全文获取类型
收费全文 | 1545篇 |
免费 | 121篇 |
国内免费 | 28篇 |
专业分类
耳鼻咽喉 | 36篇 |
儿科学 | 120篇 |
妇产科学 | 37篇 |
基础医学 | 148篇 |
口腔科学 | 54篇 |
临床医学 | 198篇 |
内科学 | 251篇 |
皮肤病学 | 15篇 |
神经病学 | 60篇 |
特种医学 | 262篇 |
外科学 | 149篇 |
综合类 | 47篇 |
预防医学 | 114篇 |
眼科学 | 9篇 |
药学 | 91篇 |
肿瘤学 | 103篇 |
出版年
2023年 | 5篇 |
2021年 | 13篇 |
2020年 | 6篇 |
2019年 | 12篇 |
2018年 | 26篇 |
2017年 | 16篇 |
2016年 | 19篇 |
2015年 | 20篇 |
2014年 | 30篇 |
2013年 | 45篇 |
2012年 | 32篇 |
2011年 | 41篇 |
2010年 | 46篇 |
2009年 | 49篇 |
2008年 | 42篇 |
2007年 | 70篇 |
2006年 | 53篇 |
2005年 | 43篇 |
2004年 | 24篇 |
2003年 | 46篇 |
2002年 | 33篇 |
2001年 | 58篇 |
2000年 | 53篇 |
1999年 | 31篇 |
1998年 | 67篇 |
1997年 | 79篇 |
1996年 | 81篇 |
1995年 | 54篇 |
1994年 | 44篇 |
1993年 | 46篇 |
1992年 | 33篇 |
1991年 | 29篇 |
1990年 | 35篇 |
1989年 | 60篇 |
1988年 | 56篇 |
1987年 | 42篇 |
1986年 | 41篇 |
1985年 | 39篇 |
1984年 | 17篇 |
1983年 | 18篇 |
1982年 | 16篇 |
1981年 | 16篇 |
1980年 | 17篇 |
1979年 | 12篇 |
1978年 | 8篇 |
1977年 | 16篇 |
1976年 | 14篇 |
1975年 | 9篇 |
1973年 | 5篇 |
1966年 | 4篇 |
排序方式: 共有1694条查询结果,搜索用时 15 毫秒
991.
National Comprehensive Cancer Network Forastiere AA Ang KK Brizel D Brockstein BE Burtness BA Cmelak AJ Colevas AD Dunphy F Eisele DW Goepfert H Hicks WL Kies MS Lydiatt WM Maghami E Martins R McCaffrey T Mittal BB Pfister DG Pinto HA Posner MR Ridge JA Samant S Schuller DE Shah JP Spencer S Trotti A Weber RS Wolf GT Worden F 《Journal of the National Comprehensive Cancer Network : JNCCN》2008,6(7):646-695
992.
DJ O'Brien G Flannelly EE Mooney M Foley 《BJOG : an international journal of obstetrics and gynaecology》2009,116(7):991-994
Objective To study the relationship between lymphovascular space involvement (LVSI) in stage 1a or 1b well-differentiated endometrial cancer and survival.
Design Retrospective study consisting of a search of an oncology database to identify women with endometrial cancer between January 1990 and December 2004.
Setting Tertiary referral centre, Dublin, Ireland.
Sample Women who had well-differentiated stage 1a or 1b endometrial cancer.
Methods During the period 1990–2004, 226 patients with endometrial cancer were treated in the National Maternity Hospital, Dublin. We looked at all patients who had well-differentiated endometrioid adenocarcinoma of the endometrium with invasion of <50% thickness of the myometrium. Forty-one patients fulfilled these inclusion criteria. The presence or absence of LSVI was determined by review of haematoxylin and eosin sections. Patients were followed for 5 years or till death if earlier. Mortality was calculated. Statistical analysis was performed using Fisher's exact test. An odds ratio and 95% confidence interval was calculated using fixed effect Mantel–Haenszel model.
Main outcome measures Death from recurrence of endometrial cancer.
Results Of the 41 patients, five (12%) were found to have (LVSI). Of the five patients with LVSI, three (60%) patients died of recurrence. All patients with recurrence died of disease and none of the patients without LVSI died (0 of 36). Overall, the survival rate was 92.7%. The presence of LVSI was a highly significant predictor of recurrence ( P < 0.001).
Conclusion In patients with early stage well-differentiated adenocarcinoma of the endometrium, the presence of LVSI is associated with a high risk of death. 相似文献
Design Retrospective study consisting of a search of an oncology database to identify women with endometrial cancer between January 1990 and December 2004.
Setting Tertiary referral centre, Dublin, Ireland.
Sample Women who had well-differentiated stage 1a or 1b endometrial cancer.
Methods During the period 1990–2004, 226 patients with endometrial cancer were treated in the National Maternity Hospital, Dublin. We looked at all patients who had well-differentiated endometrioid adenocarcinoma of the endometrium with invasion of <50% thickness of the myometrium. Forty-one patients fulfilled these inclusion criteria. The presence or absence of LSVI was determined by review of haematoxylin and eosin sections. Patients were followed for 5 years or till death if earlier. Mortality was calculated. Statistical analysis was performed using Fisher's exact test. An odds ratio and 95% confidence interval was calculated using fixed effect Mantel–Haenszel model.
Main outcome measures Death from recurrence of endometrial cancer.
Results Of the 41 patients, five (12%) were found to have (LVSI). Of the five patients with LVSI, three (60%) patients died of recurrence. All patients with recurrence died of disease and none of the patients without LVSI died (0 of 36). Overall, the survival rate was 92.7%. The presence of LVSI was a highly significant predictor of recurrence ( P < 0.001).
Conclusion In patients with early stage well-differentiated adenocarcinoma of the endometrium, the presence of LVSI is associated with a high risk of death. 相似文献
993.
Gemma O'Reilly BMus MA MT Pui Sze Cheung BSocSc MA MT Tríona McCaffrey BA MA MT Psych Dip PhD 《Journal of Midwifery & Women's Health》2023,68(2):205-209
Introduction
Attachment is a lasting psychological and emotional bond that impacts a child's social, emotional, and cognitive development. Maternal-fetal attachment is a precursor to this bond that is regarded as a predictor for mother-infant relating postbirth. Although previous studies have investigated use of music interventions to support maternal-fetal attachment, no study to date has investigated the use of maternal songwriting to support this bond during pregnancy.Methods
Four pregnant women were recruited to this pilot study. Each woman participated in 2 songwriting workshops with the aim of writing an original song to their fetus. Following the workshops, experiences of using songwriting for the purposes of supporting bonding were investigated through individual semistructured interviews and analyzed using thematic content analysis.Results
Analysis of semistructured interviews with pregnant women revealed 3 main themes: song singing promotes physical connection with the fetus; songwriting encourages open communication with the fetus; and songwriting can create a musical legacy within families.Discussion
To the best of our knowledge, this study is the first of its kind that investigated maternal songwriting to support bonding during pregnancy. Findings indicated that songwriting has the potential to support such attachment due to its capacity to enhance physical connection and open communication with the fetus, while also creating a musical legacy that can be used and passed on among other family members. Overall, songwriting may support pregnant women to draw on their inner resources to create such a bespoke musical gift to their unborn child. Further research around this topic is warranted. 相似文献994.
The present study evaluated an A-B-A single case design attention-remediation program for traumatically brain-injured survivors with chronic attention deficits. Four adult male TBI survivors participated in an intensive, hierarchically ordered, attention-remediation program based on Posner's four-component model of attention. No clinically significant improvement was obtained on the attentional measures, neuropsychological variables, psychological characteristics, activities of daily living, or subjective ratings of changes in attentional abilities. The efficacy of this attention-remediation program for TBI survivors is examined in light of other outcome studies. 相似文献
995.
骨质疏松症是一种以骨组织微结构退化和骨量减少为特怔的代谢性骨病,可致骨骼脆性增加和骨折发生率升高m。流行病学研究显示,美国骨质疏松症的发病率为18.6%121,而我国为15.7%[3],50岁以上人群骨质疏松症发病率女性为20.7%,男性为14.4%|31。到2050年我国为此每年花费约I 745亿元141。随着人口老龄化进展,骨质疏松症及其相关的骨折已成为一个世界性的严重问题。 相似文献
996.
Paclitaxel, estramustine phosphate, and carboplatin in patients with advanced prostate cancer. 总被引:6,自引:0,他引:6
W K Kelly T Curley S Slovin G Heller J McCaffrey D Bajorin A Ciolino K Regan M Schwartz P Kantoff D George W Oh M Smith D Kaufman E J Small L Schwartz S Larson W Tong H Scher 《Journal of clinical oncology》2001,19(1):44-53
PURPOSE: To determine the safety and activity of weekly paclitaxel in combination with estramustine and carboplatin (TEC) in patients with advanced prostate cancer. PATIENTS AND METHODS: In a dose-escalation study, patients with advanced prostate cancer were administered paclitaxel (weekly 1-hour infusions of 60 to 100 mg/m(2)), oral estramustine (10 mg/kg), and carboplatin (area under the curve, 6 mg/mL-min every 4 weeks). Paclitaxel levels were determined 0, 30, 60, 90, and 120 minutes and 18 hours after infusion, and a concentration-time curve was estimated. Once a safe dose was established, a multi-institutional phase II trial was conducted in patients with progressive androgen-independent disease. RESULTS: Fifty-six patients with progressive androgen-independent disease were treated for a median of four cycles. The dose of paclitaxel was escalated from 60 to 100 mg/m(2) without the occurrence of DLT. Posttherapy decreases in serum prostate-specific antigen levels of 50%, 80%, and 90% were seen in 67%, 48%, and 39% (95% confidence interval, 55% to 79%, 35% to 61%, 26% to 52%) of the patients, respectively. Of the 33 patients with measurable disease, two (6%) had a complete response and 13 (39%) had a partial response. The overall median time to progression was 21 weeks, and the median survival time for all patients was 19.9 months. Major grade 3 or 4 adverse effects were thromboembolic disease (in 25% of patients), hyperglycemia (in 38%), and hypophosphatemia (in 42%). Significant leukopenia, thrombocytopenia, and peripheral neuropathy were not observed. CONCLUSION: TEC has significant antitumor activity and is well tolerated in patients with progressive androgen-independent prostate cancer. 相似文献
997.
Low-volume nodal metastases detected at retroperitoneal lymphadenectomy for testicular cancer: pattern and prognostic factors for relapse. 总被引:2,自引:0,他引:2
F Rabbani J Sheinfeld H Farivar-Mohseni A Leon M J Rentzepis V E Reuter H W Herr J A McCaffrey R J Motzer D F Bajorin G J Bosl 《Journal of clinical oncology》2001,19(7):2020-2025
PURPOSE: To determine the incidence, pattern, and predictive factors for relapse in patients with low-volume nodal metastases (stage pN1) at retroperitoneal lymphadenectomy (RPLND) and identify who may benefit from chemotherapy in the adjuvant or primary setting. PATIENTS AND METHODS: Fifty-four patients with testicular nonseminomatous germ cell tumor had low-volume retroperitoneal metastases (pathologic stage pN1, 1997 tumor-node-metastasis classification) resected at RPLND, 50 of whom were managed expectantly without adjuvant chemotherapy. The dissection was bilateral in 12 and was a modified template in 38 patients. Retroperitoneal metastases were limited to microscopic nodal involvement in 14 patients. Follow-up ranged from 1 to 106 months (median, 31.4 months). RESULTS: Eleven patients (22%) suffered a relapse at a median follow-up of 1.8 months (range, 0.6 to 28 months). The most frequent form of recurrence was marker elevation in nine (18%) patients. Persistent marker elevation after orchiectomy and before retroperitoneal lymphadenectomy was a significant independent predictor of relapse (relative risk, 8.0; 95% confidence interval, 2.3 to 27.8; P =.001). Four of five (80%) patients with elevated markers (alpha-fetoprotein alone in three, alpha-fetoprotein and beta human chorionic gonadotropin in one) suffered a relapse, compared with seven of 45 (15.6%) patients with normal markers. CONCLUSION: Clinical stage I and IIA patients with normal markers who have low-volume nodal metastases have a low incidence of relapse and can be managed by observation only if compliance can be assured. In contrast, patients with elevated markers before retroperitoneal lymphadenectomy have a high rate of relapse and should be considered for primary chemotherapy. 相似文献
998.
Lamb DJ 《国外医学(计划生育.生殖健康分册)》2010,29(3):182-187
精子功能检测曾经是不孕夫妇进行辅助生殖技术(ART)前普遍采取的检查。如今世界各地的生殖医学中心已忽视了这些检查。精子功能检测操作步骤的确已分组纳入最新出版的《世界卫生组织人类精液分析实验室技术手册》的“研究步骤”章节。这很大程度上反映了此现状,即当前临床实践忽略了对不孕夫妇中男方因素的深入检查。认为如果能找到精子,一定就是健康、具有受精能力的、可进行胞浆内单精子注射(ICSI)的精子。然而,通过精子功能测试,可揭示造成男性不育的精子缺陷,为不孕夫妇提供指导。诚然,在某些情况下,ART可克服某些精子功能缺陷,但在其他情况下,夫妇有权了解不孕不育的原因,甚至ICSI的成功率(和精子有关)。知晓这些,有助于其真正清楚自己的生育状态,以证实是否寻求供精人工授精、领养孩子或维持无子女状态。了解不孕的真正原因,有助于说服不孕夫妇放弃艰难又毫无结果的自然妊娠,更加坚定地选择ART治疗不育。 相似文献
999.
1000.
Julia Buldo-Licciardi Michael J. Large David H. McCulloh Caroline McCaffrey James A. Grifo 《Journal of assisted reproduction and genetics》2023,40(2):289
PurposeTo investigate the role of standardized preimplantation genetic testing for aneuploidy (PGT-A) using artificial intelligence (AI) in patients undergoing single thawed euploid embryo transfer (STEET) cycles.MethodsRetrospective cohort study at a single, large university-based fertility center with patients undergoing in vitro fertilization (IVF) utilizing PGT-A from February 2015 to April 2020. Controls included embryos tested using subjective NGS. The first experimental group included embryos analyzed by NGS utilizing AI and machine learning (PGTaiSM Technology Platform, AI 1.0). The second group included embryos analyzed by AI 1.0 and SNP analysis (PGTai2.0, AI 2.0). Primary outcomes included rates of euploidy, aneuploidy and simple mosaicism. Secondary outcomes included rates of implantation (IR), clinical pregnancy (CPR), biochemical pregnancy (BPR), spontaneous abortion (SABR) and ongoing pregnancy and/or live birth (OP/LBR).ResultsA total of 24,908 embryos were analyzed, and classification rates using AI platforms were compared to subjective NGS. Overall, those tested via AI 1.0 showed a significantly increased euploidy rate (36.6% vs. 28.9%), decreased simple mosaicism rate (11.3% vs. 14.0%) and decreased aneuploidy rate (52.1% vs. 57.0%). Overall, those tested via AI 2.0 showed a significantly increased euploidy rate (35.0% vs. 28.9%) and decreased simple mosaicism rate (10.1% vs. 14.0%). Aneuploidy rate was insignificantly decreased when comparing AI 2.0 to NGS (54.8% vs. 57.0%). A total of 1,174 euploid embryos were transferred. The OP/LBR was significantly higher in the AI 2.0 group (70.3% vs. 61.7%). The BPR was significantly lower in the AI 2.0 group (4.6% vs. 11.8%).ConclusionStandardized PGT-A via AI significantly increases euploidy classification rates and OP/LBR, and decreases BPR when compared to standard NGS. 相似文献