全文获取类型
收费全文 | 1288篇 |
免费 | 221篇 |
国内免费 | 7篇 |
专业分类
耳鼻咽喉 | 4篇 |
儿科学 | 24篇 |
妇产科学 | 24篇 |
基础医学 | 171篇 |
口腔科学 | 18篇 |
临床医学 | 261篇 |
内科学 | 413篇 |
皮肤病学 | 5篇 |
神经病学 | 236篇 |
特种医学 | 58篇 |
外科学 | 77篇 |
综合类 | 14篇 |
一般理论 | 5篇 |
预防医学 | 54篇 |
眼科学 | 6篇 |
药学 | 26篇 |
肿瘤学 | 120篇 |
出版年
2022年 | 6篇 |
2021年 | 5篇 |
2020年 | 6篇 |
2019年 | 5篇 |
2018年 | 12篇 |
2017年 | 10篇 |
2016年 | 9篇 |
2015年 | 12篇 |
2014年 | 19篇 |
2013年 | 33篇 |
2012年 | 50篇 |
2011年 | 58篇 |
2010年 | 35篇 |
2009年 | 32篇 |
2008年 | 39篇 |
2007年 | 54篇 |
2006年 | 54篇 |
2005年 | 61篇 |
2004年 | 51篇 |
2003年 | 57篇 |
2002年 | 56篇 |
2001年 | 54篇 |
2000年 | 66篇 |
1999年 | 40篇 |
1998年 | 36篇 |
1997年 | 35篇 |
1996年 | 32篇 |
1995年 | 16篇 |
1994年 | 29篇 |
1993年 | 23篇 |
1992年 | 42篇 |
1991年 | 34篇 |
1990年 | 38篇 |
1989年 | 47篇 |
1988年 | 45篇 |
1987年 | 44篇 |
1986年 | 36篇 |
1985年 | 39篇 |
1984年 | 23篇 |
1983年 | 28篇 |
1982年 | 15篇 |
1981年 | 8篇 |
1980年 | 15篇 |
1979年 | 21篇 |
1978年 | 22篇 |
1977年 | 12篇 |
1976年 | 9篇 |
1975年 | 10篇 |
1973年 | 4篇 |
1972年 | 7篇 |
排序方式: 共有1516条查询结果,搜索用时 31 毫秒
1.
Michael S Benninger Peter C Appelbaum James C Denneny David J Osguthorpe James A Stankiewicz 《Otolaryngology--head and neck surgery》2002,127(1):7-12
OBJECTIVE: Traditional assessments of the microbial flora associated with acute bacterial rhinosinusitis have relied on maxillary sinus punctures (taps) and culture. These taps are now considered the gold standard for obtaining cultures and are used as the method of identifying bacterial pathogens in antimicrobial trials. Maxillary sinus taps are limited by discomfort to the patients and technical concerns. Because of these factors, the standard of performing taps has limited antibiotic trials and microbial surveillance. Alternatives to maxillary sinus taps have been explored. STUDY DESIGN: We conducted a retrospective, systematic review of the literature from 1950 to 2000 of articles comparing culture techniques in the nose and paranasal sinuses for acute bacterial rhinosinusitis. RESULTS: Nasal cultures have poor correlation to maxillary sinus cultures, whereas there is 60% to 85% concordance between endoscopically guided middle meatal cultures and maxillary sinus cultures. These studies, however, are all limited by small sample sizes and therefore are inadequate to make any concrete recommendations regarding the relative role of endoscopically guided middle meatal cultures as a formal method of pathogen identification in acute bacterial rhinosinusitis. CONCLUSION: A formal prospective study with sufficient sample size to assess the concordance between the microbial flora of the maxillary sinus punctures and middle meatal cultures in acute rhinosinusitis is recommended. 相似文献
2.
3.
4.
5.
Treatment of acute graft-versus-host disease with a nonmitogenic anti-CD3 monoclonal antibody. 总被引:2,自引:0,他引:2
C Anasetti P J Martin R Storb F R Appelbaum P G Beatty J Davis K Doney H F Hill P Stewart K M Sullivan 《Transplantation》1992,54(5):844-851
Treatment with the monoclonal antibody OKT3 specific for the CD3 complex associated with the T cell antigen receptor can reverse acute rejection of human renal allografts. However, efficacy of anti-CD3 antibodies for treatment of patients with acute graft-versus-host disease after marrow transplantation has not been established. The dose-limiting side effects resulting from T cell activation induced by some anti-CD3 antibodies in vivo have discouraged their use for this application. We now report a phase I-II study of GVHD treatment with the anti-CD3 antibody BC3, a monoclonal murine IgG2b that, unlike OKT3, does not activate T cells. Fourteen patients were treated with BC3 after progression of acute GVHD despite treatment with cyclosporine and corticosteroids, and three patients received BC3 as primary treatment for GVHD. BC3 was administered at a dose of 0.1 or 0.2 mg/kg/day for seven or eight days. Five patients achieved complete resolution of GVHD, eight patients had partial improvement, two patients had no change, and two patients had progression of GVHD on therapy. Responses were sustained in 8 of 13 patients. Mild chills, fever, hypertension, and chest discomfort occurred in various combinations following 6 of 17 (35%) initial infusions of BC3 and following 4 of 99 (4%) subsequent infusions. In each instance it was possible to continue BC3 therapy without adjusting the dose or treatment schedule. In each patient treated, the absolute count of peripheral blood lymphocytes decreased transiently but returned to baseline within 22 hr after the first infusion. Circulating T cells had surface CD3 molecules saturated by the infused antibody in all but one patient. Four patients survived longer than one year after treatment with antibody BC3, and 13 patients died of infection or organ failure. Administration of the nonmitogenic anti-CD3 antibody BC3 was associated with improvement in the clinical manifestations of GVHD with minimal acute toxicity. Efficacy of antibody treatment did not depend on depletion of circulating T cells. Therefore, antibody BC3 may be achieving therapeutic immunosuppression by modulating T cell function. Controlled studies in patients treated earlier in the course of GVHD should determine whether antibody BC3 can improve survival. 相似文献
6.
J S Appelbaum R P Roos E F Salazar-Grueso A Buchman S Iannaccone R Glantz T Siddique R Maselli 《Neurology》1992,42(8):1488-1492
Although there are varied inheritance patterns in motor neuron disease (MND), the phenotype of MND is reported to be constant within these families, ie, cases of amyotrophic lateral sclerosis or primary lateral sclerosis do not occur in pedigrees with cases of spinal muscular atrophy. We describe four pedigrees whose members diverged in the phenotype of MND expressed. The intrafamilial variation of phenotype suggests a similar pathogenesis for some of the varied types of familial MND and the need for careful inquiry of family history in all patients with MND. 相似文献
7.
Delayed sternal closure following cardiac operations 总被引:2,自引:0,他引:2
E Milgater G Uretzky D V Shimon S Silberman A Appelbaum J B Borman 《The Journal of cardiovascular surgery》1986,27(3):328-331
In 13 patients, sternal closure was delayed at the end of open heart procedures. Seven patients underwent coronary artery bypass surgery (CAB), 5 valve replacements, and one left ventricular aneurysmectomy and closure of post myocardial infarction VSD. In all, primary closure of the sternum was considered impossible or inadvisable. The major indications for delaying sternal closure were: cardiac dilatation with tamponade-like behaviour upon attempted sternal closure (8 patients); intractable bleeding (2); intractable arrhythmia (1); insertion of mediastinal assist devices (3) and intraoperative non-cardiogenic pulmonary edema (1). In all, only the skin was closed. Delayed sternal closure (DSC) was performed 36-120 hours later on 10 of the patients, when their condition had stabilized. Nine patients are long term survivors. None of these patients has developed mediastinitis, wound infection, osteomyelitis or instability of the sternum. The judicious use of DSC in selected situations has several advantages: hemodynamic deterioration from pressure upon the heart may be prevented; a quick access to the heart in case of tamponade or intractable arrhythmia is obtained; insertion of mediastinal assist devices is facilitated. With careful technique the risk of infection is low. 相似文献
8.
The ligand for c-kit, stem cell factor, stimulates the circulation of cells that engraft lethally irradiated baboons. 总被引:5,自引:1,他引:4
R G Andrews W I Bensinger G H Knitter S H Bartelmez K Longin I D Bernstein F R Appelbaum K M Zsebo 《Blood》1992,80(11):2715-2720
Recombinant human stem cell factor (SCF), the ligand for c-kit, has been shown to stimulate increased numbers of hematopoietic progenitor cells of multiple types to circulate in the blood of baboons, but it was not known if the cells stimulated to circulate by SCF contained cells capable of engrafting and rescuing lethally irradiated baboons. Peripheral blood mononuclear cells (PBMNC) were collected by leukapheresis from four untreated control baboons and from three baboons on the 10th or 11th day of treatment with SCF (200 micrograms/kg/d). All animals were transplanted with 1.00 to 1.04 x 10(8)/kg of cryopreserved autologous PBMNC after treatment with a single dose of 1,020 cGy total body irradiation (TBI). Three animals were transplanted with PBMNC that had been collected during SCF treatment, 24 to 38 days after the last dose of SCF. Rapid trilineage engraftment was documented by bone marrow biopsy in all three. The mean time to a total white blood cell count (WBC) > or = 500/microL, WBC > or = 1,000/microL, and an absolute neutrophil count (ANC) > or = 500/microL was 15 +/- 3 (mean +/- SD), 19 +/- 1, and 19 +/- 2 days, respectively. Two animals remain alive with stable engraftment more than 180 and 245 days posttransplant. The third died of sepsis 32 days posttransplant with a hypercellular marrow showing trilineage engraftment. The surviving animals were transfusion independent by 10 and 59 days posttransplant. Four control animals were transplanted with PBMNC collected in the absence of SCF stimulation. One was treated for 11 days with SCF (200 micrograms/kg/d) after PBMNC were collected. This animal was transplanted 25 days after the last dose of SCF. None of the four control animals engrafted and they died 13, 16, 28, and 38 days posttransplant with marrow aplasia. Treatment with SCF stimulates the circulation of cells that engraft and rescue lethally irradiated baboons. The characteristics of the transplantable cells present in the circulation are now amenable to direct study. 相似文献
9.
Massachusetts civil commitment criteria were compared in an emergency setting with a set of criteria developed by Dr. Alan Stone. Contrary to expectations, the Stone criteria proved to be more restrictive in a sample of 503 patients. Few patients would be newly committable under the Stone criteria; of the 35 patients committable under the Stone standard, 32 also met the current Massachusetts criteria for commitment. The clinical and policy implications of the adoption of the Stone criteria are discussed. 相似文献
10.
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