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41.
Volkmar Müller Sabine Riethdorf Brigitte Rack Wolfgang Janni Peter A Fasching Erich Solomayer Bahriye Aktas Sabine Kasimir-Bauer Klaus Pantel Tanja Fehm 《Breast cancer research : BCR》2012,14(4):1-8
Introduction
There is a multitude of assays for the detection of circulating tumor cells (CTCs) but a very limited number of studies comparing the clinical relevance of results obtained with different test methods. The DETECT trial for metastatic breast cancer patients was designed to directly compare the prognostic impact of two commercially available CTC assays that are prominent representatives of immunocytochemical and RT-PCR based technologies.Methods
In total, 254 metastatic breast cancer patients were enrolled in this prospective multicenter trial. CTCs were assessed using both the AdnaTest Breast Cancer and the CellSearch system according to the manufacturers' instructions.Results
With the CellSearch system, 116 of 221 (50%) evaluable patients were CTC-positive based on a cut-off level at 5 or more CTCs. The median overall survival (OS) was 18.1 months in CTC-positive patients. (95%-CI: 15.1-22.1 months) compared to 27 months in CTC-negative patients (23.5-30.7 months; p<0.001). This prognostic impact for OS was also significant in the subgroups of patients with triple negative, HER2-positive and hormone receptor-positive/HER2-negative primary tumors. The progression free survival (PFS) was not correlated with CTC status in our cohort receiving different types and lines of systemic treatment (p = 0.197). In multivariate analysis, the presence of CTCs was an independent predictor for OS (HR: 2.7, 95%-CI: 1.6-4.2). When the AdnaTest Breast was performed, 88 of 221 (40%) patients were CTC-positive. CTC-positivity assessed by the AdnaTest Breast had no association with PFS or OS.Conclusions
The prognostic relevance of CTC detection in metastatic breast cancer patients depends on the test method. The present results indicate that the CellSearch system is superior to the AdnaTest Breast Cancer in predicting clinical outcome in advanced breast cancer.Trial registration
Current Controlled Trials Registry number ISRCTN59722891. 相似文献42.
Svetlana V Glinianaia Judith Rankin Tanja Pless-Mulloli Mark S Pearce Martin Charlton Louise Parker 《BMC pregnancy and childbirth》2008,8(1):1-12
Background
In Australia and internationally, there is concern about the growing proportion of women giving birth by caesarean section. There is evidence of increased risk of placenta accreta and percreta in subsequent pregnancies as well as decreased fertility; and significant resource implications. Randomised controlled trials (RCTs) of continuity of midwifery care have reported reduced caesareans and other interventions in labour, as well as increased maternal satisfaction, with no statistically significant differences in perinatal morbidity or mortality. RCTs conducted in the UK and in Australia have largely measured the effect of teams of care providers (commonly 6–12 midwives) with very few testing caseload (one-to-one) midwifery care. This study aims to determine whether caseload (one-to-one) midwifery care for women at low risk of medical complications decreases the proportion of women delivering by caesarean section compared with women receiving 'standard' care. This paper presents the trial protocol in detail.Methods/design
A two-arm RCT design will be used. Women who are identified at low medical risk will be recruited from the antenatal booking clinics of a tertiary women's hospital in Melbourne, Australia. Baseline data will be collected, then women randomised to caseload midwifery or standard low risk care. Women allocated to the caseload intervention will receive antenatal, intrapartum and postpartum care from a designated primary midwife with one or two antenatal visits conducted by a 'back-up' midwife. The midwives will collaborate with obstetricians and other health professionals as necessary. If the woman has an extended labour, or if the primary midwife is unavailable, care will be provided by the back-up midwife. For women allocated to standard care, options include midwifery-led care with varying levels of continuity, junior obstetric care and community based general medical practitioner care. Data will be collected at recruitment (self administered survey) and at 2 and 6 months postpartum by postal survey. Medical/obstetric outcomes will be abstracted from the medical record. The sample size of 2008 was calculated to identify a decrease in caesarean birth from 19 to 14% and detect a range of other significant clinical differences. Comprehensive process and economic evaluations will be conducted.Trial registration
Australian New Zealand Clinical Trials Registry ACTRN012607000073404. 相似文献43.
44.
Exploring Educational Disparities in Risk of Preterm Delivery: A Comparative Study of 12 European Birth Cohorts 下载免费PDF全文
Gry Poulsen Katrine Strandberg‐Larsen Laust Mortensen Henrique Barros Sylvaine Cordier Sofia Correia Asta Danileviciute Manon van Eijsden Ana Fernández‐Somoano Ulrike Gehring Regina Grazuleviciene Esther Hafkamp‐de Groen Tine Brink Henriksen Morten Søndergaard Jensen Isabel Larrañaga Per Magnus Kate Pickett Hein Raat Lorenzo Richiardi Florence Rouget Franca Rusconi Camilla Stoltenberg Eleonora P. Uphoff Tanja G. M. Vrijkotte Alet H. Wijga Martine Vrijheid Merete Osler Anne‐Marie Nybo Andersen 《Paediatric and perinatal epidemiology》2015,29(3):172-183
45.
46.
Margareta Larsson Minna Berglund Emelie Jarl Tanja Tydén 《Upsala journal of medical sciences》2017,122(4):254-259
Background: The aim of the study was to investigate if expecting parents wanted to know the sex of the fetus during ultrasound examination and if they had discussed it with the midwife. Another aim was to explore any interest in sex selection.Methods: A longitudinal survey in early and late pregnancy among 2393 women in Sweden.Results: Almost all (95.8%, n?=?2289) women had discussed sex determination with the partner before the ultrasound scan, and 57% (n?=?1356) of women and their partners wanted to find out the fetal sex. The expecting parents mostly initiated a discussion with the midwife (46%, n?=?1088), but 10% (n?=?229) stated that the midwives initiated the discussion. Few (5%, n?=?118) expressed a potential interest in selecting sex of a baby. Women who were interested in sex determination did not differ from those who were not, with respect to age, origin, education, parity, level of pregnancy planning, or importance of religion, but women who had chosen another fetal diagnostic method were more interested in sex determination and in potential sex selection.Conclusions: Half of women and their partners wanted to know the fetal sex, and 5% were interested in sex selection. This high interest in sex determination is a challenge, since present national guidelines do not include sex determination as an option. 相似文献
47.
48.
Prevalence of youth gambling and potential influence of substance use and other risk factors throughout 33 European countries: first results from the 2015 ESPAD study 下载免费PDF全文
Sabrina Molinaro Elisa Benedetti Marco Scalese Luca Bastiani Loredana Fortunato Sonia Cerrai Natale Canale Pavla Chomynova Zsuzsanna Elekes Fernanda Feijão Anastasios Fotiou Anna Kokkevi Ludwig Kraus Liudmila Rupšienė Karin Monshouwer Alojz Nociar Julian Strizek Tanja Urdih Lazar 《Addiction (Abingdon, England)》2018,113(10):1862-1873
49.
Michaela Coenen Tanja A. Stamm Gerold Stucki Alarcos Cieza 《Quality of life research》2012,21(2):359-370
Purpose
To compare two different approaches to performing focus groups and individual interviews, an open approach, and an approach based on the International Classification of Functioning, Disability and Health (ICF). 相似文献50.