收费全文 | 23774篇 |
免费 | 2526篇 |
国内免费 | 481篇 |
耳鼻咽喉 | 195篇 |
儿科学 | 569篇 |
妇产科学 | 259篇 |
基础医学 | 2468篇 |
口腔科学 | 860篇 |
临床医学 | 2952篇 |
内科学 | 4046篇 |
皮肤病学 | 404篇 |
神经病学 | 1710篇 |
特种医学 | 478篇 |
外国民族医学 | 11篇 |
外科学 | 2512篇 |
综合类 | 2641篇 |
现状与发展 | 4篇 |
预防医学 | 2572篇 |
眼科学 | 1210篇 |
药学 | 1148篇 |
9篇 | |
中国医学 | 702篇 |
肿瘤学 | 2031篇 |
2024年 | 45篇 |
2023年 | 513篇 |
2022年 | 528篇 |
2021年 | 1250篇 |
2020年 | 1051篇 |
2019年 | 1080篇 |
2018年 | 1025篇 |
2017年 | 1048篇 |
2016年 | 1039篇 |
2015年 | 1060篇 |
2014年 | 1516篇 |
2013年 | 1869篇 |
2012年 | 1240篇 |
2011年 | 1298篇 |
2010年 | 1100篇 |
2009年 | 1058篇 |
2008年 | 1058篇 |
2007年 | 1074篇 |
2006年 | 928篇 |
2005年 | 869篇 |
2004年 | 725篇 |
2003年 | 642篇 |
2002年 | 597篇 |
2001年 | 483篇 |
2000年 | 414篇 |
1999年 | 367篇 |
1998年 | 312篇 |
1997年 | 260篇 |
1996年 | 258篇 |
1995年 | 219篇 |
1994年 | 205篇 |
1993年 | 200篇 |
1992年 | 172篇 |
1991年 | 176篇 |
1990年 | 137篇 |
1989年 | 103篇 |
1988年 | 99篇 |
1987年 | 83篇 |
1986年 | 84篇 |
1985年 | 128篇 |
1984年 | 95篇 |
1983年 | 66篇 |
1982年 | 83篇 |
1981年 | 58篇 |
1980年 | 48篇 |
1979年 | 27篇 |
1978年 | 31篇 |
1977年 | 20篇 |
1976年 | 11篇 |
1975年 | 13篇 |
Background
Acute myocardial infarction (AMI) causes irreversible myocardial damage and release of inflammatory mediators, including cytokines, chemokines and miRNAs. We aimed to investigate changes in the levels of cytokines (IL-6, TNF-α and IL-10), miRNAs profiles (miR-146 and miR-155) and distribution of different monocyte subsets (CD14++CD16-, CD14++CD16+, CD14+CD16++) in the acute and post-healing phases of AMI.Methods
In eighteen consecutive AMI patients (mean age 56.78?±?12.4 years, mean left ventricle ejection fraction – LVEF: 41.9?±?9.8%), treated invasively, monocyte subsets frequencies were evaluated (flow cytometry), cytokine concentrations were analyzed (ELISA) as well as plasma miRNAs were isolated twice – on admission and after 19.2?±?5.9 weeks of follow-up. Measurements were also performed among healthy volunteers.Results
AMI patients presented significantly decreased frequencies of classical cells in comparison to healthy controls (median 71.22% [IQR: 64.4–79.04] vs. 84.35% [IQR: 81.2–86.7], p?=?0.001) and higher percent of both intermediate and non-classical cells, yet without statistical significance (median 6.54% [IQR: 5.14–16.64] vs. 5.87% [IQR: 4.48–8.6], p?=?0.37 and median 5.99% [IQR: 3.39–11.5] vs. 5.26% [IQR: 3.62–6.2], p?=?0.42, respectively). In AMI patients both, analyzed plasma miRNA concentrations were higher than in healthy subjects (miR-146: median 5.48 [IQR: 2.4–11.27] vs. 1.84 [IQR: 0.87–2.53], p?=?0.003; miR-155: median 25.35 [IQR: 8.17–43.15] vs. 8.4 [IQR: 0.08–16.9], p?=?0.027, respectively), and returned back to the values found in the control group in follow-up. miR-155/miR-146 ratio correlated with the frequencies of classical monocytes (r=0.6, p?=?0.01) and miR-155 correlated positively with the concentration of inflammatory cytokines ? IL-6 and TNF-α.Conclusions
These results may suggest cooperation of both pro-inflammatory and anti-inflammatory signals in AMI in order to promote appropriate healing of the infarcted myocardium. 相似文献Objectives: To describe and analyze the outcomes of patients with stroke from a rural PHC setting in the Western Cape, South Africa.
Methods: In a longitudinal survey, 93 stroke patients, referred to home and community-based care services (HCBC) between June 2015 and December 2017, were assessed at baseline, one month and three months. Changes in function (Barthel Index (BI)), caregiver strain (Caregiver Strain Index (CSI)), impact of environmental factors and satisfaction with stroke care were measured.
Results: HCBC was delayed, fragmented and brief (median session duration 20 minutes (IQR 15.0–30.0)). Although function improved significantly, dependence remained high: median BI score changed from 40.0 (IQR 15.0–70.0) to 62.5 (IQR 30.0–81.25) (p = .019). A third (33.0% (30/91)) of caregivers initially experienced strain and the median CSI score remained 3.0 (IQR 0.0–7.0) (p = .672). Overall, patient and caregiver satisfaction with HCBC was low with only 46.9% (31/66) of caregivers and 17.4% (12/69) of patients satisfied with all aspects of care. Only 47.6% of assistive product needs were met. Environmental factors negatively impacted on patient function and caregiving.
Conclusions: Clinical practice pathways and referral guidelines should be developed for the HCBC platform. Specific training of CHWs, focusing on how to educate, support and train family caregivers, provide assistive devices and refer to health services is needed. 相似文献