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51.
Anorexia nervosa (AN) has recently become one of common disorders in adolescent girls. A chronic course of AN is related to morbidity, with one of the most serious medical complications being severe osteopenia. The prevalence of osteoporosis is estimated to be 40 % in AN during the follow up. The incidence of bone fracture in AN after the recovery of body weight is reported to be two to seven higher than that in healthy age-matched controls. Because adolescence is a critical time in terms of acquisition of peak bone mass, osteopenia during this time may be permanent. Adult woman with adolescence-onset AN has lower bone mineral density than that with adult-onset AN. In addition, bone mineral density (BMD) of AN has been shown to be influenced by several factors, including reduced body weight due to malnutrition, intake of calcium and vitamin D, and duration of estrogen deficiency. Among them, body weight is known to be the most important prognostic factor, both in a short and long period of years. Thus, medical doctor should monitor BMD in patients with AN throughout their life. 相似文献
52.
53.
Hiromu Moriyama Moeko Tsutsuura Nana Kojima Yuki Mizukami Sho Tashiro Sumika Osa Yuki Enoki Kazuaki Taguchi Kazutaka Oda Satoshi Fujii Yoshiko Takahashi Yukihiro Hamada Toshimi Kimura Yoshio Takesue Kazuaki Matsumoto 《Journal of infection and chemotherapy》2021,27(5):781-785
We carried out a systematic review and meta-analysis exploring the relationship between vancomycin (VCM) trough concentrations and its effectiveness and nephrotoxicity in pediatric patients. We conducted our analysis using MEDLINE, Web of Sciences, and Cochrane Register of Controlled Trials as electronic databases (June 29, 2019). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. We identified 16 studies that were eligible for the meta-analysis. A total of 351 and 3,266 patients were included in the analysis for effectiveness and nephrotoxicity, respectively. Pediatric MRSA infection patients with VCM trough concentrations ≥ 10 μg/mL had significantly lower treatment failure rates (OR 0.54, 95% CI 0.30–0.96). The incidence of nephrotoxicity was significantly higher in trough concentrations ≥ 15 μg/mL than when they were < 15 μg/mL (OR 3.02, 95% CI 2.08–4.38). We identified the optimal VCM trough concentrations associated with effectiveness and nephrotoxicity in pediatric patients with MRSA infection. Further prospective studies are needed to find optimal dosing and monitoring strategy on VCM in pediatric population. 相似文献
54.
55.
Varicose bleeding after liver transplantation in a patient with severe portosystemic shunts 总被引:1,自引:0,他引:1
Nosaka T Teramoto K Tanaka Y Igari T Takamatsu S Kawamura T Inoue Y Goseki N Arii S Iwai T Inomata Y Tanaka K 《Journal of gastroenterology》2003,38(7):700-703
Recipients for liver transplantation often have portosystemic shunts due to portal hypertension. It is an important problem whether such shunts should be ligated during operations. Ligating the shunts seems of benefit for increasing portal blood flow to the liver, but it is sometimes difficult technically, and it is invasive to the patient. We experienced a recipient with huge portosystemic shunts and no esophageal varices before living-related liver transplantation. Some shunts were ligated during operation to increase portal blood flow to the graft. Unfortunately, the patient suffered severe bleeding from esophagogastric varices after he underwent retransplantation owing to accidental liver failure. Based on our experience, extreme care should be exercised to avoid varicose bleeding after ligating the portosystemic shunts of liver transplantation patients. 相似文献
56.
Development of angiogenic cell and gene therapy by transplantation of umbilical cord blood with vascular endothelial growth factor gene. 总被引:11,自引:0,他引:11
Yukihiro Ikeda Noboru Fukuda Mika Wada Taro Matsumoto Aya Satomi Shin-Ichiro Yokoyama Satoshi Saito Koichi Matsumoto Katsuo Kanmatsuse Hideo Mugishima 《Hypertension research》2004,27(2):119-128
Endothelial progenitor cells (EPCs) are present in the mononuclear cells (MNCs) of umbilical cord blood and peripheral blood. To establish the efficiency of angiogenic cell and gene therapies, we transfected the human vascular endothelial growth factor (hVEGF) gene into cord blood MNCs to enhance endothelialization. MNCs from cord blood and peripheral blood were isolated and transfected with pCR3 expressing hVEGF165 or GFP by the Hemagglutinating Virus of Japan (HVJ)-envelope and the cells were cultured in endothelium basal medium-2. The number of attached cells from cord blood was higher than that from peripheral blood. Attached cells expressed Flk-1, VE-cadherin, PECAM-1, CD34, and Tie-2. The increase in the number of attached cells was transient with the transfection of vascular endothelial growth factor (VEGF) gene early in the experimental period. Flt-1 mRNA was not expressed early in the culture period, but was expressed at 2 weeks after separation. VEGF gene transfer into MNCs at 12 days after separation, i.e., when Flt-1 mRNA was expressed continuously, increased the number of attached cells. We evaluated the effects of the transplantation of cord blood MNCs expressing the hVEGF gene on regional blood flow in an ischemic area in a rat model of chronic hindlimb ischemia. Blood flow was significantly improved in nude rats that received transplanted control MNCs. Transplantation of cord blood MNCs transfected with the hVEGF gene yielded greater improvements in blood flow. These results indicate that the hVEGF gene enhances endothelialization of EPCs, and that the transplantation of cord blood MNCs transfected with the VEGF gene may be feasible for the treatment of ischemic diseases as a type of angiogenic cell and gene therapy. 相似文献
57.
Masahiro Goto Naoyuki Miyagawa Kaori Kikunaga Masaru Miura Yukihiro Hasegawa 《Clinical Pediatric Endocrinology》2015,24(3):69-75
Combination treatment with intravenous immunoglobulin (IVIG) plus prednisolone is
effective for prevention of cardiovascular complications in children with Kawasaki disease
(KD). However, administration of prednisolone for approximately 20 d in this regimen
causes adrenocortical suppression in a high proportion of treated children. To establish a
simple method to screen for this suppression, we performed a prospective study on 72
children with KD treated with this regimen in our institution from February 2012 to March
2014. By performing ROC analysis of 21 initial patients treated between February and June
2012, a serum cortisol value at 09:00 h of 5 mcg/dL was established as a threshold for
intact adrenocortical function, which is equivalent to a peak serum cortisol value of
higher than 15 mcg/dL in the CRH stimulation test. Then, we applied this screening test to
51 subsequent patients treated between July 2012 and March 2014. Approximately 90% of the
patients with morning serum cortisol values above 5 mcg/dL 2 to 6 mo after the cessation
of initial prednisolone treatment had peak serum cortisol values exceeding 15 mcg/dL,
suggesting the efficacy of this approach. 相似文献
58.
A randomized controlled trial of radiofrequency ablation with ethanol injection for small hepatocellular carcinoma 总被引:35,自引:0,他引:35
Shiina S Teratani T Obi S Sato S Tateishi R Fujishima T Ishikawa T Koike Y Yoshida H Kawabe T Omata M 《Gastroenterology》2005,129(1):122-130
BACKGROUND & AIMS: Percutaneous radiofrequency ablation is a recently introduced treatment for hepatocellular carcinoma, whereas ethanol injection is now a standard therapy. We compared their long-term outcomes. METHODS: Two hundred thirty-two patients with hepatocellular carcinoma who had 3 or fewer lesions, each 3 cm or less in diameter, and liver function of Child-Pugh class A or B were entered onto a randomized controlled trial. The primary end point was survival, and the secondary end points were overall recurrence and local tumor progression. RESULTS: One hundred eighteen patients were assigned to radiofrequency ablation and 114 to ethanol injection. The number of treatment sessions was smaller (2.1 times vs 6.4 times, respectively, P < .0001) and the length of hospitalization was shorter (10.8 days vs 26.1 days, respectively, P < .0001) in radiofrequency ablation than in ethanol injection. Four-year survival rate was 74% (95% CI: 65%-84%) in radiofrequency ablation and 57% (95% CI: 45%-71%) in ethanol injection. Radiofrequency ablation had a 46% smaller risk of death (adjusted relative risk, 0.54 [95% CI: 0.33-0.89], P = .02), a 43% smaller risk of overall recurrence (adjusted relative risk 0.57 [95% CI: 0.41-0.80], P = .0009), and an 88% smaller risk of local tumor progression (relative risk, 0.12 [95% CI: 0.03-0.55], P = .006) than ethanol injection. The incidence of adverse events was not different between the 2 therapies. CONCLUSIONS: Judging from higher survival but similar adverse events, radiofrequency ablation is superior to ethanol injection for small hepatocellular carcinoma. 相似文献
59.
Satoshi Honjo Yoko Murakami Hiroshi Odajima Yuichi Adachi Koichi Yoshida Yukihiro Ohya Akira Akasawa 《Allergology international》2019,68(1):26-32