全文获取类型
收费全文 | 3043篇 |
免费 | 186篇 |
国内免费 | 13篇 |
专业分类
耳鼻咽喉 | 21篇 |
儿科学 | 62篇 |
妇产科学 | 65篇 |
基础医学 | 339篇 |
口腔科学 | 113篇 |
临床医学 | 230篇 |
内科学 | 788篇 |
皮肤病学 | 44篇 |
神经病学 | 368篇 |
特种医学 | 277篇 |
外国民族医学 | 1篇 |
外科学 | 324篇 |
综合类 | 20篇 |
预防医学 | 106篇 |
眼科学 | 22篇 |
药学 | 139篇 |
中国医学 | 2篇 |
肿瘤学 | 321篇 |
出版年
2023年 | 16篇 |
2022年 | 25篇 |
2021年 | 45篇 |
2020年 | 35篇 |
2019年 | 43篇 |
2018年 | 44篇 |
2017年 | 48篇 |
2016年 | 48篇 |
2015年 | 72篇 |
2014年 | 92篇 |
2013年 | 101篇 |
2012年 | 149篇 |
2011年 | 165篇 |
2010年 | 101篇 |
2009年 | 95篇 |
2008年 | 145篇 |
2007年 | 164篇 |
2006年 | 143篇 |
2005年 | 132篇 |
2004年 | 142篇 |
2003年 | 97篇 |
2002年 | 76篇 |
2001年 | 68篇 |
2000年 | 99篇 |
1999年 | 77篇 |
1998年 | 65篇 |
1997年 | 69篇 |
1996年 | 74篇 |
1995年 | 64篇 |
1994年 | 63篇 |
1993年 | 43篇 |
1992年 | 51篇 |
1991年 | 52篇 |
1990年 | 48篇 |
1989年 | 49篇 |
1988年 | 48篇 |
1987年 | 38篇 |
1986年 | 53篇 |
1985年 | 46篇 |
1984年 | 24篇 |
1983年 | 33篇 |
1982年 | 22篇 |
1981年 | 15篇 |
1980年 | 14篇 |
1979年 | 16篇 |
1978年 | 15篇 |
1977年 | 19篇 |
1976年 | 20篇 |
1975年 | 18篇 |
1969年 | 15篇 |
排序方式: 共有3242条查询结果,搜索用时 15 毫秒
51.
N Kr?ger A R Zander G Martinelli P Ferrante J M Moraleda G A Da Prada T Demirer G Socie G Rosti 《Annals of oncology》2003,14(4):554-558
BACKGROUND: To determine the incidence of secondary myelodysplasia (sMDS) or acute myeloid leukemia (AML) in node-positive breast cancer patients who received high-dose chemotherapy (HDCT) followed by autologous stem-cell support as adjuvant therapy. PATIENTS AND METHODS: The incidence of sMDS/AML was retrospectively assessed in 364 node-positive breast cancer patients who received HDCT followed by autologous stem-cell support as adjuvant therapy between November 1989 and December 1997 and were reported to the European Group for Blood and Marrow Transplantation registry. RESULTS: The median age of the patients was 45 years (range 22-62 years). Two hundred and ninety-one patients received peripheral blood stem cells and 55 patients received autologous bone marrow as stem-cell support. The most frequently used conditioning regimen was the STAMP-V regimen (32%), followed by melphalan-thiotepa (22%) and melphalan-mitoxantrone-cyclophosphamide (21%). The 5-year probability of overall survival is 71% (95% CI 65% to 77%). After a median follow-up of 48 months (range 1-108 months) only one case of AML was observed, resulting in a crude incidence of 0.27%. This case of AML was observed 18 months after HDCT consisting of three cycles of epirubicin and cyclophosphamide with a cumulative dose of epirubicin 960 mg and cyclophosphamide 19 g. The French-American-British type of AML was M4, and the cytogenetic analysis showed a translocation t(9;11)(p22;q23). After complete remission following high-dose cytarabine and idarubicin the patient relapsed and died. CONCLUSIONS: In contrast to patients with malignant lymphoma there seems to be no increased risk of sMDS/AML after HDCT in breast cancer. Continued monitoring is required to confirm this low incidence after a longer follow-up period. 相似文献
52.
Wang WS; Hsieh RK; Chiou TJ; Liu JH; Fan FS; Yen CC; Tung SL; Chen PM 《Japanese journal of clinical oncology》1998,28(9):551-554
A 54-year-old man was treated with weekly 24-h infusion of high-dose
5-fluorouracil (2600 mg/m2) and leucovorin (100 mg/m2) for metastatic colon
cancer. At first, he tolerated the treatment well and no significant
toxicity was identified. After a total of eight courses of treatment, a
stable disease was observed, but mild shortness of breath was found on
occasion. The patient had no previous history of cardiac disease and the
heart performance assessed by left ventricular ejection fraction before
treatment was normal. Unfortunately, acute pulmonary edema with lethal
cardiogenic shock occurred during the ninth course of treatment, in spite
of intensive medical treatment. The chest X-ray showed extreme
cardiomegaly. Repeated assessment of his heart function by echocardiogram
and ventricular ejection fraction revealed a very poor cardiac performance.
Toxic cardiogenic shock during weekly 24-h infusion of high-dose
5-fluorouracil and leucovorin is extremely rare. To the best of our
knowledge, no case has been reported in the English literature. We report a
case and the relevant literature about the incidence, clinical picture and
possible pathophysiology on 5-fluorouracil-related cardioxicity is
reviewed.
相似文献
53.
Percutaneous repair of the Achilles tendon in athletes 总被引:4,自引:0,他引:4
Martinelli B 《Bulletin of the Hospital for Joint Diseases》2000,59(3):149-152
The rupture of the Achilles tendon during amateur or professional sport-related activities is becoming more frequent, as is the request for treatments that enable the fastest possible recovery. This study includes 30 patients who sustained rupture of the Achilles tendon during various sport activities; for the last five years we have performed percutaneous suture repair by means of two parallel Dacron threads equipped with a harpoon and a malleable needle. This method alone enables immediate mobilization and an early load, preserves the blood supply of the paratenon, benefits from the motion which accelerates repair, without the well known complications produced both by the non-operative and by open surgical treatments. Excellent results have been achieved and all patients returned to their pre-injury level of sports activity after 120 to 150 days. 相似文献
54.
Carotid surgery without angiography is possible and safe 总被引:2,自引:0,他引:2
Benedetti-Valentini F Gossetti B Irace L Intrieri F Martinelli O Trenti E Stumpo R Costa P 《The Journal of cardiovascular surgery》2000,41(4):601-605
BACKGROUND: To evaluate the possibility to perform carotid surgery without angiography. METHODS: From January 1994 to June 1998, 514 patients with carotid obstructive disease were operated upon, 225 of them (43.8%) without previous angiography; 55 out of 68 (80.8%) during the last six months. Eighty-one (36.0%) had lateralizing symptoms, 50 aspecific ones (22.2%) and 94 were asymptomatic (41.8%). All patients were investigated by color-coded duplex sonography (CDS) of the arteries at the neck and by transcranial Doppler (TCD) and computed tomography (CT). One hundred eighty-eight patients were operated upon under local anaesthesia and 37 under general anesthesia; 204 had a carotid endartereotomy (90.7%) with patch angioplasty in 154 (75.5%), and 21 required a bypass graft (9.3%). In 26 patients (11.5%) an indwelling shunt was needed. RESULTS: Findings at surgery were consistent with CDS for plaque composition, ulcerations and degree of stenosis. There were no early deaths. Neurologic or ocular deficits occurred in 2 cases (0.9%). No strokes were observed in follow-up from 6 to 34 months. CONCLUSIONS: Carotid endarterectomy can be done without angiography in selected cases provided CDS plus TCD are of high quality. Under such conditions it can be considered a safer way to deal with carotid obstructive disease. 相似文献
55.
Simona Soverini Giovanni Martinelli Gianantonio Rosti Simona Bassi Marilina Amabile Angela Poerio Barbara Giannini Elena Trabacchi Fausto Castagnetti Nicoletta Testoni Simona Luatti Antonio de Vivo Daniela Cilloni Barbara Izzo Milena Fava Elisabetta Abruzzese Daniele Alberti Fabrizio Pane Giuseppe Saglio Michele Baccarani 《Journal of clinical oncology》2005,23(18):4100-4109
PURPOSE: Point mutations within the ABL kinase domain of the BCR-ABL gene have been associated with clinical resistance to imatinib mesylate in chronic myeloid leukemia (CML) patients. To shed further light on the frequency, distribution, and prognostic significance of ABL mutations, we retrospectively analyzed a homogeneous cohort of late chronic phase CML patients who showed primary cytogenetic resistance to imatinib. PATIENTS AND METHODS: Using denaturing high-performance liquid chromatography (D-HPLC) and sequencing, we screened for ABL mutations in a total of 178 bone marrow and/or peripheral blood samples from 40 late chronic phase CML patients homogeneously treated with imatinib 400 mg/d, who did not reach a major cytogenetic response at 12 months. RESULTS: Mutations were found in 19 of 40 patients (48%). Mutations were already detectable by D-HPLC at a median of 3 months from the onset of therapy. The presence of a missense mutation was significantly associated with a greater likelihood of subsequent progression to accelerated phase/blast crisis (P = .0002) and shorter survival (P = .001). Patients carrying mutations falling within the P-loop seemed to have a particularly poor outcome in terms of time to progression (P = .032) and survival (P = .045). CONCLUSION: Our results show that, irrespective of the hematologic response, monitoring for emerging mutations in the first months of therapy may play a role in detecting patients with worse prognosis, for whom a revision of the therapeutic strategy should be considered. 相似文献
56.
57.
M. Martinelli A. Zappa S. Bianchi E. Frati D. Colzani A. Amendola E. Tanzi 《Clinical microbiology and infection》2012,18(6):E197-E199
Human papillomavirus (HPV) causes cutaneous and mucosal infections in both adults and children. In order to evaluate HPV prevalence and the spectrum of genotypes in the oral cavity of paediatric subjects, a retrospective study was carried out on oral-pharyngeal swabs collected from 177 newborns aged 0–6 months. HPV-DNA was detected by a nested-PCR; the viral typing was made through DNA sequencing. HPV infection was identified in 25 subjects (14.1%) and the sequence analysis showed eight distinct genotypes. These data confirm HPV detection in newborn oral mucosa. Further investigations are needed to clarify the methods of HPV acquisition. 相似文献
58.
59.
60.
Rens Zonneveld Roberta Martinelli Nathan I Shapiro Taco W Kuijpers Frans B Pl?tz Christopher V Carman 《Critical care (London, England)》2014,18(1):204
Sepsis is a severe and life-threatening systemic inflammatory response to infection that affects all populations and age groups. The pathophysiology of sepsis is associated with aberrant interaction between leukocytes and the vascular endothelium. As inflammation progresses, the adhesion molecules that mediate these interactions become shed from cell surfaces and accumulate in the blood as soluble isoforms that are being explored as potential prognostic disease biomarkers. We critically review the studies that have tested the predictive value of soluble adhesion molecules in sepsis pathophysiology with emphasis on age, as well as the underlying mechanisms and potential roles for inflammatory shedding. Five soluble adhesion molecules are associated with sepsis, specifically, E-selectin, L-selectin and P-selectin, intercellular adhesion molecule-1 and vascular cell adhesion molecule-1. While increased levels of these soluble adhesion molecules generally correlate well with the presence of sepsis, their degree of elevation is still poorly predictive of sepsis severity scores, outcome and mortality. Separate analyses of neonates, children and adults demonstrate significant age-dependent discrepancies in both basal and septic levels of circulating soluble adhesion molecules. Additionally, a range of both clinical and experimental studies suggests protective roles for adhesion molecule shedding that raise important questions about whether these should positively or negatively correlate with mortality. In conclusion, while predictive properties of soluble adhesion molecules have been researched intensively, their levels are still poorly predictive of sepsis outcome and mortality. We propose two novel directions for improving clinical utility of soluble adhesion molecules: the combined simultaneous analysis of levels of adhesion molecules and their sheddases; and taking age-related discrepancies into account. Further attention to these issues may provide better understanding of sepsis pathophysiology and increase the usefulness of soluble adhesion molecules as diagnostic and predictive biomarkers. 相似文献