全文获取类型
收费全文 | 89210篇 |
免费 | 7148篇 |
国内免费 | 3479篇 |
专业分类
耳鼻咽喉 | 1484篇 |
儿科学 | 1012篇 |
妇产科学 | 1114篇 |
基础医学 | 13149篇 |
口腔科学 | 1946篇 |
临床医学 | 9308篇 |
内科学 | 15694篇 |
皮肤病学 | 2211篇 |
神经病学 | 5962篇 |
特种医学 | 4746篇 |
外国民族医学 | 22篇 |
外科学 | 10308篇 |
综合类 | 6417篇 |
现状与发展 | 13篇 |
一般理论 | 12篇 |
预防医学 | 4786篇 |
眼科学 | 1949篇 |
药学 | 8827篇 |
38篇 | |
中国医学 | 2883篇 |
肿瘤学 | 7956篇 |
出版年
2024年 | 191篇 |
2023年 | 1122篇 |
2022年 | 2951篇 |
2021年 | 4293篇 |
2020年 | 2758篇 |
2019年 | 2854篇 |
2018年 | 3059篇 |
2017年 | 2684篇 |
2016年 | 3054篇 |
2015年 | 4281篇 |
2014年 | 4994篇 |
2013年 | 5157篇 |
2012年 | 7453篇 |
2011年 | 7695篇 |
2010年 | 4648篇 |
2009年 | 3816篇 |
2008年 | 5050篇 |
2007年 | 4817篇 |
2006年 | 4397篇 |
2005年 | 4101篇 |
2004年 | 3075篇 |
2003年 | 2742篇 |
2002年 | 2344篇 |
2001年 | 1872篇 |
2000年 | 1776篇 |
1999年 | 1627篇 |
1998年 | 809篇 |
1997年 | 730篇 |
1996年 | 577篇 |
1995年 | 504篇 |
1994年 | 462篇 |
1993年 | 289篇 |
1992年 | 503篇 |
1991年 | 425篇 |
1990年 | 430篇 |
1989年 | 367篇 |
1988年 | 330篇 |
1987年 | 293篇 |
1986年 | 252篇 |
1985年 | 183篇 |
1984年 | 125篇 |
1983年 | 105篇 |
1982年 | 54篇 |
1981年 | 71篇 |
1979年 | 60篇 |
1978年 | 43篇 |
1977年 | 45篇 |
1976年 | 40篇 |
1974年 | 42篇 |
1970年 | 35篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
1.
Kevin Kyung Ho Choi Santosh Sanagapalli 《World journal of gastrointestinal oncology》2022,14(3):568-586
Barrett's esophagus (BE) is the precursor to esophageal adenocarcinoma (EAC). Progression to cancer typically occurs in a stepwise fashion through worsening dysplasia and ultimately, invasive neoplasia. Established EAC with deep involvement of the esophageal wall and/or metastatic disease is invariably associated with poor long-term survival rates. This guides the rationale of surveillance of Barrett’s in an attempt to treat lesions at an earlier, and potentially curative stage. The last two decades have seen a paradigm shift in management of Barrett’s with rapid expansion in the role of endoscopic eradication therapy (EET) for management of dysplastic and early neoplastic BE, and there have been substantial changes to international consensus guidelines for management of early BE based on evolving evidence. This review aims to assist the physician in the therapeutic decision-making process with patients by comprehensive review and summary of literature surrounding natural history of Barrett’s by histological stage, and the effectiveness of interventions in attenuating the risk posed by its natural history. Key findings were as follows. Non-dysplastic Barrett’s is associated with extremely low risk of progression, and interventions cannot be justified. The annual risk of cancer progression in low grade dysplasia is between 1%-3%; EET can be offered though evidence for its benefit remains confined to highly select settings. High-grade dysplasia progresses to cancer in 5%-10% per year; EET is similarly effective to and less morbid than surgery and should be routinely performed for this indication. Risk of nodal metastases in intramucosal cancer is 2%-4%, which is comparable to operative mortality rate, so EET is usually preferred. Submucosal cancer is associated with nodal metastases in 14%-41% hence surgery remains standard of care, except for select situations. 相似文献
2.
Forgiveness has been found one substantial element in the recovery for women survivors from intimate partner violence following the termination of the abusive relationship. To further investigate the details of forgiveness in this specific context, the present study explored the process of forgiveness using grounded theory. In-depth and semi-structured interviews were conducted with 25 Chinese women survivors of IPV. The findings suggest that forgiveness is a strength-based process including empowerment, transformation, and integration phases. In the empowerment phase, survivors obtain strength at the intrapersonal, behavioural, and interpersonal levels. In the transformation phase, survivors complete cognitive transformation for their IPV experiences and emotional transformation towards former partners. In the integration phase, survivors—now freed from the past—reflect upon and apply the changes they have undergone. Two trajectories in the process were found. One trajectory is going through stages sequentially and the other trajectory is experiencing back and forth between empowerment and transformation stages before moving into the integration stage. The study's findings broaden our knowledge of the strength-based forgiveness process that women survivors of IPV undergo during recovery. Practitioners and policymakers could develop programmes and policies that support forgiveness by holistically facilitating their recovery and empowerment like assistance in dealing with life difficulties and promoting their reconnection with social networks. To improve the transferability and validity of the findings, the forgiveness of survivors of IPV could be explored in a diverse sample (e.g., survivors with low educational background or live in the rural area). 相似文献
3.
Moderate sedatives have been increasingly used to improve patient comfort during flexible bronchoscopy (FB). However, routine use of moderate sedation during FB is controversial because its efficacy and safety are not well established.This study aims to evaluate the efficacy and safety of moderate sedation during FB.A search was made of Medline, EMBASE, and the Cochrane Library to May 2014.Randomized controlled trials (RCTs) and quasi-RCTs were included.The main analysis was designed to examine the efficacy of moderate sedation during FB in sedation than no-sedation.The willingness to repeat FB was significantly more in sedation than no-sedation (odds ratio [OR] 2.30; 95% confidence interval [CI] 1.11–4.73; P = 0.02; I2 = 22.5). The duration of FB was shorter in sedation group than no-sedation group (standardized mean difference [SMD] −0.21; 95% CI −0.38 to −0.03; P = 0.02; I2 = 78.3%). Event of hypoxia was not significantly different between sedation and no-sedation groups (OR 0.86; 95% CI 0.42–1.73; P = 0.67; I2 = 0%). The SpO2 during procedure was not different between sedation and no-sedation groups (SMD −0.14; 95% CI −0.37 to 0.08; P = 0.21; I2 = 49.9%). However, in subgroup analysis without supplemental oxygen, the SpO2 was significantly lower in sedation than no-sedation group (SMD −0.45; 95% CI −0.78 to −0.11; P = 0.01; I2 = 0.0%).According to this meta-analysis, moderate sedation in FB would be useful in patients who will require repeated bronchoscopies as well as safe in respiratory depression. To our knowledge, although the various sedative drugs are already used in the real field, this analysis was the first attempt to quantify objective results. We anticipate more definite and studies designed to elucidate standardized outcomes for moderate sedation in FB. 相似文献
5.
文题释义:
细胞膜片技术:是在体外接种培养高密度的细胞,使其相互融合生长至100%而形成的透明致密膜状物。该技术不需要胰酶消化即可收集细胞,因此保留了大量的胞外基质、细胞间连接以及细胞-基质连接等结构。目前细胞膜片技术已成为组织工程领域的研究热点,已被推广应用于牙周膜、角膜、心脏、软骨、食管等多种组织器官修复。
成骨细胞:主要由内外骨膜和间充质始祖细胞分化而来,在复杂的骨形成过程中发挥着主要的功能,承担着骨基质的合成、分泌和矿化。骨髓间充质干细胞具有多向分化潜能,能定向分化为成骨细胞,其成骨分化过程可受多种因素的影响,如细胞因子的调控、遗传因素和激素水平等。背景:现阶段骨形态发生蛋白2和碱性成纤维生长因子2对骨髓间充质干细胞膜片增殖、成骨分化的影响和作用机制还尚未可知,如何将生长因子与组织工程细胞膜片技术相整合,最终将其用于骨缺损修复具有重要意义。
目的:探讨单独及联合应用骨形态发生蛋白2和碱性成纤维生长因子2对骨髓间充质干细胞膜片增殖和成骨分化的影响。
方法:体外分离培养鉴定SD大鼠骨髓间充质干细胞并构建细胞膜片,选用不同质量浓度的骨形态发生蛋白2和碱性成纤维生长因子2单独及联合诱导骨髓间充质干细胞膜片,CCK-8法结合碱性磷酸酶活性检测确定2种因子促进膜片增殖和成骨分化的最佳有效质量浓度;然后对骨髓间充质干细胞膜片进行成骨诱导,通过大体及显微镜观察、Vonkossa染色、茜素红染色、RT-PCR检测相关成骨标志物来评估诱导效果。
结果与结论:单独应用骨形态发生蛋白2可增强骨髓间充质干细胞膜片的碱性磷酸酶活性,最佳质量浓度为100 μg/L(P < 0.001),单独应用碱性成纤维生长因子2能加速骨髓间充质干细胞膜片的增殖,最佳质量浓度为20 μg/L(P < 0.001),而联合应用既可以促进膜片增殖又能提高其碱性磷酸酶活性(P < 0.001);经成骨诱导后,4组膜片在形态学上无明显差异,均能诱导骨髓间充质干细胞膜片的成骨分化,其中联合组钙结节最明显(P < 0.001),可显著促进膜片晚期成骨分化并抑制其早期成骨分化,具有明显的协同促进作用(P < 0.001)。结果表明,骨形态发生蛋白2和碱性成纤维生长因子2联合应用时具有协同作用,既可以促进骨髓间充质干细胞膜片增殖,又能显著增强其成骨诱导能力。ORCID: 0000-0003-1918-579X(何惠宇)
中国组织工程研究杂志出版内容重点:干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程 相似文献
6.
Hyun Jong Choi Jong Ho Moon Yun Nah Lee Hyun Su Kim Ji Su Ha Tae Hoon Lee Sang‐Woo Cha Young Deok Cho Sang‐Heum Park 《Digestive endoscopy》2015,27(7):772-775
Direct peroral cholangioscopy (POC) using an ultra‐slim upper endoscope is one modality of POC for intraductal endoscopic evaluation and treatment of the bile duct. Choledochoduodenostomy (CDS) is one modality of biliary bypass surgery that provides a new route to the bile duct. We carried out direct POC using an ultra‐slim upper endoscope without the use of accessories in 10 patients (four sump syndromes, three bile duct strictures and three intrahepatic duct stones) previously undergoing surgical CDS. Direct POC was successful in all patients. The use of an intraductal balloon catheter was required in one patient for advancement of the endoscope into the bile duct. Distal bile ducts with sump syndromes were cleared using baskets and water irrigation under direct POC. Cholangiocarcinoma was diagnosed in one patient with hilar bile duct stricture after cholangioscopic evaluation and a targeting forceps biopsy under direct POC. Intrahepatic duct stones were successfully extracted after intraductal fragmentation under direct POC. Oozing bleeding occurred during intraductal lithotripsy but stopped spontaneously. Direct POC using an ultra‐slim upper endoscope without the assistance of accessories can easily be carried out in patients undergoing CDS. 相似文献
7.
目的对比可弯曲胸腔镜和硬质胸腔镜在不明原因胸腔积液诊断中的准确性和安全性。方法采用前瞻性随机对照研究,连续筛选四川大学华西医院2012年3月至2014年3月期间不明原因胸腔积液住院患者,患者年龄18~75岁。经知情同意后,患者随机进入可弯曲胸腔镜组或硬质胸腔镜组进行检查。结果可弯曲胸腔镜组入组49例患者,硬质胸腔镜组入组48例患者。两组共有44例患者通过胸腔镜检查确诊为恶性疾病,48例确诊为良性疾病。两组诊断不明原因胸腔积液总体准确性分别为93.9%和95.8%,可弯曲胸腔镜组诊断肿瘤的敏感性为96.0%,硬质胸腔镜组诊断肿瘤的敏感性为95.2%,两组诊断肿瘤的特异性均为100.0%,两组之间差异无统计学意义。两种胸腔镜技术并发症多数轻微,患者均耐受良好。结论对于不明原因胸腔积液,可弯曲胸腔镜诊断的准确性与硬质胸腔镜相当。尽管可弯曲胸腔镜取材组织小,但是通过多点多次取材,所获得的组织标本能满足病理科医生进行包括免疫组织化学检测在内的疾病诊断。 相似文献
8.
9.
10.
L.‐Q. Zheng X.‐C. Han Y. Huang H.‐W. Li X.‐D. Niu J. Li 《Clinical and experimental dermatology》2015,40(3):293-297
Porocarcinoma is an unusual, locally aggressive and potentially fatal neoplasm. Several cutaneous malignancies have been described in association with porocarcinoma, including squamous cell carcinoma, basal cell carcinoma and tricholemmal carcinoma. Previous reports have indicated that the occurrence of malignant tumours in combination with porocarcinoma is extremely rare, in particular with regard to Bowen disease (BD). We report an uncommon case of porocarcinoma occurring synchronously in a single BD lesion in a 63‐year‐old woman with multiple BD lesions. The clinical and histological findings confirmed this diagnosis. 相似文献