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181.
Bastiaan R Klarenbeek Alexander AFA Veenhof Elly SM de Lange Willem A Bemelman Roberto Bergamaschi Piet Heres Antonio M Lacy Wim T van den Broek Donald L van der Peet Miguel A Cuesta 《BMC surgery》2007,7(1):16
Backround
Diverticulosis is a common disease in the western society with an incidence of 33–66%. 10–25% of these patients will develop diverticulitis. In order to prevent a high-risk acute operation it is advised to perform elective sigmoid resection after two episodes of diverticulitis in the elderly patient or after one episode in the younger (< 50 years) patient. Open sigmoid resection is still the gold standard, but laparoscopic colon resections seem to have certain advantages over open procedures. On the other hand, a double blind investigation has never been performed. The Sigma-trial is designed to evaluate the presumed advantages of laparoscopic over open sigmoid resections in patients with symptomatic diverticulitis. 相似文献182.
Virginia L Willour Peter P Zandi Judith A Badner Jo Steele Kuangyi Miao Victor Lopez Dean F MacKinnon Francis M Mondimore Barbara Schweizer Melvin G McInnis Erin B Miller J Raymond Depaulo Elliot S Gershon Francis J McMahon James B Potash 《Neuropsychopharmacology》2007,61(5):725-727
BACKGROUND: We are interested in identifying susceptibility genes that predispose subjects to attempted suicide. METHODS: We conducted a secondary analysis of genome-wide linkage data from 162 bipolar pedigrees that incorporated attempted suicide as a clinical covariate. RESULTS: The strongest covariate-based linkage signal was seen on 2p12 at marker D2S1777. The logarithm of odds (LOD) score at marker D2S1777 rose from 1.56 to 3.82 after inclusion of the suicide covariate, resulting in significant chromosome-wide empirically derived p-values for the overall linkage finding (p = .01) and for the change in LOD score after the inclusion of the covariate (p = .02). CONCLUSIONS: The finding on chromosome 2 replicates results from two previous studies of attempted suicide in pedigrees with alcohol dependence and in pedigrees with recurrent early-onset depression. Combined, these three studies provide compelling evidence for a locus influencing attempted suicide on 2p12. 相似文献
183.
Prophylactic laparoscopic-assisted total gastrectomy for hereditary diffuse gastric cancer. 总被引:2,自引:0,他引:2
Wesley P Francis Daniald M Rodrigues Nolan E Perez Fulvio Lonardo Donald Weaver John D Webber 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2007,11(1):142-147
BACKGROUND: Ten percent of gastric cancer (GC) cases are familial, with one third resulting from a mutation in the tumor suppressor gene CDH1. Loss of this important structure can result in hereditary diffuse gastric cancer (HDGC), which carries a high mortality if early diagnosis is not made. Despite its clear genetic origin, optimal management of HDGC family members is controversial, as the utility and efficacy of current cancer screening programs for mutation carriers are unproven. METHODS: A 53-year-old Caucasian woman was initially seen for genetic screening because multiple family members had mutations of the CDH1 gene. Her pedigree analysis demonstrated 4 generations of gastric cancer, and 2 of the generations carried the CDH1 germline mutation, consistent with HDGC. At endoscopy, the patient's gastric mucosa was normal and random biopsies were also normal. The patient underwent a laparoscopic total gastrectomy. RESULTS: The gross examination of her stomach appeared normal. On histologic examination, however, the stomach was found to have diffuse (signet ring cell) adenocarcinoma in-situ with 11 microscopic foci of invasive adenocarcinoma limited to the lamina propria. CONCLUSION: Our case is the first reported prophylactic total gastrectomy utilizing a laparoscopic approach, and it highlights the importance of taking a thorough family history and obtaining a pedigree analysis. Endoscopic screening in HDGC cannot rule out diffuse GC, because the stomach and biopsies can be normal despite the presence of adenocarcinoma. Therefore, our case supports the recommendation for prophylactic gastrectomy in HDGC. 相似文献
184.
Björn-Christian Link Emre F. Yekebas Dean Bogoevski Asad Kutup Gerhard Adam Jakob R. Izbicki Gerrit Krupski 《Journal of gastrointestinal surgery》2007,11(2):166-170
Symptomatic biliary leakage following major upper abdominal surgery is a severe complication resulting in increased morbidity
and mortality. Treatment options usually include either endoscopic intervention or surgical revision. These options may be
burdened by a high perioperative risk for the patient (e.g., patients with severe disease) or simply may not be possible (e.g.,
nonpreserved gastroduodenal passage). In the past, percutaneous transhepatic cholangiodrainage did only seem to be a viable
option for patients with dilated bile ducts. Here, we present our experience in a consecutive series of patients with symptomatic
biliary leakage following major upper abdominal surgery and without dilation of the biliary system that underwent percutaneous
transhepatic cholangiodrainage. Percutaneous transhepatic cholangiodrainage was feasible in 15 of 18 patients (83.3%). The
procedure was technically not possible in three patients (16.7%). In 10 of the 15 patients (66.6%) with feasible percutaneous
transhepatic cholangiodrainage, biliary leakage was definitely controlled without the need for surgical revision. Depending
on the experience with the interventional procedure, percutaneous transhepatic cholangiodrainage should be considered as an
alternative for treatment of symptomatic biliary leakage instead of immediate reoperation.
Presented at the Digestive Disease Week 2005 (DDW), Chicago, IL, May 14–19, 2005 (poster presentation). 相似文献
185.
186.
Summary: Mast cells (MCs) are major effector cells of immunoglobulin E (IgE)‐mediated allergic inflammation. However, it has become increasingly clear that they also play important roles in diverse physiological and pathological processes. Recent advances have focused on the importance of MCs in both innate and adaptive immune responses and have fostered studies of MCs beyond the myopic focus on allergic reactions. MCs possess a variety of surface receptors and may be activated by inflammatory mediators, IgE, IgG, light chains, complement fragments, proteases, hormones, neuropeptides, and microbial products. Following activation, they produce a plethora of pro‐inflammatory mediators and participate in inflammatory reactions in many organs. This review focuses on the role of MCs in inflammatory reactions in mucosal surfaces with particular emphasis on their role in respiratory and gastrointestinal inflammatory conditions. 相似文献
187.
188.
Cynthia A James Donald W Hadley Neil A Holtzman Jerry A Winkelstein 《Genetics in medicine》2006,8(4):234-242
PURPOSE: While the mode of inheritance of a genetic condition has long been considered to have not only medical, but also psychosocial consequences for families, this supposition has never been tested. METHODS: We surveyed 112 members of 51 families (59% response) with chronic granulomatous disease to determine the influence of mode of inheritance on parents', siblings', and patients' (1) knowledge of inheritance and reproductive risk; (2) concern about risk to future family-members; (3) feelings of guilt and blame; and (4) feelings of stigmatization. Ninety-six members of 51 families (49% response) with Duchenne/Becker muscular dystrophy and spinal muscular atrophy types II/III were also studied. RESULTS: X-linked families had better understanding of inheritance (P < 0.001) and reproductive risks (P < 0.01). X-linked mothers worried more about risks to future generations; other autosomal-recessive family members were as worried. X-linked mothers were more likely to feel guilty (P < 0.01) and blame themselves (P < 0.001). X-linked fathers blamed their child's mother (P < 0.05) and X-linked mothers felt more blamed by the father (P < 0.01). X-linked family-members were more likely to consider being a carrier stigmatizing (P < 0.05). CONCLUSION: When providing genetic counseling, attention should be given to guilt and blame in X-linked families and understanding reproductive risks in autosomal recessive families. 相似文献
189.
190.