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11.
ObjectivesThis study aims to: (i) evaluate the outcome of patients with Harrington class III lesions who were treated according to Harrington classification; (ii) propose a modified surgical classification for Harrington class III lesions; and (iii) assess the efficiency of the proposed modified classification.MethodsThis study composes two phases. During phase 1 (2006 to 2011), the clinical data of 16 patients with Harrington class III lesions who were treated by intralesional excision followed by reconstruction of antegrade/retrograde Steinmann pins/screws with cemented total hip arthroplasty (Harrington/modified Harrington procedure) were retrospectively reviewed and further analyzed synthetically to design a modified surgical classification system. In phase 2 (2013 to 2019), 62 patients with Harrington class III lesions were classified and surgically treated according to our modified classification. Functional outcome was assessed using the Musculoskeletal Tumor Society (MSTS) 93 scoring system. The outcome of local control was described using 2‐year recurrence‐free survival (RFS). Owing to the limited sample size, we considered P < 0.1 as significant.ResultsIn phase 1, the mean surgical time was 273.1 (180 to 390) min and the mean intraoperative hemorrhage was 2425.0 (400.0 to 8000.0) mL, respectively. The mean follow‐up time was 18.5 (2 to 54) months. Recurrence was found in 4 patients and the 2‐year RFS rate was 62.4% (95% confidence interval [CI] 31.6% to 93.2%). The mean postoperative MSTS93 score was 56.5% (20% to 90%). Based on the periacetabular bone destruction, we categorized the lesions into two subgroups: with the bone destruction distal to or around the inferior border of the sacroiliac joint (IIIa) and the bone destruction extended proximal to inferior border of the sacroiliac joint (IIIb). Six patients with IIIb lesions had significant prolonged surgical time (313.3 vs 249.0 min, P = 0.022), massive intraoperative hemorrhage (3533.3 vs 1760.0 mL, P = 0.093), poor functional outcome (46.7% vs 62.3%, P = 0.093), and unfavorable local control (31.3% vs 80.0%, P = 0.037) compared to the 10 patients with IIIa lesions. We then modified the surgical strategy for two subgroup of class III lesions: Harrington/modified Harrington procedure for IIIa lesions and en bloc resection followed by modular hemipelvic endoprosthesis replacement for IIIb lesions. Using the proposed modified surgical classification, 62 patients in the phase 2 study demonstrated improved surgical time (245.3 min, P = 0.086), intraoperative hemorrhage (1466.0 mL, P = 0.092), postoperative MSTS 93 scores (65.3%, P = 0.067), and 2‐year RFS rate (91.3%, P = 0.002) during a mean follow‐up time of 19.9 (1 to 60) months compared to those in the phase 1 study.ConclusionThe Harrington surgical classification is insufficient for class III lesions. We proposed modification of the classification for Harrington class III lesions by adding two subgroups and corresponding surgical strategies according to the involvement of bone destruction. Our proposed modified classification showed significant improvement in functional outcome and local control, along with acceptable surgical complexity in surgical management for Harrington class III lesions.  相似文献   
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目的 研究俄歇电子发射体67Ga-EDTMP对人骨肉瘤细胞株 (HOS - 86 0 3)的辐射效应 ,探讨67Ga作为原发肿瘤和骨转移癌内照射治疗核素的可能性。方法 用成集落实验和透射电镜研究受照细胞的形态变化。结果 发现67Ga-EDTMP对肿瘤细胞有明显的杀伤和抑制增殖作用 ,并随剂量的加大 ,抑制效率增加 ;倒置显微镜下细胞集落数量减少 ,集落偏小 ,细胞稀疏。电镜下胞浆中空泡形成 ,细胞溶解、坏死 ,细胞核固缩 ,出现典型的细胞凋亡改变 ,形成凋亡小体。结论 67Ga可能是一种有前途的骨肉瘤和骨转移癌的放射性治疗核素  相似文献   
14.
Non immunohematopoietic murine tumor cells ectopically expressing Fc gamma RIIB1 (B1) were recently shown to express a higher tumorigenicity phenotype than cells not expressing this receptor. Utilizing a genetic approach we studied the possible contribution of a soluble form of B1 to tumor enhancement. A mutated form of the B1, lacking the cleavage site responsible for the generation of soluble B1 was produced using gene splicing by overlap extension PCR. A deletion confirmed by sequence analysis from 172 to 178 residues was generated. Stable transfectants expressed the B1 deleted form (B1 Delta) both as specific RNA and as a membrane protein receptor allowing a low level of ligand binding. The soluble form of B1 was undetectable in tissue culture supernatants of Bib transfected cells while it was present in supernatants of wild type B1-transfectants. Stable B1 Delta transfectants were significantly more tumorigenic than negative control transfectants. Tumor incidence was almost as high as that of intact B1 and lagged in the latency period before the appearance of palpable tumors. It is suggested that the soluble B1 has a minimal contribution to tumor enhancement.  相似文献   
15.
目的为经皮腹膜后隙牌肾静脉分流术(PRESS)技术的开发提供形态学依据。方法选取30例经甲醛固定的成人尸体标本,观察牌静脉、左肾静脉的走行及两者之间的关系,并对相关数据进行测量。结果牌静脉紧靠肠系膜上动脉起端右前方与肠系膜上静脉汇合为门静脉,脾静脉与左肾静脉在肠系膜上动脉起点左侧位置关系较为恒定。结论经股静脉的插管须先进入左肾静脉,然后在肠系膜上动脉起端左侧穿向脾静脉。  相似文献   
16.
茯苓萜类的高效液相色谱指纹图谱研究   总被引:3,自引:1,他引:3  
目的 建立茯苓三萜化合物的指纹图谱。方法 反相高效液相色谱法。结果 道地药材茯苓及不同地区收集的市场商品具有相当稳定的、相似程度很高的指纹图谱。结论 可利用液相色谱的特征峰控制茯苓及其制剂的质量。  相似文献   
17.
白鲜皮质量标准研究   总被引:1,自引:0,他引:1  
目的:为中药白鲜皮制定2005年版药典标准。方法:采用TLC法鉴别、反相高效液相色谱法测定白鲜皮中活性成分末梣酮含量,并对各地产白鲜皮药材的水分、总灰分、酸不溶性灰分、浸出物含量进行测定。结论:本方法操作简单,重现性好,可用于白鲜皮药材的质量控制。  相似文献   
18.
目的 分析多种血清标志物预测老年急性缺血性脑卒中(AIS)患者卒中后认知障碍(PSCI的价值。方法 回顾性收集2019年1月至2023年1月哈尔滨医科大学附属第一医院神经内科收治的326例老年AIS患者的资料。根据发病后6个月的简易精神状态量表(MMSE)评分,将患者分为PSCI组(MMSE评分≤26分)和非PSCI组(MMSE评分>26分)。比较两组患者的一般资料和血清指标。采用多因素Logistic回归分析老年AIS患者发生PSCI的危险因素,并采用受试者工作特征(ROC)曲线下面积(AUC)分析血清标志物预测老年AIS患者发生PSCI的效能。结果 326例患者中,127例(38.96%)在发病后6个月发生PSCI。PSCI组年龄>75岁、患糖尿病、有脑卒中史的患者比例,入院时NIHSS评分,同型半胱氨酸、尿酸水平,中性粒细胞/淋巴细胞比值(NLR),低密度脂蛋白胆固醇(LDL-C)水平,C-反应蛋白(CRP)水平均高于非PSCI组,差异均有统计学意义(均P<0.05);高密度脂蛋白胆固醇(HDL-C)低于非PSCI组,差异有统计学意义(P<0.05)。多因...  相似文献   
19.
目的 探讨芳香疗法缓解妇科恶性肿瘤术后患者恶心呕吐的效果.方法 选取2019年1月至2019年8月间中国医学科学院肿瘤医院收治的行手术治疗的202例妇科恶性肿瘤患者,按病房号奇偶数随机分为试验组(102例)和对照组(100例).对照组患者采用常规护理,试验组患者在常规护理基础上采用嗅柠檬香氛作为芳香疗法进行干预,比较两...  相似文献   
20.
Background:Vascular dementia (VaD) is a comprehensive syndrome related to the damage of cognitive function and various cerebral vascular illnesses. VaD is also generally recognized as the second most common type of dementia after Alzheimer disease, contributing to 30% of the dementia population in Asia and developing countries. The ability of donepezil hydrochloride and nimodipine had been respectively proven in improving cognitive function in vascular dementia. However, whether the combined application of both drugs contribute to better efficacy remains as a research hotspot. Studies had shown definite satisfactory result with such combination, however evidence-based evaluation of the efficacy is still lacking. Therefore, meta-analysis is employed in this study to evaluate the efficacy and safety of using donepezil hydrochloride combined with nimodipine in treating VaD to provide references for clinical treatments. The efficacy of donepezil hydrochloride combined with nimodipine on treating vascular dementia is systematically reviewed to provide evidence-based references for clinical applications.Methods:Both Chinese and English databases were searched from the start till August, 2020 for any RCT regarding the combined use of the 2 drugs in treating vascular dementia. Two investigators would later evaluate and screened out research and data based on an improved Jaded scale. Software Rev Man 5.3.0 was employed to carry out meta-analysis on clinical effificacy, mini-mental state examination (MMSE) ratings, activity of daily living (ADL) ratings, and clinical dementia scale (CDR) ratings.Results:Donepezil hydrochloride combined with nimodipine had demonstrated satisfactory efficacy on the treatment of vascular dementia. Improvements were namely spotted on MMSE scale, ADL scale, and CDR scale, with the utmost efficacy by 12 weeks after intervention.Conclusions:Donepezil hydrochloride combined with nimodipine had good efficacy in the treatment of patients with vascular dementia, mainly in terms of improving the Simple MMSE scores, the ability to use daily living scale (ADL) scores and the CDR, and the best results were obtained after 12 weeks of intervention. Such conclusion should be cautiously evaluated.  相似文献   
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