首页 | 本学科首页   官方微博 | 高级检索  
文章检索
  按 检索   检索词:      
出版年份:   被引次数:   他引次数: 提示:输入*表示无穷大
  收费全文   1052篇
  免费   73篇
  国内免费   18篇
耳鼻咽喉   7篇
儿科学   16篇
妇产科学   41篇
基础医学   136篇
口腔科学   10篇
临床医学   93篇
内科学   112篇
皮肤病学   10篇
神经病学   147篇
特种医学   9篇
外科学   171篇
综合类   99篇
预防医学   44篇
眼科学   41篇
药学   127篇
  3篇
中国医学   37篇
肿瘤学   40篇
  2023年   16篇
  2022年   17篇
  2021年   34篇
  2020年   39篇
  2019年   34篇
  2018年   46篇
  2017年   25篇
  2016年   38篇
  2015年   30篇
  2014年   42篇
  2013年   76篇
  2012年   50篇
  2011年   49篇
  2010年   52篇
  2009年   43篇
  2008年   45篇
  2007年   45篇
  2006年   29篇
  2005年   24篇
  2004年   30篇
  2003年   23篇
  2002年   25篇
  2001年   32篇
  2000年   24篇
  1999年   16篇
  1998年   15篇
  1997年   19篇
  1996年   14篇
  1995年   22篇
  1994年   13篇
  1993年   10篇
  1992年   13篇
  1991年   14篇
  1990年   8篇
  1989年   12篇
  1988年   8篇
  1987年   4篇
  1986年   4篇
  1985年   17篇
  1984年   15篇
  1983年   6篇
  1982年   11篇
  1981年   14篇
  1980年   8篇
  1979年   8篇
  1978年   6篇
  1977年   4篇
  1976年   3篇
  1974年   4篇
  1973年   3篇
排序方式: 共有1143条查询结果,搜索用时 15 毫秒
1.
2.
ObjectiveWe report the 1-year outcomes of the Safety and Efficacy Study for Reverse Flow Used During Carotid Artery Stenting Procedure (ROADSTER) multicenter trial. This trial introduced a novel transcarotid neuroprotection system (NPS), the ENROUTE transcarotid NPS (Silk Road Medical Inc, Sunnyvale, Calif). Postoperative results demonstrated that the use of the ENROUTE transcarotid NPS is safe and effective. The aim of this study was to evaluate the safety of transcarotid artery revascularization (TCAR) and to present the 1-year outcomes.MethodsThis study is a prospective, single-arm clinical trial. Current enrollment occurs in 14 centers. Primary end points were incidence rates of ipsilateral stroke at 1 year after TCAR. Occurrence of stroke was ascertained by an independent Clinical Events Committee. Patients with anatomic or medical high-risk factors for carotid endarterectomy (CEA) were eligible to be enrolled in the ROADSTER trial.ResultsOverall, 165 patients were included in the long-term follow-up (112 of 141 patients from the pivotal phase and 53 of 78 patients from the extended access). Mean age was 73.9 years (range, 42.1-91.3 years). Patients aged 75 years and older were 43.3% of the cohort. The majority of patients were white (92.7%) and male (75.2%). Most patients were asymptomatic (79.9%). Anatomic risk factors were distributed as follows: contralateral carotid artery occlusion (11.0%), tandem stenosis of >70% (1.8%), high cervical carotid artery stenosis (25.0%), restenosis after CEA (25.6%), bilateral stenosis requiring treatment (4.3%), and hostile neck (14.6%). Medical high-risk criteria included two-vessel coronary artery disease (14.0%) and severe left ventricular dysfunction with ejection fraction <30% (1.8%). In general, 43.3% of patients had at least one anatomic high-risk factor, whereas 29.9% of patients had medical high-risk factors. Both subsets of factors were present simultaneously in 26.8% of the cohort. At 1-year follow-up, ipsilateral stroke incidence rate was 0.6%, and seven patients (4.2%) died. None of the deaths were neurologic in origin.ConclusionsTCAR with dynamic flow reversal had previously shown favorable 30-day perioperative outcomes. This excellent performance seems to extend to 1 year after TCAR as illustrated in this analysis. The promising results from the ROADSTER trial likely stem from the novel cerebral protection provided through the ENROUTE transcarotid NPS in comparison to distal embolic protection devices as well as the transcarotid approach's circumventing diseased aortic arch manipulation and minimizing embolization. TCAR offers a safe and durable revascularization option for patients who are deemed to be at high risk for CEA.  相似文献   
3.
BackgroundEmergency departments (EDs) are faced with a growing number of patients with traumatic brain injury (TBI) using direct oral anticoagulants (DOACs). However, there remains uncertainty about the bleeding risk, rate of hematoma expansion, and the efficacy of reversal strategies in these patients.ObjectiveThis study aims to identify the risk of traumatic hemorrhagic complications in patients with TBI using DOACs.MethodsIn this retrospective study we included patients with TBI. All TBI patients were using DOACs, attended one of the three EDs of our hospital between January 2016 and October 2019, and received a computed tomography (CT) scan of the brain. The primary outcome was any traumatic intracranial hemorrhage on CT. Secondary outcomes were the use of reversal agents, secondary neurological deterioration, a neurosurgical intervention within 30 days after the injury, length of stay (LOS), Glasgow Outcome Scale (GOS) at discharge, and mortality.ResultsOf the included patients (N = 316), 24 patients (7.6%, 95% confidence interval [CI] 4.2–9.8) presented with a traumatic intracranial hematoma (ICH). Seven patients (2.2%, 95% CI 0.6–3.8) received a reversal agent and 1 patient (0.3%, 95% CI ?0.3–0.9) underwent a neurosurgical intervention. Of the 24 patients with a traumatic ICH, progression of the lesion was seen in 6 patients (1.9%, 95% CI 0.4–3.4). The mean LOS was 6.5 days (95% CI 3.0–10.1) and the mean GOS at discharge was 4 (95% CI 3.6–4.6). Death occurred in 1 patient (0.3%, 95% CI ?0.3–0.9) suffering from an ICH.ConclusionBased on the present findings it can be postulated that TBI patients using DOACs have a low risk for ICH. Hematoma progression occurred, however, in a substantial number of patients. Considering the retrospective nature of the present study, future prospective trials are needed to confirm this finding.  相似文献   
4.
5.
6.
间变性淋巴瘤激酶(ALK)抑制剂是目前治疗NSCLC伴ALK阳性的有效药物,然而,耐药性的产生严重限制了其临床应用。本文对ALK抑制剂耐药产生的主要机制如二次基因突变、基因扩增、旁路通路激活等进行了简要介绍,并对联合用药、开发新型PROTAC降解剂等逆转耐药策略进行了综述,以期为ALK抑制剂药物的未来发展提供参考。  相似文献   
7.
8.
BackgroundOur group has previously shown that short-term treatment (48 h) with esmolol reduces left ventricular hypertrophy (LVH) in spontaneously hypertensive rats (SHRs). However, we do not know the mechanism that explain this effect. The aim of this study was to assess the role that the subcellular organelle phenotype plays in early cardiac reverse after short-term treatment with esmolol.Methods14-Month-old male SHRs were randomly assigned to receive esmolol (300 μg/kg/min) (SHR-E) or vehicle (SHR). Age-matched male Wistar-Kyoto rats (WKY) served as controls. After 48 h of treatment, an ultrastructural analysis of heart tissue (left ventricle) was performed. We studied cardiomyocyte ultrastructural remodeling of subcellular organelles by electronic microcopy in all groups.ResultsSHR group showed significant morphometric and stereological changes in mitochondria and subcellular organelles (cytoplasm and nucleus, myofibril structure, mitochondria structure, Z-Disk, intercalated disk, T-system and cystern), and also changes in the extracellular matrix (collagen) with respect to WKY group. Esmolol significantly improved the morphology and stereology mitochondrial, reduced the organelle phenotype abnormalities but no produced changes in the extracellular matrix with respect to SHR group. Interesantly, parameters of mitochondria (regularity factor, ellipsoidal form factor and density of volume), and all parameters of subcellular organelles returned to the normality in SHR-E.ConclusionOur results show that left ventricular hypertrophy reversal after short-term treatment with esmolol is associated with reversal of subcellular organelle phenotype.  相似文献   
9.
《中国现代医生》2019,57(11):71-74
目的 研究胎臀位外倒转术(ECV)实施孕周情况,分析胎臀位外倒转术成功率的影响因素。 方法 临床纳入2017年9月~2018年9月期间在我院分娩的65例单胎孕妇作为研究对象,所有孕妇均接受外倒转术。观察不同孕周孕妇实施胎臀位外倒转术的成功率,分析孕周对手术成功的影响。收集所有孕妇临床资料,观察外倒转术成功与不成功孕妇临床资料差异性,采用Logistic回归方程分析胎臀位外倒转术成功的影响因素。 结果 不同孕周孕妇胎臀位外倒转术的成功率对比无差异(P>0.05)。手术成功孕妇与手术失败孕妇在臀位类型、产次、胎盘位置、羊水量以及脐带绕颈方面均有差异(P<0.05)。通过Logistic回归方程计算分析发现,上述有差异资料均为胎臀位外倒转术成功的影响因素。 结论 超过32周的孕妇不同孕周对ECV的成功率并无影响,影响ECV成功的因素包括臀位类型、产次、胎盘位置、羊水量以及脐带绕颈情况,严格掌握ECV的指征和操作方法,可有效提高ECV的成功率,保障孕妇安全。  相似文献   
10.
《中国现代医生》2019,57(18):9-14+169
目的通过细胞和在体研究探讨ABT-737联合吉非替尼对EGFR T790M突变肺腺癌细胞EGFR-TKIs耐药的逆转机制。方法利用MTT和FCM法检测ABT-737联合吉非替尼对RPC-9细胞的增殖和凋亡的影响,以RT-PCR检测细胞内Bim、Bak、Caspase-3 mRNA表达水平。以皮下异位移植法建立EGFR T790M突变肺腺癌裸鼠模型,对各组瘤体组织进行组织病理学检查、基因测序法检测、Real-time PCR和免疫组织化学法分析Bim、Bak、Caspase-3 mRNA及蛋白表达水平。结果 ABT-737联合吉非替尼对RPC-9细胞有生长抑制作用和凋亡作用,且在ABT-737浓度4μmol/L范围内呈浓度依赖性,最大抑制率为(54.113±2.986)%,最大凋亡率为(55.042±3.151)%,差异均有统计学意义(P0.05);Bim、Bak及Caspase-3 mRNA表达水平随着ABT-737浓度的升高而增加(P0.05)。各组瘤体组织病理均为腺癌;ABT-737联合吉非替尼灌胃组裸鼠瘤体体积较其他组小(P0.05),Bim、Bak、Caspase-3 mRNA和蛋白表达水平较其他组显著增高(P0.05)。结论 ABT-737能增强吉非替尼促细胞凋亡作用,使耐药细胞重新发生凋亡。  相似文献   
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号