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Jacobo E Mintzer Larry E Tune Christopher D Breder René Swanink Ronald N Marcus Robert D McQuade Andy Forbes 《The American journal of geriatric psychiatry》2007,15(11):918-931
OBJECTIVE: To assess the efficacy and safety of aripiprazole for psychosis associated with Alzheimer dementia (AD). METHODS: In this double-blind, multicenter study, 487 institutionalized patients with psychosis associated with AD were randomized to placebo or aripiprazole, 2, 5 or 10 mg/day. Primary efficacy assessment was the mean change from baseline to week 10 on the Neuropsychiatric Inventory-Nursing Home (NPI-NH) version Psychosis Subscale score. Secondary measures included NPI-NH Total, Clinical Global Impression-Severity of Illness (CGI-S), Brief Psychiatric Rating Scale (BPRS) Core and Total, and the Cohen-Mansfield Agitation Inventory (CMAI) scores. RESULTS: Aripiprazole 10 mg/day showed significantly greater improvements (mean change [2 x SD]) than placebo on the NPI-NH Psychosis Subscale (-6.87 [8.6] versus -5.13 [10.0]; F = 6.29, df = 1, 422, p = 0.013 by analysis of covariance [ANCOVA]); CGI-S (-0.72 [1.8] versus -0.46 [1.6]; F = 4.68, df = 1, 419, p = 0.031 [ANCOVA]); BPRS Total (-7.12 [18.4] versus -4.17 [21.6]; F = 4.72, df = 1, 399, p = 0.030 [ANCOVA]); BPRS Core (-3.07 [6.9] versus -1.74 [7.8]; F = 7.30, df = 1, 407, p = 0.007 [ANCOVA]); CMAI (-10.96 [22.6] versus -6.64 [28.6]; F = 5.23, df = 1, 410, p = 0.023 [ANCOVA]), and NPI-NH Psychosis response rate (65 versus 50%; chi(2) = 5.52, df = 1, p = 0.019 [CMH]). Aripiprazole 5 mg/day showed significant improvements versus placebo on BPRS and CMAI scores. Aripiprazole 2 mg/day was not efficacious. Cerebrovascular adverse events were reported: aripiprazole 2 mg/day, N = 1; 5 mg/day, N = 2; 10 mg/day, N = 4; placebo, N = 0. No deaths in any group (aripiprazole 2 mg/day, 3%; 5 mg/day, 2%; 10 mg/day, 7%; placebo, 3%) were considered to be treatment-related. CONCLUSION: Aripiprazole 10 mg/day was efficacious and safe for psychosis associated with AD, significantly improving psychotic symptoms, agitation, and clinical global impression. However, clinicians should be aware of the safety considerations of atypical antipsychotic uses in this population. 相似文献
33.
目的:探讨抗人热休克蛋白60或抗分枝杆菌热休克蛋白65抗体是否能够预测因急性心源性胸痛入院的患者一年预后不良。设计:前瞻性观察研究。地点:教学医院。患者:连续588例急诊收治的疑似急性心源性胸痛患者。主要观察指标:测定入院后晨起血样的抗人热休克蛋白60和抗分枝杆菌热休克蛋白65效价。出院后终点为冠心病死亡、非致死性心肌梗死、冠状动脉搭桥术、经皮穿刺腔内冠状动脉成形术、血管造影或因心脏缺血性胸痛加重再次入院。 相似文献
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目的 探讨常年性变应性鼻炎 (PAR)患者细胞免疫功能状态及微波凝固治疗的作用机制。方法 观察组 2 5例PAR患者分别于微波治疗前以及治疗 1个月后应用免疫组化法检测鼻粘膜上皮和外周血CD3、CD4、CD8、CD4/CD8水平。健康对照组 1 5例亦作相应检测。结果 PAR患者治疗前鼻粘膜及外周血CD3、CD4明显高于正常人 ,CD8低于正常人 ,CD4/CD8比值升高 ,与正常人比较差异有显著性 (P <0 .0 5)。微波治疗后CD4明显减少 ,CD8升高 ,CD4/CD8接近于健康对照组。结论 PAR患者存在明显的细胞免疫功能障碍 ;微波局部凝固治疗可改善PAR患者的细胞免疫状况。 相似文献
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观察18例32眼下蹲运动与高眼压的关系,分为下蹲120次,100次及80次三且,每组分别观察10眼、11眼及11眼,结果各组运动后眼压均见下降,平均为1.027±0.486kPa,1.355±0.770kPa及1.325±0.422kPa,运动前后有非常显著性差异,但各组之间差异不显著。同时观察3小时内眼压动态变化,下蹲120次组眼压下降维持时间最长,在运动后3小时与运动前眼压比较及与其余两组第3 相似文献
39.
Steven S Clark Li Zhong Daniele Filiault Sarah Perman Zhibin Ren Michael Gould Xinhai Yang 《Clinical cancer research》2003,9(12):4494-4504
PURPOSE: Perillyl alcohol (POH) displays preventive and therapeutic activity against a wide variety of tumor models, and it has been suggested that this might be associated with the ability of POH to interfere with Ras prenylation. POH also selectively induces G(1) arrest and apoptosis in Bcr/Abl-transformed hematopoietic cells. Because signaling through Ras is necessary for Bcr/Abl transformation, we examined whether POH induces its anti-leukemia effect by inhibiting Ras signaling. EXPERIMENTAL DESIGN: The ability of POH to inhibit posttranslational farnesylation and signaling from Ras as well as signaling through the Raf-Mek-Erk cascade was examined in Bcr/Abl-transformed and mock-transformed cells and related to the anti-leukemia effect of POH. RESULTS: POH does not affect Ras prenylation or Ras activity, but it blocks signaling downstream of Ras by reversing the state of activation of the Erk kinase, Mek. POH affects Mek activity only when it is added to intact cells. Treatment of either cell lysates or of purified Mek with POH has no effect on Mek activity. Inhibition of the Mek-Erk pathway seems to be related to the POH anti-leukemia effect for the following reasons: (a) the concentration of POH needed to block the Erk pathway, as well the kinetics with which POH inhibits this signaling cascade, both correlate with the anti-leukemia effect of POH; (b) both U0126 (a specific Mek inhibitor) and POH induce similar anti-leukemia effects; and (c) mock-transformed hematopoietic cells are simultaneously resistant to POH anti-leukemia effects and inhibition of the Mek-Erk pathway. CONCLUSION: Blocking Mek is sufficient to induce growth arrest and apoptosis in Bcr/Abl-transformed cells; therefore, POH represents a novel small molecule inhibitor of Mek that might be effective for treating Bcr/Abl leukemias. 相似文献
40.
不同类型高危儿早期干预的临床研究 总被引:4,自引:0,他引:4
目的 探索早期干预对窒息、高胆、早产三类高危儿智力发育改善的效果,寻找更合适的早期干预措施。方法 将三类高危儿分为干预组及对照组,同时随机选取正常对照组进行随访。干预组采用鲍秀兰教授“0~3岁”早期干预方案训练,各组均在6个月、1岁时分别采用婴幼儿智能发育量表(CDCC)进行智力发育测评,结果用MDI、PDI表示。结果 (1)6个月龄时MDI各干预组与对照组间有显著性差异,窒息组、早产组与正常组间亦有显著性差异;高胆组与正常组间无差异;PDI窒息组中干预组与对照组之间有显著差异(P<0.01),高胆组、早产组均无差异(P>0.05)。(2)1岁时MDI和PDI结果一致,干预组与对照组间比较窒息组、高胆组有显著差异,早产组无差异;窒息组、高胆组干预组与正常组比较无差异,对照组和早产组与正常组比较均有显著差异(P<0.01)。(3)所有干预组测评分值均高于对照组,6个月与1岁之间比较有显著差异,各观察组间比较有显著性差异(P<0.01)。结论 三类高危儿早期干预效果差异较大,干预组均较对照组分值高,早期干预有改善智力发育的作用;三类高危儿中,窒息组、高胆组效果最好,均达到或超过正常水平。所有未干预组均不及正常水平;早期干预对足月高危儿效果显著,对早产儿欠佳,远期效果尚需进一步随访观察。 相似文献