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71.
High-dose therapy and autologous blood stem cell transplantation in POEMS syndrome 总被引:17,自引:1,他引:17 下载免费PDF全文
We treated 5 patients with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome and multifocal bone lesions or diffuse bone marrow plasmacytic infiltration with high-dose therapy (HDT) and autologous blood stem cell transplantation. In all cases, the treatment produced remission of plasma cell proliferation associated with marked improvement in the patients' performance status, neurologic symptoms, and other manifestations of the syndrome. HDT with stem cell support should be investigated further as a therapeutic option in patients with POEMS syndrome and disseminated plasma cell dyscrasia. 相似文献
72.
Dr. Robert J. Stratta MD Mark S. Shaeffer PharmD Rodney S. Markin MD PhD R. Patrick Wood MD Alan N. Langnas DO Elizabeth C. Reed MD Jeremiah P. Donovan MD Gail L. Woods MD Kathleen A. Bradshaw RN Todd J. Pillen PA Byers W. Shaw Jr. MD 《Digestive diseases and sciences》1992,37(5):673-688
Cytomegalovirus is the single most important pathogen in clinical transplantation. Although much progress has been made in our understanding of the molecular biology and epidemiology of CMV infection and in our ability to diagnosis and treat CMV disease, it remains a major cause of morbidity but is no longer a major cause of mortality after liver transplantation. Risk factors for CMV disease after liver transplantation include donor and recipient serologic status, the use of antilymphocyte therapy, and retransplantation. CMV disease occurs early after transplantation, and the most frequent site of disease is the hepatic allograft. We have treated 79 patients with intravenous ganciclovir, with ultimate control of disease achieved in 69 patients (87.3%). Preliminary results using intravenous immunoglobulin and oral acyclovir for CMV prophylaxis in high-risk patients have been encouraging. In addition to producing clinical syndromes, CMV may have direct immunologic effects and is a marker of the net state of immunosuppression. 相似文献
73.
The vagus nerve,recurrent laryngeal nerve,and external branch of the superior laryngeal nerve have unique latencies allowing for intraoperative documentation of intact neural function during thyroid surgery 下载免费PDF全文
74.
Effects of monoclonal antibody therapy in patients with chronic lymphocytic leukemia 总被引:4,自引:0,他引:4
Foon KA; Schroff RW; Bunn PA; Mayer D; Abrams PG; Fer M; Ochs J; Bottino GC; Sherwin SA; Carlo DJ 《Blood》1984,64(5):1085-1093
A phase I clinical trial was initiated to treat patients with stage IV B-derived chronic lymphocytic leukemia (CLL) with the IgG2a murine monoclonal antibody T101. This antibody binds to a 65,000-mol wt (T65) antigen found on normal T lymphocytes, malignant T lymphocytes, and B- derived CLL cells. All of the patients had a histologically confirmed diagnosis of advanced B-derived CLL and were refractory to standard therapy, and more than 50% of their leukemia cells reacted with the T101 antibody in vitro. The patients received T101 antibody two times per week, over two to 50 hours by intravenous administration in 100 mL of normal saline containing 5% human albumin. Twelve patients were treated with a fixed dosage of 1, 10, 50, or 100 mg, and one patient was treated with 140 mg of antibody. It was demonstrated that patients given two-hour infusions of 50 mg developed pulmonary toxicity, with shortness of breath and chest tightness. This toxicity was eliminated when infusions of 50 or 100 mg of T101 were prolonged to 50 hours. All dose levels caused a rapid but transient decrease in circulating leukemia cell counts. In vivo binding to circulating and bone marrow leukemia cells was demonstrated at all dose levels with increased binding at higher dosages. Antimurine antibody responses were not demonstrated in any patients at any time during treatment. Circulating free murine antibody was demonstrated in the serum of only the two patients treated with 100 mg of antibody as a 50-hour infusion and the patient treated with 140 mg of antibody over 30 hours. Antigenic modulation was demonstrated in patients treated at all dose levels but was particularly apparent in patients treated with prolonged infusions of 50 and 100 mg of antibody. We were also able to demonstrate antigenic modulation in lymph node cells, which strongly suggests in vivo labeling of these cells. Overall, T101 antibody alone appears to have a very limited therapeutic value for patients with CLL. The observations of in vivo labeling of tumor cells, antigenic modulation, antibody pharmacokinetics, toxicity, and antimurine antibody formation may be used in the future for more effective therapy when drugs or toxins are conjugated to the antibody. 相似文献
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Oscar Bernal‐Pacheco MD Genko Oyama MD PhD Kelly D. Foote MD Yunfeng E. Dai MS Samuel S. Wu PhD Charles E. Jacobson IV BS Natlada Limotai MD Pamela R. Zeilman ARNP Janet Romrell PA Nelson Hwynn DO Ramon L. Rodriguez MD Irene A. Malaty MD Michael S. Okun MD 《Neuromodulation》2013,16(1):35-40
Objectives: To screen for potentially underreported behavioral changes in patients with idiopathic Parkinson's disease (PD) pre‐ and post‐deep brain stimulation (DBS), a retrospective data base review was performed. Methods: In total, 113 patients who underwent unilateral or bilateral DBS at the University of Florida in either subthalamic nucleus or globus pallidus internus for PD were screened for behavioral issues by asking about the presence or absence of seven neuropsychiatric symptoms (panic, fear, paranoia, anger, suicidal flashes, crying, and laughing). Results: There was a high prevalence of fear (16.3%), panic (14.0%), and anger (11.6%) at baseline in this cohort. In the first six months following DBS implantation, anger (32.6%), fear (26.7%), and uncontrollable crying (26.7%) were the most frequent symptoms reported. Those symptoms also were present following six months of DBS surgery (30.2%, 29.1%, and 19.8%, respectively). New uncontrollable crying occurred more in the acute postoperative stage (less than or equal to six months) (p= 0.033), while new anger occurred more in the chronic postoperative stage (greater than six months) (p= 0.017). The frequency of uncontrollable laughing significantly increased with bilateral DBS (p= 0.033). Conclusions: Many of the neuropsychiatric issues were identified at preoperative baseline and their overall occurrence was more than expected. There was a potential for worsening of these issues post‐DBS. There were subtle differences in time course, and in unilateral vs. bilateral implantations. Clinicians should be aware of these potential behavioral issues that may emerge following DBS therapy, and should consider including screening questions in preoperative and postoperative interviews. Standardized scales may miss the presence or absence of these clinically relevant issues. 相似文献
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80.
Cognitive function and patient‐reported memory problems after radiotherapy for cancers at the skull base: A cross‐sectional survivorship study using the Telephone Interview for Cognitive Status and the MD Anderson Symptom Inventory‐Head and Neck Module 下载免费PDF全文
Chase C. Hansen MD Joshua B. Smith BS Abdallah S. R. Mohamed MD MSc Collin F. Mulcahy MD Jeffrey S. Wefel PhD Katherine A. Hutcheson PhD Kelsey Chrane PA Jack Phan MD PhD Steven J. Frank MD Adam S. Garden MD Blaine D. Smith BS Hillary Eichelberger BA Carthal Anderson BS Colton McCoy BS Marina Horiates BS Conner Patrick BS Sarah Floris BS Chloe French BS Beth M. Beadle MD PhD William H. Morrison MD Shirley Y. Su MD Carol M. Lewis MD Michael E. Kupferman MD Jason M. Johnson MD Heath D. Skinner MD PhD Stephen Y. Lai MD PhD Ehab Y. Hanna MD David I. Rosenthal MD Clifton D. Fuller MD PhD G. Brandon Gunn MD The MD Anderson Head Neck Cancer Symptom Working Group 《Head & neck》2017,39(10):2048-2056