignancy.PRESENTATION OF CASEA 54-year-old woman was admitted to our hospital with a complaint of nausea and vomiting after a meal. Upper gastrointestinal examination and a duodenogram revealed a Type 2 tumor of the 4th portion of the duodenum, which was diagnosed as well-differentiated tubular adenocarcinoma by endoscopic biopsy. Partial resection of the duodenum and jejunum was performed on the basis of intraoperative evaluation of negative lymph node metastasis around the pancreas and proximal duodenum with no macroscopic invasion toward the pancreas and proximal duodenal margin. Her postoperative course was uneventful without any sign of recurrence 5 years later.DISCUSSIONPrimary adenocarcinoma in the 4th portion is relatively less common. It is not easy to diagnose this disease. Patients with primary duodenal adenocaricinoma, who are medically fit to undergo surgery, should be given the option of aggressive resection. Duodeno-cephalo-pancreatectomy remains the standard treatment for adenocarcinomas of the 1st and 2nd portion of the duodenum. Partial resection is the preferred surgical method for patients with adenocarcinoma of the 3rd and 4th portions of the duodenum.CONCLUSIONThis report describes a rare case of primary adenocarcinoma of the 4th portion of the duodenum, successfully treated by partial resection of the duodenum and jejunum. However, larger studies are required to clarify the indications for the preferred surgical method for this malignancy. 相似文献
55.
Shunji Hasegawa Takeshi Matsushige Hirofumi Inoue Midori Takahara Madoka Kajimoto Hiroshi Momonaka Chiemi Ishida Saya Tanaka Tsuneo Morishima Takashi Ichiyama 《Brain & development》2013
Background: Influenza-associated encephalopathy (IE) is a serious complication during influenza viral infection. Common clinical symptoms of IE include seizures and progressive coma with high-grade fever. We previously reported that hypercytokinemia and monocyte/macrophage activation may play an important role in the pathogenesis of IE. CD163 is a scavenger receptor for hemoglobin–haptoglobin complexes and is expressed by monocytes/macrophages. Proteolytic cleavage of monocyte-bound CD163 by matrix metalloproteinases releases soluble CD163 (sCD163). However, there have been no reports regarding serum sCD163 levels in IE patients. Methods: We measured serum levels of sCD163 as a marker of monocyte/macrophage activation in IE patients with poor outcomes, those without neurological sequelae, influenza patients without IE, and control subjects. Results: Serum sCD163 levels were significantly higher in IE patients with poor outcomes than in those without neurological sequelae. In particular, sCD163 levels in cases of death were significantly higher than those in other cases. Conclusions: Our results suggest that monocyte/macrophage activation is related to the pathogenesis of severe IE. 相似文献
56.
Okada A Tsukamoto C Hosogi M Yamanaka E Watanabe K Ootyou K Morishima T 《Acta medica Okayama》2007,61(5):261-269
Phagophobia is a disorder characterized by a conditioned excessive fear of eating and is initiated by an event such as vomiting or choking. During childhood, vomiting often occurs as a result of infection or overeating, and painful experiences bring about maladaptive eating behavior like food refusal. There have been few reports of phagophobia, and patients have sometimes been misdiagnosed with anorexia nervosa (AN). The objective of this study was to elucidate the psycho-pathology and current treatment of patients with phagophobia by analyzing case studies. We describe 6 cases with phagophobia. Patients with strong obsessions were refractory to treatment, indicating that evaluation of premorbid personality is crucial to the prognosis. It is important to classify this disorder according to psycho-pathology into "post-traumatic type" and "gain-from-illness type" to make a treatment plan. A solution focused approach is also effective for patients and their family. Paying close attention to these conditions and to the diagnostic concept referred as "hagophobia" is useful in achieving these aims. 相似文献
57.
Saga T Yoshikawa K Ishizu K 《Rinsho byori. The Japanese journal of clinical pathology》2007,55(7):630-638
Positron emission tomography (PET) is a functional imaging modality that can non-invasively visualize the distribution and dynamic movement of injected PET probes. In this article, the basic principle of PET technique is briefly explained followed by the introduction of various positron-emitters and PET probes used in clinical and research settings. With the coincidence detection of a pair of annihilation radiation emitted from positron emitters and the attenuation correction technique, PET can afford highly sensitive and quantitative data for analysis. However, spatial resolution of PET is limited and not suitable for detecting small lesions. In addition, PET image lacks anatomical information, and correct anatomical localization of the detected uptake is sometimes difficult. Most positron emitters are produced by cyclotrons and have very short half-lives. Therefore, PET institution should be equipped with an in-house cyclotron to produce positron emitters as well as the facility to prepare PET probes. Using positron emitters such as C-11, N-13 and O-15, functional/physiological molecules such as water, oxygen gas, carbon dioxide gas and ammonia, can be radiolabeled without modifying the structure or behavior, which makes these molecules suitable for the precise evaluation of physiological function and its deviation under pathological conditions. Although 18F-fluorodeoxyglucose (FDG), a marker of glucose metabolism, is the most commonly used PET probe especially in the field of oncology, many PET probes are available to evaluate various important characteristics such as blood flow, metabolism, tumor hypoxia, and neurotransmitter and receptor conditions, and are applied in the fields of oncology, neurology/psychiatry and cardiology. 相似文献
58.
Taguchi Kumiko Bessho Nanami Hida Mari Narimatsu Haruka Matsumoto Takayuki Kobayashi Tsuneo 《Naunyn-Schmiedeberg's archives of pharmacology》2018,391(10):1075-1083
Naunyn-Schmiedeberg's Archives of Pharmacology - Abnormal G protein-coupled receptor kinase 2 (GRK2) accumulation has a crucial role in the development of insulin resistance and diabetes.... 相似文献
59.
Inoue Takahiro Ishihara Ryu Shibata Tomotaka Suzuki Kosuke Kitagawa Yuko Miyazaki Tatsuya Yamaji Taiki Nemoto Kenji Oyama Tsuneo Muto Manabu Takeuchi Hiroya Toh Yasushi Matsubara Hisahiro Mano Masayuki Kono Koji Kato Ken Yoshida Masahiro Kawakubo Hirofumi Booka Eisuke Yamatsuji Tomoki Kato Hiroyuki Ito Yoshinori Ishikawa Hitoshi Tsushima Takahiro Kawachi Hiroshi Oyama Takashi Kojima Takashi Kuribayashi Shiko Makino Tomoki Matsuda Satoru Doki Yuichiro 《Esophagus》2022,19(3):375-383
Esophagus - Endoscopic diagnosis of the invasion depth of superficial esophageal squamous cell carcinoma (ESCC) is an important determinant of the treatment strategy. The three endoscopic imaging... 相似文献
60.