全文获取类型
收费全文 | 2263篇 |
免费 | 181篇 |
国内免费 | 10篇 |
专业分类
耳鼻咽喉 | 6篇 |
儿科学 | 130篇 |
妇产科学 | 68篇 |
基础医学 | 308篇 |
口腔科学 | 82篇 |
临床医学 | 280篇 |
内科学 | 486篇 |
皮肤病学 | 36篇 |
神经病学 | 96篇 |
特种医学 | 296篇 |
外科学 | 198篇 |
综合类 | 42篇 |
一般理论 | 1篇 |
预防医学 | 188篇 |
眼科学 | 28篇 |
药学 | 101篇 |
1篇 | |
中国医学 | 1篇 |
肿瘤学 | 106篇 |
出版年
2023年 | 15篇 |
2022年 | 14篇 |
2021年 | 20篇 |
2020年 | 17篇 |
2019年 | 29篇 |
2018年 | 43篇 |
2017年 | 32篇 |
2016年 | 39篇 |
2015年 | 29篇 |
2014年 | 45篇 |
2013年 | 65篇 |
2012年 | 97篇 |
2011年 | 75篇 |
2010年 | 61篇 |
2009年 | 76篇 |
2008年 | 97篇 |
2007年 | 61篇 |
2006年 | 80篇 |
2005年 | 58篇 |
2004年 | 69篇 |
2003年 | 78篇 |
2002年 | 59篇 |
2001年 | 74篇 |
2000年 | 59篇 |
1999年 | 51篇 |
1998年 | 63篇 |
1997年 | 77篇 |
1996年 | 61篇 |
1995年 | 50篇 |
1994年 | 58篇 |
1993年 | 59篇 |
1992年 | 40篇 |
1991年 | 44篇 |
1990年 | 33篇 |
1989年 | 66篇 |
1988年 | 63篇 |
1987年 | 47篇 |
1986年 | 48篇 |
1985年 | 47篇 |
1984年 | 27篇 |
1983年 | 41篇 |
1982年 | 27篇 |
1981年 | 30篇 |
1980年 | 30篇 |
1979年 | 26篇 |
1978年 | 19篇 |
1977年 | 22篇 |
1976年 | 18篇 |
1975年 | 25篇 |
1974年 | 19篇 |
排序方式: 共有2454条查询结果,搜索用时 31 毫秒
1.
2.
Electrophysiologic effects of d-sotalol in humans 总被引:1,自引:0,他引:1
J M McComb B McGovern J B McGowan J N Ruskin H Garan 《Journal of the American College of Cardiology》1987,10(1):211-217
Sotalol is a beta-adrenergic blocking agent that prolongs the duration of the cardiac action potential in humans, without affecting the upstroke velocity of depolarization. The dextrorotatory isomer, d-sotalol, retains these class III effects, but has little beta-blocking activity in vitro. d-Sotalol has not been studied extensively in humans. The electrocardiographic (ECG) and electrophysiologic effects of d- and d,l-sotalol were therefore assessed in a prospective randomized study of 20 patients. Each patient received either d-sotalol (1, 1.5 or 2 mg/kg body weight) or d,l-sotalol (1 mg/kg) by intravenous infusion. The QT and QTc intervals were prolonged and refractoriness increased in the atrium, atrioventricular (AV) node, His-Purkinje system and right ventricle after both d- and d,l-sotalol. After d-sotalol, the increases in both QT and QTc intervals and in atrial and ventricular effective refractory periods were dose dependent. Highly significant linear correlation was demonstrated between the plasma sotalol level and the change in QT (r = 0.86, p = 0.001) and QTc intervals (r = 0.79, p = 0.002), and between the plasma sotalol level and the effective refractory period of the right atrium (r = 0.75, p = 0.005) and ventricle (r = 0.70, p = 0.025). This study confirms that d-sotalol has effects consistent with class III properties. It demonstrates these effects in humans, and suggests that d-sotalol may prove to be a useful antiarrhythmic agent. 相似文献
3.
Preliminary evidence for a role of apolipoprotein E alleles in identifying haemodialysis patients at high vascular risk 总被引:1,自引:0,他引:1
Olmer M; Renucci JE; Planells R; Bouchouareb D; Purgus R 《Nephrology, dialysis, transplantation》1997,12(4):691-693
Conventional risk factors have very low predictive power in identifying
haemodialysis patients at high risk of vascular accidents. A role for
apolipoprotein E isotypes was looked for in a small, but rigorously
defined, cohort of longterm haemodialysis patients. In individuals with
high vascular risk, as identified by higher common carotid intima/media
thickness, we found an excess of apolipoprotein E4 alleles. This
preliminary result requires confirmation in large patient cohorts.
相似文献
4.
5.
OBJECTIVE: The aim of this study was to assess the severity of epilepsy and
its effect on patients lives, and to describe patients' use of and
attitudes to health care. METHOD: A questionnaire was sent to 595 people
with epilepsy identified from 14 general practices in north-west Bristol.
All patients aged 16 years and over receiving anti-epileptic medication for
their epilepsy were included in the study. Areas investigated included
severity of epilepsy and its effect on quality of life, anti-epileptic
medication and its perceived effect, health care utilization and
preferences for health care. RESULTS: Seizure frequency was strongly
associated with adverse effects of epilepsy. Attacks of epilepsy were
experienced at least monthly by 20.4% (95% confidence intervals (Cl)
17.0-23.7%) of patients, 29.4% (25.4-33.4%) took more than one
anti-epileptic drug, 56.1% (50.1-62.2%) reported drug side effects, 74.1%
(70.3-77.8%) would prefer to receive all or most of their epilepsy care in
a general practice setting, and 69.8% (63.5- 76.2%) would like contact with
a primary care-based epilepsy specialist nurse. During the previous year
42.4% (35.9-48.8%) of patients had not seen a doctor about their epilepsy.
Of patients who had attended the general practice only 13.4% (9.6-17.2%)
had regular arrangements to see their GP about epilepsy. Patients receiving
both primary and secondary care had the greatest needs and wants for
improved care. CONCLUSIONS: Structured care, including regular
appointments, co-ordination of primary and secondary care, and increased
monitoring and discussion, may improve the quality of life of people with
epilepsy, but requires evaluation.
相似文献
6.
7.
Duplications of the alimentary tract. Clinical characteristics, preferred treatment, and associated malformations. 总被引:5,自引:0,他引:5 下载免费PDF全文
S T Ildstad D J Tollerud R G Weiss D P Ryan M A McGowan L W Martin 《Annals of surgery》1988,208(2):184-189
Duplications of the alimentary tract are unusual congenital anomalies that frequently present a diagnostic as well as therapeutic challenge to the surgeon. Because these lesions occur so infrequently, they are often not suspected until encountered intraoperatively. Due to the complicated anatomy and common blood supply shared between the duplication and associated native bowel, appropriate management requires a familiarity with the anatomy and clinical characteristics of this entity. To better define the range of patient characteristics, clinical presentation, and preferred therapy, 20 enteric duplications were reviewed in 17 patients treated at the Children's Hospital Medical Center from 1956 to 1986. Ages of patients ranged from 1 day to 11 years; 60% were less than 2 years of age at initial presentation. Seven duplications in six patients involved alimentary tract structures of foregut derivation (esophagus, stomach, and Parts I and II of duodenum), with a predominance of girls (4 of 6). Most of these patients (67%) presented with moderate to severe acute respiratory distress and a mass present on chest radiograph. In 67% of the patients, the correct diagnosis was established before operation. None required emergency operative intervention. By contrast, 13 duplications in 11 patients were of midgut or hindgut derivation (Parts III and IV of the duodenum, jejunum, ileum, and colon). In this group of patients, 62% of the duplications involved the cecum, 23% involved the ileum, and 16%, the jejunum. Seventy-eight per cent of the patients were boys. The most common symptoms were nausea and vomiting, and the most common sign was a palpable abdominal mass. Emergency operative intervention was required of eight of 11 patients with duplications involving the small bowel and colon. Three patients presented with an intussusception, four with signs and symptoms consistent with acute appendicitis, one with a small bowel obstruction, and two with gastrointestinal hemorrhage due to the presence of ectopic gastric mucosa within the duplication. It was found that two important points must be considered in regard to the management of enteric duplications: (1) the common blood supply shared between the duplication and native bowel must be carefully protected to avoid undue sacrifice of normal bowel, and (2) the presence of heterotopic gastric mucosa in 35% of patients negates internal drainage.(ABSTRACT TRUNCATED AT 400 WORDS) 相似文献
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.
Solitary bronchioloalveolar carcinoma: CT criteria 总被引:14,自引:0,他引:14
Kuhlman JE; Fishman EK; Kuhajda FP; Meziane MM; Khouri NF; Zerhouni EA; Siegelman SS 《Radiology》1988,167(2):379-382
The computed tomographic (CT) scans of 30 patients with solitary bronchioloalveolar carcinoma were reviewed. Common features at CT included the peripheral or subpleural location of a pulmonary mass (25 cases), pseudocavitation (18 cases), heterogeneous attenuation (17 cases), irregular margins forming a star pattern (22 cases), and pleural tags (21 cases). Using these CT criteria, four independent observers attempted to identify cases of bronchioloalveolar carcinoma from a larger sample of lung cancers and benign lesions by categorizing a series of test cases into four probability categories. Although the bronchioloalveolar carcinomas were correctly ranked in the two highest probability categories 75% of the time (in 45 of 60 cases), there was considerable overlap with other lung lesions, particularly with adenocarcinoma and large cell undifferentiated carcinoma. However, even though the typical features of bronchioloalveolar carcinoma are not invariable or highly specific, they are characteristic enough to suggest the diagnosis. 相似文献
10.
Early detection of colorectal cancer by quantitative fluorescence image analysis of exfoliated cells
P F McGowan R E Hurst R A Bass G P Hemstreet M M Lane E Zompa C K Murray R G Postier 《American journal of surgery》1990,159(1):172-6; discussion 176-7
Early-stage colorectal cancer is potentially curable. In the present study, we applied quantitative fluorescence image analysis (QFIA) cytology to the detection of experimental colorectal cancer in a rodent model. QFIA cytology combines visual cytologic examination with quantitation of DNA content in single exfoliated cells. Cancer was induced by treating 110 rats with subcutaneous 1,2-dimethylhydrazine. Sequential colon washes were obtained weekly from each animal for 20 weeks. Control animals were treated identically except for the administration of carcinogen. Cells that were cytologically abnormal or had increased DNA content were found starting in the second week. By the eighth week, roughly 50 percent of animals had positive results, and this level remained approximately constant for the duration of the study. Tissue pathologic results were normal during weeks 1 to 7. Dysplasias became common during weeks 8 to 15 whereas most cancers appeared during weeks 16 to 21. These results indicate that QFIA cytology is a highly sensitive method for detecting even preneoplastic changes resulting from carcinogen administration and may prove useful in detecting human colorectal cancer. 相似文献