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91.
Autologous bone marrow transplantation for acute myeloid leukemia using busulfan plus etoposide as a preparative regimen 总被引:1,自引:0,他引:1
We have studied the use of a new preparative regimen for the treatment of patients in remission of acute myeloid leukemia (AML) with autologous bone marrow transplantation. Chemotherapy consisted of busulfan 1 mg/kg every 6 hours for 4 days (total dose, 16 mg/kg) on days -7 through -4 followed by an intravenous infusion over 6 to 10 hours of etoposide 60 mg/kg on day -3. Autologous bone marrow, treated in vitro with 100 micrograms/mL of 4-hydroperoxycyclophosphamide, was infused on day 0. We have treated 58 patients up to the age of 60 years, 32 in first remission, 21 in second or third remission, and 5 with primary refractory AML unresponsive to high-dose Ara-C, but achieving remission with aggressive salvage regimens. Of the first remission patients, there has been 1 treatment related death and 5 relapses. With median follow-up of 22 months, the actuarial relapse rate is 22% +/- 9% and disease-free survival is 76% +/- 9% at 3 years. Patients with favorable French-American-British (FAB) subtypes (M3 or M4 EO) did especially well, with no relapses seen in 15 patients observed for a median of 30 months. Actuarial relapse rate at 3 years was 48% for first remission patients with less favorable FAB subtypes. Of patients in second or third remission, there were 5 treatment related deaths and 4 relapses. With median follow-up of 22 months, the actuarial relapse rate is 25% +/- 11% and disease-free survival is 56% +/- 11% at 3 years. Four of five primary refractory patients died during treatment and 1 remains in remission with short follow-up. These preliminary data are very encouraging and, if confirmed, support the use of autologous purged bone marrow transplantation using aggressive preparative regimens as one approach to improve the outcome of adults with AML. 相似文献
92.
A new quantitative immunoperoxidase method is presented for determining absolute amounts of peroxidase and, consequently, surface antigen densities of individual cells in B lymphocytes from normal individuals, from subjects with CLL and prolymphocytic leukemia, and during ontogeny of B lympocytes in the mouse. The following results were observed: (1) The density of B antigenic sites were lower on CLL than on normal B lymphocytes. (2) The B antigens density of leukemic lymphocytes varied less from cell to cell, forming a homogeneous peak on histograms. (3) In a very rare case of CLL, the antigen density was measured at the time of initial diagnosis (22,500 sites or 647 U) and during the development of a blastic crisis (135,000 sites or 2576 U). The cell by cell distribution changed from a homogeneous peak with a low number of antigenic sites per cell to a heterogeneous peak with a high number of antigenic sites per cell. (4) In prolymphocytic leukemia, the density of B antigenic sites was greater than on normal B lymphocytes and much more heterogeneous than on CLL lymphocytes. (5) During ontogeny of B lymphocytes in the mouse, maturation is associated with the appearance of a population of cells of intermediate to high Smig density. The finding of a decrease in, and altered distribution of, surface markers in CLL is compared with these ontologic findings in the mouse, and the concept that a monoclonal B lymphocyte in CLL may be arrested at a particular stage in its differentiation is discussed. 相似文献
93.
94.
The accuracy of International Classification of Diseases coding for dental problems not associated with trauma in a hospital emergency department 下载免费PDF全文
95.
Gilberto Sabino-Santos Jr Felipe Gon?alves Motta Maia Thallyta Maria Vieira Renata de Lara Muylaert Sabrina Miranda Lima Cristieli Barros Gon?alves Patricia Doerl Barroso Maria Norma Melo Colleen B. Jonsson Douglas Goodin Jorge Salazar-Bravo Luiz Tadeu Moraes Figueiredo 《The American journal of tropical medicine and hygiene》2015,93(2):404-406
Hantaviruses are zoonotic viruses harbored by rodents, bats, and shrews. At present, only rodent-borne hantaviruses are associated with severe illness in humans. New species of hantaviruses have been recently identified in bats and shrews greatly expanding the potential reservoirs and ranges of these viruses. Brazil has one of the highest incidences of hantavirus cardiopulmonary syndrome in South America, hence it is critical to know what is the prevalence of hantaviruses in Brazil. Although much is known about rodent reservoirs, little is known regarding bats. We captured 270 bats from February 2012 to April 2014. Serum was screened for the presence of antibodies against a recombinant nucleoprotein (rN) of Araraquara virus (ARAQV). The prevalence of antibody to hantavirus was 9/53 with an overall seroprevalence of 17%. Previous studies have shown only insectivorous bats to harbor hantavirus; however, in our study, of the nine seropositive bats, five were frugivorous, one was carnivorous, and three were sanguivorous phyllostomid bats.Hantaviruses (family Bunyaviridae) are present throughout the globe in rodents, bats, and shrews.1 Humans exposed to rodent excreta from hantaviral reservoirs may develop life-threatening diseases. However, none of the other reservoirs are associated with human illness presently.1,2 Bats (order Chiroptera) are known to harbor a broad diversity of emerging zoonotic pathogens.2 Their ability to fly and social behavior favors maintenance, evolution, and spread of pathogens.1,2 The prevailing hypothesis has been that hantaviruses have coevolved with their rodent reservoirs over millions of years.1,3 With the recognition of new species of hantavirus in bats in Africa and Asia,4 Guo and others5 hypothesized that hantaviruses originated primarily in bats and then spilled over into rodents and shrews, but it seems that shrews are the original hosts from which the viruses jumped into both rodents and bats.3 To determine if New World bats in Brazil may harbor hantaviruses, we screened bat sera for antibodies that react against the recombinant nucleoprotein (rN) of Araraquara hantavirus (ARAQV).Bats were collected at five ecologically distinct sites in the northeast region of São Paulo state (sites 1–3) and north region of Minas Gerais state (sites 4 and 5), southeastern Brazil (Figure 1
and 9 and one specimen per species by trap-night was anesthetized to collect blood by cardiac puncture; blood samples were stored in cryovials and flash-frozen in liquid nitrogen. At sites 4 and 5, five specimens per trap-night were randomly selected for blood collection. All bats were handled and sampled according to Sikes and others10 guidelines. This research project, along with its procedures and protocols, is in accordance with Brazilian environment and wildlife protection laws and regulations, and have been approved by the Chico Mendes Institute of Biodiversity Conservation (Ministry of Environment, Brasília, Distrito Federal, Brazil.), protocols nos. 19838-1 and 41709-3. It has also been approved by the Ethics Committee for Animal Research of University of São Paulo and Federal University of Minas Gerais (nos. 020/2011 and 333/2013, respectively). From 270 captured bats, 53 were bled for detection of immunoglobulin G (IgG) antibodies to rN-ARAQV by indirect enzyme-linked immunosorbent assay (ELISA) using anti-bat (Bethyl Laboratories, Inc., Montgomery, TX) secondary antibody. This ELISA, as previously described, showed 97.2% sensitivity, 100% specificity, 100% positive predictive value, and 98.1% negative predictive value when compared with an IgG-ELISA using rN antigen of Andes virus, which is the serological test for hantavirus most used in South America.11,12Open in a separate windowFigure 1.Study areas, highlighting the states of São Paulo and Minas Gerais in southeastern Brazil. The map shows cities where bats have been captured.
Open in a separate windowJES = Jatai Ecological Station; LGEP = Lapa Grande Ecological Park; MG = Minas Gerais state; NEF = Nova Esperança Farm; SEP = Sapucai Ecological Park; SGF = Santa Gabriela Farm; SP = Sao Paulo state.*Cerrado = Brazilian savanna-like biome.†Dry forest = deciduous seasonal forest.Nine bats had IgG antibodies to ARAQV, which represents an overall seroprevalence of 17%. Five of these bats were from São Paulo state and four were from Minas Gerais state. Of these, five were frugivorous, one was carnivorous, and three were sanguivorous (Family Species Captured Infected/tested Main feeding items Phyllostomidae Artibeus lituratus 41 1/6 Fruits Phyllostomidae A. obscurus 2 1/2 Fruits Phyllostomidae A. planirostris 41 1/3 Fruits Phyllostomidae Carollia perspicillata 43 1/10 Fruits and insects Phyllostomidae Chiroderma villosum 1 1/1 Fruits Phyllostomidae Chrotopterus auritus 1 1/1 Small vertebrates Phyllostomidae Desmodus rotundus 11 3/5 Mammals blood Phyllostomidae Glossophaga soricina 22 0/5 Nectar and pollen Phyllostomidae Lonchophylla spp. 1 0/1 Nectar and pollen Phyllostomidae Micronycteris minuta 1 0/1 Insects Molossidae Molossops neglectus 1 0/1 Insects Molossidae Molossops temminckii 2 0/1 Insects Vespertilionidae Myotis nigricans 13 0/5 Insects Vespertilionidae Myotis albescens 4 0/1 Insects Phyllostomidae Platyrrhinus lineatus 23 0/4 Fruits Phyllostomidae Sturnira lilium 38 0/6 Fruits
Table 1
Trap sites general features6Trap sites/altitude (m) | City/state | Main vegetation | Secondary vegetation | Features | |
---|---|---|---|---|---|
1 | JES/600 | Luis Antonio/SP | Cerrado* | Semideciduous forest | Continuous Cerrado |
2 | NEF/775 | Cajuru/SP | Grassland | Cerrado | Monocultures |
3 | SGF/860 | Batatais/SP | Sugarcane | Cerrado | Monocultures |
4 | SEP/872 | Montes Claros/MG | Dry forest†7 | Cerrado | Karst topography |
5 | LGEP/1,009 | Montes Claros/MG | Cerrado8 | Gallery forest | Caves and shelters |