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排序方式: 共有2935条查询结果,搜索用时 18 毫秒
21.
Akira Yoneda Shunsuke Murakami Hanako Tetsuo Saeko Fukui Takayuki Miyoshi Tatsuya Okamoto Amane Kitasato Hiroaki Takeshita Tamotsu Kuroki 《Clinical Case Reports》2022,10(5)
We describe a case of pancreatic tumor associated with a giant type IV hiatal hernia that had prolapsed into the posterior mediastinum. Hiatal hernia repair should be performed first because it enables laparoscopic distal pancreatectomy to be performed in the normal anatomical position. 相似文献
22.
Squamous cell carcinoma of the breast is a rare type of cancer, the origin of which is still uncertain. We report a case of
squamous cell carcinoma of the breast with a recurrent tumor that showed undifferentiated features. The patient was a 55-year-old
woman who originally presented with a left breast mass in the upper outer quadrant. Echography showed a 46 × 29 × 23-mm mass
with cavity formation, and aspiration cytology confirmed a diagnosis of squamous cell carcinoma. A modified radical mastectomy
with level III lymph node dissection was performed. Pathologically, the tumor was composed of squamous cell carcinoma and
noninvasive ductal carcinoma. A recurrent tumor showing undifferentiated features was detected in the left forechest 3 months
after the operation, and tumorectomy with partial resection of the major and minor pectoralis muscles was performed. Despite
intensive therapy including chemotherapy (CEF: cyclophosphamide, epirubicin, 5-fluorouracil) and irradiation (50 Gy), the
patient died from pulmonary and skin metastases 20 months after her initial operation. The squamous cell carcinoma of the
breast in this patient grew rapidly and her prognosis was poor. Immunohistochemical findings indicated the possibility that
the squamous cell carcinoma developed from noninvasive ductal carcinoma of the comedo type, and that the undifferentiated
cells from the site of recurrence developed from dedifferentiation of the squamous cell carcinoma.
Received: August 10, 2001 / Accepted: March 5, 2002 相似文献
23.
Koji Goto Satoshi Hagiwara Seigo Hidaka Shunsuke Yamamoto Junya Kusaka Norihisa Yasuda Chihiro Shingu Takayuki Noguchi 《Journal of anesthesia》2010,24(1):11-16
Purpose
To examine the effect of landiolol on cerebral blood flow in patients with normal or deteriorated cardiac function. 相似文献24.
Acute subdural hematoma (ASDH) is a critical condition following the onset of traumatic brain injury, and it is essential to immediately reduce elevated intracranial pressure (ICP). Single burr hole surgery/twist drill craniostomy is commonly performed in patients with ASDH as an emergency surgical intervention, usually preceding decompressive craniotomy. A novel method using a cerebrospinal fluid (CSF) drainage catheter kit for rapid drainage of ASDH is described. Percutaneous twist drill craniostomy using a CAMINO(?) micro ventricular bolt pressure-temperature monitoring kit was performed in the emergency room in 12 patients with severe ASDH. The kit contained a closed-system CSF drainage and pressure-temperature monitoring catheter, which allowed aspiration of the hematoma and monitoring of the ICP. The tip of the catheter was inserted into the hematoma from the forehead. The mean initial ICP was 61 mmHg, with a range of 31 to 120 mmHg. The liquid hematoma was aspirated, and the ICP was temporarily controlled to the normal range. Pupil dilation recovered immediately after aspiration of the hematoma in 3 patients. No complications occurred either during or after the operation. This new method for craniostomy is easy, safe, and effective to monitor and rapidly control ICP in the emergency room. This technique also offers the possibility of evaluating the patient's prognosis and determining indications for further decompressive craniectomy by the continuation of ICP control under ICP monitoring and evaluation of the reversibility of pupillary findings in ASDH patients. 相似文献
25.
Parungo CP Soybel DI Colson YL Kim SW Ohnishi S DeGrand AM Laurence RG Soltesz EG Chen FY Cohn LH Bawendi MG Frangioni JV 《Annals of surgical oncology》2007,14(2):286-298
Background Understanding lymph drainage patterns of the peritoneum could assist in staging and treatment of gastrointestinal and ovarian
malignancies. Sentinel lymph nodes (SLNs) have been identified for solid organs and the pleural space. Our purpose was to
determine whether the peritoneal space has a predictable lymph node drainage pattern.
Methods Rats received intraperitoneal injections of near-infrared (NIR) fluorescent tracers: namely, quantum dots (designed for retention
in SLNs) or human serum albumin conjugated with IRDye800 (HSA800; designed for lymphatic flow beyond the SLN). A custom imaging
system detected NIR fluorescence at 10 and 20 minutes and 1, 4, and 24 hours after injection. To determine the contribution
of viscera to peritoneal lymphatic flow, additional cohorts received bowel resection before NIR tracer injection. Associations
with appropriate controls were assessed with the χ2 test.
Results Quantum dots drained to the celiac, superior mesenteric, and periportal lymph node groups. HSA800 drained to these same groups
at early time points but continued flowing to the mediastinal lymph nodes via the thoracic duct. After bowel resection, both
tracers were found in the thoracic, not abdominal, lymph node groups. Additionally, HSA800 was no longer found in the thoracic
duct but in the anterior chest wall and diaphragmatic lymphatics.
Conclusions The peritoneal space drains to the celiac, superior mesenteric, and periportal lymph node groups first. Lymph continues via
the thoracic duct to the mediastinal lymph nodes. Bowel lymphatics are a key determinant of peritoneal lymph flow, because
bowel resection shifts lymph flow directly to the intrathoracic lymph nodes via chest wall lymphatics.
Dr. Parungo was the recipient of an award at the SSO meeting. 相似文献
26.
A 58-year-old woman underwent laparoscopy-assisted transverse colectomy for transverse colon cancer. On postoperative day
7, she experienced sudden abdominal pain accompanied by vomiting and fever. Computed tomography showed a small bowel obstruction
caused by an internal hernia. Laparotomy revealed an internal hernia through the mesenteric defect at the anastomotic colonic
stumps, which had not been closed in the previous operation. Almost the entire small bowel protruding through the mesenteric
defect was found in the omental bursa. We resected part of the jejunal loop, which was strangulated and congested by an adherent
band. Our experience suggests that if the mesenteric defect is relatively small, it should be closed completely during laparoscopy-assisted
colectomy; however, more studies are required to determine the indications for closure of the mesenteric defect to prevent
this complication. 相似文献
27.
Saito H Hida K Asano T Yano S Aoyama T Iwasaki Y Houkin K 《No shinkei geka. Neurological surgery》2011,39(4):375-380
Perimedullary arteriovenous fistula (AVF) is usually located on the surface of the spinal cord and is fed by the anterior spinal artery and/or the posterior spinal artery. We report a rare case of Conus perimedullary AVF with multiple shunt points including the cauda equina. A 68-year-old man presented with leg pain when walking long distances. Magnetic resonance imaging at the thoracic and lumbar level revealed multiple signal voids with marked cord signal change. Angiography showed the perimedullary AVF fed by the anterior spinal artery from the right T9 intercostal artery at the level of the conus medullaris and the fistula fed by the left lateral sacral artery from the left internal iliac artery at the level of the cauda equina. In the first surgery, we performed surgical interruption of feeding arteries from the filum terminale and coagulated AV shunt of the conus medullaris. However residual perimedullary AVF was found at the conus medullaris in the postoperative angiography. Secondary surgery was carried out to treat residual AVF. Follow-up angiography showed complete disappearance of all AVFs. Postoperatively, the patient`s symptoms were improved. Because the Conus perimedullary AVF has the characteristics of multiple feeding arteies, multiple shunt points, and complex venous drainage, it must be kept in mind that other fistula could exist in the cauda equina or filum terminale. 相似文献
28.
Nakayama T Mizoguchi T Uehara S Yamashita T Kawahara I Kobayashi Y Moriyama Y Kurihara S Sahara N Ozawa H Udagawa N Takahashi N 《BONE》2011,49(6):1331-1339
Osteoclasts form ruffled borders and sealing zones toward bone surfaces to resorb bone. Sealing zones are defined as ringed structures of F-actin dots (actin rings). Polarized osteoclasts secrete protons to bone surfaces via vacuolar proton ATPase through ruffled borders. Catabolic enzymes such as tartrate-resistant acid phosphatase (TRAP) and cathepsin K are also secreted to bone surfaces. Here we show a simple method of identifying functional vestiges of polarized osteoclasts. Osteoclasts obtained from cocultures of mouse osteoblasts and bone marrow cells were cultured for 48 h on dentin slices. Cultures were then fixed and stained for TRAP to identify osteoclasts on the slices. Cells were removed from the slices with cotton swabs, and the slices subjected to TRAP and Mayer's hematoxylin staining. Small TRAP-positive spots (TRAP-marks) were detected in the resorption pits stained with Mayer's hematoxylin. Pitted areas were not always located in the places of osteoclasts, but osteoclasts existed on all TRAP-marks. A time course experiment showed that the number of TRAP-marks was maintained, while the number of resorption pits increased with the culture period. The position of actin rings formed in osteoclasts corresponded to that of TRAP-marks on dentin slices. Immunostaining of dentin slices showed that both cathepsin K and vacuolar proton ATPase were colocalized with the TRAP-marks. Treatment of osteoclast cultures with alendronate, a bisphosphonate, suppressed the formation of TRAP-marks and resorption pits without affecting the cell viability. Calcitonin induced the disappearance of both actin rings and TRAP-marks in osteoclast cultures. These results suggest that TRAP-marks are vestiges of proteins secreted by polarized osteoclasts. 相似文献
29.
Yamamoto S Goto K Yasuda N Hidaka S Shingu C Kitano T Noguchi T 《Masui. The Japanese journal of anesthesiology》2008,57(6):691-695
BACKGROUND: Propofol-anesthesia administerd using target-controlled infusion (TCI) has been proposed for cardiac surgery. But, moderate target concentration of propofol during induction using TCI has not been studied in detail. METHODS: Thirty patients scheduled for cardiac surgery under cardiopulmonary bypass (CPB) and TCI propofol anesthesia were randomly divided into two groups to receive a computer-controlled infusion of propofol with target concentrations of 1.5 or 2.0 micro/g x ml(-1) [1.5 microg x ml(-1) group (n=15) and 2.0 microg x ml(-1) group (n=15)]. Mean arterial pressure (MAP), heart rate (HR) and bispectral index scale (BIS) values were recorded at 5 time points during induction of anesthesia. RESULTS: MAP was significantly lower in 2.0 microg x ml(-1) group compared with 1.5 microg x ml(-1) group. In both groups, a rise of BIS value did not occur during tracheal intubation. CONCLUSIONS: We have demonstrated that propofol TCI at a target concentration of 1.5 microg x ml(-1) is effective for hemodynamic stability during induction of anesthesia in patients for cardiac surgery under CPB. 相似文献
30.
Regions of oropharyngeal cancer, hypopharyngeal cancer, and cervical esophageal cancer in a 70-year-old man were surgically resected and reconstructed with a free jejunal flap. Postoperatively the patient showed severe dysphagia and a chimneylike protrusion in the oral cavity. In a second operation, a dorsal, longitudinal incision for phimosis was made to release the stenosis; however, the dysphagia persisted, and peristalis seemed to interfere with deglutition. Here, we discuss the cause of the dysphagia, a complication of total reconstruction of oroesophageal defects with a single free jejunal flap, and the procedures of reconstruction. 相似文献