全文获取类型
收费全文 | 1073篇 |
免费 | 58篇 |
国内免费 | 11篇 |
专业分类
耳鼻咽喉 | 1篇 |
儿科学 | 115篇 |
妇产科学 | 11篇 |
基础医学 | 82篇 |
口腔科学 | 36篇 |
临床医学 | 173篇 |
内科学 | 248篇 |
皮肤病学 | 15篇 |
神经病学 | 22篇 |
特种医学 | 214篇 |
外科学 | 69篇 |
综合类 | 35篇 |
预防医学 | 52篇 |
眼科学 | 7篇 |
药学 | 30篇 |
1篇 | |
肿瘤学 | 31篇 |
出版年
2021年 | 4篇 |
2020年 | 7篇 |
2019年 | 7篇 |
2018年 | 12篇 |
2017年 | 12篇 |
2016年 | 9篇 |
2015年 | 20篇 |
2014年 | 19篇 |
2013年 | 18篇 |
2012年 | 18篇 |
2011年 | 17篇 |
2010年 | 38篇 |
2009年 | 45篇 |
2008年 | 29篇 |
2007年 | 11篇 |
2006年 | 15篇 |
2005年 | 18篇 |
2004年 | 17篇 |
2003年 | 15篇 |
2002年 | 21篇 |
2001年 | 15篇 |
2000年 | 10篇 |
1999年 | 19篇 |
1998年 | 85篇 |
1997年 | 85篇 |
1996年 | 89篇 |
1995年 | 58篇 |
1994年 | 52篇 |
1993年 | 45篇 |
1992年 | 20篇 |
1991年 | 21篇 |
1990年 | 11篇 |
1989年 | 37篇 |
1988年 | 30篇 |
1987年 | 37篇 |
1986年 | 18篇 |
1985年 | 30篇 |
1984年 | 21篇 |
1983年 | 19篇 |
1982年 | 16篇 |
1981年 | 17篇 |
1980年 | 9篇 |
1979年 | 4篇 |
1978年 | 6篇 |
1977年 | 8篇 |
1976年 | 9篇 |
1975年 | 8篇 |
1971年 | 2篇 |
1969年 | 2篇 |
1966年 | 2篇 |
排序方式: 共有1142条查询结果,搜索用时 15 毫秒
81.
McCullough JA Evoy D Sweeney KJ Meyers C Ravi N Keeling N Byrne PJ Reynolds JV 《Irish journal of medical science》2003,172(3):132-135
Background Gastric carcinoma is a significant cause of death in Ireland. Surgery offers the best option of cure, but the five-year survival
following resection remains dismal at 10–15%. Experience from Japan and from some Western units suggest that an extended (D2)
lymphadenectomy in association with gastrectomy increases the prospect of cure, but concern about the morbidity and mortality
of this operation and lack of evidence from randomised studies has limited its acceptance.
Aims This study reports the experience of a specialist upper gastrointestinal unit with D2 gastrectomy in a four-year audit.
Methods Sixty-two resections were performed for gastric cancer. Results Nineteen patients were deemed unsuitable for the D2 procedure
and underwent a more limited lymphadenectomy (DO or D1). Forty-three patients underwent D2 resection, 12 with an oesophagogastrectomy,
22 with total gastrectomy and nine with a sub-total distal resection. Eight patients undergoing D2 resection had extended
resections, five with splenectomy and three with a distal pancreatectomy. Post-operative complications occurred in 31% of
patients. Thirty-day and 90-day mortality were zero. Median survival was 822 days in the D2 group (range 120–1,320).
Conclusions These results show that a D2 gastrectomy can be performed with a low morbidity and mortality and a median survival of greater
than two years. 相似文献
82.
Background The contribution of dysmotility to dysphagia in oesophageal cancer is unclear.
Aim To examine oesophageal motility in patients with oesophageal carcinoma and to assess the effect of chemoradiotherapy on motility.
Methods Stationary manometry and 24-hour pH-metry were performed in 12 patients with oesophageal carcinoma and one week following
completion of chemoradiotherapy using 5-fluorouracil (5-FU), cisplatin and 40Gy radiotherapy.
Results All patients had abnormal motility prior to treatment. Peristalsis was impaired in 11 patients with a mean (SD) of 25% (9)
of waves normally propagated. Eight patients had 20% or more simultaneous waves. Following chemoradiotherapy, the percentage
of waves normally propagated increased from 25% (9) to 52% (10) (p < 0.03) and normal peristalsis was restored in four patients.
The percentage of simultaneous waves decreased from 38% (11) to 21.6% (10) (p=0.129) while the percentage of dropped or increased
waves decreased from 20% (11) to 8.3% (4) (p=0.264).
Conclusions Oesophageal motility is disturbed in oesophageal cancer. Dysphagia in oesophageal cancer may be partly explained by oesophageal
dysmotility. This is improved by chemotherapy. 相似文献
83.
Cuppen JG Van den Brink PJ Camps E Uil KF Brock TC 《Aquatic toxicology (Amsterdam, Netherlands)》2000,48(2-3):233-250
Effects of chronic application of the fungicide Derosal(R) (active ingredient carbendazim) were studied in indoor macrophyte-dominated freshwater microcosms. The concentrations (0, 3.3, 33, 100, 330 and 1000 μg/l) were kept at a constant level for 4 weeks. This paper is the first of a series of two, and describes the fate of carbendazim and its effects on water quality parameters, breakdown of POM, and responses of macroinvertebrates. Carbendazim proved very persistent in the water layer. Values for t(12) varied between 6 and 25 weeks, and decreased with the treatment level. Significant effects on water quality parameters (DO, pH, alkalinity, conductivity) could not be demonstrated. After 4 weeks of incubation, the breakdown of Populus leaves was significantly slower at the two highest carbendazim concentrations. The macroinvertebrate community was seriously affected by carbendazim application, with Oligochaeta, Turbellaria, Hirudinea and some Crustacea as the most sensitive groups. The snail Bithynia decreased in numbers, but other gastropods increased in numbers. Safety factors as proposed by the Uniform Principles (European Union) for the risk assessment of pesticides, to be multiplied with toxicity data of the standard test species (Daphnia, fish, algae), appeared to ensure adequate protection of sensitive populations present in the microcosms. 相似文献
84.
Lidocaine has been used in treatment of patients with refractory headache. Personal observations of neuropsychiatric toxicity in these patients led us to review our cases and the literature systematically for lidocaine side-effects, especially neuropsychiatric symptoms. In our series of 20 patients, side-effects were observed in all, the most frequent being neuropsychiatric (75%) and cardiological (50%). When reviewing published series on intravenous lidocaine use, reports of side-effects range from 0 to 100%, with neuropsychiatric symptoms being reported in 1.8–100%. Thirty-six case reports of lidocaine-induced psychiatric symptoms were also analysed. Psychiatric symptoms of toxicity were similar in most patients, despite their differing ages, pathologies, co-therapies and lidocaine dosages. In conclusion, lidocaine neuropsychiatric toxicity has a well-recognized stereotypical clinical presentation that is probably unrecognized in headache series. As lidocaine represents an emerging alternative therapy in headache, particularly in short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing, clinicians and patients should be aware of the extent of this problem. 相似文献
85.
H Kaube YE Knight RJ Storer KL Hoskin A May PJ Goadsby 《Cephalalgia : an international journal of headache》1999,19(6):592-597
It remains an open question as to whether cortical spreading depression (CSD) is the pathophysiological correlate of the neurological symptoms in migraine with aura. In the experimental animal, CSD is an electrophysiological phenomenon mainly mediated via NMDA receptors. However, according to case reports in humans, visual aura in migraine can be alleviated by vasodilator substances, such as amyl nitrite and isoprenaline. There is also circumstantial evidence that brainstem nuclei (dorsal raphe nucleus and locus coeruleus) may play a pivotal role in the initiation of aura. In this study, CSD was elicited in alpha-chloralose anesthetized cats by cortical needle stab injury and monitored by means of laser Doppler flowmetry. Topical application of isoprenaline (0.1-1%) and amyl nitrite (0.05%) onto the exposed cortex had no effect on the elicitation or propagation of CSD. Also, after supracollicular transection, subsequent CSDs showed no differences in the speed of propagation and associated flow changes. We conclude from these data that--given CSD probably exists in humans during migraine--spreading neurological deficits during migraine aura are independent of brainstem influence and have a primarily neuronal rather than vascular mechanism of generation. 相似文献
86.
Gabriella M van Dijk Cindy Veenhof Francois Schellevis Harry Hulsmans Jan PJ Bakker Henk Arwert Jos HM Dekker Guus J Lankhorst Joost Dekker 《BMC musculoskeletal disorders》2008,9(1):95
Background
This study aims to contribute to the knowledge of the influence of comorbidity in OA. The objectives of the study were (i) to describe the prevalence of comorbidity and (ii) to describe the relationship between comorbidity (morbidity count, severity and the presence of specific diseases) and limitations in activities and pain in elderly patients with knee or hip OA using a comprehensive inventory of comorbidity. 相似文献87.
WS Lee PJ McKiernan J de Ville de Goyet MS Tanner PR John 《Acta paediatrica (Oslo, Norway : 1992)》2001,90(11):1352-1355
A 16-y-old boy who had undergone bone marrow transplantation for relapsed acute lymphoblastic leukaemia developed liver cirrhosis and refractory ascites, which did not respond to salt restriction, diuretics and abdominal paracentesis. Liver transplantation was not feasible because of poor nutritional status, pre-existing renal dysfunction and uncertainty about the prognosis of his leukaemia. The patient underwent a successful transjugular intrahepatic portosystemic shunt (TIPS), with immediate resolution of ascites, enabling cessation of diuretics and improvement in nutritional status. At 24 mo following TIPS there has been no re-accumulation of ascites. CONCLUSION: TIPS may have a role in the management of refractory ascites secondary to liver cirrhosis in selected children. 相似文献
88.
Russell SM Elliott R Forshaw D Kelly PJ Golfinos JG 《中国神经肿瘤杂志》2005,3(4):295-295
OBJECT: The goal of this study is to report the incidence and clinical evolution of neurological deficits in patients who underwent resection of gliomas confined to the parietal lobe. METHODS: Patient demographics, findings of serial neurological examinations, tumor location and neuroimaging characteristics, extent of resection, and surgical outcomes were tabulated by reviewing inpatient and office records, as well as all pre- and postoperative magnetic resonance (MR) images obtained in 28 consecutive patients who underwent resection of a glial neoplasm found on imaging studies to be confined to the parietal lobe. Neurological deficits were correlated with hemispheric dominance, location of the lesion within the superior or inferior parietal lobules, subcortical extension, and involvement of the postcentral gyms. The tumors were located in the dominant hemisphere in 18 patients (64%); had a mean diameter of 39 mm (range 14-69 mm); were isolated to the superior parietal lobule in six patients (21%) and to the inferior parietal lobule in eight patients (29%); and involved both lobules in 14 patients (50%). Gross-total resection, documented by MR imaging, was achieved in 24 patients (86%). Postoperatively, nine patients (32%) experienced new neurological deficits, whereas seven (25%) had an improvement in their preoperative deficit. A correlation was noted between larger tumors and the presence of neurological deficits both before and after resection. Postoperatively higher-level (association) parietal deficits were noted only in patients with tumors involving both the superior and inferior parietal lobules in the dominant hemisphere. At the 3-month follow-up examination, five of nine new postoperative deficits had resolved. CONCLUSIONS: Neurological deterioration and improvement occur after resection of parietal lobe gliomas. Parietal lobe association deficits, specifically the components of Gerstmann syndrome, are mostly associated with large tumors that involve both the superior and inferior parietal lobules of the dominant hemisphere. New hemineglect or sensory extinction was not noted in any patient following resection of lesions located in the nondominant hemisphere. Nevertheless, primary parietal lobe deficits (for example, a visual field loss or cortical sensory syndrome) occurred in patients regardless of hemispheric dominance. 相似文献
89.
Inward buckling of the dura at C1-2 may occasionally occur with hyperextension of the neck and can result in a difficult or unsuccessful puncture when the posterior lateral C1-2 approach is used for cervical myelography. In this circumstance, placement of the head in a neutral or slightly flexed position may widen the posterior subarachnoid space and facilitate the needle puncture. 相似文献
90.
Cor P van der Hart Michel PJ van den Bekerom Thomas W Patt 《Journal of orthopaedic surgery and research》2008,3(1):24