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101.
Posttraumatic volar tendon subluxation out of the first extensor compartment: a case report 总被引:1,自引:0,他引:1
Symptomatic volar subluxation of the abductor pollicis longus and the extensor pollicis brevis tendons developed in a 29-year-old man after a sprain that occurred with the wrist in flexion and ulnar deviation. The extensor retinaculum, which forms the extensor compartment, was partially avulsed from its insertion on the radius. Palmar abduction and extension of the thumb with the wrist flexed produced subluxation of the tendons over the volar side of the radius ridge where the retinaculum forming the first extensor compartment attached. Nonoperative treatment including steroid injection and splinting was ineffective. Surgery was performed to reconstruct a new tendon restraint with part of the extensor retinaculum. 相似文献
102.
Takenaka T Suzuki H Okada H Inoue T Kanno Y Ozawa Y Hayashi K Saruta T 《Kidney international》2002,62(2):558-565
BACKGROUND: This study assessed the calcium-activating mechanisms mediating glomerular arteriolar constriction by angiotensin II (Ang II). METHODS: Immunohistochemical and physiological studies were carried out, using antibody against transient receptor potential (TRP)-1 and an isolated perfused kidney model. RESULTS: Immunohistochemical experiments demonstrated that TRP-1 proteins were transcribed on both afferent and efferent arteriolar myocytes. In the first series of physiological experiments, Ang II (0.3 nmol/L) considerably constricted afferent (20.2 +/- 0.9 to 14.9 +/- 0.7 microm) and efferent arterioles (18.4 +/- 0.7 to 14.0 +/- 0.7 microm). The addition of nifedipine (1 micromol/L) restored decrements in afferent (to 20.0 +/- 0.8 microm) but not efferent arteriolar diameters. Further administration of SKF-96365 (100 micromol/L), a TRP channel blocker, reversed efferent arteriolar constriction (to 16.2 +/- 0.8 micromol/L). In the second group, although 2-aminoethoxydiphenyl borate (100 micromol/L), an inhibitor of inositol trisphosphate-induced calcium release (IP3CR), did not alter glomerular arteriolar diameters, it prevented Ang II-induced afferent arteriolar constriction and attenuated efferent arteriolar constriction (18.8 +/- 0.8 to 16.9 +/- microm). Subsequent removal of extracellular calcium abolished residual efferent arteriolar constriction (to 19.1 +/- 0.8 microm). CONCLUSIONS: Our data provide evidence that Ang II elicits IP3CR, possibly inducing a cellular response that activates voltage-dependent calcium channels on afferent arterioles. The present results suggest that Ang II-induced efferent arteriolar constriction involves IP3CR and calcium influx sensitive to SKF-96365. 相似文献
103.
A gastric duplication cyst with an aberrant pancreatic ductal system: report of a case 总被引:2,自引:0,他引:2
Muraoka A Tsuruno M Katsuno G Sato N Murata T Kokudo Y Tatemoto A Sone Y Kagawa S Tsumura M Mizobuchi K 《Surgery today》2002,32(6):531-535
We report an extremely rare case of a gastric duplication cyst together with an aberrant pancreatic ductal system, which communicated
with the stomach rather than the pancreatic ductal system with no evidence of pancreatitis. A 46-year-old woman developed
severe abdominal pain after a 10-year history of occasional mild abdominal pain. Upper gastrointestinal barium radiography
showed a rigidity of the stomach wall, and gastroscopy revealed a fistula orifice at a greater curvature of the gastric body.
Subsequent endoscopic suction of mucous secretion from within the fistula provided immediate pain relief. Abdominal computed
tomography and ultrasonography showed a cystic mass contiguous with the stomach wall. Surgical exploration revealed an uncommon
anomaly of a gastric duplication cyst with the aberrant pancreatic lobe. The patient made an uneventful recovery and remains
well 4 years after surgery. We also herein review ten other similar cases of this uncommon congenital anomaly reported in
the literature.
Received: August 20, 2001 / Accepted: January 8, 2002 相似文献
104.
Complete paralysis of the quadriceps muscle caused by traumatic iliacus hematoma: a case report 总被引:1,自引:0,他引:1
Kazuya Tamai Taro Kuramochi Hiroya Sakai Norio Iwami Koichi Saotome 《Journal of orthopaedic science》2002,7(6):713-716
A 15-year-old girl who developed traumatic iliacus hematoma and complete paralysis of the quadriceps muscle is reported.
The current case and literature review revealed that incomplete quadriceps paralysis associated with traumatic iliacus hematoma
is likely to progress to complete paralysis in days or weeks as a result of increased intracompartmental pressure. However,
surgical decompression of the femoral nerve could produce good results even in patients who have complete quadriceps paralysis
preoperatively.
Received: April 9, 2002 / Accepted: June 28, 2002
Offprint requests to: K. Tamai 相似文献
105.
Shinji Yoshioka Koichi Sairyo Toshinori Sakai Natsuo Yasui 《Journal of orthopaedics and traumatology》2010,11(3):183-187
We report a rare case of congenital absence of the L5-S1 facet joint, which was associated with a conjoined nerve root. Combination
of these two anomalies has been quite rarely reported in the literature. A 39-year-old man presented with acute low back pain
and right leg radiating pain. Muscle weakness and sensory disturbance of the right leg were also apparent in the region innervated
by L5 and S1 nerve roots. Preoperative multidetector three-dimensional computed tomography (3D-CT) showed complete absence
of the right S1 superior articular process. Magnetic resonance (MR) images showed lumbar disc herniation at right L5-S1 level
that migrated cranially. Intraoperative findings revealed that the right L5 nerve root and S1 nerve root were conjoined, and
the conjoined nerve root was compressed by L5-S1 disc herniation, which led to impairment of the conjoined nerve root by a
single-level lumbar disc herniation. After removal of the disc herniation, his right leg pain immediately subsided, however
muscle weakness and sensory disturbance persisted. Surgeons should be aware of this nerve root anomaly when examining a patient
who shows an unusual clinical presentation and/or congenital osseous anomaly. 相似文献
106.
Hiroya Takeuchi Yoshiro Saikawa Takashi Oyama Soji Ozawa Koichi Suda Norihito Wada Tsunehiro Takahashi Rieko Nakamura Naoyuki Shigematsu Nobutoshi Ando Masaki Kitajima Yuko Kitagawa 《World journal of surgery》2010,34(2):277-284
Background
Salvage esophagectomy is potentially the only treatment available that can offer a chance of long-term survival when definitive chemoradiotherapy (CRT) fails to achieve local control for patients with esophageal squamous cell carcinoma (ESCC). However, salvage esophagectomy is a highly invasive procedure with various postoperative complications compared to planned esophagectomy after neoadjuvant chemoradiotherapy (CRT). We hypothesize that severe postoperative complications may affect not only surgical mortality but also tumor recurrence and long-term survival for patients with salvage esophagectomy after definitive CRT.Methods
For the present study we reviewed the surgical procedures, postoperative complications, and the prognosis of 65 consecutive patients with thoracic ESCC who underwent the esophagectomy after neoadjuvant (neoadjuvant group: n = 40) or definitive (salvage group: n = 25) CRT.Results
Most patients underwent right-transthoracic extended esophagectomy and reconstruction using gastric conduit by way of subcutaneous route with left cervical anastomosis. The incidence of postoperative pneumonia was found to be higher in the salvage group than in the neoadjuvant group. In both groups, the survival of patients with R0 resection was significantly better than those with R1/R2 resection. Moreover, in the salvage group, the postoperative survival rate of patients with pneumonia or bacteremia/sepsis was significantly lower than that for patients who did not suffer the same complications. In the neoadjuvant group, R0 resection was selected to be the only independent prognostic factor in univariate and multivariate analysis. In contrast, in the salvage group, R0 resection and bacteremia/sepsis remained significant and were independent of the other factors in multivariate analysis.Conclusions
This study reveals that postoperative morbidity affects not only the perioperative mortality but also the long-term survival of patients with ESCC who undergo salvage esophagectomy after definitive CRT. 相似文献107.
Ishikawa T Wanifuchi H Abe K Kato K Watanabe A Okada Y 《Neurologia medico-chirurgica》2010,50(11):1027-1030
A 51-year-old man presented with a rare case of brain metastasis of malignant pleural mesothelioma (MPM) manifesting as intratumoral hemorrhage. He had undergone several treatments such as left pneumonectomy, pleurectomy, chemotherapy with cis-diamminedichloroplatinum and gemcitabine hydrochloride, and irradiation. Five years later, computed tomography revealed right parietal metastasis with intratumoral hemorrhage and the patient was treated by surgery and irradiation. Six months after the surgery, recurrent intratumoral hemorrhage occurred and a second surgery was performed. MPM has a poor prognosis and brain metastasis is rare, but long-term survival has recently improved through the application of multi-modality approaches. Therefore, the number of opportunities for treating MPM metastasis will increase in the near future. Intratumoral hemorrhage may occur in patients with solitary brain metastasis of MPM, so surgery should be considered as a general candidate treatment for metastatic tumors. 相似文献
108.
Kajiwara K Saito K Yoshikawa K Ideguchi M Nomura S Fujii M Suzuki M 《Neurologia medico-chirurgica》2010,50(9):749-755
The recent clinical results are reviewed of stereotactic radiosurgery/radiotherapy for the treatment of pituitary adenomas. The outcomes of pituitary adenomas treated by stereotactic radiosurgery/radiotherapy with gamma knife, CyberKnife, or linear accelerator (LINAC) radiosurgery were evaluated from articles published after 2004. Each study was evaluated for the number of patients, radiosurgical parameter (marginal dose), length of follow up, tumor growth control, rate of hormonal normalization in secretary adenomas, and adverse events. After gamma knife radiosurgery, the tumor reduction rates varied from 42.3% to 89% in non-secreting adenomas. However, the tumor control rates in non-secreting adenomas were more than 90% in most studies. In growth hormone-secreting adenomas, the rates of insulin-like growth factor-1 normalization ranged from 36.9% to 82%. In adrenocorticotropin-secreting adenomas, the rates for 24-hour urine free cortisol normalization ranged from 27.9% to 54%. In prolactin-secreting adenomas, the prolactin normalization ranged from 17.4% to 50%. New hormonal deficits ranged from 0% to 34%. New visual deficits were relatively low. The number of patients treated with CyberKnife and LINAC radiosurgery/radiotherapy was small and follow-up periods were relatively short compared to those with gamma knife treatment, but the clinical outcomes after these therapies were similar to those after gamma knife therapy. Image-guided stereotactic radiosurgery/radiotherapy with the gamma knife, CyberKnife, or LINAC system is effective and safe against pituitary adenomas. Careful long-term follow up of the patients is necessary because of long-term anti-tumor effects and delayed adverse events. 相似文献
109.
Kimura N Yamaguchi A Noguchi K Adachi K Adachi H Ino T 《General thoracic and cardiovascular surgery》2007,55(5):212-216
A 59-year-old man with a long history of hypertension and diabetes was admitted to our hospital with acute type B aortic dissection
14 days after the sudden onset of back pain. The dissecting descending thoracic aorta was enlarged to 5.2 cm in diameter,
and laboratory tests showed an elevated white blood cell count (15 530/mm3) and an increased C-reactive protein level (19.2 mg/dl). Computed tomography performed 2 days after admission revealed rapid
growth of the aortic dissection. Blood cultures obtained upon admission were positive for Salmonella. Impending rupture of the aortic dissection complicated by Salmonella infection was strongly suspected, and the patient underwent emergency surgery consisting of debridement and prosthetic graft
placement covered by an omental flap. In this case, it is believed that insidious Salmonella aortitis caused acute type B aortic dissection. 相似文献
110.
Funakoshi K Koga M Takahashi M Hirata K Yuki N 《Journal of the neurological sciences》2006,246(1-2):163-168
Campylobacter coli was isolated from two Guillain-Barré syndrome (GBS) patients who had anti-GM1 and anti-GD1 IgG antibodies. Although both this bacteria and Campylobacter jejuni are common causes of diarrheal illness, previous studies have focused only on C. jejuni as the causal agent of GBS. To determine whether C. coli also is a causative agent, we examined the hypothesis that production of anti-ganglioside antibodies is induced by ganglioside-mimics on that bacterial lipo-oligosaccharide (LOS), as in C. jejuni-associated GBS. LOSs of both C. coli isolates had very weak reactivities with anti-GM1 and anti-GD1a IgG monoclonal antibodies, whereas those of some GBS-related C. jejuni isolates had strong reactivities. Anti-GM1 and anti-GD1a IgG antibodies from the two patients were not absorbed as much by the LOSs of their isolates as were those of GBS-related C. jejuni strains. These findings do not support the hypothesis of ganglioside mimicry on C. coli isolates' LOSs. We next made a serological assay of recent C. coli infection in 74 patients with GBS, 26 with Fisher syndrome (FS), 49 with other neurological diseases (OND), and 37 normal controls (NC) using the bacterial outer membrane protein as antigen. Eight (11%) GBS and two (8%) FS patients had two or three classes of IgG, IgM, and IgA anti-C. coli antibodies. Anti-C. jejuni IgG and IgA antibody titers were significantly higher than those of anti-C. coli (respectively, p = 0.03 and 0.01). This suggests that anti-C. coli antibodies cross-react with C. jejuni protein. We concluded that a C. coli infection was not the cause of GBS in our patients. Both isolation of a microorganism from, and the positive infectious serology of, GBS patients do not always indicate the causal agent. 相似文献