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71.
Rajendra Karkee Andy H. Lee Vishnu Khanal Paras K. Pokharel Colin W. Binns 《International journal of gynaecology and obstetrics》2014
Objective
To determine the incidence of obstetric complications, the stillbirth rate, and the factors associated with cesarean delivery in central Nepal.Methods
A community-based prospective cohort study was undertaken in the Kaski district during 2011–2012. In total, 701 women who were at least 5 months pregnant were recruited and interviewed. Participants were followed-up and interviewed again within 45 days after delivery.Results
Of the 658 women who remained in the cohort after 43 were lost to follow-up, 12 (1.8%) had stillbirths. Cesareans accounted for 13.3% of the total deliveries. Age, urban residency, college-level education, and particularly presence of intrapartum symptoms significantly increased the likelihood of cesarean delivery. Prepartum, intrapartum, and postpartum symptoms were reported by 21.1%, 24.4%, and 10.2% of women, respectively. Common danger signs included prolonged labor, severe abdominal pain, swollen hand and body, and heavy bleeding.Conclusion
Obstetric complications and stillbirth rates were relatively high in central Nepal. Cesarean delivery appeared to meet obstetric need and was performed with medical indication, particularly after the onset of labor. 相似文献72.
Inactivated Francisella tularensis live vaccine strain protects against respiratory tularemia by intranasal vaccination in an immunoglobulin A-dependent fashion 下载免费PDF全文
Francisella tularensis is a gram-negative intracellular bacterium that is considered to be a potential category A biological weapon due to its extreme virulence. Although vaccination with the attenuated live vaccine strain (LVS) of F. tularensis can protect against lethal challenge, use of inactivated or subunit forms as vaccine candidates for induction of protective antibody responses has not been fully evaluated. In the present study, we examined whether immune protection in the lung could be stimulated by intranasal administration of inactivated LVS together with interleukin-12 (IL-12) as an adjuvant. LVS was inactivated by heat, paraformaldehyde treatment, or exposure to UV, and inactivation of the preparations was confirmed by assessing bacterial growth and the survival of mice after direct inoculation. We found that mucosal vaccination with inactivated LVS provided 90 to 100% protection in mice after lethal intranasal challenge with 10(4) CFU of LVS, and this protection was dependent on inclusion of exogenous IL-12 during vaccine administration. Survival of vaccinated mice after live bacterial challenge was correlated with reduced bacterial burden, decreased pulmonary inflammation, increased serum antibody titers, and lower levels of gamma interferon (IFN-gamma), tumor necrosis factor alpha, and IL-6 in the lungs, livers, and spleens. Whereas NK cells were primarily responsible for the production of IFN-gamma in unvaccinated, challenged animals, vaccinated mice had increased levels of lung IFN-gamma+ CD4+ T cells after challenge. Significantly, mice genetically deficient in immunoglobulin A (IgA) expression were unable to survive lethal challenge after vaccination. These results are the first results to demonstrate that IgA-mediated protection against lethal respiratory tularemia occurs after mucosal vaccination with inactivated F. tularensis LVS. 相似文献
73.
74.
Anuraag Shrivastav Shailly Varma Arnie Senger Ramji L Khandelwal Svein Carlsen Rajendra K Sharma 《The Journal of pathology》2009,218(3):391-398
N‐myristoyltransferase (NMT) catalyses the myristoylation reaction. Since NMT activity is elevated in various cancers and activated Akt/PKB leads to cell survival, we were interested in studying if activation of Akt/PKB has any effect on NMT. Overexpression of constitutively active Akt/PKB in HepG2 cells (HepG2‐CA‐Akt/PKB) led to an approximately 50% reduction of NMT compared with parental HepG2 cells. Reduced NMT activity in HepG2‐CA‐Akt/PKB was found to be due to the NMT1 phosphorylation. We determined NMT activity in various human breast cancer cell lines with differing metastatic potentials and pseudo‐normal breast cells (HBL‐100). Tumourigenic or metastatic breast cancer cell lines such as MDA‐MB‐231, MDA‐MB‐435, and Hs 578T displayed reduced NMT activity. Western blot analysis revealed that NMT1 is phosphorylated in these breast cancer cells. Furthermore, patients' breast cancer tissue array revealed strong positivity and high intensity for NMT in malignant breast tissues compared with normal breast cells. A gradation in the NMT staining was observed for grade I, II, and III infiltrating ductal carcinoma breast tissues. These studies demonstrate that overexpression of Akt/PKB results in NMT1 phosphorylation and that NMT1 is phosphorylated in breast cancer cells. Immunohistochemical analysis suggests that NMT may prove to be an added diagnostic biomarker for breast cancer. Copyright © 2009 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. 相似文献
75.
Sudarsan De Rajendra Kumar Tanwar Ram Murti Kamble Vinod Raina Subirendra Kumar Goura Kishore Rath 《Indian journal of otolaryngology and head and neck surgery》1996,48(1):41-44
Primary lymphoma is the most common nonepithelial malignant tumour arising from the paranasal sinus region. It occurs mostly in middle aged and elderly patients with a nonspecific clinical profile resembling that of commoner epithelial sinonasal malignancies. Modified Rappaport’s and the Working Formulation are the frequently used histopathological classification systems. Radiation therapy is the mainstay of treatment with excellent local control of the disease. Most of the failures occur at distant sites outside the treatment area or in the form of disseminateed disease. Chemotherapy, though used in limited number of patients in some series, seems to have a better role to play in the management of these tumours in future as most of the sinonasal lymphomas are of poorly differentiated variety or of unfavourable histology. 相似文献
76.
Surgical Strategy for Cystic Diseases of the Liver in a Western
Hepatobiliary Center 总被引:12,自引:0,他引:12
Ammori BJ Jenkins BL Lim PC Prasad KR Pollard SG Lodge JP 《World journal of surgery》2002,26(4):462-469
The aim of this study was to define the
indications and evaluate the results of various management options in
patients with cystic liver disease. Between 1992 and 1999 we managed 60
consecutive patients with cystic liver disease. Diagnoses included a
simple cyst (solitary 12, multiple 10), adult polycystic liver disease
(APLD 17), Caroli’s disease (8), hydatid cysts (4), and neoplastic
cysts (9). Half of the patients with simple cysts had mild or no
symptoms and required no treatment. Percutaneous drainage in eight
patients (simple cyst 4, APLD 4) was followed by symptomatic recurrence
in three. Laparoscopic deroofing in three patients (multiple simple
cysts 2, APLD 1) was followed by symptomatic enlargement of the
remaining cysts that required further intervention (laparoscopic
deroofing 2, transplantation 1). Laparoscopic hepatectomy was
successful in three patients with solitary simple cysts. Of 18 patients
who underwent open hepatic resection (neoplastic 8, Caroli’s 4, simple
cysts 3, hydatid cysts 2, APLD 1), 2 patients with Caroli’s disease
required liver transplantation for disease progression. Nine patients
(Caroli’s 5, APLD 4) underwent liver transplantation, and three had a
concomitant renal transplant. Seven patients developed complications,
and three died (5%). Cholangiocarcinoma developed in three patients
with bilateral Caroli’s disease, and all died. Radiologic treatment
has a limited role in the management of patients with simple cysts or
APLD. Laparoscopic deroofing of simple cysts may have to be repeated,
whereas resection minimizes cyst recurrence. Unilobar Caroli’s disease
may be resected, whereas bilateral disease requires early liver
transplantation owing to the high risk of malignancy. Transplantation
is a reserved option in patients with extensive APLD. 相似文献
77.
HLA associations with HBV carriage and proteinuria 总被引:7,自引:0,他引:7
Bhimma R Coovadia M Hammond MG Kramvis A Adhikari M Kew MC 《Pediatric nephrology (Berlin, Germany)》2002,17(9):724-729
Human leucocyte antigen (HLA) associations have been reported in children with hepatitis B virus (HBV) associated membranous nephropathy (MN). In a previous study, we found an association with HLA DQB1*0603 in black children with HBVMN. To determine whether HLA DQB1*0603 predisposes to HBV carriage and development of abnormal proteinuria, we studied 70 family members of 14 children with HBVMN positive for HLA DQB1*0603. HBV was determined using third generation ELISA, slot-blot hybridisation, and nested polymerase chain reaction. HLA class I antigens were determined using a two-staged lymphocytotoxic test whereas class II antigen typing was done using sequence-specific primers. Abnormal proteinuria was defined by a protein/creatinine ratio > or =0.2. Associations of HLA DQB1*0603 with HBV carriage and abnormal proteinuria were determined using the mean probability ratio (LOD scores). Forty-seven (67%) family members were positive for HBV infection. Nineteen (27%) had abnormal range proteinuria. LOD scores in the study subjects with DQB1*0603 who were HBV negative versus those with DQB1*0603 who were HBV positive was not significant (anti-log sum =2.0559 and average 0.23). When a similar calculation was made for abnormal proteinuria, there were no significant findings (anti-log sum =3.8587 and average 0.43). This lack of association of HLA DQB1*0603 with either HBV carriage or abnormal proteinuria in family members suggests that additional factors may play a role in predisposing children to chronic HBV carriage and the development of MN. We therefore conclude that the main effect of HLA DQB1*0603 that distinguishes family members from HBVMN is the degree of proteinuria, which is a reflection of the severity of glomerular basement membrane damage in the latter. 相似文献
78.
Treatment of hepatitis B virus-associated nephropathy in black children 总被引:15,自引:0,他引:15
Bhimma R Coovadia HM Kramvis A Adhikari M Kew MC 《Pediatric nephrology (Berlin, Germany)》2002,17(6):393-399
The efficacy of interferon (IFN) in the treatment of hepatitis B virus (HBV)-associated nephropathy in black children has not been established. Twenty-four black children with biopsy-proven HBV-associated nephropathy were recruited into the study during the period April 1997 to June 1999. Five defaulted treatment and were excluded from the primary analysis. IFNalpha 2b was administered for 16 weeks. Response to treatment was defined as loss of HBeAg, decrease in proteinuria, and prevention of deterioration in renal and liver function. A control group of 20 patients was followed up for the same period. Ten (52.6%) of the treated children responded with clearance of HBeAg by 40 weeks. None cleared HBsAg. All responders showed remission of proteinuria, 90% maintained normal renal function and 1 (10%) showed improvement of renal function. HBV DNA levels decreased in this group. Nine patients did not clear HBeAg; none showed remission of proteinuria, and two showed deterioration of renal function. Liver enzymes rose during treatment but subsequently declined irrespective of response to therapy. No serious side effects were encountered. Only 5% of controls showed spontaneous clearance of HBeAg, and none had remission of proteinuria. Black children with HBV-associated nephropathy show accelerated clearance of HBeAg with remission of proteinuria following treatment with IFNalpha 2b. IFNalpha 2b was well tolerated. 相似文献
79.
Human,Rat, and Mouse Metabolism of Resveratrol 总被引:10,自引:0,他引:10
Yu C Shin YG Chow A Li Y Kosmeder JW Lee YS Hirschelman WH Pezzuto JM Mehta RG van Breemen RB 《Pharmaceutical research》2002,19(12):1907-1914
Purpose. Resveratrol, a phenolic phytoalexin occurring in grapes, wine, peanuts, and cranberries, has been reported to have anticarcinogenic, antioxidative, phytoestrogenic, and cardioprotective activities. Because little is known about the metabolism of this potentially important compound, the in vitro and in vivo metabolism of trans-resveratrol were investigated.
Methods. The in vitro experiments included incubation with human liver microsomes, human hepatocytes, and rat hepatocytes and the in vivo studies included oral or intraperitoneal administration of resveratrol to rats and mice. Methanol extracts of rat urine, mouse serum, human hepatocytes, rat hepatocytes, and human liver microsomes were analyzed for resveratrol metabolites using reversed-phase high-performance liquid chromatography with on-line ultraviolet-photodiode array detection and mass spectrometric detection (LC-DAD-MS and LC-UV-MS-MS). UV-photodiode array analysis facilitated the identification of cis- and trans-isomers of resveratrol and its metabolites. Negative ion electrospray mass spectrometric analysis provided molecular weight confirmation of resveratrol metabolites and tandem mass spectrometry allowed structural information to be obtained.
Results. No resveratrol metabolites were detected in the microsomal incubations, and no phase I metabolites, such as oxidations, reductions, or hydrolyzes, were observed in any samples. However, abundant trans-resveratrol-3-O-glucuronide and trans-resveratrol-3-sulfate were identified in rat urine, mouse serum, and incubations with rat and human hepatocytes. Incubation with -glucuronidase and sulfatase to release free resveratrol was used to confirm the structures of these conjugates. Only trace amounts of cis-resveratrol were detected, indicating that isomerization was not an important factor in the metabolism and elimination of resveratrol.
Conclusion. Our results indicate that trans-resveratrol-3-O-glucuronide and trans-resveratrol-3-sulfate are the most abundant metabolites of resveratrol. Virtually no unconjugated resveratrol was detected in urine or serum samples, which might have implications regarding the significance of in vitro studies that used only unconjugated resveratrol. 相似文献