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71.
目的 探讨HIV感染者开始抗病毒治疗(ART)时基线CD4+T淋巴细胞计数(CD4)不同水平对治疗脱失的影响。方法 采用回顾性队列研究方法,从艾滋病防治基本信息系统ART库选取2008-2015年广西壮族自治区(广西)首次开始ART、年龄≥18岁的HIV感染者,分析其ART脱失情况,随访时间截至2016年5月30日。采用Cox比例风险模型分析ART时基线CD4不同水平对ART脱失的影响。结果 共计58 502例HIV感染者进入队列,平均脱失比例为4.8/100人年。在控制了年龄、性别、婚姻状况、感染途径、ART前WHO临床分期、初始治疗方案、目前治疗方案、治疗方案改变、ART开始年份等因素后,基线CD4为200~、351~、≥500个/μl组HIV感染者的脱失风险分别是<200个/μl组的1.110(95% CI:1.053~1.171,P<0.001)、1.391(95% CI:1.278~1.514,P<0.001)、1.695(95% CI:1.497~1.918,P<0.001)倍。HIV感染者因为依从性差而停药的比例为56.0%(1 601/2 861)。结论 随着HIV感染者接受ART时CD4水平提高,ART脱失风险明显增加。为减少ART脱失,应充分考虑开始ART时CD4水平,加强依从性宣传教育和治疗机构人员培训。 相似文献
72.
目的 优化万古霉素N4氨基还原烷基化的反应条件。方法 以万古霉素为原料,筛选还原烷基化反应的溶剂、还原剂、醛用量和反应温度,用HPLC方法测定原料和产物含量。结果 确立了以甲醇/二甲基亚砜=1:1为溶剂、硼烷叔丁胺为还原剂、1.3倍醛用量、缩合温度65℃、还原温度为室温的最优反应条件。结论 利用本文优化后的条件可以有效合成万古霉素N4氨基还原烷基化产物,研究结果为其他糖肽类抗生素的半合成衍生化提供技术基础。 相似文献
73.
目前,有关与人体神经系统直接或者间接接触的植入类医疗器械越来越多。这些植入类医疗器械可能会引起神经系统结构和/或功能的不利反应,导致广泛的副作用,这些副作用则被称为医疗器械产品的神经毒性。由于神经系统有限的修复能力,因此增加了临床前评价神经毒性的重要性。目前,还没有特定的标准或指南来规范医疗器械产品的神经毒性评价要求。本文结合国内外最新的相关标准和参考文献,给出植入类医疗器械神经毒性评价的要点,为相关产品的临床前安全性评价、质量控制及注册前技术审评提供技术参考。 相似文献
74.
75.
Maribel D. Lacambra Ilan Weinreb Elizabeth G. Demicco Chit Chow Yun‐Shao Sung David Swanson Ka‐Fai To Kwok‐Chuen Wong Cristina R. Antonescu Brendan C. Dickson 《Genes, chromosomes & cancer》2019,58(10):705-712
Fibroblastic/myofibroblastic neoplasms represent a broad, and occasionally diagnostically challenging, category of soft tissue neoplasms. A subset of these tumors defy conventional classification. However, with the advent of next‐generation sequencing, the identification of disease‐defining molecular alterations is gradually improving their subclassification. Following identification of two index cases of a distinctive fibroblastic neoplasm with a fusion gene involving PRRX1 and NCOA1, we performed a retrospective review to further characterize this entity. We identified two additional cases, including one with a fusion between PRRX1 and NCOA2. The average patient age was 38 years, and three patients were female. Two tumors occurred on the neck, and the others involved the groin and thigh. Tumors were centered in the subcutis and ranged from 2.3 to 14.0 cm (average 5.8 cm). Morphologically, they were predominantly hypocellular, with focal hypercellularity. They were composed of monomorphic spindle‐stellate cells with a vague fascicular pattern. The nuclei were bland with only rare mitotic activity, and occasional multinucleation. The intervening stroma was typically abundant and ranged from myxoid to collagenous, with frequent rope‐like collagen bundles. Three of the cases had a prominent vasculature ranging from numerous small curvilinear vessels to ectatic and branching staghorn‐like vessels. Immunohistochemistry was negative for desmin, smooth muscle actin, S100, CD34, keratin, and epithelial membrane antigen. Each of the patients was treated by simple excision and none of the tumors were associated with local recurrence or metastasis. Based on their unique morphological and molecular attributes, we believe this represents a novel fibroblastic tumor for which we have tentatively proposed the name “PRRX‐NCOAx‐rearranged fibroblastic tumor.” 相似文献
76.
Sarah M. Choi Steven B. Van Norman Dale L. Bixby Lina Shao 《Genes, chromosomes & cancer》2019,58(11):756-774
Conventional karyotyping is essential standard practice in the initial evaluation of myelodysplastic syndrome (MDS) and is the most impactful single component of the Revised International Prognostic Scoring System (IPSS‐R). While single nucleotide polymorphism array (SNP‐A) has demonstrated the ability to detect chromosomal defects with greater sensitivity than conventional karyotype, widespread adoption is limited by the unknown additional prognostic impact of SNP‐A analysis. Here, we investigate the significance of additional SNP‐A abnormalities in the setting of MDS and demonstrate differences in survival of patients with additional abnormalities, even those initially characterized as relatively lower risk either by cytogenetic score or IPSS‐R. Our findings identify specific abnormalities, particularly KMT2A partial tandem duplication, that are invisible to conventional karyotype and potentially contribute to the poor prognosis of MDS patients. Furthermore, these results demonstrate the added value of SNP‐A analysis in identifying patients who may benefit from more aggressive therapy, particularly those who would otherwise be classified into lower risk categories. 相似文献
77.
[摘要]目的:研究早期判别难治性肺炎支原体肺炎(RMPP)的特征性临床表现及干预措施。方法:收集2013年10月至2014年9月在苏州大学附属儿童医院住院治疗并确诊为RMPP的63例患儿(RMPP组)以及采用抽签法抽取同期住院治疗的32例普通MPP患儿(MPP组)的临床特征及实验室检查资料,进行比较研究。结果:RMPP组患儿平均年龄高于MPP组(P<0.01),热程(16.17±4.60)d长于MPP组的(6.97±1.77)d(P<0.01);RMPP组患儿大叶性肺炎、呼吸音减低及肺部叩诊浊音、胸腔积液、肝脏损伤的发生率均高于MPP组(P均<0.05);RMPP组MP鄄DNA拷贝数高于MPP组(P<0.01);RMPP组外周血中WBC、中性粒细胞计数及 LDH、IgG、IgA、IgM水平均高于MPP组(P均<0.05);RMPP组CRP>40 mg/L及ALT升高发生率均高于MPP组(P均<0.05);RMPP组使用支气管镜冲洗治疗的比例高于MPP组,使用大环内酯类抗生素1个疗程后退热时间及住院时间明显长于MPP组(P均<0.01)。结论:RMPP易发生于大年龄儿童,更易出现大叶性肺部炎症,MP鄄DNA 拷贝数高,热程长,CRP>40 mg/L的比例高,胸腔积液、肝脏受损发生率高,需要支气管镜冲洗治疗的比例高,住院时间长。 相似文献
78.
Rongrong Sheng Changchang Li Qiong Wang Lianping Yang Junzhe Bao Kaiwen Wang Rui Ma Chuansi Gao Shao Lin Ying Zhang Peng Bi Chuandong Fu Cunrui Huang 《International journal of hygiene and environmental health》2018,221(3):423-428
Background
Despite increasing concerns about the health effects of climate change, the extent to which workers are affected by hot weather is not well documented. This study aims to investigate the association between high temperatures and work-related injuries using data from a large subtropical city in China.Methods
We used workers’ compensation claims to identify work-related injuries in Guangzhou, China during 2011–2012. To feature the heat effect, the study period was restricted to the warm seasons in Guangzhou (1 May-31 October). We conducted a time-stratified case-crossover study to examine the association between ambient outdoor temperatures, including daily maximum and minimum temperatures, and cases of work-related injury. The relationships were assessed using conditional Poisson regression models.Results
Overall, a total of 5418 workers’ compensation claims were included over the study period. Both maximum and minimum temperatures were significantly associated with work-related injuries, but associations varied by subgroup. One?°C increase in maximum temperature was associated with a 1.4% (RR?=?1.014, 95%CIs 1.012–1.017) increase in daily injury claims. Significant associations were seen for male and middle-aged workers, workers in small and medium-sized enterprises, and those working in manufacturing sector. And 1?°C increase in minimum temperature was associated with 1.7% (RR?=?1.017, 95%CIs 1.012–1.021) increase in daily injury claims. Significant associations were observed for female and middle-aged workers, workers in large-sized enterprises, and those working in transport and construction sectors.Conclusions
We found a higher risk of work-related injuries due to hot weather in Guangzhou, China. This study provides important epidemiological evidence for policy-makers and industry that may assist in the formulation of occupational safety and climate adaptation strategies. 相似文献79.
目的探讨集束化管理预防肝移植患者术后肺部感染的效果,以降低肺部感染发病率。方法选择2016年1月—2017年12月某院肝胆外科行肝移植的患者为研究对象。2016年1月—2017年3月的患者为对照组,实施常规护理措施,2017年4—12月的患者为试验组,实施集束化肺部管理。比较两组患者肺部感染发病率、肺不张发生率、第一次下床活动时间、住院费用和患者满意度。结果对照组共110例肝移植患者,试验组67例肝移植患者。两组患者均顺利完成手术。试验组肺部感染发病率为6.0%,低于对照组的16.4%,差异有统计学意义(P<0.05)。试验组肺不张发生率为7.5%,低于对照组的18.2%,差异有统计学意义(P<0.05)。试验组第一次下床活动时间为(83.81±7.56)h ,短于对照组的(91.67±13.93)h,差异有统计学意义(P<0.01)。试验组住院时间为(30.22±3.23)d ,短于对照组的(31.49±4.34)d,差异有统计学意义(P<0.05)。试验组患者对护理的总体满意度为92.5%,优于对照组的78.2%,差异有统计学意义(P<0.05)。结论采用集束化管理能有效降低肝移植患者术后肺部感染发病率、肺不张发生率,缩短卧床时间及住院时间,提高患者满意度。 相似文献
80.
SY-1和MDX4-4210硅橡胶热老化性能试验 总被引:7,自引:0,他引:7
目的 对比SY-1和MDX4-4210硅橡胶的热老化性能。方法 在相同条件下对两种硅橡胶材料进行了热老化试验,对其老化性能加以评价。结果 热老化后,SY-1硅橡胶的扯断强度性能变化百分比与MDX4-4210硅橡胶无显著差异(P>0.05);SY-1硅橡胶的邵氏硬度、扯断伸长率、永久变形率(3min后)、撕裂强度的性能变化百分比优于MDX4-4210硅橡胶(P<0.01)。结论 SY-1硅橡胶热老化性能略优于MDX4-4210硅橡胶,热老化性能可以满足作为面部软组织缺损赝复材料的要求。 相似文献