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101.
Preliminary experience with new bioactive prosthetic material for repair of hernias in infected fields 总被引:15,自引:5,他引:10
Surgisis (Cook Surgical, Bloomington, Ind., USA) is a new four-ply bioactive, prosthetic mesh for hernia repair derived from
porcine small-intestinal submucosa. It is a naturally occurring extracellular matrix which is easily absorbed, supports early
and abundant new vessel growth, and serves as a template for the constructive remodeling of many tissues. As such, we believe
that Surgisis mesh is ideal for use in contaminated or potentially contaminated fields in which ventral, incisional, or inguinal
hernia repairs are required. From November 2000 through May 2002, 25 patients (11 male, 14 female) underwent placement of
Surgisis mesh for a variety of different hernia repairs. A total of 25 hernia repairs were performed in our patient population.
Fourteen procedures (56%) were performed in a potentially contaminated setting (i.e. with incarcerated/strangulated bowel
within the hernia or coincident with a laparoscopic cholecystectomy/colectomy). Eleven repairs (44%) were performed in a grossly
contaminated field, including one in which an infected polypropylene mesh from a previous inguinal hernia repair was replaced
with Surgisis and one in which necrotic bowel was discovered within the hernial sac. Median follow-up was 15 months with a
range of 1–20 months. Of the 25 total repairs, there was one wound infection complicated by enterocutaneous fistula in a patient
originally operated on for ischemic bowel. The fistula was in a location independent of the Surgisis mesh. There were no mesh-related
complications or recurrent hernias in our early postoperative follow-up period. Surgisis mesh appears to be a promising new
prosthetic material for hernia repair, especially in contaminated or potentially contaminated fields. Obviously, long-term
follow-up is still required.
Electronic Publication 相似文献
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106.
Granulocyte-macrophage colony stimulating factor (GM-CSF) modulates various functions of monocytes/ macrophages including antigen-presenting capacity. Recently it was found that astrocytes produce GM-CSF in the central nervous system (CNS) and that GM-CSF can induce proliferation and morphological changes of microglia. Here we show that GM-CSF can down regulate the interferon-γ-mediated induction of major histocompatibility complex (MHC) class II antigens in microglia, but not in astrocytes. GM-CSF pretreatment completely prevents myelin basic protein-specific T cell proliferation induced by microglia but not astrocytes. GM-CSF did not affect the cell surface expression on microglia of either MHC class I or cell adhesion molecules. The inhibition of microglial MHC class II expression and antigen-presenting function is specific for GM-CSF, as treatment with a different CSF (interleukin-3) did not modulate microglial phenotype or functional capacity. These data suggest that GM-CSF might be involved in the regulation of immune responses within the central nervous system. 相似文献
107.
Angela J. Drake-Holland Mark I. M. Noble Sara Pugh Christopher Mills 《Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy》1988,2(2):239-243
Summary In this study any changes in action potential duration or Q-T interval due to acute doses of ketanserin were monitored. The effect of a bolus dose (10 or 20 mg) followed by an infusion (10 or 20 mg over 20 minutes) of ketanserin on the Q-T interval and action potential duration was studied in six patients undergoing routine cardiac catheterization. Action potential duration was measured with a silver-silver chloride electrode catheter while heart rate was kept constant by atrial pacing and reflex effects avoided by -adrenergic blockade. There were some prolongations of the action potential duration but they were not in excess of 40 msec and did not reach statistical significance (control 263±46.0 msec; bolus 269±52.1 msec; infusion 262±53.6 msec; nor were there any significant changes in Q-T interval. Thus acute intravenous doses of ketanserin, in the absence of hypokalaemia or other Q-T interval-prolonging drugs, have no consistent effect on Q-T interval or action potential duration; prolongation of the action potential, when it occurs, is small. 相似文献
108.
Although pilomatrixomas are well known to dermatologists and dermatopathologists, surgeons encountering these lesions over the parotid gland frequently do not consider this benign neoplasm in the differential diagnosis. Presentation of a subcutaneous preauricular lesion, coupled with an erroneous cytologic diagnosis of malignancy, can potentially result in histologic "overdiagnosis" and more aggressive therapy than is required for these benign hair follicle neoplasms. A case is reported to illustrate this potential diagnostic trap, and a series of 206 cases collected at the University Hospital of Zurich from 1975 to 1987 is reviewed. 相似文献
109.
R A Franklin 《The Nursing clinics of North America》1992,27(3):631-642
Cigarette smoking remains a major health problem in not only the United States but the world. The dependency-producing effects of nicotine are well documented. Primary prevention, preventing the initiation of smoking, is receiving increased attention in the field of health education. Secondary prevention, smoking cessation, is showing promising results. Perhaps the goal of a smoke-free America by 2000 is not a "pipe dream" after all. 相似文献
110.
We compared results of comprehensive neuropsychological testing in 42 patients with clinically diagnosed Alzheimer's disease (AD) and in an equal number of patients with clinically definite chronic-progressive multiple sclerosis. Age, sex, and education were controlled using demographically corrected T scores based on a large normal sample. Both groups showed significant impairment on the test battery, but the degree of dementia was more severe in the patients with AD. A deviation score analysis, controlling for overall level of cognitive impairment, revealed significant differences between the groups. Alzheimer's disease was associated with relatively greater impairment of learning, memory, and verbal skills, whereas the MS group showed greater relative impairment of attention, incidental memory, and psychomotor functions. These data suggest that both the degree and pattern of mental impairement differ in patients with AD and patients with multiple sclerosis. Our results support a distinction between "gray matter" and "white matter" dementia, and may help clarify the issue of "cortical" vs "subcortical" dementia by demonstrating neuropsychological differences based on secure neuropathologic distinctions. 相似文献