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21.
E. Perucca R. Grimaldi G. Ruberto C. Gelmi F. Trimarchi A. Crema 《European journal of clinical pharmacology》1986,29(6):729-730
Summary The kinetics of phenobarbital (PB) was compared after oral administration of equivalent doses of the drug as the acid or the propylhexedrine salt (barbexaclone) to 7 normal volunteers. The absorption and elimination parameters were very similar. It was concluded that propylhexedrine did not affect the serum kinetics of PB given as barbexaclone. 相似文献
22.
WEIGUANG ZENG PIERRE-OLIVIER REGAMEY KEITH ROSE YUZHOU WANG ERNST BAYER 《Chemical biology & drug design》1997,49(3):273-279
The use of N, O-bisFmoc-N-(2-hydroxy-4-methoxybenzyl) amino acid derivatives in the synthesis of peptides with difficult sequences has already been described. With these amino acid derivatives the reversible protecting group 2-hydroxy-4-methoxybenzyl (Hmb) for the backbone amide bonds of peptide chains is introduced, and thus the aggregation due to hydrogen-bond interchain association is inhibited. This paper describes the synthesis and use of Fmoc-N-(2-hydroxy-4-methoxybenzyl)amino acid derivatives as an alternative means of introducing Hmb backbone protection. These new monoFmoc derivatives were obtained in higher yield than the bisFmoc derivatives. Coupling yields to the amino peptide resin were the same as those obtained with bisFmoc derivatives, under the TBTU/HOBt/DIEA conditions. We also compared different syntheses of a difficult peptide with the Fmoc approach [triple coupling, capping, use of chaotropic agents, backbone protection using monoFmoc (Hmb)Ala] and with optimized Boc chemistry. Both the backbone protection and optimized Boc chemistry approaches gave the desired product in excellent yield and purity. © Munksgaard 1997. 相似文献
23.
目的:分析损伤性肝外胆管狭窄发生的原因和损伤后狭窄的修复术式选择。方法:损伤性肝外胆管狭窄45例,诊断方法以B超,PTC、ERCP为主,全组分别行胆管空肠吻合术,胆管十二指肠吻合术,肝门胆管整形术等手术治疗。结果:随访36例,末次手术行胆管空肠吻合术33例,优良87.9%。结论:可见性损伤和隐性损伤所致的瘢痕收缩是胆道狭窄的主要原因,损伤性肝外胆管狭窄的治疗方法以胆管空肠Y形吻合术较为理想。 相似文献
24.
Maria P. Panozzo Carlo Fabris Daniela Basso Giuseppe Del Favero Aldo Infantino Attilio Cecchetto Mario Plebani Remo Naccarato 《Clinical and experimental pharmacology & physiology》1993,20(3):185-191
1. The authors investigated the effect of two extrahepatic cholestasis models (one by bile duct ligation and the other by choledocho-jugular fistula) on the hepatic clearance of horseradish peroxidase in male Sprague-Dawley rats divided into four groups. 2. In groups A (n = 5 rats) and B (n = 5), bile duct ligation was performed, while a choledocho-jugular fistula was created in groups C (n = 5) and D (n= 7). A 10 mg intravenous bolus of horseradish peroxidase was injected after 24 h (groups A and C), 48 h (groups B and D) or 1 h (Group E; five sham-operated rats). Serum and bile samples were then serially collected for 2 h. 3. In all groups, serum horseradish peroxidase levels increased soon after injection and then rapidly decreased, the curves being similar. Biliary excretion increased for 30 min and then slowly decreased. The highest horseradish peroxidase biliary concentrations and outputs were found in Group B followed by Group A; both groups had significantly higher levels than Group E. No difference was found between horseradish peroxidase biliary excretion of groups C and D and that of sham-operated rats. 4. When each group was considered separately, sampling times correlated with the corresponding ratios of bile/ plasma HRP. Significant differences were found between the relative slopes of groups A, B and E, but not between those of groups C, D and E. 5. In conclusion, bile duct obstruction greatly affects the plasma-bile transfer of fluid phase markers, such as horseradish peroxidase, while single retention, caused by choledocho-jugular fistula, has no influence. The increased biliary hyperpressure related to the duration of cholestasis may account for the degree of horseradish peroxidase transfer which, in turn, probably depends on an enhanced paracellular passage. 相似文献
25.
Results of the routine use of a modified endoprosthesis to drain the common bile duct after laparoscopic choledochotomy 总被引:6,自引:1,他引:5
A. L. DePaula K. Hashiba M. Bafutto C. Machado A. Ferrari M. M. Machado 《Surgical endoscopy》1998,12(7):933-935
Background: One hundred eighty-one patients were submitted to laparoscopic common bile duct exploration.
Methods: A transcystic approach was used in 147 patients, choledochotomy in 14, and both in 20. The indications to perform a choledochotomy
included stones larger than 20 mm, stones proximal to the cystic duct entrance, and cases in which the transcystic duct approach
proved impossible or unsuccessful.
Results: The common bile duct was drained by a T-tube in four patients, by laparoscopic sphincterotomy in one, by laparoscopic choledochoduodenostomy
in one, and by a 10 Fr endoprosthesis in 28. The stent placement was technically feasible in all patients but one. The biliary
drainage was adequate. Mean hospital stay was 2.1 days. Complication was limited to one umbilical infection and one self-limited
biliary leak.
Conclusions: The procedure proved to be technically simple, safe, and efficient, and resulted in a low morbidity rate and short hospital
stay.
Received: 29 March 1996/Accepted: 12 June 1996 相似文献
26.
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28.
Mesut Akarsu Murat Meral Sakine Bahceli Dilek Solmaz Hasan Kayahan Mujde Soyturk Hale Akpinar 《Digestive endoscopy》2007,19(1):49-51
Fascioliasis is a worldwide zoonotic infection with fasciola hepatica and fasciola gigantica. The zoonoses are particularly endemic in sheep‐raising countries and are also endemic in Turkey. Clinical features of fascioliasis relate to the stage and intensity of infection. Fasciola hepatica infection comprises two stages: hepatic and biliary, with different signs and symptoms. Cholestatic symptoms may be sudden, but, in some cases, they may be preceded by a long period of fever, eosinophilia and vague gastrointestinal symptoms. We reported a case with fever and upper‐quadrant abdominal pain since 3 months that comes from an area endemic for fasciola hepatica, with suspected imaging about fasciola hepatica in common bile duct on ultrasonography. After that, fasciola hepatica was extracted with endoscopic retrograde cholangiography. 相似文献
29.
超声引导下经皮经肝胆管穿刺置管引流在梗阻性黄疸病人中的应用 总被引:1,自引:0,他引:1
目的 评价超声引导下经皮经肝穿刺胆管置管引流 (UPTBD)对梗阻性黄疸病人的治疗价值。方法 对 1995年 1月至 2 0 0 2年 7月期间的 4 17例梗阻性黄疸病人进行 4 97次UPTBD治疗 ,并回顾总结他们的临床资料。结果 接受PTBD治疗共有 4 17例 (5 1例病人进行了两个胆管枝的PTBD) ,穿刺成功率达 93.2 % (4 36 / 4 6 8) ,32例首次穿刺失败的病人有 2 9例进行了第二次穿刺置管 ,全部成功。发生胆汁漏 /胆汁性腹膜炎 9例 ,胆道出血 8例 ,感染性休克 1例 ,无腹腔出血、后腹膜血肿、气胸等其他并发症。对 6 4例置管引流患者进行肝功能检测 ,与穿刺前相比 ,引流后 1周和 3周检测病人血清胆红素、转氨酶均显著下降。结论 UPTBD是一项姑息性治疗梗阻性黄疸的快捷、安全、有效的方法 相似文献
30.
E. Croce M. Golia M. Azzola R. Russo L. Crozzoli S. Olmi C. Pompa M. Borzio 《Surgical endoscopy》1996,10(11):1064-1068
Background: Thirty-three patients were candidates for laparoscopic choledochotomy. The indications for this operation are described.
Methods: The procedure was completed 32 times (97%). We had 29 successful common bile duct (CBD) clearances, three negative explorations,
and one failed clearance which needed to be converted to laparotomy. All the completed procedures ended with primary closure
of the main duct. Median duration of surgery was 180 min (range 100–300), including three associated laparoscopic procedures.
Results: There were three postoperative complications (9.4%), none major. Average postoperative hospital stay was 7.1 days (range
4–14). In May–June 1995 we controlled 31 out of the 32 consecutive patients (one patient was lost to follow-up) who had a
successful laparoscopic choledochotomy from October 1991 to December 1994. Median follow-up was 22 months (range 5–44). Besides
clinical control, 23 patients also had ultrasound (US) controls and 24 had blood tests. Eleven had intravenous cholangiotomography.
Two patients died 11 and 22 months after the operation for unrelated causes and without biliary symptoms. Two patients had
umbilical hernias. One had a small residual asymptomatic stone, which was removed endoscopically. None had signs of postoperative
CBD stricture. At US, CBD was ≤7 mm in 15 patients, 8–10 mm in four patients, and 10–12 mm in three patients. The last group
had preoperative CBD dilation, too. We could compare preoperative and postoperative CBD diameters in 22 patients: 11 had no
change; in nine it decreased; and two had a slight increase (8–10 mm).
Conclusions: We conclude that laparoscopic choledochotomy with primary closure is a very good operation: It has a high success rate and
low morbidity. Mortality is nil so far. Medium-term results are very positive: We had no CBD stricture and only one case of
asymptomatic residual stone, which could have been avoided. Our results suggest that intraductal biliary drainage is useless,
and its specific complications are well known.
Received: 20 October 1995/Accepted: 28 February 1996 相似文献