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1.
目的由于卒中风险随着狭窄严重程度的增加而升高,因此认为颈内动脉(ICA)接近闭塞患者的卒中风险很高。在现有的随机试验中,还没有专门针对这种情况进行探讨,因此其处理尚存在争汶。方法:对相关文献进行系统评价。结果:对ICA接近闭塞患者的处理还存在争议:一些学者支持进行干预,而另一些学者则认为存在风险或没有益处而反对进行干预。在ICA接近闭塞的有症状患者中进行一项比较外科治疗与最佳内科治疗的多中心前瞻性随机试验似乎非常困难,因为这类研究需要大量的患者。尽管如此,基于目前的证据,似乎很难拒绝手术治疗。结论:由于目前对ICA接近闭塞患者的最佳处理方案仍存在着争议,因此需要前瞻性观察性研究以证实其在有症状和无症状人群中的患病率以及相关的卒中风险。基于目前的证据,大多数医疗中心选择手术治疗,但它相对干内科治疗的特粱尚右待证章. 相似文献
2.
Percutaneous transhepatic placement of biliary endoprostheses: results in 100 consecutive patients. 总被引:4,自引:0,他引:4
B W Dick R L Gordon J M LaBerge M M Doherty E J Ring 《Journal of vascular and interventional radiology : JVIR》1990,1(1):97-100
One hundred patients with malignant biliary obstruction underwent palliative therapy by means of percutaneous transhepatic placement of 114 biliary endoprostheses. All patients were then followed up for at least 18 months or until death. Retrospective evaluation of the 95 patients who died showed an average survival time of 5.0 months. The five remaining patients have survived an average of 29.8 months. During the 1st week after stent insertion, a second manipulation was performed to improve stent function in nine patients. Overall, 14 (12.3%) of the stents became obstructed and six (5.2%) migrated; 86 patients required no further therapy for biliary obstruction or stent malfunction. The 30-day mortality rate was 12%; none of the deaths were directly attributable to a complication of the stent placement procedure. 相似文献
3.
J P Dick 《Journal of the Royal Society of Medicine》1992,85(9):517-518
4.
E. Andrs G. Kaltenbach E. Noel M. Noblet‐Dick A.‐E. Perrin T. Vogel J.‐L. Schlienger M. Berthel J. F. Blickl 《International journal of laboratory hematology》2003,25(3):161-166
Background: It has been suggested that oral cobalamin (vitamin B12) therapy may be an effective therapy for treating cobalamin deficiencies related to food‐cobalamin malabsorption. However, the duration of this treatment was not determined. Patients and method: In an open‐label, nonplacebo study, we studied 30 patients with established cobalamin deficiency related to food‐cobalamin malabsorption, who received between 250 and 1000 μg of oral crystalline cyanocobalamin per day for at least 1 month. Endpoints: Blood counts, serum cobalamin and homocysteine levels were determined at baseline and during the first month of treatment. Results: During the first month of treatment, 87% of the patients normalized their serum cobalamin levels; 100% increased their serum cobalamin levels (mean increase, +167 pg/dl; P < 0.001 compared with baseline); 100% had evidence of medullary regeneration; 100% corrected their initial macrocytosis; and 54% corrected their anemia. All patients had increased hemoglobin levels (mean increase, +0.6 g/dl) and reticulocyte counts (mean increase, +35 × 106/l) and decreased erythrocyte cell volume (mean decrease, 3 fl; all P < 0.05). Conclusion: Our findings suggest that crystalline cyanocobalamin, 250–1000 μg /day, given orally for 1 month, may be an effective treatment for cobalamin deficiencies not related to pernicious anemia. 相似文献
5.
Prof. Dr. W. Lorenz B. Stinner M. Rothmund D. Duda W. Dick H. Menke Th. Junginger 《European Surgery》1992,24(3):128-134
Zusammenfassung Probleml?sungsstrategien zu perioperativen Prophylaxema?nahmen umfassen mehr Studienarten als Tierexperimente und kontrollierte
klinische Studien. Dabei verhelfen Methoden der kognitiven Psychologie und künstlichen Intelligenz zu neuen Verfahren, um
kontroverse Standpunkte in der klinischen Versorgung zu formalisieren. Der Weg vom Tierexperiment zur klinischen Indikation,
mag mühevoll und beschwerlich sein, aber die Strategie hat sich bei der perioperativen Antihistaminikaprophylaxe als eine
neue Form der Prophylaxe schon bew?hrt. Gerade wurde im Refresher Course der ASA, der amerikanischen Gesellschaft für An?sthesie
und Intensivmedizin, diese Prophylaxe für alle US-An?sthesisten empfohlen.
Mit Unterstützung durch die Deutsche Forschungsgemeinschaft (Lo 199/16-2). 相似文献
6.
The concept of uniform reporting of data in resuscitation has demonstrated
its potential value in pre-hospital and in-hospital cardiac arrest in
adults, infants and children, in laboratory research, in disaster research
and, hopefully, also in trauma care and research.
相似文献
7.
J Graeme Houston Stephen J Gandy Wendy Milne John B C Dick Jill J F Belch Peter A Stonebridge 《Nephrology, dialysis, transplantation》2004,19(7):1786-1791
BACKGROUND: Spiral or helical arterial blood flow patterns have been widely observed in both animals and humans. The absence of spiral flow has been associated with carotid arterial disease. The aim of this study was to detect the presence of aortic spiral flow using magnetic resonance imaging (MRI) and to evaluate the relationship of the presence of spiral aortic flow with renal arterial disease and renal function in the follow-up of patients with suspected renal atheromatous disease. METHODS: Prospective study of 100 patients with suspected renal arterial disease and 44 patient controls. Using a 1.5 T MRI unit (Siemens Symphony), phase contrast flow quantification and three-dimensional contrast enhanced MR angiography of the abdominal aorta were performed. Renal arterial stenoses (RAS) were classified minimal, moderate or severe. Renal function was followed at 3 months before and 6 months after MRI. RESULTS: Non-spiral flow was more prevalent in patients with more severe RAS. Renal impairment progressed significantly in severe RAS without spiral flow (P = 0.0065), but did not progress significantly in severe RAS with spiral flow (P = 0.12). In minimal or moderate RAS with or without spiral flow there was no significant progression (P = 0.16, 0.13, 0.47, 0.092, respectively). CONCLUSIONS: Aortic spiral blood flow can be assessed with MRI. Lack of aortic spiral blood flow in patients with severe RAS is associated with significant short-term renal function deterioration. Determination of blood flow patterns may be a useful indicator of renal impairment progression in patients with suspected renal artery stenosis. 相似文献
8.
Nicole Y. L. Oei Bernet M. Elzinga Oliver T. Wolf Michiel B. de Ruiter Jessica S. Damoiseaux Joost P. A. Kuijer Dick J. Veltman Philip Scheltens Serge A. R. B. Rombouts 《Brain imaging and behavior》2007,1(1-2):31-41
Glucocorticoids (GCs, cortisol in human) are associated with impairments in declarative memory retrieval. Brain regions hypothesized
to mediate these effects are the hippocampus and prefrontal cortex (PFC). Our aim was to use fMRI in localizing the effects
of GCs during declarative memory retrieval. Therefore, we tested memory retrieval in 21 young healthy males in a randomized
placebo-controlled crossover design. Participants encoded word lists containing neutral and emotional words 1 h prior to ingestion
of 20 mg hydrocortisone. Memory retrieval was tested using an old/new recognition paradigm in a rapid event-related design.
It was found that hydrocortisone decreased brain activity in both the hippocampus and PFC during successful retrieval of neutral
words. These observations are consistent with previous animal and human studies suggesting that glucocorticoids modulate both
hippocampal and prefrontal brain regions that are crucially involved in memory processing.
Electronic Supplementary Material The online version of this article (doi:) contains supplementary material, which is available to authorized users. 相似文献
9.
F.?W. Ahnefeld J. Barth W. Dick A. Doenicke T. Fuchs H. Gervais H. Laubenthal H. L?llgen W. Lorenz H.?H. Mehrkens G.?H. Meuret H. M?llmann S. Piepenbrock B. Przybilla R. Ring W. Schmutzler G. Schultze-Werninghaus J. Schüttler H.?P. Schuster P. Sefrin M. Tryba J. Zander M. Zenz 《Der Anaesthesist》1994,43(4):211-222
10.