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排序方式: 共有3183条查询结果,搜索用时 15 毫秒
71.
目的:探讨原发性胆囊癌的彩色超声图像特征,提高原发性胆囊癌的超声诊断准确率,减少临床的误诊和漏诊。方法回顾性分析了该院2009年以来45例原发性胆囊癌患者的超声图像特征及检查结果,并与手术后的病理结果进行了对照。结果45例胆囊癌中术前彩色超声诊断了35例,准确率77.8%,误诊10例,误诊率22.2%,根据彩色超声图像的特点将原发性胆囊癌分为5型。结论彩色超声为原发性胆囊癌的首选检查方法,对临床诊断和鉴别诊断具有重要价值,但还应与其他检查相结合以提高早期诊断率。 相似文献
72.
Abstract: Point mutation of the p53 tumor suppressor gene appears to be an important event in tumor development and progression, and overexpression of the p53 gene product has been widely studied in a variety of neoplasms. Some point mutations of the p53 gene lead to an increase in half-life in the gene product, which accumulates in the nucleus and can be detected by immunohistochemical means. We studied overexpression of p53 protein in specimens from 12 patients with adenocarcinoma of the gallbladder, two gallbladders with epithelial dysplasia without carcinoma, eight carcinomas of the common bile duct, 13 hilar cholangiocarcinomas, and six peripheral cholangiocarcinomas. The monoclonal antibody Ab-2 (Oncogene Science) was used in conjunction with citrate microwave antigen retrieval. Nuclear staining was scored as positive (graded 1 to 3, depending on number of positive nuclei) or negative. Overexpression of p53 protein was present in 7/12 (58%) gallbladder carcinomas, and was seen more often in moderately or poorly differentiated tumors. Intramucosal carcinoma adjacent to invasive carcinoma was positive in three cases, although fewer cells stained than in the carcinoma. Two cases of low-grade dysplasia not associated with carcinoma were negative. Expression of p53 was not an independent prognostic factor when survival was related to grade and stage of tumor. Three of eight (38%) common bile duct carcinomas and 5/13 (38%) hilar cholangiocarcinomas were positive for p53. Slightly fewer (2/6, 33%) peripheral cholangiocarcinomas were positive. No difference in survival relative to p53 expression was demonstrated. 相似文献
73.
Thomas A. Ruffolo Stuart Sherman Dr. Glen A. Lehman MD Robert H. Hawes 《Digestive diseases and sciences》1994,39(2):289-292
Theoretically, relative distal common bile duct obstruction due to sphincter of Oddi dysfunction may be a cause of poor gallbladder evacuation observed on quantitative cholescintigraphy. In this study, the relationship of sphincter of Oddi dysfunction to the gallbladder ejection fraction by quantitative cholescintigraphy was explored. Eighty-one patients with biliary-type pain and otherwise normal evaluations underwent quantitative cholescintigraphy, sphincter of Oddi manometry, and ERCP. Abnormalities of stimulated quantitative cholescintigraphy and/or sphincter of Oddi manometry were present in 70% of this study group. Manometric evidence of sphincter dysfunction was present in patients with similar frequency irrespective of the degree of gallbladder evacuation. In conclusion, abnormalities of quantitative cholescintigraphy and sphincter manometry appear to be independent factors, although frequent findings in this patient population. 相似文献
74.
Yukihiro Tsuchiya Fumitake Ishihara Goro Kajiyama Saburo Nakazawa Masao Otho Hiroshi Tanimura Yoshikazu Akura Minoru Harada Masabumi Hihara Yukio Kawai Yukihiro Kono Hajime Koshiyama Masahiro Morita Michiko Nakajima Kyoichiro Nishina Hiroshi Sagawa Terufumi Sakai Mitsuo Shoji Kayoko Sone Yoshihiro Sugimoto Keiichi Sugiyama Osamu Takahara Tomoo Takamura Susumu Tazuma Hideki Wakamatsu 《Journal of gastroenterology》1995,30(6):768-774
The use of bile acid dissolution therapy in extracorporeal shockwave lithotripsy of gallstones, remains controversial. Our
study examined whether chemolitholysis after sufficient disintegration enhanced stone clearance within 6 months of the first
lithotripsy. A total of 143 patients who developed one to three radiolucent stones measuring⪯30 mm in diameter were randomly
separated into two treatment groups: 47% were given lithotripsy alone, and 53% lithotripsy plus ursodeoxycholic acid (UDCA).
Repeated piezoelectric lithotripsy was given, with no limit on the total number of treatment sessions, to pulverize or disintegrate
stones into fragments<3 mm. Stones were disintegrated in 97% of all patients, and the fragments were ⪯2 mm in 50% of these
patients. According to an intention-to-treat analysis, 52% in the lithotripsy alone group and 58% in the UDCA group were free
of stones 6 months after the first lithotripsy (P=0.61). Of the patients with fragments⪯2 mm, 71% in the former and 86% in the latter group were free of stones 6 months after
the first lithotripsy, with no significant difference between the groups. Biliary pain occurred in 25% of all patients, including
3 with acute cholecystitis. We concluded that the sufficient disintegration of gallstones achieved with repeated lithotripsy
enhanced the early clearance of fragments, regardless of whether chemolitholysis was employed. 相似文献
75.
Dr. Vicente Garrigues MD Julio Ponce MD Carmen Cano MD Ramón Sopena MD Melchor Hoyos MD Adolfo Del Val MD Joaquin Berenguer MD 《Digestive diseases and sciences》1992,37(1):101-104
In this study we investigated the effect of selective (M1) and non-selective (M1 and M2) pharmacologic blockade of muscarinic receptors on cholecystokinin-induced gallbladder emptying. After validating the method of study, the gallbladder function was evaluated in 15 normal volunteers by quantitative biliary scintigraphy, and the effect of intravenous atropine (0.15 mg/10 kg) and pirenzepine (10 mg) was analyzed in each subject. Atropine significantly reduced the ejection period and the ejection fraction of gallbladder evacuation. Pirenzepine reduced the ejection period, but the ejection fraction remained unchanged. We conclude that the effect of cholecystokinin on gallbladder motility is mediated through muscarinic receptors. Our results suggest that M2 receptors, but not M1 receptors, are involved in this response. 相似文献
76.
Arasi Thangavelu Steven Rosenbaum Devi Thangavelu 《The Journal of emergency medicine》2018,54(6):892-897
Background
Cholecystitis is an inflammation of the gallbladder that most commonly occurs as a result of obstruction of the cystic duct by gallstones. The current standard of treatment for acute cholecystitis is cholecystectomy.Objective
Our goal was to discuss the benefits of and compare early laparoscopic cholecystectomy and delayed laparoscopic cholecystectomy in the treatment of acute cholecystitis.Materials and Methods
A Medline literature search was performed dating from January 1982 to July 2015. We limited the search to human studies written in English and using the keywords “Acute Cholecystitis,” early vs. delayed laparoscopic cholecystectomy, surgical management, and surgical complications.Results
There were 225 articles reviewed, of which 25 met criteria for selection. Our recommendations are based on these 25 articles.Conclusion
Early laparoscopic cholecystectomy is preferred over delayed, due to overall better quality of life, lower morbidity rates, and lower hospital cost. Ultimately, management of acute cholecystitis by emergency physicians should be made based on patient's clinical status and available resources in their particular hospital. 相似文献77.
78.
79.
肝硬化患者血浆VIP、CCK水平与胆囊排空功能的关系 总被引:1,自引:2,他引:1
探讨肝硬化时血浆胃肠激素水平对胆囊运动的影响。用放免法测定肝硬化患者及对照者血浆血管活性肠肽 (VIP)和胆囊收缩素 (CCK)含量 ;用B超测定餐前、餐后胆囊容积及排空率。结果 :肝硬化时血浆VIP、CCK均明显增高 (P <0 0 1,P <0 0 5 ) ;胆囊空腹容积、剩余容积均明显增大 (P <0 0 1,P <0 0 0 1) ,最大排空率较对照组无明显差异 (P >0 0 5 ) ,但Child -PughC级降低 (P <0 0 5 )。肝硬化组胆囊最大排空率与VIP呈负相关 ,胆囊空腹容积及剩余容积与VIP均呈正相关 ,胆囊空腹容积、剩余容积及最大排空率与CCK均无相关。提示肝硬化时VIP增高既抑制胆囊运动 ,又明显降低胆囊张力 ,肝硬化时可能存在对CCK的抵抗。 相似文献
80.
Tadanori Ishikawa Tadashi Horimi Yasuo Shima Takahiro Okabayashi Yutaka Nishioka Madoka Hamada Junichi Ichikawa Atsuhito Tsuji Masahiro Takamatsu Sojiro Morita 《Journal of hepato-biliary-pancreatic sciences》2003,10(3):233-238
Background/Purpose. An aggressive approach is required to resect advanced carcinoma of the gallbladder. Therefore, an extended surgical procedure often brings about a poor surgical outcome. To test whether an aggressive surgical treatment can improve the survival rate for primary advanced carcinoma of the gallbladder, 59 patients with stage IV primary gallbladder carcinoma were studied. Methods. Patients were divided into three treatment groups for the survival analysis: group A (resectional surgery, n = 29), group B (low-dose cis-diamminedichloroplatinum-II and 5-fluorouracil therapy, n = 10), and group C (exploratory laparotomy, other treatment modalities, or no treatment, n = 20). Results. The prognosis of group A patients was significantly better than that of group B (P = 0.018) or group C (P = 0.0009). Furthermore, group A patients were divided into subgroups. The prognosis of patients resected with no distant metastasis (group A1) was significantly better than that of patients resected with distant metastases of the distant lymph nodes and the liver (group A2) (P = 0.0004). Also, there was no significant difference in the survival rate between the patients resected with distant metastasis (group A2) and chemotherapy cases (group B). Conclusions. These results indicated that radical surgery should be performed for patients with no distant metastasis, and that chemotherapy might be a useful alternative treatment for patients with distant metastasis in advanced carcinoma of the gallbladder. 相似文献