全文获取类型
收费全文 | 2765篇 |
免费 | 165篇 |
国内免费 | 3篇 |
专业分类
耳鼻咽喉 | 6篇 |
儿科学 | 125篇 |
妇产科学 | 48篇 |
基础医学 | 314篇 |
口腔科学 | 53篇 |
临床医学 | 220篇 |
内科学 | 651篇 |
皮肤病学 | 37篇 |
神经病学 | 282篇 |
特种医学 | 282篇 |
外科学 | 322篇 |
综合类 | 37篇 |
预防医学 | 297篇 |
眼科学 | 11篇 |
药学 | 130篇 |
中国医学 | 1篇 |
肿瘤学 | 117篇 |
出版年
2022年 | 13篇 |
2021年 | 25篇 |
2019年 | 13篇 |
2018年 | 37篇 |
2017年 | 40篇 |
2016年 | 28篇 |
2015年 | 39篇 |
2014年 | 48篇 |
2013年 | 73篇 |
2012年 | 79篇 |
2011年 | 90篇 |
2010年 | 74篇 |
2009年 | 83篇 |
2008年 | 93篇 |
2007年 | 89篇 |
2006年 | 91篇 |
2005年 | 106篇 |
2004年 | 91篇 |
2003年 | 86篇 |
2002年 | 78篇 |
2001年 | 87篇 |
2000年 | 58篇 |
1999年 | 75篇 |
1998年 | 69篇 |
1997年 | 84篇 |
1996年 | 70篇 |
1995年 | 59篇 |
1994年 | 62篇 |
1993年 | 59篇 |
1992年 | 55篇 |
1991年 | 62篇 |
1990年 | 52篇 |
1989年 | 66篇 |
1988年 | 78篇 |
1987年 | 58篇 |
1986年 | 60篇 |
1985年 | 71篇 |
1984年 | 52篇 |
1983年 | 61篇 |
1982年 | 41篇 |
1981年 | 39篇 |
1980年 | 38篇 |
1979年 | 36篇 |
1978年 | 31篇 |
1977年 | 27篇 |
1976年 | 28篇 |
1975年 | 32篇 |
1974年 | 28篇 |
1971年 | 12篇 |
1969年 | 17篇 |
排序方式: 共有2933条查询结果,搜索用时 15 毫秒
1.
U. Meyding-Lamadé K. Rieke D. Krieger W. Hacke Michael Forsting Klaus Sartor Christian Sommer 《Journal of neurology》1995,242(5):335-343
Acute ischaemia of the vertebrobasilar circulation leads to a variety of clinical manifestation and is mostly due to cardiogenic or artery-to-artery embolism. We describe four neurological emergency situations involving vertebrobasilar artery aclusion of other origins: basilar migraine, extrinsic compression by rheumatoid inflammatory tissue, generalized vasculitis in subacute rheumatic fever and basilar artery dissection. The differential diagnosis of acute vertebrobasilar artery occlusion may have an important impact on patient management. 相似文献
2.
AIDS, policy analysis, and the electorate: the role of schools of public health. 总被引:2,自引:2,他引:0 下载免费PDF全文
Current debates concerning appropriate policy to combat the epidemic of acquired immunodeficiency syndrome (AIDS) have raised critical questions regarding the role that schools of public health and individual public health professionals should play, if any, in AIDS-related policy analysis and social advocacy. In the summer of 1986, the School of Public Health at the University of California at Berkeley initiated a telegram sent by the Deans of all 23 schools of public health to protest US Department of Justice AIDS policy and, in the subsequent fall, the school expanded its public educational role in an unprecedented manner by initiating and issuing, with California's other three schools of public health, a policy analysis of Proposition 64, the LaRouche AIDS Quarantine Initiative. That analysis exposed the proposition's fallacious claims regarding casual transmission of AIDS and served to educate the electorate on the likely public health impact of this deleterious legislation. Based on these experiences, and in light of ongoing national controversy regarding AIDS, we believe schools of public health have an important role to play in policy analysis, and individual public health professionals have a role to play in social advocacy. 相似文献
3.
Nancy S Krieger Kevin K Frick Kelly LaPlante Strutz Anne Michalenka David A Bushinsky 《Journal of bone and mineral research》2007,22(6):907-917
Chronic metabolic acidosis induces net Ca efflux from bone; this osteoclastic bone resorption is mediated by increased osteoblastic prostaglandin synthesis. Cyclooxygenase, the rate-limiting enzyme in prostaglandin synthesis, is present in both constitutive (COX-1) and inducible (COX-2) forms. We report here that acidosis increases both osteoblastic RNA and protein levels for COX-2 and that genetic deficiency or pharmacologic inhibition of COX-2 significantly reduces acid-induced Ca efflux from bone. INTRODUCTION: Incubation of neonatal mouse calvariae in medium simulating physiologic metabolic acidosis induces an increase in osteoblastic prostaglandin E2 (PGE2) release and net calcium (Ca) efflux from bone. Increased PGE2 is necessary for acid-induced bone resorption, because inhibition of cyclooxygenase activity with indomethacin significantly decreases not only PGE2 production but also Ca release. Cyclooxygenase is present in both constitutive (COX-1) and inducible (COX-2) forms. Because COX-2 activity has been implicated in several forms of pathological bone resorption, we tested the hypothesis that COX-2 is critical for acid-induced, cell-mediated bone Ca efflux. MATERIALS AND METHODS: To determine the effect of metabolic acidosis on COX-2 RNA and protein, primary cells isolated from neonatal CD-1 mouse calvariae were cultured in neutral (Ntl) or physiologically acidic medium (Met). RNA levels for COX-2 and COX-1 were measured by quantitative real-time PCR. Levels of COX-2 and COX-1 protein were measured by immunoblot analysis. To determine the effect of acidosis on bone Ca efflux in genetically deficient COX-2 mice, mice heterozygous for the COX-2 knockout (strain B6;129S7-Ptgs2(tm1Jed)/J) were used as breeders, and neonatal calvariae were cultured in Ntl or Met. To determine the effects of the specific COX-2 inhibitor, NS398, on acid-induced bone resorption, CD-1 calvariae were incubated in Ntl or Met with or without NS398 (1 microM). Medium PGE2 was assayed by ELISA. RESULTS: Incubation of mouse calvarial cells in Met significantly increased COX-2 RNA and protein levels without a change in COX-1. Increased COX-2 protein levels in response to Met were also observed in cultured calvariae. Acid-induced, cell-mediated Ca efflux from B6;129S7-Ptgs2(tm1Jed)/J calvariae was dependent on genotype. From 0 to 24 h, when physicochemical Ca efflux predominates, Met significantly increased net Ca efflux in all genotypes. After 24 h, when cell-mediated Ca efflux predominates, Met induced greater Ca efflux from (+/+) than from (+/-), and there was no increase from (-/-). In calvariae from CD-1 mice, NS398 significantly inhibited both the acid-induced increase in PGE2 and Ca release. CONCLUSIONS: The specific acid-induced increase in COX-2 RNA and protein levels and the dependency of the increased Ca efflux on COX-2 activity, as determined by both genetic deficiency and pharmacologic inhibition, show that COX-2 is critical for acid-induced, cell-mediated bone resorption. 相似文献
4.
B van der Loo E Krieger J Katavic S Spring V Rousson B Amann-Vesti R Koppensteiner 《European journal of vascular and endovascular surgery》2005,30(5):469-474
OBJECTIVE: To determine the relationship between carotid intima-media thickness (IMT), carotid wall shear stress (WSS) and restenosis after femoro-popliteal percutaneous transluminal angioplasty (PTA). PATIENTS AND METHODS: Thirty-one subjects (18 men, 13 women, median age 69 years) treated with femoro-popliteal PTA for symptomatic peripheral arterial occlusive disease were enrolled. On admission, IMT, internal diameter and blood velocity of the common carotid artery (CCA) were assessed by high-resolution ultrasonography. Blood viscosity was measured and carotid WSS was calculated. Patients were followed up for 6 months for the occurrence of significant restenosis (>50%) as documented by duplex ultrasonography. Two patients were lost to follow-up. RESULTS: Fourteen patients (48%) developed restenosis at 6 months. IMT and WSS were not different in patients without and with restenosis (IMT: 0.90 (0.85-0.97) vs. 0.89 (0.84-0.93) mm, p = 0.51; WSS: 14.1 (11.9-19.2) vs. 15.9 (12.8-21.5) dyne/cm2, p = 0.48). The hazard ratio of incident restenosis as estimated by Cox regression analysis was 0.04 for IMT (p = 0.23; 95% CI 0.0001-8.22) and 1.07 for WSS (p = 0.10; 95% CI 0.98-1.17). CONCLUSIONS: In this pilot study involving a limited number of patients, carotid IMT and carotid WSS are not significantly related to restenosis at 6 months after femoro-popliteal PTA. This might be the result of different underlying pathophysiology for atherosclerosis and restenosis. 相似文献
5.
Intracranial Angioplasty and Stenting in the Awake Patient 总被引:1,自引:0,他引:1
Alex Abou-Chebl MD Derk W. Krieger MD Christopher T. Bajzer MD Jay S. Yadav MD FACC 《Journal of neuroimaging》2006,16(3):216-223
BACKGROUND AND PURPOSE: Endovascular treatment for intracranial atherosclerosis is evolving, but complications remain an issue. Most interventions are performed under general anesthesia, preventing intraprocedural clinical evaluations. We describe our approach to intracranial angioplasty and stenting, using local rather than general anesthesia, and intraprocedural neurological assessment. METHODS: We prospectively collected procedural and outcome information on all patients undergoing intracranial angioplasty and stenting. Patients underwent interventions under local anesthesia with mild intravenous sedation or analgesia only if needed. Intraoperative neurological evaluations were performed, and symptomatology was used to guide the interventional technique. RESULTS: Forty-eight arteries in 40 patients with a mean age of 65.2 years were treated. Thirty-two anterior and 16 posterior circulation segments were treated. Technical success was achieved in 100% of patients with reduction of the mean pretreatment stenosis from 85 +/- 8.6% to 7 +/- 10.1%. Stents were deployed in 40 segments; five patients were treated with drug-eluting stents. The cobalt-chromium coronary stents were the easiest to deliver. Thirty-seven patients were treated under local anesthesia and, of those, 61.4% experienced intraprocedural symptoms that led to some alteration of the interventional technique. Headache was the most common symptom, and, when persistent, it heralded the occurrence of subarachnoid hemorrhage. There were seven total neurological complications, but only five (10.5%) led to permanent morbidity (4 strokes) or mortality (1 death). CONCLUSIONS: Intracranial angioplasty and stenting can be successfully performed using coronary techniques and equipment including drug-eluting stents. Local anesthesia permits neurological evaluations and often leads to the adjustment of the interventional technique, potentially making the procedure safer. 相似文献
6.
7.
8.
Hodgkin disease: CT of the thymus 总被引:2,自引:0,他引:2
The computed tomography (CT) scans in two groups of patients with Hodgkin disease were reviewed to determine the frequency of thymic enlargement. In 50 CT scans from 50 patients with evidence of thoracic disease on CT scans who were examined for primary staging, the thymus was enlarged in 15 of 50 (30%). Fifty CT scans were obtained from 44 patients at the time of 50 separate episodes of known or suspected relapse. Relapse occurred in the mediastinum in 12 episodes, lung parenchyma in five, and both sites in one. Thymic enlargement thought to be due to involvement by disease was present in seven of 18 (38%). Mediastinal disease was associated with thymic enlargement in all but one patient in whom a thymic cyst developed after radiation therapy. Differentiation of thymic enlargement from enlarged superior mediastinal lymph nodes was easily made in all but two patients. Thymic enlargement in the absence of lymph node enlargement may indicate a different disease, since isolated Hodgkin disease of the thymus is uncommon. Primary thymic tumor should be considered initially, whereas after treatment, rebound hyperplasia of the thymus may be the cause of enlargement. 相似文献
9.
Current clamp recordings were used to analyze responses of cultured cerebellar Purkinje neurons to quisqualate and several other selective non-N-methyl- D-aspertate (NMDA) agonists. Quisqualate, a potent agonist in the cerebellar Purkinje neuron, evoked both short- and long-term changes in excitability, that activated within seconds and lasted for several minutes. Two components of the response were activated differentially by subtype selective agonists, and differed in their mechanism of expression and time course. The initial component of the response was activated by ionotropic agonists ((RS)-d-amino-3-hydroxyl-5-methyl-4-isoxazolepropionic acid (AMPA) domoate), and by quisqualate and glutamate which are effective at both the ionotropic and metabotropic quisqualate receptor subtypes, but not by the metabotropic agonist trans (+/-)-1-amino-1,3-cyclopentanedicarboxylic acid (ACPD). This component was dependent on extracellular Na+, and characterized by a rapid depolarization with a short latency (less than 1-2 s) and a decrease in membrane resistance as expected for an ionotropic reponse. The rapid depolarization extended into an agonist-dependent plateau phase, which could not be evoked by depolarization alone. The second ('late') phase of the response was a slowly-activating, long-lasting change in membrane excitability, accompanied by little or no change in the membrane potential. The late phase, marked by an increase in voltage-dependent bursting spike activity, was induced by the metabotropic agonist, ACPD, and by quisqualate and glutamate, but not by ionotropic selective agonists such as AMPA. Little or no bursting was evoked by AMPA, domoate, kainate or homocysteate. This late phase was also accompanied by increases in the magnitude and duration of the complex spikes and in the afterhyperpolarization following brief current-driven depolarizations. The slower time course of the late component is consistent with a pathway involving second messenger systems. Our results support the hypothesis that coregulation of both ionotropic and metabotropic mechanisms produces the complex and prolonged excitatory response characteristic of the Purkinje neuron. 相似文献
10.
We investigated the utility of a noninvasive respiratory inductive plethysmograph (RIP) to continuously monitor and record the breathing pattern of 44 patients who had been mechanically ventilated. Seven patients deteriorated on intermittent mandatory ventilatory rate of zero; seven deteriorated within 48 h following extubation; 30 were successfully extubated. Respiratory alternans was documented by RIP in 11 patients who failed whereas it was absent in all other patients. Respiratory rates in the 14 failure patients increased when compared with rates one hour before clinical deterioration and with rates of 30 patients who were successfully extubated. Total compartmental displacement/tidal volume increased in every patient who developed respiratory failure. Changes in the breathing pattern, specifically onset of rib cage-abdominal asynchrony, can be diagnosed noninvasively, thus alerting the clinical staff prior to onset of overt respiratory failure and arrest. 相似文献