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81.
This report focuses on a case of major depression and panic disorder after heart transplantation. Due to these disorders, the male patient's compliance with cardiological treatment became increasingly insufficient. There are no controlled studies on psychopharmacological opportunities in cases such as this one. The patient was treated with sertraline and the outcome was healthy, without cardiovascular adverse effects or drug-drug interactions. 相似文献
82.
We present a case report of a 60-year-old Malay man who was undergoing an urgent coronary artery bypass graft (CABG) operation when a well encapsulated thymoma-like tumor was found incidentally. Total thymectomy was performed together with the CABG. Histopathological report of the tumor, however, confirmed a rare thymic carcinoid. The clinical features, management, and outcome of surgery are discussed. 相似文献
83.
84.
Current protocols for the treatment of neuroblastoma emphasize total or near total resection of tumor to improve survival. This is preferentially performed as a primary procedure, or is attempted at a second-look operation. Unfortunately, this tumor often grows to large size with invasion of the spinal canal, or encasement of major vascular or other retroperitoneal structures. A primary attempt at complete removal may result in difficult-to-control hemorrhage or injury to, or loss of, vital organs. A second-look procedure carries other intrinsic risks. It often must be performed during a period of chemotherapeutically induced hematologic and immunologic suppression. The presence of adhesions and dense scar tissue increases the complexity of the dissection. The Cavitron Ultrasonic Surgical Aspirator (CUSA) combines continuous fragmentation, irrigation, and aspiration in one instrument. Tissues high in water content are selectively fragmented and aspirated, while tissues high in collagen and elastin (such as blood vessels and pseudocapsular walls) are selectively spared. Five patients, two with large pelvic dumbell tumors, two with large intrathoracic tumors, and one with a seemingly unresectable large right adrenal tumor (crossing the midline with extensive aortocaval nodal involvement) had total or near-total resection accomplished using the CUSA. In these patients, initial resection of the relatively soft inner part of the tumor left a collapsed pseudocapsule, which was then removed under greatly improved exposure in a relatively small field. The constant aspiration virtually eliminated tumor spillage. Since most vessels were skeletonized without penetration, total blood loss was minimized. There were no intraoperative or postoperative complications. 相似文献
85.
The haematopoietic effect of recombinant human erythropoietin in haemodialysis is independent of the mode of administration (i.v. or s.c.) 总被引:1,自引:1,他引:0
De Schoenmakere G; Lameire N; Dhondt A; Van Loo A; Van der Goten J; Duym P; Vanholder R 《Nephrology, dialysis, transplantation》1998,13(7):1770-1775
Background: Previous studies comparing intravenous
(i.v.) and subcutaneous (s.c.) administration of recombinant human
erythropoietin (rHuEpo) often did not achieve optimal iron reserve, were
restricted to a limited follow-up period (not allowing equilibration)
and/or did not exclude the role of other confounding factors. In addition
all papers focused on the conversion from i.v. to s.c.
Methods: In this study, 30 equilibrated patients on
s.c. rHuEpo were randomized into two groups, one converting to i.v. after 6
months of follow-up and one remaining on s.c. rHuEpo. In both groups rHuEpo
was administered three times weekly. Only patients completing a further 6
months follow-up were considered for statistical evaluation. Serum ferritin
was targeted at 200 ng/ml and haematocrits between 28 and 35% were pursued.
Results: The average haematocrit levels before
conversion were 31.9±1.1% in the conversion group and
31.4±1.6% at the same time point in the non-conversion group
(P-NS). After 6 months haematocrits were 31.5±0.5% in the
conversion group and 31.1±0.9% in the non-conversion group
(P=NS). Ferritin concentration in the conversion group was
219±49 ng/ml before and 230±83 mg/ml after the
conversion. For the non-conversion group ferritin was 224±25
ng/ml and 236±52 ng/ml respectively (P=NS). The
weight-standardized average rHuEpo dose per injection remained the same in
the conversion group before and after conversion (44.0±1.8
U/kg/injection vs 45.4±4.7 U/kg/injection)
P=NS). In the non-conversion group the corresponding rHuEpo doses were
32.9±4.2 U/kg/injection and 39.6±7.0 U/kg/injection
respectively (P=NS). There were no differences in serum PTH, aluminium,
vitamin B12, folic-acid levels, and intake of co-trimoxazole, ACE
inhibitors or theophylline. Conclusion: No changes in
rHuEpo dose wee observed after conversion from s.c. to i.v. There were no
significant differences between the conversion and non-conversion group.
These results are in contrast to some earlier studies suggesting lower
rHuEpo requirements in case of s.c. administration. Key
words: anaemia; erythropoietin; intravenous erythropoietin;
iron; subcutaneous erythropoietin
相似文献
86.
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88.
M H Gault L L Longerich J C Loo P T Ko A Fine S C Vasdev M A Dawe 《Clinical pharmacology and therapeutics》1984,35(1):74-82
Serum digoxin and metabolites were assayed in plasma and urine by HPLC in 10 dialysis-dependent patients with end-stage renal failure (group I) and in five patients with comparatively normal renal function (group II) after ingestion of 150 muCi 3H-digoxin-12 alpha. Thirteen patients were on maintenance digoxin therapy and were at steady state. Metabolites found regularly but usually in small amounts, were 3 beta-digoxigenin and its mono- and bis-digitoxosides, and 3-keto and 3 alpha(epi)-digoxigenin. Quantitatively the most abundant metabolites were polar and averaged 26% (7 to 76) of the radioactivity in plasma 6 hr after drug, and 60% (11 to 88) for digoxin for all 15 patients. Neither values between group I and II for the polar metabolites nor digoxin differed significantly. The metabolites reacted with antibody to digoxin to varying degrees and may make up an important component of the serum digoxin concentration when determined by standard radioimmunoassay. In some patients, digoxin undergoes extensive biotransformation, mainly, we suggest by hydrolysis, oxidation, epimerization, and conjugation to polar end-metabolites. 相似文献
89.
Association of plasmid-mediated quinolone resistance with extended-spectrum beta-lactamase VEB-1 总被引:1,自引:0,他引:1
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Poirel L Van De Loo M Mammeri H Nordmann P 《Antimicrobial agents and chemotherapy》2005,49(7):3091-3094
Association of the plasmid-mediated quinolone resistance determinant QnrA and the bla(VEB-1) gene was identified in a single Enterobacter cloacae isolate from K.-Bicêtre, France, and in 11 out of 23 bla(VEB-1)-positive enterobacterial isolates from Bangkok, Thailand. This result may explain in part the association between quinolone and extended-spectrum beta-lactam resistance. 相似文献
90.
Smeets RL Joosten LA Arntz OJ Bennink MB Takahashi N Carlsen H Martin MU van den Berg WB van de Loo FA 《Arthritis and rheumatism》2005,52(7):2202-2211
OBJECTIVE: To discern the mode of interleukin-1 (IL-1) inhibition of soluble IL-1 receptor accessory protein (sIL-1RAcP) by comparison with IL-1 receptor antagonist (IL-1Ra) in arthritis. METHODS: Adenoviral vectors encoding either sIL-1RAcP or IL-1Ra were administered systemically before onset of collagen-induced arthritis in DBA/1 mice. Anti-bovine type II collagen IgG and IL-6 were quantified in serum. Proliferative response of splenic T cells was determined in the presence of sIL-1RAcP or IL-1Ra. The effect on IL-1 inhibition of recombinant sIL-1RAcP and IL-1Ra was further examined in vitro, using NF-kappaB luciferase reporter cell lines. Quantitative polymerase chain reaction was used to determine the relative messenger RNA expression of the IL-1 receptors. RESULTS: Adenoviral overexpression of both sIL-1RAcP and IL-1Ra resulted in amelioration of the collagen-induced arthritis. Both IL-1 antagonists reduced the circulating levels of antigen-specific IgG2a antibodies, but only IL-1Ra was able to inhibit lymphocyte proliferation. By using purified lymphocyte populations derived from NF-kappaB reporter mice, we showed that sIL-1RAcP inhibits IL-1-induced NF-kappaB activity in B cells but not T cells, whereas IL-1Ra inhibited IL-1 on both cell types. A study in a panel of NF-kappaB luciferase reporter cells showed that the sIL-1RAcP inhibits IL-1 signaling on cells expressing either low levels of membrane IL-1RAcP or high levels of IL-1RII. CONCLUSION: We show that the sIL-1RAcP ameliorated experimental arthritis without affecting T cell immunity, in contrast to IL-1Ra. Our results provide data in support of receptor competition by sIL-1RAcP as an explanation for the different mode of IL-1 antagonism in comparison with IL-1Ra. 相似文献