全文获取类型
收费全文 | 3941篇 |
免费 | 177篇 |
国内免费 | 33篇 |
专业分类
耳鼻咽喉 | 47篇 |
儿科学 | 26篇 |
妇产科学 | 60篇 |
基础医学 | 457篇 |
口腔科学 | 95篇 |
临床医学 | 264篇 |
内科学 | 994篇 |
皮肤病学 | 88篇 |
神经病学 | 235篇 |
特种医学 | 223篇 |
外科学 | 703篇 |
综合类 | 11篇 |
预防医学 | 81篇 |
眼科学 | 28篇 |
药学 | 216篇 |
中国医学 | 6篇 |
肿瘤学 | 617篇 |
出版年
2024年 | 5篇 |
2023年 | 48篇 |
2022年 | 72篇 |
2021年 | 156篇 |
2020年 | 95篇 |
2019年 | 112篇 |
2018年 | 126篇 |
2017年 | 94篇 |
2016年 | 99篇 |
2015年 | 117篇 |
2014年 | 149篇 |
2013年 | 172篇 |
2012年 | 282篇 |
2011年 | 282篇 |
2010年 | 176篇 |
2009年 | 151篇 |
2008年 | 260篇 |
2007年 | 274篇 |
2006年 | 249篇 |
2005年 | 254篇 |
2004年 | 217篇 |
2003年 | 189篇 |
2002年 | 202篇 |
2001年 | 33篇 |
2000年 | 24篇 |
1999年 | 28篇 |
1998年 | 28篇 |
1997年 | 36篇 |
1996年 | 33篇 |
1995年 | 38篇 |
1994年 | 26篇 |
1993年 | 14篇 |
1992年 | 14篇 |
1991年 | 13篇 |
1990年 | 10篇 |
1989年 | 12篇 |
1988年 | 8篇 |
1987年 | 9篇 |
1986年 | 11篇 |
1985年 | 2篇 |
1984年 | 7篇 |
1983年 | 2篇 |
1982年 | 3篇 |
1981年 | 5篇 |
1980年 | 2篇 |
1979年 | 2篇 |
1978年 | 3篇 |
1968年 | 1篇 |
1941年 | 1篇 |
1933年 | 2篇 |
排序方式: 共有4151条查询结果,搜索用时 15 毫秒
41.
Kazuhiro Kitajima Shingo Yamamoto Yusuke Kawanaka Hisashi Komoto Kimihiro Shimatani Takeshi Hanasaki Motohiro Taguchi Seiji Nagasawa Yusuke Yamada Akihiro Kanematsu Koichiro Yamakado 《Medicine》2021,100(23)
This study aimed to evaluate the clinical use of choline-PET/CT for discriminating viable progressive osteoblastic bone metastasis from benign osteoblastic change induced by the treatment effect and evaluating the response of bone metastasis to treatment in metastatic castration-resistant prostate cancer (mCRPC) patients. Thirty patients with mCRPC underwent a total of 56 11C-choline-PET/CT scans for restaging, because 4 patients received 1 scan and 26 had 2 scans. Using 2 (pre- and post-treatment) 11C-choline-PET/CT examinations per patient, treatment response was assessed according to European Organization for Research and Treatment of Cancer (EORTC) criteria in 20 situations, in which only bony metastases were observed on 11C-choline-PET/CT scans. Viable bone metastases and osteoblastic change induced by the treatment effect were identified in 53 (94.6%) and 29 (51.8%) of 56 11C-choline-PET/CT scans, respectively. In 27 cases (48.2%), 11C-choline-PET/CT scans could discriminate the 2 entities. The mean SUVmax of the metastatic bony lesions was 5.82 ± 3.21, 5.95 ± 3.96, 6.73 ± 5.04, and 7.91 ± 3.25 for the osteoblastic, osteolytic, mixed, and invisible types, respectively. Of the 20 situations analyzed, CMR, PMR, SMD, and PMD, as determined by the EORTC, were seen in 1, 2, 3, and 14 cases, respectively. Of the 13 patients with increasing PSA trend, all 13 showed PMD. Of the 2 patients with PSA response of <50%, both 2 showed SMD. Of the 5 patients with PSA response of ≥50%, 1 showed CMR, 2 showed PMR, 1 showed SMD, and 1 showed PMD. Choline-PET/CT is very useful to discriminate viable progressive osteoblastic bone metastasis from osteoblastic change, and assess treatment response of bone metastases in mCRPC. 相似文献
42.
Indicators for Surgical Resection and Intraoperative Radiation Therapy for Pelvic Recurrence of Colorectal Cancer 总被引:4,自引:0,他引:4
Hashiguchi Y Sekine T Kato S Sakamoto H Nishimura Y Kazumoto T Sakura M Tanaka Y 《Diseases of the colon and rectum》2003,46(1):31-39
PURPOSE: We retrospectively analyzed prognostic factors for surgical resection and intraoperative radiation therapy to identify indicators for this treatment strategy.
METHODS: Thirty-nine consecutive patients with locally recurrent colorectal cancer who underwent surgical resection with intraoperative radiation therapy from January 1, 1987, to June 30, 1999, were analyzed. The mean electron energy was 10.5 MeV and the mean intraoperative radiation dose was 22.6 Gy. Kaplan-Meier survival estimates were obtained for the 37 patients who recovered postoperatively. Prognostic factors were analyzed univariately by log-rank test and multivariately by Coxs proportional hazards model.
RESULTS: Three-year cumulative survival was 44 percent (standard error = 11) for 26 patients free of unresectable distant metastasis who underwent surgical resection and intraoperative radiation therapy for pelvic recurrence of colorectal cancer, but none of the 11 patients with unresectable distant metastasis survived 3 years. Preoperative prognostic factors which were significant on univariate and multivariate analysis were unresectable distant metastasis (P = 0.001) and elevated preoperative serum CA 19–9 (P = 0.02). Patients with synchronous resection of local recurrence and distant metastasis had a significant survival advantage over those without resection of metastases (P = 0.02). Univariate analysis in a subgroup of 26 patients without unresectable distant metastasis revealed pain (P = 0.0003) to be a useful preoperative prognostic indicator, whereas tumor fixation (P = 0.01) and amount of residual tumor after surgical resection (P = 0.01) were significant intraoperative and postoperative factors, respectively. Fluorouracil-based postoperative systemic chemotherapy produced a significant survival benefit (P = 0.04).
CONCLUSIONS: Patients with unresectable distant metastasis are not suitable candidates for surgical resection and intraoperative radiation therapy, whereas those with resectable metastasis are potential candidates. Intraoperative radiation therapy may be less useful for patients with pain, elevated preoperative CA19–9, fixed tumors, or gross residual tumor after surgical resection. Multimodal treatment strategies combining preoperative and/or postoperative external beam radiation therapy and intraoperative radiation therapy with fluorouracil-based systemic chemotherapy are recommended for patients with these indicators. 相似文献
43.
Kazumi Hayashi Eijiro Nagasaki Koji Nakada Miho Tamura Yasuhiro Arakawa Tadashi Uwagawa Shingo Yano 《Journal of infection and chemotherapy》2018,24(4):298-301
Although, gastric cancer is one of the most common cancers worldwide, alpha-fetoprotein (AFP) producing human epidermal growth factor receptor 2 (HER2) positive gastric cancers are rare. AFP producing gastric cancer has a poor prognosis and an appropriate treatment option has not been established to date. A 75-year-old woman with AFP- producing gastric cancer was treated with S-1, an oral fluoropyrimidine derivative, chemotherapy after distal gastrectomy. Recurrence of gastric cancer was observed after 18 months and immunohistochemistry analysis showed AFP and HER2 positive gastric cancer. The patient received combination therapy containing capecitabine, cisplatin, and trastuzumab. Computed tomography scans showed regression of the lymph node metastasis. The patient's quality of life substantially improved after the treatment. Thus, the present case suggests that AFP and HER2 positive gastric cancer can be effectively treated with, capecitabine, cisplatin, and trastuzumab combination therapy. 相似文献
44.
Nobuyasu Hirai Kei Kasahara Hiroyuki Fujikura Shingo Yoshihara Taku Ogawa Yoshihiko Ogawa Naokuni Hishiya Yuki Suzuki Ryuichi Nakano Hisakazu Yano Masahide Yoshikawa Keiichi Mikasa 《Journal of infection and chemotherapy》2018,24(7):570-572
Mycotic aneurysm is a rare but life-threatening disease that warrants an integrated therapeutic approach involving surgical intervention and prolonged antibiotic use. However, the causative organisms are often unidentified because antibiotics started empirically render blood and tissue cultures negative. Molecular diagnosis has been reported to be useful in such culture-negative cases. We report a case of a culture-negative mycotic aortic aneurysm due to Haemophilus influenzae, diagnosed by direct 16S rRNA polymerase chain reaction (PCR) and sequencing of the resected aneurysm tissue. PCR for serotype revealed type b, and PCR and sequencing of the ftsI gene revealed alterations in penicillin-binding protein 3, suggesting resistance to ampicillin. Multilocus sequence typing demonstrated that the isolate belonged to sequence type 54. 相似文献
45.
Mami Uchida Hitoshi Kawazoe Shingo Takatori Hiroyuki Namba Ryuji Uozumi Akihiro Tanaka Hiromu Kawasaki Hiroaki Araki 《Clinical therapeutics》2018,40(7):1214-1222.e1
Purpose
Oxaliplatin-induced peripheral neuropathy has remained an unresolved issue in clinical practice. Our previous study hypothesized that inhibition of the renin-angiotensin system (RAS) may produce a preventive effect on oxaliplatin-induced neuropathy. The aim of this study was to clarify whether RAS inhibitors prevent oxaliplatin-induced peripheral neuropathy.Methods
This study retrospectively analyzed data from cancer patients who had received chemotherapy including oxaliplatin and were treated with or without RAS inhibitors. This retrospective observational study was conducted at Ehime University Hospital using electronic medical records from May 2009 to December 2016. The primary end point was the incidence of severe peripheral neuropathy during or after oxaliplatin treatment, according to the Common Terminology Criteria for Adverse Events, version 4.0. A multivariate Cox proportional hazards model analysis was used to identify risk factors.Findings
A total of 150 patients were included in the study. The estimated incidence of peripheral neuropathy was 36.9% and 91.7% in the RAS inhibitor group and the non–RAS inhibitor group, respectively. The multivariate analysis using a Cox proportional hazards model showed that the RAS inhibitor group was slightly associated with a decreased risk of neurotoxicity (adjusted hazard ratio, 0.42 [95% CI, 0.18–0.99]; P?=?0.048).Implications
The present findings suggest that RAS inhibitors have the ability to prevent oxaliplatin-induced peripheral neuropathy. 相似文献46.
Masami Shibukawa Masaru Yanagisawa Ryota Morinaga Tomomi Shimasaki Shingo Saito Shao-ting Wang Yu-qi Feng 《RSC advances》2018,8(47):26849
The effects of temperature and background counterions on ion-exchange selectivity for alkali metal ions and tetraalkylammonium ions on strongly acidic cation-exchange resins have been investigated using superheated water ion-exchange chromatography (SW-IEC). We have found out that alkali metal ions show reversal in the order of the distribution coefficient (KD), from Li+ < Na+ < K+ < Rb+ in water at ordinary temperature to Rb+ < K+ < Na+ < Li+ in superheated water, when a relatively large cation such as cesium ion is used as the background counterion. The effect of counterion on the ion-exchange selectivity is enhanced with the ion-exchange resins of higher ion-exchange capacity and cross-linking degree. Tetraalkylammonium ions chosen as model ions for poorly hydrated ions also exhibit reversal in the order of KD at around 430 K in superheated water. However, the effect of the nature of alkali metal counterions on the change in KD values of tetraalkylammonium ions is rather small compared with the effect on the KD of alkali metal ions. These results are attributed to the change in local hydration structures of the ions in the ion-exchange resin due to dehydration of alkali metal ions enhanced by interionic contacts of the analyte ion with the coexisting counterion and lower hydration energy of the ions at elevated temperatures. Although it has been considered that temperature is not effective at changing the ion-exchange separation selectivity, significant selectivity changes can be achieved by SW-IEC.Metal ions in cation-exchange resins are dehydrated by interionic contacts with a co-existing counterion at elevated temperatures, which causes a drastic change in separation selectivity. 相似文献
47.
Shingo Nasu Kunimitsu Kawahara Yuki Han Norio Okamoto Yoshitaka Tamura Hidekazu Suzuki Takayuki Shiroyama Yumiko Samejima Tomohiro Kanai Yoshimi Noda Ayako Tanaka Naoko Morishita Kayo Ueda Shoji Hashimoto Tomonori Hirashima Takayuki Nagai 《Internal medicine (Tokyo, Japan)》2021,60(3):445
Miliary tuberculosis is a potentially lethal type of tuberculosis that results from the hematogenous dissemination of Mycobacterium tuberculosis bacilli. We herein describe the case of a 34-year-old man that presented with a one-month history of cough and fever, while his sputum smear results were negative. Chest computed tomography revealed bilateral centrilobular ground-glass opacification (GGO), suggestive of hypersensitivity pneumonitis; thus, bronchoscopy was performed. Cryobiopsy specimens revealed necrotic granulomas. A re-examination of sputum after bronchoscopy identified Mycobacterium tuberculosis, and miliary tuberculosis was diagnosed. A cryobiopsy might be useful for diagnosing miliary tuberculosis pathologically, particularly when miliary nodules may be masked by GGO. 相似文献
48.
Atsuko Furukawa Yukio Abe Atsushi Morizane Tsuyoshi Miyaji Shingo Hosogi Hiroshi Ito 《Journal of cardiology》2021,77(6):613-619
BackgroundNo established methodology exists for diagnosis of aortic stenosis (AS) using focused cardiac ultrasound (FOCUS). We evaluated the diagnostic accuracy of our developed visual AS score for screening AS in an emergency department.MethodsSeventy-two emergency outpatients with suspected cardiovascular disease were studied. Emergency physicians assessed the visual AS score in addition to conducting the standard FOCUS, and then the aortic valve area index (AVAI) was measured by expert sonographers in the echocardiography laboratory. AVAI values >0.85 cm2/m2, 0.6–0.85 cm2/m2, and <0.6 cm2/m2 were defined as no or mild AS, moderate AS, and severe AS, respectively.ResultsSeventeen (24%) patients had moderate or severe AS. Visual AS scores assessed by emergency physicians and by expert sonographers showed excellent agreement (κ = 0.93), and a strong association was noted between the visual AS score assessed by emergency physicians and the AVAI assessed by expert sonographers (R = –0.71, p < 0.0001). A visual AS score ≥3 assessed by emergency physicians had a sensitivity of 82%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 95% for diagnosing moderate or severe AS. The prevalence of new-onset AS-related events during hospitalization was higher in patients with visual AS score ≥3 assessed by emergency physicians than in the remaining patients [7 (50%) vs. 2 (3%), p < 0.0001].ConclusionThe visual AS score is a useful AS screening tool for emergency physicians who are not expert cardiologists. 相似文献
49.
Shinzaki Shinichiro Matsuoka Katsuyoshi Tanaka Hiroki Takeshima Fuminao Kato Shingo Torisu Takehiro Ohta Yuki Watanabe Kenji Nakamura Shiro Yoshimura Naoki Kobayashi Taku Shiotani Akiko Hirai Fumihito Hiraoka Sakiko Watanabe Mamoru Matsuura Minoru Nishimoto Shohei Mizuno Shinta Iijima Hideki Takehara Tetsuo Naka Tetsuji Kanai Takanori Matsumoto Takayuki 《Journal of gastroenterology》2021,56(6):560-569
Journal of Gastroenterology - This multicenter prospective study (UMIN000019958) aimed to evaluate the usefulness of serum leucin-rich alpha-2 glycoprotein (LRG) levels in monitoring disease... 相似文献
50.
Shingo Tsujinaka Hideyuki Suzuki Tomoya Miura Yoshihiro Sato Chikashi Shibata 《World journal of gastroenterology : WJG》2022,28(47):6732-6742
This review aimed to highlight the etiology, diagnosis, treatment, and prevention of obstructive and secretory complications associated with diverting ileostomy (DI). Obstructive complications at the stoma site are termed stoma outlet obstruction (SOO) or stoma-related obstruction (SRO). The incidence of SOO/SRO is 5.4%-27.3%, and the risk factors are multifactorial; however, the configuration of the stoma limb and the thickness of the rectus abdominis muscle (RAM) may be of particular concern. Trans-stomal tube decompression is initially attempted with a success rate of 33%-86%. A thick RAM may carry the risk of recurrence. Surgical refinement, including a wider incision of the anterior sheath and adequate stoma limb length, avoids tension and immobility and may decrease SOO/SRO. Secretory complications of DI are termed high output stoma (HOS). Persistent HOS lead to water and sodium depletion, and secondary hyperaldosteronism, resulting in electrolyte imbalances, such as hypomagnesemia. The incidence of HOS is 14%-24%, with an output of 1000-2000 mL/d lasting up to three days. Treatment of HOS is commenced after excluding postoperative complications or enteritis and includes fluid intake restriction, antimotility and antisecretory drug therapies, and magnesium supplementation. Intensive monitoring and surveillance programs have been successful in decreasing readmissions for dehydration. 相似文献