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排序方式: 共有663条查询结果,搜索用时 16 毫秒
81.
Mackinnon S; Papadopoulos EB; Carabasi MH; Reich L; Collins NH; Boulad F; Castro-Malaspina H; Childs BH; Gillio AP; Kernan NA 《Blood》1995,86(4):1261-1268
Infusions of large numbers (> 10(8)/kg) of donor leukocytes can induce remissions in patients with chronic myeloid leukemia (CML) who relapse after marrow transplantation. We wanted to determine if substantially lower numbers of donor leukocytes could induce remissions and, if so, whether this would reduce the 90% incidence of graft-versus-host disease (GVHD) associated with this therapy. Twenty-two patients with relapsed CML were studied: 2 in molecular relapse, 6 in cytogenetic relapse, 10 in chronic phase, and 4 in accelerated phase. Each patient received escalating doses of donor leukocytes at 4- to 33-week intervals. Leukocyte doses were calculated as T cells per kilogram of recipient weight. There were 8 dose levels between 1 x 10(5) and 5 x 10(8). Lineage-specific chimerism and residual leukemia detection were assessed using sensitive polymerase chain reaction (PCR) methodologies. Nineteen of the 22 patients achieved remission. Remissions were achieved at the following T-cell doses: 1 x 10(7) (n = 8), 5 x 10(7) (n = 4), 1 x 10(8) (n = 3), and 5 x 10(8) (n = 4). To date, 15 of the 17 evaluable patients have become BCR-ABL negative by PCR. The incidence of GVHD was correlated with the dose of T cells administered. Only 1 of the 8 patients who achieved remission at a T-cell dose of 1 x 10(7)/kg developed GVHD, whereas this complication developed in 8 of the 11 responders who received a T-cell dose of > or = 5 x 10(7)/kg. Three patients died in remission, 1 secondary to marrow aplasia, 1 of respiratory failure and 1 of complications of chronic GVHD. Sixteen patients who were mixed T-cell chimeras before treatment became full donor T-cell chimeras at the time of remission. Donor leukocytes with a T-cell content as low as 1 x 10(7)/kg can result in complete donor chimerism together with a potent graft-versus-leukemia (GVL) effect. The dose of donor leukocytes or T cells used may be important in determining both the GVL response and the incidence of GVHD. In many patients, this potent GVL effect can occur in the absence of clinical GVHD. 相似文献
82.
Bone marrow transplantation for patients with Philadelphia chromosome- positive acute lymphoblastic leukemia 总被引:1,自引:2,他引:1
Forman SJ; O'Donnell MR; Nademanee AP; Snyder DS; Bierman PJ; Schmidt GM; Fahey JL; Stein AS; Parker PM; Blume KG 《Blood》1987,70(2):587-588
We report the treatment outcome of allogeneic bone marrow transplantation in ten patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Six patients are alive and well for 6 to 30 months (median 19 months) after transplantation. Four patients died with transplant related complications. In view of the poor prognosis associated with this disease, marrow ablation followed by allogeneic or syngeneic marrow grafting may be the preferred treatment modality if a suitable marrow donor is available. 相似文献
83.
In our search for cell surface markers expressed on hematopoietic stem cells and/or very early progenitor cells we found that the Joro 177 monoclonal antibody (MoAb) bound to most hematopoietic cells in day 8/8.5 yolk sac, day 12 fetal liver, and day 13 fetal thymocytes; it stained hematopoietic stem cells and less immature lymphoid, myeloid, and erythroid-lineage cells, but not most thymocytes and splenic lymphocytes in adult mice. Joro 177 MoAb stimulated tyrosine phosphorylation of an integral of 124-kD protein and induced homotypic aggregation of lymphoid progenitor cells. Importantly, Joro 177 MoAb inhibited cell survival/growth and consequently the generation of lymphoid, myeloid, and erythroid lineage cells in vitro from early Lin- hematopoietic precursors. Joro 177 MoAb induced apoptosis of hematopoietic progenitor cells. Molecular cloning and expression indicated that Joro 177 MoAb recognizes a type II transmembrane protein, which is the mouse homologue of the human CD98 heavy chain gene. We suggest that CD98 is a cell membrane receptor involved in the control of cell survival/death of hematopoietic cells. 相似文献
84.
Snyder DS; Negrin RS; O'Donnell MR; Chao NJ; Amylon MD; Long GD; Nademanee AP; Stein AS; Parker PM; Smith EP 《Blood》1994,84(5):1672-1679
Ninety-four consecutive patients with chronic myelogenous leukemia in first clinical chronic phase, median age of 34.0 years (range, 6.8 to 52.4 years), with a histocompatible sibling donor, were treated with fractionated total body irradiation (1,320 cGy) and high-dose etoposide (60 mg/kg) followed by allogeneic bone marrow transplantation (BMT). The median time from diagnosis to BMT was 7.0 months (range, 2.3 to 72.0 months). Sixty patients were treated before BMT with hydroxyurea alone, four patients with busulfan alone, one patient with interferon alone, and the other 29 patients were treated with various combinations of these drugs. Cumulative probabilities of overall survival, event- free survival, and relapse at 5 years were 73%, 64%, and 14%, respectively. The median follow-up time for surviving patients was 38 months, ranging from 12 to 88 months. By stepwise Cox regression analysis, significant prognostic variables were age at transplant, acute graft-versus-host disease > or = grade II, cytomegalovirus- associated interstitial pneumonitis, and years from diagnosis to BMT. 相似文献
85.
Comparison of clinical and self-reported diagnoses for participants on a community-based arthritis self-management programme 总被引:2,自引:0,他引:2
OBJECTIVE: With the advent of community-based arthritis education
programmes, it is important to determine the accuracy of participants'
self-reported diagnoses. The purpose of this study was to determine the
level of agreement between general practitioner (GP)-recorded and self-
reported diagnoses of participants attending an Arthritis Self- Management
Programme (ASMP). METHODS: Participants enrolling on the ASMP were asked to
(a) identify their type of arthritis via a self- administered postal
questionnaire and (b) obtain a written confirmation of their diagnosis from
their GP. The sample (n = 613) comprised mainly women (83%) with a mean age
of 58.8 yr (S.D. 12.6) and a mean disease duration of 15.4 yr (S.D. 12.5).
RESULTS: Participants' self-reported diagnoses were confirmed by GPs in 534
cases [87.1%, 95% confidence interval (CI): 84.4 89.8%]. Confirmed
diagnoses were reported by 86.9% (95% CI: 83.1-90.7%) of those with
osteoarthritis (OA) and 96.1% (95% CI: 93.6 98.6%) of those with rheumatoid
arthritis (RA). The concordance rate for all other types of arthritis
combined was lower at 60.5% (95% CI: 49.5-71.5%). There were no significant
differences with respect to age, gender, education, physical functioning,
duration of disease and number of GP visits between those who correctly
identified their type of arthritis and those who did not. CONCLUSIONS: This
study suggests that the majority of RA and OA participants attending an
arthritis education programme can correctly identify their specific type of
arthritis.
相似文献
86.
Domenico De Mattia Rosa Penza Paola Giordano Giovanni C. Del Vecchio Gabriella Aceto Maria Altomare Francesco Schettini 《Pediatric nephrology (Berlin, Germany)》1995,9(5):603-605
Levels of von Willebrand factor antigen (vWf: Ag) and factor XIII activity (F XIII) were studied in relation to the severity of clinical symptoms (scored from 0 to 3) and to immunological parameters [IgA, C3, C4, and circulating immune complexes (CIC) in 16 children (7 males, 9 females, aged 3–11 years) with Henoch-Schonlein purpura (HSP) at presentation. vWf: Ag was increased in 7 patients, F XIII activity was decreased in 6. In all children we found high levels of IgA, while C3 and C4 levels were normal; CIC were elevated in 11. vWf: Ag correlated with clinical score and with IgA and CIC, probably as a result of immune-mediated endothelial cell damage. The haemostatic alterations observed in HSP are important for understanding the pathophysiology of the disease. 相似文献
87.
D Bickham P Le Rossignol C Gibbons AP Russell 《Journal of Science and Medicine in Sport》2002,5(4):372-382
The purpose of this study was to re-assess the accumulated oxygen deficit (AOD), incorporating recent methodological improvements i.e., 4 min submaximal tests spread above and below the lactate threshold (LT). We Investigated the Influence of the VO2 -speed regression, on the precision of the estimated total energy demand and AOD. utilising different numbers of regression points and including measurement errors. Seven trained middle-distance runners (mean +/- SD age: 25.3 +/- 5.4y, mass: 73.7 +/- 4.3kg. VO2max 64.4 +/- 6.1 mL x kg(-1) x min(-1)) completed a VO2max, LT, 10 x 4 min exercise tests (above and below LT) and high-intensity exhaustive tests. The VO2 -speed regression was developed using 10 submaximal points and a forced y-intercept value. The average precision (measured as the width of 95% confidence Interval) for the estimated total energy demand using this regression was 7.8mL O2 Eq x kg(-1) x min(-1). There was a two-fold decrease in precision of estimated total energy demand with the Inclusion of measurement errors from the metabolic system. The mean AOD value was 43.3 mL O2 Eq x kg(-1) (upper and lower 95% CI 32.1 and 54.5mL o2 Eq x kg(-1) respectively). Converting the 95% CI for estimated total energy demand to AOD or including maximum possible measurement errors amplified the error associated with the estimated total energy demand. No significant difference in AOD variables were found, using 10,4 or 2 regression points with a forced y-intercept. For practical purposes we recommend the use of 4 submaximal values with a y-intercept. Using 95% CIs and calculating error highlighted possible error in estimating AOD. Without accurate data collection, increased variability could decrease the accuracy of the AOD as shown by a 95% CI of the AOD. 相似文献
88.
PROBLEM. Resolution of alcohol problems without formal treatment or participation in self-help groups.
METHODS. Qualitative study using grounded theory (N = 11).
FINDINGS. The onset of alcohol problems begins with negligible penalties. Over time, the cost-benefit ratio of drinking habits continues to rise and the risks become too great. Individuals find it necessary to change their drinking patterns by reinvesting in themselves. Assets such as the ongoing availability of information, life-management skills, and self-confidence promote the change process; cultural mores and behaviors of some healthcare providers serve as liabilities. The dividends of self-resolving alcohol problems include self-pride, mental and physical health, conscientious work performance, rewarding relationships, enhancement of creative talents, and spiritual well-being.
CONCLUSIONS. Nurses can play an important role in promoting self-resolution of alcohol problems by providing accurate information and encouraging clients to reinvest in long-standing priorities and values. 相似文献
METHODS. Qualitative study using grounded theory (N = 11).
FINDINGS. The onset of alcohol problems begins with negligible penalties. Over time, the cost-benefit ratio of drinking habits continues to rise and the risks become too great. Individuals find it necessary to change their drinking patterns by reinvesting in themselves. Assets such as the ongoing availability of information, life-management skills, and self-confidence promote the change process; cultural mores and behaviors of some healthcare providers serve as liabilities. The dividends of self-resolving alcohol problems include self-pride, mental and physical health, conscientious work performance, rewarding relationships, enhancement of creative talents, and spiritual well-being.
CONCLUSIONS. Nurses can play an important role in promoting self-resolution of alcohol problems by providing accurate information and encouraging clients to reinvest in long-standing priorities and values. 相似文献
89.
Musculoskeletal modelling in determining the effect of botulinum toxin on the hamstrings of patients with crouch gait 总被引:2,自引:0,他引:2
NS Thompson FRCS RJ Baker PhD AP Cosgrove MD FRCS IS Corry MD FRCS HK Graham MD FRCS FRACS 《Developmental medicine and child neurology》1998,40(9):622-625
This study aimed to determine the effect of hamstring botulinum toxin A (Btx-A) injection in 10 children with crouch gait in terms of changes in muscle length and lower-limb kinematics. Before Btx-A injection limb kinematics were recorded. Maximum hamstring lengths and excursions were calculated by computer modelling of the lower limb. Data were compared with the averaged hamstring lengths of 10 control children. Hamstrings were denned as short if their length was shorter than the average maximum length minus one standard deviation. Gait analysis was repeated 2 weeks after isolated hamstring Btx-A injection. Pre- and postinjection kinematic data and muscle lengths were then compared. Four of 18 injected limbs in three subjects had short medial hamstring before injection, none of the subjects had short lateral hamstrings. Muscle excursion was significantly reduced in the short and adequate maximum muscle length groups. A significant increase in the semimembranosus and semitendinosus length in all of the injected limbs was noted. Only in the short muscle group was a significant increase in muscle excursion observed. Knee extension improved by 13° in the adequate muscle length group and by 15.6° in the short muscle length group. Pelvic tilt and hip flexion increased in both groups non-significantly. Average walking speed postinjection increased from 0.60 ms-1 to 0.71 ms-1 . Short hamstrings are over-diagnosed in crouch gait. Hamstring Btx-A injection in patients with crouch gait produces significant, repeatable muscle lengthening and improved ambulatory function. 相似文献