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931.
932.
To determine the optimal site for antegrade puncture of the femoral artery, the authors evaluated three cadaver specimens and computed tomographic (CT) scans of 50 patients. The relationships among the common femoral artery, the femoral artery bifurcation, the center of the femoral head, and the inguinal ligament were evaluated. CT showed that the center of the femoral head was always located caudal to the level of the inguinal ligament but cranial to the bifurcation of the common femoral artery. Therefore, the femoral head seems to provide a reliable landmark for entering the common femoral artery. 相似文献
933.
Long term follow-up of patients with side to side choledochoduodenostomy and transduodenal sphincteroplasty. 总被引:3,自引:1,他引:2 下载免费PDF全文
A. R. Baker J. P. Neoptolemos T. Leese D. C. James D. P. Fossard 《Annals of the Royal College of Surgeons of England》1987,69(6):253-257
From a consecutive series of 190 patients with choledochoduodenostomy (CDD) and 56 patients with transduodenal sphincteroplasty (TDS), there were 10 and 3 hospital deaths respectively. A long term follow-up study was performed on the remainder. Late deaths occurred in 35 CDD and 5 TDS patients. Serious long term complications occurred in 3.3% of CDD cases, comprising 5 cases of 'sump syndrome' and a further case of cholangitis in the presence of a clear biliary tree. Cholangitis occurred in 2 of the TDS patients (3.8%). Recurrent common duct stones were found in 3 of the 'sump syndrome' cases (1.6%) and one of the TDS patients with cholangitis (1.9%). Eighty-eight per cent of the CDD patients and 90.2% of the TDS patients, who were reviewed, were subjectively well. Serum alkaline phosphatase was raised in 21.6% of the CDD patients and only 3.4% of the TDS group (P less than 0.05). Radiological studies showed that the CDD stoma admitted air and barium more often than the TDS stoma (P less than 0.001). Neither the biochemical nor the radiological findings correlated with the long term symptomatic results of the two procedures. Dynamic HIDA scans showed a shorter time to peak activity in the common hepatic duct for both CDD (P less than 0.01) and TDS (P less than 0.05) as compared with endoscopic sphincterotomy (ES). These long-term clinical, biochemical and radiological results are similar to those reported following ES. 相似文献
934.
935.
Polk HC Bowden TA Rikkers LF Balch CM Organ CH Murie JA Pories WJ Buechler MW Neoptolemos JP Fazio VW Schwartz SI Cameron JL Kelly KA Grosfeld JL McFadden DW Souba WW Pruitt BA Johnston KW Rutherford RB Arregui ME Scott-Conner CE Warshaw AL Sarr MG Cuschieri A MacFadyen BV Tompkins RK 《World journal of surgery》2002,26(6):637-638
936.
F Gottrand D Turck V Mitchell JP Farriaux 《Acta paediatrica (Oslo, Norway : 1992)》1992,81(5):399-401
We analyzed the results of 607 small bowel biopsies performed over a seven-year period: 284 biopsies were obtained using a fiberendoscope and 323 biopsies using a Watson capsule. Three to six specimens were removed during endoscopy. The biopsy fragments obtained with the fiberendoscope were deeper than those obtained with the Watson capsule (p less than 0.0001) and were more often located in the duodenum (p less than 0.0001). The failure rate of the fiberendoscope biopsies (1%) was lower than for the Watson capsule biopsies (9%) (p less than 0.0001). Multiple biopsies increased the diagnostic value of fiberendoscopy which was 95% versus 85% for Watson capsule. The mean duration of the endoscopic procedure recorded in 30 children was 6.5 min for four to six samples, i.e. 1.5 min per biopsy specimen. Fiberendoscopy appears to be an efficient and safe method for performing small bowel biopsies in infants and children. 相似文献
937.
Pancreatic ductal adenocarcinoma is one of the most common causes of cancer death in the developed world. Long-term survival is currently only achieved through surgical resection. Most patients have locally advanced or metastatic disease at the time of diagnosis and are therefore not amenable to resection, whilst chemotherapy and radiotherapy are by and large ineffective. Gene therapy offers an alternative to current adjuvant strategies. With approximately two-thirds of all gene therapy trials worldwide directed at cancer, the gene therapy approaches that are currently being explored for pancreatic cancer are specifically examined. Gene delivery systems, genetic targets, and combined gene delivery with chemotherapy are discussed in the context of pancreatic cancer treatment. 相似文献
938.
Heat shock protein expression independently predicts clinical outcome in prostate cancer 总被引:28,自引:0,他引:28
Cornford PA Dodson AR Parsons KF Desmond AD Woolfenden A Fordham M Neoptolemos JP Ke Y Foster CS 《Cancer research》2000,60(24):7099-7105
Heat shock proteins (hsps) occupy a central role in the regulation of intracellular homeostasis, and differential expression of individual hsps occurs in a broad range of neoplastic processes. This study was performed to test the hypothesis that the particular patterns by which individual hsps become specifically modulated in human prostate cancers are correlated with behavioral phenotype and hence may be of value in determining the most appropriate clinical management of individual patients. Monoclonal antibodies specific for each hsp protein were used to assess expression of hsp27, hsp60, and hsp70 in formalin-fixed, paraffin wax-embedded, archival tissue specimens of early prostatic adenocarcinomas (pT1-2N0M0) removed at radical prostatectomy (n = 25) and in advanced cancers (n = 95) identified at transurethral resection of prostate (TURP). These findings were compared with similar data from control prostates (n = 10) removed at primary cystectomy for urinary bladder neoplasia not involving the prostate and also at TURP for benign prostatic hyperplasia (n = 50). Western blotting of whole cell lysates derived from established human prostatic epithelial cell lines PNT2, LNCaP, DU145, and PC3 was compared with expression of hsps by the primary human tissues. This study found that early in situ neoplastic transformation of normal prostatic epithelium was consistently associated with loss of hsp27 expression and that the level of hsp27 expression by individual prostate cancers was correlated with their Gleason grade. In advanced cancers, hsp27 expression was invariably associated with poor clinical outcome (P = 0.0001). Data from cell lines supported the primary tissue findings, with elevated hsp27 expression only in aggressive malignant cell lines and androgen-insensitive cell lines. Expression of hsp60 was significantly increased in both early and advanced prostate cancer when compared with nonneoplastic prostatic epithelium (P < 0.0001), as well as in malignant prostate cancer cell lines. Expression of hsp70 was unaltered in early prostate cancers when compared with nonneoplastic prostatic epithelium but showed a diminished expression in morphologically advanced cancers (P = 0.0029). No consistent correlation was found between levels of hsp60 or hsp70 expression and phenotypic behavior of individual primary prostatic cancers. Thus, patterns of hsp expression have been confirmed to be specifically and consistently modulated in both early and advanced human prostate cancers. Whereas absence of hsp27 is a reliable objective marker of early prostatic neoplasia, reexpression of this protein by an individual invasive prostatic carcinoma invariably heralds poor clinical prognosis. Because this protein has been shown to alter the balance between proliferation and apoptosis, understanding the mechanism(s) by which individual hsps regulate intracellular homeostasis may assist in explaining some key processes that occur during evolution of human prostate cancers. We suggest that hsp27 expression provides novel diagnostic and prognostic information on individual patient survival which, if obtained at the time of primary diagnosis, would assist in determining tumor-specific management strategies. Development of techniques to therapeutically modulate hsp27 expression raises the possibility of novel targeted approaches to regulate this homeostatic mechanism, thus allowing better control over tumor cell proliferation and hence patient survival. 相似文献
939.
940.
Intravenous angiography of the extracranial cerebral arteries 总被引:1,自引:0,他引:1