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81.
Henry Q Xiong Arthur Rosenberg Albert LoBuglio William Schmidt Robert A Wolff John Deutsch Michael Needle James L Abbruzzese 《Journal of clinical oncology》2004,22(13):2610-2616
PURPOSE: To determine the response rate, time to disease progression, survival duration and rate, and toxicity with the combination of cetuximab and gemcitabine in patients with epidermal growth factor receptor (EGFR)-expressing advanced pancreatic cancer. PATIENTS AND METHODS: Patients with measurable locally advanced or metastatic pancreatic cancer who had never received chemotherapy for their advanced disease and had immunohistochemical evidence of EGFR expression were eligible for the multicenter phase II trial. Patients were treated with cetuximab at an initial dose of 400 mg/m(2), followed by 250 mg/m(2) weekly for 7 weeks. Gemcitabine was administered at 1,000 mg/m(2) for 7 weeks, followed by 1 week of rest. In subsequent cycles, cetuximab was administered weekly, and gemcitabine was administered weekly for 3 weeks every 4 weeks. RESULTS: Sixty-one patients were screened for EGFR expression, 58 patients (95%) had at least 1+ staining, and 41 were enrolled onto the trial. Five patients (12.2%) achieved a partial response, and 26 (63.4%) had stable disease. The median time to disease progression was 3.8 months, and the median overall survival duration was 7.1 months. One-year progression-free survival and overall survival rates were 12% and 31.7%, respectively. The most frequently reported grade 3 or 4 adverse events were neutropenia (39.0%), asthenia (22.0%), abdominal pain (22.0%), and thrombocytopenia (17.1%). CONCLUSION: Cetuximab in combination with gemcitabine showed promising activity against advanced pancreatic cancer. Further clinical investigation is warranted. 相似文献
82.
Viremia and excretion of TT virus in immunosuppressed heart transplant recipients and in immunocompetent individuals 总被引:1,自引:0,他引:1
BACKGROUND: The TT virus (TTV) was discovered in patients with symptomatic posttransfusion hepatitis, but many viremic individuals are asymptomatic. Inadvertent transfusion-associated transmission must therefore be anticipated. We screened blood donors and heart transplant recipients for TTV infections. METHODS: Nested polymerase chain reaction was used to detect TTV DNA in plasma, serum, urine, and fecal samples from 600 blood donors, from 100 healthy individuals, and from 495 heart transplant recipients. RESULTS: A total of 3.2% of the blood donors, but 25% of the heart transplant recipients were viremic. TTV subtypes G1a/b and G2a/b were observed in both groups, but the subtype distributions were discrepant. A severe, acute infection with TTV subtype 3 was observed in one blood donor. The prevalence of TTV infections in heart transplant recipients was not correlated to transfusion frequency. Nine viremic heart transplant recipients and their 75 blood donors were studied in detail. Seven blood donors were viremic, but only two "pairs" of viremic blood donors and transfusion recipients had identical TTV isolates. TTV DNA was detected in the feces of 5% (5/100) of immunocompetent individuals (staff), in 46% (52/112) of viremic heart transplant recipients, and in the urine of 55% (20/36). TTV DNA was detected in six of six batches of pooled "virus-inactivated" plasma (solvent/detergent treated), and in none of eight batches of commercial immunoglobulins. CONCLUSION: Although TTV is transfusion-transmissible, the parenteral transmission rate may have been overestimated. Many TTV infections are apparently acquired by nonparenteral routes. Immunoglobulins are safe but pooled plasma is not safe regarding TTV transmission. 相似文献
83.
The gastric banding is an effective operation for treatment of the morbid obesity. We report about 188 patients, we treated from April 1997 to December 1999. This review takes a stand on the indication for operation, the operative technique, the lost of weight and the complications. The benefit of this operation is the minimal invasive technique. 相似文献
84.
Wolff H 《Zentralblatt für Chirurgie》2000,125(4):387-393
By way of example, two scientific controversies that played a decisive role in shaping and determining the development--in the areas of chest and trauma surgery--of 20th century surgery, were discussed. In the former area, the spectacular method involving the use of a negative-pressure chamber, developed by Sauerbruch in 1904 was described--an innovation representing an enormous step forward in the field of surgery on the chest. However, the method failed to find widespread favour, and the opposite concept involving the use of positive-pressure was developed, and intratracheal ventilation--already under discussion at the beginning of the 20th century--finally won the day, and still remains in use. Medullary nailing of bone fractures as introduced by Küntscher initially prompted controversial discussion and at first appeared to have been rejected--only to find widespread acceptance nevertheless. It continues to be a justified method of achieving a stable osteosynthesis which, thanks to methodological refinements and improvements over the years, is an important option in the list of indications for surgical treatment of bone fractures. All in all, the following remark would appear applicable: An achievement alone does not suffice--someone is needed to recognize and endorse it. 相似文献
85.
GA Smith SD Strausbaugh C Harbeck-Weber DM Cohen BJ Shields JD Powers 《Pediatrics》1997,100(5):825-830
OBJECTIVE: To compare the effectiveness of three new topical anesthetics that do not contain cocaine (prilocaine-phenylephrine, tetracaine-phenylephrine [tetraphen], and tetracaine-lidocaine-phenylephrine) to that of tetracaine-adrenaline-cocaine (TAC) during laceration repair in children. DESIGN: Prospective, randomized, double-blind clinical trial. SETTING: The emergency department of an urban children's hospital. PARTICIPANTS: Children 1 year of age or older with a laceration = 5 cm in length that required suturing. Intervention. A total of 240 children were randomly assigned to one of four treatment groups. OUTCOME MEASURES: Pain felt during suturing was scored by suture technicians, research assistants, parents, and patients >/= 5 years of age using a visual analogue scale (VAS). Suture technicians, research assistants, and parents also scored pain using a seven-point Likert scale. In addition, suture technicians completed an anesthetic effectiveness scale. RESULTS: There was consistently no difference demonstrated between the effectiveness of tetraphen and that of TAC for each outcome measure of each observer group. A statistically significant difference was seen among anesthetics when comparing VAS and Likert scale scores of suture technicians and Likert scale scores of research assistants. Based on post hoc analyses, these statistically significant differences were between TAC and prilocaine-phenylephrine (suture technician VAS and Likert scale) and between TAC and tetracaine-lidocaine-phenyl-ephrine (suture technician Likert scale), but not between TAC and tetraphen. When power analyses were performed using alpha = 0.05 and beta = 0.20, it was possible to detect a difference of 1.2 VAS units for each of the observer groups. Based on anesthetic effectiveness scale scores, the three new topical preparations collectively performed significantly better on the face and scalp than on the extremities (relative risk = 1.83; 95% confidence interval 1.20 < relative risk < 2.79). CONCLUSION: This study demonstrated the effectiveness and safety of three new non-cocaine-containing topical anesthetics. Consistently, there was no statistical difference demonstrated between the effectiveness of tetraphen and that of TAC for each outcome measure of each observer group. Tetraphen offers an effective alternative to TAC during laceration repair in children. 相似文献
86.
F. Wolff 《Der Gyn?kologe》1997,30(9):726-736
Die Frühgeburt ist die führende Ursache der perinatalen Mortalit?t und Morbidit?t. Die Erkennung und Behandlung ist daher
eine vorrangige Aufgabe der Geburtshilfe. Zwei Drittel aller Kinder, die perinatal versterben, sind Frühgeborene mit einem
Geburtsgewicht von weniger als 1.500 Gramm. Zwischen 20 und 30% dieser Kinder werden sp?ter Auff?lligkeiten von neurologischen
St?rungen bis zu geringeren Handicaps aufweisen. 相似文献
87.
Non-typhoid Salmonella gastroenteritis 总被引:2,自引:0,他引:2
88.
The gestagenic and antiandrogenic drug cyproterone acetate (CPA) is
mitogenic, tumorigenic and induces DNA-adducts and DNA-repair synthesis in
rat liver. Thus CPA is expected to be mutagenic. However in vitro
mutagenicity test systems were negative. To examine whether CPA induces
mutations in rat liver, the in vivo mutation assay based on Big Blue
transgenic F344 rats was employed. Single oral doses of 25, 50, 75, 100 and
200 mg CPA/kg b.w. respectively were administered to female Big Blue rats.
Six weeks after treatment, liver DNA was assayed for mutations. At the
highest dose, 200 mg CPA/kg b.w., the frequency of (17 +/- 4) x 10(-6)
spontaneous mutations was increased to a maximum of (80 +/- 8) x 10(-6)
mutations. One-hundred and 75 mg CPA/kg b.w. resulted in mutation
frequencies of (35 +/- 5) and (27 +/- 5) x 10(-6), respectively. The
mutation frequency at doses of 50 and 25 mg CPA/kg b.w. was similar to that
of vehicle treated controls. Statistical analysis of the dose-effect
relationship revealed that it was not possible to decide whether a
threshold dose exists or not. DNA adducts were analyzed by the
32P-postlabelling technique. The total level of the major and the two minor
adducts observed in the autoradiograms increased between doses of 25 to 75
mg CPA/kg b.w. to a maximum of approximately 12,000 +/- 3000 adducts per
10(9) nucleotides. The level did not further increase significantly with
100 and 200 mg CPA/kg b.w. After CPA treatment no preneoplastic liver foci
were observed. However, single glutathione-S-transferase placental form
(GST-P) positive hepatocytes were observed and the frequency was dependent
on the dose. These cells are not supposed to represent initiated cells,
since they occurred only transiently after 6 weeks and disappeared
thereafter completely. In conclusion, our results demonstrate that CPA is
mutagenic in vivo. The mutation frequency increased at high CPA doses, when
the increase of the DNA adduct formation had already ceased. This suggests
that the mitogenic activity of CPA is required to express the mutations.
相似文献
89.
Summary: Purpose: Vigabatrin (VGB) is a new‐generation anticonvulsant used in the treatment of partial seizures and West syndrome. Side effects of VGB treatment in adults and children are well described. Acute encephalopathy with VGB has recently been reported in eight adults. They developed stupor, confusion, and electroencephalographic abnormalities after starting VGB. Does the acute encephalopathy with VGB also occur in childhood? Methods: We describe a 6‐month‐old girl with infantile Alexander disease with hydrocephalus who developed similar clinical symptoms with apathia, somnolence, and sopor, as well as slowing of the background activity in EEG, 3 days after starting VGB. After exclusion of shunt dysfunction, encephalitis, metabolic dysfunction, and renal failure, VGB was discontinued. Results: During the next 2 days, symptoms subsided, and after 10 days, EEG background activity returned to the one before starting VGB. Conclusions: Acute encephalopathy associated with VGB in children seems to be very rare, but should not be ignored. 相似文献
90.
A CT-based method of marking superficial intracranial lesions with a needle is presented. This form of neuronavigation can be applied in every neurosurgical centre. Owing to its rapid application it is also suitable for cases of emergency. The neurosurgical approach can be centred precisely over the lesion providing for a minimally invasive operation. The method has proved its efficacy in numerous cases of haematomas and cystic lesions. 相似文献