全文获取类型
收费全文 | 2719篇 |
免费 | 195篇 |
国内免费 | 142篇 |
专业分类
耳鼻咽喉 | 220篇 |
儿科学 | 46篇 |
妇产科学 | 73篇 |
基础医学 | 414篇 |
口腔科学 | 12篇 |
临床医学 | 216篇 |
内科学 | 822篇 |
皮肤病学 | 5篇 |
神经病学 | 9篇 |
特种医学 | 64篇 |
外科学 | 338篇 |
综合类 | 357篇 |
预防医学 | 56篇 |
眼科学 | 16篇 |
药学 | 117篇 |
2篇 | |
中国医学 | 36篇 |
肿瘤学 | 253篇 |
出版年
2024年 | 6篇 |
2023年 | 60篇 |
2022年 | 101篇 |
2021年 | 98篇 |
2020年 | 102篇 |
2019年 | 99篇 |
2018年 | 91篇 |
2017年 | 82篇 |
2016年 | 76篇 |
2015年 | 86篇 |
2014年 | 186篇 |
2013年 | 162篇 |
2012年 | 126篇 |
2011年 | 121篇 |
2010年 | 125篇 |
2009年 | 141篇 |
2008年 | 144篇 |
2007年 | 160篇 |
2006年 | 148篇 |
2005年 | 139篇 |
2004年 | 116篇 |
2003年 | 74篇 |
2002年 | 73篇 |
2001年 | 69篇 |
2000年 | 72篇 |
1999年 | 57篇 |
1998年 | 36篇 |
1997年 | 42篇 |
1996年 | 34篇 |
1995年 | 30篇 |
1994年 | 30篇 |
1993年 | 32篇 |
1992年 | 23篇 |
1991年 | 21篇 |
1990年 | 14篇 |
1989年 | 18篇 |
1988年 | 14篇 |
1987年 | 5篇 |
1986年 | 5篇 |
1985年 | 5篇 |
1984年 | 3篇 |
1983年 | 5篇 |
1982年 | 5篇 |
1981年 | 4篇 |
1980年 | 4篇 |
1979年 | 2篇 |
1978年 | 5篇 |
1977年 | 1篇 |
1976年 | 3篇 |
1972年 | 1篇 |
排序方式: 共有3056条查询结果,搜索用时 15 毫秒
1.
目的 临床观察白花蛇舌草干预湿热瘀滞型肠内多发息肉患者内镜治疗术后复发情况。方法 采用前瞻性的随机空白对照试验设计,选取2019年9月1日—2020年12月31日上海中医药大学附属普陀医院消化科收治的门诊及住院结直肠多发息肉患者132例作为研究对象。采用随机方法分为对照组和试验组,每组66例。对照组行内镜治疗术给予常规治疗后无药物干预,试验组在对照基础上给予白花蛇舌草汤剂(每日取白花蛇舌草15 g、大枣3枚,煎取400 mL汤剂,分2次饭后温服)治疗,连续干预1年。观察并比较两组术前与术后1年肠道内息肉的复发率、息肉数目、息肉最大直径、中医证候评分及肝肾功能及血常规的差异。结果 干预1年后,试验组复发9例(14.75%),对照组复发21例(33.33%),两组息肉复发率比较,差异有统计学意义(P<0.05)。试验组腺瘤、伴重度异型增生、体质量指数(BMI)≥24 kg·m-2患者治疗后息肉复发率均较对照组同类型降低,差异显著(P<0.05);术后1年试验组息肉最大直径及息肉数目均较对照组显著减小,差异显著(P<0.05);术后1年试验组中医证候各项评分均显著低于对照组(P<0.05);术后1年,两组中医证候疗效比较,差异具有统计学意义(P<0.05),且术前、术后1年两组患者肝肾功能、凝血功能等安全性指标无显著差异。结论 应用白花蛇舌草干预结直肠息肉术后患者,1年后明显降低肠内息肉的复发率,尤以腺瘤性息肉、重度异型增生、BMI超重患者更显著,不仅改善临床症状,还能有效预防结直肠息肉的复发,改善患者的预后。 相似文献
2.
Hiroshi Kashida 《Digestive endoscopy》2019,31(1):16-23
The aim of the present review was to clarify how we should detect and diagnose sessile serrated polyps (SSP) endoscopically. A systematic search was conducted of MEDLINE from January 2004 through March 2018. Nine findings: (i) proximal location; (ii) size >10 mm; (iii) irregular shape; (iv) indistinctive border; (v) cloud‐like surface; (vi) mucus cap; (vii) rim of debris in white‐light endoscopy; (viii) dilated vessels; and (ix) dilated crypts (pits) in image‐enhanced endoscopy were considered to be candidate discriminators of SSP from hyperplastic polyps. Prospective studies in a general setting are warranted to validate the above‐mentioned endoscopic features of SSP during real‐time colonoscopy and to determine whether these features are useful for the differential diagnosis of SSP. 相似文献
3.
The serrated pathway (SP) can be viewed as two parallel, but partially overlapping, arrays of colorectal precursor lesions, and their respective endpoint carcinomas, that are distinct from those of the conventional adenoma–carcinoma sequence (APC‐pathway). In this review we focus at the outset on the clinical impact, pathological features, molecular genetics and biological behaviours of the various SP cancers. Then we summarize the clinicopathological features, classification and molecular profiles of the two main precursor lesions that anchor the respective pathways: (i) sessile serrated adenoma/polyp (SSA/P), also called sessile serrated lesion (SSL), and (ii) traditional serrated adenoma (TSA). Activating mutations of the RAS–RAF–MAPK pathway initiate and sustain the lesions of the SP, and CpG island methylation of the promoter regions of tumour suppressor and DNA repair genes play the major role in their neoplastic progression. The SP includes microsatellite stable (MSS) carcinomas that are among the most biologically aggressive colorectal carcinomas (CRC), and also accounts for the great preponderance of sporadic hypermutated, mismatch repair (MMR)‐deficient or microsatellite instable (MSI) CRC. The identification, removal and appropriate classification of at‐risk SP precursors and surveillance of individuals who harbour these lesions present a challenge and opportunity for CRC prevention and mortality reduction. 相似文献
4.
Takashi Murakami Naoto Sakamoto Akihito Nagahara 《Journal of gastroenterology and hepatology》2019,34(10):1685-1695
Sessile serrated adenoma/polyps (SSA/Ps) are early precursor lesions in the serrated neoplasia pathway, which results in BRAF‐mutated colorectal carcinomas with not only high levels of microsatellite instability but also microsatellite stable. SSA/Ps with advanced histology, including cytological dysplasia or minimally invasive carcinomas, are important lesions because SSA/Ps are considered major contributors to “interval cancers” and these lesions can rapidly become dysplastic or invasive carcinomas. Clinicopathologically, SSA/Ps with dysplasia or invasive carcinoma were associated with advanced age, female sex, and proximal colon. Although SSA/Ps with submucosal invasive carcinoma were smaller and invaded less deeply into the submucosal layer than conventional tubular adenomas with submucosal invasive carcinoma, SSA/Ps with submucosal invasive carcinoma frequently had a mucinous component and exhibited a higher potential for lymphatic invasion and lymph node metastasis. In an SSA/P series, endoscopic characteristics, including (semi)pedunculated morphology, double elevation, central depression, and reddishness, may help accurately diagnose SSA/Ps with advanced histology. Removal of SSA/Ps with dysplasia or invasive carcinoma was recommended. Endoscopic treatment such as endoscopic mucosal resection or endoscopic submucosal dissection is useful for those lesions. However, surgical resection with lymph node dissection might be indicated when SSA/Ps with invasive carcinoma are endoscopically suspected, because these have the high risk of lymph node metastasis. Greater awareness may promote further research into improving the detection, recognition, and complete resection rates of SSA/Ps with dysplasia or invasive carcinoma and reduce the interval cancer rates. 相似文献
5.
6.
目的探讨全结肠切除后三环形回肠贮袋-肛管吻合加选择性截流术的价值。方法1994年9月至2004年9月对18例全结肠切除患者应用三环形回肠贮袋加选择性截流术,其中家族性大肠腺瘤性息肉病14例,溃疡性结肠炎4例。结果18例获12月~5年随访,无手术死亡。术后发生并发症3例(16.7%),贮袋阴道瘘、早期炎性肠梗阻、切口感染各1例,均治愈。术后平均排便频率:术后2周内4.9次/d,1个月3.8次/d,6个月3.1次/d,1年1.8次/d。至6个月时都能控制干便,其中控制正常者15例(83.3%),控制欠佳者3例(16.7%),无大便失禁。但稀便控制能力较差,至1年时仍有1例(5.6%)患者稀便失禁。无一例须插管排空。结论全结肠切除后三环形回肠贮袋肛管吻合加选择性截流术操作简单,手术并发症少,术后排便功能好,是家族性大肠腺瘤性息肉病和严重溃疡性结肠炎全结肠切除后较为合适的消化道重建方式。 相似文献
7.
G. Biswas S. K. Ghosh S. Mukhopadhyay H. Bora 《Indian journal of otolaryngology and head and neck surgery》2002,54(3):193-195
Out of 36511 patients attending the ENT OHD of R. G,. Aur Medical Callege & Hospital. Kolkata, in one year 0.08% patients
were found tuning naspharyngeal mass. 30 cases of nasopharyngeal mass were studied. The peak incidence of nasopharyngeal mass
was in the age group between II to 20 years (40%). The incidence in males (73%) was more than females(27%). The maximum ineldence
was found among students (74%). Commonest ntuopharyngeal nuns teas antrochoanal polyp (30%). Next commlon masses were adenoids
(23%)Juvenile angwfibroma(20%) and nasophartngeal carcinoma (13%). Nasal obstruction was the main presenting symptom(83%)
followed by epistaxis (40%). 相似文献
8.
MASAHIKO NAKASONO MITSUYOSHI HIROKAWA NAOKI MUGURUMA SEISUKE OKAMURA SUSUMU ITO MICHIYO OKAZAKI TAKAHIRO HORIE MASUO KIMURA MAYUKO TAKEUCHI TOSHI INOSHITA TOSHIAKI SANO 《Journal of gastroenterology and hepatology》2006,21(1):79-83
Background and Aim: Duodenal lymphangitis carcinomatosa has been sporadically described, but so far little attention has been paid to duodenal lymphangitis carcinomatosa. Methods: Four cases with duodenal lymphangitis carcinomatosa were endoscopically and histologically examined. Results: The four cases exhibited multiple polypoid lesions along the Kerckring's folds and/or were covered by characteristically granular, non‐ulcerated mucosa upon thickening. The granularity seems to been caused by dilated lymph vessels containing the carcinoma cells. The lesions were microscopically characterized by: (i) involvement of lymph vessels located in the upper portion of the lamina propria; (ii) no inflammatory changes; and (iii) no desmoplastic changes. Primary sites were thought to be the stomach in case 1, the pancreas in cases 2 and 4, and unknown in case 3. All patients died within 6 months after admission or endoscopic examination. Conclusions: As duodenal lymphangitis carcinomatosis shows characteristic endoscopic appearance, endoscopic diagnosis is not difficult. We should realize that the lesion represents extremely poor prognosis, and it should be distinguished from ordinary metastatic duodenal carcinoma. 相似文献
9.
M. Pickard E. P. Dewar R. C. Kapadia R. B. N. Khan I. F. Hutchinson A. Nejim 《Colorectal disease》2007,9(3):203-206
OBJECTIVE: The publication of the BSG guidelines in 2002 provided a framework for the follow up of patients with colorectal polyps. The aim of the present study was to determine whether they had, or were being correctly adhered to in a moderately sized District General Hospital. METHOD: A total of 598 patients were on the waiting list for colonoscopy at Airedale General Hospital (AGH) in February 2005. Of these, 203 were being followed up as a result of the previous finding of a polyp. RESULTS: Only 14.8% of patients had been or were being followed up according to the BSG guidelines. The majority of the 85.2% of patients who did not comply with follow up did so as a result of over investigation. Seventy-eight per cent of the low-risk group and 55% of the intermediate-risk group had been colonoscoped, or were waiting to have colonoscopy, too soon or too frequently according to the BSG guidelines. Twenty-four patients with hyperplastic polyps were being followed up incorrectly, as were 17 patients discovered to have a polyp pathology on flexible sigmoidoscopy. It was established that 131 extra colonoscopies had been, or were planned to be performed unnecessarily. CONCLUSION: These data have major implications with regard to patient safety, service provision and cost to the NHS. 相似文献
10.
R. Machtinger J. Korach A. Padoa E. Fridman M. Zolti J. Segal Y. Yefet M. Goldenberg & G. Ben-baruch 《International journal of gynecological cancer》2005,15(2):325-328
The aim of this study is to assess accuracy of transvaginal ultrasound (TVUS) and diagnostic hysteroscopy in diagnosing endometrial polyps and to determine premalignancy and malignancy rates in asymptomatic women. The study was designed to retrospectively analyze 438 women who underwent operative hysteroscopy in a day-care unit when endometrial polyp was suspected after TVUS and diagnostic hysteroscopy. Multivariate logistic regression modeling showed effects of age, previous breast cancer with tamoxifen treatment, and menopause with or without bleeding on pathologic results. The results indicate that positive predictive value of TVUS with diagnostic hysteroscopy was 79.9%. Premalignancy or malignancy occurred in 3.2% and was significantly related to menopause with abnormal bleeding (P < 0.001), which carried a 20-fold higher risk of pathology than any other group. Age was also a risk factor. It was concluded that TVUS with diagnostic hysteroscopy reliably evaluates endometrial polyps. The low incidence of endometrial tumors in asymptomatic (especially premenopausal) women suggests that their operative evaluation may not be cost effective. Larger studies are needed to support this tentative conclusion. 相似文献