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51.
Akira Sato Kazutaka Aonuma Toshihiro Nozato Yukio Sekiguchi Osamu Okazaki Kazuo Kubota Michiaki Hiroe 《Journal of nuclear cardiology》2008,15(5):671-679
Background. This study was designed to assess the influence of coronary endothelial function and the serial changes of dual myocardial
single photon emission computed tomography (SPECT) imaging in transient left ventricular (LV) apical ballooning.
Methods and Results. We evaluated 35 consecutive patients (8 men and 27 women; mean age, 71 ±13 years) with transient LV apical ballooning. All
patients underwent coronary angiography with acetylcholine provocation 1 month after onset. Iodine 123 β-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) and thallium 201 dual myocardial SPECT was serially performed on day 1 of admission
and 1 month and 6 months later. In 8 of 35 patients (23%), epicardial coronary spasm was induced by acetylcholine infusion.
At the peak acetylcholine dose (100 μg), diffuse coronary vasoconstriction developed in 19 of 35 patients (54%). Of 19 patients,
13 had diffuse coronary vasoconstriction with chest pain and ST-segment depression. The total defect score of I-123 BMIPP
and Tl-201 SPECT showed marked perfusion-fatty acid metabolic mismatches (13.7±3.6 vs 8.7±2.3, P<.001) at the LV apex during the acute phase but few mismatched areas (2.1±1.1 vs 1.5±1.4, P = not significant) at 6 months.
Conclusions. Transient LV apical ballooning might be caused by stress-induced coronary epicardial spasm or endothelial dysfunction, resulting
in myocardial stunning. 相似文献
52.
Efficacy of dynamic CT perfusion imaging in conjunction with three dimensional CT angiography for the evaluation of acute ischemic stroke 总被引:2,自引:0,他引:2
Nakaguchi H Teraoka A Adachi S Yanagibashi K 《No shinkei geka. Neurological surgery》2003,31(1):17-25
BACKGROUND AND PURPOSE: Through the use of a high-speed spiral CT scanner (GEMedical HiSpeedZX/i), CT/P/A technique, where conventional CT, CT perfusion imaging (CTP) and CT angiography (CTA) are consecutively performed, can now be performed with an imaging time of 90 seconds and a total contrast medium volume of 100 ml. A prospective clinical study was performed to ascertain the effectiveness of CT/P/A in diagnosing acute ischemic strokes. METHODS: 29 consecutive patients of Teraoka Memorial Hospital suspected of suffering from the occlusion or constriction of cerebral arteries and who underwent CT/P/A within 3 hours from the onset served as subjects. The sensitivity, specificity, or Odds ratio of CTP and CTA in detecting lesions that caused cerebral infarction was calculated. RESULTS: CTP detected a hypoperfusion area with a sensitivity, specificity, and Odds ratio of 80%, 64%, and 7.2. The sensitivity in lobar infarcts, white matter infarcts, basal ganglia infarcts, and brainstem infarcts was 100%, 100%, 100%, 0% (p = 0.0022). The sensitivity and Odds ratio of CT/P/A in cerebral infarcts differed according to the diameter of the infarcts. That with infarcts of 10 mm or more was 91%, 20. That with infarcts smaller than 10 mm was 50%, 2. CTA detected arterial lesions that caused cerebral ischemic attack with a sensitivity of 94% and specificity of 90%. The examination time for CT/P/A was 18 minutes, total radiation time being 90 seconds. CONCLUSIONS: Although CT/P/A was ineffective for the diagnosis of brainstem infarcts and lesions smaller than 10 mm, CT/P/A was useful in detecting moderate-sized hypoperfusion areas and arterial lesions three-dimensionally before an infarct is completed. 相似文献
53.
Tetsuhiko Mimura Shigeharu Uchiyama Masanori Hayashi Kazutaka Uemura Hideki Moriya Hiroyuki Kato 《Journal of orthopaedic science》2017,22(6):1026-1030
Background
During the surgery for a distal radius fracture, we encountered a large anomalous muscle lying across the distal radius. The muscle was identified as a flexor carpi radialis brevis muscle (FCRB), based on its location, function, and innervation. This experience led us to clarify its prevalence in living subjects and alert surgeons of its presence.Methods
We reviewed wrist MRI scans of 515 hands of 379 patients with carpal tunnel syndrome (CTS). The prevalence of the FCRB was calculated. The cross sectional area (CSA) of the FCRB was compared with that of the hypothenar muscles. Signal intensity and fat infiltration of the FCRB were assessed using semiquantitative methods. The anterior compartment ratio (CSA of the anterior compartment of the forearm was divided by CSA of the forearm. CSA of the FCRB was excluded for measurement) was compared between patients with and without FCRB.Results
We found seven hands of six patients (1.6%) with a FCRB. All of these tendons were inserted into the second metacarpal base. CSA of FCRB was smaller than that of the hypothenar muscles. Semiquantitative assessment revealed normal signal intensities of the FCRB compared with those of other muscles. The anterior compartment ratio was smaller in patients with FCRB than without FCRB. None of the FCRB in our series demonstrated any sign of tendinitis on MRI. Furthermore, the postoperative clinical course for those patients was uneventful.Conclusions
Prevalence of FCRB in patients with CTS was 1.6%. FCRB should function as a wrist flexor. Its strength varied according to the individuals but was not greater than that of the hypothenar muscles. It is still unclear if the FCRB could cause the development of CTS. However, it was found that the FCRB could be a mass which occupies and narrows the anterior compartment. 相似文献54.
Nahoko Kawamura Makoto Tomita Midori Hasegawa Kazutaka Murakami Kunihiro Nabeshima Hiroko Kushimoto Masami Kasugai Kazuo Takahashi Yoshiyuki Hiki Tsuneo Kinukawa Nobumitsu Usuda Satoshi Sugiyama 《Clinical transplantation》2005,19(S14):27-31
Abstract: The effects of antibody-mediated rejection on long-term graft survival have not been fully investigated. The aim of this study is to clarify the influence on long-term survival of deposition of the complement split product C4d in allografts using polyclonal anti-C4d antibody. Inclusion criteria were recipients who underwent graft biopsy during acute deterioration of graft function within the first 2 yr after transplantation. Patients whose graft did not survive more than 1 yr and who received graft from an human leucocyte antigen (HLA)-identical sibling or an ABO-incompatible donor were excluded. Among the 92 recipients investigated, 22 (23.9%) had peritubular capillary C4d deposition, 15 (16.3%) had glomerular capillary C4d deposition and seven (7.6%) had both peritubular and glomerular capillary C4d deposition. Twenty of these 22 patients revealed acute cellular rejection, including borderline changes. There was no significant relationship between pathological severity of acute rejection and presence or absence of peritubular capillary C4d deposition. Graft survival was inferior in patients with peritubular capillary C4d deposition to that in patients without C4d deposition (p = 0.0419). Graft survival in patients with glomerular C4d deposition did not differ from that in patients without C4d deposition. In conclusion, C4d deposition in peritubular capillaries has a substantial impact on long-term graft survival. 相似文献
55.
56.
Severe exacerbation of hepatitis after short-term corticosteroid therapy in a patients with "latent" chronic hepatitis B 总被引:2,自引:0,他引:2
Shiota G Harada K Oyama K Udagawa A Nomi T Tanaka K Tsutsumi A Noguchi N Kishimoto Y Horie Y Suou T Kawasaki H 《Liver》2000,20(5):415-420
We present a case of severe exacerbation of hepatitis after short-term corticosteroid therapy for chronic inflammatory demyelinating polyneuropathy (CIPD) with "latent" chronic hepatitis B showing no HBV-related antigens and antibodies. After corticosteroid pulse therapy for CIPD, the patient had severe exacerbation of hepatitis twice. Although she did not show any hepatitis B virus (HBV)-related antigens or antibodies, sequences of HBV were detected in serum and liver by a nested polymerase chain reaction. A sequence analysis of HBV at the second exacerbation showed that the G-to-A point mutation at nucleotide 1896 that converted codon 28 from tryptophan (TGG) to a stop codon (TAG) in the precore region resulted in amino acid change, which has been frequently observed in fulminant hepatitis and severe hepatitis in Japan. 相似文献
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60.
Toko Maehara Kenjiro Matsumoto Kazuhide Horiguchi Makoto Kondo Satoshi Iino Shunji Horie Takahisa Murata Hirokazu Tsubone Shoichi Shimada Hiroshi Ozaki Masatoshi Hori 《British journal of pharmacology》2015,172(4):1136-1147