全文获取类型
收费全文 | 9209篇 |
免费 | 371篇 |
国内免费 | 92篇 |
专业分类
耳鼻咽喉 | 120篇 |
儿科学 | 373篇 |
妇产科学 | 71篇 |
基础医学 | 989篇 |
口腔科学 | 91篇 |
临床医学 | 1201篇 |
内科学 | 837篇 |
皮肤病学 | 36篇 |
神经病学 | 1430篇 |
特种医学 | 427篇 |
外科学 | 791篇 |
综合类 | 853篇 |
一般理论 | 1篇 |
预防医学 | 730篇 |
眼科学 | 451篇 |
药学 | 759篇 |
1篇 | |
中国医学 | 155篇 |
肿瘤学 | 356篇 |
出版年
2023年 | 120篇 |
2022年 | 296篇 |
2021年 | 342篇 |
2020年 | 280篇 |
2019年 | 310篇 |
2018年 | 328篇 |
2017年 | 286篇 |
2016年 | 253篇 |
2015年 | 298篇 |
2014年 | 648篇 |
2013年 | 597篇 |
2012年 | 516篇 |
2011年 | 585篇 |
2010年 | 452篇 |
2009年 | 429篇 |
2008年 | 450篇 |
2007年 | 343篇 |
2006年 | 294篇 |
2005年 | 235篇 |
2004年 | 239篇 |
2003年 | 183篇 |
2002年 | 142篇 |
2001年 | 150篇 |
2000年 | 132篇 |
1999年 | 113篇 |
1998年 | 109篇 |
1997年 | 107篇 |
1996年 | 93篇 |
1995年 | 85篇 |
1994年 | 82篇 |
1993年 | 77篇 |
1992年 | 80篇 |
1991年 | 64篇 |
1990年 | 57篇 |
1989年 | 50篇 |
1988年 | 72篇 |
1987年 | 53篇 |
1986年 | 51篇 |
1985年 | 84篇 |
1984年 | 73篇 |
1983年 | 61篇 |
1982年 | 55篇 |
1981年 | 61篇 |
1980年 | 55篇 |
1979年 | 47篇 |
1978年 | 39篇 |
1977年 | 38篇 |
1976年 | 44篇 |
1975年 | 25篇 |
1973年 | 24篇 |
排序方式: 共有9672条查询结果,搜索用时 15 毫秒
41.
Dr W. Strecker L. Gürtler M. Schilling M. Binibangili K. Strecker 《European journal of epidemiology》1994,10(1):95-98
1275 patients were evaluated for HIV-1+2 seroprevalence and its association with clinical symptoms of HIV infection. Of 667 apparently healthy subjects, 8.2% had anti-HIV-1 antibodies. In 465 patients with clinical signs of AIDS, 39.4% were seropositive. 143 patients with miscellaneous symptoms had positive predictive values for HIV infection between 67% (vaginal ulcerations) and 20% (profound pyogenic abscesses). The WHO definition for AIDS had a specificity of 78.3%, a sensitivity of 72.2% and a predictive value of 61.6%. 相似文献
42.
中枢性神经细胞瘤:17例临床病理分析 总被引:2,自引:0,他引:2
背景与目的:中枢性神经瘤是少见的中枢神经系统肿瘤。为了提高对该病的认识、减少误诊率.我们结合文献复习,对患者的临床症状、影像学、病理改变及预后进行了研究讨论。方法:复习中国人民解放军总医院1970-2000年收治的中枢性神经瘤病例共17例,对患者的临床症状、影像学、病理改变及预后进行了回顾性研究。结果:中枢性神经细胞瘤发病率占同期原发性中枢神经系统肿瘤的0.14%。患者男10例,女7例.年龄从11岁-51岁不等,平均年龄32.7岁。肿瘤均位于脑室系统,7例位于透明隔位于侧脑室及三脑室者各5例。手术全部切除7例,部分切除10例,术后放疗者9例。9例进行了长期随访无复发迹象。另外,17例行免疫组化及2例行电镜检查,显示肿瘤呈神经元分化,仅4例局部表达GFAP;所有病例均无恶性组织学迹象,4例已做Ki-67免疫组化的阳性细胞〈2%。结论:综合上述及结合文献我们认为大多数中枢性神经细胞瘤是预后良好的肿瘤,部分预后较差,增加GFAP的阳性表达、细胞增殖指数的增加以及血管的增生可能提示较差的预后。手术切除为治疗该肿瘤的较好方法。对部分切除的病例、组织学呈间变改变的病例(细胞的异形性、核分裂像增加、血管内皮细胞增生及坏死)以及增殖指数增加者应辅以放疗。 相似文献
43.
Paola Sarchielli Andrea Alberti Beatrice Gallai Francesca Coppola Antonio Baldi Ardesio Floridi Virgilio Gallai 《The journal of headache and pain》2002,3(3):129-135
Little has been done to investigate the biochemical basis of chronic daily headache (CDH). Our group has recently demonstrated
an increase in the cerebrospinal fluid (CSF) levels of nerve growth factor (NGF) in CDH patients, supporting the involvement
of this growth factor in the abnormal processing of head pain in this pathological condition. Other members of the neurotrophin
family, especially brain-derived neurotrophic factor (BDNF), have been hypothesized as being involved in the development of
chronic head pain in patients affected by CDH, but so far no data are available on this subject. BDNF, NGF and glutamate levels
were determined in the CSF of 25 patients affected by CDH with a previous history of migraine. These levels were compared
with those of a group of 20 control subjects, for whom the CSF examination and other instrumental investigations excluded
diseases of the central and peripheral nervous systems. Significantly higher levels of BDNF, NGF and glutamate were found
in CDH patients compared with control subjects (p<0.0001, p<0.0002 and p<0.001, respectively). A significant positive correlation emerged between CSF values of BDNF and those of NGF (r=0.61, p<0.001) and glutamate (r=0.44, p<0.025) in CDH patients. No significant differences were detected in BDNF, NGF and glutamate levels between CDH patients with
analgesic overuse and those without. These results support the involvement of BDNF in CDH through the potentiation of glutamatergic
transmission involved in the processing of head pain. The significant correlation between BDNF and NGF levels suggests that
NGF-mediated up-regulation of BDNF in central sites involved in long-term sensitization plays a key role in persistent head
pain in CDH patients.
Correspondence to P. Sarchielli 相似文献
44.
Astrocytes contribute to the immunocompetence of the central nervous system (CNS) via their expression of class II major histocompatibility complex (MHC) antigens and the production of inflammatory cytokines such as interleukin-1 beta (IL-1β), tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6). Of these cytokines, IL-6 is of particular interest because one of its many immune and inflammatory actions is the promotion of immunoglobulin synthesis, and it is thought that IL-6 expression within the brain exacerbates autoimmune diseases of the CNS, which are marked by local immunoglobulin production. Several stimuli induce astrocyte IL-6 expression, including such inducible endogenous factors as IL-1β and TNF-α. We have investigated the possibility that a constitutively present endogenous factor, the neurotransmitter norepinephrine (NE), can induce astrocyte IL-6 production. We report that NE induces both IL-6 mRNA and protein in primary neonatal rat astrocytes, with optimal induction at 10 μM. IL-6 protein induction by NE is comparable to that seen with IL-1β or TNF-α, and NE synergizes with these cytokines for a ten-fold enhanced effect. In contrast to astrocytes, microglia are relatively unresponsive to NE, IL-1β and TNF-α for IL-6 production. Experiments with the β-adrenergic receptor agonist isoproterenol, and α and β-adrenergic receptor antagonists (propranolol, phentolamine, atenolol, and yohimbine) indicate that β2 and α1-adrenergic receptors are involved in NE induction of astrocyte IL-6 expression. These results help to further the understanding of neuron-glial interactions, and the role of astrocytes and adrenergic activity in immune responses within the CNS. 相似文献
45.
V. G. Wilson M. Grohmann U. Trendelenburg 《Naunyn-Schmiedeberg's archives of pharmacology》1988,337(4):397-405
Summary The O-methylation and accumulation of 3H-isoprenaline in slices of the rat cerebral cortex were studied before and after inhibition of COMT. 1. Inhibition of COMT by mol/l U-0521 virtually abolished the O-methylation and increased the accumulation of 3H-isoprenaline; hence, there is evidence for the existence of a central O-methylating system (with a transport mechanism and intracellular COMT). 2. Experiments were carried out with selective uptake inhibitors for uptake, (cocaine and desipramine) or uptake2 (corticosterone and OMI), with phenoxybenzamine (known to inhibit both carriers) and with changes in the ionic composition of the incubation medium. They revealed that the central carrier differed from both, uptake, and uptake2, although exhibiting some resemblance with uptake2 (lack of dependence on Na+ and Cl–, sensitivity to K+ and phenoxybenzamine, ability to transport 3H-isoprenaline). 3. Although the central carrier was rather sensitive to inhibition by beta-adrenoceptor antagonists (propranolol, carteolol), the effect of propranolol was not stereoselective; hence, beta-adrenoceptors do not seem to be involved. 4. Virtually identical IC30-values were obtained for inhibitors, when determined with or without inhibition of COMT. Only OMI was found to inhibit COMT as well as the central transport system; hence it was more potent in inhibiting the O-methylation than the accumulation of 3H-isoprenaline. 5. IC50-values (against initial rates of accumulation of 3H-isoprenaline; COMT inhibited) were determined for various substrates and inhibitors of peripheral uptake2. There was no correlation with the IC50-values determined earlier for uptake2 in rat heart (Grohmann and Trendelenburg 1984). 6. Unlabelled catecholamines half saturated the intracellular COMT when slices were incubated with 0.22 mol/l [(±)-dobutamine] to 4.9 mol/l [(–)-noradrenaline]. As the presence of unlabelled catecholamines increased tissue levels of 3H-isoprenaline, catecholamines are substrates of the central carrier. 7. The carrier of the central O-methylating system differs from uptake2 of peripheral organs, although it resembles the peripheral carrier in some respects.Abbreviations COMT
catechol-O-methyl transferase
- DOPEG
dihydroxyphenylglycol
- MAO
monoamine oxidase
- OMI
3-Omethyl-isoprenaline
Supported by the Deutsche Forschungsgemeinschaft (Tr 96 and SFB 176) and by a scholarship of the Royal Society for V. G. Wilson. Some of the results were presented to the British Pharmacological Society (Trendelenburg and Wilson 1986) 相似文献
46.
Professor C. Martin J. -P. Auffray C. Badetti G. Perrin L. Papazian F. Gouin 《Intensive care medicine》1992,18(2):101-104
Continous monitoring of mixed venous (SvO2) and central venous (ScO2) oxygen saturation was compared in 7 critically-ill patients (Apache II score: 19±2.1) to determine whether or not information derived from ScO2 were reliable in clinical practice. Patients were catheterized with both a pulmonary artery (PA) and a central venous (CV) catheter, each of them mounted with fiberoptic sensors (Opticath PA Catheter P7110 and Opticath CV Catheter U440, Abbott). A total of 580 comparative measurements were obtained during periods without and with therapeutic interventions (drug-titration, bronchial suction, use of PEEP, changes in FiO2...). The systematic error between the 2 measurement techniques was 0.6% and 0.3% in periods with and without therapeutic interventions, respectively. The variability between the 2 techniques was 10% for both periods. Differences between the values were 5% in 49% of values during periods of stability and in 50% of values during periods with therapeutic interventions. There were poor correlations between the values during periods without (r=0.48) and with therapeutic interventions (r=0.62). Better, but still less than ideal, correlations were obtained with changes in SvO2 and ScO2 during periods without (r=0.70) and with therapeutic interventions (r=0.77). Although there is a need to develop a simple technique to monitor mixed venous oxygen saturation, the present study indicates that ScO2 monitoring was not reliable in the study patients. 相似文献
47.
Zehr EP Haridas C 《Experimental brain research. Experimentelle Hirnforschung. Expérimentation cérébrale》2003,149(2):260-266
Stimulation of cutaneous nerves innervating the hand evokes prominent reflexes in many arm muscles during arm cycling. We
hypothesized that the mechanisms controlling reflex modulation during the rhythmic arm swing of walking would be similar to
that documented during arm cycling. Thus, we expected cutaneous reflexes to be modulated by position in the walking cycle
(phase dependence) and be different when walking compared to contraction while standing (task dependence). Subjects performed
static postures similar to those occurring during walking and also walked on a treadmill while the superficial radial nerve
was electrically stimulated pseudorandomly throughout the step cycle. EMG was recorded bilaterally from upper limb muscles
and kinematic recordings were obtained from the elbow and shoulder joints. Step cycle information was obtained from force-sensing
insoles. Analysis was conducted after averaging contingent upon the occurrence of stimulation in the step cycle. Phase-dependent
modulation of cutaneous reflexes at early (~50–80 ms) and middle (~80–120 ms) latencies was observed. Coordinated bilateral
reflexes were seen in posterior deltoid and triceps brachii muscles. Task dependency was seen in that reflex amplitude was
only correlated with background EMG during static contraction (75% of comparisons for both early and middle latency reflexes).
During walking, no significant relationship between reflex amplitude and background EMG level was found. The results show
that cutaneous reflex modulation during rhythmic upper limb movement is similar to that seen during arm cycling and to that
observed in leg muscles during locomotion. These results add to the evidence that, during cyclical movements of the arms and
legs, similar neural mechanisms observed only during movement (e.g. central pattern generators) control reflex output.
Electronic Publication 相似文献
48.
B. Bozdogan P. C. Appelbaum L. M. Kelly D. B. Hoellman A. Tambic-Andrasevic L. Drukalska W. Hryniewicz H. Hupkova M. R. Jacobs J. Kolman M. Konkoly-Thege J. Miciuleviciene M. Pana L. Setchanova J. Trupl P. Urbaskova 《Clinical microbiology and infection》2003,9(7):653-661
Objective To test the activity of telithromycin against 1034 Streptococcus pneumoniae isolates from pediatric patients in ten centers from ten central and eastern European countries during 2000–2001, and to compare it with the activities of erythromycin A, azithromycin, clarithromycin, clindamycin, and quinupristin–dalfopristin.
Methods The minimum inhibitory concentrations (MICs) of telithromycin, erythromycin A, azithromycin, clarithromycin, clindamycin, levofloxacin, quinupristin–dalfopristin and penicillin G were tested by the agar dilution method with incubation in air, and mechanisms of resistance to macrolides and quinolones were investigated.
Results Strains were isolated from sputum, tracheal aspirates, ear, eye, blood, and cerebrospinal fluid. Among S. pneumoniae strains tested, 36% had raised penicillin G MICs (≥ 0.12 mg/L). Susceptibilities were as follows: telithromycin, quinupristin–dalfopristin and levofloxacin, ≥ 99%; clindamycin, 83%; and erythromycin A, azithromycin and clarithromycin, 78%. Of 230 (22.3%) erythromycin A-resistant S. pneumoniae strains, 176 (79.6%) had erm(B) , 38 (16.1%) had mef(A) , and 10 (4.3%) had mutations in 23S ribosomal RNA or in ribosomal protein L4. The rates of drug-resistant S. pneumoniae are high in all centers except Kaunas, Riga, and Prague.
Conclusion Telithromycin had low MICs against all strains, irrespective of macrolide, azalide or clindamycin resistance. Ribosomal methylation was the most prevalent resistance mechanism among all resistant strains, except in Sofia, where the prevalence of the efflux mechanism was higher. 相似文献
Methods The minimum inhibitory concentrations (MICs) of telithromycin, erythromycin A, azithromycin, clarithromycin, clindamycin, levofloxacin, quinupristin–dalfopristin and penicillin G were tested by the agar dilution method with incubation in air, and mechanisms of resistance to macrolides and quinolones were investigated.
Results Strains were isolated from sputum, tracheal aspirates, ear, eye, blood, and cerebrospinal fluid. Among S. pneumoniae strains tested, 36% had raised penicillin G MICs (≥ 0.12 mg/L). Susceptibilities were as follows: telithromycin, quinupristin–dalfopristin and levofloxacin, ≥ 99%; clindamycin, 83%; and erythromycin A, azithromycin and clarithromycin, 78%. Of 230 (22.3%) erythromycin A-resistant S. pneumoniae strains, 176 (79.6%) had erm(B) , 38 (16.1%) had mef(A) , and 10 (4.3%) had mutations in 23S ribosomal RNA or in ribosomal protein L4. The rates of drug-resistant S. pneumoniae are high in all centers except Kaunas, Riga, and Prague.
Conclusion Telithromycin had low MICs against all strains, irrespective of macrolide, azalide or clindamycin resistance. Ribosomal methylation was the most prevalent resistance mechanism among all resistant strains, except in Sofia, where the prevalence of the efflux mechanism was higher. 相似文献
49.
Assays of serum benzylamine oxidase (BzAO) have led some workers to postulate a relationship between elevated BzAO activity and diseases characterized by proliferating connective tissue. The present study was designed to determine whether BzAO activity of a cellular tissue is also affected. BzAO was assayed in homogenates of normal and atherosclerotic human aortae. Characterization done in normal aortae showed that BzAO is not a classical monoamine, diamine, polyamine, or lysyl oxidase, nor is it a ceruloplasmin. The enzyme is heat stable at 60 degrees C and is associated primarily with the microsomal fraction on density centrifugation. Compared with phenylethylamines and indoleamines, benzylamine is the best substrate. BzAO is sensitive to inhibition by hydrazines and chymotrypsin but not trypsin, and is insensitive to Triton X-100 and sulfhydryl-group blockade. BzAO activity of atherosclerotic plaque (expressed per gram wet weight or per milligram protein) was decreased markedly compared to that in adjacent, nonplaque regions and in normal aortae. However, on a per milligram DNA basis, the BzAO activity of plaque did not differ from that of nonplaque tissue. We conclude that there is a decreased cell population density in plaque, a contention supported by kinetic analysis. Plaque BzAO showed a decreased Vmax with no change in the Km of benzylamine compared with nonplaque tissue. Thus, if a relationship exists between BzAO activity and proliferating connective tissue, it is not apparent at the level of the cellular enzyme in atherosclerotic aortae of man. 相似文献
50.
Toshiko Sawaguchi Patricia Franco Hazim Kadhim Jose Groswasser Martine Sottiaux Hiroshi Nishida Andre Kahn 《Pathophysiology》2004,10(3-4):223-228
Background: The Ki-67 antigen appears in all human proliferating cells during late G1, S, M and G2 phases of the cell cycle, but is consistently absent in the Go phase (noncycling) cells. The correlation between Ki-67 in the brainstem and sleep apnea in victims of the sudden infant death syndrome (SIDS) was investigated to elucidate cell kinetics in the brainstem of this condition, which is still the main cause of postneonatal infant death. Materials and methods: Twenty-six cases of SIDS occurred among 38 infants dying under 6 months of age in a cohort of 27,000 infants studied prospectively to characterize their sleep–wake behavior. All the infants had been recorded during one night in a pediatric sleep laboratory some 3–12 weeks before death. The frequency and duration of sleep apnea were analyzed. At autopsy, brainstem material was collected and immunohistochemistry for Ki-67 was carried out. The density of Ki-67-positive neurons was measured semiquantitatively. Correlation analyses were carried out between the density of Ki-67-positive neurons and the data on sleep apnea. Results: Except in two cases in SIDS victims and in one control, the detection of Ki-67 was negative. No correlation analysis between the Ki-67 and of sleep apnea was found. Conclusions: There were no abnormal cell kinetics detected by the demonstration of Ki-67 antigen in the brainstems of SIDS victims. 相似文献