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51.
Michio Kuwahara Youhei Arai Eriko Takehara Yasunori Sasaki Tomoharu Yoshimine Keita Kusaka Satomi Shikuma Wataru Akita Shinichi Uchida 《Clinical and experimental nephrology》2016,20(4):585-594
Background
Renal anemia complicated with chronic kidney disease is usually treated with erythropoiesis-stimulating agents (ESAs). However, few studies have compared the early response of hemoglobin (Hb) to different kinds of ESAs.Methods
The effects of three types of ESAs—epoetin alfa or beta (EPO), darbepoetin alfa (DPO), and epoetin beta pegol (EPObp)—on renal anemia were followed in 416 pre-dialysis chronic kidney disease (CKD) patients. After the initial 12-week administration of ESAs, ΔHb/ESA dose/kg was calculated as an index of efficacy of each ESA. Furthermore, independent variables associated with ΔHb/ESA dose/kg (dependent variable) were determined using multiple linear regression analysis. The ten independent variables selected for analysis were: presence of diabetic nephropathy, estimated glomerular filtration rate (eGFR), Hb, albumin, iron (Fe), transferrin saturation (TSAT), ferritin, phosphate (P), intact parathyroid hormone (iPTH), and C-reactive protein.Results
The efficacy of DPO and EPObp were similar and higher than EPO. TSAT was most strongly correlated with ΔHb/EPO dose/kg in all three types of ESAs. Other significant independent factors were Hb, albumin, P, iPTH, and diabetic nephropathy in the EPO group, eGFR in the DPO group, and Fe in the EPObp group. The adjusted coefficient of determination (R 2) ranged from 0.415 to 0.520 in the three ESA groups.Conclusions
The study results suggest that TSAT is the best predictor of the initial 12-week responsiveness to ESA, irrespective of the type. Variables not investigated in this study also affect responsiveness to ESA in Japanese pre-dialysis CKD patients.52.
Tomimori K Uema E Teruya H Ishikawa C Okudaira T Senba M Yamamoto K Matsuyama T Kinjo F Fujita J Mori N 《Infection and immunity》2007,75(11):5223-5232
53.
3-Phosphoglycerate dehydrogenase (Phgdh) is the initial step enzyme in the phosphorylated pathway of L-serine biosynthesis. We have previously revealed in the brain that Phgdh is preferentially expressed in glial cells, but not in neurons, and that glia-borne L-serine exerts strong neurotrophic actions to neuronal survive, differentiation, and development. To investigate whether such an L-serine-meditated intercellular relationship is constructed in peripheral organs and tissues, we examined the kidney, which is one of the organs with the highest expression of Phgdh mRNA in the body. We found that Phgdh was distributed highly in the renal papilla and inner layer of the outer zone and moderately in the cortex, whereas it was almost negative in the outer layer of the outer zone. This heterogeneous distribution was due to selective expression in distinct tubular segments, i.e., the Bowman's capsule, proximal tubule, and thin limbs of the Henle's loop. Interestingly, neutral amino acid transporter ASCT1, which preferentially transports alanine, serine, cysteine, and threonine, was selectively expressed in Phgdh-negative tubular segments, i.e., the distal tubule and collecting duct. Therefore, either Phgdh or ASCT1 is provided to each segment of renal tubules, suggesting that metabolic interplay mediated by L-serine biosynthesis and supply may exist in the kidney too. 相似文献
54.
Okada A Tsukamoto C Hosogi M Yamanaka E Watanabe K Ootyou K Morishima T 《Acta medica Okayama》2007,61(5):261-269
Phagophobia is a disorder characterized by a conditioned excessive fear of eating and is initiated by an event such as vomiting or choking. During childhood, vomiting often occurs as a result of infection or overeating, and painful experiences bring about maladaptive eating behavior like food refusal. There have been few reports of phagophobia, and patients have sometimes been misdiagnosed with anorexia nervosa (AN). The objective of this study was to elucidate the psycho-pathology and current treatment of patients with phagophobia by analyzing case studies. We describe 6 cases with phagophobia. Patients with strong obsessions were refractory to treatment, indicating that evaluation of premorbid personality is crucial to the prognosis. It is important to classify this disorder according to psycho-pathology into "post-traumatic type" and "gain-from-illness type" to make a treatment plan. A solution focused approach is also effective for patients and their family. Paying close attention to these conditions and to the diagnostic concept referred as "hagophobia" is useful in achieving these aims. 相似文献
55.
Inaniwa T Kohno T Yamagata F Tomitani T Sato S Kanazawa M Kanai T Urakabe E 《Medical physics》2007,34(5):1684-1692
In proton therapy, it is important to evaluate the field irradiated with protons and the deposited dose distribution in a patient's body. Positron emitters generated through fragmentation reactions of target nuclei can be used for this purpose. By detecting the annihilation gamma rays from the positron emitters, the annihilation gamma ray distribution can be obtained which has information about the quantities essential to proton therapy. In this study, we performed irradiation experiments with mono-energetic proton beams of 160 MeV and the spread-out Bragg peak beams to three kinds of targets. The annihilation events were detected with a positron camera for 500 s after the irradiation and the annihilation gamma ray distributions were obtained. In order to evaluate the range and the position of distal and proximal edges of the SOBP, the maximum likelihood estimation (MLE) method was applied to the detected distributions. The evaluated values with the MLE method were compared with those estimated from the measured dose distributions. As a result, the ranges were determined with the difference between the MLE range and the experimental range less than 1.0 mm for all targets. For the SOBP beams, the positions of distal edges were determined with the difference less than 1.0 mm. On the other hand, the difference amounted to 7.9 mm for proximal edges. 相似文献
56.
Masaru Morita Hajime Otsu Hiroyuki Kawano Yuta Kasagi Yasue Kimura Hiroshi Saeki Koji Ando Satoshi Ida Eiji Oki Eriko Tokunaga Tetsuo Ikeda Tetsuya Kusumoto Yoshihiko Maehara 《Surgery today》2014,44(3):505-512
Purpose
The purpose of this study was to clarify the gender differences in the prognosis, as well as mortality and morbidity, of patients who have undergone esophagectomy for esophageal cancer.Methods
The clinical results of esophagectomy were compared between 975 male and 156 female patients with esophageal cancer.Results
The male to female ratios of cervical and thoracic esophageal cancer were 1.87 and 7.38, respectively (P < 0.01). The incidence of preoperative comorbidities was 32.4 and 17.4 %, respectively, and the rates of both tobacco and alcohol abuse were significantly lower in the females than in the males. The mortality rate was lower in the females (3.8 %) than in the males (5.7 %), although the differences were not significant. The overall survival was significantly better in the female than in the male patients (P = 0.039). The 5- and 10-year overall survival rates were 32.6 and 20.5 % in the males and 39.5 and 32.5 % in the females, respectively. A multivariate analysis revealed gender to be an independent prognostic factor. However, no significant differences were recognized in disease-specific survival.Conclusions
These results suggest that the prognosis of females with esophageal cancer is better than that of males after esophagectomy, most likely due to multiple clinical factors, such as a more favorable lifestyle and general status. 相似文献57.
Masaru Morita Hiroshi Saeki Shuhei Ito Yasue Kimura Nami Yamashita Koji Ando Yukiharu Hiyoshi Eriko Tokunaga Eiji Oki Tetsuo Ikeda Sei Yoshida Torahiko Nakashima Yoshihiko Maehara 《Surgery today》2014,44(9):1603-1610
Esophageal cancer is frequently associated with squamous cell carcinoma in the head and neck. Both cigarette smoking and alcohol consumption are risk factors for multiple cancers of the head and neck, as well as the esophagus. Routine screening and close follow-up for second cancers are important in patients with esophageal cancer or head and neck cancer. For this purpose, endoscopy with Lugol’s staining, as well as narrow-band imaging combined with magnifying endoscopy, is a powerful tool for the early detection of esophageal cancer. Multimodal therapy is essential for patients with double cancers. When considering surgical treatment, the curability of both cancers must be carefully evaluated. If both tumors are potentially curable, each lesion should be treated individually. In patients with metachronous double cancers, the prior treatment of the first primary carcinoma often affects the treatment of the second cancer. Close cooperation among medical staff members is essential for complicated surgeries for double cancers. Techniques that are appropriate for each case must be adopted, such as careful dissection, staged operations, muscular flaps and microvascular anastomosis. 相似文献
58.
Yuichiro Yamada Tatsuhito Himeno Kotaro Tsuboi Yuka Shibata Miyuka Kawai Yuriko Asada-Yamada Yusuke Hayashi Emi Asano-Hayami Tomohide Hayami Yuichiro Ishida Yohei Ejima Mikio Motegi Saeko Asano Makoto Kato Eriko Nagao Hiromi Nakai-Shimoda Takahiro Ishikawa Yoshiaki Morishita Masaki Kondo Shin Tsunekawa Yoshiro Kato Takayuki Nakayama Motohiro Kamei Jiro Nakamura Hideki Kamiya 《Journal of diabetes investigation.》2021,12(8):1430-1441
59.
Ryu Kanzaki Eriko Fukui Takashi Kanou Naoko Ose Soichiro Funaki Masato Minami Yasushi Shintani Meinoshin Okumura 《Journal of thoracic disease》2021,13(4):2590
Pulmonary metastasectomy (PM) is an established treatment that can provide improved long-term survival for patients with metastatic tumor(s) in the lung. In the current era, where treatment options other than PM such as stereotactic body radiation therapy (SBRT), immunotherapy, and molecular-targeted therapy are available, thoracic surgeons should review the approach to the preoperative evaluation and the indications. Preoperative evaluation consists of history and physical examinations, physiological tests, and radiological examinations. Radiological examinations serve to identify the differential diagnosis of the pulmonary nodules, evaluate their precise number, location, and features, and search for extra thoracic metastases. The indication of PM should be considered from both physiological and oncological points of view. The general criteria for PM are as follows; (I) the patient has a good general condition, (II) the primary malignancy is controlled, (III) there is no other extrapulmonary metastases, and (IV) the pulmonary lesion(s) are thought to be completely resectable. In addition to the general eligibility criteria of PM, prognostic factors of each tumor type should be considered when deciding the indication for PM. When patients have multiple poor prognostic factors and/or a short disease-free interval (DFI), thoracic surgeons should not hesitate to observe the patient for a certain period before deciding on the indication for PM. A multidisciplinary discussion is needed in order to decide the indication for PM. 相似文献
60.
Masashi TSUNODA Takamasa KIDO Sachiyo MOGI Yumiko SUGIURA Eriko MIYAJIMA Yuichiro KUDO Tatenao KUMAZAWA Yoshiharu AIZAWA 《Industrial health》2014,52(5):439-444
Glass wool and continuous glass filaments have been used in industry. We examined the
irritability of those among Japanese. A patch test was performed on 43 volunteers for the
followings: glass wool for non-residential use with and without a urea-modified phenolic
resin binder, that for residential use with and without the binder, and continuous glass
filaments with diameters of 4, 7, 9, and 13 µm. Materials
were applied to an upper arm of each volunteer for 24 h. The skin was observed at 1 and
24 h after the removal. At 1 h after removal, slight erythema was observed on the skin of
a woman after the exposure to glass wool for residential use without the binder. Erythema
was observed on the skin of another woman at 1 h after a 24-h exposure to glass wool for
non-residential use without the binder. There were no reactions at 24 h after the removal.
The low reactions in the patch test suggested that the irritability caused by glass wool,
irrespective of a resin component, could be induced mechanically, and that the
irritability caused by continuous glass filaments with resin could be slight and either
mechanical or chemical. 相似文献