全文获取类型
收费全文 | 182312篇 |
免费 | 5424篇 |
国内免费 | 2673篇 |
专业分类
耳鼻咽喉 | 1908篇 |
儿科学 | 6350篇 |
妇产科学 | 3153篇 |
基础医学 | 22629篇 |
口腔科学 | 4413篇 |
临床医学 | 11837篇 |
内科学 | 34565篇 |
皮肤病学 | 3167篇 |
神经病学 | 10932篇 |
特种医学 | 3812篇 |
外国民族医学 | 1篇 |
外科学 | 28238篇 |
综合类 | 12071篇 |
一般理论 | 4篇 |
预防医学 | 9197篇 |
眼科学 | 3417篇 |
药学 | 19891篇 |
10篇 | |
中国医学 | 6682篇 |
肿瘤学 | 8132篇 |
出版年
2022年 | 1115篇 |
2021年 | 2502篇 |
2020年 | 1323篇 |
2019年 | 12790篇 |
2018年 | 12531篇 |
2017年 | 5799篇 |
2016年 | 1619篇 |
2015年 | 1551篇 |
2014年 | 3493篇 |
2013年 | 5441篇 |
2012年 | 3872篇 |
2011年 | 4181篇 |
2010年 | 3615篇 |
2009年 | 3623篇 |
2008年 | 4301篇 |
2007年 | 5380篇 |
2006年 | 5572篇 |
2005年 | 5381篇 |
2004年 | 4229篇 |
2003年 | 4176篇 |
2002年 | 3845篇 |
2001年 | 3732篇 |
2000年 | 3907篇 |
1999年 | 3433篇 |
1998年 | 3351篇 |
1997年 | 2598篇 |
1996年 | 2351篇 |
1995年 | 2684篇 |
1994年 | 2475篇 |
1993年 | 1914篇 |
1992年 | 1486篇 |
1991年 | 1480篇 |
1990年 | 1229篇 |
1989年 | 975篇 |
1988年 | 1014篇 |
1987年 | 976篇 |
1986年 | 817篇 |
1985年 | 5397篇 |
1984年 | 7271篇 |
1983年 | 5817篇 |
1982年 | 6252篇 |
1981年 | 5704篇 |
1980年 | 4901篇 |
1979年 | 4958篇 |
1978年 | 4061篇 |
1977年 | 3047篇 |
1976年 | 3522篇 |
1975年 | 2732篇 |
1974年 | 2523篇 |
1973年 | 2226篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
81.
A Well-Balanced Positivity-Preserving Quasi-Lagrange Moving Mesh DG Method for the Shallow Water Equations 下载免费PDF全文
A high-order, well-balanced, positivity-preserving quasi-Lagrange moving
mesh DG method is presented for the shallow water equations with non-flat bottom
topography. The well-balance property is crucial to the ability of a scheme to simulate perturbation waves over the lake-at-rest steady state such as waves on a lake or
tsunami waves in the deep ocean. The method combines a quasi-Lagrange moving
mesh DG method, a hydrostatic reconstruction technique, and a change of unknown
variables. The strategies in the use of slope limiting, positivity-preservation limiting,
and change of variables to ensure the well-balance and positivity-preserving properties are discussed. Compared to rezoning-type methods, the current method treats
mesh movement continuously in time and has the advantages that it does not need to
interpolate flow variables from the old mesh to the new one and places no constraint
for the choice of a update scheme for the bottom topography on the new mesh. A selection of one- and two-dimensional examples are presented to demonstrate the well-balance property, positivity preservation, and high-order accuracy of the method and
its ability to adapt the mesh according to features in the flow and bottom topography. 相似文献
82.
83.
84.
Sadahiro Hijikata Igen Hongo Shu-ichi Nakayama Tetsuo Yamaguchi Yoshiyuki Sekikawa Toshihiro Nozato Takashi Ashikaga 《The Canadian journal of cardiology》2019,35(1):104.e9-104.e11
Syphilis is a sexually transmitted disease caused by Treponema pallidum. Syphilitic aortitis might coexist in a dysfunctional aortic valve, but the etiology remains unclear, because microbiological diagnosis is difficult. A 62-year-old man with low-grade fever was diagnosed with aortitis and infective endocarditis, due to Treponema pallidum infection, using polymerase chain reaction analysis. This case suggests that syphilis might cause infective endocarditis. 相似文献
85.
86.
A. Montalto V. Piazza F. Albi R. Gherli C. Contento A. Palermo F. Musumeci 《Transplantation proceedings》2019,51(1):206-209
Background
Pump speed optimization in patients implanted with a ventricular assist device represents a major challenge during the follow-up period. We present our findings on whether combined invasive hemodynamic ramp tests and cardiopulmonary exercise testing (CPX) can help optimize patient management.Methods
Eighteen patients implanted with a HeartMate 3 (HM3) device underwent ramp tests with right heart catheterization (including central venous pressure [CVP], pulmonary artery pressure, pulmonary capillary wedge pressure [PCWP], and blood pressure) and echocardiography. Data were recorded at up to 4 speed settings. Speed changes were in steps of 200 revolutions/min (rpm). Evaluation of functional capacity by CPX was conducted according to the modified Bruce protocol.Results
Only 30% of patients had normal PCWPs at their original rpm settings. In going from lowest to highest speeds, cardiac output improved by 0.25 ± 0.35 L/min/step (total change, 1.28 ± 0.3 L/min), and PCWP decreased by 1.9 ± 0.73 mm Hg/step (total change, 6 ± 1.6 mm Hg). CVP and systolic blood pressure did not change significantly with rpm. The rpm assessment was adjusted based on test results to achieve CVPs and PCWPs as close to normal limits as possible, which was feasible in all patients. On CPX, all patients demonstrated good performance (peak VO2, 16.8 ± 3.5 mL/kg/min).Conclusion
Hemodynamic ramp testing provides an objective means of optimizing rpm, and has the potential to provide good exercise tolerance. 相似文献87.
88.
Alexander C. Egbe Rosalyn Adigun Vidhu Anand Collin P. West Victor M. Montori Hassan M. Murad Emmanuel Akintoye Karim Osman Heidi M. Connolly 《The Canadian journal of cardiology》2019,35(12):1784-1790
BackgroundAlthough there are robust data about the pathophysiology and prognostic implications of left ventricular (LV) systolic dysfunction in patients with acquired heart disease, similar prognostic data about LV systolic dysfunction are sparse in the tetralogy of Fallot (TOF) population. The purpose of this study was to perform a meta-analysis of all studies that assessed the relationship between LV ejection fraction (LVEF) and cardiovascular adverse events (CAEs) defined as death, aborted sudden death, or sustained ventricular tachycardia.MethodsWe used random-effects models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsOf the 1,809 citations, 7 studies with 2,854 patients (age 28 ± 4 years) were included. During 5.6 ± 3.4 years' follow-up, there were 82 deaths, 17 aborted sudden cardiac deaths, and 56 sustained ventricular tachycardia events. Overall, CAEs occurred in 5.1% (144 patients). As a continuous variable, LVEF was a predictor of CAE (HR 1.29, 95% CI, 1.09-1.53, P = 0.001) per 5% decrease in LVEF. Similarly, LVEF < 40% was also a predictor of CAE (HR 3.22, 95% CI, 2.16-4.80, P < 0.001).ConclusionsLV systolic dysfunction was an independent predictor of CAE, and we observed a 30% increase in the risk of CAE for every 5% decrease in LVEF, and a 3-fold increase in the risk of CAE in patients with LVEF <40% compared with other patients. These findings underscore the importance of incorporating LV systolic function in clinical risk stratification of patients with TOF and the need to explore new treatment options to address this problem. 相似文献
89.
Granat Nadav Klang Eyal Tau Noam Kleinbaum Yeruham 《The American journal of emergency medicine》2019,37(10):1823-1828
ObjectiveTo evaluate the significance of sonographic perinephric fluid collection on the emergent management of patients with acute urinary stone obstruction.MethodsWe conducted a prospective study with retrospective analysis. Since January 2016 through July 2017, patients admitted to our tertiary hospital's emergency department (ED) with suspected symptomatic urinary stones underwent ultrasound evaluation. Images were prospectively interpreted by experienced radiologist who analyzed each case for the following imaging features: hydronephrosis, perinephric fluid and urethral stone identification. The presence and measurements of perinephric fluid were re-evaluated by second radiologist who was blinded for the first reader's measurements. Retrospective analysis was conducted to evaluate for an association between perinephric fluid collection and the following outcome variables: need for analgesics, the number of doses of analgesics and the amount of morphine (mg) in the ED, elevation of creatinine levels, hospitalization and need for urological interventions.ResultsThe need for analgesics, the number of doses of analgesics and the amount of morphine were significantly associated with the presence of perinephric fluid (p < 0.05). The odds ratio for the need for analgesics was 3.8 in the presence of any perinephric fluid, and 8.9 in the presence of moderate/severe perinephric fluid. No other patient outcome variables were found to be significantly associated with the presence of perinephric fluid (p > 0.05).ConclusionsThis study shows a correlation between sonographic evidence of perinephric fluid and more severe pain. Therefore, an emergency physician can consider the evidence of perinephric fluid, in acute urethral stone obstruction, a predictor for more severe pain. 相似文献
90.
Understanding why persons with human immunodeficiency virus (HIV) have accelerated atherosclerosis and its sequelae, including coronary artery disease (CAD) and myocardial infarction, is necessary to provide appropriate care to a large and aging population with HIV. In this review, we delineate the diverse pathophysiologies underlying HIV-associated CAD and discuss how these are implicated in the clinical manifestations of CAD among persons with HIV. Several factors contribute to HIV-associated CAD, with chronic inflammation and immune activation likely representing the primary drivers. Increased monocyte activation, inflammation, and hyperlipidemia present in chronic HIV infection also mirror the pathophysiology of plaque rupture. Furthermore, mechanisms central to plaque erosion, such as activation of toll-like receptor 2 and formation of neutrophil extracellular traps, are also abundant in HIV. In addition to inflammation and immune activation in general, persons with HIV have a higher prevalence than uninfected persons of traditional cardiovascular risk factors, including dyslipidemia, hypertension, insulin resistance, and tobacco use. Antiretroviral therapies, although clearly necessary for HIV treatment and survival, have had varied effects on CAD, but newer generation regimens have reduced cardiovascular toxicities. From a clinical standpoint, this mix of risk factors is implicated in earlier CAD among persons with HIV than uninfected persons; whether the distribution and underlying plaque content of CAD for persons with HIV differs considerably from uninfected persons has not been definitively studied. Furthermore, the role of cardiovascular risk estimators in HIV remains unclear, as does the role of traditional and emerging therapies; no trials of CAD therapies powered to detect clinical events have been completed among persons with HIV. 相似文献