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Abdominal Surgery in Nonagenarians: Short-Term Results 总被引:3,自引:1,他引:2
PURPOSE: To determine the short-term results of abdominal surgery in nonagenarians. METHODS: Retrospective analyses of 193 patients aged 90 and older operated on for abdominal complaints during a 15-year period (1990-2004) in a 500-bed tertiary care institutional hospital and 100-bed rural institutional hospital in Spain. The factors analyzed included the following: perioperative risk, diagnosis, operative procedures, timing of operation (elective or emergency), morbidity, mortality, and length of hospital stay. RESULTS: The most common diagnoses were hernia in 69 cases, colorectal cancer in 39, and biliary lithiasis in 24. One hundred and thirty-seven patients (71%) were operated on on an emergency basis. Forty-seven patients died (24%), with mortality rates of 9% (5/56) and 31% (42/137) respectively, for elective and emergency surgery. None of the 15 patients classified as grade I according to the criteria of the American Society of Anesthesiologists (ASA) died and only 3 out of 63 (5%) died who were ASA grade II. Eighty patients (41%) had postoperative complications. Local morbidity was 16% (n = 30), and systemic morbidity was 30% (n = 58). CONCLUSIONS: Our results support the notion that elective and acute abdominal surgery in nonagenarians can be performed with acceptable rates of mortality and morbidity. Mortality for surgery in nonagenarians is strongly related to the perianesthetic risk (ASA grade), emergency operation, and seriousness of the disease in question. 相似文献
995.
Ribeiro JA de Campos LM Alves RJ Lages GP Pianetti GA 《Journal of pharmaceutical and biomedical analysis》2007,43(1):298-303
A simple procedure for obtaining and purifying two degradation products of efavirenz (amino alcohol and quinoline derivatives) from drug substance hydrolysis is described. These impurities are known to exhibit very different UV absorbance properties from those of the parent compound, making determination using a quantitation factor (QF) inaccurate. The obtained hydrolysis products were characterized by physicochemical methods to assure identity, purity and strength. Quinoline derivative was of high purity degree (100%) and amino alcohol was 98.74% pure. Both were set as reference standards in chromatographic related compounds test for efavirenz drug substance and tablets analyses. 相似文献
996.
997.
Gustavo Ribeiro De Oliveira Ajith K. Sankarankutty Orlando Castro e Silva Juliana Ferreira Cristina Kurachi Sergio Zucoloto Hélio Vannucchi Alceu Afonso Jordão Jr Júlio Sergio Marchini Vanderlei Salvador Bagnato 《Liver international》2009,29(3):331-336
Background: Steatosis is diagnosed on the basis of the macroscopic aspect of the liver evaluated by the surgeon at the time of organ extraction or by means of a frozen biopsy. Aim: In the present study, the applicability of laser‐induced fluorescence (LIF) spectroscopy was investigated as a method for the diagnosis of different degrees of steatosis experimentally induced in rats. Material and methods: Rats received a high‐lipid diet for different periods of time. The animals were divided into groups according to the degree of induced steatosis diagnosis by histology. The concentration of fat in the liver was correlated with LIF by means of the steatosis fluorescence factor (SFF). Results: The histology classification, according to liver fat concentration was, Severe Steatosis, Moderate Steatosis, Mild Steatosis and Control (no liver steatosis). Fluorescence intensity could be directly correlated with fat content. It was possible to estimate an average of fluorescence intensity variable by means of different confidence intervals (P=95%) for each steatosis group. SFF was significantly higher in the Severe Steatosis group (P<0.001) compared with the Moderate Steatosis, Mild Steatosis and Control groups. Conclusion: The various degrees of steatosis could be directly correlated with SFF. LIF spectroscopy proved to be a method capable of identifying the degree of hepatic steatosis in this animal model, and has the potential of clinical application for non‐invasive evaluation of the degree of steatosis. 相似文献
998.
Francisco Díaz de Rojas MD PhD ; Trinidad De Frutos MD PhD ; Ana Ponte MD PhD ; Joaquin Mateos Chacón MD ; Gustavo C. Vitale MD ; for the PRINCEPS Investigators 《Preventive cardiology》2009,12(2):65-71
The authors assessed a large cohort of patients with coronary heart disease (CHD) or at high risk for developing CHD in terms of lipid profile, lipid-lowering treatment, and attainment of National Cholesterol Education Program (NCEP) target low-density lipoprotein cholesterol (LDL-C) levels. The investigation was a cross-sectional study involving Spanish outpatients treated in primary or secondary care facilities. From a total of 26,598 attending patients, 12,128 with CHD or CHD risk equivalents were recruited by 1875 physicians; 49% had CHD and 69% had multiple risk factors. Only 25% of patients attained LDL-C values <100 mg/dL, 76.6% patients received lipid-lowering therapy (statins in 95.4% of cases), and 54% of physicians considered that a treatment change was required (the most frequent choice was the addition of ezetimibe to current statin therapy). In this large cohort of high-risk coronary patients, only 25% attained a target LDL-C of <100 mg/dL. These results highlight a need for improved patient care and physician awareness/training. 相似文献
999.
Padmanabha H Hidalgo M Valbuena G Castaneda E Galeano A Puerta H Cantillo C Mantilla G 《Vector borne and zoonotic diseases (Larchmont, N.Y.)》2009,9(5):483-490
In order to characterize the patterns of human exposure to spotted fever group (SFG) rickettsial and leptospiral infection, IgG surveys were conducted on 642 residents of ten different areas of the rural district of Necoclí, Colombia. Areas were selected based on forest cover and human settlement pattern, and individual risk factors were elucidated through multivariate logistic models, controlling for variance clustering within communities. Overall, prevalence of high antibody titers indicating previous exposure to SFG rickettsia and leptospira was 29.2% and 35.6%, respectively, and both were most prevalent in the same peri-urban neighborhood. Forest cover .10% demonstrated the strongest independent association with leptospiral exposure, followed by homes with outdoor storage sheds. Isolated rural housing was the only variable independently associated with SFG rickettsia exposure. Community-level variables significantly modified the effects of individual risk factors. For both pathogens the eldest quartile was less exposed in periurban areas although there was no age effect overall for either. Females living in population settlements were more exposed to SFG rickettsiae but there was no sex association in isolated rural houses. Similarly, in sites with forest cover .10%, individuals working at home had higher leptospira seroprevalence, but place of work was not a risk factor in areas of forest cover ,10%. These data suggest that the patterns of maintenance and/or exposure to leptospira and rickettsia vary across different human created landscapes and settlement patterns. While contrasting risk factors may reflect the unique transmission cycles of each pathogen, the observed patterns of geographic variation suggest that both diseases may respond similarly larger scale human-ecological dynamics. 相似文献
1000.
Marín GH Mansilla E Mezzaroba N Zorzet S Núñez L Larsen G Tau JM Maceira A Spretz R Mertz C Ingrao S Tripodo C Tedesco F Macor P 《Current Clinical Pharmacology》2010,5(4):246-250
The aim of this study was to determine if Rituximab coated Biodegradable Nanoparticles (BNPs) loaded with Chlorambucil and Hydroxychloroquine could induce apoptosis of B-Chronic Lymphocytic Leukemia (B-CLL), MEC-1 and BJAB cells in vitro and evaluate their toxic and therapeutic effects on a Human/Mouse Model of Burkitt Lymphoma at an exploratory, proof of concept scale. We found that Rituximab-Chlorambucil-Hydroxychloroquine BNPs induce a decrease in cell viability of malignant B cells in a dose-dependent manner. The mediated cytotoxicity resulted from apoptosis, and was confirmed by monitoring the B-CLL cells after Annexin V/propidium iodide staining. Additional data revealed that these BNPs were non toxic for healthy animals, and had prolonged survival in this mice model of human lymphoma. 相似文献