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41.
Balasubramanian P Desire S Panetta JC Lakshmi KM Mathews V George B Viswabandya A Chandy M Krishnamoorthy R Srivastava A 《Bone marrow transplantation》2012,47(9):1178-1185
CY in combination with BU is a widely used conditioning regimen for haematopoietic SCT (HSCT). The aim of this study was to evaluate the pharmacokinetics (PK) of CY and its major metabolite 4-hydroxyCY (HCY) in patients with thalassemia undergoing HSCT. A total of 55 patients received BU (16 mg/kg) followed by CY (160-200 mg/kg) both over 4 days before HSCT. A population PK model was developed to describe the disposition of CY and HCY and the inter-individual (IIV) and inter-occasion variability (IOV). The model was also used to determine the effects covariates including: demographics, Lucarelli classification and polymorphisms in enzymes involved in the metabolism or biotransformation of CY had on CY and HCY disposition. Overall, 17-114% IIV and 12-103% IOV in CY and HCY PK parameters were observed. Body weight and age were the main covariates, which explained the largest portion of the IIV. In addition, CYP2C9*2 explained a significant portion of the IIV in the clearance (P<0.002) and thus the area under the concentration curve (P<0.05) of CY. This covariate model may be used to design and plan targeted dose therapy in this group of pediatric patients, if clinical outcome association with CY PK are proved and target range established. 相似文献
42.
N. Palaniappan I. S. Cole K. Damodaran A. Kuznetsov K. R. Justin Thomas Balasubramanian K. 《RSC advances》2020,10(21):12151
In acidic medium, nickel alloys severely suffer from long term corrosion problems as a result of the breakdown of their passivating oxide. The present study considers polyaniline functionalized fish-scale graphitic carbon as an anticorrosion coating on the nickel alloy surface. The fish-scale porous carbon materials are characterized by XRD, ATR-FITR, UV, Raman, TGA, SS NMR, FESEM, and TEM methods. The surface of the alloy is covalently bound with a polyaniline long chain protonated polymer so that the polyaniline functionalized honeycomb fish-scale carbon structure can exchange electrons with the metal surface. The corrosion inhibition efficiency has been investigated in different acid media like sulfuric acid and hydrochloric acid by electrochemical methods. Polyaniline functionalized porous carbon showed in 1 M H2SO4 inhibition efficiency around 64% and in 1 M HCl inhibition efficiency was around 74%. The inhibition efficiency was higher in HCl because chloride ions were not able to penetrate the graphitic sheet. The novelty of this coating is in the fact that the polyaniline functionalized porous carbon has high conductivity and is electrochemically stable in acidic medium. It is able to donate electrons to the polarized metal surface.Polyaniline functionalized fish scale carbon chemisorption on 111 nickel alloy surface by polyaniline polaron nitrogen free electron. 相似文献
43.
44.
Chalhoub E Xie L Balasubramanian V Kim J Belovich J 《Annals of biomedical engineering》2007,35(3):474-491
A model of reaction and transport in the liver was developed that describes the metabolite concentration and reaction flux
dynamics separately within the tissue and blood domains. The blood domain contains equations for convection, axial dispersion,
and transport to the surrounding tissue; and the tissue domain consists of reactions representing key carbohydrate metabolic
pathways. The model includes the metabolic heterogeneity of the liver by incorporating spatial variation of key enzymatic
maximal activities. Simulation results of the overnight fasted, resting state agree closely with experimental values of overall
glucose uptake and lactate output by the liver. The incorporation of zonation of glycolytic and gluconeogenic enzyme activities
causes the expected increase in glycolysis and decrease in gluconeogenesis along the sinusoid length from periportal to perivenous
regions, while fluxes are nearly constant along the sinusoid length in the absence of enzyme zonation. These results confirm
that transport limitations are not sufficient to account for the observed tissue heterogeneity of metabolic fluxes. Model
results indicate that changes in arterial substrate concentrations and hepatic blood flow rate, which occur in the high-intensity
exercise state, are not sufficient to shift the liver metabolism enough to account for the 5-fold increase in hepatic glucose
production measured during exercise. Changes in maximal activities, whether caused by exercise-induced changes in insulin,
glucagon, or other hormones are shown to be needed to achieve the expected glucose output. This model provides a framework
for evaluating the relative importance to hepatic function of various phenomenological changes that occur during exercise.
The model can also be used to assess the potential effect of metabolic heterogeneity on metabolism. 相似文献
45.
Effect of oropharyngeal colostrum therapy in the prevention of necrotising enterocolitis among very low birthweight neonates: A meta‐analysis of randomised controlled trials 下载免费PDF全文
B. D. Garg H. Balasubramanian N. S. Kabra A. Bansal 《Journal of human nutrition and dietetics》2018,31(5):612-624
Background
Necrotising enterocolitis (NEC ) is one of the most common life‐threatening emergencies of the gastrointestinal tract in preterm neonates. The present study aimed to determine the efficacy of oropharyngeal colostrum with respect to reducing NEC in preterm neonates.Methods
A literature search was conducted for various randomised control trials by searching the Cochrane Central Register of Controlled Trials, PubMed, EMBASE and ongoing clinical trials. Randomised or quasi‐randomised trials comparing oropharyngeal colostrum versus placebo in neonates (birthweight ≤ 1500 g or gestational age ≤ 32 weeks) were included in the review. The methodological quality of each trial was independently reviewed by the authors. For categorical and continuous variables, typical estimates for relative risk and typical estimates for weighted mean difference were calculated, respectively. A random effect model was assumed for meta‐analysis.Results
In total, four eligible trials were included in the review. Oropharyngeal colostrum therapy was not associated with a statistically significant reduction in the incidence of NEC stage ≥2 [typical relative risk (RR ) = 0.64; 95% confidence interval (CI ) = 0.27–1.49], mortality from any cause (typical RR = 0.86; 95% CI = 0.15–4.80) and time to reach full feed [typical weighted mean difference (WMD) = ?3.26; 95% CI = ?8.87 to 2.35]. Duration of hospital stay was significantly less in the control group (typical WMD = 9.77; 95% CI = 3.96–15.59).Conclusions
The current evidence is insufficient for recommending oropharyngeal colostrum as a routine clinical practice in the prevention of NEC . We emphasise the need for large randomised controlled trials with an adequate sample size and validated clinical outcomes in preterm neonates.46.
Lasse Jrgensen Cehofski Kentaro Kojima Nobuhiro Terao Koji Kitazawa Sasikala Thineshkumar Jakob Grauslund Henrik Vorum Bent Honor 《Investigative ophthalmology & visual science》2020,61(14)
PurposeLarge-scale protein analysis may bring important insights into molecular changes following branch retinal vein occlusion (BRVO). Using proteomic techniques this study compared aqueous humor samples from patients with BRVO to age-matched controls.MethodsAqueous humor samples from treatment naive patients with BRVO complicated by macular edema (n = 19) and age-matched controls (n = 18) were analyzed with label-free quantification nano liquid chromatography – tandem mass spectrometry (LFQ nLC-MS/MS). The severity of macular edema was measured as central retinal thickness (CRT) with optical coherence tomography. Control samples were obtained prior to cataract surgery. Proteins were filtered by requiring quantification in at least 50% of the samples in each group without imputation of missing values. Significantly changed proteins were identified with a permutation-based calculation with a false discovery rate at 0.05.ResultsIn BRVO, 52 proteins were differentially expressed. Regulated proteins were involved in cell adhesion, coagulation, and acute-phase response. Apolipoprotein C-III, complement C3, complement C5, complement factor H, fibronectin, and fibrinogen chains were increased in BRVO and correlated with CRT. Fibronectin also correlated with best corrected visual acuity (BCVA) and vascular endothelial growth factor (VEGF). Monocyte differentiation antigen CD14 (CD14) and lipopolysaccharide-binding protein (LBP) were upregulated in BRVO. Contactin-1 and alpha-enolase were downregulated in BRVO and correlated negatively with CRT.ConclusionsMultiple proteins, including complement factors, fibrinogen chains, and apolipoprotein C-III, correlated with CRT, indicating a multifactorial response. Fibronectin correlated with BCVA, CRT, and VEGF. Fibronectin may reflect the severity of BRVO. The proinflammatory proteins CD14 and LBP were upregulated in BRVO. 相似文献
47.
48.
A. Bagul H. P. Patel D. Chadwick B. J. Harrison S. P. Balasubramanian 《World journal of surgery》2014,38(3):534-541
Background
Preoperative imaging in patients undergoing surgery for primary hyperparathyroidism (PHPT) is used primarily to facilitate targeted parathyroidectomy. Failure of preoperative localisation mandates a bilateral exploration. It is thought that the results of imaging may also predict the success of surgery. The aims of this study were to assess whether the findings on preoperative localisation influenced outcomes following parathyroidectomy for PHPT and to explore factors underlying failure to cure at surgery.Methods
We analysed outcomes of all patients who underwent first-time surgery for PHPT in two centres over a 5-year period to determine an association with demographic characteristics and findings on preoperative imaging. Records of patients not cured by initial surgery were reviewed to explore factors underlying failure to cure.Results
The failure rate (persistent disease) in the entire cohort was 5 % (25/541) (bilateral neck explorations, 5 %; unilateral exploration, 7 %; targeted approach, 4 %), while two patients developed recurrent disease. In patients who had undergone dual imaging with an ultrasound scan and 99mTc-sestamibi scintigraphy, failure rates with “lateralised and concordant” imaging, “nonconcordant” imaging, and “dual-negative” imaging were 2, 9, and 11 %, respectively (p = 0.01). Of the 25 patients with persistent disease, multigland disease (MGD) was present in 52 % (13/25) and ectopic adenoma in 24 % (6/12).Conclusions
Patients with PHPT who do not have lateralised and concordant dual imaging are at higher risk of persistent disease. A significant proportion of failures are due to the inability to recognise the presence and/or extent of MGD. 相似文献49.
Antony George Attokaran FRACP FCICM Mahesh Ramanan MMed FCICM Lisa Hunt MBBS Kavita Chandra MBBS Rajbir Sandha FACEM Stacey Watts RN BN GC Balasubramanian Venkatesh MD FCICM FAHMS 《Emergency medicine Australasia : EMA》2023,35(4):657-663
Objective
To test the hypothesis that fluid resuscitation in the ED with plasmalyte-148 (PL) compared with 0.9% sodium chloride (SC) would result in a lower proportion of patients with diabetic ketoacidosis (DKA) requiring intensive care unit (ICU) admission.Methods
We performed a prespecified nested cohort study at two hospitals within a cluster, crossover, open label, randomised, controlled trial comparing the effects of PL versus SC as fluid therapy for patients who presented to the ED with DKA. All patients presenting within a fixed recruitment period were included. The primary outcome was the proportion of patients admitted to ICU.Results
Eighty-four patients were enrolled (SC n = 38, PL n = 46). The SC group had a lower median pH on admission (SC: 7.09 [interquartile range (IQR) 7.01–7.21], PL: 7.17 [IQR 6.99–7.26]). The median volume of intravenous fluids administered in ED was 2150 mL (IQR 2000–3200 mL; SC) and 2200 mL (IQR 2000–3450; PL); respectively. A higher proportion of patients in the SC group, 19 (50%), was admitted to ICU compared with PL group, 18 (39.1%); however, after adjustment for pH at presentation and diabetes type in a multivariable logistic regression model, the PL group did not have a significantly different rate of ICU admission compared with the SC group (odds ratio for ICU admission 0.73, 95% confidence interval 0.13–3.97, P = 0.71).Conclusion
Patients with DKA treated with PL compared with SC in the EDs had similar rates of requiring ICU admission. 相似文献50.
S. P. Balasubramanian J. Brignall H. Y. Lin T. J. Stephenson J. Wadsley B. J. Harrison W. L. Craig L. Smart Z. Krukowski 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2014,399(2):245-251