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1.
When the COVID-19 pandemic hit, blood transfusion services worldwide started collection of convalescent plasma as early as possible, as exemplified by the response in Norway. There were challenges related to donor selection, donor safety, testing for relevant antibodies and indications for and dosing of the convalescent plasma. As more knowledge became available, the product quality was more standardised. Multiple case reports, observational studies and some randomized studies were published during the pandemic, as well as laboratory studies reporting different approaches to antibody testing. The results were conflicting and the importance of convalescent plasma was disputed.Even though there has been strong international collaboration with involvement of many key organisations, we may better prepare for the next pandemic. An even stronger, more formalised collaboration between these organisations could provide more clear evidence of the importance of convalescent plasma, based on the principles of passive immunisation.  相似文献   
2.
目的观察在超声辅助引导下利用体外冲击波联合富血小板血浆来治疗骨不连的疗效。 方法将48例符合骨不连(BU)入组标准的患者,采用随机数字法分为3组。即在肌肉骨骼超声的引导下,分别采用体外冲击波(SW),富血小板血浆(PRP)和冲击波联合富血小板血浆(SW-PRP)的方法治疗。对比分析患者治疗前后X射线图像,并分析3组在治愈率及患者治疗周期等方面的差异。组间比较采用单因素方差分析,组间两两比较采用LSD-t检验,组间比较采用卡方检验。 结果3组BU患者在治疗12个月时:SW组治愈所需时间为(24.8±1.7)周,治愈率81.25%;PRP治疗组治愈所需时间为(25.8±1.4)周,治愈率为75.0%;SW-PRP组治愈所需时间为(21.8±1.5)周,治愈率为93.8%。SW-PRP组的治愈时间短于PRP组(P=0.01)和SW组(P=0.03)。 结论体外SW联合PRP治疗BU,相比于单一治疗方法可缩短其治疗周期,但在治愈率上没有差异。  相似文献   
3.
目的 探讨耳穴贴压对腹部术后胃肠功能紊乱家兔模型的作用机制,为耳穴贴压治疗腹部术后胃肠功能紊乱提供参考。 方法 将30只SD清洁型家兔采用随机数字表法分为空白组、模型组、耳穴组各10只。耳穴组于造模成功后耳穴贴压胃、大肠、耳中穴,每日按压3次,每次每穴30 s,连续干预7 d;模型组进行造模手术未进行耳穴贴压;空白组不给予任何处理。 结果 耳穴组术后首次排便时间及肠鸣音恢复时间显著早于模型组(均P<0.05)。三组术后6 h、3 d及7 d血清皮质醇浓度的干预效应、时间效应、交互效应显著,模型组及耳穴组术后6 h及3 d血清皮质醇浓度显著高于空白组,且术后3 d耳穴组显著低于模型组(均P<0.05)。干预后,三组小肠推进率、C-kit蛋白阳性表达、iNOS活性有显著差异,其中耳穴组、空白组小肠推进率、C-kit蛋白阳性表达显著高于模型组,但iNOS活性显著低于模型组,耳穴组的C-kit蛋白阳性表达显著低于空白组(均P<0.05)。 结论 耳穴贴压可缩短腹部术后家兔首次排便及肠鸣音恢复时间,降低血清皮质醇浓度及应激反应,有助于提升小肠推进率及结肠组织中C-kit蛋白阳性表达,促进腹部术后胃肠蠕动恢复。  相似文献   
4.
《Vaccine》2022,40(19):2679-2695
Vaccinations are essential for preventing infectious diseases in children with chronic diseases as they have increased risk of infection from frequent use of biologics. Response to immunizations in this group is not well known.ObjectiveA systematic review was performed to evaluate three primary outcomes: efficacy; immunogenicity; and safety of vaccines in children with chronic conditions treated with biologics.MethodsThe protocol for our systematic review and meta-analysis was registered and published with PROSPERO. We searched electronic bibliographic databases for studies published from 2009 to 2019, focusing on vaccinations in children with chronic conditions treated with biologics.ResultsWe retrieved 532 records. Thirty-one full-text articles were selected, and 14 were included in the meta-analysis. No significant publication bias was found. Efficacy: limited data are available regarding the efficacy of vaccination, as most studies have focused on immunogenicity as surrogate outcome for efficacy. Immunogenicity: patients receiving anti-TNF-alpha therapy had a statistically significant risk of poor seroconversion (p = 0.028) and seroprotection by the serotype B influenza vaccine [inflammatory bowel disease (IBD) p = 0.013; juvenile idiopathic arthritis (JIA) p = 0.004]. We found adequate responses with H1N1 and H3N2 serotypes. Few studies existed for pneumococcal, hepatitis A virus, hepatitis B virus, varicella-zoster virus, Measles Mumps Rubella virus, and multiple vaccine administration. Safety: vaccine administration was not associated with serious side effects, but JIA patients on anti-TNF alpha therapy had a statistically significant risk of presenting with myalgia or arthralgia postinfluenza vaccine (p = 0.014).ConclusionsMore evidence concerning efficacy, immunogenicity, and safety of vaccinations is needed to guide physicians in the vaccine decision process for this pediatric population.  相似文献   
5.
Full-thickness macular hole is a rare complication of macular telangiectasia type 2, and its treatment is still controversial. A patient with a full-thickness macular hole secondary to macular telangiectasia type 2 underwent vitreoretinal surgery with a plasma rich in growth factors membrane in the macular hole. At the sixth month of follow-up, anatomical and functional improvements were achieved, with no adverse effects. Plasma rich in growth factors is a new option, with advantages due to its biological properties that achieves good results in terms of safety and effectiveness in the surgical treatment of macular hole.  相似文献   
6.
BackgroundTherapeutic plasma exchange (TPE) is an extracorporeal treatment that can be used in adult and pediatric patients with acute demyelinating syndromes of the central nervous system. In this study, the efficacy and safety of TPE was evaluated in 10 pediatric patients who underwent TPE that were unresponsive to corticosteroid treatment.MethodsRecords of 10 pediatric patients who underwent TPE in our pediatric intensive care unit (PICU) between May 2017 and June 2020 were used. Expanded Disability Status Scale (EDSS), Gait Scale (GS), and Visual Outcome Scale (VOS) were applied to the patients before and after TPE.ResultsOf the 10 patients who underwent TPE, five were diagnosed with multiple sclerosis (MS), three with transverse myelitis (TM), and two with acute disseminated encephalomyelitis (ADEM). The median age of the patients was 13.3 years (IQR 8-15), and the median day from symptom onset to onset of TPE was 12.5 days (IQR 7-28). A total of 104 TPE sessions were performed successfully. While no complications were encountered in three patients during the sessions, the most common complication was hypofibrinogenemia. The decrease in EDSS and GS scores was found to be consistent with the clinical response of the patients. There was no statistically significant decrease in the VOS.ConclusionsWith this study, we can say that TPE is a feasible, effective, and safe treatment modality in children with acute demyelinating syndromes of the central nervous system.  相似文献   
7.
Skin infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and the spread of antimicrobial resistance are a major problem in Japan. Here, we investigated the susceptibility of S. aureus clinical isolates to ozenoxacin (OZNX), a topical antimicrobial approved for superficial skin infection treatment in Japan. Susceptibility to OZNX was measured in 110 skin-derived methicillin-susceptible S. aureus (MSSA) and 130 MRSA strains isolated in 2019 and 2020 in Japan. The broth microdilution method was performed, and results were analyzed according to the Clinical and Laboratory Standard Institute (M07 and M100) guidelines. The results were compared with those of other antimicrobials used against S. aureus. The minimum inhibitory concentrations (MIC)90 of OZNX for MSSA and MRSA were 0.12 and 0.25 μg/mL, respectively, indicating that OZNX exhibited the same or stronger antibacterial activity than that of the other antimicrobials tested, such as nadifloxacin, fucidic acid, and gentamicin. No strains exhibited reduced OZNX susceptibility. Notably, a low MIC of OZNX was observed even for strains with reduced susceptibility to nadifloxacin, a similar quinolone-based topical antimicrobial. OZNX is a highly potent antimicrobial used in Japan for superficial skin infections caused by S. aureus, such as impetigo contagiosa and related diseases.  相似文献   
8.
PurposeTo investigate the pharmacokinetics (PK) and early effects of conventional transarterial chemoembolization (TACE) using sorafenib and doxorubicin on tumor necrosis, hypoxia markers, and angiogenesis in a rabbit VX2 liver tumor model.Materials and MethodsVX2 tumor-laden New Zealand White rabbits (N = 16) were divided into 2 groups: 1 group was treated with hepatic arterial administration of ethiodized oil and doxorubicin emulsion (DOX-TACE), and the other group was treated with ethiodized oil, sorafenib, and doxorubicin emulsion (SORA-DOX-TACE). Animals were killed within 3 days of the procedure. Levels of sorafenib and doxorubicin were measured in blood, tumor, and adjacent liver using mass spectrometry. Tumor necrosis was determined by histopathological examination. Intratumoral hypoxia-inducible factor (HIF) 1α, vascular endothelial growth factor (VEGF), and microvessel density (MVD) were determined by immunohistochemistry.ResultsThe median intratumoral concentration of sorafenib in the SORA-DOX-TACE group was 17.7 μg/mL (interquartile range [IQR], 7.42–33.5 μg/mL), and its maximal plasma concentration (Cmax) was 0.164 μg/mL (IQR, 0.0798–0.528 μg/mL). The intratumoral concentration and Cmax of doxorubicin were similar between the groups: 4.08 μg/mL (IQR, 3.18–4.79 μg/mL) and 0.677 μg/mL (IQR, 0.315–1.23 μg/mL), respectively, in the DOX-TACE group and 1.68 μg/mL (IQR, 0.795–4.08 μg/mL) and 0.298 μg/mL (IQR, 0.241–0.64 μg/mL), respectively, in the SORA-DOX-TACE group. HIF-1α expression was increased in the SORA-DOX-TACE group than in the DOX-TACE group. Tumor volume, tumor necrosis, VEGF expression, and MVD were similar between the 2 groups.ConclusionsThe addition of sorafenib to DOX-TACE delivered to VX2 liver tumors resulted in high intratumoral and low systemic concentrations of sorafenib without altering the PK of doxorubicin.  相似文献   
9.
目的:探讨荧光免疫层析法(fluorescence immunochromatography assay,FICA)与酶联免疫吸附法(ELISA)检测英夫利西单抗(infliximab,IFX)血药浓度结果的相关性与一致性。方法:采用已上市的IFX药物浓度测定试剂盒(荧光免疫层析法)与实验室建立的检测IFX浓度的ELISA方法测定克罗恩病患者血液样本IFX浓度。通过Spearman相关分析、Passing-Bablok回归、单样本t检验、Bland-Altman散点图和Cohen's Kappa系数等对检测结果统计分析。结果:共收集到44份血液样本,FICA和ELISA法检测IFX结果的Spearman系数为0.87(P<0.01)。Passing-Bablok回归分析显示,FICA和ELISA法检测IFX结果的回归方程为CFICA=0.5071CELISA+0.6230。单样本t检验提示2种方法检测IFX结果差值与0有显著差异。Bland-Altman散点图显示FICA与ELISA法所测IFX血药浓度的差值中有91.43%(32/35)在一致性界限内(差值均值±1.96 SD)。对2种分析方法检测IFX结果定性分析表明一致性为68.18%(30/44),Cohen's KAppa系数为0.51。结论:FICA与ELISA法检测IFX结果高度相关,但一致性存在差异。ELISA法所测IFX浓度结果高于FICA,提示运用IFX检测结果进行临床决策时要关注检测方法。  相似文献   
10.
目的 探讨年龄因素对腹部肿瘤手术患者丙泊酚靶控输注麻醉中血药浓度和药效学的影响,为临床丙泊酚的合理应用提供参考。方法 回顾性分析成武县人民医院2017年6月至2020年2月收治的160例经丙泊酚靶控输注麻醉的腹部肿瘤手术患者的临床资料,按照年龄不同将其分为3组。对所有患者的脑电双频指数(bispectral index,BIS)、平均动脉压(mean arterial pressure,MAP)、警觉/镇静观察(the observer's assessment of alertness/sedation,OAA/S)评分进行常规监测,在给予患者进行丙泊酚靶控输注麻醉后,即刻进行OAA/S评分,并记录不同OAA/S评分时,患者的BIS、MAP及丙泊酚血药浓度情况。比较丙泊酚靶控输注麻醉过程中3组患者不同OAA/S评分时,其BIS、MAP、血药浓度达标需要时间。结果 各组患者MAP、BIS值随着OAA/S评分降低逐渐降低,丙泊酚血药浓度及达到OAA/S评分需要的时间逐渐升高,差异有统计学意义(P<0.05)。同一评分点下,75岁以上组患者的MAP、BIS值均明显高于其他组,丙泊酚血药浓度及达到OAA/S评分需要的时间均明显低于其他组(P<0.05)。结论 随着腹部肿瘤手术患者年龄的增加,丙泊酚靶控输注麻醉意识消失时,丙泊酚血浆浓度降低,麻醉起效较快,临床应用时需引起重视。  相似文献   
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