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81.
Hasler G Buysse DJ Gamma A Ajdacic V Eich D Rössler W Angst J 《The Journal of clinical psychiatry》2005,66(4):521-529
OBJECTIVE: Excessive daytime sleepiness (EDS) is a symptom with high clinical and public health importance because of its association with increased risk for accidents, decreased productivity, and impaired quality of life. Little information is available regarding the longitudinal course or clinical correlates of EDS. The aim of this study was to explore associations between self-reported EDS, sleep disorder symptoms, major depression, and anxiety in a longitudinal community study of young adults. METHOD: A prospective single-age community study of young adults (Zurich Cohort Study) was conducted from 1978 through 1999. Information was derived from 6 interviews administered when participants (N = 591) were ages 20, 22, 27, 29, 34, and 40 years. Trained health professionals administered a semistructured interview for health habits and psychiatric and medical conditions. The presence of either or both of 2 symptoms-accidentally falling asleep or excessive need for sleep during the day-was used to establish the presence of EDS. RESULTS: EDS was a common complaint among the study participants, with increasing prevalence with age. Cross-sectionally, EDS was associated with insomnia symptoms, nocturnal hypersomnia, anxiety disorders, somatization, and reduced quality of life. Longitudinally, impaired sleep quality, waking up too early, and anxiety were associated with later EDS. Conversely, EDS was not significantly associated with later anxiety or depressive disorders. CONCLUSIONS: Insomnia symptoms and anxiety are associated with the subsequent occurrence of EDS. Although these findings do not demonstrate causality, insomnia and anxiety disorders are prevalent and treatable conditions, and our results may have important clinical implications for the prevention and treatment of EDS. Whether the results of this study are limited to populations with elevated levels of psychopathology remains to be tested. 相似文献
82.
Ladenheim JC 《The Journal of trauma》2004,57(1):199; author reply 199
83.
This report describes a second-generation photostimulator with four primary lights that allows independent control of the stimulation of the four receptor types in the human eye. The new design uses LEDs (with light levels controlled by eight drivers that include voltage-to-frequency converters that provide 1-micros pulses at frequencies up to 250 kHz), with four center channels being combined by use of a fiber optic assembly, and likewise for four surround channels. Four fiber optic bundles are merged into a single bundle whose output is fed into a spatial homogenizer terminated by a diffuser. An interference filter is sandwiched between each LED and the fiber optic bundle. Two camera lenses collimate light from the diffusers, one for center and one for surround. The center-surround field configuration is formed by a photometric cube with a mirrored ellipse on the hypotenuse. A field lens places images of the diffusers in the plane of an artificial pupil. The fields are highly uniform. Following alignment and calibration, the center and surround fields are indistinguishable. An observer calibration procedure, designed to compensate for prereceptoral filtering, is shown by calculation to correct also for normal observer receptoral spectral sensitivity variation. With the instrument calibrated for the individual observer, a peripherally fixated 200-ms 40% contrast rod center field pulse, highly conspicuous under dark adaptation, is invisible following light adaptation. 相似文献
84.
Pharmacokinetics of etoricoxib in patients with renal impairment 总被引:1,自引:0,他引:1
Agrawal NG Matthews CZ Mazenko RS Kline WF Woolf EJ Porras AG Geer LA Wong PH Cho M Cote J Marbury TC Moncrief JW Alcorn H Swan S Sack MR Robson RA Petty KJ Schwartz JI Gottesdiener KM 《Journal of clinical pharmacology》2004,44(1):48-58
The effect of renal insufficiency on the pharmacokinetics of etoricoxib, a selective inhibitor of cyclooxygenase-2, was examined in 23 patients with varying degrees of renal impairment (12 moderate [creatinine clearance between 30 and 50 mL/min/1.73 m2], 5 severe [creatinine clearance below 30 mL/min/1.73 m2], and 6 with end-stage renal disease requiring hemodialysis) following administration of single 120-mg oral doses of etoricoxib. Even the most severe renal impairment was found to have little effect on etoricoxib pharmacokinetics. The low recovery of etoricoxib in dialysate (less than 6% of the dose) supports that hemodialysis also has little effect on etoricoxib pharmacokinetics, and binding of etoricoxib to plasma proteins was generally unaffected by renal disease. Single doses of etoricoxib were generally well tolerated by patients with renal impairment. Based on pharmacokinetic considerations, dosing adjustments are not necessary for patients with any degree of renal impairment. However, because patients with advanced renal disease (creatinine clearance below 30 mL/min/1.73 m2) are likely to be very sensitive to any further compromise of renal function, and there is no long-term clinical experience in these patients, the use of etoricoxib is not recommended in patients with advanced renal disease. 相似文献
85.
86.
Molecular biology of upper gastrointestinal malignancies 总被引:8,自引:0,他引:8
While cancers of the upper gastrointestinal tract are related by location, they have distinct clinical and molecular characteristics. This review will focus on the molecular biology of esophageal adenocarcinoma (EAC) of which alterations in p53, overexpression of cyclin D1, loss of p16, and aneuploidy have been best characterized. Key similarities and differences, when compared to esophageal squamous cell carcinoma (ESCC), gastric adenocarcinoma (GC), and adenocarcinoma of the gastric cardia (AGC), will also be highlighted. Currently, malignancies of the upper gastrointestinal tract are often diagnosed at an advanced stage and are generally associated with a poor patient prognosis. With an improved understanding of the molecular biology of these tumors, there is hope that new targets for diagnosis, chemoprevention, and therapy will be developed. 相似文献
87.
Obsessive-compulsive severity spectrum in the community: prevalence,comorbidity, and course 总被引:3,自引:0,他引:3
Angst J Gamma A Endrass J Goodwin R Ajdacic V Eich D Rössler W 《European archives of psychiatry and clinical neuroscience》2004,254(3):156-164
OBJECTIVES: To describe lifetime prevalence rates, course and comorbidity of obsessive-compulsive disorder (OCD), obsessive-compulsive syndromes (OCS) and OC-symptoms (OC-sx) up to age 41. METHODS: In the Zurich community cohort study 591 subjects were selected after screening at the age of 19 and studied prospectively by 6 interviews from 20 to 40; they represent 1599 subjects of the normal population. The diagnoses of OCD met DSM-IV criteria.Course was assessed by graphic illustrations and prospective data. RESULTS: The lifetime prevalence rate was 3.5 % for OCD (males 1.7%, females 5.4 %) and 8.7 % for OCS (males 9.9%, females 7.5 %). The onset of OC-sx was 18 years (median); and in 70% before age 20. OCD was treated in one third of cases, OCS in 6.1%. The course of symptoms was chronic in 60%,but OCD and OCS showed in most cases considerable improvements over time. OCD reduced quality of life mostly in the subject's psychological wellbeing and at work but to a considerable extent also in other social roles. Comorbidity was prominent with bipolar disorder, panic disorder and social phobia and also significant with bulimia, binge eating, generalized anxiety disorder and suicide attempts; there was no association with substance abuse/dependence. CONCLUSION: OCD and OCD are manifestations of a wide spectrum of severity with high prevalence and strong clinical validity. The long-term course is better than generally assumed. 相似文献
88.
Angst J Gerber-Werder R Zuberbühler HU Gamma A 《European archives of psychiatry and clinical neuroscience》2004,254(2):82-91
Abstract.Objectives: The question whether bipolar I disorder should be subdivided into a preponderantly manic group (M) with no depression or only mild depression (Md) and a nuclear manic-depressive group (MD) has been rarely studied although the problem was raised more than 50 years ago. This paper seeks to elucidate this question by contributing further data.Methods: 406 patients with mood disorders hospitalised at some time during the period 1959–1963 were followed-up every five years until 1985; mortality data were collected up to 1997. Data on episodes, outcome, suicides and attempted suicides, alcohol and substance abuse/dependence and long-term medication, as well as on personality (melancholic and manic type) were collected. Major mood disorders were subclassified according to their hospitalisation for depression (D) and/or mania (M).Results: 30 manic patients (M/Md), 130 bipolar I (MD), 60 bipolar II patients (Dm) and 186 major depressive patients (D) were compared. The manic group differed from the bipolar I group in several variables: better school achievement, milder course of the illness (fewer recurrences), significantly less suicidality and a trend to less chronicity and more recovery. Manic patients required less long-term medication than bipolars and they differed in personality types from bipolars, the personality of manic patients being more often of the manic rather than the melancholic type, they were also more aggressive than bipolars. The family history data showed that the overall morbidity risk of first degree relatives of manic patients was significantly lower than that of bipolar patients.Conclusions: In accord with several other studies our data point to the existence of a more manic (M/Md) group of bipolar subjects. The diagnosis predicts a better course, lower suicidality and fewer and different treatment needs than does nuclear bipolar I (MD) disorder. The M/Md groups, as clinically interesting subgroups of the mood spectrum, should become a target of further research. 相似文献
89.
Davidson DA Wilkinson AC Kimpe LE Blais JM 《Environmental toxicology and chemistry / SETAC》2004,23(3):540-549
The exchange of chlorinated organic pollutants between air and vegetation in cold, mountain environments was investigated through the extraction of coniferous vegetation and high-volume air samples collected from the Canadian Rocky Mountains during the summers of 1999 and 2000. Concentrations of several compounds in vegetation increased as temperatures decreased, whereas atmospheric concentrations were not related to temperature. Daily cycling of these compounds between air and vegetation as a result of diurnal temperature changes was not observed. Compared with concentrations in vegetation from the Canadian Rocky Mountains, plant samples from the western valley in British Columbia (Canada) showed higher pollutant levels. Chemical partitioning between vegetation and air was not correlated with temperature, indicating that air contamination is governed by long-range transport and not by local revolatilization events. Based on these observations, we show that both deposition at higher altitudes and long-range atmospheric transport influence chemical accumulation in vegetation from the Canadian Rocky Mountains. 相似文献
90.