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21.
J. M. Vallat M. J. Leboutet M. O. Jauberteau F. Tabaraud P. Couratier F. Akani 《Muscle & nerve》1994,17(4):378-380
The so-called “widenings of the myelin lamellae” are thought to be specific ultrastructural features of peripheral nerve myelin in patients with peripheral neuropathy associated with a monoclonal dysglobulinemia of IgM type and antiglycolipid activity. We report here a case of Guillain–Barré syndrome with no evidence of serum monoclonal dysglobulinemia, presenting the typical widenings of the myelin lamellae in small-diameter myelinated fibers from a sural nerve biopsy. In view of the positive reaction with anti-C3d complement on direct immunofluorescence, an immunological mechanism may be involved in the widenings of the myelin lamellae. © 1994 John Wiley & Sons, Inc. 相似文献
22.
16例胸膜间皮瘤临床分析 总被引:2,自引:0,他引:2
16例胸膜间皮瘤,其中1例有石棉接触史,占6.17%;>40岁者占81.5%。主要临床表现为胸痛、气短、咳嗽、低热和胸腔积液,临床上易误诊为结核性胸膜炎、肺癌胸膜转移等。胸部x线检查及胸部CT对该病的诊断有帮助,大都有特征性表现。确诊靠针刺胸膜活检及开胸活检。胸膜间皮瘤的治疗主要采用手术、放疗和化疗,对于局限型治疗首选手术切除。肿瘤的良、恶性、疾病的分期及治疗与预后有一定关系。 相似文献
23.
Atsuhiro Yoshida Asami Takeda Katsushi Koyama Yasuhiro Ohtsuka Kunio Morozumi Tadashi Oikawa 《Clinical and experimental nephrology》1997,1(4):292-296
Kimura's disease is a rare disorder that involves regional lymph nodes and the major salivary glands, which become infiltrated
by eosinophils and lymphocytes. Renal lesions associated with Kimura's disease are rare. We describe the case of a 60-year-old
Japanese woman who first noted a nodular mass in a salivary gland. As the nodule grew, nephrotic syndrome and heart failure
developed. A biopsy of the nodule revealed Kimura's disease, and surgical excision was performed. After the operation, the
heart failure and nephrotic syndrome, which were diagnosed as minimal change disease on renal biopsy, improved rapidly without
steroid therapy. Four months later, the nephrotic syndrome recurred without recurrence of Kimura's disease. The patient showed
marked improvement during prednisolone therapy (40 mg/d) and was in complete remission 4 weeks after the initiation of steroid
therapy. This case shows that surgical excision and prednisolone therapy are useful for nephrotic syndrome associated with
Kimura's disease. 相似文献
24.
对病理学确诊的25例病毒性心肌炎(VMC)和10例扩张型心肌病(DCM)患者心内膜心肌活检标本,运用ABC技术,进行了免疫球蛋白IgG、IgM、IgA和补体C3的检测。结果:20例VMC和9例DCM的标本中,发现了IgG和IgM的沉积,主要分布于心肌肌膜和毛细血管内皮,IgG的肌膜沉积与同步做的病理切片中观察到的心肌细胞坏死和炎性细胞浸润有病理形态学联系。两组患者中均未发现IgA和C3沉积。结果显示,IgG是参与VMC和DCM心肌损伤的主要免疫球蛋白,心肌病变与抗体诱导的免疫反应有关。 相似文献
25.
S. Gururangan R. A. M. Lawson P. Morris Jones R. F. Stevens R. H. A. Campbell 《Pediatric hematology and oncology》1992,9(2):107-113
The role of open lung biopsy (OLB) in the diagnosis of the etiology of lung infiltrates in children was analyzed for a 10-year period 1979-1989 in a tertiary referral center. A total of 18 children had 19 lung biopsies to ascertain the cause of lung infiltrates. Thirteen of these children (72 %) were immunocompromised due to treatment of hematological/solid malignancies and bone marrow transplantation. The clinical diagnosis was bilateral lung infiltrates of unknown etiology in 17 of 18 children. Eight of these children were ventilated for respiratory failure. The biopsy was useful in achieving a histological diagnosis in 18 of 19 samples (diagnostic yield 95%) and an etiological diagnosis in 14 of 19 samples (etiological yield 74 %). Therapeutic strategy was altered in 14 of 18 patients based on the biopsy results. Five of 14 patients responded favorably to a change in specific treatment. The lime interval from onset of respiratory illness to biopsy was 2-60 days (mean 16 days). Despite the critical state of these children there were few complications associated with the biopsy and no mortality directly related to the procedure. We recommend that OLE be undertaken sooner rather than later in immunocompromised children with bilateral pulmonary infiltrates of unknown etiology. 相似文献
26.
目的:探讨经皮肺活检及支气管肺泡灌洗(BAL)对周围性肺疾病诊断的价值。方法:对以结节或块状阴影为主的52例病人行经皮肺活检;对以弥漫性周围性肺疾病为主的33例病人行BAL检查;对采用两种不同方法的检查结果进行阳性率分析。结果:52例经皮肺活检对肺周围性病变诊断敏感性为88%,特异性100%。33例行BAL检查对结核及恶性弥漫性肺周围性病变诊断敏感性为75%~80%,特异性100%。结论:BAL检查及经皮肺活检对肺周围块状阴影或弥漫性病变的确诊有很高价值。 相似文献
27.
阻塞性黄疸:PTC下胆管钳夹活检的技术方法学研究 总被引:1,自引:0,他引:1
目的探索切实可行的胆管病理学检查新途径.资料与方法连续92例阻塞性黄疸患者接受经皮肝穿刺胆管造影(PTC)和经皮肝穿胆管引流(PTCD)治疗.PTCD过程中,影像监测下经皮经肝胆管穿刺,向胆管内引入活检钳对梗阻段钳夹活检,行组织病理学检查.统计学分析用χ2检验或Fisher确切概率计算法,以α=0.05作为检验水准.结果 92例钳夹活检患者90例成功获得组织块,技术成功率97.83%(90/92).钳夹活检敏感性为88.04%,63例胆管癌性恶性肿瘤钳夹活检敏感性较25例非胆管癌性恶性肿瘤高(93.65%比72.00%,P<0.05).结论PTC下胆管钳夹活检操作简单,创伤小,敏感性高,是一种值得推广的胆管病理学诊断新途径. 相似文献
28.
多发性肌炎与皮肌炎25例,其中多发性肌炎21例,皮肌炎2例,多发性肌炎或皮肌炎伴发恶性肿瘤2例。从临床表现、生化检查、肌电图及肌肉活检等方面进行分析,提出多发性肌炎与皮肌炎的诊断条件。本组均采用皮质类固醇治疗,5例合并免疫抑制剂治疗,其中临床治愈4例,显著好转10例,好转5例,无效2例,死亡4例。 相似文献
29.
Fine-needle cytology of an eccrine spiradenoma of the breast: diagnosis made by a holistic approach.
Eccrine spiradenoma is a rather rare adnexal tumor of the skin. When the clinical presentation is that of a breast neoplasm, diagnosis can be difficult. As cytology was a new procedure for this tumor, the approach of choice appeared to be a holistic one. The cytologic picture showed bland groups of uniformly sized cuboid cells with scant cytoplasm, round to ovoid nuclei, and inconspicuous nucleoli, while in the groups rosettelike structures could be discerned. Only by integrating the data of clinical history, inspection, palpation, reaction on breast puncture, and immunologic findings could the diagnosis be made. 相似文献
30.
Background: Percutaneous closed needle biopsy of musculoskeletal neoplasms has gained in popularity. However, it remains controversial
whether or not to resect the needle tract for fear of a local recurrence. A single published case report exists, noting the
lone tract recurrence of an extremity skeletal osteosarcoma.
Methods: We report on three additional individuals who demonstrated that tract local recurrences may occur after a closed needle biopsy
for nonosteosarcoma, nonextremity sarcomas. For perspective, the world literature is reviewed to identify tract recurrences
for other malignancies and the results of needle biopsy in musculoskeletal neoplasms.
Results: Eighty-nine percent of needle tract local recurrences occur when carcinomas are subjected to biopsy, as reported in the literature.
Forty-seven cases since 1950 are described representing essentially all tumor types. The nature of musculoskeletal neoplasms
makes closed biopsy more difficult than for softer, more homogeneous, and easier to access neoplasms.
Conclusions: Local recurrences of sarcoma may occur in closed needle biopsy tracts. Strong consideration should be given to open biopsy
and tract resection. 相似文献