全文获取类型
收费全文 | 6466篇 |
免费 | 318篇 |
国内免费 | 65篇 |
专业分类
耳鼻咽喉 | 47篇 |
儿科学 | 197篇 |
妇产科学 | 143篇 |
基础医学 | 649篇 |
口腔科学 | 146篇 |
临床医学 | 444篇 |
内科学 | 1698篇 |
皮肤病学 | 127篇 |
神经病学 | 384篇 |
特种医学 | 382篇 |
外科学 | 1175篇 |
综合类 | 18篇 |
预防医学 | 219篇 |
眼科学 | 53篇 |
药学 | 297篇 |
中国医学 | 8篇 |
肿瘤学 | 862篇 |
出版年
2024年 | 10篇 |
2023年 | 90篇 |
2022年 | 128篇 |
2021年 | 253篇 |
2020年 | 154篇 |
2019年 | 218篇 |
2018年 | 272篇 |
2017年 | 169篇 |
2016年 | 195篇 |
2015年 | 201篇 |
2014年 | 308篇 |
2013年 | 358篇 |
2012年 | 504篇 |
2011年 | 517篇 |
2010年 | 283篇 |
2009年 | 251篇 |
2008年 | 404篇 |
2007年 | 384篇 |
2006年 | 342篇 |
2005年 | 403篇 |
2004年 | 338篇 |
2003年 | 308篇 |
2002年 | 259篇 |
2001年 | 35篇 |
2000年 | 31篇 |
1999年 | 39篇 |
1998年 | 64篇 |
1997年 | 47篇 |
1996年 | 39篇 |
1995年 | 33篇 |
1994年 | 27篇 |
1993年 | 23篇 |
1992年 | 15篇 |
1991年 | 12篇 |
1990年 | 22篇 |
1989年 | 21篇 |
1988年 | 18篇 |
1987年 | 8篇 |
1986年 | 13篇 |
1985年 | 5篇 |
1984年 | 9篇 |
1983年 | 4篇 |
1982年 | 6篇 |
1981年 | 4篇 |
1980年 | 6篇 |
1977年 | 3篇 |
1975年 | 2篇 |
1971年 | 2篇 |
1965年 | 2篇 |
1904年 | 2篇 |
排序方式: 共有6849条查询结果,搜索用时 0 毫秒
51.
V Vagnoni R Schiavina D Romagnoli M Borghesi G Passaretti H Dababneh S Concetti G Martorana 《Urologia》2012,(0):0
Background: Routine pathological examination can miss micro-metastatic tumor foci in the lymph nodes (LN) of patients with prostate cancer (PCa) that undergo radical prostatectomy and pelvic lymph node dissection (PLND). The aim of the present prospective study was to evaluate the impact of micrometastases assessed by serial section (SS), immunohistochemistry (IHC), and Real-time Polymerase Chain Reaction (RT-PCR) in patients undergoing radical prostatectomy with extended PLND. Materials and methods: 32 consecutive patients who underwent radical prostatectomy with extended PLND (obturator, internal/external and distal 2cm common iliac lymph-nodes (LN)) for intermediate (clinical T1c-T2 and PSA:10-20 ng/mL and clinical Gleason Score = 7) or high (clinical stage T3 or PSA>20 or clinical Gleason Score = 8-10) PCa were enrolled. The nodes were processed by the one uropathologist, both according to the routine pathological examination (analysis of the central section for 4 mm nodes or every 2 mm for LN>4 mm), which served as comparative method, both according to SS, IHC with antibodies against PSA and broad-spectrum Cytokeratins (BSCK), and quantitative RT-PCR targeting PSA, PSMA (PS Membrane Antigen), and Glucuronidase-S-Beta (GUSB) mRNA, that are over-expressed in prostatic cancer cells. Results: A total of 628 LN were analyzed, with a mean number of LN removed of 19.6 (SD = 7.2). Applying the routine pathological examination, 10 (31.2%) patients and 23 (3.9%) LN resulted positive for nodal involvement, with mean positive LN of 2.2 (SD = 1.4). After applying the SS and the molecular method of analysis (IHC and RT-PCR), micrometastases were found in 7 LN (SS showed micrometastases in 3 of them, IHC in 6 of them and RT-PCR in 7 of them); a total of 3 (9.3%) node-negative patients showed micrometastases at routine pathological examination (in 2 patients with RT-PCR and in 1 with IHC). Conclusions: The significance of micrometastases in PCa and the potential therapeutic role of PLND is not yet clarified, but the molecular analysis of the LN can detect a significant percentage of patients who harbor micro-metastatic PCa missed at routine pathological examination, and can enhance the accuracy of lymphadenectomy as a staging method. 相似文献
52.
Riccardo Manca Micaela Mitolo Maria Rosaria Stabile Francesca Bevilacqua Basil Sharrack 《Postgraduate medicine》2013,125(7):523-532
Objectives: Many people affected by multiple sclerosis (MS) experience cognitive impairment, especially decreases in information processing speed (PS). Neural disconnection is thought to represent the neural marker of this symptom, although the role played by alterations of specific functional brain networks still remains unclear. The aim is to investigate and compare patterns of association between PS-demanding cognitive performance and functional connectivity across two MS phenotypes.Methods: Forty patients with relapsing-remitting MS (RRMS) and 25 with secondary progressive MS (SPMS) had neuropsychological and MRI assessments. Multiple regression models were used to investigate the relationship between performance on tests of visuomotor and verbal PS, and on the verbal fluency tests, and functional connectivity of four cognitive networks, i.e. left and right frontoparietal, salience and default-mode, and two control networks, i.e. visual and sensorimotor.Results: Patients with SPMS were older and had longer disease history than patients with RRMS and presented with worse overall clinical conditions: higher disease severity, total lesion volume, and cognitive impairment rates. However, in both patient samples, cognitive performance across tests was negatively correlated with functional connectivity of the salience and default-mode networks, and positively with connectivity of the left frontoparietal network. Only the visuomotor PS scores of the RRMS group were also associated with connectivity of the sensorimotor network.Conclusions: PS-demanding cognitive performance in patients with MS appears mainly associated with strength of functional connectivity of frontal networks involved in the evaluation and manipulation of information, as well as the default mode network. These results are in line with the hypothesis that multiple neural networks are needed to support normal cognitive performance across MS phenotypes. However, different PS measures showed partially different patterns of association with functional connectivity. Therefore, further investigations are needed to clarify the contribution of inter-network communication to specific cognitive deficits due to MS. 相似文献
53.
Salvatore Giaquinto Ida Ferrara Riccardo Muschera Gilda Pagano Giuseppe Nolfe 《Disability and rehabilitation》2013,35(5):204-208
Purpose : This study evaluates the negative effects of atrial fibrillation (AF) on after stroke recovery and its relationship with age and other concomitant diseases. Method : One hundred and ninety-nine consecutive inpatients, after their first stroke, were enrolled and entered a rehabilitation program lasting 60 days. The mean interval since the stroke was 19 days. The disability, both at admission and at discharge, was assessed by Functional Independence Measure (FIM). Atrial fibrillation was diagnosed at admission on the basis of electrocardiographic recordings. Gender, age, blood pressure and blood sugar level were also taken into account. Results : Stroke patients suffering from AF, when compared to those lacking AF, have higher disability at admission as well as at discharge and had a lesser gain in functional recovery. No statistical difference of the AF occurrence was found between male and female patients. The negative correlation between age and functional gain was found only in AF patients. There was also a significant association between AF and hypertension, but not between AF and diabetes. At the beginning and at the end of the study, the median FIM scores of all the patients with AF were quite similar irrespective of manifesting hypertension, diabetes or neither of these two. Conclusions : The presence of AF has a negative prognostic value on post stroke outcome, particularly in the elderly patients. The pattern of recovery of stroke subjects having AF is not influenced by concomitant diseases like hypertension or diabetes. 相似文献
54.
Gaidano G Pasqualucci L Capello D Berra E Deambrogi C Rossi D Maria Larocca L Gloghini A Carbone A Dalla-Favera R 《Blood》2003,102(5):1833-1841
The pathogenesis of AIDS-related non-Hodgkin lymphomas (AIDS-NHLs) is associated with chromosomal translocations that deregulate the expression of various oncogenes. Recently, a novel mechanism of genetic lesion, termed aberrant hypermutation, has been identified in diffuse large B-cell lymphoma (DLBCL) of immunocompetent hosts. In these tumors, the somatic hypermutation (SHM) process that normally targets immunoglobulin V (IgV) genes in B cells appears to misfire and causes mutations in the 5' sequences of multiple proto-oncogenes, including PIM-1, PAX-5, RhoH/TTF, and c-MYC. To investigate whether aberrant hypermutation occurs also in AIDS-NHL, we studied the mutation profile of these 4 genes in various histologic subtypes. Mutations in 1 gene or more were detected in 19 of 39 (48.7%) AIDS-NHL cases (10 of 18 AIDS-diffuse large B-cell lymphoma; 4 of 11 AIDS-Burkitt lymphoma; 4 of 6 AIDS-primary effusion lymphoma; 1 of 4 AIDS-primary central nervous system lymphoma), with 9 of 39 (23.1%) cases carrying mutations in 2 or more genes. Overall, PIM-1 was mutated in 5 of 39 (12.8%), PAX-5 in 8 of 39 (20.5%), RhoH/TTF in 9 of 39 (23.1%), and c-MYC in 7 of 27 (25.9%) AIDS-NHL cases. Mutations were represented mainly by single base pair substitutions (n = 63) with rare deletions/insertions (n = 5) and displayed features typical of the IgV-associated SHM process. In addition, a number of mutations in PIM-1 and c-MYC were found to affect coding exons, leading to amino acid substitutions with likely functional consequences. Analysis of intraclonal heterogeneity documented that the aberrant hypermutation activity may be ongoing in at least some cases. These data indicate that aberrant hypermutation is associated with various subtypes of AIDS-NHL and may represent a major contributor to their pathogenesis. 相似文献
55.
Francesco Scolari Elisa Delbarba Domenico Santoro Loreto Gesualdo Antonello Pani Nadia Dallera Laila-Yasmin Mani Marisa Santostefano Sandro Feriozzi Marco Quaglia Giuliano Boscutti Angelo Ferrantelli Carmelita Marcantoni Patrizia Passerini Riccardo Magistroni Federico Alberici Gian Marco Ghiggeri Claudio Ponticelli Pietro Ravani for the RI-CYCLO Investigators 《Journal of the American Society of Nephrology : JASN》2021,32(4):972
56.
Michael J. Klingler Stephen K. Babitz Alexander Kutikov Riccardo Campi Georgios Hatzichristodoulou Francesco Sanguedolce Sabine Brookman-May Bulent Akdogan Umberto Capitanio Marco Roscigno Alessandro Volpe Martin Marszalek Robert G. Uzzo Alessandro Antonelli Johan Langenhuijsen Marco Carini Andrea Minervini Brian R. Lane 《Urologic oncology》2019,37(1):33-39
Purpose
Partial nephrectomy (PN) is standard for small renal masses, improving renal function by preserving renal parenchyma compared with radical nephrectomy. Recent work demonstrated that postoperative surgeon assessment of volume preservation (SAVP) and 3D imaging measurements agree and correlate with postoperative function. We hypothesize preoperative assessment of volume preservation (PAVP) with PN based on preoperative imaging will reliably indicate postoperative renal function.Materials and Methods
Data were collected from 336 patients undergoing PN for suspected renal cancer by 40 surgeons at 12 centers in Europe and the United States within the Surface-Intermediate-Base International Consortium. Surgeons recorded PAVP and SAVP for individual patients; pre- and postoperative glomerular filtration rate (GFR) was estimated by Chronic Kidney Disease Epidemiology Collaboration equations. Correlations between PAVP, SAVP, and postoperative GFR were assessed with linear regression models. Bland–Altman analysis was used to assess agreement between PAVP and SAVP with a significant cutoff of 5%.Results
Median PAVP was 90% (interquartile range [IQR] 85%–100%) and SAVP was 90% (IQR: 80%–94%). PAVP and SAVP were moderately correlated (R2?=?0.67, P < 0.0001) and deemed “interchangeable” by Bland–Altman analysis at a 5% acceptable rate of difference (95% CI: ?5.4, ?3.1). Median postoperative GFR was 77.3 (IQR: 56.2, 92.0). Both PAVP (R2?=?0.82, P < 0.0001) and SAVP (R2?=?0.83, P < 0.0001) were correlated with postoperative GFR. Multivariable models utilizing volume-adjusted GFR based on PAVP or SAVP significantly and similarly predicted postoperative GFR (R2?=?0.72 for each).Conclusion
Renal function is closely linked to the amount of parenchymal volume preservation, whether estimated prior to surgery (PAVP) or afterward (SAVP). PAVP provides reasonably accurate information for decision-making in patients considering PN. 相似文献57.
Federico Cagnazzo Pierre-Henri Lefevre Daniel Mantilla Aymeric Rouchaud Riccardo Morganti Paolo Perrini Davide Di Carlo Cyril Dargazanli Gregory Gascou Carlos Riquelme Alain Bonafe Vincent Costalat 《Journal of neuroradiology. Journal de neuroradiologie》2019,46(1):9-14
Background and purpose
Placement of flow-diverters across the ostia of major ICA branches carries a risk of arterial occlusion. We determined the rate of occlusion of the supraclinoid ICA branches and the related symptoms, following coverage with flow-diverters.Materials and methods
A systematic search was performed in PubMed, MEDLINE, and EMBASE. We selected studies reporting treatments with flow-diverters in which the device was placed across the ostium of the OphtA, PcomA, or AchorA. Random-effects meta-analysis was used to pool the following outcomes: rate of arterial occlusion, diminished flow, incidence of related symptoms, factors associated with arterial occlusion.Result
Twenty-one studies evaluating 1152 supraclinoid ICA branches were included in the meta-analysis. The incidence of OphtA occlusion and associated symptoms was 5.9% (95 CI%?=?3.1–8.6%) (incidence rate?=?6% per patient-year), and 0.8% (95% CI?=?0.1–1.4%) (incidence rate?=?0.8% per patient-year), respectively. Although asymptomatic in all cases, PcomA showed a higher occlusion rate (20.7%, 95% CI?=?8.9–32.4%) (incidence rate?=?19.5% per patient-year). AchorA was occluded in 1% (95% CI?=?0.3–2.4%) of cases, with approximately 1% (95% CI?=?0.4–2.3%) of transient neurological symptoms (incidence rate?=?0.96% per patient-year). There was a trend toward higher odds of arterial patency among arteries arising from the aneurysm (OR?=?2.94, P?=?0.06). Demographic factors and multiple stents were not associated with higher risk of arterial impairment. Adequate collateral circulation was reported in 94.5% of patients with arterial occlusion.Conclusions
During aneurysm treatment, the ostium of the supraclinoid ICA branches can be covered with flow-diverter devices with low rates of neurological symptoms related to arterial occlusion. 相似文献58.
Andrei Fodor Sara Broggi Elena Incerti Italo Dell’Oca Claudio Fiorino Ana M. Samanes Gajate Marcella Pasetti Mauro G. Cattaneo Paolo Passoni Luigi Gianolli Riccardo Calandrino Maria Picchio Nadia Di Muzio 《Clinical lung cancer》2019,20(1):e29-e38
Introduction
The objective of this study was to present the outcomes of moderately hypofractionated helical intensity-modulated radiation therapy (HT) with/without simultaneous integrated boost (SIB) on fluorodeoxyglucose-positron emission tomography (FDG-PET) positive areas (gross tumor volume [GTV]-PET) for patients with progressive malignant pleural mesothelioma (MPM) after previous treatments.Methods and Materials
From May 2006 to April 2014, 51 patients with a median age of 68.8 years (range, 38.6-82 years) were treated. There were 41 men and 10 women; 43 epithelioid MPM and 8 sarcomatoid, involving the left pleura in 25 patients and the right pleura in 26 patients. The initial stage was: I, 11 patients; II, 14 patients; III, 17 patients; and IV, 9 patients. Chemotherapy was prescribed for 46 patients, for 6 cycles (range, 0-18 cycles). Eighteen patients had pleurectomy/decortication, and 33 had talc pleurodesis. FDG-PET was used for target identification. A median dose of 56 Gy/25 fractions was prescribed to the involved pleura, and SIB to 62.5 Gy to GTV-PET was added in 38 patients.Results
The median survival from diagnosis was 25.8 months (range, 8.4-99.0 months). One patient, treated with SIB, was alive at the October 2017 follow-up. Two cases of grade 5 radiation pneumonitis were registered. A GTV-PET ≤ 205 cc was predictive of late ≥ grade 2 lung toxicity, but also of better survival in stage III and IV disease: 5.9 versus 11.7 months (P = .04). A GTV-PET ≥ 473 cc was predictive of early death (P = .001).Conclusions
Moderately hypofractionated, FDG-PET guided salvage HT in patients with progressive MPM after previous treatments showed acceptable toxicity and outcome results similar to adjuvant radiotherapy after pleurectomy/decortication, suggesting that the delay of radiotherapy is not detrimental to survival, and has the associated benefit of postponing inherent toxicity. 相似文献59.
60.