全文获取类型
收费全文 | 20837篇 |
免费 | 1806篇 |
国内免费 | 361篇 |
专业分类
耳鼻咽喉 | 186篇 |
儿科学 | 555篇 |
妇产科学 | 334篇 |
基础医学 | 1753篇 |
口腔科学 | 433篇 |
临床医学 | 2646篇 |
内科学 | 3192篇 |
皮肤病学 | 198篇 |
神经病学 | 1195篇 |
特种医学 | 514篇 |
外国民族医学 | 1篇 |
外科学 | 1839篇 |
综合类 | 2628篇 |
现状与发展 | 1篇 |
一般理论 | 3篇 |
预防医学 | 4015篇 |
眼科学 | 307篇 |
药学 | 1498篇 |
14篇 | |
中国医学 | 552篇 |
肿瘤学 | 1140篇 |
出版年
2024年 | 10篇 |
2023年 | 533篇 |
2022年 | 784篇 |
2021年 | 1132篇 |
2020年 | 1124篇 |
2019年 | 989篇 |
2018年 | 1019篇 |
2017年 | 901篇 |
2016年 | 901篇 |
2015年 | 867篇 |
2014年 | 1589篇 |
2013年 | 1706篇 |
2012年 | 1197篇 |
2011年 | 1323篇 |
2010年 | 1005篇 |
2009年 | 984篇 |
2008年 | 966篇 |
2007年 | 887篇 |
2006年 | 751篇 |
2005年 | 622篇 |
2004年 | 531篇 |
2003年 | 401篇 |
2002年 | 351篇 |
2001年 | 287篇 |
2000年 | 300篇 |
1999年 | 241篇 |
1998年 | 174篇 |
1997年 | 156篇 |
1996年 | 172篇 |
1995年 | 135篇 |
1994年 | 138篇 |
1993年 | 107篇 |
1992年 | 87篇 |
1991年 | 82篇 |
1990年 | 69篇 |
1989年 | 71篇 |
1988年 | 71篇 |
1987年 | 45篇 |
1986年 | 36篇 |
1985年 | 50篇 |
1984年 | 37篇 |
1983年 | 21篇 |
1982年 | 34篇 |
1981年 | 10篇 |
1980年 | 25篇 |
1979年 | 20篇 |
1978年 | 17篇 |
1977年 | 9篇 |
1976年 | 6篇 |
1974年 | 7篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
41.
Victoria A. Chang Dawn M. Meyer Brett C. Meyer 《Journal of stroke and cerebrovascular diseases》2019,28(1):163-166
Background
Acute stroke codes may be activated for anisocoria, but how often these codes lead to a final stroke diagnosis or alteplase treatment is unknown. The purpose of this study was to assess the frequency of anisocoria in stroke codes that ultimately resulted in alteplase administration.Methods
We retrospectively assessed consecutive alteplase-treated patients from a prospectively-collected stroke registry between February 2015 and July 2018. Based on the stroke code exam, patients were categorized as having isolated anisocoria [A+(only)], anisocoria with other findings [A+(other)], or no anisocoria [A?]. Baseline demographics, stroke severity, alteplase time metrics, and outcomes were also collected.Results
Ninety-six patients received alteplase during the study period. Of the 94 who met inclusion criteria, there were 0 cases of A+(only). There were 9 cases of A+(other) (9.6%). A+(other) exhibited higher baseline National Institutes of Health (NIH) Stroke Scale scores compared to A? (17 versus 7; P?=?.0003), and no additional differences in demographics or alteplase time metrics. Final stroke diagnosis and other outcome measures were no different between A+(other) and A?. Of the A+ patients without pre-existing anisocoria, 5 of 6 (83%) had posterior circulation events or diffuse subarachnoid hemorrhage.Conclusions
In this exploratory analysis, zero patients with isolated anisocoria received alteplase treatment. Anisocoria as a part of the neurologic presentation occurred in 10% of alteplase patients, and was strongly associated with a posterior circulation event. Therefore, we conclude that anisocoria has a higher likelihood of leading to alteplase treatment when identified in the presence of other neurologic deficits. 相似文献42.
43.
44.
Julia Thornton Snider Jesse Sussell Mahlet Gizaw Tebeka Alicia Gonzalez Joshua T. Cohen Peter Neumann 《Value in health》2019,22(3):332-339
Background
Payers frequently rely on budget impact model (BIM) results to help determine drug coverage policy and its effect on their bottom line. It is unclear whether BIMs typically overestimate or underestimate real-world budget impact.Objective
We examined how different modeling assumptions influenced the results of 6 BIMs from the Institute for Clinical and Economic Review (ICER).Study Design
Retrospective analysis of pharmaceutical sales data.Methods
From ICER reports issued before 2016, we collected estimates of 3 BIM outputs: aggregate therapy cost (ie, cost to treat the patient population with a particular therapy), therapy uptake, and price. We compared these against real-world estimates that we generated using drug sales data. We considered 2 classes of BIM estimates: those forecasting future uptake of new agents, which assumed “unmanaged uptake,” and those describing the contemporaneous market state (ie, estimates of current, managed uptake and budget impact for compounds already on the market).Results
Differences between ICER's estimates and our own were largest for forecasted studies. Here, ICER's uptake estimates exceeded real-world estimates by factors ranging from 7.4 (sacubitril/valsartan) to 54 (hepatitis C treatments). The “unmanaged uptake” assumption (removed from ICER's approach in 2017) yields large deviations between BIM estimates and real-world consumption. Nevertheless, in some cases, ICER's BIMs that relied on current market estimates also deviated substantially from real-world sales data.Conclusions
This study highlights challenges with forecasting budget impact. In particular, assumptions about uptake and data source selection can greatly influence the accuracy of results. 相似文献45.
46.
Nicolás Menéndez Granados Manuel Vaquero Abellán Manuel Toledano Estepa Manuel Modesto Pérez Díaz Rosa Redondo Pedraza 《Gaceta sanitaria / S.E.S.P.A.S》2019,33(1):38-44
Objective
To describe the distribution of frequent attenders (FA) through the different primary care practices in Cordoba-Guadalquivir Health District (Córdoba, Spain).Methods
An ecological study was performed, including data from 2011 to 2015. Defining FA as those subjects who made12 or more appointments per year; independently analysed for nursing, general practice and paediatrics. Prevalence of frequent attendance and FA/professional ratio were used as dependent variables. Demographic characteristics from district population, number of health professionals and use of general facilities were also examinated. Aiming to understand FA distribution, primary health settings were classified according to facility size and environmental location (urban, suburban and rural).Results
The mean prevalence for FA was 10.86% (0.5 SE) for nursing; general practice 21.70% (0.7 SE) and for paediatrics 16.96% (0.7 SE). FA/professional ratios for the different professional categories were: 101.07 (5.0 SE) for nursing, 239.74 (9.0 SE) for general practice and 159.54 (9.8 SE) for paediatrics.Conclusions
A major part of primary health care users make a high number of consultations. From this group, women overuse nursing and general practitioner services more compared to men. A higher prevalence of FAs was observed in smaller settings, in rural areas. Although taking the FAs:professional ratio as the bar, medium-size practices are more highly overused. 相似文献47.
《Clinical colorectal cancer》2020,19(4):236-247.e6
BackgroundThe multicenter, single-arm, phase II study CEBIFOX evaluated the efficacy of a biweekly cetuximab administration in combination with FOLFOX6 as first-line therapy in KRAS (exon 2) wild-type (wt) metastatic colorectal cancer (mCRC).Patients and methodsPatients received FOLFOX6 with cetuximab (500 mg/m2) every second week. Primary endpoint was objective response rate (ORR), among others secondary endpoints were safety, progression-free survival (PFS), overall survival (OS), and patient-reported outcome (PRO). The impact on the treatment efficacy was evaluated in explorative subgroup analyses, including extended molecular profiling and primary tumor location.ResultsIn total, 57 were included in the intention-to-treat (ITT) analyses. New RAS mutations were detected in 14.0% by post hoc next-generation sequencing analysis in 43 patients. The ORR in the all RASwt population was 70.3% with a median PFS and OS of 10.9 (95% confidence interval [CI], 9.0-12.9) and 33.8 (95% CI, 21.1-45.5) months. Grade 3-5 adverse events occurred in 66.7% of the ITT, without significant impact on the PRO. Patients with right-sided primary tumors had a reduced ORR (54.5%), and median PFS and OS (10.1 and 23.8 months). BRAF mutations were detected in 11.3%. These patients had a significantly lower ORR, and median PFS and OS. Patients with RASwt/BRAFwt tumors had a notably high median PFS and OS of 14.3 and 38.9 months.ConclusionsThis study supports the efficacy and safety of biweekly cetuximab given in combination with FOLFOX6 in patients with RASwt/BRAFwt mCRC with left-sided primary tumor. CEBIFOX is the first trial reporting the complete dataset, including extended molecular profiling and tumor location of a biweekly administered cetuximab/FOLFOX6 in mCRC. Clinical trial number: NCT01051167. 相似文献
48.
49.
《中国现代医生》2020,58(14):5-8
目的研究经导管动脉化疗栓塞(TACE)对原发性肝癌患者的疗效及中性粒细胞/淋巴细胞计数比(NLR)、血小板/淋巴细胞计数比(PLR)的影响。方法选择2015年6月~2019年1月我院接诊的原发性肝癌患者80例作为研究对象,采用随机数表法将患者分为两组,每组各40例。对照组予传统肝切除术治疗,观察组采用TACE治疗。对比两组治疗后的临床效果,NLR、PLR、癌胚抗原(CEA)、可溶性B7-H4、可溶性白细胞介素-2受体(sIL-2R)及并发症发生情况。结果治疗后,两组患者的总有效率分别为75.00%和52.50%,观察组高于对照组,差异有统计学意义(P0.05);治疗前,两组患者NLR、PLR水平对比,差异无统计学意义(P0.05);治疗后,患者NLR、PLR水平下降,观察组低于对照组,差异有统计学意义(P0.05);治疗前,两组患者CEA、B7-H4、sIL-2R水平对比,差异无统计学意义(P0.05);治疗后,两组患者CEA、B7-H4、sIL-2R水平下降,观察组低于对照组,差异有统计学意义(P0.05);两组患者并发症发生率分别为17.50%、40.00%,观察组低于对照组,差异有统计学意义(P0.05)。结论在原发性肝癌患者中使用TACE效果显著,可有效改善患者肿瘤标志物水平,减少并发症,值得推广应用。 相似文献
50.
背景 抑郁症的康复技能训练是一种很好的辅助治疗方法,本课题通过引进成熟的抑郁症康复技术,使基层医务人员熟练掌握,为辖区内广大抑郁症患者开展康复训练,以期提高抑郁症患者的疗效,降低自杀风险。目的 探讨抑郁症康复技能训练程式在基层医院推广应用的价值。方法 选取门头沟区龙泉医院2018年1-9月门诊就诊的65例抑郁症患者为研究对象。入选患者全部接受康复训练,分别于训练前和训练结束3个月后采用汉密尔顿抑郁量表(HAMD)、社会功能缺陷筛选量表(SDSS)、服药依从性、自杀风险评估量表(nurses' global assessment of suicide risk,NGASR)和自杀风险问卷对患者进行评估。结果 共61例患者完成研究,与训练前比较,训练结束3个月后患者HAMD、SDSS评分明显降低,服药依从性除自行停药外均明显提高,自杀风险明显降低,差异有统计学意义(P<0.05)。结论 抑郁症康复训练程式能有效提高患者服药依从性,改善抑郁症状,减少自杀观念,在基层医院有推广价值。 相似文献