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目的 对近5年失神经肌萎缩相关研究的现状、热点及前沿进行可视化分析。方法 利用Web of Science核心数据库检索失神经肌萎缩领域相关文献,通过CiteSpace 5.8.R3软件分别从年发文量、被引频次、国家、机构、作者、关键词、参考文献等方面进行可视化分析。结果 2017年至2021年共检索到516篇文献。年发文量总体呈上升趋势,被引频次逐年增加。美国、加拿大及英国为高影响力国家,意大利帕多瓦大学为领先机构,作者孙华林发文量最多,作者Bodine S C和Sandri M为主要影响人物。基于细胞学、分子生物学和组织形态学的生理病理机制,以及物理因子疗法、药物、运动锻炼等防治措施,是该领域的研究热点。预测以活性氧为靶点,以寻找多靶向蛋白水解系统药物为目标,探究有效的失神经肌萎缩防治措施,可能成为前沿趋势。结论 该可视化分析总结了失神经肌萎缩领域研究趋势和发展,并预测潜在的研究前沿和热点方向。  相似文献   
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ObjectivesThe authors performed an updated meta-analysis of randomized placebo-controlled trials of renal denervation and specifically compared the effect of renal denervation in patients taking medications and in those not taking medications.BackgroundRenal denervation has now undergone several blinded placebo-controlled trials, covering the spectrum from patients with drug-resistant hypertension to those not yet taking antihypertensive medications.MethodsAll blinded placebo-controlled randomized trials of catheter-based renal sympathetic denervation for hypertension were systematically identified, and a random-effects meta-analysis was performed. The primary efficacy outcome was the change in ambulatory systolic blood pressure beyond the effect of the placebo procedure. Analysis was stratified by whether there was background antihypertensive medication use.ResultsThere were 7 eligible trials, totaling 1,368 patients. Denervation significantly reduced ambulatory systolic (mean difference −3.61 mm Hg; 95% CI: −4.89 to –2.33 mm Hg; P < 0.0001), ambulatory diastolic (−1.85 mm Hg; 95% CI: −2.78 to −0.92 mm Hg; P < 0.0001), office systolic (−5.86 mm Hg; 95% CI: −7.77 to −3.94 mm Hg; P < 0.0001), and office diastolic (−3.63 mm Hg; 95% CI: −4.77 to −2.50; P < 0.0001) blood pressure. There was no evidence that the use of concomitant antihypertensive medication had a significant impact on the effect of denervation on any of these endpoints (Pinteraction = NS for each comparison).ConclusionsThe randomized placebo-controlled trials show consistently that renal denervation provides significant reduction in ambulatory and office blood pressure. Although the magnitude of benefit, about 4/2 mm Hg, is modest, it is similar between patients on background antihypertensive medications and those who are not. Denervation could therefore be a useful strategy at various points for patients who are not willing to add antihypertensive agents. Whether the effect changes with time is currently unknown.  相似文献   
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《Heart rhythm》2022,19(11):1765-1773
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AimThis review aims to summarize and discuss some of the most relevant clinical trials in epidemiology, diagnostics, and treatment of hypertension published in 2020 and 2021.Data synthesisThe trials included in this review are related to hypertension onset age and risk for future cardiovascular disease, reliability of different blood pressure monitoring methods, role of exercise-induced hypertension, treatment of hypertension in patients with SARS-CoV-2 infection, management of hypertension high-risk patient groups, e.g., in the elderly (≥80 years) and patients with atrial fibrillation, and the interplay between nutrition and hypertension, as well as recent insights into renal denervation for treatment of hypertension.ConclusionsHypertension onset age, nighttime blood pressure levels and a riser pattern are relevant for the prognosis of future cardiovascular diseases. The risk of coronary heart disease appears to increase linearly with increasing exercise systolic blood pressure. Renin-angiotensin system blockers are not associated with an increased risk for a severe course of COVID-19. In elderly patients, a risk-benefit assessment of intensified blood pressure control should be individually evaluated. A J-shaped association between cardiovascular disease and achieved blood pressure could also be demonstrated in patients with atrial fibrillation on anticoagulation. Salt restriction and lifestyle modification remain effective options in treating hypertensive patients at low cardiovascular risk. Sodium glucose co-transporter 2 inhibitors and Glucagon-like peptide-1 receptor agonists show BP-lowering effects. Renal denervation should be considered as an additional or alternative treatment option in selected patients with uncontrolled hypertension.  相似文献   
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目的 依据髌周解剖学特点,探讨全膝关节置换术(total knee arthroplasty,TKA)中应用髌周电灼去神经化的临床效果。 方法 纳入82名诊断为骨性关节炎的患者(91膝),予行双侧或单侧不置换髌骨的TKA,按随机对照原则将病人分为两组,共有41名实验组患者(45膝)在TKA中接受了髌周去神经化处理,41名对照组患者(46膝)未做该处理。手术主刀为同一骨科医师,均使用相同的膝关节假体系统。主要评价项目包括膝关节KSS评分、Western Ontario and McMaster Universities(WOMAC)、Feller髌骨评分及VAS评分。 结果 82名患者术后均获随访,平均随访时间为12个月,两组病人的膝关节KSS评分、WOMAC、Feller髌骨评分及VAS评分均无显著统计学差异(P>0.05)。 结论 在TKA中行髌周电灼去神经化,不能显著改善病人的预后。  相似文献   
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Acute kidney injury (AKI) is frequently accompanied by activation of the sympathetic nervous system (SNS). This may result from pre‐exisiting chronic diseases associated with sympathetic activation prior to AKI or it may be induced by stressors that ultimately lead to AKI such as endotoxins and arterial hypotension in circulatory shock. Conversely, sympathetic activation may also result from acute renal injury. Focusing on studies in experimental renal ischaemia and reperfusion (IR), this review summarizes the current knowledge on how the SNS is activated in IR‐induced AKI and on the consequences of sympathetic activation for the development of acute renal damage. Experimental studies show beneficial effects of sympathoinhibitory interventions on renal structure and function in response to IR. However, few clinical trials obtained in scenarios that correspond to experimental IR, namely major elective surgery, showed that peri‐operative treatment with centrally acting sympatholytics reduced the incidence of AKI. Apparently, discrepant findings on how sympathetic activation influences renal responses to acute IR‐induced injury are discussed and future areas of research in this field are identified.  相似文献   
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BackgroundWorld Health Organization (WHO) group 1 pulmonary arterial hypertension (PAH) is a progressive, debilitating disease. Previous observational studies have demonstrated that pulmonary artery denervation (PADN) reduces pulmonary artery pressures in PAH. However, the safety and effectiveness of PADN have not been established in a randomized trial.ObjectivesThe aim of this study was to determine the treatment effects of PADN in patients with group 1 PAH.MethodsPatients with WHO group 1 PAH not taking PAH-specific drugs for at least 30 days were enrolled in a multicenter, sham-controlled, single-blind, randomized trial. Patients were assigned to receive PADN plus a phosphodiesterase-5 inhibitor or a sham procedure plus a phosphodiesterase-5 inhibitor. The primary endpoint was the between-group difference in the change in 6-minute walk distance from baseline to 6 months.ResultsAmong 128 randomized patients, those treated with PADN compared with sham had a greater improvement in 6-minute walk distance from baseline to 6 months (mean adjusted between-group difference 33.8 m; 95% CI: 16.7-50.9 m; P < 0.001). From baseline to 6 months, pulmonary vascular resistance was reduced by ?3.0 ± 0.3 WU after PADN and ?1.9 ± 0.3 WU after sham (adjusted difference ?1.4; 95% CI: ?2.6 to ?0.2). PADN also improved right ventricular function, reduced tricuspid regurgitation, and decreased N-terminal pro–brain natriuretic peptide. Clinical worsening was less (1.6% vs 13.8%; OR: 0.11; 95% CI: 0.01-0.87), and a satisfactory clinical response was greater (57.1% vs 32.3%; OR: 2.79; 95% CI: 1.37-5.82) with PADN treatment during 6-month follow-up.ConclusionsIn patients with WHO group 1 PAH, PADN improved exercise capacity, hemodynamic status, and clinical outcomes during 6-month follow-up. (Safety and Efficacy of Pulmonary Artery Denervation in Patients With Pulmonary Arterial Hypertension [PADN-CFDA]; NCT03282266)  相似文献   
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