全文获取类型
收费全文 | 2896篇 |
免费 | 170篇 |
国内免费 | 26篇 |
专业分类
耳鼻咽喉 | 16篇 |
儿科学 | 153篇 |
妇产科学 | 58篇 |
基础医学 | 349篇 |
口腔科学 | 67篇 |
临床医学 | 161篇 |
内科学 | 647篇 |
皮肤病学 | 25篇 |
神经病学 | 147篇 |
特种医学 | 106篇 |
外科学 | 661篇 |
综合类 | 12篇 |
预防医学 | 51篇 |
眼科学 | 101篇 |
药学 | 235篇 |
中国医学 | 31篇 |
肿瘤学 | 272篇 |
出版年
2024年 | 2篇 |
2023年 | 14篇 |
2022年 | 25篇 |
2021年 | 87篇 |
2020年 | 42篇 |
2019年 | 67篇 |
2018年 | 86篇 |
2017年 | 71篇 |
2016年 | 74篇 |
2015年 | 97篇 |
2014年 | 121篇 |
2013年 | 126篇 |
2012年 | 168篇 |
2011年 | 218篇 |
2010年 | 105篇 |
2009年 | 117篇 |
2008年 | 173篇 |
2007年 | 214篇 |
2006年 | 183篇 |
2005年 | 196篇 |
2004年 | 215篇 |
2003年 | 169篇 |
2002年 | 187篇 |
2001年 | 30篇 |
2000年 | 32篇 |
1999年 | 26篇 |
1998年 | 27篇 |
1997年 | 32篇 |
1996年 | 26篇 |
1995年 | 25篇 |
1994年 | 17篇 |
1993年 | 9篇 |
1992年 | 14篇 |
1991年 | 12篇 |
1990年 | 9篇 |
1989年 | 11篇 |
1988年 | 10篇 |
1987年 | 7篇 |
1986年 | 2篇 |
1985年 | 9篇 |
1984年 | 4篇 |
1983年 | 3篇 |
1982年 | 7篇 |
1981年 | 2篇 |
1980年 | 4篇 |
1979年 | 4篇 |
1976年 | 4篇 |
1968年 | 1篇 |
1966年 | 1篇 |
1956年 | 1篇 |
排序方式: 共有3092条查询结果,搜索用时 46 毫秒
91.
Yukihiro Iida Masato Matsuoka Ichirou Shimizu Takashi Wakisaka Akitoshi Katsumata 《Oral Radiology》2013,29(1):56-63
Objectives
We examined the usefulness of micro-computed tomography (micro-CT) to measure the distributions of contrast media in materials that simulated the properties of test foods for videofluoroscopic (VF) swallowing studies (VFSS).Methods
Food samples that simulated rice, rice gruel, custard pudding, udon noodles, and liquids were prepared with barium sulfate and iodine contrast media. These samples and simulated foods containing no contrast medium were subjected to micro-CT. The micro-CT scanning was performed using a ScanXmate-RB090SS. Each sample was used to fill a cylindrical container with an inner diameter of 8 mm and a height of 35 mm or a 1-mL plastic syringe, and images were acquired at a voltage of 90 kV, current of 45 μA, and magnification power of 2.5. From the acquired data, 610 × 610-pixel 8-bit image slices were prepared and observed using OsiriX software. The image densities (pixel values) were measured for regions of interest. The obtained pixel values were then normalized on the basis of the density of the barium sulfate contrast medium and water.Results
The infiltration or distributions of the contrast media in the VF test materials were successfully observed, and their values ranged widely compared with the barium sulfate contrast medium.Conclusions
Micro-CT imaging was capable of numerically presenting or visualizing the density and distribution of VF test materials, thereby showing its usefulness as an objective evaluation method. Using this technique, it may be possible to adjust test foods to the optimum contrast properties for clinical VF examinations. 相似文献92.
Atsushi Okada Takahiro Yasui Kazumi Taguchi Kazuhiro Niimi Yasuhiko Hirose Shuzo Hamamoto Ryosuke Ando Yasue Kubota Yukihiro Umemoto Keiichi Tozawa Shoichi Sasaki Yutaro Hayashi Kenjiro Kohri 《Urological research》2013,41(6):487-492
To evaluate the efficacy of company-initiated training of urologists on shock wave lithotripsy (SWL) treatment results, we retrospectively assessed 602 patients who underwent SWL in Nagoya City University Hospital between January 2004 and June 2011 using Lithotripter S (Dornier MedTech, Japan). Training—provided by a training specialist of the company in June 2010—focused on the targeting of renal and proximal ureter stones with a combination of radiography and ultrasonography (US). The stretcher wedges were positioned in the semi-prone position or the semi-supine position for middle and distal ureter stones, respectively. Success rates between 519 pre-training treatments and 83 post-training treatments were compared. Patient age and stone location, burden, number, and composition did not significantly differ between pre- and post-training. Training improved the overall success rate from 66.3 to 87.2 % (P < 0.0001). The mean number of SWL treatments decreased from 1.8 ± 1.8 to 1.4 ± 1.3 (P = 0.01). The first SWL treatment success rate increased from 67.1 to 83.7 % (P = 0.002), and the need for multiple treatments decreased. The frequency of detection of renal and proximal ureter stones by both radiography and US increased from 10.5 % before training to 58.2 % after training (P < 0.0001). Significant factors for successful SWL were determined to be training and prone position for distal ureter stones by multivariate analysis and ultrasonic detection for renal and proximal ureter stones by univariate analysis. Skills in targeting stones using ultrasonography and selecting the proper therapeutic position are essential for improving the success rate of stone removal. 相似文献
93.
Ikemoto T Hojo Y Kondo H Takahashi N Hirose M Nishimura Y Katsuki T Shimada K Kario K 《Heart and vessels》2012,27(4):344-351
Recent clinical studies have revealed that the expression of endoglin, an accessory protein for the TGF-β receptor, is increased in patients with atherosclerotic diseases. The plasma endoglin level is thought to represent endothelial activation, inflammation, and senescence. To clarify the significance of plasma endoglin in chronic coronary artery disease. Human umbilical vein endothelial cells (HUVECs) were cultured to examine changes in soluble endoglin (s-endoglin) levels caused by atherogenic stimulation in vitro. We studied 318 patients with stable coronary artery disease who underwent a successful percutaneous coronary intervention (PCI). Patients with acute coronary syndrome were excluded. Major adverse cardiovascular events (MACE) were congestive heart failure, acute myocardial infarction, stroke, and sudden cardiac death. All patients were followed-up to examine MACE after the procedure. We confirmed that the levels of s-endoglin was increased in the culture medium of HUVECs by senescence, tumor necrosis factor-α and hydrogen peroxide. In a clinical study, mean follow-up period was 1055?±?612?days (49–2136?days) with 27 incidents of MACE (8.5%). We divided patients into three groups according to the plasma s-endoglin levels. Kaplan–Meier curves revealed that the highest endoglin group had a significantly higher MACE rate than the lowest endoglin group (log-rank test, p?=?0.009). A Cox proportional hazards model showed that chronic kidney disease, left ventricular ejection fraction and s-endoglin level were significant factors to predict MACE. Plasma endoglin could be a marker to predict cardiovascular events in patients with chronic coronary artery disease after PCI. 相似文献
94.
95.
Keisuke Uehara Yuichiro Yoshioka Tomoki Ebata Yukihiro Yokoyama Masanao Nakamura Naoki Ohmiya Hidemi Goto Masato Nagino 《Surgery today》2013,43(9):1062-1065
The clinical introduction of double-balloon endoscopy (DBE) has brought about a revolution in the diagnosis and the treatment of diseases of the small intestine. DBE allows not only direct observation of the entire small intestine, but also interventional therapies, tissue sampling and India ink marking (tattooing). Single incision laparoscopic surgery (SILS) was developed from conventional laparoscopic surgery to further reduce the degree of invasiveness. SILS requires only one umbilical incision, thus resulting in almost scarless surgery. This report presents three cases of small intestinal bleeding successfully treated by SILS following tattooing under DBE. The average operative time was 67 min and average blood loss was 5 ml. All patients immediately recovered without any complications. SILS, in conjunction with presurgical tattooing by DBE for small intestinal bleeding is considered to be an ideal approach in terms of minimal surgical trauma and aesthetics. 相似文献
96.
Shunji Tsutsui Ryohei Kagotani Hiroshi Yamada Hiroshi Hashizume Akihito Minamide Yukihiro Nakagawa Hiroshi Iwasaki Munehito Yoshida 《European spine journal》2013,22(9):2010-2014
Introduction
Decompression with fusion is usually recommended in patients with lumbar spinal stenosis (LSS) combined with degenerative lumbar scoliosis (DLS). However, elderly patients with LSS and DLS often have other comorbidities, and surgical treatment must be both safe and effective. The aim of this study was to investigate whether decompression surgery alone alleviates low back pain (LBP) in patients with LSS and DLS, and to identify the predictors of postoperative residual LBP.Materials and methods
A total of 75 patients (33 males and 42 females) with a mean age of 71.8 years (range 53–86 years) who underwent decompression surgery for LSS with DLS (Cobb angle ≥ 10°) and had a minimum follow-up period of 1 year, were retrospectively reviewed using the Japanese Orthopaedic Association scoring system for the assessment of lumbar spinal diseases (JOA score). Radiographic measurements included coronal and sagittal Cobb angles, apical vertebral rotation (Nash-Moe method), and anteroposterior and lateral spondylolisthesis. Logistic regression analysis was performed to investigate the predictors of residual LBP after surgery.Results
Forty-nine patients had preoperative LBP, of which 29 (59.1 %) experienced postoperative relief of LBP. Logistic regression analysis demonstrated that the degree of apical vertebral rotation on preoperative radiography was significantly associated with postoperative residual LBP (odds ratio, 8.16, 95 % confidence interval, 1.55–83.81, p = 0.011).Conclusion
A higher degree of apical vertebral rotation may therefore be an indicator of mechanical LBP in patients with LSS and DLS. Decompression with fusion should be recommended in these patients. 相似文献97.
Purpose
We describe a new rat model of biliary atresia, induced by biliary ablation with pure ethanol.Methods
A catheter was inserted and fixed in the common bile duct of male rats. Saline or pure ethanol was injected through the catheter and the animals were monitored for 8 weeks thereafter. We measured total bilirubin (T-Bil), aspartate aminotransferase (AST), alanine transaminase (ALT), and hyaluronic acid (HA) and examined liver biopsy specimens immunohistochemically for α-smooth muscle actin staining (α-SMA) and transforming growth factor-β1 (TGF-β1).Results
The ethanol injection group animals were further divided into a temporary and a persistent liver dysfunction group. In the persistent group, T-Bil, AST, ALT and HA levels were significantly higher after 8 weeks in the persistent group than in the control group and the temporary group. In the ethanol injection group, α-SMA expression was prominent in the surrounding proliferative bile ducts and portal areas. The distribution of TGF-β1 was found prominently in hepatocytes in the center of nodules and in ductular epithelial cells.Conclusions
This study characterizes the effects of ethanol-induced bile duct injury in rats, resulting in sclerosing cholangitis and its secondary effects. We believe that this experimental model will prove useful in the study of biliary atresia. 相似文献98.
Takayuki Takeichi Yasuko Narita Kwang-Jong Lee Hidekazu Yamamoto Katsuhiro Asonuma Yukihiro Inomata 《Surgery today》2013,43(11):1326-1329
Sclerosing encapsulating peritonitis (SEP) is a rare cause of bowel obstruction. It is difficult to diagnose and the prognosis is poor. This report describes a case of SEP after living donor liver transplantation that was successfully treated with tamoxifen. A 56-year-old male, that had received a liver transplant for hepatitis C virus-related hepatocellular carcinoma 5 years earlier, was admitted with continuous abdominal pain and nausea. He had increased C-reactive protein levels and white blood cell count, and underwent laparotomy 5 days after hospitalization. The surgical findings showed ascites and SEP of the small bowel. An attempt to peel off the adhesions was stopped because there was a strong risk of intestinal tract damage. Tamoxifen treatment was initiated for SEP after surgery. The patient’s symptoms gradually improved and he was able to resume feeding. He had been symptom-free for over 3 years at the last follow-up. 相似文献
99.
Hiroshi Kinashi Yasuhiko Ito Masashi Mizuno Yasuhiro Suzuki Takeshi Terabayashi Fumiko Nagura Ryohei Hattori Yoshihisa Matsukawa Tomohiro Mizuno Yukihiro Noda Hayato Nishimura Ryosuke Nishio Shoichi Maruyama Enyu Imai Seiichi Matsuo Yoshifumi Takei 《Journal of the American Society of Nephrology : JASN》2013,24(10):1627-1642
Peritoneal fibrosis (PF) causes ultrafiltration failure (UFF) and is a complicating factor in long-term peritoneal dialysis. Lymphatic reabsorption also may contribute to UFF, but little is known about lymphangiogenesis in patients with UFF and peritonitis. We studied the role of the lymphangiogenesis mediator vascular endothelial growth factor-C (VEGF-C) in human dialysate effluents, peritoneal tissues, and peritoneal mesothelial cells (HPMCs). Dialysate VEGF-C concentration correlated positively with the dialysate-to-plasma ratio of creatinine (D/P Cr) and the dialysate TGF-β1 concentration. Peritoneal tissue from patients with UFF expressed higher levels of VEGF-C, lymphatic endothelial hyaluronan receptor-1 (LYVE-1), and podoplanin mRNA and contained more lymphatic vessels than tissue from patients without UFF. Furthermore, mesothelial cell and macrophage expression of VEGF-C increased in the peritoneal membranes of patients with UFF and peritonitis. In cultured mesothelial cells, TGF-β1 upregulated the expression of VEGF-C mRNA and protein, and this upregulation was suppressed by a TGF-β type I receptor (TGFβR-I) inhibitor. TGF-β1–induced upregulation of VEGF-C mRNA expression in cultured HPMCs correlated with the D/P Cr of the patient from whom the HPMCs were derived (P<0.001). Moreover, treatment with a TGFβR-I inhibitor suppressed the enhanced lymphangiogenesis and VEGF-C expression associated with fibrosis in a rat model of PF. These results suggest that lymphangiogenesis associates with fibrosis through the TGF-β–VEGF-C pathway.The decrease in ultrafiltration capacity that is associated with the high peritoneal solute transport that is observed after prolonged peritoneal dialysis (PD) treatment is a major reason for its discontinuation.1–4 Several studies have shown that a higher peritoneal solute transport rate is associated with reduced survival of PD patients.1,2,5 The characteristic features of chronic peritoneal damage in PD treatment are associated with submesothelial fibrosis and neoangiogenesis.6,7 Analyses of the surface peritoneum showed no significant changes in vessel density with duration of PD.6,8 In addition, the vessel density in patients with ultrafiltration failure (UFF) was significantly higher than the vessel density in normal individuals or non-PD patients, but it was not higher than the vessel density in patients undergoing PD.6 These findings suggest that factors other than increased vascular density may be involved in disease states associated with increased transport of peritoneal membranes. In addition, the relationship between peritoneal fibrosis and UFF remains obscure.Blood capillaries have a continuous basal lamina with tight interendothelial junctions and are supported by pericytes and smooth muscle cells. In contrast, lymphatic capillaries are thin-walled with a wide lumen and do not contain pericytes or basement membrane. The structures of lymphatic vessels are suitable for the removal of tissue fluid, cells, and macromolecules from the interstitium.9–11 If lymphangiogenesis develops in the peritoneal membrane, absorption of the PD fluid could be increased and lead to UFF. An increase in the number of lymphatic vessels has recently been reported in several disease conditions, including tumor metastasis,12–15 chronic respiratory inflammatory diseases,16–18 wound healing,19 and renal transplant rejection.20,21 We recently reported that lymphangiogenesis had developed in tubulointerstitial fibrosis of human renal biopsy specimens,22 and we also reported the mechanisms of lymphangiogenesis in rat unilateral ureteral obstruction models.23The lymphatic absorption rate, which is measured by the rate at which intraperitoneally administered radioactive serum albumin or macromolecule dextran 70 disappears, is significantly higher in patients with UFF, and lymphatic reabsorption is considered to be one of the causes of UFF.24–27 However, the results from these clinical approaches have been controversial.28,29 In addition, little is known about the pathology and the process of lymphangiogenesis in patients with UFF and peritonitis.In this study, we investigated lymphangiogenesis and the expression of vascular endothelial growth factor-C (VEGF-C), which is a potentially important mediator of lymphangiogenesis, in human peritoneal tissues, PD effluent, and peritoneal mesothelial cells. We also explored VEGF-C induction by TGF-β1 in the human mesothelial cell line (Met-5A) and cultured human peritoneal mesothelial cells (HPMCs) from the spent PD effluent of patients with varying rates of peritoneal transport. Finally, we explored the relationship between peritoneal fibrosis and lymphangiogenesis in rats that were administered chlorhexidine gluconate (CG) into the abdominal cavity, which provides a model of chemically induced peritoneal inflammation/fibrosis.30–32 This work is the first report to show that lymphangiogenesis is linked to the peritoneal fibrosis that is often associated with a high peritoneal transport rate. 相似文献
100.
Takeharu Kunieda Nobuhiro Mikuni Sumiya Shibata Rika Inano Yukihiro Yamao Takayuki Kikuchi Riki Matsumoto Jun Takahashi Akio Ikeda Hidenao Fukuyama Susumu Miyamoto 《Neurologia medico-chirurgica》2013,53(11):805-813
Surgical intervention is expected to improve the quality of life in patients with intractable epilepsy by providing adequate seizure control. Although many previous studies showed various rates of seizure freedom, definite conclusions have not yet been made regarding outcomes. In order to clarify the long-term postoperative outcome for a period up to 10 years, a retrospective review of our patients was performed longitudinally by using the survival analysis method. The postoperative state of epilepsy in 76 patients who underwent resection surgery was assessed based on Engel’s criteria. In addition, Kaplan-Meier survival analysis was used to calculate the probability of seizure freedom. In this patient group, abnormal lesion were detected by MRI in 70 out of 76 cases, and the ictal onset zone was finally identified within temporal lobe in 51 cases. The most favorable outcome, defined as Engel Class Ia, was observed in 26 (37%), 24 (40%), and 18 (41%) cases at 2, 5, and 10 years after surgery, respectively. The Kaplan-Meier survival curve in the overall group estimated the probability of seizure freedom as 75% (95% confidence interval [CI] 70–80%), 67% (62–72%), and 51% (45–57%) at 2, 5, and 10 years follow up, respectively. Half of all seizure recurrences occurred within the first 2 postoperative years. In this study, we showed that long-term favorable outcome of seizure control following resection surgery can be achieved in more than half of the patients. 相似文献