全文获取类型
收费全文 | 2570篇 |
免费 | 134篇 |
国内免费 | 14篇 |
专业分类
耳鼻咽喉 | 13篇 |
儿科学 | 88篇 |
妇产科学 | 14篇 |
基础医学 | 268篇 |
口腔科学 | 58篇 |
临床医学 | 126篇 |
内科学 | 752篇 |
皮肤病学 | 49篇 |
神经病学 | 144篇 |
特种医学 | 211篇 |
外科学 | 471篇 |
综合类 | 12篇 |
预防医学 | 59篇 |
眼科学 | 17篇 |
药学 | 145篇 |
中国医学 | 4篇 |
肿瘤学 | 287篇 |
出版年
2023年 | 18篇 |
2022年 | 32篇 |
2021年 | 65篇 |
2020年 | 34篇 |
2019年 | 57篇 |
2018年 | 81篇 |
2017年 | 56篇 |
2016年 | 67篇 |
2015年 | 58篇 |
2014年 | 78篇 |
2013年 | 104篇 |
2012年 | 159篇 |
2011年 | 167篇 |
2010年 | 82篇 |
2009年 | 73篇 |
2008年 | 139篇 |
2007年 | 151篇 |
2006年 | 158篇 |
2005年 | 155篇 |
2004年 | 173篇 |
2003年 | 131篇 |
2002年 | 128篇 |
2001年 | 61篇 |
2000年 | 47篇 |
1999年 | 40篇 |
1998年 | 28篇 |
1997年 | 30篇 |
1996年 | 23篇 |
1995年 | 24篇 |
1994年 | 17篇 |
1993年 | 14篇 |
1992年 | 25篇 |
1991年 | 30篇 |
1990年 | 19篇 |
1989年 | 23篇 |
1988年 | 17篇 |
1987年 | 15篇 |
1986年 | 29篇 |
1985年 | 23篇 |
1984年 | 17篇 |
1983年 | 15篇 |
1982年 | 5篇 |
1981年 | 4篇 |
1980年 | 5篇 |
1978年 | 4篇 |
1977年 | 5篇 |
1969年 | 4篇 |
1967年 | 3篇 |
1966年 | 4篇 |
1923年 | 3篇 |
排序方式: 共有2718条查询结果,搜索用时 15 毫秒
1.
2.
Ichiro Yasuda Takuji Iwashita Takaya Ohnishi Tsuyoshi Mukai Masamichi Enya Eiichi Tomita Hisataka Moriwaki 《Digestive endoscopy》2006,18(Z1):S92-S95
Endoscopic nasobiliary drainage (ENBD) is a well established mode of biliary decompression. Although ENBD is certainly an uncomfortable procedure with the potential risk of spontaneous dislocation or removal of the drainage catheter by disoriented patients, it has several advantages over endoscopic biliary drainage (EBD) using an indwelling stent. The current indications for ENBD are: (i) temporary drainage to treat obstructive jaundice and cholangitis caused by malignant or benign biliary stricture; (ii) urgent drainage to treat suppurative cholangitis primarily caused by common bile duct stones; (iii) temporary drainage after stone removal in patients with suspected incomplete clearance and/or with cholangitis; and (iv) biliary leaks that occur primarily after surgery, as well as other indications. Different types of nasobiliary catheters are currently available that have been designed with various diameters, shapes, and materials. However, the current catheters are not considered by most endoscopists to be sufficient. Further improvements are needed to achieve better drainage and better maneuverability. 相似文献
3.
Yukio Ito M.D. Yoshihide Fujimoto M.D. Takao Obara M.D. Takaya Kodama M.D. 《World journal of surgery》1990,14(3):330-334
Thirty-seven patients with primary aldosteronism were treated by unilateral total adrenalectomy during a 7-year period (1981–1987). The 37 patients were classified into 3 groups on the basis of adrenal pathology: unilateral solitary adenoma, 23 cases (group 1); unilateral adenomas, 3 cases (group 2); and adenoma with multiple macro- or microscopic nodules, 11 cases (group 3). The preoperative conditions of the patients (age, duration of hypertension, plasma renin activity, plasma aldosterone concentration, and serum potassium concentration), postoperative sequential changes of hormone levels, and outcome of hypertension were compared among the groups in order to determine whether the differences of adrenal pathology would affect the postoperative course. The preoperative parameters excluding age at surgery did not differ significantly among the 3 groups. The mean age in group 3, however, was slightly higher than in groups 1 and 2 (47.8 versus 42.8 versus 42.7 years).
Postoperative hormonal changes were also similar, particularly in groups 1 and 3, staying within the normal range throughout the follow-up period (mean, 31 months; range, 3–86 months). However, postoperative improvement of hypertension showed marked differences, being significantl retarded in patients with multinodular lesions (group 3), about half of whom remained hypertensive even after 1 year. Nodular lesions other than adenoma(s) were, therefore, thought not to contribute to hormonal excess but to result from intractable hypertension.
Presented at the International Association of Endocrine Surgeons in Toronto, Ontario, Canada, September, 1989. 相似文献
Resumen Treinta y siete pacientes con aldosteronismo primario fueron tratados mediante adrenalectomía total unilateral en un período de 7 años (1981–1987). Los 37 pacientes fueron clasificados en 3 grupos con base en la patología adrenal: adenoma solitario unilateral, 23 casos (grupo I); adenomas unilaterales, 3 casos (grupo 2); y adenoma con múltiples macro-o micronódulos, 11 casos (grupo 3). Las condiciones preoperatorias de los pacientes (edad, duración de la hipertensión, actividad de renina plasmática, concentración plasmática de aldosterona, y concentración sérica de potasio), los cambios postoperatorios secuenciales en los niveles hormonales, y el resultado de la hipertensión fueron comparados en los 3 grupos, con el objeto de determinar si las diferencias en la patología adrenal podrían afectar la evolución postoperatoria. Los parámetros preoperatorios, excluyendo la edad en el momento de la cirugía, no diferieron significativamente en los 3 grupos. La edad promedio en el grupo 3, sin embargo, fue ligeramente superior en los grupos 1 y 2 (47.8 versus 42.8 versus 42.7 años).Los cambios hormonales postoperatorios también fueron similares, particularmente en los grupos 1 y 3, manteniéndose dentro del rango normal a través del seguimiento (promedio, 31 meses; rango, 3–86). Sin embargo, la mejoría postoperatoria de la hipertensión exhibió diferencias marcadas, con aparación significativamente tardía en pacientes con lesiones nodulares (grupo 3); aproximadamente la mitad de éstos permanecieron hipertensos aún después de un año. Por consiguiente, se piensa que las lesiones nodulares diferentes del adenoma(s) no contribuyen al exceso hormonal sino que resultan de la hipertensión intratable.
Résumé Trente-sept patients ayant un hyperaldostéronisme primaire ont eu une surrénalectomie totale unilatérale entre 1981 et 1987. Ces 37 patients ont été classés en 3 groupes selon la pathologie surrénalienne: adénome solitaire unilatéral, 23 cas (groupe 1); adénome unilatéral, 3 cas (groupe 2); et adénome avec nodules micro ou macroscopiques multiples, 11 cas (groupe 3). On a comparé les données préopératoires (âge, durée de l'hypertension, activité rénine plasmatique, concentration d'aldostérone plasmatique et kaliémie), les changements hormonaux postopératoires, et l'évolution de l'hypertension afin de déterminer si des différences de pathologie surrénalienne peuvent influencer l'évolution postopératoire. Les paramètres préopératoires (excepté l'âge) ne différaient pas de façon significative parmi les 3 groupes. L'âge moyen était plus élevé dans le groupe 3 que dans les groupes 1 et 2 (47.8 versus 42.8 versus 42.7 ans).Les variations hormonales postopératoires étaient également similaires, surtout dans les groupes 1 et 3, restant dans les limites de la normale pendant la période de suivi (moyenne, 31 mois; extrêmes, 3 à 86 mois). Cependant l'amélioration de l'hypertension postopératoire était différente, retardée de façon significative chez les patients ayant des lésions multinodulaires (groupe 3), la moitié d'entre eux restant hypertendus après un an. Les lésions nodulaires, étant donné que les adénomes ne donnent pas d'hypersécrétion hormonale, peuvent traduire plutôt une hypertension prolongée.
Presented at the International Association of Endocrine Surgeons in Toronto, Ontario, Canada, September, 1989. 相似文献
4.
Use of Glycopeptidolipid Core Antigen for Serodiagnosis of Mycobacterium avium Complex Pulmonary Disease in Immunocompetent Patients 下载免费PDF全文
Seigo Kitada Ryoji Maekura Naomi Toyoshima Takashi Naka Nagatoshi Fujiwara Masami Kobayashi Ikuya Yano Masami Ito Kazuo Kobayashi 《Clinical and Vaccine Immunology : CVI》2005,12(1):44-51
We report the development of a serodiagnostic method for Mycobacterium avium complex (MAC) disease with an enzyme immunoassay (EIA) with the MAC-specific glycopeptidolipid (GPL) core as the antigen. In this study, we confirmed by EIA that the GPL core antibody was in the sera of immunocompetent patients with MAC disease. The EIA for quantifying the GPL core antibody was evaluated as a clinical tool for serodiagnosis of pulmonary MAC disease. A significant increase in GPL core antibodies (immunoglobulins G, A, and M) was detected in sera of patients with MAC pulmonary diseases when they were compared to patients who were colonized with MAC, patients with Mycobacterium kansasii disease or tuberculosis, and healthy subjects. The sensitivities and specificities of the GPL core-based EIA for diagnosis of MAC pulmonary disease were 72.6% and 92.2%, respectively, for IgG, 92.5% and 95.1%, respectively, for IgA, and 78.3% and 91.0%, respectively, for IgM. The best sensitivity and specificity were obtained by measuring immunoglobulin A antibodies against GPL core antigen. The level of GPL core antibodies reflected disease activity, since it decreased in cured MAC patients who had responded to chemotherapy. Measurement of serum antibodies against GPL core is useful for both diagnosis and assessment of disease activity in MAC disease of the lung. 相似文献
5.
Fumio Yamauchi Yoshihiro Takebayashi Takaya Abe Toshinari Muramatsu Rika Murakami Masaki Ohtsuka Masayuki Endoh Yasuo Nomoto Hideto Sakai Miho Hida 《Clinical and experimental nephrology》1997,1(3):243-246
A 52-year-old woman who had had 6 months of chemotherapy using mitomycin C and cisplatin for cervical cancer presented with
hemolytic uremic syndrome. Conventional plasmapheresis using whole-plasma fraction was ineffective. However, plasmapheresis
using the cryosupernatant fraction dramatically improved symptoms of hemolytic anemia and thrombocytopenia in this case. The
activity of factor VIII in the cryosupernatant fraction of plasma as a replacement fluid decreased after removal of cryoprecipitate,
indicating effective removal of von Willebrand factor. The pathogenesis of her hemolytic uremic syndrome may have been associated
with von Willebrand factor multimers contained in the cryoprecipitate of plasma. Similar use of the cryosupernatant fraction
of plasma could not be found in other reports of cases of hemolytic uremic syndrome. Plasmapheresis using the cryosupernatant
fraction of plasma may improve refractory hemolytic uremic syndrome. 相似文献
6.
Association of Vascular Endothelial Growth Factor Expression with Tumor Angiogenesis and with Early Relapse in Primary Breast Cancer 总被引:10,自引:0,他引:10
Masakazu Toi Seigo Hoshina Toshiaki Takayanagi Takeshi Tominaga 《Cancer science》1994,85(10):1045-1049
Angiogenesis is an independent prognostic indicator in breast cancer. In this report, the relationship between expression of vascular endothclial growth factor (VEGF; a selective mitogen for endothelial cells) and the microvessel density was examined in 103 primary breast cancers. The expression of VEGF was evaluated by immunocytochemical staining using anti-VEGF antibody. The microvessel density, which was determined by immunostaining for factor VIII antigen, in VEGF-rich tumors was clearly higher than that in VEGF-poor tumors ( P <0.01). There was a good correlation between VEGF expression and the increment of microvessel density. Furthermore, postoperative survey demonstrated that the relapse-free survival rate of VEGF-rich tumors was significantly worse than that of VEGF-poor tumors. It was suggested that the expression of VEGF is closely associated with the promotion of angiogenesis and with early relapse in primary breast cancer. 相似文献
7.
Tetsuji Kai Yang Il Kim Hirokazu Kitamura Katsunori Kawano Seigo Kitano 《Journal of Hepato-Biliary-Pancreatic Surgery》1997,4(4):423-430
There is a growing body of evidence that the cytokine, tumor necrosis factor-α (TNF-ga), plays an important role in the development
of hepatic ischemia/reperfusion injury. We found that the immunosuppressants, cyclosporine-A (CsA), azathioprine, and FK506,
have protective effects on such injury. The purpose of the present study was to elucidate mechanisms involved in these beneficial
effects of the immunosuppressant, CsA, on liver injury following cold preservation and transplantation, with special reference
to the suppression of TNF-α release. Rat livers were stored in Euro-Collins solution (EC) at 4°C for 6h and orthotopically
transplanted. The animals allotted to two groups: group A (untreated controls) and group B (CsA pretreatment of recipients).
CsA (10 mg/kg, p.o.) was given for 3 consecutive days preoperatively. CsA pretreatment of the recipients significantly improved
the 2-week survival rate (0/6 for group A, 3/6 for group B;P<0.05) and this was associated with a significant decrease in serum TNF-α levels 2h posttransplantation (group A, 69.8±15.7
pg/ml; group B, 22.8±6.8; mean±SEM;n=12 each;P<0.05) and amelioration of sinusoidal endothelial injury, assessed by electron microscopy. Plasma endotoxin levels following
reperfusion of the grafts were not altered by the CsA therapy. Morphologically, CsA pretreatment of the recipients did not
alter activation of Kupffer cells. CsA pretreatment of the recipient aids in preventing cold preservation/reperfusion injury
of the liver graft, possibly by modulating effects of TNF-α. 相似文献
8.
Shunichi Takaya MD Shunzaburo Iwatsuki Takashi Noguchi Hisaaki Koie Iman Zaghloul Raman Venkataramanan Thomas E. Starzl 《Surgery today》1989,19(1):49-56
The influence of experimentally induced hepatic dysfunction on the pharmacokinetics of Cyclosporine A (CsA) was determined
in dogs. The pharmacokinetics of oral (PO) and intravenous (IV) CsA were studied before and after 70 per cent hepatectomy
or complete bile duct ligation (CBDL). Changes in liver function were monitored by serial measurements of serum bilirubin,
and by the maximum removal rate (Rmax) and plasma disappearance rate (ICG-K) of indocyanine green (ICG). Concentrations of
CsA in whole blood were measured by HPLC. Seventy per cent hepatectomy caused significant liver dysfunction: the ICG-Rmax
decreased by 47.7±7.1 per cent (mean±SD) and the ICG-K decreased by 61.3±9.7 per cent during the first week after hepatectomy.
At the same time, the systemic clearance (CLs) of IV-CsA decreased by 43.9±8.2 per cent, the area under the concentration
curve (AUC) of IV-CsA increased by 35.4±20.8 per cent and the bioavailability of CsA decreased by 26.4±14.8 per cent. CBDL
also induced significant liver dysfunction: the ICG-Rmax decreased by 39.1±12.8 per cent and the ICG-K decreased by 65.6±3.6
per cent in the second week after the operation. During the same period, the AUC of PO-CsA decreased by 69.9±10.7 per cent
and the bioavailability of CsA also decreased markedly by 73.9±15.6 per cent. These data indicate that hepatic impairment
significantly influences the pharmacokinetics of CsA, not only by the changes in intestinal absorption, but also by those
in hepatic, metabolism. Dose adjustment is therefore necessary in the presence of hepatic dysfunction in order to maintain
an adequate blood concentration of CsA without causing side effects.
This research was performed in the Department of Surgery, University of Pittsburgh Health Center, University of Pittsburgh,
USA 相似文献
9.
Magnesium deficiency in pregnant women is frequently seen because of inadequate or low intake of magnesium. Magnesium deficiency during pregnancy can induce not only maternal and fetal nutritional problems, but also consequences that might last in offspring throughout life. Many epidemiological studies have shown that restricted fetal growth, i.e. intrauterine growth retardation (IUGR), is associated with an increased risk of insulin resistance in adult life. We previously postulated that the intracellular magnesium of cord blood platelets is lower in the small for gestational age group than in the appropriate for gestational age group, suggesting that intrauterine magnesium deficiency may result in IUGR. Taken together, intrauterine magnesium deficiency in the fetus may lead to or program the insulin resistance after birth. We hypothesize that intrauterine magnesium deficiency may induce a metabolic syndrome in later life. Prospective studies will further clarify whether infants with IUGR induced by magnesium deficiency are at higher risk for metabolic syndromes in childhood or adulthood. 相似文献
10.
The Role of Donor Bone Marrow Infusions in Withdrawal of Immunosuppression in Adult Liver Allotransplantation 总被引:3,自引:0,他引:3
Panagiotis Tryphonopoulos reas G. Tzakis Debbie Weppler Rolando Garcia-Morales Tomoaki Kato Juan R. Madariaga David M. Levi Seigo Nishida Jang Moon Gennaro Selvaggi Arie Regev Caio Nery Pablo Bejarano Amr Khaled Gary Kleiner Violet Esquenazi Joshua Miller Philip Ruiz Camillo Ricordi 《American journal of transplantation》2005,5(3):608-613
We investigated the role of donor bone marrow cell (DBMC) infusions in immunosuppression withdrawal in adult liver transplantation. Patients enrolled were at least 3 years post-transplantation, with stable graft function. Forty-five (study group: G1) received DBMC, and 59 (control group: G2) did not. Immunosuppression was reduced by one third upon enrollment, by another third the second year of the study and was completely withdrawn the third year. Patient and graft survival were similar between the two groups. Although rejection episodes were significantly less in G1 the first 2 years of the study (35% vs. 57%, p = 0.016), there was no significant difference overall (74% vs. 81%, p = 0.14). Until February 2004, 20 patients, 10 in each group, were immunosuppression free for 1-3 years. Approximately 20% of long-term survivors of liver transplantation can successfully discontinue their immunosuppression. DBMC infusions, do not increase this likelihood. 相似文献