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91.
Montry S. Suprono John Won Roberto Savignano Zhe Zhong Abu Ahmed Gina Roque-Torres Wu Zhang Udochukwu Oyoyo Paul Richardson Joseph Caruso Robert Handysides Yiming Li 《Journal of the American Dental Association (1939)》2021,152(6):455-462
BackgroundThe route of transmission of severe acute respiratory syndrome coronavirus 2 has challenged dentistry to improve the safety for patients and the dental team during various treatment procedures. The purpose of this study was to evaluate and compare the effectiveness of dental evacuation systems in reducing aerosols during oral prophylactic procedures in a large clinical setting.MethodsThis was a single-center, controlled clinical trial using a split-mouth design. A total of 93 student participants were recruited according to the inclusion and exclusion criteria. Aerosol samples were collected on blood agar plates that were placed around the clinic at 4 treatment periods: baseline, high-volume evacuation (HVE), combination (HVE and intraoral suction device), and posttreatment. Student operators were randomized to perform oral prophylaxis using ultrasonic scalers on 1 side of the mouth, using only HVE suction for the HVE treatment period and then with the addition of an intraoral suction device for the combination treatment period. Agar plates were collected after each period and incubated at 37 °C for 48 hours. Colony-forming unit (CFU) counts were determined using an automatic colony counter.ResultsThe use of a combination of devices resulted in significant reductions in CFUs compared with the use of the intraoral suction device alone (P < .001). The highest amounts of CFUs were found in the operating zone and on patients during both HVE and combination treatment periods.ConclusionsWithin limitations of this study, the authors found significant reductions in the amount of microbial aerosols when both HVE and an intraoral suction device were used.Practical ImplicationsThe combination of HVE and intraoral suction devices significantly decreases microbial aerosols during oral prophylaxis procedures. 相似文献
92.
Objectives
This in vitro study aimed to investigate the protective effect of four commercial novel agents against erosion.Methods
Ninety human molars were distributed into 9 groups, and after incubation in human saliva for 2 h, a pellicle was formed. Subsequently, the specimens were submitted to demineralization (orange juice, pH 3.6, 3 min) and remineralization (paste slurry containing one of the tested novel agents, 3 min) cycles, two times per day, for 4 days. The tested agents were: (1) DenShield Tooth; active ingredient: 7.5% W/W NovaMin® (calcium sodium phosphosilicate); (2) Nanosensitive hca; active ingredient: 7.5% W/W NovaMin®; (3) GC Tooth Mousse; active ingredient: 10% Recaldent™ (CPP-ACP); (4) GC MI Paste Plus; active ingredients: 10% Recaldent™, 900 ppm fluoride. Two experimental procedures were performed: in procedure 1, the tested agents were applied prior to the erosive attack, and in procedure 2 after the erosive attack. A control group receiving no prophylactic treatment was included. Surface nanohardness (SNH) of enamel specimens was measured after pellicle formation and after completion of daily cyclic treatment.Results
SNH significantly decreased at the end of the experiment for all groups (p < 0.05). In both procedures, there was no statistically significant difference between the control group and those treated with paste slurries (p > 0.05). In addition, the changes in SNH (ΔSNH = SNHbaseline − SNHfinal) did not show statistically significant difference between both procedures (p > 0.05).Conclusion
Tooth erosion cannot be prevented or repaired by these novel agents, regardless of fluoride content. 相似文献93.
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Intraoperative mean blood pressure of <60-70 mmHg is associated with a higher prevalence of myocardial injury in non-cardiac surgery, acute kidney injury and mortality. Systolic blood pressure of <100 mmHg is also associated with an increase rate of myocardial injury in non-cardiac surgery and mortality.The injury is related to the severity and duration of intraoperative hypotension episode. Avoiding the mean arterial blood pressure to decrease below >30% of baseline, is recommended. It is reasonable to normalize mean blood pressure to baseline values as soon as possible. Baseline blood pressure defined as the usual blood pressure at home or blood pressure in the preoperative assessment. Although the evidence is not conclusive, it is reasonable to avoid the blood pressure to increase >180 mmHg or mean blood pressure >110 mmHg. Importantly, noting that current evidence shows there is a much higher risk of injury associated with a mean blood pressure lower than >30% of baseline, than associated with an increase of systolic blood pressure >180 mmHg.It is reasonable to use low dose of prophylactic vasopressors, as well as, hypnotics with less effect on systemic vascular resistance (etomidate or ketamine) on high risk patients (severe septic shock, severe hypovolemia, severe left or right ventricle systolic impairment) to avoid anesthesia induction-associated hypotension.It is reasonable to attenuate the hemodynamic response associated to laryngoscopy and intubation, with short half-live drugs, in selected patients (chronic hypertension poorly controlled and hypertension in elderly more than 70 years-old).To determine the cause of the hypertension and the presence of problems associated with hypertension might be crucial to choose the best antihypertensive drug and, therefore, leading to the most appropriate hypertension treatment. 相似文献
100.
《Cirugía espa?ola》2020,98(4):187-203
Surgical site infection is associated with prolonged hospital stay and increased morbidity, mortality and healthcare costs, as well as a poorer patient quality of life. Many hospitals have adopted scientifically-validated guidelines for the prevention of surgical site infection. Most of these protocols have resulted in improved postoperative results. The Surgical Infection Division of the Spanish Association of Surgery conducted a critical review of the scientific evidence and the most recent international guidelines in order to select measures with the highest degree of evidence to be applied in Spanish surgical services. The best measures are: no removal or clipping of hair from the surgical field, skin decontamination with alcohol solutions, adequate systemic antibiotic prophylaxis (administration within 30-60 minutes before the incision in a single preoperative dose; intraoperative re-dosing when indicated), maintenance of normothermia and perioperative maintenance of glucose levels. 相似文献