全文获取类型
收费全文 | 1677篇 |
免费 | 136篇 |
国内免费 | 8篇 |
专业分类
耳鼻咽喉 | 5篇 |
儿科学 | 60篇 |
妇产科学 | 59篇 |
基础医学 | 196篇 |
口腔科学 | 38篇 |
临床医学 | 171篇 |
内科学 | 291篇 |
皮肤病学 | 17篇 |
神经病学 | 107篇 |
特种医学 | 119篇 |
外科学 | 258篇 |
综合类 | 43篇 |
一般理论 | 2篇 |
预防医学 | 166篇 |
眼科学 | 13篇 |
药学 | 128篇 |
中国医学 | 4篇 |
肿瘤学 | 144篇 |
出版年
2021年 | 39篇 |
2020年 | 11篇 |
2019年 | 21篇 |
2018年 | 28篇 |
2017年 | 22篇 |
2016年 | 29篇 |
2015年 | 35篇 |
2014年 | 31篇 |
2013年 | 56篇 |
2012年 | 81篇 |
2011年 | 88篇 |
2010年 | 59篇 |
2009年 | 49篇 |
2008年 | 70篇 |
2007年 | 65篇 |
2006年 | 67篇 |
2005年 | 60篇 |
2004年 | 42篇 |
2003年 | 66篇 |
2002年 | 50篇 |
2001年 | 57篇 |
2000年 | 52篇 |
1999年 | 47篇 |
1998年 | 42篇 |
1997年 | 26篇 |
1996年 | 33篇 |
1995年 | 30篇 |
1994年 | 17篇 |
1993年 | 23篇 |
1992年 | 37篇 |
1991年 | 30篇 |
1990年 | 32篇 |
1989年 | 28篇 |
1988年 | 36篇 |
1987年 | 36篇 |
1986年 | 39篇 |
1985年 | 30篇 |
1984年 | 21篇 |
1983年 | 12篇 |
1982年 | 15篇 |
1980年 | 13篇 |
1979年 | 13篇 |
1978年 | 10篇 |
1977年 | 13篇 |
1976年 | 20篇 |
1975年 | 12篇 |
1973年 | 11篇 |
1972年 | 10篇 |
1971年 | 15篇 |
1967年 | 10篇 |
排序方式: 共有1821条查询结果,搜索用时 15 毫秒
1.
Pure motor hemiplegia (PMH) is, in most cases, caused by a lacunar infarction. However, pure motor monoparesis (PMM), i.e., isolated motor involvement with spasticity in one limb, has drawn little attention. We studied prospectively 5 patients with PMM and found that it was always due to a mass lesion in the contralateral superficial cerebral hemisphere. Our observation suggests that PMM should not be regarded as simply a variant of PMH. 相似文献
2.
G L Hines Y Mishriki L Williams K Monroe N Metwally 《The Journal of cardiovascular surgery》1991,32(4):485-490
This study attempted to evaluate the efficacy of chronic extra-aortic counterpulsation with a latissimus dorsi neuro vascular flap. Five dogs had a preliminary procedure consisting of the creation of a latissimus dorsi flap and a thoracotomy in which the flap was wrapped around the descending aorta just distal to the left subclavian artery. An epicardial lead was placed on the left ventricle and a nerve stimulating lead placed around the thoraco-dorsal nerve. Three weeks later, both leads were connected to a cardiomyostimulator programmed to function in a counterpulsation mode with a 1:2 assist frequency. Hemodynamic measurements were made at 6 and 8 and 10 and 12 weeks and the dogs were sacrificed. Three dogs had all sets of hemodynamic measurements made. Two of the three dogs demonstrated diastolic augmentation at 6 and 8 and 10 and 12 weeks average 20 to 25 mmHg. The third dog failed to demonstrate any change. All dogs were sacrificed at 12 weeks and specimens were submitted for histologic evaluation. The muscle flap was preserved in all animals. The aorta subjacent to the flap showed, (1) normal intima with no evidence of disruption or thrombus in all animals, (2) in the animals in whom counterpulsation was observed, there appeared to be thinning of the media in the aorta subjacent to the muscle flap, and (3) no evidence of distal emboli. This study demonstrated that chronic counterpulsation can be obtained with a latissimus dorsi flap. The actual hemodynamic benefits are not determined from this study. The medial thinning in the aortic wall may limit the long-term benefit of this procedure. 相似文献
3.
Cerebellar toxicity with high-dose cytosine arabinoside 总被引:1,自引:0,他引:1
R H Herzig J D Hines G P Herzig S N Wolff P A Cassileth H M Lazarus D J Adelstein R A Brown P F Coccia S Strandjord 《Journal of clinical oncology》1987,5(6):927-932
CNS dysfunction, especially impaired cerebellar function, is the dose-limiting toxicity associated with high-dose cytosine arabinoside, which precludes doses of greater than 48 g/m2. Four hundred eighteen patients between the ages of 2 and 74 years with leukemia or lymphoma received 36 to 48 g/m2 cytosine arabinoside either alone or with anthracycline antibiotics, 4'-(9-acridinylamino) methane sulfon-m-anisidine (m-AMSA), or total body irradiation. In only 35 of 418 patients (8%) did severe cerebellar toxicity develop; it was irreversible or fatal in four (1%) patients. The age of the patient was a critical factor in the incidence of severe cerebellar toxicity. Patients greater than 50 years old had a statistically significant greater incidence of cerebellar toxicity compared with younger patients (26/137, 19%, v 9/281, 3%; P less than .0005, chi 2). Neither the diagnosis, disease status, sex, nor the regimen altered the incidence of severe cerebellar toxicity (when corrected for age). A second course of high-dose cytosine arabinoside, administered to 62 patients, did not increase the incidence of severe cerebellar toxicity, which occurred in five (8%) of these patients. Two of the five patients had severe toxicity with the initial course. Of the 60 patients with no antecedent cerebellar dysfunction, three (5%) had severe toxicity with the second course: one of 41 patients were less than 50 years old; two of 19 patients were greater than or equal to 50 years. Since the occurrence of severe cerebellar dysfunction is greatly affected by age, reduced doses of high-dose cytosine arabinoside should be given to patients greater than 50 years old, and methods for reducing the cerebellar toxicity should be investigated in these patients. 相似文献
4.
Pseudomembranous tracheobronchitis caused by Aspergillus 总被引:1,自引:0,他引:1
D W Hines M H Haber L Yaremko C Britton R W McLawhon A A Harris 《The American review of respiratory disease》1991,143(6):1408-1411
Four immunosuppressed patients with a rapidly evolving, febrile, respiratory distress syndrome were found at autopsy to have Aspergillus pseudomembranes of their lower tracheobronchial tree. Steroids, neutropenia, broad spectrum antibiotic use, and alcoholism appear to be predisposing risk factors. Bronchoscopy may reveal the pathology but antemortem diagnosis is difficult because of the low yield of sputum cultures and fulminant nature of the disease. 相似文献
5.
Mary ER O'Brien Janet Hardy Sylvia Tan Jackie Walling Brian Peters Sarah Hatty Eve Wiltshaw 《Cancer chemotherapy and pharmacology》1992,30(3):245-248
Summary A total of 16 patients with recurrent epithelial ovarian cancer were treated with sulofenur (LY 186641), a novel oral sulfonylurea. All subjects had received previous chemotherapy. Anaemia occurred in all 16 patients, 14 of whom required a blood transfusion, and 2/16 patients received methylene blue for breathlessness due to methaemaglobinaemia. Treatment was discontinued in 2/16 cases due to rising liver enzyme values, which reverted to normal on cessation of the drug. There was no nausea or alopecia. Only two minor responses were seen. Plasma drug levels were insufficient to result in antitumour activity as extrapolated from animal data. Further studies that attempt to increase the bioavailability and improve the therapeutic index are warranted. 相似文献
6.
G L Hines P Scheaffer L Williams P Mantell P Cheifitz 《The Journal of cardiovascular surgery》1990,31(3):283-288
Changes in atrial adenosine triphosphate (ATP) and the presence of postoperative arrhythmias were studied in 14 patients during routine coronary artery bypass grafting to 1) attempt to evaluate atrial preservation, and 2) determine if a relationship exists between changes in ATP and the development of postoperative arrhythmias. Atrial biopsies were obtained at the time of cannulation (preischemic sample) and after the removal of the aortic crossclamp (postischemic sample). Methods of myocardial protection included systemic hypothermia (28 degrees C), periodic reinfusion of crystalloid cardioplegia into the aortic root and completed vein grafts, and iced slush in the pericardial well. Atrial temperature was monitored. Preischemic ATP was 0.412 +/- 0.32 mu mol/gm, and the postischemic value was 0.220 +/- 0.13 mu mol/gm (p less than .02). Atrial temperature routinely decreased to 13-18 degrees C after cardioplegic infusion but rose to 24 degrees C between infusions. There was no correlation between postoperative supraventricular arrhythmias (4 patients) and changes in ATP. In conclusion, routine coronary artery bypass grafting with standard methods of cardiac preservation does not appear to satisfactorily preserve atrial tissue. The clinical correlation and significance of this remains to be elucidated. 相似文献
7.
C. T. Conti M. Moncure J. Hines Z. Clack T. Smith C. O. Simpkins 《Journal of the National Medical Association》1998,90(3):171-175
Background characterization of assault-related injuries have demonstrated that lifestyle, substance abuse, education, employment, mental illness, and high-risk behavior contribute to low self-esteem in repeat assault victims. Recurrent-assault patients have never been studied with respect to self-esteem. This study evaluated self-esteem and assault-related injury in 28 consecutive male assault patients (11 first-assault and 17 recurrent-assault patients) and 19 controls with no previous assault history. Study participants were administered the Walmyr Assessment Scales Index of Self-Esteem (WASISE) as part of a three-item survey to determine the relationship between self-esteem and assault-related injury. No demographic differences were found between the groups. The mean (+/- standard error) WASISE score for recurrent-assault patients (34.9 +/- 3.4) was significantly higher than mean scores for no-assault and first-time assault-injured patients (14.7 +/- 1.4 and 15.0 +/- 2.3, respectively). The recurrent-assault patients had a lower mean education level than both no-assault and first-time assault-injured patients (2.1 +/- 0.26 and 1.9 +/- 0.57, respectively). Eighteen (2%) first-time assault-injured and 11 (7%) recurrent-assault patients were employed. These data suggest that self-esteem, education, and employment history need to be considered when evaluating and developing interventions for repeat-assault patients. 相似文献
8.
Twenty-four patients who underwent surgery for pararenal aortic aneurysms between January 1992 and April 1997 are reviewed.
Eighteen patients had primary atherosclerotic aneurysms, three patients had symptomatic infected aneurysms, two patients had
an aneurysm proximal to a prior aortic repair, and one patient had a pseudoaneurysm of a proximal aortic graft anastomosis.
Thirteen patients underwent elective operation, five had an urgent operation, and six patients underwent an emergency procedure.
Five patients had the proximal aortic clamp placed between the renal arteries (Group I), three patients had it placed between
the superior mesenteric and the renal arteries (Group II), and 16 patients had it placed in a supraceliac location (Group
III). Aneurysm size, age, sex, preoperative blood chemistries (including hemoglobin, hematocrit, liver function studies, and
coagulation studies) were similar in all groups. Two patients in Group III were on hemodialysis preoperatively. Preoperative
renal function (blood urea nitrogen and creatinine) was the same in all groups. Visceral ischémic time was 43.4 ± 9.37 min
to the distal kidney in Group I, 26.6 ± 7.63 min in Group II, and 24.5 ± 6.22 min in Group III. Mean transfusion requirements
were similar in all groups. Two patients in Group I required postoperative hemodialysis. No patient in either Group II or
III developed renal insufficiency. Mortality was the same in each group but was related to the urgency of operation (elective
7.6%, urgent 40%, emergent 50%). Intrarenal clamping (Group I) was associated with more renal and gastrointestinal complications
than either suprarenal or supraceliac clamping. Although suprarenal and supraceliac clamping had similar results, our preference
is supraceliac clamping because it is technically easy to achieve and is associated with few end-organ complications. 相似文献
9.
Linkage of the MHC to familial multiple sclerosis suggests genetic heterogeneity. The Multiple Sclerosis Genetics Group 总被引:5,自引:0,他引:5
Haines JL; Terwedow HA; Burgess K; Pericak-Vance MA; Rimmler JB; Martin ER; Oksenberg JR; Lincoln R; Zhang DY; Banatao DR; Gatto N; Goodkin DE; Hauser SL 《Human molecular genetics》1998,7(8):1229-1234
Multiple sclerosis (MS) is a demyelinating autoimmune disease of the
central nervous system. While its etiology is not well understood, genetic
factors are clearly involved. Until recently, most genetic studies in MS
have been association studies using the case-control design testing
specific candidate genes and studying only sporadic cases. The only
consistently replicated finding has been an association with the HLA-DR2
allele within the major histocompatibility complex (MHC) on chromosome 6.
Using the genetic linkage design, however, evidence for and against linkage
of the MHC to MS has been found, fostering suggestions that sporadic and
familial MS have different etiologies. Most recently, two of four genomic
screens demonstrated linkage to the MHC, although specific allelic
associations were not tested. Here, a dataset of 98 multiplex families was
studied to test for an association to the HLA-DR2 allele in familial MS and
to determine if genetic linkage to the MHC was due solely to such an
association. Three highly polymorphic markers (HLA-DR, D6S273 and TNFbeta)
in the MHC demonstrated strong genetic linkage (parametric lod scores of
4.60, 2.20 and 1.24, respectively) and a specific association with the
HLA-DR2 allele was confirmed (TDT; P < 0.001). Stratifying the results
by HLA-DR2 status showed that the linkage results were limited to families
segregating HLA-DR2 alleles. These results demonstrate that genetic linkage
to the MHC can be explained by the HLA-DR2 allelic association. They also
indicate that sporadic and familial MS share a common genetic
susceptibility. In addition, preliminary calculations suggest that the MHC
explains between 17 and 62% of the genetic etiology of MS. This
heterogeneity is also supported by the minority of families showing no
linkage or association with loci within the MHC.
相似文献
10.