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51.
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
52.
脾动脉栓塞治疗外伤性脾破裂28例临床疗效观察 总被引:3,自引:0,他引:3
目的:探讨脾动脉栓塞术对外伤性脾破裂的疗效及并发症的处理。方法:采用Seldinger法行脾动脉栓塞术治疗外伤性脾破裂28例。结果:所有患者出血立即停止,其中4例行2次栓塞。28例均有脾区疼痛,22例发热。脾动脉栓塞5天后血小板、白细胞上升近1倍,7天后恢复至正常范围。28例随访6-36月,查免疫球蛋白、CT等结果满意,未有再出血及发生暴发性感染。结论:脾动脉栓塞不但有良好的止血作用,而且能保留脾脏的免疫功能,可在非手术治疗失败时选用,是外伤性脾破裂的一种有效治疗方法。 相似文献
53.
Lymphatic drainage from the skin of the back to retroperitoneal and paravertebral lymph nodes in melanoma patients 总被引:4,自引:1,他引:3
Dr. Roger F. Uren MBBS Robert Howman-Giles MD John F. Thompson MD 《Annals of surgical oncology》1998,5(4):384-387
Background: Preoperative lymphoscintigraphy (LS) with99mTc antimony sulphide colloid is now part of the routine management of patients with intermediate thickness melanoma at the
Sydney Melanoma Unit. Over a 13-year period, 1375 patients have been examined using LS, and we have observed many unusual
lymphatic drainage pathways, including direct drainage through the body wall to retroperitoneal and paravertebral lymph nodes
from the skin of the back. The aim of this study was to determine the incidence of such drainage in the 542 patients who had
primary melanoma sites on the posterior trunk.
Methods: The lymphoscintigrams performed on these patients were examined for the presence of direct lymphatic drainage through the
posterior body wall to sentinel nodes in the retroperitoneal and paravertebral regions.
Results: Lymphatic drainage directly through the body wall to such lymph nodes occurred in 14 of these 542 patients.
Conclusions: Preoperative knowledge of the presence of this lymph drainage pattern may influence surgical management, and follow-up investigations
in these patients can be tailored to ensure that the relevant areas are examined with anatomic imaging or F18-FDG PET scans. 相似文献
54.
Katherine Wiegmann Shylaja Muthyala Duk Hwan Kim Barry G. W. Arnason Ewa Chelmicka-Schorr 《Journal of neuroimmunology》1995,56(2)
Chronic/relapsing experimental allergic encephalomyelitis (CREAE) serves as an animal model for relapsing/remitting multiple sclerosis. Treatment with the β-adrenergic agonist isoproterenol or the β2-adrenergic agonist terbutaline significantly suppressed both the first acute attack and the number of relapses in CREAE Lewis rats. The number of relapses was decreased even when treatment with β-adrenergic agonist was started after the onset of the first acute attack of CREAE. β-adrenergic receptor number was increased significantly on splenocytes from CREAE rats as compared to healthy controls or CFA-injected rats. Terbutaline treatment of CREAE rats lowered the splenocyte receptor number to normal values. 相似文献
55.
A. V. Meera S. Sen P. Raghupathy D. Walter M. Chandy H. Krishnaswami J. Chacko N. Zachariah K. E. Mammen 《Pediatric surgery international》1995,10(5-6):389-390
We present two children with massive bleeding into the serous body cavities accompanied by intractable consumption coagulopathy. One had a large spleen palpable at admission, the other developed progressive splenomegaly while in hospital. Neither child had any external evidence of angiomatous lesions. A splenic hemangioma was suspected clinically and on abdominal ultrasound; the diagnosis was confirmed at laparotomy. Splenectomy resulted in a prompt cure in both cases. 相似文献
56.
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
57.
58.
Grabau DA Rank F Friis E 《APMIS : acta pathologica, microbiologica, et immunologica Scandinavica》2005,113(1):7-12
The study presents the results from intraoperative frozen section assessment of axillary sentinel lymph nodes (SLNs) in breast cancer. Routine histological frozen sections from one level were used, two sections stained with haematoxylin and eosin. Immunohistochemistry for cytokeratins was applied to the permanent SLN paraffin sections only. Axillary dissection was performed on all SLN-positive cases regardless of the size of the metastatic deposits. With a detection rate of 83%, 272 patients entered the study over a period of 46 months. A total of 61 cases were SLN positive by frozen section analysis. The paraffin sections gave an additional 23 SLN-positive cases. The false-negative rate for frozen sections was then 27% (23/84). Micrometastases were found in 28 of 84 cases, and macrometastases in 56. The false-negative rate of frozen sections for micrometastases was 71% (20/28), and for macrometastases 5% (3/56). A total of 73% (61/84) of the patients underwent axillary surgery as a one-step procedure. 相似文献
59.
Sato A Taniguchi I Fujiwara D Ichikawa H Suzuki M Nawata S Murakami G 《Anatomical science international / Japanese Association of Anatomists》2003,78(4):211-222
Gaps and fragmentation of the superficial lymph node cortex are considered to provide intranodal shunt flow between the afferent
and efferent vessels. Using serial sections of 205 nodes obtained from 27 donated cadavers more than 70 years of age, we examined
the histological architecture of the abdominal and pelvic nodes in elderly Japanese. Secondary follicles were rare in the
specimens. Cortex gaps were, to a greater or lesser degree, found in all nodes. We classified these nodes into three types
according to how often the gap occurred. Type 1 nodes, with a relatively complete shield for the afferent lymph, were most
frequently found in gastric nodes, whereas type 3 nodes, with numerous gaps, were often observed in the colic, para-aortic
and pelvic nodes. The type 3 nodes showed a specific architecture characterized by a fragmented superficial cortex, three-dimensionally
assembled cords and a common sinus between them. Primary follicles were located in the assembled cord structures as well as
at the superficial cortex. Irrespective of the type, B and T lymphocyte areas were intermingled in the cortex-like areas.
The present results reveal region-specific histological heterogeneity in aged human visceral nodes. Due to increased surface
areas, the type 3 architecture seemed to accelerate systemic immunity rather than act as a local barrier in the para-aortic
and pelvic nodes, which are located centrally along the lymphatic drainage routes. However, thick trabeculae often seemed
to develop in the type 3 sinus to decrease nodal function with aging. 相似文献
60.
Class switch recombination (CSR), somatic hypermutation, and gene conversion are immunoglobulin diversification mechanisms that are strictly dependent on the activity of the activation-induced cytidine deaminase (AID). The precise role and substrate(s) of AID in these processes remain to be well defined. The closest homologue of AID is APOBEC-1, a bona fide mRNA-editing enzyme, which shares with AID the ability to deaminate cytidines within single-stranded DNA in vitro and in prokaryotic cells. To determine whether APOBEC-1 can therefore substitute for AID in activated B cells, we expressed human AID, a catalytic mutant thereof, and rat APOBEC-1 in AID-deficient murine B cells. Whereas AID rescued CSR, neither the inactive mutant nor APOBEC-1 could complement AID deficiency. This indicates that cytidine deaminase activity is necessary but not sufficient to initiate CSR, and suggests that AID is specifically targeted to its cognate substrate, the immunoglobulin genes or a distinct mRNA, by an as-yet-unknown mechanism. 相似文献