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101.
BACKGROUND: The recent introduction of urea sensors for dialysis monitoring
has made possible new approaches to urea kinetic modelling. In this study
we show how the equilibrated postdialysis urea concentration (Ceq) and Kt/V
corrected for double-pool urea kinetics (Kt/Vdp) can be accurately
determined using an on-line sensor providing a continuous measure of blood
water urea. A modification of the Smye constant volume double-pool theory
led to the following equations for Ceq and Kt/Vdp [formula: see text] where
Cpre is the blood concentration measured at the start of dialysis, t is the
length of the dialysis session (in min) and S(ex) is the constant slope of
the blood urea logarithm concentration decline following development of the
intercompartmental urea concentration gradient in the first 30-60 min of
dialysis. METHODS: These equations were tested in 11 patients undergoing
165-240 min of paired filtration dialysis with continuous monitoring of
blood urea concentration. Cpre was determined as the plateau concentration
during a preliminary period of 15-20 min of slow isolated ultrafiltration.
S(ex) was accurately determined from linear regression applied to the urea
sensor data from the 80-min point to the end of dialysis. RESULTS: Ceq and
Kt/Vdp determined from the above equations compared closely to values
determined from 25-40 min of urea rebound monitoring with the urea sensor:
10.6 +/- 3.0 versus 10.8 +/- 2.7 mmol/l (mean +/- SD) for Ceq and 1.21 +/-
0.24 versus 1.18 +/- 0.20 for Kt/Vdp, compared to single-pool values of
Kt/V = 1.34 +/- 0.23. CONCLUSION: This technique may be readily programmed
into on-line urea monitors to provide current and extrapolated values of
Ceq and Kt/Vdp from about the first hour of dialysis.
相似文献
102.
R E Brolin MD JH Gorman MD RC Gorman MD AJ Petschenik M D LJ Bradley MS RD HA Kenler PhD RP Cody Pb D 《Journal of gastrointestinal surgery》1998,2(5):436-442
Although iron, vltamm B12, and folate deficiency have been well documented after gastric bypass operations performed for morbid obesity, there is surprisingly
little information on either the natural course or the treatment of these deficiencies in Roux-en-Y gastric bypass (RYGB)
patients Durmg a l0-year period, a complete blood count and serum levels of iron, total iron-binding capacity, vltamin B12, and folate were obtained in 348 patients preoperatively and postoperatively at 6-month intervals for the first 2 years,
then annually thereafter The principal objectives of this study were to determine how readily patients who developed metabolic
deficiencies after Roux-en-Y gastric bypass responded to postoperative supplements of the deficient micronutrient and to learn
whether the risk of developmg these deficiencies decreases over time Hemoglobin and hematocrit levels were slgnificantly decreased
at all postoperative intervals in comparison to preoperative values Moreover, at each successive interval through 5 years,
hemoglobin and hematocrit were decreased signifiantly compared to the preceding interval Folate levels were significantly
increased compared to preoperative levels at all time intervals Iron and vltamin B12 levels were lower than preoperative measurements and remained relatively stable postoperatively Half of the low hemoglobin
levels were not associated with iron deficiency Taking multivltamin supplements resulted in a lower incidence of folate deficiency
but did not prevent iron or vitamin B12 deficiency Oral supplementation of iron and vitamin B12 corrected defiaencies in 43% and 81% of cases, respectively Folate deficiency was almost always corrected with multivitamins
alone No patient had symptoms that could be attributed to either vitamin B12 or folate deficiency Conversely, many patients had symptoms of iron deficiency and anenua Lack of symptoms of vitamin B12 and folate deficiency suggests that these deficiencies are not clinically important after RYGB Conversely, iron deficiency
and anemia are potentially serious problems after RYGB, particularly in younger women Hence we recommend prophylactic oral
iron supplements to premenopausal women who undergo RYGB 相似文献
103.
Keller TT van der Sluijs KF de Kruif MD Gerdes VE Meijers JC Florquin S van der Poll T van Gorp EC Brandjes DP Büller HR Levi M 《Circulation research》2006,99(11):1261-1269
Influenza infections increase the risk of diseases associated with a prothrombotic state, such as venous thrombosis and atherothrombotic diseases. However, it is unclear whether influenza leads to a prothrombotic state in vivo. To determine whether influenza activates coagulation, we measured coagulation and fibrinolysis in influenza-infected C57BL/6 mice. We found that influenza increased thrombin generation, fibrin deposition, and fibrinolysis. In addition, we used various anti- and prothrombotic models to study pathways involved in the influenza-induced prothrombotic state. A reduced capacity to generate activated protein C in TM(pro/pro) mice increased thrombin generation and fibrinolysis, whereas treatment with heparin decreased thrombin generation in influenza-infected C57Bl/6 mice. Thrombin generation was not changed in hyperfibrinolytic mice, deficient in plasminogen activator inhibitor type-1 (PAI-1(-/-)); however, increased fibrin degradation was seen. Treatment with tranexamic acid reduced fibrinolysis, but thrombin generation was unchanged. We conclude that influenza infection generates thrombin, increased by reduced levels of protein C and decreased by heparin. The fibrinolytic system appears not to be important for thrombin generation. These findings suggest that influenza leads to a prothrombotic state by coagulation activation. Heparin treatment reduces the influenza induced prothrombotic state. 相似文献
104.
Zhao P Qin ZL Ke JS Lu Y Liu M Pan W Zhao LJ Cao J Qi ZT 《第二军医大学学报》2005,26(10):1167-1167
SARS-CoV isa newly identified coronavirus that causes severe acute respiratory syndrome (SARS). Currently, there is no effective method available for prophylaxis and treatment of SARS-CoVinfections. In the present study, the influence of small interfering RNA (siRNA) on SARS-CoV nucleocapsid (N) protein expression was detected in cultured cells and mouse muscles. Four siRNA expression cassettes driven by mouse U6 promoter targeting SARS-CoV N gene were prepared, and their inhibitory effects on expression of N and enhanced green fluorescence protein (EGFP) fusion protein were observed. 相似文献
105.
Differences in attentional functioning between preterm and full‐term children underline the importance of new neuropsychological detection techniques 下载免费PDF全文
106.
Marina Pollán Nieves Ascunce María Ederra Alberto Murillo Nieves Erdozáin Jose Enrique Alés-Martínez Roberto Pastor-Barriuso 《Breast cancer research : BCR》2013,15(1):R9
Introduction
It is not clear whether high mammographic density (MD) is equally associated with all subtypes of breast cancer (BC). We investigated the association between MD and subsequent BC, considering invasiveness, means of detection, pathologic subtype, and the time elapsed since mammographic exploration and BC diagnosis.Methods
BC cases occurring in the population of women who attended screening from 1997 through 2004 in Navarre, a Spanish region with a fully consolidated screening program, were identified via record linkage with the Navarre Cancer Registry (n = 1,172). Information was extracted from the records of their first attendance at screening in that period. For each case, we randomly selected four controls, matched by screening round, year of birth, and place of residence. Cases were classified according to invasiveness (ductal carcinoma in situ (DCIS) versus invasive tumors), pathologic subtype (considering hormonal receptors and HER2), and type of diagnosis (screen-detected versus interval cases). MD was evaluated by a single, experienced radiologist by using a semiquantitative scale. Data on BC risk factors were obtained by the screening program in the corresponding round. The association between MD and tumor subtype was assessed by using conditional logistic regression.Results
MD was clearly associated with subsequent BC. The odds ratio (OR) for the highest MD category (MD >75%) compared with the reference category (MD <10%) was similar for DCIS (OR = 3.47; 95% CI = 1.46 to 8.27) and invasive tumors (OR = 2.95; 95% CI = 2.01 to 4.35). The excess risk was particularly high for interval cases (OR = 7.72; 95% CI = 4.02 to 14.81) in comparison with screened detected tumors (OR = 2.17; 95% CI = 1.40 to 3.36). Sensitivity analyses excluding interval cases diagnosed in the first year after MD assessment or immediately after an early recall to screening yielded similar results. No differences were seen regarding pathologic subtypes. The excess risk associated with MD persisted for at least 7 to 8 years after mammographic exploration.Conclusions
Our results confirm that MD is an important risk factor for all types of breast cancer. High breast density strongly increases the risk of developing an interval tumor, and this excess risk is not completely explained by a possible masking effect. 相似文献107.
A model of corrective gene transfer in X-linked ichthyosis 总被引:5,自引:0,他引:5
Freiberg RA; Choate KA; Deng H; Alperin ES; Shapiro LJ; Khavari PA 《Human molecular genetics》1997,6(6):927-933
Single gene recessive genetic skin disorders offer attractive prototypes
for the development of therapeutic cutaneous gene delivery. We have
utilized X-linked ichthyosis (XLI), characterized by loss of function of
the steroid sulfatase arylsulfatase C (STS), to develop a model of
corrective gene delivery to human skin in vivo. A new retroviral expression
vector was produced and utilized to effect STS gene transfer to primary
keratinocytes from XLI patients. Transduction was associated with
restoration of full-length STS protein expression as well as steroid
sulfatase enzymatic activity in proportion to the number of proviral
integrations in XLI cells. Transduced and uncorrected XLI keratinocytes,
along with normal controls, were then grafted onto immunodeficient mice to
regenerate full thickness human epidermis. Unmodified XLI keratinocytes
regenerated a hyperkeratotic epidermis lacking STS expression with
defective skin barrier function, effectively recapitulating the human
disease in vivo. Transduced XLI keratinocytes from the same patients,
however, regenerated epidermis histologically indistinguishable from that
formed by keratinocytes from patients with normal skin. Transduced XLI
epidermis demonstrated STS expression in vivo by immunostaining as well as
a normalization of histologic appearance at 5 weeks post-grafting. In
addition, transduced XLI epidermis demonstrated a return of barrier
function parameters to normal. These findings demonstrate corrective gene
delivery in human XLI patient skin tissue at both molecular and functional
levels and provide a model of human cutaneous gene therapy.
相似文献
108.
A. Krieg A. Röhrborn J. Schulte am Esch D. Schubert L. W. Poll C. Ohmann S. Braunstein W. T. Knoefel 《European journal of medical research》2009,14(1):30-36
Objective
Necrotizing fasciitis is a life threatening soft-tissue infection with a high morbidity and mortality. Prompt treatment based on extensive surgical debridement and antibiotic therapies are the therapeutic principles.Methods
The medical records of patients with necrotizing fasciitis (n = 26) from 1996 to 2005 were retrospectively analyzed.Results
The localization of necrotizing fasciitis was most commonly the trunk (42.3%). Type I polymicrobial infection was the dominating infection. The involvement of anaerobic bacteria was associated with an increase in the number of surgical revisions (p = 0.005). Length of postoperative intensive care unit stay, duration of postoperative ventilation and mortality were significantly increased in the ASA IV-V group. Computed tomography displayed only a limited significance as diagnostic tool for initial diagnosis.Conclusions
In severe cases the combination of necrotic skin and soft tissue gas facilitates the correct diagnosis, which should than be followed by immediate - and most often - repeated debridement. If anaerobes are isolated an early and aggressive second look is necessary.109.
110.
van De Poll SW Römer TJ Volger OL Delsing DJ Bakker Schut TC Princen HM Havekes LM Jukema JW van Der Laarse A Puppels GJ 《Arteriosclerosis, thrombosis, and vascular biology》2001,21(10):1630-1635
Quantitative characterization of atherosclerotic plaque composition with standard histopathological methods remains limited to sectioned plaques. Raman spectroscopy enables nondestructive quantification of atherosclerotic plaque composition. We used Raman spectroscopy to study the effects of diet and lipid-lowering therapy on plaque development in apolipoprotein (APO) E*3-Leiden transgenic mice. Raman spectra were obtained over the full width and entire length of the ascending aorta and aortic arch. Spectra were modeled to calculate the relative dry weights of cholesterol and calcium salts, and quantitative maps of their distribution were created. In male mice (n=20) that received a high-fat/high-cholesterol (HFC) diet for 0, 2, 4, or 6 months, Raman spectroscopy showed good correlation between cholesterol accumulation and total serum cholesterol exposure (r approximately 0.87, P<0.001). In female mice (n=10) that were assigned to an HFC diet, with or without 0.01% atorvastatin, a strong reduction in cholesterol accumulation (57%) and calcium salts (97%) (P<0.01) was demonstrated in the atorvastatin-treated group. In conclusion, Raman spectroscopy can be used to quantitatively study the size and distribution of depositions of cholesterol and calcification in APOE*3-Leiden transgenic mice. This study encourages Raman spectroscopy for the quantitative investigation of atherosclerosis and lipid-lowering therapy in larger animals or humans in vivo. 相似文献