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101.
Yair Lotan Matthew T Gettman Claus G Roehrborn Margaret S Pearle Jeffrey A Cadeddu 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2003,7(2):111-115
BACKGROUND AND OBJECTIVES: To evaluate the experience with laparoscopic nephrectomy in a large county hospital and perform a cost comparison between uncomplicated open and laparoscopic nephrectomy. METHODS: Eleven consecutive patients who underwent an uncomplicated laparoscopic nephrectomy in a large county hospital were compared with 8 patients who underwent uncomplicated open nephrectomy during the same period. Patient charts and corresponding billing records were reviewed to determine overall hospitalization cost and individual cost components. RESULTS: No perioperative complications occurred in either the laparoscopic or open group, and no statistically significant differences existed between groups with regard to patient demographics or operative parameters. The overall operating room costs favored the open nephrectomy group by dollars 1070 (P=0.003). However, the overall cost of hospitalization, surgeon professional fees, duration of hospitalization, room and board costs, laboratory, and radiology costs, pharmacy costs, intravenous solution and infusion pump costs all significantly favored the laparoscopic patient group. The mean difference in overall hospital cost between laparoscopic and open nephrectomy was dollars 1211 in favor of laparoscopy (P=0.037). CONCLUSIONS: Our experience with laparoscopic nephrectomy in a large county hospital demonstrates a clear economic advantage in favor of the laparoscopic approach. Given limited funding for public hospitals and a clear patient benefit, laparoscopic nephrectomy should constitute first-line therapy when nephrectomy is indicated. 相似文献
102.
Radionuclide targeting and dosimetry at the microscopic level: the role of microautoradiography 总被引:1,自引:0,他引:1
Matthew R. B. Puncher Philip J. Blower 《European journal of nuclear medicine and molecular imaging》1994,21(12):1347-1365
The understanding of localisation mechanisms and microdosimetry of diagnostic and therapeutic radiopharmaceuticals depends
on knowledge of their biodistribution at the microscopic level (cellular and subcellular) in the target tissues. Various methods
have been advanced for obtaining information about this microdistribution: subcellular fractionation, secondary ion mass spectrometry
imaging, microprobe elemental analysis in the electron microscope, and microautoradiography. This review compares these approaches,
and discusses in detail the methodology of microautoradiography (the most generally useful approach) with imaging and therapy
radionuclides. Literature examples of applications of microautoradiography in nuclear medicine are reviewed, and the future
potential contribution of the techniques is assessed. 相似文献
103.
Paul F. Jaques Matthew A. Mauro Jeet Sandhu 《Cardiovascular and interventional radiology》1997,20(3):211-212
The hepatic falciform artery is an occasional terminal branch of the left or middle hepatic artery, and may provide an uncommon
but important collateral route when the principal visceral arteries are occluded. 相似文献
104.
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107.
Michael F Grunebaum Hanga C Galfalvy C Matthew Nichols Nathilee A Caldeira Leo Sher Kanita Dervic Ainsley K Burke J John Mann Maria A Oquendo 《Bipolar disorders》2006,8(5P1):496-502
Objectives: The goal of this retrospective study was to examine factors differentiating persons with bipolar disorder who did or did not have comorbid lifetime substance use disorders (SUD) at an index assessment. We also explored the chronology of onset of mood and SUD.
Methods: We studied 146 subjects with DSM-defined bipolar disorder. Subgroups with and without lifetime SUD were compared on demographic and clinical measures.
Results: Substance abuse disorders in this bipolar sample were associated with male sex, impulsive-aggressive traits, comorbid conduct and Cluster B personality disorders, number of suicide attempts and earlier age at onset of a first mood episode. In a multivariable logistic regression analysis, male sex and aggression and possibly earlier age at mood disorder onset were associated with SUD. In those with or without SUD, the first mood episode tended to be depressive and to precede the onset of SUD.
Conclusions: In persons with bipolar disorder, an earlier age of onset and aggressive traits appear to be factors associated with later development of comorbid SUD. 相似文献
Methods: We studied 146 subjects with DSM-defined bipolar disorder. Subgroups with and without lifetime SUD were compared on demographic and clinical measures.
Results: Substance abuse disorders in this bipolar sample were associated with male sex, impulsive-aggressive traits, comorbid conduct and Cluster B personality disorders, number of suicide attempts and earlier age at onset of a first mood episode. In a multivariable logistic regression analysis, male sex and aggression and possibly earlier age at mood disorder onset were associated with SUD. In those with or without SUD, the first mood episode tended to be depressive and to precede the onset of SUD.
Conclusions: In persons with bipolar disorder, an earlier age of onset and aggressive traits appear to be factors associated with later development of comorbid SUD. 相似文献
108.
Owen M McKay Arun V Krishnan Mark Davis Matthew C Kiernan 《Clinical neurophysiology》2006,117(9):2064-2068
OBJECTIVE: To investigate the cause of the transient weakness that occurs in recessive myotonia congenita (RMC) following sustained muscle contraction. METHODS: Nerve excitability studies were performed on a 35-year-old male with RMC due to a novel 696+1G>A CLCN1 mutation. The median nerve was stimulated at the wrist and compound muscle action potentials (CMAPs) were recorded from abductor pollicis brevis (APB). Stimulus-response behaviour using two stimulus durations, threshold electrotonus to 100-ms polarizing currents, a current threshold relationship and the recovery of excitability following supramaximal stimulation were recorded at rest. Excitability parameters were also recorded before and after maximal voluntary contraction (MVC) of APB against resistance for 60s. Results were compared to data obtained from 12 normal controls. RESULTS: Baseline axonal excitability parameters were all normal, indicating that axonal function was normal at the point of stimulation. Following one minute of MVC, excitability parameters demonstrated a significant increase in threshold when compared to controls (RMC 54.9%; controls 15.5+/-3.1%). In the RMC patient, this increase in threshold was associated with a 39% reduction in the amplitude of the maximal CMAP, which remained unaffected in controls. CONCLUSIONS: The reduction in maximal CMAP is likely to represent muscle activation failure due to depolarization block, with the increase in threshold possibly reflecting a compensatory attempt by motor axons to overcome prolonged contraction-induced changes in the muscle membrane. SIGNIFICANCE: The prolonged recovery of excitability following sustained muscle contraction is likely to be a contributing factor to symptoms of weakness and fatigue experienced by RMC patients. 相似文献
109.
Adherence to continuous positive airway pressure treatment in patients with Alzheimer's disease and obstructive sleep apnea. 总被引:2,自引:0,他引:2
Liat Ayalon Sonia Ancoli-Israel Carl Stepnowsky Matthew Marler Barton W Palmer Lianqi Liu Jose S Loredo Jody Corey-Bloom Deborah Greenfield Jana Cooke 《The American journal of geriatric psychiatry》2006,14(2):176-180
OBJECTIVE: This analysis examined whether patients with Alzheimer disease (AD) tolerate continuous positive airway pressure (CPAP). METHOD: Thirty patients with AD were randomized to CPAP or sham CPAP and completed sleep, depression, and quality-of-life questionnaires. Participants could choose to continue treatment after the trial. RESULTS: Patients wore CPAP for 4.8 hours per night. More depressive symptoms were associated with worse adherence (rS=-0.37; N=30, p<0.04). Patients who continued using CPAP had fewer depressive symptoms (t [19]=2.45, p=0.02) and better adherence (t [19]=2.32, p=0.03) during the trial. CONCLUSION: Patients with AD with obstructive sleep apnea can tolerate CPAP. Adherence and long-term use may be more difficult among those patients with more depressive symptoms. 相似文献
110.