全文获取类型
收费全文 | 36484篇 |
免费 | 1859篇 |
国内免费 | 249篇 |
专业分类
耳鼻咽喉 | 363篇 |
儿科学 | 966篇 |
妇产科学 | 698篇 |
基础医学 | 4658篇 |
口腔科学 | 1072篇 |
临床医学 | 2872篇 |
内科学 | 9657篇 |
皮肤病学 | 541篇 |
神经病学 | 3366篇 |
特种医学 | 1341篇 |
外科学 | 5709篇 |
综合类 | 129篇 |
一般理论 | 14篇 |
预防医学 | 1823篇 |
眼科学 | 473篇 |
药学 | 2053篇 |
中国医学 | 86篇 |
肿瘤学 | 2771篇 |
出版年
2023年 | 266篇 |
2022年 | 536篇 |
2021年 | 1157篇 |
2020年 | 687篇 |
2019年 | 940篇 |
2018年 | 1236篇 |
2017年 | 829篇 |
2016年 | 959篇 |
2015年 | 1113篇 |
2014年 | 1497篇 |
2013年 | 1838篇 |
2012年 | 2993篇 |
2011年 | 2909篇 |
2010年 | 1743篇 |
2009年 | 1511篇 |
2008年 | 2483篇 |
2007年 | 2449篇 |
2006年 | 2370篇 |
2005年 | 2230篇 |
2004年 | 1977篇 |
2003年 | 1727篇 |
2002年 | 1696篇 |
2001年 | 238篇 |
2000年 | 182篇 |
1999年 | 249篇 |
1998年 | 290篇 |
1997年 | 254篇 |
1996年 | 240篇 |
1995年 | 213篇 |
1994年 | 173篇 |
1993年 | 155篇 |
1992年 | 111篇 |
1991年 | 97篇 |
1990年 | 110篇 |
1989年 | 93篇 |
1988年 | 83篇 |
1987年 | 60篇 |
1986年 | 80篇 |
1985年 | 59篇 |
1984年 | 88篇 |
1983年 | 78篇 |
1982年 | 78篇 |
1981年 | 59篇 |
1980年 | 57篇 |
1979年 | 39篇 |
1978年 | 45篇 |
1977年 | 30篇 |
1976年 | 29篇 |
1975年 | 24篇 |
1973年 | 28篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
71.
Paolo Cossu Rocca Matteo Brunelli Stefano Gobbo Albino Eccher Emma Bragantini Maria M Mina Vincenzo Ficarra Filiberto Zattoni Alberto Zamò Maurizio Pea Aldo Scarpa Marco Chilosi Fabio Menestrina Franco Bonetti John N Eble Guido Martignoni 《Modern pathology》2007,20(7):722-728
S100A1 is a calcium-binding protein, which has been recently found in renal cell neoplasms. We evaluated the diagnostic utility of immunohistochemical detection of S100A1 in 164 renal cell neoplasms. Forty-one clear cell, 32 papillary, and 51 chromophobe renal cell carcinomas, and 40 oncocytomas, 164 samples of normal renal parenchyma adjacent to the tumors and 13 fetal kidneys were analyzed. The levels of S100A1 mRNA detected by quantitative RT-PCR analysis of frozen tissues from seven clear cell, five papillary, and six chromophobe renal cell carcinomas, four oncocytomas, and nine samples of normal renal tissues adjacent to neoplasms were compared with the immunohistochemical detection of protein expression. Clear cell and papillary renal cell carcinomas showed positive reactions for S100A1 in 30 out of 41 tumors (73%) and in 30 out of 32 (94%) tumors, respectively. Thirty-seven renal oncocytomas out of 40 (93%) were positive for S100A1, whereas 48 of 51 (94%) chromophobe renal cell carcinomas were negative. S100A1 protein was detected in all samples of unaffected and fetal kidneys. S100A1 mRNA was detected by RT-PCR in all normal kidneys and renal cell neoplasms, although at very different levels. Statistical analyses comparing the different expression of S100A1 in clear cell and chromophobe renal cell carcinomas observed by immunohistochemical and RT-PCR methods showed significant values (P<0.001), such as when comparing by both techniques the different levels of S100A1 expression in chromophobe renal cell carcinomas and oncocytomas (P<0.001). Our study shows that S100A1 protein is expressed in oncocytomas, clear cell and papillary renal cell carcinomas but not in chromophobe renal cell carcinomas. Its immunodetection is potentially useful for the differential diagnosis between chromophobe renal cell carcinoma and oncocytoma. Further, S100A1 protein expression is constantly detected in the normal parenchyma of the adult and fetal kidney. 相似文献
72.
An evaluation of the cardiovascular safety profile of duloxetine: findings from 42 placebo-controlled studies. 总被引:3,自引:0,他引:3
Joachim Wernicke Alberto Lledó Joel Raskin Daniel K Kajdasz Fujun Wang 《Drug safety》2007,30(5):437-455
BACKGROUND AND OBJECTIVE: In recent years, new classes of medication, such as the serotonin-noradrenaline reuptake inhibitors (SNRIs), have been developed for use in the treatment of major depressive disorder (MDD). For many years, treatment options were largely limited to the use of monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). However, there have been published reports of orthostatic hypotension, arrhythmias and corrected QT (QTc) interval changes in patients treated with TCAs. As new medications become available, it is important to understand how their cardiovascular safety profile compares with that of more established agents to aid clinicians and patients in choosing the best treatment options. This study was designed to evaluate the cardiovascular safety profile of the SNRI duloxetine through evaluation of cardiovascular-related parameters and adverse events (AEs). METHODS: The cardiovascular safety of duloxetine was assessed using all placebo-controlled duloxetine clinical trial data as of December 2005. This consisted of data from 42 placebo-controlled clinical trials of 8504 patients who were treated with duloxetine. Additional information from a high-dose clinical pharmacology study and postmarketing safety surveillance are also presented. Of the placebo-controlled trials included in this analysis, clinical indications under investigation included MDD (15 studies), diabetic peripheral neuropathic pain (3 studies), fibromyalgia (2 studies), generalised anxiety disorder (3 studies) and lower urinary tract disorders (19 studies, all related to incontinence). Cardiovascular safety was evaluated based on vital signs, ECGs and the incidence of treatment-emergent AEs potentially related to cardiovascular safety. These safety parameters were analysed across all indications. To identify both serious and non-serious cardiovascular-related AEs, as well as AEs reported as the reason for discontinuation, a comprehensive list of terms derived from the Medical Dictionary for Regulatory Activities (version 8.0) was generated and used to search the duloxetine databases for cardiovascular-related events. RESULTS: Calculation of change from baseline to maximum in ECG parameters showed significant differences between treatment groups for all parameters, with decreases from baseline in RR, QRS and QT intervals for patients receiving duloxetine and increases from baseline for patients treated with placebo. These shifts were related to small heart rate changes, but the mean differences were not considered clinically relevant. Categorical analyses of shifts from normal to abnormal (or abnormal to normal) for heart rate and QT corrected for heart rate using Fridericia's formula (QTcF) values showed that most patients did not shift from their baseline category. Patients with MDD who were treated for up to 1 year with duloxetine had blood pressure changes early in treatment that then stabilised. Even in patients with elevated blood pressure at baseline in these clinical trials, no increased risk of sustained blood pressure elevation with duloxetine treatment was found. CONCLUSION: Overall, the findings presented here support our conclusions that use of duloxetine does not appear to be associated with significant cardiovascular risks in patients with conditions for which the drug has been approved or studied. 相似文献
73.
Imad Sheiban M. D. Dino Casarotto Giampaolo Trevi Paolo Benussi Alberto Marini Roberto Accardi Antonio Motta Massimo Brunelli Claudio Muneretto Alessandro Tenuti Ludovico Antonio Scuro 《Cardiovascular and interventional radiology》1987,10(3):157-161
The accuracy of two-dimensional echocardiography in the detection of intracardiac masses was verified in 334 patients who
underwent cardiac catheterization in our laboratory over 21 consecutive months. A complete two-dimensional echocardiographic
(2DE) examination was performed a day before catheterization. The presence or absence of a mass was verified at surgery in
77 patients who successively underwent mitral or aortic valve replacement (51), left ventricular aneurysmectomy with or without
myocardial revascularization (25), and resection of atrial myxoma (2). In 32 patients 2DE revealed the presence of a mass-left
or right atrial thrombi in 12, left atrial myxoma in 2, left ventricular thrombi in 16, and endocardial vegetations in 2.
The other 45 patients were free of intracardiac masses on 2DE. Anatomic verification at surgery revealed the presence of an
intracardiac mass in 34 patients. In 30 (true positives) of these, 2DE revealed the mass as well, and in 4 (false negatives)
the presence of a mass had not been identified by 2DE. In 2 patients (false positives) the predicted mass was not found at
surgery. Absence of a mass was correctly predicted by 2DE in 41 patients (true negatives). Thus 2DE detected intracardiac
masses with sensitivity of 88.2% and a specificity of 95.3%. We recommend that 2DE be performed in all patients prior to hemodynamic
study and/or cardiac surgery to enable safer management of patients with intracardiac masses during cardiac catheterization
and/or cardiac surgery. 相似文献
74.
Simona Cabib Claudio Castellano Vincenzo Cestari Umberto Filibeck Stefano Puglisi-Allegra 《Psychopharmacology》1991,105(3):335-339
Pretreament with small, per se ineffective doses of the selective D1 antagonist SCH 23390 inhibited hyperactivity induced by cocaine. On the other hand, the classic neuroleptic haloperidol and the selective D2 antagonist metoclopramide prevented the stimulatory effects of cocaine on locomotion only at hypokinetic doses, while the atypical neuroleptic (–)-sulpiride, a selective D2 antagonist, did not produce significant effects when administered at the hypokinetic dose of 12 mg/kg. Finally, at low doses (–)-sulpiride dose-dependently potentiated the locomotor-stimulating effects of cocaine, an effect that is not shared either with haloperidol or with metoclopramide. These results are discussed in terms of different roles of DA receptor subtypes in the modulation of the stimulant effects of cocaine on locomotion. 相似文献
75.
Gianmauro Sacchetti Eugenio Inglese Angelo S Bongo Franco Aina Marco Brambilla Alberto Baroli Carmelo Cernigliaro Pierfranco Dellavesa Edgardo Pittaluga Marco Rudoni 《European journal of nuclear medicine and molecular imaging》1997,24(10):1230-1236
The aim of this study was to determine the diagnostic accuracy of technetium-99m tetrofosmin myocardial imaging for the localization
of coronary artery stenoses of different degrees of severity. Stress-rest single-photon emission tomography (SPET) was performed
on separate days in 80 patients (64 males, 16 females; mean age 61 years; 43 patients with previous myocardial infarction;
18 patients with pharmacological stress), within 6 months of coronary angiography. Scintigraphic images were blindly and independently
evaluated by three observers. Coronary stenosis was defined as a >50% narrowing in luminal diameter; severe stenosis was defined
as a proximal stenosis of >75% or a peripheral stenosis of >90%. Coronary angiography revealed normal coronary arteries or
insignificant coronary stenosis in 13 patients and significant coronary stenoses in 67 patients. The sensitivity and specificity
of 99mTc-tetrofosmin SPET in respect of severely stenosed vessels were, respectively, 80% and 65% for the left anterior descending
artery (LAD), 100% and 46% for the right coronary artery (RCA) and 58 and 78% for the left circumflex artery (LCx) territories.
Considering all the significantly stenosed vessels, a significant decrease in sensitivity was observed for LAD territories
(to 59%, P=0.05), and a nonsignificant decrease for RCA (88%) and LCx (47%) territories while specificity values remained essentially
unchanged. No significant changes in sensitivity or specificity were observed when regions with previous myocardial infarction
were excluded. In conclusion, the sensitivity of 99mTc-tetrofosmin SPET for the localization of individual stenosed vessels is only moderate when all significant stenoses are
considered, but the ability of this technique to predict the location of severe coronary artery stenoses seems satisfactory,
with the exception of the low specificity in respect of RCA territories.
Received 26 April and in revised form 7 June 1997 相似文献
76.
Marc G Weisskopf Honglei Chen Michael A Schwarzschild Ichiro Kawachi Alberto Ascherio 《Movement disorders》2003,18(6):646-651
Anxiety disorders are common in Parkinson's disease (PD). However, the risk of PD among people with anxiety has not been examined in a prospective cohort study. We examined this relation prospectively within the Health Professionals Follow-Up Study, a cohort of US male health professionals. In 1988, anxiety was assessed using the Crown-Crisp phobic anxiety index in 35,815 men without PD, stroke, or cancer at baseline. There were 189 incident cases of PD during 12 years of follow-up. After adjusting for age, smoking, and caffeine intake, the relative risk of PD among men with the highest level of anxiety (Crown-Crisp index scores of 4 and above) was 1.5 (95% CI = 1.0-2.1; P-trend = 0.01) compared to men with the lowest level of anxiety. This positive association persisted after excluding cases of PD with onset in the first 2 years of follow-up. Use of anxiolytic medication was also associated with an elevated risk of PD (RR= 1.6; 95% CI = 0.9-3.1), but adjusting for this potential confounder did not materially affect the association between anxiety and risk of PD. Our results suggest that anxiety is a risk factor for PD. Whether this association is causal or the result of shared underlying biology remains a question. 相似文献
77.
Giorgio Nanni Federica Majorani Anna Maria Bassi Claudio Canepa Giuseppe Maloberti Anna Casu 《Experimental and toxicologic pathology》2002,54(1):43-50
The content of dolichol, an isoprenoid present in all biological membranes, was determined in isolated sinusoidal liver cells after treatment of rats for 2 and 4 months with a low dosage of the hepatotoxin thioacetamide. The significant decrease in dolichol observed in hepatocytes after 2 months might be explained by peroxidation of the isoprenoid. At the same time point, retinol was retained, and decreased only after 4 months of treatment. After 4 months of treatment therefore both lipids decreased. In a subfraction of hepatic stellate cells, Ito-1 cells, the main storage site of vitamin A, dolichol decreased significantly only after 4 months. A remarkable difference from hepatocytes is that in Ito-1 cells retinol content significantly decreased after 2 months of treatment. In another subfraction, Ito-2 cells, the content of the two isoprenoids decreased in parallel. This heterogeneous subfraction might represent those transitional hepatic stellate cells that, while losing retinol, are in the process of differentiating into myofibroblasts secreting extracellular matrix components. In Kupffer cells and sinusoidal endothelial cells, impairment of dolichol might be observed later, only after 4 months of treatment, while retinol decreases uniformly over time. Starting after two months of treatment, the decrease of dolichol and the increase of retinol in hepatocytes, at the same time as retinol decreases in hepatic stellate cells, might be taken as an early index of incipient liver injury due to thioacetamide. This hypothesis is discussed with regard to a role of dolichol in the modulation of membrane fluidity for intracellular and intercellular retinol transport. 相似文献
78.
Adriano Rizzi Gaetano Rocco Mario Robustellini Gerolamo Rossi Claudio Della Pona Giuseppe Vertemati 《World journal of surgery》1997,21(5):488-491
n
= 8), multidrug resistance
or noncompliance to the medical treatment (
n
= 11),
parenchymal sequelae (
n
= 3), suspected cancer
(
n
= 5), and for the correction of postpneumonectomy
bronchopleural fistula and empyema (
n
= 1). On
admission, eight patients presented with sputum positivity (28.6%).
Similar to previous series, tubercular predilection for upper lobes was
confirmed (21/28, 75%); accordingly, upper lobectomy through an
extrapleural approach was the most common procedure (16/28, 57.1%).
Atypical segmental resections or segmentectomies were performed in
seven patients (25%), whereas a bilobectomy was necessary in another
three patients (10.7%) and a completion pneumonectomy in one (3.6%).
Additional procedures were an open-window thoracostomy with
transpericardial closure of the main bronchus and a tailored
thoracoplasty. No operative mortality was reported. Healing was
achieved in 26 patients (93%). Bleeding, either from the chest wall or
hilar dissection, was the only reported intraoperative complication.
Median blood loss, inclusive of early postoperative collections from
chest tubes, reached 1330 ml (range 100–3700 ml). Major postoperative
complications included recurrent disease (2/28, 7%) in sputum-positive
patients and segmental pulmonary embolism (3.5%). Causes of minor
morbidity were air leaks resulting in residual space undergoing
spontaneous resolution (18%), wound breakdown (14%), and, fever
(11%). This limited series confirms the therapeutic value of the
surgical treatment of postprimary tuberculosis, provided that correct
indications, adequate pre- and postoperative medical coverage, and
meticulous technique are applied. 相似文献
79.
R Bassan P E Cornelli R Battista F Terzi M Buelli A Rambaldi P Viero A D'Emilio E Dini T Barbui 《Hematological oncology》1992,10(2):105-110
Twenty-three patients (16 adults) failing their first or subsequent (n = 8) intensive treatment for de novo acute lymphoblastic leukemia (ALL) and chronic myeloid leukemia lymphoid blast phase (n = 2) were managed with protocol POG 8201, originally introduced in relapsed ALL of childhood. In this programme, a four-drug induction phase is followed by early consolidation with teniposide-cytarabine, intrathecal chemotherapy, continuation weekly chemotherapy alternating teniposide-cytarabine with vincristine-cyclophosphamide, and periodic reinduction courses. Fourteen adults and five children with ALL achieved a complete response (CR) (86 per cent). The highest response rate (100 per cent) was obtained in 12 patients treated at first relapse after an initial CR of greater than 18 months (p = 0.07). Median duration of CR was 8 months in adults and 11 months in children. A longer than previous one CR (inversion) was obtained in four cases. Four ALL patients were successfully transplanted from a matched sibling after 3-11 months from achievement of CR. Median overall survival in adults with ALL was 11 months, significantly longer than for 40 comparable cases treated intensively but without rotational continuation therapy in previous years (p less than 0.001). This regimen is applicable to adults with relapsed ALL, where prolongation of survival may allow time for effective salvage with bone marrow transplantation. 相似文献
80.
Andrea Gallamini Alberto Biggi Adriana Fruttero Francesco Pugno Giobatta Cavallero Patrizia Pregno Mariella Grasso Chiara Farinelli Alessandro Leone Eugenio Gallo 《European journal of nuclear medicine and molecular imaging》1997,24(12):1499-1506
The purpose of this study was threefold: to evaluate the role of gallium-67 scintigraphy in the staging of low-grade non-Hodgkin’s
lymphomas (LGNHL), to assess the relationship between the expression of CD71 on the surface of the neoplastic cells and the
67Ga uptake by the tumour, and to establish the contribution of 67Ga scan in defining the prognosis of LGNHL. Forty-eight patients with untreated LGNHL diagnosed in a single institution over
a decade were reviewed. The end point of the study was survival of the patients according to the scintigraphic 67Ga score at diagnosis. In addition to 67Ga scan, other prognostic variables were studied, relating to the neoplastic burden, the biology of the tumour and the host.
Univariate and multivariate analyses were used. 67Ga scan identified only 116/286 (41%) nodes involved by lymphoma that were detected by clinical examination or computed tomography
scan. A scintigraphic scoring system with an arbitrary cut-off value of 3 (high scan score) was able to predict patients with
a dismal prognosis: with a mean follow-up of 47 months (range: 1–146 months) the median survival time was 28 months in patients
with a high scan score and 74 months in patients with a low scan score (P=0.002). CD71 values were 27.4%±14.9% (mean ±SD) in the former and 8.9%±7.2% in the latter (P=0.0001). Only performance status and extranodal sites were significant variables for prognosis in multivariate analysis.
It is concluded that 67Ga scan is inaccurate in staging but might be very important in defining the prognosis in LGNHL, in association with other
prognostic variables.
Received 1 May and in revised form 6 August 1997 相似文献