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141.
142.
143.
Michael G. T. Raraty Conor J. Magee Paula Ghaneh John P. Neoptolemos 《Acta oncologica (Stockholm, Sweden)》2002,41(7):582-595
Pancreatic ductal adenocarcinoma represents a major oncological challenge. Despite improvements in surgical techniques, long-term survival after resection is poor, with few patients surviving after 5 years. Until recently, there have been no large randomized trials of adjuvant therapy in pancreatic ductal adenocarcinoma. However, major trials such as the European Study Group for Pancreatic Cancer (ESPAC-1) and ESPAC-3 trials have set new standards for patient recruitment and development in this field. Adjuvant therapy has the potential to improve both patient survival and quality of life after curative resection. Currently, the best treatment is with 5-fluorouracil with folinic acid, but in the light of ongoing clinical trials, this may be supplanted by gemcitabine as the treatment of choice. Chemoradiotherapy does not appear to be beneficial in the adjuvant setting, but trials of a wide variety of other techniques and agents in the treatment of advanced disease are being undertaken and some of these will almost certainly be extended into the adjuvant setting in time. Great progress has been made in the adjuvant treatment of pancreatic cancer in the past 10 years and similar advances are likely over the next decade. 相似文献
144.
Dysgenesis of thyroid is the common type of childhood hypothyroidism in environmentally iodine deficient areas of north India 总被引:1,自引:0,他引:1
SM Shankar PSN Menon MG Karmarkar PG Gopinath 《Acta paediatrica (Oslo, Norway : 1992)》1994,83(10):1047-1051
Forty-five children (28 girls and 17 boys; mean age 4.5 years) with hypothyroidism referred to us from January 1989 to November 1990 were evaluated prospectively for the pattern of hypothyroidism by hormone assays, scintiscan and urinary iodine estimation. Among the 6 children from non-endemic areas, athyreosis and/or hypoplasia were seen in 3, ectopia in 2 and dyshormonogenesis in 1. Of 39 children from moderate to severe environmentally iodine deficient regions, 18 (46%) had athyreosis and/or hypoplasia and 10 (26%) ectopic thyroid. Iodine deficiency was seen in 4, dyshormonogenesis in 4, secondary/tertiary hypothyroidism in 2 and thyroiditis in 1. The mean age of these children at the onset of symptoms was 1.4 years and at clinical presentation 4.5 years. There was significant growth retardation with 54% of children being below the 5th centile of Indian standards. There was no significant difference in the age at onset of symptoms and presentation, clinical features and bone age for the different types. The levels of serum total T4 were significantly low in dysgenesis (athyreosis, hypoplasia and ectopia, p < 0,001). Dysgenesis of the thyroid is the most common type of childhood hypothyroidism in iodine deficiency endemias. We postulate that severe iodine deficiency in the intrauterine and early neonatal period may lead to dysgenesis of the thyroid. 相似文献
145.
Plasma interleukin-8 (IL-8) concentrations were measured in patients with atopic dermatitis. Plasma IL-8 was not detected in 25 controls (0/25), in allergic rhinitis (0/20), or in bronchial asthma during remission (0/13), while low concentrations of IL-8 were detectable in a few patients with urticaria (1/19), contact dermatitis (4/17), and bronchial asthma at the time of attack (6/16). In contrast, IL-8 was detectable in most cases of atopic dermatitis (41/52). Moreover, IL-8 concentrations were significantly higher in severe than in mild or moderate atopic dermatitis. IL-8 concentrations decreased as atopic dermatitis was improved by treatment, and IgE production in vitro was also decreased while serum IgE concentrations remained unchanged. IL-8 measurement may be a useful tool for the study of the pathogenesis and clinical course of atopic dermatitis. 相似文献
146.
A Fryer R Appleton MG Sweeney L Rosenbloom AE Harding 《Archives of disease in childhood》1994,71(5):419-422
The mitochondrial DNA (mtDNA) mutation 8993 is an important cause of Leigh's encephalopathy. A family is reported where other affected members have presented with non-specific delayed development or cerebral palsy. The diagnosis should be considered not only in children with Leigh's encephalopathy, but also in those with mild neurological dysfunction (including cerebral palsy) if there is a pigmentary retinopathy or a family history of neurological or ophthalmological disease. There was some correlation in this family between the disease severity and the proportion of mutant mtDNA in the blood. This mutation appears to segregate to high levels of mutant mtDNA rapidly within pedigrees and the mother of a severely affected child has a high risk of having further children with a high proportion of mutant mtDNA and a severe phenotype. 相似文献
147.
Abstract: Nurse-controlled analgesia (NCA) using a patient-controlled analgesia (PCA) device has been described for intensive care and postoperative use. This report describes the effective use of this technique for severe episodic and procedural pain in four children with advanced malignancy and high opioid requirements where conventional parenteral analgesia had been inadequate. Both morphine and fentanyl were used. Average duration of NCA was 6.75 days (range 4–12). 相似文献
148.
DRB1-DQA1-DQB1 loci and multiple sclerosis predisposition in the Sardinian population 总被引:2,自引:0,他引:2
Marrosu MG; Murru MR; Costa G; Murru R; Muntoni F; Cucca F 《Human molecular genetics》1998,7(8):1235-1237
Multiple sclerosis (MS) is a common neurological disease caused by genetic
and environmental factors. Previous genetic analyses have suggested that
theMHC/HLA region on chromosome 6p21 contains an MS- predisposing
component. Which of the many genes present in this region is primarily
responsible for disease susceptibility is still an open issue. In this
study, we evaluated, in a large cohort of MS families from the
Mediterranean island of Sardinia, the role of allelic variation at the
HLA-DRB1, DQA1 and DQB1 candidate loci in MS predisposition. Using the
transmission disequilibrium test (TDT), we found significant evidence of
association with MS in both the Sardinian- specific DRB1*0405(DR4)-
DQA1*0501-DQB1*0301 haplotype and the DRB1* 0301(DR3)-DQA1*0501-DQB1*0201
haplotype. Detailed comparative analysis of the DRB1-DQA1- DQB1 haplotypes
present in this data set did not identify an individual locus that could
explain MS susceptibility. The predisposing effect is haplotype specific,
in that it is confined to specific combinations of alleles at the DRB1,
DQA1 and DQB1 loci. Cross- ethnic comparison between the two HLA haplotypes
associated with MS in Sardinians and the DRB1*1501 (DR2)-DQA1*0102-DQB1*
0602 haplotype, associated with MS in other Caucasian populations, failed
to identify any shared epitopes in the DR and DQ molecules that segregated
with disease susceptibility. These results suggest that another MHC
gene(s), in linkage disequilibrium with specific HLA-DRB1, DQA1, DQB1
haploypes, might be primarily responsible for genetic susceptibility to MS.
Alternatively, the presence of complex interactions between different HLA
haplotypes, other non-HLA predisposing genes and environmental factors may
explain different associations in different populations.
相似文献
149.
Margolis RL; Stine OC; McInnis MG; Ranen NG; Rubinsztein DC; Leggo J; Brando LV; Kidwai AS; Loev SJ; Breschel TS; Callahan C; Simpson SG; DePaulo JR; McMahon FJ; Jain S; Paykel ES; Walsh C; DeLisi LE; Crow TJ; Torrey EF; Ashworth RG; Macke JP; Nathans J; Ross CA 《Human molecular genetics》1996,5(5):607-616
The two most consistent features of the diseases caused by trinucleotide
repeat expansion-neuropsychiatric symptoms and the phenomenon of genetic
anticipation-may be present in forms of dementia, hereditary ataxia,
Parkinsonism, bipolar affective disorder, schizophrenia and autism. To
identify candidate genes for these disorders, we have screened human brain
cDNA libraries for the presence of gene fragments containing polymorphic
trinucleotide repeats. Here we report the cDNA cloning of CAGR1, originally
detected in a retinal cDNA library. The 2743 bp cDNA contains a 1077 bp
open reading frame encoding 359 amino acids. This amino acid sequence is
homologous (56% amino acid identify and 81% amino acid conservation) to the
Caenorhabditis elegans cell fate-determining protein mab-21. CAGR1 is
expressed in several human tissues, most prominently in the cerebellum, as
a message of approximately 3.0 kb. The gene was mapped to 13q13, just
telomeric to D13S220. A 5'-untranslated CAG trinucleotide repeat is highly
polymorphic, with repeat length ranging from six to 31 triplets and a
heterozygosity of 87-88% in 684 chromosomes from several human populations.
One allele from an individual with an atypical movement disorder and
bipolar affective disorder type II contains 46 triplets, 15 triplets longer
than any other allele detected. Though insufficient data are available to
link the long repeat to this clinical phenotype, an expansion mutation of
the CAGR1 repeat can be considered a candidate for the etiology of
disorders with anticipation or developmental abnormalities, and
particularly any such disorders linked to chromosome 13.
相似文献
150.
Virus-induced cytokines regulate circulating lymphocyte levels during primary SIV infections 总被引:1,自引:0,他引:1
Rosenberg YJ; Cafaro A; Brennan T; Greenhouse JG; Villinger F; Ansari AA; Brown C; McKinnon K; Bellah S; Yalley-Ogunro J; Elkins WR; Gartner S; Lewis MG 《International immunology》1997,9(5):703-712
Decline in blood CD4+ lymphocytes during primary symptomatic infections
with HIV is usually attributed to viral killing, and has not been
considered in terms of altered lymphocyte migration and sequestration. We
therefore sought to examine whether CD4+ cell loss from blood of macaques
undergoing an acute primary SIV infection might be due to increased
synthesis of cytokines, known to profoundly affect lymphocyte trafficking,
rather than to direct lymphocyte destruction by virus. The findings
indicate that rapid lymphocyte depletion following acute infection is not
selective for CD4+ cells, correlates precisely with increased plasma
IFN-gamma and tumor necrosis factor-alpha levels, and is reversible.
CD4/CD8 ratios in lymph nodes with high viral burdens remain relatively
unchanged despite lymphocyte loss from blood. Levels of cytokine mRNA
measured in lymphoid organs reflect neither cytokine plasma levels nor
their potential to induce sequestration. These results support a model of
cytokine-induced lymphocyte extravasation to account for the acute
HIV/SIV-induced CD4+ cell lymphopenia and raise questions regarding the
extent to which altered lymphocyte migration plays a role in the gradual
CD4+ cell depletion throughout infection.
相似文献