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51.
Li Y Boggia J Thijs L Hansen TW Kikuya M Björklund-Bodegård K Richart T Ohkubo T Kuznetsova T Torp-Pedersen C Lind L Ibsen H Imai Y Wang J Sandoya E O'brien E Staessen JA;International Database on Ambulatory Blood Pressure Monitoring in relation to Cardiovascular Outcomes Investigators 《Blood pressure monitoring》2008,13(3):145-147
The objective of this study was to investigate the prognostic significance of the ambulatory blood pressure (BP) during night and day and of the night-to-day BP ratio (NDR). We studied 7458 participants (mean age 56.8 years; 45.8% women) enrolled in the International Database on Ambulatory BP in relation to Cardiovascular Outcome. Using Cox models, we calculated hazard ratios (HR) adjusted for cohort and cardiovascular risk factors. Over 9.6 years (median), 983 deaths and 943 cardiovascular events occurred. Nighttime BP predicted mortality outcomes (HR, 1.18-1.24; P<0.01) independent of daytime BP. Conversely, daytime systolic (HR, 0.84; P<0.01) and diastolic BP (HR, 0.88; P<0.05) predicted only noncardiovascular mortality after adjustment for nighttime BP. Both daytime BP and nighttime BP consistently predicted all cardiovascular events (HR, 1.11-1.33; P<0.05) and stroke (HR, 1.21-1.47; P<0.01). Daytime BP lost its prognostic significance for cardiovascular events in patients on antihypertensive treatment. Adjusted for the 24-h BP, NDR predicted mortality (P<0.05), but not fatal combined with nonfatal events. Participants with systolic NDR of at least 1 compared with participants with normal NDR (> or = 0.80 to <0.90) were older, at higher risk of death, but died at higher age. The predictive accuracy of the daytime and nighttime BP and the NDR depended on the disease outcome under study. The increased mortality in patients with higher NDR probably indicates reverse causality. Our findings support recording the ambulatory BP during the whole day. 相似文献
52.
Virus-associated hemophagocytic syndrome in an international traveler as a differential diagnosis of SARS 总被引:3,自引:0,他引:3
During the epidemic of severe acute respiratory syndrome in 2003, a 27-year- old Japanese woman presented a high fever and acute respiratory distress with pulmonary infiltrates after traveling to a high-risk area. An alternative diagnosis was made as Epstein-Barr virus-associated hemophagocytic syndrome, based on the proliferation of macrophages with hemophagocytosis in the bone marrow and Epstein-Barr viral marker profiles. Virus-associated hemophagocytic syndrome in an international traveler should be included in the differential diagnosis of severe acute respiratory syndrome. 相似文献
53.
54.
Suda A Nagaoka S Ohono S Ideguchi H Soga T Ishigatsubo Y 《Modern rheumatology / the Japan Rheumatism Association》2008,18(6):609-614
We investigated the efficacy and safety of bucillamine administered as a second-line DMARD compared to administration as a
first-line DMARD in the treatment of rheumatoid arthritis (RA). We conducted a retrospective cohort study and reviewed medical
records of 86 patients with active RA who began to receive bucillamine at Yokohama Minami Kyosai Hospital between January
1998 and July 2004. The efficacy of treatments was compared based on rates of achievement of 20, 50, and 70% improvement in
ACR core set 6 months after initiation of the therapy. In the group administered bucillamine as a first-line DMARD (18 patients),
44.4, 22.2, and 11.1% of patients achieved ACR 20, 50, 70, respectively, while 56.5, 34.1, and 19.5% achieved ACR 20, 50,
70, respectively, in the group administered bucillamine following switching from MTX (46 patients), and 53.3, 33.3, and 13.3%
achieved ACR 20, 50, and 70, respectively, in the group administered bucillamine following switching from Sulfasalazine (SSZ)
(15 patients). The rates of achievements of ACR 20, 50, 70 did not differ statistically between the three groups and there
was no increase in risk of serious adverse effects related to previous DMARDs. The usefulness of bucillamine as a second-line
DMARD was demonstrated. 相似文献
55.
Dr. Masafumi Kogire MD Kazutomo Inoue MD Shoichiro Sumi MD Ryuichiro Doi MD Mitsutoshi Yun MD Hiromu Kaji MD Takayoshi Tobe MD 《Digestive diseases and sciences》1992,37(11):1666-1670
Gastric inhibitory polypeptide (GIP) has considerable structural homology with glucagon, which is known to increase liver blood flow. We compared the effects of GIP on portal venous and hepatic arterial flow with those of glucagon in conscious dogs. Injection of GIP significantly increased portal venous flow in a dose-related manner (by 7%, 15%, and 46% at doses of 1, 100, and 500 pmol/kg, respectively). The increase in portal venous flow induced by GIP and glucagon was comparable; however, the increase in portal venous flow after GIP injection reached its peak significantly earlier than that after glucagon injection. Hepatic arterial flow decreased after GIP injection (by 17%, 21%, and 35% at doses of 1, 100, and 500 pmol/kg, respectively), whereas it was not altered by glucagon. Thus, GIP causes significant changes in both portal venous and hepatic arterial flow in conscious dogs. Although structurally related, GIP and glucagon may influence liver blood flow through different mechanisms.Supported by a grant from the Ministry of Education, Japan (No. A-02404052) 相似文献
56.
Microvascular resistance in response to iodinated contrast media in normal and functionally impaired kidneys 下载免费PDF全文
Osamu Kurihara Masamichi Takano Saori Uchiyama Isamu Fukuizumi Tetsuro Shimura Masato Matsushita Hidenori Komiyama Toru Inami Daisuke Murakami Ryo Munakata Takayoshi Ohba Noritake Hata Yoshihiko Seino Wataru Shimizu 《Clinical and experimental pharmacology & physiology》2015,42(12):1245-1250
Contrast‐induced nephropathy (CIN) is considered to result from intrarenal vasoconstriction, and occurs more frequently in impaired than in normal kidneys. It was hypothesized that iodinated contrast media would markedly change renal blood flow and vascular resistance in functionally impaired kidneys. Thirty‐six patients were enrolled (32 men; mean age, 75.3 ± 7.6 years) undergoing diagnostic coronary angiography and were divided into two groups based on the presence of chronic kidney disease (CKD), defined as an estimated glomerular filtration rate (eGFR) of < 60 mL/min per 1.73 m2 (CKD and non‐CKD groups, n = 18 in both). Average peak velocity (APV) and renal artery resistance index (RI) were measured by Doppler flow wire before and after administration of the iodinated contrast media. The APV and the RI were positively and inversely correlated with the eGFR at baseline, respectively (APV, R = 0.545, P = 0.001; RI, R = ?0.627, P < 0.001). Mean RI was significantly higher (P = 0.015) and APV was significantly lower (P = 0.026) in the CKD than in the non‐CKD group. Both APV (P < 0.001) and RI (P = 0.002) were significantly changed following contrast media administration in the non‐CKD group, but not in the CKD group (APV, P = 0.258; RI, P = 0.707). Although renal arterial resistance was higher in patients with CKD, it was not affected by contrast media administration, suggesting that patients with CKD could have an attenuated response to contrast media. 相似文献
57.
Kiba T 《Pancreas》2004,29(2):e51-e58
Substantial new information has accumulated on the mechanisms of secretion, the development, and regulation of the gene expression, and the role of growth factors in the differentiation, growth, and regeneration of the pancreas. Many genes that are required for pancreas formation are active after birth and participate in endocrine and exocrine cell functions. Although the factors that normally regulate the proliferation of the pancreas largely remain elusive, several factors to influence the growth have been identified. It was also reported that the pancreas was sensitive to a number of apoptotic stimuli. The autonomic nervous system influences many of the functions of the body, including the pancreas. In fact, the parasympathetic nervous system and the sympathetic nervous system have opposing effects on insulin secretion from islet beta cells; feeding-induced parasympathetic neural activity to the pancreas stimulates insulin secretion, whereas stress-induced sympathetic neural activity to the pancreas inhibits insulin secretion. Moreover, it has been reported that the autonomic nervous system is one of the important factors that regulate pancreatic regeneration and stimulate the carcinogenesis. The present review focuses on the relationships between the autonomic nervous system and the pancreas, and furthermore, presents evidence of the autonomic nervous system-related pancreatic regeneration and carcinogenesis. 相似文献
58.
Shinichi Nakamura Nobuyuki Torii Satoru Yatsuji Hiroyuki Konishi Maiko Kishino Makiko Taniai Katsutoshi Tokushige Etsuko Hashimoto Keiko Shiratori 《Hepatology research》2008,38(4):340-347
Aim: Because the procedure of balloon-occluded retrograde transvenous obliteration (B-RTO) causes extensive thrombosis of the major shunt that connects the spleen and gastric/renal venous systems, an increase in portal pressure is unavoidable. The aim of the present study was to assess the long-term outcome of B-RTO, including changes in esophageal varices. Methods: B-RTO was conducted in 22 patients with gastric varices, who were divided according to the severity of esophageal varices at baseline; there were no esophageal varices (n = 7), F(1) varices (n = 11), and F(2) varices (n = 4). The outcome measures included the development/worsening of esophageal varices after B-RTO and survival rates. Results: The cumulative bleeding-free probability for all 22 patients at 3 years after B-RTO was 100%. The overall 3-year survival was 94.4%. Seven patients who had no esophageal varices prior to B-RTO did not develop any after the procedure. Seven (63.6%) of the 11 patients with stage F(1) esophageal varices prior to B-RTO showed no changes in the varices after B-RTO, while two patients progressed to F(2) varices and two developed F(3) varices. The cumulative treatment-free probability of the esophageal varices at 24 months after B-RTO was 100% for patients without esophageal varices at baseline, 80.8% for patients with pre-existing F(1) varices, and 75% for those with pre-existing F(2) varices. Conclusion: Although the B-RTO procedure is considered useful for the treatment of gastric varices, changes in hemodynamics due to obliteration of this major shunt must be taken into account and observed closely. 相似文献
59.
Champion HC Georgakopoulos D Takimoto E Isoda T Wang Y Kass DA 《Circulation research》2004,94(5):657-663
Nitric oxide (NO) functions principally as a diffusible paracrine effector. The exception is in cardiomyocytes where both NO synthases (NOS) and target proteins coexist, allowing NO to work in an autocrine/intracrine fashion. However, the most abundant myocyte isoform (NOS3) is far more expressed in vascular endothelium; thus, the in vivo contribution of myocyte-NOS3 remains less clear. The present study tested this role by transfecting whole hearts of NOS3-null (NOS3(-/-)) mice with adenovirus-expressing NOS3 coupled to a alpha-MHC promoter (AdV(NOS3)), comparing results to hearts transfected with marker-gene beta-galactosidase (AdVbeta(gal)). Total myocardial NOS3 protein and activity were restored to near wild-type (WT) levels in NOS3(-/-)+AdV(NOS3) hearts, and NOS3 relocalized normally with caveolin-3. Ejection function by pressure-volume analysis was enhanced in NOS3(-/-)+AdVbeta(gal) over WT or NOS3(-/-)+AdV(NOS3). More prominently, isoproterenol (ISO)-stimulated systolic and diastolic function in WT was amplified in NOS3(-/-)+AdVbeta(gal), whereas NOS3(-/-)+AdV(NOS3) returned the response to control. ISO-activated systolic function was inhibited 85% by concomitant muscarinic stimulation (carbachol) in NOS3(-/-)+AdV(NOS3) but not NOS3(-/-)+AdVbeta(gal) hearts. Lastly, NOS3(-/-)+AdVbeta(gal) mice displayed enhanced inotropy and lusitropy over WT at slower heart rates but a blunted rate augmentation versus controls. A more positive rate response was restored in NOS3(-/-)+AdV(NOS3) (P<0.001). Thus, myocyte autocrine/intracrine NOS3 regulation in vivo can underlie key roles in beta-adrenergic, muscarinic, and frequency-dependent cardiac regulation. 相似文献
60.
Toshio Kurihara Takao Itoi Atsushi Sofuni Fumihide Itokawa Takayoshi Tsuchiya Shujirou Tsuji Kentaro Ishii Nobuhito Ikeuchi Akihiko Tsuchida Kazuhiko Kasuya Takashi Kawai Yoshihiro Sakai Fuminori Moriyasu 《Journal of hepato-biliary-pancreatic sciences》2008,15(2):189-195