全文获取类型
收费全文 | 4169篇 |
免费 | 217篇 |
国内免费 | 23篇 |
专业分类
耳鼻咽喉 | 62篇 |
儿科学 | 81篇 |
妇产科学 | 31篇 |
基础医学 | 458篇 |
口腔科学 | 94篇 |
临床医学 | 267篇 |
内科学 | 1065篇 |
皮肤病学 | 106篇 |
神经病学 | 300篇 |
特种医学 | 124篇 |
外科学 | 927篇 |
综合类 | 18篇 |
预防医学 | 90篇 |
眼科学 | 77篇 |
药学 | 256篇 |
中国医学 | 4篇 |
肿瘤学 | 449篇 |
出版年
2023年 | 37篇 |
2022年 | 50篇 |
2021年 | 104篇 |
2020年 | 52篇 |
2019年 | 80篇 |
2018年 | 99篇 |
2017年 | 80篇 |
2016年 | 81篇 |
2015年 | 82篇 |
2014年 | 100篇 |
2013年 | 117篇 |
2012年 | 183篇 |
2011年 | 237篇 |
2010年 | 142篇 |
2009年 | 109篇 |
2008年 | 185篇 |
2007年 | 210篇 |
2006年 | 214篇 |
2005年 | 228篇 |
2004年 | 242篇 |
2003年 | 183篇 |
2002年 | 203篇 |
2001年 | 99篇 |
2000年 | 129篇 |
1999年 | 136篇 |
1998年 | 60篇 |
1997年 | 45篇 |
1996年 | 51篇 |
1995年 | 42篇 |
1994年 | 39篇 |
1993年 | 51篇 |
1992年 | 80篇 |
1991年 | 61篇 |
1990年 | 67篇 |
1989年 | 67篇 |
1988年 | 78篇 |
1987年 | 56篇 |
1986年 | 59篇 |
1985年 | 40篇 |
1984年 | 29篇 |
1983年 | 20篇 |
1982年 | 15篇 |
1981年 | 14篇 |
1979年 | 21篇 |
1978年 | 14篇 |
1977年 | 18篇 |
1976年 | 11篇 |
1974年 | 12篇 |
1973年 | 8篇 |
1972年 | 11篇 |
排序方式: 共有4409条查询结果,搜索用时 13 毫秒
81.
Tsukasa Higuchi Kazuhiro Shimada Yoshiaki Cho Kisei Minami Kouichi Takeuchi Akiyuki Sakamoto 《Pediatrics international》2016,58(8):760-763
Although the effectiveness of subarachnoid continuous drug infusion has been established in cancer pain management, its clinical use in children is rare. A 14‐year‐old girl with neurofibromatosis type I complained of right leg pain stemming from a growing tumor on her right buttock. Continuous and breakthrough right leg pain were unbearable, even at high doses of systemic opioids that caused severe constipation and deep sedation. Subsequent continuous infusion of bupivacaine and morphine through a subarachnoid catheter effectively relieved the girl's pain. The corresponding decrease in systemic opioid also improved her activities of daily living. The patient eventually died of cachexia due to the rapidly growing buttock lesion that was pathologically confirmed post‐mortem as a malignant peripheral nerve sheath tumor. Subarachnoid continuous drug infusion may be very useful in controlling severe pain with few side‐effects, even in the field of pediatric palliative care. 相似文献
82.
Involvement of central opioid systems in human interferon-alpha induced immobility in the mouse forced swimming test 总被引:5,自引:0,他引:5
Makino M Kitano Y Komiyama C Hirohashi M Takasuna K 《British journal of pharmacology》2000,130(6):1269-1274
1. We investigated the mechanism by which human interferon-alpha (IFN-alpha) increases the immobility time in a forced swimming test, an animal model of depression. 2. Central administration of IFN-alpha (0.05 - 50 IU per mouse, i.cist.) increased the immobility time in the forced swimming test in mice in a dose-dependent manner. 3. Neither IFN-beta nor -gamma possessed any effect under the same experimental conditions. 4. Pre-treatment with an opioid receptor antagonist, naloxone (1 mg kg(-1), s.c.) inhibited the prolonged immobility time induced by IFN-alpha (60 KIU kg(-1), i.v. or 50 IU per mouse. i.cist. ). 5. Peripheral administration of naloxone methiodide (1 mg kg(-1), s. c.), which does not pass the blood - brain barrier, failed to block the effect of IFN-alpha, while intracisternal administration of naloxone methiodide (1 nmol per mouse) completely blocked. 6. The effect of IFN-alpha was inhibited by a mu(1)-specific opioid receptor antagonist, naloxonazine (35 mg kg(-1), s.c.) and a mu(1)/mu(2) receptor antagonist, beta-FNA (40 mg kg(-1), s.c.). A selective delta-opioid receptor antagonist, naltrindole (3 mg kg(-1), s.c.) and a kappa-opioid receptor antagonist, nor-binaltorphimine (20 mg kg(-1), s.c.), both failed to inhibit the increasing effect of IFN-alpha. 7. These results suggest that the activator of the central opioid receptors of the mu(1)-subtype might be related to the prolonged immobility time of IFN-alpha, but delta and kappa-opioid receptors most likely are not involved. 相似文献
83.
Haruhiko Shiiya Masaaki Sato Aya Shinozaki-Ushiku Chihiro Konoeda Kentaro Kitano Jun Nakajima 《Annals of thoracic and cardiovascular surgery》2022,28(4):298
A 40-year-old woman with idiopathic pleuroparenchymal fibroelastosis (IPPFE) and flat chest underwent left single lung transplantation (SLT). Although she had developed over-systemic pulmonary arterial pressure (PAP) at transplantation, it was alleviated. However, her PAP gradually increased again. Her transplanted lung was well-inflated, but progression of fibrosis in her right native lung appeared to have caused a mediastinal shift, and her flat chest caused obstruction of the outflow tract of the pulmonary vein. She died of heart failure and associated infection 1.5 years after transplantation. An autopsy confirmed irreversible pulmonary arterial and venous changes in the transplanted lung, suggestive of chronic pressure overload. The flat chest associated with IPPFE can affect pulmonary circulation after SLT. 相似文献
84.
Hayashi Yuki Wagatsuma Kohei Nojima Masanori Yamakawa Tsukasa Ichimiya Tadashi Yokoyama Yoshihiro Kazama Tomoe Hirayama Daisuke Nakase Hiroshi 《Journal of gastroenterology》2021,56(5):421-421
Journal of Gastroenterology - A correction to this paper has been published: https://doi.org/10.1007/s00535-021-01786-z 相似文献
85.
ObjectiveAlthough cochlear implantation (CI) is a relatively safe operation, postoperative complications sometimes occur. We reviewed the frequency and severity of complications of CI at our hospital. We compared our results with previously reported complications and considered measures to improve patient outcomes.MethodsThis retrospective study examined the medical records of 70 patients who received CI between March 2005 and December 2018. We collected the following data: age at the time of the first surgery, etiology of hearing impairment, date of implantation, type of implanted devices, and complications. Surgical complications were divided by time into perioperative, early, and late, and by severity into major or minor.ResultsRecords of 38 adults and 32 children were analyzed. Bilateral CI was performed in 16 patients, 8 of whom were sequential, and unilateral CI was performed in 54 patients. The total number of operations was 78 for 86 CI. Complications were observed in 15 of 78 operations (19%), and the rates of minor and major complications were 15% and 4%, respectively. Complication rates were 21% (8/39) for children and 10% (4/39) for adults. All of the perioperative and early complications were minor. There were three major complications, all of which were infections presenting with mastoiditis and subcutaneous or subperiosteal abscesses. One case required reimplantation twice because of recurrent mastoiditis and temporal abscess.ConclusionsThere was no significant difference in the incidence of complications between children and adults, but all major complications were infection in pediatric cases. Careful attention is needed to prevent postoperative infection. 相似文献
86.
Tetsuo Yamaguchi Daisuke Ueshima Makoto Utsunomiya Akihiro Matsui Toru Miyazaki Masaaki Matsumoto Tsukasa Shimura Naotaka Murata Yasushi Komatsu Kazuki Tobita Yo Fujimoto Takahide Kodama Kenji Suzuki Hitoshi Anzai Kentaro Jujo Michiaki Higashitani 《Journal of cardiology》2021,77(2):109-115
BackgroundMalnutrition measured by the geriatric nutritional risk index (GNRI) was reported to be associated with poor prognosis for patients with peripheral artery disease (PAD). However, the optimal cut-off value of preprocedural GNRI for critical limb ischemia (CLI) and intermittent claudication (IC) is unknown. We aimed to determine its optimal cut-off value for CLI or IC patients requiring endovascular revascularization.MethodsWe explored data of 2246 patients (CLI: n = 1061, IC: n = 1185) registered in the Tokyo-taMA peripheral vascular intervention research COmraDE (TOMA-CODE) registry, which prospectively enrolled consecutive PAD patients who underwent endovascular revascularization in 34 hospitals in Japan from August 2014 to August 2016. The optimal cut-off values of GNRI were assessed by the survival classification and regression tree (CART) analyses, and the survival curve analyses for major adverse cardiovascular and limb events (MACLEs) were performed for these cut-off values.ResultsIn addition to the first cut-off value of 96.2 in CLI and 85.6 in IC, the survival CART provided an additional cut-off value of 78.2 in CLI and 106.0 in IC for further risk stratification. The survival curve was significantly stratified by the GNRI-based malnutrition status in both CLI [high risk: 47.7% (51/107), moderate: 30.1% (118/392), and low: 10.2% (53/520), log–rank p < 0.001] and IC [high risk: 14.3% (7/49), moderate: 4.5% (29/646), and low: 0.5% (2/407), log–rank p < 0.001]. The multivariate Cox-proportional hazard analysis showed that a higher GNRI was significantly associated with a better outcome in both CLI [hazard ratio (HR) per 1-point increase: 0.97, 95% CI: 0.96–0.98, p < 0.001] and IC (HR: 0.94, 95% CI: 0.91–0.97, p < 0.001).ConclusionsPreprocedural nutritional status significantly stratified future events in patients with PAD. Given that the optimal cut-off value of GNRI in CLI was almost 10-points lower than that of IC, using a disease-specific cut-off value is important for risk stratification. 相似文献
87.
88.
Aoi Ohira Sayaka Yamaguchi Takuya Miyagi Yu‐ichi Yamamoto Satoshi Yamada Hideo Shiohira Keisuke Hagiwara Tsukasa Uno Hiroshi Uezato Kenzo Takahashi 《The Journal of dermatology》2013,40(8):629-631
Fixed drug eruption is a common cutaneous adverse reaction in young patients with a characteristic clinical appearance. However, the diagnosis and identification of the substance may be difficult if food or food additives provoke the fixed eruption. A 26‐year‐old man had a history of two episodes of cutaneous erythema with residual pigmentation. Close examination of the history including his diet in addition to an oral challenge test and patch testing led to the diagnosis of fixed eruption secondary to quinine in tonic water. We examined for the presence of quinine in commercially available brands of tonic water using ultraviolet A and irradiation and high‐performance liquid chromatography. Both Schweppes and CANADA DRY brands of tonic water emitted fluorescent light upon ultraviolet A irradiation, and contained quinine at concentrations of 67.9 and 61.3 mg/L, respectively. Quinine contained in some tonic waters may trigger fixed eruption. 相似文献
89.
Contrast‐enhanced harmonic endoscopic ultrasonography for differential diagnosis of localized gallbladder lesions
下载免费PDF全文
![点击此处可从《Digestive endoscopy》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Ken Kamata Mamoru Takenaka Masayuki Kitano Shunsuke Omoto Takeshi Miyata Kosuke Minaga Kentaro Yamao Hajime Imai Tosiharu Sakurai Naoshi Nishida Hiroshi Kashida Takaaki Chikugo Yasutaka Chiba Takuya Nakai Yoshifumi Takeyama Andrea Lisotti Pietro Fusaroli Masatoshi Kudo 《Digestive endoscopy》2018,30(1):98-106
Background and Aim
Differential diagnosis of localized gallbladder lesions is challenging. The aim of the present study was to evaluate the utility of contrast‐enhanced harmonic endoscopic ultrasonography (CH‐EUS) for diagnosis of localized gallbladder lesions.Methods
One hundred and twenty‐five patients with localized gallbladder lesions were evaluated by CH‐EUS between March 2007 and February 2014. This was a single‐center retrospective study. Utilities of fundamental B‐mode EUS (FB‐EUS) and CH‐EUS in the differentiation of gallbladder lesions and sludge plug were initially compared. Thereafter, these two examinations were compared with respect to their accuracy in the diagnosis of malignant lesions. Five reviewers blinded to the clinicopathological results evaluated microcirculation patterns in the vascular and perfusion images.Results
In the differentiation between gallbladder lesions and sludge plug, FB‐EUS had a sensitivity, specificity, and accuracy of 82%, 100%, and 95%, respectively, whereas CH‐EUS had a sensitivity, specificity, and accuracy of 100%, 99%, and 99%, respectively. FB‐EUS‐based diagnosis of carcinomas based on tumor size and/or shape had a sensitivity, specificity, and accuracy of 61–87%, 71–88%, and 74–86%, respectively. Additional information regarding irregular vessel patterns in the vascular image and/or heterogeneous enhancement in the perfusion image on CH‐EUS increased the sensitivity, specificity, and accuracy for the diagnosis of carcinomas to 90%, 98%, and 96%, respectively. There was a significant difference between FB‐EUS and CH‐EUS in terms of carcinoma diagnosis.Conclusion
CH‐EUS was useful for the evaluation of localized gallbladder lesions. 相似文献90.
Endoscopic ultrasonography‐guided choledochoduodenostomy using a newly designed laser‐cut metal stent: Feasibility study in a porcine model
下载免费PDF全文
![点击此处可从《Digestive endoscopy》网站下载免费的PDF全文](/ch/ext_images/free.gif)