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101.

Introduction and hypothesis

The objective of this study was to evaluate the modification of a shortened tape and reduced dissection of the inside-out transobturator procedure on the tape??s relationship to the relevant anatomical structures.

Methods

In ten fresh frozen cadavers, relevant distances between the two different tapes and anatomical structures were recorded.

Results

The shorter tape traversed less muscular structures, but consistently traversed the obturator membrane. The median distance from the tape to the obturator canal measured 2.0 versus 1.9?cm, to the anterior obturator nerve 3.0 versus 2.7?cm, and to the posterior obturator nerve 2.2 versus 2.0?cm [modified versus original procedure, respectively (p?>?0.05)]. Significantly, less mesh was inserted in the modified procedure on each side of the body (6.1 versus 9.9?cm, p?Conclusions The shorter, inside-out transobturator tape traverses less muscular structures than its original counterpart, while still consistently anchoring in the obturator membrane at a similarly safe distance from the obturator canal.  相似文献   
102.
It is not known whether the results of decompressive surgery to treat the mild and moderate forms of spondylotic cervical myelopathy (CSM) are any better than those of a conservative approach. A 10-year prospective randomised study was performed. The objective of the study was to compare conservative and operative treatments of mild and moderate, non-progressive, or slowly progressive, forms of CSM. Sixty-four patients were randomised into two groups of 32. Group A was treated conservatively while group B was treated surgically. The clinical outcome was evaluated by modified JOA score, timed 10-m walk, score of daily activities recorded by video and evaluated by two observers blinded to the type of therapy, and by subjective assessment by the patients themselves. Seventeen patents died of natural, unrelated causes, during the follow-up. A total of 25 patients in the conservatively and 22 in the surgically treated group were used for the final evaluation. There was no statistically significant difference between both groups in mJOA score, in subjective evaluation by the patients themselves and in evaluation of video-recordings of daily living activities by two observers blinded to treatment mode. There was neither any difference found in the percentage of patients losing the ability to walk nor in the time taken to cover the 10-m track from a standing start. Comparison of conservative and surgical treatment in mild and moderate forms of CSM in a 10-year follow-up has not shown, on average, a significant difference in results. In both groups, patients get better and worse. According to the power analysis it is necessary admit that these results possess the low ability to answer definitely the question which treatment is better for the patients with a mild and moderate non-progressive CSM because of the low number of patients for the final evaluation and for clinically negligible differences between two compared arms. These findings can serve as a worthy odds-on hypothesis which needs the confirmation.  相似文献   
103.
104.
BackgroundThe metabolic syndrome (MTS) is comprised of insulin resistance, glucose intolerance, obesity, hypertension, and dyslipidemia. Secondary renal dysfunction can develop after prolonged duration of each component except for dyslipidemia. Here we present 7 obese individuals in whom MTS and proteinuria developed concomitantly during adolescence.Subject and methodsSeven (f:m = 4:3) individuals (Caucasian or African American, ages 11–17 at disease onset) developed macroproteinuria of whom 6 were directly evaluated and had typical MTS characteristics. Body mass index range was 30.8–73.2 kg/m2, being highest in African Americans. All had positive family history of MTS. Six patients underwent complete general, hormonal and metabolic work-up, including fasting and stimulated insulin and C-peptide levels. Genomic DNA of 4 patients and their relatives was studied by linkage analysis for MODY 1–4 genes, and for a locus associated with focal segmental glomerulosclerosis (FSGS) and microalbuminuria.ResultsFasting and stimulated insulin and C-peptide levels were elevated. All patients were normoalbuminemic, and five of six patients had mildly elevated liver enzymes. The 24-h urinary protein excretion range was 2.5–9 g, and decreased markedly in 2 patients who lost weight. Renal biopsy of 3 patients showed FSGS. In 2 pedigrees FSGS was familial. Genomic DNA analysis excluded any linkage with common MODY genes or with familial FSGS.ConclusionsThe early concomitant development of MTS, proteinuria and FSGS appears to be associated with hyperinsulinemia, presenting as early as adolescence, and may be reversed by weight loss. We propose that in genetically predisposed individuals, excessive insulin plays a crucial pathogenic role in development of the metabolic syndrome and FSGS.  相似文献   
105.
106.
Successful treatment of iron overload by phlebotomies has been reported in two splenectomized siblings with congenital dyserythropoietic anemia--type II (CDA-II). In both patients 400 ml of blood were withdrawn every month. During three years 12 200 ml of blood were removed. The serum ferritin levels decreased from 1450,4 microg/L and 1131,7 microg/L to 447 microg/L and 457 microg/l, respectively. The transferrin saturation dropped from 0,99 at the start of the therapy to 0,64 and 0,86, respectively. The values of Hb, Hct, erythrocyte counts and MCV did not change as well as did not change reticulocyte counts, reticulocyte index, and RDW. Both patients tolerated repeated phlebotomies well. The decrease of bilirubin and normal values of haptoglobin might be the concequence of diminished destruction of erythrocytes and their precursors. Our observation confirms that phlebotomies can be used with success in CDA patients with mild anemia as treatment modality of iron overload.  相似文献   
107.
S100A4 (Mts1) belongs to the S100 family of calcium binding proteins, which are involved in diverse biological regulatory activities. An association between S100A4 and tumor progression has been demonstrated in several studies. S100A4 binds to distinct intracellular target proteins and regulates specific functions involved in tumor progression such as cell motility, proliferation and apoptosis as well as remodelling of the extracellular matrix. Once released from the tumor or tumor-activated stromal cells, it may influence certain functions of target cells towards a more aggressive phenotype. Extracellular S100A4 has been demonstrated to contribute to angiogenesis and the increased production of matrix-degrading enzymes by both endothelial and tumor cells. Moreover, S100A4 might be responsible for TCRgammadelta T-cell mediated lysis and negative regulation of matrix mineralization. Increased expression of S100A4 mRNA has recently been found in proliferating rheumatoid arthritis synovial fibroblasts and synovial tissues from rheumatoid arthritis patients. Synovial hyperplasia in rheumatoid arthritis consists of inflammatory cells and activated synovial lining cells which contribute to the progressive destruction of the joints during the disease. Since several phenomena are similar between rheumatoid arthritis and malignant tumors it can be hypothesized that S100A4 contributes to the invasive and tumor-like behavior of rheumatoid arthritis synovium.  相似文献   
108.
109.
It has been shown that home teams supported by their audience win over 50% of the games in sports competitions. Researchers have also been paying increased attention to this topic during the last 10-15 years. Their main goal, in addition to verifying the existence of this phenomenon, was to find explanatory factors which can be associated - at least partly - with the development of home advantage. Our study demonstrates the biological basis of this phenomenon through the connection between the hormone system and territoriality, moreover, it discusses in detail the four possible contributing factors: noise of the supporting audience; familiarity; travel and rules. Latest research has emphasized an evolutionary explanation of home advantage, which, beyond the context of sports competitions, tries to give an answer to the differences found between male and female coping strategies.  相似文献   
110.
SMI-32 antibody recognizes a non-phosphorylated epitope of neurofilament proteins, which are thought to be necessary for the maintenance of large neurons with highly myelinated processes. We investigated the distribution and quantity of SMI-32-immunoreactive(-ir) neurons in individual parts of the rat auditory system. SMI-32-ir neurons were present in all auditory structures; however, in most regions they constituted only a minority of all neurons (10–30%). In the cochlear nuclei, a higher occurrence of SMI-32-ir neurons was found in the ventral cochlear nucleus. Within the superior olivary complex, SMI-32-ir cells were particularly abundant in the medial nucleus of the trapezoid body (MNTB), the only auditory region where SMI-32-ir neurons constituted an absolute majority of all neurons. In the inferior colliculus, a region with the highest total number of neurons among the rat auditory subcortical structures, the percentage of SMI-32-ir cells was, in contrast to the MNTB, very low. In the medial geniculate body, SMI-32-ir neurons were prevalent in the ventral division. At the cortical level, SMI-32-ir neurons were found mainly in layers III, V and VI. Within the auditory cortex, it was possible to distinguish the Te1, Te2 and Te3 areas on the basis of the variable numerical density and volumes of SMI-32-ir neurons, especially when the pyramidal cells of layer V were taken into account. SMI-32-ir neurons apparently form a representative subpopulation of neurons in all parts of the rat central auditory system and may belong to both the inhibitory and excitatory systems, depending on the particular brain region.  相似文献   
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