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101.
Heleen Lameijer Ytje T. Sikkema Albert Pol Maike G.E. Bosch Femke Beije Rieneke Feenstra Bas W.J. Bens Ewoud ter Avest 《The American journal of emergency medicine》2017,35(5):692-696
Background
Procedural sedation for painful procedures in the emergency department (ED) can be accomplished with various pharmacological agents. The choice of the sedative used is highly dependent on procedure- and patient characteristics and on personal- or local preferences.Methods
We conducted a multicenter retrospective cohort study of procedural sedations performed in the EDs of 5 hospitals in the Netherlands over a 4 year period to evaluate the efficacy- (success rate of the intended procedure) and safety (incidence of sedation (adverse) events) of propofol sedations compared to midazolam sedations.Results
A total of 592 ED sedations were included in our study. Patients sedated with propofol (n = 284, median dose 75 mg) achieved a deeper level of sedation (45% vs. 25% deep sedation, p < 0.001), had a higher procedure success rate (92% vs. 81%, p < 0.001) and shorter median sedation duration (10 vs. 17 min, p < 0.001) compared to patients receiving midazolam (n = 308, median dose 4 mg). A total of 112 sedation events were registered for 99 patients. Transient apnea was the most prevalent event (n = 73), followed by oxygen desaturation (n = 18) airway obstruction responsive to simple maneuvers (n = 13) and hypotension (n = 6). Propofol sedations were more often associated with the occurrence of apnea's (20% vs. 10%, p = 0.004), whereas clinically relevant oxygen desaturations (< 90%) were found more often in patients sedated with midazolam (8% vs. 1%, p = 0.001). No sedation adverse events were registeredConclusion
Propofol is more effective and at least as safe as midazolam for procedural sedation in the ED. 相似文献102.
S. Benjamens S.P. Berger A.W.J.M. Glaudemans J.S.F. Sanders R.A. Pol R.H.J.A. Slart 《Transplantation reviews (Orlando, Fla.)》2018,32(2):102-109
Background
Clinicians use several diagnostic modalities to recognize post-transplant complications, such as acute tubular necrosis, acute rejection, urologic and vascular complications. Currently, there is no consensus about the best procedural approach to evaluate post-transplant renal dysfunction. Renal needle-biopsy is often required, however, this is invasive and may lead to sample errors and complications, and most clinicians prefer using one of the noninvasive diagnostic modalities.Methods
A systematic literature search was performed using PubMed, EMBASE, the Cochrane Library, MEDLINE (OvidSP), Web of Science, and Google Scholar to identify relevant articles. This review provides a literature overview of the technical aspects, new developments and clinical value of renal scintigraphy (RS), after kidney transplantation. Additionally, the advantages and limitations of RS in comparison to other diagnostic modalities are addressed. The study protocol is registered with PROSPERO, protocol number CRD42017078391.Results
A total of 32 studies were included. Studies were categorized in the following groups: tracer pharmacokinetics; acute rejection and acute tubular necrosis; vascular complications; urological complications; postoperative fluid collections; early transplant outcomes; one-year transplant outcomes.Conclusions
Several studies have described the use of RS for the diagnosis of acute rejection, however, differentiating between rejection and acute tubular necrosis remains difficult. For the diagnosis of vascular complications, RS has been described as an alternative for invasive procedures. For urologic complications, studies support the use of RS in combination with routine ultrasonography (US) surveillance. For the diagnosis of postoperative fluid collections, RS provides information to differentiate lymphoceles and urinomas. Altogether, RS should be considered in case of non-acute complications, and if US provides insufficient results. 相似文献103.
104.
Jan J. van Wingerden 《Journal of plastic, reconstructive & aesthetic surgery》2018,71(2):279-280
105.
J. van Wersch R.Rodrigues Pereira 《Clinica chimica acta; international journal of clinical chemistry》1983,130(3):363-368
Bartter's syndrome has so far been considered to be an autosomal recessive inherited disease, because of the occurrence of the syndrome in siblings. Both sexes are equally involved. Until now no family has been described in which parents as well as children suffered from the disease.
It has recently been found that ‘obligatory carriers’, i.e. parents of affected children, showed the same pattern of platelet aggregation inhibition as their affected children. We investigated eight patients as well as their parents and siblings, and found that all persons included in the study showed impaired thrombocyte aggregation, especially after low salt intake.
We conclude that the restriction of dietary sodium facilitates the measurement of the platelet abnormality. 相似文献
106.
H J Schuurman C L de Ligny 《Clinica chimica acta; international journal of clinical chemistry》1978,89(2):191-207
The minimal detection limit and the conditions of maximal sensitivity of a one-step solid-phase inhibition radioimmunoassay for human immunoglobulin A have been determined by application of statistical methods of experimental optimization. The choice of the optimal combination of qualitative variables, such as the origin of the antibody and the nature of the solid phase, was made by the study of a covariable under non-optimal conditions of the quantitative variables, such as the amount of antibody. The covariable was the avidity of the antibody, which is expected to have a large influence on the sensitivity. Only the difference in avidity between two immunosorbents with cellulose or Sepharose as solid-phase material proved to be statistically significant, and further study was done with cellulose. The experimental optimization of the sensitivity as a function of five quantitative variables yielded a reduction of the detection limit by a factor 5.6 (from 23.5 to 4.2 ng IgA). The variables determining the amount of insolubilized antibody in the assay had the largest influence on the value of the detection limit. The conditions of optimal sensitivity did agree with the predictions by a physical model of radioimmunoassay. The results are discussed in relation to the assay parameters such as the amount and the avidity of the insolubilized antibody and the initial percentage of binding, and in relation with theoretical optimization of the sensitivity. 相似文献
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