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81.
Jesus C. Fabregas Kristen E. Riley Jeannine M. Brant Thomas J. George E. John Orav Miranda B. Lam 《Journal of gastrointestinal oncology.》2022,13(3):1204
BackgroundPancreatic cancer disparities have been described. However, it is unknown if they contribute to a late diagnosis and survival of patients with metastatic disease. Identifying their role is important as it will open the door for interventions. We hypothesize that social determinants of health (SDH) such as income, education, race, and insurance status impact (I) stage of diagnosis of PC (Stage IV vs. other stages), and (II) overall survival (OS) in Stage IV patients.MethodsUsing the National Cancer Database, we evaluated a primary outcome of diagnosis of Stage IV PC and a secondary outcome of OS. Primary predictors included race, income, education, and insurance. Covariates included age, sex and Charlson-Deyo comorbidity score. Univariate, multivariable logistic regression models evaluated risk of a late diagnosis. Univariate, multivariable Cox proportional hazards model examined OS. 95% confidence intervals were used.Results230,877 patients were included, median age of 68 years (SD 12.1). In univariate analysis, a better education, higher income, and insurance decreased the odds of Stage IV PC, while Black race increased it. In multivariable analysis, education [>93% high-school completion (HSC) vs. <82.4%, OR 0.96 (0.93–0.99)] and insurance [private vs. no, OR 0.72 (0.67–0.74)] significantly decreased the risk of a late diagnosis, whereas Black race increased the odds [vs. White, OR 1.09 (1.07–1.12)]. In univariate Cox analysis, having a higher income, insurance and better education improved OS, while Black race worsened it. In multivariable Cox, higher income [>$63,333 (vs. <$40,277), HR 0.87 (0.85–0.89)] and insurance [private vs. no, HR 0.77 (0.74–0.79)] improved OS.ConclusionsSDH impacted the continuum of care for patients with advanced pancreatic cancer, including stage at diagnosis and overall survival. 相似文献
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Outcome of children and adolescents with Down syndrome treated on Dana‐Farber Cancer Institute Acute Lymphoblastic Leukemia Consortium protocols 00–001 and 05‐001 下载免费PDF全文
Uma H. Athale Maneka Puligandla Kristen E. Stevenson Barbara Asselin Luis A. Clavell Peter D. Cole Kara M. Kelly Caroline Laverdiere Jean‐Marie Leclerc Bruno Michon Marshall A. Schorin Maria Luisa Sulis Jennifer J. G. Welch Marian H. Harris Donna S. Neuberg Stephen E. Sallan Lewis B. Silverman 《Pediatric blood & cancer》2018,65(10)
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85.
Benoit K 《Midwifery today with international midwife》2008,(86):26-27
For many women living in New York, finding a licensed midwife to attend their birth at home is impossible. This article seeks to discuss the process by which Certified Professional Midwives (CPMs) can become licensed in New York and to explain a barriers to practicing outside the hospital. It will also explore what is being done to work toward making home-birth a more easily accessible option in New York. 相似文献
86.
Women have many options regarding contraception. A patient's desire for a long- or short-term method, for one that is reversible or permanent, and her belief that she can be compliant with the method all factor into the choice of contraceptive method. Practitioners must discuss coexisting conditions, contraindications, and whether the patient desires scheduled monthly bleeding or if she will tolerate unscheduled bleeding. Finally, cost and coverage by insurance tends to be one of the most important factors in choosing the method of contraception. 相似文献
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Möllers Carl Lewin Van Eweyk Seiffert Max Steiger Kleemann Kehrer Ötvös Neukirch Toenniessen Scholz Simmel Beltz Ebstein Heyer Planner J. Bauer Lauda Nonnenbruch Klieneberger 《Journal of molecular medicine (Berlin, Germany)》1922,1(28):1431-1439
Ohne Zusammenfassung 相似文献
89.
Design and Conduct of an Internet‐Based Preconception Cohort Study in North America: Pregnancy Study Online 下载免费PDF全文
90.
Miruthula Tamil Selvan Sachithra Gunasekara Ping Xiao Kristen Griffin Shannon R. Cowan Sai Narayanan Akhilesh Ramachandran Darren E. Hagen Jerry W. Ritchey Jennifer M. Rudd Craig A. Miller 《Viruses》2022,14(6)
Continued emergence of SARS-CoV-2 variants highlights the critical need for adaptable and translational animal models for acute COVID-19. Limitations to current animal models for SARS CoV-2 (e.g., transgenic mice, non-human primates, ferrets) include subclinical to mild lower respiratory disease, divergence from clinical COVID-19 disease course, and/or the need for host genetic modifications to permit infection. We therefore established a feline model to study COVID-19 disease progression and utilized this model to evaluate infection kinetics and immunopathology of the rapidly circulating Delta variant (B.1.617.2) of SARS-CoV-2. In this study, specific-pathogen-free domestic cats (n = 24) were inoculated intranasally and/or intratracheally with SARS CoV-2 (B.1.617.2). Infected cats developed severe clinical respiratory disease and pulmonary lesions at 4- and 12-days post-infection (dpi), even at 1/10 the dose of previously studied wild-type SARS-CoV-2. Infectious virus was isolated from nasal secretions of delta-variant infected cats in high amounts at multiple timepoints, and viral antigen was co-localized in ACE2-expressing cells of the lungs (pneumocytes, vascular endothelium, peribronchial glandular epithelium) and strongly associated with severe pulmonary inflammation and vasculitis that were more pronounced than in wild-type SARS-CoV-2 infection. RNA sequencing of infected feline lung tissues identified upregulation of multiple gene pathways associated with cytokine receptor interactions, chemokine signaling, and viral protein–cytokine interactions during acute infection with SARS-CoV-2. Weighted correlation network analysis (WGCNA) of differentially expressed genes identified several distinct clusters of dysregulated hub genes that are significantly correlated with both clinical signs and lesions during acute infection. Collectively, the results of these studies help to delineate the role of domestic cats in disease transmission and response to variant emergence, establish a flexible translational model to develop strategies to prevent the spread of SARS-CoV-2, and identify potential targets for downstream therapeutic development. 相似文献