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1.
2.
This paper describes the tragic case of a young woman who died of cancer of
the colon after successfully donating eggs to her younger sister. Although
there is no direct link between her operation and the subsequent
development of bowel carcinoma, this case imparts a feeling of unease when
seen in conjunction with other cases reported during the last few years. It
is a reminder that little is known of the long-term consequences of some
aspects of assisted conception. Women undergoing ovarian stimulation for
themselves or a matched recipient have the right to be advised, in an
agreed format, that there is some concern about unproven potential risks
from the stimulatory drugs. The safety of egg donors must assume priority
over all other considerations, including lack of donors or any moral
position. The recent decision by the Human Fertilisation and Embryology
Authority (HFEA) to withdraw any form of payment or recompense to egg
donors does not seem to us to be based on a balance of scientific advances,
patient needs and the ethics of gamete supply. They state that the
intention to withdraw payments was implicit in the 1990 Human Fertilisation
and Embryology (HFE) Act. However the Act was based on the Warnock report
made 6 years earlier. Even in 1990 ovum donation was uncommon and fertility
drugs had not yet caused any unease. The Act provided the HFEA with
discretionary powers to issue directions so that the future policies would
be consistent with any emerging new medical evidence. It is imperative that
the HFEA provide convincing evidence on how the current policy of payment
to donors harms society, donors or recipients, and how in the UK the new
policy will improve medical practice in assisted conception. Successful
pilot studies must precede the implementation of any new policy. Failure to
do this could cause irreversible harm to the practice of assisted
conception using donor gametes, which will ultimately be against the basic
aims of the 1990 HFE Act.
相似文献
3.
Infarction of omentum and epiploic appendage: Diagnosis, epidemiology and natural history 总被引:7,自引:0,他引:7
Epiploic appendagitis and segmental omentum infarction are considered to be rare conditions, which may mimic an abdominal
surgical emergency. The purpose of our study was to describe clinical findings, US and CT appearance of infarction of an epiploic
appendage and omentum, and to determine their epidemiological characteristics and natural history. We retrospectively studied
clinical, US and CT findings at hospital admission and follow-up of all patients who were diagnosed at our institution with
epiploic appendagitis or omentum infarction between June 1988 and November 1997. We found a relatively high incidence of 40
cases: 20 patients with epiploic appendagitis, 11 with omentum infarction, and 9 in whom it was not possible to discriminate
between the both. All 40 patients recovered under conservative treatment without complications. We conclude that US and CT
features allow a reliable diagnosis, thereby obviating unnecessary surgery. Discriminating between both conditions is of no
practical relevance since treatment and prognosis are identical.
Received: 30 November 1998; Revised: 30 March 1999; Accepted: 6 September 1999 相似文献
4.
Anne EG Lenferink Joanne Magoon Christiane Cantin Maureen D O'Connor-McCourt 《Breast cancer research : BCR》2004,6(5):R514
Introduction
This report describes the isolation and characterization of three new murine mammary epithelial cell lines derived from mammary tumors from MMTV (mouse mammary tumor virus)/activated Neu + TβRII-AS (transforming growth factor [TGF]-β type II receptor antisense RNA) bigenic mice (BRI-JM01 and BRI-JM05 cell lines) and MMTV/activated Neu transgenic mice (BRI-JM04 cell line). 相似文献5.
OBJECTIVE: To assess the antibody response to influenza vaccine of children vertically infected with HIV. DESIGN: Prospective study in HIV infected children vaccinated during the winter of 1994-5. SETTING: Family HIV clinic at St Mary's Hospital, Paddington. SUBJECTS: 25 children, aged 1-11 years, vertically infected with HIV. MAIN OUTCOME MEASURES: Responses to influenza antigens (H1N1-A/Taiwan/1/86, H3N2-A/Shandong/9/93, B/Panama/45/ 90) were tested by haemagglutination inhibition. Antibody responses were assessed according to clinical symptoms and immune function, stratified according to the 1994 revised classification for HIV infection in children. RESULTS: 23 children (92%) had either very low or no detectable antibody before vaccination. New protective antibody responses were made by 10 children (40%): in seven to a single antigen, in two to two antigens, and in one to all three antigens. For each antigen there was an overall small increase in the mean geometric titre of antibody produced, but this only reached a protective level for antigen H1N1 and for children with minimal symptoms. Less symptomatic children were significantly more likely to produce a protective antibody response to influenza vaccination. No association was found between immune function, as measured by CD4 count, and vaccine response. CONCLUSIONS: Only vaccination of the least symptomatic HIV infected children against influenza is likely to be effective. This will not only protect them against influenza, but will also protect other more immunosuppressed and vulnerable members of their families. 相似文献
6.
7.
In a prospective two-centre study targeted US was performed as an adjunct to mammography in a population of 1103 patients
with 272 breast cancers, 517 benign lesions and no abnormalities in 314 patients. The purpose of the study was to analyse
the distribution of the different US variables among the breast lesions and to determine the prognostic value of these variables
with respect to the diagnosis of malignancy. The following variables were analysed: border; contour; orientation; structure;
echogenicity; sound transmission; and size. These variables were correlated with the definitive diagnosis and univariate analysis
was performed. A statistically significant association with breast cancer (p < 0.001) was present for irregular border; ill-defined contour; indeterminate or vertical orientation; homogeneous, complex
or heterogeneous structure; hypoechogenicity; and unchanged or decreased sound transmission. Multivariate analysis showed
a high independent prognostic value for malignancy for irregular border, followed by ill-defined contour and unchanged or
decreased sound transmission. However, their discriminative power was not absolute: in 38 cancers none of the malignant US
variables were present, and in 11 benign lesions all variables were present. There were hardly any benign-looking lesions
that proved to be malignant.
Received: 6 October 1999; Revised: 3 March 2000; Accepted: 26 June 2000 相似文献
8.
The "early-labeled" peak (ELP) of 14CO excretion following injection of glycine-2-14C was used to study erythropoiesis in a patient with sideroblastic anemia and in four subjects with myeloproliferative disorders. The ELP was greatly enlarged in all patients, as compared with a normal volunteer. The contour of the peaks from the hematologically abnormal subjects suggested the presence of increased erythroid heme degradation. In the patient with sideroblastic anemia, all hours of the early peak were significantly reduced after transfusion. This was interpreted to mean that even the earliest or "nonerythroid" phase of the peak is influenced by erythropoietic activity, at least under conditions of erythropoietic stress. 相似文献
9.
10.
Miranda EG Armstrong Oksana Kirichek Benjamin J Cairns Jane Green Gillian K Reeves Valerie Beral for the Million Women Study Collaborators 《Journal of bone and mineral research》2016,31(4):725-731
Height has been associated with increased risk of fracture of the neck of femur. However, information on the association of height with fractures at other sites is limited and conflicting. A total of 796,081 postmenopausal women, who reported on health and lifestyle factors including a history of previous fractures and osteoporosis, were followed for 8 years for incident fracture at various sites by record linkage to National Health Service hospital admission data. Adjusted relative risks of fracture at different sites per 10‐cm increase in height were estimated using Cox regression. Numbers with site‐specific fractures were: humerus (3036 cases), radius and/or ulna (1775), wrist (9684), neck of femur (5734), femur (not neck) (713), patella (649), tibia and/or fibula (1811), ankle (5523), and clavicle/spine/rib (2174). The risk of fracture of the neck of femur increased with increasing height (relative risk [RR] = 1.48 per 10‐cm increase, 99% confidence interval [CI] 1.39–1.57) and the proportional increase in risk was significantly greater than for all other fracture sites (pheterogeneity < 0.001). For the other sites, fracture risk also increased with height (RR = 1.15 per 10 cm, CI 1.12–1.18), but there was only very weak evidence of a possible difference in risk between the sites (pheterogeneity = 0.03). In conclusion, taller women are at increased risk of fracture, especially of the neck of femur. © 2015 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR). 相似文献