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21.
Kotler DP 《Journal of the Physicians Association for AIDS Care》1995,2(1):12-15
The author reviews the role of malnutrition in HIV infection. He hypothesizes that malnutrition contributes to complications encountered by an HIV-infected person and malnutrition problems are independent of the degree of immune depletion. Healthcare professionals have placed little emphasis on nutritional education. Nutritional trials have been a low priority for organized clinical trials groups, and clinical application of nutritional therapies is flawed. There is no advocacy for proper nutrition and no accepted standard of nutritional care in HIV disease. Cost cutting may further hamper efforts to provide nutritional support. While the last few years have seen advances in the understanding of the weight loss that results from HIV-associated malnutrition, much is left to be done. Preliminary results of a small randomized controlled trial suggest that treatment with an oral enteral supplement may provide an effective and far less costly alternative to treatment with total parenteral nutrition (TNP). Studies on how malnutrition may relate to problems with food intake, nutrient absorption, or intermediary metabolism are reviewed. The author concludes that definitive clinical trials must be performed, including estimates of costs and clinical outcomes, and nutritional end points. The results of these studies must be used in the continuing development of healthcare financing policy. 相似文献
22.
Spivak B Lamschtein C Talmon Y Guy N Mester R Feinberg I Kotler M Weizman A 《Clinical neuropharmacology》1999,22(2):98-101
The aim of this retrospective study is to determine whether lipid levels rise in neuroleptic-resistant chronic schizophrenic patients during clozapine treatment and if this rise is correlated with a decrease in aggressive and suicidal behavior. Seventy neuroleptic-resistant schizophrenic patients treated with clozapine for at least 6 months were compared with 30 chronic schizophrenic patients treated with classic antipsychotic agents for the same length of time. Data on serum levels of cholesterol and triglycerides and on aggressive and suicidal behavior, as measured by the Overt Aggression Scale (OAS), were collected in both groups before treatment and 6 months later. A significant reduction in aggressive and suicidal behavior was noted in the clozapine-treated group but not in the classical antipsychotic-treated group. Clozapine treatment was associated with an elevation in serum triglyceride level, whereas classic antipsychotic treatment was associated with an increase in serum cholesterol level. We conclude that serum cholesterol level does not play a role in the clozapine-induced attenuation in aggressive and suicidal behavior in neuroleptic-resistant schizophrenic patients, though the accompanying elevation in triglycerides may be relevant to a behavioral effect. 相似文献
23.
Bioelectrical impedance methods in clinical research: a follow-up to the NIH Technology Assessment Conference 总被引:5,自引:0,他引:5
Ellis KJ Bell SJ Chertow GM Chumlea WC Knox TA Kotler DP Lukaski HC Schoeller DA 《Nutrition (Burbank, Los Angeles County, Calif.)》1999,15(11-12):874-880
In 1994, the National Institutes of Health (NIH) convened a Technology Assessment Conference "to provide physicians with a responsible assessment of bioelectrical impedance analysis (BIA) technology for body composition measurement." In 1997, Serono Symposia USA, Inc., organized an invited panel of scientists and clinicians, with extensive research and clinical experience with BIA, to provide an update. Panel members presented reviews based on their own work and published studies for the intervening years. Updates were provided on the single and multifrequency BIA methods and models; continued clinical research experiences; efforts toward establishing population reference norms; and the feasibility of establishing guidelines for potential diagnostic use of BIA in a clinical setting. This report provides a summary of the panel's findings including a consensus on several technical and clinical issues related to the research use of BIA, and those areas that are still in need of additional study. 相似文献
24.
25.
Economic costs of functional dyspepsia 总被引:5,自引:0,他引:5
Dyspepsia is defined as chronic or recurrent symptoms believed to originate in the upper gastrointestinal tract. When routine investigation results in no identifiable explanation for those symptoms patients are labelled as having functional dyspepsia. In community-based surveys, approximately 30% of the otherwise apparently healthy population report dyspeptic symptoms and the majority are believed to have functional dyspepsia. Although only 1 in 4 or 5 patients make use of healthcare resources, this patient category is one of the largest in ambulatory care (1.6 to 5% of all consultations in general practice). The annual frequency of consultations for functional dyspepsia in Sweden has been estimated at 47 per 1000 population. In consequence of its high prevalence and associated absenteeism, the total costs of functional dyspepsia are considerable. In Sweden in 1981, the costs were estimated at $US55 000 per 1000 population ($US113 630 in 1991 dollars). The most cost-effective management strategy remains to be defined. Evidence is accumulating that the traditional 'wait-and-see' policy with initial empirical therapeutic trials without investigation may not be the most cost conserving strategy. 相似文献
26.
The involvement of the proliferating cell nuclear antigen (PCNA) in the
process of DNA repair induced by alkylating agents or by oxidative damage
was investigated in human quiescent fibroblasts by immunofluorescence and
flow cytometry. Transition from soluble to the DNA-bound form of PCNA, was
taken as the parameter to determine its involvement in repair DNA
synthesis. Treatment with the alkylating agents methylmethane sulfonate and
N-methyl-N'-nitro-N-nitrosoguanidine resulted in the rapid and
dose-dependent increase in the nuclear binding of PCNA. Similar results
were obtained with compounds such as hydrogen peroxide or tert-butyl
hydroperoxide, which are known to induce oxidative DNA damage. Tert-butyl
hydroperoxide may also generate malondialdehyde through a reaction of lipid
peroxidation. This mutagenic and carcinogenic product has been previously
shown to form adducts with DNA. Therefore, the possibility that tert-butyl
hydroperoxide could induce DNA damage through this pathway was investigated
by incubating cells directly in the presence of malondialdehyde. Such
treatment resulted in an increase in immunofluorescence associated with
nuclear-bound PCNA. The ability of oxidative and alkylating agents to
induce the nuclear binding of PCNA was also assessed in proliferating
cells. In these conditions, treatment with hydrogen peroxide or
methylmethane sulfonate, resulted in an increase in nuclear-bound PCNA in
the G1 and in the G2 + M compartments, but not in S phase. At longer times
after treatment, PCNA immunostaining was reduced to basal levels, while an
increase in nuclear binding of p21(waf1/cip1) protein was found in
concomitance with cell-cycle arrest. These results indicate that agents
inducing DNA base alterations in vivo, promote the nuclear binding of PCNA.
These lines of evidence support the role of a PCNA-dependent reaction in
the base excision repair system.
相似文献
27.
Hansen LA; Malarkey DE; Wilkinson JE; Rosenberg M; Woychik RE; Tennant RW 《Carcinogenesis》1998,19(10):1837-1845
We previously reported that papillomas can arise from the follicular
epithelium of v-Ha-ras transgenic TGxAC mice. Since the viable-yellow
mutation (A(vy)) of the mouse agouti gene which regulates coat color
pigmentation by acting within the micro-environment of the hair follicle
has been shown to function as a tumor promoter in the liver, we
hypothesized that it may also play a role in TGxAC skin tumorigenesis.
Endogenous agouti protein product was detected in the outer root sheath of
anagen hair follicles following plucking of the hair shaft, but not in the
interfollicular epithelium, in TGxAC mice on an FVB/N genetic background.
It was also detected in papillomas from these mice produced by
12-O-tetradecanoylphorbol-13-acetate (TPA) treatment or plucking.
Expression of the A(vy) allele in the v-Ha-ras transgenic TGxAC mouse line
results in an approximately 2-fold increase in papilloma development
compared with controls which did not carry the A(vy) allele following
twice-weekly treatment with 1.25, 2.5 or 5.0 microg TPA. In addition,
TPA-treated, papilloma-bearing F1 mice which carried the A(vy) allele, but
not F1 mice which did not carry the A(vy) allele, exhibited a syndrome of
humoral hypercalcemia mediated by parathyroid hormone-related protein
(PTHrP) that led to weight loss, hypercalcemia and hypophosphatemia. Thus,
we conclude that the A(vy) allele can influence the development of skin
tumors and PTHrP-mediated humoral hypercalcemia in v-Ha-ras transgenic
TGxAC mice.
相似文献
28.
Non-invasive detection of fecal protein kinase C betaII and zeta messenger RNA: putative biomarkers for colon cancer 总被引:2,自引:0,他引:2
Davidson LA; Aymond CM; Jiang YH; Turner ND; Lupton JR; Chapkin RS 《Carcinogenesis》1998,19(2):253-257
We have developed a non-invasive method utilizing feces, containing
sloughed colonocytes, as a sensitive technique for detecting diagnostic
colonic biomarkers. In this study, we used the rat colon carcinogenesis
model to determine if changes in fecal protein kinase C (PKC) expression
have predictive value in monitoring the neoplastic process. Weanling rats
were injected with saline or azoxymethane (AOM) and 36 weeks later fecal
samples and mucosa were collected, poly A+ RNA isolated, and quantitative
RT-PCR performed using primers to PKC betaII and zeta. Fecal PKC betaII and
zeta mRNA levels were altered by the presence of a tumor, with
tumor-bearing animals having a 3-fold higher (P < 0.05) PKC betaII
expression as compared with animals without tumors. In addition,
AOM-injection increased mucosal PKC betaII mRNA expression compared with
saline controls. No effect of tumor incidence on mucosal PKC betaII
expression was observed. In contrast, fecal PKC zeta expression was
2.5-fold lower (P < 0.05) in animals injected with azoxymethane versus
saline. Since tumor incidence exerts a reciprocal effect on fecal PKC
betaII and zeta mRNA expression, data were also expressed as the ratio
between PKC betaII and zeta. The isozyme ratio was strongly related to
tumor incidence, i.e. ratio for animals with tumors was 2.18 +/- 1.25,
animals without tumors was 0.50 +/- 0.16, P = 0.025. We demonstrate that
the expression of fecal PKC betaII and zeta may serve as a noninvasive
marker for development of colon tumors. A sensitive technique for the
detection of colon cancer is of importance since early diagnosis can
substantially reduce mortality.
相似文献
29.
宫颈病变液基细胞学筛查与组织病理学对照观察 总被引:5,自引:1,他引:5
目的 探讨液基薄层细胞学(ThinPrepCytologyTest, TCT)技术在妇科门诊人群宫颈病变筛查的准确性。方法 回顾性分析10 980例TCT,与组织学对比观察。结果 TCTLSIL以上阳性率45. 7% ( 373 /817),组织学检查阳性率50. 1% ( 409 /817 ),两者统计学比较无显著性差异(P>0. 05 )。TCT诊断符合率LSIL75. 8% (191 /252),HSIL98. 1% (101 /103),SCC90. 9% (10 /11),AC85. 7% (6 /7)。鳞状上皮内病变诊断符合率HSIL与LSIL统计学比较有显著性差异(P<0. 01)。结论 液基细胞学检查是宫颈癌早期筛查的有效手段,加强制片技术及诊断质量控制对提高诊断的准确性有重要意义。 相似文献
30.