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101.
The purpose of this prospective study was to determine the range of "normalcy" in the radiologic measurement of thoracic kyphosis in children by using a standardized position and full-length radiograph in 121 normal children. Using +/- two standard deviations from the mean as the definition of "normal," a range of 20 degrees - 50 degrees was determined. There was no difference between the various age subgroups or between genders. 相似文献
102.
Patricia J Eifel Kathryn Winter Mitchell Morris Charles Levenback Perry W Grigsby Jay Cooper Marvin Rotman David Gershenson David G Mutch 《Journal of clinical oncology》2004,22(5):872-880
PURPOSE: To report mature results of a randomized trial that compared extended-field radiotherapy (EFRT) versus pelvic radiotherapy with concomitant fluorouracil and cisplatin (CTRT) in women with locoregionally advanced carcinomas of the uterine cervix. PATIENTS AND METHODS: Four hundred three women with cervical cancer were randomly assigned to receive either EFRT or CTRT. Patients were eligible if they had stage IIB to IVA disease, stage IB to IIA disease with a tumor diameter > or = 5 cm, or positive pelvic lymph nodes. Patients were stratified by stage and by method of lymph node evaluation. RESULTS: The median follow-up time for 228 surviving patients was 6.6 years. The overall survival rate for patients treated with CTRT was significantly greater than that for patients treated with EFRT (67% v 41% at 8 years; P <.0001). There was an overall reduction in the risk of disease recurrence of 51% (95% CI, 36% to 66%) for patients who received CTRT. Patients with stage IB to IIB disease who received CTRT had better overall and disease-free survival than those treated with EFRT (P <.0001); 116 patients with stage III to IVA disease had better disease-free survival (P =.05) and a trend toward better overall survival (P =.07) if they were randomly assigned to CTRT. The rate of serious late complications of treatment was similar for the two treatment arms. CONCLUSION: Mature analysis confirms that the addition of fluorouracil and cisplatin to radiotherapy significantly improved the survival rate of women with locally advanced cervical cancer without increasing the rate of late treatment-related side effects. 相似文献
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104.
Postoperative deep wound infection in adults after posterior lumbosacral spine fusion with instrumentation: incidence and management 总被引:5,自引:0,他引:5
Picada R Winter RB Lonstein JE Denis F Pinto MR Smith MD Perra JH 《Journal of spinal disorders》2000,13(1):42-45
The authors reviewed 817 instrumented lumbosacral fusions in adults and found an incidence of 3.2% deep wound infections. The primary focus of this study was the management of these infections, with particular attention to whether the implants needed to be removed. A consulting infectious disease specialist indicated that an acute infection of a low back fusion wound could not be healed without removal of the metallic implants. This opinion was in contrast to the authors' daily experience and prompted this study. The authors identified and reviewed 817 cases of instrumented posterior lumbosacral arthrodeses in adults. A detailed analysis of any case with a deep wound infection was performed and yielded and infection rate of 3.2% (26 patients). Of these, 24 achieved a clean, closed wound without removal of instrumentation through a protocol of aggressive debridement and secondary closure. Instrumentation removal is not necessary to obtain a clean, closed wound using an aggressive approach with early diagnosis, vigorous debridement in the operative room under general anesthesia, delayed primary or secondary closure, and appropriate antibiotic coverage. 相似文献
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108.
C KAPPAGODA DN SCHELL RM HANSON & P HUTCHINS 《Journal of paediatrics and child health》1998,34(6):508-512
109.
A. Josting I. Kàtay U. Rueffer S. Winter H. Tesch A. Engert V. Diehl P. D. Wickramanayake 《Annals of oncology》1998,9(3):289-295
Background: Disease status before high-dose chemotherapy with autologous bone marrow transplantation (ABMT) or peripheral blood stem cell transplantation (PBSCT) is an important predictor of transplantation-related toxicity and event-free survival (EFS) for patients with relapsed or refractory Hodgkin's disease (HD). We performed a phase II study in patients with relapsed or refractory HD to evaluate the feasibility of four cycles of Dexa-BEAM followed by high-dose chemotherapy with ABMT or PBSCT.Patients and methods: Twenty-six patients (median age 30, range 20–40 years) were treated with 2–4 courses of dexamethasone, carmustine, etoposide, cytarabine and melphalan (Dexa-BEAM) as salvage chemotherapy in order to attain maximal response. Patients achieving complete response (CR) or partial response (PR) received high-dose chemotherapy with ABMT or PBSCT. The conditioning regimen used was CVB (cyclophosphamide, carmustine, etoposide).Results: Eighteen patients responded to Dexa-BEAM, resulting in a response rate of 69%. At the time of transplant 16 patients were in CR two patients in PR. At present 14 patients transplanted are in continous CR (median follow-up 40 months, range 14–60 months). Two patients with PR after four courses of Dexa-BEAM relapsed and died three months posttransplantation. Two patients with CR at the time of transplant relapsed after nine and 13 months respectively. Eight patients had rapid progressive disease after 2–4 cycles of Dexa-BEAM. One patient with progressive disease died in gram-negative sepsis after four cycles of Dexa-BEAM. There was no transplantation-related death.Conclusion: These data suggests the use of high-dose chemotherapy followed by stem cell transplantation at the time of maximal response. 相似文献
110.
Associations between both genetic and environmental biomarkers and lung cancer: evidence of a greater risk of lung cancer in women smokers 总被引:3,自引:4,他引:3
Tang DL; Rundle A; Warburton D; Santella RM; Tsai WY; Chiamprasert S; Hsu YZ; Perera FP 《Carcinogenesis》1998,19(11):1949-1953
This molecular epidemiologic case-control study of lung cancer incorporated
three complementary biomarkers: the glutathione S- transferase M1 (GSTM1)
null genotype, a potential marker of susceptibility, and polycyclic
aromatic hydrocarbon-DNA adducts (PAH- DNA) and sister chromatid exchanges
(SCE), both indicators of environmentally induced genetic damage.
Associations between biomarkers and lung cancer were investigated, as were
possible gene-environment interactions between the GSTM1 null genotype and
tobacco smoke exposure. Subjects included 136 primary non-small cell lung
cancer surgical patients and 115 controls at the Columbia Presbyterian
Medical Center. Questionnaire and Tumor Registry data, pre-treatment blood
samples and biomarker measurements on blood were obtained. Overall, GSTM1
null genotype was significantly associated with lung cancer [odds ratio
(OR) = 2.04, 95% confidence interval (CI) = 1.13-3.68]. ORs for GSTM1 and
lung cancer were significant in females (2.50, 1.09-5.72) and smokers
(2.25, 1.11-4.54) and not significant in males (1.4, 0.58-3.38) and
non-smokers (0.88, 0.18-4.33). However, ORs for males versus females and
smokers versus non-smokers did not differ significantly. The OR for GSTM1
and lung cancer in female smokers was 3.03 (1.09- 8.40), compared with 1.42
(0.53-4.06) in male smokers. In contrast to PAH-DNA adducts in leukocytes,
SCE did not differ between cases and controls. Neither biomarker differed
significantly between the two GSTM1 genotypes. The combined effect of
elevated PAH-DNA adducts and GSTM1 genotype on case-control status (16.19,
1.2-115) appeared multiplicative. Results suggest that the effect of the
GSTM1 null genotype is greatest in female smokers, which is consistent with
other evidence that indicates that women are at higher risk of lung cancer
than males, given equal smoking. Persons with both the GSTM1 deletion and
elevated PAH-DNA adducts may represent a sensitive subpopulation with
respect to carcinogens in tobacco smoke and other environmental media.
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