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71.
Funda Aksu Nazli Gulriz Ceri Candan Arman Fatma Gulah Zeybek Suleyman Tetik 《Clinical anatomy (New York, N.Y.)》2009,22(5):559-562
The location and incidence of the zygomaticofacial foramen (ZFF) was studied in 80 dry skulls (160 sides) of unsexed adult skulls of West Anatolian people. The average distances from the ZFF to the frontozygomatic suture, to the zygomaticomaxillary suture, and to the inferior orbital rim were found to be 26.2 ± 3.2 mm, 18.6 ± 3.14 mm, and 5.94 ± 1.43 mm, respectively. The zygomas were evaluated for the number of foramina on their facial aspects. There was none in 25 (15.6%), one in 71 (44.4%), two in 45 (28.1%), three in 10 (6.3%), four in seven (4.4%), and five in two (1.3%) sides. The ZFF was also studied for its distribution around the zygoma by dividing the surface into four anatomical areas. There was no statistical difference between the morphometrical results on both sides. Data regarding the location and variation in the number of the ZFF is important in avoiding zygomatic nerve and vessel injury during surgery, but by virtue of the great variability found, ZFF is an unreliable landmark for maxillofacial surgery. Clin. Anat. 22:559–562, 2009. © 2009 Wiley‐Liss, Inc. 相似文献
72.
73.
Bahceci E Epperson D Douek DC Melenhorst JJ Childs RC Barrett AJ 《British journal of haematology》2003,122(6):934-943
To study immune recovery after non-myeloablative, reduced-intensity stem cell allografts (NST) and T-cell-depleted myeloablative transplants (TCD), we measured T-cell subset recovery by flow cytometry, T-cell repertoire by spectratyping and thymic T-cell output using a T-cell receptor excision circle (TREC) assay. We found a rapid and comparable increase in lymphocyte numbers in both NST and TCD, supporting the presence of a powerful drive for lymphocyte recovery after transplant. Spectratyping on d 45 and 100 revealed almost complete normalization of the T-cell repertoire in NST patients by d 45, whereas TCD patients demonstrated marked skewing of the repertoire, persisting to d 100. After NST, there was a significantly higher number of TREC-positive CD4+ and CD8+ cells (P = 0.02 and P = 0.01 respectively). However, in both NST and TCD, early T-cell recovery after transplant appeared to result entirely from post-thymic T cells, the expansion pattern of which is most influenced by the starting T-cell dose, but not markedly by graft-versus-host disease (GVHD) or mixed chimaerism. These results define important qualitative differences in the T-cell repertoire according to the type of transplant schedule used. 相似文献
74.
PURPOSE: The aim of this study was to evaluate the changes in salivary gland function in patients with chronic renal failure (CRF) undergoing hemodialysis. METHODS: The group consisted of 23 patients with CRF (13 female, 10 male; mean age: 40 +/- 13 yr) and 14 healthy control subjects (mean age: 40 +/- 13 yr). All underwent dynamic salivary gland scintigraphy with gustatory stimulation. After intravenous administration of 99mTc pertechnetate, first, perfusion images at 2 seconds per frame were acquired for 1 minute, then dynamic images at 1 minute per frame were acquired for 45 minutes. At 30 minutes after injection, 10 ml lemon juice was given for 15 minutes as a gustatory stimulus. We obtained time-activity curves derived from regions of interest centered over the four major salivary glands. The following functional indices were calculated for each gland: the time of maximum radioactivity (Tmax) for the prestimulated period, the time of minimum radioactivity (Tmin), as an indicator of velocity of secretion after stimulation, and the Lem E5% value as an indicator of the secretion function. RESULTS: When the patients with CRF undergoing hemodialysis were compared to the controls, there were statistically significant differences in Tmax, Tmin and Lem E5% values for bilateral parotid glands, and Tmin values for bilateral submandibular glands (p < 0.05), there were no statistically significant differences in Tmax and Lem E5% values for bilateral submandibular glands. There were also significant differences in Tmax and Lem E5% values for bilateral parotid glands between mild oral problems and severe oral problems in patients with CRF (undergoing hemodialysis). CONCLUSION: In this study, prolonged Tmax and Tmin values, and decreased Lem E5% values for parotid glands and prolonged Tmin values for submandibular glands on salivary scintigraphy pointed out decreased parenchymatous and excretory function in patients with CRF undergoing hemodialysis. 相似文献
75.
Solorzano CC Middleton LP Hunt KK Mirza N Meric F Kuerer HM Ross MI Ames FC Feig BW Pollock RE Singletary SE Babiera G 《American journal of surgery》2002,184(4):364-368
BACKGROUND: Intracystic papillary carcinoma (IPC) of the breast is a rare form of noninvasive breast cancer. An appreciation of associated pathology with IPC may be critical in surgical decision-making. METHODS: The medical records of all patients with IPC treated between 1985 and 2001 were retrospectively reviewed. Three patient groups were identified according to the pathologic features of the primary tumor: IPC alone, IPC with associated ductal carcinoma in situ (DCIS), and IPC with associated invasion with or without DCIS. Types of treatment and outcomes were compared between groups. RESULTS: Forty patients were treated for IPC during the study period. Fourteen had pure IPC, 13 had IPC with DCIS, and 13 had IPC with invasion. The incidence of recurrence and the likelihood of dying of IPC did not differ between the three groups regardless of the type of surgery (mastectomy or segmental mastectomy) performed and whether radiation therapy was administered. The disease-specific survival rate was 100%. CONCLUSIONS: When IPC is identified, it is frequently associated with DCIS and or invasion. Standard therapy should be based on associated pathology. The role of radiation therapy in pure IPC remains to be determined. 相似文献
76.
Predictors of locoregional recurrence among patients with early-stage breast cancer treated with breast-conserving therapy 总被引:15,自引:2,他引:13
Mirza NQ Vlastos G Meric F Buchholz TA Esnaola N Singletary SE Kuerer HM Newman LA Ames FC Ross MI Feig BW Pollock RE McNeese M Strom E Hunt KK 《Annals of surgical oncology》2002,9(3):256-265
Background Our aim was to identify predictors of locoregional recurrence (LRR) in patients with early-stage breast cancer treated with
breast-conserving therapy (BCT) and long-term follow-up.
Methods From 1970 to 1994, 1153 patients with stage I to II breast cancer underwent BCT and radiotherapy at our institution. Patients
with prior breast cancer or other primary malignancies were excluded. Clinical and pathologic characteristics evaluated were
age, race, tumor size, stage, pathologic tumor margins, axillary nodal involvement, estrogen and progesterone receptor status,
Black's nuclear grade, type of surgery, and use of adjuvant therapy.
Results Of 1083 patients, 54% presented with stage I disease and 46% with stage II disease. Median age was 50 years, and median follow-up
was 9 years. Axillary nodes were positive in 31% of the patients who underwent axillary dissection. LRR developed in 6%, LRR
followed by systemic recurrence in 5%, and systemic recurrence alone in 13%, 76% had no evidence of recurrence at last follow-up.
Age, tumor size, positive lymph nodes, and not receiving chemotherapy or hormonal therapy were independent predictors of LRR.
Disease-specific survival among patients with LRR was similar to that among patients with no recurrence.
Conclusions Multidisciplinary treatment strategies should be used to accomplish durable locoregional control after BCT.
Presented at the 54th Annual Cancer Symposium of the Society of Surgical Oncology, Washington, DC, March 15–18, 2001. 相似文献
77.
Long-term complications associated with breast-conservation surgery and radiotherapy 总被引:5,自引:0,他引:5
Meric F Buchholz TA Mirza NQ Vlastos G Ames FC Ross MI Pollock RE Singletary SE Feig BW Kuerer HM Newman LA Perkins GH Strom EA McNeese MD Hortobagyi GN Hunt KK 《Annals of surgical oncology》2002,9(6):543-549
Background Breast-conservation surgery plus radiotherapy has become the standard of care for early-stage breast cancer; we evaluated
its long-term complications.
Methods We selected patients treated with surgery and radiotherapy between January 1990 and December 1992 (an era in which standard
radiation dosages were used) with follow-up for at least 1 year. Patients were prospectively monitored for treatment-related
complications. Median follow-up time was 89 months.
Results A total of 294 patients met the selection criteria. Grade 2 or higher late complications were identified in 29 patients and
included arm edema in 13 patients, breast skin fibrosis in 12, decreased range of motion in 4, pneumonitis in 2, neuropathy
in 2, fat necrosis in 1, and rib fracture in 1. Arm edema was more common after lumpectomy plus axillary node dissection than
after lumpectomy alone. Arm edema occurred in 18% of patients who underwent surgery plus irradiation of the lymph nodes and
10% who underwent surgery without nodal irradiation.
Conclusions Breast-conservation surgery plus radiotherapy was associated with grade 2 or higher complications in only 9.9% of patients.
Half of these complications were attributable to axillary dissection, it is hoped that lower complication rates can be achieved
with sentinel lymph node biopsy. 相似文献
78.
HER2/neu in the management of invasive breast cancer 总被引:5,自引:0,他引:5
Meric F Hung MC Hortobagyi GN Hunt KK 《Journal of the American College of Surgeons》2002,194(4):488-501
79.
Prognostic Implications of Pathological Lymph Node Status After Preoperative Chemotherapy for Operable T3N0M0 Breast Cancer 总被引:2,自引:0,他引:2
Meric F Mirza NQ Buzdar AU Hunt KK Ames FC Ross MI Pollock RE Newman LA Feig BW Strom EA Buchholz TA McNeese MD Hortobagyi GN Singletary SE 《Annals of surgical oncology》2000,7(6):435-440
Background: Although preoperative chemotherapy has become the standard of care for inoperable locally advanced breast cancer, its role for downstaging resectable primary tumors is still evolving. The purpose of this study was to determine whether the prognostic information from an axillary node dissection in patients with clinical T3N0 breast cancer was altered by preoperative chemotherapy compared with surgery de novo.Methods: Between 1976 and 1994, 91 patients with clinically node-negative operable T3 breast cancer received doxorubicin-based combination chemotherapy on protocol at one institution. Fifty-three patients received both preoperative and postoperative chemotherapy (PreopCT), and 38 received postoperative chemotherapy only (PostopCT). All patients underwent axillary lymph node dissection as part of their definitive surgical treatment. There were no differences between the PreopCT and PostopCT groups in median age (51 vs. 49 years), median tumor size at presentation (6 cm vs. 6 cm), tumor grade, or estrogen receptor status (estrogen receptor negative 38% vs. 32%). The median follow-up time was 7 years.Results: Patients in the PreopCT group had fewer histologically positive lymph nodes (median, 0 vs. 3, P < .01), and a lower incidence of extranodal extension (19% vs. 42%, P 5 .02). By univariate analysis, the number of pathologically positive lymph nodes (P < .01) and extranodal extension (P < .01) were predictors of disease-specific survival in PreopCT patients. Multivariate analysis showed that extranodal extension was the only independent prognostic factor in PreopCT patients (P < .01). Overall, PreopCT and PostopCT patients had similar 5-year disease-free survival rates (66% vs. 57%); however, PreopCT patients had worse disease-free (P 5 .01) and diseasespecific survival (P 5 .04) when survival was compared after adjustment for the number of positive lymph nodes. Furthermore, PreopCT patients with 4–9 positive lymph nodes had a lower 5-year disease-free survival rate than PostopCT patients with 4–9 positive nodes (17 vs. 48%, P 5 .04).Conclusions: Axillary lymph node status remains prognostic after chemotherapy. Pathologically positive lymph nodes after preoperative chemotherapy are associated with a worse prognosis than the same nodal status before chemotherapy. 相似文献
80.
Surgery After Downstaging of Unresectable Hepatic Tumors With Intra-Arterial Chemotherapy 总被引:5,自引:0,他引:5
Meric F Patt YZ Curley SA Chase J Roh MS Vauthey JN Ellis LM 《Annals of surgical oncology》2000,7(7):490-495
Background: This retrospective study was performed to assess the outcome among patients who underwent hepatic resection or tumor ablation after hepatic artery infusion (HAI) therapy downstaged previously unresectable hepatocellular carcinoma (HCC) or liver metastases from colorectal cancer (CRC).Methods: Between 1983 and 1998, 25 patients with HCC and 383 patients with hepatic CRC metastases were treated with HAI therapy for unresectable liver disease. We retrospectively reviewed the records of 26 (6%) of these patients who underwent subsequent surgical exploration for tumor resection or ablation.Results: At a median of 9 months (range 7–12 months) after HAI treatment, four patients (16%) with HCC underwent exploratory surgery; two underwent resection with negative margins, and the other two were given radiofrequency ablation (RFA) because of underlying cirrhosis. At a median postoperative follow-up of 16 months (range 6–48 months), all four patients were alive with no evidence of disease. At a median of 14.5 months (range 8–24 months) after HAI therapy, 22 patients with hepatic CRC metastases underwent exploratory surgery; 10 underwent resection, 6 underwent resection and RFA or cryotherapy, and 2 underwent RFA only. At a median follow-up of 17 months, 15 (83%) of the 18 patients with CRC who had received surgical treatment had developed recurrent disease; the other 3 died of other causes (1 of postoperative complications) within 7 months of the surgery. One patient in whom disease recurred underwent a second resection and was disease-free at 1 year follow-up.Conclusions: Hepatic resection or ablation after tumor downstaging with HAI therapy is a viable option for patients with unresectable HCC. However, given the high rate of recurrence of metastases from CRC, hepatic resection or ablation after downstaging with HAI should be used with caution.Presented at the 53rd Annual Meeting of the Society of Surgical Oncology, New Orleans, Louisiana, March 16–19, 2000. 相似文献