全文获取类型
收费全文 | 209336篇 |
免费 | 19734篇 |
国内免费 | 7679篇 |
专业分类
耳鼻咽喉 | 1232篇 |
儿科学 | 5282篇 |
妇产科学 | 3072篇 |
基础医学 | 38441篇 |
口腔科学 | 3848篇 |
临床医学 | 13916篇 |
内科学 | 36426篇 |
皮肤病学 | 3329篇 |
神经病学 | 17765篇 |
特种医学 | 4217篇 |
外国民族医学 | 58篇 |
外科学 | 15485篇 |
综合类 | 25467篇 |
现状与发展 | 31篇 |
一般理论 | 6篇 |
预防医学 | 10230篇 |
眼科学 | 2383篇 |
药学 | 26743篇 |
23篇 | |
中国医学 | 6887篇 |
肿瘤学 | 21908篇 |
出版年
2024年 | 404篇 |
2023年 | 3131篇 |
2022年 | 5799篇 |
2021年 | 8476篇 |
2020年 | 7231篇 |
2019年 | 8224篇 |
2018年 | 7810篇 |
2017年 | 7711篇 |
2016年 | 7522篇 |
2015年 | 8965篇 |
2014年 | 12781篇 |
2013年 | 14291篇 |
2012年 | 12927篇 |
2011年 | 15240篇 |
2010年 | 12935篇 |
2009年 | 12336篇 |
2008年 | 11758篇 |
2007年 | 10499篇 |
2006年 | 9514篇 |
2005年 | 8108篇 |
2004年 | 7098篇 |
2003年 | 6075篇 |
2002年 | 4745篇 |
2001年 | 4056篇 |
2000年 | 3383篇 |
1999年 | 3074篇 |
1998年 | 2666篇 |
1997年 | 2426篇 |
1996年 | 2096篇 |
1995年 | 1802篇 |
1994年 | 1562篇 |
1993年 | 1314篇 |
1992年 | 1133篇 |
1991年 | 995篇 |
1990年 | 832篇 |
1989年 | 703篇 |
1988年 | 608篇 |
1987年 | 485篇 |
1986年 | 481篇 |
1985年 | 876篇 |
1984年 | 888篇 |
1983年 | 614篇 |
1982年 | 674篇 |
1981年 | 532篇 |
1980年 | 433篇 |
1979年 | 380篇 |
1978年 | 295篇 |
1977年 | 237篇 |
1976年 | 221篇 |
1975年 | 153篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
71.
目的 研究血清窖蛋白-1 (Cav-1) 在慢性阻塞性肺疾病 (COPD) 相关肺动脉高压 (PAH) 患者中的表达及其意义。方法 选取稳定期COPD患者65例, 根据是否合并PAH分成COPD组 [肺动脉收缩压 (PASP) <40 mmHg, 35例] 及COPD-PAH组 (PASP ≥40 mmHg, 30例)。另选取在本院健康体检的志愿者30例作为对照组。对比各组基线资料、 动脉血气分析、 肺功能指标, 以及血清Cav-1、 白细胞介素 (IL) -6和肿瘤坏死因子-α (TNF-α) 的表达水平。绘制受试者工作特征 (ROC) 曲线, 评价Cav-1对COPD合并PAH的诊断价值。结果 COPD-PAH组与COPD组第一秒用力呼吸容积 (FEV1) /用力肺活量 (FVC)、 FEV1占预计值百分比 (FEV1%) 及氧分压 [p (O2 )] 低于对照组, 而二氧化碳分压 [p (CO2 )]、 PASP均高于对照组 (P<0.01)。COPD-PAH组p (O2 ) 低于COPD组, p (CO2 )、 PASP均高于COPD 组 (P<0.01)。对照组、 COPD组及COPD-PAH组Cav-1表达水平呈逐渐降低趋势, 而IL-6、 TNF-α表达水平呈逐渐升高趋势 (P<0.01)。血清Cav-1诊断COPD合并PAH的ROC曲线下面积为0.902 (0.821~0.955), 最佳截断值为 6.66 μg/L, 此时诊断敏感度为76.7%, 特异度为85.7%, 与多普勒超声诊断仪测量PASP结果比较一致性较好 (Kappa 值=0.627)。结论 血清Cav-1在COPD相关PAH患者表达明显下调, 可以作为预测COPD相关PAH的新型血清标志物。 相似文献
72.
《Clinical genitourinary cancer》2022,20(3):e217-e226
Background: Intraductal carcinoma and cribriform (IDC/C) tumor features are well-established prognosticators of biochemical recurrence (BCR), metastasis, and prostate cancer (PCa)-specific mortality. However, approximately 70% of PCa patients undergoing a radical prostatectomy are IDC/C negative, yet up-to 20% of these patients progress and experience BCR. Thus, tumor histopathologic characteristics such as IDC/C alone are limited in their ability to predict disease progression. Conversely, several nomograms such as Cancer of the Prostate Risk Assessment-Surgery (CAPRA-S) have been developed to aid in the prognostication of BCR, but not yet widely applied in clinical settings. Materials and methods: In this study, we assessed the combined prognostic utility of IDC/C, and CAPRA-S for BCR in 3 PCa patient cohorts. Results: CAPRA-S+IDC/C improved the predictive accuracy of BCR in all 3 cohorts (P < .001). Specifically, among IDC/C negative cases, CAPRA-S improved the prognostication of BCR in low-risk (Cohort 1; P < .001, Cohort 2; P < .001, Cohort 3; P = .003), intermediate (Cohort 1; P < .001, Cohort 2; P = .006, Cohort 3; P = .03) and high-risk (Cohort 1-3; P < .001) patients. Conversely, IDC/C improved the prognostication of BCR among CAPRA-S low-risk (Cohorts 1; P < .001 and Cohort 3; P = .003) patients. Conclusion: Our results suggest the investigation of histopathological IDC/C features in CAPRA-S low-risk patients and conversely, nomogram CAPRA-S among IDC/C negative patients improves the identification of patients likely to experience BCR, which would otherwise be missed through current assessment regimens. These patients can be offered more intensive monitoring and adjuvant therapies upfront to circumvent the development of recurrent cancer or overtreatment at the time of surgery. 相似文献
73.
Y. Ermias I.A. Morgan K.M. Curtis M.K. Whiteman L.G. Horton L.B. Zapata 《Contraception》2019,99(5):300-305
ObjectiveIdentify factors associated with healthcare providers' frequency of depot medroxyprogesterone acetate (DMPA) provision to adolescents.Study designWe analyzed data from surveys mailed to a nationally representative sample of public-sector providers and office-based physicians (n=1984). We estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of factors associated with frequent DMPA provision to adolescents in the past year.ResultsAlthough most providers (>95%) considered DMPA safe for adolescents, fewer reported frequent provision (89% of public-sector providers; 64% of office-based physicians). Among public-sector providers, factors associated with lower odds of frequent provision included working in settings without Title X funding (aOR 0.44, 95% CI 0.30–0.64), reporting primary care as their primary clinical focus versus reproductive or adolescent health (aOR 0.42, 95% CI 0.28–0.61), and providing fewer patients with family planning services. Among office-based physicians, factors associated with lower odds of frequent provision included specializing in obstetrics/gynecology (aOR 0.50, 95% CI 0.27–0.91) and family medicine (aOR 0.21, 95% CI 0.09–0.47) versus adolescent medicine, completing training ≥15 versus <5 years ago (aOR 0.27, 95% CI 0.09–0.83), and reporting that 0–24% of patients pay with Medicaid or other government healthcare assistance versus ≥50% (aOR 0.23, 95% CI 0.09–0.61). The reason most commonly reported by providers for infrequent DMPA provision was patient preference for another method.ConclusionsWhile most providers reported frequently providing DMPA to adolescents, training on evidence-based recommendations for contraception, focused on subgroups of providers with lower odds of frequent DMPA provision, may increase adolescents' access to contraception.ImplicationsAlthough >95% of providers considered depot medroxyprogesterone (DMPA) a safe contraceptive for adolescents, only 89% of public-sector providers and 64% of office-based physicians reported frequently providing DMPA to adolescents. Provider training on evidence-based recommendations for contraception counseling and provision may increase adolescents' access to DMPA and all methods of contraception. 相似文献
74.
Conall T. Morgan Brigitte Mueller Varsha Thakur Vitor Guerra Callaghan Jull Luc Mertens Mark Friedberg Fraser Golding Mike Seed Steven E.S. Miner Edgar T. Jaeggi Cedric Manlhiot Lynne E. Nield 《The Canadian journal of cardiology》2019,35(4):453-461
Background
The purpose of the study was to evaluate the association between fetal echocardiographic measurements and the need for intervention (primary coarctation repair, staged coarctation repair, or catheter intervention) in prenatally diagnosed coarctation of the aorta.Methods
A single-centre retrospective cohort study (2005-2015) of 107 fetuses diagnosed with suspected coarctation of the aorta in the setting of an apex-forming left ventricle and antegrade flow across the mitral and aortic valves.Results
Median gestational age at diagnosis was 32 weeks (interquartile range, 23-35 weeks). Fifty-six (52%) did not require any neonatal intervention, 51 patients (48%) underwent a biventricular repair. In univariable analysis, an increase in ascending aorta (AAo) peak Doppler flow velocity (odds ratio [OR], 1.40 [95% confidence interval [CI], 1.05-1.91] per 20 cm/s; P = 0.03) was associated with intervention. No intervention was associated with larger isthmus size (OR, 0.23; P < 0.001), transverse arch diameter (OR, 0.23; P < 0.001), and aortic (OR, 0.72; P = 0.02), mitral (OR, 0.58; P = 0.001), and AAo (OR, 0.53; P < 0.001) z-scores. In multivariable analysis, higher peak AAo Doppler (OR, 2.51 [95% CI, 1.54-4.58] per 20 cm/s; P = 0.001) and younger gestational age at diagnosis (OR, 0.81 [95% CI, 0.70-0.93] per week; P = 0.005) were associated with intervention, whereas a higher AAo z-score (OR, 0.65 [95% CI, 0.43-0.94] per z; P = 0.029) and transverse arch dimension (OR, 0.44 [95% CI, 0.18-0.97]; P = 0.05) decreased the risk of intervention.Conclusions
In prenatally suspected coarctation, the variables associated with intervention comprised smaller AAo and transverse arch size, earlier gestational age at diagnosis, and the additional finding of a higher peak AAo Doppler. 相似文献75.
Xiaojie Wu Leyan Zhang Jiadi Zhou Luying Liu Qiang Fu Aili Fu Xiaoying Feng Rui Xin Hongrui Liu Yong Gao Jiangnan Xue 《Current problems in cancer》2019,43(1):18-26
Aim
Leukocyte-associated immunoglobulin-like receptor-1 (LAIR-1) is an immune inhibitory receptor which is expressed within most types of hematopoietic cells and negatively regulates immune responses. Recently, we found LAIR-1 expression to be present within tumors of nonhematopoietic lineages. However, the roles of LAIR-1 in hepatocellular carcinoma (HCC) have yet to be examined. The purpose of this study was to investigate the expression of LAIR-1 in HCC tissue and assess its clinical significance at this site.Materials and methods
Expression levels of LAIR-1 within HCC samples collected from 90 patients and compared with that of slides of normal liver tissue collected from 9 non-HCC patients were measured by immunohistochemistry using tissue microarrays. A semiquantitative score was assigned, as was based on staining intensity and percent of positive cells and a Spearman Rank correlation test was used to assess any potential significant correlations between LAIR-1 expression and clinicopathological factors. Overall survival analysis was performed using the Kaplan-Meier and Log Rank statistical test.Results
LAIR-1 expression was detected in cancer tissue and adjacent tumor tissue, but not in normal liver tissue. The percent of LAIR-1-positive expression in cancer tissue of HCC samples was 97.78% (88/90) while that in adjacent tumor tissue was 96.67% (87/90). Significantly greater expression levels of LAIR-1 were obtained from cancer tissue (Mean?±?SD?=?5.722?±?2.145) than that in adjacent tumor tissue (4.141?±?1.486). In addition, LAIR-1 expression was found to be significantly correlated with pathological grade of HCC, T stage, and age. Expression levels of LAIR-1 were related with worse overall survival rates of HCC patients, especially in HCC patients with hepatic cirrhosis.Conclusion
Results of this study show that LAIR-1 is expressed in HCC tissues and that high levels of LAIR-1 expression are associated with the poor cancer differentiation. In addition, overexpression of LAIR-1 was significantly associated with worse overall survival in the patients with HCC. These data suggest that LAIR-1 may be an independent predictor for clinical outcomes in patients with HCC. 相似文献76.
《Vaccine》2019,37(31):4302-4309
Influenza A virus (IAV) vaccines in pigs generally provide homosubtypic protection but fail to prevent heterologous infections. In this pilot study, the efficacy of an intradermal pDNA vaccine composed of conserved SLA class I and class II T cell epitopes (EPITOPE) against a homosubtypic challenge was compared to an intramuscular commercial inactivated whole virus vaccine (INACT) and a heterologous prime boost approach using both vaccines. Thirty-nine IAV-free, 3-week-old pigs were randomly assigned to one of five groups including NEG-CONTROL (unvaccinated, sham-challenged), INACT-INACT-IAV (vaccinated with FluSure XP® at 4 and 7 weeks, pH1N1 challenged), EPITOPE-INACT-IAV (vaccinated with PigMatrix EDV at 4 and FluSure XP® at 7 weeks, pH1N1 challenged), EPITOPE-EPITOPE-IAV (vaccinated with PigMatrix EDV at 4 and 7 weeks, pH1N1 challenged), and a POS-CONTROL group (unvaccinated, pH1N1 challenged). The challenge was done at 9 weeks of age and pigs were necropsied at day post challenge (dpc) 5. At the time of challenge, all INACT-INACT-IAV pigs, and by dpc 5 all EPITOPE-INACT-IAV pigs were IAV seropositive. IFNγ secreting cells, recognizing vaccine epitope-specific peptides and pH1N1 challenge virus were highest in the EPITOPE-INACT-IAV pigs at challenge. Macroscopic lung lesion scores were reduced in all EPITOPE-INACT-IAV pigs while INACT-INACT-IAV pigs exhibited a bimodal distribution of low and high scores akin to naïve challenged animals. No IAV antigen in lung tissues was detected at necropsy in the EPITOPE-INACT-IAV group, which was similar to naïve unchallenged pigs and different from all other challenged groups. Results suggest that the heterologous prime boost approach using an epitope-driven DNA vaccine followed by an inactivated vaccine was effective against a homosubtypic challenge, and further exploration of this vaccine approach as a practical control measure against heterosubtypic IAV infections is warranted. 相似文献
77.
A. Cattapan K. Browne D.M. Halperin A. Di Castri P. Fullsack J. Graham J.M. Langley B.A. Taylor S.A. McNeil S.A. Halperin 《Vaccine》2019,37(2):289-295
Introduction/Hypothesis
Recruitment of participants into phase 1 vaccine clinical trials can be challenging since these vaccines have not been used in humans and there is no perceived benefit to the participant. Occasionally, as was the case with a phase 1 clinical trial of an Ebola vaccine in Halifax, Canada, during the 2014–2016 West African Ebola virus outbreak, recruitment is less difficult. In this study, we explored the motivations of participants in two phase 1 vaccine trials that were concurrently enrolling at the same centre and compared the motivations of participants in a high-profile phase 1 Ebola vaccine trial to those in a less high-profile phase 1 adjuvanted seasonal influenza vaccine study.Methods
An online survey which included participants’ prior experience with clinical trials, motivations to participate (including financial incentives), and demographic information was developed to examine the motivations of healthy participants in two phase 1 clinical vaccine trials conducted at the Canadian Center for Vaccinology in Halifax, Nova Scotia. Participants were invited via email to complete the online survey. Readability and clarity were assessed through pilot testing.Results
A total of 49 (55.7%) of 88 participants of the two studies completed the survey (22 [55%] of 40 participants from the Ebola vaccine study and 27 [56.3%] of 48 from the adjuvanted influenza vaccine study). Motivations that were most frequently ranked among participants' top three in both trials were (1) wanting to contribute to the health of others, (2) wanting to participate in something important, (3) wanting to contribute to the advancement of science, and (4) wanting to receive an incentive such as money or a tablet.Conclusions/Recommendations
Although media attention and financial compensation were more often cited by Ebola vaccine trial participants as a reason to participate, both altruistic and self-interested factors were important motivations for participants in their decision to participate in a phase 1 vaccine clinical trial. 相似文献78.
79.
器官移植术是20世纪出现的针对器官功能衰竭的最有效治疗方法,每年拯救全球超过12万例患者。但供器官短缺的现状,与器官移植技术和辅助药物的发展不匹配,制约了器官移植事业的发展。我国自2015年起已成为全球器官捐献和移植大国之一,2017年公民逝世后器官捐献数量超过5 000例,占全球捐献总量的15%以上。黄洁夫教授总结的器官捐献与移植"中国模式"得到了世界卫生组织、国际移植界的高度重视和充分肯定。本文通过整理全球及各国的器官捐献与移植数据,剖析全球现状与发展趋势,进一步探索我国公民器官捐献的影响因素并提出针对性的应对策略,以期实现我国器官捐献和移植的"自给自足"。 相似文献
80.
Caveolin-1 (Cav-1) appears to be both a pathophysiological contributor and a target in different inflammatory and hyperproliferative skin conditions as well as in skin aging. Skin fibroblasts demonstrate an up-regulation of Cav-1 expression both in chronological and UV-induced aging, and such an up-regulation was observed both in vitro and in vivo. Typical alterations in aging skin involve a reduction of the dermis thickness, a significant expansion of the dermal white adipose tissue as well as modifications of the content and distribution of hyaluronan, impairment of autophagic flux, a reduction of collagen expression and an increase in tissue inflammation. All of these phenomena can be connected with changes in Cav-1 expression in the aging skin. Modified expression of Cav-1 can also significantly influence the mechanical properties of individual skin layers, thus changing the total mechanical stability of the layered composite skin/WAT, leading to typical structural modifications of the skin surface in the aging skin. Selective reduction of Cav-1 expression has the potential to exert anti-aging effects on the skin. 相似文献