全文获取类型
收费全文 | 4792篇 |
免费 | 323篇 |
国内免费 | 35篇 |
专业分类
耳鼻咽喉 | 82篇 |
儿科学 | 114篇 |
妇产科学 | 45篇 |
基础医学 | 576篇 |
口腔科学 | 121篇 |
临床医学 | 423篇 |
内科学 | 1342篇 |
皮肤病学 | 31篇 |
神经病学 | 324篇 |
特种医学 | 207篇 |
外科学 | 809篇 |
综合类 | 23篇 |
一般理论 | 1篇 |
预防医学 | 124篇 |
眼科学 | 154篇 |
药学 | 249篇 |
中国医学 | 3篇 |
肿瘤学 | 522篇 |
出版年
2024年 | 11篇 |
2023年 | 99篇 |
2022年 | 177篇 |
2021年 | 315篇 |
2020年 | 152篇 |
2019年 | 168篇 |
2018年 | 191篇 |
2017年 | 146篇 |
2016年 | 179篇 |
2015年 | 156篇 |
2014年 | 174篇 |
2013年 | 239篇 |
2012年 | 369篇 |
2011年 | 418篇 |
2010年 | 201篇 |
2009年 | 139篇 |
2008年 | 237篇 |
2007年 | 244篇 |
2006年 | 203篇 |
2005年 | 199篇 |
2004年 | 170篇 |
2003年 | 172篇 |
2002年 | 161篇 |
2001年 | 24篇 |
2000年 | 32篇 |
1999年 | 37篇 |
1998年 | 32篇 |
1997年 | 26篇 |
1996年 | 28篇 |
1995年 | 29篇 |
1994年 | 28篇 |
1993年 | 20篇 |
1992年 | 38篇 |
1991年 | 25篇 |
1990年 | 31篇 |
1989年 | 35篇 |
1988年 | 19篇 |
1987年 | 19篇 |
1986年 | 24篇 |
1985年 | 16篇 |
1984年 | 20篇 |
1983年 | 20篇 |
1982年 | 13篇 |
1981年 | 10篇 |
1980年 | 11篇 |
1977年 | 8篇 |
1976年 | 11篇 |
1975年 | 13篇 |
1974年 | 16篇 |
1973年 | 8篇 |
排序方式: 共有5150条查询结果,搜索用时 93 毫秒
61.
Katsuhisa Honda Ryo Tatsukawa 《Archives of environmental contamination and toxicology》1983,12(5):543-550
Cadmium and zinc concentrations were determined in the tissues and organs, including the fetus, of striped dolphins. The kidney showed the highest cadmium concentration and the hepatic cadmium concentration was also relatively high. A similar distribution pattern among soft tissues was also observed with zinc, where its concentration varied less than that of cadmium. A significant positive correlation between zinc and cadmium was found in both the kidney and the liver; the increase of zinc concentration with cadmium was more marked in the liver (Zn:Cd 3∶1 on molar basis) than kidney (Zn:Cd 1∶1). Negligible cadmium concentration in the fetus suggested that cadmium is not transferred to the fetus via the placenta from the mother. Organ-specific age trends of cadmium and zinc concentrations were presented in detail for muscle, liver, kidney, pancreas, brain, and blood. Both metals showed rapid change during the periods of the fetus and weaning. 相似文献
62.
Ryoichi Sato Ichiro Hisatome Yasunori Tanaka Norito Sasaki Hiroshi Kotake Hiroto Mashiba Ryo Katori 《Naunyn-Schmiedeberg's archives of pharmacology》1991,344(3):331-336
Summary Aprindine is a class Ib antiarrhythmic agent. We studied effects of aprindine (3 µmol/l) on the Na+ current using whole cell voltage clamp (tip resistance = 0.5 , [Na]i ando = 10 mmol/l at 18°C). Aprindine revealed tonic block (Kdrest = 37.7 µmol/l, Kdi = 0.74 µmol/l; n = 4). Aprindine, shifted inactivation curve to hyperpolarizing direction by 11.4 ± 3.5 mV (n = 4) without changes in slope factor. In the presence of 3 µmol/l aprindine, aprindine showed phasic block, i.e., duration-dependent block at 2 Hz (64% ±3070 at 1.5 ms, 82%±6% at 20 ms, 93%±7% at 200 ms; n = 4). Short single prepulse also produced aprindine-induced phasic block (12% at 1.5 ms, 22% at 100 ms; n = 2). After removal of fast inactivation of Na+ current by 3 mmol/l tosylchloramide sodium, aprindine revealed phasic block, independent of holding potential. The recovery time constant from aprindine-induced phasic block was 4.8 s at holding potential = –100 mV and 5.0 s at holding potential = –140 mV. This use-dependent block of aprindine had pH dependency. Under acidic condition (pH 6.0), 3 µmol/l aprindine showed smaller use-dependent block (14% ± 7% at 2 Hz; n = 4) comparing with either at pH 7,4 (68% ± 13%; n = 4) or at pH 8.0 (90% ±12%; n = 4).The results suggest that aprindine could bind to the receptor via activation process through channel pore, resulting in decrease of Na+ current, and egress from the receptor through the lipid bilayer. These effects might be attenuated under acidic condition due to changes in intracellular ratio of charged to neutralized form of drug molecule.
Send offprint requests to: R. Sato at the above address 相似文献
63.
Kato M Imamura M Hosotani R Shimada Y Doi R Itami A Komoto I KosakaM T T Konishi J 《World journal of surgery》2000,24(11):1425-1430
The intravenous secretin injection test (secretin test) has been used for the differential diagnosis of gastrinoma. In this
study we report that the intraoperative secretin test (IOS test) is also useful for determining the extent of curability in
patients with Zollinger-Ellison syndrome (ZES). Twelve patients with ZES underwent surgical exploration and the IOS test.
The results of the IOS test were obtained by rapid radioimmunoassay of the serum gastrin level (IRG) within 60 minutes. The
test was diagnosed as negative when the maximum increase of serum IRG was less than 80 pg/ml and also less than 20% of the
basal serum IRG level. Three of the twelve patients underwent pancreatoduodenectomy (PD), and two patients underwent distal
pancreatectomy. Extirpation of duodenal tumors with dissection of regional lymph nodes was performed in seven patients. In
two of the seven patients the IOS test remained positive after extirpation of the duodenal tumors and the dissection of regional
lymph nodes. In one patient PD was performed on the basis of the positive results, and the IOS test became negative after
PD. In the other patient, two tiny metastatic liver tumors were identified and were resected, but the IOS test did not become
negative. We closed the abdomen in 11 patients when we obtained negative results from the IOS test. The results of the IOS
test were almost identical to the data obtained by the standard assay postoperatively. The serum IRG levels of all but one
patient fell to the normal level, and the secretin test became negative postoperatively. The IOS test is thus useful and indispensable
for curative resection of microgastrinomas in patients with ZES. 相似文献
64.
Matrix metalloproteinase-2 status in stromal fibroblasts, not in tumor cells, is a significant prognostic factor in non-small-cell lung cancer. 总被引:5,自引:0,他引:5
Shinya Ishikawa Kazumasa Takenaka Kazuhiro Yanagihara Ryo Miyahara Yozo Kawano Yosuke Otake Seiki Hasegawa Hiromi Wada Fumihiro Tanaka 《Clinical cancer research》2004,10(19):6579-6585
PURPOSE: The purpose is to assess clinical significance of matrix metalloproteinase (MMP)-2 and MMP-9 status, especially MMP-2 status, in stromal cells in non-small-cell lung cancer (NSCLC) because experimental studies have revealed that stromal MMP-2 plays important roles in progression of malignant tumors, but most clinical studies focused on tumoral MMP-2 expression, not stromal MMP-2 expression. EXPERIMENTAL DESIGN: We conducted a retrospective study on MMP-2 and MMP-9 expression as evaluated immunohistochemically in a total of 218 consecutive patients with completely resected pathological stage I-IIIA, NSCLC. RESULTS: Strong MMP-2 expression in tumor cells and stromal fibroblasts were documented in 54 (24.8%) and 132 (60.6%) patients, respectively. Strong MMP-2 expression in stromal fibroblasts was more frequently seen in squamous cell carcinoma (72.7%) than in adenocarcinoma (54.9%; P = 0.016). Tumors showing strong MMP-2 expression in stromal fibroblasts showed a significantly higher intratumoral microvessel density (IMVD) than weak stromal MMP-2 tumors (mean intratumoral microvessel density, 50.9 versus 32.4, P = 0.003). In addition, postoperative prognosis of strong stromal MMP-2 patients was significantly poorer than that of weak stromal MMP-2 patients (5-year survival rate, 77.5 versus 60.2%, P = 0.032), and the prognostic significance was enhanced in squamous cell carcinoma patients but disappeared in adenocarcinoma patients. Multivariate analyses confirmed that strong stromal MMP-2 expression was a significant factor to predict a poor prognosis in squamous cell carcinoma patients, not in adenocarcinoma patients. In contrast, MMP-2 or MMP-9 status in tumor cells was not a significant prognostic factor. CONCLUSIONS: MMP-2 status in stromal fibroblasts, not in tumor cells, was a significant prognostic factor associated with angiogenesis in NSCLC. 相似文献
65.
Hitoshi Kameyama Yoshio Shirai MD Kazutoshi Date Akifumi Kuwabara Ryo Kurosaki Katsuyoshi Hatakeyama 《Journal of gastrointestinal cancer》2005,35(2):153-155
Although exfoliative dermatitis (erythroderma) secondary to malignancy is commonly associated with lymphomas or leukemias, coincident gastrointestinal (GI) malignancy and erythroderma is rare. The authors recently encountered a patient with gallbladder carcinoma presenting as erythroderma. A 77-yr-old Japanese man presented with a 3-mo history of erythematous eruptions with pruritus over almost the entire body. After confirming the diagnosis of erythroderma, asymptomatic gallbladder carcinoma was found. Further investigations detected no malignancies in other organs. An extended cholecystectomy was performed. Histologic examination of resected specimens revealed poorly differentiated adenocarcinoma with negative resection margins. The eruptions with pruritus resolved within 1 wk after the operation. This is the first report, to our knowledge, of coincident biliary malignancy and erythroderma. The experience of the current patient suggests that erythroderma secondary to GI malignancy may resolve spontaneously after curative resection of the tumor. 相似文献
66.
The "glove" phenomenon is caused by arterial injection of a bone-imaging agent into the antecubital fossa. The authors describe a patient who incidentally received an arterial injection of bone-imaging agent into the right distal radial artery near the wrist, which resulted in a "hot" palm and thumb. The phenomenon of hot palm and thumb can be explained by normal anatomic-physiologic blood flow after radial artery injection. The radial artery contributes the blood supply to the thumb through the dorsal metacarpal arteries of the first metacarpals, and the dorsal carpal branch of the radial artery, a branch of the interosseous artery, and dorsal carpal branch of the ulnar artery form the dorsal carpal rete. The normal vascular anatomic-physiologic dynamic constituted the mixture and dilution effects after the distal radial artery injection that resulted in hot areas limited to the palm and thumb of the hand on bone scintigraphy. 相似文献
67.
Daisuke Tamanoi Koichi Saruwatari Kosuke Imamura Ryo Sato Takuya Jodai Shohei Hamada Yusuke Tomita Sho Saeki Shikiko Ueno Yuji Yonemura Hidenori Ichiyasu Takuro Sakagami 《Internal medicine (Tokyo, Japan)》2022,61(11):1731
The effect of radiotherapy during immunotherapy on immune-related adverse events (irAEs) is not fully understood. We herein report a 74-year-old woman diagnosed with lung adenocarcinoma with programmed death ligand 1 expression ≥50% and treated with pembrolizumab. She developed fatal immune thrombocytopenia associated with pembrolizumab immediately following radiotherapy. A flow cytometry analysis of peripheral blood detected an increased expression of programmed death-1 (PD-1) and Ki-67 in CD4+ and CD8+ T cells after radiotherapy, compared with pre-irradiation measurements. This case suggests that radiotherapy may evoke irAEs during treatment with anti-PD-1 antibodies, which physicians should consider when using radiotherapy in patients treated with these drugs. 相似文献
68.
Kota Tsutsumimoto Takehiko Doi Hyuma Makizako Ryo Hotta Sho Nakakubo Minji Kim Satoshi Kurita Takao Suzuki Hiroyuki Shimada 《Journal of the American Medical Directors Association》2018,19(6):504-510
Objectives
To examine the association between each type of frailty status and the incidence rate of depressive symptoms among community-dwelling older adults.Design
Prospective cohort study.Setting
General communities in Japan.Participants
Participants comprised 3538 older Japanese adults.Measurements
We assessed our participants in terms of frailty status (physical frailty, cognitive impairment, and social frailty), depressive symptoms (geriatric depression scale ≥6), and other covariates, and excluded those who showed evidence of depression. Then, after a 4-year interval, we again assessed the participants for depressive symptoms. Physical frailty was defined by the Fried criteria, showing 1 or more of these were physical frailty. To screen for cognitive impairment, receiving a score below an age-education adjusted reference threshold in 1 or more tests was cognitive impairment. Finally, social frailty was defined using 5 questions, and those who answered positively to 1 or more of these were considered to have social frailty.Results
After multiple imputations, the incidence rate of depressive symptoms after 4 years of follow-up was 7.2%. The incidence rates of depressive symptoms for each frailty status were as follows: 9.6% for physical frailty vs 4.6% without, 9.3% for cognitive impairment vs 6.5% without, and 12.0% for social frailty vs 5.1% without. Finally, through the application of multivariable logistic regression analysis, the incidence of depressive symptoms was found to have a significant association with social frailty (odds ratio 1.55; 95% confidence interval 1.10–2.20) but not with physical frailty or cognitive impairment.Conclusions
This study revealed that social frailty, in comparison with physical frailty and cognitive impairment, is more strongly associated with incidences of depressive symptoms among elderly. 相似文献69.
Iori Sato Akiko Higuchi Takaaki Yanagisawa Akitake Mukasa Kohmei Ida Yutaka Sawamura Kazuhiko Sugiyama Nobuhito Saito Toshihiro Kumabe Mizuhiko Terasaki Ryo Nishikawa Yasushi Ishida Kiyoko Kamibeppu 《Health and quality of life outcomes》2010,8(1):1-14
Background
The Pediatric Quality of Life Inventory? (PedsQL?) is a widely-used modular instrument for measuring health-related quality of life in children aged 2 to 18 years. The PedsQL? Brain Tumor Module is comprised of six scales: Cognitive Problems, Pain and Hurt, Movement and Balance, Procedural Anxiety, Nausea, and Worry. In the present study, we developed the Japanese version of the PedsQL? Brain Tumor Module and investigated its feasibility, reliability, and validity among Japanese children and their parents.Methods
Translation equivalence and content validity were verified using the standard back-translation method and cognitive debriefing tests. Participants were recruited from 6 hospitals in Japan and the Children's Cancer Association of Japan, and questionnaires were completed by 137 children with brain tumors and 166 parents. Feasibility of the questionnaire was determined based on the amount of time required to complete the form and the percentage of missing values. Internal consistency was assessed using Cronbach's coefficient alpha. Test-retest reliability was assessed by retesting 22 children and 27 parents. Factorial validity was verified by exploratory factor analyses. Known-groups validity was described with regard to whole brain irradiation, developmental impairment, infratentorial tumors, paresis, and concurrent chemotherapy. Convergent and discriminant validity were determined using Generic Core Scales and State-Trait Anxiety Inventory for children.Results
Internal consistency was relatively high for all scales (Cronbach's coefficient alpha > 0.70) except the Pain and Hurt scale for the child-report, and sufficient test-retest reliability was demonstrated for all scales (intraclass correlation coefficient = 0.45-0.95). Factorial validity was supported through exploratory factor analysis (factor-item correlation = 0.33-0.96 for children, 0.55-1.00 for parents). Evaluation of known-groups validity confirmed that the Cognitive Problems scale was sensitive for developmental impairment, the Movement and Balance scale for infratentorial tumors or paresis, and the Nausea scale for a patient currently undergoing chemotherapy. Convergent and discriminant validity with the PedsQL? Generic Core Scales and State-Trait Anxiety Inventory for children were acceptable.Conclusions
The Japanese version of the PedsQL? Brain Tumor Module is suitable for assessing health-related quality of life in children with brain tumors in clinical trials and research studies. 相似文献70.
Hirotoshi IMAMURA Shoichi TANI Hidemitsu ADACHI Ryu FUKUMITSU Tadashi SUNOHARA Nobuyuki FUKUI Yoshihiro OMURA Natsuhi SASAKI Tomoaki AKIYAMA Tatsumaru FUKUDA Shinji KAJIURA Masashi SHIGEYASU Kento ASAKURA Ryo HORII Nobuyuki SAKAI 《Neurologia medico-chirurgica》2022,62(5):223
Vasospasm, initial neurological damage, rebleeding, and periprocedural complications are associated prognostic factors for clinical outcomes after aneurysmal subarachnoid hemorrhage (SAH). In this study, factors related to delayed ischemic neurological deficit (DIND) are evaluated using data from our institute for the last 18 years. Data from 2001 to 2018 of patients with aneurysmal SAH who underwent surgical clipping (SC) or endovascular coiling (EC) within 7 days of onset were retrospectively analyzed. Cases of mortality within 5 days after treatment were excluded. Multivariate analysis was used to identify the risk factors for DIND. In total, 840 cases of SAH were assessed; among these cases, 384 (45.7%) and 456 (54.3%) were treated with SC and EC, respectively. The frequency of DIND in the EC group was significantly less than that in the SC group (11.8% vs. 17.7%; p = 0.016). In the results of multivariate analysis, internal carotid artery (ICA) aneurysm and hemorrhagic complications were the risk factors for DIND. Cilostazol administration and EC were significant factors for vasospasm prevention after aneurysmal SAH (odds ratio of ICA aneurysm: 1.59, hemorrhagic complications: 1.76, SC: 1.51, and cilostazol administration: 0.51, respectively). Cilostazol administration was also a significant factor in patients who were treated with EC. ICA aneurysm, treatment strategy, hemorrhagic complications, and cilostazol administration were associated with DIND. Oral administration of cilostazol and avoiding hemorrhagic complications were effective in DIND prevention. If both treatments are available for ruptured aneurysms, clinicians should choose EC on the basis of its ability to prevent DIND. 相似文献