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Metelmann C. Metelmann B. Scheer C. Gründling M. Henkel B. Hahnenkamp K. Brinkrolf P. 《Der Anaesthesist》2018,67(8):584-591
Die Anaesthesiologie - Sepsis hat eine hohe Mortalität, die durch einen frühzeitigen Therapiebeginn reduziert werden kann. Da Patienten mit Sepsis häufig durch den Rettungsdienst in... 相似文献
74.
Andrea Poretti Andrea Capone Anette Hackenberg Ingeborg Kraegeloh-Mann Gerhard Kurlemann Guido Laube Joachim Pietz Mareike Schimmel Wolfram Schwindt Ianina Scheer Eugen Boltshauser 《Cerebellum (London, England)》2016,15(6):705-709
We report on seven patients with a novel neuroimaging finding that involves exclusively the cerebellar gray matter at the bottom of several fissures of both hemispheres but spares the vermis. The abnormal fissures were predominantly located in the lower and lateral parts of the cerebellar hemispheres. The affected cerebellar cortex was hypointense on T1-weighted and hyperintense on T2-weighted and fluid attenuation inversion recovery sequences. In some patients, the involved cerebellar gray matter was mildly thickened and the affected fissures slightly widened. In three of seven patients, the neuroimaging findings were unchanged on follow-up studies up to 6 years. The seven patients had various indications for the brain magnetic resonance imaging studies, and none of them had cerebellar dysfunction. Based on the similarity of the neuroimaging pattern with the cerebral “bottom-of-sulcus dysplasia,” we coined the term “cerebellar bottom-of-fissure dysplasia” to refer to this novel neuroimaging finding. The neuroimaging characteristic as well as the unchanged findings on follow-up favors a stable “developmental” (malformative) nature. The lack of cerebellar dysfunction in the affected patients suggests that cerebellar bottom-of-fissure dysplasia represents most likely an incidental finding that does not require specific diagnostic investigation but allows a reassuring attitude. 相似文献
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Rohrbach M Klein A Köhli-Wiesner A Veraguth D Scheer I Balmer C Lauener R Baumgartner MR 《Journal of inherited metabolic disease》2010,33(6):751-757
Pompe disease is a rare lysosomal glycogen storage disorder characterized by deficiency of acid α-glucosidase enzyme (GAA)
and caused by mutations in the GAA gene. Infantile-type Pompe disease is a multiorgan disorder presenting with cardiomyopathy, hypotonia, and muscular weakness,
which is usually fatal. Enzyme replacement therapy (ERT) with recombinant human GAA (rhGAA) has recently been shown to be
effective and subsequently yielded promising results in cross-reactive immunologic material (CRIM)-positive patients. CRIM-negative
patients showed a limited response to ERT and died or were ventilator dependant. Over a period of 44 months, we monitored
cognitive and motor development, behavior, auditory function, and brain imaging of a CRIM-negative infantile Pompe disease
patient on rhGAA and monoclonal anti-immunoglobulin E (anti-IgE) antibody (omalizumab) treatment due to severe allergic reaction.
Cardiorespiratory and skeletal muscle response was significant, with almost normal motor development. Cognitive development—in
particular, speech and language—deviated increasingly from normal age-appropriate development and was markedly delayed at
44 months, unexplained by moderate sensorineural hearing impairment. Brain magnetic resonance imaging (MRI) at 18, 30, and
44 months of age revealed symmetrical signal alteration of the deep white matter. Titer values of IgG antibodies to rhGAA
always remained <1:800. The potential role of omalizumab in immune modulation remains to be elucidated; however, this is the
first report presenting a ventilator-free survival of a CRIM-negative patient beyond the age of 36 months. The central nervous
system (CNS) findings are hypothesized to be part of a yet not fully described CNS phenotype in treated patients with longer
survival. 相似文献
77.
Introduction and hypothesis To prospectively evaluate anorectal symptoms, quality of life (QoL), sphincter integrity and function after subsequent childbirth
following previous obstetric anal sphincter injuries (OASIS).
Methods A validated Manchester Health Questionnaire, endoanal sonography and manometry were performed during the third trimester and
13 weeks postpartum. Women without objective compromise of anal function were recommended a vaginal delivery and the others
a caesarean section.
Results Seventy-three consecutive women with previous OASIS were seen during a subsequent pregnancy of whom 59 were reviewed 13 weeks
following delivery. Anal manometry findings did not change significantly following a subsequent vaginal delivery or caesarean
section. Only one new defect (internal sphincter) occurred after a vaginal delivery. There was no significant change in symptoms
or QoL. Three (6.8%) sustained repeat OASIS.
Conclusions Women who have no antenatal evidence of objective compromise of anal sphincter function can be reassured that a vaginal delivery
is not associated with any significant deterioration in function or QoL.
This paper was presented at the 36th Annual meeting of the International Continence Society in Christchurch, New Zealand and
a preliminary abstract is published in: Neurourology Urodynamics 2006;25(6):512–513. 相似文献
78.
Liesmaa I Kokkonen JO Kovanen PT Lindstedt KA 《Journal of molecular and cellular cardiology》2007,43(5):593-600
Cardioprotective bradykinin type-2 receptors (BK-2Rs) are downregulated in the myocardial endothelium of both human and rat failing hearts. Statins are cardioprotective drugs that reduce the level of plasma cholesterol but also exert cholesterol-independent pleiotropic effects. Here we examined the effect of lovastatin on BK-2R expression in cultured human coronary artery endothelial cells. The effect of lovastatin on the expression of BK receptors in human coronary artery endothelial cells (HCAECs) was examined by real-time PCR, Western blot analysis and immunocytochemistry. Lovastatin induced a time- and concentration-dependent increase in both BK-2R and BK-1R mRNA expression in the cultured HCAECs. Also, the number of functional BK-2Rs capable of inducing BK-mediated NO production and cGMP signaling was increased in the lovastatin-treated HCAECs. Mevalonate, the direct metabolite of HMG-CoA reductase, reversed the effect of lovastatin. Furthermore, lovastatin inhibited Rho activation and a selective inhibitor of Rho-associated kinases, Y-27632, induced a similar increase in BK-2R expression as lovastatin. In contrast, a specific inhibitor of COX-2, NS398, significantly inhibited the lovastatin-induced expression of BK-2Rs. Here we show for the first time that lovastatin induces the expression of BK-2Rs in cultured human coronary artery endothelial cells through a novel cholesterol-independent pleiotropic mechanism that involves RhoA kinase inhibition and COX-2 activation. Thus, reported beneficial effects of statins in cardiovascular diseases may be partly mediated by an increased expression of cardioprotective BK-2Rs in the endothelial cells of the coronary tree. Moreover, the use of COX-2 inhibitors may affect the level of endothelial BK-2Rs in a negative fashion. 相似文献
79.
OBJECTIVES: To evaluate the time-course and reversibility of toxicity of a low-osmolar and an iso-osmolar radiographic contrast medium on renal tubular cell cultures. MATERIALS AND METHODS: LLC-PK1-cells were incubated with iomeprol, iodixanol, and mannitol (4.7-75 mg I/mL, 2-24 hours). Metabolic activity was assessed with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide-(MTT) assay. RESULTS: Iomeprol and iodixanol induced a time- and dose-dependent inhibition of MTT conversion (75%-19% and 70%-23% of control for iomeprol and iodixanol, respectively, at concentrations ranging from 4.7 to 75 mg I/mL after an incubation time of 2 hours and 64%-14% and 65%-12% of control after 24 hours). The mannitol induced inhibition of the MTT conversion was significantly weaker than that induced by iomeprol (99%-47% of control at concentrations corresponding to 4.7-75 mg I/mL after an incubation time of 24 hours, P < 0.001). After 24 hours incubation with iomeprol, iodixanol, or mannitol and a recovery time of 2 hours after removal of the test-solutions, there was only a small inhibition of MTT-conversion (89%, 88%, and 95% of control at 75 mg I/mL). CONCLUSIONS: Contrast medium induced cytotoxicity consisted of a reversible part and an irreversible part. There was no difference in cytotoxicity between iomeprol and iodixanol over a broad range of concentrations and incubation-times. 相似文献
80.
Marissa Penna-Martinez Elizabeth Ramos-Lopez Inka Robbers Heinrich Kahles Stefanie Hahner Holger Willenberg Nicole Reisch Christian Seidl Maria Segni Klaus Badenhoop 《BMC medical genetics》2009,10(1):126