全文获取类型
收费全文 | 79906篇 |
免费 | 6040篇 |
国内免费 | 2381篇 |
专业分类
耳鼻咽喉 | 197篇 |
儿科学 | 1908篇 |
妇产科学 | 902篇 |
基础医学 | 7413篇 |
口腔科学 | 644篇 |
临床医学 | 12681篇 |
内科学 | 14367篇 |
皮肤病学 | 454篇 |
神经病学 | 4041篇 |
特种医学 | 2931篇 |
外国民族医学 | 6篇 |
外科学 | 5497篇 |
综合类 | 14520篇 |
现状与发展 | 10篇 |
预防医学 | 4693篇 |
眼科学 | 752篇 |
药学 | 7973篇 |
79篇 | |
中国医学 | 7484篇 |
肿瘤学 | 1775篇 |
出版年
2024年 | 123篇 |
2023年 | 1073篇 |
2022年 | 1302篇 |
2021年 | 2928篇 |
2020年 | 2851篇 |
2019年 | 2391篇 |
2018年 | 2307篇 |
2017年 | 2539篇 |
2016年 | 2635篇 |
2015年 | 2638篇 |
2014年 | 4749篇 |
2013年 | 5387篇 |
2012年 | 4380篇 |
2011年 | 4579篇 |
2010年 | 3670篇 |
2009年 | 3366篇 |
2008年 | 3414篇 |
2007年 | 3613篇 |
2006年 | 3217篇 |
2005年 | 3012篇 |
2004年 | 2671篇 |
2003年 | 2506篇 |
2002年 | 2186篇 |
2001年 | 2127篇 |
2000年 | 1761篇 |
1999年 | 1534篇 |
1998年 | 1420篇 |
1997年 | 1486篇 |
1996年 | 1205篇 |
1995年 | 1205篇 |
1994年 | 1143篇 |
1993年 | 860篇 |
1992年 | 852篇 |
1991年 | 767篇 |
1990年 | 615篇 |
1989年 | 578篇 |
1988年 | 586篇 |
1987年 | 473篇 |
1986年 | 428篇 |
1985年 | 658篇 |
1984年 | 556篇 |
1983年 | 353篇 |
1982年 | 488篇 |
1981年 | 365篇 |
1980年 | 317篇 |
1979年 | 219篇 |
1978年 | 173篇 |
1977年 | 164篇 |
1976年 | 153篇 |
1975年 | 71篇 |
排序方式: 共有10000条查询结果,搜索用时 46 毫秒
51.
52.
目的 评价逐瘀止血汤加减对慢性子宫内膜炎(CE)气虚血瘀证患者妊娠结局的影响及对免疫炎症因子的调节作用。方法 将144例患者随机按数字表法分为观察组和对照组各72例。观察组脱落、失访4例,剔除2例,完成66例;对照组脱落、失访3例,剔除5例,完成65例。两组均给予抗感染治疗14 d。对照组口服妇科千金片,6片/次,3次/d。观察组内服逐瘀止血汤加减,1剂/d。两组疗程均为3个月,并随访6个月。记录治疗前后月经经量、经期和周期变化情况;进行治疗前后宫腔镜和阴道彩色多普勒超声检查,评价子宫内膜形态、子宫内膜容受性(CP)[子宫内膜厚度、阻力指数(RI),搏动指数(PI)和血流指数(FI)]等,并进行子宫内膜病理检查;进行治疗前后气虚血瘀证评分;检测治疗前后月经血白细胞介素-1β(IL-1β),IL-6和肿瘤坏死因子-α(TNF-α)水平和外周血测T淋巴亚群(CD3+,CD4+,CD8+)水平;随访记录妊娠情况和流产情况。进行安全性评价。结果 治疗后观察组经量、经期、周期和月经完全正常率均高于对照组(P<0.05);观察组子宫内膜厚度和FI均高于对照组(P<0.01),RI和PI均低于对照组(P<0.01);观察组月经血IL-1β,IL-6和TNF-α水平均低于对照组(P<0.01);观察组CD3+,CD4+水平和CD4+/ CD8+均高于对照组(P<0.01),CD8+水平低于对照组(P<0.01);在6个月随访期间,观察组妊娠率46.97%(31/66),高于对照组的27.69%(18/65)(χ2=5.197,P<0.05);观察组子宫内膜形态疗效总有效率为96.97%(64/66),高于对照组的86.15%(56/65)(χ2=4.981,P<0.05);观察组子宫内膜病理组织疗效总有效率为95.45%(63/66),高于对照组的84.62%(55/65)(χ2=4.304,P<0.05);观察组综合临床疗效总有效率为93.94%(62/66),高于对照组的81.54%(55/65)(χ2=4.696,P<0.05);两组治疗期间均未发现与中药相关不良反应。结论 逐瘀止血汤加减治疗CE气虚血瘀证患者,可调经月经、减轻临床症状,改善宫腔镜下内膜形态,调节全身和局部的免疫炎症反应,提高了CP,从而改善了妊娠结局,有着较好的综合疗效,且安全。 相似文献
53.
Susan C. Fox Jane A. May Natalia Dovlatova Jackie R. Glenn Andrew Johnson Ann E. White 《Platelets》2019,30(3):290-295
Measurement of P-selectin on activated platelets as a means of measuring platelet function utilizing the technology described here has the advantage of not requiring immediate access to specialist equipment and expertise. Blood samples are activated, fixed, stored, and transported to a central laboratory for flow cytometric analysis. Here we have compared P-selectin with other more traditional approaches to measuring platelet function in blood and/or platelet-rich plasma (PRP) from patients with acute coronary syndromes on treatment for at least 1 month with either aspirin and clopidogrel or aspirin with prasugrel. The comparators were light transmission aggregometry (LTA), VerifyNow and Multiplate aggregometry (for determining the effects of aspirin) and LTA, VerifyNow and Multiplate together with the BioCytex VASP phosphorylation assay (for the P2Y12 antagonists). The P-selectin Aspirin Test revealed substantial inhibition of platelet function in all but three of 96 patients receiving aspirin with clopidogrel and in none of 51 patients receiving aspirin and prasugrel. The results were very similar to those obtained using LTA. There was only one patient with high residual platelet aggregation and low P-selectin expression. The same patients identified as “non-responders” to aspirin also presented with the highest residual platelet activity as measured using the VerifyNow system, although not quite as well separated from the other values. With the Multiplate test only one of these patients clearly stood out from the others. The results obtained using the P-selectin P2Y12 Test in 102 patients taking aspirin and clopidogrel were similar to the more traditional approaches in that a wide scatter of results was obtained. Generally, high values seen with the P-selectin P2Y12 Test were also high with the LTA, VerifyNow, Multiplate, and BioCytex VASP P2Y12 Tests. Similarly, low residual platelet function using the P2Y12 test was seen irrespective of the testing procedure used. However, there were differences in some patients. Prasugrel was always more effective than clopidogrel in inhibiting platelet function with none of 56 patients (P-selectin and VerifyNow), only 2 of 56 patients (Multiplate) and only 3 of 56 patients (Biocytex VASP) demonstrating high on-treatment residual platelet reactivity (HRPR) defined using previously published cut-off values. The exception was LTA where there were 11 of 56 patients with HRPR. It remains to be seen which experimental approach provides the most useful information regarding outcomes after adjusting therapies in treated patients. 相似文献
54.
Rotary ventricular assist devices (VADs) are less sensitive to preload than the healthy heart, resulting in inadequate flow regulation in response to changes in patient cardiac demand. Starling‐like physiological controllers (SLCs) have been developed to automatically regulate VAD flow based on ventricular preload. An SLC consists of a cardiac response curve (CRC) which imposes a nonlinear relationship between VAD flow and ventricular preload, and a venous return line (VRL) which determines the return path of the controller. This study investigates the importance of a physiological VRL in SLC of dual rotary blood pumps for biventricular support. Two experiments were conducted on a physical mock circulation loop (MCL); the first compared an SLC with an angled physiological VRL (SLC‐P) against an SLC with a vertical VRL (SLC‐V). The second experiment quantified the benefit of a dynamic VRL, represented by a series of specific VRLs, which could adapt to different circulatory states including changes in pulmonary (PVR) and systemic (SVR) vascular resistance versus a fixed physiological VRL which was calculated at rest. In both sets of experiments, the transient controller responses were evaluated through reductions in preload caused by the removal of fluid from the MCL. The SLC‐P produced no overshoot or oscillations following step changes in preload, whereas SLC‐V produced 0.4 L/min (12.5%) overshoot for both left and right VADs. Additionally, the SLC‐V had increased settling time and reduced controller stability as evidenced by transient controller oscillations. The transient results comparing the specific and standard VRLs demonstrated that specific VRL rise times were improved by between 1.2 and 4.7 s ( = 3.05 s), while specific VRL settling times were improved by between 2.8 and 16.1 seconds ( = 8.38 s) over the standard VRL. This suggests only a minor improvement in controller response time from a dynamic VRL compared to the fixed VRL. These results indicate that the use of a fixed physiologically representative VRL is adequate over a wide variety of physiological conditions. 相似文献
55.
目的 观察高通量血液透析(HFHD)与低通量血液透析(LFHD)的不同模式运用到老年患者维持性血液透析(MHD)中对其血压的影响。方法 选择2015年2月—2017年10月本院治疗的MHD老年患者74例,先为其施LFHD 3个月,再为其辅以3个月的HFHD,3次/周,4 h/次,对比不同透析模式对患者血压的影响。结果 实施HFHD后患者的平均动脉压(MAP)有所降低,在第3 h与第4 h透析后,血压把控优于LFHD(P<0.05)。结论 对于MHD老年患者来说,实施HFHD是优良的透析方法。 相似文献
56.
57.
J.A. Hannam S.J. Mitchell D. Cumin C. Frampton A.F. Merry M.R. Moore C.J. Kruger 《British journal of anaesthesia》2019,122(2):198-205
Background
Etomidate is frequently selected over propofol for induction of anaesthesia because of a putatively favourable haemodynamic profile, but data confirming this perception are limited.Methods
Patients undergoing cardiac surgery were randomised to induction of anaesthesia with propofol or etomidate. Phase I (n=75) was conducted as open-label, whereas Phase II (n=75) was double blind. Mean arterial blood pressure (MAP) and boluses of vasopressor administered after induction were recorded. The primary endpoint was the area under the curve below baseline MAP (MAP-time integral) during the 10 min after induction. Secondary endpoints were the use of vasopressors over the same period, and the effect of blinding on the aforementioned endpoints. Groups were compared using regression models with phase and anaesthetist as factors.Results
The mean difference between etomidate and propofol in the MAP-time integral below baseline was 2244 mm Hg s (95% confidence interval, 581–3906; P=0.009), representing a 34% greater reduction with propofol. Overall, vasopressors were used in 10/75 patients in the etomidate group vs 21/75 in the propofol group (P=0.38), and in 20/74 patients during the blinded phase vs 11/76 during the open-label phase (P=0.31). The interaction between randomisation and phase (open-labelled or blinded) was not significant for either primary (P=0.73) or secondary endpoints (P=0.90).Conclusions
Propofol caused a 34% greater reduction in MAP-time integral from baseline after induction of anaesthesia than etomidate, despite more frequent use of vasopressors with propofol, confirming the superior haemodynamic profile of etomidate in this context. The proportion of patients receiving vasopressors increased slightly, albeit not significantly, in both groups in the blinded phase.Clinical trial registration
Australian and New Zealand Clinical Trials Registry, ACTRN12614000717651. 相似文献58.
《Journal of pharmaceutical sciences》2019,108(7):2500-2504
Accurately predicting the hepatic clearance of compounds using in vitro to in vivo extrapolation (IVIVE) is crucial within the pharmaceutical industry. However, several groups have recently highlighted the serious error in the process. Although empirical or regression-based scaling factors may be used to mitigate the common underprediction, they provide unsatisfying solutions because the reasoning behind the underlying error has yet to be determined. One previously noted trend was intrinsic clearance-dependent underprediction, highlighting the limitations of current in vitro systems. When applying these generated in vitro intrinsic clearance values during drug development and making first-in-human dose predictions for new chemical entities though, hepatic clearance is the parameter that must be estimated using a model of hepatic disposition, such as the well-stirred model. Here, we examine error across hepatic clearance ranges and find a similar hepatic clearance-dependent trend, with high clearance compounds not predicted to be so, demonstrating another gap in the field. 相似文献
59.
《中国现代医生》2020,58(34):60-63
目的 通过检测老年轻度认知障碍(MCI)患者血清瘦素(LEP)、甲状腺激素水平,分析其与局部脑血流量(rCBF)的关系。方法 选择本院收治的128 例老年MCI 患者,另选健康者128 例作为对照组。检测血清LEP、甲状腺激素、大脑各区域rCBF 水平并分析其相关性。结果 老年MCI 组患者左右侧额叶、右侧颞叶、左侧顶叶、左右侧基底节区域脑血流量[(43.81±8.62)mL/(100 g·min)、(43.24±7.93)mL/(100 g·min)、(45.14±6.98)mL/(100 g·min)、(45.86±6.77)mL/(100 g·min)、(67.95±8.52)mL/(100 g·min)、(68.36±8.34)mL/(100 g·min)]低于对照组[(46.39±8.31)mL/(100 g·min)、(46.52±8.56)mL/(100 g·min)、(47.37±7.04)mL/(100 g·min)、(48.25±6.98)mL/(100 g·min)、(70.34±8.96)mL/(100 g·min)、(70.58±8.57)mL/(100 g·min)](P<0.05)。老年MCI 组患者血清LEP、T3、FT3 水平[(4.87±1.56)μg/L、(1.21±0.16)nmol/L、(3.04±0.36)pmol/L]低于对照组[(11.45±3.92)μg/L、(1.68±0.21)nmol/L、(4.82±1.21)pmol/L](P<0.05),TSH 水平为(2.78±0.75)IU/mL,高于对照组的(1.13±0.38)IU/mL(P<0.05)。老年MCI 患者血清LEP 水平与左侧额叶、右侧颞叶、左侧顶叶rCBF 呈正相关(r=0.452、0.537、0.544,P 均<0.05),T3 水平与左侧额叶、右侧颞叶rCBF 呈正相关(r=0.427、0.521,P 均<0.05),FT3 水平与右侧颞叶rCBF 呈正相关(r=0.492,P<0.05),TSH 水平与左侧额叶、右侧颞叶rCBF 呈负相关(r=-0.463、-0.489,P 均<0.05)。结论 老年MCI 患者血清中LEP、T3、FT3 水平降低,TSH 水平升高,且与不同区域rCBF 有相关性,可通过调控脑血管功能影响rCBF 变化水平。 相似文献
60.