首页 | 本学科首页   官方微博 | 高级检索  
文章检索
  按 检索   检索词:      
出版年份:   被引次数:   他引次数: 提示:输入*表示无穷大
  收费全文   32989篇
  免费   2404篇
  国内免费   1014篇
耳鼻咽喉   355篇
儿科学   414篇
妇产科学   372篇
基础医学   5119篇
口腔科学   504篇
临床医学   3413篇
内科学   5324篇
皮肤病学   804篇
神经病学   2371篇
特种医学   1600篇
外国民族医学   5篇
外科学   3782篇
综合类   2487篇
现状与发展   7篇
一般理论   9篇
预防医学   1787篇
眼科学   853篇
药学   3440篇
  15篇
中国医学   1061篇
肿瘤学   2685篇
  2024年   47篇
  2023年   338篇
  2022年   888篇
  2021年   1500篇
  2020年   855篇
  2019年   937篇
  2018年   1067篇
  2017年   854篇
  2016年   1089篇
  2015年   1517篇
  2014年   1834篇
  2013年   1995篇
  2012年   2841篇
  2011年   2931篇
  2010年   1714篇
  2009年   1426篇
  2008年   1999篇
  2007年   1881篇
  2006年   1681篇
  2005年   1585篇
  2004年   1244篇
  2003年   1060篇
  2002年   877篇
  2001年   703篇
  2000年   732篇
  1999年   580篇
  1998年   264篇
  1997年   222篇
  1996年   167篇
  1995年   161篇
  1994年   137篇
  1993年   103篇
  1992年   162篇
  1991年   171篇
  1990年   140篇
  1989年   106篇
  1988年   88篇
  1987年   79篇
  1986年   72篇
  1985年   48篇
  1984年   34篇
  1983年   37篇
  1982年   30篇
  1981年   21篇
  1980年   21篇
  1979年   31篇
  1978年   18篇
  1977年   16篇
  1976年   13篇
  1974年   17篇
排序方式: 共有10000条查询结果,搜索用时 468 毫秒
961.

Purpose

To analyze overall survival (OS), prostate cancer (PCa)-specific survival (PCaSS), and non-PCaSS according to the Charlson Comorbidity Index (CCI) after radical prostatectomy (RP) for PCa.

Materials and Methods

Data from 336 patients who had RP for PCa between 1992 and 2005 were analyzed. Data included age, preoperative prostate-specific antigen (PSA), prostate volume, clinical stage, and pathologic stage. Pre-existing comorbidities were evaluated by the CCI, and patients were classified into two CCI score categories (0, ≥1).

Results

The mean age of patients was 64.31±6.12 years. The median PSA value (interquartile range, IQR) was 11.30 (7.35 and 21.02) ng/mL with a median follow-up period (IQR) of 96.0 (85.0 and 121.0) months. The mean CCI was 0.28 (0-4). Five-year OS, PCaSS, and non-PCaSS were 91.7%, 96.3%, and 95.2%, respectively. Ten-year OS, PCaSS, and non-PCaSS were 81.9%, 92.1%, and 88.9%, respectively. The CCI had a significant influence on OS (p=0.022) and non-PCaSS (p=0.008), but not on PCaSS (p=0.681), by log-rank test. In multivariate Cox regression analysis, OS was independently associated with the CCI [hazard ratio (HR)=1.907, p=0.025] and Gleason score (HR=2.656, p<0.001). PCaSS was independently associated with pathologic N stage (HR=2.857, p=0.031), pathologic T stage (HR=3.775, p=0.041), and Gleason score (HR=4.308, p=0.001). Non-PCaSS had a significant association only with the CCI (HR=2.540, p=0.009).

Conclusion

The CCI was independently associated with both OS and non-PCaSS after RP, but the CCI had no impact on PCaSS. The comorbidities of a patient should be considered before selecting RP as a curative modality for PCa.  相似文献   
962.

Purpose

Emergence agitation (EA) is frequently observed in children undergoing general anaesthesia. This study tested whether the addition of an intra-operative low-dose infusion of dexmedetomidine to fentanyl treatment reduced the incidence of emergence delirium following desflurane anesthesia in children undergoing strabismus surgery.

Materials and Methods

A total of 96 children (1-5 years old) undergoing strabismus surgery were enrolled. Anaesthesia was induced with propofol and maintained with desflurane. After induction, fentanyl (1 µg/kg) was administered to all children. During surgery, patients were infused with 0.2 µg/(kg·h)-1 dexmedetomidine (Group FD, n=47) or normal saline (Group F, n=47). Postoperative objective pain score (OPS), Paediatric Agitation and Emergence Delirium (PAED) score, and EA score were documented every 10 minutes in the post-anaesthesia care unit.

Results

There were no significant differences between the two groups in demographic characteristics and haemodynamic changes. The mean values of maximum EA, maximum PAED, and maximum OPS score were significantly lower in Group FD than in Group F at 0, 10, and 20 minutes after arrival at the post-anaesthesia care unit (p<0.001). The frequency of fentanyl rescue was lower in Group FD than in Group F (p<0.001). The incidence of severe EA was significantly lower in Group FD than in Group F (12.8% vs. 74.5%, p<0.001).

Conclusion

Intra-operative low-dose infusion of dexmedetomidine in addition to fentanyl reduces EA following desflurane anaesthesia in children undergoing strabismus surgeries.  相似文献   
963.

Purpose

Leuprorelin is a well known luteinizing hormone releasing hormone agonist. However, there are insufficient data on the efficacy and safety of high dose leuprorelin acetate, especially in Asian patients with prostate cancer. We aimed to investigate the safety and efficacy of leuprorelin acetate 22.5 mg administered at three-month intervals in patients with prostate cancer.

Materials and Methods

In an open, prospective clinical trial enrolling 47 patients, we aimed to assess the efficacy and safety of leuprorelin acetate 22.5 mg in treating patients with histologically confirmed prostate cancer. The primary objective of this study was to evaluate the efficacy of the leuprorelin acetate 22.5 mg in producing and maintaining castration levels of testosterone over a 6-month follow-up period and to determine its safety profile.

Results

All 42 patients achieved serum testosterone levels within the castration range by 4 weeks. A breakthrough response was observed in one of 36 patients by 8 weeks. However, this patient was medically castrated by 12 weeks. There were no significant prostate-specific antigen (PSA) or testosterone changes according to clinical stage or body mass index. Twenty adverse events (AEs) in 15 of 42 patients (35.7%) were observed during this study. The most common AEs were hot flushes (n=4, 20.0%) with mild intensity, pain (n=2, 10.0%), and infection (n=2, 10.0%). No patient withdrew from the study due to AEs.

Conclusion

Leuprorelin acetate 22.5 mg was shown to be effective and safe in Asian patients with prostate cancer, even though sexual function decreased.  相似文献   
964.
Tuberculosis (TB) is an ongoing threat to global health, and the lack of effective therapies for treating it is also a global problem. Previous studies have shown that human cathelicidin and defensins have effective antimicrobial activity against Mycobacterium spp. To our knowledge, there are no reports on the antimycobacterial effects of bovine neutrophil β-defensins so far. Here, we identified the antimicrobial effect of mature bovine neutrophil β-defensins (mBNBD) 5 against Mycobacterium infection both in vitro and in vivo. The mBNBD5 protein was expressed in Pichia pastoris. To increase the yield of β-defensins, a purification method was employed by adding a 6-His·tag to the C-terminus of the mBNBD5 gene. Our results indicated that recombinant mBNBD5 protein was successfully expressed and purified from Pichia pastoris with intact antimicrobial activity. The recombinant protein exhibited potent bactericidal activity in vitro against M. smegmatis and M. bovis, with a dose-dependent manner and a time-dependent manner. The electron microscope results showed that the bacterial cell wall of M. bovis was disrupted when incubated with mBNBD5 for 72 h. Our data also indicated that the exogenous addition of mBNBD5 could reduce the survival of Mycobacterium spp., especially M. tuberculosis and M. bovis in RAW 264.7 macrophages. These results provide foundations for the development of mBNBD5 as a potential new therapeutic agent for TB treatment.  相似文献   
965.
It has been reported that sleep problems and neurocognitive deficit in asthmatic children is prevalent. However, systematic studies on these problems in stable asthma using polysomnography have rarely been performed. We therefore investigated sleep and neurocognitive functioning in children with well‐controlled asthma. Forty‐three children with well‐controlled, stable asthma and 31 controls (age range: 6–9 years) were enrolled in the study. Subjects were questioned for daytime sleepiness using the Paediatric Daytime Sleepiness Scale. Complete overnight polysomnography and neurocognitive function tests were performed on all subjects. Children with stable asthma had lower pulmonary function in comparison to their age‐matched controls. Asthmatic children had a higher apnea–hypopnea index (P < 0.001) and apnea–hypopnea‐related arousal index (P < 0.001) as compared with non‐asthmatics. Deep sleep was decreased in asthmatics (P = 0.001). In the vigilance test, the mean number of correct answers was lower (P = 0.005) and the mean reaction time was slower (P = 0.002) in asthmatic children. A hierarchical multiple linear regression showed that deep sleep and apnea–hypopnea‐related arousal index were significant predictors of vigilance. The data suggest that the prevalence of paediatric sleep‐disordered breathing and sleep fragmentation could be very high among children with well‐controlled asthma. Moreover, vigilance, the ability to maintain attention and alertness, was worse in stable asthmatic children when compared with healthy controls. Sleep‐disordered breathing should be checked even in stable asthmatic children as they are at risk for developing neurobehavioural deterioration associated with frequent arousals during sleep. Furthermore, early treatment for asthma may be required in order to prevent airway remodelling that could cause sleep problems.  相似文献   
966.
 目的:探讨姜黄素对骨髓瘤细胞迁移侵袭能力的影响及其机制。方法:shRNA表达质粒沉默含IQ模序的RasGTP酶活化蛋白1(IQ motif-containing GTPase-activating protein 1,IQGAP1)后转染RPMI8226细胞,Western blotting法检测RPMI8226-shIQGAP1组、RPMI8226-shRNA阴性对照组和未转染RPMI8226组细胞IQGAP1表达;不同浓度姜黄素作用于各组细胞后,Transwell迁移实验和Matrigel侵袭实验检测细胞的迁移及侵袭力,RT-PCR法检测姜黄素作用后IQGAP1 mRNA的表达,Western blotting检测姜黄素对各组细胞IQGAP1蛋白表达的影响。结果:使用shRNA表达质粒沉默IQGAP1后,RPMI8226细胞IQGAP1表达减少;RPMI8226-shIQGAP1组较RPMI8226-shRNA 阴性对照组和未转染RPMI8226 组细胞迁移及侵袭力下降,姜黄素可降低RPMI8226-shRNA 阴性对照组和未转染RPMI8226组细胞迁移及侵袭力,无浓度相关性,不同浓度的姜黄素对RPMI8226-shIQGAP1组作用后细胞的迁移及侵袭力无明显变化。对于RPMI8226-shRNA阴性对照组及未转染RPMI8226组,姜黄素作用后IQGAP1 mRNA及蛋白的表达下降。结论:姜黄素通过抑制IQGAP1的表达降低骨髓瘤细胞的迁移力和侵袭力。  相似文献   
967.
Sepsis is a life-threatening condition, but the pathophysiological basis and biomarkers for the monitoring of sepsis and as targets for therapy remain to be determined. We have shown previously that T cell immunoglobulin and mucin domain protein 3 (Tim-3), a negative immune regulator, is involved in the physiopathology of sepsis, but the underlying mechanisms remain unclear. In the present study, we showed that Tim-3 signalling modulated the response patterns of both macrophages and T helper cells in sepsis. Blockade of the Tim-3 pathway exacerbated sepsis-induced proinflammatory macrophage responses and lymphocyte apoptosis during the early phase of sepsis, and enhanced the shift to anti-inflammatory responses for both macrophages and T helper cells during the late phase of sepsis. Tim-3 signalling was found to regulate CD80 and CD86 expression on macrophages both in vivo and in vitro. Co-culture of T cells with Tim-3 knock-down macrophages led to a biased T helper type 2 (Th2) response, partially explaining how Tim-3 signalling shapes inflammation patterns in vivo. Further studies on this pathway might shed new light on the pathogenesis of sepsis and suggest new approaches for intervention.  相似文献   
968.
Mesoporous hollow carbon spheres (HCSs) were prepared using SiO2 spheres as a hard template, and Au nanoparticles were then synthesized using NaBH4 as a reducing agent on the surface of the HCS support. Transmission electron microscopy characterization indicated that Au nanoparticles were much smaller on the HCS support than those on the active carbon (AC) support. HCl-TPD showed that the Au/HCS catalyst displayed a more active site than on Au/AC. The resulting Au/HCS catalyst showed excellent catalytic activity and stability for acetylene hydrochlorination. Acetylene conversion of Au/HCS can be maintained above 92% even after 500 h of lifetime. The excellent catalytic performance of Au/HCS was attributed to the presence of the HCS support, which limited the aggregation of Au nanoparticles.

Mesoporous hollow carbon spheres (HCS) were prepared and applied as the support of Au catalyst for acetylene hydrochlorination. Au/HCS exhibited excellent stability for acetylene hydrochlorination.  相似文献   
969.
Growing concerns about unpredictable influenza pandemics require a broadly protective vaccine against diverse influenza strains. One of the promising approaches was a T cell‐based vaccine, but the narrow breadth of T‐cell immunity due to the immunodominance hierarchy established by previous influenza infection and efficacy against only mild challenge condition are important hurdles to overcome. To model T‐cell immunodominance hierarchy in humans in an experimental setting, influenza‐primed C57BL/6 mice were chosen and boosted with a mixture of vaccinia recombinants, individually expressing consensus sequences from avian, swine, and human isolates of influenza internal proteins. As determined by IFN‐γ ELISPOT and polyfunctional cytokine secretion, the vaccinia recombinants of influenza expanded the breadth of T‐cell responses to include subdominant and even minor epitopes. Vaccine groups were successfully protected against 100 LD50 challenges with PR/8/34 and highly pathogenic avian influenza H5N1, which contained the identical dominant NP366 epitope. Interestingly, in challenge with pandemic A/Cal/04/2009 containing mutations in the dominant epitope, only the group vaccinated with rVV‐NP + PA showed improved protection. Taken together, a vaccinia‐based influenza vaccine expressing conserved internal proteins improved the breadth of influenza‐specific T‐cell immunity and provided heterosubtypic protection against immunologically close as well as distant influenza strains.  相似文献   
970.
Transglutaminase 2 (TG2) has been reported to play a role in dendritic cell activation and B‐cell differentiation after immunization. Its presence and role in T cells, however, has not been explored. In the present study, we determined the expression of TG2 on mouse T cells, and evaluated its role by comparing the behaviours of wild‐type and TG2?/? T cells after activation. In our results, naive T cells minimally expressed TG2, expression of which was increased after activation. T‐cell proliferation, expression of activation markers such as CD69 and CD25, and secretions of interleukin‐2 and interferon‐γ were suppressed in the absence of TG2, presumably due, in part, to diminished nuclear factor‐κB activation. These effects on T cells seemed to be reflected in the in vivo immune response, the contact hypersensitivity reaction elicited by 2,4‐dinitro‐1‐fluorobenzene, with lowered peak responses in the TG2?/? mice. When splenic T cells from mice immunized with tumour lysate‐loaded wild‐type dendritic cells were re‐challenged ex vivo with the same antigen, the profile of surface markers including CD44, CD62L, and CD127 strongly indicated lesser generation of memory CD8+ T cells in TG2?/? mice. In the TG2?/? CD8+ T cells, moreover, Eomes expression was markedly decreased. These results indicate possible roles of TG2 in CD8+ T‐cell activation and CD8+ memory T‐cell generation.  相似文献   
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号