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61.
Occupational risk factors represent a significant part of cancer causes and are involved in all type of cancers. Nonetheless, the frequency of these cancers is largely under-estimated. Parallel to the epidemiological approach (collective), the concept of occupational cancer is often linked (at the individual level) to the compensation of occupational diseases. To give rise to a financial compensation, the occupational origin of the exposition has to be established for a given cancer. Whatever the method used to explore an occupational cause, the approach is that of an imputation. The aim of this work is to synthesize and describe the main principles of recognition of occupational cancers, to discuss the limits of available methods and to consider the research needed to improve these methods. In France, the recognition of a cancer's occupational origin consists in tables of occupational diseases that are based on presumption of causality. These tables consist in medical, technical and administrative conditions that are necessary and sufficient for the recognition of an occupational disease and its financial compensation. Whenever causality presumption does not apply, imputation is based on case analyses run by experts within regional committees of occupational diseases recognition that lack reproducibility. They do not allow statistical quantization and do not always take into account the weight of associated factors. Nonetheless, reliability and validity of the expertise could be reinforced by the use of formal consensus techniques. This process could ideally lead to the generation of decision-making algorithms that could guide the user towards the decision of imputing or not the cancer to an occupational exposure. This would be adapted to the build-up of new tables. The imputation process would be better represented by statistical methods based on the use of Bayes' theorem. The application of these methods to occupational cancers is promising but remains limited due to the lack of epidemiological data. Acquiring these data and diffusing these methods should become research and development priorities in the cancer field. 相似文献
62.
Three hundred and twelve patients with severe aortic valve disease underwent a pre-operative haemodynamic study including coronary arteriography either as routine (age more than 50 years) or because of chest pains, previous myocardial infarction or for patients with risk factors of coronary atherosclerosis. Significant coronary artery disease was present in 9% of all cases. Coronary artery disease was more frequent in patients with angina and in patients with previous myocardial infarction but none of these factors was specific. We conclude that except young patients < 40 years old, with no chest pain and no coronary risk factors, coronary arteriography is recommended in patients with severe aortic valve disease before aortic valve replacement. 相似文献
63.
64.
Amine B Benbouazza K Harzy T Rahmouni R Guedira N Lazrak N Hajjaj-Hassouni N 《Joint, bone, spine : revue du rhumatisme》2004,71(4):331-333
IgD myeloma, which is particularly severe, accounts for only 1-3% of all myeloma cases, and the kappa subtype contributes only 10-30% of IgD myelomas. We report a new case. CASE-REPORT: A 59-year-old man was admitted for inflammatory low back pain with L5 sciatica and diffuse bone pain. The symptoms had been present for 3 months, during which he had experienced a severe decline in general health. Laboratory test abnormalities included an erythrocyte sedimentation rate of 70 mm/h, normochromic normocytic aplastic anemia, hypercalcemia (3.5 mmol/l), and serum creatinine elevation to 583 micromol/l. Tests were negative for cryoglobulinemia. Serum protein electrophoresis showed hypergammaglobulinemia but no monoclonal peak. Immunoelectrophoresis, however, detected a faint IgD kappa band in the blood and a homogeneous kappa band in the urine. Bone marrow aspirated from the sternum was found to contain 30% of malignant plasma cells. Biopsies for amyloidosis were negative. Radiographs disclosed multiple punched-out lesions with no evidence of spinal cord compression. Symptomatic treatment was given to correct the hypercalcemia, and combination chemotherapy was started. DISCUSSION: IgD kappa myeloma is a severe variant of myeloma often associated with extraosseous lesions, renal failure, and amyloidosis. The monoclonal component is absent or faint by serum protein electrophoresis, making the diagnosis difficult. The pathogenesis is unclear and the prognosis grim. 相似文献
65.
Volume-sensitive chloride channels (ICl,vol) mediate doxorubicin-induced apoptosis through apoptotic volume decrease in cardiomyocytes 总被引:2,自引:0,他引:2
d'Anglemont de Tassigny A Souktani R Henry P Ghaleh B Berdeaux A 《Fundamental & clinical pharmacology》2004,18(5):531-538
Apoptosis is associated with early changes in cell volume through a mechanism called apoptotic volume decrease (AVD). As volume-sensitive chloride channels (I(Cl,vol)) are known to play a key role in the regulation of cell volume, this study investigated the role of I(Cl,vol) and AVD in doxorubicin-induced apoptotic cell death in adult rabbit ventricular cardiomyocytes. Exposure of cardiomyocytes to 1 microm doxorubicin induced a rapid and significant reduction in cell volume of cardiomyocytes (average of 15%), i.e. AVD as well as increases in the early markers of apoptosis, annexin V labeling and caspase-3 activity. Doxorubicin also induced the activation of a current characterized as I(Cl,vol) on the basis of the external chloride sensitivity and pharmacological properties with the patch clamp technique. Doxorubicin-induced AVD and apoptosis were both abolished when cardiomyocytes were exposed to the I(Cl,vol) inhibitors 5-nitro-2-(3-phenylpropylamino) benzoic acid (NPPB) (0.1 mM) or indanyloxyacetic acid 94 (IAA-94) (10 microM). The crucial role of I(Cl,vol) during AVD and apoptosis was confirmed using C(2)-ceramide, another pro-apoptotic compound. These results demonstrate that activation of I(Cl,vol) plays a major role in the mechanism leading to cell shrinkage and apoptosis-induced AVD by agents such as doxorubicin or C(2)-ceramide in adult cardiomyocytes. 相似文献
66.
The purpose of this prospective study is to analyse the immediate effect of Rashkind's atrioseptostomy on systemic saturation in transposition of the great arteries (TGA). Thirteen neonates and infants (10 males and 3 females) with TCiA underwent balloon atrial septostomy (BAS) at a median age of 20 days (range 2 and 60 days). The mean atrial septal defect diameter after BAS was 6.5 +/- 1.1 mm. The right ventricular saturation increased from 37 +/- 17% to 67 +/- 13% (p < 0.001). There was no correlation between the atrial septal defect diameter and the increase of systemic saturation after BAS. 相似文献
67.
Yaqini K Bouderka MA Bensaid A Haddadi A Hamoudi D El Harrar R Bouaggad A Harti A 《La Tunisie médicale》2004,82(3):276-281
The purpose of this study is to specify the incidence, the risk and prognostic factors of the ARF. Transverse study about all the patients hospitalized in our department during one year. The incidence of the ARF was 18%. The state of shock, sepsis, high SAPS and advanced age were the main risk factors of the ARF happening. The mean number of multiple organ failure was 3.8 +/- 1.4 in the died patients versus 2.2 +/- 0.3 in the survivors. The whole mortality was about 46.3%. In our department, the incidence of the ARF is lower than in the literature. Age, SAPS, sepsis and state of shock are the main risk factors. ARF mortality is still high particularly in the case of shock or multiple organ failure. 相似文献
68.
Brahimi F Rachid Z Qiu Q McNamee JP Li YJ Tari AM Jean-Claude BJ 《International journal of cancer. Journal international du cancer》2004,112(3):484-491
The mechanism of action of ZR2002, a chimeric amino quinazoline designed to possess mixed EGFR tyrosine kinase (TK) inhibitory and DNA targeting properties, was compared to those of ZR01, a reversible inhibitor of the same class and PD168393, a known irreversible inhibitor of EGFR. ZR2002 exhibited 4-fold stronger EGFR TK inhibitory activity than its structural homologue ZR01 but was approximately 3-fold less active than the 6-acrylamidoquinazoline PD168393. It preferentially blocked EGF and TGFalpha-induced cell growth over PDGF and serum. It also inhibited signal transduction in heregulin-stimulated breast tumour cells, indicating that it does not only block EGFR but also its closely related erbB2 gene product. In contrast to its structural homologues, ZR2002 was capable of inducing significant levels of DNA strand breaks in MDA-MB-468 cells after a short 2 hr drug exposure at a concentration as low as 10 microM. Reversibility studies using whole cell autophosphorylation and growth assays in human breast cell lines showed that in contrast to its reversible inhibitor counterpart ZR01, ZR2002 induced irreversible inhibition of EGF-stimulated autophosphorylation in MDA-MB-468 cells and irreversible inhibition of cell growth. Moreover despite possessing a weaker binding affinity than PD168393, it induced a significantly more sustained antiproliferative effect than the latter after a pulse 2 hr exposure. More importantly, in contrast to ZR01 and PD168393, ZR2002 was capable of inducing significant levels of cell death by apoptosis in MDA-MB-468 cells. The results in toto suggest that the superior antiproliferative potency of ZR2002 may be due to its ability to induce a protracted blockade of receptor tyrosine kinase-mediated signaling while damaging cellular DNA, a combination of events that may trigger cell-killing by apoptosis. 相似文献
69.
Damin AP Karam R Zettler CG Caleffi M Alexandre CO 《Breast cancer research and treatment》2004,84(2):131-137
Human papillomavirus (HPV) DNA has been detected in breast carcinoma by different laboratorial techniques, suggesting the virus could play a role in the pathogenesis of this tumor. The aim of the present study is to investigate the presence of HPV in patients with breast carcinoma and the correlation of the viral infection with prognostic factors for the disease outcome. Between June 2001 and July 2002, 101 paraffin embedded breast carcinoma specimens were analyzed through polymerase chain reaction (PCR) and sequencing of HPV-E6 gene. Twenty specimens of reduction mammoplasty and 21 specimens of fibroadenomas were also studied as a non-malignant control group. Two different specific primer sets targeting E6 region of the HPVs 16 and 18 were used for the analysis. The HPV DNA was detected in 25 breast carcinomas (24.75%), but in none of the benign breast specimens ( p < 0.001). Out of the 25 positive cases, 14 were HPV-16 positive (56%) and 10 were HPV-18 positive (40%). An original finding was the detection of both HPV-16 and -18 in a single tumor (4%). The amplified viral sequences confirmed the presence of HPV-16 and -18. No correlation between the presence of HPV DNA and specific prognostic predictors for the disease outcome was observed. Our results suggest that the presence in the breast of either HPV-16 or -18 might be related to development of the malignant phenotype. Further studies are warranted. 相似文献
70.
Possible induction of mania or hypomania by atypical antipsychotics: an updated review of reported cases 总被引:1,自引:0,他引:1
BACKGROUND: Atypical antipsychotics are widely used in clinical practice for several psychiatric disorders. Between 1994 and 1999, 26 cases of manic and hypomanic syndromes were reported with olanzapine and risperidone and were described in a previous review article. METHOD: An updated MEDLINE search (1999-2003) using the terms atypical antipsychotics, amisulpride, aripiprazole, clozapine, flupenthixol, olanzapine, quetiapine, risperidone, sertindole, ziprasidone, zotepine, hypomania, and mania showed that 34 new cases of induced hypomanic or manic syndromes have been published, not only with olanzapine (N = 5) and risperidone (N = 6), but also with quetiapine (N = 5) and ziprasidone (N = 11) treatment. Six cases have been reported with flupenthixol and 1 with amisulpride, two antipsychotics considered as "partial" atypicals. RESULTS: A critical analysis of these case reports revealed that the effects on mood were insufficiently documented in some of the reports but that for 20 of them, evidence is highly suggestive of a causative role of atypical antipsychotics in the induction of manic/hypomanic symptomatology. CONCLUSION: This updated review continues and extends the results of the initial review and suggests that atypical antipsychotics have some intriguing effects on mood. Such effects have never been reported with conventional antipsychotics. The mechanisms involved in this phenomenon of mood switch remain to be elucidated. 相似文献