全文获取类型
收费全文 | 1308篇 |
免费 | 65篇 |
国内免费 | 4篇 |
专业分类
耳鼻咽喉 | 5篇 |
儿科学 | 25篇 |
妇产科学 | 34篇 |
基础医学 | 189篇 |
口腔科学 | 24篇 |
临床医学 | 98篇 |
内科学 | 221篇 |
皮肤病学 | 2篇 |
神经病学 | 124篇 |
特种医学 | 26篇 |
外科学 | 423篇 |
综合类 | 2篇 |
预防医学 | 40篇 |
眼科学 | 62篇 |
药学 | 19篇 |
中国医学 | 1篇 |
肿瘤学 | 82篇 |
出版年
2023年 | 9篇 |
2022年 | 21篇 |
2021年 | 40篇 |
2020年 | 12篇 |
2019年 | 32篇 |
2018年 | 38篇 |
2017年 | 28篇 |
2016年 | 27篇 |
2015年 | 33篇 |
2014年 | 77篇 |
2013年 | 84篇 |
2012年 | 97篇 |
2011年 | 98篇 |
2010年 | 65篇 |
2009年 | 53篇 |
2008年 | 82篇 |
2007年 | 77篇 |
2006年 | 79篇 |
2005年 | 70篇 |
2004年 | 71篇 |
2003年 | 68篇 |
2002年 | 67篇 |
2001年 | 15篇 |
2000年 | 11篇 |
1999年 | 20篇 |
1998年 | 16篇 |
1997年 | 8篇 |
1996年 | 6篇 |
1995年 | 6篇 |
1994年 | 2篇 |
1993年 | 5篇 |
1992年 | 10篇 |
1991年 | 5篇 |
1990年 | 5篇 |
1989年 | 2篇 |
1988年 | 4篇 |
1987年 | 2篇 |
1986年 | 3篇 |
1985年 | 4篇 |
1983年 | 3篇 |
1982年 | 3篇 |
1981年 | 3篇 |
1980年 | 3篇 |
1977年 | 1篇 |
1972年 | 1篇 |
1970年 | 1篇 |
1966年 | 2篇 |
1962年 | 1篇 |
1935年 | 2篇 |
1929年 | 2篇 |
排序方式: 共有1377条查询结果,搜索用时 15 毫秒
1.
Yair Lotan Matthew T Gettman Claus G Roehrborn Margaret S Pearle Jeffrey A Cadeddu 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2003,7(2):111-115
BACKGROUND AND OBJECTIVES: To evaluate the experience with laparoscopic nephrectomy in a large county hospital and perform a cost comparison between uncomplicated open and laparoscopic nephrectomy. METHODS: Eleven consecutive patients who underwent an uncomplicated laparoscopic nephrectomy in a large county hospital were compared with 8 patients who underwent uncomplicated open nephrectomy during the same period. Patient charts and corresponding billing records were reviewed to determine overall hospitalization cost and individual cost components. RESULTS: No perioperative complications occurred in either the laparoscopic or open group, and no statistically significant differences existed between groups with regard to patient demographics or operative parameters. The overall operating room costs favored the open nephrectomy group by dollars 1070 (P=0.003). However, the overall cost of hospitalization, surgeon professional fees, duration of hospitalization, room and board costs, laboratory, and radiology costs, pharmacy costs, intravenous solution and infusion pump costs all significantly favored the laparoscopic patient group. The mean difference in overall hospital cost between laparoscopic and open nephrectomy was dollars 1211 in favor of laparoscopy (P=0.037). CONCLUSIONS: Our experience with laparoscopic nephrectomy in a large county hospital demonstrates a clear economic advantage in favor of the laparoscopic approach. Given limited funding for public hospitals and a clear patient benefit, laparoscopic nephrectomy should constitute first-line therapy when nephrectomy is indicated. 相似文献
2.
Oberstabsarzt B. Hossfeld M. Helm G. Hölldobler L. Lampl 《Notfall & Rettungsmedizin》2005,8(3):201-206
Zusammenfassung Die Teilnahme der Bundeswehr an internationalen Missionen erfordert ein an die Bedingungen militärischer Einsätze angepasstes Konzept zur intensivmedizinischen Repatriierung. Die umfassende Transportkapazität des auf den Airbus A-310 gestützten Systems von bis zu 44 liegenden Patienten bedingte bereits mehrfach den Einsatz im Rahmen ziviler Großschadensereignisse. Der Transport der häufig vital gefährdeten Patienten erfordert sowohl eine dem Inlandsstandard anzupassende medizintechnische Ausstattung der Luftfahrzeuge als auch entsprechend qualifiziertes medizinisches Begleitpersonal, das aufgrund der Sitzplätze zahlenmäßig begrenzt ist. Dieser Umstand verlangt vom Personal Umsicht bei der Betreuung von zeitgleich mehreren Patienten sowie Befähigung zum eigenständigen Arbeiten. Die Patienten-Transport-Einheiten (PTE) entsprechen in der technischen Ausstattung dem Intensivbehandlungsplatz einer modernen Klinik und gewährleisten auch über eine längere Transportzeit eine Intensivtherapie auf höchstem Niveau. Die Arbeit mit dieser Ausrüstung, die Besonderheiten des Langstreckenlufttransportes und die spezielle Situation des militärischen Einsatzes stellen zusätzliche Anforderungen an das Personal. Um dem gerecht zu werden, erfolgt, ergänzend zur täglichen Arbeit im Rettungsdienst, in den Notaufnahmen und auf den Intensivstationen der Bundeswehrkrankenhäuser eine spezielle Schulung von Rettungsassistenten und Ärzten am Flugmedizinischen Institut der Luftwaffe. 相似文献
3.
Michelle Lampl Christopher W. Kuzawa Philippe Jeanty 《American journal of human biology》2002,14(3):398-406
Fetal ultrasound measurements were employed to investigate the relationship between weight and ponderal index at birth and kidney size during the second (23 weeks) and third (32 weeks) trimesters of pregnancy in a sample of 25 normally growing fetuses. Kidney volume and kidney volume / fetal weight ratio at 32 weeks are significantly and positively related to both weight and ponderal index at birth, controlling for sex, gestational age at birth, and day of ultrasound measurement. A second‐degree polynomial relationship approximates the predictability of kidney volume fetal weight ratio at 23 weeks to that at 32 weeks, demonstrating shifting growth rates in fetal organ and body growth relationships during midgestation. Sex and parental size are suggested as contributing to these patterns. Females have a surge in renal growth between 23 and 32 weeks to catch up to earlier growing males, and maternal weight significantly predicts incremental growth in kidney volume and the kidney volume / fetal weight ratio at 32 weeks of gestation. The observation that fetuses relatively thin at birth have relatively smaller kidneys for their size in late gestation suggests that the influence of maternal weight on birth outcome may act through organ growth. Am. J. Hum. Biol. 14:398–406, 2002. © 2002 Wiley‐Liss, Inc. 相似文献
4.
123I-FP-CIT SPECT imaging of dopamine transporters in patients with cerebrovascular disease and clinical diagnosis of vascular parkinsonism. 总被引:2,自引:0,他引:2
Mordechai Lorberboym Ruth Djaldetti Eldad Melamed Menahem Sadeh Yair Lampl 《Journal of nuclear medicine》2004,45(10):1688-1693
The purpose of our study was to prospectively evaluate the striatal uptake of 123I-labeled N-(3-fluoropropyl)-2beta-carbomethoxy-3beta-(4-iodophenyl)nortropane (FP-CIT) and the response to l-dopa therapy in patients with cerebrovascular disease (CVD) who develop clinical symptoms of vascular parkinsonism (VP). METHODS: Twenty consecutive patients who developed VP in the course of CVD were prospectively enrolled in the study. All patients had CT evidence of CVD (17 patients had lacunar infarcts, 3 patients had territorial strokes). The clinical stage of the patients was assessed using the Hoehn and Yahr scale, and the severity of the symptoms was measured using the Unified Parkinson's Disease Rating Scale score. Ten age-matched subjects were used as controls. SPECT was performed 180 min after injection of 185 MBq 123I-FP-CIT using a dual-head gamma-camera. The ratio of the mean specific-to-nonspecific striatal binding for the entire striatum, caudate, and putamen was calculated in all patients and compared with that of controls. Putamen-to-caudate binding ratios were compared as well. The response to therapy was compared between patients with normal and abnormal 123I-FP-CIT binding. RESULTS: No correlation was found between any of the clinical variables and response to therapy in patients with VP. Nine patients had normal striatal 123I-FP-CIT binding with no significant differences in striatal or subregional binding ratios compared with those of the controls. In contrast, 11 patients had significantly diminished striatal binding compared with that of controls (P < 0.001). Subanalyses showed significantly decreased binding in the caudate (P < 0.04 and P < 0.01 for the right and left caudate, respectively), diminished binding in the putamen (P < 0.04 and P < 0.01 for the right and left putamen, respectively), and a decreased putamen-to-caudate ratio on the right side (P < 0.001). The latter ratio was not significant on the left. Two of the 3 patients with territorial strokes had significantly diminished striatal 123I-FP-CIT binding in the hemisphere contralateral to the CT lesion. All 9 patients with normal scan findings had a poor response to L-dopa. Six of 11 patients with abnormal studies had no response to L-dopa, whereas 5 patients had a good response (P < 0.03). CONCLUSION: The diagnosis of VP cannot be accurately confirmed on the basis of clinical features alone because CVD may alter the typical presentation of PD. Functional imaging with 123I-FP-CIT is highly recommended in patients with CVD who develop symptoms of VP to confirm or exclude the existence of nigrostriatal dopaminergic degeneration. Identifying a subset of patients with reduced 123I-FP-CIT binding in the striatum is important for better treatment selection. 相似文献
5.
If fulminate rejection in allogeneic and xenogeneic engraftments is not an evolutionary relict feature, then any treatment that ablates the host surveillance's effector arms capabilities and eliminates graft vs. host reactivity should induce donor chimerism in transplant settings. We demonstrate here marked proliferative response of Botryllus (Urochordata) blood cells months following their infusions (2×104–105 blood cells per host) into the concordant xenogeneic environment of irradiated Botrylloides soma. The state of infused cells was followed by Botryllus specific microsatellite alleles on DNA samples from host zooids and vascular system. Increased growth rates and life spans of engrafted hosts in some cases, and sudden chimerical death following the outbreak of donor cells in others, indicate a ‘double-edged sword’ expression of concurrent evolutionary selected mechanisms. This DES phenomenon in immunity underlies divergent stem cell competition phenomena in multicellular organisms, leading in mammals, to cases of autoimmune diseases vis-à-vis long-lasting microchimerism events following an iatrogenic transplantation. 相似文献
6.
Bareket Falk Ruth Burstein Isaack Ashkenazi Ofer Spilberg Jacob Alter Ester Zylber-Katz Ardon Rubinstein Nava Bashan Yair Shapiro 《European journal of applied physiology》1989,59(3):168-173
Summary The purpose of this study was to determine the effect of caffeine ingestion on physical performance after prolonged endurance
exercise. Twenty three trained male volunteers participated in a 40-km march and were divided into two groups, matched for
caffeine clearance rate and aerobic capacity. The experimental group ingested, prior to the march, a caffeinated drink at
a dose of 5 mg·kg−1 body mass and at the 3rd and 5th h of marching an additional drink at a dose of 2.5 mg·kg−1 body mass. The control group ingested a drink of equal volume at the same times. Upon termination of the march each subject
performed a cycle ergometer test at an intensity of 90% maximal oxygen consumption. Time to exhaustion and rate of perceived
exertion (RPE) were recorded. Blood samples were drawn predrink, at the 3rd and 5th h of marching and immediately after the
cycle ergometer test, and were analysed for caffeine, free fatty acids (FFA), lactate and glucose levels. Plasma FFA levels
increased during the march (p<0.05), with no significant difference between groups. Lactate levels increased in the experimental group (p<0.05), with no significant change in the control group. Glucose levels did not change significantly in either group. After
the cycle ergometer test, lactate levels were significantly higher in the experimental, as compared to the control group (3.77±0.33
vs 2.52±0.35 mmol·l−1, respectively). There was no significant difference between treatments in the time to exhaustion on the cycle ergometer,
but RPE was different (p<0.05). Under the conditions of this study, the results do not indicate caffeine ingestion as an ergogenic aid which will
postpone exhaustion following prolonged endurance exercise.
This work was presented, in part, at the Canadian Association of Sports Sciences Annual Meeting, October 1987, Lake Louise,
Alberta, Canada 相似文献
7.
Michelle Lampl 《American journal of human biology》2005,17(1):66-80
Considering the life-long influences of fetal growth biology, it is of interest to further elucidate the nature of the fetal growth process itself. Previous analyses of longitudinal fetal ultrasound data led to the hypothesis that hypoxia signals were important aspects of normal growth biology and directed attention to the place of oxygen as a basic nutrient. From the perspective of the cell, both hypoxia and lack of energy substrate trigger a common adaptive pathway through their effects on ATP availability. Comparative data from animal studies and cell culture provide evidence for an integrated energy/oxygen signaling system that acts redundantly and hierarchically with cellular differentiation programs, providing opportunities for developmental flexibility in response to variable ecologic or environmental challenge. The multinodal and interactive design of the fetal growth process suggests that it follows what has been described as the "bow tie" model of metabolism, with implications for robust and inventive approaches to cell, organ, and whole organism construction. 相似文献
8.
Peripheral neuropathy (PN) can be a manifestation of various neurological, infectious, metabolic, autoimmune, rheumatic, and malignant diseases. During the past decade, intravenous immunoglobulin (IVIg) has been increasingly used in the therapy of PN. Compared with other immunomodulatory therapies, IVIg has an excellent safety profile. IVIg is used today as a first-line therapy in the treatment of Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, and multifocal motor neuropathy. Some small studies and reports of clinical cases presented in this article found benefit from IVIg in treating PN associated with diabetes, paraproteinemia, HIV, multisystem rheumatic diseases, and paraneoplastic PN. No clear recommendations can be made relating the use of IVIg in these conditions. Prospective, randomized trials are required to clarify this issue. 相似文献
9.
Kleta R Skovby F Christensen E Rosenberg T Gahl WA Anikster Y 《Molecular genetics and metabolism》2002,76(3):201-206
Type III 3-methylglutaconic aciduria (MGA) (MIM 258501) consists of early bilateral optic atrophy, later development of spasticity, extrapyramidal dysfunction and occasionally cognitive deficits, and urinary excretion of 3-methylglutaconic acid and 3-methylglutaric acid. The presence of the disorder in an Iraqi-Jewish genetic isolate led to mapping of the OPA3 gene to chromosome 19q13.2-q13.3, followed by isolation of the gene itself. OPA3 consists of two exons and codes for a peptide of 179 amino acids. Iraqi-Jewish patients with type III MGA are homozygous for a splice site founder mutation in OPA3 (IVS1-1G>C) which abolishes mRNA expression in fibroblasts. Here we report a novel mutation in OPA3 (320-337del) in a Kurdish-Turkish patient with optic atrophy and 3-methylglutaconic and 3-methylglutaric aciduria, previously carrying the diagnosis of type IV MGA. We conclude that type III MGA occurs in patients of non-Iraqi-Jewish ancestry, and should be considered in patients with type IV MGA that have optic atrophy and ataxia. 相似文献
10.
Complete absence of third molars and mandibular permanent second molars is reported in a 19-year-old female, with occipito-frontal head circumference and height at the 3rd centile. The patient's intelligence, appearance and physical examination were normal. Direct count of the patient's sweat pores in different areas of the palms and digits was normal. Microcephaly, short stature and normal intelligence have been reported in two families as a distinct autosomal dominant syndrome. To the best of our knowledge, oligodontia, in addition to these findings, has not been previously reported. 相似文献