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71.
Dr. David H. Berger MD Barry W. Feig MD Donald Podoloff MD James Norman MD C. Wayne Cruse MD Douglas S. Reintgen MD Merrick I. Ross MD 《Annals of surgical oncology》1997,4(3):247-251
Background: If cutaneous lymphoscintigraphy (CL) is accurate in predicting the draining lymph node basins at risk from primary axial
melanomas, then regional metastases should only occur in those lymph node basins identified by CL.
Methods: This study is a retrospective review of patients undergoing CL for primary axial melanomas from June 1, 1985, until June
31, 1992. Data retrieved included age, gender, number of basins identified, location of basins identified, management of basins,
recurrence in lymphatics, development of distant disease, and long-term follow-up.
Results: A total of 181 patients underwent elective LND, and 48 patients (27%) had melanoma in the nodes within the dissected basin.
Of these 181 patients, seven developed nodal metastases as their site of first recurrence. All seven recurrences were seen
at sites dissected or at sites indicated by CL, which the primary surgeon elected not to treat initially. Of the 116 patients
observed, 16 (14%) developed lymph node metastases as their first site of recurrence. Fifteen of these 16 patients had their
site of lymph node metastases predicted by CL. In this study, CL predicted 98.6% of all lymph node metastases.
Conclusions: The high overall reliability of CL as demonstrated by long-term follow-up indicates that the information obtained by CL can
be reliably used to guide intervention. Initial evaluation of patients with high-risk cutaneous melanomas at sites with ambiguous
lymphatic drainage must include CL in order to determine the draining lymph node basins and to plan therapy.
Presented at the 47th Annual Cancer Symposium of The Society of Surgical Oncology, Houston, Texas, March 17–20, 1994. 相似文献
72.
73.
目的 探讨前哨淋巴结活检术(SLNB)应用于外阴癌的可行性.方法 选择2004年10月-2008年4月间于中国医学科学院肿瘤医院接受手术治疗、术中采用SLNB的外阴癌患者21例,其中处于研究前期(即2005年5月前)的11例患者采用染料法识别前哨淋巴结(SLN)、处于研究后期的10例患者采用核素-染料联合法识别SLN,术后行常规病理检查.以病理检查结果为金标准,观察SLNB的检测效果;并观察与SLNB相关的并发症的发生情况.结果 21例患者中,20例(95%)检出SLN,其中8例为单侧腹股沟、12例为双侧腹股沟.20例SLN阳性患者共检出83枚SLN,每例患者平均检出4.2枚(1~9枚),每侧腹股沟平均2.6枚(1~6枚).其中,染料法每例患者平均检出4.4枚、每侧腹股沟平均2.5枚,核素-染料联合法每例患者平均检出3.9枚、每侧腹股沟平均2.7枚,分别比较,差异均无统计学意义(t=0.459,P=0.652;t=-0.421,P=0.717).20例SLN阳性患者腹股沟浅组淋巴结中均检出SLN,其中1例双侧腹股沟深组淋巴结中也检出SLN.20例SLN阳性的患者中,8例(10侧腹股沟)术后病理检查显示腹股沟淋巴结转移,其中7例患者(9侧腹股沟)的转移淋巴结中均包括有SLN、1例(1侧腹股沟)出现假阴性.以SLN识别预测同侧腹股沟淋巴结转移的假阴性率为10%(1/10),阴性预测值为96%(22/23).未发现与SLNB相关的损伤及不良反应.结论 SLNB应用于外阴癌安全、可行,以SLN预测同侧腹股沟淋巴结转移具有较高准确性. 相似文献
74.
Zhang Deli Chen Shulan 《宁夏医科大学学报》1987,(2)
Sinoatrial node electrogram (SNE) was recorded successfully in recent years, using transvenous electrode catheter. Via SNE and intratrialelectrogram (IEG), one could measure sinoatrial conduction time(SACT) directly, observe sinoatrial node (SN) potential changes in cadiac cycles, diagnose some sinus arrhythmias which couldn't be confirmed by surface ECG. All these could offer accurate evidence for differential diagnosis of sick sinus syndrome (SSS). The authors recommend a modified method for the location of the electrode catheter, by which one can increase success rate of obtaining stable SNE. Using this method, the authors recorded SNE in 10 cases with SSS successfully. 相似文献
75.
HOFFMANN E.; MATTKE S.; DORWARTH U.; MULLER D.; HABERL R.; STEINBECK G. 《European heart journal》1993,14(1):57-64
A new technique for catheter ablation of atrioventricular (AV)conduction, using temperature-controlled radiofrequency energyand a bipolar asymmetrical electrode configuration, was appliedto 12 patients (mean age, 48 ± 15 years; range, 1869years) with medically refractory atrioventricular nodal reentranttachycardia (AVNRT) or rapid atrial rhythms. The energy sourcewas a 500 kHz generator with automatic power regulation to apreselected temperature of 80 °C. A specially designed 7F bipolar asymmetric thermo-catheter was used for ablation inall cases. The endpoints of the procedure were: first-degreeAV block in patients with AVN R T and third-degree block inpatients with atrial fibrillation or flutter. Energy was appliedover a range of 114 times per patient. After a mean follow-upof 8±4 months, third- or first degree AV block persistedin eight patients. In comparison to constant-power radiofrequencyablation, where impedance rises are commonly observed, no impedancerise or coating of the electrode occurred during any of the97 energy applications in this study. Variable wall contactof the electrode was identified in 20 of 97 applications bya slow temperature rise or a drop in temperature and frequentpower adjustments. Thus, monitoring temperature and automaticpower regulation may help to reduce the total delivered energy.Temperature control during radiofrequency energy avoids coagulumformation and consequently the associated potential hazardsof constant-power application. 相似文献
76.
应用食道心房调博缩测定健康小儿窦房结功能,以了解西宁地区正常数值与平原地区进行对比。选择27例健康小儿,将F6二级电极导管从鼻腔送入,定位地食道心电图最大正负双相P波处,采用苏州东方电子仪器厂生产的DF-3A型心脏电生理治疗仪进行检查,从而作出诊断。 相似文献
77.
We present a new mathematical model for vagal control of rabbit sinoatrial (SA) node electrical activity based on the DiFrancesco-Noble
equations. The original equations were found to be unstable, resulting in progressive cycle by cycle depletion or accumulation
of ions in intra- and extracellular compartments. This problem was overcome by modifying the maximum Na−K pump current and
the time constant for uptake of intracellular calcium. We also included a formulation for the acetylcholine (ACh)-activated
potassium current which was consistent with experimental data. This formulation was based on kinetics first proposed by Osterrieder
and later modified by Yanagihara. The resulting model exhibits cycle-cycle ionic stability, and includes an ACh-activated
potassium current which accurately reproduces experimentally observed effects of vagal stimulation on both the membrane potential
and its timederivative. Simulations were performed for both brief-burst and prolonged vagal stimulation using simplified square
wave profiles for the concentration of ACh in the synaptic cleft space. This protocol permits the isolation of cardiac period
dynamics caused by changes in membrane potential and intra- and extracellular ionic concentrations from those caused by other
mechanisms including the dynamics of ACh release, diffusion, hydrolysis and washout. Simulation results for the effects of
brief-burst single cycle stimulation on the cardiac period agree closely with experimental data reported in the literature,
accurately reproducing changes in membrane potential and the phasic dependency of the response to the position of vagal stimulus
bursts within the cycle. Simulation of the effects of prolonged vagal stimulation accurately reproduced the steady-state characteristics
of heart period response, but did not yield the complex multimodal dynamics of the recovery phase, or the pronounced post
vagal tachycardia observed experimentally at the termination of the stimulus. Our results show that the major chronotropic
effects of vagal stimulation on the SA cell membrane can be explained in terms of the ACh-activated potassium current. The
effects of this membrane current however are generally fast acting and cannot contribute to any long lasting dynamics of the
cardiac period response. The modified DiFrancesco-Noble model presented in this article provides a valuable theoretical tool
for further analysis of the dynamics of vagal control of the cardiac pacemaker. 相似文献
78.
目的:检测lnc-CCDC33-1:1在甲状腺乳头状癌(PTC)中的表达,并分析其临床意义。方法:选取2021年11月至2022年3月杭州市萧山区第一人民医院收治的120例PTC患者,收集120例PTC组织及30例癌旁正常甲状腺组织。采用qRT-PCR检测lnc-CCDC33-1:1在PTC组织及癌旁组织中的表达。分析本地队列和TCGA队列中lnc-CCDC33-1:1表达水平与PTC患者临床病理因素的相关性。采用受试者工作特征(ROC)曲线评价lnc-CCDC33-1:1对PTC的诊断价值。结果:与癌旁正常甲状腺组织比,lnc-CCDC33-1:1在PTC组织中表达明显升高(P <0.001)。ROC曲线显示曲线下面积为0.803(95%CI =0.736~0.869,P <0.001)。本地队列显示lnc-CCDC33-1:1 表达与PTC肿瘤大小(P =0.048)、腺外侵犯(P =0.019)、T分期(P =0.011)和淋巴结转移(P =0.009)相关,TCGA组数据显示lnc-CCDC33-1:1表达水平与PTC腺外侵犯(P =0.036)和淋巴结转移(P <0.001)相关。结论:lnc-CCDC33-1:1在PTC中表达异常升高,与PTC高危特征相关,可能是潜在的诊断标志物和治疗靶点。 相似文献
79.
80.
PAOLO ALBONI NELLY PAPARELLA RICCARDO CAPPATO PAOLO PEDRONI GIAN CARLO CANDINI GIAN ENRICO ANTONIOLI 《Pacing and clinical electrophysiology : PACE》1989,12(2):294-300
The purpose of this study was to find out whether transesophageal pacing could be utilized for assessment of sinus node function in patients with sick sinus syndrome (SSS). In 17 patients with SSS (study group) we compared the results of sinus node tests obtained both in the basal state and after pharmacological autonomic blockade by endocavitary stimulation and, 24 hours later, by transesophageal pacing. In another group of 17 patients with SSS (control group), we compared the results obtained by two endocavitary studies. In "study group", sinus cycle length (SCL) and corrected sinus node recovery time (CSRT) did not show significant differences between the two studies both in the basal state and after autonomic blockade, whereas sinoatrial conduction time (SACT) was more prolonged during esophageal pacing (P less than 0.01). In "control group", sinus node measures did not show significant differences between the two studies. In the "study group," the following coefficients of correlation were obtained in the basal state; SCL, r = 0.65, CSRT, r = 0.57, SACT, r = 0.52 and after autonomic blockade: SCL, r = 0.95, CSRT, r = 0.62 and SACT, r = 0.53. In the basal state, the correlation for SCL and CSRT between the two studies was lower in the "study group" than in the "control group" (P less than 0.05), whereas after autonomic blockade the correlation for sinus node measures did not show significant differences between the two groups of patients. These data suggest that transesophageal study influences the autonomic tone regulating the sinus node; however, it is not responsible for important variations in sinus node measures.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献