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101.

Background

Intramedullary nailing is considered a “gold standard” for treatment of tibial shaft fractures. However, some types of fractures are typically considered as “difficult for nailing”. This group includes the periarticular fractures, fractures of both bones at the same level, comminuted and segmental fractures of the tibia. Fixator-assisted nailing (FAN) is an effective method treatment of these types of fractures. The main requirements for the ideal reduction device are an ease of its installation and an ability of multiplanar fracture reduction. Fixator-assisted nailing (FAN) with the use of two perpendicular to each other monolateral tubular frames perfectly meets these requirements. In this study we present this new surgical technique and the analysis of first 30 cases.

Methods

A prospective analysis was conducted for 30 patients with “difficult for nailing” tibial fractures treated with fixator-assisted nailing in our institution between September 1st, 2017, and March 1st, 2018. The duration of surgery and its different stages, the time of fluoroscopy, difficulties encountered during surgery, were analyzed. Clinical and radiological methods were used to evaluated reduction quality.

Results

In all 30 cases the acceptable reduction was achieved. The mean duration of the surgical procedure was 73.7?±?3?min. The mean duration of fluoroscopy 85.9?±?4.8?s. In 7 cases we faced with technical difficulties, which were successfully addressed.

Conclusion

The described technique of FAN is an effective method for the treatment of “difficult for nailing” tibial fractures. Future multi-centered studies with a larger number of patients are needed to validate our results.  相似文献   
102.
The definition of interstitial cystitis (IC) has evolved over the years from being a well-defined entity characterized by diagnostic lesion (Hunner’s ulcer) in the urothelium to a clinical diagnosis by exclusion [painful bladder syndrome (PBS)]. Although the etiology is unknown, a central theme has been an association with increased permeability of the bladder. This article reviews the evidence for increased permeability being important to the symptoms of interstitial cystitis/painful bladder syndrome (IC/PBS) and in treating the disorder. Recent work showing cross-communication among visceral organs is also reviewed to provide a basis for understanding IC/PBS as a systemic disorder of a complex, interconnected system consisting of the bladder, bowel and other organs, nerves, cytokine-responding cells and the nervous system.  相似文献   
103.
Bile reflux has been implicated in the pathogenesis and malignant degeneration of Barrett’s esophagus, but clinical studies in patients with adenocareinoma arising in Barrett’s esophagus are lacking. Ambulatory esophageal measurement of acid and bile reflux was performed with the previously validated fiberoptic bilirubin monitoring system (Bilitec) combined with a pH probe in 20 asymptomatie volunteers, 19 patients with gastroesophageal reflux disease (GERD) but no mucosal injury, 45 patients with GERD and erosive esophagitis, 33 patients with GERD and Barrett’s esophagus, and 14 patients with early adenocarcinoma arising in Barrett’s esophagus. Repeat studies were done in 15 patients under medical acid suppression and 16 patients after laparoscopie Nissen fundoplication. The mean esophageal bile exposure time showed an exponential increase from GERD patients without esophagitis to those with erosive esophagitis and benign Barrett’s esophagus and was highest in patients with early carcinoma in Barrett’s esophagus (P <0.01). Pathologic esophageal bile exposure was documented in 18 (54.5%) of 33 patients with benign Barrett’s esophagus and 11 (78.6%) of 14 patients with early adenoearcinoma in Barrett’s esophagus. Nissen fundoplieation but not medical acid suppression resulted in complete suppression of bile reflux. Bile reflux into the esophagus is particularly prevalent in patients with Barrett’s esophagus and early cancer. Bile reflux into the esophagus can be completely suppressed by Nissen fundoplication but not medical acid suppression alone. (J GASTROINTEST SURG 1998;2:333-341.) Presented at the Thirty-Eighth Annual Meeting of The Society for Surgery of the Alimentary Tract, Washington, D.C., May 11–14, 1997  相似文献   
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GPR55, an orphan G‐protein coupled receptor, is activated by lysophosphatidylinositol (LPI) and the endocannabinoid anandamide, as well as by other compounds including THC. LPI is a potent endogenous ligand of GPR55 and neither GPR55 nor LPIs' functions in the brain are well understood. While endocannabinoids are well known to modulate brain synaptic plasticity, the potential role LPI could have on brain plasticity has never been demonstrated. Therefore, we examined not only GPR55 expression, but also the role its endogenous ligand could play in long‐term potentiation, a common form of synaptic plasticity. Using quantitative RT‐PCR, electrophysiology, and behavioral assays, we examined hippocampal GPR55 expression and function. qRT‐PCR results indicate that GPR55 is expressed in hippocampi of both rats and mice. Immunohistochemistry and single cell PCR demonstrates GPR55 protein in pyramidal cells of CA1 and CA3 layers in the hippocampus. Application of the GPR55 endogenous agonist LPI to hippocampal slices of GPR55+/+ mice significantly enhanced CA1 LTP. This effect was absent in GPR55?/? mice, and blocked by the GPR55 antagonist CID 16020046. We also examined paired‐pulse ratios of GPR55?/? and GPR55+/+ mice with or without LPI and noted significant enhancement in paired‐pulse ratios by LPI in GPR55+/+ mice. Behaviorally, GPR55?/? and GPR55+/+ mice did not differ in memory tasks including novel object recognition, radial arm maze, or Morris water maze. However, performance on radial arm maze and elevated plus maze task suggests GPR55?/? mice have a higher frequency of immobile behavior. This is the first demonstration of LPI involvement in hippocampal synaptic plasticity.  相似文献   
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During early postnatal development, the N-methyl-D-aspartate (NMDA) subtype of glutamate receptor plays a dominant role in excitatory amino acid-mediated synaptic transmission in essentially every brain region that has been examined. In contrast, we have found that in the rat striatum, NMDA receptor-mediated current develops later in the medium-sized neurons (MSNs) than currents mediated by activation of non-NMDA receptors. MSNs were identified using infrared video microscopy, and voltage-clamped in a slice preparation using the whole-cell patch-clamp technique. Intrastriatal stimulation was used to evoke excitatory synaptic currents from slices in animals ranging in age from postnatal day (PND) 5 to 60. Though most cells from animals younger than PND 10 failed to respond to synaptic stimulation, postsynaptic responses were occasionally evoked in cells as young as PND 5. Synaptic currents from cells between PNDs 5 and 7 had a significant contribution due to activation of non- NMDA receptors, as evidenced by sensitivity to the non-NMDA receptor antagonist 6-cyano-7-nitroquinoxaline-2,3-dione and rapidly rising and falling response components. The relative contribution of NMDA receptors increased approximately twofold from the first to the third postnatal week; no further change was observed through PND 60. At the same ages that the NMDA receptors contributed maximally to the synaptic current, the decay time constant of the NMDA receptor-mediated current decreased significantly. The increasing weight of NMDA receptor-mediated current may reflect a change in the number of functional receptors at the synapse since there was no apparent change in the voltage dependence of the current. To more completely examine receptor function early in postnatal development, NMDA and kainate were applied either iontophoretically or in the bath. Iontophoretic application of NMDA onto cells obtained from rats between PNDs 3 and 5 only occasionally evoked current, provided that the membrane was held at depolarized potentials to remove the Mg(2+) block. In contrast, application of kainate consistently evoked a response from cells of the same age group. Bath application of the same agonists provided similar results. Taken together, the present experiments demonstrate that striatal non-NMDA receptor-mediated currents are more mature than NMDA receptor-mediated currents early in development.  相似文献   
110.
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