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51.
BACKGROUND. Research suggests that patients are more satisfied with patient-centred consultations than with doctor-centred consultations and that some health measures are positively influenced by this type of consultation. Research on the factors that influence the patient centredness of the consultation is sparse but suggests that women doctors are more patient centred than men doctors. AIM. A study was designed, first, to confirm or reject the suggestion that women general practitioners are more patient centred than men general practitioners and, secondly, to determine some of the factors that might influence the patient centredness of a general practitioner. METHOD. The audiotaped consultations of 41 general practitioners were analysed using an instrument designed to measure patient centredness. The general practitioners were selected from a group of volunteers to represent both sexes as well as a wide range of age and experience. RESULTS. The results of the analysis showed that women general practitioners, particularly trainers, had higher patient-centredness scores than men general practitioners. This behaviour is characterized by an increased frequency of open questions and greater attention to patient offers (anything of potential significance that a patient brings to the general practitioner consultation). Additionally, the combination of sexes in a consultation seemed to have an effect on the interaction, with woman general practitioner/female patient dyads (pairings) having the highest median patient-centredness score, woman general practitioner/male patient and man general practitioner/male patient dyads scoring the same as each other and man general practitioner/female patient dyads having the lowest median scores. CONCLUSION. The results suggest that women general practitioners, in this sample, were more patient centred than men general practitioners. The results also suggest that inherent inequalities exist, with female patients receiving a more patient-centred service from general practitioners of their own sex than from general practitioners of the opposite sex. Male patients, on the other hand, seemed to fare equally well, irrespective of the sex of their general practitioner. Training is required to address these inequalities and to improve the level of patient centredness in the consultation. 相似文献
52.
Ghazzawi IM; Sarraf MG; Taher MR; Khalifa FA 《Human reproduction (Oxford, England)》1998,13(2):348-352
A prospective study was carried out to compare the fertilizing capability
and pregnancy outcome following intracytoplasmic sperm injection (ICSI)
using spermatozoa obtained from ejaculates, or surgically from epididymis
or seminiferous tubules. A total of 77 ICSI cycles (one per patient) was
included. In all, 28 patients had severe oligoasthenoteratozoospermia, 19
patients had obstructive azoospermia and 30 patients had non-obstructive
azoospermia. The main outcome measures were fertilization rate per injected
metaphase II oocyte and the clinical pregnancy rate per embryo transferred
back to the female recipients. In patients with severe
oligoasthenoteratozoospermia, the fertilization and pregnancy rates were 79
and 25 %. In patients with obstructive azoospermia, for whom epididymal
spermatozoa were used, these were 75 and 28%, and in the non-obstructive
group for which testicular spermatozoa were used for injection, they were
69 and 21% respectively. These rates were not significantly different in
the three groups (P = 0.85 and P = 0.14 respectively), suggesting that
spermatozoa from the ejaculates and epididymal or testicular biopsies are
able to fertilize equally by using ICSI. Live birth per embryo transfer was
significantly reduced in patients with non-obstructive azoospermia compared
to the other two groups. The high abortion rate (50%) in the group in which
testicular spermatozoa were used raises doubts about the developmental
competence of such embryos.
相似文献
53.
Pseudoangiomatous stromal hyperplasia (PASH) is an uncommon lesion usually found in premenopausal women. Histologically, it is characterized by complex, anatomosing, empty slit-like spaces in a dense collagenous stroma. These pseudoangiomatous spaces are lined by monomorphic spindle cells of myofibroblastic differentiation. Cytological features of PASH are rarely discussed and reported, and may pose diagnostic challenge to surgical pathologists. Two cases of PASH are reported with emphasis on the FNAC features and cytologic differentiation from other benign fibroepithelial lesions. 相似文献
54.
55.
Tang NL Hui J Law LK Lam YY Chan KY Yeung WL Chan AY Cheung KL Fok TF 《Human mutation》2000,16(5):446
Glutaric acidemia type I is caused by mutations of the glutaryl-CoA dehydrogenase (GCDH) gene resulting in loss of GCDH enzyme activity. Patients present with progressive dystonia and lesions in basal ganglia. Dietary treatment, when instituted from the early neonatal period, markedly reduces dystonia and morbidity. Early diagnosis and prenatal diagnosis will be facilitated by knowledge of locally prevalent GCDH mutations. Several common GCDH mutations have been found in different ethnic groups. GCDH mutations were studied in 5 Chinese glutaric acidemia type I families. We detected two novel recurrent mutations (A219T and IVS10-2A>C) which were found in two unrelated families. An asymptomatic carrier of IVS10-2A>C was also found on screening of 120 individuals. Other mutations were identified, including two other novel (R386G & IVS3+1G>A) and two known mutations (G178R & R355H). Fibroblasts from patients carrying the novel mutations were confirmed to be deficient for GCDH activity. This is the first report of GCDH mutations describing recurrent mutations in Chinese patients. The carrier rate of IVS10-2A>C may be particularly high in Chinese. 相似文献
56.
Berge-Lefranc JL; Jay P; Massacrier A; Cau P; Mattei MG; Bauer S; Marsollier C; Berta P; Fontes M 《Human molecular genetics》1996,5(10):1637-1641
While constructing a cDNA library of human embryos, we have isolated a
clone homologous to jumonji, a mouse gene required for neural tube
formation. We have determined the complete coding sequence of the human
homologue (JMJ) and deduced the amino acid sequence of the putative
protein. We show here that human and mouse jumonji putative proteins are
homologous and present 90% identity. During human embryogenesis, JMJ mRNAs
are predominantly expressed in neurons and particularly in dorsal root
ganglion cells. They are also expressed in neurons of human adult cerebral
cortex. In view of these observations, we propose JMJ as a candidate gene
for developmental defects of the central nervous system in the human. The
human JMJ gene maps at position 6p24-6p23.
相似文献
57.
Mutations in the SLC22A5 gene, which encodes for the plasma membrane carnitine transporter OCTN2, cause primary carnitine deficiency (PCD). After our first report of OCTN2 mutations in Chinese, three more Chinese PCD patients were identified. The parents of these families were non-consanguineous and these families were unrelated. Two novel truncating mutations were found: R254X, a single-base mutation at cDNA position 981 (c.981C>T); and Y387X (c.1382T>G). Two probands, one each from Taiwan and Macau, were homozygous for R254X. The other proband from Taiwan carried both R254X and Y387X. Two additional heterozygote carriers of R254X were also identified among 250 control samples, while none was detected for Y387X. The population carrier rate for R254X would be about 1 in 125. Haplotypes of R254X alleles were examined and patients homozygous for R254X were also homozygous for the same haplotype of intragenic and microsatellites markers. Analysis of population frequencies of haplotypes revealed that the chance of 4 chromosomes having arisen as independent events was 0.016. We conclude that R254X is probably a founder mutation in Chinese. Other previously reported mutations found in the Japanese population were also screening in 250 control samples but no carrier was identified, indicating that they were either very rare or not present in Southern Chinese. 相似文献
58.
59.
60.
DNA Sequence analysis of the PorB protein of nonserotypeable serogroup C ET-15 meningococci suggests a potential mutational hot spot on their serotype antigens 下载免费PDF全文
The nucleotide sequences of the PorB proteins from 28 nonserotypeable serogroup C ET-15 meningococci recovered from invasive meningococcal disease cases were determined. PCR amplification of the porB genes responsible for encoding the serotype antigen was used for DNA sequence determination and identification of the nature of the serotype antigen. DNA sequencing revealed that three strains were of serotype 2a, and of the remaining 25 strains, 20 were found to have an identical single point mutation in the region of the VR3 gene, which encodes surface-exposed loop VI, where the serotype 2a epitope resides. This nonsynonymous mutation was confirmed by synthetic peptide immunochemical analysis to confer new serospecificity to these serotype 2a mutants. This finding of a potential novel mutational hot spot on the PorB proteins of meningococci may have implications for pathogenesis and vaccine development. 相似文献