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61.
H.I. Tahsildar B.F. Remler R.J. Creger B.W. Cooper S.M. Snodgrass R.W. Tarr H.M. Lazarus 《Journal of neuro-oncology》1996,27(3):241-250
Summary Subacute encephalopathy developed in four patients within one to two months after undergoing high-dose chemotherapy and bone marrow transplantation or peripheral blood progenitor (stem) cell transplantation for breast cancer, acute myeloid leukemia, and non-Hodgkin's lymphoma. None of the patients had previously known neurologic disorders, central nervous tumor or infection. Two patients presented with generalized tonic, clonic seizures, and two with confusion and lethargy. In all patients lumbar puncture and CT scans of the brain were normal, while magnetic resonance imaging (MRI) demonstrated multifocal predominantly white matter lesions. Phenytoin therapy was given to the two patients with seizures and all four patients improved without specific therapeutic intervention. Repeat MRIs became normal within three months. We report a delayed and transient encephalopathy which appears to be a unique complication of high-dose cytotoxic chemotherapy. The corresponding brain lesions may not be appreciated on CT scans, suggesting an expanded role for MRI studies in patients who develop neurologic findings while undergoing high-dose cytotoxic therapy. 相似文献
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The majority (217/325, 66%) of the neurons in the middle temporal (MT)
area/V5 show strong antagonistic surrounds, defined here by a decrease of
at least 50% in the summation curve. We mapped the antagonistic surround in
145 such cells, using eight circularly distributed surround stimulus
patches (Surround Asymmetry Test, SAT) and also mapped the surround in 51
of these 145 cells using a grid consisting of 25 square patches (Surround
Mapping Test, SMT). Both tests showed that the angular surround
distribution was non-uniform in the majority of these neurons. In half the
neurons, the antagonistic surround was asymmetric, and arose from a single
region on one side of the excitatory receptive field (ERF). In another
quarter of the sample the surround was bilaterally symmetric, and arose
from a pair of regions on opposite sides of the ERF. Only the remaining 20%
showed a circularly symmetric surround distribution. These three groups
differed in their laminar distribution. The SMT showed that, radially, the
surround antagonism reached a maximum, on average, at 1.5 times the ERF
radius. Detailed comparisons of the spatial relationships of excitatory and
inhibitory regions of the RF components shows that non-homogeneity of the
surround influence appears to be an intrinsic property of the surround.
Such a property may underly the extraction of the surface orientation and
curvature from speed patterns.
相似文献
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65.
Disorders of the visual system in Alzheimer's disease 总被引:3,自引:0,他引:3
Alzheimer's disease (AD) is associated with disturbances in basic visual, complex visual, and oculomotor functions. The broad range of visual system disorders in AD may result from the concentration of neuropathology in visual association cortex and optic nerves in this disease. AD patients and their caregivers frequently report visuospatial difficulties in these patients. Examination of the visual system in AD may reveal visual field deficits, prolonged visual evoked potentials, depressed contrast sensitivities, and abnormal eye movement recordings. Complex visual disturbances include constructional and visuoperceptual abnormalities, spatial agnosia and Balint's syndrome, environmental disorientation, visual agnosia, facial identification problems, and visual hallucinations. The purpose of this article is to review the spectrum of visual system disturbances found in AD and, in particular, to describe the methods used to screen for complex visual abnormalities in these patients. 相似文献
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67.
End-stage periventricular leukomalacia: MR evaluation 总被引:3,自引:0,他引:3
A prospective study was performed to assess the capabilities of magnetic resonance (MR) imaging in evaluation of end-stage periventricular leukomalacia (PVL) in six children, aged 31-54 months, in whom PVL had been documented by neurologic ultrasonography during the neonatal period. Eight children of similar age (four premature infants and four full-term infants) with normal neurologic development served as controls. A characteristic triad of PVL abnormalities was seen on MR images: (a) abnormally increased periventricular white-matter signal intensity on the first and second echo images of a T2-weighted sequence (repetition time = 2,000-2,400 msec, echo times = 20 or 30 and 80 msec), most commonly observed in the trigone regions of the lateral ventricles bilaterally; (b) marked loss of periventricular white matter in these regions of abnormal signal intensity, predominantly in the periatrial regions; and (c) compensatory focal ventricular enlargement adjacent to regions of abnormal signal intensity. In patients with the classic periatrial distribution of PVL lesions, general correlation between the degree of neurologic impairment and the severity of MR abnormalities was demonstrated. MR imaging was useful in detecting subtle forms of PVL in cases in which neurologic damage was subclinical. 相似文献
68.
Background
Monoclonal gammopathies occurs in patients with malignant diseases of plasma cells and lymphocytes and in few benign conditions. The objective of this study was to assess the precision, accuracy and confirmation of monoclonal gammopathies on serum protein electrophoresis (SPE) and the clinical relevance of detection and characterization of M component.Methods
All samples received for serum electrophoresis in the last 3 years were analysed for data on M band positivity and correlating it with clinical profile of the patients. Immunofixation (IFE), Immunoelectrophoresis (IEP) and IgG, IgM estimation were carried out in few cases. The follow up of cases was done by serial monitoring of SPE and β2 microglobulin levels.Results
1155 samples were received during the 3 years period. 282 (24.4%) samples were positive for M component on SPE. Of these, 239 (84.8%) patients had M spike in λ region and 43 patients had M spike in β region. The mean load of the M protein band in the λ region was 37.8% and in β region was 35.8%. IgG with κ chain was seen in 40%, IgG with λ chain was seen in 50%, 5% patients each had IgM with κ and IgA with λ light chain. 246 samples (96.5%) had high levels of β2 microglobulin. Of the 116 cases of multiple myeloma, IgG levels was more commonly raised (5%) as compared to IgA (6.9%) and IgM (5.2%).Conclusion
It is recommended that SPE should be performed in patients having unexplained weakness, anaemia, back pain, osteoporosis, osteolytic lesions, fractures, renal insufficiency or recurrent infections.Key Words: Serum protein, Electrophoresis, M band, Multiple myeloma 相似文献69.
Recent studies of the vestibulo-ocular reflex have revealed a distinct pathway from the anterior semicircular canal to the contralateral oculomotor nucleus via the superior vestibular nucleus. Axons of this pathway ascend in the brachium conjunctivum, while axons of the other semicircular canal pathways ascend in the medial longitudinal fasciculus (MLF). We report two cases of primary position upbeat nystagmus where lesions of the brachium conjunctivum were suggested by computed tomography (CT) scans. One of these lesions was confirmed at autopsy. We concluded that primary position upbeat nystagmus, like downbeat nystagmus, is a type of central vestibular nystagmus resulting from an imbalance of vertical vestibulo-ocular reflex activity. 相似文献
70.