全文获取类型
收费全文 | 6528篇 |
免费 | 610篇 |
国内免费 | 2篇 |
专业分类
7140篇 |
出版年
2024年 | 7篇 |
2023年 | 44篇 |
2022年 | 75篇 |
2021年 | 125篇 |
2020年 | 91篇 |
2019年 | 112篇 |
2018年 | 163篇 |
2017年 | 126篇 |
2016年 | 227篇 |
2015年 | 394篇 |
2014年 | 418篇 |
2013年 | 486篇 |
2012年 | 620篇 |
2011年 | 564篇 |
2010年 | 361篇 |
2009年 | 298篇 |
2008年 | 399篇 |
2007年 | 396篇 |
2006年 | 340篇 |
2005年 | 311篇 |
2004年 | 346篇 |
2003年 | 294篇 |
2002年 | 259篇 |
2001年 | 42篇 |
2000年 | 42篇 |
1999年 | 62篇 |
1998年 | 85篇 |
1997年 | 41篇 |
1996年 | 29篇 |
1995年 | 45篇 |
1994年 | 33篇 |
1993年 | 32篇 |
1992年 | 36篇 |
1991年 | 17篇 |
1990年 | 17篇 |
1989年 | 20篇 |
1988年 | 22篇 |
1987年 | 8篇 |
1986年 | 10篇 |
1985年 | 12篇 |
1984年 | 11篇 |
1983年 | 15篇 |
1982年 | 11篇 |
1981年 | 11篇 |
1980年 | 11篇 |
1979年 | 7篇 |
1978年 | 11篇 |
1976年 | 10篇 |
1974年 | 10篇 |
1971年 | 4篇 |
排序方式: 共有7140条查询结果,搜索用时 15 毫秒
81.
Decision-Making in Multiple Sclerosis Consultations in Italy: Third Observer and Patient Assessments
Erika Pietrolongo Andrea Giordano Monica Kleinefeld Paolo Confalonieri Alessandra Lugaresi Carla Tortorella Maura Pugliatti Davide Radice Claudia Goss Christoph Heesen Alessandra Solari the AutoMS group 《PloS one》2013,8(4)
Objective
To assess decision-making in multiple sclerosis (MS) from third observer and patient perspectives.Method
Audio recordings of first-ever consultations with a participating physician (88 outpatients, 10 physicians) at four tertiary MS care clinics in Italy, were rated by a third observer using the Observing Patient Involvement in Shared Decision Making (OPTION) and by patients using the Perceived Involvement in Care Scale (PICS).Results
Mean patient age was 37.5, 66% were women, 72% had MS, and 28% had possible MS or other disease. Mean PICS subscale scores (range 0 poor, 100 best possible) were 71.9 (SD 24.3) for "physician facilitation" (PICS-F); 74.6 (SD 22.9) for "patient information exchange" (PICS-I); and only 22.5 (SD 16.2) for "patient decision making" (PICS-DM). Mean OPTION total score (0 poor, 100 best possible) was 29.6 (SD 10.3). Poorest OPTION scores were found for items assessing “preferred patient approach to receiving information” and “preferred patient level of involvement.” Highest scores were for “clinician drawing attention to identified problem”, “indicating need for decision making,” and “need to review the decision.” Consultation time, woman physician, patient-physician gender concordance and PICS-F were associated with higher OPTION total score; older physician and second opinion consultation were associated with lower OPTION score.Conclusions
In line with findings in other settings, our third observer findings indicated limited patient involvement abilities of MS physicians during first consultations. Patient perceptions of physician skills were better than third observers’, although they correlated. Consultations with women physicians, and younger physicians, were associated with higher third observer and patient-based scores. Our findings reveal a need to empower Italian MS physicians with better communication and shared decision-making skills, and show in particular that attention to MS patient preferences for reception of information and involvement in health decisions, need to be improved. 相似文献82.
Andrea Egger Roland Kreis Sabin Allemann Christoph Stettler Peter Diem Tania Buehler Chris Boesch Emanuel R. Christ 《PloS one》2013,8(8)
Background
Intrahepatocellular (IHCL) and intramyocellular (IMCL) lipids are ectopic lipid stores. Aerobic exercise results in IMCL utilization in subjects over a broad range of exercise capacity. IMCL and IHCL have been related to impaired insulin action at the skeletal muscle and hepatic level, respectively. The acute effect of aerobic exercise on IHCL is unknown. Possible regulatory factors include exercise capacity, insulin sensitivity and fat availability subcutaneous and visceral fat mass).Aim
To concomitantly investigate the effect of aerobic exercise on IHCL and IMCL in healthy subjects, using Magnetic Resonance spectroscopy.Methods
Normal weight, healthy subjects were included. Visit 1 consisted of a determination of VO2max on a treadmill. Visit 2 comprised the assessment of hepatic and peripheral insulin sensitivity by a two-step hyperinsulinaemic euglycaemic clamp. At Visit 3, subcutaneous and visceral fat mass were assessed by whole body MRI, IHCL and IMCL before and after a 2-hours aerobic exercise (50% of VO2max) using 1H-MR-spectroscopy.Results
Eighteen volunteers (12M, 6F) were enrolled in the study (age, 37.6±3.2 years, mean±SEM; VO2max, 53.4±2.9 mL/kg/min). Two hours aerobic exercise resulted in a significant decrease in IMCL (−22.6±3.3, % from baseline) and increase in IHCL (+34.9±7.6, % from baseline). There was no significant correlation between the exercise-induced changes in IMCL and IHCL and exercise capacity, subcutaneous and visceral fat mass and hepatic or peripheral insulin sensitivity.Conclusions
IMCL and IHCL are flexible ectopic lipid stores that are acutely influenced by physical exercise, albeit in different directions.Trial Registration
ClinicalTrial.gov NCT00491582相似文献83.
Alex F?rster Hans Ulrich Kerl Holger Wenz Marc A. Brockmann Ingo N?lte Christoph Groden 《PloS one》2013,8(10)
Purpose
Characterization of lacunar infarction (LI) by use of multimodal MRI including diffusion- and perfusion-weighted imaging (DWI, PWI) is difficult because of the small lesion size. Only a few studies evaluated PWI in LI and the results are inconsistent.Methods
In 16 LI patients who underwent initial MRI within 6 hours after symptom onset and follow-up MRI within 1 week demographics, clinical presentation, and MRI findings were analyzed with special emphasis on DWI and PWI findings. Time to peak maps were classified as showing a normal perfusion pattern or areas of hypoperfusion which were further categorized in mismatch (PWI>DWI), inverse mismatch (PWI<DWI), and match (PWI=DWI). Quantitative perfusion maps were generated and analyzed by use of Signal Processing in NMR-Software (SPIN).Results
Of the 16 patients (mean age 65.5±12.9 years), 14 (87.5%) were male. Clinical symptoms comprised dysarthria (50%), hemiparesis (81.3%), and hemihypaesthesia (18.8%). Intravenous thrombolysis was performed in 7 (43.8%) patients. Clinical improvement was observed in 12 patients (75 %), while 2 (12.5%) patients showed a deterioration and another 2 (12.5%) a stable course. Acute ischemic lesions (mean volume of 0.46±0.29 cm3) were located in the thalamus (n=8, 50%), internal capsule (n=4, 25%), corona Radiata (n=3, 18.8%) and the mesencephalon (n=1, 6.3%). Circumscribed hypoperfusion (mean volume 0.61±0.48 cm3) was evident in 10 (62.5%) patients. Of these, 3 patients demonstrated a match, 4 an inverse mismatch, and 3 a mismatch between DWI and PWI lesion. Mean CBF and CBV ratios were 0.65±0.28 and 0.84±0.41 respectively. Growth of DWI lesions was observed in 7 (43.8%) and reversal of DWI lesions in 3 (18.8%) patients.Conclusions
MRI allows identification of different DWI and PWI patterns in LI, including growth and reversal of ischemic lesions. Consequently, it may serve for a better characterization of this stroke subtype and support treatment decisions in daily clinical practice. 相似文献84.
Robert P. Finger Eva Fenwick Christoph W. Hirneiss Arthur Hsueh Robyn H. Guymer Ecosse L. Lamoureux Jill E. Keeffe 《PloS one》2013,8(12)
Purpose
To assess the impact of VA loss on patient reported utilities taking both eyes into account compared to taking only the better or the worse eye into account.Methods
In this cross-sectional study 1085 patients and 254 controls rated preferences with the generic health-related (EQ-5D; n = 868) and vision-specific (Vision and Quality of Life Index (VisQoL); n = 837) multi-attribute utility instruments (MAUIs). Utilities were calculated for three levels of VA in the better and worse eyes, as well as for 6 different vision states based on combinations of the better and worse eye VA.Results
Using the VisQoL, utility scores decreased significantly with deteriorating vision in both the better and worse eyes when analysed separately. When stratified by the 6 vision states, VisQoL utilities decreased as VA declined in the worse eye despite stable VA in the better eye. Differences in VisQoL scores were statistically significant for cases where the better eye had no vision impairment and the worse seeing fellow eye had mild, moderate or severe vision impairment. In contrast, the EQ-5D failed to capture changes in better or worse eye VA, or any of the six vision states.Conclusions
Calculating utilities based only on better eye VA or using a generic MAUI is likely to underestimate the impact of vision impairment, particularly when the better eye has no or little VA loss and the worse eye is moderately to severely visually impaired. These findings have considerable implications for the assessment of overall visual impairment as well as economic evaluations within eye health. 相似文献85.
Pascal Hunziker Hassan Ghareeb Lena Wagenknecht Christoph Crocoll Barbara Ann Halkier Volker Lipka Alexander Schulz 《Plant, cell & environment》2020,43(6):1571-1583
Powdery mildew is a fungal disease that affects a wide range of plants and reduces crop yield worldwide. As obligate biotrophs, powdery mildew fungi manipulate living host cells to suppress defence responses and to obtain nutrients. Members of the plant order Brassicales produce indole glucosinolates that effectively protect them from attack by non-adapted fungi. Indol-3-ylmethyl glucosinolate is constitutively produced in the phloem and transported to epidermal cells for storage. Upon attack, indol-3-ylmethyl glucosinolate is activated by CYP81F2 to provide broad-spectrum defence against fungi. How de novo biosynthesis and transport contribute to defence of powdery mildew-attacked epidermal cells is unknown. Bioassays and glucosinolate analysis demonstrate that GTR glucosinolate transporters are not involved in antifungal defence. Using quantitative live-cell imaging of fluorophore-tagged markers, we show that accumulation of the glucosinolate biosynthetic enzymes CYP83B1 and SUR1 is induced in epidermal cells attacked by the non-adapted barley powdery mildew Blumeria graminis f.sp. hordei. By contrast, glucosinolate biosynthesis is attenuated during interaction with the virulent powdery mildew Golovinomyces orontii. Interestingly, SUR1 induction is delayed during the Golovinomyces orontii interaction. We conclude that epidermal de novo synthesis of indol-3-ylmethyl glucosinolate contributes to CYP81F2-mediated broad-spectrum antifungal resistance and that adapted powdery mildews may target this process. 相似文献
86.
Gehring Christoph Zelarayán Marcelo Correa Luz Ronildson Lima Almeida Rosângela Borges Boddey Robert Michael Leite Márcio Fernandes Alves 《Plant and Soil》2020,454(1-2):447-460
Plant and Soil - Aggressive ruderal plant species pose an increasing problem in anthropically degraded lands. They both affect and are affected by other vegetation and by soil fertility in their... 相似文献
87.
88.
89.
Natascha Verhagen Attila Teleki Christoph Heinrich Martin Schilling Andreas Unsöld Ralf Takors 《Biotechnology and bioengineering》2020,117(11):3239-3247
The improvement of cell specific productivities for the formation of therapeutic proteins is an important step towards intensified production processes. Among others, the induction of the desired production phenotype via proper media additives is a feasible solution provided that said compounds adequately trigger metabolic and regulatory programs inside the cells. In this study, S-(5′-adenosyl)- l -methionine (SAM) and 5′-deoxy-5′-(methylthio)adenosine (MTA) were found to stimulate cell specific productivities up to approx. 50% while keeping viable cell densities transiently high and partially arresting the cell cycle in an anti-IL-8-producing CHO-DP12 cell line. Noteworthy, MTA turned out to be the chemical degradation product of the methyl group donor SAM and is consumed by the cells. 相似文献
90.
Christoph Domschke Yingzi Ge Isa Bernhardt Sarah Schott Sophia Keim Simone Juenger Mariana Bucur Luisa Mayer Maria Blumenstein Joachim Rom Joerg Heil Christof Sohn Andreas Schneeweiss Philipp Beckhove Florian Schuetz 《Cancer immunology, immunotherapy : CII》2013,62(6):1053-1060