全文获取类型
收费全文 | 5171篇 |
免费 | 439篇 |
国内免费 | 116篇 |
专业分类
耳鼻咽喉 | 46篇 |
儿科学 | 163篇 |
妇产科学 | 112篇 |
基础医学 | 740篇 |
口腔科学 | 122篇 |
临床医学 | 533篇 |
内科学 | 953篇 |
皮肤病学 | 44篇 |
神经病学 | 453篇 |
特种医学 | 286篇 |
外科学 | 967篇 |
综合类 | 136篇 |
一般理论 | 2篇 |
预防医学 | 415篇 |
眼科学 | 50篇 |
药学 | 308篇 |
中国医学 | 6篇 |
肿瘤学 | 390篇 |
出版年
2023年 | 21篇 |
2022年 | 45篇 |
2021年 | 105篇 |
2020年 | 62篇 |
2019年 | 108篇 |
2018年 | 124篇 |
2017年 | 86篇 |
2016年 | 107篇 |
2015年 | 111篇 |
2014年 | 149篇 |
2013年 | 240篇 |
2012年 | 323篇 |
2011年 | 325篇 |
2010年 | 176篇 |
2009年 | 169篇 |
2008年 | 255篇 |
2007年 | 319篇 |
2006年 | 211篇 |
2005年 | 223篇 |
2004年 | 200篇 |
2003年 | 157篇 |
2002年 | 175篇 |
2001年 | 141篇 |
2000年 | 144篇 |
1999年 | 127篇 |
1998年 | 84篇 |
1997年 | 79篇 |
1996年 | 72篇 |
1995年 | 68篇 |
1994年 | 59篇 |
1993年 | 38篇 |
1992年 | 106篇 |
1991年 | 85篇 |
1990年 | 121篇 |
1989年 | 105篇 |
1988年 | 87篇 |
1987年 | 83篇 |
1986年 | 89篇 |
1985年 | 65篇 |
1984年 | 54篇 |
1983年 | 39篇 |
1982年 | 28篇 |
1981年 | 30篇 |
1979年 | 41篇 |
1978年 | 28篇 |
1977年 | 24篇 |
1976年 | 24篇 |
1975年 | 20篇 |
1974年 | 31篇 |
1971年 | 19篇 |
排序方式: 共有5726条查询结果,搜索用时 828 毫秒
91.
Hypospadias trends in two US surveillance systems 总被引:6,自引:0,他引:6
OBJECTIVE: Hypospadias is a common congenital anomaly, the cause of which is unknown. Unexplained increases in the rates of hypospadias occurred in five European countries in the 1970s and 1980s. We examined data from two birth defects surveillance systems in the United States for evidence of similar trends. METHODOLOGY: The Metropolitan Atlanta Congenital Defects Program (MACDP) provided birth prevalence rates from 1968 to 1993. The nationwide Birth Defects Monitoring Program (BDMP) provided rates from 1970 to 1993. MACDP data are population-based and could be categorized by the severity of the hypospadias. BDMP data allowed analysis of rate trends for the four census regions of the United States. RESULTS: Data from both surveillance systems showed an approximate doubling of hypospadias rates in the 1970s and 1980s. MACDP data showed that the rate of severe cases increased while the ratio of mild to severe cases decreased. BDMP data showed that hypospadias rates increased markedly in all four regions of the United States. CONCLUSIONS: The observed increases are unlikely to be attributable to increased sensitivity of the surveillance systems or the identification of more mild cases by physicians over time, because either trend would have increased rather than decreased the ratio of mild to severe cases. If real, these trends represent the largest number of cases and the first report of an increase in hypospadias rates outside of Europe. Additional investigation of a possible increase in hypospadias rates is warranted. 相似文献
92.
Talan DA Stamm WE Hooton TM Moran GJ Burke T Iravani A Reuning-Scherer J Church DA 《JAMA》2000,283(12):1583-1590
Context The optimal antimicrobial regimen and treatment duration for acute uncomplicated pyelonephritis are unknown. Objective To compare the efficacy and safety of a 7-day ciprofloxacin regimen and a 14-day trimethoprim-sulfamethoxazole regimen for the treatment of acute pyelonephritis in women. Design Randomized, double-blind comparative trial conducted from October 1994 through January 1997. Setting Twenty-five outpatient centers in the United States. Patients Of 378 enrolled premenopausal women aged at least 18 years with clinical diagnosis of acute uncomplicated pyelonephritis, 255 were included in the analysis. Other individuals were excluded for no baseline causative organism, inadequate receipt of study drug, loss to follow-up, no appropriate cultures, and other reasons. Interventions Patients were randomized to oral ciprofloxacin, 500 mg twice per day for 7 days (with or without an initial 400-mg intravenous dose) followed by placebo for 7 days (n = 128 included in analysis) vs trimethoprim-sulfamethoxazole, 160/800 mg twice per day for 14 days (with or without intravenous ceftriaxone, 1 g) (n = 127 included in the analysis). Main Outcome Measure Continued bacteriologic and clinical cure, such that alternative antimicrobial drugs were not required, among evaluable patients through the 4- to 11-day posttherapy visit, compared by treatment group. Results At 4 to 11 days posttherapy, bacteriologic cure rates were 99% (112 of 113) for the ciprofloxacin regimen and 89% (90 of 101) for the trimethoprim-sulfamethoxazole regimen (95% confidence interval [CI] for difference, 0.04-0.16; P = .004). Clinical cure rates were 96% (109 of 113) for the ciprofloxacin regimen and 83% (92 of 111) for the trimethoprim-sulfamethoxazole regimen (95% CI, 0.06-0.22; P = .002). Escherichia coli, which caused more than 90% of infections, was more frequently resistant to trimethoprim-sulfamethoxazole (18%) than to ciprofloxacin (0%; P<.001). Among trimethoprim-sulfamethoxazoletreated patients, drug resistance was associated with greater bacteriologic and clinical failure rates (P<.001 for both). Drug-related adverse events occurred in 24% of 191 ciprofloxacin-treated patients and in 33% of 187 trimethoprim-sulfamethoxazoletreated patients, respectively (95% CI, -0.001 to 0.2). Conclusions In our study of outpatient treatment of acute uncomplicated pyelonephritis in women, a 7-day ciprofloxacin regimen was associated with greater bacteriologic and clinical cure rates than a 14-day trimethoprim-sulfamethoxazole regimen, especially in patients infected with trimethoprim-sulfamethoxazoleresistant strains. 相似文献
93.
Black tea and mammary gland carcinogenesis by 7,12- dimethylbenz[a]anthracene in rats fed control or high fat diets 总被引:3,自引:1,他引:3
Epidemiological studies suggest that tea may reduce cancer risk, and in
laboratory rodents, chemopreventive effects of tea or purified extracts of
tea have been demonstrated in lung, gastrointestinal tract and skin. There
is some evidence of chemoprevention by tea in the mammary gland, but the
data are not conclusive. In order to evaluate more fully the possible
influence of black tea on 7,12-dimethylbenz[a]anthracene (DMBA)-induced
mammary gland tumors in the female S-D (Sprague-Dawley) rat, three large
studies were performed: experiment 1, tumorigenesis in rats fed AIN-76A
diet and given 25 mg/kg DMBA and 1.25 or 2.5% whole tea extract or water to
drink; experiment 2, tumorigenesis in rats given 15 mg/kg DMBA and the same
diet and fluids as in experiment 1; experiment 3, tumorigenesis in rats fed
control or HF (high fat, corn oil) diet and given 15 mg/kg DMBA and 2% tea
or water to drink. Tea was given throughout the experiment; DMBA was given
by gastric gavage at 8 weeks of age. There was no consistent effect of tea
on tumorigenesis in rats fed AIN-76A diet; there was, however, evidence in
experiment 3 of a reduction of tumorigenesis by tea in rats fed the HF
diet. In experiment 3, rats fed the HF diet and given water showed the
expected increase in tumor burden (number and weight) compared with rats
fed control diet. However, rats fed the HF diet and given 2% tea showed no
increase in tumor burden; their tumor burden was significantly lower than
in rats fed the HF diet and given water (P < 0.01) and was not different
from rats fed control diet and given water or tea. In addition, in
experiment 3, the number of malignant tumors per tumor- bearing rat was
increased by the HF diet in water-drinking rats (P < 0.01) but not in
tea-drinking rats. Therefore, it appears that tea partially blocked the
promotion of DMBA-induced mammary tumorigenesis by the HF diet.
相似文献
94.
BACKGROUND: There is evidence that the stage of illness at which antipsychotic treatment is initiated in schizophrenia may have consequences for its subsequent course. How this might relate to impaired adaptive life functioning in the long-term is poorly understood. METHODS: Thirty-eight inpatients, many of whom had been admitted in the preneuroleptic era, were assessed using the Social-Adaptive Functioning Evaluation (SAFE); constituent clinical and medication phases of the lifetime trajectory of their illnesses were then analyzed to identify predictors of SAFE score using multiple regression modeling. RESULTS: The primary, independent predictor of SAFE score was duration of initially unmedicated psychosis, which accounted for 22% of variance (p<.001) therein. Conversely, duration of subsequently treated illness, although decades longer, failed to predict SAFE score. CONCLUSIONS: These findings are consistent with some form of "progressive" process, particularly over the first several years following the emergence of psychosis, which is associated with accrual of deficits in adaptive life functioning. 相似文献
95.
John L. Moran MBBS FRACP Patricia J. Solomon PhD David E. Warn PhD 《Health services & outcomes research methodology》2004,5(3-4):207-226
Methodological aspects of meta-analytic practice, heterogeneity, publication bias, metaregression and effect metric, were investigated in 14 meta-analyses reflecting major therapeutic concern in Critical Care practice. Compared with the standard Q test, the exact Zelen test was more sensitive in identifying heterogeneity. Assessment of heterogeneity impact by the I 2 statistic was consistent with inferences afforded by both the Q and Zelen test. Publication bias was subject to test and metric determination: funnel plots exhibited variable asymmetry across studies and between metrics; the regression asymmetry test appeared more sensitive than the rank correlation test; the “trim and fill” method was the most sensitive, but suggested, on the basis of quantification of the effects of potentially missing studies, that meta-analyses may be resistant to such missingness. Metaregression of treatment effect against control risk using Bayesian hierarchical regression in all metrics (log odds ratio, log risk ratio and RD) suggested that naïve linear regression approaches over-diagnosed significant relationships and exhibited regression dilution. Heterogeneity, publication bias and risk related treatment effects all demonstrate estimator and metric dependence; the RD metric would appear the most capricious in this regard. 相似文献
96.
Stamm C Friehs I Moran AM Zurakowski D Bacha E Mayer JE Jonas RA Del Nido PJ 《The Journal of thoracic and cardiovascular surgery》2000,120(4):755-763
OBJECTIVE: A number of patients with Williams syndrome or other forms of elastin arteriopathy have stenoses of pulmonary arteries in addition to supravalvular aortic stenosis. We sought to investigate the effect of the degree of pulmonary arterial stenosis on the prognosis after an operation for supravalvular aortic stenosis to help define the optimal treatment strategy for patients with severe forms of elastin arteriopathy. METHODS: Between 1960 and 1999, 33 patients underwent operations for supravalvular aortic stenosis while having significant stenoses of the pulmonary arteries. We retrospectively reviewed patient charts, obtained current follow-up information, and determined risk factors for survival and reoperation. RESULTS: Fifteen patients with moderate right-sided obstructions (confirmed by pulmonary artery Z-scores and right ventricular/descending aortic pressure ratio) underwent operations for supravalvular aortic stenosis only. Eighteen patients had more severe right-sided obstructions and underwent surgical relief of pulmonary arterial stenoses or right ventricular outflow tract obstruction in addition to operations for supravalvular aortic stenosis. Eight patients had undergone preoperative balloon dilations of stenotic pulmonary arteries. There were 6 early deaths and 1 late death in our series. Survival at 10 and 20 years was 76% (70% confidence interval, 68%-84%) and freedom from reintervention was 59% (70% confidence interval, 46%-71%) at 10 years and 49% (70% confidence interval, 35%-62%) at 20 years. Multivariate analysis revealed that patients with a right ventricular/descending aortic pressure ratio of 1.0 or more were at higher risk for reintervention but not for death. CONCLUSIONS: Surgical treatment of pulmonary artery obstructions in elastin arteriopathy is palliative but, in conjunction with balloon dilation of peripheral pulmonary arteries, offers good long-term survival to patients with the severest form of elastin arteriopathy. 相似文献
97.
Zhao P Cao J Zhao LJ Qin ZL Ke JS Pan W Ren H Yu JG Qi ZT 《第二军医大学学报》2006,27(5):506-506
The nucleocapsid (N) protein of SARS-coronavirus (SARS-CoV) is the key protein for the formation of the helical nucleocapsid during virion assembly. This protein is believed to be more conserved than other proteins of the virus, such as spike and membrane glycoprotein. In this study, the N protein of SARS-CoV was expressed in Escherichia coli DHSalpha and identified with pooled sera from patients in the convalescence phase of SARS. A plasmid pCI-N, encoding the full-length N gene of SARS-CoV, was constructed. Expression of the N protein was observed in COS1 cells following transfection with pCI-N. The immune responses induced by intramuscular immunization with pCI-N were evaluated in a murine model. Serum anti-N immunoglobutins and splenocytes proliferative responses against N protein were observed in immunized BALB/c mice. The major immunoglobulin G subclass recognizing N protein was immunoglobulin G2a, and stimulated splenocytes secreted high levels of gamma interferon and IL-2 in response to N protein. More importantly, the immunized mice produced strong delayed-type hypersensitivity (DTH) and CD^8+ CTL responses to N protein. 相似文献
98.
99.
18F]fluorodeoxyglucose uptake by positron emission tomography predicts outcome of non-small-cell lung cancer. 总被引:9,自引:0,他引:9
Ryohei Sasaki Ritsuko Komaki Homer Macapinlac Jeremy Erasmus Pamela Allen Kenneth Forster Joe B Putnam Roy S Herbst Cesar A Moran Donald A Podoloff Jack A Roth James D Cox 《Journal of clinical oncology》2005,23(6):1136-1143
PURPOSE: To determine whether the standardized uptake value (SUV) of [(18)F]fluorodeoxyglucose uptake by positron emission tomography could be a prognostic factor for non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: One hundred sixty-two patients with stage I to IIIb NSCLC were analyzed. Overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS), and local-regional control (LRC) were calculated by the Kaplan-Meier method and evaluated with the log-rank test. The prognostic significance was assessed by univariate and multivariate analyses. RESULTS: There were 93 patients treated with surgery and 69 patients treated with radiotherapy. A cutoff of 5 for the SUV for the primary tumor showed the best discriminative value. The SUV for the primary tumor was a significant predictor of OS (P = .02) in both groups. Low SUVs (= 5.0) showed significantly better DFS rates than those with high SUVs (> 5.0; surgery group, P = .02; radiotherapy group, P = .0005). Low SUVs (= 5.0) indicated a significantly better DFS than those with high SUVs (> 5.0; stage I or II, P = .02; stage IIIa or IIIb, P = .004). However, using the same cutoff point of 5, the SUV for regional lymph nodes was not a significant indicator for DFS (P = .19), LRC (P = .97), or DMFS (P = .17). The multivariate analysis showed that the SUV for the primary tumor was a significant prognostic factor for OS (P = .03) and DFS (P = .001). CONCLUSION: The SUV of the primary tumor was the strongest prognostic factor among the patients treated by curative surgery or radiotherapy. 相似文献
100.
Interruption of the contrast column during inspiration can lead to non‐diagnostic CT pulmonary angiograms. The importance of this artefact will increase with more CT studies being performed for pulmonary embolism on multidetector row CT. We describe here an instance of such an artefact and discuss its aetiology. 相似文献