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1.
《Vaccine》2022,40(44):6431-6444
This is a Brighton Collaboration case definition of thrombosis and thromboembolism to be used in the evaluation of adverse events following immunization, and for epidemiologic studies for the assessment of background incidence or hypothesis testing. The case definition was developed by a group of experts convened by the Coalition for Epidemic Preparedness Innovations (CEPI) in the context of active development of SARS-CoV-2 vaccines. The case definition format of the Brighton Collaboration was followed to develop a consensus definition and defined levels of certainty, after an exhaustive review of the literature and expert consultation. The document underwent peer review by the Brighton Collaboration Network and by selected expert reviewers prior to submission. 相似文献
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《Indian heart journal》2022,74(2):131-134
Thrombo-embolic complications after Corona virus disease-19 (COVID-19) vaccination have been previously reported. We aimed to study the coronary thrombo-embolic complications (CTE) after COVID-19 vaccination in a single centre during the initial 3 months of vaccination drive in India. All patients admitted to our hospital between 1st March 2021 and 31st May 2021 with Acute coronary syndrome (ACS) were included.Of the 89 patients [Age 55 (47–64)y, 13f] with ACS and angiographic evidence of coronary thrombus, 37 (42%) had prior vaccination history. The timing from last vaccination dose to index event was <1, 1–2, 2–4 and >4 weeks in 9(24%), 4(11%), 15(41%) and 9 (24%) respectively. ChAdOx1 nCoV-19/AZD1222 (Covishield) was the most used vaccine- 28 (76%), while 9 (24%) had BBV152 (Covaxin). Baseline characteristics were similar in both vaccinated (VG) and non-vaccinated group (NVG), except for symptom to door time [8.5 (5.75–14) vs 14.5 (7.25–24) hrs, p = 0.003]. Thrombocytopenia was not noted in any of the VG patients, while 2 (3.8%) of NVG patient had thrombocytopenia (p = 0.51). The pre- Percutaneous Coronary Intervention (PCI) Thrombolysis in Myocardial Infarction (TIMI) flow was significantly lower [1 (0–3) vs2 (1–3), p = 0.03) and thrombus grade were significantly higher [4 (2.5–5) vs 2 (1–3), p = 0.0005] in VG. The in-hospital (2.7% vs 1.9%, p = 1.0) and 30-day mortality were also similar (5.4% vs 5.8%, p = 1.0).This is the first report of CTE after COVID-19 vaccination during the first 3 months of vaccination drive in India. We need further reports to identify the incidence of this rare but serious adverse events following COVID-19 vaccination. 相似文献
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目的 建立稳定的小鼠大脑中动脉远端氯化铁血栓模型,评价其造成的脑损伤及神经功能损伤程
度。
方法 C57BL6/J雄性小鼠随机分为脑缺血组和假手术组。脑缺血组用10%氯化铁(ferric chloride,
FeCl3)溶液诱导右侧大脑中动脉远端形成血栓。在术前、术后10 mi n、术后1 d和7 d观测术侧脑血流
和手术动脉血流量的变化。术后1 d观察脑组织梗死率。术后1 d、3 d、5 d、7 d用3种神经学评分[改良
加西亚评分(modified Garcia score,mGS)、改良神经损伤严重程度评分(modified neurological severity
scores,mNSS)和15分神经学评估表(15-point neurological evaluation scale,NES)]和胶黏纸测试评价小
鼠神经功能。术后7 d免疫荧光染色标记神经细胞核观察脑组织损伤,标记CD16/32、CD206和Iba1观
察胶质细胞表达。
结果 与假手术组相比,脑缺血组术后10 mi n、1 d、7 d脑表面血流和手术动脉血流下降,术后1 d脑
皮层梗死明显,术后7 d仍有明显脑组织损伤;脑缺血组术后1 d、3 d、5 d和7 d时3种神经学评分及胶
黏纸测试均提示小鼠神经功能不同程度损伤。术后7 d脑缺血组梗死周围皮层M1和M2型胶质细胞表
达增加。
结论 FeCl3溶液可诱导形成稳定的小鼠脑缺血模型,该模型可造成手术侧大脑中动脉远端及脑表
面血流量降低,皮层脑梗死,小鼠神经功能受损,梗死周围胶质细胞表达上调。本研究建立了稳定
氯化铁诱导血栓形成的小鼠脑缺血模型,为脑血栓形成和抗栓药物治疗提供了一种可靠的研究工
具。 相似文献
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目的:比较机械吸栓(PMT)与置管溶栓(CDT)治疗急性下肢动脉血栓的安全性与临床疗效。方法:回顾性分析2015年7月—2018年3月因急性下肢动脉血栓形成接受腔内介入治疗的67例患者的临床资料。其中37例行PMT治疗(PMT组),30例行CDT治疗(CDT组),比较两组的围手术期相关指标。结果:两组患者术前指标、术后需进一步行球囊扩张+支架植入的患者例数、一期血管开通率以及12个月一期血管通畅率均无统计学差异(均P0.05)。PMT组平均住院时间明显低于CDT组[(5.8±0.8)d vs.(8.9±0.6)d,P0.05],但平均住院费用高于CDT组[(7.0±1.1)万元vs.(4.8±0.8)万元,P0.05]。两组患者术后严重出血、术后截肢、穿刺处血肿、穿刺处感染、肾功能不全发生率均无统计学差异(均P0.05),但PMT组术后总并发症发生率明显低于CDT组(5.4%vs. 26.7%,P0.05)。结论:PMT与CDT在治疗急性下肢动脉血栓方面同样是安全、有效的。PMT相对于CDT术后总并发症发生率和住院时间减少,但住院费用增加。 相似文献
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《Radiologia》2022,64(5):464-472
Urgent and unexpected findings are very common in oncology and hematology patients. This article reviews the most important points included in the European Society of Radiology's guidelines and proposes a practical approach to reporting and communicating these findings more efficiently. This approach is explained with illustrative examples. Radiologists can provide added value in the management of these findings by helping referring clinicians reach the best decisions. To this end, it is essential to know the imaging manifestations of the most common findings that must be reported urgently, such as the specific toxicity of different treatments, the complications of tumors and catheters, infections, and thrombosis. Moreover, it is crucial to consider the individual patient's treatment, risk factors, clinical situation, and immune status. 相似文献
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《Burns : journal of the International Society for Burn Injuries》2022,48(8):1980-1989
AimsPeripherally inserted central catheters (PICCs) are becoming common and effective in acute and critical care settings recently. Burn patients need special considerations because of restricted insertion sites, burn wounds, hyper coagulation, high infection rates and others. However, the safety of PICCs in burn patients are not well elucidated and no related protocol has been formed. This study aims to investigate the thrombosis and infections of PICCs in burn patients.MethodsThis was a single center retrospective study and a systematic review. All the burn patients with PICCs between January 1, 2018 and December 31, 2020 were included. A systematic search of Medline, PubMed, EMBASE and Web of Science was performed from inception to 4 June 2021 following PRISMA guidelines. Upper extremity vein thrombosis (UEVT) and central line-associated bloodstream infection (CLABSI) were the main outcome.ResultsA total of 85 successful PICCs in 78 patients were included. Most patients were male (79.5%), adults(80.8%) and injured by flame(74.4%). The mean TBSA was 50.3% and 76.9% of patients had TBSA more than 30%. Most PICCs were punctured once (60.0%) and inserted less than 30 days after injury (80.0%) through basilar vein (70.6%). The overall line days were 2195 days and the mean line days was 25.8 ± 18.3 days. Six PICCs were complicated by UEVT (7.1%) in 21.2 ± 17.3 days after insertion. Patients with UEVT had significantly higher rate of bacteremia and later insertions than those without UEVT. One patient developed CLABSI and the CLABSI rate was 1.2% and 0.5 per 1000 line days. Six PICCs had catheter colonization. No significant risk factors were identified. Five articles involving 293 patients and 319 PICCs were ultimately evaluated in systematic review. The overall incidence of UEVT was 3.2% and CLABSI was 6.9% in burn populations.ConclusionPICCs in burn patients had acceptable incidence of UEVT and CLABSI with relative long line durations. A standardized PICC guideline for burn patients is required to further improve the feasibility and safety of PICCs. 相似文献