全文获取类型
收费全文 | 9493篇 |
免费 | 560篇 |
国内免费 | 45篇 |
专业分类
耳鼻咽喉 | 92篇 |
儿科学 | 210篇 |
妇产科学 | 251篇 |
基础医学 | 1301篇 |
口腔科学 | 202篇 |
临床医学 | 992篇 |
内科学 | 2253篇 |
皮肤病学 | 94篇 |
神经病学 | 875篇 |
特种医学 | 309篇 |
外科学 | 1131篇 |
综合类 | 115篇 |
一般理论 | 13篇 |
预防医学 | 730篇 |
眼科学 | 179篇 |
药学 | 725篇 |
中国医学 | 5篇 |
肿瘤学 | 621篇 |
出版年
2023年 | 53篇 |
2022年 | 81篇 |
2021年 | 166篇 |
2020年 | 138篇 |
2019年 | 160篇 |
2018年 | 180篇 |
2017年 | 136篇 |
2016年 | 118篇 |
2015年 | 216篇 |
2014年 | 269篇 |
2013年 | 432篇 |
2012年 | 676篇 |
2011年 | 688篇 |
2010年 | 362篇 |
2009年 | 315篇 |
2008年 | 585篇 |
2007年 | 661篇 |
2006年 | 651篇 |
2005年 | 622篇 |
2004年 | 588篇 |
2003年 | 541篇 |
2002年 | 582篇 |
2001年 | 99篇 |
2000年 | 96篇 |
1999年 | 125篇 |
1998年 | 109篇 |
1997年 | 102篇 |
1996年 | 88篇 |
1995年 | 93篇 |
1994年 | 70篇 |
1993年 | 69篇 |
1992年 | 69篇 |
1991年 | 81篇 |
1990年 | 58篇 |
1989年 | 50篇 |
1988年 | 44篇 |
1987年 | 45篇 |
1986年 | 49篇 |
1985年 | 46篇 |
1984年 | 46篇 |
1983年 | 34篇 |
1982年 | 61篇 |
1981年 | 34篇 |
1980年 | 29篇 |
1979年 | 39篇 |
1978年 | 31篇 |
1977年 | 36篇 |
1975年 | 31篇 |
1973年 | 29篇 |
1969年 | 20篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
1.
Steven V Koenen Anjoke J M Huisjes Jules Dings Yolanda van der Graaf Gerard H A Visser Hein W Bruinse 《The journal of maternal-fetal & neonatal medicine》2006,19(2):93-99
OBJECTIVE: To determine if there is a diurnal pattern in the clinical symptoms of HELLP (Hemolysis, Elevated Liver enzymes, Low Platelets) syndrome. STUDY DESIGN: A retrospective study was performed in 134 pregnancies complicated by HELLP syndrome. The medical records were reviewed to describe each HELLP episode. Time of day was divided into three periods, day, evening, and night. The following parameters were categorized according to the time of day: onset of symptoms, consultation by the doctor, initial blood sampling, diagnosis and decrease of symptoms. Biochemical parameters at clinical presentation and consecutive changes within 24 h were recorded. RESULTS: In 65 pregnancies 77 HELLP episodes were well documented. Times of onset of symptoms and consultation by the doctor were significantly higher during the evening and night (p < 0.001), whereas times of diagnosis and decrease of symptoms occurred significantly more during the day (p < 0.001). In only 49.3% of the cases were diagnostic laboratory criteria met at clinical presentation. This was mainly due to platelet values in excess of 100 x 10(9)/l. Several hours later (median 8 h, range 2-23) the decrease in platelets occurred. CONCLUSIONS: A diurnal pattern exists in the clinical symptoms of HELLP syndrome that is characterized by an exacerbation during the night and recovery during the day. There is a considerable delay between the onset of symptoms and the fulfillment of diagnostic laboratory criteria. 相似文献
2.
3.
Dexmedetomidine and Cardiac Arrest 总被引:2,自引:0,他引:2
4.
Anne Hagemeijer Arjan Buijs Elizabeth Smit Bart Janssen Geert-Jan Creemers Dorien Van Der Plas Gerard Grosveld 《Genes, chromosomes & cancer》1993,8(4):237-245
Leukemic cells from two patients with Philadelphia-negative chronic myeloid leukemia (CML) were investigated: I) Cytogenetics showed a normal 46.XY karyotype in both cases, 2) molecular studies revealed rearrangement of the M-BCR region and formation of BCR-ABL fusion mRNA with b2a2 (patient I) or b3a2 (patient 2) configuration, and 3) fluorescence in situ hybridization (FISH) demonstrated relocation of the 5′ BCR sequences from one chromosome 22 to one chromosome 9. The ABL probe hybridized to both chromosomes 9 at band q34, while two other probes which map centromeric and telomeric of BCR on 22q 11 hybridized solely with chromosome 22. For the first time, a BCR-ABL rearrangement is shown to take place on 9q34 instead of in the usual location on 22q 11. A rearrangement in the latter site is found in all Ph-positive CML and in almost all investigated CML with variant Ph or Ph-negative, BCR-positive cases. The few aberrant chromosomal localizations of BCR-ABL recombinant genes found previously were apparently the result of complex and successive changes. Furthermore in patient 2, both chromosomes 9 showed positive FISH signals with both ABL and BCR probes. Restriction fragment length polymorphism (RFLP) analysis indicated that mitotic recombination had occurred on the long arm of chromosome 9 and that the rearranged chromosome 9 was of paternal origin. The leukemic cells of this patient showed a duplication of the BCR-ABL gene, analogous to duplication of the Ph chromosome in classic CML. In addition they had lost the maternal alleles of the 9q34 chromosomal region. The lymphocytes of patient 2 carried the maternal chromosome 9 alleles and were Ph-negative as evidenced by RFLP and FISH analyses, respectively. © 1993 Wiley-Liss, Inc. 相似文献
5.
Laparoscopic hysterectomy 总被引:1,自引:0,他引:1
Michel Canis Gerard Mage Charles Chapron Arnaud Wattiez Jean Luc Pouly Maurice Antoine Bruhat 《Surgical endoscopy》1993,7(1):42-45
Summary Thirty-three patients were selected for laparoscopic hysterectomy and operated on in the Department of Obstetrics, Gynecology and Reproductive Medicine of Clermont-Ferrand University Hospital. Surgical techniques included blunt dissection with scissors and bipolar coagulation to achieve hemostasis. A case was considered successful when all the uterine vessels were treated by laparoscopy. Twenty-four cases were completed laparoscopically (72.7%). None of these patients had postoperative bleeding; 22 had an uneventful postoperative recovery. Nine procedures were converted to laparotomy (27.3%), five because of a difficult or unsatisfactory hemostasis. We conclude that in selected cases, a total hysterectomy can be performed safely by experienced laparoscopists. Further technological progress is necessary to make this procedure more acceptable. Its value as compared to the others will have to be demonstrated. 相似文献
6.
R Rozan E Albuisson D Donnarieix B Giraud J J Mazeron J P Gerard M Pernot A Gerbaulet F Baillet J Douchez 《International journal of radiation oncology, biology, physics》1992,24(3):469-477
Interstitial irradiation is a technique currently used in the treatment of bladder cancer. We report the data on 205 patients (177 men and 28 women) treated in eight French centers. The patients had received the following treatment: a short course of pre-operative pelvic irradiation, followed by surgery consisting of partial cystectomy or tumor resection, and implantation of plastic tubes filled with inactive lead wires, which were replaced by iridium 192 wires. The tumor characteristics were: transitional cell carcinoma, 88.8%; mean size of the tumor, 29 mm; pathological stages: pTis, 1; pT1, 98; pT2, 66; pT3a, 26; pT3b, 9; pT4, 1; unknown, 4 respectively; surgical lymph node status: N+, 3; N-, 118; no node dissection, 84. The mean follow-up was 51 months. Intravesical failures were seen in 35 patients (17.0%), 25 (71.4%) of them without metastases or regional recurrences. Twenty-one patients (10.2%) presented distant metastases, 2/3 of them suffered no bladder relapse. The 5-year survival, calculated according to the Kaplan-Meier method (all causes of death taken together) was 77.4% for the T1, 62.9% for the T2, and 46.8% for the T3. Fifty-three patients had immediate side-effects and three died from surgical complications. Twenty-nine patients had delayed bladder side-effects (haematuria, fistula, chronic cystitis). Six patients presented an ureteral stenosis. Of the disease-free survivors, 96.1% retained the bladder function. Three factors were significantly predictive of delayed side-effects: partial cystectomy, pre-operative radiotherapy total dose, and linear activity of the wires (p < 0.01). Comparing our results to different authors' series interstitial irradiation is likely to provide a high local and general control of the disease and good quality of life in patients with selected tumors. 相似文献
7.
C. J. Punt E. E. Voest E. Tueni A. T. Van Oosterom A. Backx P. H. De Mulder B. Hecquet C. Lucas B. Gerard H. Bleiberg 《British journal of cancer》1997,76(10):1376-1381
S9788 is a new triazineaminopiperidine derivate capable of reversing multidrug resistance (MDR) in cells resistant to chemotherapeutic agents such as doxorubicin. It does not belong to a known class of MDR revertants, but its action involves the binding of P-glycoprotein. Thirty-eight evaluable patients with advanced colorectal or renal cell cancer were treated with doxorubicin alone (16 patients) followed after disease progression with combination treatment of doxorubicin plus S9788 (12 patients) or upfront with the combination of doxorubicin plus S9788 (22 patients). S9788 was given i.v. as a loading dose of 56 mg m-2 over 30 min followed by doxorubicin given at 50 mg m-2 as a bolus infusion. Thereafter, a 2-h infusion of S9788 was administered at escalating doses ranging from 24 to 120 mg m-2 in subsequent cohorts of 4-10 patients. Pharmacokinetic analysis demonstrated that concentrations of S9788 that are known to reverse MDR in vitro were achieved in patients at non-toxic doses. Compared with treatment with doxorubicin alone, treatment with the combination of doxorubicin and S9788 produced a significant increase in the occurrence of WHO grade 3-4 granulocytopenia. Treatment with S9788 was cardiotoxic as it caused a dose-dependent and reversible increase in corrected QT intervals as well as clinically non-significant arrhythmias on 24- or 48-h Holter recordings. Although clinically relevant cardiac toxicities did not occur, the study was terminated as higher doses of S9788 may increase the risk of severe cardiac arrhythmias. Twenty-nine patients treated with S9788 plus doxorubicin were evaluable for response, and one patient, who progressed after treatment with doxorubicin alone, achieved a partial response. We conclude that S9788 administered at the doses and schedule used in this study results in relevant plasma concentrations in humans and can safely be administered in combination with doxorubicin. 相似文献
8.
Jan Paul Ouwens Wim van der Bij Thomas W van der Mark Albert Geertsma Do A Piers Wim J de Boer Gerard H Ko?ter 《The Journal of heart and lung transplantation》2004,23(1):115-121
BACKGROUND: A decrease in forced expiratory volume in 1 second (FEV(1)) as a diagnostic criterion for bronchiolitis obliterans syndrome (BOS) after single lung transplantation may be influenced significantly by the presence of the native lung. To quantify and to discriminate between the relative contribution of graft and native lung to the FEV(1), we retrospectively investigated the diagnostic value of combined FEV(1) measurements and ventilation scintigraphy in pulmonary dysfunction after single lung transplantation in 11 recipients with pulmonary vascular disease, 3 with obstructive lung disease, and 3 with restrictive lung disease. METHODS: We assessed function of the native lung and the graft, and subsequently calculated an adjusted grading of BOS by correcting routine FEV(1) measurements using linear interpolation of bi-annual lung ventilation scans. RESULTS: The contribution of the native lung to the total FEV(1) was slight (median, 9%) in recipients with obstructive disease compared with recipients with vascular (38%) or restrictive lung diseases (27%). Adjusted BOS grading was not useful in patients with obstructive disease. In the other patient groups, the onset of adjusted BOS Grade 1 and standard BOS Grade 1 was at a median of 220 days (range, 127-1146 days) and 836 days (184-3065 days), respectively. CONCLUSION: Ventilation scintigraphy is a useful adjunct in the (early) diagnosis of BOS in recipients of single lung transplants who have vascular and restrictive lung diseases. 相似文献
9.
Gerard M Ribbers Theo Mulder Alexander C Geurts Rob A den Otter 《Archives of physical medicine and rehabilitation》2002,83(1):81-85
OBJECTIVE: To test whether central motor processing can be impaired in chronic reflex sympathetic dystrophy (RSD). DESIGN: Experimental 2-group analysis. SETTING: Tertiary care center in the Netherlands. PARTICIPANTS: Five patients with stage 3 RSD of the left forearm, free of symptoms and complaints in the right forearm; and 10 healthy control subjects. INTERVENTION: On a digitizer, RSD patients and controls had to draw 3 sequences of graphemes of different complexity with their (unaffected) dominant right hand. The drawing tracks were segmented in time periods between points of velocity minima of the pen tip. MAIN OUTCOME MEASURES: Mean velocity, coefficients of variation of both length and movement time per segment, and mean intersegmental pausing time were calculated for each sequence. RESULTS: A repeated-measures analysis of variance by using the multivariate method yielded a 35% lower mean velocity (F(1,13) = 5.83, P =.031), a 110% larger segment length variability (F(1,13) = 9.72, P =.008) and a 60% larger variability of movement time per segment (F(1,13) = 5.78, P =.032) in RSD patients. No group difference was found for intersegmental pausing time or any interaction effect with the type of task. CONCLUSION: Patients with chronic RSD have a normal ability to preprogram sequential movements of their unaffected hand; but with impaired temporospatial coding and movement execution. We concluded that cortical mechanisms may be involved in motor impairments in patients with chronic RSD. 相似文献
10.
Pre-excitation disorders have an estimated prevalence of 0.15 per cent. Advances in electrophysiological mapping and the increasing sophistication of surgical techniques have resulted in an increasing role for definitive surgical treatment. A retrospective chart review of 181 patients undergoing 197 procedures for surgical ablation of accessory atrioventricular pathways between June 1981 to June 1986 was performed. Mean age of the patients was 30 years (range 6-66) with a preponderance of males (59 per cent). Associated cardiac disease was found in 18 (9.9 per cent) patients. Induction of anaesthesia employed either a barbiturate-relaxant (83 per cent) or a narcotic-benzodiazepine-relaxant (17 per cent) and was uneventful in all cases. In 14 per cent of cases a pure narcotic relaxant technique was employed for maintenance of anaesthesia, whereas a balanced technique with isoflurane (29 per cent), enflurane (34 per cent), or halothane (22 per cent) was utilized for the remainder. Muscle relaxation was provided by d-tubocurarine in 35 (18 per cent) procedures and pancuronium in the remaining 162 (82 per cent) procedures. There was no significant correlation between intraoperative arrhythmias and type of anaesthetic used. Although recognizing the potential for malignant arrhythmias, our experience (within the confines of a retrospective analysis) suggests that the majority of these patients can be managed successfully using standard anaesthetic techniques. 相似文献