全文获取类型
收费全文 | 14043篇 |
免费 | 1145篇 |
国内免费 | 36篇 |
专业分类
耳鼻咽喉 | 99篇 |
儿科学 | 493篇 |
妇产科学 | 303篇 |
基础医学 | 2017篇 |
口腔科学 | 101篇 |
临床医学 | 1891篇 |
内科学 | 2883篇 |
皮肤病学 | 224篇 |
神经病学 | 1406篇 |
特种医学 | 312篇 |
外科学 | 1392篇 |
综合类 | 147篇 |
一般理论 | 20篇 |
预防医学 | 1739篇 |
眼科学 | 165篇 |
药学 | 973篇 |
中国医学 | 16篇 |
肿瘤学 | 1043篇 |
出版年
2024年 | 28篇 |
2023年 | 236篇 |
2022年 | 290篇 |
2021年 | 576篇 |
2020年 | 374篇 |
2019年 | 628篇 |
2018年 | 618篇 |
2017年 | 414篇 |
2016年 | 457篇 |
2015年 | 453篇 |
2014年 | 563篇 |
2013年 | 818篇 |
2012年 | 1223篇 |
2011年 | 1211篇 |
2010年 | 590篇 |
2009年 | 538篇 |
2008年 | 836篇 |
2007年 | 873篇 |
2006年 | 857篇 |
2005年 | 779篇 |
2004年 | 642篇 |
2003年 | 617篇 |
2002年 | 577篇 |
2001年 | 77篇 |
2000年 | 60篇 |
1999年 | 79篇 |
1998年 | 98篇 |
1997年 | 103篇 |
1996年 | 70篇 |
1995年 | 69篇 |
1994年 | 40篇 |
1993年 | 50篇 |
1992年 | 36篇 |
1991年 | 28篇 |
1990年 | 25篇 |
1989年 | 18篇 |
1988年 | 16篇 |
1987年 | 20篇 |
1986年 | 11篇 |
1985年 | 8篇 |
1984年 | 19篇 |
1983年 | 21篇 |
1982年 | 20篇 |
1981年 | 29篇 |
1980年 | 14篇 |
1979年 | 9篇 |
1978年 | 13篇 |
1977年 | 28篇 |
1976年 | 17篇 |
1974年 | 7篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
101.
102.
Benjamin C. Fu Fred K. Tabung Claire H. Pernar Weike Wang Amparo G. Gonzalez-Feliciano Ilkania M. Chowdhury-Paulino Steven K. Clinton Edmund Folefac Mingyang Song Adam S. Kibel Edward L. Giovannucci Lorelei A. Mucci 《European urology》2021,79(3):405-412
BackgroundHyperinsulinemia and inflammation are inter-related pathways that link diet with the risk of several chronic diseases. Evidence suggests that these pathways may also increase prostate cancer risk.ObjectiveTo determine whether hyperinsulinemic diet and inflammatory diet are associated with prostate cancer incidence and mortality.Design, setting, and participantsWe prospectively followed 41 209 men in the Health Professionals Follow-up Study (1986–2014). Scores for two validated dietary patterns were calculated from food frequency questionnaires at baseline and updated every 4 yr.Outcome measurements and statistical analysisTotal, advanced, and lethal prostate cancer outcomes were assessed. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were determined for associations between two empirical hypothesis-oriented dietary patterns—empirical dietary index for hyperinsulinemia and empirical dietary inflammatory pattern—and prostate cancer risk estimated using Cox proportional hazard regression.Results and limitationsDuring 28 yr of follow-up, 5929 incident cases of total prostate cancer, including 1019 advanced and 667 fatal, were documented. In multivariable-adjusted models, there was a 7% higher risk of advanced prostate cancer (HR: 1.07; 95% CI: 1.01–1.15) and a 9% higher risk of fatal prostate cancer (HR: 1.09; 95% CI: 1.00–1.18) per standard deviation (SD) increase in the hyperinsulinemic diet. When stratified by age, the hyperinsulinemic diet was associated with only earlier-onset aggressive prostate cancer (men under 65 yr), with per SD HRs of 1.20 (95% CI: 1.06–1.35) for advanced, 1.22 (1.04–1.42) for fatal, and 1.20 (1.04–1.38) for lethal. The inflammatory diet was not associated with prostate cancer risk in the overall study population, but was associated with earlier-onset lethal prostate cancer (per SD increase HR: 1.16; 95% CI: 1.00–1.35).ConclusionsHyperinsulinemia and inflammation may be potential mechanisms linking dietary patterns with the risk of aggressive prostate cancer, particularly earlier-onset disease.Patient summaryAvoiding inflammatory and hyperinsulinemic dietary patterns may be beneficial for the prevention of clinically relevant prostate cancer, especially among younger men. 相似文献
103.
Camille Granger Paul Guedeney Camille Arnaud Soulef Guendouz Claire Cimadevilla Mathieu Kerneis Caroline Kerneis Michel Zeitouni Constance Verdonk Camille Legeai Guillaume Lebreton Pascal Leprince Eva Désiré Sabato Sorrentino Johanne Silvain Gilles Montalescot Fanny Hazan Shaida Varnous Richard Dorent 《Transplant international》2021,34(4):721-731
Available data on clinical presentation and mortality of coronavirus disease-2019 (COVID-19) in heart transplant (HT) recipients remain limited. We report a case series of laboratory-confirmed COVID-19 in 39 HT recipients from 3 French heart transplant centres (mean age 54.4 ± 14.8 years; 66.7% males). Hospital admission was required for 35 (89.7%) cases including 14/39 (35.9%) cases being admitted in intensive care unit. Immunosuppressive medications were reduced or discontinued in 74.4% of the patients. After a median follow-up of 54 (19–80) days, death and death or need for mechanical ventilation occurred in 25.6% and 33.3% of patients, respectively. Elevated C-reactive protein and lung involvement ≥50% on chest computed tomography (CT) at admission were associated with an increased risk of death or need for mechanical ventilation. Mortality rate from March to June in the entire 3-centre HT recipient cohort was 56% higher in 2020 compared to the time-matched 2019 cohort (2% vs. 1.28%, P = 0.15). In a meta-analysis including 4 studies, pre-existing diabetes mellitus (OR 3.60, 95% CI 1.43–9.06, I2 = 0%, P = 0.006) and chronic kidney disease stage III or higher (OR 3.79, 95% CI 1.39–10.31, I2 = 0%, P = 0.009) were associated with increased mortality. These findings highlight the aggressive clinical course of COVID-19 in HT recipients. 相似文献
104.
Sybille Rousseau Matthieu Peycelon Céline Grosos Valeska Bidault Anna Poupalou Garance Martin Éric Dobremez Luke Harper Claire Raquillet Alexis Arnaud Emmanuel Sapin Aurélien Scalabre Philippe Buisson Guillaume Levard Isabelle Pommepuy Maguelonne Pons Laurent Fourcade Quentin Ballouhey 《Journal of pediatric surgery》2021,56(2):332-336
IntroductionFibroepithelial polyps (FEP) of the lower urinary tract are relatively common in adults but rare in children, with fewer than 250 cases reported in the literature to date.ObjectiveThe aim of this study was to address the experience of FEP management in children.Study designA retrospective multicenter review was undertaken in children with defined FEP of the lower urinary tract managed between 2008 and 2018. The data at 18 pediatric surgery centers were collected. Their demographic, radiological, surgical, and pathological information were reviewed.ResultsA total of 33 children (26 boys; 7 girls) were treated for FEP of the lower urinary tract at 13 centers. The most common presentation was urinary outflow as hematuria (41%), acute urinary retention (25%), dysuria (19%), or urinary infections (28%). A prenatal diagnosis was made for three patients with hydronephrosis. Almost all of the children (94%) underwent ultrasound imaging of the urinary tract as the first diagnostic examination, 23 (70%) of them also either had an MRI (15%), cystourethrography (25%), computerized tomography (6%), or cystoscopy (45%). Two of these children (6%) had a biopsy prior to the surgery. The median preoperative delay was 7.52 (range: 1–48) months. Most of the patients were treated endoscopically, although four (12.1%) had open surgery and two (6.1%) had an additional incision for specimen extraction. The median hospital stay was 1.5 (range: 1–10) days. There were no recurrences and no complications after a median follow-up of 13 (range: 1–34) months.DiscussionThe main limitation of our study is the retrospective design, although it is the largest one for this pathology.ConclusionThis series supports sonography as the most suitable diagnosis tool before endoscopy to confirm the diagnosis and to perform the resection for most FEP in children. This report confirms the recognized benign nature in the absence of recurrences.Level of EvidenceLevel V. 相似文献
105.
Nathalie Chavarot Gillian Divard Anne Scemla Lucile Amrouche Olivier Aubert Marianne Leruez-Ville Marc O. Timsit Claire Tinel Julien Zuber Christophe Legendre Dany Anglicheau Rebecca Sberro-Soussan 《American journal of transplantation》2021,21(7):2448-2458
Belatacept may increase cytomegalovirus (CMV) disease risk after conversion from CNI-based therapy. We analyzed CMV disease characteristics after belatacept conversion. Propensity score matching was used to compare CMV disease incidence in belatacept- and CNI-treated kidney transplant recipients (KTRs). CMV disease characteristics and risk factors under belatacept were analyzed. In total, 223 KTRs (median age [IQR] 59.2 years [45.4–68.5]) were converted to belatacept (median of 11.5 months [2.5–37.0] post-transplantation); 40/223 (17.9%) developed CMV disease. Independent risk factors included increased age (p = .0164), D+/R− CMV serostatus (p = .0220), and low eGFR at conversion (p = .0355). Among 181 belatacept-treated patients matched to 181 controls, 32/181 (17.7%) experienced CMV disease (vs. 5/181 controls [2.8%]). CMV disease cumulative incidences were 6.33 and 0.91/100 person-years (p-y) in belatacept and control groups, respectively. CMV disease risk was particularly high in elderly patients (converted >70 years) and those with eGFR <30 ml/min; cumulative incidences were 18.4 and 5.2/100 p-y, respectively. CMV diseases under belatacept were atypical, with late-onset disease (24/40 patients [60%]), high CMV seropositivity (27/40, 67%), increased severe and tissue-invasive disease rates (gastrointestinal involvement in 32/40 [80%]) and life-threatening diseases (4/40 [10%]). These findings should stimulate further research to secure the use of belatacept as a valuable rescue therapy in KTRs. 相似文献
106.
Sarah Duncan-Park Claire Dunphy Jacqueline Becker Christine D’Urso Rachel Annunziato Joshua Blatter Carol Conrad Samuel B. Goldfarb Don Hayes Jr. Ernestina Melicoff Marc Schecter Gary Visner Brian Armstrong Hyunsook Chin Karen Kesler Nikki M. Williams Jonah N. Odim Stuart C. Sweet Lara Danziger-Isakov Eyal Shemesh 《American journal of transplantation》2021,21(9):3112-3122
Remote interventions are increasingly used in transplant medicine but have rarely been rigorously evaluated. We investigated a remote intervention targeting immunosuppressant management in pediatric lung transplant recipients. Patients were recruited from a larger multisite trial if they had a Medication Level Variability Index (MLVI) ≥2.0, indicating worrisome tacrolimus level fluctuation. The manualized intervention included three weekly phone calls and regular follow-up calls. A comparison group included patients who met enrollment criteria after the subprotocol ended. Outcomes were defined before the intent-to-treat analysis. Feasibility was defined as ≥50% of participants completing the weekly calls. MLVI was compared pre- and 180 days postenrollment and between intervention and comparison groups. Of 18 eligible patients, 15 enrolled. Seven additional patients served as the comparison. Seventy-five percent of participants completed ≥3 weekly calls; average time on protocol was 257.7 days. Average intervention group MLVI was significantly lower (indicating improved blood level stability) at 180 days postenrollment (2.9 ± 1.29) compared with pre-enrollment (4.6 ± 2.10), p = .02. At 180 days, MLVI decreased by 1.6 points in the intervention group but increased by 0.6 in the comparison group (p = .054). Participants successfully engaged in a long-term remote intervention, and their medication blood levels stabilized. NCT02266888. 相似文献
107.
Andrea M. Mayrhofer Nan Greenwood Nigel Smeeton Kathryn Almack Louise Buckingham Shaheen Shora Claire Goodman 《Health & social care in the community》2021,29(3):664-671
Although literature on postdiagnostic support for people affected by young onset dementia acknowledges financial concerns, this topic has remained underresearched. The aim of this study was to explore the financial impact of a diagnosis of young onset dementia on individuals and families. An online survey, comprising binary yes/no, multiple-response and open-ended questions, was codesigned with people living with young onset dementia. The survey was promoted via networks and online platforms. Data were collected from August to October 2019. Survey respondents across the United Kingdom (n = 55) who had received a diagnosis of young onset dementia were aged between 45 and 64, were at different stages of dementia and had been diagnosed with thirteen different types of dementia. Of the 55 respondents, 71% (n = 39) had received assistance from family members when completing the survey. The main financial impact of a diagnosis of young onset dementia resulted from premature loss of income and reduced and often deferred pension entitlements. In some cases, care-costs became unaffordable. Lack of clarity of processes and procedures around needs assessments, carers' assessments and financial assessments by different organisations resulted in some families having to ask for legal advice and, in some cases, involved lengthy appeal processes. Future research needs to involve Adult Social Care and Third Sector organisations to help codesign and test financial management interventions to support people affected by this progressive health condition. 相似文献
108.
Kenneth J. Zucker Ph.D. Jennifer Wild B.Sc. Susan J. Bradley M.D. Claire B. Lowry Ph.D. 《Archives of sexual behavior》1993,22(1):23-36
University students blind to group status rated boys with gender identity disorder and clinical control boys regarding their physical attractiveness. Ratings were made of the face and upper torso from photographs taken at the time of clinical assessment (
age, 8.1 years). On all five adjectives (attractive, beautiful, cute, handsome, and pretty), boys with gender identity disorder were judged to be more attractive than were the clinical control boys. Attractiveness correlated with extent of behavioral femininity in the clinical control group, but not in the group of boys with gender identity disorder. The extent to which the group differences in attractiveness were due to objective, structural differences in facial attractiveness vs. socially created, or subjective, processes is discussed.A version of this article was presented at the meeting of the International Academy of Sex Research, Sigtuna, Sweden, August 1990. 相似文献
109.
Corinne Antignac Catherine Kindermans Anne-Marie Dartois Michèle Dechaux Michel Broyer Claire Kleinknecht 《Pediatric nephrology (Berlin, Germany)》1990,4(6):607-613
It has been suggested that the renal functional reserve (RFR) defined by the rise in glomerular filtration rate (GFR) after a protein load could disappear in patients with severe nephron loss but with a normal GFR. This study compared, in 17 children, inulin clearance (C
in) measured by the plasma inulin plateau at the end of two 14-day randomized periods differing in protein intake: 100% (low protein, LP), or 200% (high protein, HP) of recommended dictary allowances (RDA). Diets were aimed at maintaining food habits and energy intake. Compliance was assessed by records of the last 3–4 days, an interview with the dietician and by urinary nitrogen measurements. Mean actual protein intake was 109% (56%–139%) RDA for the LP period and 220% (163%–319%) RDA for the HP period.C
in did not change in 14 children with GFR below (n=7) or within (n=7) the normal range.C
in was higher in the HP period than in the LP period (+32, 50, 63%) in 3 children who had a 50% (single kidneys) or a 25% (sclerosed glomeruli) nephron loss. Non-responding children had a GFR below 105 ml/min per 1.73 m2. Nephron loss (70% sclerosed glomeruli) was estimated in only 1 child with no RFR. The results suggest that GFR measurement after prolonged dietary stimulation could help in evaluating the severity of nephron loss in children with normal or borderline GFR. The prognostic value of this test has to be confirmed by long-term follow-up. 相似文献
110.
Objective: Children with special health care needs are increasingly enrolling in managed care arrangements. However, existing managed care organizations, including traditional HMOs, are often poorly suited for caring for this population. In the adult health care area, new managed care entities, called Social HMOs (S/HMO) and Programs for the All-inclusive Care for the Elderly (PACE), have been created to integrate health and health-related services for chronically ill and disabled adults. We describe these models and assess their potential for serving children with special health care needs. Method: We reviewed the literature on managed care for children with special health care needs and evaluation findings from the S/HMO and PACE models for the elderly. Results: Evaluations of the S/HMO and PACE models have yielded mixed findings. Some of the more positive accomplishments include lower use and expenditures for long-term care services compared to other demonstration projects, greater integration of primary care physicians in decision making concerning long-term care, and improved management of transitions between care levels. On the negative side, start-up has been slow, prospective members have been hesitant to enroll, intermittent and sometimes frequent operating deficits have emerged, no discernible positive effects on health or social outcomes are apparent, and no significant overall savings have emerged. Conclusions: With mixed results so far, caution is required in applying these or similar models for vulnerable child populations. However, given the inadequacies of traditional managed care for this population, we believe experimentation with new models of care that integrate health and health-related services is important. Such experimentation should be fostered only to the extent that the models are carefully designed and then implemented in a manner that protects the interests of children with special health care needs. 相似文献