全文获取类型
收费全文 | 4404篇 |
免费 | 258篇 |
国内免费 | 34篇 |
专业分类
耳鼻咽喉 | 57篇 |
儿科学 | 130篇 |
妇产科学 | 142篇 |
基础医学 | 553篇 |
口腔科学 | 55篇 |
临床医学 | 323篇 |
内科学 | 845篇 |
皮肤病学 | 96篇 |
神经病学 | 329篇 |
特种医学 | 124篇 |
外科学 | 704篇 |
综合类 | 186篇 |
一般理论 | 1篇 |
预防医学 | 353篇 |
眼科学 | 110篇 |
药学 | 415篇 |
中国医学 | 36篇 |
肿瘤学 | 237篇 |
出版年
2023年 | 43篇 |
2022年 | 118篇 |
2021年 | 160篇 |
2020年 | 76篇 |
2019年 | 132篇 |
2018年 | 151篇 |
2017年 | 105篇 |
2016年 | 112篇 |
2015年 | 116篇 |
2014年 | 182篇 |
2013年 | 203篇 |
2012年 | 289篇 |
2011年 | 334篇 |
2010年 | 193篇 |
2009年 | 147篇 |
2008年 | 237篇 |
2007年 | 257篇 |
2006年 | 226篇 |
2005年 | 236篇 |
2004年 | 164篇 |
2003年 | 173篇 |
2002年 | 140篇 |
2001年 | 58篇 |
2000年 | 65篇 |
1999年 | 65篇 |
1998年 | 34篇 |
1997年 | 26篇 |
1996年 | 29篇 |
1995年 | 18篇 |
1994年 | 21篇 |
1993年 | 15篇 |
1992年 | 43篇 |
1991年 | 44篇 |
1990年 | 47篇 |
1989年 | 38篇 |
1988年 | 31篇 |
1987年 | 19篇 |
1986年 | 29篇 |
1985年 | 31篇 |
1984年 | 14篇 |
1983年 | 13篇 |
1981年 | 16篇 |
1980年 | 12篇 |
1979年 | 25篇 |
1978年 | 14篇 |
1976年 | 26篇 |
1975年 | 15篇 |
1974年 | 25篇 |
1973年 | 18篇 |
1971年 | 15篇 |
排序方式: 共有4696条查询结果,搜索用时 31 毫秒
1.
2.
3.
4.
5.
Khalil Fattouch Giuseppe Bianco Giuseppe Speziale Roberta Sampognaro Carlo Lavalle Francesco Guccione Pietro Dioguardi Giovanni Ruvolo 《European journal of cardio-thoracic surgery》2007,32(2):326-332
BACKGROUND: The inflammatory cascade has been hypothesized to be an important mechanism of post-ischaemic myocardial reperfusion injury and several studies demonstrated that C1 esterase inhibitor (C1-INH) is effective in post-ischaemia myocardial protection. Therefore, we aimed to investigate prospectively in a randomised double-blind study the cardioprotective effects of C1-INH in ST segment elevation myocardial infarction (STEMI) in patients who underwent emergent reperfusion with coronary artery bypass grafting (CABG). METHODS: In this study, we enrolled 80 patients affected with STEMI who underwent emergent CABG. Patients were assigned in two groups (C1-INH group: receive 1000 UI of C1-INH; and placebo group: receive a saline solution). The effects of C1-INH on complement inhibition, myocardial cell injury extension and clinical outcome were studied. Haemodynamic data and myocardial function were monitored. C1-INH, C3a, C4a complement activation fragments and cardiac troponin I (cTnI) serum levels were measured before, during and after surgery. RESULTS: Patient characteristics were not different between the two groups. The overall in-hospital mortality rate was 6.2%. No statistical significant difference was observed between the two groups with regard to early mortality (p=0.36). Statistical significant difference between the two groups was showed for cardiopulmonary bypass support (p=0.04), administration of high dose of inotropes drugs (p=0.001), time of intubation (p=0.03), intensive care unit (ICU) stay (p=0.04) and in-hospital stay (p=0.03). A significant improvement in mean arterial pressure (p=0.03), cardiac index (p=0.02) and stroke volume (p=0.03) was showed in C1-INH group versus placebo group. The serum cTnI levels were significantly low in the C1-INH group versus placebo group after reperfusion, during the observation period. Plasma levels of C3a and C4a complement fragments were reduced significantly in C1-INH group. No drugs-related adverse effects were observed. CONCLUSIONS: The inhibition of the classic complement pathway by C1-INH appears to be an effective mean of preserving ischaemic myocardium from reperfusion injury as demonstrated by low serum cTnI levels in C1-INH group. Therefore, the use of C1-INH during CABG as a rescue therapy in STEMI patients is probably an effective treatment to inhibit complement activity and to improve cardiac function and haemodynamic performance without impacting early mortality. Large randomised study should be performed to support our results. 相似文献
6.
The modulation of co-stimulatory pathways represents a novel therapeutic strategy to regulate autoimmune diseases. Auto-reactive
CD4+ T cells play a critical role in initiating the immune response leading to inflammation and autoimmune diseases. Blocking
co-stimulatory signals prevents T-cell activation, thus diminishing autoimmune responses and possibly preventing the progression
of autoimmune disease. Blockade of several co-stimulatory pathways has been investigated in animal models and has led to clinical
trials testing specific blocking agents in humans. In this review we will describe the role of co-stimulatory pathways, primarily
the CD28-B7 pathway, in autoimmune diseases, and we will present in vivo and in vitro studies supporting the efficacy of co-stimulation blockade in animal models of autoimmune disease. Finally, we will discuss
the clinical therapeutic efficacy of blocking monoclonal antibodies in preventing or reducing auto-antigen driven T-cell activation
in humans with particular attention to the CD28/B7 pathway. Inhibiting co-stimulatory molecule interactions by using monoclonal
antibodies seems to be an original approach to regulate autoimmune diseases in humans. 相似文献
7.
Hisham Abdel Ghani Ahmed El-Naggar Mohamad Hegazy Atef Hanna Yehia Tarraf Samia Temtamy 《Journal of children's orthopaedics》2007,1(5):313-322
Purpose Congenital clasped thumb is a deformity that is associated with heterogeneous congenital anomalies and it has been addressed
in many congenital syndromes. The aim of this study was to diagnose and evaluate cases of clasped thumb as regards the associated
congenital anomalies and syndromes, and evaluation of the results of treatment of such cases.
Methods A prospective study on 40 patients with 73 clasped thumbs was done. All the patients’ data regarding their personal, family,
pregnancy and developmental histories were recorded. All the patients were exposed to thorough clinical and radiological examination
and genetic assessment. The cases were classified using the Tsuyuguchi et al. (J Hand Surg [Am] 10:613–618, 1985) classification into three types. Conservative treatment was adopted in ten hands, and surgical treatment was performed for
28 hands in 17 patients, with an average follow-up of 26 months.
Results Positive consanguinity was recorded in 57.5% of cases. Associated anomalies were recorded in 77.5% of cases. Type I was the
most common one, followed by type III and then type II. Conservative treatment is effective in type I cases when presented
early, and all patients were satisfied with the results of surgical treatment.
Conclusions We reported associated anomalies which are to our knowledge have not mentioned before in the literature which include; congenital
blindness, radial deviation of the index finger and ventricular septal defect. We found that 68% of the patients had associated
syndromes, and this has not been mentioned before. In this study, we found that there were no difference between type II and
type III clasped thumb as regards the pathological findings, severity, the operative procedures, the treatment protocol and
the operative results. Properly planned treatment gives satisfactory results. 相似文献
8.
Rajwinder Singh Jutley Mohammed Wesam Khalil Gaetano Rocco 《European journal of cardio-thoracic surgery》2005,28(1):43-46
OBJECTIVE: VATS using the conventional three ports is currently the technique of choice for blebectomy/bullectomy for spontaneous pneumothorax. However, the procedure has recently been shown to have neurological complications related to the port sites. Uniportal VATS has recently been proposed as an alternative to conventional three-port VATS. It is anticipated that the single incision will predispose to a lower incidence of neurological complications. METHODS: We report our initial single surgeon experience of uniportal VATS (n = 16) and provide a comparison of post-operative pain and residual paraesthesia to conventional three-port procedures (n = 19) for the same pathology. RESULTS: In both groups, the pneumothorax pathology was principally primary. There was no difference between the groups in terms of age, spirometry, tissue resected, drainage time and inpatient stay. A difference was, however, noted in inpatient pain scores. The uniportal group had a lower median score of 0.4 (visual analogue range 0-4) while the three-port technique reported 0.8 (P = 0.06, Mann-Whitney test). The maximum score trend was similar (1.4 vs. 2.6, respectively, P < 0.001, Mann-Whitney test). Follow-up for uniportal and three-port VATS averaged 9.4+/-6.6 and 32.1+/-9.9 months, respectively. One patient in the three-port group had a pneumothorax recurrence. Three-port VATS also had a higher residual pain score (0.5) compared to uniportal VATS (0.3). Of clinical significance was the incidence of neurological complications. Eighty-six percent of uniportal patients reported no symptoms. The remaining experienced only mild 'numbness' or 'swelling'. However, in the three-port group, only 42% reported no symptoms. A similar number experienced 'numbness'. Two females described sexual dysfunction due to altered breast sensitivity. Seventeen percent (2/12) reported 'pins and needles'. CONCLUSIONS: Uniportal VATS appears to be tolerable, safe and efficient in treating spontaneous pneumothorax in our series. Moreover, post-operative pain and paraesthesia incidence was lower than three-port VATS. Prospective randomised trials are important to evaluate this technique. 相似文献
9.
Chenicheri Balakrishnan Gil Altman Abdullah J Khalil 《CANADIAN JOURNAL OF PLASTIC SURGERY》2005,13(4):209-211
During lower extremity amputation, the objective is to provide a functional residual limb that permits maximum patient mobility and independence. Preservation of length of the fore part of the foot using salvageable tissue from the amputated part in young patients prevents equines deformity and revision of amputation to a higher level. This can be achieved using tissue available from the amputated part. The spare part concept in reconstructive surgery should be integrated into the trauma algorithm to avoid additional donor site morbidity. Reported here is a young adult patient with crush injuries to both feet, which resulted in amputations. A fasciocutaneous flap raised from one extremity was used to facilitate transmetatarsal amputation stump length preservation of the other extremity. 相似文献
10.
Alfonso Ruiz-Bravo Khalil Kouwatli Gerardo Alvarez de Cienfuegos Alberto Ramos-Cormenzana 《Immunology letters》1981,3(1):39-43
Mice pretreated with Bacillus megaterium ATCC 33085 grown on TSA medium developed a significant increase in primary antibody response to SRBC. Conversely, pretreatment with a spore suspension harvested from nutrient Agar medium decreased this antibody response. A suspension of organisms grown on a defined, phosphorus-deficient medium (P-Medium) had no effect. Otherwise, only the spore suspension was able to enhance the contact sensitivity to dinitrofluorobenzene. Peritoneal leucocyte numbers were increased by inoculation with both TSA-cultured bacteria and the spore suspension, but not by P-Medium-cultured bacteria. Administration of both the spore suspension and P-Medium-cultured bacteria decreased the in vitro phagocytosis by peritoneal adherent cells. These immunomodulator properties are discussed in relation to characteristics of the strain tested. 相似文献